The horrors of health insurance, public or private
In their proposed “budget,” House Republicans cite a couple of horror stories from Great Britain to illustrate why they are so strongly opposed to government-run health care. These cases, they argue, demonstrate that “under a government-run health system, bureaucrats would exercise increasing control over all health care decision-making and would resort to rationing of care as the sole means to control skyrocketing costs.”
The first case cited by the GOP involves Ann Marie Rogers, right, “who in 2006 filed a groundbreaking lawsuit in Britain seeking to force her local health care bureaucrat to pay for the breast cancer drug Herceptin.” They also quote Rogers:
“It makes me so angry that these trusts are playing God, saying ‘you can’t have this, you can’t have that.’ They’ve got no right to decide who can have this life-saving drug. This is not a poor country, after all. I have worked all my life and paid my taxes. It makes me sick to think a lot of women are in my position.”
The second case involves Ian Dobbin of Yorkshire, who was also refused a particular cancer treatment. Dobbin called the decision “a death sentence for me.”
“I feel absolutely gutted because there is no way I can find that sort of money. My life is dependent on getting this drug and without it I will die…. I’ve been paying my national insurance all my life and when it comes to the point that I need it to keep me alive, they are not prepared to help.”
Now, there’s a bit more to each of those heartbreaking stories. The Republicans don’t mention that Collins appealed the government decision and won her case, gaining access to Herceptin. But after a valiant battle, she died of cancer earlier this month. In Dobbin’s case, traditional chemotherapy had failed to halt his leukemia and he was seeking government payment for a drug that had not been tested on his disease. He got funding for the experimental treatment through an unknown private donor, but I can find no record of whether that treatment worked for him.
The larger point, however, is that both stories sound utterly familiar to Americans. There is nothing strange to them, nothing that makes them unique to a government-run insurance program. In fact, versions of those stories appear in American newspapers and TV news programs on almost a daily basis.
The only difference is that on this side of the Atlantic, the villain who denies coverage is some private insurance company bureaucrat; over there, the villain is a government bureaucrat.
The truth is that every insurance program — private or public — has to ration health care. There’s no getting around it. So when I hear conservatives complain that a single-payer system will mean that health care is rationed, or that some bureaucrat will intervene in decisions between you and your doctor, I have to wonder what world they live in.
Because that happens today, every day, under our current system. Insurance companies dictate health care decisions all the time.
One difference between the private and public system is motive. Under private insurance, the people making the decision on whether you get coverage are driven by the profit motive to say no. The more treatment they deny, the more money they’re going to make.
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204 comments Add your comment
Sam
March 27th, 2009
7:25 am
So Jay, how long did it take Ms. Rogers to gain approval for Herceptin (which is well proven treatment for breast cancer) and how did this wait impact her cancer progression and her survival?
If what you say is true, and single payor system is a form of rationing healthcare(which I agree with), why won’t our politicians including Obama acknowledge this?
Jay
March 27th, 2009
7:28 am
I don’t know that they’ve denied it, Sam.
If they have, I don’t recall seeing it, and I agree it would be pretty silly if they did. Every conceivable system rations health care.
I Report/ You Whine
March 27th, 2009
7:29 am
Yeah, the care given to our soldiers at Walter Reed is the model of government efficiency, efficiency the likes of you can find at any Post Office or DMV.
We can wait for stamps and be inconvenienced by driving but matters of life and death?
The health of your beloved family members in the hands of a government that would actually suggest that wounded war veterans pay for their own insurance?
Curious Observer
March 27th, 2009
7:36 am
The relevance of the commentary on government-run health care escapes me. The U.S. changes under consideration now all provide access to the 20 or so private health care plans from which federal employees now choose, with perhaps a Medicare-like option added. In other words, people would be able to choose among Blue Cross/Blue Shield, Kaiser, United Health Care, etc. Private insurers would still be making their profit and making most of the decisions about coverage, except for the removal of their ability to deny coverage to those with certain health conditions.
The people who would be taking the financial bath under such government-subsidized universal health care are those now covered under those private plans. Existing premiums are bound to increase if those plans add hundreds of thousands of people who are otherwise uninsurable.
