National Health Care

[Link]

Parker;283365 wrote:
in regards to dropping people because they cost too much...

Are insurance companies not out too make money just like every other company? Or should they just bite the bullet and start taking massive loss's?

Whats fair?

An insurance cannot drop you because a medical bill is to high. It's the risk they take. They HAVE to pay what they are held responsible for, but can drop you AFTER they uphold their end of the contract.

[out there]

and if their contractual obligations exclude expenses >$500k for a single claim (ie surgery, hospital stay, medications, rehabilitation, etc)?
my rental policy max is 500k/occurence and my house policy is $2mil/occurence, should i expect to be able to make a claim higher than that? why is there an implied (and effective) double-standard for health insurance?

[Trafik Jamz]

This made me LOL

[Trafik Jamz]

Just for shits, I decided to look up what other businesses the US Gov't owns.

The Government owned corporations of the United States are as follows:

* Tennessee Valley Authority
* Pension Benefit Guaranty Corporation
* Millenium challenge corporation
* St. Lawrence Seaway Development Corporation
* Amtrak
* NPRC
* Overseas Private Investment Corporation
* Freddie Mac
* Fannie Mae
* Panama Canal Authority
* Bank of America (and subsidiaries)
* GMC (General Motors Corp) (and others)
* AIG (American International Group) (and others)
* Legal services corp.
* Federal Crop Insurance Corporation
* CCC (Community Commodity Corp)
* Corporation for National Community Service (and all programs)
* Sallie Mae (And subsidiaries)
* Farmer Mac
* Corporation for Public Broadcasting
* Voice America
* FDIC (Federal Deposit insurance corp)
* SPIC

[Trafik Jamz]

Thought this was a pretty good read:

www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778_pf.html/

5 Myths About Health Care Around the World

By T.R. Reid
Sunday, August 23, 2009

As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.

I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:

1. It's all socialized medicine out there.

Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.

In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.

2. Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.

In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.

Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.

As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.

In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"

3. Foreign health-care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.

The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.

4. Cost controls stifle innovation.

False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.

Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

5. Health insurance has to be cruel.

Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.

Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.

In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.

This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.

Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.

[DaveH]

Trafik Jamz;286285 wrote:
Thought this was a pretty good read:

www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778_pf.html/

5 Myths About Health Care Around the World

By T.R. Reid
Sunday, August 23, 2009

Reid's new book, The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care

"FAIRER" health care? wtf does that mean?

Sick Around America" which aired March 31, 2009, on PBS. But when it appeared, Reid was nowhere to be seen, and his conclusion, that "You can't allow a profit to be made on the basic package of health insurance," was completely absent from the program

Can't allow profit to be made. Yeah.....

[Trafik Jamz]

/playing devils advocate...I've made it clear that I'm not in favor of the public option...

Fairer=everyone has the same access to medical treatments that can save their lives. Very similar in concept to your idea about everyone paying the same $ amount in taxes, only in this case everyone would receive the same medical treatment subsidized by taxes.

Now Dave...back to the article at hand. I am in favor of something like Germany has I guess.

If the "free market" is so great, why are all the insurance companies making fat cash off of their clients while offering a continually weakening product.

It seems to me that the current mindset of the CEO's of insurance companies are less concerned with your "health insurance" than they are at preserving their "wealth insurance". (Seriously....20% increases in premiums every year???)

[DaveH]

Trafik Jamz;286312 wrote:
/playing devils advocate...I've made it clear that I'm not in favor of the public option...

Fairer=everyone has the same access to medical treatments that can save their lives. Very similar in concept to your idea about everyone paying the same $ amount in taxes, only in this case everyone would receive the same medical treatment subsidized by taxes.

Using that argument, everyone should receive the same food and housing,etc, subsidized by taxes.

Trafik Jamz;286312 wrote:
Now Dave...back to the article at hand. I am in favor of something like Germany has I guess.

I'm in favor of you paying for what you want/need for yourself and your family, I'm in favor of paying for what I want/need for my family.

Trafik Jamz;286312 wrote:
If the "free market" is so great, why are all the insurance companies making fat cash off of their clients while offering a continually weakening product.

It seems to me that the current mindset of the CEO's of insurance companies are less concerned with your "health insurance" than they are at preserving their "wealth insurance". (Seriously....20% increases in premiums every year???)

