Excellent Health Insurance Article

[ERD50]

samclem - thanks for that post, lots of good points there. I'm trying to educate myself on these matters and that helped.

youbet - yes, it is very difficult to try to motivate people towards better health practices (myself included, I should be more active). We can't reach for the 'perfect', but I wonder if some 'good' plans could be put in place, to help raise the average compliance? Since we can't fine the poor, maybe turn it around and actually pay to get them in for a check-up; if everything looks good, come back in 3 years (or whatever) for another paid check-up; problems - maybe you need to show up in 6 months with improvements, with some incentive for success? I don't know, even a modest plan might be more complex than it is worth, but we might be able to define something that would get the average net costs down, while helping the people who need it?

Anyone have a good website for comparing the 'vision' ( I refuse to call it a 'plan' until it is under consideration by Congress) of the candidates on Health Care?

And, do any of those visions indicate that funding will be transparent? I hate to see us get into a Social Security issue with this - SS taxes just go into a general fund, and there really is no relationship to inflow/outflow. If we agree we want UHC, we should understand what it is costing us, and what we are getting for it, IMO.

One more thing - I've mentioned before that Ira Flatow had a Science Friday show on UHC with a panel of experts. Out of frustration he finally said - 'which country is doing this right? Can't we just COPY some other plan!!!' - silence, then a bunch of stuttering well/ifs/and/buts from the panel. That spoke volumes, I thought.

TIA - ERD50

[youbet]

Quote:

Originally Posted by ERD50 Since we can't fine the poor, maybe turn it around and actually pay to get them in for a check-up; if everything looks good, come back in 3 years (or whatever) for another paid check-up; problems - maybe you need to show up in 6 months with improvements, with some incentive for success?

We could certainly provide positive motivators. I notice my dental plan pays 100% with no deductible for 2X/yr checkups for example. My medical plan pays 100% with no deductible for 1X/yr checkup. I just think that developing accurate ways to finger violators and good criteria for defining what those violations are would be problematic and not worth it. That despite the fact it's irritating to vision folks just not trying to be healthy, consuming more benefits, yet not being punished in some way.

Also, agree with you on funding. It must be transparent, independent and not depend on future generations being larger and more wealthy than the current generation. Pay as you go would be the expression I guess. No more ponzi schemes like SS. Need 47.9 zillion to pay for NHC this year? Fine. Collect 47.9 zillion in earmarked and specifically identified taxes this year. Any deficits due to unexpected expenses such as natural disaster or pandemic should be made up the very next year, even if that is painful. Otherwise it will be just another program destined to help us and destroy the kids.

[haha]

Quote:

Originally Posted by ERD50 And, do any of those visions indicate that funding will be transparent?

I think this would be very unlikely. Transparency makes stealing harder. Ergo, no transparency will be tolerated.

Ha

[Martha]

There is a fair amount we can do to encourage healthy habits.

Free nicotine substitutes from your public health department.

Gym memberships covered by health insurance provided that you use it. Or, a tax deduction.

Ditch the transfats.

Remember Kennedy's school fitness programs? We can do better. When I was a kid in gym class, everything was based on a competitive model and being the smallest kid, I could not compete. So instead, I gave up. I think schools should be much more flexible in their physical fitness programs. Fat kids, little kids can use solitary exercise equipment. Let the ones who want to compete compete. If the goal is fitness, you need to have different programs for different kids.

Etc.

[Marquette]

Shoot, put fat and calorie information next to every meal so you know what you're buying. I used to buy a tuna sandwich from Cosi's until I found out that it contains almost 1,000 calories. If it was easier for me to make spot decisions while in-line at the restaurant, I would. I expect this is true for many people. Was it NYC that just did this? Will be interesting to see what, if any, effect that has.

[Brat]

In ancient times, when I was in grade school, cooking and nutrition were a part of the curriculum. The school nurse talked to us about preservatives and white bread with disdain. PE in early school was a lot of running around, ball throwing, and climbing on wooden bars. Not much competition until what is now called middle-school. In time the position of school nurse was cut, then the PE teacher, then the music teacher as 'unnecessary'. Kids today don't get good health education IMHO.

