PDA

View Full Version : Conservative opposition to Obama's health care reform - "it works too well!"



Doc Randy
01-08-2009, 01:30 PM
Here is a pretty good article on Obama and Daschle's plans for health care reform.

New York Times - Daschle Pledges a Bipartisan Reform of Health Care System (http://www.nytimes.com/2009/01/09/us/politics/09daschle.html?_r=1&hp=&pagewanted=print)

Obama's primary goal is to create a new public health insurance program (similar to Medicare) that can give people and businesses an additional choice when choosing insurance. They don't want to eliminate private insurance. They don't want to mandate public participation. In fact, since this is a program you would have to buy into, it wouldn't even necessarily cost anything to taxpayers.

But here is the part of the article that almost gave me a spit take:



Notwithstanding the friendly atmosphere, Mr. Daschle and the committee members were sure to engage in spirited discussions about one of the most contentious aspects of President-elect Obama’s domestic agenda: his call for a new public health insurance plan to compete with private insurers.

No other proposal so clearly defines the political and philosophical differences between Mr. Obama and Republicans, or provokes such deep disagreements.

Mr. Daschle, the point man for Mr. Obama’s campaign to revamp the health care system, supports the concept of “a government-run insurance program modeled after Medicare.” It would, he says, give consumers, especially the uninsured, an alternative to commercial insurance offered by companies like Aetna, Humana and WellPoint.

But the proposal is anathema to many insurers, employers and Republicans. They say the government plan would have unfair advantages, like the ability to impose lower fees, and could eventually attract so many customers that private insurers would be driven from the market.

“The public plan option is a terrible idea — one of our top concerns in the health reform debate,” said James P. Gelfand, senior manager of health policy at the United States Chamber of Commerce.

The public plan, as conceived by Mr. Obama, would vie with private insurers to provide better benefits and better customer service at a lower cost. Without such competition, Democrats say, private insurers cannot be expected to control costs much better than they do now.

Jacob S. Hacker, a professor of political science at the University of California, Berkeley, said the new option was essential to the success of Mr. Obama’s effort to rein in costs and make coverage available to all Americans.

“Public insurance has a better track record than private insurance when it comes to reining in costs while preserving access to care,” Mr. Hacker said. “The public plan would set a standard against which private plans must compete.”

Jeanne M. Lambrew, an associate professor at the University of Texas who is in line to be deputy director of a new White House Office of Health Reform, asks: “Why should policy makers give private insurers the exclusive right to cover Americans? If private insurers can better meet our goals for the health system, why object to a level competition with public plans?”





So... Obama's plan is a "terrible" idea and must be stopped because it gives consumers an extra choice that can "provide better benefits and better customer service at a lower cost".

Interesting.

WillieLee
01-08-2009, 01:33 PM
Free market free market free market bababooey Howard Stern's penis.

Jason California
01-08-2009, 01:46 PM
I am not read up on this so here is my question. Are premiums that benficiaries pay supposed to completely cover costs or is the system also getting tax funds from other places?

Wigner's Friend
01-08-2009, 02:13 PM
I don't think that New York Times article really says anything about the program or it's potential faults. Here's a good discussion on the issues posted in the National Journal blog. (http://healthcare.nationaljournal.com/2008/12/assessing-a-new-public-insurance-program.php)

RickLM
01-08-2009, 02:54 PM
The real test will be the fight for public opinion. Clinton's response to loud opposition was to drop the issue for seven years. I'm trusting Obama to craft a communications strategy that will cut through the bullshit; if he loses the communications battle, this thing may die.

WinterRose
01-08-2009, 03:11 PM
Republicans: "DAMMIT! You're supposed to PRIVATIZE government things like social security! Not Nationalize private things we're heavily invested in! What kind of politician are you anyway!"

Khrutch
01-08-2009, 03:25 PM
Republicans: "DAMMIT! You're supposed to PRIVATIZE government things like social security! Not Nationalize private things we're heavily invested in! What kind of politician are you anyway!"

Exactly. Please and thank you. I'll take Privatization over Nationalization any day.

Thomas Mauer
01-08-2009, 03:27 PM
Here is a pretty good article on Obama and Daschle's plans for health care reform.

New York Times - Daschle Pledges a Bipartisan Reform of Health Care System (http://www.nytimes.com/2009/01/09/us/politics/09daschle.html?_r=1&hp=&pagewanted=print)

Obama's primary goal is to create a new public health insurance program (similar to Medicare) that can give people and businesses an additional choice when choosing insurance. They don't want to eliminate private insurance. They don't want to mandate public participation. In fact, since this is a program you would have to buy into, it wouldn't even necessarily cost anything to taxpayers.

But here is the part of the article that almost gave me a spit take:






So... Obama's plan is a "terrible" idea and must be stopped because it gives consumers an extra choice that can "provide better benefits and better customer service at a lower cost".

Interesting.

So much for Adam Smith's theories about the best product prevailing.

lonesomefool
01-08-2009, 03:28 PM
Exactly. Please and thank you. I'll take Privatization over Nationalization any day.

So what is your plan to fix the health care system. Cause, it's becoming a bigger and bigger drain on our economy every year.

Also, I think WinterRose was being sarcastic.

But.....I digress.

Thomas Mauer
01-08-2009, 03:28 PM
Exactly. Please and thank you. I'll take Privatization over Nationalization any day.

Oooooooh, how you failed to read the sarcasm.

TheKraken
01-08-2009, 03:38 PM
Oooooooh, how you failed to read the sarcasm.

Surely you aren't surprised? :)

Doc Randy
01-08-2009, 03:47 PM
Exactly. Please and thank you. I'll take Privatization over Nationalization any day.

Did you read the article?

NOBODY is talking about nationalization of existing private institututions.

Thomas Mauer
01-08-2009, 03:48 PM
Surely you aren't surprised? :)

Of course not, but this and the Creationism post REALLY make me want to buy a ticket for Khrutch's standup comedy show.

(If it existed.)

c. page
01-08-2009, 03:50 PM
Surely you aren't surprised? :)

of course he isn't.

and don't call him shirley!

SMACK!
01-08-2009, 03:52 PM
Private insurers will just have to find products and ways to compete, just like UPS and FedEx found their niches in competing with the USPS.

Sounds like a fantastic compromise to me.

JHickman
01-08-2009, 04:20 PM
Sounds like the beginning of a two-tiered system to me (which I'd be perfectly fine with as long as everyone can be covered)

This is going to be an interesting year.

Jason California
01-08-2009, 04:28 PM
Is anybody able to answer my first question or is the answer unknown?

Thomas Mauer
01-08-2009, 04:30 PM
Jason, if this is anything like the German system, you pay in, and a certain amount is covered. The rest comes out of your pocket, or you get extra insurance.

Thomas Mauer
01-08-2009, 04:33 PM
E.g. prescription drugs are covered to a certain amount, there are different health plans you can choose from, and then you can also get extra insurance like for teeth and eyes.

Jason California
01-08-2009, 04:38 PM
Jason, if this is anything like the German system, you pay in, and a certain amount is covered. The rest comes out of your pocket, or you get extra insurance.


E.g. prescription drugs are covered to a certain amount, there are different health plans you can choose from, and then you can also get extra insurance like for teeth and eyes.


So in the German system funding does not come from anywhere else? I am going to have to really do some more reading on this.

Doc Randy
01-08-2009, 04:38 PM
Is anybody able to answer my first question or is the answer unknown?

The plan isn't finalized. In fact, it hasn't been proposed or even debated on yet.

From what I understand, it will be tax neutral. It will be a non-profit public organization that you have to buy into.

If it is rolled into DHHS, then there will be some public resources intermingled for administration, but the new wide-ranging plan would require enough revenue from premiums to pay for itself.

Jason California
01-08-2009, 04:41 PM
The plan isn't finalized. In fact, it hasn't been proposed or even debated on yet.

From what I understand, it will be tax neutral. It will be a non-profit public organization that you have to buy into.

If it is rolled into DHHS, then there will be some public resources intermingled for administration, but the new wide-ranging plan would require enough revenue from premiums to pay for itself.


That is my concern. If public resource are intermingled with this than the private insurance companies are at a disadvantage and would have a fair gripe.

Ray G.
01-08-2009, 04:42 PM
This sounds decent. About as good a system as I'd expect under a liberal.

Once again, a lot of the would-be social engineers who viewed a national health care system as "the great equalizer" are going to be crushed. This looks like a system that'll ease the burden on those in need without impacting the rest of us too much.

Doc Randy
01-08-2009, 04:47 PM
That is my concern. If public resource are intermingled with this than the private insurance companies are at a disadvantage and would have a fair gripe.

What does it matter if private insurance is at a disadvantage? If this new system can provide better care for a cheaper cost, why embrace the private insurance industry?

As the article said, "Why should policy makers give private insurers the exclusive right to cover Americans? If private insurers can better meet our goals for the health system, why object to a level competition with public plans?"

Here is a historical example:

There used to be private fire fighting services. They were a nightmarishly ineffective train wreck. And then came the public fire fighting services. Do you think people were really concerned that it was unfair that the public services performed more efficiently for society and thus left the private fire fighters at a disadvantage?


I don't care if the solution comes from the private sector, the public sector, or a mix. I want what works. I want what will "provide better benefits and better customer service at a lower cost".

Jason California
01-08-2009, 04:59 PM
What does it matter if private insurance is at a disadvantage? If this new system can provide better care for a cheaper cost, why embrace the private insurance industry?

As the article said, "Why should policy makers give private insurers the exclusive right to cover Americans? If private insurers can better meet our goals for the health system, why object to a level competition with public plans?"

Here is a historical example:

There used to be private fire fighting services. They were a nightmarishly ineffective train wreck. And then came the public fire fighting services. Do you think people were really concerned that it was unfair that the public services performed more efficiently for society and thus left the private fire fighters at a disadvantage?


I don't care if the solution comes from the private sector, the public sector, or a mix. I want what works. I want what will "provide better benefits and better customer service at a lower cost".


Let me see if I can be a bit clearer in getting my idea across.

Say I pay 75 a month for insurance now, but under the new system I would be paying 60 a month for premiums. I think "Wow, I am saving money! This fucking rocks!"

