Cost of Insurance Lost in Health Debate

Discussion in 'Politics, Religion, Social Issues' started by IJ Reilly, Oct 17, 2003.

  1. IJ Reilly macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #1
    The recent strikes had already set me thinking about this issue, so I was pleased to find this story in my LA Times this morning. Increasingly, labor disputes are centered around health care costs. It's becoming steadily more apparent that the entire system is on the verge of collapse, and is causing greater and greater labor and cost-related uncertainty for industry.

    Here's my prediction: Short of some major change in the current trends, calls for a comprehensive overhaul of the US health care system will come from US corporations, who are already accustomed to dealing with government supervised or provided medical care for every employee they hire, in every other nation in which they operate. For instance, the US auto companies are already aware of the cost savings and relative labor stability they enjoy in Canada, and are very supportive of the Canadian health care system as a result. It's only a matter of time before they begin to call for something similar here.

    Sadly, it's unlikely that Congress will respond to this growing crisis before then, because as we know our law-makers are far more responsive to the needs and demands of corporations then individuals.

    http://www.latimes.com/news/nationworld/nation/la-na-health17oct17001431,1,1478646.story
     
  2. mactastic macrumors 68040

    mactastic

    Joined:
    Apr 24, 2003
    Location:
    Colly-fornia
    #2
    Yeah, most of the labor trouble I have seen in this area has been due to the rising premiums for health coverage. Half the grocery stores here are picketed, Safeway's management says the workers are seeing the best offer their gonna get, and the workers can't afford to pay any more for the crappy HMO coverage thats available.

    Sooner or later a major problem will come from this, but it will probably take down several hospitals, doctors, and corporations (health care or hospitals) before something gets done. Meanwhile more and more people will be unable to afford the health care they need, and when that happens where do they go? To the federal pot. Thats right, when someone doesn't have insurance we don't turn them away, we treat them and either the hospital eats it, or the taxpayer does. So lets just get everyone covered.
     
  3. pdham macrumors member

    Joined:
    Jan 28, 2003
    Location:
    Madison
    #3
    That is not completely true... For example, because of drastic cuts to hospitals in Chicago and Milwaukee (the city I am from) patients with out insurance are often given bus tickets and sent to the Twin Cities. There has been numerous instances of patients turning up unconcious or with ganggrene because of the 6 hour bus ride.

    Another example of the growing chorus of the people in power in this country: If you are poor, you just aren't as important
     
  4. mactastic macrumors 68040

    mactastic

    Joined:
    Apr 24, 2003
    Location:
    Colly-fornia
    #4
    I could see this get as bad as strikes over health care large enough to have an effect on our economy. Health care costs will become a major issue in American politics, far beyond the traditional senior citizen demographic. If you are spending $700 a month to get your family health coverage, the government might as well be taxing you at a higher percentage. The ones who won't be affected are those in Congress who get great benefits through the government health care package.

    On a related note, since Arnold has decided to slash the car tax (which was lowered during the "good times" with the provision that it be reinstated if those should become "bad times") my local paper ran a story about all the fees it was going to have to raise to make up the shortfall. Sounds like that tax cut really helped out.:(
     
  5. yamabushi macrumors 65816

    yamabushi

    Joined:
    Oct 6, 2003
    #5
    Corporations and small businesses in the U.S. would be wise to support a federally funded health care system. Businesses often pick up part of the cost for health insurance, so eliminating that cost could help them put that money to better use.
     
  6. Desertrat macrumors newbie

    Joined:
    Jul 4, 2003
    Location:
    Terlingua, Texas
    #6
    One thing that doesn't seem to be discussed when talking about the high premiums for health insurance is the coverage.

    My wife and I were right at 60 when we ran across a bare-bones policy. The combined premium was less than $250 a month; $120 for me and $105 for her. (The premium increased a little bit each year as we aged.) It covered such things as heart attacks and cancer and car wrecks, but not "casual" office visits for colds or stubbed toes. It didn't cover elective surgery.

    My personal opinion is that it's stupid to expect total coverage at any sort of reasonable price, but reasonable coverage can be had at an affordable price.