The issue is not whether health insurance would be “government-run”–it wouldn’t be, and that argument is a mere scare tactic. Rather, the issue is whether there should be any further government involvement in subsidizing health care coverage. It’s basically a simple choice: mandate and subsidize coverage, or continue to allow 40 million people to be treated at critical junctures at our expense–the hidden tax we all pay now. Surely no one is stupid enough to believe that the cost of health care for the currently uninsured is merely absorbed by hospitals and physicians.
DB, Gwinnettian
March 27th, 2009
7:37 am
Whiner, kindly tell the class what kind of health insurance you have, and who’s paying for it? Thanks!
Copyleft
March 27th, 2009
7:41 am
What the “conservatives” prefer is for everyone to get as much healthcare as they can AFFORD, not as much as they need.
That’s fair and reasonable, isn’t it? (yeah, right.)
DB, Gwinnettian
March 27th, 2009
7:41 am
I have to wonder what world they live in.
As did I during McCain’s late-2008 stump speeches where he’d intone ominously about a “bureaucrat standing in the way of you and your doctor.” As if any American currently dealing with a for-profit private insurer wasn’t already dealing with such bureaucrats.
Oh, and Curious Observer @ 7.36, thanks for your contribution–you have far more patience and willingness to suffer fools gladly/explain the obvious than I have.
Joey
March 27th, 2009
7:42 am
Jay:
The paragraph where you give the motive(s) of the Public System was not available to me. Please repost so that I can read that statement before commenting.
Also it might be helpful to write about the procedures and options for appealing or countering both Private and Public denials.
Thanks, Joey.
DB, Gwinnettian
March 27th, 2009
7:42 am
Moreover, Copyleft, these “conservatives” also believe that children should be incentivized to live with the consequences of their decisions–in this case, their poor choice of parents.
I Report/ You Whine
March 27th, 2009
7:43 am
DeadBeat: I usually don’t encourage trolls but where you are heading with your little strawman argument is nothing more than a goony socialist talking point.
Any American, no matter if they are illegal or a citizen, can present themselves at their local emergency room and receive health care for their illness. It is against the law for the hospital to refuse them.
Even further, and something you greedy selfish liberals cannot relate to, most physicians in America donate part of their services for charitable care of the needy.
We’ll see how long that lasts with the government turning the screws on them.
Buh bye!
DB, Gwinnettian
March 27th, 2009
7:45 am
People reading this do understand the difference between the UK’s National Health (which can be realistically referred to as “socialized medicine”) and Canada’s single payer plan “Medicare”, yes?
Just checking.
Mrs. Godzilla
March 27th, 2009
7:47 am
You hit the nail on the head…..
Some reading on the subject:
9 Examples Of How Health Care In America Can Be Improved
http://www.healthcareersjournal.com/9-examples-of-how-health-care-in-america-can-be-improved/
I Report/ You Whine
March 27th, 2009
7:50 am
Off topic but pertinent to the debate, a good example of the results that government intervention can lead to-
But to the extent that the federal government is to blame, the main fed culprits are the beefed up Community Reinvestment Act and the run-amok Fannie Mae and Freddie Mac. All played a key role in loosening lending standards.-WSJ
The government thought the housing market needed it’s help and this idiot action nearly flamed out the entire world economy.
Yeah, let’s let the fed try it’s hand at health care, duh, there ya go.
DB, Gwinnettian
March 27th, 2009
7:51 am
So Whiner @ 7.43, you’re not willing to share with us what kind of insurance covers you and (if you have a family) your family?
So be it. I’ll just imagine what I have for some time, that you’re a public trough-feeder (like several of your right-wing brethren here) who has health insurance provided for him. Good for you. Must be nice.
I, on the other hand, have had to foot the bill for private insurance for some years and know very well what it’s like to deal with decisions about when to visit a doc, how to space out regular checkups, putting off non-critical treatments, and so forth.
These days I’m a bit more fortunate, since I’m in a situation where I’m “only” forking over less than half of my family’s healthcare insurance premium. But the deductables are still an issue, as is the managed-care aspect.