Now under the old system everything was paid through premiums to the private insurers. What happens if some of the funds from the public domain are actually used to cover the cost that my premiums don't? I want to make sure the the true cost of this is really lower than the system that is currently in play.

SMACK!
01-08-2009, 05:02 PM
That is my concern. If public resource are intermingled with this than the private insurance companies are at a disadvantage and would have a fair gripe.
Fuck 'em.

Jason California
01-08-2009, 05:05 PM
Fuck 'em.


you missed my point.

Taxman
01-08-2009, 05:05 PM
It will be a non-profit public organization that you have to buy into.HMOs were non-profit back when things were working much better.

Brian Defferding
01-08-2009, 05:06 PM
The obvious objection to Obama's plan is "Where the hell is he going to get the money to spend for it?" Oh yes, ostrich-syndrome deficit. Look at that shiny thing in the corner! What deficit?

The other obvious objection to this is "Where in the Constitution does it give the federal government this power?"

It seems little cares about these things now, because it doesn't suit their agenda. But let's look a little deeper into the subject, Bendis boarders.

This board is mostly for UHC, right? Some are for single payer, some are not. But I take it most of you wouldn't mind Obama and his administration creating a government insurance plan, right?

Here is the person that will be in charge:

Sen. Tom Daschle will be the new "health care czar". One of the proposals he made to a recent book he wrote is to create a Federal Health Board (FHB). The board is basically modeled on Britain's National Institute for Health and Clinical Excellence (NICE). NICE evaluates treatments for both clinical and cost effectiveness. A treatment may be clinically beneficial, but patients may not get access to it through Britain's National Health Service (NHS) if NICE determines that it's too expensive.

How is that going so far, you ask? They are poised ready to rule out four new effective treatments for kidney cancer (http://www.sciencedaily.com/releases/2008/12/081209100834.htm) because they merely double patients' life expectancies from six months to a year. British kidney cancer patients will have access only to a treatment that is 20 years old and which works in 10 percent of patients. This hurts medical research, there is little incentive there. On the other hand, by paying only for the older treatment, the National Health Service will save British taxpayers some money. Currently, there are better treatments available in the US for Alzheimer's, colon cancer, and rheumatoid arthritis that Brits cannot get.

Seeing how Democrats will be overwhelmingly be in power very soon, Daschle may get his wish, especially if Obama gets his government health care wish.

You guys wouldn't mind if the private insurers would be run out of the market and the government takes over, right?

Be careful what you ask for.

Doc Randy
01-08-2009, 05:07 PM
Let me see if I can be a bit clearer in getting my idea across.

Say I pay 75 a month for insurance now, but under the new system I would be paying 60 a month for premiums. I think "Wow, I am saving money! This fucking rocks!"

Now under the old system everything was paid through premiums to the private insurers. What happens if some of the funds from the public domain are actually used to cover the cost that my premiums don't? I want to make sure the the true cost of this is really lower than the system that is currently in play.

Nobody is suggesting what you are saying.

The biggest reasons why the public system would be cheaper are:
1) Much much much less advertising and marketing needs
2) Much cheaper administrative costs (as evidenced through Medicare)
3) Massive collective bargaining power for reducing costs of medical services

There is no need to fudge the numbers with public resources to make it seem more cost effective.

SMACK!
01-08-2009, 05:07 PM
you missed my point.No I didn't. I've been fucked by insurance companies all of my working life, and I am supposed to worry about the system being fair for them? Like I said, Fuck em.

Taxman
01-08-2009, 05:08 PM
You guys wouldn't mind if the private insurers would be run out of the market and the government takes over, right?Just as you don't seem to mind if the private insurers run the entire economy into the ground.

mlpeters
01-08-2009, 05:09 PM
I can't wait for Obama to get in. This looks like a good start.

Jason California
01-08-2009, 05:12 PM
No I didn't. I've been fucked by insurance companies all of my working life, and I am supposed to worry about the system being fair for them? Like I said, Fuck em.


Yes you did.

mlpeters
01-08-2009, 05:13 PM
You guys wouldn't mind if the private insurers would be run out of the market and the government takes over, right?

Right. Wouldn't bother me much at all, seeing how well the private insurers have handled things...

Taxman
01-08-2009, 05:14 PM
I am supposed to worry about the system being fair for them? Don't you worry about these guys who are offing themselves because their net worth has dropped from $19 billion to $12 billion?

lonesomefool
01-08-2009, 05:15 PM
No I didn't. I've been fucked by insurance companies all of my working life, and I am supposed to worry about the system being fair for them? Like I said, Fuck em.

Yep. Plus, UPS and Fed Ex dont have it fair either compared to the USPS, how many people have UPS drop offs at their home or apartment that they can just drop off in a box and know it will be picked up without them having to make prior arrangements or going to a specific place to drop it off?

It's not like private insurance groups are gonna go away, some will, but most will stick around and provide a premium service for the rich and elite of the country and some other folks who dont want to opt into the government plan.

I was always somewhat leery of universal health care, but seeing what kind of drain it has on our economy right now and it's only going to get worse, I think we need to do something. It's very clear what we have now isnt doing a very good job for most folks.

Brian Defferding
01-08-2009, 05:16 PM
Just as you don't seem to mind if the private insurers run the entire economy into the ground.

While I shouldn't be surprised, I find it very amusing that you really think that.

Doc Randy
01-08-2009, 05:17 PM
The obvious objection to Obama's plan is "Where the hell is he going to get the money to spend for it?" Oh yes, ostrich-syndrome deficit. Look at that shiny thing in the corner! What deficit?

If consumers have to buy into the program through premiums, then the plan could be tax-neutral - which would have no effect on the deficit or taxes.






The other obvious objection to this is "Where in the Constitution does it give the federal government this power?"

It seems little cares about these things now, because it doesn't suit their agenda. But let's look a little deeper into the subject, Bendis boarders.

This board is mostly for UHC, right? Some are for single payer, some are not. But I take it most of you wouldn't mind Obama and his administration creating a government insurance plan, right?

Here is the person that will be in charge:

Sen. Tom Daschle will be the new "health care czar". One of the proposals he made to a recent book he wrote is to create a Federal Health Board (FHB). The board is basically modeled on Britain's National Institute for Health and Clinical Excellence (NICE). NICE evaluates treatments for both clinical and cost effectiveness. A treatment may be clinically beneficial, but patients may not get access to it through Britain's National Health Service (NHS) if NICE determines that it's too expensive.

How is that going so far, you ask? They are poised ready to rule out four new effective treatments for kidney cancer (http://www.sciencedaily.com/releases/2008/12/081209100834.htm) because they merely double patients' life expectancies from six months to a year. British kidney cancer patients will have access only to a treatment that is 20 years old and which works in 10 percent of patients. This hurts medical research, there is little incentive there. On the other hand, by paying only for the older treatment, the National Health Service will save British taxpayers some money. Currently, there are better treatments available in the US for Alzheimer's, colon cancer, and rheumatoid arthritis that Brits cannot get.

Seeing how Democrats will be overwhelmingly be in power very soon, Daschle may get his wish, especially if Obama gets his government health care wish.

You guys wouldn't mind if the private insurers would be run out of the market and the government takes over, right?

Be careful what you ask for.


I am amazed that you think private insurance plans don't also perform a cost-benefit analysis and also ration health care. Like this is just a public thing. At least the public plan would be directly accountable to the public and not just shareholders.

Heck... the whole basis of private insurance and HMOs is predicated on the idea that they will collect more money than they pay out. If a procedure is too expensive or "not economically viable" they will deny it - regardless of its medical necessity. Not only that, but insurance companies get to select who they cover and get to deny people for any reason they want - often times after a person has been a customer and been paying and are now in their moment of need.

A big difference between the two services would be one must ration care to maximize profits. One must ration care to simply be solvent.

Regardless, nobody is suggesting eliminating private insurance. As Killgore said:


"Private insurers will just have to find products and ways to compete, just like UPS and FedEx found their niches in competing with the USPS.

Sounds like a fantastic compromise to me. "

Brian Defferding
01-08-2009, 05:18 PM
Right. Wouldn't bother me much at all, seeing how well the private insurers have handled things...

That conclusion fails to look at the big picture, and the past 50 years of health care in America.

Taxman
01-08-2009, 05:20 PM
While I shouldn't be surprised, I find it very amusing that you really think that.I certainly don't understand how you can support the market based health care insurance system we have in place.

Doc Randy
01-08-2009, 05:22 PM
I certainly don't understand how you can support the market based health care insurance system we have in place.

I understand his defense of the market.

I don't understand his opposition to what could be a tax-neutral public system that gets to compete in the market.

I am all for offering businesses and consumers more choices and more freedom in their insurance purchasing.

Deff, why do you want to deny citizens these choices and freedoms?

mlpeters
01-08-2009, 05:36 PM
That conclusion fails to look at the big picture, and the past 50 years of health care in America.

Well, the past 37 years of health care in America haven't done a damned thing for me... lucky for me, I'm generally healthy. My mom isn't so lucky.

Fuck the current system.

Taxman
01-08-2009, 05:48 PM
I understand his defense of the market.Allow me to defend the market.

The health care system has been forced onto the backs of the American employer at tremendous expense. This is done in no other industrialized country in the world. It has placed to the American worker and American products at a significant disadvantage against any non American firm they might compete with. This has been a significant factor in creating the mammoth trade deficits we currently face. These deficits are draining much of the wealth in this country, and literally threatens to destroy our economy.

So why the hell not take this one step which would help give our industries a better chance of competing in the market?

RickLM
01-08-2009, 06:04 PM
Well, the past 37 years of health care in America haven't done a damned thing for me... lucky for me, I'm generally healthy. My mom isn't so lucky.

Fuck the current system.


I totally agree. The current system is a bitch, and I hate it. If I had a family member with an expensive illness, I'd hate it times 100.

I think as a country, we almost needed to reach this point of widespread disgust with our insurance system. There were a lot of us who wanted to change it in 1992, but perhaps not enough. In the past 16 years, lots more people have been devastated by health costs, denied coverage, or who have friends who are going through awful situations.

How many of us have dropped nickels into a jar to help out someone in the community who is trying to pay cancer bills? Is that how we want to pay for medical care in this country, through fucking bake sale-type fundraisers? It's absurd.

