Let's really talk about Healthcare

[Phi for All]

I thought we were supposed to be talking about the pros and cons of other systems for a hypothetical replacement of the US model?

You were the one who brought up not modeling any one country's system. Pre-existing conditions are an important sticking point with many people, so what's your problem with the introduction of some discussion on it?

[JustinW]

Phi,

 

You were the one who brought up not modeling any one country's system. Pre-existing conditions are an important sticking point with many people, so what's your problem with the introduction of some discussion on it?

Just the risk of not following the context of the thread. I had mentioned that I wouldn't prefer any one country's system alone over the US's, but then very clearly stated one system so as to keep in the hypothetical situation that was stated as being the boundaries of this thread. And since the rules of the thread were to choose then discuss hypothetical replacements of the US's current system, that any argument about the US system would be out of bounds. Because you know this thread will turn into another discussion of people boohooing about what's wrong with the current US system, instead of talking pros and cons of other systems. Does that sound like a sensable reason?

[Phi for All]

Just the risk of not following the context of the thread.

Ah. More Slippery Slope arguments. The risk of possibly bad-mouthing the current US system should preclude discussing eliminating some of its worst aspects in a new system.

 

Not sensible, imo.

[JustinW]

I thought the point of this thread was to discuss pros and cons of other countries systems? If I am wrong then we have two threads about the same thing, right?

[iNow]

I think Justin was merely following my point on the first page. I was trying to help John to keep the topic tight since we kept going around in circles in other threads with similar topics. In short, I find myself agreeing with Justin here, but it's not a terribly big deal either way, I suppose.

[JohnB]

Well, once again I will speak in favour of the Oz system and maybe dispell some false ideas about UHC systems.

 

Firstly choice. There seems to be the view amoung Americans that there are only two possible states public insurance or private. The fact is that both can work very happily side by side. Government healthcare does not remove any choice at all, if anything it frees up choice. We have both public and private hospitals, most of our Doctors are private practice, as are the surgeons and specialists. Radiology is a mix of government (Dept at the Hospital) or a private radiology lab that leases space in hospital premises.

 

The government system only applies to strict Western medicine, I get this free because it is paid from my taxes. In the event of hospitalisation the hospital will assign me to whichever Dr they think best in the nearest or most suitable hospital. I'm not covered for dental, physio, optometry and I don't get to choose which Dr looks after me or what hospital this happens in.

 

If I choose to add private insurance to my folder then I would be able to choose Drs and hospitals, get a refund on massage and physiotherapies and a variety of other things. So there is plenty of choice in this.

 

Similarly I can go to any Dr I want for a general consult and I can present to any hospital I want to in an emergency. A problem mentioned with the Tiawanese system was overuse and this can be a problem if the whole thing is free. We get around this by actually having a small copay. It works this way. If the standard fee for a consult is $60 then the gov will refund to me $50 when I present the bill at the Medicare office. The important thing to understand is that the Dr is not limited to charging only $60 for a consult, he or she can charge whatever they want in a true free market fashion, the only thing that remains stable is that the refund will always be $50. Now if I wished to visit Drs who charged $200 for a basic consult, then I would get some private insurance as a top up. This means that after visiting the DR I would get a refund from both the government and the private insurer. Again, plenty of choice.

 

How this works in practice is like this. On Tuesday I decided to see the Dr so I dropped in to the local clinic and asked for an appointment. My preferred Dr was working Wednesday and had a space at 11.45 am so I took it. The consult on Wed took a bit longer than usual and so as I left I paid $80 and got the receipt. It is possible at this point to get the refund placed directly into your bank account, but I haven't filled out the forms for that so I'm still doing it the hard way. So today I drove to the Medicare office in the next suburb, took my little number and sat down to wait. After about 10 mins I was called, went to the counter and presented my Medicare card and the receipt and was given the $59 refund in cash. So the consult cost me $21. It is this small copay that stops people from burdening the system with fairy stories and avoids the Taiwanese problem.