Oh, and your sad right-wing talking-point fall-back of “they can always visit the ER!” will be accepted as the surrender that it is. Thanks for playing, Whiner!
Andy the welcher
March 27th, 2009
7:51 am
We have nationalized healthcare, it’s called indigent care and it costs a boatload of money.
I don’t know if nationalized healthcare is the answer but it can’t be much worse than the “for profit” model we currently have. We’ve seen the “free market” at work for 8 years, look where we are. The only reason hospitals don’t go under (and insurance companies) is the government.
G
March 27th, 2009
7:51 am
An old fashioned book report on the movie “Sicko” should be required reading for every legislator and congressional representative in the nation. Single payer health coverage already exists throughout the U.S. We are all the “single payers”. Unless the U.S. recognizes that as long as we have more lobbyists in Congress than representatives, we are doomed. The VA, regardless of whatever other problems they may have, at least enjoys the ability to negotiate with pharmaceutical companies – but not those of us in the general admission section of society!
Campaign contributions from industry representatives are the root cause of every single ill we face. When Antonin Scalia is dragged into the streets and caned for his “money is free speech” approach we will then have reached a point where powerful voices are the governed instead of the government. Name one issue that is not affected by too much money awash in the election system. You think the fourth estate is ever going to sound the alarm while they’re raking in close to a trillion dollars in media blitzes? I’m taking notes from Bill Maher on the best place to retire.
G
March 27th, 2009
8:01 am
Compelling argument in favor of single-payer healthcare system. Who should know better than nurses?
http://www.calnurses.org/media-center/press-releases/2009/january/first-of-its-kind-study-medicare-for-all-single-payer-reform-would-be-major-stimulus-for-economy-with-2-6-million-new-jobs-317-billion-in-business-revenue-100-billion-in-wages.html
DB, Gwinnettian
March 27th, 2009
8:03 am
Just FYI, Andy’s WSJ fever-swamp distraction quoted @ 7.50 comes, appropriately enough, courtesy of the Hoover Institution’s David Henderson.
And for the record, among those in that swamp/symposium on “Why Did Alan Greenspan Leave The Reservation”, this Hoover shill was the only one with the audacity to push the RusHannity meme that the meltdown was mostly the fault of CRM/Fannie/Freddie.
(Sorry to dole out troll chow, but I just wanted rational folks to know how utterly bankrupt this distraction really was.)
DB, Gwinnettian
March 27th, 2009
8:04 am
Love to stay and chat, but someone’s got to pay for Whiner’s meds. Later, all.
mike
March 27th, 2009
8:05 am
DB:
” I’ll just imagine what I have for some time, that you’re a public trough-feeder (like several of your right-wing brethren here) who has health insurance provided for him.”
What do you mean by this? Having insurance provided by youe employer as part of your compensation makes you a “trough-feeder”? Also, do you think the “right-wing” people are more likely to receive health care than are other folks?
The knee-jerk partisanship of your comment makes it hard to understand your point.
I Report/ You Whine
March 27th, 2009
8:10 am
Now the libs are bringing up Michael “Fat” Moore’s movie as proof of our “failed” health care policies, wonderful.
These are the same people that admire Cuba’s “free” health care.
I pray for you America.
~~~~~
I’ll just imagine what I have for some time, that you’re a public trough-feeder (like several of your right-wing brethren here) who has health insurance provided for him. Good for you. Must be nice.
I’ve already paid up my Social Security and Medicare taxes for the year, deadbeat, if this helps you any.
The government relies on people like me, hahahahahahahaha, the very thought always cracks me up, and here I am debating with people that rely on the government.
Unreal.
Sam
March 27th, 2009
8:10 am
Jay, perhaps I didn’t get my point across: You reported that Mrs. Rogers had to “appeal” to the NHS to get Herceptin. I suspect that appeal process took considerable effort and time. How did that “delay” adversely affect her in her outcome? In America, that is grounds for malpractice lawsuit–over there, it’s almost impossible to sue the government or doctors.