Brian Defferding
01-08-2009, 06:08 PM
If consumers have to buy into the program through premiums, then the plan could be tax-neutral - which would have no effect on the deficit or taxes.

You don't think there would be some profit making for the government?


I am amazed that you think private insurance plans don't also perform a cost-benefit analysis and also ration health care. Like this is just a public thing.

Heck... the whole basis of private insurance and HMOs is predicated on the idea that they will collect more money than they pay out. If a procedure is too expensive or "not economically viable" they will deny it - regardless of its medical necessity. Not only that, but insurance companies get to select who they cover and get to deny people for any reason they want - often times after a person has been a customer and been paying and are now in their moment of need.

A big difference between the two services would be one must ration care to maximize profits. One must ration care to simply be solvent.

Regardless, nobody is suggesting eliminating private insurance. As Killgore said:


"Private insurers will just have to find products and ways to compete, just like UPS and FedEx found their niches in competing with the USPS.

Sounds like a fantastic compromise to me. "

You just illustrated a double standard there.

People complain about high insurance premiums to cover these overhead costs, apparently that's a sin, but when the government does it, it's not?

You say nobody is suggesting eliminating private insurance, but you would be wrong. I know you support it. Corpse Reign supports it. Fake Pat supports it. You guys have been around long enough to show that you would prefer a total elimination of the private market in insurance and have Uncle Sam be the only payer. But let's ignore that point, and say nobody really isn't suggesting the elimination of private insurance. Killgore's comparison with USPS and UPS/Fed Ex is a bit apples to oranges. Post service brings things from A to B, health care is more complex than that, with potentially more drastic results.

Brian Defferding
01-08-2009, 06:13 PM
Well, the past 37 years of health care in America haven't done a damned thing for me... lucky for me, I'm generally healthy. My mom isn't so lucky.

Fuck the current system.

I agree the current system needs reform, but the reform you support is something I completely disagree with. There are other solutions out there that can work.

EdNEMO
01-08-2009, 06:24 PM
Does anyone here know how much healthcare costs an insurance company? It is horribly expensive. Way more that you might expect. This plan will quite possibly be the death of many insurance companies. That being said, most doctors will actively work to make sure that corporate insurance companies stay in business as a government run insurance system is going to drive their profits way down.

Brian Defferding
01-08-2009, 06:27 PM
Deff, why do you want to deny citizens these choices and freedoms?

:lol:

Why do I hate freedom?

I really don't understand where you are coming from. I'm actually defending choice for the patient, just because I oppose Obama's plan and Daschle's solutions doesn't mean I want patients to die and insurance companies to profit from it.

Didn't I just made a good example on how government solutions, while well-intended, are just as much victims of denying citizens new medical treatments for the sake of saving a few greasy bucks?

dEnny!
01-08-2009, 06:28 PM
I'm confused because your link and your quote aren't from the same place. Where is the quote from?

Also, Medicare is NOT cheaper than my current health care plan.

Medicare Part A (Hospital Insurance ONLY ) is $244/month (if you have 30-39 quarters of Medicare covered employment otherwise its $443.

Medicare Part B (Medical Insurance ONLY) is $94.40/month.

My single plan costs $26, adding a child(ren) my cost only goes up to $130. This is Hospital and Medical.

I have no deductible, Medicare has $135 deductible plus you cover 20% of all costs after the deductible. I have 100% coverage with copayments that range from $5, $10, and $15 (allergy injections, specialist visit, and UTC/Children's Twilight Clinic) or $50 if its ER.

dEnny!
01-08-2009, 06:31 PM
But the proposal is anathema to many insurers, employers and Republicans. They say the government plan would have unfair advantages, like the ability to impose lower fees, and could eventually attract so many customers that private insurers would be driven from the market.

They'll be driven from the market because companies will no longer provide medical coverage and will save their money. They may help cover the premium, but why provide their own network when they can just have their employees go into the national health care system?

Also, outside of "competition" why is this plan better?


would vie with private insurers to provide better benefits and better customer service at a lower cost.

Your bolded area merely states it will TRY, it will STRIVE, it will ATTEMPT, not that it WILL.


But the proposal is anathema to many insurers, employers and Republicans. They say the government plan would have unfair advantages, like the ability to impose lower fees, and could eventually attract so many customers that private insurers would be driven from the market.

The unfair advantage I believe they are pointing out is that it would not be a for profit organization, it would not have to compete with other private insurers because it would not have the same demands allowing it to lower costs because it just has to zero out at the end of the year and pay for itself.


“Why should policy makers give private insurers the exclusive right to cover Americans? If private insurers can better meet our goals for the health system, why object to a level competition with public plans?”

But would it be a level playing field if the government entity doesn't have the same responsibilities to be profitable that private insurers have. If these companies don't make money they go out of business, loss of jobs, and all that.

Doc Randy
01-08-2009, 06:33 PM
You just illustrated a double standard there.

People complain about high insurance premiums to cover these overhead costs, apparently that's a sin, but when the government does it, it's not?

The administrative costs of private insurance companies (15-25%) isn't a sin. It is just wasteful and inefficient.

If this public-run system being proposed can keep the same low administrative costs as Medicare, then it would be a much more efficient system.

Also, there is a good possibility that the premiums would be lower for this new program.




You say nobody is suggesting eliminating private insurance, but you would be wrong. I know you support it. Corpse Reign supports it. Fake Pat supports it. You guys have been around long enough to show that you would prefer a total elimination of the private market in insurance and have Uncle Sam be the only payer. But let's ignore that point, and say nobody really isn't suggesting the elimination of private insurance. Killgore's comparison with USPS and UPS/Fed Ex is a bit apples to oranges. Post service brings things from A to B, health care is more complex than that, with potentially more drastic results.

I have always thought a single-payer system like Canada's would be superior to what we have now, but have never said it was the best system available. I don't think anybody would argue that Canada has the best system in the world.

What I support and what I want, as I have said repeatedly, is whatever is most pragmatic, effective, and efficient.

Ryan Elliott
01-08-2009, 06:41 PM
My girlfriend's been flu-like sick for the past couple months. Won't go to the doctor because she can't afford it.

My dad, a few days ago, while we were driving in the car, started having extreme pains in his lower back around his kidney area, and started shaking. SHIVERING. Like he was freezing, but he wasn't cold. That went on for about thirty minutes to an hour. Went to the ER, but wouldn't stay to see a doctor because...we couldn't afford it.

Fuck this current system right up its ass.

Doc Randy
01-08-2009, 06:45 PM
I'm confused because your link and your quote aren't from the same place. Where is the quote from?

NYT changed the article after the hearings today. Here is an updated link. (http://www.nytimes.com/2009/01/08/us/politics/08daschle.html)

Doc Randy
01-08-2009, 06:50 PM
They'll be driven from the market because companies will no longer provide medical coverage and will save their money. They may help cover the premium, but why provide their own network when they can just have their employees go into the national health care system?

Also, outside of "competition" why is this plan better?

Why do you assume that if an employer has one more option when considering health insurance, they will choose "none of the above"? Seems illogical. Not only that, but employers still have to compete for employees and if employees find out that an employer has been given another avenue for insurance (one that may be cheaper and possibly more efficient), but instead chooses to drop all coverage for all of its employees, they would be at a competitive disadvantage in the market place for workers.




Your bolded area merely states it will TRY, it will STRIVE, it will ATTEMPT, not that it WILL.

True. And if it can't then the private insurance companies have nothing to worry about. Simple. So why not give it a try?




The unfair advantage I believe they are pointing out is that it would not be a for profit organization, it would not have to compete with other private insurers because it would not have the same demands allowing it to lower costs because it just has to zero out at the end of the year and pay for itself.

But would it be a level playing field if the government entity doesn't have the same responsibilities to be profitable that private insurers have. If these companies don't make money they go out of business, loss of jobs, and all that.

Like I said earlier, so?

There used to be private fire fighting services. They were a nightmarishly ineffective train wreck. And then came the public fire fighting services. Do you think people were really concerned that it was unfair that the public services performed more efficiently for society and thus left the private fire fighters at a disadvantage?

EdNEMO
01-08-2009, 06:51 PM
If you can't afford insurance then you need to change your finances. I've had good insurance, crappy insurance, and expensive insurance, even when I had to choose between insurance and eating something other than ramen noodles. I'm diabetic, I have to have insurance.

If you can't afford insurance, then do something to get it. If you want the government to give it to you, you have a problem. (Well, maybe not for long.)

I am always amazed at how people want everything to be given to them for free. People who expect their parents to pay for their college, or buy them a car. Freakin work, people! Go to school and pay your student loans off like the rest of us, and stop looking for handouts!

Boris the Blade
01-08-2009, 06:53 PM
Burn, private health care, burn!

VIVE SOCIALISM! VIVE!

Are you going to share those fries?

Doc Randy
01-08-2009, 06:53 PM
If you can't afford insurance then you need to change your finances. I've had good insurance, crappy insurance, and expensive insurance, even when I had to choose between insurance and eating something other than ramen noodles. I'm diabetic, I have to have insurance.

If you can't afford insurance, then do something to get it. If you want the government to give it to you, you have a problem. (Well, maybe not for long.)

I am always amazed at how people want everything to be given to them for free. People who expect their parents to pay for their college, or buy them a car. Freakin work, people! Go to school and pay your student loans off like the rest of us, and stop looking for handouts!

The proposal being discussed in this thread doesn't give people free health care. It gives people and businesses another option when choosing which insurance provider they want to use. It gives the public more freedom and more choices for where they can spend their money.

Boris the Blade
01-08-2009, 06:56 PM
The proposal being discussed doesn't give people free health care. It gives people and businesses another option when choosing which insurance provider they want to use. It gives the public more freedom and more choices for where they can spend their money.
You also pay for it. Taxes, right?

Doc Randy
01-08-2009, 06:57 PM
You also pay for it. Taxes, right?

Not through taxes. Through premiums. Very similar to how you purchase private insurance.

Boris the Blade
01-08-2009, 06:57 PM
The question is after this kills the economy even worse, will Obama give the Insurance Companies a bailout?

