Support The Unexplained Health Care Plan

frank, you cannot be serious. I know people on Medicare, and they don't get the best of health care by any means. They often do not have a choice in doctors or treatment, and I've seen reports of providers charging Medicare for treatment not received. Medicare doesn't have a means to deal with that kind of thing, so the person reporting the problem gives up. (http://hamptonroads.com/2008/07/medicare-complaints-draw-little-response-officials)

I've experience sciatic nerve pain, although it was short-lived (pregnancy-related), so I know your pain. I don't see how you would have gotten anything different by expanding Medicare to serve everyone. Why didn't you ask your PCP to refer you to another orthopedist to get a second opinion on your treatment options? Perhaps you'd have gotten a prescription for your inversion table and not have had to pay it all out of pocket? (Of course, I don't know your insurance plan, so that's just a guess.)

We get our health coverage through my husband's employer, and they stopped requiring a referral from your primary doctor. Even when they did, we just called the doctor and got a referral without seeing him. For example, I needed a dermatologist for a mole that suddenly appeared a few years ago, called the doctor, told him who I wanted to be referred to, and he faxed that info to the insurance company. A little bit of a pain in the butt, but that's the way it worked with my primary care doc. He didn't want to have patients jamming his busy schedule when it was obvious what kind of specialist we needed. (MDs don't typically deal with suspicious moles.)

Perhaps you should make a request to your employer that you drop the requirement for a referral, to save paying multiple bills? It might mean your company's costs go down? I find that it never hurts to ask, the worst you can hear is no. I don't want a government-run health care system, though. Having known many people with experience with government health plans (I lived in France, knew a bunch of foreigners, spent some time in Norway), I'm quite apprehensive that people who refrained from seeing doctors unnecessarily will increase, thus putting undue strain on the system, perhaps keeping people who have a more urgent need from being seen?

When I was in college, the infirmary was free to all students. So, my friends and I went for every silly thing, whether we really felt we needed to go or not. Want a pass for missing the exam you weren't prepared for? Go to the infirmary with a made-up illness for a doctor's excuse and put off the test by a couple of days. We cost our school every time we pulled that crap, probably slightly increasing tuition every time. Did we think about that or even care? No. Can I foresee that happening with a system where medical care is seen as a free thing? I think I can.

Ms. Bug,
Thank you for your reasoned post. I did try many of the things you suggested to no avail. I no longer have an employer as my plant closed last fall. In January, we were told that we were sold out for the year, just as we had been for 17 of the 18 years I worked there. Four months later, they announced the plant closure. We only had one competitor within 800 miles, but there was over capacity within the industry and my company closed our plant and the competitor likewise closed a plant in another market where they competed. I was fortunate to be able to retain my insurance by taking early retirement, though it now costs me a couple thousand per year.

My point is that even though I have what is considered excellent coverage, I seldom get very much for my and my former company's money.

I certainly am no expert on Medicare, but from what I've been told, its limitations are its deficiency. Those that I talk to say that they have to buy supplemental insurance to cover these limitations. So what I'm talking about is a Medicare with the same coverage as private insurance competing with private insurance. I believe that Medicare's overhead is much less than insurance companies and with no profit margin and no executive compensation in the hundreds of millions, costs could be comparable or less. Hopefully, Medicare would also provide more preventive care, further lowering costs.

The old model of employer based coverage cannot continue. It represents a significant cost for employers to absorb while trying to compete with foreign rivals free of these costs. It is also a drag on employment. For the last twenty-five years, every job I've had has been understaffed because it is literally cheaper to pay overtime than hire additional employees because of insurance costs.

We lead the world in medical research and the quality of care available. Yet it is also the costliest with poor coverage. Compare, for example, our infant mortality rate to other industrialized countries.

It seems to me that as long as the insurance companies have no real competition, we will be stuck in ever increasing costs and ever decreasing service.

frank,
You are missing the real reason that our health care system is set up as it is. It's not the insurance companies that want you to have a whole battery of expensive and unnecessary tests. That doesn't even make sense. More tests mean the insurance companies have to pay out more in claims. No insurance company wants to do that.

The real reason all those tests and hoops have to be jumped through is to avoid malpractice lawsuits. Until that system is reformed, nothing will change. Our doctors are forced into practicing defensive medicine, covering all the bases so some ambulance chaser looking to cash in won't end up hammering them in court.

