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[30ashopper]

It doesn't cost everybody $4,000. It costs the uninsured more than the insured. That is a BIG problem that could be fixed.

That's the main purpose of the mandate - force by law everyone into having coverage, and you no longer have the uninsured taking on the real cost while the insured get a reduced cost due to group price negotiation. Everything swings the other direction, the healthy pay for the care of the sick and the rich pay for the care of the poor. This is classic progressive tax policy.

One of the things I don't like about the plan is requiring everyone to be insured. Like President Obama told the AMA, preventive steps are part of the solution.

The current plan sort of penalizes a person for working out and staying away from junk food. A person in their 20's that is not overweight and avoids all the "bad for you" pitfalls, could easily get by with little insurance coverage if any. Maybe a catastrophic plan only.

If the government mandates the amount of coverage you must have, it would have to be at a level that protects the average American who does not make all the healthy choices. Poor, healthy 24 year old, gym-rat John will have to help pay for 35 year old, junk food junkie, chain smoking, couch-potato Jane to have the same coverage. I see no built-in financial incentive to eat clean, moderate vices, and exercise.

Yep.

For what it's worth, the gateway plans will have preventitive requirements, but I doubt it'll be any more than what you get in current plans. Nothing will be forced of course. Medicare and Medicaid work this way as well. I've met Medicaid patients that are full blown alcoholics and the government does nothing about it, they just keep dishing out care. Something we could probably reform down the road like we did with Welfare.

Of course, they may yet get around to that. Maybe it's already in the details. There needs to be some level of personal responsibility. Good behavior should be encouraged and bad behavior discouraged.

The bill details general preventitive care guidlines, but the details will be decided down the line by the HHS secretary, probably a year or so from when (and if) this gets passed. The state gateways don't have to be set up for up to three years.

I did read today that the White House is open to not having a public health-insurance plan.

Yep. I have to give props to some centrist dems in the Senate Finance Committee, they clearly see the cost pitfalls of pure government run care. I really like the non-profit co-op idea, it's a great middle ground.

Of course, dems will likely try and exert more and more control over these over time, but that is a fight for another day. All we have to do is look at what can happen when a private entity gets a presumed government guarantee (Freddie and Fannie) to know what could go wrong. The less responsibility the government has over these co-ops the better. Otherwise they'll just lose money hand-over-fist and we'll be bailing them out forever.

 

[Gidget]

The current plan sort of penalizes a person for working out and staying away from junk food. A person in their 20's that is not overweight and avoids all the "bad for you" pitfalls, could easily get by with little insurance coverage if any. Maybe a catastrophic plan only.

I'm 50 and avoid all the current pitfalls and I feel like I still pay more for coverage than what I think is fair. My plan is a $5000 deductible - purely a catastrophic plan.

If the government mandates the amount of coverage you must have, it would have to be at a level that protects the average American who does not make all the healthy choices. Poor, healthy 24 year old, gym-rat John will have to help pay for 35 year old, junk food junkie, chain smoking, couch-potato Jane to have the same coverage. I see no built-in financial incentive to eat clean, moderate vices, and exercise.

Isn't it that way now? I mean my policy costs a lot and I am on no meds, have no ailments (I treated my own high cholesterol with diet and exercise), and am avoiding the type 2 diabetes that plagued my obese mother and sister by staying fit. Yet, I have to pay out of pocket IF I need to go to a dr (stitches, small accident, etc...)

NOTHING will work till there is more incentive to be healthy. PERSONAL responsibility needs to come into play big time. I don't know all the answers but something needs fixing desperately.

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Thanks
G

 

[Gidget]

Not really like shooting fish in a barrel at all. Your first citation shows that the US lags behind countries that generally have homogeneous populations of genetically 'well' people who do not tend to be obese and cram fast food down their gullets. The American melting pot includes populations that at their baseline are at higher risk for developing hypertension, diabetes, cardiovascular disease, etc. If Australia, Andorra and Monaco had to deliver care to people of African and Hispanic descent, their rankings would slip, too.