Boris the Blade
01-08-2009, 06:58 PM
Not through taxes. Through premiums. Very similar to how you purchase private insurance.
Too many beers to read the whole thing. :s

Brian Defferding
01-08-2009, 06:58 PM
Guh...there are soooooooooooooo many things I want to say on this subject, but I'm on my way out the door. I'm coming back to this thread tomorrow night.

Boris the Blade
01-08-2009, 07:00 PM
Guh...there are soooooooooooooo many things I want to say on this subject, but I'm on my way out the door. I'm coming back to this thread tomorrow night.
Don't worry the thread should correct itself by then.

dEnny!
01-08-2009, 07:02 PM
NYT changed the article after the hearings today. Here is an updated link. (http://www.nytimes.com/2009/01/08/us/politics/08daschle.html)

Thank you.

dEnny!
01-08-2009, 07:12 PM
Why do you assume that if an employer has one more option when considering health insurance, they will choose "none of the above"? Seems illogical. Not only that, but employers still have to compete for employees and if employees find out that and employer has been given another avenue for insurance (one that may be cheaper and possibly more efficient), but instead chooses to drop all coverage for all of its employees, they would be at a competitive disadvantage in the market place for workers.

Having worked in benefits, history has shown that if an employer can cut costs...they will. The retirees and employees on W/C have to take Medicare insurance when they become eligible and used to go on a "Carve Out Plan," to cover what Medicare does not, now called Medicare Advantage. So they pay the premium for Medicare Part A and B, PLUS our premium to get the same coverage I'm currently getting, which has a $2,500 out of pocket maximum cost, but you also have higher co-payments, etc.

My organization has a hospital, but what they could easily do is begin accepting Obama's health plan, cut the medical benefit or cover a portion of this new national health insurance and save a boatload of money and bill Medicare at a higher rate than they would bill themselves.


There used to be private fire fighting services. They were a nightmarishly ineffective train wreck. And then came the public fire fighting services. Do you think people were really concerned that it was unfair that the public services performed more efficiently for society and thus left the private fire fighters at a disadvantage?

Health care and fighting fires...no where near the same ball game.

dEnny!
01-08-2009, 07:13 PM
Not through taxes. Through premiums. Very similar to how you purchase private insurance.

Oh your taxes will be subsidizing it and you'll also be paying premiums for it, but it'll be more "efficient," because that's what they'll tell you. ;)

Doc Randy
01-08-2009, 07:18 PM
Having worked in benefits, history has shown that if an employer can cut costs...they will. The retirees and employees on W/C have to take Medicare insurance when they become eligible and used to go on a "Carve Out Plan," to cover what Medicare does not, now called Medicare Advantage. So they pay the premium for Medicare Part A and B, PLUS our premium to get the same coverage I'm currently getting, which has a $2,500 out of pocket maximum cost, but you also have higher co-payments, etc.

Oddly enough, what you just described is actually used by many as an argument for single-payer systems. Not that that has anything to do with what we are talking about now. ;)



Health care and fighting fires...no where near the same ball game.

True. But the core concept is valid. If a public program has the ability to compete or be superior to a private program, why should we worry too much about the private sector? The simple fact is that there are times when some public programs are cheaper, more effective, and more efficient.

It seems criminal to prevent a public service because it might possibly work better than the private sector and the status quo. It is some sort of backwards protectionism.

dEnny!
01-08-2009, 07:18 PM
The proposal being discussed in this thread doesn't give people free health care. It gives people and businesses another option when choosing which insurance provider they want to use. It gives the public more freedom and more choices for where they can spend their money.

It will have the exact opposite affect. If private companies can't remain profitable they will close up shop and open a different business.

Employers will cut their health insurance benefit plans or alter them to take this new government plan into account and save themselves money in the long run. Once you retire you go on the federal government medicare plan, now they'll just do it sooner and cut their liability and what they have to book in their year end financials.

Are there any private fire fighting firms? :p

Organizations such as mine who have a hospital can bill Medicare the fee schedule, something that is always negotiated so without private firms what negotiating power will this national health plan have? They'll be the only game in town so then premiums will go on the rise to cover these fancy prescription drugs and expensive procedures and when people, just like they do now, say well it is either eat and pay for shelter or have health insurance they'll cut their participation, so those who are in it will have to pay more because all the people without insurance will still be seen, just won't pay for it....

Doc Randy
01-08-2009, 07:20 PM
Does anyone here know how much healthcare costs an insurance company? It is horribly expensive. Way more that you might expect. This plan will quite possibly be the death of many insurance companies. That being said, most doctors will actively work to make sure that corporate insurance companies stay in business as a government run insurance system is going to drive their profits way down.

Allow me to introduce you to Physicians for a National Health Program:
http://www.pnhp.org/

(note: they actually want a single-payer system - not what we are discussing here.)

Doc Randy
01-08-2009, 07:26 PM
It will have the exact opposite affect. If private companies can't remain profitable they will close up shop and open a different business.

Employers will cut their health insurance benefit plans or alter them to take this new government plan into account and save themselves money in the long run. Once you retire you go on the federal government medicare plan, now they'll just do it sooner and cut their liability and what they have to book in their year end financials.

Are there any private fire fighting firms? :p

My question would be... so? It seems to be working elsewhere. If our system evolved into a single-payer system, then our businesses would be free of these medical liabilities and would be better able to compete in the global market.

I don't want the Canadian system, but it works better and for cheaper than the US system.






Organizations such as mine who have a hospital can bill Medicare the fee schedule, something that is always negotiated so without private firms what negotiating power will this national health plan have? They'll be the only game in town so then premiums will go on the rise to cover these fancy prescription drugs and expensive procedures and when people, just like they do now, say well it is either eat and pay for shelter or have health insurance they'll cut their participation, so those who are in it will have to pay more because all the people without insurance will still be seen, just won't pay for it....

FYI - Daschle has said he wants to eliminate or change significantly the fee schedule method of payment.

Also, if they are "the only game in town" then they will have massive collective bargaining power. Almost absolute power to lower rates. This is called the power of monopsony (not to be confused with a monopoly). Monopsonistic power is one of the key areas that public insurance programs have been proven to reduce costs.

Taxman
01-08-2009, 07:31 PM
That being said, most doctors will actively work to make sure that corporate insurance companies stay in business as a government run insurance system is going to drive their profits way down.Why?

Private insurers have been hindering their ability to treat patients and make a profit for years.

dEnny!
01-08-2009, 07:34 PM
My question would be... so? It seems to be working elsewhere. If our system evolved into a single-payer system, then our businesses would be free of these medical liabilities and would be better able to compete in the global market.

I don't want the Canadian system, but it works better and for cheaper than the US system.

I'll take my health insurance over Canadia's any day of the week. I've heard some negative things about their system.



FYI - Daschle has said he wants to eliminate or change significantly the fee schedule method of payment.

The fee schedule actually lowered costs, before the fee schedule they were being charged ridiculous amounts of money for prescription drugs and procedures.

Is it still good? Maybe not, but it was better than what was going on. It created a limit.


Also, if they are "the only game in town" then they will have massive collective bargaining power. Almost absolute power to lower rates. This is called the power of monopsony (not to be confused with a monopoly). Monopsonistic power is one of the key areas that public insurance programs have been proven to reduce costs.

So pharmaceutical company makes great drug, hospitals want to use drug and are charged $100 per pill to recover the R&D costs. How exactly will this Monopsonistic power prevent its insured customers access to this drug if they don't want to pay the price? They REALLY want the drug and the drug is effective? Best thing since we cured the pox. Say no, we won't pay it. Okay then we'll sell it elsewhere around the world.

I don't claim to know it all, but I've worked in benefits and worker's comp and long term disability and I saw what was going on. Color me skeptical until I see actions contrary to what I've seen in the past.

Every retiree/disabled person we "forced" to have Medicare Part A and B HATED it. They complained about the cost, the service, and were not happy, but it saved us money.

Doc Randy
01-08-2009, 07:36 PM
Here is a fun chart I like to post that show what we pay for health care versus other industrialized nations:

http://content.healthaffairs.org/content/vol22/issue3/images/medium/22_3_89_Anderson_tbl1.gif

Doc Randy
01-08-2009, 07:45 PM
I'll take my health insurance over Canadia's any day of the week. I've heard some negative things about their system.


Like I said, Canada's system isn't perfect nor is it the best. It is just better than ours by almost every standard: cost (per capita and % of GDP), infant mortality rate, life expectancy at birth.




So pharmaceutical company makes great drug, hospitals want to use drug and are charged $100 per pill to recover the R&D costs. How exactly will this Monopsonistic power prevent its insured customers access to this drug if they don't want to pay the price? They REALLY want the drug and the drug is effective? Best thing since we cured the pox. Say no, we won't pay it. Okay then we'll sell it elsewhere around the world.


That isn't how monopsonies work. Nor is it an example of collective bargaining or economies of scale.

A public insurance program, by nature of its large size and potential volume of business, is able to buy in bulk or negotiate lower rates with the promise of higher volume. Think of this as the Wal-Mart effect. Wal-Mart wants to stock a product. Product manufacturer will sell it to Wal-Mart at a lower wholesale because they know Wal-Mart has a huge distribution network and the margins may be offset by the large volume.

The VA currently does this with drugs. It uses it large size and purchasing power to negotiate lower costs. Unfortunately, Medicare is explicitly forbidden from doing this.

Now if the drug maker won't budge on the price, then they lose a huge amount of volume and revenue. It is a question of negotiating a lower price or getting nothing. History has shown that when faced with this type of purchasing power, most pharmaceuticals do indeed negotiate and lower prices. They do this all over the industrialized world.

It is simple economics. The bigger the purchasing power or volume, the more leverage you have at negotiating costs. A public health insurance plan has the potential for being a very large purchaser of medical services.

dEnny!
01-08-2009, 07:49 PM
Like I said, Canada's system isn't perfect nor is it the best. It is just better than ours.

No, it might be better than yours, but I'm pretty sure mine is better. I can get a freaking transplant SUPER cheap! When my son was born we never had a problem getting seen, we paid like $130 ($20 was due to him having to go to the Twilight Clinic for his Jaundice and having labs drawn). My parking is validated, I'm seen on the same day I call...it's insanely good.

