|
Post by m52nickerson on Jun 30, 2009 14:05:00 GMT -5
I found this nice little article from Reuters which put out many facts regarding the different heath care bills. (Senate and the House) www.reuters.com/article/healthNews/idUSTRE55N3EG20090624Here is my take THE GOOD1. All the bills bar insurance companies from refusing to cover people or charging them more because of health history or gender. All the bills place some limits on insurance premiums. 2. Insurers in all bills would be required to cover some preventive services. 3. All the bills include caps on out-of-pocket expenses. The Finance Committee bill is expected to do the same. 4. The House and Senate Finance bills would both create state insurance exchanges to act as clearing houses for individuals and small businesses to buy insurance. THE BAD1. No mandate for insurances to cover drugs prescribed by your doctor, or procedures recommended by your doctor. 2. No mandate for insurance providers to work with all licensed physicians, so you still have to pick a Doctor on their lists. THE UGLY1. All individuals would be required to obtain insurance under all of the bills. - not that is is a bad idea when you include subsidizes for those who need them. I just question how this will work in practice. 2. The House bill would set up a new government plan to compete with private companies. The Senate HELP panel bill leaves this open for later consideration. - the government provided option may not make it. Strangely I might be OK with that if more regulations be put on what the insurance companies could do.
|
|
|
Post by booley on Jun 30, 2009 14:36:46 GMT -5
... THE UGLY1. All individuals would be required to obtain insurance under all of the bills. - not that is is a bad idea when you include subsidizes for those who need them. I just question how this will work in practice.... This would bother me less if politicians didn't have this amazing knack to set up social programs and then set the bar so high that few can access them. I am already sure that even though I can't afford health insurance, I won't qualify for any subsidies either. And when this hodge podge to protect the profits of insurance companies fails to be as good as single payer, cons will say "See, we told you socialized medicine wouldn't work!" Le Sigh.
|
|
|
Post by m52nickerson on Jun 30, 2009 14:48:51 GMT -5
Well the one plan does spell out that subsidizes would be payed to people well over the poverty rate, on a sliding scale.
|
|
|
Post by skyfire on Jun 30, 2009 15:49:34 GMT -5
1. All the bills bar insurance companies from refusing to cover people or charging them more because of health history or gender. All the bills place some limits on insurance premiums. The problem here, however, is that it actually violates one of the fundamental principles of insurance. To quote my intro to insurance text: (Rejda, George E. Principles of Risk Management and Insurance, 10th edition. Boston: Addison Wesley). In most instances, private insurance operates by taking money from everyone who is insured and doling the money out as claims come forward. The more people who have situations that predispose them to higher incidence rates, the more money that the company must pay out. The more money that the company must pay out, the higher the premiums they are forced to charge to everyone who they wish to insure. Asking an insurance company to simply eat the losses means you risk the company going belly-up and screwing over those who rely on it. A better idea is for the government to step in as the underwriter in question; for every person an insurance agency takes on that has a higher-than-normal risk standard, Uncle Sam will kick in the difference between what that person pays for their premium and what they should be paying in order to cover their higher risk potential.
|
|
|
Post by m52nickerson on Jun 30, 2009 16:12:30 GMT -5
With larger pools of healthier people getting insurance, through a mandate or because the insurance is more affordable, is also a solution for the problem of insurance companies having to payout more for some people. Since all the bill require people to have insurance all the companies now stand to have more customers, most of which will not be high risk.
Plus remember Sky this bill is to ensure people have health insurance, not to insure that the health insurance companies remain healthy. They will have to do that on their own.
|
|
|
Post by Old Viking on Jun 30, 2009 18:16:42 GMT -5
Even with malice aforethought we could not conceivably create a worse health care system than the current Rube Goldberg fiasco. If all insurance company employees were compelled to wear purple wizard hats, and all health care providers were forced to use masks and rattles exclusively, this would still be an improvement.
|
|
|
Post by skyfire on Jun 30, 2009 21:38:42 GMT -5
Plus remember Sky this bill is to ensure people have health insurance, not to insure that the health insurance companies remain healthy. They will have to do that on their own. ...And if the pool of unhealthy people seeing benefits at the traditional cost is greater economically than the increased pool of healthy people paying in? What happens then? My B-law textbook has a case which demonstrates just such a possibility - Citizens Communications Co. v. Trustmark Insurance (US District Court, District of Connecticut, 2004. 303F.Supp.2d 197). Citizens had an arrangement with Trustmark wherein Trustmark would pay any health insurance claim of any Citizens employee so long as the claim was at least $100,000 but less than $1 million. Citizens employee Garry Lonquist suffered from complications after heart surgery, such that he was in intensive care. Within 3 months, Lonquist's claim had gone well beyond the $1 million cap. Trustmark refused to renew Citizens' policy unless it was amended to effectively exclude Lonquist. Citizens officially accepted, but filed suit in federal court claiming breach of contract. Both sides pushed for summary judgement, with District Judge D.J. Kravitz finding in favor of Trustmark. Unless Congress couples price caps wherein all people must pay the same price with a promise that they'll pick up the slack in a worst-case scenario, they're sentencing some of the weaker insurance firms to an avoidable death. As the case above demonstrates, a single sufficiently high payout can put an entire firm at risk; too many sufficiently high payouts can be lethal.
