the new health care?

[Daseal]

Uninsured Unite!

Nope, learned my lesson. Personal coverage will kick in sometime this month!

Schneed -- are you able to go into specifics as to why uninsured and insured patients don't pay the same price for the same procedure? I just don't understand what's so pipe dream-ish about thinking that a service should cost a certain amount regardless. A procedure costs X amount, then add in however much to cover overhead/equipment/staff/profit/etc. Come to a fair price, that's your price. I know insurance companies say we'll only pay X amount, but couldn't the hospitals say 'fine' which would lead to consumers fighting for a real change to the system?

[Trample the Elderly]

Originally Posted by Daseal

Nope, learned my lesson. Personal coverage will kick in sometime this month!

You of little faith! Obama is going to take care of us.

[JoeRedskin]

Originally Posted by Daseal

Nope, learned my lesson. Personal coverage will kick in sometime this month!

Demonstrating my point of coverage dipping. Daseal is now part of a larger insurance pool. Being young and of relatively sound body, the odds are that he will not need insurance again for some time. I am betting his personal coverage is extremely expensive. Thus, he is exactly the type of person insurers need to be profitable and to make up for people like me. If Daseal, and others like him, are covered by a national policy, then people like me (married, kids) will simply have to pay more for insurance. In addition, we will be taxed to pay for Daseal's coverage and for those people my insurer rejected as being to expensive. Soon enough, people like me will not be able to afford our current coverages and have to drop into the national policy which, in turn, will just increase the cycle until the national policy is the only policy.

Is that a good thing? Not for me and those like me. Yes for the truly unisured or uninsurable - this would not include people like Daseal b/c he made the choice (either consciencely or not) to be uninsured. Eventually, under the current system, Daseal will likely reap its benefits. If it changes as Obama plans, then he will, basically, get the worst of both worlds.

[FRPLG]

After reading Joe's post I guess I'll ask this...

Is not our FUNDAMENTAL problem in this country something that has nothing to do with costs and insurance companies but more to do with our attitude about health care and about insurance?

The debate about whether health care is a right is one that I think really has no concrete answer but it seems to me we want to be able to provide everyone with Ferrari health care. At least philosophically. And to compound it we (massive generalization here) treat insurance not like real insurance but more like a sugar daddy. In a real economic market some people can afford Ferraris and some can afford Hondas. Both get you from place to another. In neither case do we pay in just a little over time to be able to get either of them. Shouldn't we change our mindsets to read insurance as simply disaster prevention? We should need to pay for basic medical care as we have to pay for basic groceries to live. I know this drives incentive to not go to the doctor but if we reduce demand on Medical care doesn't it lower the price? I knwo this is simplistic to the max but it just strikes me that we as a society rely on health insurance to just pay for everything and that drives everything out of whack right up the line.

[GhettoDogAllStars]

Originally Posted by FRPLG

After reading Joe's post I guess I'll ask this...

Is not our FUNDAMENTAL problem in this country something that has nothing to do with costs and insurance companies but more to do with our attitude about health care and about insurance?

The debate about whether health care is a right is one that I think really has no concrete answer but it seems to me we want to be able to provide everyone with Ferrari health care. At least philosophically. And to compound it we (massive generalization here) treat insurance not like real insurance but more like a sugar daddy. In a real economic market some people can afford Ferraris and some can afford Hondas. Both get you from place to another. In neither case do we pay in just a little over time to be able to get either of them. Shouldn't we change our mindsets to read insurance as simply disaster prevention? We should need to pay for basic medical care as we have to pay for basic groceries to live. I know this drives incentive to not go to the doctor but if we reduce demand on Medical care doesn't it lower the price? I knwo this is simplistic to the max but it just strikes me that we as a society rely on health insurance to just pay for everything and that drives everything out of whack right up the line.

I think a Health Savings Account is just that. Small stuff (i.e.: basic medical) you pay for yourself, and big stuff (i.e.: non-basic medical) is covered by insurance. There is incentive to avoid unnecessary doctor visits, because you have to pay for it yourself. However, you don't have to worry about not being able to cover the big stuff.

[JoeRedskin]

Obamaites can call me a naysayer if they please, but to me this statement is simply foolish:

"Our health care system is broken," Obama said. "We are not going to rest until we've delivered the kind of health care reform that's going to bring down costs for families, improve quality, affordability, accessibility for all Americans." Pelosi: House taking up health care by late July - Capitol Hill- msnbc.com

Sorry, you cannot decrease costs and increase quality of care and service. Do I hope I am wrong? Sure. Do I think this is a utopian statement that is either intentionally misleading or so incredibly naive as to be idiotic? Yes.

How does he intend to fund this pollyanish plan? Through a mix of tax increases and restrictions on current tax breaks. The biggest is repealling all or a portion of the tax-break for employer based health care payments. Essentially increasing premiums for this type of insurance (whether I am paying the insurer or the govt. or a combination thereof, the cost for insurance increases).

