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The obstructionist party, GOP, being flushed out? Healthcare
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jpbassking



Joined: 19 May 1998
Posts: 2299
Location: Leo

PostPosted: Fri Feb 12, 2010 12:51 pm    Post subject: Reply with quote

mrgybe wrote:
... Allowing the multitude of companies, who are already in the business of providing health insurance, to compete with each other seems a much more intelligent approach to me than creating yet another inefficient federal bureaucracy from scratch. Which would you prefer......having the choice of hundreds of insurance offerings from established healthcare companies, with the inevitable price competition that would bring.......or choosing from a handful of companies allowed to do business in your state, including the heathcare equivalent of the DMV


"Multitude of companies".

The major players are:

United Health
Wellpoint (which encompasses nearly all the Blue's in the country)
Kaiser
HealthNet
Blue Shield of CA
Aetna

How do you know a government plan would be the operational equivalent of the DMV? How do you know the government wouldn't farm out claims administration and processing to one of these mentioned above?

Medicare isn't perfect but it is better than nothing. My dad is on it, his claims get paid, his checkups cost a small co-pay, his heart meds cost him about $58 per month, his premiums are deducted from his social security. I don't see why people are so afraid of a government sponsored OPTION like Medicare but for people under 65. I say OPTION because under Obama's plan you can still choose your private insurance if you so choose.

Private insurance premiums go up and up, coverage is denied for pre-existing conditions, claims are not covered for procedures deemed risky by medical review boards, health insurance companys making billions on profits. This is intelligent?

Mygybe, have you ever been laid off and offered COBRA? Do you know how expensive it is? If you are 30 something with wife and kids it's not an option.

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boggsman1



Joined: 24 Jun 2002
Posts: 3327
Location: at a computer

PostPosted: Fri Feb 12, 2010 1:13 pm    Post subject: Reply with quote

Hey JP , please dont inject any real life experience and rational discussion on this forum. Mr G is having too much fun speculating on how things may be if we adopt a new healthcare agenda. Wellpoint /Anthem Blue Cross jacked up rates 39% this year in Cali. Crazy. When United bought PacificCare a few years back they squashed all practices in Cali. that used Pacific Care , by refusing new claims, Competition , HA! not really. When the USA went from 90 refiniries to 3 , prices skyrocketed. I love when newbies like MR. G, no fault of his own, speculate on competition, as a price lowering mechanism , and then realize , 10 years later, that there is no competition.
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mrgybe



Joined: 01 Jul 2008
Posts: 2441

PostPosted: Fri Feb 12, 2010 2:00 pm    Post subject: Reply with quote

boggsman1 wrote:
Im not calling anyone a liar.......


Before reading the rest of this post, imagine an angry, red faced John Wayne standing in front of you delivering this response....

"Where I come from son, you say a man ain't tellin' the truth, you're callin' him a liar........and no fancy words gonna tell me otherwise"

Now there are two differences between the Duke's approach and mine........one is the accent; the second is the absence of a whistling noise that would accompany his clenched fist as it heads, with considerable velocity, towards your soon-to-be-altered proboscis and dental work.

Ah, simpler times!!
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jpbassking



Joined: 19 May 1998
Posts: 2299
Location: Leo

PostPosted: Fri Feb 12, 2010 2:04 pm    Post subject: Reply with quote

boggsman1 wrote:
Hey JP , please dont inject any real life experience and rational discussion on this forum....


I have been so advised, thank you. Next time I am in town I will buy you a beer.

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boggsman1



Joined: 24 Jun 2002
Posts: 3327
Location: at a computer

PostPosted: Fri Feb 12, 2010 2:19 pm    Post subject: Reply with quote

jpbassking wrote:
boggsman1 wrote:
Hey JP , please dont inject any real life experience and rational discussion on this forum....


I have been so advised, thank you. Next time I am in town I will buy you a beer.

Im still lokking forward to the post Waddel, Partagas Serie D, brewski!
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mac



Joined: 07 Mar 1999
Posts: 4648

PostPosted: Fri Feb 12, 2010 2:26 pm    Post subject: Reply with quote

Mr Gybe--I appreciate your advent to the forum, you generally provide reasoned, if conservative viewpoints. And I only mind your snarky comments when you lecture me about my snarky comments. If you have a good point, I'll acknowledge it and think about it. But with that said, I think you have to check your own ideological blinders, in particular, your assumptions that 1) competition will fix everything, and 2) that all government programs are ineffecient and will increase rather than decrease costs. Both are somewhat misguided when looking at health care. You’ve read some things about competition and tort reform (not to mention term limits) that are ideologically based instead of factually supported.