    For Old Farts over 65, Medicare Plan B has ten variants of coverage. The premium varies with the company, but they all offer the same plans. For about $200 a month, you get absolute full coverage for co-pay, plus drugs, plus nursing home care during recovery/rehab. The present "Drugs for old folks" thing in Congress is just a vote-buying giant shuck on the taaxpayer.

    One misleading thing about the number of folks who don't have health insurance is that a lot of them voluntarily don't have it. They're young and healthy, generally, and absent bad luck or car wrecks, hardly ever use medical services. (I have no idea what's the percentages of this group, compared to "don't have it, and need it" crowd.)

    'Rat
     
  7. IJ Reilly thread starter macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #7
    First of all, that "bare bones" policy would probably cost half again if not twice that much today, and few people are getting "total" medical insurance policies anymore. As one who's stuck in the individual insurance market, I can tell you that "total" simply is not available to me, even though I'm in good health and not over 50. I've got a crummy HMO for about $250 a month with deductibles and stop-losses up the wazoo. I was "naked" for a long time, and not by choice, and if premiums keep going up and actual coverage keeps going down, I don't know where I'll be in a few years. And if I get sick? Well, then the insurance company may not renew me the next time, or send my premiums through the roof. That's how it's going, so it's hardly worth talking about the few people who "choose" not to be insured, because that "choice" is often a matter of "choosing" between necessities.
     
  8. Desertrat macrumors newbie

    Joined:
    Jul 4, 2003
    Location:
    Terlingua, Texas
    #8
    Well, leaving the cost to a doctor for the staff to deal with paperwork and the cost of malpractice insurance out of the discussion...:)

    I've noticed the rise in costs of such things as a simple office visit, as well as insurance premiums.

    I've also noticed the advances in medical technology, and I occasionally see articles about the costs of the modern equipment. As I'm going through treatment for colon cancer, right now, I see a lot of this stuff on a daily basis. Colonoscopy, CT scan, radiation treatment, chemo-therapy. Surgery coming in December. (Merry Christmas, 'Rat! :D) They didn't have all that capability, back in the days of low-cost medicine...

    What would be the effect on premium costs if health insurance didn't cover transplants or any complications in pregnancy?

    Ya wanna play? You're gonna pay. TANSTAAFL.

    'Rat
     
  9. IJ Reilly thread starter macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #9
    The United States is not the only country dealing with these issues, we just happen to be addressing them on a high cost, low return basis, primarily because we treat health care as a market commodity. It should be apparent by now that the health care system, as we have chosen to run it, is on the verge of collapse. Something has to give.
     
  10. pseudobrit macrumors 68040

    pseudobrit

    Joined:
    Jul 23, 2002
    Location:
    Jobs' Spare Liver Jar
    #10
    Health care, like police and fire coverage, should not be treated as a commodity. They are the services that protect life. Name one other immediate life necessity that is not guaranteed us by the state.

    It's a gross overextension of the capitalist system into areas that need to be addressed by a commonwealth.
     
  11. Desertrat macrumors newbie

    Joined:
    Jul 4, 2003
    Location:
    Terlingua, Texas
    #11
    "Health care, like police and fire coverage, should not be treated as a commodity."

    Why not? They have been and/or could be provided by the private sector. That's historic.

    "They are the services that protect life."

    So what? We band together to have a government provide these services, but that's for our own convenience. It's not built in to any natural-law requirement. They're not mandated by the Constitution.

    "Name one other immediate life necessity that is not guaranteed us by the state."

    Food. Clothing. Shelter. Electricity. Water.

    "It's a gross overextension of the capitalist system into areas that need to be addressed by a commonwealth."

    That's your own opinion; I'm happy for you to have the freedom to believe it...

    'Rat
     
  12. IJ Reilly thread starter macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #12
    Because (1) health care should not be a privilege available only to those who can afford it and (2) the present system is unsustainable and (3) it causes us to pay more and get less for our health care dollars.

    I can think of others, but this should be enough to chew on for now. Proceeding on the basis of history reminds me of Einstein's definition of insanity.
     
  13. Desertrat macrumors newbie

    Joined:
    Jul 4, 2003
    Location:
    Terlingua, Texas
    #13
    "Because (1) health care should not be a privilege available only to those who can afford it..."

