Your opinion on health insurance costs please

[ryco]

Medicaid is a separate govt insurance program for the poorest of the poor, their children, the elderly, and the disabled. Another reason so many are rejected from this program is you have to be so poor/disabled to get on it. In Oregon we have the Oregon Health Plan, which is a good deal for those too poor to be able to afford private insurance. To get on it though you can't have any assets or very much money in your savings account. My wife and I tried getting on the Oregon Health plan when we moved here, but we were denied because we own our home.

An alternate plan for the USA would have been to bring every one into coverage under Medicare - not Medicaid. One good point of going this route is the system is already set up and works pretty well. At least people who are in the program seem to like it pretty well.

I don't mind paying a private health insurance company money for my care. I would rather have private industry handle health care coverage, but I want the vast majority of what I pay an insurance company going to provide MY health care - not to let the company play the market to make their shareholders and upper management rich off of Wall Street. I hire them to provide a service unto me & my family.

By the way there is free healthcare in the USA. It's called the emergency room at your county hospital. I used the ER in leaner times. But that "free" service is payed by taxpayers and passed on to health insurance premiums. One way or another the US taxpayer is paying for everybody's health care. Might as well have everybody accountable and putting something in the pot.

[HeavyDuty]

Certain people can't keep away from the shiny political toy and ruin it for everyone... closed.

[HeavyDuty]

OK, I'll make you all a deal. I want to see thought provoking discussion like this here too, but at the same time we are trying to prevent a race to the bottom with partisan politics. Mods can't be here all the time, we rely on thread reports.

Can y'all help police this thread and use the thread report function if things go off the rails?

[jmattbassplaya]

Originally Posted by HeavyDuty

OK, I'll make you all a deal. I want to see thought provoking discussion like this here too, but at the same time we are trying to prevent a race to the bottom with partisan politics. Mods can't be here all the time, we rely on thread reports.

Can y'all help police this thread and use the thread report function if things go off the rails?

Thanks, Ken!

[Rusty Chainsaw]

HeavyDuty - can do. This is interesting discourse. Just nobody mention the word "O****care", OK?

Here's a thought I had that might get some traction in the US, since it's an almost entirely capitalist solution - how about if a single healthcare entity was set up, but wasn't government-controlled? There's no reason why single-payer healthcare has to be a government payer, it could just be a government-sanctioned monopoly, that could have its remit removed for failing to perform, and the tender could be renewed every ten years or so. The advantage here is that, in addition to being able to take full advantage of the economies of scale, the company could be floated on the stock exchange - dividends from the stock might even cover the premiums and have universal healthcare practically pay for itself!

[Relic]

Interesting idea actually..

[burk48237]

Originally Posted by Phil Smith

Do you know which CEO of a health insurance company made the least amount of money last year?

I find it hard to believe that all of the public institutions, fire, police, transportation, education, military, etc, can all be run effectively, note I didn't say perfectly, but health care can't.

The problem is your premise is false, a vast majority of public institutions are not run effectively, most are massively in debt especially if you look at their unfunded pension liabilities. California alone has more unfunded liabilities than some of the countries in the European Union.

And Health care is exponentially larger. In the US Health care is about a 2.5 Trillion dollar expenditure, Which is larger than the entire economy of England, Brazil, Russia, Italy or Canada for instance. I don't think we can even begin to fathom how to run that.

From what I can see the problem is the current system which isn't changed only subsidized and more heavily regulated under the new plan, is the worse of both worlds. We limit competition by not letting people buy across state lines, we limit choices by mandating certain types of coverage that should be elective proceeders, and we add heavily to the cost by a generous tort system (unlike any other in the world) and we eliminate the consumer from the equation. There is no competition in the US for insurance dollars for the consumers of those dollars. It's employers and regulators that make the choices.

As far as the rich CEO's of insurance companies, why don't you take it up with the rich malpractice lawyer? They are both adding massive unnecessary cost to the business.

[MakiSupaStar]

Originally Posted by HeavyDuty

OK, I'll make you all a deal. I want to see thought provoking discussion like this here too, but at the same time we are trying to prevent a race to the bottom with partisan politics. Mods can't be here all the time, we rely on thread reports.

Can y'all help police this thread and use the thread report function if things go off the rails?

