Health Insurers’ ‘Sins’ Don’t Justify Reform
The same goes with medical insurance. Did you know that non-profit (and non-government) insurers dominate markets in many states? Further, non-profit health co-ops already exist. Health Partners, Inc. in Minneapolis and the Group Health Cooperative in Seattle each have more than a half-million members. Such co-ops would be more common if government got out of the way. Current law prohibits member-based mutual insurance organizations from operating as non-profits.
Michael Moore says the way insurers “make more money is to deny claims or to kick people off the rolls.” But Medicare and Medicaid also deny claims, and they don’t make money. Medicare denies claims more often than major insurers, according to the American Medical Association. The most common reason is the treatment was “not deemed a ‘medical necessity’” by Medicare administrators. In Massachusetts, Medicaid “denied the highest share of claims” of the state’s main insurers, reports the Boston Globe.
Denying a claim is not always wrong. It’s only wrong if the insurer refuses to cover something that the policy says it covers. Denying invalid or fraudulent claims can benefit consumers by keeping premiums low. This makes some administrative costs a good investment. To be sure, denying legitimate claims is wrong, and government should penalize insurers who do not honor their contractual obligations. If insurers often deny legitimate claims, this could be a symptom of lax law enforcement or insufficient penalties, as economist Tyler Cowen has noted.
Claim denial would not be such an issue if the tax code didn’t encourage us to pay for medical care through insurance. We’d pay for more treatments with cash, and costs would decrease because providers would compete on price. The tax bias for employer-sponsored insurance makes claim denials worse: insurers know you’ll tolerate lots of red tape because it’s so costly to switch to a competing insurer. So don’t attack claim denials themselves, but the tax policy that limits insurers’ need to compete and be accountable.
As with claim denials, “kicking people off the rolls,” or rescission, is already illegal except in certain cases. An example is if the policy holder, out of either carelessness or deliberate deception, misrepresents or omits parts of his medical history when applying for insurance. Depending on the omission, the insurer can justifiably rescind the policy or re-underwrite it at a higher premium.
Almost all states allow insurers to investigate medical histories for up to two years after issuing the policy. Supporters of such provisions claim that without it, insurers would commit significant resources to thoroughly investigate each applicant’s health history before quoting a premium price. This would both increase premiums and how long applicants must wait to receive coverage. Critics claim that insurance companies who take advantage of it do it to avoid paying expensive claims. Yet this issue does not justify Democrats’ health “reform.” As Scott Harrington, a Wharton professor of insurance and risk management, writes:
If existing laws and litigation governing rescission are inadequate, there clearly are a variety of ways that the states or federal government could target abuses without adopting the president’s agenda for federal control of health insurance, or the creation of a government health insurer.
More competitive insurance markets would also discourage insurers from illegitimately rescinding policies, as an insurer’s reputation is critical to its success. For example, Aetna touts the quality and fairness of their rescission and rescission appeals process. As economist Arnold Kling notes, lifting political controls that reduce competition could encourage such actions. These controls include guaranteed issue, community rating, and the ban on buying insurance across state lines. Community rating also inhibits innovative products like health-status insurance, which would make it easier to switch your insurance company, despite having a significant medical history.
For every problem, politicians sell a “solution,” which is often legislation that erodes our freedom. Yet problems arising from health insurer profits, claim denials, and rescission arise from existing legislation and lax enforcement of contracts.
Don’t further empower politicians to “fix” problems they created in the first place.
Brian T. Schwartz is overlooking perhaps the best argument against ObamaCare: neither Obama nor any of our elected officials will be participants! This is for the common folk—and not the elites. If it is supposedly so good for us, why isn’t it also good for them? Many Americans have no idea that the Obama family will enjoy entirely different and better medical care. Getting this information out to the general public could very well kill the bill.
Yout hit the point Mr Schwartz. Just to give You a little example of Obamacare in Germany(2nd biggest health market) let me show how it works in Germany:
90% of germans have a compulsatory health care that is financed by a compulsatory deduction of the salaries(20%).
Ther is no way You can get out of this system apart from You get more than 130 tsd Dollars per year. In this case one has the chance to get out of the state system and make insurance agreement on his own.
As i said 90 % are in a state run system which needs desperately money out of tax funds. It is not sustainable in regard of the salary deduction which is one fifth of the salary!. It is in effect dysfunctional.
The whole system works that the given 10 % of the Germany who are in a sort of in the private insurance sector hold up the system by high health care bills.
The system is totally intranparent with an army of rentseekers of burocrats.
David Thomson, the teat suckers don’t care if the ‘Elites’ get different treatment just so long as they get theirs for free or for next to nothing on someone else’s dime.
Our gov has been playing the ponzi/pyramid schemes on Americans for too long and now it’s become the ‘norm’ to buy into the b.s. that is shoveled out to the liberal
indoctrinededucated masses.The real joke is WHO is going to pay for all of this? WHO? If the people who couldn’t afford insurance get insurance, who pays? Where are the jobs?
Show me da money!
Dr. Schwartz makes good points but overlooks the principal cause of the “broken” system. Medicare and Medicaid force providers to cost shift to cover underpayment by the two government systems that do not cover the cost of care at the provider level. Hospitals are reimbursed at around 85 cents on every dollar of cost for Medicare so the other 15 cents has to be shifted to those that pay. For our health system this came to $117 Million dollars in 2007 or just over $802 per bed per day for those that have insurance or pay their own bills.
Likewise for doctors particularly anesthesia where Medicare pays at around 22% of commercial rates….inflated by the underpayments of government.
This is a hidden tax on the sick or on insurance companies, but the criminal is government that now promises to “fix” the disaster they created.
When the parallel system evolves after waiting lists emerge and quality deteriorates, the true cost of much of our care will be revealed in an alternative sytem with no ERs, no EMTALA, no cost shift and best of all, no lawyers as patients will have to sign arbitration agreements to access the system.
While I wish your statement were true,I am sure that by now many people in the country are aware that the Congress will not be party to the legislation. I also believe that many are also aware of the mandatory nature of the bill as well. The polls show that over 60% of the population polled is against any of the bills as currently written, but the democrats seem to be hell bent on passing it anyway.
Let’s hope that regardless of the outcome of the vote that the democrats are swept out in the upcoming elections for even trying to pass this mess, especially in the manner that they are trying to pass it with payoffs and secrecy!
The State is bankrupt, facing Hard Times,
and will do anything for money and power.
HCR, C&T, etc. ad nauseum, all same-same;
Create a threat from an evil enemy, pass
laws to defend from and punish the enemy;
Use the money and power to ride out the
Hard Times in safety, while the taxpayers
suffer. Anyone have a problem with that ?
David, if I understand it correctly, government employees will also be exempt, as will 20 illegal immigrants, who largely live in an unreported cash economy, below the radar. Unemployed and low income participants will receive government subsidies as well as full benefits. Although it’s still in flux, you can count on a big break for union members in the final bill. will Healthy young people, who of course will live forever, will happily pay the small penalty for not buying coverage.
Who’s left?
- … health insurers’ profit margins are about 3%, …
Brian – the problem, unfortunately, is that the skyrocketing health care costs we’ve experienced over the last few decades aren’t caused by insurers’ profits, they’re created by a combination of the enormous waste in insurance industry operations (which also helps keep their profit margins low) AND, more importantly, the broken health care economy/market that results from the interposition of the insurer between the health care provider and the consumer. You allude to the latter, but I’m not sure you really get it.
Comprehensive group health care insurance can only encourage prices to rise at some multiple of inflation. The reasons for this are multiple, but the primary cost drivers are:
1. Encouragement of over-consumption, because everything is ‘covered’ – including defensive medicine to ward off malpractice litigation.
2. “Spreading the wealth around” by spreading the costs around (i.e., socialization) – in this case using private enterprise to do so). This aspect of comp/group insurance is the reason big government subsidizes it – it fits the model they wish to impose on all facets of the economy.
3. When a group pools its resources to pay for a commodity that only a subset of the group uses (at any given time), with no factors working to keep costs down, the natural tendency of price to increase eventually pushes the cost of the commodity beyond the ability of any one individual in the group to afford it.
4. When consumers don’t pay for services out-of-pocket, they completely lose any perception of the value of those services. This breaks the supply/demand model that keeps all other commodities affordable.
There are other factors at play here, but these are the main ones. Sadly, they’re the aspects of the REAL health care problem that no one seems to recognize, let alone want to talk about. IMHO, the reason for this is that we have come to conflate health CARE and health care INSURANCE so completely that every discussion on the topic degenerates into an argument about how we can get everyone “covered”. We can no longer conceive of the only health care market/model that has a chance of working: paying for routine health care out-of-pocket and using low-premium/high-deductible policies to keep non-routine care from causing bankruptcy.
Every effort by the government to ‘fix’ health care, in history, has been a push to exert control over health care. This is in keeping with government’s historic tendency to always seek more power. Once government controls access to health care, it has de facto control over every aspect of your life that affects the cost (or ‘projected’ cost) of that care.
We can fix the skyrocketing costs of health care, given time. But as with everything else the government is now doing to ‘fix’ things – all of which have had either no or negative net effect – we have to be willing to understand the dynamics of the currently broken market, break out of the broken mindset we’re trapped in, and learn to envision a market that will work.
Thank you, Brian, for a fine job of mythbusting!
Insurance companies provide a valuable service when allowed to operate in a free market by spreading risk amongst willing customers. But as you’ve noted, bad federal tax laws have turned insurance for protection against catastrophic events into inefficient pre-paid care.
If insurance companies fought for free market reforms, I’d respect and support them more.
But to the extent they advocate even more government regulations (such as an individual mandate), then they should be opposed. Such “reforms” would merely make the current problems worse.
I am a physician and happened to be hospitalized last year for a serious illness. The hospital bill was $75,000 for one week. The doctor bill was $1500, for one week. The doctor bill is way too low for the service rendered. The hospital bill is way too high. About 10 years ago this same hospitalization would have cost closer to $20,000 which is still high. Now why is it like this, because that is why the insurance companies are having to work so hard to make a buck? The reason is that medicare and medicaid do not pay their part. Medicare and medicaid make patients make up the majority of people in a hospital. That means that their cost is transfered to us and our insurance as a hidden tax. Now the government wants to cut back even more on medicare (it can’t on medicaid as they do not pay anything). And they want to add people to the government roles. On top of that they want to tax us out the bejess in addition to increasing what we pay for insurance. All they had to do was pass a simple bill to allow insurance portability, help with definitions of pre-existing illness and a few other minor problems. Then they could concentrate on paying their bills. One good way to pay their bills would be to eliminate many of the government programs like the useless DEA, OSHA, energy department and others. Allow people to buy any drug they want and thus treat themselves, after all we are a free society (I think).
10 David you are correct in your assessment of the cost transfer of medicare and medicaid to the privately insured and uninsured. However you failed to mention the increased drug prices due to the accelerated transfer of patent medicines to drugs. With the cost of developing continuing to increase and the risk of litigation increasing, while at the same time the push to limit patent length, results in significantly higher drug costs.
The states mandate that insurance must cover everything from herbal medicine to pet psychology, and then complain about the cost increasing. The demorat party has become the chief lobbyist for the trial lawyers, allowing frivolous lawsuits which increase malpractice insurance premiums, again driving costs up.
Everything the government has done to this point in time drives cost up almost by design. Now they would have us believe that the solution is to let them have more control. Is it just me or is anyone else dubious of their claims?
Goy @ #8
Bingo! These are the very arguments I’ve been using for a long time. People are so brainwashed into the “insurance companies are evil for their profits/denials/etc” rhetoric they don’t even hear me. Instead, they respond with some out of the ordinary horror story they heard without regard to how rare these stories are, nor the fact that we have an excellent system for redress when they do occur. Then our President stands up and tells us about how doctors are performing needless tonsilectomies for profit helping to perpetuate more false boogiemen stories and deflect real responsibility.
I worked for a Health Insurer for a while – until they sold the business. I was amazed at the floors of laywers, clerks, managers and IT programmers who did nothing except try to keep the company in compliance with state and federa regulations. There are only a few health insurance companies left these days because the legal overhead is crushing.
Combine that with the lawsuits – and a corporate parania about lawsuits, the pass-thru of unfunded Medicare / Medicaid expenses David mentioned, and you get to the reasons health insurance is expensive. ObamaCare will make it all worse, not better.
