Health Insurance III

[G]

I live 20 miles from the Can border. It is very common for Canadians with health issues to travel south to Fargo or Grand Forks to have their health issues addressed. Also my wife is an RN. Yes, medical costs are higher for insured patients. The hospitals are trying to make up the difference when they get $0 from uninsured patients. Is it a bad system? Is it an unfair system? In some ways yes but rather than throw the whole thing out why not fix the obvious faults and improve on what we have? Also, I wonder if there has ever been a study done on the last two weeks of life. Just how much gets spent when the outcome is going to be the same regardless?

 

[dcsnomo]

I live 20 miles from the Can border. It is very common for Canadians with health issues to travel south to Fargo or Grand Forks to have their health issues addressed. Also my wife is an RN. Yes, medical costs are higher for insured patients. The hospitals are trying to make up the difference when they get $0 from uninsured patients. Is it a bad system? Is it an unfair system? In some ways yes but rather than throw the whole thing out why not fix the obvious faults and improve on what we have? Also, I wonder if there has ever been a study done on the last two weeks of life. Just how much gets spent when the outcome is going to be the same regardless?

That's kinda what's been done. The whole thing was not "thrown out". People will still buy insurance from insurance companies that will make a profit. The insurance companies pay the bills. The recipients still make a profit.

Four big changes
1) Everyone has to have insurance. Why? Because it provides insurance companies with a new revenue stream to offset the anticipated lower premiums and increased health care
2)Government subsidizes the premium cost based upon income
3) Those citizens not covered by an employer or government plan will buy insurance from an exchange with a government subsidy based upon income
4) Insurance companies must treat us fairly in terms of pricing, existing conditions, and dropped coverage. This is the trade off to point 1. "look, we will give you 40 million new customers but you will have to treat people fairly".

I am amazed that people still think this is government run health care. The single payer health care bill was HR3200, it was not passed into law, it died in November 2009.

 

[G]

The US is a long ways from cash flowing right now. I am not against a fair and improved health system but it should have been a decision applauded by all rather than just an expression of political power. Yes, they have spun some numbers that will show the new system will pay for itself and they have even implemented a few new revenue streams but I have little faith in the numbers. The govt has a long record of blowing millions on projects that don't work. I am very much afraid that this little project will be the Mother of all failed projects. The folks that already are paying will pay more and the people that have never paid will continue to do so. And we will still have to borrow money we don't have to keep it spinning.

 

[maddogg]

Dcsnomo,

I honestly don't think that there there will be lower premiums. As the bill reads now, my employer has a "Cadillac" insurance plan for us - which I contribute to already out of my salary. As this coverage is broader then the required coverage provided for in the bill, my employer will be taxed on this. After talking with our HR coordinator on this a couple of situations are possible. 1. Those taxes will be passed along in the premium payment from my contribution. 2. My company will lower the subscribed plan they are on and I will have less coverage but equal to the requirement of the bill.

Now don't get me wrong - I'm not one of those people that says me, me, me, whine, whine, ect. But when I was unemployed I had to fine coverage for my family by myself. Part of doing business in a competitive/free market imho.

 

[dcsnomo]

Grub and maddogg- I agree with both of you. The financials of this bill could be anywhere from beneficial to a disaster, and our government is so inept that I also question their ability to make it work.

The other issue for the cadillac plans is that the government allows the "Cadillac level" to increase with inflation every year, but the rate of increase in health care costs far exceeds inflation so the cadillac plan tax will, over time, eat into more and more mid tier plans if no changes are made.

I have no issues with arguing the economics or the ability of our government to execute this program...these are fair arguments and valid concerns, and I share them. Unfortunately these discussions are few and far between.

This is from the Chicago Tribune yesterday

For many decades, U.S. government securities have been the epitome of safe, dull investments. If you wanted to be absolutely positive you'd get your money back and then some, Treasury bills were the way to go. Right now, lots of Americans who put their money into big mortgages or stocks a decade ago wish they had gone the more mundane route.

But it's mundane no more. With federal budget deficits running wild, investors are growing uneasy at the idea of lending money to an institution that seems unable to stop spending beyond its means. Last month, something extraordinary happened: Two-year bonds offered by Berkshire Hathaway Inc. commanded lower yields than those offered by the U.S. government. As Bloomberg.com put it, "The bond market is saying that it's safer to lend to Warren Buffett than Barack Obama."

That may sound common-sensical — Buffett has experience at meeting payrolls, while Obama does not — but it's actually a surprising perception. Berkshire Hathaway, after all, conceivably could make so many mistakes that it runs out of money and closes down. But the U.S. government is not about to run out of money, even if it keeps overspending.