Thanks Ken. We're at an interesting time in history. Thanks for keeping it open.

[fdeck]

Originally Posted by Rusty Chainsaw

HeavyDuty - can do. This is interesting discourse. Just nobody mention the word "O****care", OK?

Here's a thought I had that might get some traction in the US, since it's an almost entirely capitalist solution - how about if a single healthcare entity was set up, but wasn't government-controlled? There's no reason why single-payer healthcare has to be a government payer, it could just be a government-sanctioned monopoly, that could have its remit removed for failing to perform, and the tender could be renewed every ten years or so. The advantage here is that, in addition to being able to take full advantage of the economies of scale, the company could be floated on the stock exchange - dividends from the stock might even cover the premiums and have universal healthcare practically pay for itself!

Public funded private entities are among the most corrupt. The optimal strategy is to line the pockets of cronies (through "consulting fees" etc.) while posting fake results and running the business into the ground. Then the gov't would have to bail it out, and start the cycle over again.

[labman72]

I'll try to give a Canadian perspective on this issue (not sure if we've had one yet).

I've heard a lot of Americans call our system "socialist" healthcare, but up here we just refer to it as universal. Our system would be very similar to Englands. Each province has a Ministry of Health. Money for health care is collected from both provincial taxes and by way of federal money transfers (money from Federal tax). Hospitals are built using government money and through local fund raising. Money is then distrubuted by the MOH to individual hospitals to run as they see fit, offering the services that they can afford (small hospitals obviously can not offer all services). Doctors set up there own office and "bill" the MOH in a fee for service model. We are allowed to go to any doctor we choose, and can ask to be referred to any specialist we want. Eye care, dental and prescriptions are paid out of pocket or as part of employment benefits.

As a Canadian, it is foreign to think that an insurance company or hospital board of directors would profit from other peoples health problems. I also would never begrudge anyone less fortunate than me the same level of healthcare that I receive.

Just think how much less U.S health costs would be if there was no insurance companies or hospitals profiting from healthcare!

[pbasswil]

Originally Posted by labman72

I'll try to give a Canadian perspective on this issue...
I've heard a lot of Americans call our system "socialist" healthcare,

Another Canadian here.

I'll offer the opinion that the word "socialist" is politically loaded, but what it exactly signifies is ill-defined.

There are many services that various national governments fund; which exact set of services varies from country to country.

Obviously, most nations fund things like roads, police forces and military, air traffic control, (etc.) collectively. These serve common needs, so they're funded from the collective tax base.

Well all peoples need health care. In the developed world, most governments fund it out of the common tax base.
Is that socialist? It may seem to be -- if your own country _doesn't_ fund it.

I'm sure there are countries (probably not-so-developed ones) where the only available schooling is private. So publicly funded lower education may seem socialist from their point of view.

[pbasswil]

A couple of thoughts on the Canadian health system:

It's a very different approach from the American system, so naturally there are a different set of plusses and minus -- different compromises have been struck. Examples:


Plusses:
Well, up here there aren't as many paper-pushers to compete for a cut of the health care dollar.

As long as you are a Cdn. citizen, you qualify for the same care as anyone else. No one lacks coverage.
If you change (or lose) jobs, there's isn't an anxious scramble to make sure coverage isn't interrupted.

Minuses:
Because health care providers can't charge whatever they want, the professions aren't as lucrative. Without big $$ incentive, there aren't as many people choosing to become doctors and nurses. So we're kind of short on them.
(Mind you, to train to be a doctor or nurse in a Canadian university probably costs about 15% of what it costs in the US.)

Waiting times: If any Canadian citizen has a real medical emergency, chances are very good he'll get immediate care.
But if we have a gradually deteriorating condition that requires therapy or an operation, we may well end up on a waiting list. Certain operations for common non-life threatening conditions have long waiting times.

Frankly, I have the impression that our Cdn. system isn't functioning quite as well as the UK system. But I've never had serious problems getting any health care that I've needed.


It's natural to be wary of what we're not used to. Americans have no experience of nationalized medicine, so it seems foreign, and rife with dangers.

As a Canadian, the idea of living in a place where an insurance company would love to find a loop hole to deny you coverage sounds plenty dangerous to me!

