Revived GOP health care talks could hurt those with pre-existing conditions

[Monte_RCMS]

‘For profit’ is the key word there.

Its funny how insurance companies seem to be so profitable year after year…gee I wonder why?

Insurance companies follow the same rules as everyone else: if you lose money (consistently), you go out of business.

So, if you’re an insurance company, you had better make a profit. Otherwise, you will go out of business and have to lay off all your employees.

Insurance companies have other kinds of unique “needs” … namely that they must build up sufficient assets so that in a bad year, they can pay off claims made as policy holders incur damages.

Insurance companies have various kinds of corporate structures … some issue shares of stock … so, YOU can buy the shares of an insurance company and collect dividends … same as many other kinds of equities.

Heck, you could even set up your own insurance company.

 

[LeafByNiggle]

Americans can’t agree on anything. How would we all agree on what is a basic level of healthcare? We wouldn’t. A majority or even just a plurality will impose a definition on everyone else.

The problem you are describing is not unique to health care. It is a problem with any form of government by the people. What is the proper level of taxation? What is a reasonable amount of military spending? What is a reasonable setback from the street for building a house? These are all things that people argue about in the process of government. Why should deciding on what universal health care should provide be any different? The fact that people have difficulty coming to a consensus does not mean that we should abandon all efforts to arrive at these decisions.

Needed as determined by who? Even today you can find doctors who disagree as to the best treatment for any particular case.

Same answer as above.

Private insurance companies can deny coverage, but they have a contract they should be abiding by.

Similarly, a government plan has a law defining its scope and they should be abiding by that law.

If a customer disagrees with the determination they are free to pursue legal action. This would be difficult, but trying to do the same against the government is even more daunting.

I suppose that is a matter of opinion. I suppose there are insurance companies that do their best for their customers. And of course there are governments that unjustly apply the law to people. But on the whole, I would put more trust in a government plan that is negotiated by my representatives and is portable across all 50 states and is backed by the government, than to trust a private company with a plan that was designed primarily to enrich its stockholders, is limited to the geographical area where the company operates, and is only backed by the continued operation of a single corporation. Remember, without guaranteed coverage for pre-existing conditions, anyone who gets sick is no longer free to switch insurance companies. He is trapped. And if that company goes out of business, he has no recourse except charity.

Who is to say smokers don’t have a genetic defect that inclines them to smoke? Who is to say someone’s problems are not caused by a genetic defect in addition to lifestyle choices?

If facts come to light that indicate such a thing, then it is likely that smoking will be treated as a disease more than a poor lifestyle choice, and it might be treated as a pre-existing condition. But right now there is no such evidence, just as there is no evidence that bank robbers are genetically programmed to rob banks, and so we punish them. These are details that can be adjusted as new information comes to light. But right now there is no reason not to implement what we can based on the information we have.

 

[LeafByNiggle]

No one insured is complaining about flood insurance because he is getting a steal. His risk is being covered by tax payers. Federal flood insurance has led to a ridiculous building in flood prone areas.

This defect in federal flood insurance implementation is not directly applicable to health insurance. The closest comparison I can think of is coverage for smoking-related illness. But even there the problem is not the same as the one you mention for flood insurance.

In the case of flood insurance, the coverage is so generous that no matter how bad the flood, the client can completely rebuild his house be right back where he was with little loss. Therefore he has little incentive to avoid building in flood-prone areas.

But with guaranteed treatment for smoking-related illness, the coverage is by no means so complete. No matter what we do in modern medicine, we cannot fix up a cancerous lung or repair a damaged heart back to just what it was before the illness. The residual illness that cannot be remedied, in addition to the pain and suffering of the treatment itself, provides almost as much incentive to stop smoking as if there were no treatments provided. So having universal health care cover smoking-related illness is not going to do the equivalent of encourage people to build in flood-prone areas. (i.e. start smoking, just knowing that some kind of medical treatment exists.)

 

[ProVobis]

Insurance companies follow the same rules as everyone else: if you lose money (consistently), you go out of business.

So, if you’re an insurance company, you had better make a profit. Otherwise, you will go out of business and have to lay off all your employees.

Insurance companies have other kinds of unique “needs” … namely that they must build up sufficient assets so that in a bad year, they can pay off claims made as policy holders incur damages.

