Employers Changing Health Plans

[ClydeR]

While much of America focuses its attention on the impending rollout of President Barack Obama's signature health care law, another change is quietly afoot that promises to transform the way employers provide health insurance to workers.

Large companies are increasingly adopting a new strategy to cap the amount they'll pay each year for workers' coverage, while at the same time offering employees more options for their health insurance.

The new approach is pitched as a way to give workers more control over their health care, but it also is intended to save companies money by reducing their exposure to fast-rising health care costs. In essence, the shift is akin to the change made over previous decades from traditional pension plans to employee-controlled retirement plans that include a 401(k).

More... (http://www.chicagotribune.com/business/ct-biz-0918-walgreens-20130918,0,4210338.story)

By shifting employees into private insurance exchanges, employers are copying the Obamacare model that uses public exchanges. Or is it the other way around? In my usual prescient way, I wrote (http://forum.gsplayers.com/showthread.php?85310) about the pension/401(k) thing earlier.


The CBO projected this sort of thing just yesterday..


The growth of health care spending cannot exceed economic growth indefinitely, because if it did, total spending on health care would eventually account for all of the country’s economic output—an impossible outcome. Instead, over time, people will try to limit their spending for health care in order to maintain their consumption of other goods and services. Private insurers and employers will adjust the insurance coverage they offer, the benefits they provide, and the amounts and nature of their payments to health care providers. In addition, state governments— which pay a large share of Medicaid’s costs and have considerable influence on those costs—will limit the growth of spending for health care in order to manage their budgets. Those reactions to cost pressures will increase the incentives for health care providers to invest in cost-reducing technologies and to increase efficiency. Thus, even in the absence of changes in federal law, growth in per capita spending on Medicaid and on health care financed through the private sector will gradually slow. The rate of growth of Medicare spending per beneficiary is also likely to slow, though to a lesser extent, even without changes in federal law—reflecting changes in medical practices common to all patients, payment rate changes allowed or required under current law, and the increasing pressure of premiums and cost-sharing amounts, such as copayments and deductibles, on enrollees’ finances.

..From chapter 2 of the CBO's The 2013 Long-Term Budget Outlook (Sept. 17, 2013), 126 pages of glorious tedium, downloadable here (http://www.cbo.gov/publication/44521).


Now here's the question you must ask yourself. Are rising health costs because of Obamacare or in spite of it? What effect, if any, will Obamacare have on health costs and on health insurance premiums?

Obamacare takes effect in 2014. The exchanges open on October 1, less than two weeks from now.

[Tgo01]

Why would our total healthcare cost go down because of Obamacare? Anyone? Anyone?

[Gelston]

Why would our total healthcare cost go down because of Obamacare? Anyone? Anyone?

Because... Because... Shut up!!!!!

[ClydeR]

Why would our total healthcare cost go down because of Obamacare? Anyone? Anyone?

Healthcare costs aren't going down, no matter what. The question is what will slow the rate of growth.

[Atlanteax]

I am under the impression that the (generous) health care plan where I work will soon be toast at calendar year end.

Which would encourage me to ensure any (expensive) surgeries/etc that I 'need' are done by the end of the year (planning on a cochlear implant), and as it seems, this is most likely the situation for *many* others. Do it now/soon, or pay even more later.

As for the next health care plan choice I take, I will probably end up going with a minimalist version as work will not be subsidizing it. Why would/should I be paying so much in premiums/etc to 'cover' multiple health care services I rarely use? (ie I don't run to the doctor every time I cough).

Seems like we're getting to the point that aside from health insurance for freak incidents (like getting mangled in a car accident), we are better off paying in full strictly for health care services we use (ending co-pay/etc style of insurance) on a cost/benefit analysis.

[Tgo01]

Healthcare costs aren't going down, no matter what.

When did Democrats become such defeatists?

[Latrinsorm]

I am under the impression that the (generous) health care plan where I work will soon be toast at calendar year end.

Which would encourage me to ensure any (expensive) surgeries/etc that I 'need' are done by the end of the year (planning on a cochlear implant), and as it seems, this is most likely the situation for *many* others. Do it now/soon, or pay even more later.

As for the next health care plan choice I take, I will probably end up going with a minimalist version as work will not be subsidizing it. Why would/should I be paying so much in premiums/etc to 'cover' multiple health care services I rarely use? (ie I don't run to the doctor every time I cough).

Seems like we're getting to the point that aside from health insurance for freak incidents (like getting mangled in a car accident), we are better off paying in full strictly for health care services we use (ending co-pay/etc style of insurance) on a cost/benefit analysis.The whole point of employing the moral hazard is that you can't make an informed cost/benefit analysis:

Doctors have years of medical training and an incredibly advanced suite of diagnostics: MRIs, CAT scans, X-rays blood tests, urine tests, biopsies.
You have years of watching House and maybe a thermometer.

And even with all that doctors sometimes fail to diagnose correctly, what possible hope do you have of telling whether a cough is postnasal drip or early lung cancer? If you don't (and can't possibly) know how much of a product you need, it makes no sense to talk about overconsuming it.

[4a6c1]

My contract organization nixed insurance plans entirely, I still have the option to sign up with the parent company of my one longest running contract but the premiums were terrible looking, so I'm guessing it's intended for the hourly workers. I've had my own plan through Blue Cross since last year. Suprisingly they have been pretty reasonable through all the affordable care hype and offered me a dental incentive based on my income. Anything to avoid the VA.

