PDA

View Full Version : U.S. Issues The Health Care Cave-In


Ultra Peanut
05-18-2009, 09:25 PM
This is why you should be pissed at Obama.

http://robertreich.blogspot.com/2009/05/health-care-cave-in.html

The Health Care Cave-In

"Don't make the perfect the enemy of the better" is a favorite slogan in Washington because compromise is necessary to get anything done. But the way things are going with health care, a better admonition would be: "Don't give away the store."

Many experts have long agreed that a so-called "single-payer" plan is the ideal, because competition among private insurers who pay health-care bills inevitably causes them to spend big bucks trying to find and market policies to healthy and younger people at relatively low risk of health problems while avoiding sicker and older people with higher risks (and rejecting those with pre-existing conditions altogether), and also contesting and litigating many claims. A single payer saves all this money and focuses on caring for sick people and preventing the healthy from becoming sick. The other advantage of a single payer is it can use its vast bargaining power to negotiate lower prices from pharmaceutical companies, hospitals, and suppliers.

Not surprisingly, insurance and drug companies have been dead-set against a single payer for years. And they've so frightened the public into thinking that "single payer" means loss of choice of doctor (that's wrong -- many single payer plans in other nations allow choices of medical deliverers) that politicians no longer even mention it.

On the campaign trail, Barack Obama pushed a compromise -- a universal health plan that would include a "public insurance option" resembling Medicare, which individual members of the public and their families could choose if they wished. This Medicare-like option would at least be able to negotiate low rates and impose some discipline on private insurers.

But now the Medicare-like option is being taken off the table. Insurance and drug companies have thrown their weight around the Senate. And, sadly, the White House -- eager to get a bill enacted in 2009 rather than risk it during the mid-term election year of 2010 -- is signaling it's open to other approaches. What other approaches? One would create a public insurance plan run by multiple regional third-party administrators. In other words, the putative "public plan" would be broken into little pieces, none of which could exert much bargaining leverage on Big Pharma and Big Insurance. These pieces would also be so decentralized that the drug companies and private insurers could easily bully (or bribe) regional third-party administrators.

Another approach now being considered in the Senate would have states create their own insurance plans. That's even worse: Big Pharma and Big Insurance are used to buying off state legislators and officials. They'd just continue their current practices.

A third option is to create a public plan that pays for itself and, according to the office of Senator Charles Schumer, who came up with it, "adheres to private-insurance rules." But adhering to private insurance rules is exactly what the public plan is not supposed to do. How can it possibly discipline private insurers and get good deals from drug companies and medical providers if it adheres to the same rules that private insurers have wangled?

It's still possible that the House could come up with a real Medicare-like public option and that Senate Dems could pass it under a reconciliation bill needing just 51 votes. But it won't happen without a great deal of pressure from the White House and the public. Big Pharma, Big Insurance, and the rest of Big Med are pushing hard in the opposite direction. And Democrats are now giving away the store. As things are now going, we'll end up with a universal health-care bill this year that politicians, including our President, will claim as a big step forward when it's really a step sideways.And he didn't even mention what seems to be Obama's current pet plan: mandated private insurance with penalties up to 75% of the "average" for those who can't obtain or afford coverage. FUCK YEAH, BARRY!

Taco John
05-18-2009, 09:41 PM
I don't know why you're so suprised. It sounds like a government solution if ever I heard one.

Shaid
05-18-2009, 09:50 PM
Until they actually start controlling malpractice suits, hospital billing practices and the insane drug prices, they will never fix the insurance side of it.

Mr. Kotter
05-18-2009, 10:05 PM
PBJ PBJ PBJ

<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/zLScDJ7EUfE&hl=en&fs=1"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/zLScDJ7EUfE&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object>

Mr. Kotter
05-18-2009, 10:11 PM
Despite UP's histrionics....whatever plan Obama ends up pushing, will more than likely decrease costs (and profits of medical middle-men, heh) of healthcare into the next few years. We'll see if it is enough.

However, a single-payer socialized approach to medicine, similar to those of Britain or Canada, are not a desirable alternative. Decreasing costs and prodding the current system toward a more inclusive and affordable model, for everyone, while at the same time preserving "choice" for those who can afford and are willing to shell out money for extraordinary medical procedures...is, ultimately, the only plan that will prevail.

Obama seems to understand that and, to his credit, is working toward that. :thumb:

BigRedChief
05-18-2009, 10:42 PM
why is one persons opinion/blog considered "news" and worthy of a new thread?

SBK
05-18-2009, 10:55 PM
Nothing the government does reduces costs.

Mr. Kotter
05-18-2009, 11:12 PM
Nothing the government does reduces costs.

I worked for the industry in 1990. Sales Rep, Baxter Healthcare (Scientific Products Division) out of the Dallas office. The industry's response to calls for "change" was...."We WILL reduce costs over the next 10-15 years. We promise. No need for government intervention. We PROMISE!" Hence, when Clinton's Healthcare proposal came along in 1993...given the industry's claim....and general distrust toward government solutions, which you, rightly... point out... the public bought the whole Harry and Louise ads from the industry, that struck a quick and fatal blow to the Clinton healthcare proposal. And I applauded it. Yup, I did.

However, here we are 18-19 years later...and, guess what? The industry lied their fuggin' asses off. They did next to NOTHING to "reduce costs." Far too much money is spent on bloated salaries and "perks" for middle-men...in the healthcare industry, who are not vital to the delivery of healthcare--and serve no vital role, who...with a more "centralized" plan....can be eliminated. And SHOULD be eliminated.

