Health Care Reform in the US

[Gav]

Could someone explain to me why a US analyst - being interviewed on UK news last night - thought that the current US system was better because it protected Pharma' (and associated health conglomerates) profits?

[I_luv_saber]

So, you want to pay less than $300 a month but you expect someone else to pony up potentially hundreds of thousands to treat you if you need it? What do your benefactors get in return, besides your vote?

That's the key word, and that is how they make their money. Like I said, it's a gamble on the part of the insurance company... they're gambling that you'll never have to cash out, and you are gambling that you will (else that $300 a month was a pointless expenditure).

Also, as was pointed out (but conveniently ignored), insurance companies report a relatively small profit... but this includes funds they never invested, funds from their clients and from the pool. As such, that number (something in the range of 3%, I think) really more closely represents profit from the pool. Meaning that everyone is indeed able to subsidize everyone else while still returning profit. As far as a return on the company's actual investments (which are almost strictly administrative), these are much higher and are more true to the word "profit".

[I_luv_saber]

Could someone explain to me why a US analyst - being interviewed on UK news last night - thought that the current US system was better because it protected Pharma' (and associated health conglomerates) profits?

Because that's the problem?

After reading some of the posts on this particular thread. I think I would like to share this story which I think highlights just how much you lot in the US don't get the NHS.

Stephen Hawking is, in fact, alive.

Awesome.

My favorite line:

The stories of people dying on a waiting list or being denied altogether read like a horror script..

Yeah... 'cause that never happens here

[Inquartata]

First of all, about this

I don't know about y'all, but for my part, this thread is starting to get rather dreary. I think I'm about done (unless, Inq, you can manage to be outrageous enough to pull me back in ).

At the very least if I do respond I'll try and pull this back to at least 1 post responses.

I look upon post #227 and have to say, in the words of the young people: Massive Fail!

And now, to return to the tail end of #220:

Why doesn't the media blatantly spin?

Doesn't it?

If they stay subtle, fewer people catch on and they get away with it for longer.

If they hold all the cards, as you say, why bother? Subtlety becomes a waste of time and money...

I read my TOS pretty closely and didn't see anything. I could be wrong though. Since it's your assertion maybe you could post some proof of it?

Shoot, I knew I forgot to print out something at work...

However, we just got our open enrollment guide for this year, and as I was reading through the various insurance plans' terms and conditions I noted that there was an extensive section on recourse and appeals.

Of course, since I work for the state things may be somewhat different than in your average corporate policy.

Apropos des bottes, premiums have risen every year that I've been covered, but always by pretty modest ( in my estimation ) amounts. With the state in "economic difficulties", however, this year premiums for dental and vision coverage have more than doubled, and premiums for the medical plan I am currently using are going to increase around five-fold. Co-pays are also going up for everything.

And I STILL am against the government getting involved in regulating the private insurance industry any more than it is!

Because this ( the "to the best of my knowledge" clause---see how considerate I am to insert these helpful little reminders! ) is almost always the case.

I could not find it in my policy.

For that matter, I don't recall ever signing a contract, per se. We just check boxes on a website when we select a plan...

Depends on how you look at it. By denying me THEY are accusing that I have somehow breached the contract.

Unless they take you to court, no, they have not. They are just following a procedure established in the terms and conditions of their policy.

Because I know that 5% 100,000 is still 5,000 people.

How do you know it's 5%? As opposed to .5%, or .05%, or...?

However it ( the THS sucks factor in Stay and play ) was still a factor that people found that unacceptable.

Argue that with THEM!

No, they influence it. We decide it, and must accept responsibility for the consequences.

Yes, and the ox "decides" to pull the plough... ( smily )

Playing the blame game is disingenuous.

Not to mention accurate. ( smily )

However, I'd also like that they have a clue about culture, society, justice, and right and wrong. That's the key... economics is an important factor, but not the only factor in a functioning society.

Omnes non possumus omnia, and it makes a nice substitute for all the others. ( smily )

Most times I referenced it I said "pursuing crimes" in which I was speaking of both investigation and prosecution.

Eh, judges and lawyers don't do a lot of pursuing...

My opinion is the government does have the right in certain situations where the immediate welfare of people are involved.

