Health Insurance Industry Still Wants To Cancel Sick People's Coverage

[Disclaimer]

Senate Report Finds Insurers Wrongfully Charged Consumers Billions

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/24/AR2009062401636.html?hpid%3Dtopnews⊂=AR

Health insurers have forced consumers to pay billions of dollars in

medical bills that the insurers themselves should have paid, according

to a report released today by the staff of the Senate Commerce

Committee.

The report was part of a multi-pronged assault on the credibility of private insurers by Commerce Committee Chairman John D. Rockefeller

IV (D-W.Va.). It came at a time when Rockefeller, President Obama and

others are seeking to offer a public alternative to private health

plans as part of broad health reform legislation. Health insurers are

doing everything they can to block the public option.

At a committee hearing today, three health care specialists

testified that insurers go to great lengths to avoid responsibility for

sick people, use deliberately incomprehensible documents to mislead

consumers about their benefits, and sell "junk" policies that fail to

cover needed care. Rockefeller said he was exploring "why consumers get

such a raw deal from their insurance companies."

The star witness at the hearing was a former public relations

executive for major health insurers whose testimony boiled down to

this: Don't trust the insurers.

"The industry and its backers are using fear tactics, as they did in

1994, to tar a transparent and accountable -- publicly accountable --

health care option," said Wendell Potter, who until early last year was

vice president for corporate communications at the big insurer CIGNA.

Potter said he worries "that the industry's charm offensive, which

is the most visible part of duplicitous and well-financed PR and

lobbying campaigns, may well shape reform in a way that benefits Wall

Street far more than average Americans."

Insurers make paperwork confusing because "they realize that people

will just simply give up and not pursue it" if they think they have

been shortchanged, Potter said.

Sen. Mike Johanns (R-Neb.) questioned the government's ability make

matters clearer, saying federal regulation of mortgage disclosures have

made the documents borrowers encounter in real estate transactions

"hopelessly complicated."

Asked to address the hearing testimony, Robert Zirkelbach, a

spokesman for the industry group America's Health Insurance Plans, said

insurers have proposed "overhauling the market rules and enacting new

consumer protections so nobody is left out, simplifying health care

choices for individuals and small businesses, and reforming the

delivery system to improve the quality and affordability of health care

coverage."

The report released today alleged that insurers have systematically

underpaid for so-called out-of-network care. The issue had been brought

to light previously in litigation, committee hearings, and other

investigations, including a probe by New York Attorney General Andrew

Cuomo. But as politicians and interests groups clash over the current

effort to overhaul the nation's health care system, it took on new

relevance.

Cuomo described it last year as "a scheme by health insurers to defraud consumers by manipulating reimbursement rates."

Many Americans pay higher premiums for the freedom to go outside an

insurer's network of doctors and hospitals. When they do, insurers

typically pay a percentage of what they call the "usual and customary"

rates for the services. How insurers determine the usual rates had long

been opaque to consumers and difficult if not impossible for them to

challenge.

As it turns out, insurers typically used numbers from Ingenix Inc.,

which was a wholly owned subsidiary of the big insurer UnitedHealth

Group. Ingenix had an incentive to produce benchmarks that low-balled

usual and customary rates and shifted costs from insurers to their

customers, the report said.

Ingenix got all of its data from the same insurers that bought its

benchmark information, the report said. Insurers that contributed data

to Ingenix often "scrubbed" their data to remove high charges, and

Ingenix further manipulated the numbers, removing valid high charges

from its calculations, the report said.

Cuomo found that insurers under-reimbursed New York consumers by up

to 28 percent, the report said. A dozen insurers have reached

settlements agreeing to change their practices; UnitedHealth agreed to

the largest payment, $50 million, which will help a nonprofit

organization set up a new database to replace Ingenix.

In March testimony to Rockefeller's committee, UnitedHealth chief

executive Stephen J. Hemsley said UnitedHealth stands by "the integrity

of the Ingenix data."

Ingenix performed an important function, Hemsley said, because

paying whatever doctors charge "is simply not economically tenable."

[dmagicglock]

Ingenix is the devil, when I got in a motorcycle accident, they tried to subrogate my hospital bills claim to my autopolicy (no other parties were involved in the accident), needless to say with my clear documentation and persistence, they were unsuccessful in their attempt to screw me.

That being said, I don't think the government can run healthcare better than private industry, because they don't have to run with a business model that requires a profit. So if they continually lose money, its just going to cost us more in tax dollars than the private option costs me on my weekly paycheck. Not too mention adding 46 plus million people to medical care without increasing the amount of medical staff. Even if you give incentives for medical jobs, college loan forgiveness for family practice doctors as obama mentioned on his infomercial, you still have a good 15 year turn around before you make even a dent, in the patient to doctor ratio. Then you also have tax payers footing the bill for doctors medical schooling... which ... yep drives up taxes.

Edited June 26, 2009 by dmagicglock

[Disclaimer]

Ingenix is the devil, when I got in a motorcycle accident, they tried to subrogate my hospital bills claim to my autopolicy (no other parties were involved in the accident), needless to say with my clear documentation and persistence, they were unsuccessful in their attempt to screw me.

