Recently an old friend and I had a spirited exchange on Facebook.
One of the issues was health care.
Most people believe America's health care system can and should be improved.
The interesting debate is about what steps should be taken.
Government or private systems?
Let's get started!
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There is a giant middleman between you and your doctor; the insurance companies.
ReplyDeleteThese companies take our premiums and buy tv ads, pay lobbyists, payout dividends to investors, pay millions in bonuses and then, with whats left, pay our doctors and hospitals.
The decisions of wether to cover any given procedure is not done by doctors and highly educated specialists; these decisions are made by health insurance bureacrats whose main goal is to MAXIMIZE PROFITS.
How much profit is your life worth ?
Can we, as a country, afford to pay a middleman for something as critical as our health ?
Update 1/25/10 :
ReplyDeleteIn 2009, health INSURANCE companies have paid out $ 38,000,000 to lobbyists to influence the health reform bill to thier wishes.
That's 38 million dollars of our premiums going NOT to doctors and hospitals, but to lobbyists.
Is this the most efficient way of providing us health care ?
A positive change would be tax free and tax deductible medical savings accounts.
ReplyDeletePeople could have MSAs that they fund themselves.
When they need services they will be paying for it themselves and therefore aware of any tests, treatments, and medications they buy.
Will MSAs provide an equal outcome for all?
Certainly not.
MSAs are only one simple of a solution to many complex problems.
1. Goverment has no profit motive and thus no need to be efficient.
ReplyDelete2. Government can't save us money on health care by getting more involved because of the simple truth of statement #1.
3. The government's current involvement in healthcare via medicare is actually increasing the cost of healthcare for us because health care providers subsidize the cost of providing medicare patients with services by increasing the costs to non-medicare patients.
4. A Laissez-faire or free market system works best when the consumer is educated and can play his role in the competition of the free market by choosing the product or service that best fits his needs and financial situation. How many people take the time to educate themselves about their own health care? I suspect that the average person would spend more time comparing the features and reviews of a big screen TV purchase than they would reviewing doctor's credentials and success rates and options for treatment for heart disease. Personally, I say let the consumer suffer if they refuse to put the effort into educating themselves or to pay for a consultant to help them make decisions. Remaining alive each day takes the power of the mind to avoid of overcome situations that might result in death. Some situations take more thought than others.
5. When the government pays for health care for people they are spending my money for the benefit of others. This is immoral. Tax dollars are sacred and are iintended to be spent for the benefit of all.
6. When health care is paid for by the government it devalues the money spent on that health care. Those recieving that benefit put forth no productive effort to obtain that costly benefit. The hours of someones life spent to produce the value in that money has been absorbed by someone who has produced nothing of value. The tax payers do not recieve anything in return. Effectively the government has made each hard working person a slave to those who do not work for some portion of each day. (This applies to welfare in general)
7. Anyone in government who does not understand statements 1-6 is either a fool and has no place in government or has an agenda that involves taking more of our freedom from us and increasing the portion of each day that we are enslaved.
Insurance companies are mandated to maximize profits. They have a duty to their investors to maximize profits. This is a most basic tenet of an investor owned corporation. There really isn't much of a way around this fact. Without investors, there would be no insurance company. Furthermore, if a company is to be traded on any stock market it must be proven to be a company with sound financial principals. The stock market itself relies on the concept that the companies being traded are there to make a profit for the investors.
ReplyDeleteI don't like the idea of a corporation lobbying at all but who can blame them? Our elected representatives have a duty to represent the voters. If they took that duty seriously, there would be no point in a corporation lobbying or donating huge sums of money to campaigns. Its not the corporations that are at fault in the lobbying racket, its the politicians who are swayed by the lobbyists.
We really need to find ways to reduce the cost of providing the services in the first place. Reforming the way that malpractice cases are adjudicated would be a start. Under our existing system its difficult for a court to seat a jury of peers for a physician due to the highly technical nature of his work. The times I've been to jury duty I haven't see many professionals in the jury pool. I don't believe you will often find a jury that has the knowledge to fairly evaluate a physicians performance on the job. I fear the more often than not, these cases are decided on emotional merit rather than fact.
Terry;
ReplyDeleteThe MSA is an interesting idea, but does recquire that people have a lot of extra money to set aside for the eventuality of a
$ 100,000+ cancer treatment regime.
The winners would be the private corporations that administer and earn commission off such a program-- much like the doomed Social Security privitization idea.
However, like Brian points out -- people take little notice of thier own healthcare without a vested interest in it.