The problem with that theory is that "the natural progress of things is for liberty to yield and government to gain ground". That is, having power makes it thirst for more power; "helping" the people with one thing makes it cast its gaze at other things with which it can "help" them; budgets and payrolls rise, goals get displaced, and you end up with what a local columnist calls "The Tedious State". He can describe it better than I can:

http://www.azcentral.com/members/Blog/RobertRobb/28661

Anyway, this reminds me:

The Department of Energy was founded during the Carter Administration, arising out of the OPEC embargo and energy crises of the 1970s. It's mission at the time was: To eliminate our dependence on foreign oil. ( Sound familiar? )

Now, that mission has changed---excuse me, "evolved"---many times since then. Goal displacement, remember? What remains, after 32 years, is a budget of $24 billion, 16,000 employees and another 100,000 contract employees. And we are STILL dependent on foreign oil.

This is the sort of thing we risk when we call for the government to make and implement national policies affecting the marketplace. This is the sort of fate toward which IMO Mr. Obama's health care reforms are hurtling us...

It IS regulated, as jeff pointed out, albeit more indirectly.

Well, to the extent that everything---every bloody thing---in modern life is somehow regulated by The Tedious State.

But these industries are NOT regulated in the manner and to the extent to which you are calling for health care to be regulated. So I ask again: If health care, why not ALL "essentials of life"? Why are not people entitled to free food, for example, up to 8 times the poverty income level? Why shouldn't the government tax us all to distribute this basic necessity of life? Why not free housing, too? Clothing---and the rest of Maslow's physical needs?

I don't want to see nearly anything socialized.

Regulation is socialization by degree...

In fact, I'd like to see us move away from it more

Except in health care?

Put it all in the private sector, and regulate where needed. Some more than others, depending on importance to society.

Alas, the regulation moving through Congress is more like a seizure of control IMO...

At least here in Fresno, though, we have public "cooling centers"...

Communism!

That's almost exactly another definition for what I just said!

Which is why I said that I don't see anything like that in there...

that's the entire point of insurance.

That's a new one to me...

[Inquartata]

I think at least one answer you're missing is that if I understand correctly, the White House would like to put more of an emphasis on preventative medicine.

Maybe, but I'm not sure how that reduces quantity or raises quality. I am also not sure why you need the sort of changes it advocates to achieve that. Forcing people to buy insurance? Prohibiting the insurance industry from denying coverage for ANY reason OR raising premiums to compensate for higher-cost customers? What do these have to do with preventive medicine?

Under the current system, insurers will often refuse to cover the costs of preventative care.

Really? Do tell. Mine doesn't. In fact, it tries very hard to get people to use things like wellness centers and nurse phone lines and get their children vaccinated and so on. In fact, it seems almost to be begging unwilling and uncaring customers to do those things. I suspect that any insurance company knows that it would save it money in the long run, as well or better than any government analyst ( most of whom probably worked for or will work for industry themselves ).

[Inquartata]

The current system is incredibly complicated,

So, on the basis of what historical evidence should we accept the thesis that government is better at running incredibly complicated systems better and more cheaply than the market?

In my opinion, there's something wrong with a system that lets an insurer dump a patient (after receiving their premiums for years) when they get sick.

But see, it hasn't been demonstrated that it's anything like a systemic thing, as opposed to an occasional failure in a particular office or manager or what have you.

This whole issue turns on the assumption that abuse is a widespread and regularized business practice. And that is just assumed, not proven.

I think it entirely appropriate for there to be government intervention to protect people from predatory behavior, and sometimes even from their stupidity.

And that's just what has given us The Tedious State...

In modern society we like to not take the "circle of life" so literally, eh?

Just so!

Back full circle to my erstwhile student and his aversion to knowing whence milk really came.

Yes indeed, but the shoe aint fittin'!

*Place stock Ambrose Bierce definition of marriage here.*

[Inquartata]

That's true fer sure. Soon we'll forget which positions we're taking!

Give me a single-payer health care system, or give me death!

No, wait...

[Inquartata]

Ozymandias HMO - he has a preexisting condition!

Quick, notify the end-of-life advisory panel!

I was commenting on your comment to Hauptmann about "50% of all spending to serve 28% of the population" not being efficient.

Well, but it isn't...

Aren't you the guy who argues that high percentages of income and wealth accruing to the small numbers of "rich people" is "inefficient" per se for society?