    Well, I agree this would be a nice thing, but lemme ask about one thing: If the costs to the taxpayer of a government-provided healthcare system rise beyond the funding capability, will there be some form of rationing? When you add up the present costs of all private insurance, plus Medicare and Medicaid, is there not some limit, somewhere, somehow?

    "and (2) the present system is unsustainable and (3) it causes us to pay more and get less for our health care dollars."

    I have noticed that as the federal government has gotten more and more involved in our healthcare, the costs have risen much faster than the inflation rate. I won't say it's an absolute that there is a causal relationship, but it would not at all surprise me. The paperwork costs alone are staggering.

    Oh: Who pays for malpractice and/or malpractice insurance?

    'Rat
     
  14. IJ Reilly thread starter macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #14
    Health care is already rationed -- 43.5 million working Americans have little or no access to it, and that number just keeps on growing.

    You might take note that I haven't proposed a solution to this dilemma, but you've jumped right straight in the direction I've seen a thousand times already -- make any changes look impossible and/or worse then the system we have now.
     
  15. pseudobrit macrumors 68040

    pseudobrit

    Joined:
    Jul 23, 2002
    Location:
    Jobs' Spare Liver Jar
    #15
    None of those are immediate life necessities. Fire, police and medical care are.

    And the other point would be that the government does provide a safety net for those services too. No one has to starve or be homeless or go without power or water (yet -- we might get another four years of Bushy, an I imagine the poor will suffer the most under his reign).
     
  16. Desertrat macrumors newbie

    Joined:
    Jul 4, 2003
    Location:
    Terlingua, Texas
    #16
    IJ, I'm not trying to make "any" changes look worse. I guess I'm stuck with looking at the various changes that have been proposed, and finding them somehow lacking.

    When folks bring up some problem, I'm wired up to do two things: One is to try to analyze how it got "bad" in the first place; the other is how to fix it or make it better. If I am the one to bring up some issue, I try to have some proposed options for dealing with the problems.

    The years have given me certain perspectives on the changes in the way we've dealt with various issues. I don't claim to always be correct in my views, but they're generally based on what I think I've observed. :)

    'Rat
     
  17. IJ Reilly thread starter macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #17
    'Rat, I always try to start any discussion about health care by flushing out the people who don't believe that we have an actual crisis on our hands, and don't believe that every person should have access to medical care. I have found that people who reject this premise are not worth the effort of debating on the issue. Their basic point of view is, "I've got mine." Of course they'll never add "and to hell with everybody else," but that's essentially the message.

    The next step in such a debate is usually an effort to minimize the problem ("some of the people without health insurance don't want it"), and then to start cries of "socialism" before we've even agreed on whether health care is a problem in need of a solution. Another touchstone in the avoidance package is raising this issue of "rationing" health care without an acknowledgment that it's already rationed.

    So, nothing personal here, but I'm not in the habit of debating the health care situation with anyone who doesn't admit that the current system is a disaster.
     
  18. Desertrat macrumors newbie

    Joined:
    Jul 4, 2003
    Location:
    Terlingua, Texas
    #18
    Disastrous for those without insurance who have serious health problems, yes.

    43.5 million "without" means some 265 million or so "with". On a nationwide basis, I'd call it bad, but not disastrous.

    Is it not federal law that an emergency room must offer treatment, insurance or no; ability to pay or no? That's what I've read, anyway. If so, better debt than death. I read that it's common for those without health insurance to use emergency rooms for non-emergency medical needs--which is a load on the local taxpayers.

    Part of my problem with the idea of a federally provided medical system is the fear that we could start having the sorts of problems so often mentioned by Canadians and English about the delays in getting diagnosis and/or treatment. Lengthy waiting periods for non-emergency but necessary surgery, for instance.

    Overall, for me, it's one of those deals where I'd like to see less emotion from either side, and evidence that thought has been given to unintended consequences by proponents of change.

    'Rat
     
  19. Dont Hurt Me macrumors 603

    Dont Hurt Me

    Joined:
    Dec 21, 2002
    Location:
    Yahooville S.C.
    #19
    anything that is ran by the govt is going to cost 3 times as much as private industry. we need a federal backed system of private healthcare for all sort of. not govt ran but govt funded backed up for all. register with approved dr offices period with checks and balances and a voice for the public & dr's and medical profesional. no middleman insurance companies. how much gets sucked up by these guys.
     