On a broader point, the vast majority of the latest drug and medical device innovation and product development is done by the private industry with (gasp!) profit as the motivating factor. How will the single payor system reimburse the providers and manufacturers for the high cost of the latest and greatest developments that the public will want by “rationing” a limited pool of funds?
I Report/ You Whine
March 27th, 2009
8:11 am
Bite the hand that feeds you, liberals, just like any other stupid foaming at the mouth dog does.
hahahahahahahahaha
mike
March 27th, 2009
8:13 am
DB –
“Love to stay and chat, but someone’s got to pay for Whiner’s meds. Later, all.”
Just making up attacks on people now? Lame.
Bud Wiser
March 27th, 2009
8:14 am
This is indeed a very difficult subject to discuss, because of the life and/or death ramifications of delayed care, pay-as-you-go coverage, and indigent care.
With the implementation of Medicare many years ago, the government has already put their feet through a threshold into a room where they have utterly no comprehension of what is going on.
Supplementing and feeding the already bloated medical practice system in its entirety, it allowed, with the eager assistance of lobbyists, drug companies, etc., etc., to far outpace rational cost structures which may or may not have progressed on their own without federal intervention. In other words, they continued to feed the pig, and the pig got fatter and fatter.
Now, medical costs have far outstripped the ability to be covered in full, as they are currently structured, and no amount of taxpayer money will ‘fill the hog’.
There are curious happenings though which may be discussed. For instance, several years ago, my mothers drug costs began to exceed her very limited income, becoming a financial and psychological concern for her.
I was on a trip to Lima, Peru, and walked into a ‘drug store’, selling OTC medicines. I did a little comparison shopping. I ended up buying, over the counter, her drugs, for about one tenth of what it was costing her here at home. They were labeled and manufactured by the same companies, at the same doses and strengths…they were the identical drugs.
Now, think about this; I purchased her medicines over the counter, NO doctors visit required to gain the prescriptions, NO supplemental Medicare/Blue Cross/Blue Shield payments, nothing extra. The middle man of the government had been eliminated. There was no way in hell I could do this in the USA. Why? Because the government dumped untold millions into the system to cover these extra ‘costs’, meaning yet more bureaucratic red tape, more wasteful spending and ‘feeding of the hogs’ masquerading as doctors and drug companies.
What is the answer? I don’t know, short of nationalizing drug manufacturers and forcing them to supply medicines at a lower cost, and I’m not sure how effective that would be. Would it shortchange research and development, would or could drug companies even comply, would it even work ?
Interesting and informative discussion (rational, that is) might come up with an alternative solution, other than just bludgeoning the hog to death, that is. I just am not well enough schooled on the subject yet to come up with a winning and workable solution, but will check further.
I suggest we all do the same.
Sam
March 27th, 2009
8:14 am
Also as I have posted before, the oft quoted 45 million uninsure in America is a canard. If you subtract from that number the 12-20 million illegal aliens whose healthcare should be the responsibility of their home nations, the millions who currently already qualify for Medicaid but are too inept to know that they qualify, and the millions of healthy single 20 somethings who would rather buy the latest ipod than cheap health insurance for healthy individuals, the true number of the uninsured is 12-15 million—–still a huge number, but not nearly the amount the press would have you believe.
G
March 27th, 2009
8:17 am
DB, Gwinnettian,
Re: Canada’s plan – While on vacation in British Columbia last year, I had an opportunity to chat with a Canadian gentleman about their system.
He said he knows Americans are getting all kinds of incorrect info about it, so he would tell me the true story. He never pays, is very pleased with the system, has never had any problems with it, and has a wife and two children who feel the same.
He compared his Canadian aunt’s treatment for a heart problem a few years ago with the treatment given to his wife’s uncle in Michigan for a heart problem a few years ago.
His aunt was treated within 2 days, however, his wife’s uncle’s treatment was delayed for several weeks. They had virtually the same heart surgery, his Canadian aunt paid nothing. His wife’s uncle in Michigan, who is insured, was still making payments for his surgery. Both had good recoveries and are doing fine.
We really should do this. Now.
DB, Gwinnettian
March 27th, 2009
8:18 am
mike, just to illuminate before I go–by “trough feeder” I was tossing back at our resident rightie-trolls one of their favorite phrases to describe anyone who uses publicly-funded services.