You hold out hope, I'm jaded I guess just seeing how these things seem to work out. I hope I'm wrong and Obama, Senate, and House can get something pushed through that addresses this very serious issue. It is crazy how many people don't have health insurance so I hope they can find an affordable way of implementing a system that provides complete coverage and is proactive about keeping people healthy and providing the necessary services.

Taxman
01-08-2009, 08:00 PM
No, it might be better than yours, but I'm pretty sure mine is better.But is it 5% of GDP better?

WillieLee
01-08-2009, 08:13 PM
I'll take my health insurance over Canadia's any day of the week. I've heard some negative things about their system.


I've heard a lot of negative things about America. I guess they must be true.

SMACK!
01-08-2009, 10:45 PM
So everythings roses for you Denny, but it's shit for the majority of us. I paid nearly $4000 last year in premiums, and my employer kicked in another $4000. We have switched companies three times on as many years. This year, my wife gave birth and her ob that she had for the other three kids wasn't on the new list. Nor was the hospital. On top of not getting to have our child where and with whom she wanted, we've had to shell out over $2000 out of our own pocket. The insurance only paid $500. So what the hell am I paying for? If I had no insurance and just paid for of myself, I could have chosen the hospital, the doctor and I'd be ahead over $1000.

That's my story for this year. Don't get me started on how royally my parents have been screwed.

Thomas Mauer
01-09-2009, 03:20 AM
So in the German system funding does not come from anywhere else? I am going to have to really do some more reading on this.

No, the government doesn't dump anything extra on top of what you pay (unless you're a registered freelancer). Employers pay half of your health insurance, and you pay the other half. You can either go with a private or a public plan.

The government made an exception for freelancers about two decades ago creating the "Artists Social Fund." It's not applicable to all freelancers, but freelance journalists, full time authors, artists and freelance designers are covered by it. It essentially functions like the employer/employee setup, with the freelancer paying half the amount (for social security, health, and retirement plans) and this government fund paying the other half. The amount you pay is based on a projection of the next annual income, which can be revised up and down (if you make more and don't revise, you can be caught for fraud).

At any rate, there are no extra funds going into health care from the government. What does happen is that ALL money paid by the entirety of the nation is uses for the patients that need it. Each individual is assured that if/when they need the money for treatment, it's available (false claims will be investigated though) - which it is, because everybody's got health insurance and is paying into the pot. This simply means the money paid in by healthy people who don't get sick for 20 years doesn't just lay around and collects interest for the insurance company (which all of the money combined does anyway).

Thomas Mauer
01-09-2009, 03:27 AM
Allow me to defend the market.

The health care system has been forced onto the backs of the American employer at tremendous expense. This is done in no other industrialized country in the world. It has placed to the American worker and American products at a significant disadvantage against any non American firm they might compete with. This has been a significant factor in creating the mammoth trade deficits we currently face. These deficits are draining much of the wealth in this country, and literally threatens to destroy our economy.

So why the hell not take this one step which would help give our industries a better chance of competing in the market?

Not true. In Germany for example, employers and employees have shared the cost for health insurance equally for decades. And we've only had private insurance companies added as options about 15 years ago. Before that, private insurance companies weren't in the health insurance business at all.

mario
01-09-2009, 03:36 AM
Here is a fun chart I like to post that show what we pay for health care versus other industrialized nations:

http://content.healthaffairs.org/content/vol22/issue3/images/medium/22_3_89_Anderson_tbl1.gif

Belgium! Belgium! Belgium!

RickLM
01-09-2009, 05:44 AM
No, it might be better than yours, but I'm pretty sure mine is better. I can get a freaking transplant SUPER cheap! When my son was born we never had a problem getting seen, we paid like $130 ($20 was due to him having to go to the Twilight Clinic for his Jaundice and having labs drawn). My parking is validated, I'm seen on the same day I call...it's insanely good.

You hold out hope, I'm jaded I guess just seeing how these things seem to work out. I hope I'm wrong and Obama, Senate, and House can get something pushed through that addresses this very serious issue. It is crazy how many people don't have health insurance so I hope they can find an affordable way of implementing a system that provides complete coverage and is proactive about keeping people healthy and providing the necessary services.


You can move to universal coverage without duplicating the Canadian system. There are many other models -- Germany, Japan and other places manage to cover every citizen but they go about it in different ways.

Somehow this debate always ends up being a referendum on Canada -- usually talking about someone's Uncle Frank who had to wait for knee surgery in Toronto.

Doc Randy
01-09-2009, 05:53 AM
You can move to universal coverage without duplicating the Canadian system. There are many other models -- Germany, Japan and other places manage to cover every citizen but they go about it in different ways.

Somehow this debate always ends up being a referendum on Canada -- usually talking about someone's Uncle Frank who had to wait for knee surgery in Toronto.

What he said.

EdNEMO
01-09-2009, 06:05 AM
What he said.

I think more people in the US have an uncle in Canada than they do in Germany of Japan.

WillieLee
01-09-2009, 06:45 AM
You can move to universal coverage without duplicating the Canadian system. There are many other models -- Germany, Japan and other places manage to cover every citizen but they go about it in different ways.

Somehow this debate always ends up being a referendum on Canada -- usually talking about someone's Uncle Frank who had to wait for knee surgery in Toronto.

Canada is the only country that has been able to carry out their universal health care while running a balanced budget over successive years. While the European models might be more efficient, they are done so at a cost that isn't sustainable over the long-term.

Brian Defferding
01-09-2009, 06:50 AM
I certainly don't understand how you can support the market based health care insurance system we have in place.

I think that’s part of the problem right there.

Just because one is against universal health care doesn’t mean one supports and defends the current system we have now. I’ve stated many times before that this current system needs fixing. But there are more ways to get coverage than just insurance.

Have you heard of SimpleCare? (http://www.simplecare.com/about.html#patients) This is what it does:

So, how does SimpleCare work?
The secret is actually quite simple. We call it PIFATOS, and it means “Pay In Full At Time Of Service.” A patient sees a doctor, a doctor delivers the needed medical care, and the patient pays the doctor out of his/her own pocket in full directly after the appointment. Sound revolutionary? Well, it’s not. It’s just old fashioned. That’s the way healthcare costs used to be handled, before the present health insurance system.
Universal Health Care advocates claim admin costs spike up the cost of insurance and care. Simplecare dodges all of that by paying directly, thus cutting costs down 30 – 50%. Many Doctors love this method, because it gives them the ability to practice medicine the way they want and they don’t have to worry about if they are getting paid. There is also an option to buy catastrophic coverage as well. SimpleCare doesn’t deny anyone with preexisting conditions.

It’s not insurance. It’s non-profit. And it’s completely private. I think both us and the government should look more into allowing these types of solutions to work along with investigating other ways to dodge wasteful red tape processes/regulation instead of developing boorish government policies under the naïve belief that the free market is “failing” (when health care in America hasn't been close to free market for many decades now).

WillieLee
01-09-2009, 06:54 AM
Have you heard of SimpleCare? (http://www.simplecare.com/about.html#patients) This is what it does:

Universal Health Care advocates claim admin costs spike up the cost of insurance and care. Simplecare dodges all of that by paying directly, thus cutting costs down 30 – 50%. Many Doctors love this method, because it gives them the ability to practice medicine the way they want and they don’t have to worry about if they are getting paid. There is also an option to buy catastrophic coverage as well. SimpleCare doesn’t deny anyone with preexisting conditions.

It’s not insurance. It’s non-profit. And it’s completely private. I think both us and the government should look more into allowing these types of solutions to work along with investigating other ways to dodge wasteful red tape processes/regulation instead of developing boorish government policies under the naïve belief that the free market is “failing” (when health care in America hasn't been close to free market for many decades now).

Sometimes I wonder what's going on in that mind of yours.

yeamon
01-09-2009, 06:55 AM
If the argument against any plan that proposes some form of government administration is going to cite "free market" as a defense, there has to be a consideration.

If the product is considered a basic "right" of every citizen in this country (and that is exactly what the man we elected has called health care), then how does a traditional free market model apply? A balance has to be struck somehow, and I think the proposed plan outlined in the article sounds intriguing (I would like to know more).

Deff, I understand where you usually come from on these issues, arguing against any government involvement. But when the product is the "right" of a citizen, I would think the free market would allow the consumer to pool it's lobbying power in the most effective means necessary to achieve better product, services, and pricing. How else in this model, where the product is a "right", does the consumer (in this case, all US citizenry) lobby (in the same fashion of a shareholder) for improvement? Seems to me, the most effective route, and possibly the only route, is to administrate that power through the government of the people.

Brian Defferding
01-09-2009, 06:57 AM
Sometimes I wonder what's going on in that mind of yours.

Strange...I feel the same way about you.

RickLM
01-09-2009, 07:00 AM
Canada is the only country that has been able to carry out their universal health care while running a balanced budget over successive years. While the European models might be more efficient, they are done so at a cost that isn't sustainable over the long-term.


Obama's proposal seems very close to the Japanese system, from what I remember (it's been 15 years since I looked at this issue in-depth). I don't believe its a single-payer system but rather a patchwork of employer-provided insurance and government-provided plans. I wonder if they've been able to balance the books on their system.

WillieLee
01-09-2009, 07:24 AM
Obama's proposal seems very close to the Japanese system, from what I remember (it's been 15 years since I looked at this issue in-depth). I don't believe its a single-payer system but rather a patchwork of employer-provided insurance and government-provided plans. I wonder if they've been able to balance the books on their system.

Japan has been running massive budget deficits for decades so it's unknown whether their system is sustainable. Now if the US wants to keep their high-level of spending then a move to any European UHC system would be better. But at some point these countries will have to balance the books.

Brian Defferding
01-09-2009, 07:29 AM
The administrative costs of private insurance companies (15-25%) isn't a sin. It is just wasteful and inefficient.

I know, I’m using a hyperbole ;)


If this public-run system being proposed can keep the same low administrative costs as Medicare, then it would be a much more efficient system.

Also, there is a good possibility that the premiums would be lower for this new program.