So sorry, the bastards will have to get real jobs now I guess....instead of starting their weeks on Tuesday, and ending them with golf on Friday (I still know several still in the industry--so don't bullshit me,) I guess they'll actually have to work a full 50-55 hour week like the rest of us dumb bastards. Gosh, that's a real shame. You should really expect most average Americans to feel real sorry for them....

:rolleyes:

Taco John
05-18-2009, 11:42 PM
So sorry, the bastards will have to get real jobs now I guess....instead of starting their weeks on Tuesday, and ending them with golf on Friday (I still know several still in the industry--so don't bullshit me,) I guess they'll actually have to work a full 50-55 hour week like the rest of us dumb bastards.


It's funny you mention this... This is something that I'm working towards. Light and breezy Monday, with golf at 2pm on Friday. We'll see how it goes, but it's not out of the realm of possibility.

Ultra Peanut
05-18-2009, 11:46 PM
why is one persons opinion/blog considered "news" and worthy of a new thread?When the blogger was a US Secretary of Labor and incredibly smart guy?

The news isn't that Reich wrote a blog post, it's that Obama and Congress (particularly the Senate) are in bed with the insurance industry and completely cutting off any chance we have for successful, meaningful reform at the pass. Single-payer advocates are literally (http://www.nader.org/index.php?/archives/2116-Stop-the-Single-Payer-Shut-out!.html) not even being given seats at the table, all while Obama asks for donations to "stand up to" the lobbyists he's working with.

Mr. Kotter
05-19-2009, 12:01 AM
It's funny you mention this... This is something that I'm working towards. Light and breezy Monday, with golf at 2pm on Friday. We'll see how it goes, but it's not out of the realm of possibility.

Nothing at all wrong with dreaming about it. Not a dang thing. More power to you, Isaac. Really.

The problem with this in the healthcare industry though.... is sustained double and triple the rate of inflation....increases in costs of the industry's "products" over a 20 year plus cycle.

That is ASKING for trouble--in this case, in the form of government intervention. IMHO, the industry has brought it on themselves, and have no one to blame but themselves and their unmitigated greed.

patteeu
05-19-2009, 08:12 AM
Nothing at all wrong with dreaming about it. Not a dang thing. More power to you, Isaac. Really.

The problem with this in the healthcare industry though.... is sustained double and triple the rate of inflation....increases in costs of the industry's "products" over a 20 year plus cycle.

That is ASKING for trouble--in this case, in the form of government intervention. IMHO, the industry has brought it on themselves, and have no one to blame but themselves and their unmitigated greed.

The greed in this equation comes on the side where able bodied people want their healthcare insurance paid for by other people.

Velvet_Jones
05-19-2009, 08:22 AM
This is why you should be pissed at Obama.


Why - because he isn't going to nationalize 17% of the US economy?

Cannibal
05-19-2009, 08:40 AM
That is ASKING for trouble--in this case, in the form of government intervention. IMHO, the industry has brought it on themselves, and have no one to blame but themselves and their unmitigated greed.

Agreed.

Mr. Kotter
05-19-2009, 09:35 AM
The greed in this equation comes on the side where able bodied people want their healthcare insurance paid for by other people.

No, the real greed is an industry that thinks they can support lavish lifestyles for insurance executives, hospital and industry "middle-men," and administrators....on the backs of average Americans with double-to-triple the rate of inflation "cost increases" sustained over a 20-30 year period in which they knew the industry was under intense scrutiny.

The hubris and arrogance involved in that exercise would make Donald Trump blush. :shake:

patteeu
05-19-2009, 10:01 AM
No, the real greed is an industry that thinks they can support lavish lifestyles for insurance executives, hospital and industry "middle-men," and administrators....on the backs of average Americans with double-to-triple the rate of inflation "cost increases" sustained over a 20-30 year period in which they knew the industry was under intense scrutiny.

The hubris and arrogance involved in that exercise would make Donald Trump blush. :shake:

If your theory were correct, no insurance company or hospital would be able to pay their executives enough to support their lavish lifestyles because some other insurance company or hospital would clean up with a lower cost model ala Southwest Airlines. Your emotion-driven diagnosis is suspect AFAIC.

vailpass
05-19-2009, 10:04 AM
Why - because he isn't going to nationalize 17% of the US economy?

Exactly.

Mr. Kotter
05-19-2009, 10:05 AM
If your theory were correct, no insurance company or hospital would be able to pay their executives enough to support their lavish lifestyles because some other insurance company or hospital would clean up with a lower cost model ala Southwest Airlines. Your emotion-driven diagnosis is suspect AFAIC.

And your blindness to unmitigated and out-of-control greed in the industry is what is really suspect here. I worked in the industry long enough, and have enough interactions with friends and family still in the industry....to know you are the one who's out touch on this issue. Obama is on the right side on this issue. UP's beef with him, is that he isn't moving quickly or decisively enought toward a one-payer system. Obama is being pragmatic about his approach though. Take what you can get. What's sad is the industry, had they shown some sort of restraint, could have prevented this. They didn't.

patteeu
05-19-2009, 10:17 AM
And your blindness to unmitigated and out-of-control greed in the industry is what is really suspect here. I worked in the industry long enough, and have enough interactions with friends and family still in the industry....to know you are the one who's out touch on this issue. Obama is on the right side on this issue. UP's beef with him, is that he isn't moving quickly or decisively enought toward a one-payer system. Obama is being pragmatic about his approach though. Take what you can get. What's sad is the industry, had they shown some sort of restraint, could have prevented this. They didn't.

