quote:Originally posted by fugu13: Also, the comment about everyone needing health care applies quite well to numerous other things we don't expect the government to provide directly for everyone. Such as food and shelter.
Those are very poor analogies for several reasons.
First off, while everyone needs food and shelter, no one need a 5000 sqft house or $30/lb filet mignon. In developed countries, the fraction of the food and housing market that goes to meet basic human needs is relatively small so the market forces of supply and demand can work reasonably well. The same is can not be said of health care. With very few exceptions, health care is not a luxury and the difference between expensive treatments and inexpensive treatments is not a matter of aesthetics. While many people choose to go without preventative health care, there are long term consequences to those choices that can have severe impact on the persons length and quality of life as well as the over all cost of health care for the community.
Second, as a community (through the government) we do have programs like food stamps, housing vouchers, homeless shelters, food kitchens to make sure that every person has their basic food and housing needs met. We don't expect that the community pay for those who want huge houses or gourmet meals, but we do pay to make sure everyone has access to the basics.
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quote:Originally posted by fugu13: Also, the comment about everyone needing health care applies quite well to numerous other things we don't expect the government to provide directly for everyone. Such as food and shelter.
Not really.
quote:The moral-hazard argument makes sense, however, only if we consume health care in the same way that we consume other consumer goods, and to economists like Nyman this assumption is plainly absurd. We go to the doctor grudgingly, only because we’re sick. “Moral hazard is overblown,” the Princeton economist Uwe Reinhardt says. “You always hear that the demand for health care is unlimited. This is just not true. People who are very well insured, who are very rich, do you see them check into the hospital because it’s free? Do people really like to go to the doctor? Do they check into the hospital instead of playing golf?” For that matter, when you have to pay for your own health care, does your consumption really become more efficient?
heath care is very very different from food and shelter.
posted
There has been little substance in any of Obama's promises. He's going to give everyone healthcare, create green jobs for all, save the environment, end the war and bring peace and harmony to the world. He's still in campaign mode. He's had the most prime time conferences of any president in the same period and people are beginning to see through the empty promises. "Change you can believe in"....what does that mean? Anything you want it to. The problem is reality is sinking in accross the country and more and more people are losing "Hope" in his empty promises. We didn't elect an accomplished leader, we elected a community organizer. Community organizers almost always fail to improve their communities but are effective at rallying support for their own economic and political power. One only needs to look to South Side Chicago to see our president's accomplishments as a community organizer.
Maybe it'll help hone down your general statements a little. I mean, really?
quote:"...create green jobs for all, save the environment, end the war and bring peace and harmony to the world."
No wonder you don't like him so much. You seem to think he's promised to save the world single-handily.
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quote:Originally posted by fugu13: Also, the comment about everyone needing health care applies quite well to numerous other things we don't expect the government to provide directly for everyone. Such as food and shelter.
Those are very poor analogies for several reasons.
First off, while everyone needs food and shelter, no one need a 5000 sqft house or $30/lb filet mignon. In developed countries, the fraction of the food and housing market that goes to meet basic human needs is relatively small so the market forces of supply and demand can work reasonably well. The same is can not be said of health care. With very few exceptions, health care is not a luxury and the difference between expensive treatments and inexpensive treatments is not a matter of aesthetics. While many people choose to go without preventative health care, there are long term consequences to those choices that can have severe impact on the persons length and quality of life as well as the over all cost of health care for the community.
Second, as a community (through the government) we do have programs like food stamps, housing vouchers, homeless shelters, food kitchens to make sure that every person has their basic food and housing needs met. We don't expect that the community pay for those who want huge houses or gourmet meals, but we do pay to make sure everyone has access to the basics.
I agree with your first point. Your second point doesn't really go against the analogy, and, in any case, fugu has said he is for subsidies- my understanding is that stamps and vouchers are instances of such.
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If he didn't have to go through Congress to achieve those aims, I imagine he would have already done it all by now.
I only blame Obama for part of what I think should have been done by now and hasn't been. I blame another small part on Democrats not being able to get their act together. But mostly I blame obstructionist Republicans who are more concerned with political positioning than with the actual welfare of the nation.
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quote:Originally posted by fugu13: I'm not sure where I see an objection in there. All that means is that if someone can't afford health insurance without assistance, we should make sure they can afford it. A subsidy I have repeatedly come out in favor of. Where in what you said is anything that would make a private health insurance market not a reasonable (and even desirable) method of making sure people have access to care?
