What would YOU do to improve healthcare?

[Mustang]

My basic premise is that government - ESPECIALLY the federal level - needs to be gotten the hell out of the Health Insurance industry.  (Hell, it needs to be gotten out of EVERY industry, but then we're only talking about health insurance here.)

 Medicare has been running in the red for years, and if we don't shut the Ponzi scheme down, it WILL bankrupt us in real short order (2012-2014 based upon estimates made BEFORE the Ø-spending spree) and shut US down.  Who the hell cuts out the one tumor on your reproductive organ (Medicaid) but leaves the tumor on their lungs because, "it's legit"?  Cut them off, and irradiate the area, or either one, or both together will KILL you.

Not even the most conservative senior citizen or disabled person would give up their medicare. For many people it is their life line, literally.
I don't see a chance of medicare ever being dismantled. But medicaid is a total different story. 

[Chris_]

Not even the most conservative senior citizen or disabled person would give up their medicare. For many people it is their life line, literally.
I don't see a chance of medicare ever being dismantled. But medicaid is a total different story. 

If what you say is true, then there is no saving this country as currently constituted, Mustang.  We simply cannot continue to pour money down the bottomless medicare hole.  It WILL bankrupt us; it's just a question of when, not if.

Do you really believe this generation of seniors are so self absorbed that they will not let go of the gubmint goodies crackpipe even when they're shown that it's killing us all?

[Deuce]

REALLY? Show me where in COTUS that it states that Gov'ts job is to "regulate Harmful Practices."

The general welfare and interstate commerce clauses can be construed to mean just about anything and are often abused.

In any case, when the free market is creating a situation that is directly harmful to the public, something does need to be done. For instance, we don't allow car manufacturers to sell cars in the United States unless they meet our safety standards. There was a line of cars the Chinese wanted to sell here, they'd be absurdly cheap. (like $4000) However, they were built horribly and out of cheap, heavy materials with virtually no safety engineering. Their crash testing results were terrifying. A rare "zero star" frontal crash rating from the European equivalent of the IIHS, because "occupants were unlikely to survive a front-end 64kph crash." The engine compartment would just collapse into the lap of the driver.

The point I'm making is that too much government and zero government are both bad things. You need a *little* government to prevent things like "hey lets make kids toys with nice, cheap asbestos!" Or insurance companies being able to deny an insurance claim because they think the procedure is "not necessary."

[MrsSmith]

I already linked this about rising costs.
http://www.nchc.org/facts/cost.shtml

Here's a little graph that compares cost increases to wage increases
http://content.nejm.org/cgi/content/full/351/16/1591/F2

We spend way, way more than any other country.

http://assets.opencrs.com/rpts/RL34175_20070917.pdf
Here's a huge pdf full of pretty graphs, mostly about how much we spend and what we get for it.

As far as our healthcare outcomes, for one we have millions of people uninsured. Lack of access is surely a way to measure?

Somewhere I had a nice neat blog page full of graphs that compared stats on: life expectancy, infant mortality, mortality amenable to healthcare, difficulty accessing care, doctors per-capita, and even waiting times. We were very low on the rankings on all of them. (yes, even in waiting times, though we do beat Canada and the UK) I can't find it at the moment, but I'll look more tomorrow.

Why do I consider our health insurance industry to be so inefficient? We have dozens of companies with hundreds of plans, each having to tailor themselves individually to 50 different states worth of regulations. Every hospital or doctor's office has to negotiate rates with each of these companies. Pharmaceutical companies need to negotiate rates with each of these companies. This creates administrative redundancy that wastes a lot of money.

I repeat:
I hope you realize this is also untrue.  Other nations count so many of their healthcare stats differently, there is really no comparison without infinite details.  Just for one example, in most of the world, an infant born before 22 weeks is considered a miscarriage and there is no attempt to keep that child alive.  In the US, the attempt is made and, if it fails, it is counted under "Infant Mortality."  Mortality of mothers is also counted differently, in the US, any maternal death counts as such until a year after the birth (or abortion, if that fact is known), while most countries stop the count at either 4 or 6 months.  The "worst healthcare" myth is just that...a myth created by comparing apples and oranges.