I don't defer to your "expertise" in this case. LOL @ "unmitigated and out-of-control greed in the industry". Let me guess, you left the industry because you weren't willing to work for lavish lifestyle wages because it made you feel dirty.

Mr. Kotter
05-19-2009, 11:26 AM
I don't defer to your "expertise" in this case. LOL @ "unmitigated and out-of-control greed in the industry". Let me guess, you left the industry because you weren't willing to work for lavish lifestyle wages because it made you feel dirty.

That wasn't the biggest part; a minor consideration, though, perhaps. It had more to do with things like lack of training, lack of reward (IMHO,) and lack of security. However, that's really besides the point--a point which it appears you are willing to concede: the double-to-triple the rate of inflation "cost increases" sustained over a 20-30 year period.

This whole discussion and debate really could have been largely avoided, but the industry went for short-term gain over long-term sustainability. They've made their own bed.

patteeu
05-19-2009, 03:09 PM
That wasn't the biggest part; a minor consideration, though, perhaps. It had more to do with things like lack of training, lack of reward (IMHO,) and lack of security. However, that's really besides the point--a point which it appears you are willing to concede: the double-to-triple the rate of inflation "cost increases" sustained over a 20-30 year period.

This whole discussion and debate really could have been largely avoided, but the industry went for short-term gain over long-term sustainability. They've made their own bed.

I concede, if you can call it a concession, that healthcare inflation is much higher than general inflation. I don't concede that "unmitigated and out-of-control greed in the industry" has anything at all to do with it. Do you really think that the "greed" present in that particular industry is greater than in banking, or oil, or food processing, or auto, or aviation, or steel, or consumer electronics, or any other major industry? That idea sounds laughable to me. There are reasons behind the rapid rate of healthcare inflation but unusual levels of greed has to be at the bottom of that list if it makes an appearance at all. Of course, that word tests well and has an honored place in the demagoguery toolkit.

BucEyedPea
05-19-2009, 03:51 PM
I concede, if you can call it a concession, that healthcare inflation is much higher than general inflation. I don't concede that "unmitigated and out-of-control greed in the industry" have anything at all to do with it. Do you really think that the "greed" present in that particular industry is greater than in banking, or oil, or food processing, or auto, or aviation, or steel, or consumer electronics, or any other major industry? That idea sounds laughable to me. There are reasons behind the rapid rate of healthcare inflation but unusual levels of greed has to be at the bottom of that list if it makes an appearance at all. Of course, that word tests well and has an honored place in the demagoguery toolkit.

Greed is a given as part of the human condition. It exists in our govt too. If HC really was operating in a true free-market that greed would be their demise. If our patchwork socialist system doesn't work, why would more of the same make it work? Ever since our govt intervened in the healthcare markets including the HMO act passed in the 70's, their gauranteed market has made corporations happy and patients and doctor's unhappy.

The inflation in this market is caused by govt policy not the market or greed. We're forced to pay for others.

BucEyedPea
05-19-2009, 03:56 PM
No, the real greed is an industry that thinks they can support lavish lifestyles for insurance executives, hospital and industry "middle-men," and administrators....on the backs of average Americans with double-to-triple the rate of inflation "cost increases" sustained over a 20-30 year period in which they knew the industry was under intense scrutiny.
Sorry Kotter, I admit there's a problem here but it's caused by govt policy first and foremost that demands we pay for others. This drives up costs that have to be passed on to others.You're also not looking at the advances in technology ( which Europe lacks) that have reduced one's time in hospitals.

Simply Red
05-19-2009, 03:59 PM
:cuss:

patteeu
05-19-2009, 08:13 PM
Greed is a given as part of the human condition. It exists in our govt too. If HC really was operating in a true free-market that greed would be their demise. If our patchwork socialist system doesn't work, why would more of the same make it work? Ever since our govt intervened in the healthcare markets including the HMO act passed in the 70's, their gauranteed market has made corporations happy and patients and doctor's unhappy.

The inflation in this market is caused by govt policy not the market or greed. We're forced to pay for others.

I agree. I think that there are some positive results from government intervention, but there are also plenty of unintended consequences and all too often the negative outweighs the positive.

BucEyedPea
05-19-2009, 08:18 PM
I agree. I think that there are some positive results from government intervention, but there are also plenty of unintended consequences and all too often the negative outweighs the positive.

Based on what I've read, doctors dealt with payment and ability to pay with each patient. They also did a charity work and forgave bills at times. Doesn't sound like greed to me.

patteeu
05-19-2009, 08:53 PM
Based on what I've read, doctors dealt with payment and ability to pay with each patient. They also did a charity work and forgave bills at times. Doesn't sound like greed to me.

No, Kotter is nuts if he thinks this is a problem caused by greed, although I think he was talking more about insurance industry executives than doctors.

BucEyedPea
05-19-2009, 08:58 PM
No, Kotter is nuts if he thinks this is a problem caused by greed, although I think he was talking more about insurance industry executives than doctors.

Well, a good argument can be made for just insurance being available at all as a factor for increasing costs too. Ever hear that one?

Health insurance was once affordable though.

