Hits & Misses – 2009/8/12

Comments (20)

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  1. Ron Greiner says:

    Community rating will make health insurance premiums skyrocket.

  2. Rob Tz says:

    Healthcare is at best a way of trying to treat and cure ill people. People that need medical help. The costs reflect provision. The need of the ill is not always linked to the ability to afford this provision. Having lived in the US and the UK I’d rather, heaven forbid, be ill in the UK. My son was born with a disability, fortunately in the UK. Everything, absolutely everything that could be done to help him has been provided completely free of extra charges. I cannot bear to think what would have happenned in the US with insurance agents quibbling over each and every treatment. There is the option of private healthcare in the UK should one wish to pay extra. I have it as a perk through the company I work for (I didn’t even bother approaching them for my son’s difficulties, I know what the response would have been, never mind the delays). So there is always the choice, should one be able to afford it. This point seems to get, strangely, missed though. The tiny minority of the very, very wealthy for which the US system may provide overall beneifts would, and do, elect privately in the UK. If worried about one’s children’s health then the UK, form my direct experience, is the place to be. The NHS was set up with a loop hole for Doctors to keep going with private treatment.

  3. Larry C. says:

    What’s wrong with the American people? I trust the health care system 10 times more than I trust congress.

  4. Devon Herrick says:

    Ron, while speaking at a conference in Pennsylvania, I explained that guaranteed issue / community rating would jack up premiums. A researcher from Harvard stood up during the Q&A and said that would not happen when everyone is required to have coverage. That was a typical elitist response. If too few healthy people are willing to enroll in plans intentionally designed to create huge cross subsidies, just force them.

  5. Ron Greiner says:

    A 30-year-old male can get HSA individual health insurance for $46 a month in Des Moines, Iowa.

    With community rating in Massachusetts the same person costs $324 a month from Blue Cross because of community rating – even though everybody is required to have coverage. (This is an HMO that only covers 50% of Rx)

    Community rating and Obamacare will be a nightmare.

  6. Bart Ingles says:

    “…guaranteed issue / community rating would jack up premiums.”

    It would raise premiums for those who currently receive better-than-average rates. I doubt that it would have much impact on premiums for employer-sponsored coverage. So the 60(?) percent of Americans who have this kind of coverage would likely be indifferent to this issue, with some viewing guaranteed-issue private coverage as a safe fall-back option.

  7. Bart Ingles says:

    “I cannot bear to think what would have happenned in the US with insurance agents quibbling over each and every treatment.”

    From my experience they don’t quibble over each and every treatment. I’ve had a few occasions to “get my money’s worth” and that hasn’t been my experience. On the other hand, the idea that the UK pays for everything a doctor might recommend, no-questions-asked, is just absurd.

  8. Ron Greiner says:

    “I doubt that it would have much impact on premiums for employer-sponsored coverage.”

    Employer-based coverage is fighting low cost individual insurance now. If Obamacare raises the price for individual insurance, because of community rating, that will help employer-based plans compete.

    Why pay $600 a month to add your 30-year-old husband and child to your employer-based plan when it’s available in the free and open market for $100 a month with individual insurance?

    Obamacare helps employer-based insurance plans.

  9. Brian says:

    you said-
    “From my experience they don’t quibble over each and every treatment”

    Insurance ALWAYS nickles and dimes the consumer and treatments ARE decided by insurance companies, what is allowed and which is not. That is the in-escaplable fact of health-insurance. I am glad that you have not had to experience it for yourself and I hope that you never find yourself on the recieving end of health-insurance because you will quickly find, like hundredds of millions of Americans, that insurance will drive you into poverty.

    Do you live in the UK? Have you gotten ill while in UK or Canada? I will take the real experience of someone living in the UK and their experience of their healthcare from direct example rather than the words of someone who doesn’t really have first-hand knowledge of the system they are critisizing. Just shows me that you have bought into the lies told to you by republicans.

  10. Bart Ingles says:

    Brian, if you think that doctors in the UK and Canada are free to prescribe any treatment they see fit, you are living in a fantasy world.

  11. Bart Ingles says:

    P.S. Covered treatments are generally set out in the policy. Insurance companies compete on the basis of coverage, just as they do on price. Are disputes likely concerning uncommon treatments, and is there a role for government to step in when the terms of the contract are unclear? Certainly. You think this doesn’t happen with public insurance? Where do you go when you have a dispute with a public insurer?

    Similarly, insurance company payment levels are set through negotiation with providers. Public health insurance reimbursement levels are dictated to providers.

