Healthcare reform update

[lets-retire]

Switzerland is smaller than West Virginia, and has about the same population as Virginia. How many foreign countries provide health care free of charge to anyone that shows up on their door step? How much of the worlds drugs are subsidized by U.S. sales? How does the U.S. health research budget compare to say the Swiss, French or English?

I don't have an answer to any of these questions, but I know that there are no simple answers to complex questions. Comparing health care by country and proclaiming one can do it so we can too, is illogical. Only if the two countries have similar populations, size, legal structure, political structure, climate, gene pool, and the list could go on forever.

I've posted more firm facts supporting what you said, but as normal they are ignored for the arguments that you seem to be against. Something many people on here forget is there are large hospitals on the northern border that have long standing contracts with Canada for treatment of emergency cardiac issues as well as other emergency care that get added to our costs. They also choose to ignore the fact that the cost of elective cosmetic surgery is included in the cost of our health care. Looking just at that one segment shows the US spends a disproportionate amount when compared to other industrialized nations. Which is why I try to stay out of this type of discussion. It does no good when solid facts and figures are brought up, but nobody pays attention unless the facts support their position.

 

[dex]

I've posted more firm facts supporting what you said, but as normal they are ignored for the arguments that you seem to be against. Something many people on here forget is there are large hospitals on the northern border that have long standing contracts with Canada for treatment of emergency cardiac issues as well as other emergency care that get added to our costs. They also choose to ignore the fact that the cost of elective cosmetic surgery is included in the cost of our health care. Looking just at that one segment shows the US spends a disproportionate amount when compared to other industrialized nations. Which is why I try to stay out of this type of discussion. It does no good when solid facts and figures are brought up, but nobody pays attention unless the facts support their position.

Don't forget other things that the USA pays for such as treatment for veterans (what was the last Switz war?), expansion of services into suburbia, higher automobile ownership, miles driven and accidents, taking care of illegal aliens. It is sad that the US news media even tries to make the comparison.

 

[lets-retire]

Don't forget other things that the USA pays for such as treatment for veterans (what was the last Switz war?), expansion of services into suburbia, higher automobile ownership, miles driven and accidents, taking care of illegal aliens. It is sad that the US news media even tries to make the comparison.

And our proclivity toward violence, the large number of people involved in rigorous sporting activities, the large number of sports here that are not available in many other countries, etc, etc.

 

[M Paquette]

That's just the opening. In California, one of the affected states, there is already a bill on the Governor's desk to require that any firm selling that lucrative individual medical insurance in the state also sell individual policies for children.

Call and raise...

Followup: The California Governor signed AB 2244 yesterday, which implements and phases-in provisions of federal health care reform, ensuring that children cannot be denied coverage or priced out of the market if they have pre-existing conditions. The bill prohibits insurers that sell individual market policies in California from refusing to sell or renew coverage to kids with pre-existing conditions.

 

[FinanceDude]

The bill prohibits insurers that sell individual market policies in California from refusing to sell or renew coverage to kids with pre-existing conditions.

Yes, they have to offer policies, but the govt did not mandate what RATE they can charge. The insurers will rate the heck out of them and the kids or parents won't buy them anyway.......

 

[M Paquette]

Yes, they have to offer policies, but the govt did not mandate what RATE they can charge. The insurers will rate the heck out of them and the kids or parents won't buy them anyway.......

Certainly. Nothing new there. I'm looking at a 50%-70% rate increase in moving from Cal-COBRA to an individual policy with higher copays and deductibles. Individual insurance, particularly for us over-50 folks (one foot in the grave and all that), is pretty expensive.

I'm waiting for being over 50 to be a pre-existing condition, complete with policy rider.

 

[lets-retire]

Yes, they have to offer policies, but the govt did not mandate what RATE they can charge. The insurers will rate the heck out of them and the kids or parents won't buy them anyway.......

So the end result is much higher premiums and no better coverage. That sounds like good law.

 

[M Paquette]

So the end result is much higher premiums and no better coverage. That sounds like good law.

Yah. The 80% loss ratio number doesn't take effect until plan years starting in 2011, so it's time to make hay while the sun shines. The insurers don't have to rebate premiums in excess of the loss ratio until the 2012 plan year, and there's still haggling over what constitutes the net premium.

The loss ratio refers to the ratio between what the plan takes in as premiums, and what it pays out for medical claims, its losses. Large group plans have to make an 85% loss ratio or better, and small group or individual plans have to make an 80% loss ratio or better.

The National Association of Insurance Commissioners is leaning towards excluding taxes from the ratio calculation, to make the calculation look something like (losses / (premiums - taxes)).

 

[Rustic23]

I heard an interesting discussion yesterday about insuring the uninsured. One party said we should just purchase insurance for those that can not afford it and it would be cheaper.

