rahl

The key phrase is "I take the risk" that's on you not anyone else. Also no health policy has a $100,000 cap. I assume you meant $1,000,000 which in reality is a very high cap. If you need anything even aproaching $1,000,000 in medical treatment you are almost certainly going to die anyway and quite frankly aren't worth the expense. That may sound terrible but it's realistic.

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ASU2003

I wouldn't be surprised if they lowered the caps in order to lower premiums in the next few years if nothing changes.

And the health care insurance company should be the one taking the risk. That is what I am paying them for. They should want me to be healthy, and do proactive work in order to make sure I am.

rahl

Why should they be taking the risk? And you pay them so that they will pay for a covered expense. Not to babysit you.

__________________
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ASU2003

They take the risk because that is what insurance is all about. That is the definition of insurance.

Getting back to the current legislation in congress now, if people are covered from birth, then fraud goes way down (because they are covered), and they should be making sure their customers stay healthy to increase their profits. Right now, the more money they bring in and limit what they pay out, the greater amount they make.

filtherton

Rahl, you assume the worst with respect to the distribution of healthcare needs of the uninsured population and then use this as a basis for implying that forcing insurance companies to insure the uninsured will result in industry-wide bankruptcy. But you insist that your assumption is unimportant, when in fact it is the crucial part of your argument.

If you assume a different distribution of health needs for the uninsured, one which is less pessimistic (and according to dc dux, more rooted in reality), then it becomes quite possible that forcing the uninsured to become insured could actually have a net positive affect on insurance industry reserves. Shit, even if you assume a completely normal distribution of healthcare need for the uninsured population (the most "objective" assumption given that we are all basically talking out of our asses here) the insurance industry would still come out on top

I agree with you that this bill doesn't to anything to reign in the costs of healthcare and that this is unfortunate.

As for socioeconomic status and nutrition, I will say that it is a lot cheaper to eat a calorie dense diet than it is to eat a nutrient dense diet, and that depending on the smallness of one's income, one can get stuck on the wrong side of that basic fact.

Willravel

Rahl, why is it cheaper to have universal healthcare?

rahl

It's not

---------- Post added at 01:09 AM ---------- Previous post was at 01:05 AM ----------


Insurance premiums are going to rise. I don't care who here agree's with me or not that is going to be the reality of this bill. I have shown the basic mathematical certainty that when you increase the amount you are going to have to spend that you have to increase the amount that you take in to cover the difference. No one here wants to see the basic mathematical fact that this will be the case. I'm sorry but I can't help you if you're unwilling to see reality. I'm done with this debate because clearly reality is unimportant to everyone who refuses to see this simple fact

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Willravel

Jesus Christ, rahl, do your homework. I'm sorry reality doesn't jive with your political and economic ideologies, but, to quote Senator Franken, you're not entitled to your own facts. Being a conservative laissez-faire capitalist does not mean you live in a different universe than the rest of us.

Here:

The data is entirely verifiable; it's correct.

Now that we're both living in the same reality, I'll ask again: why is it cheaper to have universal healthcare?

rahl

In our country it's not. Medical costs are out of control, I'm not sure why everyone here wants to blame the insurance companies for how expensive it is to receive medical treatment.

All your little table is showing is that we pay more for healthcare(key word there, treatment) than most countries. Our life expectancy is only four years different than Japan...so what?

Healthcare is 15 percent of our GDP. Not insurance but TREATMENT. why is it again that insurance companies are such big bad evil monsters and not DR.'S and HOSPITALS?

__________________
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Willravel

The word "treatment" appears nowhere. The percent of GDP includes the cost of insurance. It's "total health expenditures", not just treatment.

rahl

Healthcare and Health insurance are two very different things. According to your graph it only shows healthcare, not health insurance. show me a different graph that has health insurance in it then we can talk.

So again why is it that Health Insurance companies are such big bad evil monsters but not hospitals and Dr.'s offices?

__________________
"Your life is Yours alone...Rise up and live it"

Willravel

Snapshots: Health Care Spending in the United States and OECD Countries - Kaiser Family Foundation
Now we can talk.
45,000 American deaths associated with lack of insurance - CNN.com

rahl

The first part of your post is more of the same, show's health care treatment costs as it relates to gdp, not insurance.

I'm not sure what the point of your second post is. If you have a medical emergency, you can go to any hospital in the country and receive treatment. If you appendix burst and you go to the hospital you will be treated, regardless of whether or not you have insurance. It's not the insurance companies fault that it will cost you tens of thousands of dollars that the hospital will charge you.

So again why is it the big bad insurance companies fault that it costs so much for treatment at a hospital?

