Health Care

[WarrenJ]

Statistics are gathered differently in different countries. In Europe when a fetus dies it is recorded as an abortion. In the U.S. it is recorded as an infant mortality. That is why the U.S. has a higher infant mortality rate and why some Europeans gloat about it.

Lies damned lies... and statistics.

Regards,

Warren

Yup, you can add that most Cancers are a disease of the elderly. And in the States most (all?) seniors are covered by Medicare...

So in a sense he is arguing that socialized health insurance doesn't work since Medicare is doing so well curing cancer...

This is really simple...

Follow the money..

This isn't about living longer, this isn't about curing cancer.

This is about large monopoly insurance companies running the show.

I used to work in the insurance industry, worked there for over 12 years. I can tell you that insurance companies at there core, do NOTHING, but they are hugely profitable, I was a vice president at the 5th largest insurance company in North America. The pay and perks were amazing. Our CEO used to joke, "we don't make people better, we don't reduce risks, we don't fix cars, or build homes"

That company basically paid for my house in 5 years, very good money...

So, do we have a health care problem, or do we have a health insurance problem?

Wall Street, basically wants us to think otherwise. They just paid the perks and we're amazing it. Don't fix cars, or build homes, Then, just exactly what did they do? Did they produce capital, Nope! They produced waste. And you and I will be asked to pay for it.

[OynxSTS]

So, do we have a health care problem, or do we have a health insurance problem?

Wall Street, basically wants us to think otherwise. They just paid the perks and we're amazing it. Don't fix cars, or build homes, Then, just exactly what did they do? Did they produce capital, Nope! They produced waste. And you and I will be asked to pay for it.

Yes, there is a HUGE problem with the health insurance industry... It is awash in waste and mismanagement.

It is one of the rare parts of your country that doesn't have to try to comply with anti-trust laws... and has been more and more of an monopoly since 1972.

Insurance is all about spreading risk... if you insuring a house against fire or a car against an accident, that makes sense. But health care is different. Most (almost all of us) will never experience a house fire, but all most all of us will need to see a doctor and most of us should see a doctor at least every other year. How can you insure against something that you know is going to happen and will happen at a regular interval.

Would you buy insurance to pay for your next dinner at a restaurant?

[Marika]

Would you buy insurance to pay for your next dinner at a restaurant?

Yes if it insured against food poisoning. I was food poisoned recently at a local diner here in New Jersey. I was taken by ambulance to a hospital. 16 hours later, I was discharged from the emergency room. The bill was over $6,000 and my insurance paid $670. The hospital had to write off the balance less a $100 copay that I had to come up with.

[Cadillac Jim]

OnyxSTS does have a point. At one time health insurance was actually insurance -- a protection against large losses. Everybody paid the doctor, and if the bill got higher than a certain amount stipulated in the policy then the insurance paid the difference, or the vast majority of it. Blue Cross was the best-known doctor and pharmacy policy, and Blue Shield sold hospitalization insurance. Up to a minimum of what today might be $200 the patient paid. Then 80% to 100% of the charges beyond the deductible were paid by the insurance.

Today you don't actually buy insurance. You buy a policy that brokers financial transactions between you and your doctor, pharmacy, and hospital. The deductibles are small and are called co-pays now, and no one expects actual charges ever to be less than the co-pays. Thus medical and hospitalization insurance gradually morphed into HMOs. Thus doctors and hospitals don't have cost pressure from their patients and costs have bloomed. I have found from multiple sources that hospitals normally settle with insurance companies for 50% of what they bill. News reports of a couple of years ago told that when they billed an individual instead of an insurance company, they went after the individual for all of it, or about double what Aetna or Blue Cross/Blue Shield would have paid for the same bill.

Another big driver not addressed by OnyxSTS is the tort mess. Large malpractice awards and resulting settlements in the shadows of those awards, and the simplicity of suing at the drop of a hat have made malpractice insurance very expensive. The insurance companies demand that their policy holders practice defensive medicine to minimize losses due to awards and settlements. Defensive medicine is scads of tests and imaging procedures that are not actually indicated by likely conditions or normal diagnostic processes and is very expensive -- and has become the norm.