Mr. Kotter
05-19-2009, 10:05 PM
Well, a good argument can be made for just insurance being available at all as a factor for increasing costs too. Ever hear that one?

Health insurance was once affordable though.

Exactly. Health Insurance, of any REAL value (reasonable deductibles, and "out of pocket" expenses)....have, are pretty much...no longer affordable to many average and middle class Americans.

It's why many say, "Screw it. I'll take my chances, and if I get really sick/hurt...I'll just go to the ER--and screw the folks who pay, and/or taxpayers, or I'll declare bankruptcy like so many others." And it is at this point, I can't say I blame many of them.

Hell, I'm older, but pretty low risk, with a family....and, supposedly, have decent-to-good insurance coverage--and we spend, on average over the last 10 years....$5,000-6,000 every year, out-of-pocket for average and routine medical expenses. I'm not joking....$5,000 plus a year, IN ADDITION to premiums.

Patty will be along soon...to tell me how much of a whiner, and a slug...that makes me. That somehow, I'd DARE to question....that nearly 20% of our disposable income on healthcare related expenses--with no major or chronic issues....is somehow insane. Actually, that makes me a "leech" as he has called it.

Gosh, all so my Dentist can work 3 1/2 days per week (no kidding,) our dermatoligist can work 35 "office" hours per week (I'm not joking,) and our coverage leaves such things as dental implants, ADD diagnosis and treatment, braces for the kids, and "pre-existing" conditions....entirely or largely uncovered.

Yup, I guess we should just thank our lucky stars that we have "good" coverage. :rolleyes:

patteeu
05-20-2009, 05:35 AM
Well, a good argument can be made for just insurance being available at all as a factor for increasing costs too. Ever hear that one?

Health insurance was once affordable though.

Sure, insurance bureaucracy insulating the consumer from costs of the services has a similar effect to that of government bureaucracy doing the same thing. donkhater posted a very good comment about some of the problems with our current health insurance concept a week or so ago. You agree though that that's not a matter of inordinate greed, right?

patteeu
05-20-2009, 05:41 AM
Exactly. Health Insurance, of any REAL value (reasonable deductibles, and "out of pocket" expenses)....have, are pretty much...no longer affordable to many average and middle class Americans.

It's why many say, "Screw it. I'll take my chances, and if I get really sick/hurt...I'll just go to the ER--and screw the folks who pay, and/or taxpayers, or I'll declare bankruptcy like so many others." And it is at this point, I can't say I blame many of them.

Hell, I'm older, but pretty low risk, with a family....and, supposedly, have decent-to-good insurance coverage--and we spend, on average over the last 10 years....$5,000-6,000 every year, out-of-pocket for average and routine medical expenses. I'm not joking....$5,000 plus a year, IN ADDITION to premiums.

Patty will be along soon...to tell me how much of a whiner, and a slug...that makes me. That somehow, I'd DARE to question....that nearly 20% of our disposable income on healthcare related expenses--with no major or chronic issues....is somehow insane. Actually, that makes me a "leech" as he has called it.

Gosh, all so my Dentist can work 3 1/2 days per week (no kidding,) our dermatoligist can work 35 "office" hours per week (I'm not joking,) and our coverage leaves such things as dental implants, ADD diagnosis and treatment, braces for the kids, and "pre-existing" conditions....entirely or largely uncovered.

Yup, I guess we should just thank our lucky stars that we have "good" coverage. :rolleyes:

Your greed shows through when you talk about "reasonable deductibles and 'out of pocket' expenses". Of course, there's nothing objectionable to be found in the concept of "reasonable" costs, but it's pretty clear that you think you should be able to walk into a doctor's office whenever you feel like it for a pittance instead of paying a doctor's "reasonable" salary for the amount of his time that you use (plus the amount you kick into the insurance pool to cover your share of the expenses of people who aren't as healthy as you are).

As a relatively healthy person, your costs should be greater than the amount of health care services you actually use. That's the purpose of insurance. The people who use less cover the extraordinary expenses of those who need to use more. In return, you get the promise that if someday you have extraordinary expenses, you won't have to finance the treatment by yourself.

BucEyedPea
05-20-2009, 07:23 AM
Sure, insurance bureaucracy insulating the consumer from costs of the services has a similar effect to that of government bureaucracy doing the same thing. donkhater posted a very good comment about some of the problems with our current health insurance concept a week or so ago. You agree though that that's not a matter of inordinate greed, right?

Yes. I said so earlier. Govt policies drives insurance up too. They have to pass the costs along when govt mandates what they must cover. It's really a racket to have all the things covered that are. Insurance should be something people can individually tailor by what they want covered and cost. Some just carry catastrophic. I did for years. It's cheaper but prevents being wiped out financially. Even govt policy drove those rates up.

dirk digler
05-20-2009, 07:37 AM
Your greed shows through when you talk about "reasonable deductibles and 'out of pocket' expenses". Of course, there's nothing objectionable to be found in the concept of "reasonable" costs, but it's pretty clear that you think you should be able to walk into a doctor's office whenever you feel like it for a pittance instead of paying a doctor's "reasonable" salary for the amount of his time that you use (plus the amount you kick into the insurance pool to cover your share of the expenses of people who aren't as healthy as you are).

As a relatively healthy person, your costs should be greater than the amount of health care services you actually use. That's the purpose of insurance. The people who use less cover the extraordinary expenses of those who need to use more. In return, you get the promise that if someday you have extraordinary expenses, you won't have to finance the treatment by yourself.

