Healthcare going forward

[Kulindahr]

I doubt it. Private insurance of preexisting illnesses cannot work and allowing some to buy cheaper insuance exacerbates that problem. Requiring states to apply to exclude mental illness and other coverage sounds like a trap. Who decides? A bureaucrat? Why not allow them to opt in? Private insurance of mental illness will be much too expensive, making everyone's insurance much too expensive. The government should pay for the medicine for the dangerously mentally ill with a jail sentence if they fail to take their meds.

Three "bullshits".

There are private insurance companies which do insure pre-existing conditions and cover mental illness, and it's not too expensive. They run on overhead in single digits as well.
But the secret is they're not-for-profit. When you're not wasting eight percent or so on excessive administrative costs, when you're not siphoning off ten percent or more to pad other people's accounts instead of paying for health care, it can -- and does -- work.

They used to be called "mutual benefit societies", and that's exactly what health care should be -- mutual benefit, not profit. The Republicans are missing a big opportunity to make the market behave morally by not incentivizing more mutual benefit or fraternal organizations which would serve to make the for-profit companies shape up and actually focus on caring for people.

 

[Kulindahr]

We confess. Republican are not very good at socialism or authoritarianism. We never wanted public health care.

Let me fix that:

"We confess. Republicans aren't very good at sharing or caring. We never wanted the public to have health care."

 

[frankfrank]

Tell me about it. It Rolls quite well down one hill but Canardly make it up the next one.


(I've been waiting over 40 years to use that joke!)

I originally heard the joke on CKLW. Do you remember them at all? Probably not, there was a station in Belleville that you may have gotten instead.

Serving the Detroit area as well, they were one of the highest rated rock and roll stations...in the world.

 

[gsdx]

^ We had a radio-HiFi set, but it was rarely, if ever, used for the radio. I don't even know what the Belleville call letters were. If it didn't play country music, it wasn't on.

 

[frankfrank]

Yeah, besides the Belleville station [CJBQ], CKLW also had to, I think, "protect" the signal from a station in Montreal. All these signals were 800 on the AM dial.

In the very late Sixties and up to the middle Seventies, everywhere you went in the Detroit area you would almost always hear CKLW on when cars went by in the summer, etc. It's hard to understate how popular that station was.

And their 20/20 newscasts (which ran at :20 and :40 of each hour) tended to be rather sensational! The report starting at 3:40...uh...there are no words...

A brief break from all the blood spewing in this Forum. We now return you to our regularly-scheduled programming.

 

[Benvolio]

Three "bullshits".

There are private insurance companies which do insure pre-existing conditions and cover mental illness, and it's not too expensive. They run on overhead in single digits as well.
But the secret is they're not-for-profit. When you're not wasting eight percent or so on excessive administrative costs, when you're not siphoning off ten percent or more to pad other people's accounts instead of paying for health care, it can -- and does -- work.

They used to be called "mutual benefit societies", and that's exactly what health care should be -- mutual benefit, not profit. The Republicans are missing a big opportunity to make the market behave morally by not incentivizing more mutual benefit or fraternal organizations which would serve to make the for-profit companies shape up and actually focus on caring for people.

i don't believe it. Please give us sources for companies which provide on going health insurance with coverage for preexisting illnesses. The mutual benefit societies were usually or always life insurance companies.

 

[Kulindahr]

i don't believe it. Please give us sources for companies which provide on going health insurance with coverage for preexisting illnesses. The mutual benefit societies were usually or always life insurance companies.

They're run by churches. They accept all church workers and families regardless. There are lifetime caps on certain things, but they're amazingly high -- like with Concordia, which is for Lutherans, it's like $500k for mental health alone.

They could easily be expanded to cover not just professional workers but local workers as well -- elders, deacons, whatever.


BTW, there's that Judeo-Christian heritage you tout, in action. It's the opposite of what you defend.

 

[Benvolio]

They're run by churches. They accept all church workers and families regardless. There are lifetime caps on certain things, but they're amazingly high -- like with Concordia, which is for Lutherans, it's like $500k for mental health alone.

They could easily be expanded to cover not just professional workers but local workers as well -- elders, deacons, whatever.


BTW, there's that Judeo-Christian heritage you tout, in action. It's the opposite of what you defend.

False. I, not you, defend private enterprise, and oppose government take over. The church groups you describe would have the advantage of a limited pool, and are not offering preexisting coverage to all comers. Actuaries would be able to compute premiums based on probable incidents within the defined group.