For most of the last 10 years, the majority of middle class Americans have had a savings rate below $ 0 . During this time healthcare costs have skyrocketed. Like the proposal to privitize Social Security, people would be encouraged to invest their MSA's in the stock market. The MSA's would look like our 401Ks today.
Brian (Part I),
ReplyDelete1) The profit motive can only lead to greater efficiency when there is a)adequate competition and b)consumers have full knowledge of the products in the marketplace.
The latest report from the AMA (http://www.businessweek.com/magazine/content/09_31/b4141022519011.htm ) reveals that "out of 314 metropolitan markets, 94% are controlled by one or two companies, or fewer. In 15 states, one insurer has 50% or more of the entire market." The "sell across state lines" argument doesn't hold water when the insurers are Blue Cross Alabama vs Blue Cross Arkansas (for example). Monopolies thwart the basic tenants of capitalism.
Regarding the ability of the consumer to pick and choose his insurance provider or doctor/hospital; you pointed out that jurys rarely (if ever) have people qualified enough to judge doctors. The average citizen does not have the expertise to judge between insurance policies, much less chose a doctor or hospital.
The profit motive does always lead to a good outcome for a society.An insurance company makes more money by denying care, under-paying claims, over-paying thier executives (to reduce the corps taxable income)and dropping chronically sick people. This is not good for our society as a whole, but works out well for the profit-oriented insurers.
I absolutely agree that people should be more envolved in thier health care. But we also want to maintain the our personal freedoms. Mandated disclosures of trans fats, salts and calories may be a start. Tax deductions for gym memberships, BMI maintenance may be another angle. Taxing fast foods, etc should also be looked at.
Brian (Part II);
ReplyDeleteStarting with your point # 5 :
It's not immoral for the strong of society to help the weak."United we stand,divided we fall". A healthy society is better than a sick one.Just because someone is poor in America doesn't mean that they 'deserve' no health care. This American paradigm that everything and everyone should be judged by money is immoral.(I'll save that rant for a diferent blog). Suffice it to say, all of us risk getting sick when the uninsured are left without preventative health care.
The way that ANY insurance (car,casualty,health)can work, is through an adequately sized Risk Pool. You have to have more money coming in from premiums than going out through claims. Econ 101. But the current health insurance systems is rigged towards the private insurers.
People over 65 incur the majority of health costs. The government(us), through Medicaire,bears the burden of the most expensive insured, while the insurers take the cream-of-the-crop, more healthy people under 65 yrs old. What a great deal for them !
(You saw how they vociferously fought the reform idea of expanding Medicaire to 55 and older).
Just as the younger working part of our population pay into Social Security to support the older pensioners, there is a similar setup whereby the healthier citizens pay for the sick. To not want to pay into the system while healthy is disingenuous; none of us will give up demanding health care when we face disease or death from the lack of it. Tax payers not onyl benefit from a more healthy productive society, but the day will come when they need to dip into the bucket for thier own needs.
Brian (Part II),
ReplyDeleteFor-profit corporations are not the best way to supply ALL of societys needs. For example :
1) National defense : If war were profitable, corporations would try to encourage more war.
2) Fire departments: imagine if it was unprofitable to put out the fire at your home.
3)Regulating the commons: it is unprofitable to control pollution, toxins in food,contract enforcement, etc.
4)Utilities:Very unprofitable to run electricity, sewers,the highway system etc.
"...if a company is to be traded on any stock market it must be proven to be a company with sound financial principals."
Really ? Like Enron,Merck(Vioxx), the S&L's during Bush I,The large investment banks linked to the current financial crisis, Hooker Chemical (Love Canal), Union Carbide (Bopol),Lehman Broters, AIG ? The stock market is an auction house-> it does NOT guarantee anything about a companies' financials.
It should be "one man,one vote". Unfortunately a corporation may have only one person, but if he has a billion dollars for lobbyists,campaign contributions (all the recent Supreme Court "mis-ruling")then his vote will count for more than a thousand other voters. This is NOT democratic.
I absolutely agree with you that it is not the fault of corporations for lobbying. It is our political system which allows money to influence politics.
Money is NOT free speech and should never usurp the rights of each voting citizen to be heard. We urgently need Campaign Finance Reform to get money out of politics. Our country is at the precipace of becoming ruled by money.
U.S. Wealth Distribution :
1900 1% of citizens held 18% of ttl US wealth
1928 1% of citizens held 21% of ttl US wealth
2004 1% of citizens held 34% of ttl US wealth
The second highest income disparity in the world (Switzerland is #1)
If money gives one more political influence, how is this a democracy ?