I am with Kotter on this one. 9 years ago I could go to the doctor and pay a $20 co-pay and that would cover my doctor visit. I could get 1 check-up a year for free and my prescriptions would only cost $5 and that was for any medicine I needed. Today my insurance is not even close to comparable. I have to meet my $2000 deductible before it will pay anything. My doctor raised his rates again so I have to pay $100 for a 10 minute office visit. If I need a simple blood test it will run me $250 for them to draw my blood and stick in a old machine for 30 seconds. No more 1 free check-up now it will cost upwards of $500 or more.

Also if you need to cover your whole family I don't know anyone can afford it. The company I work for we have Blue Cross and Blue Shield and the monthly premium is over $600 a month out of your paycheck.

I am sure there is alot of factors for why costs have sky-rocketed but I am pretty sure greed is in the Top 5.

BucEyedPea
05-20-2009, 07:47 AM
I am with Kotter on this one. 9 years ago I could go to the doctor and pay a $20 co-pay and that would cover my doctor visit. I could get 1 check-up a year for free and my prescriptions would only cost $5 and that was for any medicine I needed. Today my insurance is not even close to comparable. I have to meet my $2000 deductible before it will pay anything. My doctor raised his rates again so I have to pay $100 for a 10 minute office visit. If I need a simple blood test it will run me $250 for them to draw my blood and stick in a old machine for 30 seconds. No more 1 free check-up now it will cost upwards of $500 or more.

Also if you need to cover your whole family I don't know anyone can afford it. The company I work for we have Blue Cross and Blue Shield and the monthly premium is over $600 a month out of your paycheck.

I am sure there is alot of factors for why costs have sky-rocketed but I am pretty sure greed is in the Top 5.
I've seen that too. And I went off mine for awhile because of it. But you are assigning the wrong causes to why this is happening. Those guys are losing money while being forced to pay for others. Your beloved socialism is a major factor in this happening—not greed.

dirk digler
05-20-2009, 07:57 AM
I've seen that too. And I went off mine for awhile because of it. But you are assigning the wrong causes to why this is happening. Those guys are losing money while being forced to pay for others. Your beloved socialism is a major factor in this happening—not greed.

Are you saying with a straight face that insurance companies are losing money?

BucEyedPea
05-20-2009, 08:15 AM
Are you saying with a straight face that insurance companies are losing money?

No I am saying they pass along the costs of mandates. They need to cover themselves as people start to overuse those mandates or they won't exist and won't be able to cover anyone. You don't get something for nothing in this world.

Velvet_Jones
05-20-2009, 08:29 AM
Exactly. Health Insurance, of any REAL value (reasonable deductibles, and "out of pocket" expenses)....have, are pretty much...no longer affordable to many average and middle class Americans.

It's why many say, "Screw it. I'll take my chances, and if I get really sick/hurt...I'll just go to the ER--and screw the folks who pay, and/or taxpayers, or I'll declare bankruptcy like so many others." And it is at this point, I can't say I blame many of them.

Hell, I'm older, but pretty low risk, with a family....and, supposedly, have decent-to-good insurance coverage--and we spend, on average over the last 10 years....$5,000-6,000 every year, out-of-pocket for average and routine medical expenses. I'm not joking....$5,000 plus a year, IN ADDITION to premiums.

Patty will be along soon...to tell me how much of a whiner, and a slug...that makes me. That somehow, I'd DARE to question....that nearly 20% of our disposable income on healthcare related expenses--with no major or chronic issues....is somehow insane. Actually, that makes me a "leech" as he has called it.

Gosh, all so my Dentist can work 3 1/2 days per week (no kidding,) our dermatoligist can work 35 "office" hours per week (I'm not joking,) and our coverage leaves such things as dental implants, ADD diagnosis and treatment, braces for the kids, and "pre-existing" conditions....entirely or largely uncovered.

Yup, I guess we should just thank our lucky stars that we have "good" coverage. :rolleyes:

I have a hard time believing some of this. Apparently you have a high deductible/out of pocket health plan, are new to that plan with no similar coverage within the last 36 months and no orthodontia with you dental coverage.

Question - Why do you think Pre-Existing policy provisions are such a big deal?

BucEyedPea
05-20-2009, 08:48 AM
Question - Why do you think Pre-Existing policy provisions are such a big deal?

There are now policies out that that allow for pre-existing conditions. I used it on my new insurance immediately and paid $60 for $13k meniscus repair surgery.

patteeu
05-20-2009, 09:08 AM
I am with Kotter on this one. 9 years ago I could go to the doctor and pay a $20 co-pay and that would cover my doctor visit. I could get 1 check-up a year for free and my prescriptions would only cost $5 and that was for any medicine I needed. Today my insurance is not even close to comparable. I have to meet my $2000 deductible before it will pay anything. My doctor raised his rates again so I have to pay $100 for a 10 minute office visit. If I need a simple blood test it will run me $250 for them to draw my blood and stick in a old machine for 30 seconds. No more 1 free check-up now it will cost upwards of $500 or more.

Also if you need to cover your whole family I don't know anyone can afford it. The company I work for we have Blue Cross and Blue Shield and the monthly premium is over $600 a month out of your paycheck.

I am sure there is alot of factors for why costs have sky-rocketed but I am pretty sure greed is in the Top 5.

The dispute isn't over whether healthcare costs have risen substantially or not, it's over the cause of that increase. As such, your testimony about how rising costs have effected you is irrelevant except that it explains your motive for lashing out.