Dear Mr. Schwartz,
Thank you for your article. I respectfully disagree with your premise though. The ‘sins’ of insurance companies do indeed justify reform. However, I think that the main problem with our healthcare system is not the insurance companies but the uninsured. It is the uninsured who are largely responsible for health care inflation. We agree that insurance companies need to be able to compete with each other and that the tax exemption of health insurance must end, so I’m curious as to what your thoughts are about the impact of the uninsured on our health care system.
14 Mr. Independant And you base this opinion on what obama, reid, and pelosi’s talking points? Most of the “uninsured” fall into the categories of young healthy people and illegal aliens. Unfunded mandates, complying with federal regulations and litigation are the main proponents of increasing costs. But as to uninsured illegals how about we deport their a$$es back to where ever they came from.
Keep drinking that koolaid, and repeating obambi’s lies.
The insurance companies are evil weasels willing to bet your own money that you won’t get sick and they can try to fix the bets by changing the odds, such as pre-existing conditions.
A federal health care insurance system is an evil monster, that once turned loose could hardly ever be tamed.
The difference is that one can sue or switch private insurance companies fairly easily. Good luck sueing or switching the federal government. (Could the passengers on the underwear bombers plane sue TSA for neglect)
The $2.4 trillion health care cost or about $8 thousand per citizen is still underdefined. Was that number billed services or does it include axillary costs such as research and infrastructure? If doctors become just another commodity, like automobiles, why is it bad for the economy to recirculate the health care cash flow with domestic goods and services? Isn’t this health care crisis just another invented crisis by politicials to push another Cloven and Pivan strategy?
ObamaCare reducing the deficit is a Fairy Tale based on unreasonable and unlikely “assumptions” that the CBO is required to use. Tell me, what will be solved by dumping 47 million newly insured patients into the system without an increase in the number of health care providers (Doctors, nurses, aids, accountants).
This is insanity on parade. Nancy Pelosi and the Democrat leadership is allowed to create the illusion of the evil immoral insurance companies who must make a profit in order to stay in business. Newsflash, kiddies: The “Profit Motive” is the single reason that the quality of U.S. Health Care and the innovations are unsurpassed in the world. Destroy this and we will all be the worse for it.
I am not crazy about this bill for all sorts of reasons. However, one of the killers of small businesses, and the millstone of larger companies, is the cost of health insurance for workers. It’s a serious problem that needs to be corrected because we cannot compete with foreign corporations whose governments pick up the cost. And I see no solutions here for the millions who can’t afford insurance in the first place.
At least Obama is trying to do something, even if we don’t like it. What did the Republicans offer us during all the years they had control of Congress?
“What did the Republicans offer us during all the years they had control of Congress?”
Conservative Republicans simply could not overcome the resistance of the Democrats and their own more “moderate” Republican cohorts. Just “doing something” isn’t sufficient. One must also try not to do more harm than good. There are three things we minimally need to do.
1.) Tort reform: we must curtail the power of the legal profession.
2.) Citizens must be willing to pay high fairly high deductibles. Auto insurers do not pay for your car’s oil changes and tune ups.
3.) Health insurers must be able to offer their customers policies that match their needs. This is currently against the law in every state in the union. These policies should be legal in all states. There should no such thing as a state specific policy.
I hear the argument all the time “well at least Obama is trying to do something about it”. This is such bull. Liberals are always trying to so something about something. The problem is that they are wrong 99% of the time. The idea that their intent to do “good” somehow forgives the madness and folly of their policies is crap. The government is out of control. They are making promises that they know they cannot possibly carry out. They are lying over and over again. They cannot come forward with any example of how their socialists policies have worked anywhere in the world. The governments’ management of social security, medicare, medicaid and VA hospitals speaks for itself–piss poor. Their managaement of Homeloand Security is a joke. Imagine when they start to “kill” people with neglect and incompetence in the 20% of economoy devoted to health care. Just like their incompetence almost cost the lives of 300 people on the Detroit bound flight with the panty bomber. It is time for all Americans to stand up and just say NO!! These people need to be stopped in their tracks.
@18. sharonsj: – At least Obama is trying to do something, even if we don’t like it. What did the Republicans offer us during all the years they had control of Congress?
TIP: the federal government has neither the Constitutional authority nor the economic expertise to “do something” about the way the health care market has been corrupted. They’re the ones who broke it!
It’s not the government’s place – Socialist OR Republican – to “offer” a fix for a segment of the economy. It’s government’s place to get out of the way and let the market function, as health care once did before Medicare, HMOs, comprehensive group insurance subsidies, etc. All THAT is why we have skyrocketing health care costs.
This groupthink mindset you and so many others exhibit – that (a) government is the answer to ALL social problems and (b) health care and health care insurance are the same thing – is part of why America is going the way of the UK: decline.
gverdi27,
Actually no, I’m basing my opinion on statistics. Here’s one: there are about 37 million Americans that are uninsured. Yes many of them are young and healthy but not all and most don’t purchase insurance because that can’t afford it. Those 37 million people (in addition to 6-12 million illegals) do not have access to primary health care, so when they get sick they don’t seek treatment for what should be a small problem (like diabetes), that small problem becomes a big problem, they go to an emergency room, rack up 100K hospital bill, and since they can’t pay for their care, everyone else who has health insurance ends up paying the bill. That is the primary cause of health care inflation. There are two ways of fixing that problem: either we must have universal health coverage (not a single payer) or we have to end universal access to emergency room care. I support universal coverage.
The problems that you cite as the cause of health care inflation are almost completely wrong. Unfunded mandates (like the REB written and DEM enabled Medicare Prescription Drug, Improvement, and Modernization Act) are a drain on the Federal budget but are not responsible for health care inflation. Complying with Federal Regulations does add to the cost of health care but very little. If the opposite were true how is the oil industry able to make such enormous profits? And litigation has been proven to be just a red herring. Malpractice insurance accounts for less than 15% of operating expenses for doctors and less than 10% for hospitals. For example, the average salary for a US doctor is about $150K per year; that doctor will pay on average $18K in malpractice insurance. Do the math (it’s 12%).
Since 2000 health care costs have doubled. The reason is the uninsured. If you know of specific information that disputes that, please provide that for all of us to read.
Underpinning all of these issues and good observations is one fundamental problem. The older among us can remember when it was called health “insurance”. Insurance is a concept where many people contribute to a pool that is used to protect themselves and the unfortunate few from some event that might otherwise prove economically catastrophic. But somewhere along the line it became “comprehensive health care” and this has set up all of the problems we face.
I don’t believe anyone should be forced to pay for another’s annual routine health care or for the expenses related to minor chronic conditions. But it seems very reasonable that we band together under the classic concept of “insurance” to cover the more disastrous events that befall people. Just how this is achieved is complex but less so than the current mess of regulations and policy conditions. If there are some who cannot afford to pay into this pool or cover their basic health care costs then we already have a welfare system or perhaps tax credits that could handle this.
I lived for 20+ years with a sick wife and the constant threat of major medical expenses being dropped on us at any moment. I was grateful to have a health policy but had to pay huge premiums, sacrificed job mobility and lived in fear of being dropped or exceeding the policy “maximum”. But I never blamed the policy providers or sought help from the government. Rather, I wished for a portable policy, unconnected to my employment or my location that would cover expenses beyond some amount that I could plan for – just as I planned for all of our other expenses.
“22. Mr. Independant:
The problems that you cite as the cause of health care inflation are almost completely wrong. Unfunded mandates (like the REB written and DEM enabled Medicare Prescription Drug, Improvement, and Modernization Act) are a drain on the Federal budget but are not responsible for health care inflation.
Since 2000 health care costs have doubled. The reason is the uninsured. If you know of specific information that disputes that, please provide that for all of us to read.”
Actually you use facts , some of which are accurate. But you come to the wrong conclusion. Cost shifting is what drives up private insurance costs. Both from medicare/aid government underpayments and uninsured mostly illegals. To say that medicare underpayment for services does not raise costs on private insurance is .. well, lets just say a not very intelligent conclusion.
As to your last comment. How about you provide your links. For you do not provide specific information which supports your conclusions. You instead state a few probable facts then draw whatever conclusion you wish.
If , as you so claim, it is the uninsured driving health care costs. One would expect to see a correlation betwixt the number of uninsured in 2000 and the number of uninsured today. You say that insurance costs have doubled in that time.
http://www.americanprogress.org/issues/2004/08/b173900.html
“Today, the Census Bureau reported that 45 million Americans lacked health insurance in 2003, up by 1.4 million from 2002 and 5.2 million from 2000. The report states that this increase is “statistically significant.”
Well Mr “based my opinion on stats.” Looks like in 2000 there were 40 million uninsured, today .. according to you there are, adding illegals(do not know if those are in the count I provided) lets give the maximum benefit of the doubt and call it 49 million today or a 23% gain.
Hardly a doubling now is it? Do not look now but your stats(slip) is showing.
Just sayin’.
Conservatives need to understand and understand quickly…
Reality does not matter to the liberal/progressive/left. Secular-humanism is a RELIGION, and Obama and his ilk are zealots to it.
Therefore…
They cannot be bargained with.
They cannot have their eyes opened with reasonable arguments (I see quite a few in the comments here).
They cannot be made to see that they lie every time they open their mouths.
They cannot change their minds when faced with reality-based feedback.
They are in pursuit of raw, naked power.
Healthcare is but one facet of this undeclared religious, cultural war that has been raging since the sixties.
Conservatives must clear the scales from their eyes.
As many wise men from the Bible to Sun-Tzu have said…
Understand that you have a real enemy, and thoroughly understand his motivations, otherwise he will always prevail.
Mr. Independent:
Let me see if I understand your point.
You think that the solution to hospitals shifting the costs for the uninsured onto everyone else can be solved by putting government in charge of health care, thereby shifting the costs for the formerly-uninsured-but-now-insured onto… everyone else.
Yep, that’s real progress, alright. I stand humbled in the presence of your incredible wisdom. (Notice for the humor-deprived: this paragraph is sarcasm.)
Mr. Independant,
A 2008 Congressional Budget Office report on our rising healthcare costs came to the conclusion that hospital and physician costs are the largest proportion of expenses, and “most of the long-term growth in total healthcare spending has resulted from growth in either or both of these categories… About half of all growth in health care spending in the past several decades was associated with changes in medical care made possible by advances in technology.” Rising healthcare costs are mostly due to technological advances, as well as the high cost of labor (much of medicine, unlike other fields, CANNOT be mechanized). Here’s a link to the CBO report: http://www.cbo.gov/ftpdocs/89xx/doc8947/01-31-TechHealth.pdf
Why do technological advances make costs go up instead of down? Well… because they CAN! That is, pharmaceuticals or biotech companies can charge high prices because we as patients don’t care what the costs are (hey, it’s already “paid” for!) and insurance companies are willing to pay -and eventually charge us with higher premiums (to cover the rising costs -and their cut as well). If providers and manufacturers of healthcare products were pressured to compete by more cost-conscious patients, perhaps costs WOULD come down.
Insofar as the unisnured increasing the total cost of healthcare, their impact is limited, at best. From the 2007 Census data, of the 46 million uninsured, 19 million are 18-34 year olds. Another 8 million are 35-44. Only 500,000 of the uninsured are over 65. So more than half of the uninsured are young and generally healthy, while very few of our nation’s elderly are. I doubt the remaining 19 million unisnusred are all chronically ill and breaking the health insurance bank for the other 280 million of us who live in America…
You can find most of the data here: http://www.census.gov/prod/2008pubs/p60-235.pdf
More relevant to Obamacare, of the 46 million unisnures:
- 10 million are illegal aliens (Neither Democrat or Republican proposals aim to cover them).
- 8 million already qualify for Medicare/Medicaid/SCHIP (they simply haven’t enrolled).