I think you are taking some of those studies for granted a bit too much. It’s not as accurate as you think. According to this AHIP study for policy research: (http://www.ahipresearch.org/pdfs/Administrative_Costs_030705.pdf)


First, Medicare's "capital costs" are not included in government estimates of Medicare spending. Here is a simplistic, but revealing example: federal net interest payments to the public -- the government's overall capital cost -- totaled $160 billion in fiscal year 2004. In that year, Medicare benefits (net of premiums collected from beneficiaries) comprised about 12 percent of federal non-interest spending. Therefore, Medicare's share of the government's debt-service costs could be estimated at about $19 billion in 2004. Adding these payments alone would boost Medicare's administrative cost rate by almost 7 percentage points, to just under 10 percent.

Second, Medicare's "benefit cost per claim" is likely higher than that of private plans serving the non-elderly population. However, high-cost claims can be just as easy to process as smaller claims. For example, it might cost $50 to process either a $5,000 claim or a $1,000 claim. If Medicare's claims-paying methods were applied to a younger population with lower benefit costs per claim, its reported administration rate would be higher simply because the "denominator" -- the overall claims cost -- was smaller.

And I already brought up with you in the previous discussion on this subject matter on how Congressional budgeting and data collecting for Congress are not included in Medicare’s administration costs, so that graph you like to wave around whenever this subject pops up isn’t as accurate as you wish it to be. The fact of the matter is, with Obama’s plan, we will expect to see admin costs go up.

There is also evidence out there that due to budget shortfalls, Medicaid and SCHIP costs are a lot higher than they really should be, so they keep the procedures and costs higher to pay the tab. This study by healthaffairs.org shows Medicaid’s costs could be almost 40% lower if they simplified the process down. (http://content.healthaffairs.org/cgi/reprint/23/1/237.pdf) This problem isn't limited to Medicaid, this problem surfaced for the immigration process.

Putting more power in the government’s hands is very dangerous, Randy. Especially if it’s the American government. The last thing we need is a government insurance plan that commits the same problematic practices you and other liberals point at private insurance of doing. At least right now we can switch over to another insurance provider. If the government takes over and whittles down private options…I guess the only other option is to move to another country.

Brian Defferding
01-09-2009, 07:58 AM
There used to be private fire fighting services. They were a nightmarishly ineffective train wreck. And then came the public fire fighting services. Do you think people were really concerned that it was unfair that the public services performed more efficiently for society and thus left the private fire fighters at a disadvantage?

This is funny. Watch, I can do this too:

Amtrak is funded by the government. It is a nightmarishly ineffective trainwreck (literally). This is one of the many reasons why people stick with private transportation. The costs are lower and the time to get there is a fraction of Amtrak’s performance. Do you think people are really concerned that it is unfair to Amtrak with the reality of it being cheaper to take their car?

This is fun.

Brian Defferding
01-09-2009, 08:09 AM
If you can't afford insurance then you need to change your finances. I've had good insurance, crappy insurance, and expensive insurance, even when I had to choose between insurance and eating something other than ramen noodles. I'm diabetic, I have to have insurance.

If you can't afford insurance, then do something to get it. If you want the government to give it to you, you have a problem. (Well, maybe not for long.)

I am always amazed at how people want everything to be given to them for free. People who expect their parents to pay for their college, or buy them a car. Freakin work, people! Go to school and pay your student loans off like the rest of us, and stop looking for handouts!

I completely agree.

In places like Norway that have UHC, taxes are much higher to fund virtually everything. But they get almost total cost coverage of care.

In America, all depending on the state of course, for the most part we don’t pay income taxes to pay for everyone’s health care, we pay for our own. While this means out of pocket costs will be higher, we have more wealth from our paychecks to spend on it, thus it can even out. Go to ehealthinsurance.com and one can find a menu of different insurance plans to choose from. Obviously, the more complete and best ones will cost more. But if one’s health is important (which of course it probably is ;) ), it should be a number one priority. I’m not sure how many states out there only have health insurance providers that only offer a very limited palette of coverage, that’s something I would like to know, because when I hear stories of people saying they couldn’t afford a doctor but also drive an expensive car, SUV, or own a house, it’s hard for me to feel like they’ve been a victim of “the system.”

Having complete coverage is worth giving up some finer things in life.

Taxman
01-09-2009, 08:39 AM
Have you heard of SimpleCare? (http://www.simplecare.com/about.html#patients) What seems simple to me would be to just start up some new non-profit HMO's like the old days.

Ben
01-09-2009, 08:41 AM
My girlfriend's been flu-like sick for the past couple months. Won't go to the doctor because she can't afford it.

My dad, a few days ago, while we were driving in the car, started having extreme pains in his lower back around his kidney area, and started shaking. SHIVERING. Like he was freezing, but he wasn't cold. That went on for about thirty minutes to an hour. Went to the ER, but wouldn't stay to see a doctor because...we couldn't afford it.

Fuck this current system right up its ass.Go see a REGULAR doctor, not someone in the ER. Just a regular primary care physician. It does not cost a fortune.

Taxman
01-09-2009, 08:48 AM
Go see a REGULAR doctor, not someone in the ER. Just a regular primary care physician. It does not cost a fortune.No kidding. A lot of the drug stores here in town have clinics in them where one can get examined by a nurse practitioner at a very low cost.

If you can't afford to see a doctor, check around for something like that.

Brad N.
01-09-2009, 08:49 AM
The real test will be the fight for public opinion. Clinton's response to loud opposition was to drop the issue for seven years. I'm trusting Obama to craft a communications strategy that will cut through the bullshit; if he loses the communications battle, this thing may die.

Here's the thing that drives me nuts... the vast majority of Americans are in favor of UHC in one form or another, it's been a remarkably popular issue since long before HillaryCare. To date I'll never understand why Dems don't wrap themselves in this issue the way Republicans wrap themselves in banning gay marriage or abortion. At least with the former it's something the public is behind. BUT, for some reason (*cough* money from the insurance industry *cough*) this incredibly popular issue hasn't really been at the forefront until now.

Fake Pat
01-09-2009, 08:55 AM
Here's the thing that drives me nuts... the vast majority of Americans are in favor of UHC in one form or another, it's been a remarkably popular issue since long before HillaryCare. To date I'll never understand why Dems don't wrap themselves in this issue the way Republicans wrap themselves in banning gay marriage or abortion. At least with the former it's something the public is behind. BUT, for some reason (*cough* money from the insurance industry *cough*) this incredibly popular issue hasn't really been at the forefront until now.

You might wanna get that checked. Coughing up entire sentences can't be healthy.

Brad N.
01-09-2009, 09:02 AM
Go see a REGULAR doctor, not someone in the ER. Just a regular primary care physician. It does not cost a fortune.

It depends. For me the clinic I go to (just a primary care clinic, nothing fancy) is still pretty spendy. Not hospital prices, but I'll give you a few examples. We have a $5,000 deductible on our shitty insurance through our employer so naturally unless something major happens we pay pretty much full price for any doctor visit outside an annual physical. I say pretty much because being In-Network they do take a small percentage off the top of the bill before we get it. So yeah, a few months ago my older son needed an X-ray done in addition to getting looked at. He had a really nasty cold for a while, had RSV as a baby and they were worried about pneumonia. The bill for a 30 minute office visit and the X-rays? $470.00. I wouldn't call that affordable.

I went in for a simple rapid Strep test a month ago and it cost me $140.00. Now, that may not seem like a lot, but it adds up.

Brad N.
01-09-2009, 09:03 AM
You might wanna get that checked. Coughing up entire sentences can't be healthy.

I can't afford it. :cry:

Brad N.
01-09-2009, 09:18 AM
Ugh. So somewhat related I guess. My wife (who has had our coverage for the family for 5 years now) had to cancel our insurance. I've told the stories before here about how expensive our insurance was and how awful the coverage was but I'll go into it again.

So we both work for the same company now and my wife has held the insurance for 5 years (ever since I had a job that offered it) and we now have been priced out of coverage. A family of four with no prior conditions and starting now we would have had to pay $750 a month (that's $50 more than we pay in rent!) for our coverage. To make matters worse we would have had our deductible increased to $10,000. So, since we don't get sick often basically aside from well checks for the kids and an annual physical for the wife and I we would have paid out of pocket every dime any time we went to the doctor. The only real reason we held on so long was because of the kids, I've gone without insurance before, not that big of a deal.

So here we are, currently without any insurance (well, except for the baby who is on M.A. through the state of MN until age 1). It fucking sucks but I'm currently looking into private insurance options and to be honest after going through eHealthinsurance.com the options aren't much better. I was told though that a local provider here has a plan for a family of 4 that has a $10,000 deductible for $250 a month and it includes 3 free office visits per year for each family member. If it's all true I'll jump on that in a heartbeat.

The fucked up thing is my case isn't unique and more and more Americans are seeing their premiums skyrocket out of reach and the coverage getting less and less. I find it funny to hear people say "Well, if you want better coverage, find a better job!" especially in this economy. I'm lucky to have A job right now as it is. I'm holding out hope that something gets done here that can help not just my situation, but every other American as well. The current system we have is broken beyond repair.

dEnny!
01-09-2009, 10:30 AM
I've heard a lot of negative things about America. I guess they must be true.

I guess I just don't presribe to the notion that the grass is greener on the Canadian side.

I think you have just as many people say, "I hear they have free heatlh care. That rocks," knowing absolutely nothing about their health care system, how much they pay in taxes to have that system in place, etc.

Humphrey_Lee
01-09-2009, 10:41 AM
No, it might be better than yours, but I'm pretty sure mine is better. I can get a freaking transplant SUPER cheap! When my son was born we never had a problem getting seen, we paid like $130 ($20 was due to him having to go to the Twilight Clinic for his Jaundice and having labs drawn). My parking is validated, I'm seen on the same day I call...it's insanely good.

You hold out hope, I'm jaded I guess just seeing how these things seem to work out. I hope I'm wrong and Obama, Senate, and House can get something pushed through that addresses this very serious issue. It is crazy how many people don't have health insurance so I hope they can find an affordable way of implementing a system that provides complete coverage and is proactive about keeping people healthy and providing the necessary services.