 

We expect to expand our system to cover dental and optical soon but there's going to be a lot of paperwork done before that happens. What makes the Oz system good is that it controls the government costs not by rationing, but by limiting what the gov will pay for a particular service. Perhaps the easiest way to understand this is to use how we expect glasses to work. England had those horrible NHS glasses because the gov stipulated which glasses people could have, the idea being to limit costs. Our system works on a different philosophy. The gov limits the costs by limiting the refund, not the choice. Let's say the refund on frames is $100 and on lenses $80. (Pulling figures from the air here, just as an illustration.) Now I can choose any sort of frame or lenses want to have and can afford. If I choose glasses that cost $180 then I'll get the lot back as a refund, if I choose designer frames for $500 and $300 lenses then I'll just get the $180 back and the glasses will cost me $620 out of pocket. And by then there will be "Gap" insurance offered by the private companies anyway.

 

Another strength of the system is that it divides responsibilties reasonably well. The Federal office looks after the refund side of things, we could have combined Medicare offices with other ones like unemployment, but we haven't. Medical funding comes again from the Feds, just as it does in the US. This money is given to each State to use as the State sees fit. (A number of things are used to decide the split because a straight per capita just doesn't work.) After this it is the responsibility of each State to administer the public and private hospitals within its borders. Each individual State will always complain to the voters that it isn't getting its "fair share" or suchlike and this may be true, but the figures are all out in the open for anyone to see. And not getting all the money you wanted out of the Feds doesn't absolve a State gov from having to explain to its voters how it effectively managed the money it was given. "We know you didn't get the $55 Billion you asked for, but what did you do with the $50 Billion that you did get for Healthcare?" I predict it would be electoral suicide for any group to take Federal Healthcare funds and spend them on any form of porkbarrelling.

 

The big thing that gets in the way of effective delivery of services in the US is that your pissant little State Governments can't bring themselves to simply allow for an overarching set of Federal rules on this. Frankly I think Obama should grow a pair and tell all States that "These are the new rules, and anybody who doesn't want to play along gets no Federal healthcare money." Right now the various States are suckling at the healthcare teat to the tune of $2 trillion per year (or whatever obscene amount it is) and are doing jack to deserve it. Federal money comes with the responsibility to follow Federal rules. Deal with that reality.

 

Anyways, that's my 5 cents.

[Ophiolite]

England - complete government run system.

A nationwide system (covering the UK, not just England) is complemented by an extensive private healthcare system which one can access via direct payment or insurance. I have used this system to get various testing procedures carried out more rapidly than would be possible via the National Health Service. The procedures are directed by ones NHS GP or consultant and the results return to them. The system works, in my experience, seemlessly.

[JustinW]

JohnB,

 

I get this free because it is paid from my taxes.

Then it's obviously not free, but just out of curiousity, what percentage of income do you pay in taxes?

 

 

Frankly I think Obama should grow a pair and tell all States that "These are the new rules, and anybody who doesn't want to play along gets no Federal healthcare money."

This is why we shouldn't do it in the first place. He doesn't get to tell us, we tell HIM. If people want a dictator they can go somewhere else.

 

 

Federal money comes with the responsibility to follow Federal rules.

Are federal rules not being followed? I didn't know spending money was against the rules.

[JohnB]

Correct Justin, it isn't "free" per se, but it does operate without out of pocket expenses in many cases.

 

Taxation works very differently down here. As we are a Federation, there are strict limits on what taxes and levies a State may impose. But if we keep that out for the moment and just talk about income tax then the graduated scale is here. Nothing for the first $6k, then 15% for income from 6k to 37k, then 30% for the 37k to 80k bit and then 37% for the 80k to 180k part and finally 45% on anything over 180k. The Medicare levy is on top of that by 1.5% however if a person has an income under about 18.9k they don't pay the levy at all.

 

This is why we shouldn't do it in the first place. He doesn't get to tell us, we tell HIM. If people want a dictator they can go somewhere else.

 

Here is part of the problem. If you elect a President to do as he is told, then why bother at all? You haven't elected somebody to make any decisions or govern in any way so it's a wasted effort. Besides that, it is bull. America didn't decide on the 8th December 1941 that it was going to war with Japan, FDR told America that she was at war. Game over. But we're talking about money distribution here. It's not being dictatorial to say that if a State wants a share of the Federal money pie then that State has to follow the Federal rules.

 

Right now the US Feds spend some $2 trillion on healthcarespread over the various States. Why is it considered dictatorial to say to the States that if they want a slice of the pie then they will have to make some changes? Along the lines of standardising the rules so that the insurance companies can't screw the people any more. There's an old saying that "He who pays the piper calls the tune", if the Feds are supplying the cash why can't they make the rules?

