House "Affordable Health Care for America Act"

[samclem]

Which is why I think a significant part of the problem is lack of real and transparent competition among insurers. Many consumers, depending on their employer and/or the state where they live, have an artificially limited number of options.

Even if there was a universal mandate with no underwriting or exclusions allowed, if there was real and transparent competition you'd have a lot more efficient health insurance market than we have now, and you'd see much more incentive for better customer service and cost containment. Maybe we'd start seeing statistics for the percentage of claims that are denied, too, as part of the transparency.

That's not a magic bullet by itself -- but then, nothing in this debate is, and what we need to do is look at things which might not make all the difference by itself but might help a lot in the aggregate. And that might paradoxically mean increasing government control in some areas and adding free market reforms in other areas.

Absolutely.

And if we need to provide subsidies to the very poor--okay. But let's be reasonable: 60% of the people are not "very poor."

Regarding the "% of GDP we spend on medical care" issue: We're at the very high rate because we don't have a truly functional, efficient market for either health care or health insurance. There are only two ways to decrease the cost of health care (or anything else): Increase the supply or decrease the demand. Giving everyone access to "free" care will, unarguably, increase the demand for service. Going to a market-based approach may help moderate demand and also encourages greater supply (people will want to build rapid-care clinics, build hospitals, and study medicine if there is money to be made. We want this--it increases supply, keeps waiting times low, and moderates cost. They won't do these things if compensated at the Medicare reimbursement rate).

I want medical personnel to be smart, knowledgeable, and focused on the needs of the patient. That may not be possible at government-set rates.

 

[antmary]

Dgoldenz,

Yes, after paying, since say, 1990 about $259,200 (I low-balled it) to Blue Cross; yea, I do have a jaded attitude.

Antmary says:
Re: your question: I would like to see national health care available to all - like Medicare. Being an American citizen would give you entry. I would like to see those making over $250,000 per year (couple) have their taxes raised. I won't even get into the wall-street tar-baby."

Erd,
Yes, my share has been borderline sarcastic - that is because I am so frustrated with insurance costs. "Tongue-in-cheek"

I don't know what tax rates should be. What do you think?

 

[dgoldenz]

Dgoldenz,

Yes, after paying, since say, 1990 about $259,200 (I low-balled it) to Blue Cross; yea, I do have a jaded attitude.

Antmary says:
Re: your question: I would like to see national health care available to all - like Medicare. Being an American citizen would give you entry. I would like to see those making over $250,000 per year (couple) have their taxes raised. I won't even get into the wall-street tar-baby."

Erd,
Yes, my share has been borderline sarcastic - that is because I am so frustrated with insurance costs. "Tongue-in-cheek"

I don't know what tax rates should be. What do you think?

It seems you sidestepped the questions:

Have you ever explored the possibility of lowering your benefit level to keep your cost down, or changing carriers if you don't have any major conditions? Would you have felt better if you had paid your $259,000 and then had cancer, but were able to receive your $1 million/year cancer treatments for $13,000?

Why should those making over $250k be forced to pay for everyone else's health insurance premiums on top of paying for their own? Does everyone making over $250k get to have their health insurance for free if they have their taxes raised, or do they have to pay the same ridiculous premiums as everybody else on top of a tax increase?

 

[youbet]

Dgoldenz,

. I would like to see those making over $250,000 per year (couple) have their taxes raised.

It's interesting that you make your tax rate increase suggestion based on "couples." Are you a proponent of the so-called "marriage penalty?" Or, would you expand the $250k/couple filing jointly to also be $125k for single filers?

 

[antmary]

I do side-step some questions, because I choose not to reply. I think we have paid much more than the $200,000+ I mentioned above. I don't have the time to do the research.

Well, I'm off to the doctor's appointment - the one who would drop me in a heartbeat if I don't have insurance!

 

[samclem]

"Fix it! Charge somebody else more, and don't give the money to the people I don't like. Don't bother me with details!"

 

[youbet]

There are so many varied expectations regarding what so-called "health care reform" will do. Everyone seems to want access for all and help available so the poor can pay for it. After that, expectations are all over the place..........

I do note that included in the more popular options are:

1. Today's "problems" will be fixed.

2. It will be "better."

3. It will "cost less for me."

4. Even if I'm not poor, I'll be able to game the system. (Key for asset laden FIRE types!)

5. Someone else, probably those "rich" folks, will pay for it.

6. There will be a fair way of deciding who is covered and whether full citizenship is required.


What am I leaving out?

For myself and my family, I'm just hoping we still have medical insurance when this is all done and that any extra costs I might have to pay are small enough that my FIRE status is not interupted. And, oh yeah, if we could keep our current docs and not have to go through a gatekeeper, that would be nice too. I don't think that's asking too much........

 

[lets-retire]

dgoldinz--Be careful in these parts. The last person we had here who was in any way affiliated with health insurance finally grew tired of the insults and being called a liar when she tried to explain how the insurance business worked in her state and left.

 

[dgoldenz]

I do side-step some questions, because I choose not to reply. I think we have paid much more than the $200,000+ I mentioned above. I don't have the time to do the research.