That being said, I don't think the government can run healthcare better than private industry, because they don't have to run with a business model that requires a profit.

How can you bitch about them trying to screw you in the first paragraph, and then tout the merits of a profit driven business model? If they don't have to pay for your accident, it's profit. You got what you wanted.

Further, from here:

"If private insurers say that the marketplace provides the best quality health care ... then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business?" Obama said in response to a question at a White House news conference.

"That's not logical," he scoffed, responding to an industry warning that government competition would destabilize the employer system that now covers more than 160 million people.

Answer the question in bold.

Why would having the OPTION to select a government plan be a bad idea? You want private - keep your private insurance, otherwise, here's another option. Since when is choice a bad thing?

So if they continually lose money, its just going to cost us more in tax dollars than the private option costs me on my weekly paycheck. Not too mention adding 46 plus million people to medical care without increasing the amount of medical staff. Even if you give incentives for medical jobs, college loan forgiveness for family practice doctors as obama mentioned on his infomercial, you still have a good 15 year turn around before you make even a dent, in the patient to doctor ratio. Then you also have tax payers footing the bill for doctors medical schooling... which ... yep drives up taxes.

How do you figure your taxes will cost more? You're making a bunch of assumptions. And if those 46M uninsured people get sick... tax payers STILL foot the bill, so that reasoning is a wash. The bottom line is right now, we're on an unsustainable path of health spending. So, why would we keep things the same? That's like seeing the edge of the cliff and deciding your best strategy is to do nothing. Maybe attempt to hit the brakes? Attempt to dive out of the car? Attempt to steer away? SOMETHING other than 'do nothing'. That's illogical.

[SAMBUSA]

I think the Umbrella Corp. is the devil. They are spreading a virus to kill us all

[dmagicglock]

read this in its entirety, it explains that bold question with multiple points.

..."the first is it's unnecessary. Advocates say a government-run insurance program is needed to provide competition for private health insurance. But 1,300 companies sell health insurance plans. That's competition enough. The results of robust private competition to provide the Medicare drug benefit underscore this. When it was approved, the Congressional Budget Office estimated it would cost $74 billion a year by 2008. Nearly 100 providers deliver the drug benefit, competing on better benefits, more choices, and lower prices. So the actual cost was $44 billion in 2008 -- nearly 41% less than predicted. No government plan was needed to guarantee competition's benefits.

Second, a public option will undercut private insurers and pass the tab to taxpayers and health providers just as it does in existing government-run programs. For example, Medicare pays hospitals 71% and doctors 81% of what private insurers pay.

Who covers the rest? Government passes the bill for the outstanding balance to providers and families not covered by government programs. This cost-shifting amounts to a forced subsidy. Families pay about $1,800 more a year for someone else's health care as a result, according to a recent study by Milliman Inc. It's also why many doctors limit how many Medicare patients they take: They can afford only so much charity care.

Fixing prices at less than market rates will continue under any public option. Sen. Edward Kennedy's proposal, for example, has Washington paying providers what Medicare does plus 10%. That will lead to health providers offering less care.

Third, government-run health insurance would crater the private insurance market, forcing most Americans onto the government plan. The Lewin Group estimates 70% of people with private insurance -- 120 million Americans -- will quickly lose what they now get from private companies and be forced onto the government-run rolls as businesses decide it is more cost-effective for them to drop coverage. They'd be happy to shift some of the expense -- and all of the administration headaches -- to Washington. And once the private insurance market has been dismantled it will be gone.

Fourth, the public option is far too expensive. The cost of Medicare -- the purest form of a government-run "public choice" for seniors -- will start exceeding its payroll-tax "trust fund" in 2017. The Obama administration estimates its health reforms will cost as much as $1.5 trillion over the next 10 years. It is no coincidence the Obama budget nearly triples the national debt over that same period.

Medicare and Medicaid cost much more than estimated when they were adopted. One reason is there's no competition for these government-run insurance programs. In the same way, Americans can expect a public option to cost far more than the Obama administration's rosy estimates.

Fifth, the public option puts government firmly in the middle of the relationship between patients and their doctors. If you think insurance companies are bad, imagine what happens when government is the insurance carrier, with little or no competition and no concern you'll change to another company.

In other words, the public option is just phony. It's a bait-and-switch tactic meant to reassure people that the president's goals are less radical than they are. Mr. Obama's real aim, as some candid Democrats admit, is a single-payer, government-run health-care system.

Health care desperately needs far-reaching reforms that put patients and their doctors in charge, bring the benefits of competition and market forces to bear, and ensure access to affordable and portable health care for every American. Republicans have plans to achieve this, and they must make their case for reform in every available forum.

Defeating the public option should be a top priority for the GOP this year. Otherwise, our nation will be changed in damaging ways almost impossible to reverse." - WSJ

[dmagicglock]

How do you figure your taxes will cost more? You're making a bunch of assumptions. And if those 46M uninsured people get sick... tax payers STILL foot the bill, so that reasoning is a wash. The bottom line is right now, we're on an unsustainable path of health spending. So, why would we keep things the same? That's like seeing the edge of the cliff and deciding your best strategy is to do nothing. Maybe attempt to hit the brakes? Attempt to dive out of the car? Attempt to steer away? SOMETHING other than 'do nothing'. That's illogical.

