Okay man, I really don't enjoy being the one asking all the dumb questions. Sometimes I can't help it though. I was on the road all day today with my XM radio on, so I had way too much time to think. Help me out here. If we're going to make it illegal for health insurance companies to exclude pre-existing conditions, then why in the hell would I ever buy insurance before I got sick or injured? Wouldn't I be better off just using my cash for Bon Bons and Jujy Fruits until I had an issue, and then buying insurance after the fact? After all, the insurance company would be required to pay for my treatment, even if I had the illness or injury before I signed up with them.
This, of course, is where our messianic dictator comes in and enforces a mandate, right? They'll force me to buy insurance or pay a fine, so that they don't run into that issue. Yeah, probably, but what if my employer chose to pay the penalty and dump me into the socialist plan? (Not exactly a far-fetched possibility, since these guys aren't known for their generosity.) Then I could either pay a penalty of my own and choose to go without insurance or I could buy a policy on "the exchange" (whatever the hell that means). Since "the exchange" is set to impose a maximum ratio of 2-to-1 in terms of highest-to-lowest premiums, and old people extract costs at a ratio of 5-to-1 when compared to young people, the premium that the dictator would require me (on the younger end of the scale) to pay would be far higher than that which is justified by actuarial tables. I would be better off paying the fine. So I ask again - Why in the hell would I ever buy insurance before I got sick or injured?
I apologize if I got out in the weeds a little here, but some of this stuff just seems so basic that I can't believe nobody is asking the legitimate questions. Instead I get bullshit chain e-mails that talk about forced euthanasia and other things that are not actually in the bill. If you just stuck to the basics, I suspect that you would find rather quickly that these people have no idea what they're doing.
So anyway, yeah, I did some driving today. I was loaded quickly in Essex Junction and then headed southward toward the suburbs of Houston. It occurred to me as I drove through Burlington, Vermont that there probably couldn't be two more dissimilar cities in America. From the topography to the climate to the ethnic makeup of the citizens to their political leanings, Burlington and Houston are at opposite ends of the spectrum. Yet the folks in Texas apparently like their coffee from the folks in Vermont, so here we are.
The trip was pretty damn frustrating from start to finish this time around. Morning rush hour in Burlington makes for a pretty congested US-7. Then, after I-87 moved along well for a little while, there was a five mile backup at the toll booths by West Point. Then some heavy rain in Jersey. The highlight there came when a car cut off a flatbed. The flatbed driver locked up his brakes and started to jackknife. He didn't completely lose it, but the mini-van behind him (and next to me) swerved to his right in a panic. Not much I could do, since there was also a car on my right, so I gave the old air horn a blast and hoped for the best. Mini-van dude yanked it back to the left and we all went on our merry way. Good times, good times. More rain and congestion along most of the route through Pennsylvania followed. I got to Toms Brook, Virginia before my hours ran out and my day was through.
The same folks who want to be in charge of my health insurance are presently in charge of my work schedule, so I'm set to get screwed over the next few days. I can work around 17 hours between tomorrow and Friday. My first delivery is somewhere around 21-22 hours from here. My appointment is for 7am Saturday. So, instead of working two full days and then spending the night Friday near my consignee, I'll have to shut down early Friday afternoon and start at 2am or whatever on Saturday. Dumb.
Hey, look at that. The Tigers are actually scoring some runs tonight.
Love ya dude...but your wrong about health insurance...60% of all bankruptcy is caused by health care..We pay more dollars into health care than any country in the world and don't get proportionatly more for it.....Take a drug like Plavix...500.00 for 30 day supply in USA without prescription plan....62.00 dollars for ninety days supply in any other country without plan....I live in a town with 2 hospitals yet my wife had to wait 4 weeks to get a catscan....Read the book sick...Study the numbers world wide..I have...We have an inferior system that if left unchecked will destroy this country.....The powers to be isn't the Pres. in this issue...Healthcare costs are starting to have a significant negative financial impact on the Corps of this country..That is the real reason it will be changed...Obama will be the hero or the goat. At least someone is trying...Bush's health answer was to start wars and anhialate a percentage of the population then you don't have to cure them....
