Health insurance death spiral
Here’s another piece to read, and then send to everyone you know.
If they’re anything like my (almost universally liberal) friends, they won’t read it. Or if they do, they won’t believe it. Or if they read it and believe it, they’ll think it’s a small price to pay because it will inevitably lead to a public option and universal, although more costly, coverage.
Way back in the early days of this blog, when health care reform was barely a gleam in Obama’s eye, I wrote a piece called “The health care is always greener on the other side.” I think some of it bears repeating:
Socializing anything, including health care, tends to lead inexorably to wider availability of a more mediocre service. I am reminded of the drab high-rises of eastern Europe under the Soviets, the norm of tiny apartments shared by multiple families, the hackneyed art, the lack of variety in the stores, the dullness of reduced expectations for everyone. Everyone, that is, except the elites…
In the US, we don’t lack for proposals to solve our health care system’s problems, but my guess is that all of them are flawed because they all involve difficult choices about allocating resources. I think most people would agree (although not the most extreme Social Darwinists) that we need to have some sort of bottom line health care for everyone, although we don’t agree on how to provide it, how much is enough, or at what point it would kick in (at death’s door, or preventatively, or somewhere in between?). The answers to these questions depend on the answers to the larger questions: how far are we willing to go towards health care equality, and how low will our standards of general health care have to dive in order to attain it?
So, how low we will go?
It’s the “easy button” syndrome.
Too many Americans want things free and easy,and work and effort are simply forgotten.
Was it Burke who said that democracies die when the populace realize they can vote benefits for themselves? (huge paraphrase).
Anyway, I think we’ll sink all the way to the bottom, and then split along idealogical lines, into two countries.
We’ll go as low as the know nothing Democrats take us…
That’s not to say that the Republicans know a lot either…
So many in this country need to learn economics 101.
Look… I’ve read people who like Canada, Great Britain and Germany care and I’ve read people who actually look at the systems with open eyes.
We have problems in this country… but we will have another entirely different and worse set of problems emulating Massachusetts, GB, Germany or Canada.
What a lot of people want is health care for free…. because it is a right… when the reality slaps people upside the head… there is the simple truth that doctors won’t go to 12 years of schooling to do their practice their love for free.
Many volunteer services.
We need to have a system where people exercise MORE AND MORE personal responsibility.
Exercise, eat right on your own dime.
Buy catastrophic coverage at the least.
I’m not interested in a system owned and operated by the government.
We need more local control. We need you and i to control our own system.
That is capitalism. Capitalism defined is PEOPLE choosing who gets what resources (with our every day decisions).
THis power grab has to stop!
According to the writer, “As matters stand now, if the Baucus bill were to become law, in a couple of years Congress would be forced to take up the issue again to clean up the mess the bill will have created.”
Perhaps that’s the best outcome we can hope for from this disaster. Remind the voters what a mistake their Democratic representatives made.
http://hotair.com/archives/2009/10/15/quotes-of-the-day-174/
Obama says, “he is just getting started”. “I’m not tired, I’m just getting started”.
Well start listening Obama. Learn economics. We can all prosper then.
Baklava, how can he learn economics? That involves sitting down at a desk and actually doing some work. Has there been ANY stretch of more than two days since he arrived in office that he actually has not left the WH to do some actual real work. He is in perpetual campaign mode. I believe the man is incapable of actually doing anything other than making speeches. Maybe that’s why his college transcripts have never been released.
Hong Says:
October 16th, 2009 at 12:49 pm
According to the writer, “As matters stand now, if the Baucus bill were to become law, in a couple of years Congress would be forced to take up the issue again to clean up the mess the bill will have created.”
No need, the public option will be there pick up any slack!
p,
He won’t. We will suffer because of it.
When it comes to things like health care, i’ve about decided we can either have unequal results or we can have rampant corruption in attempts to prevent it. I’ll take the inequality, which is ironically how the entire natural world is structured.
Neo said, “I think most people would agree (although not the most extreme Social Darwinists) that we need to have some sort of bottom line health care for everyone, although we don’t agree on how to provide it, how much is enough, or at what point it would kick in (at death’s door, or preventatively, or somewhere in between?).”
We have a bottom line now. It is called the ER. No hospital ER can turn away someone who wants (not needs) healthcare. One night I accompanied a friend to our hospital ER. (He was having a heart attack – from which, thankfully, he recovered.) I sat with his wife in the ER all night. Quite an education! There were many people who were indigent (and appeared might be illegal as well) who came in and were given care for everything from sick baby care, colds, and other non-threatening illnesses to fractures, gun shot wounds, etc. (This was a city with a lot of crime and a high number of immigrants.) Most of this care is done pro-bono and the hospitals make it up by overcharging those with insurance or who have resources to pay cash.
If you have no insurance but you have a job and you end up in the hospital, you will be expected to pay. The hospitals go after those types of patients quite relentlessly. When people talk about medical bills and bankruptcy that is usually what they’re talking about. It’s very hard to payoff a $150,000 hospital bill on a salary of $40,000/year. It isn’t a good system and needs to be fixed. But not with socialized medicine.
One way to put a stop to it would be to allow ERs to refuse to treat patients with no insurance. Then people would be more motivated to buy insurance – at least catastrophic coverage. What about the indigent? That is where store front, walk-in clinics could become a lower cost way to serve this group. They could be run on a non-profit, Medicaid style plan. Walmart wants to start clinics like that to serve their customers and if they could write off the pro-bono work, or get some Medicaid cash, they think they could make them work. Life- threatening cases could still be handled by ERs and the hospitals could write these off against their taxes as charity or use charitable programs (like church run hospitals do) to help defray the costs.
