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Login to post Forums » Off-topic discussion » This is me, agreeing that health insurance reforms are necessary. AKA, how employers can screw you

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June 16, 2011 3:39 p.m. Xceler8x SuperDork

tuna55 wrote:

Xceler8x wrote:

But hey, everything is fine. Just leave it the way it is. "Market forces" will work it out. Just like they have prior to this.

Hey now, that's the kind of talk that HAS NOT been around to flounder this or the Repub thread. Careful.

Notice I, the biggest free market advocate on the board (maybe) started this thread because of my issue with the current system. So your premise is wrong to start with, I don't want to leave it alone.

Sorry chief! Wasn't trying to make it personal or rile you. I was just parroting what I hear some folks saying in response to Obamacare. It seems they don't like the legislated option but when asked for their alternative....you hear nothing but crickets. Which leads me to believe that it's more about saying "No!" than it is about finding a solution.

That or you have people, posters here excluded, yammering about "free markets" like we haven't had deregulated markets that got us into this. If you don't regulate or direct insurance companies and health providers they then collude against us to their benefit.

We didn't get to this point of extreme healthcare costs because the government was running healthcare for eons. We got here precisely because the government WAS NOT involved in healthcare for eons. Again, my opinion. I'm sure at least 50 - 70% of you disagree.

SVreX wrote:

Why eat? The same money can buy 100 lottery tickets or 15 bottles of Thunderbird.

There's an awful lot of bad choices involved in being poor in the United States today.

I never suggested people not eat. I was responding to your statement about "...making Emergency rooms the only option for the indigent and working poor". Nobody made these the only options.

I've spent decades working with impoverished people, and you are oversimplifying the problem and shifting responsibility when you blame the imaginary "they" who write non-existent policies forcing poor people to use the ER. Hogwash. It's another bad decision in a very long string of bad decisions that define the culture of poverty.

Drive through any inner city neighborhood, or Habitat for Humanity development. You'll see a lot of late model Cadillacs in the driveways.

Sure. There are some people who make bad choices and buy lotto tickets, 40's, and Cadillacs instead of healthcare. There are plenty of folks who make bad choices and run up credit cards buying SUV's, fashionable clothes, and sending their kids to questionable private institutions for supposed educations. I see that too. But why punish the guy who's working his 40+ a week and still can't afford healthcare? What if he's made all the right decisions and is still behind the 8-ball when it comes to taking care of his kids?

What I get from your statements is that you feel that people must have earned or choosen their way into poverty. It couldn't have happened because they lost their jobs, went to substandard schools, or have already suffered a medical crisis they could not afford. Is this your point? That most poor people have made choices dictating their financial status?

I think this is possible. Some have made poor decisions and ended up destitute from it. I think there are also people who are poor due to circumstance. The people suffering from misfortune deserve our help. WWJD? Turn people away because he disagreed with their choices or help the hungry because they were hungry?

SVreX wrote:
Xceler8x wrote:

I know you're a responsible and stand up guy so I know you did this. But there are degrees to being "poor". Some folks can't even afford the preventative care you were able to pay for. Some of those folks have no choice in the matter, aka kids of working poor parents or just deadbeat parents.

The emergency room is their only healthcare option because they know they will not be turned away.

At the time that I referenced, I made $25 per week. That would put me pretty low on your "degree" scale. I was married with 2 kids (she also made $25 per week). Early '90's. That was significantly less than I would have made if I had collected welfare or food stamps, but I made other choices. I chose to not become a ward of the state. I chose to buy only what I could afford, and to prioritize my purchases. I chose to get over my pride and asked for help. I wanted to work my way out of that position, not get a hand-out.

I'm in a better place now. A lot of other people make different kinds of choices, some of which do not lead to them getting to a better place. Some of them can't make different choices because they do not know how.

The solution is to help them understand the other choices and enable them to succeed, not show them only one way that leads to continued bad choices.

When you suggest there are no other options, you are limiting the human spirit and taking from people the opportunity to grow out of their circumstances.

I'm curious. You said " I chose to get over my pride and asked for help." Where did that help come from? No doubt your were in a tight spot. I commend you for making your way out. I don't see how anyone could live on $200 a month here in VA.

From reading between the lines here I think we agree in that most people do have the ability to "grow out of their circumstances." I think this is completely doable assuming they have the right help and education. To expect someone who is down and out to just change their ways, their habits, their outlook enough to magically transform on their own? I don't see that. I think some folks need financial education as well as financial help that may not be available to them from other sources.

