Health insurance
 

I'm curious what people think the government should enforce in regards to health insurance regulation.

One thing that I think is really bad, is how insurance companies are dropping coverage because some people just aren't that profitable.

Pre-existing condition? Well, your new insurance won't cover that...

Loose your job? Get COBRA for 7-800 a month for a while...then you're screwed.

Those who actually read my posts know I'm not for a single payer system and don't necessarily advocate the public option.

That being said, reform is certainly necessary even if it cuts into corporate profits.

What say you?

-spence

Tort reform for starters, not as an after thought. I still wouldn't let this bunch of two faced hypocrits reform our Health Ins. If I had a young family I would be very leary of what they will pass. Read the proposed Bill. Everything you heard last night was a lie.

spence, I've held off on this story awhile, but here it is 100% true.
Both my parents worked their entire lives, 10 years ago they semi-retired to Florida. My Mom took another career position, my Dad, worked part time. Due to corporate restructuring, my Mom was laid off. She was the insurance provider and went on Cobra. Well, then 6 months or so pass and we find out my Dad has cancer. My parents panic, I do a ton of research (which conflicts with your assertions above) and we find that as long as you do not let your insurance lapse, pre-existing conditions cannot be held against a person when applying for insurance. Its the LAW. My parents get private insurance and yup, its expensive, but way less than paying the medical costs of cancer treatment. So my sister and I offer to pay the insurance so my parents dont have the burder, they refuse. My Mom, a person who worked her entire life in an office, goes out and gets a job at a supermarket making donuts at 4am, just to get insurance. She fought to get the 30 hrs a week to be eligible for insurance, once again, prexisting conditions where not a factor since their insurance never lapsed and so they discontinued the private insurance and my mom got insurance from the supermarket. She got up 6 days a week at 4am, worked 5 hrs and then took care of my Dad. So........heres my eternal struggle as a conservative, maybe you all can help. How come my parents (mom) could do it? Is it becasue, they're lucky? blessed? white? educated (both only HS degrees)?, or just because they believed that their circumstances were their circumstances and they had to take care of themselves, please help me see the light?

So how many people pay into their insurance plans but can't afford COBRA or find a new job with coverage?

I applaud your parents for making things work, but that's not a one size fits all solution.

-spence

I would like to see Complete Tort Reform.

Interstate competition for current HC already in place.

Tax credits or rebates in a HC account for all Soc Sec card holders to help pay insurance premiums based on income.

Government enforcing the laws against the fraud/ waste of Medicare/ Medicaid.
If there is truly $900 Billion in waste and fraud, those dollars could be returned
to cover tax credits for HC premiums for everyone.

Use Medicare as a safety net for the unemployed seeking work.

Government regulation that all insurance companies offer a basic low cost
plan option.

The main reasons I'm against a government option is the additional cost to
set it up, and the temptation for employers to drop their HC plans forcing
a hugh expensive Government plan that we can't afford.

We already have things in place, tweak them and make them more affordable
being close to 80 % of Americans are happy with their current plan.

Just a few thought off the top of my head.

Spence, while there's not an easy solution that works for everyone, there are options out there. Dunkin Donuts offers BCBS health insurance for hourly employees that work 35 hours per week. And they're hiring f/t employees right now. And they're not the only company doing that. I guess some people might think they're above doing jobs that they think aren't good enough for them. Myself, I'd do what Jim's mom did and do what I have to to have insurance for my family.

The government has already made COBRA easier for people to afford with the American Recovery and Investment Act. The government now pays 65% of the person's premium and they also extended COBRA benefits. This is supposed to be temporary until 12/09, but there is already talk of extending it. And keep in mind that the cost of COBRA for a person is the total cost of the insurance company premium. It's what the employee was paying along with the portion that the employer was contributing. So if employees want to complain about the cost they pay, they should consider that the employer is picking up at least 60% and usually more of the total cost of the monthly premium.