Why not? First, it can appropriate more of its citizens' earnings through the tax system. Second, and more important, it can print money to pay its bills. Warren Buffett doesn't have those options.

So it's hard to see why investors would be leery. Well, actually, it's not so hard: The federal government is digging itself deeper into debt every month and intends to keep doing so indefinitely.

The nonpartisan Congressional Budget Office offers a prognosis: "Under the president's budget, debt held by the public would grow from $7.5 trillion (53 percent of GDP) at the end of 2009 to $20.3 trillion (90 percent of GDP) at the end of 2020." Interest payments would quadruple.

The long-term problem here is not that the government eventually would default on its obligations. The danger is that it would create money to make those debts payable, a course that would lead to much higher inflation. Then, yields on even impeccable corporate bonds would climb with those of T-bills.

The economy would also suffer as businesses and households scrambled to cope with the disruptive effects of soaring prices. It would suffer again if and when the government decided to curb inflation by driving up interest rates — a step that virtually guarantees a sharp downturn.

Frightened investors may be wrong to think they're less likely to get their money back from the government than from Buffett's Berkshire.

But they're not wrong to be frightened.

 

[ezra]

Why? Well, because it is not "government run" health care, it is "government subsidized" health care. If the primary problem is premium cost and the government is now going to subsidize premiums then about 23% of the population who cannot afford regular care is now going to be getting it (or at least paying for it) and insurance companies get 40 million new premium paying customers and drug companies sell drugs and medical equipment companies sell equipment. It's classic American capitalism except that the government is paying for those that can't afford it. Now these people will become customers and the businesses supplying those customers will benefit. Of course, those companies will have to pay taxes to help support the system.

I don't understand why people keep calling this government run health care. It is not the VA, it is not a single payer system. It is government subsidized. You will not go to a government clinic. You will get insurance form your employer as you are now, or you will buy it on an exchange (think a 40MM person "group"). The exchange will have many plans and costs from which to choose and the consumer selects the coverage they want. The government will subsidize these plans on a sliding scale based upon income. The plans will have new controls on them regarding age multipliers, pre-exisiting conditions, etc.

Insurance companies get 40MM new customers.
Hospitals get new customers
Drug companies get new customers
Profits get made throughout the industry

And if it works America gets healthier

I just hope the nation can afford it.

you say government like they have there own money no they don't me you your boss my customers will be paying for people who would rather buy a new car or a house they cant afford than buy insurance.ant this is only the beginning It was Bidden or Reid or one of those jackasses who spoke the truth 3 weeks ago when he said this bill is just the camel's nose under the tent there is allot more to come.be verry careful what you ask for.and no one has explained to me what college lending has to do with health care?may as well just take over 1 more industry whale we are at it .good night Comrades

 

[thunderstruck88]

i say when government is involved professional crooks are in OUR pockets and I for one say enough is enough We the people by the people run the government not the other way around Going to chill out my blood pressure is up I want to be )D

 

[thunderstruck88]

 

[dcsnomo]

you say government like they have there own money no they don't me you your boss my customers will be paying for people who would rather buy a new car or a house they cant afford than buy insurance.ant this is only the beginning It was Bidden or Reid or one of those jackasses who spoke the truth 3 weeks ago when he said this bill is just the camel's nose under the tent there is allot more to come.be verry careful what you ask for.and no one has explained to me what college lending has to do with health care?may as well just take over 1 more industry whale we are at it .good night Comrades

Actually, no, I clearly understand the concept of where the government's money comes from as I have been paying taxes all my life. My issue is with people who refuse to even understand the basic concepts of this legislation, which is the most significant social legislation since the late 60's! Ezra, you still refer to this as "government run" in your post. It is not! It is government subsidized! Huge difference! As I have said in my posts I am not sure we can afford it, I am extremely concerned about the growth of government debt to 92% of GDP in the next 10 years. But what I have tried to do in a non political way is to explain how the bill works and provide some credible facts to explain it.
I am not claiming this is the best or only solution. But I am trying to get the slogan yellers to at least understand how the bill works. Then America can have a meaningful discussion about health insurance.

BTW, I have a friend who is a carpenter who works hard every day. Drives a 20 year old pickup, lives in a rental apartment. He has cancer. It is killing him. He cannot get insurance for any price. Insurance companies won't touch him, he has cancer. He is too proud to quit working and just go on medicaide. Where does he fit in your formula?