Duke wrote:

Please feel free to demonstrate WHEN, in the last 40 years, we've actually had a free market healthcare system?

And why is "leave everything as it is now" automatically the only alternative to socialized medicine?

When have we haven't had a free market system for healthcare? Has healthcare costs and care been heavily regulated in the past? I don't see it. Premiums go up as the insurance company demands. Care is denied enough so that it's a public concern with citizens demanding laws against denial of care. If a law needs to be made, regulation isn't there. Maybe we're defining a free market differently.

Socialized medicine isn't the only option. It's the best option imo. Some things just don't work as for profit ventures. Fire fighting is an example. This social service was socialized for a reason. Check out the history of NYC fire dept's for a primer. They used to show up, see your house on fire, and ask you how much you were willing to pay - right F'in then - for them to put it out. You didn't pay enough? They left. "Good luck with your house fire pal!" If two fire companies showed up, they'd sometimes get into a fist fight over who was going to fight the fire and charge the owner INSTEAD OF putting out the fire. Come to think of it, a lot of this policy does sound like healthcare now.

Today we pay taxes and fire fighters are paid from those taxes for the benefit of us all. When your house is on fire they show up and put it, again, to the benefit of us all. Socialism in this case works. Socialism in the case of modern healthcare works in other countries as well. It will work here.
June 17, 2011 8:52 a.m. racerdave600 HalfDork

You make an assumption that health care costs haven't been regulated in the past, and that to an extent is not true. One of the reasons for high health care is the increased regulatory requirements from the government. Certainly the staffing needs have greatly increased due to regulations. Medicare in particular places a tremendous burdon on doctors. You'd be shocked at how much costs these add to an average visit. They pay less and have greater after care needs as well. Most people that claim more regulation is needed or want a government run system really don't understand how it will work, at least in my opinion. Most of the time, things only get worse from there. I can't think of a single thing that is better when it is run by a government agency. Productivity and government do not go together.

Also, the biggest regulatory need is not with the health care costs themselves, but the limit of frivilous lawsuit awards. Malpractice insurance is out of control because of the awards given out due to frivilous lawsuits. No one however is going to reign in the trial lawyers. Several years ago I had to do a video deposition of one of the top 5 spine surgeons in the country, and he had to book 2 days a month just for court and depositions. He was named in about 3 lawsuits a month simply from having worked on accident victims. Even though this particular doctor never had a judgement against him, who do you think pays for his missed days? Some states are getting such a bad reputation in this area that many doctors do not want to work in these states, and insurance companies are leaving them in droves. This is probably the single biggest problem faced today.

Right now, the biggest struggle, if you take out government run health care, is the battle between what the doctors need to make and what insurance wants to pay. The average doctor's office is constantly watching their costs skyrocket while the insurance companies see their expenses and costs rising alarmingly too.

So what is the real problem? The real problem is containing the costs not having the government take over the entire system. Unfortunately no one wants to deal with the real issues. What they really want is control over it, not to "fix" it. If the government controls your health care, they can control everything you do. After that, anything can be banned if they deam it to be not cost effective in providing you care. Suppose you trust this administration with your care, can you really trust who might come next?
June 17, 2011 9:04 a.m. Duke SuperDork

Xceler8x wrote:

Socialism in the case of modern healthcare works in other countries as well. It will work here.

So, great, we'll all get to share the same efficient, cost-effective care enjoyed by users of the Veterans Administration. I can hardly wait for that paradise to get here.
June 17, 2011 9:35 a.m. oldsaw SuperDork

Duke wrote:

Xceler8x wrote:

Socialism in the case of modern healthcare works in other countries as well. It will work here.

So, great, we'll all get to share the same efficient, cost-effective care enjoyed by users of the Veterans Administration. I can hardly wait for that paradise to get here.

Socialized healthcare in other countries is successful to a degree but it's also glamourized by those who can't/won't recognize its' deficiencies.

Those programs constantly face expanding costs, reduced budgets, excessive regulation and inefficient bureaucracies. Fiscal irresponsibility and a lack of foresight are forcing most (if not all) socialized program to cut back on services and coverage. Those same programs are also now farming-out some services to private sector providers.

The Veterans Administration doesn't get a lot of glowing praise from those who use it and its' a good example of what the general public can expect.
June 17, 2011 9:49 a.m. HiTempguy Dork

oldsaw wrote:

The Veterans Administration doesn't get a lot of glowing praise from those who use it and its' a good example of what the general public can expect.