Finally, in a 2008 report from the CBO, "
Life expectancies continue to rise in the U.S., but the disparity between rich and poor is widening"
http://www.cbpp.org/cms/index.cfm?fa=view&id=2908
On average, you'll live over 5 years longer if you're wealthy. The average net worth of the the richest 1% is over
$ 5 million.
Great discussion !
Malpractice Reform :
ReplyDeleteThis should be on the table and looked at.
But let's keep a few things in mind :
Corporations, motivated by profit, do not always have the best interests of the public in mind.
In England there are very few lawsuits against corporations. Instead, they rely on a strong regulatory enforcment system, complete with inspectors, etc.
In America we have regulations but very weak inspection & inforcement. The thing that often keeps corporations honest is that they will be sued for any wrong doing.
The infamous Triangle Shirt Fire of 1911 illuminated the need for fire inspections, OSHA rules,unions and,yes, trial lawyers.
If we lesson the strength of people to hold corporations accountable, then we need to strengthen the inspection and enforcement of laws that protect the consumer and labor forces.
The abuses of businesses against the consumer and labor are many-- they cannot be left to thier own devices. In our discussion here, I include the health and PHRMA industries.
Markenet
ReplyDeleteGlad you see some value to the MSA.
As I said it is one part of a solution to many problems.
Insurance policies for catastrophic illnesses
such as disabling accidents are available today.
MSAs do not require a lot of money but a small amount compounded over a lot of time.
The individual must decide what level of investment risk they are comfortable with.
My 401K has recovered nicely because I didn't panic.
Another advantage of a MSA is we could will to our children if we check out early.
Most of us will face increased medical expenses later in life. Currently tax deductable Long Term Care Insurance policies are available.
Thanks for taking part in the health blog
ReplyDeleteJust started a new one.
http://terrycan-debate-energy.blogspot.com/
Well, it looks like health reform may be a non-starter. The current senate-passed bill was practically written by the insurance companies and benefits them greatly. ( A mandated, government subsidized customer base-->Woo hoo !)
ReplyDeleteSo we will go back to the yearly 15%+ increases in premiums,denial of coverage, dropping of the unprofitable 'sick' people (recission).
From 1999 to 2009 average annual family premiums went from $ 5791 to $ 13,375 . A 131% increase.
These costs are born heavily by small businesses and the middle class. In the 5 store music retailer where I was bookkeeper,our highest costs were wages,taxes and healthcare--in that order. (Taxes & healthcare almost equal).
Once again, the middle class is shafted by big business. Let's see how far "we,the people" get in the battles with the financial sector and the energy sector. My prediction is nowhere.
There is a dangerous twisting of words in this debate.
ReplyDeleteWhat is in need of reform is Health INSURANCE -- not Health CARE.
Talk of "government takeover of health care", "government getting between you and you doctor", "death panels" --- are all distractions, like a magicians' slight of hand trick.
The INSURANCE COMPANIES ae driving up costs, manipulating the message, writing major parts of health insurance reform, paying millions to lobbyists and getting between every person and thier doctor.
IT'S HEALTH INSURANCE REFORM, NOT HEALTH CARE REFORM.
Geez, how dumb have Americans become ?
Markenet
ReplyDeleteWell said! The USA has the best health care in the world. We have an insurance problem.
The cheapest way to cover the uninsured would be for the government to write them a check.
Terry,
ReplyDeleteI think the CBO has scored Single Payer as the cheapest way to cover the uninsured, as well as lower costs for all of us.
Stay with the same great health care system we have, eliminate the middleman insurance companies, and pay the doctors & hospitals directly out of our tax dollars ; eliminating our ever-rising insurance premiums.
(Maybe that's what you meant ?)
Mark
ReplyDeleteAs a compassionate conservative I believe the uninsurable should be covered. This is a n appropriate use of government.
People that choose to take a risk and not pay for coverage do not deserve coverage at tax payer expense.
An example: Recently Skiing Magazine an article where the writer spoke about catastrophic insurance for skiers. She bought a policy. That is good. She mentioned it was the first time she had any coverage in 6 yrs. Should we have been responsible for her? She could afford skiing but insurance? This women took a risk. She choose to ski down the mountain if she gets hurt she should be responsible for her medical bills. BTW I am an avid skier.
"Paying the doctors & hospitals directly with tax dollars" is a contradiction. Any time the government handles money it sticks to many fingers.