[bkg]

 

The general welfare and interstate commerce clauses can be construed to mean just about anything and are often abused.

In any case, when the free market is creating a situation that is directly harmful to the public, something does need to be done. For instance, we don't allow car manufacturers to sell cars in the United States unless they meet our safety standards. There was a line of cars the Chinese wanted to sell here, they'd be absurdly cheap. (like $4000) However, they were built horribly and out of cheap, heavy materials with virtually no safety engineering. Their crash testing results were terrifying. A rare "zero star" frontal crash rating from the European equivalent of the IIHS, because "occupants were unlikely to survive a front-end 64kph crash." The engine compartment would just collapse into the lap of the driver.

The point I'm making is that too much government and zero government are both bad things. You need a *little* government to prevent things like "hey lets make kids toys with nice, cheap asbestos!" Or insurance companies being able to deny an insurance claim because they think the procedure is "not necessary."

Please go re-read COTUS. "promote" general welfare does not mean guarantee, nor does it mean extort the successful to buy the failed. Also reread the interstate commerce clause.  Because you're doing exactly what you say others do - construing it to mean what you want.

The free market, by definition, cannot do something harmful. It fails. And 95% of the auto safety requirements are complete bullshit, so you're going to fail using that as an example.

You're correct that no gov't is bad. But we have a government that is at least 10x the size it should be, and YOU are advocating growth in gov't in a healthcare takeover...

[Deuce]

I repeat:
I hope you realize this is also untrue.  Other nations count so many of their healthcare stats differently, there is really no comparison without infinite details.  Just for one example, in most of the world, an infant born before 22 weeks is considered a miscarriage and there is no attempt to keep that child alive.  In the US, the attempt is made and, if it fails, it is counted under "Infant Mortality."  Mortality of mothers is also counted differently, in the US, any maternal death counts as such until a year after the birth (or abortion, if that fact is known), while most countries stop the count at either 4 or 6 months.  The "worst healthcare" myth is just that...a myth created by comparing apples and oranges.

Do you have any sources for this, and are there any studies that adjust for these differences?

You're correct that no gov't is bad. But we have a government that is at least 10x the size it should be, and YOU are advocating growth in gov't in a healthcare takeover...

This is true in many fields, but I think health insurance is one industry that needs a few specific practices curtailed.

The free market, by definition, cannot do something harmful.

That's just plain ridiculous.

[MrsSmith]

Do you have any sources for this, and are there any studies that adjust for these differences?

Yes, and I've posted them here before.  Your topic is hardly brand new.  I'll spend some time finding them again tomorrow and repost them, just for you.  I wouldn't want you to have to go educating yourself or anything.

[bkg]

Do you have any sources for this, and are there any studies that adjust for these differences?

This is true in many fields, but I think health insurance is one industry that needs a few specific practices curtailed.

That's just plain ridiculous.

Please stop doing the highlighted.

You clearly don't understand how a "free market" works. Please do some research before making emotional assumptions.

[Deuce]

Please stop doing the highlighted.

You clearly don't understand how a "free market" works. Please do some research before making emotional assumptions.

The free market created a situation where people pay premiums for years only to be dropped the second they get sick. This practice harms people. The free market has shown an inability to fix this problem because people have little to no way of judging how fair their insurance company is going to act until they're already sick or injured. If such information were required to be given freely, we might see people taking their business to companies that will treat them better. The dodgy companies would go out of business. The free market would act in a way that is better for the public.

Moral objections are emotional practically by definition. That doesn't make them any less valid. Taken to the extreme, the free market will use practices that harm people. It has happened throughout history.

For example, I object to cheap, toxic Chinese toys being sold in the US without any label to show they are toxic. My only basis for that objection is emotional.

[Chump]

Deuce, your arguments are grounded in emotion and devoid of factual examples.  For example, did you know that an insurance company can't drop you for "getting sick?"  No, you didn't know that, because you just said it like it was a true story or something.  Did you also know that the health insurance industry is far from a free market?  No, you didn't know that either apparently.  A cursory glance at the creation of HMOs, Medicare and Medicaid will be enlightening, if you're interested.