  20. IJ Reilly thread starter macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #20
    Once again, your critique of a "federally funded" health care system is premature, since I haven't promoted any solution, let alone that one. One of the key reasons why we (editorially speaking) don't communicate well about this issue is because we can't seem to agree on a definition of the problem, and too many people seem to want to leap over that step to a solution. It can't be done.

    I'm prepared to state my principles:

    I believe that every American should have access to health care. Nobody in this nation should have to wait until an illness is acute enough to require emergency room treatment, or to hope it "goes away."

    No person should be ruined by medical bills.

    Hospitals should be able to treat anyone at any time, free from the fear of being crushed into bankruptcy by treating too many people who aren't insured or can't pay.

    We should be able to take our health care business to whatever doctor we please, and that doctor should be able to treat us as his best judgment dictates. Insurance company bureaucrats should not be making either of these decisions for us or our doctors.

    Other nations, in fact virtually all of them, manage this. So can we. The fact that we don't is a national disgrace, IMO. Not only is the present system is unsound morally, it is unsound economically.
     
  21. Dont Hurt Me macrumors 603

    Dont Hurt Me

    Joined:
    Dec 21, 2002
    Location:
    Yahooville S.C.
    #21
    just yesterday the news reported 40 million americans with out healthcare.
     
  22. zimv20 macrumors 601

    zimv20

    Joined:
    Jul 18, 2002
    Location:
    toronto
    #22
    a doctor's perspective

    my sister is a dentist. i've learned these things from her:

    - not all insurance companies are the same. some reimburse her (for work she's done on insured patients) in a timely manner. others drag their feet.

    - many uninsured patients end up not paying, even though funds are due at the end of the visit. the treating doctor (i.e. my sister) eats that cost.

    - many of the state and federally-funded insurance plans negotiate a very low rate for procedures. for these patients, working on them may not even cover costs.

    - she's thinking of starting her own practice. to make it successful, there are people she'll have to turn away, in favor of those w/ more cooperative insurance companies.

    i'm offering no solution to these issues, just more food for thought.
     
  23. pseudobrit macrumors 68040

    pseudobrit

    Joined:
    Jul 23, 2002
    Location:
    Jobs' Spare Liver Jar
    #23
    IOW, they're losing money by trying to be cheaper. Plus it's killing people.

    BTW, that was a wonderful summation of what we need in this nation. I'd be hard-pressed to add anything and I doubt anyone could contest a single one of your points.
     
  24. Sayhey macrumors 68000

    Sayhey

    Joined:
    May 22, 2003
    Location:
    San Francisco
    #24
    Amen. Preach on Brother IJ! I used to negotiate health plans for my union and it was a disgrace the amount of money that went off the table and into the hands of insurance companies. When we convinced the management to work with us to get the insurance companies to lower their costs we actually came up with some decent health plans. However, too many folks in this country have no union or any other voice to fight for decent health care -- it is, as IJ said, indeed a national disgrace!
     
  25. IJ Reilly thread starter macrumors P6

    IJ Reilly

    Joined:
    Jul 16, 2002
    Location:
    Palookaville
    #25
    According to the figures I've been hearing (and have not been disputed, AFAIK), somewhere on the order of 25-35% of our health care dollars end up in the pockets of the insurance industry. Of course none of these dollars goes towards the actual provision of health care; in fact, they go towards the avoidance and denial of health care, as anyone who has seen a claim form knows first hand. This appears to be the single largest reason why the United States spends the most per capita in the world on health care, but still can't seem to provide any for 43.6 million working Americans. It's a system that was designed to fail, especially if you accept as the main goal of the health care industry the task of making people healthy.

    Everyone has their own health care nightmare stories, I'm sure, but the one that has me hot under the collar at the moment is no longer being able to go to the doctor of my choice. The general practitioner I'd been seeing for over 20 years finally got so disgusted with HMOs telling him how to treat his patients, that he decided not to take their customers as patients any longer. So the insurance company assigned me like so much chattel to another doctor.
     

Share This Page