Increasing costs is a logical argument, when you add to the price of something, and the president says its a government funded incentive that means "tax dollars". The government is funded by tax money.

Also... If people don't have insurance, it doesn't mean they go to the doctor and we still cover it for free, yes we can't refuse them healthcare services but it doesn't mean we give it for free. Some people will not go to the doctor for a "common cold" that they might otherwise go for if they had a government insurance. I'm not asking that we keep things the same, we can make changes to the current system without replacing it. Creating nationalized healthcare is like taking that car and driving it off the edge of the cliff. Ask the people in Canada who come to the United States for cancer treatments how good their health care system is? Or the people there who have higher rates of colon cancer, because their system doesn't afford the frequent colonoscopies that our system allows. Listen, on paper communism is a great idea... Thats why its called a utopian society. I would love for everybody to live in peace and have free healthcare, but the fact of the matter is when actually put into action, its a terrible idea and doesn't work.

[Disclaimer]

read this in its entirety, it explains that bold question with multiple points.

..."the first is it's unnecessary. Advocates say a government-run insurance program is needed to provide competition for private health insurance. But 1,300 companies sell health insurance plans. That's competition enough. The results of robust private competition to provide the Medicare drug benefit underscore this. When it was approved, the Congressional Budget Office estimated it would cost $74 billion a year by 2008. Nearly 100 providers deliver the drug benefit, competing on better benefits, more choices, and lower prices. So the actual cost was $44 billion in 2008 -- nearly 41% less than predicted. No government plan was needed to guarantee competition's benefits.

Tell me how many of those 1300 plans you have access to? I have access to ONE through my employer, otherwise it's ungodly expensive.

Second, a public option will undercut private insurers and pass the tab to taxpayers and health providers just as it does in existing government-run programs. For example, Medicare pays hospitals 71% and doctors 81% of what private insurers pay.

Who covers the rest? Government passes the bill for the outstanding balance to providers and families not covered by government programs. This cost-shifting amounts to a forced subsidy. Families pay about $1,800 more a year for someone else's health care as a result, according to a recent study by Milliman Inc. It's also why many doctors limit how many Medicare patients they take: They can afford only so much charity care.

Fixing prices at less than market rates will continue under any public option. Sen. Edward Kennedy's proposal, for example, has Washington paying providers what Medicare does plus 10%. That will lead to health providers offering less care.

That's all bull and propaganda to make people scared that the gubment is gonna take all their money and all the doctors will quit treating people. Once again, we're the ONLY industrialized nation without public option. Market rates are what they are BECAUSE of private insurance. There's instances where you pay more for pushing papers than the actual TREATMENT you get from your doctor. Private insurance overhead is ridiculous because you have "1300 companies" with 1300 different forms the doctor has to pay someone to fill out certain ways. If insurance was really working in favor for the consumer, these would be standardized.

Not only that, but the public option, is just that, an OPTION - you want a certain doctor that doesn't accept public plan - fine, pay to go to him, otherwise the "public" can pay to see doctors in that network paid according to the public market. Why are you even scared to make it an option. Again, this trend isn't sustainable, so "stay the course" is the most asinine solution anyone can come up with.

Third, government-run health insurance would crater the private insurance market, forcing most Americans onto the government plan. The Lewin Group estimates 70% of people with private insurance -- 120 million Americans -- will quickly lose what they now get from private companies and be forced onto the government-run rolls as businesses decide it is more cost-effective for them to drop coverage. They'd be happy to shift some of the expense -- and all of the administration headaches -- to Washington. And once the private insurance market has been dismantled it will be gone.

Another crock - how would it FORCE anyone to do anything. It's an OPTION, pay to keep your own insurance, or go on the gov't one. It's just a CHOICE you have. Just because your company isn't subsidizing your private care anymore - it's the "market" right? Profit is king - so your company is going to do what they have to do. If you don't want the public option - pay to get into private insurance if you think it's worth it. Is it worth it to you?

Fourth, the public option is far too expensive. The cost of Medicare -- the purest form of a government-run "public choice" for seniors -- will start exceeding its payroll-tax "trust fund" in 2017. The Obama administration estimates its health reforms will cost as much as $1.5 trillion over the next 10 years. It is no coincidence the Obama budget nearly triples the national debt over that same period.

Medicare and Medicaid cost much more than estimated when they were adopted. One reason is there's no competition for these government-run insurance programs. In the same way, Americans can expect a public option to cost far more than the Obama administration's rosy estimates.

Wrong, again, regardless of those numbers - the current path is unsustainable, so "keep doing what we're doing" isn't a solution. Rosy estimates and all.

Fifth, the public option puts government firmly in the middle of the relationship between patients and their doctors. If you think insurance companies are bad, imagine what happens when government is the insurance carrier, with little or no competition and no concern you'll change to another company.

Yea, because you're much better off with an accountant between you and your doctor than the gov't. That argument is absurd. Like Obama said... if it's so bad, why is private industry so scared? The gov't can't run anything effectively anyway and the private insurers will win out. Why so scared?