[John003]

If you search for health insurance cost, you will get a variety of prices from different insurance companies for very similar policies. Mostly affected factors of this cost are two: 1. Physical and Medical Risk Factors 2. Lifestyle and Personal Risk

For myself I am paying 200 for a month

[Steve]

For my needs, I've pretty much found out what I wanted to know. Despite the vast difference in what people pay, they seem to have a pretty uniform view of what it is worth as a fair value.

Closing the thread would work fine for me. It's a huge deal to me and I would love to talk about it but not at the expense of causing hard feeling or high work load for the mods.

Which is really just my way of saying, past this post, It's on you guys, not me.

CNN had what I thought was a super interesting piece done by Fareed Zacaria (SP?) that compared the systems of all over the world.

As long as you cling to the notion that USA has "the best health care system in the world" it's pretty hard to talk about improving it.

If you can step back and accept about every study I've ever seem that reports vastly different ratings, change become a lot more palatable (to me at least).

[deeptubes]

Insurance companies' primary concern is making money. They don't care about anyone's health. They just want to make money off of it. It's all about the bottom line. If you need a procedure to save your life and they think it's not economically viable, they will decide it is "experimental" and watch you die. If an insurance company watches you die and does nothing to stop it, they pat each other on the back and call it "good business". If you or I watch someone die and do nothing to stop it, it's a criminal act and we can face jail time.

[1958Bassman]

Originally Posted by burk48237

Of course its underfunded as is every entitlement program. None of which have come close to the revenue (always too high) or the spending projections (always too low) that they had when they were created.

The CBO has already upped its cost estimates for the new plan considerably, and I'd be willing to bet a healthy sum of money that they are still way low on cost. Nobody has a clue how much Health care will cost for three hundred million people because it simply hasn't been attempted before. And the track record on other exponentially smaller programs which are all headed for insolvency is not good. It's a bit like taking out a 10 million dollar mortgage on a new place when your in foreclosure on three or four other places.

No entitlement program will make it through Congress if the real costs are revealed, so they're always under-stated.

[1958Bassman]

Originally Posted by pbasswil

A couple of thoughts on the Canadian health system:

It's a very different approach from the American system, so naturally there are a different set of plusses and minus -- different compromises have been struck. Examples:


Plusses:
Well, up here there aren't as many paper-pushers to compete for a cut of the health care dollar.

As long as you are a Cdn. citizen, you qualify for the same care as anyone else. No one lacks coverage.
If you change (or lose) jobs, there's isn't an anxious scramble to make sure coverage isn't interrupted.

Minuses:
Because health care providers can't charge whatever they want, the professions aren't as lucrative. Without big $$ incentive, there aren't as many people choosing to become doctors and nurses. So we're kind of short on them.
(Mind you, to train to be a doctor or nurse in a Canadian university probably costs about 15% of what it costs in the US.)

Waiting times: If any Canadian citizen has a real medical emergency, chances are very good he'll get immediate care.
But if we have a gradually deteriorating condition that requires therapy or an operation, we may well end up on a waiting list. Certain operations for common non-life threatening conditions have long waiting times.

Frankly, I have the impression that our Cdn. system isn't functioning quite as well as the UK system. But I've never had serious problems getting any health care that I've needed.


It's natural to be wary of what we're not used to. Americans have no experience of nationalized medicine, so it seems foreign, and rife with dangers.

As a Canadian, the idea of living in a place where an insurance company would love to find a loop hole to deny you coverage sounds plenty dangerous to me!

I made one point very obvious- the part about being a Canadian citizen. We have hospitals closing all over because they aren't being paid for the care they give and this is part of the reason. California, AZ and the other border states are particularly hard-hit, but even here in Milwaukee, we have lost hospitals. Your government-run health care excludes non-Canadians, yet people want the US to insure anyone who walks through the door.

Re: denying coverage through loopholes- it's easy to see why they do it when bonuses and shareholder dividends are at stake.

[pbasswil]

Originally Posted by 1958Bassman

...Your government-run health care excludes non-Canadians, yet people want the US to insure anyone who walks through the door.

We have a ton of immigrants up here, and considerable illegals too. To tell the truth, I haven't researched the issue of just how they get health care. It's not a topic that's in the news, so I guess there's no big acrimony about it.

Re: denying coverage through loopholes- it's easy to see why they do it when bonuses and shareholder dividends are at stake.