The interesting thing is what the other party said. He said that we really don't purchase health insurance but health care. The first party never understood what he was saying. That the cost for that insurance would be the total expected cost of health care for the uninsured of a year, plus overhead, and profit. Divide that by the number you are going to insure and you have the price of the policy.

I don't know why, but I had never thought of it that way.

 

[M Paquette]

I heard an interesting discussion yesterday about insuring the uninsured. One party said we should just purchase insurance for those that can not afford it and it would be cheaper.

The interesting thing is what the other party said. He said that we really don't purchase health insurance but health care. The first party never understood what he was saying. That the cost for that insurance would be the total expected cost of health care for the uninsured of a year, plus overhead, and profit. Divide that by the number you are going to insure and you have the price of the policy.

I don't know why, but I had never thought of it that way.

That's pretty much true. Take a look at the rates for a simple very high deductible policy, one where you pay for the first several thousand dollars of just about everything. Call that the price of catastrophic coverage. Now look at the cost of a low deductible, low copayment policy. The higher annual cost of that policy will be roughly the same as the high deductible of the catastrophic policy, particularly for us older types.

I think of it as catastrophic coverage plus buying prepaid service for non-catastrophic care. If you think you will probably use much less than that high deductible most years, and can afford the big hit to your wallet if you guess wrong (that is, you have cash available to cover that big deductible if needed), then the high deductible plan works out well.

On that buying insurance for those who can't afford it because it's cheaper, well, some rural hospitals in Minnesota have bought MinnesotaCare, a state subsidized insurance plan with low premiums, for their general assistance (indigent) patients needing chronic care. This lets them see patients in less costly settings than the ER.

 

[Brat]

Before my analysis was complicated by Medicare coverage, each year I would analyze the rate & benefits of the policies offered by my employer. Amazing how close the difference between the cost of the low deductible and & deductible came to the amount of the deductible spread.

 

[GregLee]

I don't know why, but I had never thought of it that way.

It's just as well you didn't. Money has interest value, which this reasoning takes no account of.

 

[chinaco]

That probably is a big factor. It is also why I think the statements about how we pay more and get less for our HC dollar are a bit misguided (though true). It's partially due to trying to meet the 'needs' of a very large and diverse society. I'm not sure there is anything substantive to say that changing the US system to a more public one is going to change that.

-ERD50

I believe it represents waste, fraud and profits due to a poorly structured (and overly complex) health care and delivery system that all parties have learned to game (or waste).... from consumer to every entity in the provider and producer of goods and services delivery chain.

Many many factors.

To optimize it will require it to change substantially (and it will disrupt the status quo).

What we have right now is a contraption that tries to leave the status qou and just increased the scale of it.

The politicians failed us... as usual! But something needed to be done.

Hope springs eternal.... hopefully a "Rose will emerge from that Turd". (supposed to be good fertilizer).

I think we have to "wait and see".

 

[Savesome2]

Federal District Court Rules Today Health Reform Act is Constitutional

A Federal district court in Michigan ruled today that the health reform act is constitutional under the Commerce Clause. Here's a link to the order for those interested:

http://www.thomasmore.org/downloads/sb_thomasmore/Healthcare10-07-10ORDERDENYINGPLAINTIFFSMOTIO.pdf

 

[harley]

I never said the courts wouldn't back it, just that it's not constitutional. As so many of the recent rulings aren't. I hate the Commerce Clause.

All Your Economic Decisions Are Belong to Us - Hit & Run : Reason Magazine

 

[dex]

A Federal district court in Michigan ruled today that the health reform act is constitutional under the Commerce Clause. Here's a link to the order for those interested:

http://www.thomasmore.org/downloads/sb_thomasmore/Healthcare10-07-10ORDERDENYINGPLAINTIFFSMOTIO.pdf

Story to continue...

http://www.nytimes.com/2010/10/08/health/policy/08health.html?_r=1&ref=todayspaper
The central question, which may ultimately fall to the Supreme Court, is whether the Commerce Clause of the Constitution gives Congress the authority to require citizens to obtain a commercial product, namely health insurance.

 

[Rustic23]

[The Congress shall have Power] "To regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes;"

and to force the people to buy health insurance! Is this nuts? If you can get that from the commerce clause there is nothing the federal government can't do, and an all powerful central government would have never been acceptable.

 

[lets-retire]

[The Congress shall have Power] "To regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes;"

and to force the people to buy health insurance! Is this nuts? If you can get that from the commerce clause there is nothing the federal government can't do, and an all powerful central government would have never been acceptable.

Can't argue with this, but it seems many recent decisions are made willy-nilly based off previous case law with no real regard to what the Constitution says.