No, it really isn't. Trust me guys, it really isn't that bad up here in the great white north (having had a couple of surgeries and asthma all my life). Could things be better? Absolutely. But it ain't that bad.

I also take issue with those arguing about government inefficiency; what do you think costs more, inefficiency or profit? Profit directly takes away from the amount of medical care a person can have (and also there is a moral issue with this IMO, but that is another discussion). Inefficiency is inherent in any system. You can't get "rid" of profit, but you can reduce inefficiencies.
June 17, 2011 9:57 a.m. tuna55 SuperDork

HiTempguy wrote:

oldsaw wrote:

The Veterans Administration doesn't get a lot of glowing praise from those who use it and its' a good example of what the general public can expect.

No, it really isn't. Trust me guys, it really isn't that bad up here in the great white north (having had a couple of surgeries and asthma all my life). Could things be better? Absolutely. But it ain't that bad.

I also take issue with those arguing about government inefficiency; what do you think costs more, inefficiency or profit? Profit directly takes away from the amount of medical care a person can have (and also there is a moral issue with this IMO, but that is another discussion). Inefficiency is inherent in any system. You can't get "rid" of profit, but you can reduce inefficiencies.

I have no issue against profit. If you are against profit why don't you also demand that cars must be socialized as well? Did it work for British Leyland? I will argue that government inefficiency will always steadily outpace profit (assuming some basic form of competition is allowed).

What people keep forgetting is that politicians and appointed boards of some form will be running this show. The average politician is more greedy and sinister than the worst CEO (in my opinion).

The current system may be getting more expensive, but honestly it isn't all that bad either. So, you're saying we should replace our "not too bad" system with one like the "not too bad" system in Canada? I'd like to think that before a major tidal wave worth of activity and legislation, we would think about a reasonable return on our change.

GRM analogy: We're not going to swap engine management systems if there is literally no gain.
June 17, 2011 10:05 a.m. oldsaw SuperDork

In reply to HiTempguy:

Some governments are more efficient and I'd agree that Canada's system is much more successful than most others. It also helps when the population is about one tenth the size of the US and that the government system evolved from one that private citizens started with their own initiative. Size and history are on your side.

The health care culture is quite different below the border as is the history. Yes, the US really needs to address the issue, but our abomination called "reform" causes as many problems as it's purported to solve.
June 17, 2011 10:28 a.m. ransom Reader

tuna55 wrote:

I have no issue against profit. If you are against profit why don't you also demand that cars must be socialized as well? Did it work for British Leyland? I will argue that government inefficiency will always steadily outpace profit (assuming some basic form of competition is allowed).

I have no issue with profit, either. But I don't feel it's the best guiding principle for all decisions. Deciding whether or not to put better but more expensive mudguards on the new Rover can be decided by ROI. Deciding whether or not to give somebody chemotherapy, in my opinion, should not.

What people keep forgetting is that politicians and appointed boards of some form will be running this show. The average politician is more greedy and sinister than the worst CEO (in my opinion).

You've stated that in a pretty non-inflammatory way, and thank you for that. But fundamentally, it's just as meaningless as my assertion that the CEO will win the evil competition most every time. There's some great quote about not attributing that to evil which can reasonably be attributed to ineptitude... (EDIT: I don't mean that all CEOs are evil, but I do think that far too many of them are completely beholden to the bottom line, to the detriment of all other concerns, i.e. people's well being)

One thing many people seem to be able to agree upon is that to figure out what's going on, you need to follow the money. I think the single biggest evil-rather-than-ineptitude issue in government is when private industry gets its fingers in a government process. How does following the money work in the government-scope-creep concerns? The people making billions while working in government aren't making it from their government positions. The money-funneling is driven by whatever private industry has them in their pocket...

The current system may be getting more expensive, but honestly it isn't all that bad either. So, you're saying we should replace our "not too bad" system with one like the "not too bad" system in Canada? I'd like to think that before a major tidal wave worth of activity and legislation, we would think about a reasonable return on our change.

GRM analogy: We're not going to swap engine management systems if there is literally no gain.

That comes back to questions of philosophy, and defining a meaningful gain. For many of us, the current system is, in many ways, not too bad. My primary concern (but far from only concern) is how bad our system is for people below a certain financial ability to access the system. People have valid concerns about where advances in medicine have and will come from. I'm still trying to find some good documentation, but my understanding is that a huge amount of the advances advertized and monetized by private industry were actually born in research universities (which are, I'm sure, given funding by private institutions. That could be changed to federal funding, the underlying point being that the actual advances are taking place in an academic setting). Obviously, until I can find some good documentation, I wouldn't expect anybody to just swallow this point.
June 17, 2011 10:29 a.m. tuna55 SuperDork

oldsaw wrote:

In reply to HiTempguy:

the government system evolved from one that private citizens started with their own initiative. Size and history are on your side.