 

[KaraBulut]

...and are not offering preexisting coverage to all comers. Actuaries would be able to compute premiums based on probable incidents within the defined group.

And private insurers didn't exclude based upon pre-existing condition for the first 50 years of the health insurance market.

Oh wait, that's back before they all changed to a for-profit model for their actuarial structure in the 1980s.

Given the current conditions, the health insurance payers are quickly becoming part of an obsolete market. Their administrative costs, overhead and desire for a profit would have probably already made their position as intermediary unnecessary... except for the $150 million that insurance companies spend in lobbying the US Senate each year.

 

[Kulindahr]

False. I, not you, defend private enterprise, and oppose government take over. The church groups you describe would have the advantage of a limited pool, and are not offering preexisting coverage to all comers. Actuaries would be able to compute premiums based on probable incidents within the defined group.

No. What you defend is do different than plutocratic privilege and despising the poor. You spit on the Judeo-Christian heritage you have claimed is important.

And a couple of million people is hardly a "limited pool", and yes they are offering coverage of pre-existing conditions to all comers, because no one is turned down from a job working for a church due to health issues.

 

[Kulindahr]

And private insurers didn't exclude based upon pre-existing condition for the first 50 years of the health insurance market.

Oh wait, that's back before they all changed to a for-profit model for their actuarial structure in the 1980s.

Given the current conditions, the health insurance payers are quickly becoming part of an obsolete market. Their administrative costs, overhead and desire for a profit would have probably already made their position as intermediary unnecessary... except for the $150 million that insurance companies spend in lobbying the US Senate each year.

In a way the situation is similar to an aspect of the tragedy of the commons, where those who lived too far away got no benefit from the common property. In this case, "too far away" is too poor or needy to share in the pooled risk. And as with the tragedy of the commons, the wealthy and healthy are all too eager to defend their privileged position as being somehow righteous.

 

[Benvolio]

No. What you defend is do different than plutocratic privilege and despising the poor. You spit on the Judeo-Christian heritage you have claimed is important.

And a couple of million people is hardly a "limited pool", and yes they are offering coverage of pre-existing conditions to all comers, because no one is turned down from a job working for a church due to health issues.

But policies are limited to members of the pool. Even a large pool is finite, allowing the actuaries to estimate the risks upon which to base premiums.

 

[Kulindahr]

But policies are limited to members of the pool. Even a large pool is finite, allowing the actuaries to estimate the risks upon which to base premiums.

Except since their goal isn't to rake in profit, they can have premiums lower than the norm and still help everyone regardless of pre-existing conditions.

At some point you're going to have to face the fact that you are arguing in favor of cruelty justified by greed, and going totally against the Judeo-Christian heritage you have touted. Instead of supporting a sensible reorganization of the U.S. health care system where everyone could get more for less, you instead praise a system where the U.S. spends more than anyone else and gets less.

 

[gsdx]

Insurance policies generally balance each other out. For every person who has an insurance policy and uses it, there is another person who has the same policy and doesn't use it. The premiums for the second person go completely to investments and profits.

Ontario has had a government-run healthcare system since 1966. The original plan was replaced by a provincial plan with federal assistance 3 years later (OHIP - Ontario Health Insurance Plan). In 1966, I was 15 years old. Except for a few minor issues (eye and hearing tests, stitches, physicals, and such), I didn't use it until I broke my hip a few years ago. Had I not had OHIP, the replacement would have cost me about $20,000. Instead, it cost me only $45 for the ambulance ride.

OHIP is a not-for-profit insurance system, and has been for over 50 years.

 

[Kulindahr]

Insurance policies generally balance each other out. For every person who has an insurance policy and uses it, there is another person who has the same policy and doesn't use it. The premiums for the second person go completely to investments and profits.

Ontario has had a government-run healthcare system since 1966. The original plan was replaced by a provincial plan with federal assistance 3 years later (OHIP - Ontario Health Insurance Plan). In 1966, I was 15 years old. Except for a few minor issues (eye and hearing tests, stitches, physicals, and such), I didn't use it until I broke my hip a few years ago. Had I not had OHIP, the replacement would have cost me about $20,000. Instead, it cost me only $45 for the ambulance ride.

OHIP is a not-for-profit insurance system, and has been for over 50 years.

And that's how it works when the people of a country have the attitude of "We're all in this together".

Ben's and the GOP's view of the attitude the people of a country should have is "Fuck you -- you're on your own".

