ONE reason for health care reform (or not)

Re: ONE reason for health care reform (or not)

PostBy: rberq On: Sun Aug 16, 2009 10:41 am

spc wrote:Are the private insurance companies allowed to do this [cherry pick] with government employees?
No. But this can be a problem with small businesses. Say a guy has a roofing business with five employees. The child of an employee gets cancer, which will boost the insurance payout way up. It's cheaper for the insurance company to drop the whole crew at renewal time. After all, it's only five employees. And what are the odds the business owner can get insurance for his crew from another insurer, except at sky-high rates, unless he fires the expensive employee? Is that how we want to encourage small businesses in this country?

The key with the government employees is, the pool of insured is large enough that the risks balance out. If the insurance company drops one group, intending to pick up another group, odds are the new group will cost just as much as the original. So cherry picking becomes impractical.
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Re: ONE reason for health care reform (or not)

PostBy: Yanche On: Sun Aug 16, 2009 11:22 am

spc wrote:
It's not government doctors it's private insurance companies!


It's not that a government plan will not work it's that the insurance companies don't want it.


Why would insurance companies not want 40 million more customers?
Clearly any insurance company would want 40 million new customers. But they want those new customers in the high profit customer pool, the small employee group or individual customers.

Here's a quote from a Federal BC/BS rep at an open enrollment session before a group of federal employee retirees. "we make most of our money from the private company plans and a lot more per person from the individual coverage plans, but since we have this network of doctors in place we might as well make some money off it even though it's not much." The complete context of the quote is my previous post, Congress’ health care bill, H.R. 3200
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Re: ONE reason for health care reform (or not)

PostBy: ErikLaurence On: Mon Aug 17, 2009 3:33 pm

The reality is we already have nationalized health care in the emergency rooms for poor people and medicare for old people. The problem is it's a really bad nationalized health care system.

We as a society don't want to see poor people dying.
ErikLaurence
 
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Re: ONE reason for health care reform (or not)

PostBy: tvb On: Mon Aug 17, 2009 5:09 pm

We as a society don't want to see poor people dying.

Unless they are democrats or murderers and then it's a good thing. Right? Because in that case, they must have deserved it.

Right?

Right?
tvb
 
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Re: ONE reason for health care reform (or not)

PostBy: tvb On: Mon Aug 17, 2009 5:15 pm

Back in 2004-2005, I experienced what I can still only call a nightmare. This is what I wrote on the day my nightmare came home.

I decided to post it here because I think many posters may not know the nightmare of getting sick without insurance. This is a diary I posted in September, 2005; it was the evening after I filed bankruptcy due to overwhelming medical bills, including a judgment for thousands of dollars.

Four years later, I still hold no regrets for doing so. It was still the days of easy credit so I was able to rebuild a credit history rather quickly and move on. Today, I am thankful that I am one of the lucky ones with excellent health insurance. Of course, the memory of what I went through is never far from my mind knowing that situations can change in a heartbeat.
What did you do today?

I filed Chapter 7 bankruptcy today.

I had been trying to avoid it but I knew there was a deadline coming. Things would be changing soon.

It was one of the biggest, saddest things I did today, this month, this year, this lifetime. When I left my attorney's office today, it felt like I had been kicked in the stomach.

It wasn't credit cards that did me in. I never really used them. I keep one for when I need to rent a car, make hotel reservations, etc. but rarely ever used it otherwise. Even when I used it to guarantee the rental or reservation, I would pay cash.

It wasn't because I was stupid and didn't pay my bills. I did.

But I got sick. Real sick...sick enough to end up in the hospital. I had no insurance and the bills were beyond my means. And the hospital sued me, and they won. The bill was more than I make in a year. Then I got sick again and spent another three days in the hospital.

I don't have medical insurance because I can't afford it. It costs about 40% of what I make. I make about $100 more per month than I can to qualify for Medicaid. My job does not offer insurance.

I have some medical issues that require drugs each month at a cost of $78. These are life-sustaining drugs. If I don't take them, I die. I should see a doctor every 6 months but I can't afford it. It is also the reason I ended up in the hospital twice. If I was able to afford private insurance, it would exclude this pre-existing medical condition.