Insurance companies have various kinds of corporate structures … some issue shares of stock … so, YOU can buy the shares of an insurance company and collect dividends … same as many other kinds of equities.

Heck, you could even set up your own insurance company.

Not that simple.

Insurance companies are normally held by holding companies, which can hold other companies. Insurance companies themselves cannot go out of business as they hold assets of their policyholders. The state regulators have a big say in bankruptcy proceedings of the holding company. For an example of such a process, check the history of Conseco. Being a preferred stockholder, I learned painfully of how insurance works.

 

[TMC]

These healthcare talks are just navel-gazing within the GOP for their own internal political reasons. Everyone knows these talks are not going anywhere. Making the already rejected bill even more uncharitable and less helpful to working people and the poor is not going to move the ball.

 

[Ridgerunner]

But on the whole, I would put more trust in a government plan that is negotiated by my representatives and is portable across all 50 states and is backed by the government, than to trust a private company with a plan that was designed primarily to enrich its stockholders, is limited to the geographical area where the company operates, and is only backed by the continued operation of a single corporation. Remember, without guaranteed coverage for pre-existing conditions, anyone who gets sick is no longer free to switch insurance companies. He is trapped. And if that company goes out of business, he has no recourse except charity.

.

Mutual of Omaha has no stockholders, is nation-wide and is a single corporation. It’s a pretty good insurer, but its premiums are no different from any other insurer’s. On the other hand, the only government-run healthcare provider in the U.S. is VA. As between the two, I would have more good to say about Mutual of Omaha than I would about VA.

A person can go from one employer that has an ERISA-qualified plan to another with an ERISA-qualified plan, without a break in coverage, and with guaranteed coverage for preexisting. Similarly, a person who had no prior coverage but goes to an employer with an ERISA-qualified plan must be covered within 60 days even for preexisting.

But you’re right in this way. If I have non-employer coverage from Company “A” and develop a chronic condition, company “A” can’t cancel me just for that. If I then switch to non-employer coverage with Company “B”, my then preexisting may result in no coverage for it. So in that sense, I’m stuck with Company “A”. And if “A” goes bankrupt, I’m pretty much out of luck on the preexisting unless I go to some employment with an ERISA-qualified plan.

One of the bad things about Obamacare, though, is that a lot of employers have cut the workers’ hours so they don’t qualify for employer-paid insurance. Possibly the most egregious example of that I have seen is the NP who worked for a clinic. Promptly at 5:00 p.m. that same clinic turns into a separate urgent care provider company owned by the clinic employer. So neither of them pays anything on her health insurance. She can buy it, but at an incredibly high price with zero employer contribution. Ultimately, she left that employer and went with another one that’s so busy and so in need of NPs that there was just nobody to take over part of her hours. So she got on the plan. But her situation is unusual in that she had to get a second certification in another field to qualify for the second employment, and that particular combination is very rare.

One has to wonder, then, whether a person like her would simply be better off if the employer wasn’t forced to have health insurance at all (under Obamacare, they are) and the employee simply paid a bit more and able to buy her own on an a la carte basis.

 

[SuperLuigi]

Eventually, the government’s involvement in the insurance marketplace will hurt more than just those with preexisting conditions, and there is no amount of left-wing feelings or sobbing that will change that.

 

[Jeanne_S]

Eventually, the government’s involvement in the insurance marketplace will hurt more than just those with preexisting conditions, and there is no amount of left-wing feelings or sobbing that will change that.

Truer words were never spoken…

 

[dixieagle]

I do too. I don’t see why we can’t have universal healthcare. I’ve seen the arguments, but arguments don’t help the sick!

I agree. I don’t particularly trust the federal government to handle something as important as health care, but I wonder about a program whereby each state (or possibly group of states) administers a healthcare system under which every citizen is covered. (Having “access” to healthcare doesn’t do much good if the premiums are so high as to be unaffordable.)

Frankly, I think that it is shameful that a country as rich as ours hasn’t been able to work this out. I’m with Pope Francis on this issue: “Health is not a consumer good, but rather a universal right, and therefore access to health care services cannot be a privilege.”

 

[SuperLuigi]

Frankly, I think that it is shameful that a country as rich as ours hasn’t been able to work this out. I’m with Pope Francis on this issue: “Health is not a consumer good, but rather a universal right, and therefore access to health care services cannot be a privilege.”