    As for taking the word of someone living in the UK, Mr. Tz’s personal testimony is purely anecdotal, and therefore meaningless in a larger discussion. In fact as far as that goes he merely speculates on what would have happened in the US, so is not even comparing personal experiences.

    My comments were not anecdotal; I was merely pointing out that a public insurer faces the same cost-containment issues as a private insurer.

  12. Brian says:

    So what you are saying is that regardless of the multitudes of “anectodes” that show 100% that the UK system is far from the disaster that republicans portray it to be, weigh less than assumed statistics with no real evidence behind them?

    So lets take the republican statement that 15% of people over 60 die while “waiting” for organ transplant. That means that 85% are healthy and successful in transplant. The percentage of people over 60 who die while waiting for a kidney transplant in the USA is 50%

    So on one hand there is a 15% death rate and on the other is a 50% death rate. which would you rather?

    Lets look at the ability to prescribe….
    on one hand you have a system that prescribes medications as needed and on the other hand you have a system where medications are dictated to the physician.
    In Canada and UK medications are prescribed without pressure. That may mean that you get a generic rather than a brand name still the medication is effective and costs you nothing.
    In the USA, doctors are routinely visited by “drug reps” . they don’t schedule an appointment and if they show up during YOUR appointment— you wait. Ypour doctor prescribes medications they are told to prescribe— most often the newest and highest priced drugs are prescribed. The drugs work, granted higher and more viscious side-effects, but they work. The problem being that they cost the earth. Rather than prescribing generic medications that work, have less toxicity, and are more cost effective…. doctors prescribe what they are told to prescribe. AND every high priced prescription they write gives them a kick-back in cash. It pays for the Doctor to prescribe the highest priced drug.

    AND you are correct…. most procedures are outlined in insurance before you purchase any plan. Yet insurance is not bound by those contracted services and can at will change their buisness model so that what you agreed would be covered is no longer covered. No appeal allowed.
    That is one thing that is wrong with the system. The ability for insurance companies to unilaterally change your insurance plan, without notice. That is just the reality. You can claim stats and what ever you want to but that doesn’t change the reality of the situation.

    Again I’ll take real-life experience every time over vague and un-supported fearmongering.

  13. Bart Ingles says:

    “So what you are saying is that regardless of the multitudes of “anectodes” that show 100% that the UK system is far from the disaster that republicans portray it to be, weigh less than assumed statistics with no real evidence behind them?”

    No, if you have access to statistics with no real evidence behind them, then their value is about equal to that of your anecdotes: zero.

    The problem is, for all the “multitudes of “anectodes” that show 100% that the UK system is far from a disaster”, there are equal “multitudes of anecdotes that show 100%” that people have been put on extremely long waiting lists for important procedures.

    …Rather than prescribing generic medications that work, have less toxicity, and are more cost effective…. doctors prescribe what they are told to prescribe…

    Brian, you are obviously making this up as you go along. Have a nice day…

  14. Brian says:

    I’m sorry you feel that way. Unfortunatly I have real life experience, both for myself and for almost everyone I know, to show otherwise. Are you really saying that there are no drug-reps that visit doctors offices? Are you saying that doctor’s don’t recieve payment for writing certain prescriptions?

    It just really ticks me off when someone reveals a reallife experience and it is swept away or dismissed as being without value. Conservatives always tend to minimize or demean those with real life experience.

    Conservatives cannot afford healthcare reform to actually have a face.
    Long lines? They already exist. Rationing? It already happens.
    Refusal of care due to age or infirmity? Already the status quo.
    The usual response to these observations? Just wait till the government gets involved. That is used to somehow excuse the behavior of today. Like rationing is alright as long as its insurance doing the rationing. That waiting for months to see a doctor is alright. That as long as its the next door neighbor being discriminated against its okay. Without realizing that the same thing can happen to you BECAUSE of insurance practises today.

    Most people do not get extremely ill. Most people don’t have to worry about medical bills in the hundred of thousands of dollars. Most people never have their insurance tested. Most people don’t realize that they are just a step away from generational poverty. By ignoring real-life experience, or worse denigrating it, conservatives are perpetuating this, to the detriment of everyone.

    How many more millions un-insured will it take until conservatives act instead of paying lip-service? What is the magic number that makes the status quo untenable? Is it 100 million? When healthcare starts to eat up 30-50% of GDP, will that be enough to spur conservatives to action? One wonders if there IS even a point that conservatives will start to take the issue seriously, listen to people and their “real-life” experience rather than depend on terrorism and intimidation to maintain control over the lives of Americans. At some point one needs to get their heads out of the clouds and actually get down in the dirt. When that time comes it helps to know what real experience is and not what the dream is.