Look, make your case.  Build it on logic and truth.  Use some examples of a truly free market scewing people over and show comparisons between that example and some examples of similar practices being used in the health insurance industry.  Otherwise, your argument comes off as, "whine whine whine insurance companies dirty rotten free market evil."  It's, well, just like a liberal to argue the way you're arguing.

Morality deals with emotional subjects (for example, children being poisoned by toxic Chinese toys) but the best debates about morality are objective and devoid of emotional appeals.  You may base an objection on an emotion, and your objection itself may be reasonable in the end, but your thinking is shaky if you argue purely from emotion.  Avoid it if you'd like to have rewarding discussions.

[bkg]

Deuce, your arguments are grounded in emotion and devoid of factual examples.  For example, did you know that an insurance company can't drop you for "getting sick?"  No, you didn't know that, because you just said it like it was a true story or something.  Did you also know that the health insurance industry is far from a free market?  No, you didn't know that either apparently.  A cursory glance at the creation of HMOs, Medicare and Medicaid will be enlightening, if you're interested.

Look, make your case.  Build it on logic and truth.  Use some examples of a truly free market scewing people over and show comparisons between that example and some examples of similar practices being used in the health insurance industry.  Otherwise, your argument comes off as, "whine whine whine insurance companies dirty rotten free market evil."  It's, well, just like a liberal to argue the way you're arguing.

Morality deals with emotional subjects (for example, children being poisoned by toxic Chinese toys) but the best debates about morality are objective and devoid of emotional appeals.  You may base an objection on an emotion, and your objection itself may be reasonable in the end, but your thinking is shaky if you argue purely from emotion.  Avoid it if you'd like to have rewarding discussions.

Well stated.

[Lacarnut]

Medicare has been running in the red for years, and if we don't shut the Ponzi scheme down, it WILL bankrupt us in real short order (2012-2014 based upon estimates made BEFORE the Ø-spending spree) and shut US down.  Who the hell cuts out the one tumor on your reproductive organ (Medicaid) but leaves the tumor on their lungs because, "it's legit"?  Cut them off, and irradiate the area, or either one, or both together will KILL you.

So you want to kick Seniors to the curb because the government has spent the money (contributions made by seniors) that was designated for this purpose. Medicaid is another ball game. The government has also stolen, robbed and pilaged the Social Security Trust money for over 40 years. There is no money in this fund;only IOU's.

[Deuce]

Look, make your case. 

Are you guys honestly of the opinion that the free market, when entirely unregulated, cannot cause harm?

I just want to clarify that before I make a more detailed response.

[Chump]

Are you guys honestly of the opinion that the free market, when entirely unregulated, cannot cause harm?

I just want to clarify that before I make a more detailed response.

Let's be clear on some things.  A "free market" is not some idea that anything goes.  For example, a free market would not allow for a monopoly, because a monopoly is the antithesis of "free market."  So clearly, an unregulated free market is an oxymoron.

But no, a free market cannot cause harm.  Someone may be harmed while dealing and trading via the free market, but that is entirely his or her own responsibility, both in cause and recourse.

Discuss.

[Deuce]

But no, a free market cannot cause harm.  Someone may be harmed while dealing and trading via the free market, but that is entirely his or her own responsibility, both in cause and recourse.

Thanks for the clarification.

The first gigantic, obvious answer is "SLAVERY." Slavery existed because it's far cheaper to import someone to be a permanent, wageless worker than it is to hire someone. Is slavery the slave's responsibility for being hurt by dealing with a free market? Of course not.

But that's too extreme, and also not entirely relevant to health insurance. So here goes.

http://www.msnbc.msn.com/id/33198459/ns/health-health_care/

In 2006, attorney Jody Neal-Post tried to get health insurance but was rejected because of treatment — counseling and Valium — she received following a domestic-abuse incident. She says the insurer told her that her medical history made her a high risk, more likely to end up in the emergency room or require additional care.