Yeah, that's fantastic for you. My girlfriend can't even find a job right now so she pays $2-300 a month right now in insurance out of pocket (god bless COBRA!). An ER visit costs her $150 in copay, just to get checked out in an emergency. She's needed her tonsils out for at least a year now but they won't operate because the company doesn't want to eat that cost. And because of it, they inflame and get infected like nothing costing her pain and more money out of pocket for antibiotics. Fuck this system. I'm glad it works for you, but you are a most distinct minority.

dEnny!
01-09-2009, 10:44 AM
Yeah, that's fantastic for you. My girlfriend can't even find a job right now so she pays $2-300 a month right now in insurance out of pocket (god bless COBRA!). An ER visit costs her $150 in copay, just to get checked out in an emergency. She's needed her tonsils out for at least a year now but they won't operate because the company doesn't want to eat that cost. And because of it, they inflame and get infected like nothing costing her pain and more money out of pocket for antibiotics. Fuck this system. I'm glad it works for you, but you are a most distinct minority.

You mean employed? I joke. I'm sorry for your girlfriend's experience. I am fortunate to have a good health insurance plan.

COBRA is a federal health insurance plan correct? You think they provide good coverage? I thought you were upset by the copayments, service, cost, etc?

RickLM
01-09-2009, 10:50 AM
You mean employed? I joke. I'm sorry for your girlfriend's experience. I am fortunate to have a good health insurance plan.

COBRA is a federal health insurance plan correct? You think they provide good coverage? I thought you were upset by the copayments, service, cost, etc?



COBRA is not an insurance plan, its simply a law that allows you to keep your former employer's insurance (at your own freaking cost) after the company tells you to leave. It's a weak-ass provision that simply prevents you from being totally thrown to the wolves, but its nothing to write home about.

Ben
01-09-2009, 10:52 AM
I thought COBRA was just being able to continue your employer-sponsored health plan after you stop working for that employer, at your expense. I did this once. I didn't think it was its own special healthcare plan.

Doc Randy
01-09-2009, 10:52 AM
COBRA is a federal health insurance plan correct? You think they provide good coverage? I thought you were upset by the copayments, service, cost, etc?

Incorrect. COBRA (part of the Consolidated Omnibus Budget Reconciliation Act of 1985) is a federal law that says if an employee want to be able to deduct health care expenses, it will have to offer extended coverage to former employees. If I leave Oni Press, Joe has to allow me the opportunity to continue my coverage for up to 18 months. This doesn't mean Oni has to pay for it. It just means I have to be allowed to keep purchasing all of it.

It isn't federal health insurance. You should know this.

Ben
01-09-2009, 10:56 AM
COBRA is not an insurance plan, its simply a law that allows you to keep your former employer's insurance (at your own freaking cost) after the company tells you to leave. It's a weak-ass provision that simply prevents you from being totally thrown to the wolves, but its nothing to write home about.Yeah, it's very expensive, especially if your former employer was really generous and had a great health plan.

Doc Randy
01-09-2009, 11:01 AM
Yeah, it's very expensive, especially if your former employer was really generous and had a great health plan.

The great irony of COBRA... the better the plan while employed, the shittier the deal when let go.

Humphrey_Lee
01-09-2009, 11:28 AM
You mean employed? I joke. I'm sorry for your girlfriend's experience. I am fortunate to have a good health insurance plan.

COBRA is a federal health insurance plan correct? You think they provide good coverage? I thought you were upset by the copayments, service, cost, etc?

No, she gets the right to use whatever her last employer was using but without their contribution, so it's downright abhorrent. It was just a branch of Blue Shield, so she pays several hundred a month just to have a shitty copay (except doctors visits, that's actually not bad) and a mediocre emergency coverage (she'd have to cough up like, 60% if they ever did take her tonsils out). That's how "good" her system was before she was terminated (and then the assholes had the good nature to take her to court twice for her unemployment benefits, but that's a different story).

Brian Defferding
01-09-2009, 11:34 AM
Ugh. So somewhat related I guess. My wife (who has had our coverage for the family for 5 years now) had to cancel our insurance. I've told the stories before here about how expensive our insurance was and how awful the coverage was but I'll go into it again.

So we both work for the same company now and my wife has held the insurance for 5 years (ever since I had a job that offered it) and we now have been priced out of coverage. A family of four with no prior conditions and starting now we would have had to pay $750 a month (that's $50 more than we pay in rent!) for our coverage. To make matters worse we would have had our deductible increased to $10,000. So, since we don't get sick often basically aside from well checks for the kids and an annual physical for the wife and I we would have paid out of pocket every dime any time we went to the doctor. The only real reason we held on so long was because of the kids, I've gone without insurance before, not that big of a deal.

So here we are, currently without any insurance (well, except for the baby who is on M.A. through the state of MN until age 1). It fucking sucks but I'm currently looking into private insurance options and to be honest after going through eHealthinsurance.com the options aren't much better. I was told though that a local provider here has a plan for a family of 4 that has a $10,000 deductible for $250 a month and it includes 3 free office visits per year for each family member. If it's all true I'll jump on that in a heartbeat.

The fucked up thing is my case isn't unique and more and more Americans are seeing their premiums skyrocket out of reach and the coverage getting less and less. I find it funny to hear people say "Well, if you want better coverage, find a better job!" especially in this economy. I'm lucky to have A job right now as it is. I'm holding out hope that something gets done here that can help not just my situation, but every other American as well. The current system we have is broken beyond repair.

I did a generic search for a family of four in St.Paul on the same website, I found this option. (http://www.ehealthinsurance.com/ehi/Quote.fs?mcei.html.screen%2B%2B.IFPOverview.row:1. x=1) It's $400 less/month than your previous insurance and the deductible is no higher than $5,500 completely, everything above that is completely covered. It's also an HSA, so you can set aside pre-tax dollars per month into an account to save up for any deductibles you need to pay.

Of course the mileage varies on age and family medical histories, but I just wanted to help a brother out :D

EDIT: Nevermind on the link, it times out the IP address. Fart! :(

Doc Randy
01-09-2009, 11:48 AM
I did a generic search for a family of four in St.Paul on the same website, I found this option. (http://www.ehealthinsurance.com/ehi/Quote.fs?mcei.html.screen%2B%2B.IFPOverview.row:1. x=1) It's $400 less/month than your previous insurance and the deductible is no higher than $5,500 completely, everything above that is completely covered. It's also an HSA, so you can set aside pre-tax dollars per month into an account to save up for any deductibles you need to pay.

Of course the mileage varies on age and family medical histories, but I just wanted to help a brother out :D

EDIT: Nevermind on the link, it times out the IP address. Fart! :(

That means they would need to spend $9,700 before their coverage kicked in. Does anybody think this is acceptable?

SMACK!
01-09-2009, 11:48 AM
The fucked up thing is my case isn't unique and more and more Americans are seeing their premiums skyrocket out of reach and the coverage getting less and less. I find it funny to hear people say "Well, if you want better coverage, find a better job!" especially in this economy. I'm lucky to have A job right now as it is. I'm holding out hope that something gets done here that can help not just my situation, but every other American as well. The current system we have is broken beyond repair.


I agree 100%.

Brian Defferding
01-09-2009, 11:51 AM
That means they would need to spend $9,700 before their coverage kicked in. Does anybody think this is acceptable?

Oh, absolutely not. But it's a significant improvement from his last insurer.

RickLM
01-09-2009, 11:53 AM
That means they would need to spend $9,700 before their coverage kicked in. Does anybody think this is acceptable?


It's not acceptable, but its not really the full story, either. My deductible is $2500 per person (so I guess that's the same as a $10,000 per family rate), and I pay $440 per month for coverage. However, there is "coverage" in that I don't pay full price for prescriptions, office visits, ER visits and other services. So the insurance company is paying for certain things even prior to me reaching the $2500 level.

And that's really the last time I'll defend an insurer.

SMACK!
01-09-2009, 11:57 AM
It's not acceptable, but its not really the full story, either. My deductible is $2500 per person (so I guess that's the same as a $10,000 per family rate), and I pay $440 per month for coverage. However, there is "coverage" in that I don't pay full price for prescriptions, office visits, ER visits and other services. So the insurance company is paying for certain things even prior to me reaching the $2500 level.

And that's really the last time I'll defend an insurer.
Have you ever tried to buy any of your prescriptions without insurance? One of my wife's prescriptions cost us a copay of $10 per month. A few months ago, she forgot to give the insurance card and it was $4.00. WTF?

Brian Defferding
01-09-2009, 11:58 AM
Have you ever tried to buy any of your prescriptions without insurance? One of my wife's prescriptions cost us a copay of $10 per month. A few months ago, she forgot to give the insurance card and it was $4.00. WTF?

It all depends on the drug. Some brand-name drugs are over $250/bottle.

RickLM
01-09-2009, 12:01 PM
Have you ever tried to buy any of your prescriptions without insurance? One of my wife's prescriptions cost us a copay of $10 per month. A few months ago, she forgot to give the insurance card and it was $4.00. WTF?


Sounds like the pharmacy is trying to gouge the insurance company, but when there was no one to gouge, they revealed the true price. Nice system we have.

Wow, I just defended the insurance companies a second time.

SMACK!
01-09-2009, 12:08 PM
It all depends on the drug. Some brand-name drugs are over $250/bottle.
Yeah, I checked out the other prescription I get, it was $150. But still, 5 years x 12 months x $6.00 = a lot of comics.

Taxman
01-09-2009, 02:33 PM
You may hear some politicians complain about the corporate tax rate and say that it is too much of a burden for companies to compete in the world market. Seldom will you hear any of those same politicians call for any sort of reform of the health care system and that is as big an issue or even bigger for many businesses.

Brian Defferding
01-09-2009, 02:43 PM
You may hear some politicians complain about the corporate tax rate and say that it is too much of a burden for companies to compete in the world market. Seldom will you hear any of those same politicians call for any sort of reform of the health care system and that is as big an issue or even bigger for many businesses.

The good bills that do reform usually fall on deaf ears.

mlpeters
01-09-2009, 02:52 PM
Have you heard of SimpleCare? (http://www.simplecare.com/about.html#patients) This is what it does:


How is that different from what us without insurance, who simply avoid going to doctors and hospitals already do -- except right now, most hospitals will bill you, just in case you don't happen to have a wad of cash on you...?

