Healthcare Part II

[TrackerNeil]

Right, but that doesn't help either. All that would do is simply make them change their plans so that they don't cover people with pre-existing conditions as well as those who do. They'll happily sell them the same plan...but it won't actually do anything for them, or it'll have such a high deductible that it won't matter.

Or they'll insert a lifetime maximum limit, or use recission to weasel out of their responsibility. It mystifies me that Americans can be so suspicious of government, whose members they elect and can fire, and yet so trusting of corporate bigwigs whom they don't and they can't.

[TerraPrime]

It mystifies me that Americans can be so suspicious of government, whose members they elect and can fire, and yet so trusting of corporate bigwigs whom they don't and they can't.

I, too, am unable to explain this odd twist of reality. We trust the government* to monitor the safety of food, the purity of the air that we breathe, the education of our children, the running of armed forces in our country's defense, the maintenance of road and airway infrastructure, the guarding of our borders, and any number of important tasks that affect us daily and immediately; but when it comes to health care, all of a sudden, we cannot trust the government at all.

To complicate matters further, the goal of corporations is to maximize profit, which, imho, seems to be at odds with the personal goal of the consumers in the context of health insurance. It is by default an antagonistic relation. If you're healthy, and you pay your premium, then everyone is happy. But when you get sick, and you need to make claims, the corporations benefit from denying you care in as many ways as they can get away with, and there are documented cases, many cases, where insurance companies did exactly this. While UHC will of course leave some treatments unattainable to patients due to cost effectiveness, your access to care is not regulated by the 3rd quarter profit report alone, and the misfortune for you in not having a treatment available through UHC is not so that the shareholders can get an extra $0.07 per share at year's end.

Ah well.

*Libertarians excepted.

[Watcher]

:agree:

I have no ideal how people can delude themselves that the current system is the best we can do. That any change will somehow destroy the nation.

[Shryke]

That's the way the opponents of Health Reform frame it though. The idea is to make people fear change while making sure everyone ignores the elephant in the room (ie - that the current system is one of the worst ideas ever implemented and will bankrupt the US).

[Watcher]

Chat, do you really think the current US Health Care system is fine the way it is?

[Shryke]

You are you also against ERs being forced to treat everyone, regardless of whether they can pay or not?

Or is that kind of socialized medicine ok with you?

PS - Also, your point is wrong since the cost of private health care is also sky rocketing to the point of becoming a problem for people and the economy.

[TrackerNeil]

Except for the uncontrolled costs of Medicare and Medicaid - yes.

I am genuinely curious. So you aren't bothered by exclusions for preexisting conditions, or the use of recission outside of intentional fraud?

[Watcher]

Except for the uncontrolled costs of Medicare and Medicaid - yes.

it's uncontrolled for the private companies also. Healthcare costs for everyone has been raising much faster then inflation. The costs are driving small buisnesses to drop their policies or have crazy deductables and bad coverage like mine does.

[Aemon Stark]

Except for the uncontrolled costs of Medicare and Medicaid - yes.

Fact #1: Neither Medicare nor Medicaid are examples of "socialized" medicine. Socialized health insurance, yes, but that is most emphatically not the same thing.

Fact #2: Private insurance seems to work fine unless one gets sick - especially if said illness occurs during an inconvenient recession, period of downsizing, or unemployment.

Moral Point #1: Allowing people to suffer because insurance bureaucrats and actuaries decree that that those with "pre-existing" conditions must do without all but the most prohibitively expensive premiums and deductibles (assuming they even get that much) is immoral and, frankly, a hallmark of an uncivilized and debased social context.

Moral Point #2: Health care - and the availability and accessibility of it to all - is a moral imperative, as much as basic sanitation, clean water and air, primary and secondary education, adequate transportation infrastructure, freedom of assembly, conscience, and religion, security of person, and - ultimately - equality before and under the law.

Efficiency Point: Single-payer and other types of public health care systems are more demonstrably more efficient than anything currently existing in the US. They do not preclude the existence of completely private care by any stretch, though it's an open question whether this is actually a good thing. In any event, everyone is entitled to the best standard of care available in their country. Note that this has nothing to do with private hospital rooms, some sort of wait list priority not based on triage, or anything purely cosmetic.

Oh, and Canada used to have a system vaguely resembling the US. Somehow we managed to get rid of it all at once 45 years ago. Surely the "greatest country in the world" can do as well.

[Filippa Eilhart]

I have to say I love Europe. It was surprisingly complicated for my boyfriend to find an insurance that would cover him for his trip outside the EU in the first place, and one that wouldn't charge him an impossible amount at that. That's what happens when things aren't regulated. I think, in the end, it cost him about twice or three times the amount a regular travel insurance would cost. That's ok for 2 weeks, but I can't imagine paying that sum monthly.

[ztemhead]

Except for the uncontrolled costs of Medicare and Medicaid - yes.

Em, you know I love you, but this is the most shocking thing I've ever seen you post.

I was thinking about how to whittle away at the huge number of uninsured piecemeal rather than solving the issue in one fell swoop like Obama is trying to do. Here's what I've got so far.

-- mandating insurance/ HMO premiums stay the same level under COBRA that they did when the employee was still working at their former employer. Much more palatable than the dreaded socialized medicine. This might have the ancillary benefit of making a company think twice before laying off 50,000 workers.

-- expansion of medicaid to the working poor/ working uninsured. Maybe do a sliding scale where they pay something for coverage based on income.

-- expansion of medicare to those 55+, again with a sliding scale based on income.

-- means test for medicare recipients 65 and older who are still earning income. Require a higher premium/ taxation of benefits for people making more money.