|
|
|
Post by mistermuncher on Jun 30, 2009 21:47:01 GMT -5
Perhaps I'm missing some detail here, but there's no indication the company was "at risk" in any severe form. AT risk of lessened profit, certainly, but there's no real indication it was about to go to the wall because of this one guy.
|
|
|
Post by skyfire on Jun 30, 2009 21:53:38 GMT -5
Perhaps I'm missing some detail here, but there's no indication the company was "at risk" in any severe form. AT risk of lessened profit, certainly, but there's no real indication it was about to go to the wall because of this one guy. Imagine, though, if the company found itself having to deal with 10 of the guy. Can we say "ouch" ? That's what I'm getting at. There may well be a threshold wherein the money acquired from additional customers cannot compensate for the increased claims from customers with higher-than-normal likelihoods for claims or higher-than-normal claims. Hence, if the government is looking to pass such a cap as they are proposing, they need to agree to be the underwriter of last resort just in case things go to hell.
|
|
|
Post by rookie on Jun 30, 2009 21:54:24 GMT -5
Unless Congress couples price caps wherein all people must pay the same price with a promise that they'll pick up the slack in a worst-case scenario, they're sentencing some of the weaker insurance firms to an avoidable death. As the case above demonstrates, a single sufficiently high payout can put an entire firm at risk; too many sufficiently high payouts can be lethal. So they sell out to the bigger fish. It happens all the time in the auto industry, banks, tech, food service, well all business really. Hey Sky, you are a capitalist. This is good for your system.
|
|
|
Post by mistermuncher on Jul 1, 2009 5:07:35 GMT -5
So, in essence, your proposal is based on extrapolation, and an extrapolation that has no statistical basis. "There may well be..." =/= "There is...".
Trustmark insurance has consistently turned around $400 million in profit for the last 10 or so years (from what figures I can find). Am I honestly to believe they're going to the wall on account of a few people with the cheek to be sick beyond their premium's coverage?
|
|
|
Post by m52nickerson on Jul 1, 2009 6:43:05 GMT -5
Sky their a huge problem with your case. It is small scale. Second that case has to do with stop loss coverage for a company that self insured its employees, different then full health insurance. Three as mistermuncher pointed out even with 10 guys with 1 million dollar claims Trustmark would still be very much in the black.
|
|
|
Post by ltfred on Jul 2, 2009 8:06:26 GMT -5
The more money that the company must pay out, the higher the premiums they are forced to charge to everyone who they wish to insure. Or they could lower their profits. They're certainly healthy enough already. Interesting that nobody ever mentions that option. So, you want to force everyone to accept innefficient private health insurance, run to profit shareholders, backed by the taxpaying public who get screwed from the whole deal. Fantastic! Here's an idea: do what the rest of the world does. People have a choice between public basic (but comprehensive) cover and a private alternative. It saves money, insures everyone, strengthens the economy, and... oh, fewer people die because they can't afford the drugs. Then build more hospitals and train more doctors to shorten the lines as 40 million people discover modern medicine that isn't provided by the Red Cross.
|
|
|
Post by Trevelyan on Jul 2, 2009 12:22:42 GMT -5
Skyfire, your arguments seem to ignore one thing. Health care, that is a persons basic right to be healthy is NOT something that should be bought and sold on the open market. Health insurance is something that should be done so that the cost of health care can be shared across multiple people and make it affordable for all. Profits shouldn't enter this equation anywhere, because once again, a persons health is NOT NOT NOT something to be bought and sold on the open market.
|
|
|
Post by Yaezakura on Jul 2, 2009 13:41:19 GMT -5
Skyfire, your arguments seem to ignore one thing. Health care, that is a persons basic right to be healthy is NOT something that should be bought and sold on the open market. Health insurance is something that should be done so that the cost of health care can be shared across multiple people and make it affordable for all. Profits shouldn't enter this equation anywhere, because once again, a persons health is NOT NOT NOT something to be bought and sold on the open market. Stop that liberal bullshit. You know full well everything should be able to be bought and sold on the open market. Including brown people and the lives of the poor.
|
|