In other words, the public option is just phony. It's a bait-and-switch tactic meant to reassure people that the president's goals are less radical than they are. Mr. Obama's real aim, as some candid Democrats admit, is a single-payer, government-run health-care system.

Health care desperately needs far-reaching reforms that put patients and their doctors in charge, bring the benefits of competition and market forces to bear, and ensure access to affordable and portable health care for every American. Republicans have plans to achieve this, and they must make their case for reform in every available forum.

Defeating the public option should be a top priority for the GOP this year. Otherwise, our nation will be changed in damaging ways almost impossible to reverse." - WSJ

Yea, who wrote the op-ed you pull that out of? It's WSJ, but who's the columnist? If that isn't a screaming advertisement for pro-Republican, pro- Big Business anti-government propaganda, I dunno what is. Republicans have plans to achieve what exactly? Please Stay the course - got it. Dumb.

Increasing costs is a logical argument, when you add to the price of something, and the president says its a government funded incentive that means "tax dollars". The government is funded by tax money.

Also... If people don't have insurance, it doesn't mean they go to the doctor and we still cover it for free, yes we can't refuse them healthcare services but it doesn't mean we give it for free. Some people will not go to the doctor for a "common cold" that they might otherwise go for if they had a government insurance. I'm not asking that we keep things the same, we can make changes to the current system without replacing it. Creating nationalized healthcare is like taking that car and driving it off the edge of the cliff. Ask the people in Canada who come to the United States for cancer treatments how good their health care system is? Or the people there who have higher rates of colon cancer, because their system doesn't afford the frequent colonoscopies that our system allows. Listen, on paper communism is a great idea... Thats why its called a utopian society. I would love for everybody to live in peace and have free healthcare, but the fact of the matter is when actually put into action, its a terrible idea and doesn't work.

For every shitty Canadian story, I can find someone that slipped through the cracks in OUR system... so, what's your point? I just read an article the other day where a lab tech left some poor woman in an CT Scanner machine for 5 hours. And for the billionth time, it's not NATIONALIZED CARE, it's an OPTION to have public insurance. Think of it as nothing more than a LARGE HMO. Why don't people get that?

Edited June 26, 2009 by JRMMiii

[Wheezle]

Wow this is way over my head in understanding!!

[dmagicglock]

the difference between my argument and yours, is that I provide figures and references, where as you provide empty rhetoric with baseless arguments. And your WHO study that you quoted, if the United States removed accidental deaths (i.e. car accidents, motorcycle accidents, etc) and homicides we would be ranked far ahead of any country based on "WHO's statistical formula.

I guess we can just agree to disagree, I'm clearly not going to change your mind on this. Even if I got miss f'ing cleo out of jail and brought her and her magic crystal ball to you and she said "eh man, this public althcar plan is bogus, i'd ratha po' jerk sauce on mah wounds dan go wit dis system man" you still wouldn't believe me.

So you can keep your unions, your government bailouts, your Government Motors, and nationalized healthcare and I'll continue to write my congressman and fight for little things like capitalism and free enterprise and less government constraint.

By the way you haven't started a thread yet on the Cap and Trade bill thats probably going to pass through the house today? I suppose imposing fuel and energy restrictions on us is something you support too, because it only adds to more government control... lets see what Obama and his cronies now control:

Car Industry

Housing Industry

Bank Industry

and possibly...

Energy & Healthcare....

And the worst part is he has appointed "Czars" to oversee all these pet projects. These Czars report directly to him... So that means the executive branch is overstepping it's boundaries and has direct control over many things, that when the legislation was enacted, should've have stopped with senate or house committees...

[Disclaimer]

the difference between my argument and yours, is that I provide figures and references, where as you provide empty rhetoric with baseless arguments. And your WHO study that you quoted, if the United States removed accidental deaths (i.e. car accidents, motorcycle accidents, etc) and homicides we would be ranked far ahead of any country based on "WHO's statistical formula.

How do you figure that there, sports fan? I think the difference is I READ your "figures and references" and you don't read mine. I address your 'facts' and have an answer for them, but you get dismissive when I present my side. If you want me to drown you in more information? I can, but like I said, most people don't read it anyway, which obviously you don't.

I guess we can just agree to disagree, I'm clearly not going to change your mind on this. Even if I got miss f'ing cleo out of jail and brought her and her magic crystal ball to you and she said "eh man, this public althcar plan is bogus, i'd ratha po' jerk sauce on mah wounds dan go wit dis system man" you still wouldn't believe me.

...because my views are that of a psychic-witch doctor?

So you can keep your unions, your government bailouts, your Government Motors, and nationalized healthcare and I'll continue to write my congressman and fight for little things like capitalism and free enterprise and less government constraint.

And you can keep your experiences getting screwed over by businesses who's only goal is to profit off you because you believe the hype that 'private industry' is better at EVERYTHING. Don't complain about getting dicked over by your insurance company. You keep writing those letters.

Instead of dismissing the issues, why don't you answer the questions?

1) What is the best solution to the healthcare crisis? It's unsustainable as is (private insurance and lobbyists) - so, what is your proposal?

2) Why are you scared of a public option? Its choice, you don't HAVE to use it.