Well, I'm off to the doctor's appointment - the one who would drop me in a heartbeat if I don't have insurance!

If you can't be bothered to take the time to research and save yourself $100,000 with about a day of work each year, you should not be complaining. If you had a good health insurance agent, you wouldn't even have to worry about doing the research yourself.


"Quick, somebody fix the problem, but let's act now and fill in the details later, the rich will pay for it one way or another!"

 

[lets-retire]

My mother had a seizure. Not good at the time, but it seemed that it might have been a reaction to the flu shot. She goes to the emergency room. They admit her and do a scan (not sure which kind). Then give her some medicines etc. Nothing more that I know of... she is admitted into the hospital where she stays for 4 days of testing and monitoring. The first benefit info showed up and the hospital bill was $30K... but the insurance amount was just under $5K. Either it cost $5K to have here there and they were charging a lot more... or they are losing money for everyone that has insurance. Not sure which. But, I am not sure why she needed to be in there 4 or 5 days.

A few years ago the DW had a seizure where she banged her head resulting in a cut approximately 3-4 inches to her forehead. She went to the emergency room, because she did not recover from the seizure quickly enough to not raise concern (learned about seizures after her brain surgery). She had butterfly stitches applied and I think an X-ray to make sure she didn't break her skull. She also had an MRI and several blood tests done. She was released the next afternoon. The cost for that trip was $8000. This year she went into a seizure monitoring unit for a week, because the normal medication for seizures wasn't working to stop or even slow down her symptoms and she was in a general state of decline. While there she had an MRI, CAT scan, and was connected to an EEG all the time. She experienced each of the different types of "seizures" she was having while hooked up to monitors. Total cost was about $10,000. So a trip to the ER and a weeks worth of monitoring at one of the county's best hospitals cost less than the 4-5 days you mom was in the hospital. That just goes to show the the difference in health costs between different areas of the country.

The final diagnosis was the medication was causing the issues with the exception of her first seizure. That one was probably a result of passing out while she was sleeping (I didn't know that was possible until the doctor explained it).

 

[ziggy29]

Its getting a little hot in here, folks, and some of the rebuttals are starting to be aimed at the person rather than at the issues.

Spirited discussion of the issues related to health care reform are welcomed here, but let's see if we can keep commentary about the individual personalities of thread participants out of it.

Thanks!

 

[HFWR]

Nothing personal, but I've never had particularly good luck relying on [-]salespeople[/-] the govt for unbiased product information and projections on future pricing.

Fixed....

 

[FinanceDude]

Can we get civilized and provide insurance for everyone just like other industrialized countries in the world? They pay only 10 percent of their GDP and everyone is covered while we paid 16.5 of our GDP and 46 millions are uninsured?

Well, I don't think those countries have 40 million illegal aliens in them...........

 

[lets-retire]

Can we get civilized and provide insurance for everyone just like other industrialized countries in the world? They pay only 10 percent of their GDP and everyone is covered while we paid 16.5 of our GDP and 46 millions are uninsured?

I missed this post earlier. Think about the number for a moment. Insurers have on average an 8% profit. With the house bill all people will be covered no matter what pre-existing conditions exist. Assuming The Secretary appointed to control the costs of insurance develops a magic formula that let's insurers continue making the same profit level, how are premiums going to be effects? The insurers cost just increased dramatically, what is going to happen to the premiums?

Even with the flood of young people and those who don't need much medical care they are a small number of the total who are not currently covered. There's over 300 million people of whom 255 million already have insurance. The expectation is that 15 million will still not be covered. That leaves the cost of covering the people with pre-existing illnesses to be spread over 30 million people (some have serious health conditions that cost a lot to treat) as compared to now. I don't see how the costs will come down. On the contrary it looks like the cost of care should go up with the increase in demand.

The insurers are able to keep their profit margin at 8% by being hawks, denying claims, denying or charging high fees for those with pre-existing conditions. If the Secretary lowers the profit margin too much it isn't worth the headache of staying in business.

You have to remember Americans are very vain. We spend a lot on unnecessary cosmetic surgery. We also extend our ER's (among other services) to the Canadians when theirs are too back logged. We have a large population of athletes. Many participate in sports that have an element of danger to them. I would guess, we have more people involved in contact sports than some countries have people. Many of the countries we are compared to have populations of less than 1/3 of the US. Germany is the closet EU nation with 82 million people (that's about 4 of the most populous states). Many of the countries close to the US or larger have large populations poor. Not "US poor", but the real poor.

 

[antmary]

Hello Again,

I want to say thank you to the people (who disagree with me) for putting up with my rant. It was (the rant), indeed, one dimensional; there are many issues that need to be addressed, and I am too busy with work to explore all of them. Thus, I see through a pretty narrow lens.

I have spent my life staying healthy - I am in excellent health - and, what tweaks me the most is the rise of insurance rates. I have had very few expenses health-wise, with the exception of yearly exams, colds, etc. I know that life is unfair, but that doesn't negate my feelings.

The problem is, indeed, complex. I don't like the high premiums, but I do like the good coverage. On the other hand, I would like to see some sort of universal system. But, on the other hand, 40 million illegal aliens gives me pause.

