The Rich get richer and the Poor get......Part 2

[CivicFan]

Originally Posted By: Win


Do you seriously believe that those of us with high deductible plans are just too dumb to know when we're sick and need to see a doctor? What is it with "progressives" thinking people can't be trusted to decide what to do with our own money and have to be told by someone else how to spend it?


No, not dumb. But you might be in minority - people who get high deductible plans usually buy it because can't afford a real health coverage. Because of that they delay getting care until it becomes a major issue.

 

[Drew99GT]

I have a high deductible plan and it's perfect for me. In fact, it saved my bacon from my appendicitis. It even has 4 doctor visits per year with a small co-pay. It's less expensive then my employer funded plan and has a higher total payment amount for major illnesses. Granted, the employer plan has unlimited doctor visits and all the stuff for people who like to go to the doctor and get prescribed medicine they see on TV ads, but I don't.

 

[Tempest]

The health care bill was specifically designed to destroy the private health care industry.

McDonalds is probably going drop health care coverage for thousands due to costs the bill mandates:
http://newmexicoindependent.com/64351/mi...ands-of-workers

This will be a continuing theme as costs skyrocket due to government mandates. This will force people into the "exchanges" and then the "evil" insurance companies will be blamed and then politicians will have the "answer" of universal health care waiting.

The bill also mandates that insurance companies spend 85% of the money they bring in on services. The current is about 65%. This ONE thing will drive insurance out of business and drive prices through the roof. So people will suffer just so the gov. can step in and fully nationalize the health care industry.

 

[LS2JSTS]

Originally Posted By: CivicFan
Originally Posted By: Win


Do you seriously believe that those of us with high deductible plans are just too dumb to know when we're sick and need to see a doctor? What is it with "progressives" thinking people can't be trusted to decide what to do with our own money and have to be told by someone else how to spend it?


No, not dumb. But you might be in minority - people who get high deductible plans usually buy it because can't afford a real health coverage. Because of that they delay getting care until it becomes a major issue.


It is "real" health care coverage designed for those smart enough to manage their own affairs. The exact opposite of the modern "progressive" nanny state mentality.

You assume those who purchase these plans do so for a certain reason and then base your conclusion on that same faulty assumption. Drop the "might" and "usually" assumptions from your argument and what are you left with?

 

[LS2JSTS]

FTR...I have said before that ALL health insurance should be eliminated. Posted prices and true competition between providers would benefit all of us. No different price structures depending on who covers you or if you have coverage. Set up a cash for care system whereby people get tax deductions for cash spent on health care and preventative measures. They should also receive tax credits for minimum privately funded "health care savings accounts".

And yes, that would still require a well managed safety net system for those unfortunate or incapable of providing for themselves.

 

[Mr Nice]

Quote from Yahoo article:

Quote:
The top-earning 20 percent of Americans — those making more than $100,000 each year — received 49.4 percent of all income generated in the U.S., compared with the 3.4 percent made by the bottom 20 percent of earners, those who fell below the poverty line, according to the new figures.

And I'm sure those top 20% of wage earners have an education, theres nothing wrong with those 20% earning what they make due to their ambition and hard work. I'm guessing the unemployment rate is still around 15% and not 10% like the article says..... many people have simply given up looking for a job. Those unemployed 99'er are in very big trouble in the near future.

 

[PandaBear]

High deductible plan is NOT a stupid idea. It is a more efficient plan that let consumers decide what quality / price they want to pay for rather than giving an impression of free for all that let people throw in pregnancy massage and what not, instead of focusing the resource in providing as much care as possible for the dollar.

The biggest problem in health care in the developed world is not technology, but afford-ability. It almost bankrupted most developed world regardless of whether they are public (i.e. Europe and Canada) or private (i.e. the US). Most people have no problem paying cash for small payment for typical doctors office visit and generic medication, so why would you want to add insurance companies and government to the mix and raise the overhead 50%?

The argument about people delaying preventive care and cause severe problems down the road aren't really valid either. Dental insurance cover preventive care like cleaning to reduce possibility of more expensive operations, with high deductible plan, insurance company can also offer mandatory / free / bulk screening and treatment that reduce long term problem as well.

Which brings us to a more important point: why do we have so many operations that cost astronomical amount in the first place? Can we reduce the complexity so that it doesn't cost everyone in the food chain as much, and let the system reduce price by competition as a result?

 

[eljefino]

Originally Posted By: PandaBear

Which brings us to a more important point: why do we have so many operations that cost astronomical amount in the first place? Can we reduce the complexity so that it doesn't cost everyone in the food chain as much, and let the system reduce price by competition as a result?


Because we invent all the cool stuff and the rest of the world is better at negotiating on price. So we pay off the R&D ourselves and the rest of the planet gets a free ride.

 

[stroked93]

In before it got locked!

 

[Shannow]

Not really.

When my better half had an arthroscope 8-9 yearws ago, Tyco weree charging $400 for a foot long length of latex (I bought a slingshot rubber for 10), and $280 for a single use rotary burr.

Yes, they have to be surgical quality, sterile, and have easy to open packaging...but 1000s of percent more expensive ?

Look at psychiatry, whose goal seems to be to find a disgnosis and hence medication treatment for the entire population.

Find a simple cure for cancer or heart disease, and whole industries will have to disappear.

It's not a health industry by any stretch.

 

[dwendt44]

Torts are generally settled out of court, so the 'huge' awards you read about are rare. And some of those are reduced significantly on appeal.
The figures I've seen, 98% are settled out of court.