Hi, Terry :
ReplyDeleteNot sure what a compassionate conservative is supposed to be. Every human sees and thinks a bit different from another, percieving life through the filter of their own experiences and background.This diversity makes us human and gives us power when we share viewpoints. I do notice that the conservatives tend to vote in lockstep and have even come up with a "conservative purity test". This approach stifles ideas, creativity and independent thinking. Not what a vibrant democracy needs.
I agree that we should have universal health care. Why ? Because the people of a society are happier and more productive when they're not sick. Communicative and/or deadly diseases would spread if not addresses early. Putting all of society at risk because some (43 million) people can't afford routine health care is not good for America.The lack of pre-natal and childhood care often stunts the mental growth of future adults. Our society will not thrive wit more stupid adults,ha,ha.
I understand what you're saying about risk and choice. But everything entails risk: driving of course, climbing Mt.Hood(without a beacon), smoking, eating fast foods, not exercising etc. Many things are just not known until it's too late-- our parents thought smoking was fine in the 40's & 50's. Anyway,I agree with your philosophy, but not sure how we could pin everyone down to what personal choices they did or didn't make. Many degenerative diseases,for instance, are a result of many factors.
"Paying the doctors & hospitals directly with tax dollars" -- this is being done now with our VA system. Any waste and corruption in government should be policed and eliminated vigorously. This is and will be a constant battle.
Most republicans and conservatives believe,ala Reagan, that government inherently CANNOT work. When in power they seem to follow through on this self-fulfilling prophecy, rather than try to improve the system while they have the reins. Given this belief, many of us "others" wonder why they want to be in government so badly, if not to simply rob and steal. Personally, I believe that our democratic government CAN work - but it takes active vigilance on the part of we, the people to work. But I digress.
Simply put, health care is a necessity for a happy and productive society. As all the data and trend lines show-- we cannot afford the way things are-- we must do something different; without even considering the expansion of coverage.Can we agree on that much ?
When you see huge the enormous sums of money spent by the health INSURANCE industry - you gotta wonder how they can afford the lobbyists, the TV ads, the campaign contributions and sky-high bonuses. What if THAT money, went towards cheaper premiums and covering the un-insured ?
My opinion is that we cannot afford so much of our monthly premiums to be wasted by these middlemen-the health insurance companies. They are fighting tooth and nail to keep ANY reform from happening- and the republicans, to a man, are buying into what these companies are telling them-- almost as if the republicans also are benefiting from the system staying just the way it is.
The democrats too, particularly in the senate, have some members that seem to put the insurance companies ahead of what's best for the majority of citizens : Baucus, Lieberman, Nelson, Landreau , Lincoln ---> they reek of corruption. Both parties have huge problems.
Hi Mark
ReplyDeleteI define a Compassionate Conservative as a person who supports the First Ten Amendments of The Bill of Rights
Passionately and will help most people less fortunate than themselves. Who does he help? Most people in need of help are in one of two categories.
A) Unable and willing.
B) Able and unwilling.
As a CC I believe the A group deserves all the help we can afford to give them. The B group needs to have their poverty made so uncomfortable they choose to work their way out of it.
A CC believes results are not equal for everyone. That is the price of Capitalism and most solutions are simple but can be difficult.
I believe Universal Health Care will result in higher costs and reduced services. People I know in medicine and Social Services tell me the truly needy are given free care through Medicare.
I can agree on expansion of coverage. We probably don’t agree on how.
I believe the companies should be unleashed. Forcing Health Insurance Companies to accept preexisting conditions will drive them out of business and lead to UHC. As a CC dropping someone for getting sick is simply wrong. I have had to consult my lawyer to make my insurance company pay.
Unleashing Private Health Insurance Companies would create longer term clients. If people can take their policies from job to job and state to state they could stay with the same company for a lifetime.
Since arriving in Washington State in 1997 I have had policies with 6 different companies. Health Insurance through the employer is a system that has outlived its usefulness. A combination of MSAs started early in life and Catsrophic care policies are a reasonable solution for the middle class. This would reduce the middle men involved.
Conservatives are promoting this style of reform.
Will it produce an equal result for all? No. As we know the government elite will not use the UHC they “know is best” for us.
Cool- I'll probably comment more later. But what about the cost of staying with the current for profit insurance / health system ?