- 17 million make over $50,000 a year -which is the average US household income…
Would you consider governemnt subsidized public health insurance for those making above the national average? Of those 17 million, 9 million earn over $75,000! Should they be included among the truly “uninsured”…? True, some may well be “uninsurable,” but I doubt they’re the brunt of the group. Subtracting the above groups leaves 11 million Americans who are truly uninsured. They should be helped… but at a cost of 1 – 2 trillion per decade? Even current proposals don’t foresee true universal coverage, but merely expanding coverage from the current 85% to about 94%. So by spending $1-2 trillion extra every 10 years, we can expand coverage by 9%…
For the most part, I am in agreement with Mr. Schwartz, Goy, and David Thompson. I recommend you read this in depth article as well: http://www.theatlantic.com/doc/200909/health-care
“Once you buy a policy, the insurance company profits most if you avoid misfortune and hence submit no claims.”
Almost, but not quite. The insurance company actually profits most if it doesn’t have to PAY any claims. That is a small, but important difference.
Your attempt at correction is false, Matthew. Consider this: if I submit a claim that the company does not pay, the company incurs administrative and investigative costs related to determining my claim is illegitimate. But if I submit no claims at all, not only does the company not pay, as per your formulation, it incurs no administrative costs either, as per Dr. Schwartz’s formulation. Maximum profits, then, occur when policy holders “submit no claims,” as he wrote.
Dear Fantom,
I don’t think you understand the concept of my last post. At no time did I state that the number of uninsured has doubled. My quote was “Since 2000 health care costs have doubled”. Health care costs not the number of uninsured.
http://www.census.gov/prod/2001pubs/p60-215.pdf
http://www.census.gov/prod/2009pubs/p60-236.pdf
Your counter argument against that line of reasoning was “One would expect to see a correlation betwixt the number of uninsured in 2000 and the number of uninsured today”. If you are suggesting that the uninsured are not responsible for health care inflation because their numbers haven’t doubled; well I’m sorry, that doesn’t make any sense. It is the use of the health care system (uncompensated) by the uninsured that is responsible for health care inflation.
Also you are (apparently) not just coming to your own conclusions based on certain ‘stats’ but are also just repeating campaign slogans. What I mean by that specifically, is that you wrote in post #24 “Both from medicare/aid government underpayments and uninsured mostly illegals”. Medicare/Medicaid is prohibited by law from negotiating for prices.
http://www.cms.hhs.gov/MMAUpdate/downloads/hr1.pdf
The government (and by extension) the tax payers are overpaying for their purchases of medical products and services. As for the 10-12 million illegals comprising the majority of the uninsured (which is 45 million or more), you might want to check your math. They are a big part of the problem but their not the majority.
Finally, if the uninsured are not the primary reason behind health care inflation; can you name any instance in American business history when 45 million individuals (or the equivalent portion of the population) was able to basically steal from that industry and those costs were not passed on to every other consumer?
28. But if you submit a legitimate claim per the terms of your policy, they have a contractual obligation to pay it. If they refuse, sue them. If you can document the fact that they refused to pay for a covered item, the court will issue an order to them to pay the claim, plus your court costs and a punitive judgment.
The so called “conservativewanderer”,
No you apparently do not understand the concept of my posts. I am not advocating putting government in charge of all health care. What I have stated is that the problem of health care inflation is the uninsured. That can be dealt with one of two ways: there has to be universal coverage (not a single-payer) or universal access to emergency room care must end. I’m in favor of universal coverage (from private insurance). BTW, the government already purchases 45-50% of all health care products and services (for FEHB, Medicare, Tricare, and the VA). If you really want government out of the health care business, are you in favor of Medicare, Tricare, the VA, and ending universal access to emergency room care ending?
Ahh, yes, I see the so-called “independent” has turned to the usual lefty talking points about whether or not we’re evil enough to end Medicare.
Thank you for proving your real ideological bent, Mr. “Independent.” And thanks for falling so nicely into my little trap.
myth buster: Taking an insurance company to court over a legitimate claim is rarely required. A simple call, or even a threatened call to the state Department of Insurance is all that is needed. In my years as an insurance customer and time in the industry, I’ve never seen a claim declared legitimate by a DOI disputed by a company. They live in fear of the DOI’s.
The so called “conservativewanderer”
No, not so much. I asked you a very simple question; you chose not to answer it. I also noticed that you didn’t dispute anything I wrote. Does that mean that you can’t? A good friend once told me that: “it’s all well and good to complain about a problem but what is your solution?” So what are your solutions to the health care problems? Do you have any?
@32. Mr. Independant: – …the problem of health care inflation is the uninsured.
This is unsupportable nonsense.
Health care costs, as well as insurance costs, have increased in direct proportion to meddling by government and direct proportion to the popularity of so-called “comprehensive” group medical insurance. The situation in Massachusetts is a perfect example.
After the passage of Medicare in the ’60s, we see health care costs begin to creep above the CPI mean for the first time. Immediately following the federally mandated HMO program, we see costs begin to diverge significantly from the CPI mean in the mid-1970s. As that system proved unworkable, and more profit-oriented concerns replaced HMOs, health care costs began to rise even more quickly. These increases were exacerbated as coverage became more “comprehensive”. These facts are illustrated here (and discussed in depth here).
Health care costs have skyrocketed since the 70s for one reason: there is absolutely nothing working to keep health care prices in check. Unlike other commodity markets, where prices are kept relatively affordable due to simple supply-and-demand, here is no longer any direct economic relationship between the provider and consumer in the health care market. Whether or not this was intentional, this was the result of decades of meddling by the federal government in areas where it has no Constitutional authority to legislate.
Today, insured health care consumers are completely disassociated from the cost of the care they receive. Virtually all care they receive is “covered” through a comprehensive plan. Health care providers and insurers both have ample cause to ‘allow’ costs to constantly increase.
The so-called “uninsured” make up a very tiny minority of the health consuming public, but only the costs incurred under EMTALA are covered by the price paid by others. Health care costs incurred by these folks is just economic ‘noise’ in a completely corrupted and dysfunctional market.
Actually, Mr. Independent, you never answered my original statement either… because you cannot.
You advocate universal coverage. That’s precisely my point.
Since you seem unable to comprehend simple logic, let me spell it out for you step-by-step.
1) In order to achieve universal coverage, those who are currently unable to purchase insurance will have to receive assistance.
2) Said assistance will have to come from the taxpayers.
3) Therefore, what is happening is that the costs of providing care for the uninsured will be shifted onto everyone else.
4) And, if you remember, that is precisely my original statement. In order to solve the problem of shifting the costs of those without insurance onto everyone else, you’re going to shift the costs onto… everyone else.
Now, if you can quit the lefty talking points and give a coherent response to that, I might answer your lefty canard about cancelling Medicare, Medicaid, etc.
Until you do so, however, I will continue to view you as a lefty trying to hide his leftism, and will treat you accordingly.
People say that millions of people can’t afford health insurance. Well, why can’t those millions of people afford health insurance? The answer is because the states won’t let them buy a plan that suits their needs. Meanwhile, they earn low wages. This is especially true of young people with no chronic health conditions. Because they’re just starting out in the workforce, they don’t make much money. Many of them just want a catastrophic health plan- something to cover hospitalizations and surgery. Cheap premiums, high deductible, covering only things that will cost thousands of dollars. However, the states all impose minimum coverage requirements prohibiting the insurance companies from selling just such a policy. Thus, rather than buy the more expensive policy required by law, they opt to go uninsured.
The lesson- when government forces people to pay more for a good or service than they are willing or able to pay, they’ll opt not to purchase it. It’s the same reason that taxes discourage cigarette consumption, causing smokers to either quit or cut back. It’s also why minimum wage laws end up hurting the people they’re intended to help.
Islamic seperatist said what they ejaculate citizen of USA does both man and woman but USA proved them wrong they cann’t ejaculate their death through their own smoking guns.
MB @ 38:
Very good points.
One of my favorite examples of states imposing minimum coverage requirements (called “mandates”) is Utah’s requirement that health insurance must cover at least $4,000 for adoption benefits. Note, this is paid to the adoptive family, not the birth family (who would be covered under existing maternity benefits, either through private insurance or through the state via Medicaid).
While adoption is a very good thing and should be encouraged, I don’t see what it has to do with the health of the adoptive family (since once the adoption is complete the child would be covered under the parent’s policy–I’ve never seen a policy in my life that discriminated between adopted and natural-born children), and thus is seems highly inappropriate to force health insurance companies to pay for it.
Of course insurance companies try to make money – it is idiotic for consumers to desire otherwise.
For profit health insurance – will want their policy holders to live as long as possible in order to continue making a profit off of them. On the individual level, there will sometimes be a “loss” year in which they lose on an individual – just like the year you crash your car. But in the long run, it is in their interest to keep you alive as long as you pay your premiums.
Government healthcare – All participants are costs. Unless you are paying big income taxes and have no estate for them to seize, it is in their best interest for you to die. They have no motivation to spend to keep you alive.
goy,
Actually, health care costs have directly increased in relation to the increased use of the health care system by the uninsured. If government intervention was responsible for health care inflation why is that not occurring in Japan’s health care system? The government of Japan has much more control of their countries’ health care system than the US and Japan has universal coverage; yet their health care costs are only a fraction of the US. How do you explain that? Now I’m not advocating for a Japan-like control mechanism for the US health care system, I’m simply pointing out that your position is undermined by Japan’s health care system.
Now I do agree with you that there is nothing to keep US health costs in check but I think it’s virtually impossible to create any system to deal with health care inflation without dealing with the uninsured. It’s akin to saying the US can have immigration reform without securing its borders. That’s what you’re suggesting on the health care debate.
Finally, if you really believe that the uninsured are just ‘economic noise’, can you name any instance in modern American business history when 45 million individuals (or their equivalent proportion of the population) were able to basically steal from a particular industry and those losses were not passed on to the consumer?
The so called “conservativewanderer”
Actually you never asked any question of me. It’s seems you have a problem with not just understanding the meaning of my posts but also with being honest.
Your statement from post #26 was “You think that the solution to hospitals shifting the costs for the uninsured onto everyone else can be solved by putting government in charge of health care, thereby shifting the costs for the formerly-uninsured-but-now-insured onto… everyone else.” You were clearly making an anti-government statement in addition to what you stated you wrote in post #37. Did you forget or are you trying to be dishonest?
The point that I’ve been continually making is that the uninsured have to be insured or denied access to emergency room care. I’ve stated that several times. What you don’t (seem) to understand, is that the cost of the uninsured is already shifted on to everyone else. It’s the primary reason for health care inflation in the US. So it can be dealt with in one of two ways: everyone must be required to have health insurance (and those you can’t afford it can have it provided to them by the taxpayers) or universal access to emergency room care must end.
So once again, if you really want government out of health care, are in favor of ending all government health care programs and universal access to emergency room care? I’ve asked you this question before, you’ve always refused to answer. I wonder if you’ll respond with anything constructive.
@42. Mr. Independant: – … health care costs have directly increased in relation to the increased use of the health care system by the uninsured.
There’s no data to support this idiotic idea. And even if there were, it wouldn’t matter. The only portion of “uninsured” health care that adds to overall health care costs is the amount covered by EMTALA statutes – that is the amount the health care provider has a statutory obligation to cover, and must recoup either by lowering profits or passing that cost on to other health care consumers. You haven’t demonstrated that such costs are anything more than economic noise in the multi-billion dollar health care market.
Clearly you are laboring under the illusion that someone with no insurance can just walk into an ER or doctor’s office and get ‘free’ health care. That’s simply not the case. “Uninsured” doesn’t mean one doesn’t have to PAY for health care products and services. The pharmacy isn’t obligated to fill your subscription for free just because you don’t have insurance.
- why is that not occurring in Japan’s health care system?
Who says it’s not. Either way, you’re comparing apples and oranges here, which is the favorite ploy of people who’ve been duped by the false promise of “universal” health care.
The U.S. government doesn’t yet mandate price controls for health care, as Japan does. The only way health care costs can be kept low when there’s no economic/market force to KEEP them low is through government legislation dictating what the price can be. You see the same thing in Europe wherever health care coverage is supposedly “universal”. Since the State is paying the bill, and passes legislation to determine what it will or will not pay, the price of care is kept artificially low. Providers have no choice but to accept that price or go into another line of business. In the U.S., this isn’t Constitutional – the federal government has no authority to dictate prices for health care goods and services. Medicare is a perfect example of why this will never work. Of all the health care insurance entities, Medicare is by far the most egregious culprit when it comes to rejecting medical claims. This demonstrates exactly what we’ll get by effectively expanding Medicare to all citizens in the country – even to all of the so-called “uninsured”. Why do you think so many health care providers are dumping Medicare?
