An Open Letter to Senator Brown from Ohio
 

Below is a letter I wrote to the US Senator from Ohio Mr. Sherrod Brown.

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This is further rambling that didn't get sent.

It's not a question of being GOP or Dem. it's about standing up for what I believe to be right and what I believe may damage our country's future generations.

I'm on the back 9 of life and closing in on the clubhouse. I golfed my round and did ok. Now, though as I make that turn and look at the few holes left to go, I must make sure the course I left is no worse to play for those coming up behind me. And I hope they see my club selections and what sand traps and water hazards I hit and they can play a better game.

(Golf analogy of life gotta love it.)... See More

Anyway, what this Democratic Congress and President want to pass as Healthcare Reform... tears up the course and puts fricking condos there. Not ONE of them will ever have to worry about receiving the healthcare they just passed. NOT ONE.

I stood up for my party when Bush's lackeys were telling them it was "unpatriotic" to stand up to the president. I believed and do believe it is the moral obligation of a Congressperson to stand up and speak out when they know a bill, law or anything government does is wrong for the country.

NOT ONE Democrat has taken that stance against this bill.

NOT ONE has allowed a GOP Senator to debate on the floor this bill.

NOT ONE has offered to listen to the people and take forth alternatives for debate and to research it's viability and effects.

NOT ONE HAS OFFERED TO READ THE BILL THEY PLAN TO MAKE THE LAW OF THE LAND TO THE PEOPLE IN ITS ENTIRETY AND HOLD TOWNHALL DEBATES. NOT ONE.

That is not the party I have been a part of for over 2 decades.

The party I WAS a part of dedicated themselves to bettering ALL people. To making sure EVERYONE had a voice and could be heard. That policies were to be debated on, studied and worked on until a bill that benefited ALL people present and future could be openly debated, voted on and passed for the president's signature.

This was none of those and the end result stinks to high heaven and my children, grandchildren and great grandchildren will never know the freedoms nor the opportunities of myself, my father and his father.

IMO....it is a good bill, in fact, a very good bill, but not a great bill or a perfect bill.

It represents the first significant health reform ever and will provide affordable and accessible insurance for 30+ million uninsured Americans and, for nearly 200 million Americans with insurance, it will provide unprecedented security in knowing that they wont have coverage being denied or go broke as a result of a health issue (among other benefits). it puts new restrictions on insurance companies to force holding down premium increases, although I hope the House version with stronger language in removing the industry's anti-trust exemption is adopted in the final conference report. And I am disappointed that it wont include a strong public option, but it is not a deal breaker.

The debate proceeded in both the House and Senate over a nine month period, through several committees, and with numerous opportunities for Republicans to make contributions and show an interest in a bi-partisan approach. They chose to go the other direction and use every procedure possible to stall the process and mislead the public.

The final Senate bill was available online for anyone to see prior to the start of the final floor action, there were hours of debate on the floor, over the course of the final week, in which both parties had equal time, and there were Republican amendments that were offered....most of which were for the sole purpose of stalling the bill, rather than improving the bill.

If I had a Senator, he/she would have my vote if they supported this bill and would lose my vote if he/she didnt.

If you think that insurance premiums are going to go down then you must be very bad at math. Increased risk will equal increased premium. It has to in order for the Insurance company to remain solvent. State insurnace departments will not allow an insurance company doing business in it's state to run the risk of becoming insolvent. Mandating that no pre-ex's be denied is all well and good, but the increase in premiums will be felt by everyone in order to cover those at higher risk. There's absolutely no way around that.

Your math leaves out the fact that he way around the higher risk is to increase the size of the risk pool (by 30+ million) and the addtional way to reduce premium costs is to increase competition in what currently is a relatively closed market in many (most states) as a result of anti-trust exemptions.

I am not suggesting that premiims will go down, although for many, I would expect marginal decreases or for rates to remain relatively stable. For most, premiums will not continue to increase at rates that are unmanageable at a personal level (6% or more annually - 2 or 3 times more than wages or more than 100% over the last 10 years).