It is not to be taken literally, of course–I bear no ill will toward those who are participating in such programs. Just those who do, who go on to try to deny such access to others.
Anyway, had you read more carefully, I’d hardly categorize those who have insurance provided by one’s employer as part of one’s compensation as “trough feeders” since that’d not only be inaccurate… I think it’s an unfair burden on employers. Such arrangments
Might’ve made some sense for America for a decade or two, post-war, when things were booming and having such perks as a recruitment tool was a win-win for so many, but today, it ain’t workin’.
And now I really must go and, possibly, pay for Andy’s meds. Later.
Observer
March 27th, 2009
8:26 am
Curious @ 7:26 – The “government” plans currently under consideration offer access to Blue Cross, Humana and other major insurance companies as ADMINISTRATORS. The federal government would be a self-insured entity. This is a very common practice. My company is self-insured but we use Humana as our administrative agent.
As a self-insured entity, the federal government would be providing all of the funding for claims and, as the funding source for the plan, they would dictate all of the underwriting guidelines for the disbursement of their funds.
Make no mistake, there is no proposal out there where government money is going to pay for you to purchase a commercially available Blue Cross plan.
Taxpayer
March 27th, 2009
8:29 am
You left out a few more differences, Jay. First, we get the honor and privilege of paying more to get, at best, equivalent coverage, if you are lucky. Also, if you purchase an individual policy (at least, in Georgia), instead of group coverage through a business or through the government (if you have a government job), you can be denied coverage of pre-existing conditions and you can even have your insurance canceled if you did not accurately disclose everything about your medical history. Hence, you have to locate every single doctor and every single file ever written about you and basically hire a team of medical experts to fill out booklets of forms in order to get a reliable insurance policy. By the way, I’m speaking from first-hand experience here and I know others that can tell much worse horror stories. Our system is not just broke — it is in ruin and utterly worthless to millions of people. It is designed to maximize profits for insurance companies, drug companies, hospitals, doctors and lawyers and lobbyists and politicians and all of their associated overhead while necessarily providing the absolute minimum in return to the largest possible number of policy holders. It is beyond unsustainable and when millions of people with group coverage lose their jobs and can no longer afford to continue coverage, it is a disaster waiting to happen. In fact, it has happened. We’re just in denial. There is a need for real change — not another bandaid to simply keep the problems covered up while they continue to fester. So, the first step that should be taken is to put politicians and all government employees on equal footing with the taxpayers. Put all of us on the same plan and let all of us pay the full price, from our income, with no behind-the-scenes subsidies that do nothing but mask the true costs. Put the actual costs for everything from an aspirin to bypass surgery out in plain sight so we can identify the waste and the areas that need the most focus in order to truly work toward a better system for we the people. I want transparency to be the first step that we take with every problem.
@@
March 27th, 2009
8:30 am
It was only a couple of years ago that my employer began offering healthcare insurance. On their first attempt, the provider’s service and restrictions were a nightmare. As employees, the staff complained and the provider was dumped at the end of, what I assume, was a contract with my employer. The staff is very pleased with the provider we have now.
Can you renegotiate in the U.K.?
My former minister, a brit, called last night, telling me to watch Hannity. I was SHOCKED! He never watches cable news networks. Anyhoo, it was this guy, Hannan, that he wanted me to see. He likes the guy. I can see why. He addresses healthcare towards the end of the video.
Amend the constitution……Hannan for President in ‘12.
It was easier to understand the brit than it is our own politicians.
lwwmm7
March 27th, 2009
8:33 am
Too many people on the planet as it is. They shoot horses, don’t they?
Observer
March 27th, 2009
8:39 am
Taxpayer – Your post regarding denial of coverage for pre-existing conditions is only partially correct. As long as you were previously covered by a group plan, you may choose to go to a private plan without any concern for pre-existing conditions. This is one of the key provisions of HIPPA (Health Insurance Privacy and Portability Act).
