health insurance bill

[brin]

Brin, I think those days are gone, for a variety of reasons. The new medical technology we have now is great, but it costs tons of money to both own and operate.

For good or bad, there are an ever-increasing number of government regulations (long before the new healthcare bill) influencing the delivery of medicine that require both time and money to comply with.

And not to beat a dead horse, but I doubt docs back in the good 'ol days spent such a large portion of their income on malpractice premiums, transcriptionists, billing clerks, secretaries, fax machines, copy machines, etc, etc. Then, of course, you have so many employees, you need an office manager.

Even the 80/20 policies, where you pay twenty percent can be a pretty big impact to your finances these days. 20% of $50,000 for a major hospitalization is gonna hurt.

Lost - I think you are right I think those days are gone....For ever and I just wonder how many other things we have cherished are gone for ever as well..

 

[ultrarunner]

Do any of you remember back prior to about the late 1970's when you got insurance from your employer it was only for a major injury or illness requiring hospitalization and or surgery. The insurance did not cover Doctor visits, drugs , tests or lab work..just covered major problems and back then we all paid that out of our pocket and then if you had to go to the hospital you paid the first 20% and insurance paid the rest...How did we stray so far ? and how can we get back to a patient/consumer driven price camparing market ?

Yes... I remember it being called major hospitalization...

Growing up in a family without Health Insurance and now working in the medical field I can see how far expectations have shifted.

It was standard for physicians to take 3 installments for service... doctors didn't take credit cards like they do now. In fact... all of the Doctors I know were very good at working out financial arrangements... our family Doctor got labor for a new patio from one patient.

The 80/20 rule has worked well for years... the original intent of most "Plans" was to inure against catastrophic loss and even those that didn't have coverage had the option to have their bills settled in a Bankruptcy Court.

Few actually take the time to find out or negotiate their Hospital Bills ahead of time... is it any wondered why costs have escalated?

 

[brin]

ultrarunner...thanks you jarred my memory...It was indeed called " Major Medical " wasn't it and it worked fine and then they began to add mandatory coverage for this & that which many folks did not even want and then they added the co pays for everything and it took the patient out of the negotiating for price equation...notice health care is about the only thing none of us bargain for the best price on...we never know what it will cost. I have even asked the Doctor - How much will that cost..and they say...Don't worry it is covered by insurance...Hey that is not the point ...I want to know. The whole system is screwed up and the new health care bill does not fix it..it only makes it worse..No where in the new bill does it control health care costs.

 

[sweettractors]

ultrarunner...thanks you jarred my memory...It was indeed called " Major Medical " wasn't it and it worked fine and then they began to add mandatory coverage for this & that which many folks did not even want and then they added the co pays for everything and it took the patient out of the negotiating for price equation...notice health care is about the only thing none of us bargain for the best price on...we never know what it will cost. I have even asked the Doctor - How much will that cost..and they say...Don't worry it is covered by insurance...Hey that is not the point ...I want to know. The whole system is screwed up and the new health care bill does not fix it..it only makes it worse..No where in the new bill does it control health care costs.

When 60% of the public did not want this budget buster bill and still does not support it after it has been signed into law, what can the majority do to correct this problem? I don't like being run over, and I am not dumb enough to think that this bill address some of the most important cost containment issues, like Tort reform, and Union members, Senators and Congressman getting sweetheart deals for their states or lobbiests. Ken Sweet

 

[brin]

When 60% of the public did not want this budget buster bill and still does not support it after it has been signed into law, what can the majority do to correct this problem? I don't like being run over, and I am not dumb enough to think that this bill address some of the most important cost containment issues, like Tort reform, and Union members, Senators and Congressman getting sweetheart deals for their states or lobbiests. Ken Sweet

" what can the majority do to correct this problem? "

Ken - To me it's like an out of control machine at this point..I would say all we can do is pray and pray hard.