It doesn't really surprise me that greedy looters like you and Mr. Kotter would assume that other people's greed is driving your pain. :)

BucEyedPea
05-20-2009, 09:13 AM
The dispute isn't over whether healthcare costs have risen substantially or not, it's over the cause of that increase. As such, your testimony about how rising costs have effected you is irrelevant except that it explains your motive for lashing out.

It doesn't really surprise me that greedy looters like you and Mr. Kotter would assume that other people's greed is driving your pain. :)

Yeah, I know, why isn't the side who wants something for nothing, below cost or to be paid by others not greed too? It's kinda like those ravishing a clearance or fire-sale sale knocking each other to be the first in line to get the goods.:D

dirk digler
05-20-2009, 09:25 AM
The dispute isn't over whether healthcare costs have risen substantially or not, it's over the cause of that increase. As such, your testimony about how rising costs have effected you is irrelevant except that it explains your motive for lashing out.

It doesn't really surprise me that greedy looters like you and Mr. Kotter would assume that other people's greed is driving your pain. :)

And Kotter is right when he says greed is part of rising costs. Insurance companies are making huge profits while screwing the little guy.

All I want is to get what I pay for Pat nothing more and nothing less.

patteeu
05-20-2009, 09:32 AM
And Kotter is right when he says greed is part of rising costs. Insurance companies are making huge profits while screwing the little guy.

What level of profit is acceptable? Is there a successful industry in the US that makes small enough profits for you or do you resent them all? Let me guess, you only resent the industries that sell stuff to you at prices that are higher than what you want to pay or that employ you at wages that are lower than what you'd like to earn. :shrug:

All I want is to get what I pay for Pat nothing more and nothing less.

One thing you've got to understand is that the concept of insurance requires that healthy people get less than they pay for so that unhealthy people can get help paying for what they get. If you're healthy, you win the game of life but lose the game of health insurance. If you're unhealthy, you win the insurance game but do relatively less well in the game of life.

dirk digler
05-20-2009, 09:43 AM
What level of profit is acceptable? Is there a successful industry in the US that makes small enough profits for you or do you resent them all? Let me guess, you only resent the industries that sell stuff to you at prices that are higher than what you want to pay or that employ you at wages that are lower than what you'd like to earn. :shrug:

One thing you've got to understand is that the concept of insurance requires that healthy people get less than they pay for so that unhealthy people can get help paying for what they get. If you're healthy, you win the game of life but lose the game of health insurance. If you're unhealthy, you win the insurance game but do relatively less well in the game of life.

I honestly don't care how much profit a company makes as long as they don't screw the little guy along the way. Just like that little girl who had insurance and needed a transplant and was denied until the public outrage but it was too late and she died. That shit happens all the time because insurance companies don't care and are greedy.

BucEyedPea
05-20-2009, 09:45 AM
And Kotter is right when he says greed is part of rising costs. Insurance companies are making huge profits while screwing the little guy.

All I want is to get what I pay for Pat nothing more and nothing less.

Why shouldn't they make a profit? And govt has padded that profit with it's policies such as mandates. Do you know anyone who works for insurance? Why has a place like New York Life lasted over a hundred years?
They are financially sound.They didn't get into the speculative junk.

Taco John
05-20-2009, 09:50 AM
The dispute isn't over whether healthcare costs have risen substantially or not, it's over the cause of that increase. As such, your testimony about how rising costs have effected you is irrelevant except that it explains your motive for lashing out.

It doesn't really surprise me that greedy looters like you and Mr. Kotter would assume that other people's greed is driving your pain. :)



I don't think that they fully understand that when the government gets involved, the net result is rising costs 100% of the time.

patteeu
05-20-2009, 10:35 AM
I honestly don't care how much profit a company makes as long as they don't screw the little guy along the way. Just like that little girl who had insurance and needed a transplant and was denied until the public outrage but it was too late and she died. That shit happens all the time because insurance companies don't care and are greedy.

What makes you think the transplant should have been covered? Have you read the policy or have you read an analysis of the policy?

patteeu
05-20-2009, 10:38 AM
I don't think that they fully understand that when the government gets involved, the net result is rising costs 100% of the time.

I'm trying to think of an example that invalidates your 100% number but I can't. In any event, it's hard to understand how so many people can be so oblivious to this effect.

dirk digler
05-20-2009, 10:43 AM
What makes you think the transplant should have been covered? Have you read the policy or have you read an analysis of the policy?

It was a standard liver transplant and the doctors signed off on it. Cigna claimed it was experimental which is laughable.

Cigna insurance initially declined to pay for the transplant for Nataline Sarkisyan because her plan did not cover "experimental, investigational and unproven services," her doctors said.

Since when is a liver transplant experimental?

patteeu
05-20-2009, 10:51 AM
It was a standard liver transplant and the doctors signed off on it. Cigna claimed it was experimental which is laughable.



Since when is a liver transplant experimental?