ReplyDeleteIf I wanted to make the case that our government and insurance companies have worked hand-in-glove to destroy our free-market healthcare system, which statistics do you think I would use? (Hint: The same ones.) In related news, water is wet. I'm happy to have these discussions every now and then but don't resort to the notion that I'm uninformed about the issue. It's quite likely that I know the liberal talking points better than most liberals do.
ReplyDeleteWe also might as well save the strawmen for the next televised town hall meeting on ABC. I can still hit a fastball and I can spot them from a mile away. Nobody has suggested that costs aren't rising too rapidly. We differ on the causes and the solutions. Implying that the other side wants to do nothing is the lazy way out. It works for politicians sometimes but it doesn't fly here.
On the ideology of it, we could go back and forth for a year and end up right where we are now. I think we would be better off removing the distortions in the market and you think we would be better off with more controls. (I may have oversimplified your view, but you get my point.) You know by now that I don't bother with that stuff. Circular discussions are boring.
I did make my observation though, so I'll gladly defend it. Your talking points here are of the single-payer variety. That's not the discussion in front of us right now. Debating single-payer vs. private would be essentially one of those circular ideological exchanges. My observation was dealing with a bill that is currently working through the House. Our dear leader has looked into the camera numerous times and said to me that he's not angling for a government takeover. "If you like your current plan, you can keep it." We've all heard it. Since you think I'm too cynical, I'm trying not to assume that he's a bald-faced liar.
So, if they're not trying to destroy the private healthcare industry, I have to conclude that they must be completely clueless. I will be banned from buying a private policy through any means other than the government's exchange. That's in the bill. The 2-to-1 max premium ratio for any policy sold on the exchange is in the bill. Actual medical costs, under either the most socialist or the most capitalist of systems, fall well outside this 2-to-1 ratio. That's a fact. So the younger working class folks will be subsidizing the costs of the elderly and the chronically ill. (We'll all get old sooner or later and need our share of care. I'm not making a morality judgment here. I'm simply observing the factual nature of the cost structure.) The bill prohibits exclusions for pre-existing conditions. So I can get insurance at any time I want to get it, by law, regardless of my health. I'll ask a third time then - Why in the hell would I buy insurance before I got sick or injured?
The only way to entice me would be to make the dictatorial penalty higher than the inflated (by the legal ratio) cost of my premiums. The discussions right now are on how they convince the "Blue Dogs" to support the bill. Namely - fewer mandates and penalties, with no public plan. I'm not going to ask a fourth time, but you know the question that inevitably follows.
Sticking with my preference not to assume that they're all a bunch of liars, and hearing them say that they don't want to take it all over, I must wonder what they think will happen to the private insurance industry when there is absolutely no reason for healthy people to buy insurance.
(The "Bush sucks" stuff is starting to reach it's shelf life, if you watch the polls. Probably time to dust of some new material. I recommend something related to Sarah Palin. You'll get plenty of mileage out of that one.)
Critical analysis of either party in regards to health care is pointless. All politicians, no matter party affiliation, are really at the whims of the money that got them elected..Perhaps a cynical point on my part but one that appears well represented..What do you wanna bet we see a nice surge in steel stocks. I've bet on that fact. So we will see..We may not see the increases at the local retail level but China will be seriously in play in the steel regards...How does that affect health care?? The bill seeks to reduce the expense to the corporations. That will probably translate to an increase in dollars to the individual which may take on the form of a tax right off.....My beef is Health Insurance Co's. If you have ever tried to buy personal health insurance it's as bad as talking to a used car salesman...Why is that ?? So in order for me to be treated for an illness I have to concern myself with insurance co's making a profit. Then Doctors making a profit. Then hospitals making a profit. Then all the various specialists making a profit as well.. Health care is not a business. It is a necessity of an advanced culture. Some may call this a socialist agenda..I don't think so at all.When I was young all the Doctors I new where wealthy all their kids went to private school. They all drove the best cars and lived in the best houses, and the cost to the individual and the companies was minimal. Now we have reached a saturation point where there are to many fingers in the pie. Eliminate Insurance companies. Stop the term GROUP POlicy.What larger group is there than the USA. Or the individual state.
ReplyDeleteI used to sell insurance to my business clients. I know the system plenty well. That's why, in my personal opinion, the fact that every effort (on both sides) aims to expand coverage is misguided. Less insurance with a bigger safety net for extreme cases would be better.