If everyone had to pay in full every time they went to the doctor, or hospital, there would be even more (and there are a lot now...) untreated sick people and except among for those with high incomes, no preventative care -- there's damned little of that currently -- but we should aim for better care, not worse, IMHO.

Brad N.
01-09-2009, 03:05 PM
It's not acceptable, but its not really the full story, either. My deductible is $2500 per person (so I guess that's the same as a $10,000 per family rate), and I pay $440 per month for coverage. However, there is "coverage" in that I don't pay full price for prescriptions, office visits, ER visits and other services. So the insurance company is paying for certain things even prior to me reaching the $2500 level.

And that's really the last time I'll defend an insurer.

With the plan we've cancelled as well as the ones I've found on eHealthinsurance it's not even that good. We got one annual physical each for the wife and I and our 5-year-old son and regular well baby checks for our 10-month-old son and that's it. Full price for office visits, prescriptions, everything is full price until you've met that massive deductible. Hell, all the plans on eHealthcare don't even allow you those annual physicals. You pay for everything and get nothing.

Thomas Mauer
01-09-2009, 04:58 PM
How is that different from what us without insurance, who simply avoid going to doctors and hospitals already do -- except right now, most hospitals will bill you, just in case you don't happen to have a wad of cash on you...?

If everyone had to pay in full every time they went to the doctor, or hospital, there would be even more (and there are a lot now...) untreated sick people and except among for those with high incomes, no preventative care -- there's damned little of that currently -- but we should aim for better care, not worse, IMHO.

This, btw, is one of the big advantages of universal healthcare. UHC makes people more receptive to getting checked up and immunized regularly, which in the long run keeps down overall medical costs because sickness doesn't become as severe before it's treated.

RickLM
01-09-2009, 06:14 PM
With the plan we've cancelled as well as the ones I've found on eHealthinsurance it's not even that good. We got one annual physical each for the wife and I and our 5-year-old son and regular well baby checks for our 10-month-old son and that's it. Full price for office visits, prescriptions, everything is full price until you've met that massive deductible. Hell, all the plans on eHealthcare don't even allow you those annual physicals. You pay for everything and get nothing.


I actually got my insurance through Sam's Club. Aetna has a certain rate for Sam's Club members, which was better than what I could get through Blue Cross. It's the only reason I renew my Sam's Club membership every year.

Mister Mets
01-09-2009, 06:21 PM
My question would be... so? It seems to be working elsewhere. If our system evolved into a single-payer system, then our businesses would be free of these medical liabilities and would be better able to compete in the global market.

I don't want the Canadian system, but it works better and for cheaper than the US system.






FYI - Daschle has said he wants to eliminate or change significantly the fee schedule method of payment.

Also, if they are "the only game in town" then they will have massive collective bargaining power. Almost absolute power to lower rates. This is called the power of monopsony (not to be confused with a monopoly). Monopsonistic power is one of the key areas that public insurance programs have been proven to reduce costs.Monopsony is my word of the day. Just wanted to add that.

Brian Defferding
01-11-2009, 08:17 AM
That means they would need to spend $9,700 before their coverage kicked in. Does anybody think this is acceptable?

I just did another search for the same parameters in an Iowa zip code, and there was better health insurance ($3000 family deductible plus HSA) for literally half the monthly premium that is offered in Minnesota. This is what I'm talking about when it comes to opening up state insurance restrictions. The cost differential can be very significant. Your only objection to this resolution, while valid to a certain degree, isn't strong enough to conclude that this wouldn't work.

Brian Defferding
01-11-2009, 08:24 AM
How is that different from what us without insurance, who simply avoid going to doctors and hospitals already do -- except right now, most hospitals will bill you, just in case you don't happen to have a wad of cash on you...?

If everyone had to pay in full every time they went to the doctor, or hospital, there would be even more (and there are a lot now...) untreated sick people and except among for those with high incomes, no preventative care -- there's damned little of that currently -- but we should aim for better care, not worse, IMHO.

Once again, this makes doctor visits a lot more affordable because you are bypassing administration of big HMO's and insurers by paying doctors directly. Some insurance plans (especially family ones) offer doctor visits to be paid in full until the deductible is fully met. SimpleCare can whittle the cost down of those doctor visits significantly, allowing more money to be distributed towards more severe care plans or into a pre-tax HSA to save for the annual deductible.

Brian Defferding
01-11-2009, 08:32 AM
This, btw, is one of the big advantages of universal healthcare. UHC makes people more receptive to getting checked up and immunized regularly, which in the long run keeps down overall medical costs because sickness doesn't become as severe before it's treated.

It can also be its flaw. This can jam up waiting periods and add too much workload for hospital/doctor staff. People may come in for a check up on things that a doctor may not be needed for, like the common cold or the flu.

Fake Pat
01-11-2009, 08:54 AM
It can also be its flaw. This can jam up waiting periods and add too much workload for hospital/doctor staff. People may come in for a check up on things that a doctor may not be needed for, like the common cold or the flu.

You mean it might create jobs?

Fuuuuuck that.

Taxman
01-11-2009, 09:05 AM
People may come in for a check up on things that a doctor may not be needed for, like the common cold or the flu.Especially those with the unspeakable audacity to actually die from the flu.

Doc Randy
01-11-2009, 09:10 AM
Once again, this makes doctor visits a lot more affordable because you are bypassing administration of big HMO's and insurers by paying doctors directly. Some insurance plans (especially family ones) offer doctor visits to be paid in full until the deductible is fully met. SimpleCare can whittle the cost down of those doctor visits significantly, allowing more money to be distributed towards more severe care plans or into a pre-tax HSA to save for the annual deductible.

The simple economics are that if people pool their resources and negotiate prices based on higher bulk volume, then they can negotiate lower individual costs. HMOs, despite their flaws, do negotiate for lower medical costs. The bigger the HMO or insurance plan, the lower the costs per individual.

I fail to see how eliminating this collective/volume bargaining power can bring down prices. If I were a doctor and all I had to deal with were individuals, as opposed to organized groups, then I could charge more per individual.

Seems to much like "divide and conquer" to me. Seems un-American. We should be more collective in this pursuit. "United we stand. Divided we fall."

RickLM
01-11-2009, 09:17 AM
"United we stand. Divided we fall."


Sounds like typical liberal collectivist bumper sticker material.

Brian Defferding
01-11-2009, 09:23 AM
You mean it might create jobs?

Fuuuuuck that.

Ha. Even in a recession, there is always job openings for health care positions, at least that is what I notice wherever I lived when looking at the classifieds.

Magnum V.I.
01-11-2009, 09:24 AM
You mean it might create jobs?

Fuuuuuck that.

Right now most Hospitals are under-staffed as it is.

I'm not arguing against or for it, jut stating a fact that we have a National Nursing Shortage.

Doc Randy
01-11-2009, 09:25 AM
Sounds like typical liberal collectivist bumper sticker material.

E pluribus unum? "Out of many, one"

Thomas Mauer
01-11-2009, 09:26 AM
It can also be its flaw. This can jam up waiting periods and add too much workload for hospital/doctor staff. People may come in for a check up on things that a doctor may not be needed for, like the common cold or the flu.

The reality that Germans live contradicts your hypothetical.

Brian Defferding
01-11-2009, 09:33 AM
The simple economics are that if people pool their resources and negotiate prices based on higher bulk volume, then they can negotiate lower individual costs. HMOs, despite their flaws, do negotiate for lower medical costs. The bigger the HMO or insurance plan, the lower the costs per individual.

I fail to see how eliminating this collective/volume bargaining power can bring down prices. If I were a doctor and all I had to deal with were individuals, as opposed to organized groups, then I could charge more per individual.

Which is completely counterintuitive to the purpose of the doctor. Charging more per individual means less people wanting to see the doctor, thus less business for the doctor.

http://www.capmag.com/article.asp?ID=1509


Our three SimpleCare codes are S-M-L: 10 minutes is an S (Short); 20 minutes is an M (Medium); and 30 minutes is an L (Long). Our clinic charges $35 for an S, $65 for an M, and $95 for an L. A reasonable fee--without the paperwork costs--is assigned to specific procedures, lab work, x-rays, etc.

...We even saved the $49 it would have cost us for a new CPT book and determined SimpleCare was immediately Y2K-compliant. Within three months, we went from losing $80,000 a month to making $10,000 a month. According to AAPP estimates, if the entire U.S. health care system were converted to SimpleCare, American patients would eventually save some $300 billion annually.

The cash-paying patients love SimpleCare: There's less wait before seeing the doctor, and they no longer have to pay exorbitant fees pushed up by excessive administrative costs. We were able to reverse our "patient-to-paperwork ratio" from 1:7 (1 minute with the patient, 7 minutes on paperwork) to 7:1 (7 minutes with the patient and 1 on paperwork).

Brad was talking about how X-rays for his family was $470.00. With this formula, it would be $95. Even adjusted for inflation from the time this article was written, it's still one-fourth the cost.

Fake Pat
01-11-2009, 09:35 AM
Right now most Hospitals are under-staffed as it is.

I'm not arguing against or for it, jut stating a fact that we have a National Nursing Shortage.

Oh I know, my mom's a nurse.

Just saying that, right now, the idea of having too many jobs open doesn't seem like a flaw.

And as you point out, it's not like that isn't an issue under our current system anyways.

Brian Defferding
01-11-2009, 09:35 AM
The reality that Germans live contradicts your hypothetical.

The assumption that America would seemlessly adopt to German's UHC model would probably contradict reality.

Brian Defferding
01-11-2009, 09:37 AM
Sounds like typical liberal collectivist bumper sticker material.

Only if that united part of it is done by force, then yes, absolutely :)

Magnum V.I.
01-11-2009, 11:45 AM
Oh I know, my mom's a nurse.

Just saying that, right now, the idea of having too many jobs open doesn't seem like a flaw.

And as you point out, it's not like that isn't an issue under our current system anyways.

Personally right now I think we should focus on bolstering the staffing of Hospitals before we open the hypothetical flood gates of everyone has free doctors.

WillieLee
01-11-2009, 12:04 PM
Brad was talking about how X-rays for his family was $470.00. With this formula, it would be $95. Even adjusted for inflation from the time this article was written, it's still one-fourth the cost.

Only if the physician he used charged the same as the founder. But they give no guidelines for price.