The fact that the market insurance model works for car insurance doesn't imply that it will work in other dissimilar markets. It doesn't imply that it won't work, but that's hardly an argument for doing it.
The best way to evaluate proposed health care reforms is to compare the effects of similar reforms on the health care systems of other countries, not to compare the proposed reforms to unrelated industries.
quote:Originally posted by SenojRetep: However, you are still able to exercise some degree of control. Making good health decisions doesn't eliminate the possibility of finding oneself liable for health-care costs, but it makes it much more unlikely. You can't get to zero (like with driving), but you can get closer. I think the tension between holding people responsible for their poor health decisions and recognizing that some illness is unavoidable is a worthwhile discussion to have, and one that has been notably absent from all the dialog I've seen in the current push. One of the reasons I like the Wyden-Bennett bill is because it preserves individual autonomy and responsibility to a much greater degree than do the other Democrat-sponsored bills.
I think having everyone covered is a precondition for holding that discussion. As it is now, the people least able to make responsible health choices are also the people most likely to be uninsured -- that is, the poor.
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Maybe it'll help hone down your general statements a little. I mean, really?
quote:"...create green jobs for all, save the environment, end the war and bring peace and harmony to the world."
No wonder you don't like him so much. You seem to think he's promised to save the world single-handily.
Very insightful. I didn't realize he made FIVE HUNDRED promises during his campaign...wow. What I find very insightful are the 40 the site indicates he has kept: No. 15: Create a foreclosure prevention fund for homeowners - He created the "fund" but is it getting to the people? Is this new government program working to stem forclosures? No. 33: Establish a credit card bill of rights -- like this on. No. 36: Expand loan programs for small businesses --- again, created another government program. How are small businesses doing, are they opening or closing up shop? No. 40: Extend and index the 2007 Alternative Minimum Tax patch - "If you reach a certain minimum income level, you have to pay this tax regardless of your deductions and exemptions." In other words, he raised taxes. No. 58: Expand eligibility for State Children's Health Insurance Fund (SCHIP) - yep you can make 80k a year and get govt healthcare for your kids. No. 76: Expand funding to train primary care providers and public health practitioners - ok, student loan program. No. 77: Increase funding to expand community based prevention programs - not suprising a community organizer would throw money at community organizations. I'm sure they're non-partisan like ACORN. No. 88: Sign the UN Convention on the Rights of Persons with Disabilities - ok, I'm sure disabled children in China will be safe now. No. 125: Direct military leaders to end war in Iraq - On "my first day in office, I would give the military a new mission: ending this war" BO - I'm quite sure the objective of any war is to end it by winning. We're still there, good thing he restated the end objective of war is to end the war. No. 134: Send two additional brigades to Afghanistan - Fitting, expand another war. No. 174: Give a speech at a major Islamic forum in the first 100 days of his administration - Did a lot of good. I can sure tell Iran likes us now but you can't blame a guy for trying...speeches are all he knows. No. 222: Grant Americans unrestricted rights to visit family and send money to Cuba - Lets help out our communist comrades to the south. No. 224: Restore funding for the Byrne Justice Assistance Grant (Byrne/JAG) program - Economic stimulus money for crime prevention programs. No. 225: Establish an Energy Partnership for the Americas - Ok, uh we have a free market but I'm sure we're going to convince Venezuala to stop drilling for oil and put up wind turbines. No. 239: Release presidential records - He reduced the timeframe for record releases of OUTGOING presidents. Gives him more ammo to continue blaming Bush. No. 241: Require new hires to sign a form affirming their hiring was not due to political affiliation or contributions. - Uh, ok, unless you're a white house Czar. No. 278: Remove more brush, small trees and vegetation that fuel wildfires - great idea, maybe California will stop burning if the environmentalists don't challenge in court...wait, they already have. Go delta smelt. No. 290: Push for enactment of Matthew Shepard Act, which expands hate crime law to include sexual orientation and other factors - If you commit a crime make sure it's against a white christian male or you'll get the book thrown at you. No. 307: Create a White House Office on Urban Policy - Community organizing the inner city from the white house. No. 327: Support increased funding for the NEA - Funny, the White house was in a conference call with the Non-partisan NEA recently calling on them to create art to push