- I think it’s virtually impossible to create any system to deal with health care inflation without dealing with the uninsured.
Good for you. When you come up with some facts to support that thought, let us know. Right now, the facts and the actual data put your concerns about the “uninsured” in the margins. The “uninsured” are the people being exploited by Big Government (i.e., the left) in the Appeal To Emotion fallacy they’re using to justify a takeover of the health care industry. That’s why they keep inflating the number to cover ANYONE who doesn’t happen to have health insurance, for any reason (illegals, young and don’t want to pay for it, wealthy and don’t want to pay for it, prefer to use a catastrophic plan and pay for routine care out-of-pocket, etc.). Clearly, you’ve fallen for that fallacy.
Again, the number of “uninsured” is absolutely irrelevant. Anyone who tells you different is locked in a broken mindset where they erroneously believe that health care and health care insurance are one and the same thing. They’re not. The group of people who can’t afford basic, routine care (note: not insurance) are the only people we have any social obligation to be concerned about, and those two groups are NOT the same. The best way to reduce the number in that latter group is to fix the broken health care market and BRING THE COST OF ROUTINE CARE BACK IN LINE WITH OTHER COMMODITIES so that it’s more affordable. You don’t do that by handing a broken market over to a broken, self-serving, inept government that has made a business of stealing Taxpayers’ money to pay for programs that keep it in power. You think a government that projects unemployment numbers with this sort of complete ineptitude has any chance of managing health care for 300M+? Or even 30M+? If so, you’re delusional. The facts don’t support your wishful thinking.
- It’s akin to saying the US can have immigration reform without securing its borders.
No, it’s not. Not at all. The problem in this country is not the “uninsured”, as you’ve been brainwashed into believing. The problem with health care is that costs have skyrocketed at rates far beyond ANY other commodity market, and because those costs are now bankrupting various State and federal entitlement programs, there’s a “crisis”. The reason for the cost increases is clear and very easy to discern: abusing insurance through comprehensive, group plans to pay for health care actually ENCOURAGES costs to rise. Market forces acting to keep health care costs down have been completely neutralized by government intervention which encourages the use of comprehensive, group plans. The result is that – unlike ANY other commodity market – health care costs have been skyrocketing out of control for decades. Costs mandated by EMTALA incurred in caring for the so-called “uninsured” have absolutely nothing to do with that.
- can you name any instance in modern American business history when 45 million individuals (or their equivalent proportion of the population) were able to basically steal from a particular industry and those losses were not passed on to the consumer?
I don’t need to. Not until you demonstrate that 45 million people (it’s 45 million now?? LOL!!!) are stealing anything significant from the health care industry.
The individuals currently stealing from that industry are the superfluous bureaucrats in health care are a completely different group. They’re the ones required to manage insurance claims and useless, idiotic HIPAA regulations. They’re the ones in government and the insurance companies whose only function is to take money from group A, pay it out to group B and keep (steal) a significant percentage in the process – all the while corrupting the health care market in such a way that costs annually rise at multiple times that of inflation.
goy,
So it seems that your entire response to my last post was nu huh. You also dodged most of my questions. So let’s start again:
First off, the health care industry is not a multi-billion dollar industry; it comprises over 2 trillion dollars annually.
Second, hospitals are required by law to provide care in their emergency rooms. If someone with diabetes has to have a 50K amputation surgery, they get it. Yes a pharmacy is not obligated to provide a few hundred dollars worth of drugs to an uninsured patient but the ER is required to provide that 50K operation. And it doesn’t even have to be someone who is ‘sick’. If you’re perfectly healthy and to get into a car accident, you’ll still receive the 100K worth of services, even if you’re uninsured.
Third, you completely dodged my question about Japan’s health care system. It is not comparing apples and oranges to compare the two systems. It in fact undermines your entire premise.
Fourth, yes the federal government doesn’t negotiate for prices of its medical purchases but it should. And contrary to what you believe, Medicare actually proves that it can work. If a certain provider or supplier doesn’t want to pay the government rate, then the government can take its contracts elsewhere. Here’s a newsflash, that’s what happens in the real world. Or are you suggesting that Aetna, BlueCross, and Humana should be outlawed from negotiating for prices of their purchases. There’s even a non-partisan way of doing it. Simply require the federal government to purchase medical services at the same rate as private insurers.
Fifth, your belief about the uninsured not being responsible for the majority of health care inflation was not supported by any sources. Why not?
Sixth, my question “can you name any instance in modern American business history when 45 million individuals (or their equivalent proportion of the population) were able to basically steal from a particular industry and those losses were not passed on to the consumer?” is especially important because it illustrates that your position is disproven by modern American business history. You didn’t answer that question BTW.
Finally, I noticed that you have repeatedly asked for sources of information but have not provided any of your own. Below are a few of mine.
http://www.census.gov/prod/2009pubs/p60-236.pdf
http://www.cbo.gov/ftpdocs/89xx/doc8947/01-31-TechHealth.pdf
Will you be responding with any credible evidence of your own?
Mr. Independant says…
#22 (snip)
“There are two ways of fixing that problem: either we must have universal health coverage (not a single payer) or we have to end universal access to emergency room care. I support universal coverage.”(end snip)
#43 (snip)
“The point that I’ve been continually making is that the uninsured have to be insured or denied access to emergency room care. I’ve stated that several times. What you don’t (seem) to understand, is that the cost of the uninsured is already shifted on to everyone else. It’s the primary reason for health care inflation in the US. So it can be dealt with in one of two ways: everyone must be required to have health insurance (and those you can’t afford it can have it provided to them by the taxpayers) or universal access to emergency room care must end.” (end snip)
I’m very happy to say my friend, CW, is correct regarding your comments, Mr. Independant. You are parroting lefty talking points. The proof is in the two above comment portions.
1) You support “universal coverage”
2) You believe the “uninsured” are responsible for health care cost increases
3) You argue that either the “uninsured” must be denied ER care (illegal thanks to Federal law, btw) OR everyone must be forced to buy insurance by the government “(and those you can’t afford it can have it provided to them by the taxpayers)”
First, let’s address your and the Ds cognitive dissonance regarding “Healthcare Access” and “Healthcare Insurance”. Currently, EVERYONE has “Healthcare Access” but not everyone has “Healthcare Insurance”. In fact, this means that “Healthcare Access” is already universal.
Second, let’s address the costs associated with universal “Healthcare Access” and “Healthcare Insurance”. You state, “What you don’t (seem) to understand, is that the cost of the uninsured is already shifted on to everyone else.” and “…everyone must be required to have health insurance (and those you can’t afford it can have it provided to them by the taxpayers) or universal access to emergency room care must end.” Your position is the uninsured using the universally accessible ERs is what is driving healthcare costs and either that must end or everyone must have health insurance. You don’t seem to understand these two concepts are not the same though. One is already providing “universal” healthcare and the other is merely for healthcare insurance. One might think that the government requiring (read as ‘forcing’) people to buy HC (HealthCare) insurance that those who are uninsured would then have ‘skin in the game’ and that would immediately drop the costs associated with healthcare. Yet, in the same sentence, you state “(and those you can’t afford it can have it provided to them by the taxpayers)”. How is this reducing the costs to those who already have HC insurance? And there is the cost to personal liberty that you simply don’t address. Find for me where, in any of our founding documents, that “healthcare insurance” or even “healthcare” are mandated by the federal government. The words simply do not exist…but I’m certain you’ll intuit and/or interpret your mandate.
Third – there is no need to even discuss a ‘third’ rebuttal point. The first two are enough to prove your view of ‘healthcare’, insurance or otherwise, to be a matter of the State. As such, you agree wholeheartedly with the Ds in the specific and statist positions in general.
By the way, also from your comment #22, “Malpractice insurance accounts for less than 15% of operating expenses for doctors and less than 10% for hospitals.”…I call BS. My uncle retired from private practice because his malpractice insurance went from $250k/yr to $750k/yr in ONE YEAR.
phycon,
No, not so much. Unless you think that insurance companies are a part of the ‘left’. In May 2008 the CEO of Aetna (Ron Williams) stated “Today we all pay for the uninsured”.
http://www.aetna.com/news/coverage/FORTUNE_E_Print.pdf
I’m sorry, but the idea that you know more about what is behind the rise of insurance costs, than the CEO of one of the largest insurance companies is absurd (unless you have similar experience).
Also your suggestion that access to uncompensated emergency room care is akin to having access to actual health care is laughable. Since uncompensated care is paid for by everyone else, does it make sense to spend tens of thousands of dollars on emergency room care, instead of a few hundred dollars a month for primary care?
Additionally, your final comment about malpractice insurance was a complete red herring. I was stating averages. There are exceptions to every rule. BTW, why didn’t you state what your ‘uncle’ or his former practice made in one year? Without that information your counter argument is worthless.
On the issue of personal liberty, I’ve stated several times that if you don’t want to have universal coverage, then universal ER access must end. If you don’t want to pay for someone else’s health care, then there can’t be any exceptions. Otherwise you end up paying for it anyway. And it’s much more expensive to pay for ER care than for universal coverage. And if you really want the government out of health care shouldn’t that include Medicare/Medicaid, FEHB, Tricare, and the VA? If not, isn’t your position completely disingenuous?
On your comments about the DEMs, you’re once again pulling at stawmen. As my handle suggests, I’m an independent. I don’t support the DEMs in general. And I am specifically against any kind of public option. My solutions (that I’ve stated in several articles) are simple:
1)universal coverage
2)universal competition
3)allowing the government to negotiate for it’s medical purchases
Finally, I’ve noticed that you and cw dodged my question about American business history. It’s a very relevant question. Can you name any instance in modern American business history when 15% (or more) of the population has been able to basically steal from that industry and those costs were not passed on all other consumers? If you’re not going to answer my questions, don’t bother responding.
I notice that PhyCon has been doing what he does best, explaining things in minute detail. In fact, he’s completely stolen my thunder, so I can only say, consider his replies as mine.
Why should I respond to your question? You did not initially ask it of me. Furthermore, my response was specifically about CW’s contention you are parroting lefty talking points. I proved you are via your own words.
Your claim of ‘strawman’ to the little anecdote about my uncle is blatantly disingenuous. Let’s say I accept your claim in #22: “Malpractice insurance accounts for less than 15% of operating expenses for doctors and less than 10% for hospitals. For example, the average salary for a US doctor is about $150K per year; that doctor will pay on average $18K in malpractice insurance. Do the math (it’s 12%).” If I accept that then some reverse math is in order: $250k/12% = $2.0833333 M/yr. The very next year his malpractice insurance jumps 200% to 750k/yr. Presuming his income did not increase the same amount then that 750k/yr is obviously much great than 12% of operating expenses…say around 36%…gee, a that would be a 200% increase in malpractice insurance expenses, imagine that. Of course your protest IS a red herring itself because you are lumping ALL physicians into one pot…those whose malpractice insurance is paid for by corporations, non-profit hospitals, and other arenas instead of the physician himself. Stats are wonderful things…they can be tortured to say whatever one wants to hear…eventually.
Again, allow me to accept your statement and that of Aetna’s CEO, “Today we all pay for the uninsured”. How is forcing everyone in the US to buy health insurance going to drop the cost of healthcare itself? All it will do is force people to buy it or have it subsidized by everyone else (gee, nothing like forcing me to pay more because someone else doesn’t ‘have the means’). You conflate, again, “Healthcare” and “Healthcare Insurance”. They are NOT THE SAME THING.
As for this paragraph:
“Also your suggestion that access to uncompensated emergency room care is akin to having access to actual health care is laughable. Since uncompensated care is paid for by everyone else, does it make sense to spend tens of thousands of dollars on emergency room care, instead of a few hundred dollars a month for primary care?” – You really don’t get it, do you? This argument that “forcing people to buy healthcare insurance” does not equate to healthcare. The fact people utilize ERs, whether insured or not, for “…primary care.” is a choice. Having healthcare insurance is a matter of personal responsibility and not one that should be mandated by government.