But you are adding HIGH RISK people to the pool. These people are largely uninsurable. They either don't work, or have some debilitating condition that has precluded them from obtaining insurance in the past. By adding these people, the rest of us will have to make up the difference in order to cover their considerable medical costs. NOBODY'S premium is going to go down because of this. At best they will increase by about 8 to 10%.

Please provide any (objective, non-partisan) data you have to support your contention that most of the added are HIGH RISK or that increases will be about 8-10% and dont just throw numbers out in the air.

The non-partisan CBO analysis came to a conclusion completely counter to yours...most of those currently uninsured are not high risk and most of those currently in employer-based group plans will see a marginal descrease or no increase in premiums.

Neither of my Senators are listening to me. The personal responses (responses that demonstrate that the responder actually read what I wrote) stopped about a year back, and all I get now is bullshit. Barbara Boxer responded to an email I wrote about pushing for single-payer with this:
This was as of December 8. The public option has subsequently been dropped, but the mandate (which is harmful without the public option) remains. I actually like Senator Boxer ()more than Senator Feinstein), but this has been very disheartening.

Most Democrats are defeatists. I'm proud to be registered Green because even if we've got the wingnuts, at least they've got the courage of their convictions.

Barbara would have my vote :)

The Democrats, with their bigger tent and greater diversity of opinion on particular components, came up with the best bill that could be adopted.

The alternative was the status quo.

I work in the industry, adding this many people who are currently uninsurable, be it health related or the inability to afford the premiums, will create an adverse selection which in turn will increase the price. There is no way that adding that many people will in any way decrease the premiums. Removing the pre-ex clause in Health insurance will only serve to further increase premiums. Do you really not understand that? That would be like mandating that no pre-exs apply to life insurance. If that was the case then every terminal cancer patient( or other terminal disease) would then be able to obtain life insurance. Ok, fine, but the premiums will have to go up astronomically in order to cover all the added pay outs or else the company will go bankrupt.

I understand risk pools (I have worked with health pools, liability pools and workers comp pools) and what 30+ million more bodies (and more healthy than high risk) in the pool means...and I also understand anti-trust exemptions, closed markets and the lack of competition in many states and possible collusion in pricing.

I'll wait for you to provide the data to support your opinion.

Those people that are at "high risk" are the ones that need the insurance the most and haven't been getting it. If this bill helps people who need the help the most then it should be supported. Giving insurance coverage to those who would need it the least, and continuing to leave those most in need out in the cold makes no sense to me.

The bill can introduce many changes to reduce costs to help these people and give everyone coverage. Stuff like allowing generic drugs from Canada would cut costs quite a bit i think. It's not like Canada is some third-world country where we have to worry about there being monkey poo mixed into the pills.

I've also heard of a lot of bad things going into this bill.. but then i look and see that all of this stuff is coming from Republicans who are, seemingly, doing everything they can to stop people from receiving proper health coverage. Why that is, i don't know. Perhaps they are sadistic motherfuckers, perhaps many of them are too rich to understand the hardships people go through in this country, or maybe they're just being flat out bribed. Very few, if any, do it because they don't like "big government".

Bringing in generic drugs is someting I can get behind. As for lowering costs, there's nothing in this bill that even begins to adress any issues that will lower the cost of insurance.

I agres on the generic drugs, assuming they can be traced to the place of manufacture so as to prevent the flooding of the market with counterfeits.

And you still have provided no data to support your opinion on costs.

Pre-ex clauses are outdated and cruel. Should I be punished because of the way I was born? Apparently.

The point is that I shouldn't be punished for the way you were born. Pre-ex clauses are not outdated and they aren't cruel. Do you think that someone who makes $15,000 a year with a credit score in the 500's should qualify for a $500,000 dollar mortgage? It's the same concept.

So is having to face personal bankruptcy as a result of a medical crisis (the number one cause of bankruptcy). Capping annual out-of-pocket expenses is a significance feature of the legislation.

I'm not sure what data you want. I'm basing my statements on the fact that I've been in the industry for 7 years. There is no data on cost increases due to the fact that this bill isn't in force yet. All anyone can do is make predictions based on how adding high risk people (due to adverse selection) increases costs. Without reducing the amount that hospitals and Dr.'s office visits cost there is no way to reduce premium.