the president's policies. Wow, propoganda at work. Isn't that a tax exempt violation of law? http://www.washingtontimes.com/weblogs/watercooler/2009/aug/27/art-obamas-sake-nea-pushes-white-house-agenda/ No. 332: Add another Space Shuttle flight - One more flight before the shuttle is cancelled. I'm sure this will stimulate the economy. No. 334: Use the private sector to improve spaceflight - Wasteful programs like this should be private sector...the government should only run healthcare, autos, banks and energy. No. 345: Enhance earth mapping - Ok, whatever. No. 346: Appoint an assistant to the president for science and technology policy - Another Czar Holdren.. Great Guy http://www.foxnews.com/politics/2009/07/21/obamas-science-czar-considered-forced-abortions-sterilization-population-growth/ No. 356: Establish special crime programs for the New Orleans area - Throw more money at the epitome of Liberal power failures, maybe Detroit and South Side Chi Town will get some help...Blemish on the record of Democratic power. No. 359: Rebuild schools in New Orleans No. 371: Fund a major expansion of AmeriCorps - Brown Shirts No. 391: Appoint the nation's first Chief Technology Officer - Yeah, an IT Czar...didn't they consider this: http://www.computerworld.com/s/article/9137294/Bill_giving_Obama_power_to_shut_Web_takes_on_new_tone I know, from right wing Computer World magazine. No. 411: Work to overturn Ledbetter vs. Goodyear - I thought we had a separation of powers? The president is working to overturn the Supreme Court? Wow, what a great guy. No. 421: Appoint an American Indian policy adviser - Indian Czar, it's time to community organize the Native Americans. There has to be a few million votes there if we promise them gov't hand outs. No. 427: Ban lobbyist gifts to executive employees - But they can be hired by Obama. No. 452: Weatherize 1 million homes per year - (low income homes). I just replace my windows and upgraded my attic insulation, glad my tax dollars will pay for someone elses home improvements. No. 458: Invest in all types of alternative energy - Green Jobs...solar, wind and bio. No. 459: Enact tax credit for consumers for plug-in hybrid cars - Govt gives $7000 to help people buy cars they otherwise do not want. No. 480: Support high-speed rail - good idea No. 498: Provide grants to encourage energy-efficient building codes - "Give federal money to states that enact building codes the federal govt wants. Will create a competitive grant program to award those states and localities that take the first steps in implementing new building codes that prioritize energy efficiency, and provide a federal match for those states with leading-edge public benefits funds that support energy efficiency retrofits of existing buildings." States rights are undermined by federal dollars. I've seen this before....raise your drinking age and lower your speed limits or you'll lose federal funding for roads. No. 502: Get his daughters a puppy - The world is saved. He spent longer making this decision than any so far. No. 503: Appoint at least one Republican to the cabinet - Kinda reminds me of the statement, token black guy. No. 507: Extend unemployment insurance benefits and temporarily suspend taxes on these benefits - this has run out. No. 513: Reverse restrictions on stem cell research. - OK
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Before you think of replying with anything to any part of that, remember: you will be replying to Malanthrop, a man who strenuously resists correction or tact to an absurd degree.
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Getting back to subjects related to health care . . .
First, the reason I brought those particular other markets up was because of the assertion that a free market does not make much sense for health care for a particular reason -- a reason that applied to all of those markets. Come to think of it, I could also bring up the relatively free market for many kinds of health care that exists in Canada. The mentions of food and shelter were just asides.
However, some of the objections to them were not as substantial as they seem. There are many parts of health care that are more optional than is being suggested: for instance, the availability of personal trainers.
And yes, twinky, it would be good to compare this reform to existing ones. This reform would keep health insurance tied to employers, absent the small possibility a "public option" is included in the bill, that would still be intended to cover a relatively small percentage of people.
In contrast, a requirement that people obtain insurance meeting certain minimal conditions combined with subsidies for poorer people, elimination of pre-existing conditions clauses, elimination of the employer insurance subsidies, and mandatory all-group coverage when covering more than a minimal number of people would far more resemble the single payer systems in several other countries that deliver better results than the US currently does. Additionally, it would be likely to draw upon the efficiencies that we have strong evidence are created in any market with properly allocated rights, information availability, and low transaction costs.
