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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 08:40 AM   #61
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Re: Healthy? Insurers don't buy it

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The second set of numbers you posted is the total percentage of new drugs developed not the level of research.
Thanks, lets-retire.. correct, but I don't think it changes my point.

Sorry, I didn't think any of this was somehow "political"..
Look at the list of countries with Universal Health Care -- I don't see a lot of political kinship between the UK and Turkey, or Korea and Canada.


Anyway.. giving a look at the first page of recent posts in the section, about half of them, based on the titles, are pretty much bound to have some content that could be deemed political. Money is political, taxes are political, health care is political. Life is political.. 8).

I will admit to a personal interest in seeing the system changed, since if I ever should come back to the US, despite having been completely "covered" where I am, I'll no doubt be heaved into the "uninsurable" dustbin, depending on where I choose to live. I just don't think that's fair on its face, and I don't care whether it's a Republican (like Mitt Romney) or a Democrat as long as somebody at least does SOMEthing to change the status quo, which is just OBJECTIVELY not working.

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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 08:59 AM   #62
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Re: Healthy? Insurers don't buy it

I agree that the content and text-flooding surrounding this and related threads is clearly obnoxious, of very questionable validity, and distracting. I hear ya.

Notwithstanding that, the H & ER forum is probably as suitable a place for such gas as any other, if it is going to occur.

Lacking any blatant slander, inappropriate content, or xxx-ism of any sort, the most powerful tool to get moderator consensus on taking action is to PM me directly with specific complaints concerning any given poster. If more than an isolated complaint is received, the moderators will take appropriate action.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 08:59 AM   #63
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Re: Healthy? Insurers don't buy it

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Originally Posted by ladelfina
I will admit to a personal interest in seeing the system changed, since if I ever should come back to the US, despite having been completely "covered" where I am, I'll no doubt be heaved into the "uninsurable" dustbin, depending on where I choose to live. I just don't think that's fair on its face, and I don't care whether it's a Republican (like Mitt Romney) or a Democrat as long as somebody at least does SOMEthing to change the status quo, which is just OBJECTIVELY not working.
The term "uninsurable" in the USA is really not a good word to use, because you are not really uninsurable, you just have to pay more here if your health status is not as good as others in order to obtain coverage, unless you are employed or eligible for government assistance.

It cracks me up the quotes that people pick and choose to comment on, with no regard to the comments in the same posts that follow. For example...in my statement on my opinions about how the extreme left views things and would like to handle the problem, I also included a statment of my opinion about the extreme right followed by another statement that I don't agree with either and that I do support reform to take care of people that slip through the cracks......but, someone managed to pick my example of my thoughts about the extreme left to pick on.

How many of you actually read the article I posted regarding insight as to how the USA may have gotten into the mess we are in right now? It gives a really good explanation about why costs here are in some cases three times higher than elsewhere.... a summation:

we still have unlimited demand with no incentives for providers to cut prices (providers don't need to compete on price, because the government is paying for half of the nation's care, and they can still make up for the difference by charging higher and higher prices to the private sector - noticed by us in the form of higher health insurance premiums). The USA is now reaching a point where price increases to the private sector are becoming intolerable, thus we have finally hit CRISIS mode. Other nations probably have price controls in place combined with extra income taxes to pay the bill (...and there is no large private sector in other countries that the providers can look to for additional income, so inflation is stifled).

Here's a link to that article again, in case anyone is interested in reading. It takes a few minutes to read through the whole thing, and it is best to read through the whole thing, because the real explanation doesn't really come together untill about the mid-end of the article...

http://doctordurante.com/Socialized_medicine.html

Lastly, an answer to your question:
[Why 2 adults pay the same as a couple with 3 kids, or 10, I have no idea.. let's not even go there for now... 2 single plans = cheaper but not an option.].
Answer: Because you are OLDER, you present a much higher risk to the insurance carrier than a young couple with kids.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 09:19 AM   #64
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Re: Healthy? Insurers don't buy it

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Originally Posted by mykidslovedogs
The term "uninsurable" in the USA is really not a good word to use, because you are not really uninsurable, you just have to pay more here if your health status is not as good as others in order to obtain coverage, unless you are employed or eligible for government assistance.
Exhibit no. 328 of how MKLD is [EDIT: "lacking in credibility" colloquialism]. We've seen numerous examples of people posting here indicating that they are "untouchables" to the health insurers in their state.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 09:26 AM   #65
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Re: Healthy? Insurers don't buy it