 

[Chuck52]

Boys, take a deep breath and relax. You might want to check your numbers...remember that just because all the people you talk with on a regular basis, and the news sources you believe, say you are the majority, it may not be true. Selective photography can make small crowds look huge and vice versa, and poll numbers can be cited to support just about anything, and change quickly to boot. If your opinions really do reflect majority opinion, you can vote in various November elections and try to be happy with the results. On the other hand, since most of you proclaim loudly to support the Constitution, if you aren't happy with what turns out to really be the majority opinion, you do have some recourse, but mainly you'll have to live with the election results just the way those of us who were less than happy with previous elections did.

Chuck

 

[2manyrocks]

This talk about majority opinion reminds me of Mark Twain's observation that most people only think they think.

also reminded of a saying that there should be another box on each ballot that says, "none of the above."

It's not just the health care system, but the days of being to get by without having to run in a marathon economic rat race appear to be about gone.

 

[canoetrpr]

Lost, you are a gentleman to debate/discuss with. Too many people get lost in all the rhetoric and are unwilling to debate the actual issues.

Most people seem to like the fact that the health care bill disallows the use of pre-existing conditions to deny coverage. I think it would be fair to say that most think this is the best part of the bill.

The requirement to purchase healthcare (individual mandate) is least liked as it takes away the freedom for one to have the individual freedom to decide whether they would like to have it or not.

What I don't think has been communicated effectively is that you cannot have one without the other - not without bankrupting the insurance companies. If insurance companies are no longer allowed to deny coverage for pre-existing conditions, then there is no point for any one to get insurance until they actually get sick enough to need it. It is much cheaper to pay for regular doctors visits, the odd treatment and so on. When you need insurance is when you have a condition that is going to cost a lot of money.

They only way to ensure that individuals don't have an incentive to do this. (get insurance only once they have an expensive to treat condition) is to have an individual mandate that requires everyone to have insurance. Not having this would effectively bankrupt all private insurance companies.

On the whole business of policies that start moving the provision of health insurance away from employer to individual... I think that your health care bill does some but not too much. My understanding is that it attempts to equalize the tax treatment of premiums so that the same deductions are available regardless of whether you choose to get your health insurance through your employer or on your own. If I understand this correctly then this ought to start the process of employers providing higher wages in lieu of health coverage. I think this is an area that they could have / should have done a lot more in, along with tort reform.

We have a very very different health care system in Canada from what you have in America. It is completely a single payer system, otherwise known as 'socialist' There is only a public healthcare system that is funded out of a combination of general tax revenues and specific contributions done by all employers. Each province administers its own public health insurance system. Doctors, X ray clinics, pathology labs etc. are private operations which simply bill the province's health insurance when you need their services. In Ontario, the public insurance is called OHIP (Ontario Health Insurance Plan).

Hospitals are not privately owned (for the most part) but are administered not-for-profit.

One very key difference between our systems is that in Canada you cannot as a patient decide to go see a specialist. You must be referred by your family doctor. Consequently, in Canada the ratio of of GPs to specialists is 3:1. This is the case for other first world nations for the most part. It is the reverse in America.

Your current health care legislation, in my opinion, does not move you towards the kind of system that we have. Despite the rhetoric, we've got a socialist system here (and it has its flaws but it isn't half bad) and I've got a pretty good idea of what one looks like. I'd say Obama's policy with no public option, elimination of pre-existing conditions and the individual mandate is very much a middle of the road capitalist way to approach the problem. It is more like Germany's than anywhere else, with the exception that they have a public option in addition to private insurance.

Wrt. rationing - everyone better get used to this - no matter where you live. We are living longer and we tend to consume far far more healthcare as we get older. Medical science is getting better and better as well. Nothing is going to stop these two trends. So either health care services re going to be rationed and we are not all going to get that billion dollar pill that will allow us to add three months to our life, or the entire economy is simply going to be health services, and we are all going to give each other checkups. Everybody might as well start having a rational conversation about this.

 

[dave1949]

Do any of you remember back prior to about the late 1970's when you got insurance from your employer it was only for a major injury or illness requiring hospitalization and or surgery. The insurance did not cover Doctor visits, drugs , tests or lab work..just covered major problems and back then we all paid that out of our pocket and then if you had to go to the hospital you paid the first 20% and insurance paid the rest...How did we stray so far ? and how can we get back to a patient/consumer driven price camparing market ?