I belong to Kaiser, and have good windsurfing buddies that are doctors in Kaiser, and support medical care reform. I also had a very long talk with a young man who sells medical equipment and got his take on what is driving prices up. I think you are absolutely wrong that the system is susceptible to reform by market forces--it is, and will remain, too cartelized for that. If you look at root cause analyses, the big costs in medical care are accidents, chronic diseases, and end of life care. The current system is a battle of wits between hospitals that have a motive to maximize the number of expensive treatments that they perform on these medical problems, and insurance companies that have a motive to minimize their exposure on these problems. The number of insurees, their health habits, their safety habits, are all subsets of those big three. The other huge issue is the high cost of entry to the market; building a new hospital and staffing it with doctors is very expensive. So most non-urban areas of the country will continue to have cartelized service options. Look at the recent New Yorker articles on excessive health care costs in a few areas in Texas to get your mind around this problem.

Kaiser is one of a handful of medical practices that devotes significant energy to both minimizing unnecessary medical procedures and improving patient health. They talked me out of a colonoscopy, despite my concerns that my mother had died of colon cancer, by showing me the statistics that demonstrated her late onset was not genetic, and the procedure has risks. But my doctor would have ordered it if I would have insisted. They have taken good care of us, and our children and grandchildren, through life threatening accidents, my daughter’s two bouts with cancer, her nearly fatal premature birth to her twins, and other less dramatic events. We’ve gotten more than our share of the actuarial base, and the cost is paid by my former employer—until Medicare kicks in.

But Kaiser is far from perfect. They were a nightmare as an insurer when we were in a terrible car accident outside of their zone, and they have had difficulty in scaling up their efforts in other markets. My main points here are 1) they are relatively rare in their approach, 2) their insurance arm still plays the game of trying to disallow coverage, and 3) I get a substantial economic benefit from my coverage which it would be fair to tax.

Now Medicare, and I’ll barely mention the truly ignorant teabag posters “keep your Government hands off my Medicare.” Three key points here. First, Medicare is already the biggest dog in the yard; there is an aging population in this country covered by Medicare, and the numbers will increase. Second, Medicare is not sustainable from an actuarial perspective, and the drug benefits provided by Bush (and not fought on this round by Obama) make that worse; and 3) costs under Medicare have risen more slowly than overall aggregate medical costs. When we were badly injured in a car accident, the Kaiser insurance arm eventually paid the Medicare-eligible portion of the doctor and hospital bills, and those care givers who saved our lives were satisfied. In fact, most of the thoughtful analyses that I have seen have concluded that Medicare, with its great size and importance has slowed the rise in medical costs, despite the onerous paperwork associated with the program. (I can assure you that the paperwork associated with Kaiser’s insurance claims was no less onerous.)

Perhaps the real debate is over whether health care should be a profit or non-profit enterprise. And for those who would oppose a non-profit enterprise, would it be inherently less efficient or less effective? My experience with Kaiser, and those in Wisconsin associated with the Marshfield clinic, and in Minnesota with the Mayo clinic don’t see either inefficiencies,

But the ideological opposition of the Republicans at the moment, joined by virtually all of the Blue Dog Democrats, is against any disturbance of the current for-profit system, despite the overwhelming evidence that it is broken. In such cultural wars, facts rarely get through ear wax.
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jpbassking



Joined: 19 May 1998
Posts: 2299
Location: Leo

PostPosted: Fri Feb 12, 2010 3:04 pm    Post subject: Reply with quote

I made an error in an earlier post, I said Wellpoint made a 2.7 billion dollar profit in the last qtr. According to this mornings paper it is actually 4.75 billion, my bad.

When asked to justify the 39% premium increase a Wellpoint spokesman said that the Individual and Small Group side of the business was down due to the poor economy, healthy people are dropping coverage leaving only the sick people. Well...DUH!

I am reminded of a bumper sticker which said "National Healthcare plan - don't get sick".

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isobars



Joined: 12 Dec 1999
Posts: 13268

PostPosted: Fri Feb 12, 2010 4:21 pm    Post subject: Reply with quote

jpbassking wrote:
I don't see why people are so afraid of a government sponsored OPTION like Medicare but for people under 65. I say OPTION because under Obama's plan you can still choose your private insurance if you so choose.

Private insurance premiums go up and up, coverage is denied for pre-existing conditions, claims are not covered for procedures deemed risky by medical review boards, health insurance companys making billions on profits. This is intelligent?

Mygybe, have you ever been laid off and offered COBRA? Do you know how expensive it is? If you are 30 something with wife and kids it's not an option.