__________________
"Your life is Yours alone...Rise up and live it"

Willravel

You're being glib. "Total health expenditures" is not difficult to understand. Admit you were wrong and move on, otherwise you're just trolling and the thread can move on or die.
It's the cost of the capitalist system, the cost in lives instead of dollars.

scout

check this out

I agree that we need health care reform but neither the House or Senate bill does anything to address the real issues. If this passes we will be so fucked we will have to go to Canada to get decent health care.

__________________
"The beauty of the second amendment is that it will not be needed until they try to take it."
Thomas Jefferson

filtherton

I think premiums will rise too, but it will have more to do with the fact that this healthcare bill doesn't really do anything to reign in costs on the supply side of health care. It has nothing to do with your "basic mathematical certainty." Your "basic mathematical certainty" isn't basic, mathematical or certain. Jumping up and down and waving your arms doesn't make it so.

No one is shocked by the notion that increasing expenditures generally require increasing revenue. The disagreement comes in because you're basing your prediction of increasing expenditures on nothing more than a hunch. There is nothing certain about your assumption that the distribution of healthcare needs among current group of uninsured people will result in higher expenditures. A just as plausible assumption would be that these uninsured folk will actually result in lower expenditures.

rahl

Ok I get it now. I disagree with your little graph there, disagree with you on healthcare so now I'm trolling...Fine whatever, I really don't care anymore. All I've tried to do is show you people that this bill will do nothing to lower health insurance premiums, it will have the opposite effect. Don't believe me, I really could care less if people on a message board, not in the industry, agreee with me or not...


Still never heard how it's the insurance companies fault that hospitals charge so much for treatment. Wait I know, they're capitalist pigs looking for a profit

And you still haven't shown which portion of GDP is from insurance and which is from the rediculously high costs of treatment. But I'm being glib and I'm wrong

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"Your life is Yours alone...Rise up and live it"

roachboy

__________________
a gramophone its corrugated trumpet silver handle
spinning dog. such faithfulness it hear

it make you sick.

-kamau brathwaite

scout

If everyone was honest neither side of the aisle likes this bill but unfortunately the attitude of "let's just get something passed and worry about it later" is prevailing and it will be you and I that not only foot the bill but we will also have to live with the consequences. These bills look as though they was wrote by the insurance companies for the insurance companies and their unpalatable in their current form and there's no compromise between the two bills that will work.

__________________
"The beauty of the second amendment is that it will not be needed until they try to take it."
Thomas Jefferson

dc_dux

Its most amusing how many of those opposed to the bills are talking out of both sides of their mouths....on one hand "Its a government take-over of health care...socialism!"...on the other hand, "Its a payoff to the insurance industry."

And one would have to wonder why the insurance industry has spent $millions in lobbying and media buys to oppose the legislation if its so great for the insurance companies

__________________
"The perfect is the enemy of the good."
~ Voltaire

dippin

As we've discussed elsewhere, single payer systems are not a "wash." They are actually significantly cheaper to run due to reduced overhead costs, which are right now about a third of all medical costs in the US.

As for reducing costs, being healthier is not an independent variable. Good access to preventive care, for example, greatly reduces those needless ER trips.

And there is no comparison to auto insurance. Auto insurance is for exceptional circumstances (theft, accidents, etc.) and doesn't deal with preventive care and the inevitable issues related to aging. Some people never get involved in a car accident. Everyone gets sick, needs preventive care, and eventually die. A system where it is more efficient to compete by excluding certain conditions and age groups is, on the macro level, less efficient than one that pools everyone.

By the way, the majority of the uninsured are not high risk. They are mostly under or unemployed 19 to 34 year olds.

scout

I haven't said anything about socialism or government take over of health care so don't don't go there. It may surprise you I'm all for a government option but I'm opposed to these bills for numerous reasons neither of which is socialism or government takeover. I do feel it is a payoff to the insurance companies and the millions spent by the insurance companies worked as one only needs to look at the two bills to figure that out.

__________________
"The beauty of the second amendment is that it will not be needed until they try to take it."
Thomas Jefferson

rahl

Auto insurance, home owners insurance, health insurance...all operate the exact same way.

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"Your life is Yours alone...Rise up and live it"

dippin

No, they do not and you should know that. Some abstract principles ("risk") are the same, but other than that they are very different. There's the fact that it's employer based for the most part, that it covers routine procedures and "maintenance," and as such private insurers have set up strict rules to reduce excessive use, and that people, through no fault of their own, will, as a virtual certainty, become uninsurable.

In a perfect world, with perfect information about each individual person and how their health will be through the course of their lifetime, the pooling of risk would be along one's own lifetime distribution. I.e., the young person is paying for coverage he will need as an old person. The exclusion of preexisting conditions (for which there is no analogous exclusion in auto or home owners) means that that pooling of risk over the individual's lifetime is impossible, and generates a situation where it is more profitable to exclude those in old age and sick than it is to compete on price or services alone.

pan6467

I have to agree with you, it isn't the health insurance companies that are the major evil here. They are part of the big 3 but they are the smallest part of the triad that is the Healthcare beast.