 

Are federal rules not being followed? I didn't know spending money was against the rules.

 

Until such time as there is a single set of rules there can't be a universal system in America. Once you have a single set of rules, then you can have a decent healthcare system. You keep letting the companies play the States against each other and you have a hideously expensive system that provides substandard care. Part of the problem is "State Pride" which is understandable. (Many of the States are so small that pride is about all they can have.) It's not about spending money, you already spend more per capita than anybody else, it's about the system that controls how the money is spent and who is responsible.

 

But seriously, aside from some vague hand waving objections, doesn't our system (as I've described it) seem to work better then yours?

[JustinW]

Correct Justin, it isn't "free" per se, but it does operate without out of pocket expenses in many cases.

 

Taxation works very differently down here. As we are a Federation, there are strict limits on what taxes and levies a State may impose. But if we keep that out for the moment and just talk about income tax then the graduated scale is here. Nothing for the first $6k, then 15% for income from 6k to 37k, then 30% for the 37k to 80k bit and then 37% for the 80k to 180k part and finally 45% on anything over 180k. The Medicare levy is on top of that by 1.5% however if a person has an income under about 18.9k they don't pay the levy at all.

It seems that is quite a lot, although we aren't much better off. How much extra do you have to pay for insurance to suppliment that which government doesn't cover?

 

 

Here is part of the problem. If you elect a President to do as he is told, then why bother at all? You haven't elected somebody to make any decisions or govern in any way so it's a wasted effort. Besides that, it is bull. America didn't decide on the 8th December 1941 that it was going to war with Japan, FDR told America that she was at war. Game over.

Presidents can make some decisions, but decision making is highly limited. They can't just decide to do whatever they want. We have a congress. We elect representatives to represent what the people want. They have the ultimate power over what gets done. FDR didn't tell America anything. You can only go to war with a majority vote from congress. And you can bet your ass that those congressmen heard from their constituents about which way they should vote. Of course congressmen don't have to listen, but then they risk getting fired come election time. This is not a socialistic country, although it's getting to be more and more so, and it's damn sure not a communist country where political leaders get to dictate the public.

 

 

Why is it considered dictatorial to say to the States that if they want a slice of the pie then they will have to make some changes? Along the lines of standardising the rules so that the insurance companies can't screw the people any more. There's an old saying that "He who pays the piper calls the tune", if the Feds are supplying the cash why can't they make the rules?

For the exact reason stated above. That would take a vote from congress, which is voiced through them by the people. You could claim that the people have already spoken with this last passing of the healthcare law, but did you notice how that law was passed. Behind closed doors, with a document so long to be barely readable in time for the public to form an opinion? That didn't seem very transparent to me. That is why it is such an outrage now, and also the reason for this push of repeal.

 

 

But seriously, aside from some vague hand waving objections, doesn't our system (as I've described it) seem to work better then yours?

This is where I am hardheaded. Maybe it's pride of country mixed with ideological principle, but hardheaded just the same.

 

First, your system goes against a majority of this country's principles because it is rather socialistic. Once government gets control of something you are left to their mercy. That is something people don't want here. Especially not with their healthcare.

 

Second, you already pay enough in taxes for healthcare. Then on top of that, you have to pay extra for an insurance to suppliment government coverage just to have some choice in the matter.

 

Third, your system controls price by rationing, which is dictated by a government body. Controling price and controling costs are two different things. Controling price can deminish value of product or service.

While controling cost can be implemented in a way that lowers price yet keeps value at a norm. Lets take perscription medication for example. Your system can ration what type of medication is available, which can lead to inefficiency and lowering choice option for those who can't afford an extra insurance to suppliment the government allowances.

 

 

Fourth, how can you prove to me that our quality of care is lower than yours? And before you use infant mortality rates or life expectancy, just know that I will argue that those numbers make an inadequate comparison, since they use the same criteria to compare completely different systems.

 

 

Fifth, why is it that private hospitals outperform public hospitals, hands down? Why ask for more of something that gets outperformed by what we already have a majority of? Now I'm not against looking for a way to help those that need help. I just don't like the ways that have been proposed.

 

 

Sixth,

Right now the US Feds spend some $2 trillion on healthcarespread over the various States.