Laughable? No. Only your response is laughable. Nowhere did I say ‘ER care is the same as having a primary physician’. What I said was that access to healthcare is universal. The fact is NO ONE can be denied healthcare at an ER. Personal responsibility dictates one should ‘take care of themselves’ and one of the easiest ways to do that with respect to medical is to have a primary care physician. You want the government to mandate personal responsibility in the area of healthcare insurance but you then destroy the freedom of individuals to choose by forcing them. Sorry, Mr. Independant, but I don’t buy your argument.
You are, of course, missing the truth about what hospitals and doctors do with their bills though. Every healthcare provider I’ve ever dealt with (my uncle included) billed me for services rendered. They usually expected payment on the date of service UNLESS one has insurance. Then they, as a matter of courtesy (so noted in almost every ‘payment terms info I’ve read’), bill my insurance. Usually they wait for the insurance company to pony up for the amount they cover. Either way, I’ve had to pay the co-pay at the very least. The only time a healthcare provider ‘writes it off’ (hence, makes the rest of society pay) is when they are convinced they will never get anything from the person who is responsible for the bill. Healthcare providers of all stripes generally use every tool available to them to collect including collection agencies and law suits.
“On the issue of personal liberty, I’ve stated several times that if you don’t want to have universal coverage, then universal ER access must end. If you don’t want to pay for someone else’s health care, then there can’t be any exceptions. Otherwise you end up paying for it anyway. And it’s much more expensive to pay for ER care than for universal coverage. And if you really want the government out of health care shouldn’t that include Medicare/Medicaid, FEHB, Tricare, and the VA? If not, isn’t your position completely disingenuous?”
False Choice Alert!!! “Universal coverage” = universal insurance, “universal ER access” = universal healthcare. Please, notice they are different this time. Personal liberty is defined by the individual being free to choose for themselves what they are going to do. It is choice to go to an ER, buy insurance, have and utilize a primary care physician, or to sit and do nothing. I’ll even agree with you that “And it’s much more expensive to pay for ER care than for universal coverage”. Still doesn’t make a bit of difference when one realizes simply buying insurance will always be cheaper than care provided in an ER.
I’m further irritated by the repetition: “If you don’t want to pay for someone else’s health care, then there can’t be any exceptions. Otherwise you end up paying for it anyway.” You’ve stated several times “(and those you can’t afford it can have it provided to them by the taxpayers)”. Either way, you are forcing people to pay for those who can’t/won’t buy healthcare insurance.
As for items such as Tricare and the VA, those that use those programs EARNED them by serving the nation. I’d not have any problem with dismissing the others as unconstitutional government involvement.
“On your comments about the DEMs, you’re once again pulling at stawmen. As my handle suggests, I’m an independent. I don’t support the DEMs in general. And I am specifically against any kind of public option. My solutions (that I’ve stated in several articles) are simple:
1)universal coverage
2)universal competition
3)allowing the government to negotiate for it’s medical purchases”
No, you don’t “totally” support them. I submit that your “universal coverage” is a huge stepping stone to that which you don’t support: single-payer. I’m all for “universal competition” so I completely agree with you. Let’s repeal the laws that don’t allow healthcare insurance companies to compete across state lines, state mandates that force those companies to set up minimum coverage packages, remove regulation that destroys competition, etc. As for your point 3, I also agree there as well…though not with the fervor you appear to have. The VA and Tricare are based upon service to the country. The VA specifically employs medical professionals and provides facilities. We all pay for that through taxation, rightfully IMHO. I think you should remove point 1 from your list and replace it with Tort Reform.
Now to your question: Yes. The alcohol industry during the prohibition years. Thanks papa Joe Kennedy!
Just so you know, Mr. Independant – I am a Conservative and have been registered as an Independent since approximately 1992. I think both major parties are generally full of crap…though the GOP tends to be much less odious about their stench.
@45. Mr. Independant: – …your entire response to my last post was nu huh.
It only seems that way to you. Quite the contrary. Your entire ‘performance’ here has been one of spewing nonsensical B.S. and telling other people to prove you wrong. My response was crystal clear: your idiotic idea – that rising costs are caused by the so-called “uninsured” – has no basis in fact.
- …health care industry is not a multi-billion dollar industry; it comprises over 2 trillion dollars annually.
That would be multi-billions, wouldn’t it, d!psh!t.
- … hospitals are required by law to provide care in their emergency rooms.
GO LOOK UP THE STATUTES, MORON. Per EMTALA, which is the controlling law, the only requirements in an ER are that ER personnel provide an examination and – if and ONLY if an emergency condition exists – stabilizing, critical care or transfer to another facility. You can NOT go to an ER and just claim you have an emergency so you can get ‘free’ surgery just because you don’t want to pay for insurance and don’t want to pay for care elsewhere. You haven’t the slightest clue what you’re talking about.
- If someone with diabetes has to have a 50K amputation surgery, they get it.
Wrong. Surgery would only be required if there was no other way to stabilize the patient. The ER is not obligated to perform surgery, per se. And if you think the few operations that ARE performed under these circumstances are the bulk of what’s causing THIS SKYROCKETING INCREASE in medical costs, again, you’re absolutely delusional – aside from having, again, produced not the slightest bit of evidence to support this baseless contention.
- … you completely dodged my question about Japan’s health care system.
I didn’t dodge your question. I demonstrated that your question was asinine. WE DO NOT LIVE IN JAPAN. WE DO NOT LIVE UNDER JAPAN’S FORM OF GOVERNMENT. Therefore, your simpleton comparison is invalid. Same goes for Europe or any other country where the State can dictate health care prices as a function of socialized medicine.
- … Medicare actually proves that it can work.
Okay, you just proved you’re certifiably insane. Or totally ignorant. You pick.
Medicare does NOT work. Not by a long shot. Their reimbursement rate is so low and their claim rejection rate so high that health care providers are dropping them on a daily basis.
On top of that, each year the bankrupt Medicare system steals more money from the Treasury’s general fund because it is not self-sustaining. ALL the money paid into the Medicare system by those not currently receiving Medicare benefits (like me, and you if you’re not retired) combined with ALL the money paid into the Medicare system by its members DOES NOT COVER the costs of Medicare’s mediocre reimbursements.
You’re probably also completely ignorant of the fact that Medicare is NOT a comprehensive insurance. There’s a boatload of stuff that isn’t covered. ALL seniors must purchase additional supplemental policies to pay for the things Medicare doesn’t cover or pay for those things out-of-pocket.
You’re undoubtedly going to tell me that seniors can just opt out of Medicare if they don’t like it. WRONG. On top of everything else, Medicare extorts premiums from seniors by denying their Social Security benefits if they opt out of Part A. That’s right – if you want to purchase your own private insurance instead of stealing more money from the Taxpayers every year, you LOSE your Social Security benefits.
In two years’ time, the only way Medicare will stay in operation is through increased annual deficit spending (e.g., borrowing money from China). If you had the slightest clue what you were talking about here, you’d be aware of some of these things.
- Simply require the federal government to purchase medical services at the same rate as private insurers.
You’re either not paying attention or you’re just not willing to let go of your brainwashing. You can’t “require” the federal government to do anything. Medicare is ALREADY BANKRUPT NOW, you fool. How do you think they could afford to operate if they paid higher, ‘competitive’ rates and stopped rejecting claims at such an egregious rate?? See above.
And – more importantly – if we’re trying to SAVE money, why on earth would you push the government to increase its reimbursement rate instead of working to BRING HEALTH CARE COSTS BACK DOWN TO AFFORDABLE LEVELS by fixing the broken market??!?! Your statements make absolutely no sense whatsoever.
- your belief about the uninsured not being responsible for the majority of health care inflation was not supported by any sources.
You have this backward, chump. You have to actually produce some evidence that shows how health care cost increases are caused by the so-called “uninsured”, as you claim. You haven’t.
- You didn’t answer that question BTW.
Yes, I did. Again, you haven’t produced ANY evidence that 45 million people are stealing anything. Your question is thus based on a False Premise.
- Finally, I noticed that you have repeatedly asked for sources of information but have not provided any of your own.
Sure I did. You were just afraid to follow the links. Neither of your “sources” provides evidence to back up your idiotic assertion about the “uninsured”.
Now, run along and find someone to teach you how to spell ‘independent’.
You are right on the money with regards to Medicare fraud. It is incredible how much this is costing us. A resource that explains ways that Medicare fraud is being committed and provides tips on how Medicare recipients can prevent Medicare fraud from happening to them can be found at http://www.planprescriber.com/Medicare/newsletter-nov2009-medicarefraud.html.
phycon,
You should answer the question because that is how intelligent debate is conducted. Have I dodged any of your questions? I don’t think so, but in the unlikely event that I have, I’ll answer them. If you’re not going to, this dialogue seems pointless. Unless you’re not interested in intelligent debate but only repeating campaign slogans. Now on to your last post.
My claim of your straw man argument about your ‘uncle’ is completely valid. Your story about your ‘uncle’s’ MI costs have to be taken in the context of how much he or his firm makes. You didn’t supply that information. So your counter argument in that regard is completely disingenuous. Furthermore, your argument is also completely worthless. As I stated in a previous post, I was discussing averages. You were attempting to dispute my position by the use on a single instance. Ask yourself; do pharmaceutical companies test new drugs on just one patient? No they don’t, they use averages.
In answer to your question: “How is forcing everyone in the US to buy health insurance going to drop the cost of healthcare itself”, health care costs will lower by using primary care to prevent much of the emergency care that is required for minor diseases (like diabetes) during most of a persons work like. So instead of spending 50K to amputate a diabetics arm in an ER, only a few hundred dollars a month will need to be spent for health insurance. An excellent comparison of this situation can be found in the immigration debate. Do you really think you can have immigration reform without securing our borders? Of course not. Likewise, you can’t have health care reform without dealing with the uninsured.
On your next point about personal responsibility, I agree. By extension, that should include ending universal access to ER care. You’re paying for that. BTW, providing that expense is much more expensive than providing universal health insurance.
On your next point about medical bill collections, your counter argument is absurd. What you describe is what exists today. It isn’t working. Use some common sense. If someone can’t afford a few hundred dollars a month to buy health insurance do you really think they have the income or assets to pay for 50K ER bill?
On your next comment about a “false choice alert”, you actually make my point for me. Yes if someone chooses not to buy insurance and you don’t want to subsidize them, that’s fine. But by the same token, if someone chooses to not buy health insurance then they should not be able to force you to pay for their ER bills.
Your next comment is actually correct. The point I’ve been making all along is that if I’m going to be forced to pay for someone else’s health care, I want it to be for a little as possible. You have agreed with me that it’s more expensive to force you to pay for the uninsured ER bills, why isn’t that the end of the argument? That is, unless you want to end universal access to ER care.
On Tricare and the VA, I agree but shouldn’t that also include FEHB? And Medicare recipients have paid for those benefits, so why shouldn’t they receive those benefits.
On you conclusions about my solutions for health care reform, I’m pleased to see that we are in agree on two of those three. However, I think that tort reform is just a red herring. Malpractice insurance cost a smaller percentage for medical professionals than I pay for workmen’s comp.
Finally, your comment about prohibition doesn’t make any sense. How were the consumers of booze stealing from that industry and those cost not being passed on to the consumers?
goy,
Well, I see your only response to my last post is still ‘nu huh’. So let’s go through your last post in more detail. After all it is very amusing.
You stated in post #44 that the US health care industry is a “multi-billion dollar health care market”. When in fact, the US health care industry is over a 2 trillion dollar industry. There are 2,000 units of 1 billion in 2 trillion. I only pointed that out in my last post,to demonstrate that you don’t know what you’re writing about.
On emergency room care, yes I understand what hospitals are required to provide. What you don’t seem to understand is how expensive that care is. An amputation can very well be necessary to stabilize a patient. Another example is someone with cancer who would die unless they had a 100K transplant surgery. No, an ER is not required to provide that. But if that same patient cannot live outside of an ICU; then guess what, the hospital must provide that.
On Japan, my comparison is very appropriate. It’s a capitalist country (the 2nd largest in the world BTW). With one strange exception (transplants), Japan has access to the best medical technology in the world. They also have the best outcome in the world. Japan has the lowest infant mortality and the highest longevity (all this despite the fact that 1/3 of them smoke). http://www.who.int/whosis/whostat/2009/en/index.html
Sorry, there is no justification for you to dodge this question. Especially since it undermines your position on costs.