If you have metastatic cancer, for example, you may be able to find one doctor to authorize a liver transplant for your failing liver, but you're going to run into trouble from your insurance company because most doctors would not have made such an authorization given that your disease is still present in other parts of your body and the new liver is unlikely to do nearly as much good in the long run for you (since you're likely to be dead) as it could for a healthy donee. I don't know what the specific circumstances were for this girl nor do I know what the insurance company's argument was, but you can't take these cases that are at the margin and draw a conclusion that the insurance companies are corrupted with greed and out to screw the consumer so they can make a buck.

dirk digler
05-20-2009, 11:06 AM
If you have metastatic cancer, for example, you may be able to find one doctor to authorize a liver transplant for your failing liver, but you're going to run into trouble from your insurance company because most doctors would not have made such an authorization given that your disease is still present in other parts of your body and the new liver is unlikely to do nearly as much good in the long run for you (since you're likely to be dead) as it could for a healthy donee. I don't know what the specific circumstances were for this girl nor do I know what the insurance company's argument was, but you can't take these cases that are at the margin and draw a conclusion that the insurance companies are corrupted with greed and out to screw the consumer so they can make a buck.

I agree this example is at the margins but this happens everyday with less important procedures. My g/f works as an insurance claims person who tries to get the insurance companies to pay for services. She says their favorite words is Deny or No. Then they argue for a while and then sometimes they relent sometimes they don't. One of the problems is that the insurance people seem to think they are smarter than the doctors when they don't have a clue what they are talking about so they deny based on cost-benefit analysis.

In the example above, the doctors wrote a letter to the insurance company and even called them and said this girl needs a transplant or she dies. They had a liver waiting for her even but they claimed it was experimental then changed and said well she might die 6 months later so no anyway.

Which goes back to what I said earlier that all I want is what I pay for. Motherfucker if I am dying and need a transplant even if I only live 6 months I paid for it so fucking do it. That is 6 more months I get to spend with my loved ones.

wild1
05-20-2009, 11:08 AM
Since when is a liver transplant experimental?

There are any number of factors that can make a procedure that is routine or vital for one person an experimental procedure for someone else. Liver transplantation can be experimental due to the nature of the illness or other intervening factors, such as Hepatitis, HIV infection, or one of ten thousand other conditions. Some patients are also at very high risk for abdominal hemorrhage, obstruction, emboli, infection etc.

Do you know the details of the individual's diagnosis? Were they status 1? What was their CTP score? What intervening conditions does this patient have?

What we see in your argument is the problem with government controlled medicine. A template being applied from a legislative body to an individual's infinitely complicated medical situation. You read an article designed to advance a viewpoint and render an opinion that the procedure was medically necessary. It may indeed have been, but you don't know that, and even if you had all the information you wouldn't be qualified to make a judgement. You have no clue whatsoever about the subject on which you are speaking. And these are the kinds of people who will be making decisions for all of us.

Do you think government will long-term result in more investigation, experimental procedures being approved? That's laughable. Government is many times worse a payor for procedures across the spectrum of health care than private insurers are.

If equality is judged to be superior to quality, which it seems to have been, then you'll love it. Misery spread equally is not an improvement.

dirk digler
05-20-2009, 11:21 AM
There are any number of factors that can make a procedure that is routine or vital for one person an experimental procedure for someone else. Liver transplantation can be experimental due to the nature of the illness or other intervening factors, such as Hepatitis, HIV infection, or one of ten thousand other conditions. Some patients are also at very high risk for abdominal hemorrhage, obstruction, emboli, infection etc.

Do you know the details of the individual's diagnosis? Were they status 1? What was their CTP score? What intervening conditions does this patient have?

What we see in your argument is the problem with government controlled medicine. A template being applied from a legislative body to an individual's infinitely complicated medical situation. You read an article designed to advance a viewpoint and render an opinion that the procedure was medically necessary. It may indeed have been, but you don't know that, and even if you had all the information you wouldn't be qualified to make a judgement. You have no clue whatsoever about the subject on which you are speaking. And these are the kinds of people who will be making decisions for all of us.

Do you think government will long-term result in more investigation, experimental procedures being approved? That's laughable. Government is many times worse a payor for procedures across the spectrum of health care than private insurers are.

If equality is judged to be superior to quality, which it seems to have been, then you'll love it. Misery spread equally is not an improvement.

wild1 the viewpoint wasn't from the article but from her doctors. I guess we should start trusting the insurance companies more than doctors. :rolleyes:

patteeu
05-20-2009, 12:00 PM
I agree this example is at the margins but this happens everyday with less important procedures. My g/f works as an insurance claims person who tries to get the insurance companies to pay for services. She says their favorite words is Deny or No. Then they argue for a while and then sometimes they relent sometimes they don't. One of the problems is that the insurance people seem to think they are smarter than the doctors when they don't have a clue what they are talking about so they deny based on cost-benefit analysis.

In the example above, the doctors wrote a letter to the insurance company and even called them and said this girl needs a transplant or she dies. They had a liver waiting for her even but they claimed it was experimental then changed and said well she might die 6 months later so no anyway.

Which goes back to what I said earlier that all I want is what I pay for. Mother****er if I am dying and need a transplant even if I only live 6 months I paid for it so ****ing do it. That is 6 more months I get to spend with my loved ones.

They're not going to get every call right, but you can't expect the insurance company to pay for everything just because you can find a single outlier doctor in the US to approve it. And you can't point to a single example of a case that they may have gotten wrong (although I'm still not convinced that that is the case) as evidence that they routinely get these calls wrong. We hear about the sad cases, but we rarely hear about all the times when the insurance company does pay for an expensive life saving procedure.

A lot of times when insurance companies say no, it's a bureaucratic issue like the doctor's office submitting a claim with the wrong code or something like that that can be easily rectified. Beyond that, I simply don't believe that denials of procedures/services that are clearly covered is routine at all despite what you hear from your gf.