  15. Joe S. says:

    Brian, you really do need to get a life. If you would stop personally attacking everyone you disagree with and start looking at the arguments and the evidence, you might learn something.

  16. Brian says:

    I am not attacking the people here. IN fact I am the one that is continuously under attack. I am looking at the arguements and I take them at face value. It isn’t my fault that real-life experience shows different than the assumptions of conservatives.

    I have learned much here and I do admit my failings when I see them. That is more than anyone else here. What has happened always is dismissal, minimizing, name-calling.
    Whether it is me, or Rob tz, or marjorie (and the list goes on….) we are the ones targeted and demeaned. Just becuase I happen to be fighting for heaslthcare for everyone, because I fight against the insurance companies stealing from consumers, because I have pointed out the history showing that republicans don’t care about reform…. I am the one attacked.

    I don’t call people names, I don’t demean them. I DO often refer to conservatives or republicans as a group. It doesn’t take a rocket scientist to see that, But I have never personally attacked anyone. I have said, at times, that the “author is wrong” . That doesn’t demean the author but just points out that the author was incorrect in their assumptions. If that’s too harsh for you then I can’t help that. I have as much right to express my opinion, and maybe more right scince this debate would affect me a lot more than it affects most people posting here. This may be a disagreement or government take-over for some here but for me this is a matter of life and death. Healthcare IS nessessary for life. And the system DOES push people into or towards poverty, (true for everyone and not just me).

    I value real-life experience over vague predictions of maybes and possibilities and for that I am told to get a life?

    But anyway…. I will be villified for even this response… oh well I’m used to it. So where is the outrage over myself being attacked? Where is your outrage over others being attacked? Oh yeah that’s right…. no-one here, except for us in favor of reform, gets attacked but who cares? I don’t matter and my opinions and experiences don’t matter beacuse I am one of the working poor and a drain on your wealth…. maybe we should just be grateful for the crumbs that are thrown our way and just accept it, continue to live in poverty and without adequate healthcare, correct? That is after all the message of conservatives on the radio, TV, and in Washington.

  17. Bart Ingles says:

    Brian, the value of an anecdote is this: If someone were to claim that “everyone is covered, no reform is needed” then your experience to the contrary, assuming it’s verifiable, would be sufficient to debunk it. The problem is that no one is making such a claim; you’re attacking a straw man. When you say that conservatives and Republicans don’t care about reform, I’m sorry, that’s just slander. Just because they don’t agree with you that all insurance companies, and drug manufacturers are inherently evil and should be abolished, doesn’t mean they don’t want reform.

    I’m sorry, I wasted enough time and bandwidth on this.

  18. Brian says:

    Look its clear that republicans are acting now because they must. When given a chance to offer their version opf healthcare reform, by leaders of the party, The silence was deafening.

    Republicans do have great ideas on reform and ones that must be considered. Insurance works for a great many people but it also does NOT work for a great many people. The system is broken. Minor adjustments, (such as de-regulation), has no chance to lower costs for the consumer. It is common sense. Buisness is about profit and profit making. That is the sole consideration in buisness. Insurance has no need to change its buisness and unless prompted will NOT change its buisness model.
    De-regulation lowers costs but only for the buisness, (saving in admin and infra-structure– loss of jobs there). Buisness and the profit consideration can guarantee that those savings are kept as profit. Not passed to consumers. There is no profit sense in that. Untilrepoublican can actually see themselves changing the healthcare industry… the rest are mere band-aids.
    Republicans had their chance at reform and didn’t take it. Now they want me to believe they have always wanted to reform the system???? Then I ask what kept ya?

  19. Mo says:

    I agree with Bart. Anecdotal evidence isn’t scientific evidence. As for your real life-experience Brian, I can find other people with different life-experiences. These experiences are subjective depending on what you’ve been through– and I have my own experience to share–

    I’ll take the scientific evidence any day over these personal experiences. Also your fear-mongering about big evil “insurance” and pharma companies doesn’t fly with me and the insults you throw at people just show your a bigot.

  20. Brian says:

    Think what you want to think. The fact and proof shows that I am NOT a bigot. I am a realist and While experiences do var7y from person to person there is one fundamental underlying theme. Insurance is broken and needs to be fixed. You can keep your head in the sand and ignore the reality around you. That is your right. Anyone can go and finds out the same “scientific” facts that I have. Pharma is overcharging claiming buisness costs that just don’t exist. Insurance is doing the same. You want to pay 3 or 4 times when you should only be paying once—- that’s your perogative. Doesn’t bother me. Just don’t insist that I have to pay 3 or 4 times for the single service.
    Anyway, scince its over anyway…. just get your arguements raedy for the next round of talks—- in another 10-20 years.