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Please don't feed the troll. This has been a more or less interesting debate and I'd hate to see that change.
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To keep things focused, I'm just going to respond to one bit:
quote:Originally posted by fugu13: In contrast, a requirement that people obtain insurance meeting certain minimal conditions combined with subsidies for poorer people, elimination of pre-existing conditions clauses, elimination of the employer insurance subsidies, and mandatory all-group coverage when covering more than a minimal number of people would far more resemble the single payer systems in several other countries that deliver better results than the US currently does.
Has anyone actually objected to this type of reform in this thread?
Added: And when the crap did you pass my postcount? Posts: 10886 | Registered: Feb 2000
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Given that it involves private insurance companies doing all the insurance providing, I'm pretty sure all the people objecting to private insurance as a way of providing health care are objecting to that type of reform.
And it appears I passed your post count at least a year or two ago Posts: 15770 | Registered: Dec 2001
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posted
I meant to say objected specifically to this proposal, rather than a blanket objection to a bill without a public option or a bill that isn't a wholesale move to single-payer/universal health care.
I certainly agree that your proposal would be far superior to your system as it currently stands, and it seems reasonable that a comparatively incremental approach to reform would have a better chance of success than a wholesale changeover (not that the current bills contain the latter).
I'm not convinced it would stop insurance companies from dumping high risk/high load members; these people would be dumped down (or held at) the minimum coverage level rather than being cut off completely. Depending on the minimum coverage level for catastrophic or chronic care, that might not make a very big dent in health-related bankruptcies unless the proportion of people who are currently dumped due to preexisting conditions (as opposed to some other excuse) makes up the lion's share of the dumping.
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posted
Your objection can be dealt with in two ways: make the minimum required insurance level include most of the basic care options considered essential, and don't let companies price discriminate within groups. An insurance company can't kick a person down in coverage if they're required to cover the group the person is a part of at the same price for anyone who chooses to purchase.
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quote:There are many parts of health care that are more optional than is being suggested: for instance, the availability of personal trainers.
I've never even heard of a health insurance plan that covered personal trainers but that is beside the point. Optional is a loaded word. Setting a broken leg is "optional", even if it means being crippled for the rest of your life. Taking antibiotics for sepsis if optional, even if it means you die in a few days. What do you consider "optional medical care"? Are annual physicals "optional"? How about high blood pressure medication? mamograms?, anti-depressants?, well baby check ups?, immunizations? hip replacement surgery? pain killers?
Studies do in fact show that people use less health care if they have to pay for it. The problem is that it isn't luxury items they are going with out like personal trainers and cosmetic surgery. Those items make up only a miniscule fraction of health care costs. When people have to pay more for medical care, they cut back on preventative treatments that would in the long run save money system wide and result in better health outcomes. That is a large part of why the US pays twice as much as other developed countries for health care and yet has worse outcomes.
Consider for example emergency medicine. If someone is having a stroke or a heart attack, getting treatment fast is critical and can make an enormous impact on both the cost of treatment and the success of treatment. The fastest treatment comes if you call the paramedics and an ambulance. That's true even if a friend can drive you to the hospital in under a minute because ambulance patients get treated faster in emergency rooms than walk ins. But an ambulance ride costs thousands of dollars and you can't be certain it will make a difference so most people I know simply would not call 911 or an ambulance unless they had no other options.
Financial considerations do not lead people to make wiser user of medical care over the long run. Every study that has looked at it has found the same thing.
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"But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright brothers. But they also laughed at Bozo the Clown." - Carl Sagan
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That statement doesn't apply to me directly, it's obvious it applies to conservatives in general at this time, in our country.
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quote:Originally posted by fugu13: Your objection can be dealt with in two ways: make the minimum required insurance level include most of the basic care options considered essential, and don't let companies price discriminate within groups. An insurance company can't kick a person down in coverage if they're required to cover the group the person is a part of at the same price for anyone who chooses to purchase.
Given the system as it exists in the US now, if I lived there I imagine I'd consider that a satisfactory reform, if coupled with your original proposal.
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quote:Originally posted by The Rabbit: Financial considerations do not lead people to make wiser user of medical care over the long run. Every study that has looked at it has found the same thing.
^
Listen to this.
This is true. People get less-wise care, then they later incur absurd costs within a broken care system.
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quote: Has anyone actually objected to this type of reform in this thread?
