Meanwhile, at the Capital...

aircooled wrote:

fritzsch wrote: We could always do away with insurance like a normal 1st world country...

I will just throw this in, and maybe Swank can comment on the possibility... ...many 1st world countries (e.g. Germany, Japan) DO have insurance, but there is one very critical difference, the insurance companies are non profit (!). They are also, in general, setup like the ACA, compulsory and the poor / elderly are subsidized. An interesting possibility, I am just wondering if there is ANY way the US would be able to convert the insurance industry into a non-profit industry. (can you say lobbyist sh$tstorm!) There is a very interesting Frontline program (I am told it is on Netflix) on various countries healthcare systems call Sick Around the World, that looks at various systems that are somewhat close to the US system (he does look at England which is fully government run). They are not as different as you might think. The insurance companies though, that's a big difference. Anyway, check it out, it's pretty objective about it (looks at problems etc.) Edit: Apparently you can watch it online: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/view/ I can honestly say, I am a bit embarrassed that I really did not know how other countries HC systems worked. I just assumed they were all single payer, fully government run systems (England, Canada?). I think there are a lot of people who might normally object, would look at these systems and say "hey, that's not that bad".

It's all a shell game. It's nice that everyone seems to have fallen for this misconception that insurance companies are the main issue, though. Made the initial push for the ACA to go through pretty easy, didn't it?

Forcing all health insurance companies to go non-profit won't change anything.

The non-profit goes along with tight government standards of course. I am not sure of the specific, but one of the insurance companies they talked to had operations cost of around 8%. I think they said in the US it was around 18%.

Not trying to say it would solve the problem (clearly there are others, legal being a big one) but it seems to be a common characteristic of non-US systems. Even in such a system, there would still be room for standard insurance, it would just be more of a supplemental system (kind of like medicare).

aircooled wrote: ...many 1st world countries (e.g. Germany, Japan) DO have insurance, but there is one very critical difference, the insurance companies are non profit (!). They are also, in general, setup like the ACA, compulsory and the poor / elderly are subsidized.

Couple of notes about this very nice line...

First of all- what does a insurance company do? Take my money, shave off some of it for cost of work, take some more off to pay shareholders and make money, and then the rest is used where they tell us how we are allowed to spend our healthcare $$. So we have midless breurocrat that tells me what to do, with their goal making money. How that is different from a government agency doing the same thing is beyond me. To pretend that the "for profit" will do a better job is laughable- since their goal is to just make money.

Second, again- what does an insurance company do- basically launder money- again, take it, pay for some paperworking, and then pay profits, and then pay for actual healthcare. They really bring nothing to the economy- they build or make nothing, they don't actually provide a service (that's the doctor's job- just move money around. So why we think this is such a great way of making money is interesting.

Thirsd- based on the last paragraph- how is it morally acceptable that we have an entire industry who makes money laudering based on paying out healthcare money? As a society, we make doctors take an oath of "do no wrong", which implies that we really care about taking care of each other, but turn right around and have an industry who's sole job is to just make money based on sick people.

Heath insurance IS NOT LIKE CAR OR HOME insurance. It's not hard to find people who don't or barely use their home owners or car insurance. But find one person who has never been to a hospital or not ever seen a doctor- those people are so few and far between, it's not even funny. Everybody is born, everyone dies- both of those time, 99.99999% of the population will do those two items using some kind of healthcare- you don't find many people not born in a hospital or not using some kind of ambulance/doctor/health system when they die. And virtually ALL people will go to a doctor sometime in between birth and death. The point of the system should be to minimize the expensive parts as much as we can. Not make massive profits- leave that to the industies who do stuff- like make cell phones, drill for oil, turn ore into steel.

Had to get that off my chest.

If all insurance companies were non profit, and the pay scale was similar to government positions, I'd be totally fine with that. Bonuses could be given if they keep more people healthy. Or single source.

But for-profit companies who launder money for health care- yea- not so much.

Well... they do provide a service. They are a bit like a shock absorber (dampener) in a suspension system, they average out the costs. Most people, strangely, do really see them that way though. Most people seem to view insurance as a more of a "pre-paid service" then an "averaging system". Maybe it's just not a good fit for Healthcare (for the reasons you state).

This is why I don't post in these threads anymore. Inaccurate figures, anecdotes passed as fact, when the anecdotes themselves are often comolete bullE36 M3, and the effects of a shell game that has caused a total misdirection of blame.

Followed by lots of great ideas that do nothing to adress the larger issues at hand.

Inb4 someone bitches about some huge surplus that some insurance company somewhere has.

'Murica!

Swank Force One wrote: Forcing all health insurance companies to go non-profit won't change anything.