 

[Shannow]

Tort reform was going to cure sickness care costs in Oz, as the payouts were killing the industry.

Now, if a doctor leaves a tool kit inside you while on the table, you suffer years of being called a hypochondriac because of "phantom pain", when they finally find the tool kit left behind, they only have to open you up to take it back out.

Don't even cover your time off work, let alone any pain suffering etc.

Guess what it did to prices ?

 

[CivicFan]

Originally Posted By: PandaBear
High deductible plan is NOT a stupid idea. It is a more efficient plan that let consumers decide what quality / price they want to pay for rather than giving an impression of free for all that let people throw in pregnancy massage and what not, instead of focusing the resource in providing as much care as possible for the dollar.


Pandabear, I deal with people with high deductible plans every day. Here is the pattern:
1. these patients cannot afford proper insurance plans because wither they are self employed or belong to small and risky plans and thus the employer only offers [censored] plans;
2. these patients delay care because they cannot afford or do not see the value of spending out of pocket money for basic care;
3. when these patients do seek care, they rack up large amounts of bills (in the 100k+ range) indicating extensive care;
4. the deductible amount is not paid because they still cannot afford to pay so we either write it off or send to the collection agencies depending on the ability and willingness to pay.

The overall result is that the high deductible plays only one role: IT IS A BARRIER TO SEEK HEALTH CARE. Because in aggregate, the written off costs are covered by other parties like Medicare or properly insured patients.

 

[buster]

http://www.ritholtz.com/blog/2010/09/you-vs-corporations/

www.webofdebt.com

 

[Tempest]

Quote:
I deal with people with high deductible plans every day.

Do these people have the ability to buy plans across state lines in an open market in order find the cheapest rates? Probably not. Do they get the same tax breaks their employer gets so they can buy a better policy on their own? NO.
So, we have government policy actively working to make health insurance more expensive and scarce.

Compare this to laser eye surgery as well as plastic surgery which has had their prices plunge and quality improve due to free market competition.

BMI will now be mandated to be on our gov. required medical records so they will know how fat people are so they can be directed to "preventative care". Good chance there will be a "fat tax" to "nudge" people into loosing weight and costing the gov. less money.

 

[CivicFan]

Originally Posted By: Tempest
Quote:
I deal with people with high deductible plans every day.

Do these people have the ability to buy plans across state lines in an open market in order find the cheapest rates? Probably not. Do they get the same tax breaks their employer gets so they can buy a better policy on their own? NO.
So, we have government policy actively working to make health insurance more expensive and scarce.

Compare this to laser eye surgery as well as plastic surgery which has had their prices plunge and quality improve due to free market competition.

BMI will now be mandated to be on our gov. required medical records so they will know how fat people are so they can be directed to "preventative care". Good chance there will be a "fat tax" to "nudge" people into loosing weight and costing the gov. less money.


The cost of insurance is primarily a function of the size of the risk pool. The smaller the pool, the riskier it gets hence the cost gets higher. That's why the country-wide universal coverage would be least risky and the least costly method. Next in line would have been to have state based co-ops as suggested at one point by one of the versions of the health care bill.

But such approach would not be in the interests of the payers like UnitedHealth, Wellpoint or any other insurer.

BTW, with a term like 'Obamacare', the link or posting loses its credibility and simply becomes partisan B. S. .

 

[Drew99GT]

Increasingly, health insurance cost are a direct result of absolutely idiotic government intervention and mandates, like mandating a specific level of premium be spent on benefits.

I know I've said in a perfect world, the best solution is a nation wide single payer with set in stone legislation that all revenue for the system be spent on the system. That will never work though because of corruption. So I guess the next best thing would be get the government out and completely open up the health car and insurance industry nation wide and mandate up front pricing. It would cause prices to drop and also costs/exorbitant wages for health care workers to drop and come in line with reality. The same thing has happened in every de-regulated industry like transportation.

Medicine is like the last great cabal in this country. I envision Walmart like clinics, hospitals, and Dr/s offices in the future where you can actually get pricing up front for treatment.

 

[Tempest]

How about this link:
http://www.shortnews.com/start.cfm?id=84788

And the original link actually reference the text of the law.

Quote:
Next in line would have been to have state based co-ops as suggested at one point by one of the versions of the health care bill.

You mean like in Mass.? Where prices are skyrocketing?

 

[VNTS]

Well if is so insignificant, why do Doctors and hospitals pay huge premiums for malpractice insurance? THat cost is passed on to you when you see them.

It is a huge cost and was not adressed in the health care bill because the lawyer lobby/special interest group would not allow it.


Originally Posted By: dwendt44
Torts are generally settled out of court, so the 'huge' awards you read about are rare. And some of those are reduced significantly on appeal.
The figures I've seen, 98% are settled out of court.

 

[CivicFan]

Originally Posted By: Tempest
How about this link:
http://www.shortnews.com/start.cfm?id=84788

And the original link actually reference the text of the law.

Quote:
Next in line would have been to have state based co-ops as suggested at one point by one of the versions of the health care bill.

You mean like in Mass.? Where prices are skyrocketing?


The Massachusetts model is flawed. It followed the logic that the insurance should be provided to individuals through a brokerage/marketplace. The flaw is that these individuals do not belong to a group but are treated as individuals which increases the risk and as a consequence, the premium. Had there been a co-op or a public option where there was a large group for individual purchasers to be participants in - the pool would have reduced the risk and kept the premiums lower.