First and foremost, we have malpractice insurance and lawsuits that feed the beast, probably moreso than all other reasons combined. Somewhere, in this great country's journey we became an extremely litigious country. We sue for ANYTHING, we believe it is our right to, we deserve it and we look at lawsuits as ways to "get rich quick" without thinking of what the end will bring.

Doctors of certain areas (such as OB/GYN Dr. here in Ohio) in some states can't afford the malpractice insurance. Doctors that do stay in business, then have to see more people, cover themselves better by issuing tests that they know are not needed but due to liability have to authorize to cover their asses. If they miss anything, they run the risk of getting sued into oblivion.

Hospitals are the same way. Their #1 cost (for most hospitals) is not equipment, people who can't pay or staff but insurance. Then it's the equipment that they have to have. They have to cover their asses for malpractice in far more ways than any doctor. So they tack those prices onto the services.

Pharmaceutical companies, as much as I hate them are also in the same boat. They spend years developing a med that helps. FDA tests and approves it (this is where the Pharms fucked themselves). Med comes out... starts affecting a percentage of people adversely and a class action comes up... they lose millions. They have to raise prices on meds to cover any potential litigation.

(I say the Pharm companies fucked themselves because they lobbied the FDA to be more lax in the regulations and testing... the FDA did. However, in doing so, meds come out that show bad long term effects or even short term because they were allowed to rush testing.)

So we have side one of the Triad. Malpractice and liability insurance.

Part 2 of the triad is the uninsured and those that cannot pay. This causes prices for those that can pay to go up. Again, when someone comes in and complains of chest pains, the hospital needs to perform all kinds of expensive tests to cover their ass from a wrongful death lawsuit. (Trust me, even that homeless bum on the corner has family that will come out of the woodwork if he dies and they think they can get money for a wrongful death suit.)

Again, the hospital runs these tests and no one pays. So that cost has to be passed on to those that do.

Finally, we have the insurance companies and government (medicare/medicaid). They get the brunt of everything because they do pay. Thus, they get all these tests, meds, everything thrown at them, because the money is prime for the taking. The insurance companies try to protect themselves a little but in the end they really can't because the doctors and hospitals know ways around all the loopholes. So things like "Tonail Fungus" become big money. Which feeds into the "we have a cure for everything"... erectile dysfunction... we have a cure.

Regulating the whole industry and throwing tax money at it, giving government control over you life.... is NOT going to end any of the Triad. If anything the Triad will get worse and the beast become even more of a financial drain to the GDP.

__________________
I just love people who use the excuse "I use/do this because I LOVE the feeling/joy/happiness it brings me" and expect you to be ok with that as you watch them destroy their life blindly following. My response is, "I like to put forks in an eletrical socket, just LOVE that feeling, can't ever get enough of it, so will you let me put this copper fork in that electric socket?"

dippin

The claim that malpractice suits are the main culprit for the US's poor healthcare system is simply a red herring from those who want to avoid change at any cost. It ignores that several states have already implemented tort reform without all the supposedly wonderful cost reductions. In fact, 23 states have limits on non-economic damages and 34 have limits on punitive damages.

The sum of all malpractice payouts and all malpractice insurance is less than 2% of all healthcare spending in the US.

Derwood

correct. malpractice suits rarely get paid out, and the amount that IS paid out is very small in comparison to the total healthcare expenditures each year. It's a compelte red herring

rahl

for the purposes of this discussion they are the same as it relates to pre exs.

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dippin

No, they are not, no matter how many times you say they are.

First of all, there are no "preexisting conditions" in auto and home insurance. You have previous behavior that indicates current and future risk, but you don't have a condition or a risk that is completely excluded from coverage. And that is because the nature of the insurance is different. The risk distribution is different. And in statistics, distribution is everything. That is why a true health insurance would pool the risk across a person's lifetime.

rahl

yes they are no matter how many times u say they're not. if u have damage to your automobile before u have coverage u can't expect them to cover it. if they are forced to cover it that creates an adverse selection sotuation. premiums will have to rise to compensate for the increased exposure that the insurance company will face. that is reality...ignore it all u want but that doesn't change what is

__________________
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dippin

Except that you are comparing apples and oranges. Exclusion from preexisting conditions is not refusing to pay retroactive coverage of existing damages, but additional charges stemming from a known problem. And it is not the same because the risk distribution is not the same. Everybody will get sick and die. Not everyone will get their car stolen or be involved in an accident.