Taxpayer
March 27th, 2009
8:53 am
Observer,
Your description of coverage leaves out some information as well. Once you try shopping around for more affordable coverage, you can throw HIPPA out the window because you will give up coverage one way or another in order to get something affordable. It may be in the form of exclusionary clauses that may last for the life of the policy or for several years or it may be through caps, etc. Then again, if you happen to make enough money, it doesn’t matter, does it. It’s like buying an expensive car or house — if you have to ask about the cost, then you cannot afford it.
Copyleft
March 27th, 2009
8:56 am
So in our privatized system we’re paying more, getting less, and not even ensuring full coverage, with massive inefficiencies…
And the ones who love this system are supposedly the “champions of the free market!” Because the marketplace ensures “efficiency.”
Uh-huh. Tell us another one.
Juju
March 27th, 2009
8:59 am
I’m just tired of insurance period. I had to take my son to the doctor this weekend. Thank God, I pay the $600 a month premium and have a $3000 deductible!It was so nice to pay all of that money for some antibiotics! ( Oh, and thanks to the parents that were in the waiting room because “he got poked in the finger with a pencil”, “he just doesn’t look well”, and “she has a runny nose and I just can’t miss work”. It was so nice to know that you were wasting my time, the doctor’s time, and running up my premium with your petty complaints!)
I would also like to know why the cough syrup my doctor prescriped should have cost $25 under my insurance but was only $10.99 retail? Luckily the pharmacist told me she wouldn’t file with my insurance company.
I don’t have any answers. I do know that I can’t sustain the price of my premium for much longer. It also seems like people are abusing the system. I have insurance as a “just in case” fall back. I do not run to the doctor because I want to “try” a new prescription, need an excuse for work, or just feel “bad”. Doctors are not nursemaids. They should be a last resort!
Dave R
March 27th, 2009
9:04 am
A couple of things to note here:
The Canadian system works pretty well. Not as good as G’s comment above, but not as badly as some GOP-ers like to claim, either. I have tons of relatives in Canada, and their stories range from long waits to short waits; adequate coverage to limited coverage, so I think the overall assessment is that it is better than socialized medicine, but not as good as private insurance.
Mrs. G, trotting out 10 “horror stories” on private insurance is not the way to approach this issue. For every horror story you can show, there is another horror story in Canada or Great Britain. It is disingenuous to point out only the bad in a system that is clearly the best health care system in the world (still).
Now, let’s move on to how to fix this mess.
There was a story the other day that said that some insurers are considering lowering their premiums for people who have had previous, serious illnesses. They are finding out that with new treatments, these people do not have the recurrences they did in the past, so the need to charge higher premiums is no longer there. Good for them. The market is correcting itself in this one regard.
Next, states need to get out of the insurance control business. Too many states MANDATE minimum coverages for health insurance companies. For instance, at my age and personal situation, neither I nor my wife have any need to have coverage for anything to do with pregnancy or pediatrics. Nor do we wish for any coverage for psychological issues. However, those are mandated minimums. The solution is to go with a menu of choices that the patient wants, and here is where they have to choose carefully. Most people could be well-taken care of with basic wellness and catastrophic coverage, and the premiums would be far lower than the all-inclusive coverage usually offered now. Co-pays for basic office visits should be a bit higher than the usual $10-$20 dollars, to help keep costs lower as well.
Next, install a “loser pays” legal system in this country. The high cost of health care is exacerbated by the increased cost of medical malpractice insurance doctors have to pay. People will think twice about suing anyone for a payday if they have to pay court costs if they lose their case.
Next, open up the AMA records on doctors. Too many bad doctors are shielded by their brethren in refusing to note doctors who have had malpractice judgments against them. Doctors, like lawyers, need to have their records out in the public like any other profession.
Next, no insurance coverage for “designer” drugs that do not treat a life-debilitating illness, i.e. Viagra. Unless the insured wishes to pay higher premiums for that drug. If it isn’t an “I can’t function on a day-to-day basis without this” kind of situation, the user needs to pay the full cost or the higher premium.