The simple solution to making health insurance more affordable (not considering tort reform) is to have standardized costs for services. Certain procedures, surgeries, imaging, etc... will have a fixed price set by the governnment in conjunction with medical professionals and insurance companies. Hospitals will have fixed prices for rooms and medical devices also. I know it's probably a longer shot than tort reform, but to me it seems to be the most logical solution that wouldn't require 900 billion dollars right off the bat.

There's a lot of people working sh_t jobs for insurance purposes - they could better contribute to society if health insurance was affordable. I think affordable health insurance would free a lot of people to start their own businesses or work at better paying jobs that don't typically provide insurance.

salty, your insurance wont cover your sons broken leg? What DO they cover?
My mom was paying less than 700 a month, private insurance, with full blown cancer. Everything covered!

God bless your Mom and Dad, Jimmy.

Sounds like your parents grew up and worked in the American tradition
where you find ways to take care of yourself.

Your Mom found there have always been ways in this country to take care of yourself if you are
willing to work and sacrifice without Nanny assistance.

can someone please define for me what "affordable health insurance" would be?

Spence is unhappy with his $13,000 a year policy(how much of that do you pay Spence?)

Jimmy's mom was admirably willing to work her butt off to provide their health care insurance for her famly while many would rather complain and whine for divine government intervention rather than put down their cell phone, turn off their big screen, down size their vehical or give up any other lifestyle amenity because they believe someone else should bear the costs of their healthcare and/or insurance

Joe thinks everything would be better if we had affordable insurance..is that 100/month?....300/month?...does this include all the healthcare that you desire and require, dental, specialists, perscriptions, marriage counseling and sex change operations? etc...


seems to me the folks that have the best health insurance situation...government workers, unions ..find themselves complaining about having to pay "COPAYS" !!!!!

so, what exactly is affordable? how much do you want for little or nothing out of your own pocket ?

and even if you get it for little or nothing, will you still be unhappy?

all good info, I usually stay out of the healtcare debate because I dont have a solution. I do know that raising taxes and having the government run with it will be a bad thing. Reform i am for, but a government run plan is not a good thing. We have to stop the tax=solution problem with this country.
Why isnt a simple thing like - you get cheap government insurance if you volunteer 10 hours a month. The governmenr has a website, like ebay where you bid for the use of people's time. If I need help painting a house, I can search for a house painter in the area, I bid for his time, the money goes to the government to pay for insurance? May sound wacky but look how succesfull ebay and craigslist are. These are the type of things I expected from Obama, he was SUPPOSED to be young, hip, tech friendly, all we've seen is a lame democrat who over reaches and relies on tax. Where is the creativty all the youth movement wanted from him? His soluton.....hire a "czar" for every problem.

I wasn't suggesting that Salty...much of the problem with the system is government involvement currently, RI has I believe more than 1000 mandates for coverage and requirements for h-ins companies presently, as a result there are only 3 providers in RI...many states will not let you purchase catastrophic policies which I believe are the most sensible solution...I've had one for years, I mentioned this before..my family of 5 premium is 300 per month...I pay out of pocket for checkups, dentist, perscriptions up to a max deductible and still come out far ahead after many years of paying BC/BS individually...I spent this morning "shopping" for an abdominal CT scan for my wife... I spoke to the head of the department at Newport Hospital regarding his fee for reading the catscan, when he found out that we were self pay he reduced the cost by 50%...we found the same to be true with the scan itself....I'm not done "shopping" because there are scores of facitities within 50 miles that provide that service at many different prices...few people ever consider what these things cost, they simply pull out their card and someone else takes care of everything...with that reality it's hard to complain when you think that things have gone amuck, in some cases you have no choice but to head right to the emergency room...but in most cases you could absolutely shop around for a doctor that you liked/preferred and felt was not robbing you if you actually had the incentive, you don't with most insurance these days because you purchase through someone else like an employer, a policy that includes for more coverage than you will ever require because they are in most cases mandated to include scores of things by the state....if you purchased individually a policy with things that you felt were necessary and didn't expect an insurance policy to pay for every little bit of medical attention as well as anything that could somehow be construed as medical care(botox, viagara) you'd be far better off and you'd have far more freedom to "shop" for what is best for your particular situation...

in my opinion far too many people now assume that healhcare as well as insurance and medical services are just something that someone else should be paying for, providing and taking care of all of the nasty paperwork so that they may use it at will...


when I say "you"...I'm not saying..you Salty...just you...anyone you..

