Bombadillo
Ranger of the North
Alliance: Fangorn
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ILvEowyn
Ringbearer
Alliance: Servant to Galadriel
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Location: lovely Western NY
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basil
Alliance: Valinor
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Posted: Thu Oct 29, 2009 12:53 pm |
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Gandalf'sMother said:
Exactly. I'm sorry, but people and insurers in Massachusetts shouldn't have to deal with the crud coming out of Alabama.
Allowing more interstate selling of health insurance increases the chance of fraud, not just "crud".
Something Reflublicans have a lot of experience in.
Quote:
Just last month, Minnesota Attorney General Lori Swanson sued two out-of-state companies for allegedly misleading customers with phony claims about their health plans; 10 more investigations are underway, she said.
"Here, they're targeting people who are pretty sophisticated, and who really asked all the right questions," Swanson said. People believe them, she said, because they're "so desperate to find affordable coverage."
This incident, and many others like it that aren't reported in daily news stories, reveals the insidious aspects of these vapid arguments made by the radical right-wing, who often aren't aware that they're ruining their own lives and country.
Poor ignorant teabaggie sloggers. Dumb as fenceposts.
At least fenceposts have a good use.
b
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Cenedril_Gildinaur
Mariner
Alliance: Grey Havens
Last Visited: 19 Nov 2009
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Bombadillo
Ranger of the North
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Xhen
Mariner
Alliance: Saruman
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Bombadillo
Ranger of the North
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portia
Mariner
Alliance: The Shire
Last Visited: 18 Nov 2009
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Location: Lost in the forest
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Posted: Fri Oct 30, 2009 8:17 am |
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Lack of competition usually is bad for the consumer.
I live in an area with a lot of competition on health coverage, so I can't get a good idea how it would be if there were only one company (although, since we get our coverage from Mr. Portia's former employer's plan, we have to go with whatever company (ies) work with that employer.) On the other hand, that employer has a lot of clout and can keep companies from behaving too badly.
If there really is not any real competition in an area, maybe the public option is a good answer. No one would be forced to take it, I expect, and maybe a local company would want to keep the business.
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Jnyusa
Ranger of the North
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Posted: Fri Oct 30, 2009 8:33 am |
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It's really a shame that
Faramond's
questions are drowned out by the one-note vitriolic posts of our resident ideologues.
He asked awhile back how the costs would be determined under the public option, and this is indeed the thorniest issue in US health care right now, not just for the public option but for any regulation of private companies as well.
I'm not sure that those of us who are progressive are fully aware of the complexity of this problem, and the teabrain conservatives are making it impossible (once again) to address the substance of the problem.
On the surface, the problem is one of executive salaries within the insurance industry and the need for profits growth among insurance stockholders. But beneath that problem lies a different problem - the cost of the advanced technology used in treatment these days (the executive salaries and stockholder profits in those equipment industries), the cost of pharmeceutical R&D (the executive salaries and stockholder profits in those research industries), and the practice of doctors to bill by the procedure.
These underlying cost issues in health care are not addressed by any of the bills before the House and Senate, as far as I can see. Generally, our government has been extremely reluctant to regulate prices in any industry throughout its history, and it has absolutely refused since 1980 to extend its traditional regulatory purview to the new instruments created by the financial services industries (which include insurance).
I view this (recent) abdication by government to be a fairly profound problem within the economy because there are good reasons, consistent with free market practice, to involve government in price regulation of health care, and to involve government in regulation of all financial instruments. These are industries where the consumer is at a relative disadvantage, being unable to opt for ill-health or death rather than pay exhorbitant prices.
But for this to happen in the health care industry, we
are
talking about government regulation of the actuarial process and the setting of premiums and reimbursement rates for private insurers as well as under the public option.
One of the things I've seen mentioned (but don't know the details) is the idea of having costs negotiated between the government insurance program and the health care providers, rather than relying on the Medicare rates. I do think this would be a very good idea. The option that would best serve consumers ....
(and my I remind our resident ideologues that free markets are intended to operate on behalf of consumers, not on behalf of executives or stockholders)
... the option that would best serve consumers would imply the creation of an arena where costs can be negotiated directly, since the price system as such does not function when consumers cannot opt not to pay the price, and we have found (and can also prove mathematically) that direct negotiation of costs and prices are the second best solution in such cases. This is very much preferable to a government panel or committee that would set prices by fiat.
I wish very much that the one-note vitriolic ideologues who are long on snide and short on education would basically shut up, so that these very serious problems that beset out economy at this point in time could be illuminated and discussed reasonably.
I would also like to add that this is a very serious issue of productivity, affecting the future growth potential of our nation as a whole. You cannot expect a work force in poor health to perform well. You cannot expect a work force whose earnings are constantly eroded by exorbitant prices for goods necessary to the functioning of an advanced capitalized economy, like health care, transportation, energy, housing, and credit services, to perform competitively.