The bankruptcy filing listed $35K or so in hospital bills. Another $2000 or so was other stuff--nothing major and out of control. The judgment on the first bill was limited to what Medicaid would have paid by the judge. The difference was enormous---thousands of dollars. They were trying to sue for retail because I didn't have insurance and which was way more than HMO and Medicaid reimbursements. That was the only bright spot...that they could not gouge me further because I am poor; the judge would not give them that amount One mistake I made is that I didn't show up with an attorney that day in court but my limited budget forced me to make a decision--I knew I would lose the judgment because I was in their facility and knew my dollars would be better spent on the bankruptcy filing. In our country, dead people can't even get out of medical bills...they will sue the estate according to my attorney.

It got bad after that judgment. My parents who live in another state started to get calls. At first I couldn't figure out why they were calling there. It turns out they got that number because she was listed as my emergency contact at the hospital. The night my mom was dying and ultimately died, a debt collector called repeatedly like it was a game. She called every twenty minutes or so. This was all by a hospital that is non-profit and receives government subsidies. In court, the attorney had with him my medical records; so much for HIPAA. I guess it only applies to those with insurance.

And finally, I gave in and decided, "Screw them". It ultimately came down to those calls to my parents and then only to my dad where they would deliberately ask for my mom. I know this because they were told by him that she had passed away months ago.

When I went over the final filing today with my attorney before it was submitted (it's all done online these days), I was both angry and amused that he knew the names and addresses of all the people I owed money to. He said it is always the same people.

I know I am not alone in what happened to me. Most bankruptcies are due to medical bills

A national health care program could put an end to thousands of bankruptcies. But big business prevails these days and allows banks and credit card issuers to make a fresh start more difficult for those who did nothing to deserve it, other than getting sick in one of the few nations in the world that does not provide medical care to their residents.

My attorney indicated he has never been busier. Gee, I wonder why?
tvb
 
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Re: ONE reason for health care reform (or not)

PostBy: billw On: Tue Aug 18, 2009 9:22 am

TVB, I've been through similar circumstances. The only thing that kept me from bankruptcy was my 401K. I withdrew money to cover my medical expenses so I didn't lose my home. I'll be able to retire about two years after I die. It was my choice to spend my retirement to keep my home so I'll deal with the consequences.

There are several things I see wrong with employer based medical insurance. First is employers aren't required to provide insurance. My youngest son works a full time job and a part time job. The company he works for full time decided last January to drop medical insurance for the workers and only provide it for management. This company isn't a Mom & Pop, it's a corporation with over 500 employees in PA. My kid has a pre-existing condition. He was refused an individual policy by two insurance carriers. In both rejection letters the insurance companies told him to get a job that provides group insurance. Gotta love the irony. I won't mention company names because of possible liability issues for the site owner but right now he can't get medical insurance at any cost. He makes to much to qualify for government assistance so he's uninsured.

The second thing is a long disability. After several months (three in my case, six is the average) you get switched to long term disability if it's offered. In my case it was a benefit I paid for out of pocket. Once that happens you are no longer an employee and you have to go on COBRA. The problem with that is my COBRA benefit cost 1,000 a month for my family. My disability benefit was 1,600 a month. Couldn't afford the premiums so we went without until my wife was able to change jobs to one that offered benefits.


If this country wants to stay on the employer based insurance standard only, then every employer should be forced to provide insurance. I'm not saying they have to foot the entire cost, no employer can do that anymore, but they should be forced to provide a group insurance plan for at least catastrophic events.

The biggest drawback to a totally employer based system is you have medical insurance when you're healthy. It disappears when you need it most. I'm really not sure why big business, other than those in the medical industry, are so against a government option. At one point GM was spending more for healthcare than they were for sheet metal. Domestic corporations are at a competitive disadvantage to companies in Europe, Australia and parts of Asia because they are saddled with healthcare costs where their competitors are not. I guess I'm not bright enough to understand the resistance. Welcome to globalization, it's going to be a wild ride.