[cwolff]

The only we know for sure is that there is something SERIOUSLY wrong with the system. Why does healthcare in this country cost so much? Like a college education, healthcare costs are rising at an incredible rate. It makes no sense at all. It used to be that the lawsuits were the problem; remember tort reform? That wasn't it. We pay more for our health than anyone but do not see a benefit for all this spending. Just the fact that we even have to talk about healthcare costs eventually surpassing GDP is incredible.

The system we have in place is broken. Obamacare may just be the first shot in a long battle to fix it.

[Tgo01]

We pay more for our health than anyone but do not see a benefit for all this spending.

We don't have among the best healthcare in the world? Isn't that a benefit from all of that spending?

[cwolff]

We don't have among the best healthcare in the world? Isn't that a benefit from all of that spending?

I can never tell with you TG. That was sarcasm right?

[Tgo01]

I can never tell with you TG. That was sarcasm right?

Don't we have among the best healthcare in the world? Note I didn't say "system" because I know how that sets the Democrats off into a frenzy.

The actual healthcare we receive, isn't it among the best? How is it not among the best? THE BEST! USA! USA! USA!

[Latrinsorm]

The only we know for sure is that there is something SERIOUSLY wrong with the system. Why does healthcare in this country cost so much? Like a college education, healthcare costs are rising at an incredible rate. It makes no sense at all. It used to be that the lawsuits were the problem; remember tort reform? That wasn't it. We pay more for our health than anyone but do not see a benefit for all this spending. Just the fact that we even have to talk about healthcare costs eventually surpassing GDP is incredible.

The system we have in place is broken. Obamacare may just be the first shot in a long battle to fix it.It makes sense if you try and put a dollar value on your own life, or your child's. Just because people can make pretty graphs with demand does not indicate that it is mathematical and sterile through and through.

[Buckwheet]

Don't we have among the best healthcare in the world? Note I didn't say "system" because I know how that sets the Democrats off into a frenzy.

The actual healthcare we receive, isn't it among the best? How is it not among the best? THE BEST! USA! USA! USA!

https://www.youtube.com/watch?v=q49NOyJ8fNA

[cwolff]

Don't we have among the best healthcare in the world? Note I didn't say "system" because I know how that sets the Democrats off into a frenzy.

The actual healthcare we receive, isn't it among the best? How is it not among the best? THE BEST! USA! USA! USA!

It's pretty average among developed countries. All these other places are doing it cheaper than we are too. Even as a measure of federal spending on health care per capita we spend more and that's for a private system. Our costs are just WAY WAY out of line. The cash value of the service provided for many things is so much cheaper than what it's billed out at.

[Tgo01]

https://www.youtube.com/watch?v=q49NOyJ8fNA

Get out of here, Commie!


It's pretty average among developed countries.

How do you figure it's average? Cause the media says so?

[Buckwheet]

Get out of here, Commie!

Join me comrade.

[crb]

We are far above average if you look at things like 5 year cancer survival rates, wait times to see specialists etc.

Our healthcare market is incredibly inefficient though. The consumer of the service is not the purchaser of the service, the provider of the service rarely deals with the actual purchaser of the service. As such there are no normal pricing signals and when you lack pricing signals you get out of control pricing. We also use insurance like prepaid healthcare plans, and not like insurance.

This is a good recent editorial that touches on these issues:

http://online.wsj.com/article/SB10001424127887324139404579017113415486176.html

Its about a guy who saved $17,000 by pretending he didn't have insurance. It shows how the third party payment system distorts the market.

Imagine if no one paid for their own food at restaurants, but third parties or the government always paid for restaurants. If you shopped at the grocery store you still paid, but if you ate out at a restaurant someone else paid, an insurance company paid for by your boss, or the government. Now imagine you're at the restaurant and given a menu, and because no one ever pays for their own food the menu doesn't have any prices on it. But still, you're curious so you ask the waiter how much something costs, and the waiter has no idea. He explains that the restaurant employs a billing company that goes back over the tickets, assigns prices, and then bills third parties, and that how much the third party can get billed can differ even for the same meal.

In this alternate universe would people eat out at restaurant more often, or less often? Would we end up possibly with a restaurant shortage? Do you think the price someone pays for the food you eat would be higher or lower than the average cost of eating out today? Would McDonalds bother having a Dollar Menu, Value Menu, or any size other than super? Would restaurants ever advertise coupons or discounts still? Would the amount of dollars as a percentage of our GDP spent eating out increase or decrease?

We need healthcare to function more like restaurants (in this universe) if we want to control costs. It doesn't require paying doctors or nurses like waitresses, plastic surgeons aren't paupers and they already function in a restaurant-like environment (that has resulted in lower costs and better care).

[Tgo01]

I agree something needs to be done about our healthcare costs.

Maybe I'm just a socialist pig but I think the government should have "taken over" healthcare. With just the government running things we can eliminate insurance companies and their profits, all of those people who are hired to do nothing but try to get money from insurance companies. Imagine a "customer" as huge as the US government telling doctors, hospitals, drug companies, medical equipment makers that they better start lowering their prices or they'll find someone who can do it cheaper?

But then again it is the US government we're talking about, they'll probably just increase payments to everyone by 20% because of the medical lobby.

[Latrinsorm]

I agree something needs to be done about our healthcare costs.

Maybe I'm just a socialist pig but I think the government should have "taken over" healthcare. With just the government running things we can eliminate insurance companies and their profits, all of those people who are hired to do nothing but try to get money from insurance companies. Imagine a "customer" as huge as the US government telling doctors, hospitals, drug companies, medical equipment makers that they better start lowering their prices or they'll find someone who can do it cheaper?