On my comment about Medicare reimbursement, it was made in the context that not all or even most providers are dropping Medicare patients. If a particular company doesn’t want to accept the fees that the taxpayers are willing to pay, that’s their right. By the same token, the government has a responsibility to save the taxpayers as much money as possible. They can do that by negotiating for discounts just like private insurance companies do. They are prohibited by law from doing that now.
http://www.cms.hhs.gov/MMAUpdate/downloads/hr1.pdf
Yes I’m aware that Medicare is not comprehensive and that they can lose their SS benefits if they withdraw from Medicare. I think that should change. There’s no disagreement there, so why mention it. It sounds like just another one of your red herrings.
Yes I’m also aware that Medicare is going bankrupt which is why the taxpayers thru the federal government must be allowed to negotiate for prices. Healthcare Alliance, Healthnet, and Humana are all allowed to negotiate for their medical purchases, why shouldn’t the government? The companies I listed above are not going bankrupt; neither is Aetna, BlueCross, or Celtc. Those are three of the largest health insurance companies in the country. They are not required by law to overpay for their medical purchases, why should the taxpayer? The government purchases between 45% – 50% of all medical products and services BTW. But even with that step, health care costs will continue to rise ahead of revenue if health care reform doesn’t take place.
In previous posts, I provided a link to an interview with the CEO of Aetna (Ron Williams). Mr. Williams states (on several occasions) positions that directly support my argument that the uninsured are responsible for health care inflation.
http://www.aetna.com/news/coverage/FORTUNE_E_Print.pdf
Are you honestly going to try and claim that you know more about the costs of health care than the CEO of one of the largest health insurance companies in the country?
Additionally, if you read my previous posts you’ll notice that I have included links to credible sources that support my claims. You on the other hand have posted links that are mostly to your blog. Those are not credible sources.
Also, you (and others) have failed to answer my basic question about the costs of the uninsured; can you name any instance in modern American business history when 15% of the population were able to basically steal from that industry and those costs weren’t passed on to all other consumers? If you could name several instances where that has occurred, who might be able to undermine my position (which is also the position of advocacy groups, the government, and the industry itself) that the uninsured are the primary reason for health care inflation. But you (and others) can’t even name one.
Furthermore, I know how independent is spelt. I used the word in post #47 but that’s not my handle. It’s Mr. Independant.
Finally, I must say this has been one of the most entertaining ‘dialogues’ I’ve ever had on this website. I mean seriously, you are hilarious. You really are the joke that keeps on giving. It’s not just that your main response to almost everything in “nu huh”, or that your ‘sources’ of information are mainly your own blog, but the best part is your statement “There’s no data to support this idiotic idea. And even if there were, it wouldn’t matter”. It’s not just that you don’t know what you don’t know but you think it doesn’t matter that you don’t know.
@54. Mr. Independant: – i see your only response to my last post is still ‘nu huh’.
That’s what you WANT to see, chump. As with your responses to the others here, you seem to think you’re in some sort of pissing contest where all you have to do is disregard what’s been written and invent your own version to respond to. This is what’s known on the left as “intelligent debate”.
- You stated in post #44 that the US health care industry is a “multi-billion dollar health care market”.
And it is, as you’ve clearly pointed out. Not sure why you seem to think trillions are not multi-billions, but everything else you’ve written has been just as stupid, so it’s really no surprise.
- On emergency room care, yes I understand what hospitals are required to provide.
Obviously you don’t. Go read the statute. Nowhere in it does it require that ER personnel provide services free of charge for whomever walks in the door. So until you provide some actual data to back up your insipid little contention, you’re just spewing obvious nonsense.
- On Japan, my comparison is very appropriate.
Your comparison is bullsh!t. We don’t live in Japan. We don’t have Japan’s cultural factors. Our Constitution is not the same as Japan’s. Our federal government does not have the same authority as Japan’s. Our health care is not socialized like Japan’s. Thus, your comparison is stupid, just like everything else you’ve written.
- On my comment about Medicare reimbursement, it was made in the context that not all or even most providers are dropping Medicare patients.
Is this the best backpedaling you can come up with?? How predictably lame.
You use Medicare as an example to prove that so-called “universal coverage” will “work”. NOTHING could be further from the truth. Medicare is BANKRUPT. The FACT is that more providers are dropping Medicare every month. Whether it’s a majority – yet – is completely irrelevant. And on top of THAT irrelevance, you were obviously completely unaware of all the other issues with Medicare until I pointed them out to you or you wouldn’t have made such an idiotic statement (well…). Here’s another point you won’t be able to resolve: nowhere in the U.S. Constitution is the federal government given the authority to run a health care insurance company with the Taxpayers’ money. The fact that they’ve gotten away with it so far is, again, irrelevant. Medicare needs to be dismantled and privatized. The federal government needs to get OUT of the business of running an insurance Ponzi scam, not increasing it’s size.
- Yes I’m aware that Medicare is not comprehensive and that they can lose their SS benefits if they withdraw from Medicare. I think that should change. There’s no disagreement there, so why mention it. It sounds like just another one of your red herrings.
See, here’s where you go COMPLETELY off the rails and destroy your own ‘argument’. MEDICARE IS BANKRUPT. It survives solely through theft of Taxpayers’ money, extortion and maintaining the WORST claims rejection rate of any insurer. Soon, on top of all that it will require additional deficit spending – more each year – to survive. Yet YOU – in your infinite stupidity – use Medicare as an example of why so-called “universal coverage” will “work”.
That makes you an idiot, chump.
- Healthcare Alliance, Healthnet, and Humana are all allowed to negotiate for their medical purchases, why shouldn’t the government?
Because, you moron, those companies are all private businesses operating in a market where they are free to negotiate any terms they like within the constraints of the law. And people are free to take their business wherever they like in return. That’s what a free market economy is all about. The reason the government shouldn’t – and the primary reason it’s not Constitutionally authorized to play this game – is that the government is free to change the law to it’s own benefit whenever it likes, and once insurance is nationalized through socialized medicine, people will no longer have the option to go to a different insurer. They’ll be forced to pay through the nose for whatever the government gives them, at the point of a gun. Again, Medicare is the perfect example here. The government will NEVER let Social Security recipients opt out of Medicare – especially at the rate providers are dropping support for it – because it’s ALREADY BANKRUPT. With the unprecedented level of debt this administration has piled onto the backs of the American Taxpayer, pulling any more funds from that broken, ill-conceived program will make it that much more obvious how stupid it is.
- In previous posts, I provided a link to an interview with the CEO of Aetna (Ron Williams). Mr. Williams states (on several occasions) positions that directly support my argument…
Williams’ statement of opinion doesn’t support squat. When he produces some facts to back up his statement, someone might take him seriously. Stop blindly parroting talking points and think for a change. This guy is making millions, literally, by running a business that inherently drives up the cost of health care. Of COURSE he’s going to prescribe more widespread “coverage”, you dolt.
- … I have included links to credible sources that support my claims.
Nothing in either of those sources supports your idiotic assertion. In fact it’s clear you never even bothered to read and/or comprehend them, because the first one completely disproves your claim. If you check the Uninsured Rate from 1987 to 2008 (which is graphed in that first document) you’ll see that it hardly changes at all over that entire 20-year period. Yet the rate of increase in cost of health care has literally skyrocketed at multiple times that of inflation throughout that entire period. That rate of increase in cost is what’s causing the problem, not the relatively few uninsured whose health care ends up being covered by someone else.
- Also, you (and others) have failed to answer my basic question about the costs of the uninsured;
YOU HAVE NEVER PRODUCED ANY DATA supporting your stupid notion. Why on earth should anyone answer your question, chump? Stop repeating your idiotic talking points for five minutes, turn your brain back on and think about it.
Nicely done, Mr. Indepenant. You came just short of calling me a liar outright. Also, nice bit of disrespect by never using my correct handle: “PhyCon”. I doubt you ever wanted intellectual debate since you remain obstinate to recognizing the main fallacy of your statements:
Healthcare Insurance IS NOT Healthcare
You state: “…health care costs will lower by using primary care to prevent much of the emergency care that is required for minor diseases…” and later “providing that expense (universal ER access) is much more expensive than providing universal health insurance”. (You sure your aren’t parroting lefty talking points? TOTO liked that same claim about “$50k amputations”.)
No. By “providing universal health insurance” you are doing two things: #1) taking money out of my pocket to provide such insurance to those who can’t/won’t buy it for themselves and #2) expanding the base of the insured who will then utilize the medical system.
#1) Above is the exact same thing as “universal ER access” and means you are still taking money out of ‘my pocket’. No differnce except now those ‘without insurance now’ will have it and #2) applies.
While #2) sounds like a good idea, please note this: Your Titanic
(in case the link dies: http://www.american.com/archive/2010/january/the-high-cost-of-no-price)
With that, your case is moot.
@56. PhyCon: – Your Titanic
Excellent point. One of several that demonstrates how the “universal coverage” notion is fatally flawed.
From Medicare to HMOs to comp. insurance subsidies, every action pushed by the socialists in government has been aimed at nurturing the entitlement mindset by shifting the burden of health care costs from the individual onto the collective. Dr. Drew Foy and I have discussed the topic at length. After the article I wrote last September (which Thomas Lifson deemed too long for American Thinker, and he was probably right), Drew wrote this one, which discusses the issue in depth. The bottom line is that it’s an economic problem, not a civic one, which means there’s no chance the government can ever resolve it.
As with most things the government has no authority to legislate, there is no solving the health care issue without making individuals more directly responsible for and involved in understanding the cost of their health care. Group comprehensive policies do just the opposite, which is why the government has been pushing them so hard for so long.
Basic economics is simply too difficult for the contemporary left, I’m afraid. People like “Mr. I’m A Pedant” refuse to understand this. Just like they shield their eyes from the evidence showing how FDR’s largely unconstitutional socialist programs extended the Great Depression for almost a decade. Just like they ignore similar evidence showing how Japan’s ‘Lost Decade’ resulted from the same Keynesian nonsense. Just like they ignore similar evidence from the Carter era. Here we are, watching the left repeat all those same mistakes once more – more arrogantly and with more money.
PhyCon,
Thank you for the compliment at the beginning of you last post. And just for the record, you’ll notice a recurring theme with my posts; I don’t engage in personal attacks. I wasn’t deliberately miss capitalizing your handle, it just isn’t that important for me to get it right. But since, it bothers you that much, I’ll fix it. OK?
Now on calling you a liar, I’ve asked you several times what was the gross income of your ‘uncle’ or his firm. I’ve pointed out repeatedly that that information is important and they reasons why. You have refused to supply that information. Why? I do give you credit though: you only suggest ideas that are false but you don’t outwardly lie. BTW, you didn’t answer my follow up questions about averages.
Yes I understand that health insurance is not health care; but health insurance allows most people to afford health care by pooling risk. For example, an X-ray machine can cost 2 million dollars or more; do you think that the average person can afford to pay for the cost of using that machine all by him/herself? Of course not. This is why health insurance is key.
On your comment about my analysis concerning health insurance, it should be noticed that you agreed with that assessment in post #49. As I’ve pointed out in previous posts, that position is not just mine but it is also the position of the government and the industry itself. Additionally, your suggestion (which is once again not an outright lie but still a false suggestion) that my example of a limb amputation is not valid; is in fact supported by the following article: http://www.costhelper.com/cost/health/amputation.html
The source listed for that article is The Society for Vascular Surgery.
According to your own previous posts, the cost of providing universal health coverage is less expensive than paying for universal ER access for the uninsured. So contrary to your own statements, they are not the same. As I’ve pointed out several times, if you don’t want to pay for anyone else’s health care, why aren’t you advocating the elimination of universal ER access? I appreciate that this is a libertarian leaning website and if you believe in that philosophy, fine. But you’re being very disingenuous by not wanting to pay for universal health insurance (which even you have admitted is less expensive than the status quo) and at the same time not being against universal ER access.
On your final comment about out-of-pocket expenses, you might want to re-read (or if you just looked at the graph, you should actually read) that article.
That article:
http://www.american.com/archive/2010/january/the-high-cost-of-no-price
actually supports my position. It stated in part “Economists have shown that if a good’s price is zero or decreasing, then the demand for this good will likely increase”. The uninsured do not pay for their very expensive ER care. Hence, their use of ER care that they do not have to pay for increases the cost of that product/service. Just as a suggestion; when you try to use a red herring, you should make sure that it doesn’t support your opponent’s position.