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Originally Posted by brewer12345
Exhibit no. 328 of how MKLD is FOS. We've seen numerous examples of people posting here indicating that they are "untouchables" to the health insurers in their state.
Click here to get information about how to get "guaranteed issue" coverage in your state. You probably have to pay more than in the private market, but your coverage will be guaranteed with NO medical underwriting:

http://www.tnhis.com/statebystateguide.htm
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 09:45 AM   #66
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Re: Healthy? Insurers don't buy it

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Originally Posted by mykidslovedogs
Click here to get information about how to get "guaranteed issue" coverage in your state. You probably have to pay more than in the private market, but your coverage will be guaranteed with NO medical underwriting:

http://www.tnhis.com/statebystateguide.htm
Unless the state high risk pool is full up. Or you aren't able to follow every letter of the law that gives you access to guaranteed coverage. Or the premiums of your guaranteed coverage don't leave you enough income to eat and live indoors. Or... You get the idea.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 10:06 AM   #67
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Re: Healthy? Insurers don't buy it

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Lastly, an answer to your question:
[Why 2 adults pay the same as a couple with 3 kids, or 10, I have no idea.. let's not even go there for now... 2 single plans = cheaper but not an option.].
Answer: Because you are OLDER, you present a much higher risk to the insurance carrier than a young couple with kids.
Sorry MKLD, no cigar here..

For my small MA company (3 equal partners and no employees) my business partner (same age as I am, married, 2 kids) and I (married, but no kids) paid the exact same amount. At that point in time in HMO-land, "family" = any number of people greater than ONE. Hence we paid the "family" rate. Either that or DH goes w/o health care. Non-group at the time (2000) was either unavailable or insanely expensive (there have since been a series of intervening reforms in MA, so I don't know exactly what the landscape is like there now, cost-wise or otherwise).

Just to have the privilege of accessing the "group" plans we had to pay extortion a 'membership' fee each year to an organization that did nothing but play middleman, lumping small businesses together to make the Almighty Group.

I will look more closely at your links, but I'm not so super-interested how we got INTO the mess, more interested in how are we going to get OUT of it. If every other country in the developed world is getting along OK (and in some cases even better) doing something different than what we're currently doing, I don't see why it isn't worth a try. As I've said elsewhere, I believe in most all of these places there's always ALSO private insurance for those who want it.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 10:07 AM   #68
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Re: Healthy? Insurers don't buy it

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Originally Posted by brewer12345
Unless the state high risk pool is full up. Or you aren't able to follow every letter of the law that gives you access to guaranteed coverage. Or the premiums of your guaranteed coverage don't leave you enough income to eat and live indoors. Or... You get the idea.
I have never heard of a risk pool being filled up. (**edit....OK....I stand corrected...my lack of knowledge on other states, but the following links may prove useful to you... just trying to help until we can figure out a way to get out of this mess!)

To be eligible for risk pool coverage, you must meet HIPAA eligibility guidelines in most states. In Colorado, you have to have only been declined by private insurance or have a disease that makes you instantly eligible. If your state doesn't have a risk pool, look here:

http://www.nahu.org/consumer/healthc...ic.cfm?catID=3

If you still can't afford risk pool coverage, then you are likely eligible for Medicaid OR ONE OF THESE PROGRAMS:

http://www.nahu.org/consumer/healthc...ic.cfm?catID=3

I know there are still some that slip through the cracks, for which I support reform (as discussed in my earlier posts):

http://www.nahu.org/legislative/unin...dfactsheet.pdf
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 10:14 AM   #69
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Re: Healthy? Insurers don't buy it

There is guaranty issue only if you are HIPAA eligible. Otherwise, you are dependent on what a state provides. Not all states have risk pools and some risk pools have waiting lists or are closed. The Florida risk pool has been closed for some time. California has had waiting lists and now move people off their risk pool after three years. Risk pools are very expensive and if you are low income you will not be able to afford them. Some have low lifetime limits that leave you SOL if you have hit the maximum. You will have to impoverish yourself to get care and even then you may not be eligible for any coverage.

If you are not HIPAA eligible, the private market does not have to sell you a policy.

Most states do not allow you on medicaid unless you are disabled, elderly, and maybe if you have children in the home. If you are without children, not disabled, and dirt pooryou are not eligible for medicaid.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 10:15 AM   #70
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Re: Healthy? Insurers don't buy it

Quote:
Originally Posted by ladelfina
For my small MA company (3 equal partners and no employees) my business partner (same age as I am, married, 2 kids) and I (married, but no kids) paid the exact same amount. At that point in time in HMO-land, "family" = any number of people greater than ONE. Hence we paid the "family" rate. Either that or DH goes w/o health care. Non-group at the time (2000) was either unavailable or insanely expensive (there have since been a series of intervening reforms in MA, so I don't know exactly what the landscape is like there now, cost-wise or otherwise).
Ah yes, some healthplans have two-teired rating instead of four. Colorado has four-tiered rating so EE&SP is less expensive FAMILY.