But then again it is the US government we're talking about, they'll probably just increase payments to everyone by 20% because of the medical lobby.Ok you twisted my arm, government takeover it is!

[crb]

I agree something needs to be done about our healthcare costs.

Maybe I'm just a socialist pig but I think the government should have "taken over" healthcare. With just the government running things we can eliminate insurance companies and their profits, all of those people who are hired to do nothing but try to get money from insurance companies. Imagine a "customer" as huge as the US government telling doctors, hospitals, drug companies, medical equipment makers that they better start lowering their prices or they'll find someone who can do it cheaper?

But then again it is the US government we're talking about, they'll probably just increase payments to everyone by 20% because of the medical lobby.

My Internet Sarcasm Detector is giving an inconclusive reading. Not sure how to respond. I find it incredulous anyone could honestly think a moral hazard wrought government bureaucracy could more efficiently do anything better than the private sector (considering the track record), and yet the deadpan delivery has me wondering.

[Latrinsorm]

My Internet Sarcasm Detector is giving an inconclusive reading. Not sure how to respond. I find it incredulous anyone could honestly think a moral hazard wrought government bureaucracy could more efficiently do anything better than the private sector (considering the track record), and yet the deadpan delivery has me wondering.I thought my House comparison was a pretty apt explosion of the moral hazard myth, didn't you like it?

[Tgo01]

My Internet Sarcasm Detector is giving an inconclusive reading. Not sure how to respond. I find it incredulous anyone could honestly think a moral hazard wrought government bureaucracy could more efficiently do anything better than the private sector (considering the track record), and yet the deadpan delivery has me wondering.

In theory I think the government writing the check (not actually taking over hospitals and telling doctors what to do etc etc) would be the best solution as far as costs go.

In practice though I think the government would fail.

[Dhe'nar Witch]

http://www.youtube.com/watch?v=qSjGouBmo0M

[Tgo01]

http://www.youtube.com/watch?v=qSjGouBmo0M

I was somewhat listening to that guy's rant until he mentioned life expectancy at the 2 minute mark, that's when I had to close that video out before my brain suffered permanent damage. That's the reasoning I thought cwolff was going to give for why our healthcare supposedly sucks, heck the guy in the video even phrased it the same way "We pay more but don't get anything for that extra amount!"

Why do people think life expectancy is a good measure of how good the healthcare is? I know the guy in that video dismissed the fact that Americans are fat as if it has no bearing on our healthcare but how can anyone think that? It's not some lunatic in a bell tower somewhere saying obese people will spend more on healthcare than a non obese person, it's a proven medical fact and such. I bet even Latrin would be hard pressed to disagree with this fact!

It's also no secret that obese people tend not to live as long as non obese people, it's also not a secret than the US has more murders than a lot of other Western countries. We also have more car accidents that result in death than a lot of other Western countries. We also have a lot more smokers (or at least number of cigarettes consumed) than a lot of other Western countries too. I wouldn't be surprised in the least if we're the number one in the world in regards to sugar and salt consumption. All of this spells unhealthy people spending more money on healthcare and doesn't have a darn thing to do with our healthcare system affecting our life expectancy.

Let's also talk about the poor record keeping of some countries in regards to life expectancy. Japan for instance counts many infant deaths as still born meaning they don't even factor that into their average life expectancy because the child was never "born". Also it was a couple of years ago that Japan was in the news because it turns out many of their centenarians that they thought were still alive were actually dead because of either poor record keeping or the family never reported the death so they could keep collecting money. Heck they had someone on record as being 140 years old.

I'd love to see an argument that states the US healthcare sucks because XYZ that does not include the words "life expectancy." You can use the words but there has to be at least three words in between the two words.

[ClydeR]

Why do people think life expectancy is a good measure of how good the healthcare is? I know the guy in that video dismissed the fact that Americans are fat as if it has no bearing on our healthcare but how can anyone think that? It's not some lunatic in a bell tower somewhere saying obese people will spend more on healthcare than a non obese person, it's a proven medical fact and such. I bet even Latrin would be hard pressed to disagree with this fact!


Not so fast.


The researchers found that the group of healthy, never-smoking individuals had the highest lifetime healthcare costs, because they lived the longest and developed diseases associated with aging; healthcare costs were lowest for the smokers, and intermediate for the group of obese never-smokers.

More... (http://www.sciencedaily.com/releases/2008/02/080204212858.htm)

[Tgo01]

In their study, van Baal and his co-workers created three hypothetical populations of 1000 men and women, all aged 20 years at the start: a group of obese, never-smoking individuals; a group of healthy-never smoking individuals of normal weight; and a group of smokers of normal weight. The model produced an estimate of the likely proportion of each group who would encounter certain long term (chronic) diseases, and then estimated what the approximate cost of medical care associated with each disease was likely to be. The researchers found that the group of healthy, never-smoking individuals had the highest lifetime healthcare costs, because they lived the longest and developed diseases associated with aging; healthcare costs were lowest for the smokers, and intermediate for the group of obese never-smokers.

What the hell is this shit? I just created three hypothetical groups and estimated what medical problems they might encounter in their lifetime and my conclusion is that the fatties cost more.

Come on ClydeR! I expect more out of you! Oh wait...

[Atlanteax]

ClydeR = "the sooner you die, the lower your lifetime healthcare costs ... and you'll die sooner if you smoke or are obsese"

Unsurprising ... really.