Finally, as you noticed I’ve stated a way for you and others to disprove my position. I do that because intelligent debate (like science) is based on an inability is disprove a theory. If you (or others) were able to cite specific instances in modern American business history, when 15% of consumers were able to steal from a particular industry and those costs were not passed on to all other consumers, you could (depending on how many instances you could cite are that industries’ portion of the economy) disprove my position on the uninsured. But you haven’t, not even once. You tried one of your typical red herrings by referring to prohibition but that didn’t make any sense. I’m basing my position on stats and credible sources (one of which you provided) and I’ve even told you specifically how you could disprove it. Could the reason that you can’t be that because you’re wrong? I think so.
goy,
Actually no, ‘nu huh’ is in effect what you’ve been writing.
I continue to point out your ignorance about the health care industry by illustrating your comment about the size of health care industry. Do you know anyone who refers to 2 trillion dollars as multi-billions? You don’t know what you’re writing about. You can do all the back peddling you want but you can’t change what you wrote.
On ER care, once again you’re wrong. The EMTALA reads in part that an ER must conduct an medical screening to determine if the patient is in fact in an emergency medical situation [section (1) subsection (a)] and that the ER must stabilize the patient [section (1) subsection (b)]. They must provide that care, regardless of a patient’s ability to pay [section (2) subsection (b). ER’s have to treat emergencies. Those are expensive and when those costs are not paid for they are passed onto everyone else and the overall cost of health care rises. Another poster tried to throw a red herring in his response to this position and produced and article which actually supports my position.
http://www.american.com/archive/2010/january/the-high-cost-of-no-price
It reads in part: ”Economists have shown that if a good’s price is zero or decreasing, then the demand for this good will likely increase”. Sorry you’re wrong again.
On Japan, you are not surprisingly wrong again. Japan’s health care supports my position on the need for universal health coverage. You also illustrated that once again that you don’t know what you’re writing about. Japan’s health care system is not “socialized”. But even if you could call Japan’s health care system “socialized” our health care system is even more so. What you don’t understand is that in Japan almost everyone not in retirement is required to have PRIVATE health insurance. Their public health insurance covers retirees and the indigent. In the US, public health insurance covers retirees, indigent, and government employees. So to summarize, you’re wrong to dodge to comparison with Japan and you don’t know what you’re writing about concerning Japan’s health care system.
On Medicare payments, I wasn’t back peddling on anything. I stated in post #45 “If a certain provider or supplier doesn’t want to pay the government rate, then the government can take its contracts elsewhere”. This is common sense, yes some providers don’t want to pay the rate that Medicare is offering, in that case Medicare should just take the taxpayers business elsewhere. If you had cited credible evidence that all or at least most providers were dropping Medicare patients, you might have a point but you didn’t, you named one Mayo Clinic.
Furthermore I did not cite Medicare as an example of how universal coverage could work; I cited it as a rebuttal that your position on reimbursements will force (most or all) providers to drop Medicare patients. There are some that are but not most. The example that you gave was of one Clinic.
On your response to my question about Healthcare Alliance, Healthnet, and Humana, you have unknowingly undermined your position and just supported mine. I selected those companies specifically because they are the contractors for the US Military health care system Tricare. Now if the slippery slope that you describe hasn’t occurred because of Tricare what makes you think that it will happen with Medicare?
On the interview with the CEO of Aetna, I find your response further proof that you don’t just know what you don’t know but you think it’s not important that you don’t know what you don’t know. As the CEO of one of the largest health insurance companies in the country, he is in one of the best positions to know what costs are affecting his companies’ bottom line. Additionally, you seem to have changed your position on what is driving up health care costs. So now it’s not the government but insurance companies?
On one my supporting sources does in fact support my position. The problem that you seem to be having is that you are not reading that report but are only looking at the pictures (like the graphs).
http://www.census.gov/prod/2009pubs/p60-236.pdf
If you had looked a little closer (or actually read the report) you would have noticed that the number of uninsured has risen from over 30 million in 1987 to over 46 million in 2008. I’m sorry but your math is wrong. More importantly as those without health insurance age their trips to ERs become more expensive.
Also, as I’ve pointed out to other posters there is a way to disprove my position: if you (or others) were able to cite specific instances in modern American business history, when 15% of consumers were able to steal from a particular industry and those costs were not passed on to all other consumers, you could (depending on how many instances you could cite and that industries’ portion of the economy) disprove my position on the uninsured. However, you and others have been unable to do so.
Finally, as I stated in a previous post, this exchange has been hilarious. Your positions don’t make sense, you contradict yourself, and most of your ‘sources’ are links to your own blog. Comedy really is the gift that keeps on giving. And you have given me so many laughs that I can’t thank you enough.
@58. Mr. Independant: – …I’ve stated a way for you and others to disprove my position. I do that because intelligent debate (like science) is based on an inability is disprove a theory.
Aside from the fact that your grammar sucks, this is typical adolescent leftist drivel: make an assertion and tell others to prove you wrong. Sorry, you get an F in Logic 101 because you never presented any evidence IN SUPPORT of your theory in the first place. You don’t have the first clue what ‘intelligent debate’ is, chump.
The information in the resources you’ve cited merely suggests, based on estimates and computer modeling, that there are N uninsured individuals in America. That’s it. Even if we ignore the shoddy methodologies used to estimate those numbers, what you don’t seem to understand is this: the details regarding those individuals’ health care consumption over the past 40 years is not addressed in any of the sources you keep linking to. As such, no one needs to expend any effort whatsoever to ‘disprove’ your idiotic theory. You don’t have any evidence to support it in the first place.
You haven’t presented any evidence to support the notion that “uninsured” individuals – who have comprised a relatively constant rate going back two decades, according to YOUR source – have been ramping up their consumption of “free” health care almost exponentially for the last few decades.
You haven’t presented any evidence whatsoever to support the idiotic notion that 15% of consumers are “stealing” anything. You have YET to produce a shred of evidence that 15% of consumers are getting “free” health care simply by virtue of being “uninsured”. And to top it off, what’s most laughable is that your remedy for this mythical problem you’ve invented is to have EVERYONE’s health care covered at taxpayers’ expense.
Your problem is that you don’t have the slightest understanding of economics OR the proper use of insurance. Insurance is a tool for mitigating financial risk. It is NOT well-suited to be used as a pooling mechanism to redistribute the cost of routine commodities, as is currently done with health care. That misguided practice has removed all downward pressure on health care prices and actually encouraged the cost of health care to rise constantly for decades. This is easy to understand IF you have the slightest clue how commodity economics works. You obviously don’t.
@59. Mr. Independant:- ‘nu huh’ is in effect what you’ve been writing.
I have yet to write anything remotely resembling “nu huh”. You’re forced into this fantasy because all you can do is keep copying and pasting the same talking points over and over. You don’t have an actual argument to present.
- EMTALA reads in part that an ER must conduct an medical screening to determine if the patient is in fact in an emergency medical situation
That’s exactly what I wrote up above, you flaming nitwit: “the only requirements in an ER are that ER personnel provide an examination and – if and ONLY if an emergency condition exists – stabilizing, critical care or transfer to another facility”. You desperately need to take a reading comprehension course.
Unless there’s an actual emergency, as defined in the statute, the only thing the ER is required to perform is a screening exam. That’s it. And a screening exam IS NOT HEALTH CARE.
You have YET to produce any reliable, verifiable data that show how much actual emergency care – in dollars and sense – is provided ‘free’ to people with no insurance; LET ALONE have you produced anything in this regard that demonstrates a causal relationship between that and the skyrocketing rate of health care cost increases. Until you do, your theory and your constant, repetitious yammering are bullsh!t.
- Japan’s health care supports my position…
That would only be true in a fantasy where we lived in Japan, under Japan’s laws, with Japan’s history, Japan’s cultural factors. In the real world, your comparison is, what’s the word… bullsh!t.
- I did not cite Medicare as an example of how universal coverage could work; I cited it as a rebuttal that your position on reimbursements will force (most or all) providers to drop Medicare patients.
Right. None of what you’re suggesting is related to anything else you’re suggesting. You’re pushing “universal coverage”, chump. You used Medicare to try to “prove” such a system can work (i.e., by negotiating contracts). As such, you didn’t ‘rebut’ anything. The newsflash you MISSED while you were brainlessly copying and pasting your idiotic talking points is that MEDICARE IS ALREADY BANKRUPT JUST PAYING OUT WHAT IT DOES NOW! It has already proved that you’re wrong: IT CAN’T COMPETE with private insurance companies you moron.
… if the slippery slope that you describe hasn’t occurred because of Tricare what makes you think that it will happen with Medicare?
You only tricked yourself, doofus. IT HAS ALREADY HAPPENED. MEDICARE IS BANKRUPT. As any sort of model for any facet of so-called “universal coverage”, it is PROOF that it can’t work. So again, you just demonstrated that you’re an idiot.
- you seem to have changed your position on what is driving up health care costs. So now it’s not the government but insurance companies?
Again – reading comprehension. Get some. In a number of my posts I’ve provided the link to my extensive analysis of this problem. You’ve clearly decided it wasn’t worth your time to read it, yet you thought it was okay to post your nonsensical drivel on my site. The problem is insurance companies AND government.
- the number of uninsured has risen from over 30 million in 1987 to over 46 million in 2008.
Over the course of twenty-one years. During that time, because the U.S. population was also growing, the RATE of uninsured has remained relatively constant. Meanwhile, the rate of increase in the cost of health care has been steadily rising, to where the year-to-year rate of increase is now almost exponential. THERE IS NO CORRELATION (let alone, causality) between the rising cost of health care and the factor (the rate of so-called “uninsured”) you’ve been brainwashed into believing is the cause. And the facts are clearly indicated in the graphs AND the text, you juvenile smartass. If you’re unable to understand basic math and comprehend the information in your own sources, no one can help you.
Also, as I’ve pointed out to other posters there is a way to disprove my position:
Geez, you make a bag of hammers look intelligent. Here’s the thing: no one needs to “disprove” your position, chump. You’ve never presented sufficient evidence to support your position in the first place, as I clearly outlined up above.
You have spouted generalities and I have given you specifics.
As to how much my uncle made as a physician? I have no bloody idea…he never told me that. I was in the room when he opened his new MI bill though.
Averages – sure, drug companies use averages…and then their test studies report how many incidences there were of X, Y, and Z…versus palcebo controlled population…etc. All of that info gets rolled into their “potential side effects” statement if/when a drugs gets approved/marketed. So ONE instance of a test patient having an upset stomach means that gets lumped into that report/notice. Try reading a double-blinded Stage 2 or 3 drug test someday from start to finish.
Quite bluntly, you have misread my “agreement” because you STILL fail to recognize Insurance is not Care. My agreement was specifically on providing insurance being cheaper than providing care. Buy all the insurance you want…it’s the CARE that costs. Buy insurance though and people who’ve never really used the medical system will. Won’t matter how much insuance they’ve purchased since you have already shown they can’t even afford their co-pays. The result is MORE demand with LESS recompense for physicians. Which leads to FEWER physicians. Which leads to RATIONED CARE. Hell of a way to destroy an albeit imperfect but best in the world medical system.
I skimmed most of the rest of what you wrote after this, “I do give you credit though: you only suggest ideas that are false but you don’t outwardly lie.”
Goodbye Mr. I. You finally called me a liar. Sleep well in your self-convinced cocoon of correctness since apparently there is absolutely nothing that may convince you to change your mind. I hope to see you before the death panels take me.
goy,
The substance of almost all of your responses has in fact been ‘nu huh’.
On EMTALA, actually no you didn’t write what I did on the provisions of the law. No where in you previous posts are there any references to the specific sections and subsections. I think that’s because you haven’t actually read the legislation but just looked at the pictures on its website.
On emergency care, use a little common sense. Do you think that the uninsured are going to ERs just for fun? The uninsured are using ERs for the same reason as anybody else, emergencies.
On my comparison of Japan’s health care system, your refusal to address that issue with any response other than ‘that doesn’t count’ further undermines your position. It is not enough to just write that it doesn’t matter, you have to demonstrate why. But then, that would require you to actually research something other than your blog.