-- NFP co-ops for self employed people/ small business owners so they can increase buying power and the size of their risk pool. as has been said, there will probably be some sort of mandated coverage because without it, you run the risk of adverse selection, meaning a higher percentage of sick people signing up, who will make the costs prohibitavely expensive.

Any one of these, or a combination of them a few at a time wouldn't be enough to mobilize the Powers of Darkness like the spectre of a government run "public option" is now doing. Before he started nailing interns, it's what Clinton was trying with the S-Chip program.

[TrackerNeil]

Those are problems within the existing system (nothing is perfect). All that is needed is some additional regulation - something that can be done with little fanfare.

I can also agree with these points of ztem's, which are essentially regulation add ons, and not a huge change to the entire system:

-- means test for medicare recipients 65 and older who are still earning income. Require a higher premium/ taxation of benefits for people making more money.

-- NFP co-ops for self employed people/ small business owners so they can increase buying power and the size of their risk pool. (note that we already have NFP co-ops for health care in some areas, so this is not a change to the system).

-- mandating insurance/ HMO premiums stay the same level under COBRA that they did when the employee was still working at their former employer. (note: I thought this was supposed to happen anyways, but I guess sometimes it doesn't).

These would all be great things, would not cost 1 - 1.5 trillion dollars (assuming the co-ops would be true NFP's and non-governmental, and therefore, self-sustaining).

Well, it seems then that you and I aren't as far apart as I thought, except of course that I definitely would like to see a public option and I am guessing you don't. As to means testing...well, I'm leery of that, because programs that lean more towards the poor inevitably become poorly supported, because the constituency just isn't as powerful. Part of the political genius of Social Security, IMO, is that every single American is equally eligible, so that the constituency for that program is more than 200 million people. Little wonder no Republican has ever been able to dismantle it, the gods be thanked.

[Arlingzen Bill]

just tossing this in, it is a discussion of where the death panels came from.

I was in La Crosse WI through part of my childhood and my colege years. I know of both medical facilities. My father had his back treated at one facility and my oldest nephew was born at the other. Amazing how rational some things can be when the politics are removed.

[Watcher]

Em, you know I love you, but this is the most shocking thing I've ever seen you post.

I was thinking about how to whittle away at the huge number of uninsured piecemeal rather than solving the issue in one fell swoop like Obama is trying to do. Here's what I've got so far.

-- mandating insurance/ HMO premiums stay the same level under COBRA that they did when the employee was still working at their former employer. Much more palatable than the dreaded socialized medicine. This might have the ancillary benefit of making a company think twice before laying off 50,000 workers.

-- expansion of medicaid to the working poor/ working uninsured. Maybe do a sliding scale where they pay something for coverage based on income.

-- expansion of medicare to those 55+, again with a sliding scale based on income.

-- means test for medicare recipients 65 and older who are still earning income. Require a higher premium/ taxation of benefits for people making more money.

-- NFP co-ops for self employed people/ small business owners so they can increase buying power and the size of their risk pool. as has been said, there will probably be some sort of mandated coverage because without it, you run the risk of adverse selection, meaning a higher percentage of sick people signing up, who will make the costs prohibitavely expensive.

Any one of these, or a combination of them a few at a time wouldn't be enough to mobilize the Powers of Darkness like the spectre of a government run "public option" is now doing. Before he started nailing interns, it's what Clinton was trying with the S-Chip program.

Which might work as far as it goes, but the other issue is the raising cost of the American health care system. Normally it's the insurance companies that help keep costs down but the health insurance industry went a different route and raised fees instead of working on ways to control costs of hospitals and doctors

[Shryke]

What's your solution to rising costs then?

Also:

So are you also against ERs being forced to treat everyone, regardless of whether they can pay or not?

[Shryke]

So nothing. Gotcha.

[Kalbear]

Well, if the company had purchased a "better" (read: more expensive) plan, then maybe certain things wouldn't get denied. But the company has a duty to try and control costs so that they can offer insurance to its employees.

Right - but how do you change that?

The insurers have all the incentive in the world to offer shitty, poorly-covering plans. The employers have only small incentives to buy the good plans. The employees have almost no power whatsoever here. They don't have the option most of the time to go up and find another job - in which time they'll be uninsured. This is especially true if they have any preexisting conditions that came up when they had the insurance; they're almost bound at that point to that insurer on that plan. You say that you can just quit and find another job that has better coverage, and that's theoretically possible, but how many jobs actually offer that? How many are geographically similar to where you are? Heck, how many offer anything at all?

So what you're suggesting is basically a continuation of the system we're in, which underinsures 100 million people and which rate is growing faster than the population rate. All the while it is costing Americans more and more of their general takehome pay, and giving them fewer and fewer options.

Why is this system so good? The only reason you're supporting it is because it works for you, right?

[TrackerNeil]

Why is this system so good? The only reason you're supporting it is because it works for you, right?

I would hazard that's the cause of most current support. Many of those people probably don't realize that one layoff plus a medical condition they could not prevent could ruin them, no sweat.

[TerraPrime]

I would hazard that's the cause of most current support. Many of those people probably don't realize that one layoff plus a medical condition they could not prevent could ruin them, no sweat.

To be fair to Chat, I think her POV is that people, everyone, in good jobs or bad ones, should have savings and financial plans to safeguard against this sort of calamity. Ultimately, of course, we cannot foresee what sort of accidents might befall us, and should our planned safety net fail us at that time, then, well, life is tough and full of tragedies.

[Kalbear]

To be fair to Chat, I think her POV is that people, everyone, in good jobs or bad ones, should have savings and financial plans to safeguard against this sort of calamity.

That's fair, but with the medical industry what it is you shouldn't bother saving money; if you get something serious, there's literally no hope for you via savings unless you're absolutely loaded. You might as well give up.

And that's not a great situation to be in.

And that's just one of the awesome perks our system gives us.