[cwolff]

That's the reasoning I thought cwolff was going to give for why our healthcare supposedly sucks

Slow down dude. I said our healthcare costs are high while our health care is average.


It's also no secret that obese people tend not to live as long as non obese people, it's also not a secret than the US has more murders than a lot of other Western countries. We also have more car accidents that result in death than a lot of other Western countries. We also have a lot more smokers (or at least number of cigarettes consumed) than a lot of other Western countries too.

Don't worry, other countries are getting just as fat as the US. Australia may have passed us up for obesity already. It's interesting that the more people start to emulate our eating habits the worse off they get physically. Maybe we should forget about Obamacare and just regulate shit-food into extinction. We don't have more car related deaths than other places. In fact, we do pretty well by that measure. We do have a lot of murders and especially a shit load of murders with firearms. That's a whole different thread but add up sandy hook and the naval yard fatalities and we've already passed gun violence deaths for a country like the UK.

That's all off-topic though. The point is, we pay a shit load for health and don't get a shit load of return on this investment. It's not a good deal. The insurance companies keep on posting record profits, hospital mgmt. is making money and Americans are not getting any better. The Free Market does not work in this sector and why should it? Insurance dictates health care because they pay for it. It's in their interests to pay less, charge more and limit coverage.

BTW, did you know that if you go to the hospital and pay cash you'll pay 3x more than the total bill for someone who has insurance? That's because the big carriers don't pay the full bill and they also don't pay on time. Some Dr's are experimenting with cash only services and forsaking getting involved with billing insurance. They can provide you the same service for pennies on the dollar. It's also why medical tourism is on the rise.

You'd not believe how many people have bad credit because they went to the hospital AND had health insurance. I see it everyday and wonder how much money that costs us by making people pay more for credit because they have medical collections even though they were hospitalized while fully covered. Imagine if all those late pmnts didn't exist. There'd be ton more people with higher credit scores, cheaper access to financing, and more money to spend because of it.

[Warriorbird]

I was somewhat listening to that guy's rant until he mentioned life expectancy at the 2 minute mark, that's when I had to close that video out before my brain suffered permanent damage.

Mustn't allow anything to possibly challenge your worldview. Must insure that America pays more and more of its GDP for healthcare!

[Tgo01]

Slow down dude. I said our healthcare costs are high while our health care is average.

Samething. We are either the best or we suck, America doesn't half ass anything.

[cwolff]

Samething. We are either the best or we suck, America doesn't half ass anything.

Ooh Fuckin' Rah!

[Latrinsorm]

It's not some lunatic in a bell tower somewhere saying obese people will spend more on healthcare than a non obese person, it's a proven medical fact and such. I bet even Latrin would be hard pressed to disagree with this fact!I do not disagree that you believe that is a fact. :cool2:

[Tgo01]

Mustn't allow anything to possibly challenge your worldview. Must insure that America pays more and more of its GDP for healthcare!

SIGH!

[Archigeek]

We don't have among the best healthcare in the world? Isn't that a benefit from all of that spending?

Top 20 I suppose. But generally I'd say no.

[Tgo01]

Top 20 I suppose. But generally I'd say no.

Top 3, tops.

[Archigeek]

Top 3, tops.


http://www.theatlantic.com/health/archive/2013/01/new-health-rankings-of-17-nations-us-is-dead-last/267045/

[Tgo01]

http://www.theatlantic.com/health/archive/2013/01/new-health-rankings-of-17-nations-us-is-dead-last/267045/

The US has:

The highest rate of death by car accident, also dramatically so

BOOM! Headshot cwolff!

Granted Archigeek I just skimmed that article but it looks like it's classifying nations based on their health...not necessarily faulting the healthcare in said country.

For example:


Compared to people in other developed nations, Americans die far more often from injuries and homicides. We suffer more deaths from alcohol and other drugs, and endure some of the worst rates of heart disease, lung disease, obesity, and diabetes.

Most (all?) of which have to do with people doing this shit to themselves. Lung disease could just be from all of the pollution we have (don't we produce the second highest amount of pollution in the world?) which wouldn't be the fault of the individual but wouldn't be the fault of our healthcare either.

More examples:


For three decades, Americans, particularly men, have had either the lowest or near the lowest likelihood of surviving to age 50. The most powerful reasons found for that were homicide, car accidents, other kinds of accidents, non-communicable diseases, and perinatal problems like low birth weight and premature birth, which contribute to high infant mortality.


Among the most striking of the report's findings are that, among the countries studied, the U.S. has:

The highest rate of death by violence, by a stunning margin
The highest rate of death by car accident, also dramatically so
The highest chance that a child will die before age 5
The second-highest rate of death by coronary heart disease
The second-highest rate of death by lung disease



As individuals, the study found, "Americans are less likely to smoke and may drink less heavily than their counterparts in peer countries, but they consume the most calories per capita, abuse more prescription and illicit drugs, are less likely to fasten seatbelts, have more traffic accidents involving alcohol, and own more firearms."

And here's the part that actually helps prove the healthcare in the US doesn't suck:


The report does reveal bright spots: Americans are more likely to survive cancer or stroke, and if we live to age 75 we're likely to keep on living longer than others.

[cwolff]

You're a legend in your own mind TG. The report you think makes your case is based on 17 countries. 13 are in Europe! Ever been to Europe? It's not a car culture. The others are Canada, Japan and Australia.

US has 12.3 road fatalities per 100,000 people. World average is 28 per 100k.

US has 15 road fatalities per 100,000 motor vehicles. World average is 93.3 per 100k.