By the way you haven't started a thread yet on the Cap and Trade bill thats probably going to pass through the house today? I suppose imposing fuel and energy restrictions on us is something you support too, because it only adds to more government control... lets see what Obama and his cronies now control:

Car Industry

Housing Industry

Bank Industry

and possibly...

Energy & Healthcare....

And the worst part is he has appointed "Czars" to oversee all these pet projects. These Czars report directly to him... So that means the executive branch is overstepping it's boundaries and has direct control over many things, that when the legislation was enacted, should've have stopped with senate or house committees...

Overstepping their bounds like, warrentless wiretapping, authorizing torture, etc, etc. But that's OK because it was all to keep us safer. If the current administration would spin it to make it seem like these pieces of legislation would somehow protect us from terrorism - you'd bet the fearful masses would be all for it.

No, I haven't started a thread on it - but you feel free, I'll definitely read and comment.

[dmagicglock]

Your Figures: I addressed them extensively… and debunked them and the basis of their statistical analysis on how their studies only encompass lifespan and how that doesn’t necessarily correlate to good medicine. Liars figure and figures lie.

Solution: Tort reform... it lowers malpractice insurance costs, it lowers defensive medicine costs, and lowers the bottom line of costs to consumers.

This is the same answer I’ve given previously, so maybe you’re the one not reading my posts?

Public Health Option: it’s not an option if you still have to pay for it, yeah I can still pay for private insurance if my job allows it, or I can pay for insurance through a private insurance corporation out of my own pocket… But I’m still paying for other people’s “public option” through my tax dollars. And why would my company want to subsidize a health insurance option if the government is going to offer it? I’m supposing many small businesses will no longer do that and drop employee coverage, increasing the amount of people insured on the government option. Don’t believe me… believe the Hawaiian children’s healthcare plan that went bankrupt. So many people dropped their kids off their employer based healthcare coverage, because they could get it for “free” through the state. Why should I have to pay for something twice over method, led to bankrupting the system in less than a few years. Or look at Medicare and Medicaid... they’re the only FICA tax deduction that isn’t capped. Yet with uncapped tax deductions on payroll earnings, those systems are set to be bankrupt or taking in less than they dole out by 2017? Everyone that works pays into that system and it only supports the elderly.

Referencing terrorism and the bush administration: Typical liberal dialogue, when the going gets tough and the argument isn’t making sense, reference the bush administration and get them off track. But since we’re there... maybe you should check out this website… http://www.thereligionofpeace.com/ and see if you can youtube the videos of the airplanes crashing into the twin towers on 9/11 and people jumping out of windows hundreds of feet so they wouldn’t be burned alive, ask their daughters, brothers, parents… if “water boarding or wiretapping suspected al qaeda members phone calls” is “okay” But I digress…

[V4junkie]

I've only perused, but I would like to point out that IMO when the phrase "Typical liberal" is used there is some bigotry on the way.

As you were gentlemen

[Disclaimer]

The only thing you "debunked", and I use that term loosely was this:

And your WHO study that you quoted, if the United States removed accidental deaths (i.e. car accidents, motorcycle accidents, etc) and homicides we would be ranked far ahead of any country based on "WHO's statistical formula.

I concede that there are some additional factors in that statistic, but I do not believe the bolded statement. Where's your source for that?

Tort reform - but that means the government has to step in and limit liabilities. How is that fair to all the *small business* law practices that are just trying to help people become whole again after they've been wronged? So, it's OK that lawyers get the shaft because, why? Can you tell me exactly what your arm is worth? What's your finger worth? What's your life worth? You're going to let the gov't put a cap on the value of your life if some incompetent doctor screws up?

Public Health option - again, ONLY industrialized country without some form of it. Basic scientific method would show that our way should either be better or worse than comparative systems. We're not the best... so, that's a pretty strong indication we could do better, like offering similar program to the countries that DO work the best, understanding that a health utopia will never be achieved, but we need something MUCH better than what we have.

And like it or not, you're going to end up paying for other people's healthcare, so why not benefit from it yourself? I've read the Hawaii case (though it's been awhile) and they administered it improperly. Which I believe they admitted, because they had to do things the bipartisan way, rather than how experts would've ran it. These types of programs have no place for 50/50 compromise between Reps and Dems - they need to be placed and administered in the hands of experts that've spent their entire lives in the health care/insurance industry.

And no... Medicare and Medicaid support WAY more than just the elderly.

-------------------------------------------------------------------------

"Typical neo-conservative, religious right dialogue" - thereligionofpeace.com, srsly? The religious right is tolerant of everyone as long as they're all the same religion. Ohh, and news flash, torture doesn't work.

And I don't understand how everyone is completely willing to give up their privacy for a sense of perceived safety, are the exact same people that don't want the government in their lives, in their business. I can't fathom why people are willing to let the gov't tap their phone, spy on their internet searches, and look at their credit card statements all because it's in the name of the War on Terror, and then turn around and bitch that the government needs to stay out of their business and quit trying to run their lives. Makes sense?

[Disclaimer]

Obama: If the Private Sector's So Great, Why Worry About Public Option?