Of course, it is the CEO's job to make sure the company is profitable and growing. I know that is job description for the CEO of the company I work, and I'd assume it is the same for the CEO of the company you work at.

If you don't like their product, you are "free" go somewhere else. Or simply pay as you go and just buy a inexpensive major medical insurance policy. Personally i think it's rediculous to pay a huge insurance premium so that the insurance company pays for every little thing a person goes in for. Why not keep the premium $$ in your pocket and pay for it yourself and avoid the middleman.

[24valvenotak]

DaveH;286320 wrote:
Using that argument, everyone should receive the same food and housing,etc, subsidized by taxes.

thats nonsense, we all cant live in a whitehouse!

[Trafik Jamz]

My point is I'm ok with having a government paid for health insurance, I am not ok with a gov't run insurance company. The fact that every other industrial country in the world has a higher life expectancy and lower infant mortality rate than the US AND their governments spend LESS on healthcare annually than ours does tells me that maybe we are doing it wrong. I don't want Canada's system as I think there are too many flaws in it, but Germany and Japan's system seems like a better choice.

In ND if you chose to go to someone other than your employer sponsored plan (most likely BC/BS) your choices are EXTREMELY limited (6 total companies, all priced about the same). I don't think that your ability to receive preventive healthcare (which would save HUGE money) should be limited to your income.

Then there is the case of the pre-existing conditions....many times diseases/illnesses from childhood (diabetes or asthma for example) severely limit your ability to purchase major medical insurance as an adult. I have asthma and w/o a employer plan I wouldn't be covered. If I wanted to own my own business and pay for a private plan I couldn't find one at anywhere near a reasonable rate (I've tried when I was self employed)....and I don't even use an inhaler more than once every 5 years or so.

I can't remember who said it, but they were spot on when they said "Buying health insurance is easy, buying sick insurance is very hard and expensive".

There has to be a better way than the way we do it now. Free markets are good, but greed fucks it up.

[thrash]

Know why you don't have more than 6 options in ND for health insurance?

Because selling insurance is regulated by the ND government Otherwise, I'd sell you health insurance. As long as your not made of sugar, I don't mind insuring a healthy guy who installs sprinkler systems.

Regarding pre-existing conditions: something that people expect to cover stuff that is already wrong with them shouldn't be allowed to call what they want "insurance" without me being allowed to kick them in the face repeatedly.

It's not "insurance" when they want someone else to pay for "guaranteed trouble". What they want is a handout, plain and simple.

If you think people that are unlucky, health-wise, ought to have some sort of slush fund of money they get to draw from, that's fine, but call it the "bad luck tax", because insurance is about risk, and people that are likely to have problems shouldn't be buying the same products as people who are mostly healthy, and for whom medical costs truly are a "whoa, never saw that coming" sort of deal.

[DaveH]

Trafik Jamz;286349 wrote:
My point is I'm ok with having a government paid for health insurance

It's not the governments job to give us stuff. If the insurance companies are doing things that are illegal or unethical, then it is the governments job to regulate that. Thats it. What stage are we currently at in the quote below?

"A democracy will continue to exist up until the time that voters discover that they can vote themselves generous gifts from the public treasury. From that moment on, the majority always votes for the candidates who promise the most benefits from the public treasury, with the result that every democracy will finally collapse due to loose fiscal policy, which is always followed by a dictatorship."

[PSiedTSi]

DaveH;286444 wrote:
What stage are we currently at in the quote below?

Yes.

[Trafik Jamz]

DaveH;286444 wrote:
It's not the governments job to give us stuff. If the insurance companies are doing things that are illegal or unethical, then it is the governments job to regulate that. Thats it. What stage are we currently at in the quote below?

"A democracy will continue to exist up until the time that voters discover that they can vote themselves generous gifts from the public treasury. From that moment on, the majority always votes for the candidates who promise the most benefits from the public treasury, with the result that every democracy will finally collapse due to loose fiscal policy, which is always followed by a dictatorship."

I thought regulations were non-conservative and impede the free market? My thoughts are that I'd rather have publicly funded health insurance than a war in Iraq. Can I take all of my federal income tax money and put it towards insurance instead of war?