The current H.R. 3962 is not health care reform. It simply transfers the health care business from the private sector to a Government bureaucracy (111 agencies???); there are many ways that coverage can be transferred to the "public option" and no way to move back to private insurance in the bill, making the "public option" a vacuum cleaner that quickly becomes a monopoly, Single Payer. Nothing is done to reform practices in the health care industry, and nothing is done to deal with tort reform or defensive medicine. Accountability of private insurance companies vanishes and their jobs are taken by civil servants. This simply transfers all the waste and abuse to an amorphous Government bureaucracy. In addition, essentially free medical care is provided to tens of millions of new patients, including illegal immigrants because no citizenship test is allowed to be applied to applicants for benefits, and since taxes pay for it and your taxes aren't itemized...

This is not the Canadian system, which by OnyxSTS's account is simply a national HMO run by the Government. That's bad enough because it removes competition and accountability from the health insurance process and removes the option of the less expensive old-fashioned "real" heath insurance and hospitalization coverage with a large deductible, which is still available to those who want it, and is affordable to almost everyone. But it assimilates and entrenches the problems that drive costs and continue to increase costs while not addressing any of the true issues with health care such as tort reform and hospitalization inefficiencies at all.

MoveOn.org has threatened to run any Democrat who opposes the "public option" out of the party. They have some credibility here because they ran Joe Lieberman, the Democratic VP candidate in the 2000 election, out of the party in the 2006 elections. What is the big deal here, and why does MoveOn.org care (and, who is MoveON.org anyway?)? Follow the money and decide for yourself. It's 1/6 of the economy of the USA, and nothing is done to reduce that percentage.

[OynxSTS]

Another big driver not addressed by OnyxSTS is the tort mess. Large malpractice awards and resulting settlements in the shadows of those awards, and the simplicity of suing at the drop of a hat have made malpractice insurance very expensive. The insurance companies demand that their policy holders practice defensive medicine to minimize losses due to awards and settlements. Defensive medicine is scads of tests and imaging procedures that are not actually indicated by likely conditions or normal diagnostic processes and is very expensive -- and has become the norm.

You are right there! The tort mess in America is a huge driver of your cost. Don't expect either party to tackle that one.

This is not the Canadian system, which by OnyxSTS's account is simply a national HMO run by the Government. That's bad enough because it removes competition and accountability from the health insurance process

Gotta slightly disagree with that point... In Canada we have a government run monopolized health insurance system, in the states you have a privately run monopolized health insurance system. Both are equally accountable (or unaccountable) depending on your POV... In Canada the health insurance is paid out of our income tax system. If costs are not managed, (aka accountable), then taxes go up... And governments that increase taxes in Canada are as popular as they are in the States. I would add that the fact that Canadian Health Care Costs are about half the cost per person as they are in the States means that there must be some degree of control and accountability. And since about 1985 Taxes in Canada have been fairly steady... even decreasing...

Oh and an illuminating example. One province, Ontario, directly charges there residents for there health insurance as a separate form of tax... The cost of insurance in Ontario ranges from $300 per year to $800 per year per family for families making over $100,000 per year. I know of Americans who pay $300 per MONTH, per PERSON.

[Cadillac Jim]

The Demcrats are heavily supported by trial lawyers' associations, local and national. The Republicans, less so. Tort reform is promoted by some Republican politicians on state and national levels. It's been implemented in some states with varying but generally encouraging success (see earlier posts by WarrenJ and myself). Perhaps this is something that should be looked at by more States. Tort litigation is usually at the local or state level, so that's quite possibly where tort reform belongs. In fact, that may be where health care reform belongs too.

Federal leverage for state level reforms might be applied if relevant funding can stipulate standards of State level tort reform as standards set for funding. I don't know how this would work because I don't know of significant Federal funding that might be health related to individual States.

One big problem with the H.R. 3962 is that it provides the administrators of the "public option" unilateral powers of assignment of people to the "public option." For example, it allows the Federal Bureaucracy to unilaterally force business with GOR of $250M or less to use the "public option" instead of getting bids from private options, even if they have plans in place, according to a speech by Mike Rogers, R-Mich and a member of the House Subcommittee on Health that I saw on a Web video. An example how that can be a problem is that if that disrupts a processes that, say, an employees dependent's health care such as a household member's scheduled cancer or heart surgery, the law itself might be challenged under Constitutional grounds. There is nothing in the Constitution that allows the Federal Government to set up health plans, much less to coerce people to join them, and the Tenth Amendment reads

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

This, once established as a legal principal to proceed with arguments on dependent matters, opens up a real Pandora's Box of issues, such as any and all issues that may be caused by the "public option" to the due process clause in the Fifth Amendment.