EDIT:
Another thing I would like to see is competition in the medicare prescription drug plan. The way it was originally set up was the drug companies can charge whatever they want for their product. Why are Merck, Ely Lily, Pfizer and the rest given no bid contracts for their products? Let them compete for those sales! It will produce some serious savings running that plan. Currently competition for the medicare drug plan is off the table. Must be nice to be able to buy your way into a deal like that.
billw
 
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Re: ONE reason for health care reform (or not)

PostBy: jpete On: Tue Aug 18, 2009 5:58 pm

So why not let people deal directly with their doctors? Why does a 15 minute exam at your primary doctor "cost" $100? Is it because he knows he'll only get reimbursed a fraction of that and the fraction is the "real" cost?

Let me keep the $105/week I'm currently paying, and maybe I'll get the $200/week my employer is paying and I'll buy some "major medical" insurance. Then when I go to the doctor, which is rarely, I'll take it out of my own pocket. Maybe let me invest my money with a health savings account and I can make a little money on top of what I save.

Anything besides handing over more money to a group of people who have never shown they can handle money.

Anyone who believes that the government can do anything cheaply or efficiently clearly hasn't been paying attention.
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Re: ONE reason for health care reform (or not)

PostBy: billw On: Tue Aug 18, 2009 6:33 pm

I know this isn't supposed to be a discussion but I do understand what you're saying Jpete. The government, the insurance and drug companies will never allow the end of Medicare, VA, Medicaid and private insurance. There is to much money in it. We aren't ever going to go back to the 19th century unless the entire economy collapses. And when it does having medical insurance is going to be the least of our worries.

I'm just trying to be realistic. The elderly, veterans and poor have decent medical insurance. Who is getting hammered by this are workers like my son, unemployed people who can't afford COBRA, and small business people who can't afford to buy insurance. These are the people that actually build this country and they are being locked out.

All I'm saying is there should be a method to allow anyone to buy at least catastrophic insurance irregardless of their health. I don't really care if it's a government sponsored plan, a co-op or a regulation that forces non profit insurance companies (Blue Cross) to offer basic coverage to everyone. My kid would jump at the chance to buy basic medical coverage but he can't at any price.
billw
 
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Re: ONE reason for health care reform (or not)

PostBy: jpete On: Tue Aug 18, 2009 7:12 pm

billw wrote:I know this isn't supposed to be a discussion but I do understand what you're saying Jpete. The government, the insurance and drug companies will never allow the end of Medicare, VA, Medicaid and private insurance. There is to much money in it. We aren't ever going to go back to the 19th century unless the entire economy collapses. And when it does having medical insurance is going to be the least of our worries.

I'm just trying to be realistic. The elderly, veterans and poor have decent medical insurance. Who is getting hammered by this are workers like my son, unemployed people who can't afford COBRA, and small business people who can't afford to buy insurance. These are the people that actually build this country and they are being locked out.

All I'm saying is there should be a method to allow anyone to buy at least catastrophic insurance irregardless of their health. I don't really care if it's a government sponsored plan, a co-op or a regulation that forces non profit insurance companies (Blue Cross) to offer basic coverage to everyone. My kid would jump at the chance to buy basic medical coverage but he can't at any price.


I feel for your son. I've done the deal of spending most of my money on COBRA and going without because I couldn't afford it. And then needed it and didn't have it.

But getting government involved is NEVER the answer. If BHO was the "Change" agent he sold himself to be, this wouldn't have ever come up. But he is a false prophet. This is just a money grab grab to prop up a bankrupt Medicare system and to exert more federal control over our lives.