Posted: 25 Jun 2009 01:00 PM PDT

I could be wrong, but I just don't remember members of the media jumping to include our views when we were the minority party. Then again, this is Charlie Gibson, who's not exactly a flaming liberal:

On the "Nightline" edition of the health care forum, Gibson read the president a letter from Republicans on the Senate Finance Committee expressing concern about the creation of a government-run health care plan.

"At a time when major government programs like Medicare and Medicaid are already on a path to fiscal insolvency, creating a brand new government program will not only worsen our long-term financial outlook but also negatively impact American families who enjoy the private coverage of their choice," the senators wrote.

"The end result would be a federal government takeover of our health care system, taking decisions out of the hands of doctors and patients and placing them in the hands of a Washington bureaucracy."

"They're wrong," the president said, arguing that in a Health Insurance Exchange, the public plan would be "one option among multiple options."

The concern, Gibson articulated, is that such a plan wouldn't be offered on a level playing field.

The president rebuffed that, arguing that "we can set up a public option where they're collecting premiums just like any private insurer and doctors can collect rates,"

but because the public plan will have lower administrative costs "we can keep them [private insurance companies] honest."

Obama said he didn't understand those advocates of the free market who constantly say the private sector can do things better and are yet worried about this plan.

"If that's the case, no one will choose the public option," the president said.

He also suggested, however, that the private sector might not necessarily be better, point out that users of Medicare and Veterans Administration hospitals constantly rate "pretty high satisfaction."

The rest was about what you'd expect - umbrage and horror from Charlie and Diane Sawyer who are always so worried on behalf of any of their friends who are mildly uncomfortable with the concept of paying a few of Their Hard-Earned Dollars so that others might live. You can read a more robust version here.

Ignoring the obviously biased commentary... debunk the arguments the president makes.

[dmagicglock]

You're comparing apples to oranges... A government system doesn't need to operate to make a profit. And if it's just another option, just like the private sector, why do we need it? why should we spend a trillion dollars to replace or imitate something that is provided by 1300 different companies or options. And why should we allow government officials decide which healthcare procedures are covered? And what treatment we should get? Just as you think there shouldn't be limit on tort reform, why should there be limits on healthcare procedures? Even obama didn't answer that question... You failed to quote this question from a neurosurgeon from obama's infomercial:

A neurosurgeon asked Obama: "Okay, you've got the healthcare plan that you're going to prescribe for everybody else. Your wife or your daughter comes down with a major illness. Your plan goes through the diagnosis. And then you find out that there's some other doctor out there somewhere with another procedure and another form of treatment, another opinion, but your plan doesn't cover it. Are you going to stick with the plan you forced on everybody else, or are you going to use your wealth and go outside the plan to get the treatment for your wife and daughter that other people are not going to be able to do because they don't have the money?'' That's the question. He did not answer it. Obama: "You're absolutely right. That if it's my family member, uh, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care."

I don't need to explain his reply I think it speaks for itself...

Is V.A. care good? I hope so... these men and women devoted their lives to our country and in their case, I'm okay with them receiving healthcare, because in exchange for our sovereignty they offered up their lives and limbs, and families to make sure we're safe. So yes they should have quality care and money well spent on healthcare. The problem is those satisfaction rates don't mention the amount of time it takes for these veterans to receive care because of the influx of patients.

"Private hospitals, which make their money treating people who come to them sick, don't profit from heavy investments in preventive care... But the VA, which is funded by tax dollars, "has its patients for life," notes Kizer... So to keep government spending down, "it makes economic sense to keep them healthy and out of the hospital." Kizer eliminated more than half the system's 52,000 hospital beds and plowed the money saved into opening 300 new community clinics so vets could have easier access to family-practice-style doctors. He set strict performance standards that graded physicians on health promotion. As the reforms produced results, veterans began "voting with their feet," says Dr. Jonathan Perlin... Hundreds of thousands abandoned private physicians and enrolled in the lower-cost and higher-quality VA care. But that created a new problem. The VA's budget from Congress (currently about $30 billion annually) couldn't cover the influx. By January 2003, with hundreds of thousands waiting six months or more for their first appointment, the VA began limiting access to only vets with service-related injuries or illness or those with low income.

" - Mark Thoma Economists View

[dmagicglock]

I’d like to break the argument down even further. On basic economic principles…

Prices are typically driven by two basic things.

1. Supply

2. Demand

Nationalizing healthcare is essentially putting at least a 20% increase on the demand for healthcare, because it’s now provided to essentially everyone. However to be provided it has to be supplied. Yet we’re not going to increase our medical professionals by 20%.

So when you have an increase in demand but lack in supply, you get shortages. You also get an increase in price when demand is greater than supply. Look at gas shortages, or opec cuts that drove gas to over 4 dollars a gallon last year.

Quality:

Quality of healthcare will decrease because you will have fewer doctors doing more work. If you think a doctor doesn’t spend enough time with you now, increase their patient load and lower the amount of time they can spend on diagnosing and treatment and see how the quality is affected. I know some people think less is more, but not in the case with doctors.

At the end of the Day, you’re going to have lower quality healthcare, longer waits, and an increase in the cost of healthcare.