Several people have stated they want single payer, which is not exactly saying they object to those ideas but single payer does make them irrelevant
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quote:Originally posted by fugu13: In contrast, a requirement that people obtain insurance meeting certain minimal conditions combined with subsidies for poorer people, elimination of pre-existing conditions clauses, elimination of the employer insurance subsidies, and mandatory all-group coverage when covering more than a minimal number of people would far more resemble the single payer systems in several other countries that deliver better results than the US currently does.
I actually would object to the elimination of the employer subsidies. You'd charge more to the people who were responsible and doing what they should have been all along. I'm all for the rest of it (again, without the conflict of interest of a government plan), but that part I find a bit insulting.
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The largest problems with our health care system are because of the employer subsidies. Because employer-subsidized health care is so much cheaper, other health care providers than the one available through your employer basically can't compete for your health care.
This means people have to switch jobs if they want to switch health care, and many people have health care plans that do not effectively meet their needs. This means that health insurance companies have very little incentive to meet the needs of insured people, and a lot of incentive to meet the needs of companies (which frequently don't line up).
Not removing subsidized employer health care is the largest factor influencing insurance companies to ignore the wishes of health consumers.
Also, it doesn't charge more to people who have been responsible in the least. If a company isn't paying a large chunk of health care dollars, those dollars go back into the compensation pot (almost certainly as salary).
Subsidies are tempting. They always sound like they're making things cheaper. But not only are they always taking money from someone else in order to make it cheaper for the subsidized person, they can restructure a market in a way that harms everyone, and they frequently do, something seen over and over again.
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quote:Originally posted by fugu13: This means people have to switch jobs if they want to switch health care, and many people have health care plans that do not effectively meet their needs.
Maybe this is the bit I don't get. What does any insurance do other than establish a cheap copay for the doctor, lower the cost of your perscriptions, and cover hospital stays? I don't think I've used enough health care or seen enough insurance plans to get why there would be a difference.
As for Dark Knight's suggestion that I'd actually get the money instead, I'm ambivilant. Sure, it's nice to get more money, but if my employer gets a better deal because they're insuring 100+ at a time, I may not get enough to make up the difference in what I get now.
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quote:Originally posted by AvidReader: I don't think I've used enough health care or seen enough insurance plans to get why there would be a difference.
Suppose you or a member of your family suffered from a malady that was expressly not covered by your insurance, or your insurer refused to pay for procedures you or your doctor felt were important, but you could not afford yourself. It could be something as simple as feeling that you need coverage for psychiatry, but not having it covered.
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quote:Originally posted by Orincoro: Suppose you or a member of your family suffered from a malady that was expressly not covered by your insurance, or your insurer refused to pay for procedures you or your doctor felt were important, but you could not afford yourself. It could be something as simple as feeling that you need coverage for psychiatry, but not having it covered.
I thought they all did that?
Let's face it, if insurers were interested in offering what the patient wanted, they'd offer supplemental packages. I've got accidental death and dismemberment, long term disability, and turned down the optional cancer insurance. If they're not offering it now as an extra, I'm not sure I trust them to come out with better packages because you're buying your own.
And while I trust my employer to pass along at least most of what they pay for my insurance, I wouldn't have trusted my last one. I'm willing to bet if you do away with the employer subsidy, most Americans will never see a penny of it.
It goes back to the greedy CEO/indifferent board problem we've been ignoring for the past couple decades. If we deal with that, maybe we can trust business as a whole to do right by their employees. At the tail end of a recession is not when I'd put my faith in employee bargaining power.
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I don't disagree, just trying to point out why a system that offers vastly unequal standards of coverage would be inherently problematic. The solution in the states to this problem has been to ignore it. Not a great plan, but it's an American tradition. As Churchill said: "You can always count on Americans to do the right thing - after they've tried everything else."
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But coverage will always be unequal. Even if we went single payer, there isn't enough money to give every American access to the best treatments. I have no idea what criteria the government would use to decide who gets all their treatments and who just gets some. The one advantage to the current system is we all know better jobs mean better benefits. We can plan around that.
Of course it's not fair. But no system we can devise will ever be fair. People with more money get better stuff because they can always afford to go around the rules if they have to. No plan can change that fact until we find a way to do away with finite resources.