As FRPLG said, one of the fundamental problems is that people are looking for a Ferrari but seem to think they can get it at the cost of Hyundai. If we want top quality universal health care coverage, it comes with an incredible price. I don't see the vast majority of americans willing to pay that price. In fact, I don't see the vast majority of insured Americans (82% or approximately 202 million) willing to increase their costs for what will result in a benefit to minority of americans (18%, approximately 46 million) and a likely detriment to themselves (i.e. more costs or worse, more costs and worse benefits).

Is reform necessary, sure - every system needs should be reviewed to ensure or try for improvement. Is creating a universal national health care policy funded by tax increases and restrictions on benefits the answer? Not in my opinion. Rather, focus on cutting medical costs by revamping doctor oversight which will help lower litigation cost and thus lower malpractice rates and payouts. Find ways to lower the costs to become a medical professional. Possilby create a workman's comp type system for malpractice awards (just throwing that one out there off the cuff)- i.e. get rid of the traditional defenses to malpractice and require only that an injury occurred to get a payout, in return, the payouts will be set up like worker's comp. no puni's. These two thing may help cut down the cost of malpractice insurance which, in turn, cut down fees which will cut down costs to insurers.

With costs lowered, insurance becomes more affordable and fewer people are uninsured.

The emphasis, of course, is first to lower prices then find ways to cover the remainder.

Personally, I just don't see any of it happening. Far too many vested interests in the current system. Much will be talked about but I doubt any real change will come.

[Schneed10]

Originally Posted by JoeRedskin

Obamaites can call me a naysayer if they please, but to me this statement is simply foolish:

"Our health care system is broken," Obama said. "We are not going to rest until we've delivered the kind of health care reform that's going to bring down costs for families, improve quality, affordability, accessibility for all Americans." Pelosi: House taking up health care by late July - Capitol Hill- msnbc.com

Sorry, you cannot decrease costs and increase quality of care and service. Do I hope I am wrong? Sure. Do I think this is a utopian statement that is either intentionally misleading or so incredibly naive as to be idiotic? Yes.

How does he intend to fund this pollyanish plan? Through a mix of tax increases and restrictions on current tax breaks. The biggest is repealling all or a portion of the tax-break for employer based health care payments. Essentially increasing premiums for this type of insurance (whether I am paying the insurer or the govt. or a combination thereof, the cost for insurance increases).

As FRPLG said, one of the fundamental problems is that people are looking for a Ferrari but seem to think they can get it at the cost of Hyundai. If we want top quality universal health care coverage, it comes with an incredible price. I don't see the vast majority of americans willing to pay that price. In fact, I don't see the vast majority of insured Americans (82% or approximately 202 million) willing to increase their costs for what will result in a benefit to minority of americans (18%, approximately 46 million) and a likely detriment to themselves (i.e. more costs or worse, more costs and worse benefits).

Is reform necessary, sure - every system needs should be reviewed to ensure or try for improvement. Is creating a universal national health care policy funded by tax increases and restrictions on benefits the answer? Not in my opinion. Rather, focus on cutting medical costs by revamping doctor oversight which will help lower litigation cost and thus lower malpractice rates and payouts. Find ways to lower the costs to become a medical professional. Possilby create a workman's comp type system for malpractice awards (just throwing that one out there off the cuff)- i.e. get rid of the traditional defenses to malpractice and require only that an injury occurred to get a payout, in return, the payouts will be set up like worker's comp. no puni's. These two thing may help cut down the cost of malpractice insurance which, in turn, cut down fees which will cut down costs to insurers.

With costs lowered, insurance becomes more affordable and fewer people are uninsured.

The emphasis, of course, is first to lower prices then find ways to cover the remainder.

Personally, I just don't see any of it happening. Far too many vested interests in the current system. Much will be talked about but I doubt any real change will come.

I can tell you that every single finance professional at my employer, the biggest Medicaid and under-insured provider in the state of Pennsylvania, agrees wholeheartedly with you.

From the chief financial officer down to the VP of finance down to the CFOs of the hospitals down to me as the manager of financial planning, we all think the same thing: wouldn't it be nice if Obama could get it done because it would mean a huge boost in funding for us. Quality would go up in the inner city hospitals who are currently underfunded, while quality would plummet at the suburban community hospitals in working class neighborhoods. And there are a lot more of them than there are of us.

It's an absurd pipe dream which shows how out of touch Obama can be with reality. He's a great leader, and strong on law and ethics, but his strength is not with financials. One look at the numbers tells you this: you can't cut the nation's overall healthcare bill without cutting quality. The only way he can make affordable healthcare happen is by having the rich subsidize it.

I named some areas in which expense savings could be realized earlier in this thread. But to accomplish what he wants (affordable healthcare for everyone), those savings would barely register as a drop in the bucket.

Someone just needs to do the math for him, and hopefully he'll come down to reality on this issue and get practical.

[saden1]

Your cynicism is dually noted. One thing I am fairly certain of is that the quality of care for 45 million people without coverage will improve. My employer still has the option of paying our HMO $$$ so I don't see how the quality of care will decrease. Maybe most employers decide to drop their HMO plans and rely on the government?