Seems to me that we've had Medicare coverage for quite some time in this country and most elderly aren't "waiting in lines forever" to see a doctor. Most are very happy with the service and coverage that they receive. They, of course, still have medicare supplements provided by the private sector that fill the gaps at a very reasonable rate.

Thrash, I understand pre-existing conditions affect insurance companies decision on who not to cover (former insurance agent here....) But some have ridiculous stipulations. I'm ok with an insurance company refusing to cover me for asthma coverage for things like inhalers or medications. However, if I were to have a serious attack and went w/o oxygen for an extended period of time and end up seriously hospitalized I'd like to have some coverage to protect me from that (odds are EXTREMELY unlikely of that actually playing out).

Just for shits I called 2 insurance companies to see what a private policy would cost me. Non-smoker, very seldom do I drink anymore, non-drug user, average health, married w/ child, no family history of heart disease or cancer....only negative I had was asthma diagnosis and not using any meds...of any kind for asthma or any other disease/illness.

Cost from company #1:

$1200/month (family coverage) w. a $6,000 annual deductible, 70/30 coinsurance w/ a $250,000 out of pocket maximum per person.

Company #2:

$1150/month (set up same as above)

All this cuz I had an asthma attack many many years ago and saw a Dr. for it.

FWIW, I asked for the cheapest policy I could get from #1 & then matched #2 to #1's criteria.

I guess for the price of my mortgage I can have enough insurance to ensure I can get treated but not enough to insure that I wouldn't go bankrupt and lose my house if I had a major illness.

[DrifterExtreme]

no offense chuck but that's life.

but on a serious note. if you had to pay for health care/insurance like you described. wouldn't that play a role in your housing/food/auto/ etc... expenses? this way you can protect yourself against the unlikely incident that could come up?

I'm getting the feeling you want your cake and eat it to here. that's not how it works.

I can also tell you my dad pays $800/m or used to (before switching to the company offered plan) for insurance. Which covered him/mom/sister. (I'm to old/out of school to be covered). So your prices don't reflect everyone.

Also my dad has heart problems and has a stint in his heart. so...... idk what to tell you.

[Trafik Jamz]

DrifterExtreme;286454 wrote:
but on a serious note. if you had to pay for health care/insurance like you described. wouldn't that play a role in your housing/food/auto/ etc... expenses? this way you can protect yourself against the unlikely incident that could come up?

I'm getting the feeling you want your cake and eat it to here. that's not how it works.

No, I want a policy that won't bankrupt me in the event that I have something major happen (That's why you have insurance...for financial protection). I don't have $250,000 just laying around. I'd have to sell my house to cover my expenses if I reached the $250,000 out of pocket maximum (and heaven forbid I exceed the $1million maximum coverage that they cover...then it is 100% back on me again). I buy insurance to protect me against major illness, not minor ones. In all honesty, if I were not covered under a "company plan" I'd do the pay as I go method and hope for the best.

[DrifterExtreme]

A lot of Americans have shit all ass backwards. If you don't have insurance provided you need to live cheaper to afford insurance. most people are willing to pay for that $1500/m house and think the insurance/health care should be free( or not bankrupt them as you put it). where's the logic in that?

DO i think health care is getting to a point were cost is of a great concern? YES. but do i think any form of hand out because i'm to stupid to prioritize my spending to allow for health care is ok? NO.

And i'm not talking welfare type health care, as we were at one time on some of those systems. so yes that is needed to help out. but to many people abuse the systems provided.

[Trafik Jamz]

Good, we actually agree on most aspects.

What you may not realize is that (as it currently sits) the US Gov't already spends more on health insurance than any other country that offers "socialized" healthcare.

Would you be in favor of a tax write-off for health insurance premiums? Meaning, if you bought health insurance you'd be able to deduct it from the taxes?

[amicheze]

I thought this was a cool video.

[ame]http://www.youtube.com/watch?v=Jng4TnKqy6A[/ame]

[63vette]

amicheze;286504 wrote:
I thought this was a cool video.
You can believe a cartoon presentation or a real world argument.
Oh... and Obesity and alcoholism are not diseases they are choices.

[ame]http://www.youtube.com/watch?v=G44NCvNDLfc&feature=player_embedded[/ame]