And I have to say it – Trial lawyers are one of the top campaign contributors to Democrats. The lawyers know who butters their bread.

About Medicare – Doctors lose money on Medicare patients, and make up the difference by raising the price of health care to everyone else. That causes our insurance rates to skyrocket. That's why many doctors won't even take new Medicare patients.

This country spends $2.5 trillion on health care every year. If my calculations are correct, that comes out to about $8,300 per person. That is the true cost if spread among all the citizens (socialized). Since nobody wants to pay that much for insurance, the ONLY solution to the problem is to reduce health care costs. We can start doing that by having the patient and his/her doctor make the decisions, rather than having lawyers, insurance companies, or the government making the decisions instead.

Rev,
Not only are the Dems thinking of taxing health care benefits, they are also considering a VAT tax, a consumer tax that would drive up the cost of every single thing we purchase (all to "help the little guy," of course).

There's no free lunch.

I have not heard that Obama's plan will remove the public option. That flies in the face of everything he said on the campaign trail. That was kinda the whole idea of obtaining his goal of universal coverage.

It's hard to compare our infant mortality rate with other countries because other countries define live births very differently. Some don't count babies who under a certain size, others don't count babies born before six months, etc. The U.S. counts all of them if they show any sign of life.

It's also difficult for me to believe anyone thinks bureaucratic costs and delays will lessen under government control.

It might be difficult for some people to believe. That's possible. But, so what?

If insurance companies want to get off the stock market and go totally non-profit…..then, I'm in. But they won't…and I'm not.

Don't worry, profits-protecting conservatives, there will be no public option for the masses….that wouldn't be prudent.

larry d.,
Medicare's overhead costs are 4%. For private insurance, the lowest is 12% with most over 20%.

How is that overhead figured, frank? It sounds hinky.

Rev, how can an insurance company go non-profit? This is one of the last remaining investments that may be safe to make if you plan on retiring.

I will tell you how we could save a ton of money in America and give everyone affordable health care. This will surely be unpopular but I will say it anyway.
I recently lost my mother. She was a victim of congestive heart disease. Thank goodness I was able to keep her home until she passed and she didn't have to live in a nursing home. I am currently volunteering in a local nursing home. They provided excellent service to us when my mom had to rehab from surgery as well as home hospice services. (I hope to start a "Make a Wish" type of non-profit organization for residents of this home that have non-mental dibilitating diseases. It is amazing how many patients have MS in these homes that are still functioning, they have just lost the use of thier muscles) Here is what I see as a huge waste of American cash. Out of about 120 people in this home, 10-12 are totally non-functioning human vegetables with no chance of ever recovering. They are in their 70's and 80's and just lie there moaning in pain. They cannot communicate and are being fed through a peg tube inserted in their belly. Why are we keeping these people alive? Same with the severely retarded. Why? There is no quality of life, all they do is stare at the ceiling, literally. These folks are living in constant severe pain. They are nothing but a drain on our society as well as being tortured for their entire life. We are aborting perfectly healthy babies, yet we keep people alive that would rather die with dignity. WHy? Is it because the doctors and homes are making big bucks off of these people?

King, the day I get a request from the DNC for money, for any reason, is the day that I break some laws with a reply full of profanity and invective. All they have to do is put their boy to work and he can raise untold millions of dollars.

Rev, how many years have you been on Medicare? I just finished my 11th and I have seen way too much bull going on. I have requests to them for money from hospitals and doctors for the whole period and can see a whole lot of reasons for the cost of health care in this nation in each of them.

Too much of our problem stems from the fact that the bureaucrats on state Medicare boards really know nothing about what they are controlling. They pay amounts for some things that make me sick and fail too often on others. Of course, when health care providers get only about 60% of what they ask for they just add what they missed onto the next insurance claim and the insurance companies have little choice, but to pay.

I am sure that your method will be non-profit since it will be government supplied and when has the government made a profit on anything? I think I will reserve judgement on health care till I see Obama and bunch making a profit for us at GM (Geithner Motors).

larry d.,
Overhead is the cost of running a business, including such things as salaries, building maintenance, advertising, etc. I don't know all the reasons for the disparity, but I can guess at some. Medicare doesn't spend anywhere near what the private sector pays in executive compensation. It doesn't need to maintain a division to invest premiums. It doesn't need to turn or increase a profit margin. I'm sure there are other reasons, but I can think of these three off the top of my head.