Hey now - the US was like this too - Independence day and all that?
June 17, 2011 10:35 a.m. Duke SuperDork

HiTempguy wrote:

I also take issue with those arguing about government inefficiency; what do you think costs more, inefficiency or profit? Profit directly takes away from the amount of medical care a person can have (and also there is a moral issue with this IMO, but that is another discussion). Inefficiency is inherent in any system. You can't get "rid" of profit, but you can reduce inefficiencies.

I will gladly pay someone who gives me efficient care 10%-20% extra in profit rather than pay the same amount in inefficiency. Profit doesn't waste my time. Inefficiency does. Profit is not evil. It is why people make the effort to work.

Besides, read all the stories about cost-efficiency in government - like the legendary $400 hammer - and tell me if you think that government inefficiency is anywhere close to being less than 20%. You say you can "reduce" inefficiencies, but in a government system there is absolutely zero incentive to do that.

I can fire my doctor and go somewhere else. Let me know how firing the government is working out.
June 17, 2011 10:45 a.m. HiTempguy Dork

Duke wrote: I can fire my doctor and go somewhere else. Let me know how firing the government is working out.

But you already are paying $75 for that box of bandages (as was quoted elsewhere in this thread). You also are saying that inefficiencies would be equal to the amount of money given to profit, to which I say, ludicrous.

Also, from what I can tell, our "not that bad" is WORKING better than your "not that bad". Anybody, anywhere in Canada can get treatment, and they aren't going to go bankrupt. You can not say that for the US, and that is a large difference to me. Of course, it also opens up a whole new can of worms on the core differences of our societies, but still...

I also (as said before) take issue with somebody making a 20% profit on the misfortune of others that they can't help.
June 17, 2011 10:58 a.m. tuna55 SuperDork

HiTempguy wrote:

Duke wrote: I can fire my doctor and go somewhere else. Let me know how firing the government is working out.

But you already are paying $75 for that box of bandages (as was quoted elsewhere in this thread). You also are saying that inefficiencies would be equal to the amount of money given to profit, to which I say, ludicrous.

Also, from what I can tell, our "not that bad" is WORKING better than your "not that bad". Anybody, anywhere in Canada can get treatment, and they aren't going to go bankrupt. You can not say that for the US, and that is a large difference to me. Of course, it also opens up a whole new can of worms on the core differences of our societies, but still...

I also (as said before) take issue with somebody making a 20% profit on the misfortune of others that they can't help.

I understand your sentiment, and I think you understand mine. Furthermore, if we went in to a room with real facts about each system, I am sure we'd see issues with both and good points as well. It's simply that the right side wants more privatization as a solution and the left side wants more socialization as a solution. The truth is that our system, like many of them, is pretty muddied between socialism and capitalism and honestly probably takes a lot of the bad points of both and combines them into a fierce evil thing where the worst parts of each stick out like crazy. Does the fact that rationing care is going to be just about inevitable mean socialization is without merit? No. Do $75 band-aids mean that the capitalization is without merit? No as well.
June 17, 2011 11:05 a.m. oldsaw SuperDork

HiTempguy wrote:

But you already are paying $75 for that box of bandages (as was quoted elsewhere in this thread). You also are saying that inefficiencies would be equal to the amount of money given to profit, to which I say, ludicrous.

The price we pay for that package of bandages is heavily influenced by government regulation. The cost is high because it establishes a negotiation point; start high and work down in the hopes of breaking even and maybe (even) make some profit.

A socialized program in the US would take away the profit but the regulatory restrictions and rules would never go away. With dwindling resources and a huge increase in the numbers of those covered, the burden would only get worse.

Eliminating the profit influence would sure help in further exposing the bureaucratic waste, though.
June 17, 2011 11:35 a.m. Duke SuperDork

HiTempguy wrote:

But you already are paying $75 for that box of bandages (as was quoted elsewhere in this thread). You also are saying that inefficiencies would be equal to the amount of money given to profit, to which I say, ludicrous.

I don't think it's anything like ludicrous, for all the reasons oldsaw outlines above, plus my own observations. However, I don't have time or energy to bring up figures, and I haven't seen any from you, so I'm willing to table this part of the discussion.