We talk endlessly about the right of stockholders to profits and the right of executives to massive compensation, and we talk very little about the right of workers to discretionary income. But the average schlub who is actually creating the product and services we enjoy has just as much claim to quality of life as anyone else in the economy, and WILL withdraw his participation, his motivation, his honesty, and his good will if the current robber baron trend continues.
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vison
Mariner
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Posted: Fri Oct 30, 2009 9:53 am |
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Somehow, other countries manage these negotiations. It is not impossible, but in the case of the US, it looks more and more unlikely.
The other thing is, as I have stated over and over again, what is at issue is "sick care", not "health care". As long as the agri/chemical industries are so powerful, the lifestyle diseases afflicting (and about to afflict) North Americans will continue to cost billions and billions and clog up the medical delivery systems.
Still, the truth is that for those of us lucky enough to live in Canada or most of Europe, we simply do not have to worry about health insurance. On the other hand, the costs of medical care will continue to rise as the population ages and as new drugs and treatments come on line. Those costs will rise everywhere, not just in the US.
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basil
Alliance: Valinor
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Voronwe_the_Faithful
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Cenedril_Gildinaur
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DeadRinger
Ranger of the North
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Posted: Fri Oct 30, 2009 4:59 pm |
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I actually think that the police force and the entire military should be privatised. Only those who can pay should receive protection. Why should billions of dollars of taxpayers money go to protecting people who are too lazy to pay for it? Such a waste.
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Gandalf'sMother
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Bombadillo
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Cenedril_Gildinaur
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Bombadillo
Ranger of the North
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Gandalf'sMother
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Posted: Sat Oct 31, 2009 11:52 am |
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What about a state monopoly on the legitimate use of physical force within its borders?
-GM
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Cenedril_Gildinaur
Mariner
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basil
Alliance: Valinor
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portia
Mariner
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Location: Lost in the forest
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Posted: Sun Nov 1, 2009 3:52 pm |
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There are health insurance companies around which are non-profit. This does not stop them from paying very high salaries to their executives, but the stockholders don't exist and can't press for more dividends. There are also mutual insurance companies, owned by the policyholders.
Encouraging these models in the industry would be a big help in holding down costs.
As to restraining the costs of things like equipment and pharmaceuticals, what level of cost/profit control will still encourage investors to put their money there, as opposed to somewhere else? That is a delicate issue. The regulated utility industry struggles with it all the time.
Billing by procedure is an aspect of the PPO model of health insurance, which also involves being able to choose one's own doctor and not having to delay treatment while a utilization committee decides if the treatment is "necessary." A lot of people are unwilling to give up the benefits of that model, in return for the lower cost, reduced co-pays, etc. of the HMO model. Are we willing to force that choice on them?
Negotiation of rates is, I think, crucial as more and more providers are unwilling to take patients on Medicare (to say nothing of Medicaid) because of the low rates. We can't exect to have the health care system work if large numbers of providers will not sign up.
Free markets are intended to function for the benefit of all parties--considered as groups--even if individual participants are not benefitted. Greatest good for the greatest number.
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Lord_Morningstar
Mariner
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Posted: Sun Nov 1, 2009 7:46 pm |
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Jnyusa said:
He asked awhile back how the costs would be determined under the public option, and this is indeed the thorniest issue in US health care right now, not just for the public option but for any regulation of private companies as well.
It’s an interesting question, and I don’t actually know who makes that decision in Australia.
Australian Medicare covers people for 75-100% of the cost of a pre-set fee (called an MBS fee) for each type of treatment covered. Doctors can charge above the MBS fee, in which case the patient either pays out-of-pocket or can take out private health insurance to cover it. In my experience, most basic treatments are within the MBS fee. There is an incentive to do so – doctors may bulk-bill Medicare (ie. charge Medicare directly for the cost of treating a patient by swiping their Medicare card), but if they do so then they can charge no further fee for that service. Bulk billing is most convenient for both doctor and patient as it charges the patient nothing out-of-pocket and guarantees that the doctor will get promptly paid, so they have good reason to only charge the MBS rate. The alternative is to charge the patient directly and let them claim the money back from Medicare, which is much rarer.
There are no regulations on what doctors can charge private health insurance companies as far as I know, but they need to compete with Medicare regardless. This leaves open the possibility of doctors still providing expensive, high-end treatments to patients who can afford it, or who have private health insurance willing to pay for it.
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Cenedril_Gildinaur
Mariner
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basil
Alliance: Valinor
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Posted: Mon Nov 2, 2009 6:10 am |
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Dealing with your statements is very similar to grappling in a vat of Jello.
But without the babes.
. . . and the flavoring.
b
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Cenedril_Gildinaur
Mariner
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Gandalf'sMother
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vison
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Give Bombadillo a Premiere Membership!
But, C_G, it's Manwe. 
There are no intellectuals here, and there are no intellectual discussions. There are generally only assertions and anecdotes. Anecdotes, as I have frequently commented, are not data. Assertions are opinion, by and large. Some more interesting and valuable than others.