The rate at which Americans are dying from motor vehicle related deaths is dropping and has been for the past two decades.

[Tgo01]

You're a legend in your own mind TG. The report you think makes your case is based on 17 countries. 13 are in Europe! Ever been to Europe? It's not a car culture. The others are Canada, Japan and Australia.

US has 12.3 road fatalities per 100,000 people. World average is 28 per 100k.

US has 15 road fatalities per 100,000 motor vehicles. World average is 93.3 per 100k.

The rate at which Americans are dying from motor vehicle related deaths is dropping and has been for the past two decades.

Nowhere did I ever say the US was among the worst in the world. I was very specific in saying the US is among the worst compared to other Western countries. I don't care if all of Europe has one car that everyone shares, point is America has more road fatalities (than most Western countries) which has zero to do with our healthcare. Deny or confirm?

[Jarvan]

The only we know for sure is that there is something SERIOUSLY wrong with the system. Why does healthcare in this country cost so much? Like a college education, healthcare costs are rising at an incredible rate. It makes no sense at all. It used to be that the lawsuits were the problem; remember tort reform? That wasn't it. We pay more for our health than anyone but do not see a benefit for all this spending. Just the fact that we even have to talk about healthcare costs eventually surpassing GDP is incredible.

The system we have in place is broken. Obamacare may just be the first shot in a long battle to fix it.

One of the things that you may not realize is, all the medical innovations and Pharma advances, generally it's our country that pays for it. If Company A comes out with a pill to fix/maintain/cure problem Q, they charge Americans the most, other first world countries a reasonable amount, and then 3rd world countries almost nothing. Why? Because all in all, Americans have the most disposable income in the world. We waste more money on stuff then most countries even earn. If it costs company A 5 billion to bring something to market, they need to not only re-coop that cost, but also make a profit. To do so, they have to look at how long they will have the patent, approx how many people will need/take it, how costly it is to manufacture, etc etc etc. Then price it accordingly. In countries with single payer systems, the government tells THEM what they will pay for it. If they even do. So if to break even on a pill for example, the company has to charge 5$ a pill, and say England says they will only pay 3$ a pill. They need to make up for that somewhere.

Sadly, it's us. Then again, compared to say... Haiti, we can afford 7$ for that pill.

As for where we see the benefit of that spending. If you know anyone that survived cancer, then please shut the fuck up about not seeing the benefit. You see the benefit every single day. You just don't look at it that way.

The system we have in place isn't perfect, and it is broken. Obamacare does NOTHING it fix it. It does 3 things. Tells everyone they have to have healthcare or pay a fine, tells employers they have to offer it or pay a fine, and mandate what is covered and how. This does not even come CLOSE to fixing the issue. It actually makes it worse.

With point 1 - Healthy people will just pay the fine. It's maybe 10% of what healthcare costs would be. In 5 years, only sick people will have healthcare, and costs will be 10x what they are now.
With point 2 - Companies will just not employe as many people, or people as long, thereby bypassing the need. or they will just pay the fine, which is STILL cheaper then buying healthcare. Less people covered, more people on the government plans means the program will be a lot more expensive.
Point 3 - making me pay for birth control, mammograms, pap smears, and colon screenings (just to name a few) that I don't need is idiotic. And yes, I will pay for them. These things are mandated that every policy needs to have. If I am a Male in his 30's, I don't need any of those, so why would I have them in my plan? The fact that I have to, means that the plan now costs more then it would without them.

Lets not even take into account the fact that healthcare is a limited resource. As a limited resource, the more people that want it, the more costly it becomes. Take into account then the fact that Dr's spend what, 8 years in college, then 4? years as an intern before they even make any money. So thats what, 12 years? of student loans and interest. Then there is the fact that a Dr has to do 97 tests before he can say.. "I don't know" Just to cover his ass that MAYBE the 2,000$ cat scan could have found something. Cause if he didn't do it, and you had something that MAYBE could have been detected, not even a for sure, just a maybe, he gets sued for millions of dollars.

Frankly, I think health care insurance is fucking stupid. It's worse now that the government has said "You can't charge more for sick people and old people". It would be like if the Gov stepped in, in the life insurance policy market, and told them. "Hey, you have to give a 99 year old man the same rates as a 22 year old guy, it's only fair" If you can honestly read that last sentence, and say that makes sense, then you should seriously think about having yourself committed. Yet that is basically what they are saying for healthcare. A 22 year old healthy person shouldn't even NEED healthcare.

Lets look at it this way...

Insurance : a : the business of insuring persons or property
b : coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril
c : the sum for which something is insured
2
: a means of guaranteeing protection or safety

Really, you are paying someone on the off chance you get sick, you are not paying them KNOWING you will be sick. It's like buying home owners insurance after your house burned down. Makes no sense.

We should all just pay for the services we need.

[Warriorbird]

One of the things that you may not realize is, all the medical innovations and Pharma advances, generally it's our country that pays for it. If Company A comes out with a pill to fix/maintain/cure problem Q, they charge Americans the most, other first world countries a reasonable amount, and then 3rd world countries almost nothing. Why? Because all in all, Americans have the most disposable income in the world. We waste more money on stuff then most countries even earn. If it costs company A 5 billion to bring something to market, they need to not only re-coop that cost, but also make a profit. To do so, they have to look at how long they will have the patent, approx how many people will need/take it, how costly it is to manufacture, etc etc etc. Then price it accordingly. In countries with single payer systems, the government tells THEM what they will pay for it. If they even do. So if to break even on a pill for example, the company has to charge 5$ a pill, and say England says they will only pay 3$ a pill. They need to make up for that somewhere.