[Disclaimer]

My point is you don't have 1300 options. You have maybe 3 or 4, in all reality. We need another option because a lot of people can't get affordable coverage under any other plan. What's better, treating people that won't pay anyway because they can't afford it, or taking some out of their paychecks so at least they've contributed SOME? That's pretty self-explanatory.

How is allowing the gov't to decide what practices and procedures ANY different than letting some executive, some "suit", 1000 miles away do the same thing? Your choice is who you trust to make the decision - the suit or the gov't, and you STILL get to pick which.

If you don't like the system, you don't have to be IN it. Take your private insurance. That's the answer to the neurosurgeons question. If you don't like the public option (which no one is FORCED into - that's a false statement), use your wealth to pay for what you think is a better option. Easy solution.

And it's funny you didn't copy the rest of the article where you pulled that paragraph from - like I did:

http://www.afge.org/index.cfm?page=VeteransAffairs&Fuse=Content&ContentID=762

Continued from your paragraph... and not only that, you credited the wrong person, I don't know WHERE you get your information from.

How VA Hospitals Became The Best [Time Magazine]

Friday September 29, 2006

Time Magazine

By DOUGLAS WALLER

"Veterans' groups understandably want the health-care system expanded to accommodate vets with higher incomes and no service-related ailments. Tom Bock, commander of the American Legion, has another idea: allow elderly vets not in the system who are drawing Medicare payments to spend those benefits at a VA facility instead of going to a private doctor, as is now required by Medicare. "It's a win-win-win situation," he argues. Medicare, which pays more than $6,500 per patient annually for care by private doctors, could save with the VA's less expensive care, which costs about $5,000 per patient. The vets would receive better service at the VA's facilities, which could treat millions more patients with Medicare's cash infusion. But conservatives fear such an arrangement would be a Trojan horse, setting up an even larger national health-care program and taking more business from the private sector. Congress has no plans to enlarge the scope of veterans' health care--much less consider it a model for, say, a government-run system serving nonvets. But it's becoming more and more "ideologically inconvenient for some to have such a stellar health-delivery system being run by the government," says Margaret O'Kane, president of the National Committee for Quality Assurance, which rates health plans for businesses and individuals. If VA health care continues to be the industry leader, it may become more difficult to argue that the market can do better."

That is to say, the thought that privatization is better is a tired ideology and will become hard to argue against the fact that "the market" can do better than a publically administered system like the VA.

I think that might be check and mate, sir.

[dmagicglock]

You still don't get it... its not an option if i'm paying for both. My treatment may be an option on which one i want to use, but i'm still paying for two insurances. If you want to let people pay into a public option that requires ZERO tax dollars from people who use a private option, then go for it! And providing insurance to people that contribute nothing to our economy hardly equates to your something is better than nothing policy.

And also from that article is this statement " Vets still gripe about wading through red tape for treatment. Some 11,000 have been waiting 30 days or more for their first appointment."

So not quite check mate there buddy

[dmagicglock]

Lets say you see a homeless guy on the street and I give him 5 dollars to help him out, is that okay?

Now what if I put a gun to your head and tell you to give him 5 dollars too, is that still okay?

The governments healthcare option isn't much different.

[SAMBUSA]

Lets say you see a homeless guy on the street and I give him 5 dollars to help him out, is that okay?

Now what if I put a gun to your head and tell you to give him 5 dollars too, is that still okay?

The governments healthcare option isn't much different.

Why not use said gun and eliminate the homeless person. Problem solved.

[Disclaimer]

Why not use said gun and eliminate the homeless person. Problem solved.

There's usin' the ol' noodle.

Back to the discussion:

30 days for an appointment? OMG! My g/f had to wait 2 months to get hers, and she's got GREAT insurance. What's your point?

You're still paying for BOTH insurances regardless - you still pay for Medicare and Medicaid. Your $5 example is silly. No one is holding a gun to your head to pay taxes either - you don't like it, stop paying them if you're morally opposed. The only thing that is consistent is a gun to your head and your health care are both life and death decisions.

But, according to the plan, the gov't would give a tax credit for those that decide to take a private option to give the equivalent contribution back to the consumer. I have a feeling the public option will still end up cheaper, but hey - that's economics.

[Disclaimer]

I'm well aware of economic principles, so we don't need to cover that. The issue is that you're making a lot of false assumptions. For instance:

Quality:

Quality of healthcare will decrease because you will have fewer doctors doing more work. If you think a doctor doesn’t spend enough time with you now, increase their patient load and lower the amount of time they can spend on diagnosing and treatment and see how the quality is affected. I know some people think less is more, but not in the case with doctors.

At the end of the Day, you’re going to have lower quality healthcare, longer waits, and an increase in the cost of healthcare.

You assume that because people are covered they'll WANT to stay in a hospital because they can. False.

You also assume doctors can't handle the patient load when they spend a sizable chuck of their time muddled with paperwork because they want paid from the insurers. So, again, the patient load issue is debunked.

How do they handle this in all the other industrialized nations?

[Uncle Punk]

How do they handle this in all the other industrialized nations?

Poorly compared to our current system.