I have high blood pressure and am 57 years old. I own 2 businesses and make a comfortable living and pay my taxes. I work, my wife works. We are proud Americans, we pay our share. Our health insurance has doubled over the last 7 years, and will go up again by 25% in 2010. My premiums are higher than my house payment. I can't change companies because of my pre-existing condition. This year I will be forced to lower coverage just to make the payments. Would you prefer I sell my house and a car to make the insurance payments? How do I fit into your formula?

America has lost over 2million jobs during this recession. These are people who made your truck, built your home, manufactured your appliances. About 55% of them had employer health care, when they lost their jobs they lost their insurance. They can't find work, these hardworking blue-collar Americans are now uninsured and are one serious health problem from bankruptcy. How do they fit into your formula?

My head housekeeper's husband builds homes. His business has dried up. I cannot afford to buy health insurance for my employees, it is too expensive. They had to drop their insurance and are now 2 45 year old hardworking Americans without insurance. Where do they fit in your formula?

 

[mrsrunningbear]

I have to say ….you can read and read…you can listen and listen… it so hard to understand some of it...its all so much....but then someone like you dcsnomo puts it out there like you have…. its sure helps me understand of some the issues better…thanks

 

[kevisip]

Oh boy. The end is near.

Dont rely on the gov't to cure that cancer, or build you a home if your in an apartment, or give you a car if yours is 20 years old.

A lot of Americans now think that. They think if they get this new health care, there cancer will be cured by the holy one.

We need healthcare change, but if you think rules and regs are tough now, just wait for gov't to deny you. They already do when it comes to Medicare/Medicaid.

I dont pretend to have all the answers, but I don't want the gov't making them for me, then
tell me I HAVE to take insurance.

I would not have minded having my own HSA, and save taxfree til I need it. Then I can atleast be mostly responsible for myself and not have to rely on anyone else.

Sometimes it is that easy, and when I get terminal cancer like my uncle, no amount of money, gov't healthcare, or priest will be able save me....just time to say goodbye and hope I lived a fruitfull life....AMEN and have a happy Easter.

 

[ash2266]

I think talking about this is good. It is hard not to bring politics into it. We have gone so long with having control over aspects of our life. Most things the gov. should stay out of. The list is long and I could go on and on but, no need.
Just a last thought, when anyone says free 99.98% of the time it is not. Only GOD can give us free things...Our gov. is not God.

 

[kevisip]

I think talking about this is good. It is hard not to bring politics into it. We have gone so long with having control over aspects of our life. Most things the gov. should stay out of. The list is long and I could go on and on but, no need.
Just a last thought, when anyone says free 99.98% of the time it is not. Only GOD can give us free things...Our gov. is not God.

Well said ASH.

 

[dcsnomo]

C'mom kevisip, give me a little credit here! I'm not asking for the government to build me a house. Let's try this again...

My buddy is a good old fashioned American carpenter, not an illegal alien, not a scofflaw, doesn't beat his wife, drinks beer like the rest of us. He's a guy that goes to work every day and you would like him.

He gets cancer
to get quality health care he needs insurance
He can't get insurance
Why? Because he has cancer!

Follow that? He's sick, he needs insurance...can't get insurance because he's sick! Catch 22.

27% of the American population either doesn't have insurance or buys their own, that 's 83 million people. For those 83 million people the insurance industry either won't cover them, drops them if they get sick quadruples their rates as they age, or excludes their sicknesses. Think about it, there are 83 million people who can't get health care on a consistent quality basis. You only get quality affordable insurance if you are young and healthy. If you get old or sick (when you need health care) you get dropped or you pay exorbitant rates.

My issue with this is that the whole premise is like auto insurance, if you become a higher risk you pay more. That's faulty logic with health insurance. With auto insurance if I have accidents and speeding tickets it's my careless driving and I should pay more. I did not choose to get older. My buddy did not choose to get cancer. He needs health care but he cannot afford the mechanism to receive it because he needs it.

Now, for those of you getting health care from your employers (53% of population) pay attention. Employer based health insurance used to be the primary source of health care in the US, covering 75% of the population. That has now declined to 53%. Additionally, health care costs represent 11% of payroll expense, op 72% since 2001. In the future more of you will lose benefits, all of you will pay more.

If you get laid off, you loose your insurance. If you choose to start your own business you will be able to get insurance as long as you don't need it. If you get sick, or heaven forbid old, you will loose that insurance. And, all pre-exisiting conditons are excluded.

All this has resulted in the most expensive health care system in the world which provides mediocre care at best to its citizens as a whole.