On Medicare, you are once again attempting to dodge my questions. Your last comment on the subject contradicted your own statement. I didn’t use Medicare to prove anything, except that you don’t know what you’re writing about. Specifically, you suggested that eventually all private providers will drop Medicare patients; that hasn’t happened.
On Tricare, you are also attempting to change the subject. Tricare is not going bankrupt.
On your so called analysis, the majority of your ‘sources’ is your own blog. Sorry, that’s not a credible source.
On the impact of the uninsured, what you don’t seem to understand, is that as the number of uninsured rise, so does their health costs. 1/4 of all health care costs are spent on the elderly. In case you didn’t know, over the course of the 21 year time frame that you cited, those uninsured have gotten older. So not only are there more uninsured, there are more elderly, and the problems for those people were exacerbated by their lack of primary health care.
On my sources, it’s absurd for you to complain about them when you haven’t read them (you apparently just look at the pictures) and you haven’t provided credible counter sources to dispute them. The majority of all of your ‘sources’ has been a link to your blog. That’s a joke. My sources on the other hand have included governmental and industry research and experts to support my claims. Additionally, I’ve even told you how you can disprove them. Contrary to what you’ve written, I have provided evidence to support my position. You’re failed logic and science 101. When you establish a theory that is supported by evidence you next task is to attempt to disprove it. In the field of health care, pharmaceutical companies use the double blind elimination method to determine if their products can work. That’s what I’ve been doing. Not only have you (and others) been able to disprove my position, you personally have just dodged the question.
Finally, I want to thank you again for your comments. You have been one of the funniest jokes I read about in a long time. You don’t understand basic economic concepts but you pretend you do. You don’t understand the issues that are being discussed but pretend you do. And you think that just because you’ve written something on your blog that it’s true but guess what, it’s not. If you want to have any chance of furthering your understanding on this subject (or anything), I would suggest a few things; work on your reading comprehension (so you’ll stop contradicting yourself), stop relying on pictures for your ‘information’ (try actually reading), and when you conduct research on a subject stop relying on your blog for sources. I hope to read your posts in the future; not because I think you have anything intelligent to offer but because you really are the joke that always seems to make me laugh.
Repeating yourself all you like Mr. I. Your drivel doesn’t get any more valid.
Sorry sport, you wore out your welcome. You parrot the same debunked, collectivist talking points over and over, ignoring history, reality, facts and the evidence. You insist on using juvenile, passive-aggressive, disingenuous misrepresentation of the responses that have been offered to you so that you can dismiss them out-of-hand. In short, you haven’t a clue what “intelligent debate” entails.
So pay attention and you may learn something. There won’t be a quiz. You won’t be graded. Your response, if you post one, won’t even be read.
When you contradict someone – like the author of this article – with an assertion like “[t]he ‘sins’ of insurance companies do indeed justify reform,” as you did in your initial post here, you need to back it up with something factual and rational. You never did. This baseless statement completely destroyed any credibility you might have had right from the start.
When you go on to make counter-assertions like “the main problem with our health care system is not the insurance companies but the uninsured” and “[i]t is the uninsured who are largely responsible for health care inflation,” without presenting even the slightest evidence to support them, you invite open ridicule. With all the impertinent blather you’ve posted in this thread you have YET to provide a single fact that would support this demonstrably absurd notion.
Like a trout distracted by a shiny lure, you’re fixated on the fact that the number of so-called “uninsured” has increased numerically according to “estimates” you’ve found – estimates generated by a broken, wholly unaccountable government that is overwhelmed at every level by ineptitude and politically correct groupthink. On top of this, you ignore the fact that the U.S. population has increased numerically at the same time (not to mention the massive influx of illegals). This trivial distraction you’re obsessing over is NOT evidence.
You have yet to provide a shred of evidence showing that any significant amount of ‘free’ services are provided to the so-called “uninsured” in the nation’s ERs. You have yet to demonstrate any causal relationship between ‘free’ services supposedly provided to the so-called “uninsured” in the nation’s ERs and skyrocketing rate of health care cost increases we’ve seen beginning in the ’70s. In fact, you have yet to even consider the likelihood that a significant portion of the so-called “uninsured” simply pay for their health care out-of-pocket via cash, loan or credit card. As PhyCon observes, your fixation is due to the fact that – like far too many people – you can’t understand the difference between health care and health care insurance. Coverage is not care.
Instead of providing any evidence – rather, blindly following instructions from your collectivist overlords – you fixate on the percentage that are supposedly “uninsured”. You base this percentage on dubious estimates and statistical computer programs written by the same government bureaucrats who gave you this risible nonsense. Then you mindlessly parrot the objectively false notion that ALL of the health care for ALL of those people is being paid for by others. To “support” this demagoguery you use Appeal to Authority fallacy, quoting a politicized statement by one insurance company CEO, whose obvious conflict of interest in this area completely escapes your overwhelming naivete.
Here’s a tip: your parroting behavior isn’t rational. It’s just gullibility. Persisting in it after all this has been pointed out to you reveals you to be a blithering idiot.
But you don’t stop there.
You go on to tout the Japanese health care system as superior to ours, pretending you live in a fantasy world where our two societies and cultures can be compared. They can’t.
To begin with, you’re obviously unclear on the difference between the terms socialized and nationalized, as Japanese health care is indeed socialized; the fact that some insurers are non-governmental entities and some health care facilities are not run by the State is irrelevant. All Japanese are required by law to buy into the comprehensive group insurance pool that pays for health care. All insurance companies are required by law to provide identical coverage – they can’t compete – and profit is prohibited. As such, those entities may as well be owned and operated by the State. All health care providers operate based on fees negotiated with or legislatively determined by the State. That is the very definition of socialism, and socialized medicine.
Japan’s stagnant economy may be ostensibly capitalist, but its health care sector is absolutely not, it is clearly socialist. The extent to which Japan’s health care and health care insurance industries are regulated would NOT be constitutional in the United States. On top of this, the Japanese system isn’t sustainable, based on current trends (see link above).
Other differentiating factors demonstrate the depth of your False Analogy.
- Japanese are nominally healthier than Americans due to their superior diet and lifestyle, which means their critical care needs are reduced as compared to Americans’.
- Japan’s GDP-per-capita (2008) is only about 70% of the U.S., i.e., they can’t afford to spend as much on health care.
- Japan has about 1/10th the frequency of ‘obesity’ we have in America. Despite the low incidence of this problem, compulsory obesity screening is mandated – something that would not be constitutional in the U.S.
- Japan has far less violent crime and far fewer vehicle accidents, reducing expensive critical care needs resulting from those factors.
- Japan has no tort problem when it comes to health care. Increased expenses due to ‘defensive medicine’ – which 98% of American doctors admit can arbitrarily inflate health care consumption – are virtually nonexistent.
So the crux of your problem is that Japan’s system isn’t compatible with a Republic based on our Constitution and comparison is not justified due to the other significant differences between our societies and cultures.
What’s more, based on current trends, it’s in no way clear that Japan’s system will remain intact as it currently stands. Thus, there is no compelling case to be made for adopting Japan’s policies, as opposed to simply fixing the broken health care market here in the U.S. Despite the fact that the Japanese government artificially clamps health care fees to about half what Americans pay (in simple dollars), the cost of providing ‘universal coverage’ helped drive Japan’s public debt-to-GDP ratio over 170% by 2008 (see the CIA World Factbook on this). It is second only to Zimbabwe in this regard. High public debt-to-GDP is a phenomenon observed in other countries with so-called “universal” coverage, including France, Germany and the UK. America’s public debt during that same time was a relatively low 37.5%.
That’s changing, of course, now that we have a socialist administration imposing marxist economic policies and driving our public debt through the roof as a result – all without providing anyone with improved health care.
Interestingly, Japan’s system provides ample evidence that comprehensive group coverage artificially increases consumption, just as one would expect, and just as the Rand Study found back in the ’70s and early ’80s. Without government price controls, like those imposed by the Japanese State, artificially increased consumption artificially increases price. This is a facet of basic economics you don’t seem to grasp. Meanwhile, if Rand is any indication, it’s clear that the reason the Japanese generally consume less expensive, less critical care is, again, due to a generally healthier lifestyle: Rand found that increased consumption of health care services didn’t lead to improved health outcomes. So the fact that the Japanese see the doctor twice as often as Americans, and hospital stays are longer, on average, isn’t necessarily the cause of their generally better health.
Where it not for statutory limitations on health care fees and tight regulations that outlaw insurance company profit and competition – neither of which would be constitutional in the U.S. – the Japanese economy would be overwhelmed by it’s collectivized health care system. Current trends indicate that this will likely happen anyway in ten years or so unless significant changes are made.
Japan’s dilemma is no surprise since, again, the State has never succeeded in solving an economic problem using a meddlesome regulatory approach – it has only ever succeeded in making that problem much worse. Freeing the market to seek its own equilibrium is the only approach that will result in primary, routine health care that is generally affordable by the majority of the People. High-deductible, low-premium insurance can easily prevent so-called “medical bankruptcy”. This is the only type of insurance where group policies makes sense, especially if they’re administered by entities like municipalities, which can leverage huge actuarial group sizes in the tens of thousands while still remaining accountable to their members/constituents.
We can skip another round of discussion regarding your woefully abject ignorance of Medicare, and your efforts to hide that ignorance. Medicare is bankrupt. It can’t compete with private insurance even with billion$ pouring in from American Taxpayers’ bank accounts. Medicare survives solely through theft and extortion (and, soon, more deficit spending). You don’t seem too clear on the obvious fact that the Democrats’ socialized medicine bill is intended to do one thing: turn the tables on the private insurance companies so that THEY can no longer compete, which will lead to “Medicare for everyone”. This would be a disaster of existential proportions for this Republic. Pointing to Medicare as an example of how ANY form OR facet of State-run, socialized medicine can “work” is either a bad joke or a dangerous sign of insanity. Feel free to pick.
Appendix A
@63. Mr. Independant: The substance of almost all of your responses has in fact been ‘nu huh’.
You persist in this sad fantasy so as to dismiss any response.
- No where in you previous posts are there any references to the specific sections and subsections.
Not needed. I linked directly to the statute, which you’d obviously never seen before. Your statement here translates to “nu huh”.
- On emergency care, use a little common sense.
Clearly you don’t possess common sense. Try using some actual facts and data. Until you do, your statement here translates to “nu huh”.
- On my comparison of Japan’s health care system, your refusal to address that issue …
I addressed that issue in depth. You refuse to recognize the facts. Your statement here translates to “nu huh”.
- I didn’t use Medicare to prove anything, …
That’s a complete lie. See #45: unless there’s more than one moron using your insipid handle, you wrote “…Medicare actually proves that it can work.” QED. You’re worse at this game than David S, the resident brainless socialist.
- Tricare is not going bankrupt.
Medicare is bankrupt. Medicare is the entity you pointed to as “proof” that the “federal government [should] negotiate for prices of its medical purchases”. Again, read your own statement in #45. Tricare was your juvenile attempt at a bait and switch. It failed.
- …the majority of your ‘sources’ is your own blog.
Wrong. Links to the article you’re afraid to read are reference to my analysis. Meanwhile, none of the sources you’ve cited provides the slightest support for your idiotic statements. Your statement here translates to “nu huh”.
- On the impact of the uninsured, …
When you can provide some factual data to support your suppositions about the so-called “uninsured”, do so. Until then you sound like a lunatic and your statement here translates to “nu huh”.
- On my sources, it’s absurd for you to complain about them when you haven’t read them (you apparently just look at the pictures) …
Now you’re just repeating yourself like a child. I read them. None of them contain data that supports your ill-conceived assumptions. As such, there is nothing to dispute. You have no argument in the first place and your statement here translates to “nu huh”.
- You don’t understand basic economic concepts … blah, blah, blah…
LOL!!! Projection at its finest. Your statement here translates to “nu huh”.
Now you can see what “nu huh” really looks like. Enjoy your irrelevance.
This may not be the place to ask, but anyone know where I can find some inexpensive health insurance? I’ve been reading about the costs and i think my best choice would be to go with affordable health insurance, even though it has a crazy high deductible. This article says it is up to $5000 for health insurance deductible!