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AR: a few things. First, if two employers stop offering health insurance, and one rolls the (many thousands of dollars) they were paying for health insurance into wage compensation and the other doesn't, do you think the second one won't suffer significant disadvantages? It isn't like they aren't choosing to pay the health insurance premiums in the first place. If you feel they're so greedy as to not offer in pay what they're paying in health insurance, how on earth do you explain that they're offering health insurance?
The idea that people in bad jobs should be subject to bad health care is abominable. It is not something that can be "planned around". Moving to a system where prices are equalized across large, overlapping groups, people can choose which available health insurance to buy without being cornered into purchasing just one option by price insurance, health insurance companies can offer varied products (such as how they cover prescription medication, hospice care, supplemental programs like smoking cessation, et cetera) that drive competition, and those who cannot afford health insurance due to their income are given assistance would do much to rectify the sorry state of healthcare we have now. Keeping things tied to employers is unlikely to make any significant dent in the current health system, because health insurance providers will continue to have near-monopoly service provision ability, and perverse incentives to please companies instead of provide good health care coverage (since quitting a job is very costly for an employee -- everything up to that limit is profit that can be captured by the company).
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posted
There are a lot of differences between health insurances.
- Copay to see PCP - Copay to see Specialist - Copay to see out of network provider - Requirement or no requirement to see in-network - Copay for emergency room visit - Deductible for hospital stay - Copay for prescriptions - How hard it is to be prescribed certain meds under your insurance (pre-authorization requirements) - Whether Mental Health is treated under a Parity agreement (in which mental illness is reimbused like all other medical illnesses)... this will be federally mandated but I don't think it's taken effect yet. - How well therapy vs med management for Mental Health is covered (copay, number of visits, deductible) - How insurance treats hospitalizations (how quickly do they stop paying, or how cutthroat are they) - Do they cover things like nutrition consult, benefits for gym membership, things like that
That's all I could think of from the top of my head.
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A big difference I have noted is which doctors you can see. Right now, I am having fun picking out a dentist with my new insurance plan. Right now, I am switching doctors because my health care plan changed.
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quote:Originally posted by fugu13: AR: a few things. First, if two employers stop offering health insurance, and one rolls the (many thousands of dollars) they were paying for health insurance into wage compensation and the other doesn't, do you think the second one won't suffer significant disadvantages?
If people are already having a hard time finding work and no word has come on when we can expect to see new jobs created, no. Not really.
quote: If you feel they're so greedy as to not offer in pay what they're paying in health insurance, how on earth do you explain that they're offering health insurance?
I think not offering it at all under the current system would be hard for most big companies. I think many people who want to work for a large company are interested in the stability, so health insurance is a big draw. I also think the minute a handful manage to do away with it without the employees all leaving for other jobs, the rest will follow suit.
Honestly, if the single payer crowd gives it another decade or two, the idea of employer provided coverage may be downright passe.
quote: The idea that people in bad jobs should be subject to bad health care is abominable.
Well, what it should be and what's possible are two different things here, in my opinion. Again, when we fight for finite resources, the people with more resources people want will always win. Even if your employeer isn't part of things, how much money you make - and can afford to spend - will still determine how good your coverage will be.
The exception would be the single payer system, and again, I have no idea how they would divide things. Do we continue to give better care to rich people since they pay more taxes? Do we give it to the young since they have the most earning potential left? Do people with dependants get first priority? Any way we slice it, it's still unfair to someone. Money seems as good as any standard to set at random.
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Yes, money is a fairly reasonable standard, once we're above basic care. Tying health insurance to place of employment actively defeats that, making it so health care is determined less by money and more by a person's chosen/available career paths. The system I've proposed would make money a far more potent force in helping people receive health care. The system you're supporting allows insurance companies to capture more of a person's income without giving them proportionally more care, since there's such a barrier to switching to insurance that would fit their needs better.
quote:If people are already having a hard time finding work and no word has come on when we can expect to see new jobs created, no. Not really.
The proposed plans in Congress wouldn't go into full effect for years. We aren't creating a health care plan for the next year or two, we're creating a health care plan for generations.
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quote:Originally posted by fugu13: The system I've proposed...
Fugu-
Did you ever look at Wyden's plan? If not, you should. It is nearly point for point what you've proposed here.