Because EVERYONE will get sick or die, the issue of risk segmentation is completely different, especially when you figure in employer based health insurance.

pan6467

Really??? That's why there are certain types of doctors that because of malpractice insurance are unable to practice because of the economic reality in some states. (Like OB/GYNs)?

High Cost Of Malpractice Insurance - CBS Evening News - CBS News

Taken from a professional medical magazine website

Do You Have the Right Malpractice Insurance Policy? - Nov-Dec, 2004 - Family Practice Management

http://www.freerepublic.com/focus/f-news/2374999/posts

(Yes, the above was taken from the Free Republic posting boards... however, I do not have a subscription to Investors.com or IBD to get the article.)

For people to ignore the high cost and severity of Malpractice lawsuits and insurance is fucking ignorant.

It's not the only cause of out of control expensive healthcare but it is an integral part of it.

Those who want to claim it is the insurance industry and HMO's and the medical profession just raping the people are not seeing the whole picture.

The plan that is being put forth is not going to make the triad I put forth any cheaper at all. In fact it will make it far worse, far more expensive and services far more ineffective.

I am all for healthcare reform.... have been for many many moons and I have argued for it here since I have joined TFP. But what is being passed is bullshit and in no way a healthy, beneficial plan. What Congress is pushing through is destructive. There were and are far, far better, more efficient, economically sound ways to get reform and protect the people uninsured and keep government out of our lives.

The saddest part of all this is some of you are more than willing to sacrifice freedoms for what YOU believe everyone else needs.

__________________
I just love people who use the excuse "I use/do this because I LOVE the feeling/joy/happiness it brings me" and expect you to be ok with that as you watch them destroy their life blindly following. My response is, "I like to put forks in an eletrical socket, just LOVE that feeling, can't ever get enough of it, so will you let me put this copper fork in that electric socket?"

dippin

"Fucking ignorant" is picking a couple of cases portrayed by the media and turning them somehow into the norm.

You can use all the expletives in the world, but it doesn't change the fact that malpractice insurance is actually an incredibly minor portion of the costs associated with healthcare.

http://www.rwjf.org/files/research/no8primer.pdf


Medical Malpractice Reform and Employer-Sponsored Health Insurance - RWJF

rahl

I'm comparing apples to apples when it comes to insurance principles. I'm sorry you refuse to see how ALL insurance works. When you have a certainty for risk(claims payout, pre-ex, retroactive coverage) isnurance companies(auto coverage, homeowner, health) all operate the EXACT SAME WAY, they will deny the claim. With the current legislation that will change with health insurance only, the result will be increased premiums to cover the increased payouts.

__________________
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dippin

Except you still refuse to understand that the risk distribution is different in health insurance. By making it a impossibility to do certain types of risk segmentation, at the same time you make insurance mandatory, you force companies and people to pool risk along a person's lifetime.

That is at least "less bad" than the current system, with its perverse incentives for adverse selection .

Of course, in the end it still means that private, for profit basic health insurance is still worse than most public systems.

rahl

I'm not sure there's anything left to discuss here. You refuse to see how basic insurance principles work, I assume because you are not in the industry. When you force a company to take on people with pre-ex's premiums will rise. When you force a company to put maximums on how much a covered person is responsible to pay premiums will rise. Don't believe me, doesn't matter.

__________________
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dippin

Is your claim to being right here solely that you "work" on the industry?

Alas, let''s break it down:

You force insurance companies to cover pre-existing conditions. All else being constant, premiums should rise. But all else is NOT constant. By prohibiting companies from risk segmentation like that, you essentially end the practice of competition through coverage of only low risk individuals. Then, of course, you have the other side of the coin: mandatory coverage. With that, you end the adverse selection effects on the other side of the coin: young people not having insurance because they are very low risk. As such, you move towards the ideal of pooling risk across one's lifetime. Premiums would only go up if those currently uninsured were those uninsurable, but that is simply not true. The currently uninsured are mostly low risk young people who are under or unemployed.

With the current system you get closer to the risk pooling ideal of considering the entire lifetime, because EVERYONE will die.

Of course, this is still suboptimal, but in a private insurance for basic healthcare setting it is actually an improvement.

rahl

If out of pocket maximums weren't being capped then they would only marginally rise. But since this legislation also caps out of pocket maximums as well as removes the cap for lifetime benefits premiums will rise. So taken as a whole insurance companies have no choice but to raise premiums to cover their exposure.

__________________
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Derwood

this thread really makes me wish that insurance was 100% not-for-profit.

dippin

This is all speculation without taking into account the numerous factors that apply here, such as the risk distribution of the uninsured being included in the risk pool, increased access to maintenance and preventive care, and so on.

And again, if that is the outcome, it will be simply another reason for why single payer universal health care is far superior to for profit basic health insurance.