Stop the frivolous lawsuits, and give actual US citizens matching funds dollar for dollar that they put away in a tax free Health savings plan. and also along the same standards as EIC, give lower income families a 5,000 tax credit each year for their health savings account, then each family only pay for a low cost catastrophic plan to cover the major crisis like cancer.

Many doctor visits and hospital visits are up to 40% cheaper if you pay cash, with these accounts they could pay up front for additional saving..

This simple plan would work and cost way less than the public option.

Of course this health savings account cannot be used for anything not medically related.

So you want to give poor people 5000 cash?

-spence

How come in the US we pay 6000-10000 for a stent, but in other countries it is like 1000-2000? There is something wrong with that. There is something wrong wrong with the health care system, when in the us an MRI cost 1200, but in Japan it is only 98 bucks. We are subsidizing everyone.


http://www.pbs.org/wgbh/pages/frontl...s/ikegami.html

$5,000 instead of earned income credit, deposited directly into their Health Saving Account, that can be accessed only via an ATM like card that is valid only at medical facilities.

Interesting read on that link, thanks for posting it.

I think one of the huge reasons for that is in Japan, it is almost impossible to sue a doctor or medical facility. A doctor may get charged with negligent homicide on cases where his intentions were to cause harm, but otherwise it isn't going to happen.

They believe doctors are trying to help you, not hurt you, so if an occasional accident does happen it is not held against them,, kind of like a Good Samaritan's law.

Mass Commonweatlh Care won't pay. Mass has some of the highest premiums in the nation and some of the highest paid exec in the health ins..

Jim, did you folks get ins. in FL or RI

Tort Reform. my wife obgyn pays 600K are year for insurance.

How's this for ironic, Comm. Care is managed by a NJ company. What a stupid state I live in

The Healing of America
 

Interesting writeup

http://www.nytimes.com/2009/09/13/op...stof.html?_r=1

See it anytime you go to the E-Room and wait

:agree: good read. Some things we could incorporate in our system.
I like the fact that while their government pays 1/4 of insurance premiums based on income, employers and employees pay the rest with the max $6000/yr.

However, workers have a 30% co-pay for treatment and drugs which is the highest in the world.

From reading other articles i saw where Doctors see about 100-150 patients a day and spend about 3 Min's per patient and make
$100-$150,000/year depending on wether they work in a hospital or clinic I can't see why anyone would want to put in the extra 6 years in time and $$$
to become a doctor to make make $150,000 a year.
Then pay all kinds of overhead and insurance.
I read here that one of the guy's wife's pays $600,000 for OB/GYN coverage.

The best thing about Japan is Malpractice insurance is very low as there are few lawyers.

Hospitals are tight on help and there are few nurses at night.

The Prime Minister determines the price increases every 2 years.
Too much power, IMHO. :(

While they go to the doctor something like 4x more than we do, it's mostly minor stuff that a general practitioner can treat. They are a much healthier people
with 3% obese vs 30% in USA.

I remember when CAT scanners first came out here. The state limited them to 6
hospitals in the state because of cost. Same with the MRI's. Talk about waiting lists.
Anytime you get the government involved things get backed up, and messed up.

My girlfriend is in school to become a Physician's Assistant. The "Assistant" term is misleading, in that a PA can do almost as much as an M.D., and significantly more than a Nurse Practitioner. Graduates from her college last year had a *minimum* pay of $88,000 - one person who moved to work a Montana ER started at $110,000.

Their malpractice insurance is also significantly less that an Doc's. It will get to the point where people will say "Why am I going to go to school for 9 years, when I can be come a PA in 5 1/2 to make a similar amount?"