ReplyDeleteSome Fun Stats :
2008 Ttl Health care Costs = 16.2% of GDP
2009 Ttl Health care Costs = 17.3% of GDP
2019 Ttl Health care Costs = 19.3% of GDP *
* projected
2010 Medicaire+Medicaid cost =$ 725 billion
2014 Medicaire+Medicaid cost =$ 950 billion *
1990 Family Health Ins cost= 7% of ttl income
2009 Family Health Ins cost= 17% of ttl income
(Wall Street Journal)
These costs are born not only by consumers, but especially by small businesses who will pay lower wages as a result of spiralling insurance costs.
And if you have a pre-existing condition, like having a malignant mole removed, then you are forced to pay for insurance or risk being forever denied due to a pre-existing condition.
This is the system that the insurance companies are fighting tooth & nail to keep. Should we really be supporting this status quo ?
Maybe the Health insurance companies will be well-enriched, but our country may well go bankrupt.
Effective reform that lowers costs is critical and must not be passed on to another generation. This discussion has been going on since before Truman.
Thank you for your definition of a CC. I was somewhat alarmed, since some people that really screwed the country call themselves CC's (Cheney, Bush,Tom Delay to name a few).
ReplyDeleteIt wouldn't be fair to lump you in with them, which I do not.
Universal health care is offered in most countries in the world, with the obvious exception of impoverished Africa and many of the former soviet-block nations...oh, and the U.S. We should look at thier models and not be so wed to our unique profit-based system.
The Health Insurance Companies have been "unleashed" for most of the last century. Look at where we are today, as a result. A libertarian friend insists that the problems with health (and finance) are owed to a still too onerous regulatory system-he feels we need less government rules and regulation. Our country has gone through the abuses of non-regulated capitalism before. The curren abuses of the Finance Industry, Enron,Savings & Loan Crisis,Love Canal; just a few of the many, many instances were unleashed companies have caused great harm. It's amazing to see folks defending a system with little regulation that has allowed such huge disasters to occur. When do we stop banging our heads against the wall and try something different ?
15 million people don't have jobs today and cannot utilize your job to job scenario. Buying insurance from state to state abrogates States rights, since most have different laws regarding health insurance. These laws would be supplanted by Federal rules, which are more easily manipulated by insurance lobbyists. This is a goal pushed by these insurance companies, who don't care about states' rights when it benefits their bottom lines.
I agree with you that Employer-based healthcare has outlived its usefulness. The MSA idea, seems far-fetched. One serious illness, like cancer would wipeout any meager savings the average person might have. In 2007 the rate of savings in the U.S. was NEGATIVE.
Between Q3 2007 and Q1 2009, in the aggregate, U.S. household net worth fell by $17.5 trillion, or 26.5% of 1 yrs' GDP. The causes of these losses were out of the control of most people. To think that savings, stocks and housing values (or any MSA's) would appreciate is not looking at the most recent evedince to the contrary. Nice in theory, but it is placing the risk, but little of the financial control in the hands of the average "Joe the plumber". But even the experts blew it.
We need a stronger social sfety net when it comes to retirement,health and safety.
I agree with you about encoraging those that can to take responsibility for their own lives. While we should not let them die or be homeless, we also should not be giving them cadillacs and HDTVs.
Any system will have some people gaming the system- being moochers. We should try our best to prevent this - BUT, we cannot eliminate a working model simply because it is not perfect. If we seek perfection and 100% agreement then nothing will ever get done. ( We're seeing this in Congress right now-- particularly the Senate).
Ever thought of setting up an Economic / Finance industry blog ?
Terry,
ReplyDeleteSorry for gabbing so much...but I thought todays' article in WSJ is particulary relevant to our discussion :
PUBLIC SHARE OF HEALTH TAB TO TOP 50% (2011)
Last year, the federal actuaries had predicted the 50% mark wouldn't be reached until around 2016.
Over the longer term, the public share of health spending is expected to rise further because the first baby boomers will turn 65 in 2011 and become eligible for Medicare.
My words:
The way that any insurance works, is that there is more money paid in than taken out. However, with health insurance, the deck is rigged in favor of the private insurers.
The most expensive health costs occur in the over 55 age group. The insurers don't have to worry about this, because Medicaid bears this high-risk group. The poor and unemployed are also a high risk group--they fall into Medicaid.
Any remaining "unprofitable" customers are eliminated from the Private Insurance pools through recission and pre-existing conditions.
To prevent thier monopolies from being broken up, they have an anti-trust exemption built into the law.
What a great deal for them, at the taxpayers expense. This is not the free market and should not stand. Regardless of our ideologies, should we really stay with a health insurance system that is so rigged?
