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Old 02-12-2009, 10:47 AM   #81
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As a side note, the government really does not protect you, they simply pick up the pieces in most cases after you've been mowed down. As for exterior threats, that would bring a very long discussion.

When I worked for State government (insurance commission), our job was to make sure that the industry we regulated was well stocked with enough cash to fulfill it's contracts sold to the public. That was one aspect Many times I had to step in as an agent and straighten out messes consumers got into by the incompetence and sticky fingers of the vendors. People were clueless when buying insurance, any kind of insurance. My job for many years was to unravel the mess and confusion.

So that is one thing the Government does do good, regulate a complex product needed by the public, but poorly understood. Without regulation, the insurance industry would have went the same way the banking industry did. Incidently, wall street was looking to "securitirize" insurance risk. That would have been interesting, but I guess government got in the way.

As for AIG, that's another discussion. In short, the damage done was selling swaps out of the reach of US regulators, by a subsidiary, putting the whole mothership in the hole

Banking is another, until recent years, the government had to make sure banks were solvent. Guess deregulation and loosening of capital requirements speaks for itself.

Or course we have Freddie and Fannie, partly thrown in the hole by Government prompting to loan money to the subprime people. So I guess there is good and bad in this mix.

As much as I love freedom to go out and open up my own hot dog stand, some things need oversight. Government surely was needed to keep the banking and securities free marketeers from running amuck and taking down the whole place with it.

Guess there'll be a new baby sitter in town now, if we survive this fiasco.
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Old 02-12-2009, 10:49 AM   #82
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Let's be careful with using political labels such as "liberal." This is a good, relevant thread and I'd hate to see it turn into a partisan snipe-fest.
Wait a minute, why does "liberal" (or "conservative" or left/right ) have to be considered a "snipe"? Isn't is a reasonable descriptor when used in the proper context? Some policies are "liberal", some are "conservative", no?

To me, that's like saying I can't refer to a High Yield Bond fund, because some people call them "Junk Bonds", and that might offend someone. Should I need to tip-toe around that and say , "you might want to look at this bond fund, currently yielding 9%"?

Let's be grown up about this. I don't see anything wrong with using these words as descriptors, when it makes sense. Now, to say something like "those envious-give-me-yours-cause-I-don't-have-any-liberals", or "those-don't-care-if-you-starve-in-the-street-libertarians", sure, that's meaningless sniping, and it does not facilitate learned debate.

But let's no go overboard on the political correctness, please. That stifles conversation.

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Old 02-12-2009, 11:01 AM   #83
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People were clueless when buying insurance, any kind of insurance. My job for many years was to unravel the mess and confusion.

So that is one thing the Government does do good, regulate a complex product needed by the public, but poorly understood. Without regulation, the insurance industry would have went the same way the banking industry did.
jug, while I agree that some regulation is needed, I think the focus should be on transparency, education, and standardization (to make education easier - just like terms like APY makes it easier to compare interest rates).

If you can make it easier to understand through some standardization, and provide the education (often a pamphlet is all that is needed to cover the basics), most problems can be prevented rather than fixed after the fact.

Regulation to help ensure the companies are funded to some minimum level makes sense. The individual doesn't have the power to do that. But that should be made transparent, maybe a score 0-10 for "financial soundness", which everyone would see on the application forms. "Your insurer ranks a score of 8.0, the average score for all providers is 7.6" or something.

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Old 02-12-2009, 12:01 PM   #84
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jug, while I agree that some regulation is needed, I think the focus should be on transparency, education, and standardization (to make education easier - just like terms like APY makes it easier to compare interest rates).
There are some insurance/banking/finance/security products out there that you can "educate" the public about for years, and it just ain't gonna penetrate.

Ok, a mortgage is simple, "this is what you're gonna pay each month for 30 years"

But the other stuff is based on contracts and small print that is endless. And what happens if the person selling you an annuity doesn't disclose that he takes 10% off the top, reducing your initial principle?

Derivatives, oh boy, these are complicated leveraged side bets made on nuances of possible three dimensional moves made by the performance of a package of mortgages pegged to the index of the mating habits of homeowners. Try to make that transparent. Try to make an annuity transparent. Most people do not want, nor can't (except after shock treatment) understand an annuity product.