Only in the narrow and irrelevant sense that if it cost $0 he might go into that business.

Or even in the perfectly normal economic sense that the higher its cost the less likely he is to do so... or to put it another way, the higher the price, the lower his quantity demanded.

could we drop discussion of topics that are utterly unconnected to it? (this thread would not be quite so long if we stayed on track, eh?)

Good grief, I never thought that I would exhaust you!

Uh, no. Lower costs, in other words, because the practitioners affected can't use the ability to refer to themselves as an infinite cookie jar they can reach into at will.

Wait, you said that they were not sensitive to cost; but now they would like to seek lower costs if only the law permitted them to do so?

Choose a side, man!

You're claiming that a doctor writing a script is a significant cost? Why? What makes you think so?

I'm saying that if he has to hire office staff and have filing systems and so on there must be some substantial cost to all of the little administrative stuff he has them do in the course of daily business. They are his employees, and just because he has them handle some things doesn't mean that those things are therefore without cost to him. And as I'm sure you are quite aware, "insignificant costs" when added up have a way of becoming substantial in the aggregate...

The very same. What we have is an imperfect system that filters out a lot of risk, but not all of it. It would be silly to eliminate that in favor of no system at all, which filters out nothing.

I'm not so sure. Uncle Miltie is still too convincing. ( smily---I was so close! )

And off to fencing!

[jeff]

Wait, you said that they were not sensitive to cost; but now they would like to seek lower costs if only the law permitted them to do so?

Choose a side, man!

No, no, no - lower cost to everyone else, not to the practitioner!

Gotta keep that "to whom" and "who benefits" clearly in the picture.

Must go for the same reason as you - off to fencing. Later for the rest.

[Bayou Bum]

I'm a student. $300/month is alot. Oh and I posted this like what a month ago? Did you really want to engage me in dialogue that bad? Don't bother responding because I don't care.

I apologize. I didn't realize you were a student and therefore are ignorant of the real world. College students should be required to place a warning label at the end of their posts: "Caution, although the poster thinks he/she knows what they are talking about, they are really a student and are ignorant of the real world!"

[Bayou Bum]

Ladies and gentlemen, for his latest trick, Bayou Bum demonstrates that he doesn't have the faintest concept of the underlying principles of how insurance works.

Since you are so knowledgeable about how insurance works, please enlighten all of us as to what insurance company provides comprehensive medical coverage for less than $300 a month! None, because to do so the insurance company would have to severely limit who and what is covered. If you think that you can, then you should start such a private insurance company and you could become one of those evil capitalists that the majority of people need to exist.

Your idea of insurance is to take from those with the means and give it to those with need, after all, the wealthy would not have what they have if it weren't for the labors of the poor, right?

I'm just so glad that Obama's deathcare is dying the death it so deserves. It actually brings back faith in this Republic! God bless the USA!

[downunder]

You know that you can get private cover in the UK as well? Private healthcare in the UK only costs around £40 a month, and that covers everything forever. I can't believe that you guys (or your employer, or someone) have to pay $300+ a month for private health insurance.

[Capt. Slo-mo]

Since you are so knowledgeable about how insurance works, please enlighten all of us as to what insurance company provides comprehensive medical coverage for less than $300 a month!

Actually, just a few years back, Pacificare in the Pac NW was providing my son--at the time 20, never goes to the doctor--fairly comprehensive healthcare for under $200 a month. However; my wife's individual policy was more like $800 for the exact same coverage.

None, because to do so the insurance company would have to severely limit who and what is covered.

But fortunately, the insurance companies don't now severely limit who and what is covered.
My daughter--a world-class athlete in prime physical condition--was deemed uninsurable by Pacificare at the same time, simply because she had visited a chiropractor, as directed by her coach, to get some knee tendonitis treatment. While I was there with her, I had my stiff neck popped by the same chiro. Even though I had been to no other doctor in the previous 5 years, I was also deemed uninsurable by the same health care company...solely because of that visit.

Your idea of insurance is to take from those with the means and give it to those with need, after all, the wealthy would not have what they have if it weren't for the labors of the poor, right?

Help, help...you're being reverse-repressed! Actually, I think her idea of the way insurance works is that everyone pays into a pool, and the insurance company bets it can take in more than it pays out. The mechanisms by which the companies do so are what's in dispute.