That "option" is admitted by Barack Obama, Barney Frank, and many other comparable Democrats to be a Trojan horse (their objective, my word). Their stated objective is to push towards a single-payer universal health care system ASAP. Obama said he could imagine it taking up to 15-20 years, Frank wants to stop beating around the bush and do it now. It is to remain an "option" only so long as 51% of the public still objects, with many Gotchas in the Democrat's health care bill to force people into it every time they hiccup. You knew that; why do "you people" keep bringing it up?

Are you going to sell auto collision insurance for a beat-up 1990 Pinto for the same premium you'd charge for a flawless new Maserati? If so, there's no way I'm buying insurance from you until I buy my first Maserati.

Just because Sam chooses to have kids while employed in an at-risk job doesn't give him any right to have the government take money at gunpoint from other people to pay Sam's living expenses. The minute Sam takes on dependents, insurance should be his highest priority expense behind adequate food and shelter. A TV set or a clunker is not his neighbor's obligation, and we already have all sorts of programs in place to provide health care, education, food, etc. IF WE WANT NICE STUFF, FROM KIDS TO LEVI BRAND JEANS (my jeans cost me $3.50), IT'S UP TO US TO WORK HARD ENOUGH TO BUY IT. Clinton proved that given that option, people kicked off welfare got off their asses and got jobs.

You deal with exceptional cases individually rather than through blanket programs encouraging a hundred million slackers. How do you feel about giving food stamps to families earning $51,000 ... about twice my pension? Subsidizing health care insurance for families earning $82,000 with millions in savings?
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swchandler



Joined: 08 Nov 1993
Posts: 5435

PostPosted: Fri Feb 12, 2010 4:36 pm    Post subject: Reply with quote

mac,

An interesting post.

I'm currently covered by United Healthcare, and I can say that much of what you've highlighted mirrors my experiences, especially the unfortunate fact that insurance companies often can play games regarding what they will or will not cover.

In 2004, I had a heart attack in Hood River of all places, which for me is about 1100 miles from home. UHC tried to hit me with the position that all my care was "out of network", thereby greatly increasing my financial responsibility. I adamantly fought back on this, because the original documentation outlined in my policy specifically stated that emergencies, like a heart attack, would be covered "in network" irrespective of any agreement that they may or may not have had with hospitals. I ultimately won on this, and also on a number of other attempts on UHC's part to disallow coverage.

While everything worked out to my satisfaction over time, the thing that stands out in my mind is that if I didn't have health insurance, my financial obligations would have staggering. I don't think that many folks have a clue how heavy the price can be. That brings to mind this foolish fat women at the tea party in DC on 9/12/09 (if I recollect correctly, she was depicted in the video you posted). She was asked if she currently had healthcare coverage, and she said no. When the questioner asked about what she would do if involved in an unforeseen accident or health crisis, she basically said she had no worries because there were physicians in her immediate family. This woman was totally clueless about reality. The costs for the physician or surgeon are only a faction of huge costs that can be quickly realized if one has to be hospitalized for an extended period.

With respect to your recent decision not to proceed with a colonoscopy, I would recommend reconsidering. My father had colon cancer, but fortunately he was able to beat it with surgery and radiation treatments. So, to be safe, I've elected to be screened over the years. In late December I just had my third colonoscopy. Fortunately, no problems with my health or anything to do with the procedure process. But one thing that I wanted to highlight for many here is that a colonoscopy can often be considered a preventative procedure, so it can be 100% covered like mine. Sounds like your coverage might be extensive, so it also might be covered at 100%, but for me, if it wasn't considered a preventative procedure, my portion of the bill would have been either 100% or 20% depending on whether I'd met my deductible requirements. Needless to say, being savvy about the specific details of your health insurance coverage really makes sense.
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mac



Joined: 07 Mar 1999
Posts: 4648

PostPosted: Fri Feb 12, 2010 5:03 pm    Post subject: Reply with quote

Thanks Chandler. Our circumstances were similar. We were in Wisconsin for a family wedding, and were in a car accident where 2 people were killed. The hospital bills that we saw before my lawyer took over were well over $200,000--but we both survived and it cost us relatively little out of pocket. I think Kaiser is a pretty good model of health care (but not insurance) no matter what, and their emphasis on whole body health and chronic disease prevention works in the Bay area, where they can convince enough people that it adds quality of life that it saves them money. They've tried it in one of the Carolinas and found out that it doesn't export really well to the South. I'll leave you to figure that out, noting only that the obesity index, frighteningly high for the whole country (and pretty low for windsurfers--except Isobars head) is even higher in the South.

My issue is for people like my daughters--my younger one has been underemployed for most of the time since she graduated from college, and my older, with 4 kids, is terrified with the prospect of her husband being laid off. Her payments, by the way, are over $1000/month.
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