The world has become very complex, the products are more and more complex, it's the nature of the Bancoinsurofinancio complex. This is how they make their money, through confusion. Even the head honchos can't figure this stuff out, but their actuaries and math guys can. See the point. A lot of crap out there made to confuse, thus abuse.

If everyone lived below their means like me, not getting involved with this crap, the economy would be cut in half. Now isn't that what we are trying to avoid here?
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Old 02-12-2009, 12:54 PM   #85
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jug, I thought we were talking about medical insurance, not complex derivatives in the finance industry?

I only gave the APY as an example of how the govt can standardize lingo to help people more easily educate themselves and compare products. The same could be done to help people purchase health insurance. Maybe standardized plan A, B, C,... and a list of defined options and a glossary of standardized terms would be a start.

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Old 02-12-2009, 03:34 PM   #86
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Anyway, it's important to realize that correlation does not equal causation. And just because we can say:

* Europe has "socialized medicine";
* Many European countries have higher life expectancies

doesn't mean we can conclude, "therefore socialized medicine leads to higher life expectancy." There can very well be other social and cultural factors at work here.
True but we can conclude that America spends a LOT more per capita for health care yet doesn't receive the benefits of the additional costs. At least according to Johns Hopkins and various other studies.

Getting rid of health care companies would shave off some costs; EMR would shave off some more; but the real sticker is...prices.
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Old 02-12-2009, 03:37 PM   #87
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You already have socialized medicine, the minute you enter into an HMO plan...So what is the difference whether the government is the gate keeper or the insurer, same employees just collecting a pay check of a different color.
The difference is that in the case of the HMO they are doing business with whoever is paying the bills. In most cases that would be the employer and employees who jointly foot the cost, and who can decide to change HMO providers. If the government is providing the service, policy is decided by politicians and carried out by bureaucrats who know they are working for a monopoly.

My former employer gives me several HMOs to choose from along with other options for health care insurance. Some costs more than others, but I am free to choose. And some prior HMOs no longer are available because they received too many complaints about their service.

I'm not always tickled pink by my dealings with the HMO, but the government as an alternative make me cringe in fear. Forced to pay, forced to join, forced to accept their decisions with practically no recourse is a nightmare I don't want to participate in.
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Old 02-12-2009, 04:54 PM   #88
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Free market solutions to problems are almsot always better. Why? Because an individual business is far more agile and nimble that the lumbering slow federal govt. I hear this complaint all the time. What about people that are born into a higher risk pool, and no one wants to insure them? Usually the claim is that govt healthcare would be better.... because it would guarantee their coverage will not be dropped.

How about this for a free market solution? Let's say you have a son/daughter that has a much higher risk for a certain type of cancer. Your family history says so. You natuarally fear for your child in the future and work out this deal with an insurance company. You pay that insurance company every year since your child in born, and once your child turns 21 they will not cancel their coverage, or raise their rates for 20 years. So basically the insurance company gets your money free and clear for 21 years, but in return, you never have to worry about cancelled coverage, or rased rates again. Or at least not for a good long time. Is this solution perfect... certainly not! But it demostrates what a free market solution can do. It also shows how this sort of arangement is voluntary, vs, govt forced. Like I have said many times before I really do not like the idea of govt coercion at all. And I think most problems can be solved privately in a volutary manner...
This same idea was promoted by a prior poster who was an insurance agent. I understand the reasoning but there are problems which make it not work. Insurance companies go out of business. Even more frequently, an insurer terminates a plan, especially if that particular plan becomes expensive. If the plan is terminated, underwriting is required. Or, the price of the plan becomes unaffordable because those who are left are the ones who can't get insurance elsewhere.

The market has not worked. If we insist on keeping an insurance model we need to make sure everyone one way or another has insurance so that we do not have adverse selection problems. We then can eliminate underwriting.

One oddity of our system is our high per capita cost, but without universal coverage. We do need to look in detail why our costs are so high as compared to other countries that have outcomes as good or better than our country's outcomes. I know some of the review being done about cost issues indicate that some areas of the country have much lower costs, equally good satisfaction and even better results than other parts of the country that are high cost. What is one of the differences? The number of specialists. The more specialists, the more procedures and the higher the cost, but not better outcomes for the same diseases.

Sorry, no citation in front of me. Information is from a Dartmouth University study.