Next, drugs. Studies have shown that for every drug that hits the market, 10-12 of them never see the light of day. If you want to know why drugs cost so much, look no farther than this statistic. How much do you think your car would cost if one out of every 10 models were a Ford Pinto? Government requirements should change from exhaustive testing to exhaustive information BEFORE receiving these drugs. Take a LISTEN to the Celebrex TV commercials these days. The ENTIRE commercial is all about side effects; not about what the drug can do FOR you, but TO you.
Finally, get outside and do something. We are one of the most laid-back societies on the planet. No exercise. Our kids are getting fatter because our adults don’t do things with them like we did when we were kids. Ride a bike or take a walk. Wellness reduces the cost of heath care more than any other drug or surgery.
And notice I never said once that we need the government in the middle of this system.
Mrs. Godzilla
March 27th, 2009
9:07 am
Daniel Hannon
http://www.dailykos.com/storyonly/2009/3/26/55033/7601
Taxpayer
March 27th, 2009
9:11 am
And, on top of all the problems with our lousy (for the recipient of health care) health care system, we add insult to injury in so many ways that it is more like a playbook that would make Shakespeare cry. We do nothing to promote better lifestyles over convenience. We buy into fast food, preservatives, sugar, carbonated drinks, etc., as a way of life when it is actually more of a fast track to the hospital bed. The number one consideration from business is always “how much can I make” when it should be a balance between making a decent return and maintaining a healthy customer base. After all dead customers don’t pay. The bottom line is that another key part of a sustainable health care plan is preventive care and that should include everything from cleaning up the air that we breathe to the water that we drink to the foods that we eat. In fact, I expect that it is safe to say that there is nearly nothing about our entire approach to health care that does not need to change — except breast implants and other cosmetic surgery.
jt
March 27th, 2009
9:14 am
In a perfect world, the goverment would have never got involved in our medical descisions in the first place. be that as it may, the goverment will never yeild in it’s intrusion. therefore, why have insurance? there should be goverment ran hospitals and clinics for the poor and the rich should be able to buy their insurance. I would rather pay with my tax money a doctor or nurse’s salary than a i9nsurance agent’s salary.
their simply does not have to be the parasitic middle man of insurance.
it is a scam.
Mrs. Godzilla
March 27th, 2009
9:15 am
Dave R
I will take your advice under consideration.
However, since I don’t believe information is a dangerous thing, and the most frequent stories we hear in the healthcare debate are horror stories from Canada or England….a little balance was called for.
RW-(the original)
March 27th, 2009
9:17 am
I also must not be able to display the entire article. We get a paragraph that purports to tell us the difference between the motives of public/private, but I only get to display the “motive” of the private version.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
DB,
Do you have an auto insurance policy that pays for oil changes? Assuming the answer is no, why would you want a health insurance policy that pays for routine maintenance?
Sam
March 27th, 2009
9:18 am
What galls me is the hypocracy of our elected officials when they talk about healthcare. How many times have we heard politicians say (including Obama on his campaign) say that EVERY American should have the same healthcare that members of Congress get. Like in what universe do they live in where the average Joe can go to Duke Med center like Ted Kennedy recently went for his brain cancer?(personally, he should be getting prison healthcare after his Chappaquiddiq incident…but I digress)
Fact is, thruout history, the rich have ALWAYS had better healthcare..just like better food, housing, cars, etc. There is no way in hell that you can afford a healthcare system where EVERYONE can go to a Duke or Mayo Clinic or Johns Hopkins for complicated problems. They’re just pandering to populist sentiment and promising a product that they can’t deliver.
You want to cover the 45 million so called uninsured, and give them a basic bare bones coverage?—I have no problems with that. But be honest with yourselves. It takes money. An additional 1-2 cent national sales tax? I’m okay with that…anyone else?
catlady
March 27th, 2009
9:19 am
It seems reasonable that if you cut out the profit making middleman, the costs would be less, doesn’t it.
I DON”T think folks should have the kind of free access I understand that families on Peachcare have: unlimited dr visits, dental, vision, therapy, etc without a copay. I have seen too many in the ER who were there over the sniffles. (Same goes for Medicaid and some Medicare recepients as well) When I was in the ER recently with a friend with off the scale bp, there was a woman there who chose the ER because it was more convenient to bring her kid there than the drs. office the next day. She didn’t have to wait long and she had a babysitter for her other kids, but the next day she’d have to take them with her to the dr. and wait!