---------- Post added at 01:41 AM ---------- Previous post was at 01:40 AM ----------

And another reason premiums will go up.

Where do you think all this money is going to come from in order to pay for these things?

You're still ignoring the issue of a much larger pool (and still assuming that most are high risk) and much greater competition.

So if I have been paying (or have been covered my whole life), but lost my job for a year and lost coverage, and happened to get some bad illness at that time, I would never be able to get healthcare insurance again?

I'm not ignoring the larger pool, I'm telling you that the larger pool is a higher risk and it will increase premiums. I still don't understand why people think that there is no competition. Do you think that by passing this bill that somehow there is going to be massive amounts of new Insurnace Companies that will be created? There are already 5 major companies that dominate the industry, I don't know about you but to me thats a considerable amount of competition.

Under the current system and practices, you can have a job, have insurance, and still be denied coverage for a major medical illness or emergency.

And I am still telling you that the CBO, the Kaiser Foundation, an MIT study and others disagree with you.

From what i understand the big reason why costs are so high in the first place is *because* of insurance (of various forms.) Doctors can charge a lot because there's a big insurance company that is going to shell out the money. A lot of costs can probably be cut by the government simply saying "no, we're not going to pay that inflated price." Costs should be properly justified.

No you can still get insurance, it's just going to cost you more since the chances of a large amount of claims will most likely occur. If you currently have a car, 1989 honda civic worth about $2,000(pulling that out of my ass) and you trade it in and get a brand new Mercedes Benz for about $75,000, how is it in any way fair or feasable for you to pay the same amount in auto insurance premiums that you were paying for you old ass civic? It isn't. The risk on the civic is very minimal, where the Benz is considerably higher. Health insurance has to work the same way or else you deplete the Claim reserve and the company goes bankrupt.

Human bodies are not cars or houses.

If you have a job, and insurance, you will not be denied coverage for a major medical illness unless it is specifically stated so in the policy. In such a case you know about it at the time of the initial application.

If the CBO, MIT and others think that then they have no idea what Adverse selection means and how it will effect premiums.

---------- Post added at 01:55 AM ---------- Previous post was at 01:54 AM ----------

Financially speaking they are the same.

There are endless numbers of examples that would suggest otherwise.

I'll stick with the CBO health care analysts, the Kaiser analysts and other experts for now.

If I were starting from scratch, I would suggest that a single payer system w/o any industry role, would be my system of choice. But we cant get there from here so I'll take what I believe is the most achievable and meaningful reform we can get and, IMO, that is what is currently on the table and has my support.

Not based in reality. If you have a policy that covers x condition, and you go the hospital to be treated for x condition you are covered and the claim will be paid. The only way that it won't be payed is that if it is specifically excluded in the policy language, and like I said you would know that at the time of the application so there aren't any suprises.


And you can stick with the CBO projections all you want, but the simple mathematical fact is that if you increase liability you have to increase assets in order to balance out. Taking on people with pre-exs will undisputably increase premiums.

You may feel thats unfair, but thats the way reality works. There's no way around it

---------- Post added at 02:09 AM ---------- Previous post was at 02:05 AM ----------

A single payer system would eliminate premiums, but it will raise taxes so it's a wash either way. You can't get something for nothing.

The only way to truely reduce costs is to be healthier as a nation(if you have a choice) Eliminate medicaid, and all the abuses that people take advantage of. And you may or may not like this next statement, but if you skip out on a medical bill, your assets should be seized. Far too often people go the the ER with no intention of paying their bill, for totally trivial problems, or for drug seeking.

We're not talking about seniors (covered by Medicare) or indigent (covered by Medicaid) or just those with pre-existing conditions.....we're talking, in large part, about millions of hard working people who happen to be employed by a small business where subsidized insurance is not offered or as an alternative and on a personal level, affordable insurance is not available on the current open market.

High risk people? Not in the opinion of many experts.