And as Rich and Meadh know, evidenced based medicine can improve outcomes and arguably reduce cost through reduction of unneeded procedures.
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Old 02-12-2009, 04:58 PM   #89
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This same idea was promoted by a prior poster who was an insurance agent. I understand the reasoning but there are problems which make it not work. Insurance companies go out of business. Even more frequently, an insurer terminates a plan, especially if that particular plan becomes expensive. If the plan is terminated, underwriting is required. Or, the price of the plan becomes unaffordable because those who are left are the ones who can't get insurance elsewhere.
One only has to look at long term care insurance as another example. Many of LTC insurers mispriced the product and underestimated costs a decade or more ago, and now everyone in those plans are being socked with huge premium increases to keep the plan solvent.

When you have a new product where pricing depends on unknowable costs many years into the future, there are a lot of pitfalls.
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Old 02-12-2009, 05:24 PM   #90
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The discussion of health care always boils down to the same arguments supported by the same studies and anecdotal evidence.

Most studies, on both sides, that are quoted are by agencies with a bias. I don't know how you get around this, but IMO it is so.

The Big Lie, if you say it long enough and loud enough, people will believe it is true.

i.e. This is the worst economic crisis since the great depression!
The U.S. has a horrible health care system, and just about every other country in the modern world has a better one. Ever wonder why so many people come here for treatment?
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Old 02-12-2009, 05:37 PM   #91
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Rustic, people come here for treatment (1) because they think we are great (2) we do have some notable treatment centers (3) they are rich. How come people in the US go to Mexico for dental care?

Pertinent comparisons include how are the worst off doing in the US compared to the worst off in Germany, Canada, France, etc. How is the middle class doing as compared to these countries? What are our outcomes? What effects the outcomes? One person working on this issue is former Minnesota Senator Dave Durenberger, a Republican now head of the National Institute of Health Policy . He recognizes the problems with our health care sector. Some of his solutions are not necessarily my solutions, but there is no dispute that all is not well in healthcare in the United States.
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Old 02-12-2009, 06:25 PM   #92
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anecdotal evidence.
[...]

Ever wonder why so many people come here for treatment?
Huh.
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Old 02-13-2009, 05:03 AM   #93
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It pinches my toes that I have to drive on a highway that the government built each day I go to work. If they would just put a toll on each quarter mile I not only would still get to work but I wouldn't have to share the road with someone who can't pay the toll. I even hope the toll rises by twice inflation and five times wage inflation so more of those deadbeats also going to work get the hell out of my way and understand I am important and deserve to get to work more than they.
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Old 02-13-2009, 06:02 AM   #94
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Interesting you chose 'protecting the citizens'. If we were to add up all the money government spends on this, and we spent the same on health care, we might not be having this discussion.
Right, but then we'd all be healthy but called English, or Germans, or Russians, or Muslims. Not that any of these are all bad in themselves, but we wouldn't be AMERICANS.

Jug--You mention a lot of government programs that should work, but sadly have failed to do what they were intended to do. You lay the blame on a lessoning of the enforcement of regulations. That is a possibility, but since that is not what this thread is about I'll take your work for it. It was ultimately the GOVERNMENT that lessoned the enforcement of those regulations, not private industry. How would you like to have some doctor decide you are an alcoholic, because the government decided any alcohol related incident makes you one. That one I've seen. Recently I was privy to the questionnaire the military uses to determine whether a person abuses alcohol or is addicted. The questionnaire consisted of something like 15 questions. Of the 15 questions there were only five distinct questions, the rest were the same question asked a different way. If the person taking the quiz answered yes to more than two of the 15 questions they abused alcohol. If they answered yes to more than four of the 15 questions they were addicted. Since people were sent to the clinic to see this doctor any time they were involved in an alcohol related incident, every one of them had to honestly answer yes to at least three of the questions. I had a friend who was diagnosed as an alcoholic by military doctors. Much later after he retired his doctor, a retired AF doctor, told him that they were under extreme pressure to diagnose anybody who came to them for an alcohol related incident as being an alcoholic.