The reason why the country can’t work it out is too many think it’s an entitlement that can just magically appear of out thin air and of course the federal government (the biggest excuse to not do any real thinking on the issues) is the solution.

The lack of thinking along the lines of incentives is revolting.

I agree. I don’t particularly trust the federal government to handle something as important as health care, but I wonder about a program whereby each state (or possibly group of states) administers a healthcare system under which every citizen is covered. (Having “access” to healthcare doesn’t do much good if the premiums are so high as to be unaffordable.)

Healthcare SHOULD be a province of the states under the 10th amendment. There are good state programs like MinnesotaCare and bad ones like RomneyCare.

But people pay more attend to where state money goes than federal money. That’s why even big spending blue states will vote in fiscally conservative governors.

 

[stinkcat_14]

The reason why the country can’t work it out is too many think it’s an entitlement that can just magically appear of out thin air and of course the federal government (the biggest excuse to not do any real thinking on the issues) is the solution.

I think the healthcare debate illustrates very well that we don’t have a true conservative party in the US, just a decision as to which flavor of big government we want. In the case of healthcare, we have a single payer system in the form of medicare, yet look how quiet these so called conservatives get when you talk about dismantling it. I had one poster accuse me of envy because I argued that those with means should not get a subsidy from working people. This poster was supposedly a conservative, but that is not clear. In the area of healthcare, 90% of the voters are not consistent.

 

[Ridgerunner]

I agree. I don’t particularly trust the federal government to handle something as important as health care, but I wonder about a program whereby each state (or possibly group of states) administers a healthcare system under which every citizen is covered. (Having “access” to healthcare doesn’t do much good if the premiums are so high as to be unaffordable.)

Frankly, I think that it is shameful that a country as rich as ours hasn’t been able to work this out. I’m with Pope Francis on this issue: “Health is not a consumer good, but rather a universal right, and therefore access to health care services cannot be a privilege.”

Unfortunately, access to healthcare will always be a “privilege” at some level of care. Cuba, I understand, purports to have universal healthcare. But what good is it to see a doctor for free, then get a prescription for an aspirin for the savage pain of a blown disc, and then find that there are no aspirins in the store? But they have universal healthcare all right.

Anybody in the U.S. can get healthcare, even if it’s the ER or Medicaid. But what is the quality? Yes, there are Indian “free clinics” in Oklahoma (and undoubtedly elsewhere), but the quality is terrible compared to say, the Mercy or Cox or Freeman clinics where I live. And those latter clinics wouldn’t hold a candle to Mayo’s I’m sure.

But it can’t be open-ended, no matter what. I might feel justified in getting a total workup at the Mayo Clinic twice/year. But can I really call on others to pay for my self-indulgence? Clearly, not everybody can do that on the public dime. So who is more privileged than whom in whatever we devise, or is the whole country going to be on Medicaid, which will eventually result in “Indian clinics for all”?

So how is the scarce resource of medical care going to be allocated? That’s the real question. But one way or another, there will be allocation in the future, just as there is now.

 

[tomarin]

Unfortunately, access to healthcare will always be a “privilege” at some level of care. Cuba, I understand, purports to have universal healthcare. But what good is it to see a doctor for free, then get a prescription for an aspirin for the savage pain of a blown disc, and then find that there are no aspirins in the store? But they have universal healthcare all right.

Anybody in the U.S. can get healthcare, even if it’s the ER or Medicaid. But what is the quality? Yes, there are Indian “free clinics” in Oklahoma (and undoubtedly elsewhere), but the quality is terrible compared to say, the Mercy or Cox or Freeman clinics where I live. And those latter clinics wouldn’t hold a candle to Mayo’s I’m sure.

But it can’t be open-ended, no matter what. I might feel justified in getting a total workup at the Mayo Clinic twice/year. But can I really call on others to pay for my self-indulgence? Clearly, not everybody can do that on the public dime. So who is more privileged than whom in whatever we devise, or is the whole country going to be on Medicaid, which will eventually result in “Indian clinics for all”?

So how is the scarce resource of medical care going to be allocated? That’s the real question. But one way or another, there will be allocation in the future, just as there is now.

Why is it do you think that in say Canada or Japan they have universal coverage without the indignity of ‘Medicaid for all’? Honest question.