The real problem we have is the model of employer paid health insurance. That was a good plan back in the 40s and 50s when it got started. In those days people worked for the same company for 30 years and had some healthcare coverage in their retirement plan too. Today, very few people are staying at the same company for a full career and the lion’s share of employers are small businesses that can’t afford the good plans that the big corporations provide. The result is that people lose coverage when they lose their job. Or the coverage they have with their small employer is not that good. Result: Many more uninsured or underinsured people. The solution: Encourage employers to give their employees a Healthcare Reimbursement Account (HRA). That way the employee could use the money to buy his/her own policy tailored to his/her needs that is portable. Another piece to the puzzle for personal health insurance is to allow individuals to deduct the full value of their policy premiums from their taxes. Finally, if companies could compete across state lines it would increase competition and lower costs overall.
It would take time, but in a few years it would be just like auto insurance. Individuals would buy it when they first needed it and keep it all the way to Medicare. (Assuming Medicare survives!)
However, the dems want to punish the insurance companies. (Huge profits you know. Can’t have that!) Many, I assume, want to punish them until they just drop out of the business and the “government option” becomes the only game in town. That is why Obama’s pronouncements on healthcare reform never quite meet the common sense test.
My dad was a top executive at a major medical insurance company; worked in the business from college to retirement. They sold the “major medical” policies to companies. He started in 1950.
Several things were different back then, he says: there were many more competitors, and you had to really stay lean and mean to underbid your competitors. Second, the policies were for MAJOR medical expenses, like catastrophic illnesses and accidents. Everyone paid for their routine health care out of pocket. Ergo, policies were a lot cheaper. And no one expected to buy insurance to cover hangnail treatments, for heaven’s sake.
Finally, he said that, because of competition and (for most of the men he worked with, anyway) a sense of honor and ethical dealing meant that you didn’t try to cheat your customers. And you sure as hell didn’t make cheating them part of your business plan. If a claim was due, it was paid, with very few exceptions.
He’s been bewildered and infuriated by Blue Cross’s perfidious behavior in our sister’s hospice case: they claim that, because she awoke out of a coma, she didn’t need hospice after all (never mind that she died just five weeks later). These bastards stuck my elderly father with the bill — and he’s paying for nursing care for our mother, who’s ill with pancreatic cancer, as well.
THAT kind of behavior is what makes people hate the insurance companies. And it’s commonplace these days. My own owes me $600 from two years ago, even though every customer “service” rep tells me they do, in fact and under contract, owe me the damn money.
Socialized medicine will suck worse, though, because there isn’t even the feeble incentive of competition and an outside authority to kick its behind. If they stiff you, you’re truly stuck.
I’m seriously thinking of getting a major medical policy. They’re so much cheaper, and the money that I’m shoveling across the table monthly can go into my own health savings account and pay for the checkups and so on.
Beverly,
Your dad and I must be about the same age. Like him, I remember a totally different picture back in the 40s, 50s and 60s. It was the advent of Medicare and Medicaid (1965) that changed many things. I remember reading in the paper that many hospitals had been just staying open until Medicare and Medicaid began because they had so little business. A couple of years after the Ms began hospitals were flourishing with lots of new patients. The low reimbursements were, for them like manna from Heaven. But the picture really changed when the government passed the law requiring ERs to take any and all patients. I’m not sure when that happened, but judging from the way hospital costs shot up between 1980 and 1990, I think it happened in that time frame. The hospitals began raising their prices to insureds and those who could pay to cover all the pro-bono treatment.
Our daughter is self employed. She has been able to obtain good health insurance with a $2500 deductible at a reasonable cost. If most people had $2500-$5000 deductible it would bring costs way down. When people pay the first dollars out of pocket, they do not seek treartment for a simple ailments, and they usually try to do some preventive activities by eating right and exercising.
I don’t think most people know what it means when the dems say they are going to cut $500 billion out of Medicare Advantage. Medicare Advantage is a program offered by HMOs and PPOs that combije Medicare and Medigap into one seamless policy. It’s a good deal for those who hcan afford it. For another $3000 – $8000/year a Medicare patient gets medical, hospitalization, drug and preventive care all wrapped together. If a Medicare recipient buys a separate Medigap policy it entails dealing with two different entities in getting claims taken care of. When the government cuts $500 billion in payments to Medicare Advantage, those Medicare recipients are going to have to cough up more money to keep their same level of benefits. So, is it any wonder that Medicare Advantage recipients are up in arms about this? If they aren’t they just don’t understand what’s going on.
I think you covered it in your words well. Essentially, what is a flaw is not seen as a flaw by those who support an theoretical ideal over the practical. They will be whining when they have no good insurance, but right now they “know” that won’t happen and even if it does, they will be covered by the government option.
I do not even know how to talk to these people. Do they understand what they will be giving up? No. Do they care? Not yet. By the time they do, if they have their way, there will be no fixing it.
On some people, I am quits politically. They simply cannot or will not understand. I am sure, however, you understand having been on that side (and more recently than I). Can’t make a horse drink, though shooting it might be sorely tempting at times. *grimace* I almost wish I was morally half as politically sociapathic as they seem to be.
I have the misfortune of having a liberal couple from Canada in my circle of acquaintances….their smug attitude on all things health-related is so annoying! Funny thing is, they moved here many years ago, but have recently become American citizens. They keep extolling the benefits of Canadian style socialism, but don’t seem to want to live it, hmmm………