Yes, it would.

Do some quick math- google the best of the best companies in terms of your money in vs. money out. At the best group rate ever, companies take off about 15%, so that every dollar you pay, the money available to pay for health stuff is $0.85. Most real plans are 18-25% taken off. Whereas medicare, the worst I've ever seen posted- even on the most conservative is about 7%, but more like 3-5%.

Companies can be a lot more efficeint in their paperwork, certainly, but when it's a profit game, it's amazing how much is taken.

Anyway, if all of us who had insurance paid exactly the same, and used exactly the same, going from 15% to 5% would cover all people who are not insured. And have some left over.

It would not fix everything, sure. But it would be a massive game changer.

Datsun1500 wrote: If I am born with a birth defect I should expect someone else to pick up the cost of that issue? Why? Serious question, why is it up to someone else to have that burden? It sucks, but sometimes life sucks. I think you should be able to to get insurance that will cover everything except the pre existing condition, but expecting someone else to cover the cost of the pre existing condition seems unreasonable. Where will that money come from?

I am not saying that person shouldn't have to pay more but to deny them completely is ridiculous.

slefain wrote: <---------Like that?

fritzsch wrote: It seems crappy on the face of it until a drunk driver slams into you and you lose a leg.

After dealing with my car insurance company, my health insurance company, and various doctors I got to see first hand just how insane our medical system is. The worst was the collection-style phone calls from my own health insurance company. I legally didn't owe a dime to them but they sent countless "statement of benefits" forms with prepaid envelopes detailing how I can make a payment. Then they would call and berate me for not paying them because "someone has to pay" (their words). Not once did they ever send a proper bill with a due date nor state that I legally owed them money, just intimidating phone calls and letters. Who knows how many people fall for this scummy tactic. I finally told someone on the phone that I was forwarding all their "bills" to our state insurance commissioner. I never heard from them again! The medical industry in general needs an overhaul, but no politician will ever have the stones to try it.

Well said stefain…these non value added activities are a huge cost driver in our medical system and from a technical prospective, can be greatly reduced quickly and easily; it’s just the lack of political will.

I have no problem with chipping in to help someone that was born with birth defects. In fact, much of the cost would be recovered by eliminating the cat-n-mouse game we now have of hiding conditions, denying claims, etc.. What I object to is having a system that blatantly encourages people to blow off getting insurance until they have a big expense which exactly what the AHA does. It’s an insult to even call it insurance at that point.

A movie quote I find myself coming back to more and more is from Top Gun when Maverick buzzes the control tower and the commanding officer yells in the radio saying “hey man, the tax payers spent 20 million on that plane, you're cutting checks your ass can’t cover”. This is the AHA in a nut shell…it increases compassion without a reasonable plan to pay for it. Instead, we should minimize the waste and then apply the savings to increasing compassion.

Mr. President, you’re cutting checks your ass can’t cover.

aircooled wrote: Well... they do provide a service. They are a bit like a shock absorber (dampener) in a suspension system, they average out the costs. Most people, strangely, do really see them that way though. Maybe it's just not a good fit for Healthcare (for the reasons you state).

A non-profit governent agency can take a pool of money and average out the costs. Or just a non-profit company.

yeS! Let's grow the gov't even MORE! That will fix it. I've never seen a gov't agency completely overstep it's bounds, come in at 4 times the cost and fix absolutely nothing before.

Look, you want complete gov't oversight, move to Europe. LEave us the berkeley alone.

In reply to RX Reven':

Where does the Individual Mandate fall with regard to preventing people "blowing off" insurance 'til they have a big expense?

I would like to know where the funds for non-compliance penalties go; I would hope, in simplified terms, that they'd be available as part of the same pool of funds people are paying into when they buy insurance. Thus even people who don't buy insurance are helping to pay for the fundamental fact that we all pay for people who don't have it and get sick/injured.

This is the first thing that springs to mind when I hear the suggestion that the ACA encourages not carrying insurance.

Swank Force One wrote: This is why I don't post in these threads anymore. Inaccurate figures, anecdotes passed as fact, when the anecdotes themselves are often comolete bullE36 M3, and the effects of a shell game that has caused a total misdirection of blame. Followed by lots of great ideas that do nothing to adress the larger issues at hand. Inb4 someone bitches about some huge surplus that some insurance company somewhere has. 'Murica!

http://www.bcbsm.com/content/dam/public/Consumer/Documents/about-us/bcn-annual-report-2012.pdf page 13- the non proft Blue Care Network of Michigan reports premiuim revenue of $2.632B (that's what we pay), and Health Care Benefits of $2.185B. So for this non-profit company, 83% of what the users pay in are paid back out to keep them healthy.

this is their report, mind you.

