Obama finally called them out

[me&thegals]

If they would do thngs that would allow insurances to compete across state lines that would help.

I think that is what I heard proposed in his speech, wasn't it? Allowing for more competition?

There is so much regulation at the state level that most states only have a few companies that compete for the business out of a possible 1300 companies selling health insurance. The states regulate what things must be covered. Why should I have to pay for maternaty services, or prostate exams. I am a post menopausal woman. Why should I have to have coverage for sex changes, I like my gender. These are all things that drive costs. Most states have many things that they require covered that I do not need and should not have to pay for.

This is what my husband keeps saying. I would like to know more about this. I wonder if part of the problem is that super-specializing plans would actually be pretty cost inefficient, you know? I may not need prostate coverage, but having someone work out a plan that is just perfect for me would take time, therefore $.

I would like to know more of what you mean about this, though.

 

[reinbeau]

The problem is there will be no competition once everyone is on the government plan - and that is the plan, to get everyone on the government 'insurance'. In his own words

 

[patandchickens]

A difficulty of letting people elect what coverage they want is that it will typically become more expensive, and can approach the cost of a person simply paying retail cash-on-the-barrelhead for a procedure (which is what insurance is designed to AVOID, of course).

The reason is that as you self-select for a narrower and narrower pool, you get a higher and higher fraction of the pool likely to use that service. Up to the point where, and VT-Chicklit's example of sex change surgery is a good example here, you can end up with nearly everyone electing to be *covered* for a particular procedure ending up *having it done*. In that case, there is no cost-spreading... if everybody insured to cover sex change surgery HAS sex change surgery (and I would think few people would sign up to pay for such coverage if they did not feel inclined to use it ), then the only way for it to work is if the premium equals the full cost of the procedure. At which point it's not insurance anymore.

The whole POINT of insurance is to spread costs by having them as don't need things pay for them as do. We buy into this and think it's a good idea, of course, because we do not know which group we will fall into as the years pass. But the only thing that makes the thing WORK is that, statistically speaking, most people who are covered for <whatever> do not in fact end up using that benefit, so the portion of their premium that would go to that condition gets rolled into payments for the few people who unluckily DO need to use the benefit.

Those of us whose house never burns down are the ones whose money is paid out to the few whose house DOES burn down; and this is (often, not always) useful and prudentrather than stupid because if your house DOES burn down you are probably otherwise going to be seriously s-o-l unless you have unusually large savings.

But it all rests on having a broad pool with many/most people not needing a particular service. Anything you do to narrow the pool of people being insured down to a group more likely to use the insurance, necessarily raises the cost to each of those people.

So it is a difficult tradeoff, and what's in a person's best SELFISH interest depends entirely on how their luck ends up running.

People vary of course in how heavily they weight their own self-interest in determining their feelings on what's the best policy for the whole issue, running the gamut from some who only favor what happens to be best for them personally to some who may be able to genuinely step aside entirely from self-interest in forming their opinion. The great majority of us lie somewhere in between

Pat

 

[me&thegals]

The problem is there will be no competition once everyone is on the government plan - and that is the plan, to get everyone on the government 'insurance'. In his own words

Unfortunately, dial-up internet and a 10-year-old computer don't allow for YouTube viewing

I listened to the speech and he definitely did not say that in the speech. He said public insurance would be allowed to compete with private. Which sounds like a good way to me to force private to get WAY more efficient.

Okay, fawning time--Pat, can I just have your brain? Your whole description above was a huge 'Duh' moment for me. Of course that's why we have huge pools of insured. Why didn't I think of that? Not only is it more efficient, it's the whole way insurance works. Thanks

Still, I bet we could get plans a teensy bit more specialized to cut some costs. I really don't know. I'd like to hear more from VT-Chicklit since she seems to have the data on regulations and such.

 

[k0xxx]

Dem Senator Warns of 'Big, Big Tax' on Middle Class in Baucus Bill

It's not every day that you hear a Democratic senator charge that a fellow Democrat is proposing to raise taxes on the middle class, but that is what happened on Tuesday when Sen. Jay Rockefeller, D-W.Va., ripped into the health-care bill developed by Sen. Max Baucus, D-Mt., the chairman of the Senate Finance Committee.

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IBD poll: 45% of doctors would consider quitting under Obamacare

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

The poll contradicts the claims of not only the White House, but also doctors own lobby the powerful American Medical Association both of which suggest the medical profession is behind the proposed overhaul.

It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administrations claim that the government can cover 47 million more people with better-quality care at lower cost.