I've spoken out of turn- sorry--I'll listen now, LOL !
Hi Mark
ReplyDeleteI lived in the Socialist paradise of Australia for two years. They have UHC for most people and private health plans for the wealthy. If you need a surgery on the UHC you have 2 options.
A) Get in line and wait.
B) Pay cash for it.
Option A can be referred to as rationing. Option B is out of the question for most Australians. On the surface Australia’s UHC looks good. If your Doctor accepts “bulk billing” you pay nothing for an office visit. There are free clinics available. Prescriptions are heavily subsidized.
The trouble starts when you have a serious illness. You better hope you live long enough to get treatment.
Our definition of an unleashed business is bound to be different. I agree with the antitrust laws set up by Teddy Roosevelt. No one company should be allowed to control the entire supply of any service or commodity. Oil and Steel monopolies were broken up under TR. During our lifetimes Bell Telephone was broken up.
Our 15 million unemployed will miss out on many opportunities available. That is not reason enough to deny opportunity to the 150 million working tax payers a better value for there own money.
I sell a life events legal plan in Washington State. My clients can take this service any where in the country. The product will vary from state to state. They remain my clients regardless of their address.
I don’t understand the “abrogating states rights” issue. We are free to spend money any of our 50 states. When it comes to health insurance we can’t buy an out of state product or take it with us. Conservatives are trying to change this.
The MSA seems viable to me. A serious illness would be covered under a catastrophic policy. With government out of the way we could be lifetime customers for our CP insurance. I have spent my entire career working with “Joe the Plumber” he understands more than the elite media give him credit for. Remember one definition of intelligence is: “The ability to explain the complex simply.”
As I said before about our safety nets. The doctors and social workers I know say they a fairly good. They do get health care but have to wait in line for it. Fraud and abuse in these services does exist and should be prosecuted. Trouble is how do you fine someone that has no money?
Will set up an Economic / Finance Industry blog.
Saw the WSJ clip “PUBLIC SHARE OF HEALTH TAB TO TOP 50% (2011)” This trend will accelerate as the government forces more private HI companies out of business. The aging boomers are going to strain Medicaid, Medicare, and Social Security to a train wreck. Allowing people more freedom to use MSAs, CPs, and IRAs will reduce government’s role for these services. Will the people that manage their money better live longer and better than those who don’t? I hope they do.
If an insurance company or any other company doesn’t make profit they go out of business. Profit is not evil. Profit is good. Insurance like Oil pays a small about a 3% return. Do the liberals scream to tax the profits and regulate Google, Apple, Microsoft, and the entertainment industry? Look the huge profits made on sneakers and other fashion. These industries are left out of the debate.
In conclusion:
There are two ways to motivate a man. One is with money the other is with a gun.
Everything our government does is socialistic. This is not inherently bad.
ReplyDeleteBut I think our government is broken today because corporations and money unduly influence politicians.
Sounds like Australias HC model only needs a fix regarding rapid treatment of critical illnesses. That's workable.
We somewhat agree on monopolies. Do you think that these laws should be applied, to investment banks and Health insurance companies ?
There are 32 countries with UHC.If UHC is so abhorrant, why do they keep it?
Every citizen should have an EQUAL opportunity to succeed regardless of income.
My comment about states rights was this : each state has different laws regarding health insurance. In order to 'sell across states lines' we would have to federalize the laws and ignore current individual states' laws. Insurers have formed differently named corporations in each state to get around this. Blue Cross AL, Blue Cross HI, Blue Cross R.I. -- are all still Blue Cross.
Business Week had a great article on the current monopolistic practices of H.I. companies : http://www.businessweek.com/magazine/content/09_31/b4141022519011.htm
Do you include Fox News, Rush Limbaugh,Michael Savage, Mark Levin etc, as part of the Elite Media ?
Intelligence: when it comes to areas as complex as the economy, health care, brain surgery, climatology, energy etc-> the professionals trained in these areas know more about them. Expertise is differant from opinion and should be weighted as such.
The HI firms are scared to death of losing their anti-trust exemption and/or of having a non-profit option paid for by our tax dollars. God forbid they should have real competition.They know that they have a monopoly now and are making bank with it. Offering more competition should please any capitalist. Their business model would not survive without such government intervention.I recognise the difficulty of having the government, representing the citizens, as a competitor. But the spiralling costs of healthcare is the lynchpin to our retirement,deficits,security and well-being. It must be fixed- even if an entire industry must go bye-bye for the greater good.