With regards to the OB/GYN malpractice being so high, an ob/gyn doctor is on the hook to be sued for an incident until that child becomes 18. All other doctors, cases must be filed within 3 or 4 years (not sure the exact number), but if a parent has even the slightest proof that their child *might* have suffered brain damage during birth, they can sue the doctor even if the child is 17 years old. Tell me that's not a joke.

That's because most 12-16 year olds "Appear" to be brain-damaged....it takes to the age of 18 before you can actually verify medical proof of the condition :hihi: (and that's still debatable)

It's a joke for sure JD, and the fact that a person can sue on a contingency basis
without putting out their own $$$ is another joke.

I know a story of doctor being sued (and lost) because he referred a patient to a brain surgeon and the person decided not to go. The patient had a brain tumor as shown with an MRI, and a biopsy needed to be done so that they could evaluate the next step. Patient didn't go, doc referred again, patient didn't go. Two or three months later the person dies and the family sued the doctor for negligence. Received millions.

Of course, we can disregard my suggestion in another thread that insurance IS the problem, and that paying out of pocket would solve that problem. Naturally, that is and old-fashioned concept and is not relevant to the modern world.

Perhaps, you might reframe your question. Instead of what regulations SHOULD the government enforce, might we instead ask what should the government DEREGULATE. Tort reform has been mentioned (damned good point that gets not even a tweak of a response). Instead of federally and by state restricting choices, ALLOW competition between private ins. cos.(not the false competition of privately run by profit versus government run by taxes, debt, and printing money). Insist that people should be AT LEAST as interested and involved in, and ready to pay for their health as they are in paying for TVs, cars, food, clothes, entertainment, education. . .

If you want private ins. cos. to exist, you must let them make the profit they desire. They are looking to make the best return on their investments. And if you restrict that, they can invest elsewhere. If bottom-line profits are so objectionable, then, by all means, let's have the public option. The beauty of that is that it will halt the booming progression of products that extend life. Research will wither for lack of profit motive. Existing drugs will eventually lose proprietary rights, falling into the public domain and be strictly produced for government distribution, many becoming obsolete as resistant biological strains develop. Life span will shrink, solving much of our social security, medicare, and health care costs. Population growth will halt, solving overpopulation, which will solve the global warming problem through decreased use of carbon. The terrorists will not think it worthwile to destroy such a diminished state, besides they won't have enough money due to falling oil sales. And people will finally see the necessity and greatness of an all-powerful, benevolent government and NEVER vote Republican again. UTOPIA!!!

the way that his question is phrased indicates that he is oblivious to any problems existing in healthcare that are not somehow the fault of the private sector, it's evil ceo's and it's management and the delivery of these services, no indication or admission that government's role in healthcare through legislation has led to the exploding costs, just the suggestion that the only way to "make it better" is for government to attach more leaches to the private sector in the form of harsh regulation, his examples regarding what's wrong are simplistic and inaccurate as usual...this is the fundamental reason for the huge impass with healthcare reform, the left is of the mind that the only way to "fix" healthcare is with massive government regulation, take over, dictates and control, unfortunately, they fail to recognize that the other programs currently run by government that you can look to as models of failure are what in fact are currently bankrupting the system, "the socialists(and their programmes) are running out of other peoples money" as Thatcher and Buck indicate and the typical solution from the left is for government to envelop a private sector entity and feed off of it's flesh for a while, until it collapses and dies and then government will move onto another victim (source of cash).....the necessary fixes for healthcare require government to get out of healthcare and reduce the regulatory demands that are put on the system and burden it with over regulation and let competition in the market reduce overall costs...just as with the housing crisis, it is government inserting itself into the system and dictating to the service providers what must and must not be done, or else..that leads to disaster...but a disaster that benefits the BIG government types because it gives them the excuse to insert themselves further of take over and run things themselves..

I saw some poll figures yesterday:

Doctors are against the current proposed HC plan 2 to 1.

45% of Doctors said they would retire if the plan went through.