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I've looked it over some. Many of the parts of it make sense. I don't see any reason to institute an employer tax to subsidize health care; that should be dealt with using the current tax system (changing rates as needed), not by adding new taxes.
If I'm reading it right, the minimum level of care for a plan might even be too high, but better to err on that side.
I'm not sure that requiring insurance companies to enroll everyone makes sense. My rough approach is to have the government divide the population into very broad, overlapping groups using simple demographic data. Any insurer who insures more than N people in a group (N would need to be tuned, of course) must be available to everyone in that group. This would result in many large insurance companies required to cover anyone, a few medium insurance companies that aren't yet required to cover anyone, but are required to cover large parts of the population, and a lot of small insurance companies offering specialized things that can pick and choose. I suspect it is in those companies that a lot of innovation would happen, eventually reaching the big companies.
It would also prevent a company trying out a new system from suddenly having to cover a huge number of people overnight.
I would also prefer it if the questions of physician compensation were left more to the market. Government involvement in physician compensation has had pretty severe negative effects in several other countries.
But yes, overall, from overview information, I like the plan.
Posts: 15770 | Registered: Dec 2001
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quote:Originally posted by fugu13: I'm not sure that requiring insurance companies to enroll everyone makes sense. My rough approach is to have the government divide the population into very broad, overlapping groups using simple demographic data. Any insurer who insures more than N people in a group (N would need to be tuned, of course) must be available to everyone in that group. This would result in many large insurance companies required to cover anyone, a few medium insurance companies that aren't yet required to cover anyone, but are required to cover large parts of the population, and a lot of small insurance companies offering specialized things that can pick and choose. I suspect it is in those companies that a lot of innovation would happen, eventually reaching the big companies.
Yeah, when you mentioned that earlier I thought "that's a better idea."
I wonder if the principle would be too difficult to sell in legislation, though. "Cover everyone; no exceptions" is cognitively much simpler. There's complexity not only in tuning "N" but also choosing the right "groups," since demographics can be sliced and diced in so many ways.
Posts: 2926 | Registered: Sep 2005
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quote:Originally posted by AvidReader: Honestly, if the single payer crowd gives it another decade or two, the idea of employer provided coverage may be downright passe.
That's my theory, anyway.
Posts: 15421 | Registered: Aug 2005
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posted
Yahoo's got an article up on a new healthcare compromise. I hadn't seen this one before, but I admit I've just been skimming the plans. I think my favorite part is this:
quote: Insurers would be required to release their administrative costs included in premiums and profits. That provision is designed to help customers determine whether they are getting a fair deal at a good price.
This I love. It provides really important information to consumers without getting terribly intrusive into the business. It's like when my charity I donate to sends me the anual pie chart of where the money goes.
Honestly, that's what I'd love to see most of all. If the insurance companies really think their prices are fair, why not break down their costs for us? And if they don't want us to know where the money's going, it probably is time to get a non-profit doing the same job.
I really hope something along those lines ends up in the final bill.
Posts: 2283 | Registered: Dec 2003
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posted
I don't understand why the press keeps saying time is running out for healthcare reform. So if we don't pass something this instant we have lost our last, best hope? If nothing passes, it can't be brought up again?
Posts: 1918 | Registered: Mar 2005
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posted
DK, right now we have it on the top of our todo list, with a congress and a president both interested in making a big change.
But if it gets defeated, and the Dems lose ground in the Senate after the next election, there won't be the same drive to get it done.
And those suffering under the system as is, will continue to suffer. (I don't mean just the uninsured, but he small businesses that have to turn over more and more of their profits to keep their employees insured, the doctors who fight as hard as the patients to get paid and coverage, etc.)
It will have gone down twice in 20 years to viscous defeat.
It won't be resurrected again until some major disaster leaves people dead due to bad health care.
Posts: 1941 | Registered: Feb 2003
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quote:Originally posted by TomDavidson: I love the idea of "viscous defeat." It's actually a fortuitous typo.
In 9 AD (2000 years ago) in a battle the lasted from Sept. 9 through Sept. 11, the Roman General Varus and three Roman legions were defeated by Germanic tribes lead by Hermann (also known as Arminius). Archeological evidence recently discovered near Osnabruck Germany, suggests that the Germanic tribes maneuvered the Roman legions into a swamp where they were forced by the mud and quick sand to break ranks. I think "viscous defeat" describes it very well. (and its timely to boot).
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