Calcountry
05-20-2009, 01:27 PM
When the blogger was a US Secretary of Labor and incredibly smart guy?

The news isn't that Reich wrote a blog post, it's that Obama and Congress (particularly the Senate) are in bed with the insurance industry and completely cutting off any chance we have for successful, meaningful reform at the pass. Single-payer advocates are literally (http://www.nader.org/index.php?/archives/2116-Stop-the-Single-Payer-Shut-out!.html) not even being given seats at the table, all while Obama asks for donations to "stand up to" the lobbyists he's working with.ROFLROFLROFLROFLROFLROFL

wild1
05-20-2009, 01:34 PM
wild1 the viewpoint wasn't from the article but from her doctors. I guess we should start trusting the insurance companies more than doctors. :rolleyes:

You somehow missed all 5 major points of the post.

BigRedChief
05-20-2009, 09:50 PM
From his website:

President Obama has announced three bedrock requirements for real health care reform. It must:

Reduce Costs — Rising health care costs are crushing the budgets of governments, businesses, individuals and families and they must be brought under control
Guarantee Choice — Americans must have the freedom to keep whatever doctor and health care plan they have, or to select a new doctor or health care plan if they choose
Ensure Quality Care for All — All Americans must have quality and affordable health care
Now we have to show Congress where the American people stand.

Ultra Peanut
05-23-2009, 08:18 PM
Obama. Is. Full. Of. Shit.

Any "new health care plan" the people will be given the choice of switching to is going to be completely hamstrung piece of shit, in order to protect the insurance industry and "not change things too rapidly." Hope! Change! Lobbyist appeasement!

And all Americans must have "quality" and "affordable" health care because the shit's most likely going to end up being mandated.

prhom
05-23-2009, 09:14 PM
From his website:

President Obama has announced three bedrock requirements for real health care reform. It must:

Reduce Costs — Rising health care costs are crushing the budgets of governments, businesses, individuals and families and they must be brought under control
Guarantee Choice — Americans must have the freedom to keep whatever doctor and health care plan they have, or to select a new doctor or health care plan if they choose
Ensure Quality Care for All — All Americans must have quality and affordable health care
Now we have to show Congress where the American people stand.

My favorite part is B, especially in light of the newest plan to tax health benefits. Sure, you can keep your current health care plan, but your employer will now have to reduce your benefits to account for the added tax. Irritating.

BucEyedPea
05-23-2009, 10:03 PM
My favorite part is B, especially in light of the newest plan to tax health benefits. Sure, you can keep your current health care plan, but your employer will now have to reduce your benefits to account for the added tax. Irritating.

The idea is to ruin private insurance so it can be destroyed and we can move into a single-payer govt system. Then the govt can completely control us.
Providing govt psychiatic screening of school children and pregnant mothers for a wonderful life as Winston Smiths. Throw in the thought crimes like hate
crime legislation. Terrorists off in the distance fighting an endless war. Ninety-Eighty Four 25 years late.

Notice how those who support destroying an entire industry with millions of jobs at stake were for saving Big Auto because millions would lose their jobs?

Greed.

googlegoogle
05-24-2009, 02:29 AM
Beer tax coming.

craneref
05-24-2009, 10:37 AM
Beer tax coming.

Hey watch it, there is no need for "CRAZY" talk!! :shake:

Dave Lane
05-24-2009, 11:07 AM
I worked for the industry in 1990. Sales Rep, Baxter Healthcare (Scientific Products Division) out of the Dallas office. The industry's response to calls for "change" was...."We WILL reduce costs over the next 10-15 years. We promise. No need for government intervention. We PROMISE!" Hence, when Clinton's Healthcare proposal came along in 1993...given the industry's claim....and general distrust toward government solutions, which you, rightly... point out... the public bought the whole Harry and Louise ads from the industry, that struck a quick and fatal blow to the Clinton healthcare proposal. And I applauded it. Yup, I did.

However, here we are 18-19 years later...and, guess what? The industry lied their fuggin' asses off. They did next to NOTHING to "reduce costs." Far too much money is spent on bloated salaries and "perks" for middle-men...in the healthcare industry, who are not vital to the delivery of healthcare--and serve no vital role, who...with a more "centralized" plan....can be eliminated. And SHOULD be eliminated.

So sorry, the bastards will have to get real jobs now I guess....instead of starting their weeks on Tuesday, and ending them with golf on Friday (I still know several still in the industry--so don't bullshit me,) I guess they'll actually have to work a full 50-55 hour week like the rest of us dumb bastards. Gosh, that's a real shame. You should really expect most average Americans to feel real sorry for them....

:rolleyes:

Rob's best post EVAR!!!!


n rep :)

BillyMaze
05-24-2009, 04:04 PM
Despite UP's histrionics....whatever plan Obama ends up pushing, will more than likely decrease costs (and profits of medical middle-men, heh) of healthcare into the next few years. We'll see if it is enough.

However, a single-payer socialized approach to medicine, similar to those of Britain or Canada, are not a desirable alternative. Decreasing costs and prodding the current system toward a more inclusive and affordable model, for everyone, while at the same time preserving "choice" for those who can afford and are willing to shell out money for extraordinary medical procedures...is, ultimately, the only plan that will prevail.

Obama seems to understand that and, to his credit, is working toward that. :thumb:I hope every greedy doctor bleeds, hospital, and HMO bleeds.