Where are all these Doc's coming from to handle another 20-50 million people
under this new plan?
The wait to see a specialist is long enough now.
My family had 2 occasions within the last 6 months to need specialists.
It was a 6 week wait to see a neurologist and 4 weeks to see a gastroenterologist. Then another 3 or so weeks to get the tests and wait for the results.
It's like 7 -9 weeks before you know what's wrong.
Imagine what it would be if HC passed.

RIIIIGGGHHHTT... :smash:
and 2 out of 3 dentists say...

I agree there are issues, but a line like that begs for a follow up..

Did they only interview doctors over 60?
I can't imagine the doctor who is 45, experienced, finally set-up and comfortable with a career, maybe has his loans paid off, to suddenly retire... right...

it's not just the "providing" of health insurance for everyone, you have to consider that once you begin providing it you have little control over how much the providees will use it, compounding the problem that you mention above...when you are getting something from the government or your employer that you think is your entitlement, you really have no reason not to overuse it, after all, you deserve it, don't you?

I can only tell you what the poll said.
Having said that even if it was only the over 60's, that were fed up and retired, there still wouldn't be enough Docs to fill the breech.

yep, Rock, it was probably like that CNN poll of Obama's speech where they polled 45% democrats and 16% republicans to find out what percentage of Americans were swayed by the messiah's words...

I know several young doctors that have closed their practices because they were tired of dealing with paperwork, insurance and regulatory nightmares....particularly related to medicare and the restrictions put on them...some just work for various clinics now and one volunteered at the VA for a while but found he spent most of his time filling out paperwork instead of doctoring...

Yup, that's why the people in Japan go to the Doc 4 times more than Americans.

Yes, having worked in the medical field and still having contact
with a few physicians, i know how they feel about medicine now,
let alone what it may become.
Many are going into ER Medicine because there are set hours and they
don't have the headaches of overhead and paper work.

I find it interesting that the Japanese make HC "more affordable" by having a government version of "out of pocket" payment (Charge what payer can afford or go out of business). The gov. is a proxy representative of all the individual payers and insurance companies (of which there are many) and states this is what we can afford to pay. Accept it, or go out of business. What a concept!

As for Japan's best-in-world macro health indicators (infant mortality and longevity), it is demonstrably because of their lifestyle, homegeneous culture and lack of immigration problems, etc., NOT because of health care. Their need of health care is less pressing than U.S. citizens who are rather careless, in general, about their health, and who are a far more diverse, uncontrolled population. But survival rates of those undergoing U.S. medical procedures is tops.

Ikegami favors socialistic over market approach to HC only because, in his opinion, HC is a life and death situation. Actually, most HC is not, and what is could be covered by various private ins. cos.--catastrophic, health savings, etc.

Amazing that only 70% of Japanese favor the universal package--80% of US are happy with what they have.

LOL, just reminded me of my Mother-in-law. About 20 years ago the government
was handing out cheese every month to senior citizens.

She had a decent income and needed cheese like she needed a hole in the head.
But every month she would line up with the others and brag she got her "free" Cheese. :hihi:

Little did she know, she and i were paying for it with our taxes. :(

Ya get nothin for nothin. :doh:

What first hit me as curious about this story was the sketchy account of Nikki having a job with health insurance and while on that job discovering she had lupus, then getting progressively sicker until she could no longer work, thereby losing her insurance. If, as stated, lupus can be controlled under a doctor's care, why wasn't that done while she was still employed with insurance?

Then, even more curious, because she couldn't re-acquire insurance because of the pre-existing condition, it was lack of insurance that caused her to die--NOT LACK OF MEDICAL ATTENTION. How about a little pro bono docs/hospitals. You do it all the time for others. Here's a young woman with a life threatening condition and you can't even offer her a cut-rate price (as is often done for uninsured in "insurance situations") and let her make monthly payments. Those might still be high, but there are, at least ways to make them--live at home, drive a used car, eat in, get financial help from parents, she doesn't have to "qualify" for those. And if you help her, she can be healthy enough to work and make the payments. But, no, it all must be INSURANCE, private, government, universal . . . we must all lower our quality of life so that some few can maintain theirs. That's an insult to people like Jimmy's parents.