You do pay out of pocket now - until you have reached your annual per person/family deductible level - which varies by policy.

When you combine the deductible with the amount you pay in premiums, that adds up to significant health care out of pocket spending before further costs are reimbursed by the insurance company.

No matter how it is sliced and diced, the sum of: not covered by insurance spending + co-pay + deductible + self-payed premiums + employer-paid premiums (if applicable) amounts are your out of pocket expenses for health care.

If your and/or your family's total annual health care costs exceed that sum, you actually had health care expenses that were paid by other members in your insurance pool.
Dave.

 

[dave1949]

Lost, you are a gentleman to debate/discuss with. Too many people get lost in all the rhetoric and are unwilling to debate the actual issues.

Most people seem to like the fact that the health care bill disallows the use of pre-existing conditions to deny coverage. I think it would be fair to say that most think this is the best part of the bill.

The requirement to purchase healthcare (individual mandate) is least liked as it takes away the freedom for one to have the individual freedom to decide whether they would like to have it or not.

What I don't think has been communicated effectively is that you cannot have one without the other - not without bankrupting the insurance companies. If insurance companies are no longer allowed to deny coverage for pre-existing conditions, then there is no point for any one to get insurance until they actually get sick enough to need it. It is much cheaper to pay for regular doctors visits, the odd treatment and so on. When you need insurance is when you have a condition that is going to cost a lot of money.

They only way to ensure that individuals don't have an incentive to do this. (get insurance only once they have an expensive to treat condition) is to have an individual mandate that requires everyone to have insurance. Not having this would effectively bankrupt all private insurance companies.

On the whole business of policies that start moving the provision of health insurance away from employer to individual... I think that your health care bill does some but not too much. My understanding is that it attempts to equalize the tax treatment of premiums so that the same deductions are available regardless of whether you choose to get your health insurance through your employer or on your own. If I understand this correctly then this ought to start the process of employers providing higher wages in lieu of health coverage. I think this is an area that they could have / should have done a lot more in, along with tort reform.

We have a very very different health care system in Canada from what you have in America. It is completely a single payer system, otherwise known as 'socialist' There is only a public healthcare system that is funded out of a combination of general tax revenues and specific contributions done by all employers. Each province administers its own public health insurance system. Doctors, X ray clinics, pathology labs etc. are private operations which simply bill the province's health insurance when you need their services. In Ontario, the public insurance is called OHIP (Ontario Health Insurance Plan).

Hospitals are not privately owned (for the most part) but are administered not-for-profit.

One very key difference between our systems is that in Canada you cannot as a patient decide to go see a specialist. You must be referred by your family doctor. Consequently, in Canada the ratio of of GPs to specialists is 3:1. This is the case for other first world nations for the most part. It is the reverse in America.

Your current health care legislation, in my opinion, does not move you towards the kind of system that we have. Despite the rhetoric, we've got a socialist system here (and it has its flaws but it isn't half bad) and I've got a pretty good idea of what one looks like. I'd say Obama's policy with no public option, elimination of pre-existing conditions and the individual mandate is very much a middle of the road capitalist way to approach the problem. It is more like Germany's than anywhere else, with the exception that they have a public option in addition to private insurance.

Wrt. rationing - everyone better get used to this - no matter where you live. We are living longer and we tend to consume far far more healthcare as we get older. Medical science is getting better and better as well. Nothing is going to stop these two trends. So either health care services re going to be rationed and we are not all going to get that billion dollar pill that will allow us to add three months to our life, or the entire economy is simply going to be health services, and we are all going to give each other checkups. Everybody might as well start having a rational conversation about this.

Thank you CanoeTrpr, that is a rational presentation of the topic.

It's a shame many USA folks do not keep up with other countries news and systems. There is a dearth of factual international news. A smidgen in a newspaper or TV as it relates to wars, etc. Very little about issues that tell us how it is to actually live in another country. We tend to be very USA-centric and the cultural isolation that results is not good. In the absence of facts and actual knowledge, demagoguery rules.
Dave.