I guess having uninsured is good for the insured. Less competition is always good for the apex predator. Is anyone working a book titled "Universal Healthcare: Tragedy Waiting to Happen" yet?

[firstdown]

Originally Posted by saden1

Your cynicism is dually noted. One thing I am fairly certain of is that the quality of care for 45 million people without covrage will improve. My employer still has the option of paying our HMO $$$ so I don't see how the quality of care will decrease. Maybe they will all decide to drop their HMO plans and rely on the government. I having uninsured is good for the insured. I suppose less competition is always good for the apex predator.

Is anyone working a book titled "Universal Healthcare: Tragedy Waiting to Happen" yet?

First off take that 45 million and cut that in half and thats closer to the number of people who cannot get or cannot afford health ins.

[dmek25]

Originally Posted by firstdown

First off take that 45 million and cut that in half and thats closer to the number of people who cannot get or cannot afford health ins.

link? and anyway, isn't 22 million people without insurance enough?

[firstdown]

Originally Posted by dmek25

link? and anyway, isn't 22 million people without insurance enough?

22 million is not enough in the big picture to tear apart our complete health care system. I'm too lazy to look up the numbers but in that 45 million that encludes people who loose their coverage for a short period of time, young adults who feel they dont need coverage, people who could afford coverage but decide to buy other things, ect.... Heck, if our goverment cannot run Medicare or Social Security right why do would we want them to run our health care which will be a much larger task? Medicare and Social Security are both in trouble now and have been in the pass so the goverment has had to cut the coverage, raise deductibles, tax SS, etc... and that's the same thing that will happen to goverment provided health coverage. Heck, even with the cuts they have made in those programs both are still in trouble.

[JoeRedskin]

Originally Posted by saden1

Your cynicism is dually noted. One thing I am fairly certain of is that the quality of care for 45 million people without coverage will improve. My employer still has the option of paying our HMO $$$ so I don't see how the quality of care will decrease. Maybe most employers decide to drop their HMO plans and rely on the government?

I guess having uninsured is good for the insured. Less competition is always good for the apex predator. Is anyone working a book titled "Universal Healthcare: Tragedy Waiting to Happen" yet?

1. With a national health plan, your employer's HMO coverage will eventually become more expensive. Initially, your quality of care will not decrease. At some point, as more and more people become "uninsured" and rely on the national plan, your employer's HMO become more expensive and he will eventually drop it leaving you with the national plan.

2. In general, and as I have pointed out above, having uninsured is NOT good for the rest of the insurance pool. Rather, having a large number of healthy young people paying for insurance lowers costs for all insureds.

3. I have not said that universal health care is a tragedy, rather, I suggest that to expect, in a nation of 250 million, high quality care at bargain basement prices is unrealistic. Clearly, universal healthcare improves coverage for the uninsured. I merely suggest that for a vast majority of americans, such changes will make their own insurance either more expensive or provide less insurance.

4. Wow!!! I get to be an apex predator?? Cool!! (usually, I am just some middle of the pack herd animal attempting to find todays veggies).

[Hog1]

Originally Posted by JoeRedskin

1. With a national health plan, your employer's HMO coverage will eventually become more expensive. Initially, your quality of care will not decrease. At some point, as more and more people become "uninsured" and rely on the national plan, your employer's HMO become more expensive and he will eventually drop it leaving you with the national plan.

2. In general, and as I have pointed out above, having uninsured is NOT good for the rest of the insurance pool. Rather, having a large number of healthy young people paying for insurance lowers costs for all insureds.

3. I have not said that universal health care is a tragedy, rather, I suggest that to expect, in a nation of 250 million, high quality care at bargain basement prices is unrealistic. Clearly, universal healthcare improves coverage for the uninsured. I merely suggest that for a vast majority of americans, such changes will make their own insurance either more expensive or provide less insurance.

4. Wow!!! I get to be an apex predator?? Cool!! (usually, I am just some middle of the pack herd animal attempting to find todays veggies).

I think that is probably the case. How have the Cannucks and the Brits faired with similar idea's in mind. From the people I know that live or have lived in those countries, They have it........but it.......ain't great. Hard to see anyone for an appointment....marginal quality. I do not believe as you have stated it can be done "GOOD AND CHEAP". It will require a....shocking financial commitment. And finally "Apex predator"? That's sweet. Wil;l we be seeing you on the next episode of "the Cougar"?

[budw38]

Very well thought out posts , Mr. Joe Redskin !!

[FRPLG]

What about eliminating the employer/health insurance link alltogether?

Make a total overhaul and allow people to join associations (or something of that ilk) that provide health insurance. Then people can pick and choose what association they'd like to be a part of...the association can more precisely manage membership demographics to provide a good balance. The associations should be non-profit orgs driven to balanced budgets. Just an idea that needs a lot more thought to it but maybe it could at least remove the barrier of needing employment to even have a chance to afford insurance. Even lower income folks could find an association that provides basic major medical at a low cost because of the group insurance rates and that would be a plus.