Sadly, it's us. Then again, compared to say... Haiti, we can afford 7$ for that pill.

As for where we see the benefit of that spending. If you know anyone that survived cancer, then please shut the fuck up about not seeing the benefit. You see the benefit every single day. You just don't look at it that way.

The system we have in place isn't perfect, and it is broken. Obamacare does NOTHING it fix it. It does 3 things. Tells everyone they have to have healthcare or pay a fine, tells employers they have to offer it or pay a fine, and mandate what is covered and how. This does not even come CLOSE to fixing the issue. It actually makes it worse.

With point 1 - Healthy people will just pay the fine. It's maybe 10% of what healthcare costs would be. In 5 years, only sick people will have healthcare, and costs will be 10x what they are now.
With point 2 - Companies will just not employe as many people, or people as long, thereby bypassing the need. or they will just pay the fine, which is STILL cheaper then buying healthcare. Less people covered, more people on the government plans means the program will be a lot more expensive.
Point 3 - making me pay for birth control, mammograms, pap smears, and colon screenings (just to name a few) that I don't need is idiotic. And yes, I will pay for them. These things are mandated that every policy needs to have. If I am a Male in his 30's, I don't need any of those, so why would I have them in my plan? The fact that I have to, means that the plan now costs more then it would without them.

Lets not even take into account the fact that healthcare is a limited resource. As a limited resource, the more people that want it, the more costly it becomes. Take into account then the fact that Dr's spend what, 8 years in college, then 4? years as an intern before they even make any money. So thats what, 12 years? of student loans and interest. Then there is the fact that a Dr has to do 97 tests before he can say.. "I don't know" Just to cover his ass that MAYBE the 2,000$ cat scan could have found something. Cause if he didn't do it, and you had something that MAYBE could have been detected, not even a for sure, just a maybe, he gets sued for millions of dollars.

Frankly, I think health care insurance is fucking stupid. It's worse now that the government has said "You can't charge more for sick people and old people". It would be like if the Gov stepped in, in the life insurance policy market, and told them. "Hey, you have to give a 99 year old man the same rates as a 22 year old guy, it's only fair" If you can honestly read that last sentence, and say that makes sense, then you should seriously think about having yourself committed. Yet that is basically what they are saying for healthcare. A 22 year old healthy person shouldn't even NEED healthcare.

Lets look at it this way...

Insurance : a : the business of insuring persons or property
b : coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril
c : the sum for which something is insured
2
: a means of guaranteeing protection or safety

Really, you are paying someone on the off chance you get sick, you are not paying them KNOWING you will be sick. It's like buying home owners insurance after your house burned down. Makes no sense.

We should all just pay for the services we need.

You're entirely indifferent to the positive aspects of Obamacare because you don't actually care about anybody and you're scared of the people that will be covered, the people who will be able to maintain coverage, and the people who's medical bills would be foisted on the rest of the country suddenly not actually being foisted on the rest of the country.

People also seem to neglect the very Heritage Foundation notion of "skin in the game." Another conservative idea that I used to hear people around here talking about that Obama's stolen.

Is it the bill I would have wanted? No. Do the people who want to continue having healthcare eat up our GDP protest too much? Fuck yes.

[Archigeek]

We should all just pay for the services we need.

You say this like it will all work out fine. You must be perfectlly healthy, today.

Try negotiating for health care after you're healthy self has been diagnosed with cancer. And not the terminal kind, that you treat and either you survive or dead. Try the kind that requires maintenance drugs for the rest of your life, at 3 grand a month. Insurance for only those who need it is an idiotic plan.

[Tgo01]

Do the people who want to continue having healthcare eat up our GDP protest too much? Fuck yes.

I don't think I've ever seen a single person say they want healthcare costs to continue to rise so we can continue to take it up the ass, and I'm not referring to a colonoscopy.

Are you sure these people aren't just in your head, WB? It might be time to turn over those guns...

[Latrinsorm]

One of the things that you may not realize is, all the medical innovations and Pharma advances, generally it's our country that pays for it. If Company A comes out with a pill to fix/maintain/cure problem Q, they charge Americans the most, other first world countries a reasonable amount, and then 3rd world countries almost nothing. Why? Because all in all, Americans have the most disposable income in the world. We waste more money on stuff then most countries even earn. If it costs company A 5 billion to bring something to market, they need to not only re-coop that cost, but also make a profit. To do so, they have to look at how long they will have the patent, approx how many people will need/take it, how costly it is to manufacture, etc etc etc. Then price it accordingly. In countries with single payer systems, the government tells THEM what they will pay for it. If they even do. So if to break even on a pill for example, the company has to charge 5$ a pill, and say England says they will only pay 3$ a pill. They need to make up for that somewhere. Can we go one thread without Merala's chickens getting involved?
In 5 years, only sick people will have healthcare, and costs will be 10x what they are now.I am so happy when people make specific empirical claims with definite endpoints. We'll see! :)
A 22 year old healthy person shouldn't even NEED healthcare.This is absolutely true. The trouble is discerning which 22 year olds are healthy, and which are only apparently healthy to the lay person. Amen I say to you: the latter are frequently (and emphatically) not the former.

Your principles are very sound in the ivory tower liberal professor fantasy world, I'll give you that very straightforward and not at all backhanded compliment. Out here in the real world, though, we have to deal with the reality that what is known is not necessarily true, and is in fact frequently false.