Quote:
Originally Posted by ladelfina
I will look more closely at your links, but I'm not so super-interested how we got INTO the mess, more interested in how are we going to get OUT of it. If every other country in the developed world is getting along OK (and in some cases even better) doing something different than what we're currently doing, I don't see why it isn't worth a try. As I've said elsewhere, I believe in most all of these places there's always ALSO private insurance for those who want it.
From an investigative point of view, I think a look at how we got into the mess in the first place will help shed some light on how to reverse the problem and get out of the mess. All of my counterparts here on this forum are very eager to give their opinions, too, so why not have a closer look at some of the economics of the situation? Being a productive member of society, I am simply trying to get educated (partly by getting some of your opinions and partly by doing some of my own investigations) so I can make good voting decisions in the future.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 10:16 AM   #71
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Re: Healthy? Insurers don't buy it

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Originally Posted by mykidslovedogs
I have never heard of a risk pool being filled up.

To be eligible for risk pool coverage, you must meet HIPAA eligibility guidelines in most states. In Colorado, you have to have only been declined by private insurance or have a disease that makes you instantly eligible. If your state doesn't have a risk pool, look here:

http://www.nahu.org/consumer/healthc...ic.cfm?catID=3

If you still can't afford risk pool coverage, then you are likely eligible for Medicaid or one of these programs:

http://www.nahu.org/consumer/healthc...ic.cfm?catID=3

I know there are still some that slip through the cracks, for which I support reform (as discussed in my earlier posts):

http://www.nahu.org/legislative/unin...dfactsheet.pdf
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 10:43 AM   #72
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Re: Healthy? Insurers don't buy it

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Originally Posted by ladelfina
---I guess this was supposed to be sarcastic, but only a small %age of health issues can be chalked up to "personal responsibility." If your kid has a brain tumor, or leukemia, is that a Calvinist defect of character?? WTF?
This was sarcasm, and I actually don't believe that everyone who is uninsured is in that situation due to personal responsibility. My point was that the very farthest of the left believe in no personal responsibility at all and would have everyone being equal. Just under half of the uninsured in our country are aged 19-34, the majority of which I assume are healthy. Many of them CHOOSE to be uninsured. I say this, because the cost of coverage for them can be as low as $40-100/mo. (unless they live in a guaranteed issue, community rated state). I don't call that a small percentage: Here is some factual data about the uninsured market in America:

http://www.ncpa.org/pub/ba/ba460/
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 10:52 AM   #73
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Re: Healthy? Insurers don't buy it

Look, I just finished Dr. Durante's article, and I can't say that I've read a more hysterical picture of the situation.

I can, from direct experience (my dad was a surgeon) completely back up this statement:
Quote:
He'll be told whom he can treat, and how, and what payment he'll receive. His livelihood and his freedom will be in the hands of the same bureaucrats who hold your life and health.
Except in my dad's case (and the case of every other doctor working in the US today, unless their practice is restricted to plastic surgery or wealthy Saudis) the bureaucrats weren't government bureaucrats, they were INSURANCE COMPANY bureaucrats.

I remember, in the mid-'60s, my dad almost in tears from frustration after the umpteenth battle with Blue Cross over a patient's care. At the demand of "why was the patient still in the hospital" he scrawled in big, violent letters "PATIENT IS SICK!!"

When I look at figures like this they just make me want to vomit:
Quote:
Dale B. Wolf of the HMO company Coventry Health Care Inc., who led the 2004 rankings with $32.3 million in total compensation -- including an especially large option grant that accompanied his elevation to chief executive -- slipped to 12th on the 2005 list with $13.1 million.
http://tinyurl.com/w3fbn

I think it's safe to say that there is no doctor, not even the most specialized neurosurgeon, that makes $32million a year from patient treatments.. despite actually putting their hands inside people's living bodies, hearts, and brains and saving lives day in and day out.

My dad got paid in tomatoes (I am not kidding) from people who needed his help but couldn't afford insurance or out-of-pocket.