This woman was denied health insurance because her ex-husband beat the crap out of her. That made her "high-risk." Eight states do not have a law preventing this practice - using abuse history as a reason for denying coverage. A victim of a crime is being punished by the free market.

http://articles.latimes.com/2009/jun/17/business/fi-rescind17

Blue Cross of California encouraged employees through performance evaluations to cancel the health insurance policies of individuals with expensive illnesses, Rep. Bart Stupak (D-Mich.) charged at the start of a congressional hearing today on the controversial practice known as rescission.

Encouraging dropping policies for sick people. They have people paid to pore over legalese that only a lawyer can truly dissect and find reasons to drop coverage for the sick. They don't apply this process to the profitable clients. This is not an isolated incident, I recall an article about another company offering bonuses to those who exceed a rescission quota.

http://www.walletpop.com/blog/2009/09/02/think-youve-got-health-insurance-better-double-check-and-be/
This woman had a $30,000 claim retroactively denied and her policy canceled because she failed to disclose a back that was occasionally sore after playing soccer. This was a "pre-existing condition." (guess I should stop exercising) The claim was for some cysts on her scalp being removed.

Health insurance companies do not need to review your medical history at the time the policy is issued. The fact that they can collect premiums on a policy they do not intend to actually provide is harmful. You think you're covered, but they can drop the policy after a claim is made, leaving you with the medical bills and no right to collect your premiums back. Worse: once this happens to you, you're going to have an extremely hard time getting coverage from any other company. After all, you have a pre-existing condition on record!

http://www.huffingtonpost.com/2009/09/18/in-health-care-number-of_n_291881.html

Data on how often insurance claims are denied -- and for what reasons -- is collected and analyzed by the insurance companies themselves. But except in California, the companies aren't required to provide those records to any state or federal agency. "The number is knowable, but not known by regulators or policy makers or patients," Pollitz said.

A citizen is unable to easily judge the behavior of the insurance company they sign a contract with, because nothing forces that company to reveal information about those practices. The free market would function better if people had foreknowledge of how their policy would be handled.


http://www.cnn.com/2009/POLITICS/06/19/begala.health.care/

"Peggy Raddatz, whose brother Otto Raddatz lost his insurance coverage right before he was scheduled to receive an expensive stem-cell transplant to treat his lymphoma. Why? Because Fortis Insurance Company discovered his doctor had found gall stones and an aneurysm on a CT scan -- conditions that had nothing to do with his cancer, that never bothered him and that he wasn't even aware of.

Dropping coverage due to unrelated illnesses that the patient isn't even aware of. An individual wishing to avoid this pretty much needs precognition or their own medical degree.



Conclusion
The free market works, but it requires the public have access to the information they need to make a decision about what they're purchasing. Since health insurance operates on a "what if," future basis, it can be extremely difficult to judge the quality of your plan until it's too late. Providing such information goes against the best interests of your health insurance company, so they simply will not do it unless forced to do so.

You may think these are anecdotal cases, not representative of the industry as a whole, but you can spend literally all day reading about cases like these. The very fact that they can legally do this sort of thing shows that they are capable of causing harm when it suits their best interests - the profit margin. Health insurance workers aren't bad people, the company just has an incentive to not provide you with care when you need it.

edit: And I haven't even touched on how insurance companies "get between you and your doctor" yet!

[Eupher]

Deuce,

Just a real short question for you:

Have you ever gotten sick in a foreign country?

Just a simple yes or no will do.

Thank you.

[Deuce]

Deuce,

Just a real short question for you:

Have you ever gotten sick in a foreign country?

Just a simple yes or no will do.

Thank you.

No.

Why do you ask?

[Eupher]

No.

Why do you ask?

If you'd ever gotten health care in a foreign country - virtually ANY foreign country - you'd never again attempt to equate health care in this country to another country.

We've got the best there is. Period.

[rich_t]

edit: And I haven't even touched on how insurance companies "get between you and your doctor" yet!

That doesn't happen.  A person always has the option of paying out of pocket for any medical treatment they desire and there ain't jack shit the insurance companies can do about it.

Insurance companies don't deny treatment.  They can and sometimes do refuse to pay for it, but that ain't the same as denying it.