Or are employed by a large company that starts with the letter W that thinks it is a competitive advantage to not offer healthcare in order to have to lowest prices.

Maybe from the perspective of the insurance industry. But I don't think this bill is designed specifically to appease the insurance industry. It's designed for the general population.

From the perspective of the government and the general population, human bodies are not the same as houses and cars. Houses have a distinct market value that appreciates and depreciates, while cars have a distinct market value that, in most cases, depreciates. Human bodies, on the other hand, are generators of wealth via labour. A healthy population is an efficient population. If America wants to remain competitive, they need to maintain a healthy workforce. Absenteeism is a huge cost, and I'm sure that there are a number of people who are not in the labour pool for health reasons that could be reintroduced with proper health coverage. And then there's the power of prevention.

Bankruptcies as a result of health issues need to be stemmed, especially considering that credit checks are now a prominent hiring tool.

This isn't just a money issue. It's a labour issue as well. I'll spare you the discussion of class politics. For now.

I agree with you about a healthier population. But the simple fact is that the human body, just like houses and cars, takes money to cover. If you raise the liabilities of the insurer without raising their cash reserve, they are going to be unable to pay for your healthcare. It's very basic math. That's the only point I'm trying to get you to see. Yes I know that the Human body has a higher value(in most cases) than a piece of property.

Not really. Unless you think that everyone has the same value, and that people who damage their own bodies lower their worth. But, by needing expensive healthcare, my premium shouldn't go up. That is why you buy insurance in the first place.

And the healthcare companies should be doing their job to make people healthier in order to make more money. It's not my fault if they go out of business because people are unhealthy. They made the bet and took the risk that as a whole, we would pay more in premiums than expenditures. Instead, the doctors want more patients to make more money, the patients want the best healthcare and everything the doctors say, but it's the job of the health insurance industry to make sure people don't need to use it.

By needing more health care, you are depeting the reserves of the insurance company. If those reserves aren't replenished there isn't enough money to cover claims. How can you people not understand simple math.

People don't have the same value, nor does their worth go down if they're injured. But their premiums have to(and should) go up when they have a higher risk.

I don't get why people are ok with this when their auto insurance goes up when they have a claim, but they get all pissy when their medical insurance goes up.

In a nutshell, you've admitted that the goal of insurance companies is to not pay for sick people.

Not at all, I've simply stated that in order to pay for sicker people the reserves will need to be higher in order to cover the higher expense.

Again it's very simple, basic, gradeschool level math.

But the problem is that you are trying to use home or auto insurance style in the healthcare field. Home insurance premiums go down if I live close to a police/fire station, have a new house, and have a smoke detector. There are also a long list of regulations and building codes that standardize things.

The thing is, we are trying to come up with a way to fix the health insurance model without going to socialized healthcare (not that I have a problem with it, if it was done correctly).

And the only way I can see getting a healthier society within the current system is if the profits of the health insurance companies are tied to the health of every person in America. If America is healthy, I have no problem with them making lots of money, if Americans are unhealthy, well then the government should be allowed to fix things and the reserves of the health insurers should go into the red.

This is where the personal responsibility of the insured comes into play. If you don't take care of yourself you should have to pay higher premiums. Just like your example of incentives given by inurance companies to people who live closer to fire/police stations. Insurance is insurance, they all work exactly the same. You can't seperate health insurance from home owners or auto in the way they work. It just can't be done.

actually you can shift basic definitions and you do it through a political process that changes the nature of the game of health insurance itself. in a better, more comprehensive bill, one that actually operated on the assumption that access to basic health care is a fundamental human right---maybe narrowed into a citizenship right (this is america after all & after 30 years of reactionary politics about the undocumented, maybe they're understood as less-than-human...but across the figleaf of not being citizens)--then the game would change. access would be guaranteed because a political decision had been made that this end was socially desirable.

like any game, insurance operates within rules that the industry itself did not make in their entirety.

as to the rather bland insistence that folk who "don't take care of themselves" should pay higher premiums---the fact is that there is a rather brutal and stark class system in the united states & that "taking care oneself" can and typically does end up being a projection based on a relatively narrow class position onto others who do not occupy that kind of class position. the notion is not neutral, in other words. that one can transpose it into cash money doesn't make the category any less problematic to the extent that it is a class-specific category.

one of the central points of health care reform, such as it is, is to reduce the consequences of this kind of class biais--something which once mapped out into the world institutionally becomes a mechanism of class warfare.

btw i disagree entirely with the op. i think it operates in an inverted world.

