health insurance + free market == rescission

[Gary_Yngve]

The way rescission has been practiced lately by insurance execs is disgusting. It's guilty until proven innocent, and sick folks who need urgent treatment (example being the lady w/ aggro breast cancer who had a glitch on her charts regarding acne) are being denied, because a few bucks is more important than a life.

 

Now what I don't understand is how the repubs, the party of life, argues that a public plan will kill people, as if the rescissions are just fine. The insurance companies are denying coverage because the costs are too much. Pure greed. No consideration on severity and urgency. They say they rescind less than a fraction of a percent, but that's the percent of people who are unlucky to acquire serious problems.

 

If it ever comes necessary for a public plan to triage cases due to a lack of resources (as is done already wrt mass-casualty incidents or a blood shortage), the considerations will not be based on money but on severity and urgency.

 

Some of the repubs anecdotes about procedures being denied for being "too old" may not even be an insurance issue, even though they are selling it as such. Certain procedures temporarily insult the body greatly (e.g., transplants), and a patient must be strong enough to withstand the procedure.

 

So I'm still at a loss. Why is the party of life so against it?

 

 

[astrov]

"Our health care system is based on the premise that health care is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. That's not what health care should be. Health care is a need; it's not a commodity, and it should be distributed according to need. If you're very sick, you should have a lot of it. If you're not sick, you shouldn't have a lot of it. But this should be seen as a personal, individual need, not as a commodity to be distributed like other marketplace commodities. That is a fundamental mistake in the way this country, and only this country, looks at health care. And that market ideology is what has made the health care system so dreadful, so bad at what it does." - attributed to Marcia Angell.

 

She was on Bill Moyers last night; you should check her work out Gary.

[pink]

funny how people take better care of their vcr's, cars, computers etc. than their own bodies. if i had a dollar for every time the fat guy across the street washed his car and shined his wheels.

[Gary_Yngve]

Thanks for the ref to Marcia Angell!

 

 

[Vickster]

Nobody is "owed" or "deserves" anything in this life. If you think you are, you have not fully grown up yet. I get by with good health, a first aid kit, and disaster health insurance. Perhaps I will get a better plan down the road when I can afford it.

 

Government cannot even run itself, how the hell can it manage my health care? Lastly, I am so thankful that Obama will let me "keep" my current plan, it is so gracious for him to let me keep what I am already earned.

[Gary_Yngve]

And how do you know your catastrophic plan won't be rescinded if something were to happen to you?

 

That's the point. You think you have a plan, until some pointyhead decides you don't have a plan anymore. Needed urgent care and were denied coverage? Sucks to be you.

[Bug]

Every Health insurance company pays huge penalties every day for wrongly denied claims. It is cheaper to deny legitimate claims and pay the penalties because many people do not know they can appeal without spending money. Others simply die.

 

As Gary said, it is about money. Not about hte contrat they promised to uphold. And guess what? Health insurance companies are one of the largest contributors to campaigns and lobbying efforts in DC. Obama owes his allegience to the people who sent him donations in $100 payments or less. Not the packs and huge contributors that donated to, and supported most senators and representatives in DC today.

As the internet backing that Obama's camp orchestrated is successfully utilized by more and more congresspeople, we will see more and more of them stand up to the corporate buyouts that characterize national politics of the last couple decades.

 

[pink]

Nobody is "owed" or "deserves" anything in this life. If you think you are, you have not fully grown up yet. I get by with good health, a first aid kit, and disaster health insurance. Perhaps I will get a better plan down the road when I can afford it.

 

Government cannot even run itself, how the hell can it manage my health care? Lastly, I am so thankful that Obama will let me "keep" my current plan, it is so gracious for him to let me keep what I am already earned.