 

[rareboy]

 

[rareboy]

While we're waiting for the GOP to do their final deals with the devil and pass their bill before the August recess.

I think that if they don't pass it by then, the likelihood of passing it before the 2018 elections starts to look poor.

 

[thewiz]

One would think that after voting 70+ times to abolish the Affordable Care Act (ACA), the Republicans would have the magic plan to replace that they always bragged about each time they voted.

Let's be clear about a couple of things. First, the replacement language passed by the House is so riddled with errors and typos that it could not be introduced in the Senate and is the reason that the Senate struggles. It is a non-starter. If the House opted to open the bill, it cannot be done under the budget reconciliation process; any move on their part would require that the new bill progress through committee hearings, amendment processes, and various votes. The Republicans and the House know this would blow up in their faces and result in even more embarrassment.

In the Senate, they are getting bombarded with proponents of the ACA. They have taken several "secret, unoffficial" votes that show they might lose as many as 30 Senators if it were taken to the floor. That number is getting larger this week. Again, trying to do it under a reconciliation process with 0 public hearings, 0 amendment opportunities, 0 hearings, and not even releasing a bill for review prior to a vote is making it less than stink. Senators are also worried about being tarred with stories of people dying from being unable to get insurance, having homes foreclosed, etc. Insurance companies, hospitals, and doctors are also against the bills in the House and Senate.

Contrary to the Republican mouth points, the ACA is functioning. It does need tweaking -- particularly to ensure continued stabilization of prices. In the vacuum created by the Republican blustering, insurers are hedging their bets by projecting large cost increases. Again, what the politicians and news media does not tell you is that prices are submitted to the individual states in April-May with approvals given over the course of the summer/fall for those prices to take effect with the new year. There is also NOTHING to prevent states from pooling or allowing insurers to sell in multiple states; none do because "state rights" normally preclude that option. Each state has an insurance commission of some type that oversees the insurance companies and medical services. How active and thorough they each function is a state-by-state difference.

The talk on the hill (I was there yesterday) is to now blame Democrats for being unwilling and unable to fix Obamacare. Ted Cruz was flowing BS from his lips yesterday as I watched. That is all interesting considering the Dems (and many Republicans) were not allowed to see the bills before they were voted on; they were precluded from hearings; they were precluded from amendments; and they were precluded from even contributing to the bills. Republicans are now trying to figure out how to blame everyone but themselves for what is occurring. Hopefully people will become informed and news organizations will report the bizarre actions taking place.

ACA fixed the access problem to health care. With changes such as funding for catastrophic events in the early years of the new system, penalties and review of costs charged, and limits on executive compensation/overhead -- ACA would function. Continued work will have to be done to not just lower price increases but lower prices overall. Unfortunately that doesn't play to 30 second sound bites that the Congress loves.

 

[Sausy]

Thanks wiz on that inside perspective. The whole audacity of repeal and replace... if it were genuine, you HAVE a well thought out plan that phases in, and no one is at risk to lose coverage or be denied it in the meantime. Both GOP plans, however, take us backwards and put millions in the position of huge increases in spending on premiums and or deductibles (when things are even covered). We need to move to continue with the progress we have achieved... hopefully with the ultimate goal of single payer or a Medicare for all. These GOP plans in both the House and the Senate are awful and as even John Mc Cain predicted recently, will likely die.

 

[Kulindahr]

ACA fixed the access problem to health care. With changes such as funding for catastrophic events in the early years of the new system, penalties and review of costs charged, and limits on executive compensation/overhead -- ACA would function. Continued work will have to be done to not just lower price increases but lower prices overall. Unfortunately that doesn't play to 30 second sound bites that the Congress loves.

I have to vigorously disagree with "ACA fixed the access problem to health care" -- it eased it, but it didn't fix it, since it left deductibles high enough that many people "covered" still can't afford to get medical care. Access won't be fixed until either deductibles are eliminated or are made a refundable tax credit.

Several things can be done to make the price structure work better. First, require that 87.5% of all premiums be spent on actual care. Second, tax direct-to-public advertising at 20%. Third, allow states to negotiate prices with pharmaceuticals (and to band together to do so).

Of course better would be that 0.1% tax on financial transactions dedicated primarily to pay off the national debt but with a portion, maybe 10%, dedicated to backing Medicare and Medicaid. Trump is an idiot not to push such a tax; it would set his legacy as one of our greatest presidents for not just reducing but paying off the national debt (if he gets a second term).