Swank Force One wrote: Protect them from what, for example?

pre-existing deniability, price gouging, non-competitive (monopolistic) market environments...there is a pretty long list

Bobzilla wrote: yeS! Let's grow the gov't even MORE! That will fix it. I've never seen a gov't agency completely overstep it's bounds, come in at 4 times the cost and fix absolutely nothing before. Look, you want complete gov't oversight, move to Europe. LEave us the berkeley alone.

So you are ok with a healthcare company denying you some basic service so that they shareholders profit more? We are not talkign about an OEM radiator, but giving you the most up to date heart opreartion.

BTW, being a part of industry that has massive amounts of goverment regulations to field- from workers, working conditions, plant pollution, car safety, car emissions, etc... the auto industry somehow STILL manages to be one of the biggest industries in the world. Heck in the time I've worked here, government regulations have increased quite a bit- yet we've figured out how to make cleaner, safer, more efficent cars, with more content, all for less money. All with increased regulation. It's amazing how creative people can get....

Again, you want more gov't oversight, there's plenty of places offering that right now.

Our gov't has yet to run anything at cost or on time. The LAST thing I want them involved with is my berkeleying HEALTH. Wife had a very serious surgery 2 years ago. Spent well over aweek in the ICU and has had multiple things pop up since.

NOt a single claim has been declined. WE've never paid more than our deductibles. A $100+k surgery/hospital stay cost us $1000. What do I have to complain about?

alfadriver wrote:

Swank Force One wrote: Forcing all health insurance companies to go non-profit won't change anything.

Yes, it would. Do some quick math- google the best of the best companies in terms of your money in vs. money out. At the best group rate ever, companies take off about 15%, so that every dollar you pay, the money available to pay for health stuff is $0.85. Most real plans are 18-25% taken off. Whereas medicare, the worst I've ever seen posted- even on the most conservative is about 7%, but more like 3-5%. Companies can be a lot more efficeint in their paperwork, certainly, but when it's a profit game, it's amazing how much is taken. Anyway, if all of us who had insurance paid exactly the same, and used exactly the same, going from 15% to 5% would cover all people who are not insured. And have some left over. It would not fix everything, sure. But it would be a massive game changer.

Most real plans are not 18-25% off, because there's regulations for that that have been in play since 2011. Look how much lower your premiums were and how much improvement was made when that happened. Pretty incredible, huh? Oh, wait..... that's not gone well.

Using Medicare as a model for pretty much anything is one of the more laughable things i've seen in recent history, so... thanks for that.

But again.... sure, changing the mandated percentages to 90% and 95% respectively would give more money to pay out. (And cause a lot of job loss and efficiency.) It still doesn't do anything but put a band-aid on a symptom.

4cylndrfury wrote:

Swank Force One wrote: Protect them from what, for example?

pre-existing deniability, price gouging, non-competitive (monopolistic) market environments...there is a pretty long list

Pre-existing is going away already. I'll agree with that one.

Price gouging, you're going to have to explain, since it doesn't make sense.

Monopolistic environments, sure... there's 2-3 really big companies, then a bunch of small companies. Not really a monopoly, but with the regulations in place, a monopoly probably wouldn't change anything.

Let's flip this around, though, it'll be fun-ish.

What do health insurance companies protect you from?

In reply to Swank Force One:

No sarcasm or ill intention, Im honestly interested simply for the sake of information. I seem to remember you being employed in a field related to Medical Insurance (if this is incorrect, you have my apologies). Are there potential "fixes" to the current insurance industry that could make obtaining/affording coverage easier for those on the fringe? If so, what are they? Is the answer really ACA, or are there other corrective actions that should take place in our current situation?

ransom wrote: In reply to RX Reven': Where does the Individual Mandate fall with regard to preventing people "blowing off" insurance 'til they have a big expense? I would like to know where the funds for non-compliance penalties go; I would hope, in simplified terms, that they'd be available as part of the same pool of funds people are paying into when they buy insurance. Thus even people who don't buy insurance are helping to pay for the fundamental fact that we all pay for people who don't have it and get sick/injured. This is the first thing that springs to mind when I hear the suggestion that the ACA encourages not carrying insurance.

In 2014, the fine for not having insurance will be a tiny fraction of the price of a policy. Although the fines will increase over the next several years, even at their cap, they’ll be much lower than a policy for lower income people.

Perhaps you’ve heard of what’s being referred to as the “death spiral” which is the possible scenario that more young, healthy people will opt for the fine than expected. If this happens, rates will need to be increased causing even more to opt for the fine and down the whole system will go.