Sorry to say, but it's as simple as that. The government doesn't care how healthy you are or how much it costs you.
jpete
 
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Re: ONE reason for health care reform (or not)

PostBy: sterling40man On: Wed Aug 19, 2009 2:20 pm

Looks like Barney Frank got a little upset today! :lol:


http://news.yahoo.com/s/ap/20090819/ap_on_re_us/us_health_care_frank
This link is broken, either the page no longer exists or there is some other issue like a typo.
sterling40man
 
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Re: ONE reason for health care reform (or not)

PostBy: Poconoeagle On: Wed Aug 26, 2009 6:00 pm

Mike Rodgers point of view...
Poconoeagle
 
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Re: ONE reason for health care reform (or not)

PostBy: coaledsweat On: Wed Aug 26, 2009 6:28 pm

I don't know who that guy is but I'm wondering why he isn't the POTUS.
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Re: ONE reason for health care reform (or not)

PostBy: Poconoeagle On: Wed Aug 26, 2009 10:17 pm

near the motor city... Lansing Mi
http://mikerogers.house.gov/default.aspx
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Re: ONE reason for health care reform (or not)

PostBy: mikeandgerry On: Thu Aug 27, 2009 3:04 am

rberq wrote:The rules:
(1) Name ONE SPECIFIC thing that reform should include. Or, name ONE SPECIFIC thing that reform should not take away.
(2) Don’t argue or agree with what the last poster said. Just make your own SINGLE, SPECIFIC point.
(3) It’s OK to say “Everything is great now, no reform is needed.”


My one thing: Eliminate the public and third party payment systems. They are the root of the problem. To do that:

Everyone must buy their own health insurance/health savings accounts using 17% of their income (that is the current cost of health care in the US) regardless of income size. Everyone must be informed of expected costs and be invoiced directly. The government would mandate that individual proof of insurance is to be filed each year. The 17% is a starting point for health costs. As costs go up or down as accounted for by the federal government, so too will the required contributions for insurance and MSA's.

Employers are prohibited from providing health insurance coverage. No public insurance of any kind would be legal. Only private insurance coverage, subject to federal regulation, would be legal. Consumers could choose between luxury, standard or catastrophic-only packages. The excess of the 17% of income over policy cost must be placed in an MSA. All premiums, health care expenses, and contributions to MSA's are to be tax deductible or tax deferred.

No individual could be awarded more than their economic lifetime earnings value prorated to their life expectancy in a malpractice suit. Awards for pain and suffering are limited to 50% of the prorated expected lifetime earnings. The individual lifetime aggregate of all awards will be capped at $3,000,000 (indexed). All awards will be structured. There will be no punitive damages awarded. Culpable doctors, technicians and corporations who have an inordinate number of suits filed against them will lose their licenses.

The unemployed/indigent children/disabled/indigent retired will be covered by private insurance companies who will assess a premium on all policies as a reserve for the coverage of the unemployed/disabled/children as mandated by law. There will be no exclusions of pre- existing conditions and such risks will be pooled by the insurance companies. Policies will be non cancellable. Policies will be ratable for criminally high risk or illicit behavior.

No coverage for illegal immigrants or aliens.

Bear in mind that the government has every constitutional right to regulate commerce but no right to destroy private enterprise or create public individual health care in the name of "the general welfare".
mikeandgerry
 
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Re: ONE reason for health care reform (or not)

PostBy: franco b On: Fri Aug 28, 2009 9:30 pm

Yanche wrote:
franco b wrote:Whatever happens I want to see all government employees covered the same as everyone else. No special health plans for congressmen.
I already described the existing Congressional Health Plan. See my post in another health care thread. See: Congress’ health care bill, H.R. 3200
It's apparently to much trouble to download the pdf file that describes it. It's much easier for the wingnuts to just run their mouth, err. I mean their typing fingers. If you like links instead here's one: http://www.heritage.org/research/report ... ealth-plan
The government run plan does work and has been working for years. It's the same one almost all federal government employees and retirees have. Stop bitching and look at the plan. It's not government doctors it's private insurance companies! Make a cost vs. benefit to what you have. As I posted previously what's not known, but likely could be found with some research or a freedom of information request the governments contribution to premiums. That cost would be what a non-government person would have to contribute some how, either by their employer or directly. It's not that a government plan will not work it's that the insurance companies don't want it.


It's apparently too much trouble to use a little logic instead of name calling. The quote you referred to was not in any way judgmental as to the merits of the health plan offered to government employees. The point it was intended to make was that if government employees were included in the same plan as the public at large, then that plan would have a greater chance of being something worthwhile.

Richard
franco b
 
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