The MSA's should be looked at. I don't think the numbers would quite work out, but people do need to take responsibility for thier own health.
"Joe, the plumber" doesn't know squat about investment,dividend yields, daily compounding,derivative contracts or reading a companies' financials. He should not be penalized by dying early and living in poor health.We can't all be good at everything.
We rely on the government to keep the playing field fair and make sure we have the accurate information we need to invest. When ratings companies like Moodys or Standard & Poors are nor regulated and end up rating, say, mortgage-backed securities as AAA, when they are actually filled with hidden sub-prime time bombs--then the world economic system faces a near collapse, regardless of the investing skills of anyone. We all suffer together, regardless of our personal good financial decisions.
How can a society survive if it's citizens are only motivated by force or the selfish, single-lifetime goals of personal enrichment ? So much for Jesus, Ghandi or Mother Theresa.
I asked an old friend to join in this blog. He commented through an email. Reprinted with his permission here is what "Dr Duck Hunter" (not the Doctor's real name) said.
ReplyDelete"Hey Terry,
As a proud member of the "Angry Mob" and, for the most part, a supporter of the
"party of no" I have many thoughts on this issue. As virtuous an idea as
universal healthcare is (and many liberal ideas have virtuous motivations behind them)
the reality is that, as a nation, we cannot afford the current menu of entitlements as
promised. That's a fact. Once China's economy overwhelms us our ability to sustain our
role as the world's policeman and a beacon of democracy will no longer exist. Do we give
up? Do we become protectionist? Your friend's assertion that "Simply put, health
care is a necessity for a happy and productive society. " is really just an opinion,
and one that conveniently forgets that "healthcare" is a recent phenomenon in
human history. Were there no happy and productive societies prior to the discovery of
antibiotics in the 40's and the near doubling of our life expectancy in the last 100
years? National healthcare, by necessity, if it comes, can never be state of the art,
only bare bones. Rationing would not only be inevitable, but appropriate. And so long
as we live in a country where a majority of the electorate can vote themselves benefits
with other peoples resources I fear the impending implosion will be catastrophic on many
fronts. We have veered a long way from the vision of the Founding Fathers."
Dr Duck Hunter speaks volumes in a few words.
This comment has been removed by a blog administrator.
ReplyDeleteDr Hunter,
ReplyDeleteA few items you said that I failed to address :
Health care & Insurance, as it is today, is too expensive and may bankrupt our country.
What changes do you propose ?
Since when is Americas role, that of world policeman ?
The way to be a beacon for democracy, is by living it.
Your insinuation that we will lose our democracy and world-policeman role because we are longer the richest country in the world seems odd indeed and reflects a paradigm that anything worth having is purchased by money.
Conversely, when China passes us in GDP, are they then, "the shining beacon on the hill"? Sorry-- that seems illogical. When did capitalism merge with democracy ?
Fascism= the merging of state and corporate interests combined with beligerent nationalism.
"Healthcare" has been around for all time: Shamans, medicine men and barbers were the precursors . Granted, the technology has advance greatly ( thankfully!).
The more recent phenomena, is "Health INSURANCE".
Today, there is rationing.The 43 million people who cannot afford it, the millions that are denied coverage or rescinded by the health insurance companies.
The "death panels" are in the offices of these companies today. Yes, universal health care would probably not include cuttig edge technologies (often the "bleeding edge"). We have limited resources, as our national budget shows. We have to make adult choices in everything, including health care.
Today, while a few can have state-of-the-art, many have NOTHING. While some feast, the rest starve. This is not a society.
"a majority of the electorate can vote themselves benefits with other peoples resources"
I know this is a common conservative meme, but it does have some validity. I do like the idea of " a hand-up, not a hand out".
Defining the line is tricky and Terry has expounded on this as well (the A vs B comment). I don't have a knee-jerk reaction to some people gaming the system out of laziness- this will always happen to some extent. We don't deny everyone just because of a few "bums".
But as a society, we should encourage the things that benefit the whole of society : education, good health , volunteerism, compassion, generosity, critical thinking, respect.
Money should not be a part of these ideals.
As others have said, "Don't let perfection be the enemy of the good"
The richest nation in the world should be able to offer health care to all its citizens-not just to the 5%
ReplyDeletethat, through luck, birth or skill, hold 90% of the wealth of the nation. "Justice & equality" is not just for the wealthy.
You mention that we can't afford the current menu of entitlements. TRUE.