The reported overhead figure for Medicare may be lower than the average overhead of private health insurers, as Frank states. It does not follow that Medicdare is more cost effective. Medicare is funded with taxpayer dollars. Private insurance is not.

I know what overhead is, frank. In the calculations you're citing does the government count executive compensation at all? Surely, someone will be watching over.

Speaking of, does it count congressional costs–congress will surely be reviewing everything every year, which I'd guess would cost millions.

I also wonder if the calculations take into account any marketing or education costs. People will need to know how they can navigate the system.

Do the calculations take into account the cost of collecting the taxes needed for the new system? Private insurance companies surely take capitalization costs into account.

I'm sure the insurance companies count taxes in their overhead. Is that accounted for in the numbers you cite?

And finally, do the calculations take into account the fact that Medicare serves a large majority of patients who are over 65? They surely have more expensive medical costs–more tests, heart transplants, cancer treatments and such–that would drive the overhead per claim cost much higher than an insurance company that covers all ages.

In the last sentence, I meant "much lower" rather than "much higher," though that should be obvious from the context.

To the folks who think the health insurance industry should be non-profit:

In 2007, commercial health insurance companies made a 3.9% profit, down from the 4.4% profit they made in 2006.

http://findarticles.com/p/articles/mi_m0EIN/is_2007_August_14/ai_n27342953/

That doesn't seem overly greedy to me.

In addition, the insurance companies are not the ones driving the high cost of health care in this country. They just react to those escalating costs by adjusting their rates accordingly, as they must if they are to stay in business. When American health care was relatively cheap, up until the mid-1970's, we still had insurance companies.

So ridiculous.

Consider:

A) Health insurance is based on pooling large numbers of people into a kind of a socialized risk group. Money from some members go to pay for other members needs. Do conservatives agree that this is how health insurance works?

If A is correct, and it is, then the most efficient way to deal with national health care would be to include all citizens in the socialized risk group. Making the pool as large as possible, thus diluting risk, spreading it over the entire group. That suggests that single-payer, single pool, Medicare for all, would be the most cost effective.

How folks can defend for-profit health insurers, who, like frank correctly states, are inefficient and exclusive, is beyond my comprehension….but then these are the same people who defend torture, so….I guess it doesn't have to make sense.

average….My condolences on the loss of your mother. Your volunteerism is to be commended. Yes, I am for voluntary, assisted-suicide regulations for those tragic cases you mention. Like the state of Oregon has. But third trimester abortions, which are rare, are almost exclusively carried out because of extremely tragic situations…..horrible deformities, dead fetuses, incest and rape of young girls. No one in the medical business is simply exterminating babies for the helluva it. Contrary to Bill-o, abortion providers are not "death mills". They are legal clinics carrying out legal procedures in fulfilling a woman's reproductive choices.

King….you must not be serious. You said that for-profit health insurance isn't raising the cost of health care…..even though all evidence demonstrates that health insurance adds 15-25% to health care costs. Why do you support profit making in an industry that relieves suffering and misery?

And this from Quid….

"The reported overhead figure for Medicare may be lower than the average overhead of private health insurers, as Frank states. It does not follow that Medicdare is more cost effective. Medicare is funded with taxpayer dollars. Private insurance is not."

Tell me….how does the source of the revenue effect "overhead" differently? Money is money. I don't understand what you're saying. It would be like saying roads repaired with tax dollars are not repaired efficiently because it's tax dollars being used to do the repair. Makes no sense to me. But, you know, I'm hard headed.

larry d.,
I don't know how these figures are calculated, but they seem in line with other reports. The 15-25% the Rev cites also rings true.

My wife once worked for an independent insurance broker. They received 20% of the premiums of the policies that they sold. Can you imagine any industry employing outside contractors to sell their products and paying 20% of the gross?

And if you go back to my original post, what I am advocating is setting up competition between the public and private sector. According to conservative economic theory, the market will determine which provides better, more cost effective service.

Of course, this discussion is all academic. The insurance companies like the status quo. Their generous campaign contributions to both parties insure that "reform" will be limited to indirect subsidies to the insurance companies, preserving or expanding their profits. We have a government of the money, by the money, and for the money.

If you don't know whether it is accurate and don't think it's important enough to check it out, why parrot the talking point?