And so, it seems that we are in a big mess, full of contradictions.

 

[antmary]

Yea, sounds good!

 

[Martha]

Careful folks, we do not have close to 40 million illegal aliens in this country by anyone's estimation.

 

[antmary]

Samclem says:
"Fix it! Charge somebody else more, and don't give the money to the people I don't like. Don't bother me with details!"

Yea, that's about the way I feel. Crazy huh?! And, lower my premiums.

 

[samclem]

Careful folks, we do not have close to 40 million illegal aliens in this country by anyone's estimation.

Well, there are people estimating numbers about that high:

“My estimate of 38 million illegal aliens residing in the United States is calculated, however, using a conservative annual rate of entry (allowing for deaths and returns to their homelands) of three illegal aliens entering the United States for each one apprehended. My estimate includes apprehensions at the Southern Border (by far, the majority), at the Northern Border, along the Pacific, Atlantic, and Gulf of Mexico coasts, and at seaports and airports. Taking the DHS average of 1.2 million apprehensions per year and multiplying it by 3 comes to 3.6 million illegal entries per year; then multiplying that number by 10 for the 1996–2005 period, my calculations come to 36 million illegal entries into the United States. Add to this the approximately 2 million visa overstays during the same period, and the total is 38 million illegal aliens currently in the United States.” — James H. Walsh, former Associate General Counsel of the Immigration and Naturalization Service

His methodology seems very suspect. And, I think many "visitors" have gone home since 2005.

Of course the real number is unknowable. I'll bet 15-20 million is close.
And, can we please stop calling them "illegal aliens" and start calling them "potential voters"? Thank you.

 

[Martha]

Right. It is beyond suspect. Numbers are estimated by most at 11, 12 million and by some at 15 to 20 million.

 

[youbet]

And, can we please stop calling them "illegal aliens" and start calling them "potential voters"?

Experts here in the Chicago area say that "potential" is moving quickly to "kinetic" and they are now an important voting block in many wards. Unless that impacts obtaining or maintaining FIRE status, it's moot to this discussion however.

 

[youbet]

I am in excellent health - and, what tweaks me the most is the rise of insurance rates. .

I understand your feelings, but that's what insurance is all about. Lots of folks pay in so that there is a pool of money for the few that need it.

I don't see any way that a "reformed" health care system is going to be able to make health insurance coverage cheap or free for folks who can afford to pay. There are lots of issues that can be fixed, but having healthy middle class Americans pay no or small premiums isn't going to be one of them. In my opinion, anyway.

I'm not lowering my budget for health insurance one bit going forward.

 

[FinanceDude]

Careful folks, we do not have close to 40 million illegal aliens in this country by anyone's estimation.

Even if that number is high, probably still 15-20 millio illegals. How do you propose we cover them? Oh, that's right, they just keep showing up at the ERs across America.....

IF the Senate passes the Health Care Bill, it needs to stipulate that of you are not here legally, you are not going to be covered.

In regards to govt run health care in Europe, how many of them have a huge illegal immigration problem like the US? Probably none........never heard of anyone willing to risk life and limb to go to France or Germany or Britain........

 

[lets-retire]

I did not take into consideration the illegals when I typed my last post. When they are taken into consideration that leaves only about 19 million people this bill is supposed to cover. The question then becomes, is that going to bring down the cost of insurance for everyone? Since the amount of money an insurer makes is limited to an as of yet unspecified percentage of medical loss and there isn't a provision for a carryover of loss to future years, an insurer would be foolish to have the premiums set so low that they would not be giving a refund every year. Currently with the "cut throat" claims payouts and underwriting standards the insurers only make 8% profit The expectation is that the infusion of new people will bring the costs down further. My WAG is when the number of new people is balanced against those with preexisting conditions and having to cover everything, it is at best a wash.

 

[hguyw]

Failure to have adequate insurance doesn't just effect the person without insurance. So, OPM is already in use.

I'm glad to see that someone else gets this; it's rarely mentioned in the debate these days. Everyone in this country (including illegals) already has insurance coverage, whether they're officially insured or not. Several years ago my Mom was hospitalized for 10 days with pancreatitis. When she got the bill there was a fee/item of several thousand dollars (IIRC, the fee was $2000-$3000), for uninsured coverage. When she questioned it with the hospital, they said that's a fee the State allows them to tack on to every bill in order to cover their losses for treating the uninsured. When she called the relevant State agency, they confirmed this and my Mom's insurance company was obligated to pay it. At least here in NY, signs in waiting rooms specifically state that the uninsured cannot be refused treatment.

As I see it, one of the things that makes the current system so unsustainable is that the uninsured actually piggy-back on other people's insurance, but in the most expensive way possible. Because they have no coverage of their own they generally wait until they are VERY sick and then seek ER treatment. IMO, getting these people real coverage (even if it's through a public option, subsidized by my taxes) will result in somewhat lower costs because they'll no longer wait to seek treatment and can do it through a routine visit with the Dr. rather than the ER.

I'm sure that if illegals are specifically excluded in any health care bill, they will continue to receive treatment under the incredibly expensive "coverage" they have now. We'll pay for it either way.