But the private pay companies ALWAYS make a profit (by increasing rates or denying or postponing coverage) and know that few will challenge their “decisions”. So getting rid of them would have to be a benefit, wouldn’t it?
I am one of the lucky ones: I do have insurance (whose benefits decrease and expenses increase every year).
lovelyliz
March 27th, 2009
9:19 am
My sistyer’s employer dropped group health insurance. The only policy she could afford was a high deductible private plan. Last year she had surgery that put her out $4K. 3 months later, in January of this year, the condition came back. it’s an new calender year so her deductible starts all over again. The hospital wanted her to pay her entire deductible $5K up front before they would admit her. She begged pleaded and the surgeon intervened. The performed the surgury and didn’t keep her overnight this time so her debt to the hospital only went up by a little less than $3K.
My sister had worked hard her entire life. She’s productive and profitable, but evidently has no right to health care that won’t drive her into bankruptcy.
BTW her daughter has a kidney disease that has never occurred on either side of the family. The rest of her health is fine, but this is a mark on her record that can never go away. My sister’s ex-husband has a government job that will cover their little girl’s medical needs, but when she beomes an adult, my niece’s only option for any type of health coverage is group health car. Either that or move to France.
Observer
March 27th, 2009
9:19 am
Taxpayer, you are correct. I guess the full and complete story lies somewhere in the combination of our posts. Unfortunately, that story would be so long that nobody here would read it.
One of the problems we have with health insurance in this country is that people view it as a right and expect it to pay for everything. That is simply an unreasonable expectation. Insurance is supposed to cover unexpected and catastrophic costs. For example, your auto insurance covers repairs due to unforeseen accidents. It does not cover oil changes and regular maintenance. That’s the way health insurance used to work in this country. There were no “$20.00 co-pays”. You went to the doctor and paid the bill – and then YOU filed that bill with your insurance company to get reimbursed. Back then, people used to shop around for services because they had skin in the game.
Today, nobody has any clue what medical services really cost because none of their money is on the line – other than their $20.00 co-pay. Next time you need an MRI, shop around – you will find that prices vary greatly. Next time you have to have a prescription filled, shop around – you will find a GREAT variance in price from one pharmacy to another. Sadly, the current system offers no incentive for us to shop for services. This removes market forces from the equation.
If doctors knew that the PRICE of their services was being shopped as well as the quality, they would adjust their prices accordingly. Competition in the market place always favors the consumer. Unfortunately, our current model has removed all competitive forces and we are all left to pay the price in the form of higher premiums.
PoliticalMan
March 27th, 2009
9:24 am
It’s not correct to call the British system “insurance.” Their incentive is not to deny service, contrary to the US system. The shame of the US system is not even that tens of millions do not have health insurance, but the inability of those who do to get treatment and medicines. What’s the point of premiums?
lovelyliz
March 27th, 2009
9:26 am
So people “expect” health insurance to pay for everything.
What about insurances who expect to pay for nothing?
ByteMe
March 27th, 2009
9:27 am
Dave R @ 9:04: a very good prescription for what ails the system. My only difference would be to make “universal coverage” a free policy from the state or federal government (underwritten by payroll taxes and administered by the existing insurance companies) that would work with any doctor and have high deductible and $40 co-pays for doctor visits and $20 co-pay for drugs. Let this be “bankruptcy protection” more than anything as well as a way to get the very expensive uninsured out of the emergency rooms of hospitals (who — by law — must treat them regardless of ability to pay, so they do it for free and then pass the financial loss onto insured patients). Then, instead of buying expensive health care for their employees, companies would be able to pocket more profits OR buy lower-cost supplemental policies to provide a way to bridge the gap between what employees are used to for insurance deductibles and the state-provided policy’s deductible.
ByteMe
March 27th, 2009
9:29 am
RW: Auto insurance is primarily a liability and accident protection policy and not a “health of the car” policy. Although that would be cool, wouldn’t it? Would definitely provide more work for actuaries.