Obama being a gay cabdriver-loving crackhead Muslim terrorist rings true to some folks, too.

larryd.,
I believe it is accurate. I lack the details as to how it was calculated as you requested, but I still believe it is accurate.

So you no longer believe that Obama is a gay cabdriver-loving crackhead Muslim terrorist, but you believe he was drunkenly leering the Broadway starlets the other night?

Frank – You are probably pretty close with those percentages. I have seen some financial products sell at 12% or points. Especially in the Auto industry. The american auto industry has about 10 -12% commissions and dealers pack(fees for advertising floorplan etc) in their cars and trucks. There are many products on the internet with profits as high as 60%.

Oh he was leering the starlets. The white ones especially. That's why Oprah and Michelle are so pissed. By the way did any of you read that in 2000 or so Obama and Michelle were having marital problems? It's in a new book. Isn't that around the time of …..you know, the cab driver incident. This proves positive that something was going on and it smells like gay crackhead to me.

Rev,
The first problem with your analysis is, neither Obama nor Congress are proposing single-payer nationalized health care, so that is not an option at this point.

Second, by bring torture into a discussion about health care, you make yourself appear to be a loon.

Third, if we remove profit from health care, do you suppose that will increase or decrease the number of people who go into health care ? I'm 100% positive that would reduce both the number of health care workers and the level of health care we receive.

And if we're going to remove profit, why single out health care ? Let's remove the profit from everything, so all goods and services will be cheaper. Of course, we'd no longer have all those goods and services without the profit motive, but at least we'd feel good about ourselves.

If you want to get rid of insurance companies, go ahead and make that argument. You really aren't making that argument. You just want to replace all the private insurance companies with one enormous public insurance company, the U.S. federal government (the most fiscally irresponsible institution on the entire planet). I don't see a big advantage there, and judging by England and Canada, I see huge potential disadvantages. Why don't we just open up the competition of the private insurance companies nationwide instead, rather than the state-to-state restrictions we have now ?

It's so funny. King doesn't want single payer because government can't run anything efficiently. Look around. Aren't there a bunch of bailed out private corporations lying around that trough? Real efficient, they were.

Non-profit, single payer, government run, health provider.

A competing public OPTION is what Obama promised. I ain't holding my breath.

Health care employment doesn't rely on profits. Doctors, nurses, and all the rest are not dependent on corporate profits to continue working in the field. A strictly non-profit health care system wouldn't affect doctors and the like, at all. It would affect those capitalistic parasites in health insurance corporate offices and at home counting their dividend money and watching the ticker.

Once again. Health insurance corporations play no positive role in health care. They are parasitical. They profit from the suffering of Americans, many who can't really afford their parasitical "product." A Christian nation, it would seem, would understand this.

So what kind of commission does a personal injury lawyer get?

"Doctors, nurses, and all the rest are not dependent on corporate profits to continue working in the field."

I once visited England a while back and stayed with friends of my father. The guy was a surgeon at a large hospital in London, his wife was a mid-wife. They lived in a 1100-square foot townhouse and shared a Ford Festiva.

You're right, I guess, Reverend. They are still working in the field.

"Doctors, nurses, and all the rest are not dependent on corporate profits to continue working in the field"

On what planet is that true ? Not this one. Doctors are among our most highly paid citizens, so I think profit is motivating them pretty strongly. If doctors, nurses, and the rest were all getting minimum wage, you think that would have no impact on the number of doctors and nurses ? Obviously, money is a motivating factor.

"Health insurance corporations play no positive role in health care."

Tell me that again after you get seriously ill and the insurance company forks over hundreds of thousands of dollars for your care, instead of it all coming out of your own pocket and sending you to the poorhouse. Health insurance, like ALL insurance, exists to lessen risk and provide a safety net. It's also voluntary. You can choose not to have it, but I wouldn't recommend that.

You still believe in "free stuff," don't you ? The health care fairy.

Doesn't health insurance work on the premise that everyone pays a little into a big pot? How will it be cheaper for taxpayers when only 40 percent are contributing to the pot?

King, your mention of the kind of money doctors make can be borne out by what an peridontist once told me. I asked him how he could stand to work in ugly sites like human mouths and his reply was that I would see 800 good reasons when I paid the bill for that day. His assistant got a real laugh out of that one.

The narrowing of the spinal canal (through which the spinal cord runs), often by the overgrowth of bone caused by osteoarthritis of the spine.