Anyone who has ever seen one of their billing code sheets knows how insurance co. bean-counters and paper pushers "enslave" doctors. They just don't want anyone else horning in on the franchise.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 11:06 AM   #74
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Re: Healthy? Insurers don't buy it

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Just under half of the uninsured in our country are aged 19-34, the majority of which I assume are healthy. Many of them CHOOSE to be uninsured.
take a stroll over to http://tinyurl.com/yymt2d
in which the first provider I clicked on offers for singles 25 and under the bargain rate of $784/month. An HMO for $615/month. Gotta flip a lotta hamburgers to come up with $615/month after taxes.

How can you be amazed, then, that so many young people (relatively healthy AND relatively low-salaried) are going to take a pass?
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 11:08 AM   #75
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Re: Healthy? Insurers don't buy it

Quote:
Originally Posted by ladelfina
Anyone who has ever seen one of their billing code sheets knows how insurance co. bean-counters and paper pushers "enslave" doctors. They just don't want anyone else horning in on the franchise.
These high paid executives, albeit earning what seem like rediculous salaries, I don't beleive are at the root of the problem for the high cost of care. As a PERCENTAGE of total sales, their salaries are probably about comparable to any other EXEC. Take a look at total sales in the pharmaceutical market in a recent study:

http://publicintegrity.org/rx/images...pPharmaCos.png

The article I posted earlier totally explains why Drs aren't paid enough. Price controls in the Medicaid and Medicare industry. (Medicaid pays less than 20cents on the dollar for every dollar billed.) Insurance carriers NEGOTIATE pricing with doctors. The government just TELLS doctors what they will make (which is less than what they are paid by insurance carriers, by the way). Therefore, providers look to the private sector to make up lost profits.....Thus....exhorbitant inflation!
Inelastic demand + price controls + no incentive to compete on price due to the ability to look to other markets (private health insurance) for income = Heavy Inflation.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 11:10 AM   #76
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Re: Healthy? Insurers don't buy it

Quote:
Originally Posted by ladelfina
take a stroll over to http://tinyurl.com/yymt2d
in which the first provider I clicked on offers for singles 25 and under the bargain rate of $784/month. An HMO for $615/month. Gotta flip a lotta hamburgers to come up with $615/month after taxes.

How can you be amazed, then, that so many young people (relatively healthy AND relatively low-salaried) are going to take a pass?
Your talking about MA, where heavy government regulation (and the forcing of guaranteed issue on insurance carriers has CAUSED higher premiums. If you look at any state that does not have guaranteed issue, rates are much, much lower.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 11:17 AM   #77
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Re: Healthy? Insurers don't buy it

Ladelfina-- In response to your comment that the doctors are enslaved by the insurance bureaucrats. What do you think will happen when the doctors are essentially faced with the choice of accepting whatever the insurance companies will pay or go out of business. That is what will happen if there is guaranteed insurance, paid for by the government. If the government provides the insurance, as in Medicare it wouldn't be any better.

There was an emergency room doc on here not too long ago talking about working 10 12-hour days and making a very good living. I don't see that happening when the doctors are mandated to accept whatever the for profit insurance companies will pay (customary charges will be whatever the company decides they are), or when they are on the payroll of the government.


For the record: my family would fall into the very expensive category of health insurance and until at least one of us dies, or is eligible for Medicare will most likely need to have a job for the insurance. This has probably diminished my potential for any type of early retirement.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 11:35 AM   #78
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Re: Healthy? Insurers don't buy it

I glanced through the article by the famous dentist Dr Salvatore Durante and then looked him up on Google. You may be interested to know that he won't accept insurance rates, he insists on payment in full i.e. your insurer pays their part and you pay the difference up to his rate. He justifies this with quotes from his interview with the Ayn Rand Institute.

Real credibility for an analysis of the state of healthcare in the US.

I think I'll pop down to the library and beg JG to come back...............

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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 11:47 AM   #79
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Re: Healthy? Insurers don't buy it

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I think I'll pop down to the library and beg JG to come back...............
He'd get along real well with our resident leech health insurance eckspurt.
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Re: Healthy? Insurers don't buy it
Old 01-04-2007, 11:49 AM   #80
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Re: Healthy? Insurers don't buy it

Quote:
Originally Posted by ladelfina
I think it's safe to say that there is no doctor, not even the most specialized neurosurgeon, that makes $32million a year from patient treatments.. despite actually putting their hands inside people's living bodies, hearts, and brains and saving lives day in and day out.


I guess I shouldn't complain since I only make half that myself Most of my colleages earn in the billions. The nice thing about that is that with compounding, if you start young, you can FIRE 7 minutes later. .

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