[Jarvan]

You say this like it will all work out fine. You must be perfectlly healthy, today.

Try negotiating for health care after you're healthy self has been diagnosed with cancer. And not the terminal kind, that you treat and either you survive or dead. Try the kind that requires maintenance drugs for the rest of your life, at 3 grand a month. Insurance for only those who need it is an idiotic plan.

So you agree with me that Obama's plan is idiotic? Good.

As for me, no I am not healthy really. And I pay for all my medical bills myself. I really don't believe in insurance. It's like a reverse of playing the lotto, but instead of hoping you win, you are praying you lose every single month.

[crb]

Mustn't allow anything to possibly challenge your worldview. Must insure that America pays more and more of its GDP for healthcare!

You make an inaccurate assumption. Why is spending a high portion of your GDP on healthcare bad? Why is it a problem?

We had to spend money on something, we used to spend more money on food, we spend less now, why?

There are countries out there that spend huge portions of their GDP on food, is that better, or worse, than us? Why?

The fact is, you only need so much car, you only need so much house, you only need so much food, etc. If you're in a very wealthy country you can meet your necessities with a relatively small portion of your income, what else do you spend the rest of your income on? Entertainment? Sure, Hookers, xboxes, 20 year old text based internet games. However you might also spend it on wellness, by spending $5 for a half gallon of organic free range grass fed omega three boosted milk, by getting massages, by buying creams and lotions and peels and all that frippery girls put on their faces, and by using more medicine.

http://www.huffingtonpost.com/kelly-maclean/surviving-whole-foods_b_3895583.html?ncid=edlinkusaolp00000009

That article is funny, and also because there is truth to it. You've probably already ready it, 3 people shared it on Facebook with me. One quote:



Ever notice that you don't meet poor people with special diet needs? A gluten intolerant house cleaner?

How many locations does Whole Foods have in Africa? It all goes part and parcel together, I imagine the US spends more on "Wellness" than other countries too. Poor people in poor countries don't go to the doctor for minor ailments, they don't have that luxury. Are they better off then because they spend less of their GDP on healthcare? I wouldn't trade with them.

It isn't a problem for us to be spending 16% of our GDP on healthcare, we could spend 99% of our GDP on healthcare and it'd be nothing but a marker of extreme prosperity.

The problem is if we aren't getting value for our dollars. The problem is if this lack of value, and various other unnatural influences on the insurance market, or abnormal uses of insurance apart from the actual dictionary definition of insurance, have resulted in people being priced out of the insurance system. The problem is various unnatural influences on the healthcare market artificially restricting access and supply. That we spend a lot isn't necessarily a bad thing, you have to ask why. If we're spending a lot because we're not getting good value, we need to fix that. If we're spending a lot because we're all fat obese smokers who eat something green only once a year, on St Patrick's Day, that's a problem. But if we're spending a lot just because we're prosperous, that is a good thing. And honestly our healthcare spending is a composite of all three.

Also, there is a lot of really stupid posts in this thread, many by cwolf, which should be ignored. I already posted the answer to the healthcare problem on page 1, no further discussion is needed. I will specifically say how stupid it is to compare US vehicle death rates vs. the world average and then compare US healthcare (by life expectancy) amongst first world countries. It is like saying "The US has worse healthcare than Japan because the US has lower life expectancy than Japan, and the point (that anyone with a brain recognizes) that US life expectancy is influenced by accidents is irrelevant because compared to Brazil and Zimbabwe we don't have higher vehicle deaths."

Honestly, life expectancy as a barometer of healthcare services is like the most debunked thing in the world, beneath bigfoot, but above the lochness monster.

[Latrinsorm]

We had to spend money on something, we used to spend more money on food, we spend less now, why?...thanks a lot, Obama?
I already posted the answer to the healthcare problem on page 1, no further discussion is needed.Says the guy who doesn't even moisturize??? Pfft. I can't take that comment with enough grains of salt because salt is bad for me and therefore illegal.

[crb]

You're entirely indifferent to the positive aspects of Obamacare because you don't actually care about anybody and you're scared of the people that will be covered, the people who will be able to maintain coverage, and the people who's medical bills would be foisted on the rest of the country suddenly not actually being foisted on the rest of the country.

People also seem to neglect the very Heritage Foundation notion of "skin in the game." Another conservative idea that I used to hear people around here talking about that Obama's stolen.

Is it the bill I would have wanted? No. Do the people who want to continue having healthcare eat up our GDP protest too much? Fuck yes.

I know, John Mccain's bill (ironically, more "socialist") would have been so much better and resulted in more coverage.

But what "good" parts about Obamacare? I can't think of a single redeeming feature. The whole thing does nothing about the problem (cost of insurance) and tries to expand access through a variety of poorly thought out methods of dubious constitutionality while being an albatross around the neck of our economy and it is full of tons of special interest giveaways. It is 2000 pages of shit.

Even things that the media likes to say are well liked, like the 27 year old slacker mandate, are bad public policy. Forcing today's poor to subsidize tommorow's rich.