 

[dixieagle]

So how is the scarce resource of medical care going to be allocated? That’s the real question. But one way or another, there will be allocation in the future, just as there is now.

The heart of the matter…

 

[Thorolfr]

The heart of the matter…

There will undoubtedly always be allocation so that rich people will get better medical care than poor people. And rich people already live significantly longer than poor people.

 

[tomarin]

There will undoubtedly always be allocation so that rich people will get better medical care than poor people. And rich people already live significantly longer than poor people.

That’s why, it pays to be rich.

 

[SuperLuigi]

I think the healthcare debate illustrates very well that we don’t have a true conservative party in the US, just a decision as to which flavor of big government we want. In the case of healthcare, we have a single payer system in the form of medicare, yet look how quiet these so called conservatives get when you talk about dismantling it. I had one poster accuse me of envy because I argued that those with means should not get a subsidy from working people. This poster was supposedly a conservative, but that is not clear. In the area of healthcare, 90% of the voters are not consistent.

Inconsistency amounts to hypocrisy. People cannot stand hypocrisy. That’s why so many people find Catholicism, non denominational Christianity and to some extent Islam attractive.

When he was on the air, Jason Lewis would get points from conservatives about how we would need to get these people off of welfare and Section 8, but he asked them about stadium or farm subsidies, oh boy, gotta have those!

Fact is a lot of people with means in America are getting a subsidy and not just healthcare. A lot of it is “necessary” because local governments raise the cost of living through property taxes to keep insolvent local institutions on life support. If we took the poorest relevant demographic in this country, they’d still make the top 20 for global economic output.

I don’t think Medicare is the same as single-payer. It’s just another insolvent, inefficient government program that doesn’t pay providers on time, and providers compensate by passing the cost onto customers who have private insurance----one reason why their costs are high. If the USA had single payer, people from rural Vermont would be going to Boston for any kind of doctor appointment besides the flu and the like. The VA Clinic is more like single-payer.

To be frank, even Canada has diluted its single payer system as multiple private clinics have been opened in the past 10 years. The Quebec Supreme Court even ruled in favor of private insurance because people were dying waiting for treatment.

 

[SuperLuigi]

There will undoubtedly always be allocation so that rich people will get better medical care than poor people. And rich people already live significantly longer than poor people.

So what does that mean? That the government should kill rich people to make it more “equal”?

No matter how much government is called for, there will ALWAYS be inequality of some kind.

Life isn’t always fair, and the American left needs to accept that or give of their own stock for once and be the change they want to see in the world instead of running to Washington to solve problems.

 

[LeafByNiggle]

So what does that mean? That the government should kill rich people to make it more “equal”?

No matter how much government is called for, there will ALWAYS be inequality of some kind.

Life isn’t always fair, and the American left needs to accept that or give of their own stock for once and be the change they want to see in the world instead of running to Washington to solve problems.

You make the point that government cannot solve everything. But clearly government can solve something. What you have not shown is that government cannot or should not solve this particular thing.

Tracing back through the comments we see that this particular exchange started with Ridgerunner’s claim that health care is a scare resource that needs to be allocated. That is not exactly true. Health care is an exchangeable resource. Any form of wealth can be translated into health care. Perhaps total wealth is a limited resource for a society, but within that total limitation, its use in health care is limited only by the will to use it for health care.

 

[Ridgerunner]

. Health care is an exchangeable resource. Any form of wealth can be translated into health care. Perhaps total wealth is a limited resource for a society, but within that total limitation, its use in health care is limited only by the will to use it for health care.

You’re assuming, first, that healthcare is only a matter of money. There are other things that limit the provision of healthcare, one being the number of qualified people to provide it. Apparently the number of physicians in Japan is dropping, particularly in rural areas. I have not yet seen a good explanation for that except the speculation that it’s a byproduct of oncoming “demographic winter”; i.e., the increasing number of aged takes a number of older doctors out, without enough qualified young ones coming on to take their places.

Also, of course, there are limitations in this country of the number and type of physicians due to the medical schools’ control of the number of graduates and their particular views of what a proper incoming student is. At present, government has no way to deal with that, and money alone won’t cure it.

You’re also at least suggesting the assumption there is enough elasticity in government spending to generate whatever amount of money it might take to provide whatever amount of healthcare a population demands. Utilization of health services is almost certainly more elastic than is government money to provide it.