[dmagicglock]

what statistics and figures have you given from these so called "industrialized nations" that prove your point? Why do sheiks from the middle east come to the United States for high profile medical procedures? Why does America have the best treatment rate for 14 of the top 16 cancers? I'm confused... I dont see anyone from the U.S. going to Canada to get radiation or chemotherapy?

And you can't just stop paying taxes? unless I just stop working, and then I'd be just like everyone else with a hand out? Nah, I'd rather work harder so other people don't have to.

I like McDonalds... who doesn't, right? Lets say you go to McDonalds and you want to order a big mac... BUT we gotta feed everyone, and the government option means you can walk in and get a quarter pounder for free, but you just don't like the quarter pounder, the onions don't sit well with your stomach and you want that special sauce. So you HAVE a choice to get the big mac, you just gotta pay for a quarter pounder for the schmuck behind you in line. BUT i mean Yeah. YOU STILL HAVE A CHOICE right? You got your Big Mac, you just had to pay for two sandwiches in the process

[Disclaimer]

Poorly compared to our current system.

Disagree. Japan does it well.

what statistics and figures have you given from these so called "industrialized nations" that prove your point? Why do sheiks from the middle east come to the United States for high profile medical procedures? Why does America have the best treatment rate for 14 of the top 16 cancers? I'm confused... I dont see anyone from the U.S. going to Canada to get radiation or chemotherapy?

Sources?

And you can't just stop paying taxes? unless I just stop working, and then I'd be just like everyone else with a hand out? Nah, I'd rather work harder so other people don't have to.

We should do a survey of how many people are taking handouts. Are you pissed that some of the fellow bikers on this site are collecting unemployment? Many of these people have the same view that they don't want to pay for 'handouts' yet they're accepting them now because they're in a tight spot, but THEY aren't the lazy dirtbags taking handouts like everyone else, they're just a victim of the economy. They're a special case. You're working hard so they can get their check - so do you harbor any animosity towards them for that? I don't - other than thinking it's a bit hypocritical. But, I accept that I may be in their spot one of these days and have to rely on the 'system' to work for me.

I like McDonalds... who doesn't, right? Lets say you go to McDonalds and you want to order a big mac... BUT we gotta feed everyone, and the government option means you can walk in and get a quarter pounder for free, but you just don't like the quarter pounder, the onions don't sit well with your stomach and you want that special sauce. So you HAVE a choice to get the big mac, you just gotta pay for a quarter pounder for the schmuck behind you in line. BUT i mean Yeah. YOU STILL HAVE A CHOICE right? You got your Big Mac, you just had to pay for two sandwiches in the process

Fine, we have to feed everyone, but the manager realizes that his restaurant now has 4x the customers, so he can half the costs of everything. Now a Big mac costs the same as the quarter pounder, and the quarter pounder costs even less. So, in the end, everyone gets food, and the Big Mac actually only costs 75% of what you normally would've had to pay for it anyway. Win-win for everyone.

Tons of articles on the wiki page that are cited.

This is a good one. Start reading @ page 15: http://books.google.com/books?id=oUM39nDp2s4C&dq=employer+provided+private+health+insurance+in+canada

Public vs. Private Care: http://www.cbc.ca/news/background/healthcare/public_vs_private.html

Single Payer 101: http://www.amsa.org/uhc/SinglePayer101.pdf

How Adverse Selection Affects the Insurance Market; There may be a price to pay (in terms of inefficient Health coverage) if competition among health insurers is encouraged as a way to give patients greater choice and to achieve better control over insurance providers: http://www-wds.worldbank.org/servlet/WDSContentServer/WDSP/IB/2001/04/13/000094946_01040505331570/Rendered/PDF/multi0page.pdf

US Health Care; Entitlement or Privilege? http://circ.ahajournals.org/cgi/content/full/109/12/1460

Single Payer FAQ from the Physicians for a National Health Program: http://www.pnhp.org/facts/singlepayer_faq.php

The Best Care Anywhere http://www.washingtonmonthly.com/features/2005/0501.longman.html

Another VA review, ending with

As the health-care crisis worsens, and as more become aware of how dangerous and unscientific most of the U.S. health-care system is, maybe we will find a way to get our minds around these strange truths. Many Americans still believe that the U.S. health-care system is the best in the world, and that its only major problems are that it costs too much and leaves too many people uninsured. But the fact remains that Americans live shorter lives, with more disabilities, than people in countries that spend barely half as much per person on health care. Pouring more money into the current system won't change that. Nor will making the current system even more fragmented and driven by short-term profit motives. But learning from the lesson offered by the veterans health system could point the way to an all-American solution.

Doctors support universal health care: survey http://in.reuters.com/article/health/idINN3143203520080331

INSTITUTE OF MEDICINE Shaping the Future for Health

INSURING AMERICA’S HEALTH: PRINCIPLES and RECOMMENDATIONS http://www.iom.edu/Object.File/Master/17/732/Uninsured6-EnglishFINAL.pdf

Same group - IT IS NOW TIME TO EXTEND COVERAGE TO ALL

Project on the Consequences of Uninsurance: An Overview: http://www.iom.edu/Object.File/Master/17/736/Fact%20sheet%20overview.pdf

Edited June 26, 2009 by JRMMiii