HiTempguy wrote:

I also (as said before) take issue with somebody making a 20% profit on the misfortune of others that they can't help.

I "can't help" that I was hungry last night at dinnertime. It was a naturally occurring event caused by the very process of my being alive.

Does that mean it was immoral for the farmers and store to profit from selling me the hamburgers and corn that I grilled? After all, I was born with the "misfortune" to need food. I can't help getting hungry.
June 17, 2011 11:35 a.m. oldtin Dork

Just some random thoughts: Part of the problem with our healthcare/insurance system is that the customer/patient is disconnected or at least two degrees separate from the finances. In effect, the patient is not actually the customer (ask most doctors about this). If there is free market activity going on it's between insurers and healthcare providers and has little to do with the individual.

Insurers don't want to deal with the public for the most part. It's much more efficient to deal with larger groups, making it very difficult or at least expensive to get individual plans. Insurance group plans also have built-in bias against small groups/employers. Oh, and healthcare rationing is the norm now.

Most people go through the majority of their lives with minimal utilization of healthcare - up to the last few years or so of life, when they become heavy users - generally under a single payer system. People designing healthcare systems don't actually use it all that often.

There's a cultural issue as Americans - i.e. someone gets diagnosed with late stage cancer - from a big picture decision standpoint - attempts at curative care would be wasteful of resources - just make them comfortable for what is left of their life. What often happens now - "my family member is sick" - do whatever is available to fix them (usually with same outcome as doing nothing). Taking one for the team doesn't particularly sit well when it's you.
June 17, 2011 11:51 a.m. tuna55 SuperDork

It's my thread, so back on my personal situation...

2 days ago [ME] Hold on – after speaking with Gwen, I’m checking payroll records to confirm whether pay and benefits were extended past the 10/14/10 last day worked. Will let you know ASAP. [HR Jerk]

[HR jerk], Here is my last paycheck showing deductions for health insurance up to the very last day as I originally told you. As I specified, I got paid with benefits up until October 29. -[me]

today [HR Jerk] It's been nearly 48 hours now. Have you looked at the attached paystub clearly showing that I paid health insurance premiums up until October 29th? -[me]

[me] Enough smart mouth Brian. I put up with it when you were here. That was plenty.

You did NOT explain to me that your pay and benefits were extended through October 29. I had to sort that out myself.

48 hours is not too long to reconstruct and undo the mess that happened 8 months ago. If I’m inclined. You’re attitude isn’t helping.

[HR Jerk]

I actually did tell him three day ago that I was paid until 10/29, so he's dead wrong there, but other than that, did I actually say anything smart assed? I am confused.

now back to your regularly scheduled health care debate...
June 17, 2011 12:21 p.m. 92CelicaHalfTrac SuperDork

HR people don't like being proved wrong.

I'm dealing with an obnoxious head of HR lady right now for one of my clients.
June 17, 2011 1:09 p.m. tuna55 SuperDork

In reply to 92CelicaHalfTrac:

Apparently it's possible. I bit my lip and I think I got what I wanted.

[HR JERK] I genuinely fail to see how anything I have written thus far (or any conversations with you during my employment) can be construed as "smart mouth". Furthermore, my E-mail from 3 days ago does mention that my pay was extended to October 29, 11:30am, see the except below:

"Here is the note from [redacted] from when I left. I can get you a copy of my pay stub to prove that you paid me until the 29th. You ([redacted]) promised health insurance and pay until that period."

You replied roughly two days ago that you had received further information apparently agreeing with my account and that you were going to let me know "ASAP". I simply waiting 48 hours before asking you for an update.

Seriously, [HR JERK], I fail to see where this animosity is coming from. I have not been unkind or demanding. I simply wish to get this situation resolved quickly. Certainly your last statement seems to hinge the resolution of this issue on "my attitude", which gives me cause for concern.

Can you please provide a status and perhaps an estimated timeframe for resolution?

Thank you -[ME]

[ME],

[redacted] is out of the office this week and she is the authorized contact to make corrections to benefits effective and termination dates with Highmark Blue Cross. I have a note on her desk asking her to contact Highmark when she returns on Monday and change the effective date of your insurance coverage to extend through October 29, 2010 and to direct Highmark to reprocess and pay any claims not previously paid through that effective date. I expect [redacted] will be able to verify those instructions Monday or Tuesday of next week and that Highmark will process the claims via their standard procedures, which might take an additional week or two.

[HR JERK]
June 17, 2011 1:14 p.m. z31maniac SuperDork

Good, hope it all gets resolved for you.

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