I have a dear friend that lives just down the street from me...he has been a sole proprietor of a small modest business in Newprort for about 25 years and is in his early 60's, he did not have health insurance several years back when he discovered that he had non- Hodgkins lymphoma, he has received at least two rounds of treatments since and it may be three, the treatments caused degredation of his lower spine and nerve problems resulting in severe neuropathy requiring fusion, he was bed ridden for most of the early part of the year and since reovered only to the point that he can barely get around on his own, his galbladder quit on him late Sunday night and he's been in the hospital since having it removed on Sunday/Monday am and recovering...my point to all of this is that he had/ has no health insurance....he should have had at least purchased a major medical policy but for some reason chose not to, he is not wealthy and despite all of this he has never been refused treatment, he has not lost his house nor his business and is not in danger of doing so, there are a remarkable number of charitable organizations and foundations available to help with expenses for these situations, he has no family but has had help from friends with recovery and day to day activities...if you believe the rhetoric coming from the proponents of this so called reform my friend should be bankrupt, on the street having lost his home and business but it is simply not the case...it's simply scare tactics designed to create an atmosphere that will allow them to massively expand government and it's control and direction of the lives of individual Americans on a daily basis and has nothing to do with compassion... it's socialism....and it's the wrong way for America

this just in...
September 17, 2009
Gee - only a week later we learn Obama was wrong about insurance sob story
Rick Moran
He stood in the well of the House a week ago, looked right into the camera at the American people and lied.

No, not that lie. Not the laughable notion that illegals will be unable to buy into Obamacare. This is a lie where he indicted the entire US healthcare system by claiming someone died because private insurance companies are too greedy.

Jonathan Weisman of the Wall Street Journal has uncovered the real story of what happened to the man Obama claimed was dropped by his insurance company during chemo treatment because of an unreported gallstone:


President Barack Obama, seeking to make a case for health-insurance regulation, told a poignant story to a joint session of Congress last week. An Illinois man getting chemotherapy was dropped from his insurance plan when his insurer discovered an unreported gallstone the patient hadn't known about. "They delayed his treatment, and he died because of it," the president said in the nationally televised address.

In fact, the man, Otto S. Raddatz, didn't die because the insurance company rescinded his coverage once he became ill, an act known as recission. The efforts of his sister and the office of Illinois Attorney General Lisa Madigan got Mr. Raddatz's policy reinstated within three weeks of his April 2005 rescission and secured a life-extending stem-cell transplant for him. Mr. Raddatz died this year, nearly four years after the insurance showdown.

Obama aides say the president got the essence of the story correct. Mr. Raddatz was dropped from his insurance plan weeks before a scheduled stem-cell transplant.


No, the president did most assuredly NOT get the "essence" of the story correct. In fact, he got the essence wrong - completely.

The "essence" of the story is that the patient died because his treatment was delayed by greedy, heartless, insurance companies. Any boob knows that the point Obama was trying to make was that the patient's death was directly the result of insurance company actions.

But the patient's sister testified before Congress:


The patient's sister, Peggy M. Raddatz, testified before the House Energy and Commerce oversight subcommittee June 16 that her brother ultimately received treatment that "extended his life approximately three years." Nowhere in the hearing did she say her brother died because of the delay. Ms. Raddatz didn't return calls seeking comment.

[QUOTE=justplugit;712156]LOL, just reminded me of my Mother-in-law. About 20 years ago the government
was handing out cheese every month to senior citizens.

She had a decent income and needed cheese like she needed a hole in the head.
But every month she would line up with the others and brag she got her "free" Cheese. :hihi:

Little did she know, she and i were paying for it with our taxes. :(

Ya get nothin for nothin. :doh:[/QUOT]

We subsidize the dairy industry in case there is a problem with cows getting sick or producing bad milk in one area of the country, they can quarantine or destroy them and the country can still have milk from other parts. Milk is a necessity for children, the subsidies insure that we always have a safe milk source.