[Midpack]

Quote:

Originally Posted by ERD50 Anyone have a good website for comparing the 'vision' ( I refuse to call it a 'plan' until it is under consideration by Congress) of the candidates on Health Care?

Here's one:

[Grizz]

Quote:

Originally Posted by youbet You can try to educate people, encourage people, have publicity programs that try to sell healthy living as "cool" and all that, but you can't punish people that don't succeed. How could you establish criteria? 10 pounds overweight is OK but at 11 you pay more? What if you gain some weight while recovering from two broken legs? What if you're underweight due to an eating disorder? What if you quit smoking 5 yrs ago? 10 years ago? 15 years ago? (That would be me btw) 1 beer a day OK? How about 2? 3? Wine OK? Who measures your consumption? Etc. etc. Poor lifestyle habits also overlap with genetics. Keeping the two separated would probably be troublesome. Some folks should never be in the sun at all, period. Others tolerate it much better. What would the criteria be? If you have fine red hair, freckles and fair skin we'll double your insurance rates if we catch you outside without being fully clothed and wearing two gallons of SPF 50 sunscreen? How do you check on people without becoming big brother or impacting personal rights and freedoms more than our current Homeland Security? How do enforce if enforcement might involve higher costs for people who can't afford it? I understand the temptation to conclude that just obvious violations would get tabbed......such as being a heavy smoker. Or being obese. But I still wonder how to set criteria, deal with exceptions, monitor without violating privacy and enforce without inappropriate harsh punishment such as denying coverage or witholding care. And I share the frustration. People display unhealthy life habits yet get medical coverage for the same price as folks with healthy habits. Kinda sucks. But I really don't think there is a viable solution. Anyone know how it works in Canada, UK or Australia?

I don't know if this is done in the U.S. or not but in Canada there is a $1000 tax credit per child that is involved in a gov't approved physical activity. You need to submit a receipt for fees along with your tax return. My girls both take Irish Dance lessons and that qualifies.

In Canada we tax the sin items like you wouldn't believe. I just did a bit of googling on cigarette prices in Can VS U.S. and it looks like an average pack in Canada is about $11 and closer to $5 in the U.S. Liquor is way pricier in Canada as well. Seems like it's the logical thing to do. This way you can have universal health care and have the intentionally unhealthy and higher risk folks pay more.

[haha]

http://www.nytimes.com/2008/11/20/us...l?ref=business

Insurers say they will take all comers, provided only that governemnt force everyone to have coverage.

This is how most European systems work. Seems better than the UK or Canadian single payer systems, and also better than our current mess.

Ha

[Martha]

The failure to require everyone to be covered was a major weakness in Obama's plan.

[ERD50]

Quote:

Originally Posted by haha http://www.nytimes.com/2008/11/20/us...l?ref=business Insurers say they will take all comers, provided only that government force everyone to have coverage.

Quote:

Originally Posted by Martha The failure to require everyone to be covered was a major weakness in Obama's plan.

Thanks for re-visiting this haha. Many of us have come to that same conclusion - it's tough to see how an insurance co can function if they are required to take on anybody, but don't have to take on everybody (govt requires everybody to be in the pool). I fail to see how that would not drive up costs for those currently with insurance.

Looks like change.gov has been updated. Obama has this up there:

Quote:

Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums. .... Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.

I think Martha's comments are an understatement - I don't see this as a "weakness" in the plan (or even a "major weakness"), it seems unworkable to me. I expect weaknesses in any plan - this is complex and nothing's going to be perfect, but this seems like an outright contradiction to me.

Am I missing something, or does the current Obama plan just seem unworkable?

-ERD50

PS: I hope this isn't sounding too 'soap-boxy', that's not my intent. I'm just trying to understand this plan as stated. I'd love to see the $2500 lower premium, and more people covered, but it's looking like smoke & mirrors to me.