The leading cause of medical problems in this country is heart disease(contributed to by poor diet and lack of excersice). By having such a lack of personal responsibility be you poor or rich is at the very heart of why health care costs are so high. By not forcing people to take responsibility for their actions all you are doing is enabling their bad behavior even further. I'm sorry but I'm not responsible for your bad choices. Just as you are not responsible for mine.

As far as the govn't changing the definition that defines the health insurance process, I think that is completely antidemocratic.

you act as though dietary choices are not a function of class position.
this is not to say that there's a 1:1 correlation...but in the main the two are very closely linked. but you'd have to think sociologically about health insurance and not simply in terms of a professional means-end rationality to see that. i'm not sure it's worth arguing the point here, but i'd be happy to try (when i'm not pretending to work)

as for the matter of who sets the rules within which insurance operates: if you think that government setting the rules is anti-democratic, then you'd have to concede that the current system is anti-democratic and that any such system would be because any such system operates within a legal framework.

but i think that's upside-down: state action allows for at least the fiction of public participation, responds to public pressure and so opens an otherwise private area to the public. so i think it's ENTIRELY anti-democratic for corporate entities to NOT be subject to legal constraints and/or pressure and/or action by way of the state. i know the neo-liberal fictions concerning corporations as in themselves democratic, but i think the arguments are nutty.

Aren't you supposed to consult a physician before beginning an exercise regimen?

Vicious cycle anyone?

Personally, if I didn't have access to a doctor (i.e. if I couldn't afford one), I'd be damned if I'd do any serious exercise in fear of getting injured or aggravating a latent medical problem. Oh, sure, I'd walk a lot, but I wouldn't lift weights or do intense cardio (which is far more beneficial than walking alone.)

rahl, it is quite possible that premiums will go up, but it's also possible they will remain stable. It's hard to predict. But how many reforms go untouched without refinements? If the system is broken, you fix it. You don't avoid it completely in fear of it not working they way you want it to. Most things worth doing have risks involved.

Diet has nothing to do with class. It's a personal choice. A bushell of apples costs as much as a bag of chips, but if you choose the chips you are making a personal(bad) choice and you have to own it. Saying said person made the choice because of their class is bullshit.

---------- Post added at 02:51 PM ---------- Previous post was at 02:49 PM ----------

I agree that things need fixed. This bill doesn't do that, it doesn't address the high cost of care, which in turn will do nothing to the high cost of coverage.

uh huh. nice way to avoid the issue, rahl. as if personal responsibility, location, infrastructure (groceries, transportation) and income weren't tied together in some areas (amuricans like spatial segregation as the primary expression of class stratification) more than in others.

Wow, that's pretty extreme. What about the families who are eating hot dogs, mac & cheese, and canned peas....for every meal?

Okay, assuming health care will only get more expensive. So what? Health care is important. Why not trim the military budget by 1%, and it will pay for the whole thing. Plus there would probably be enough change left over to double the education budget. (Am I exaggerating?)

I haven't avoided anything. You, and other extreme liberals, believe that it's not the fault of the individual for the choices they make. Nobody forces a poor or rich person to buy and eat one particular type of food. So if you CHOOSE to eat poorly that is on you, not your circumstances, or lot in life. That is a cop out. There are fat and unhealthy rich people just as there are fat and unhealthy poor people. They both made the choice to not eat right and not excercise. That's fine, that's there right, but I'm not responsible for their decision

---------- Post added at 03:03 PM ---------- Previous post was at 03:01 PM ----------


The families who eat hot dogs and mac and cheese for every meal are making a concsious choice to do so. for the price of a pack of hot dogs and mac and cheese you could buy trimmed turkey breasts and broccoli. It's a choice nothing more.