True because when these people go back to their indigenous diets voila - the "modern Western diseases" are no more. Good point!!


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Gidget

 

[seanote]

I did read today that the White House is open to not having a public health-insurance plan.

Obama still wants a public plan. His statement this morning:

I am pleased by the progress we're making on health care reform and still believe, as I've said before, that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest. I look forward to a final product that achieves these very important goals.

We need the public option to provide an affordable alternative to private 'for-profit' insurance to keep costs from increasing at this unsustainable level.


Health-Care Market Characterized By Consolidation, Not Competition | TPMMuckraker

The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country's insurance markets are defined as "highly concentrated," according to Justice Department guidelines. Predictably, that's led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.

428% profit!! Coincidentally, my premium costs have risen 475% from 1996-present. I've had the same plan the whole time. I can't afford it any more and am now shopping for a lower cost plan that will no doubt be a 'catasrophic' plan with high deductibles and out of pocket fees.

These companies are also taking a nice piece of their profits and lobbying Congress, at the cost of $1.4 million a day, to try and kill the public option.
Former Lawmakers and Congressional Staffers Hired to Lobby on Health Care - washingtonpost.com

 

[Winnie]

That's the main purpose of the mandate - force by law everyone into having coverage, and you no longer have the uninsured taking on the real cost while the insured get a reduced cost due to group price negotiation. Everything swings the other direction, the healthy pay for the care of the sick and the rich pay for the care of the poor. This is classic progressive tax policy.

This could be fixed now without a big, expensive government health care plan. Make pricing transparent. Make it a rule that large groups, such as BC/BS get no more than a 10% discount. Apply a similar discount for pre-payment by the un-insured.

Isn't it that way now?
Thanks
G

The difference is that now you are not required to buy insurance at all. You can buy as little or as much coverage as you feel comfortable with. The healthy among us do currently get more affordable coverage than those who aren't.

 

[Winnie]

Obama still wants a public plan.

What he wants and what he demands are different in this case.

The White House indicating it will settle for reform even without the public plan is a great sign for a workable compromise.

 

[scooterbug44]

Clarification - I thought part of the reason health care costs were high was because UNinsured people's costs were passed on to the insured/those paying their bills.

 

[Winnie]

NOTHING will work till there is more incentive to be healthy. PERSONAL responsibility needs to come into play big time. I don't know all the answers but something needs fixing desperately.

Thanks
G

I meant to agree with you on this in my last post! I forgot to copy and paste that part of your comment.

I may have been misunderstood.

We do need to do something about the current healthcare system. I just don't think the answer is everyone having insurance. I think that it shouldn't cost more than the average person can afford for basic health care services. You should only need insurance for accidents and major illnesses. Your yearly check-ups and occasional tests should be more affordable. We need to fix those things that are making the costs so high.

Certainly personal responsibility is really lacking in some cases.

 

[scooterbug44]

I was thinking that too - that we could just all have "catastrophic" insurance and pay for normal stuff out of pocket.

The problem is that there is SO much stuff between the 2.

Biggest example I could think of is pregnancy/childbirth, but I am sure there are a ton of other things. What about technically elective (but needed) or preventative surgery?

 

[Winnie]

I was thinking that too - that we could just all have "catastrophic" insurance and pay for normal stuff out of pocket.

The problem is that there is SO much stuff between the 2.

Biggest example I could think of is pregnancy/childbirth, but I am sure there are a ton of other things. What about technically elective (but needed) or preventative surgery?

That's one of the areas I wouldn't mind seeing subsidized. Particularly pre-natal care. My first thought is that you buy a pregnancy policy if you think you may need it. However, if we approached it that way it would probably be just as inexpensive to save up for it as to buy the policy.

I can't think of the preventative surgery case you refer to. Like having a club foot fixed to prevent back trouble?

There is also the issue of birth defects. Some things will just have to be paid for with tax dollars. But, they are already. We can improve our current system. We really need to.

I would like to see our great minds in Washington come up with some workable ideas beyond throwing taxpayer dollars at every problem.