ReplyDeleteYou're fond of comparing today to the days when our parents and grandparents were growing up. How did it work back then? The doctor showed up, did what he had to do, and you paid him for it. If you didn't have the money, you made other arrangements. Nobody else was involved and the profit motive of various entities was never called into question. There is a straight-line correlation between the growth in insurance coverage and the growth in medical costs. Replace the insurance company with Uncle Sam if it makes you feel better, but you haven't changed this dynamic. The end user is still twice removed from the price tag.
On the elimination of group coverage, you're preaching to the choir here brother. Obviously we see different directions following from that elimination, but the guy running his own corner bakery shouldn't be treated any differently than an employee of G.E. This is the opposite of what is being proposed though. More groups will be in the works until the whole thing collapses.
You are still making an ideological case for the most part. My ideology tells me that I don't give a damn if a brain surgeon is rich as long as he gets the job done. That $500 scrip for Plavix, it seems to me, would become irrelevant if Plavix had never been invented. I'm guessing that the company that created the drug did so in order to make a profit. Your ideology is clearly different, but that's just the way ideologies are. They rarely change.
You say that the current bill aims to reduce costs, but there's nothing in it that does so. Nada. The congress' own budget office has said as much, more than once. It will actually increase costs. The biggest cost killer would have been tort reform, but that's not on the table. (Shocking.) So defensive medicine will continue. Short of that, price controls and rationing are all that are left to reduce costs, especially once competition for profits has been removed. (File the phrase "five member panel" away for future reference.)
So what does the bill actually accomplish? It expands insurance coverage, theoretically. You and I both seem to agree that this isn't so swell though, at least on its own. Yet, even in terms of expanding coverage, there's still the one main issue that I raised - Why would a healthy person buy into the system when he could just pay the penalty for now and then buy in after the fact?
That's my beef. Make an honest case for single-payer if that's the goal. This is essentially your argument but the politicians know that it's a loser, so they're either lying or ignorant when they say that a government takeover isn't the endgame. If they can't make an honest case for single-payer with overwhelming majorities in the House, the Senate, and the White House, then it ain't gonna happen. People who are buying into the notion that the current bill is some innocuous effort to help people are suckers. If it wasn't okay for Bush, Clinton, Kerry, et al to "lie" about Iraq when 80% of the country thought it was a problem, then it's not okay to lie about our health insurance when 80% of the country is happy with its current coverage.
(Ole Barney Frank seemed to give me a little extra ammo on this point last night, didn't he?)
Do you know how much it costs Conway per year in health care coverage. Not just Truckload, but the whole shebang. Compare that to 5 years ago. You will see a disproportionate increase. As a 1st year driver you qualify for a max out policy nothing more. Why is that?? Costs perhaps. This is the issue. Period. 80% ok with current health care. I think not..Conway is a prime example. So is GM..GE. It is an employer based system. A slave system. If you have a preexisting condition you will find health care available to you but not affordable..Thats done on purpose....If I was in a position of say owning my own Construction Co. Had a heart attack They will laugh at you. Is that right..Should I run the risk of loosing everything because of an illness that I unfortunatly lived through..The new american Health care credo..Work for someone else or face death or bankrupcy..Selling insurance and selling health insurance are two completely differnt things
ReplyDeleteWho said that costs aren't going up too fast? Again with the strawmen? My clients provided health insurance to their employees. As much as you would like to downplay my familiarity with these things, I know them quite well from the inside and out. The premiums were ludicrous three years ago. I'm sure they're ultra-ludicrous now. Some passed on the costs to their employees and some chose to find creative ways to limit exposure (aka limit coverage).
ReplyDeletePresently, pre-existing conditions can only be excluded for a year and that year is reduced by the number of months that you had coverage in the prior calendar year. The idea that people are being excluded forever is a leftist myth, but the exclusion period does exist for a reason. It makes people contribute at least something before they bleed money from everyone else. Most prior coverage comes from employers though, and many people can't afford to pick up the rest on their own through Cobra when they leave. This is also why Con-way's initial coverage sucks. Most people who come into this industry were unemployed and uninsured before arriving. Many of them pay a few bucks in premiums and then extract a fortune in claims. With no roadblock, the whole thing would collapse post-haste. Their way of limiting the cost to the rest of us is to limit the coverage for new people; those who pay in the least and take out the most. Guess how the single-payer systems control costs. They limit coverage for the elderly and for extremely ill newborns. Two sides of the same coin, my friend.