As to trimming other govn't spending to pay for health reform that would be fine, and that is what they should do, but they won't. Once the govn't starts spending it's not going to cut back.

Here comes the inherent dishonesty of capitalism. You're not paying for my preexisting condition, rahl. The medical costs across my lifetime more than pay for everything that I've ever had done and will have done even if i wasn't paying a premium. All I ask is that my preexisting condition not be simply an excuse to hike up the price of my insurance well beyond what my condition costs.

Even if that were't true, [i]this is how insurance works[i/]. We all pay into a pot in case of emergency and should something bad happen, our collective funds pay for it (minus the administrative fees to run the insurance company). If you get run over by a one horse open sleigh, I'm glad that the money we all put together will be able to keep you from bankruptcy. Why? I care about people other than myself. And that's the inherent code of "socialism".
I'm not talking about a $500,000 home, I'm talking about basic health needs. Shame on you for not seeing the difference.

Will your not looking at this objectively, your looking at it emotionally. What the insurance company pays out in your lifetime is irrelevant. It's what they could potentially have to pay out is the problem. I'm sorry if someone has a debilitating condition, but that can't be my responsibility to pay for. I don't have the money to take care of me and you at the same time, so I choose me. Just like everyother person who thinks rationally would do.

And talking about basic health needs and a $500,000 dollar house are the exact same thing when talking about insurance.

It's an absolute bare-minimum healthcare bill, and yes it's what should be expected from a big-tent party, but it's not what I want and it's not what we need. Because we're moving too slowly on this, people that would be living under single-payer are dying under free-market. People are going bankrupt. This is not an acceptable situation and I feel I was mislead by the Democrats on the inclusion of a public option. That public option was supposed to be the step that finally got us on the road to universal healthcare, much the same as a public option has done so elsewhere.

A box of mac & cheese (Kraft Dinner, say) made with a water (or a bit of milk if you're feeling sassy) and cheap margarine makes 4 servings at a very low cost. I imagine it would be around $1 or so. How much turkey breast and bread can you buy for $1? The last time I checked, turkey hot dogs were far cheaper than turkey breast meat, pound for pound. What do you buy when you're down to you last $5? I think canned peas are cheaper than fresh broccoli. And kids tend to like them better too.

That's the problem. But you still deal with it.

you're only looking at it from the view of money and that's not objective in the least.

You still havent addressed the issue that I raised in this post.

Nearly two thirds of the uninsured are not elderly, indigent, or with a pre-existing conditions - but include families with at least one able-bodiied, full time worker and nearly two-thirds are between the ages of 20-55.

Using your "simple mathematical fact is that if you increase liability you have to increase assets", I would suggest that these folks will increase assets more than liabilities.

So why are they high risk again?

Why do these people not have insurance now? Can they not afford it or do they not qualify for it because of a pre-ex?

If they can't afford it how are they going to afford it once the bill is passed?
If it's because they have a pre-ex they will then be eligible but their premiums will be higher than someone who doesn't.

---------- Post added at 03:24 PM ---------- Previous post was at 03:23 PM ----------

I'm looking at it from a logical financial standpoint, which is objective.
Health care is expensive, I can't afford to take care of you on top of myself, so I choose me. That is logical and rational

No decision is ever purely rational. This aspect of the discussion, though interesting, isn't very relevant. Looking at this from a purely financial standpoint is shortsighted at the very least. This is a social issue as well.

Damn...if you work in the industry, you should know why they dont have insurance now.

Its simple....because they work for small businesses where subsidized insurance is not offered. It has little or nothing to do with pre-existing conditions or adverse selection. These are hard-working people in the prime of life who cant afford insurance on the current open market.

The intent of the Insurance Exchange is to offer affordable insurance to these workers, individually or pooled through a larger group of employers .

And you are sill are dodging the question of how these millions of hard working folks are "high risk" by continuing to raise the red herring of pre-existing conditions.