Tadpole--While I would agree that some public roads are pretty good, just as many are badly in need of repair. From what I recall of my learnin' the roads actually belong to the military of troop movement. I don't know if this is really accurate, but that's what I was told. I do not think the private sector would build roads any better, but to say the roads are good throughout the country is a bit of a stretch. I would classify them as alright, but not much better than that.
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Old 02-13-2009, 07:29 AM   #95
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I think the Interstate system was actually built for the movement of the military. Started during the Cold War by the President Eisenhower administration (who was also a Five Star General in another life). BTW if you don't think our roads are pretty nice try a few other countries first - and not just the ones they show in the tourist videos.
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Old 02-13-2009, 08:49 AM   #96
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I think the Interstate system was actually built for the movement of the military. Started during the Cold War by the President Eisenhower administration (who was also a Five Star General in another life). BTW if you don't think our roads are pretty nice try a few other countries first - and not just the ones they show in the tourist videos.
I've been to other countries, and must say their roads are generally worse. That's why I rated ours as just alright and not bad.
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Old 02-14-2009, 10:22 AM   #97
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Stragely enough, I got into a conversation at work yesterday about healthcare. Certainly interesting to see others points of view. The people I was talking to basically had the general idea that a vast majority of people in the US are just not smart enought to handle their own affairs in life. This applies to bad loans, retirement savings, and even health care. So their point was that since these folks are too mentally deficient to take of their own affairs, it is the govt's responsibility to take care of them. (With our tax money of course).

They also went on to say that if all of society was more like us (all engineers in the room), they would probably agree with what I was saying. That since I was smarter than 90% of the general population, I can make real meaningful, rational decisions, but the vast majority of the US are just incapable.

First off I found this view as somewhat eliteist, and insulting to 90% of americans. I guess I have a hard time believing that unless you are an engineer, doctor, or lawyer, that somehow that makes you mentally incompetant to run your own life. But even if it were true... wouldn't a better way to go be to start a massive education program? If all that these people were telling me is true then I would think education is the way out of it.

Rather than the govt giving the proverbial "fish" to so many, teach them all to "fish". Maybe I am wrong, I guess I will never know for certain. But I firmly believe that having the right mindset, and a proper education, will equip almost anyone with enough mental prowess to deal with all maner of decisions that come into their lives. There is a big difference between stupidity, and a willfull lack of thinking.
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Old 02-14-2009, 10:39 AM   #98
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The people I was talking to basically had the general idea that a vast majority of people in the US are just not smart enought to handle their own affairs in life. This applies to bad loans, retirement savings, and even health care. So their point was that since these folks are too mentally deficient to take of their own affairs...

They also went on to say that if all of society was more like us (all engineers in the room), they would probably agree with what I was saying. That since I was smarter than 90% of the general population, I can make real meaningful, rational decisions, but the vast majority of the US are just incapable.
Good point about how some feel about this, at least in theory.

Health care is different from many other life issues. It is fine to take things into our own hands when it comes to run of the mill physicals, elective procedures, chronic illness, prevention, etc. But an acute life-threatening event has a way of taking you out of your own picture very fast. You can die from a ruptured appendix, infected gallbladder, pneumonia, trauma, or a host of other events if you don't act and decide within minutes to hours. The idea of going to Mexico, or shopping around, or trying some herbal remedies first, or arguing endlessly with your providers just doesn't present itself. I face this every week over and over.

Physicians we have to help people understand their options, involve them as much as we can, etc. But the bottom line is that you are well-advised to do what is recommend now or your life may be in danger. It's still your choice, but sometimes you just have to trust and relinquish control to some extent.

I don't like those situations but they sure take the politics out of the discussion in a hurry.
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Old 02-14-2009, 10:41 AM   #99
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Read the Paradox of Choice and see how debilitating so many choices and decisions can be.

Sometimes I am surprised that as many people start businesses as do. They have to know about health insurance. Have to understand tax, from sales to withholding. Have to understand employment law. Have to understand marketing. And on and on.
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Old 02-14-2009, 11:14 AM   #100
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Sometimes I am surprised that as many people start businesses as do. They have to know about health insurance. Have to understand tax, from sales to withholding. Have to understand employment law. Have to understand marketing. And on and on.
Not only that, but because of the strong link between employment and health insurance, you have to take the leap of faith to allow yourself to lose your employer's health insurance to go it on your own. I have to think, as I said before, that can't be good for fueling the entrepreneurial spirit. I wonder how many people would be able to unleash their talents and energies into building great, growing businesses that create more jobs if they weren't tethered to their employer by health insurance.
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