 

yup

[mythosgrl]

Actually, Medicare has the lowest overhead costs when compared to every other insurance provider. Part of the reason is that there isn't a CEO taking millions out of the system every year for his/her paycheck like all of the private insurance companies. Fun facts:

 

United Health Group

CEO: William W McGuire

2005 salary: 124.8 mil

5-year: 342 mil

 

Aetna

CEO: John Rowe

2005: 22.1 mil

5-year:57.8 mil

 

 

[billcoe]

Actually, Medicare has the lowest overhead costs when compared to every other insurance provider. Part of the reason is that there isn't a CEO taking millions out of the system every year for his/her paycheck like all of the private insurance companies.

 

If true, does this figure including the time private companies must spend filing government paperwork etc etc?

[Fairweather]

Lastly, I am so thankful that Obama will let me "keep" my current plan, it is so gracious for him to let me keep what I am already earned.

 

I like your post, but read the fine print. The bastard's lying to you about this. Flat out lying.

[JayB]

Actually, Medicare has the lowest overhead costs when compared to every other insurance provider. Part of the reason is that there isn't a CEO taking millions out of the system every year for his/her paycheck like all of the private insurance companies.

 

If true, does this figure including the time private companies must spend filing government paperwork etc etc?

 

Doesn't account for the cost of generating revenues via the IRS, doesn't include the costs of government employees in other agencies that are involved in administering Medicare, doesn't include the costs of capital reserves that private insurers are required to hold in order to meet statutory requirements for capital adequacy, doesn't include taxes that private insurers have to pay, the fact that overhead as a percentage of claims is affected by the average size of the claim, and I'm sure that there are others that I'm forgetting.

 

If private insurers got all of their money for free from the government, didn't have to pay any taxes, spent next to nothing on claims revue and fraud prevention, and contracted out the task satisfying claims to the outside vendor with the low bid, etc - then the Medicare vs private insurer comparison would be meaningful.

 

It's also worth examining whether or not a reduction in a given enterprises' profits will necessarily translate into proportionate benefits for consumers. GM, for example, has done a phenomenal job of eradicating profits in the past three years, but it's worth asking if consumers have enjoyed either increases in quality or reductions in price that are commensurate with the magnitude of GM's lost profits plus outright losses.

[JayB]

The way rescission has been practiced lately by insurance execs is disgusting. It's guilty until proven innocent, and sick folks who need urgent treatment (example being the lady w/ aggro breast cancer who had a glitch on her charts regarding acne) are being denied, because a few bucks is more important than a life.

 

Now what I don't understand is how the repubs, the party of life, argues that a public plan will kill people, as if the rescissions are just fine. The insurance companies are denying coverage because the costs are too much. Pure greed. No consideration on severity and urgency. They say they rescind less than a fraction of a percent, but that's the percent of people who are unlucky to acquire serious problems.

 

If it ever comes necessary for a public plan to triage cases due to a lack of resources (as is done already wrt mass-casualty incidents or a blood shortage), the considerations will not be based on money but on severity and urgency.

 

Some of the repubs anecdotes about procedures being denied for being "too old" may not even be an insurance issue, even though they are selling it as such. Certain procedures temporarily insult the body greatly (e.g., transplants), and a patient must be strong enough to withstand the procedure.

 

So I'm still at a loss. Why is the party of life so against it?

 

 

1. Does it necessarily follow that establishing a public plan is the optimal remedy for this problem? E.g. - instead of simply drafting legislation to minimize or eliminate it?

 

2. What evidence do you have to support the claim that severity and urgency will be the sole criteria by which a public plan allocates scarce resources with many alternative uses? Is this a statement of fact, or an article of faith?

[Gary_Yngve]

1. It may not be the optimal remedy. But the problem is the relationship between stockholders and stakeholders. The healthcare system (pharma + insurance) is designed to provide maximum benefit to the stockholders. The stakeholders are the patients whose lives are at stake.

 

2. Article of faith. I think Medicare is pretty good, though w/ some modern fraud analysis, it could be even better.

[j_b]

Actually, Medicare has the lowest overhead costs when compared to every other insurance provider. Part of the reason is that there isn't a CEO taking millions out of the system every year for his/her paycheck like all of the private insurance companies.

 

If true, does this figure including the time private companies must spend filing government paperwork etc etc?

 

Doesn't account for the cost of generating revenues via the IRS,

[...]