You don't seem to realize it, but you and I are in almost total agreement about this part of the topic. It's a failed way of doing things. I like to think of bakeries rather than construction companies, but to each his own. You're venting though and still not answering my question. If there is no exclusion period, why should I pay now when I can just bide my time and pay later? If the answer is that I shouldn't, then those who say they're not trying to destroy private coverage are lying. I'm sure you're fine with the idea of destroying private coverage, but most Americans are not.
As for what Con-way pays, again you're making a point that I would make, but arriving at the opposite conclusion. Walk with me for a minute here...
I would have somewhere around $20-30,000 in my HSA right now if my employer-paid premiums were used in the way that I prefer. Let's suppose that the law says I can withdraw and spend anything over $25K for anything I like. As long as I'm below $25K, the money has to be used for medical costs. A 100% coverage catastrophic policy at my age, with a $25K deductible, might cost me $50 a month, tops. Triple it because I'm in a riskier occupation if you wish. That $150 a month could be completely subsidized by the taxpayer (which should make you feel better) for a fraction of what they're going to spend on the current bill instead. If I were unemployed and had no HSA built up, the premium would be higher. It's part of a publicly-funded safety net though (in my ideal plan), so your tales of sorrow and woe hold no sway here.
This system would incentivize me to make smart decisions when it came to spending the money, since I would have to build the account back up to $25K if I ran it down and I could buy beer and pretzels with any excess. There's some legitimate cost control for you, with nobody between me and the doctor. If it's the Con-way plan or John Q. Public paying the bill, I'll just spend whatever the hell I want and won't worry about the price. There's a reason that lasik and fake tits have gotten cheaper, not more expensive, over the years. The people who get those procedures actually have to pay for them.
And if I decide not to be a slave to the man, then guess what. I still have my fully funded HSA because it's mine. Under any other system, all that money goes down the memory hole and I have nothing to show for it.
There, I've managed to wade into a big-picture debate, haven't I?
Well without going to deep into the subject lets just say that I understand perfectly well the nuts and bolts of the current system.. I had a medical condition several years back and was forced to walk the plank to oblivion at musket point by the current system..I was talked down to by uneducated 21 year olds that new nothing. I was threatened to have my house leaned upon, my bank accounts leaned upon, was asked how much I had in my retirement account. Was asked how much my wife made...I have never bounced a check...never been late on any payment, and have one of the highest credit scores obtainable...The system declared war..I responded in kind and paid of the amount at a negotiated price...Thank god I worked my ass off when I was young and saved a little...otherwise I would have nothing left.....From that day forward I have researched the system inside and out. Compared it to other sytems around the world...studied the numbers...I want the current sytem DESTROYED...Socialized, Communistized. Taken over by the French.. I dont care...Anything is going to be an improvement...You want to destroy me you better come with everything you got...You and I see a lot of the same places does it not bother you that all you hear out of the medical industry is how much money they are losing yet everywhere I go I see new hospitals going up, new heart clinics, new urgent care facilities..all over the country in every small town...It bugs the shit out of me
ReplyDeleteI'll take that as an acknowledgment that I'm right and they're lying about "giving me more choices." Destroying everything and going to Medicare for all is the only logical outcome from the bill in Congress right now.
ReplyDeleteGiven your own history on the topic, it's intriguing that you're so eager to spend $1.5 trillion in borrowed money to increase medical costs, increase the burden on bankrupt state governments, and eliminate choices, simply to replace the 21-year-old know-nothing from the insurance office with a 21-year-old know-nothing from the health czar's office. I wish I shared your faith in the same federal government that has bankrupted everything that it has ever touched. Alas, I don't. I'd rather have nobody between me and my doctor. Not an insurance adjuster, not a political appointee, not a five member panel, not a union, and not an employer.
As I've said before, me and two other guys, apparently...
No your right..in theory...reality is different....I would gladly accept 5 bucks more a week coming out of my check in taxes or whatever you want to call it for a affordable health situation...Not free, just affordable
ReplyDelete