Bobzilla wrote: Our gov't has yet to run anything at cost or on time. The LAST thing I want them involved with is my berkeleying HEALTH.

As I've been saying since 2006, go to a VA Hospital for an example of Government Health Care.

(Hint - It's not pretty)

I'd like to see how many people were flat denied any life saving medical treatment in this country because they couldn't pay for it.

Go ahead, I'll wait. Oh, that's right, they aren't. So save me the sob story "oh think of the children" bullE36 M3. If someone needs medical attention, they receive it. Period. We're already paying for it as it is. Why the berkeley we need to get the gov't involved to make it even more complex, convoluted, overpriced and berkeleyed up is beyond me.

Some people just need to be told what to do. I'm not one of them. So please, take your Big Brother gov't somewhere else. Canada is always accepting more people to pay their taxes.

Swank Force One wrote: What do health insurance companies protect you from?

Simply: Not being able to afford to stay alive.

Now, in a previous post, I mentioned that part of the problem, as I see it, is that medical care has become incredibly expensive due to medical providers needing to cover their asses - unnecessary medical procedures being performed to avoid a negligence suit among other things. As well as the problem of providers charging their patients more in order to cover the malpractice insurance (gasp) costs incurred by them - the docs pass the cost of insuring them against a suit on to us.

Fix these problems that have driven costs up, and the ACA may not have been necessary

4cylndrfury wrote: In reply to Swank Force One: No sarcasm or ill intention, Im honestly interested simply for the sake of information. I seem to remember you being employed in a field related to Medical Insurance (if this is incorrect, you have my apologies). Are there potential "fixes" to the current insurance industry that could make obtaining/affording coverage easier for those on the fringe? If so, what are they? Is the answer really ACA, or are there other corrective actions that should take place in our current situation?

You're not asking the right questions, though. Nobody in this thread is, which is a repeat of every single thread we've ever had on the subject. Everyone fell for the shell game.

Insurance costs are reactionary. Yes, there's some thing about health insurance in this country that aren't great. They're far outweighed by what's not great about health CARE.

And you won't offend me, don't worry. I'm just in this for the paycheck. As of 2014, the portion of my insurance premiums that i'm responsible for have increased 2.5x, and the amount my employer is contributing to my HRA has been halved. But yet, i'm not mad at the insurance company. (Well... in a roundabout way, i am, but that's just because they cut my paychecks and i'm disappointed that my employer wouldn't have stepped up to the plate and covered more of the premium. But, it's better than getting laid off because of the increase in costs.)

bravenrace wrote: Not at all. You just misunderstood what I said.

At the end of the day, it is the evil big bad guberment that makes it even possible. If left to normal everyday shortsighted people, we'd end up with... a system like you guys currently have.

Bobzilla said: Canada is always accepting more people to pay their taxes.

Bob, first of all dude, take it easy. You have seriously been getting in a lot of fights on GRM lately. CHILL buddy! I know these topics can be exciting and get us worked up, but step back for a second and pause.

Anywho, Canadians on average pay no more tax than the typical American. That is fact. You're suggestion that people are "flat denied any life saving medical treatment" is not the point. First, a proper healthcare system is preventative. SECOND, your system may allow people to receive said treatment, and then it bankrupts them for the rest of their lives... might as well be dead at that point.

Swank Force One wrote:

4cylndrfury wrote: In reply to Swank Force One: No sarcasm or ill intention, Im honestly interested simply for the sake of information. I seem to remember you being employed in a field related to Medical Insurance (if this is incorrect, you have my apologies). Are there potential "fixes" to the current insurance industry that could make obtaining/affording coverage easier for those on the fringe? If so, what are they? Is the answer really ACA, or are there other corrective actions that should take place in our current situation?

You're not asking the right questions, though. Nobody in this thread is, which is a repeat of every single thread we've ever had on the subject. Everyone fell for the shell game. Insurance costs are reactionary. Yes, there's some thing about health insurance in this country that aren't great. They're far outweighed by what's not great about health CARE. And you won't offend me, don't worry. I'm just in this for the paycheck. As of 2014, the portion of my insurance premiums that i'm responsible for have increased 2.5x, and the amount my employer is contributing to my HRA has been halved. But yet, i'm not mad at the insurance company. (Well... in a roundabout way, i am, but that's just because they cut my paychecks and i'm disappointed that my employer wouldn't have stepped up to the plate and covered more of the premium. But, it's better than getting laid off because of the increase in costs.)

So then provide us more insight. If youre an insider, tell us what it is that we are missing. I posted a few times now regarding the cost of care versus the cost of insurance.