I'm just so glad that Obama's deathcare is dying the death it so deserves. It actually brings back faith in this Republic! God bless the USA!

If by faith in the Republic, you mean faith that certain Republicans can engage in bald-faced hypocrisy about "Death Panels" for partisan advantage, while assuming no one will fact check their previous support for such just such end of life counselling in the past...yes, the Republic is indeed secure.

Some of the rest of us think there might be room for improvement, health care wise.

[I_luv_saber]

I look upon post #227 and have to say, in the words of the young people: Massive Fail!

Nah. I've mostly stepped out of it. My longest reply was still a single post, which as I said was the very least I would do (and a mantra of mine is always to do the very least that I can do! )

[Hauptman]

There is somewhat of a catch 22 in that the longer someone lives, the more healthcare they will consume. In return the quality of that healthcare allows them to live longer and so then consume more healthcare.

However, the numbers show that the vast amount of healthcare costs come in the last years of life. For insurance companies it would be ideal if people just died in their sleep or from accidents or heartattacks; much lower costs. But in reality we spend enormous amounts of money trying to prevent the inevitable, in that eventually we all must die.

Too many of our healthcare options are being promoted by the healthcare industries. There is an inherent conflict of interest there in that they want to make money by selling more drugs/services, and they have a captive consumer in that it is natural human nature to spend anything to avoid death. They should not be making the evaluations or unduly influencing those decisions; anyone notice the spike in healthcare costs, and drugs in particular, since we allowed drug companies to start advertising in the media? Interesting correlation there.

Many of the most expensive drugs/procedures are shown to only prolong life for a few months on average, but the money spent accounts for a huge percentage of healthcare spending. That is why Medicare consumes such a large percentage; it is primarily elderly and disabled people who naturally consume more healthcare.

Now we have the 800 pound gorilla in the room; do we make rational decisions about the efficacy of a given drug/procedure that MAY prolong the life of a dying individual? Is it rationing? Is that a bad thing?

Do we pay $100,000 for a drug that even the drug companies studies say will only prolong life by 3 months? Likely the patient will say "yes". And just about any person approaching end of life (senior citizens) will have a very personal interest in these choices. Senior citizens are also a very powerful voting block.

Tough questions without easy answers. Any comments without partisan attacks are welcome.

[lindajdunn]

Mine doesn't. In fact, it tries very hard to get people to use things like wellness centers and nurse phone lines and get their children vaccinated and so on

Mine does.

I get no discounts for having a healthy lifestyle, nothing at my wellness center is covered, and certain recommended wellness exams are not covered.

[pinkelephant]

All I can say is, God bless the National Health Service in the UK. Yes, it has its faults - what huge organisation doesn't? But if I have an accident in the street, or I acquire a serious illness, I know I will be taken care of and my family will not be bankrupted. And if I want extra choice I can pay for it.

[I_luv_saber]

Any comments without partisan attacks are welcome.

Pinko-commie just wants to kill off our elderly! Bah, you're probably a terrorist sympathizer, too!



/smart-aleckness

[Hauptman]

Pinko-commie just wants to kill off our elderly! Bah, you're probably a terrorist sympathizer, too!



/smart-aleckness

lol

Just to be clear; is a pinko kind of a white-bread red?

[Inquartata]

You know that you can get private cover in the UK as well? Private healthcare in the UK only costs around £40 a month, and that covers everything forever. I can't believe that you guys (or your employer, or someone) have to pay $300+ a month for private health insurance.

"Everything"? Really? There are NO exclusions? NO kind of treatment for which it won't pay? I find it difficult to believe that it will cover faith healing or vodon rituals, for example. Or a heart transplant when you're 90.

Mine does.

I get no discounts for having a healthy lifestyle, nothing at my wellness center is covered, and certain recommended wellness exams are not covered.

As a government employee you have options, yes? You can change to a provider that does, can you not?

As an aside, I am reading news articles today that Obama is expressing some willingness to give up on a public option in favor of non-profit co-ops, and that the end-of-life advisory panels are unlikely to survive in whatever bill emerges from Congress.

Now if only they'd get rid of that bit about forcing people to buy insurance, which is an egregious infringement on personal liberty...




PS Sorry I haven't been able to post more in this thread this weekend, I've been arguing with Darius about whether strip-coaching offers any value instead...