[QUOTE=Baraka_Guru;2743829]. Looking at this from a purely financial standpoint is shortsighted at the very least. QUOTE]

and this is why we have a rediculous deficit. runaway rampent spending by the govn't with no thought to the consequences. That is not a dem or rep attack, it's just how govn't works. it it were run like any other business, it would have to balance expenses with revenue, not just spend because it feels like it.

Can you list other logical standpoints from which to view healthcare?

But this isn't what the bill is proposing. It isn't simply spending for the heck of it.

And even China is working towards getting health care access to their rural poor through reform and a co-op system.

Isn't the U.S. starting to fall behind when it comes to health care access? If the nation keeps humming and hawing over this, you'll never have anything remotely resembling accessible health care or universal health care.

People need access to healthcare, which everyone currently has. The problem is the cost of that Healthcare. There's no other way to look at it at this point. This bill doesn't address the cost of treatment, nor does it address the cost of insurance. So it is a complete failure. Without fixing the out of control costs of treatment, you can't bring down the cost of coverage, be it privately owned or single payor.

Still dodging the fact that the vast majority of the uninsured are not high risk as you claim (with no data) but simply dont have access to affordadle insurance w/o that employer subsidy that nearly 200 million of their fellow citizens receive.

The bill creates a larger pool, Insurance Exchange, to drive down the cost to small businesses and their employees and through which these folks are likely to contribute more than they take out.

I'm not dodging anything. Unless you have access to these peoples medical records you have no way of knowing that they have no health issues or are not high risk. I am assuming they are, rightly or wrongly doesn't matter. If they are high risk premiums will go up. If they are not high risk premiums are still going to go up with the inclusion of out of pocket maximum ceilings being put in place. My point is that no matter what, with this current bill premiums will go up.

I got it now. You are assuming they are all high risk who will take out more than they contribute and, as a result, premiums will go up...which defies every objective study on the issue.

No, premiums won't go up based on the assumption. They will go up based on the health information on the application. They will also go up since the insurance company will have greater exposure with the implementation of an out of pocket maximum ceiling.

Your entire argument is based on assumptions and IMO, not very objective.

Thanks, but I will stick with the studies by health policy experts.

It's not based on assumption, it's based on math. It's also based on insurance principals, something all of you are ignoring

math is not based on assumptions? on what planet?

If anyone here can explain mathematicaly how an insurance company can have the funds to pay out claims if the reserves aren't there without raising premiums I'm all ears. Otherwise none of you have any ground to stand on in this argument. If Insurance companies have to pay out more money they will have to take in more money in order to pay. That is reality, ignore it all you want, but that doesn't change the fact.

You are assuming that these 30+ million hard-working folks in the prime of life will take out more than they put in at a far greater rate than those currently with employer-based insurance.

And offer nothing to support that assumption.

You are assuming that these 30+million people have no medical issues or health problems, which without access to their medical records that's a claim you can't make.

I conceded that I'm making an assumption they are more than likely unhealthy, but I also demonstrated that premiums are going to go up regardless if these people are healthy or not because of the out of pocket maximum ceiling. As well as the pre-ex eclsusions. Even if alot of those people are perfectly healthy, the very sick people will more than likely offset the risk pool.

No...I am assuming that their medical issues may only be marginal worse than those 200 million presently with insurance. These folks are not elderly or indigent'. In addtion, I am also excluding kids (higher risk) of these families, many of whom are covered by SCHIP.

You are assuming they most or all are high risk and/or with pre-existing conditions....or that most will reach a high-level of out of pocket expenses (that would be capped), rather than contribute more than they take out.

http://www.cherylforberg.com/.a/6a00...041c970c-800wi

The health insurance companies should be run by these two. If you watch The Biggest Loser next week, you will see the problem. Then in 11 weeks, they fix the problem, and they won't have high healthcare costs. But, then the doctors wouldn't get paid as much, and the drug companies would lose out too.

But where was the healthcare insurance industry when the government banned trans-fats, put in anti-smoking laws, lower pollution, etc... The whole scheme is that if they make their profits, with growth for their stockholders, they are happy. They don't care about limiting coverage, adding fine print to what is and isn't covered, raising premiums for everyone, or whatever else and that is the problem with the current system. They need to start working on reducing their expenditures by making society healthier. And I would have no problem if they would fine people for their unhealthy activities if they aren't taking steps to fix them, but they shouldn't charge me more if some random unexpected health issue comes up.