The system is broken, it will continue to get worse, and sooner or later the problems will show up at your door 'cause your gonna get older, you might get sick, you might get laid off, or your employer reduces or drops coverage.

Is the new plan the answer? I don't know
Was it ramrodded through? Yup
Is it expensive? Yup?
Is it a BFD (Biden)? Yup
Is it better than the status quo? Yup

The status quo is not sustainable. Employer provided coverage is a declining benefit.

 

[dcsnomo]

Thanks Linda, I appreciate you reading it objectively!

 

[kevisip]

DCSNOMO,

For the most part, I am not disagreeing with you. Maybe people are getting mixed up with health-care and health insurance. 2 completely different topics.

Even if you have an accident, or a disease a hospital can not deny you access to health care. Now who pays for it is another question.

I have had health insurance, I also have been with out. And when I had my own business, I went out and got my own....with a HIGH deductable because I balance the risk I want to take.

But I took it upon my own responsibility to pay for it my self.

Now for states that might have its own citizens who are in a financial mess might have
programs for such incidents. But times are getting tough, and states are cutting programs.

But to have the Fed gov't take over a states right might be to far reaching for me.

We all have our opinions on how this will or will not work. But we are all going to pay for
this some how. If you think heath-insurance is expensive now, wait til its free.

 

[G]

Auto insurance vs health insurance is not a comparable argument. A person can CHOOSE not to have a car and therefore does not need insurance. There are a lot of people in large cities that don't have a car. It is their choice. This upcoming health package does not work that way. You must have some form of health insurance in place or you will be fined. Not exactly fined, the IRS will just tax it out of you. We will have no choice in the matter. Some say this is unconstitutional.
I have a small business in MN. I provide good coverage/low deductable insurance for my employees. (Blue Cross/Blue Shield.) For as long as I can remember the premiums I pay have a little surcharge to fund MinnesotaCare which is health insurance for MN residents that can't afford health insurance. So in a way we have had universal health coverage in MN for quite some time. As I am understanding some of the wording of the new health deal MN is one of ten states that have something like this in place and will not be as adversly affected as other states. At least not right away. The Fed Government will now basically pay the surcharge instead of folks like me.

 

[dcsnomo]

Auto insurance vs health insurance is not a comparable argument. A person can CHOOSE not to have a car and therefore does not need insurance. There are a lot of people in large cities that don't have a car. It is their choice. This upcoming health package does not work that way. You must have some form of health insurance in place or you will be fined. Not exactly fined, the IRS will just tax it out of you. We will have no choice in the matter. Some say this is unconstitutional.
I have a small business in MN. I provide good coverage/low deductable insurance for my employees. (Blue Cross/Blue Shield.) For as long as I can remember the premiums I pay have a little surcharge to fund MinnesotaCare which is health insurance for MN residents that can't afford health insurance. So in a way we have had universal health coverage in MN for quite some time. As I am understanding some of the wording of the new health deal MN is one of ten states that have something like this in place and will not be as adversly affected as other states. At least not right away. The Fed Government will now basically pay the surcharge instead of folks like me.

Ahh, bit I wasn't using the argument to discuss mandatory coverage, on that you are correct.

I was using the comparison to discuss risk. Reckless behavior as a driver increases risk and therefore should result in a higher premium. It is punitive...you screw up, we charge more to cover your risk. Getting older, getting cancer, prostate problems, general health problems are not caused by reckless behavior. These are people who need health care, it is not their behavior that caused it. They got sick, or they got old. Why are they penalized? People who need health care need health care. Our system says that the more you need health care the less chance you will have of getting it.

Insurance companies make money by removing the lower margin customers from their business. Older, sick people are low margin. Unfortunately, sick people need the health care.

 

[G]

dcsnomo - OK. We currently have 40 million people that do not have health insurance. Many of these are the very people you speak of. Old or sick. It is going to be a very expensive endeavor. The early funding proposals are heavily weighted on the young and healthy. The young and healthy will be paying for not only their own health insurance but for that of the old and sick. This is a great departure from life as we have come to know it here in the US. The young people will want to buy cars and houses and snowmobiles like their parents before them. How long before the young and healthy tire of this system and opt out of their coverage and pay the minimal fine for coverage. (About $4000 per year as I read it.) What if 30 million young people decide that they would rather pay the non-compliance fee and use their money for other things. What the heck - they still have health insurance - right? There is no money coming in to fund the health needs of the old and/or sick. The whole plan is screwed. It will not take long for the young to figure this out and we will be back to square one.

 

[mrsrunningbear]

This is so interesting...each and everyone with such good points....!!!!!