That, to me, is a terrifying concept. The best care for me, pitted squarely against the best profit for legions of professional paper-pushers and investors? ≈8^{ Who's likely to win that tug of war? Would I have to fight tooth and nail to dispute denials -- at exactly a time when I or a family member were going thru a health crisis?

Honestly, I have nothing against free enterprise or profits; but to a non-American that sounds like the wild west at its harshest. Mercy for the sick and injured!

[bassguppy]

Originally Posted by John003

If you search for health insurance cost, you will get a variety of prices from different insurance companies for very similar policies. Mostly affected factors of this cost are two: 1. Physical and Medical Risk Factors 2. Lifestyle and Personal Risk

For myself I am paying 200 for a month

Can u provide a little information on your health coverage? Is it a $200 a month private policy or partially funded by your employer? Any deductible? Full coverage or catastrophic? $200 for a private policy seems like a great deal.

[burk48237]

Originally Posted by pbasswil

A couple of thoughts on the Canadian health system:

It's a very different approach from the American system, so naturally there are a different set of plusses and minus -- different compromises have been struck. Examples:


Plusses:
Well, up here there aren't as many paper-pushers to compete for a cut of the health care dollar.

As long as you are a Cdn. citizen, you qualify for the same care as anyone else. No one lacks coverage.
If you change (or lose) jobs, there's isn't an anxious scramble to make sure coverage isn't interrupted.

Minuses:
Because health care providers can't charge whatever they want, the professions aren't as lucrative. Without big $$ incentive, there aren't as many people choosing to become doctors and nurses. So we're kind of short on them.
(Mind you, to train to be a doctor or nurse in a Canadian university probably costs about 15% of what it costs in the US.)

Waiting times: If any Canadian citizen has a real medical emergency, chances are very good he'll get immediate care.
But if we have a gradually deteriorating condition that requires therapy or an operation, we may well end up on a waiting list. Certain operations for common non-life threatening conditions have long waiting times.

Frankly, I have the impression that our Cdn. system isn't functioning quite as well as the UK system. But I've never had serious problems getting any health care that I've needed.


It's natural to be wary of what we're not used to. Americans have no experience of nationalized medicine, so it seems foreign, and rife with dangers.

As a Canadian, the idea of living in a place where an insurance company would love to find a loop hole to deny you coverage sounds plenty dangerous to me!

Living in a border town I see many of the things you see about the Canadian system. There is no doubt that it is a great system for the young and healthy.

For the most part their care needs are limited and not as time constrained. And they pay into the system far more than they take out even though their contributions in many cases are limited by lower incomes.

In Emergency care from what I've read and the Canadians I've talked to, it really depends on the Hospital. There is a doctor shortage in Canada (it's far worse in the UK), as medicine is becoming less and less a field that is attractive to the best and brightest due to low earning potential.

A large percentage of Canada's medical students leave the country with their degrees to make real money in the States. I suspect this problem will get worse, although maybe not because Canada seems to be moving back to some private HC for the wealthy (much like the US system).

OTOH, when it comes to terminal diseases and long term survival rates, the US Health care system is far superior. Your chances of getting diagnosed early and getting treatment for Cancer, or a Heart condition is far better in the States than most anywhere on the planet. The Cancer survival rates (early treatment is key) are almost 10% in the US than most of Europe and Canada.

Obviously if you're waiting six months to a year for testing, a common problem in Canada your survival rates when something like Cancer is going to be far lower.

One of the other things that skewers HC statistics is that the US has a much higher murder and violent crime rate. Obviously chest wound gun shot victims survival rates aren't that good. I suspect if you took illegal immigrant care and victims of violent crime out of the HC stats the US would rate far better.

The US does not have the best HC system in the world, all though I don't know if there is such a thing. They all have problems. But, for those who can afford it, the US offers the best HC in the world, there is a reason that Sheiks and European monarchs fly here for treatment to places like Karmonos and Mayo Clinic.

The question in the US is how to pay for all this care?

Should everyone be eligible no matter what their income or life style?

I don't know the answer to that one. In Canada a 69 year old man will probably not be approved for a knee replacement. Even though he could live another twenty years and the pain could be excruciating with out it. In the US some insurance companies pay for knee replacements for 80 year old men. These are not easy choices.