 

Rightwing spin isn't supported by the evidence (some of it is nonsensical because most healthcare dollars are already paid by taxes):

 

"These administrative spending numbers have been challenged on the grounds that they exclude some aspects of Medicare’s administrative costs, such as the expenses of collecting Medicare premiums and payroll taxes, and because Medicare’s larger average claims because of its older enrollees make its administrative costs look smaller relative to private plan costs than they really are. However,the Congressional Budget Office (CBO) has found that administrative costs under the public Medicare plan are less than 2 percent of expenditures, compared with approximately 11 percent of spending by private plans under Medicare Advantage.16 This is a near perfect “apples to apples” comparison of administrative costs, because the public Medicare plan and Medicare Advantage plans are operating under similar rules and treating the same population.

(And even these numbers may unduly favor private plans: A recent General Accounting Office report found that in 2006 Medicare Advantage plans spent 83.3 percent of their revenue on medical expenses, with 10.1 percent going to non-medical expenses and 6.6 percent to profits—a 16.7 percent administrative share.)"

 

http://institute.ourfuture.org/files/Jacob_Hacker_Public_Plan_Choice.pdf

[Gary_Yngve]

All forms of healthcare, public or private, could really use a major IT overhaul to modern technology. Might be easier to swing it in the public sector.

 

Maybe next we could finally convert to metrics..

[billcoe]

Thanks JB! Good find. Speaking only for myself, I think I truly don't know enough to make any kind of a call on the healthcare issue. I hope those better educated will make the correct choices, whatever they are.

[j_b]

Nobody is "owed" or "deserves" anything in this life.

 

False! For example, anybody has the right to emergency care regardless of ability to pay. Note also that healthcare is cheaper than emergency care.

[prole]

 

I hope those better educated will make the correct choices, whatever they are.

 

Bedtime for Democracy. That was a fun little idea for a while...

[j_b]

Thanks JB! Good find. Speaking only for myself, I think I truly don't know enough to make any kind of a call on the healthcare issue. I hope those better educated will make the correct choices, whatever they are.

 

I am not an expert either but the difference between healthcare costs in the US and other developped nations is staggering (on average OECD nations pay 1/6 the amount we spend) while 1/4 of our population is under-insured or has no coverage, so irrespective of spin and hair-splitting it's easy to see that something can be done.

 

Small business owners have great incentives to support a public insurance/single payer since benefits are so important in securing/retaining competent employees.

[Crux]

All forms of healthcare, public or private, could really use a major IT overhaul to modern technology. Might be easier to swing it in the public sector.

 

Maybe next we could finally convert to metrics..

The idea that advancements in information technology can be implemented by our government is laughable. By the American public sector, millions of dollars were squandered on the creation of the Internet, and we all know how pointless that was.

 

"The Internet is irrelevant" -- Bill Gates, renowned private sector innovator (1994).

[billcoe]

I hope those better educated will make the correct choices, whatever they are.

 

Bedtime for Democracy. That was a fun little idea for a while...

 

Well, I don't know. Anyone can go to any hospital emergency room they want anytime they want and get care. Then you pay for it, and in a big way. Seems to me that there is plenty of room for improvement. My biggest fear is that by the time everyone in big government all toss in their pet issues, then all the big pharmas rework that, then all the healthcare insurers have their way to revise the revisions: we wind up with something which doesn't resemble anything which truly makes economic sense for the citizens who will need the benefits and we all may be hosed in a big way. Our system is designed to produce that kind of an end product.

[KaskadskyjKozak]

All forms of healthcare, public or private, could really use a major IT overhaul to modern technology. Might be easier to swing it in the public sector.

 

Maybe next we could finally convert to metrics..

 

Paying all those IT folks for their fancy, buggy software would be so cheap too. A no-brainer!

 

[Bug]

Let's just buy them all an abacus and save tons of money.

[KaskadskyjKozak]

Let's just buy them all an abacus and save tons of money.

 

What's a few hundred billion here or there? I'm sure Micro$oft would be eager to do the "job".