The reason people don't like Obamacare, outside of all the economic reasons to hate, the way it was passed, all the giveaways and slush funds (did you know it included a 5 billion appropriation to pay the healthcare benefits of union members who wanted to retire in their 50s? So they're taxing people who are 60 years old and working so someone who is 50 can have a better early retirement, seriously), is that, because it does nothing about the actual problem, the end result is going to be care will be rationed by access or waiting or both. Already hospitals that rely on government insurance, because of cuts in reimbursements, have had to close whole departments. This reduces quality of care for everyone, including my family, and because I'm clannish (not klannish mind you) I care deeply about that, as do millions of people. As Obamacare does nothing to increase supply, while boosting demand, and actually making insurance even more expensive (coverage mandates aren't free), the end result will be lower quality of care for the 85% of people who had insurance. It doesn't even mean better quality of care for the around 7% who didn't have insurance involuntarily, as the largest driver of increased "coverage" is medicaid and medicaid sucks, Oregon did a study where they showed medicaid patients actually got lower quality of care than uninsured patients.

The bill is a piece of shit.

I like John McCain's plan from 08, which is similar to Germany and a few other EU countries.

1. Remove the bias in the tax code for employer benefits (ie, tax them).
2. Give every man woman and child a refundable tax credit (aka check) for the purchase of insurance, or to cover their tax bill from their employer coverage, make sure it is high enough to obtain a certain level of care, fairly barebones though. IE, people get barebones for free, anything else they pay more for. By giving this tax credit to everyone, you avoid all those notches in the tax code that Obamacare created whereby people making as low as $30k a year can get marginal income tax rates in excess of 100%. If you feel like giving the rich a $5k tax credit isn't fair, raise their income tax rate to make up for it. Far better idea than phaseouts, which screw with work incentives through the aforementioned stupidly high marginal tax rates they create.
3. Using census data, if any tax credit is unclaimed, take the appropriated funds and give them to facilities in the geographic area that treat the uninsured or indigent.
4. Remove 90% of the bullshit special interest coverage mandates current in the insurance system. If someone wants to buy a cadillac, let them, but if someone wants to buy a kia, let them too.
5. Let each state decide if it wants an individual mandate and a preexisting condition ban. More constitutional that way.
6. This system can entirely replace medicaid and medicare, btw. Probably using a phaseout for medicare so as to not disrupt people in retirement or close to.

You get competition, innovation, patient directed spending, a simpler tax code, more private sector involvement... AND more coverage for more people than Obamacare. Whats not to like? Sure, there will be less favors for politicians to dole out to special interests, guess they'll need a new way to come up with campaign contributions.

[Warriorbird]

You make an inaccurate assumption. Why is spending a high portion of your GDP on healthcare bad? Why is it a problem?

We had to spend money on something, we used to spend more money on food, we spend less now, why?

There are countries out there that spend huge portions of their GDP on food, is that better, or worse, than us? Why?

The fact is, you only need so much car, you only need so much house, you only need so much food, etc. If you're in a very wealthy country you can meet your necessities with a relatively small portion of your income, what else do you spend the rest of your income on? Entertainment? Sure, Hookers, xboxes, 20 year old text based internet games. However you might also spend it on wellness, by spending $5 for a half gallon of organic free range grass fed omega three boosted milk, by getting massages, by buying creams and lotions and peels and all that frippery girls put on their faces, and by using more medicine.

http://www.huffingtonpost.com/kelly-maclean/surviving-whole-foods_b_3895583.html?ncid=edlinkusaolp00000009

That article is funny, and also because there is truth to it. You've probably already ready it, 3 people shared it on Facebook with me. One quote:



How many locations does Whole Foods have in Africa? It all goes part and parcel together, I imagine the US spends more on "Wellness" than other countries too. Poor people in poor countries don't go to the doctor for minor ailments, they don't have that luxury. Are they better off then because they spend less of their GDP on healthcare? I wouldn't trade with them.

It isn't a problem for us to be spending 16% of our GDP on healthcare, we could spend 99% of our GDP on healthcare and it'd be nothing but a marker of extreme prosperity.

The problem is if we aren't getting value for our dollars. The problem is if this lack of value, and various other unnatural influences on the insurance market, or abnormal uses of insurance apart from the actual dictionary definition of insurance, have resulted in people being priced out of the insurance system. The problem is various unnatural influences on the healthcare market artificially restricting access and supply. That we spend a lot isn't necessarily a bad thing, you have to ask why. If we're spending a lot because we're not getting good value, we need to fix that. If we're spending a lot because we're all fat obese smokers who eat something green only once a year, on St Patrick's Day, that's a problem. But if we're spending a lot just because we're prosperous, that is a good thing. And honestly our healthcare spending is a composite of all three.

Also, there is a lot of really stupid posts in this thread, many by cwolf, which should be ignored. I already posted the answer to the healthcare problem on page 1, no further discussion is needed. I will specifically say how stupid it is to compare US vehicle death rates vs. the world average and then compare US healthcare (by life expectancy) amongst first world countries. It is like saying "The US has worse healthcare than Japan because the US has lower life expectancy than Japan, and the point (that anyone with a brain recognizes) that US life expectancy is influenced by accidents is irrelevant because compared to Brazil and Zimbabwe we don't have higher vehicle deaths."

Honestly, life expectancy as a barometer of healthcare services is like the most debunked thing in the world, beneath bigfoot, but above the lochness monster.

You are inextricably biased. Not being (in many cases artificially) forced to spend more and more of GDP in certain areas produces tremendous advantages for a country.

[Warriorbird]

I don't think I've ever seen a single person say they want healthcare costs to continue to rise so we can continue to take it up the ass, and I'm not referring to a colonoscopy.

Are you sure these people aren't just in your head, WB? It might be time to turn over those guns...

Dude. They're even in this thread. Refer to a couple posts down from my last.

[Tgo01]

Dude. They're even in this thread. Refer to a couple posts down from my last.

You know I can't read.