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You can't pay for this without raising taxes. The current bill raises taxes on insurance companies to the tune of 30 percent of the premiums received, which will be passed on to the insured. You also cannot add 30 million, 35 million, 40 million, 45 million, or however many, to the the ranks of the insured and not get rationing. It's called reality.

The American people deserve to be told the truth (by our representatives) so that they can make an informed decision, either for or against.


Edited to add Poll info

 

[enjoy the ride]

To me, the only real reason to do anything about health care is to rein in the huge costs of getting any medical treatment. Congess is not willing to cross the powerful lobbies of insurance companies, doctors and drug companies to make effective changes.
So what is the only thing they do feel is safe to do? Why take the money spent on health care and divvie (never spelled that word before) among all people they can. Those who have good coverage will get less and those without any will get some. And subsidies passed out with a ladle..............
Scary- another Congressional cop out that will take more and more money and provide less and less service. It will make it impossible for most to be able to afford anything beyond what the government chooses they will have.

 

[me&thegals]

Most people don't seem to want more gov't control, of lobbies, banks, auto manufacturers. I think the idea is for gov't subsidized healthcare to compete in the free market with private healthcare, hopefully forcing them to greater efficiency. If I can choose Gov't Plan A at $400/month and Private Plan B costs $800/month (pulled numbers from the air, just for the sake of example), I know which plan I am going to choose, assuming they are roughly the same co-pays, deductibles and services offered. If enough people do that, Private Plan B may need to tighten its belt a little and get with the program, as my grandpa would say.

 

[sylvie]

A difficulty of letting people elect what coverage they want is that it will typically become more expensive, and can approach the cost of a person simply paying retail cash-on-the-barrelhead for a procedure (which is what insurance is designed to AVOID, of course).
Pat

We are seeing something approaching this with the Medicare Part D plans. In an attempt to stay out of the dreaded donut hole or merely put off entry, many are paying cash for most meds except the most expensive. When Walmart offers generic for $4 per month or 3 mo for $10 and the Part D plans charges $8 plus per mo for the same meds that choice again is to pay cash.
I sincerely hope the plans we are offered from the health care reform don't end up like this in 3 years and that they don't pattern them after the Part D or Advantage Plans(which we dropped like a hot potato!!!).

 

[Big Daddy]

To me, the only real reason to do anything about health care is to rein in the huge costs of getting any medical treatment. Congess is not willing to cross the powerful lobbies of insurance companies, doctors and drug companies to make effective changes.
So what is the only thing they do feel is safe to do? Why take the money spent on health care and divvie (never spelled that word before) among all people they can. Those who have good coverage will get less and those without any will get some. And subsidies passed out with a ladle..............
Scary- another Congressional cop out that will take more and more money and provide less and less service. It will make it impossible for most to be able to afford anything beyond what the government chooses they will have.

In their efforts to craft a bill that would satisfy both sides I'm afraid they will satisfy none. They are talking about mandated health coverage for all but no public option. So no competition for the insurance companies. Just another 47 million people to sell insurance too. So far the only people happy with the Baucus plan is the insurance companies. Of course they contributed 3 illion to his reelection campaign so they should get some bang for the buck.

Thank you Pat for your explanation. That is the reason why single payer would be so much more effective. You have a pool of 320 million insureds. I don't have much hope for what will be the final bill. I don't think it's going to do what they set out to do.

 

[Big Daddy]

A difficulty of letting people elect what coverage they want is that it will typically become more expensive, and can approach the cost of a person simply paying retail cash-on-the-barrelhead for a procedure (which is what insurance is designed to AVOID, of course).
Pat

We are seeing something approaching this with the Medicare Part D plans. In an attempt to stay out of the dreaded donut hole or merely put off entry, many are paying cash for most meds except the most expensive. When Walmart offers generic for $4 per month or 3 mo for $10 and the Part D plans charges $8 plus per mo for the same meds that choice again is to pay cash.
I sincerely hope the plans we are offered from the health care reform don't end up like this in 3 years and that they don't pattern them after the Part D or Advantage Plans(which we dropped like a hot potato!!!).

Medicare part D was created by Bush to try to bankrupt Medicare. Remember at the time busloads of seniors were going to Canada to buy their prescriptions. Why? Because Canada was negotiating prices with our pharmaceutical companies. If Bush would have had Congress craft the bill with the government being able to negotiate bulk prices the part D would be great. Instead they did it so that the pharm companies set the prices and they could not be negotiated. Served 2 purposes. Wasted all the funding for Medicare and put it on the verge of collapse. Pushed up stock prices and profits for big pharm.

They need to correct that.