[Chump]

The first gigantic, obvious answer is "SLAVERY." Slavery existed because it's far cheaper to import someone to be a permanent, wageless worker than it is to hire someone. Is slavery the slave's responsibility for being hurt by dealing with a free market? Of course not.

But that's too extreme, and also not entirely relevant to health insurance. So here goes.

The problem with that example is not that it's extreme, it's that it's ignorant.  Would you consider slavery to be an act of dealing and trading via the free market?  Of course not.  A free market is not had through use of force, as slavery is.  A slave's only recourse is through equal or greater force but at this point we're no longer even talking about economics, but about morality.

http://www.msnbc.msn.com/id/33198459/ns/health-health_care/
This woman was denied health insurance because her ex-husband beat the crap out of her. That made her "high-risk." Eight states do not have a law preventing this practice - using abuse history as a reason for denying coverage. A victim of a crime is being punished by the free market.

Do we know the outcome?  Did every insurance company in the state also deny her coverage for the same reasons?  At face value, this is an inflammatory case that has strong emotional appeal, but we don't know the germane facts.  Let's also not delude ourselves and pretend she has no recourse.

http://articles.latimes.com/2009/jun/17/business/fi-rescind17
Encouraging dropping policies for sick people. They have people paid to pore over legalese that only a lawyer can truly dissect and find reasons to drop coverage for the sick. They don't apply this process to the profitable clients. This is not an isolated incident, I recall an article about another company offering bonuses to those who exceed a rescission quota.

Of course an insurance company would desire to drop policies that are net losses for them.  That is pure reason from a economic standpoint, anyone's need for coverage notwithstanding.  That is why, when you enter into the act of trading with an insurance company, you do so through a contract for services.  If an insurance company violates its contract in any manner, the offended party again has recourse, through lawyers undoubtedly similar to those working for the insurance company.  "Legalese," "rescission" and "bonuses based on quotas" don't scare me, nor should they scare you.

http://www.walletpop.com/blog/2009/09/02/think-youve-got-health-insurance-better-double-check-and-be/
This woman had a $30,000 claim retroactively denied and her policy canceled because she failed to disclose a back that was occasionally sore after playing soccer. This was a "pre-existing condition." (guess I should stop exercising) The claim was for some cysts on her scalp being removed.

Again, strong emotional appeal without relevant facts.  And again, she has recourse if she feels the terms of her contract with the insurance company were violated.

Health insurance companies do not need to review your medical history at the time the policy is issued. The fact that they can collect premiums on a policy they do not intend to actually provide is harmful. You think you're covered, but they can drop the policy after a claim is made, leaving you with the medical bills and no right to collect your premiums back. Worse: once this happens to you, you're going to have an extremely hard time getting coverage from any other company. After all, you have a pre-existing condition on record!

Do you actually believe this?  Do you have health insurance?  Do you understand the terms of your contract and the relevant laws of your state?  You sound so frightened of a relatively straightforward thing.

http://www.huffingtonpost.com/2009/09/18/in-health-care-number-of_n_291881.html
A citizen is unable to easily judge the behavior of the insurance company they sign a contract with, because nothing forces that company to reveal information about those practices. The free market would function better if people had foreknowledge of how their policy would be handled.

What behavior does a potential customer need to understand, other than the terms of their contract?

http://www.cnn.com/2009/POLITICS/06/19/begala.health.care/
Dropping coverage due to unrelated illnesses that the patient isn't even aware of. An individual wishing to avoid this pretty much needs precognition or their own medical degree.

That sounds terrible.  Have the terms of the contract been violated?  What was the resolution?

Essentially, your examples provide a very strong case for knowing exactly what you're getting into when you enter into a contract with a health insurance company.  Far too many people in this country believe you write a check, send it off, and then *poof* you're golden.

Conclusion
The free market works, but it requires the public have access to the information they need to make a decision about what they're purchasing. Since health insurance operates on a "what if," future basis, it can be extremely difficult to judge the quality of your plan until it's too late. Providing such information goes against the best interests of your health insurance company, so they simply will not do it unless forced to do so.