So let's look at what is the fastest and greatest costs of Medicare, Medicaid and , today, over 17% of our nations GDP :
THE PRICE OF HEALTH INSURANCE & HEALTH CARE.
1998 Health Care costs in U.S. = 13% of GDP
2008 Health Care costs in U.S. = 16% of GDP
2015 Health Care costs in U.S. = 20% of GDP (Projected at current rate of growth)
These costs hurt businesses ,families and our entire economy. We cannot leave the system as it is -- it will bankrupt our country.
So what are the possible causes of this crippling rise in health costs ?
* an aging population
* proliferation of new technologies
* poor diet and lack of exercise
* the tendency of supply (physicians, hospitals, tests, pharmaceuticals, medical devices, and novel treatments) to generate its own demand,
* excessive litigation and defensive medicine
* tax-favored insurance coverage
* Procedure based payments rather than outcome based
HOW DO WE COMPARE TO OTHER NATIONS ?
32 other nations have government sponsored health care. Their costs are far cheaper and outcomes
are better in almost all measurable categories ( Lifespan, infant mortality, etc). Among these nations, the per capita health
expenditures range from $ 2,581 (Japan) to $ 5,910 (Norway). In the United States, its $ 7,290 .
We are paying 25% more than these countries, but getting far less for our dollars.
In addition, while rates have increased by no more than 2% in any of these 32 nations, America's rates have
increased 4% ( 1998-2005) . While some rich nationals can afford to come here for some quality, expensive procedures; it is no surprise that many
more Americans are going overseas to get procedures that they can't afford in the U.S. -- even with insurance.
HOW IS THE AMERICAN HEALTH INSURANCE/CARE SYSTEM DIFFERENT ?
• Our Health Insurance is a Commercialized , for profit one
• Dominance of for-profit Insurance & Pharmaceutical companies ( The only companies exempt from Anti-trust laws)
• Investor owned specialty hospitals
• Profit maximizing behavior
• Costs of profit, billing, marketing, bureaucracies siphoned from every premium dollar
Yes, unlike the 32 other countries that offer health care to all their citizens, we have a for-profit middleman-> the insurance / pharmaceutical companies.
The ways that these companies reduce costs is by denying services, eliminating risks (recession), cutting reimbursements to providers, raising premiums, hike deductibles and co-payments. Rather than allocating resources based on the medical needs of our country, these companies allocate based on profitability. The result is extreme waste. Researchers estimate that 1/5 to 1/3 of medical outlays do nothing to improve health.
In many cases, the private, for-profit model of business leads to efficiencies and cost savings. This model does not work in health care.
The most efficient way to pay for our nations’ health care is to have a single-payer government system, like expanded Medicare that includes a risk pool of the healthier and younger .
This has been proven cheaper and more efficient by every country in the World that offers it.
Making a profit off of peoples sickness and/or fears of becoming sick is immoral and not fitting with the goals of a great and compassionate nation.
When Credit Card companies were allowed to sell across state lines, they looked at all the states varying rules. Many of them settled in the states that were most favorable for their bottom lines-- like Wilmington, Delaware.
ReplyDeleteIf we allowed health insurance companies to sell across state lines, they would do the same thing-locate in the one state that offers the companies the best deals in taxes and regulations. The consumers in any state would have to abide by the rules of the one state that the insurance companies locate their offices in. This is often referred to as "a race to the bottom".
SOCIALISM- BOO !
ReplyDeleteDid I scare you ?
This is what the health reform discussion has boiled down to-- blind ideology, keeping us from looking at facts and making decisions that actually solve our problems. If you're being swept away by the currents of a fast-moving river--- it is a good idea to start swimming towards the shore. But our government, and the conservatives backing the minority, have decided to do nothing. This leads to drowning-- which is exactly where our country is headed, on so many issues.
Here is an excellent site, put together by physicians, on why a single payer system is the ONLY way to reduce our health costs. Lest we become like "socialist" Canada or Germany-- they have cited many studies and evidence to back the claim. Read it, IF YOU DARE !
http://www.pnhp.org/resources/pnhp-research-the-case-for-a-national-health-program
Looked at the site. It appears to be written by a group of University Elites from Sanford.
ReplyDeleteDoes a socialist America scare me? Yes. As said before I lived in a socialist country for two years. Long enough to experience the difference. They are metric but they are not better than the USA.
If the rich man making $100k/yr has his wealth redistributed to the man who makes $30k/yr the "poor man" will have less motivation to become a "rich man". The less comfortable poverty is the greater the motivation will be to rise out of it.