Insurance companies are just like every single other business in the world. Their goal is to provide a service for a profit. If you didn't read the application to know what isn't covered that's your fault. If you feel strongly enough about it you could try to sue the agent who wrote you the policy but it will almost certainly get tossed out because you signed on the dotted line agreeing to the terms of the policy.

I have no choice in who my employer picks. And why would they limit what is covered except to scam people into paying for something expecting it to work when they need it?

You do have the choice of to pick your own individual policy. And the insurance company isn't scamming anybody. You know exactly what is covered at the time of application. You even get an explanation of benefits mailed home to you. It's not the insurance companies fault if you didn't read it.

As to why they limit coverage, As with all insurances(I'll use auto for an example) If you have a nice new car that you crashed into a firehydrant, but didn't have insurance at the time, how can you expect an insurance company to pay for the damage that was caused before you were covered with them. You can't, same is true with health insurance right now. Now if you want to have them pay for something that is pre-existing then you are going to have to live with the increased premium that the company will need in order to have the money in reserves for claims.

I did read it, so what if I want something changed? There is nothing I can do unless I complain to my HR dept, and they work on it next year. But that is a long shot.

And paying $1000 with my company vs. $4000 by going on my own, yeah that's not happening. That is why the public option or the health insurance exchange looked good, since I could team up with other people outside of my company.

---------- Post added at 04:52 PM ---------- Previous post was at 04:50 PM ----------

And stop using the car insurance thing. I have been covered since I was born, yet I know if I got really sick, they would try and reduce my benefits (or show me the fine print where it was excluded), say the paperwork wasn't filled out right, say that procedure wasn't pre-approved, or whatever else to reduce the amount they have to pay out.

THE GOVN"T WON'T LET YOU CHANGE IT not the insurance company. If your employer paid health insurnace is being pre-taxed(section 125 regulated by the IRS) which almost every single business now participates in the IRS won't let you make any changes except for a qualifying event(marriage, divorce, birth of child etc.) until open enrollment time. It has nothing to do with insurance companies.

---------- Post added at 04:57 PM ---------- Previous post was at 04:54 PM ----------


I'm using car insurance because it operates the same way but nobody is up in arms over it. Insurance companies can not currently deny you coverage just because you get sick, they never have been able to nor will they be able to, as long as you had no gap in coverage. And if you didn't fill out the paperwork right you can't expect to be paid. If something is covered they are obligated by law to pay out the covered expense provided the claim is filed

I get that it's simple math, rahl. In the simplest possible terms, an insurance company covering only the healthiest people = highest profits, right? Every person you add who actually (gasp) needs to use their insurance cuts into the bottom line. Thus, insurance companies (as private, for-profit companies) would like nothing more than to cover the highest possible # of people who won't ever use their insurance, and the fewest # who will

I know I know, profit is an evil thing that has no place in America. I bet whatever you do for a living and the company you work for doesn't strive to make profits right.

Profits aren't evil. Companies making profits by trying as hard as possible NOT to provide the service that people are paying for is a little iffy, however

They're not trying as hard as possible not to pay. If your covered they'll pay, if your not they won't. Pretty simple. If the claim wasn't filed properly, rectify it. It's not their responsibility to rectify it for you. They have to be on the look out for insurance fraud, which believe it or not is a pretty big problem.

I was talking about the terms of the health insurance policy. If they put a cap of $100,000 on it, no mental health, no vision, and a high deductible, I can either live with it, or pay my employers share and get a policy on the open market.

I am a healthy person, so I take the risk, but I know that I would go bankrupt if I had to go to the hospital for a week or two.

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.

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.

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

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.

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.

Rahl, why is it cheaper to have universal healthcare?

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

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:
http://loadedterms.com/stats/why-spending.gif
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?

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?

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

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?

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

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?

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.

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.

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.

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

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.

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