Again, what are you talking about?  There is no limit of information.  Shopping for health insurance and going over the details will take you roughly half a day to narrow things down.  Properly studying each policy and how it relates to your current needs may take several days.  There is a plethora of information out there.

You may think these are anecdotal cases, not representative of the industry as a whole, but you can spend literally all day reading about cases like these. The very fact that they can legally do this sort of thing shows that they are capable of causing harm when it suits their best interests - the profit margin. Health insurance workers aren't bad people, the company just has an incentive to not provide you with care when you need it.

edit: And I haven't even touched on how insurance companies "get between you and your doctor" yet!

The company has an incentive to make money.  That's it.  An insurance company has no other goal than to make money.  They do that by taking in more revenue than they spend on claims.  This is not an evil thing.  I'm quite sure you could dig up story after story illustrating the evils of the health insurance companies, and more likely than not I'd end up saying, "yeah, that sounds shitty," to a lot of them.  Maybe our responses are different because I don't actually put any amount of faith or trust into an industry.  I know what I'm paying for and I know what options are open to me if I've been cheated by a dishonest company.

We can find ways to reform the worst aspects of the health insurance industry, no doubt, but we don't have to demonize the free market and take a sledgehammer to the entire industry, agreed?

[Deuce]

If you'd ever gotten health care in a foreign country - virtually ANY foreign country - you'd never again attempt to equate health care in this country to another country.

We've got the best there is. Period.

Since people demanded I do so, I will ask you to cite some sources that back up your claim. My word wasn't taken at face value, and I wont be taking yours.

That doesn't happen.  A person always has the option of paying out of pocket for any medical treatment they desire and there ain't jack shit the insurance companies can do about it.

Insurance companies don't deny treatment.  They can and sometimes do refuse to pay for it, but that ain't the same as denying it.

When it's a procedure you can't afford, it amounts to the same thing. THAT does happen. A public option, by the way, would have the same result. The government might refuse a procedure, but you could still pay for it out of pocket.

Eupher, I see your post avatar says retired military. Have you had any experience with the VA healthcare system? If so, how would you describe its effectiveness and overall service?

Chump - You're dumping all of the responsibility on the prey and exonerating the predator. People are dumb and can't understand the huge contracts they're signing. Insurance companies abuse this. Also, what reasonable person would have considered "sore back when I exercise" to be a pre-existing medical condition? Yes, she may have had recourse - spending money on a lawyer to battle it out in a lethargic court system, all the while being called by collections agencies about that $30,000 she owes. It's a system weighted in favor of the health insurance company.

Let's say it was within the bounds of the contract for the insurance company to drop a policy base on the sore back. She still paid premiums to a company who never had any intention of paying out.

As far as what a customer needs to understand? They need to understand just how their contract will be interpreted. The words on the paper mean different things to you than they do to your adjuster.

We can find ways to reform the worst aspects of the health insurance industry, no doubt, but we don't have to demonize the free market and take a sledgehammer to the entire industry, agreed?

That's exactly what I'm proposing. Reforming the worst aspects of the health insurance industry. Nothing more. I'm not saying the government should take over. I'm not saying we should go single-payer, or ban profits. Or dismantle insurance companies. Just stop the practices that hurt people.

[rich_t]

When it's a procedure you can't afford, it amounts to the same thing.

You ever hear of a "payment plan"?

Nobody is saying you have to be able to pay the entire bill up front.

People are dumb and can't understand the huge contracts they're signing.

Then they shouldn't sign it without consulting a lawyer.

[rich_t]

Oh and BTW....


Nobody has a RIGHT to health care insurance.

PERIOD!!!!!!!!!!

[Deuce]

You ever hear of a "payment plan"?

Nobody is saying you have to be able to pay the entire bill up front.

Then they shouldn't sign it without consulting a lawyer.

Unaffordable is unaffordable. There are people who die from lack of money.

Oh and BTW....


Nobody has a RIGHT to health care insurance.

PERIOD!!!!!!!!!!

Does that mean we shouldn't do anything to improve the affordability and effectiveness of our health insurance industry?

[Hawkgirl]

There are people who die from lack of money.

People with lots of money die too.