By no means does this new reform cut costs. Can you imagine how many companies will drop their employees from their company health insurance plans? The tax penalty for not providing their employees insurance is alot less than the premiums they pay. Which way do you think they will go? So why use what we already spend as an argument in support of it? I have proposed something about the cost aspect in another thread, (which didn't settle well and I'm sure you've already seen), but there was a model that came out that projected a value of money spent. A so called bang for your buck approach that reflects the value you get out of dollars spent in a free market. It showed that we spend more per capita in corrolation to what we make per capita. It showed that we are still in line with value per dollar spent. And part of this 2 trillion you mention is wastefull spending and fraud. I believe a huge chunk of that could be saved if we reduced waste and cracked down on fraud. But it seems that that is too much to ask. Instead, a liberal left wants to socialize the system because somehow they think government bureaucracy is an efficient tool. I'd like to see an example of that in the US government.

 

It was in the thread that you said this:

Justin, you don't understand freedom at all. I'd love to be an employer in the US. So long as there was a good health plan I could treat my workers like the slaves they are.

and I didn't comment at the time about this:

Just like a fire brigade, ambulances, honest cops and an uncorrupted judiciary

but I think I will now. None of these are rights. We pay a fire brigade to put out your house when it's on fire, not rebuild the house. Just like an emergency room, here, does not fix you entirely, just addresses the problem at hand. We pay police to try and keep the peace and enforce the law. Their protection is not a right either. This is why your family cannot sue if they DON'T protect you. These are matters of efficiency and convenience. Not matters of rights and responsibilities. In my view healthcare falls into this category. The same as house or life insurance. It is your responsibility to provide house insurance to fix your house when you need to. It is also your responsibility to buy health insurance in case you need to fix yourself if you need to. Taking that which comes from the sweat of anothers brow is little different than slavery. Or thievery at the very least when there is nothing gained by the person doing the sweating. Forcing such a thing would mean that the idea of personal property is null and void.

 

 

I don't think they are vague hand waving objections. I think they are pointed lagitimate objections that are blown off way too easily.

 

 

edit:as afterthought. I haven't gotten an answer for this yet, so I will ask again. Some claim that if people's healthcare is provided to them for "free", that this will open people up to be more free. I ask, how? And, do people with universal care make more of themselves than people that don't?

Edited April 19, 2012 by JustinW

[questionposter]

A lot of health care would be nice for many people. It would take a large burden off a large population of the United States, which would probably make people less stressed and in effect kinder (like Canada?), as well as able to focus more on work. I really don't mind paying a little bit more on taxes either from on products or my Capital Gains tax seeing as how it could do a lot of good.

Edited April 19, 2012 by questionposter

[JohnB]

Justin, some fair questions and others which just show the differences between our systems.

 

It seems that is quite a lot, although we aren't much better off. How much extra do you have to pay for insurance to suppliment that which government doesn't cover?

 

That's why I said taxes were tricky, we cannot have State Income Taxes, but it appears that you can so this makes it messy. As to the second part here is a listing of private insurers in Australia. Obviously it is a competitive field and the various plans aren't too different, so here is what you get as "extras" for $57.40 per week from the Medibank Private company. Even with only 7 States things get messy. For example the first thing on the list is Ambulance but here in Queensland we pay a levy in our power bills that pays for the Ambulance. Each household chips in $75 per year and we all get free amulance travel whenever we need it.

 

Presidents can make some decisions, but decision making is highly limited. They can't just decide to do whatever they want. We have a congress. We elect representatives to represent what the people want. They have the ultimate power over what gets done. FDR didn't tell America anything. You can only go to war with a majority vote from congress. And you can bet your ass that those congressmen heard from their constituents about which way they should vote. Of course congressmen don't have to listen, but then they risk getting fired come election time. This is not a socialistic country, although it's getting to be more and more so, and it's damn sure not a communist country where political leaders get to dictate the public.

 

For the exact reason stated above. That would take a vote from congress, which is voiced through them by the people. You could claim that the people have already spoken with this last passing of the healthcare law, but did you notice how that law was passed. Behind closed doors, with a document so long to be barely readable in time for the public to form an opinion? That didn't seem very transparent to me. That is why it is such an outrage now, and also the reason for this push of repeal.

 

Here is a difference between our two political systems. Neither the Republicans nor the Democrats have any policies worth talking about. Aside from very general soporifics, what exactly will they do if elected? And how will they achieve these targets? Here are the "policy" pages concerning healthcare from both the GOP and the Dems. Seriously? A nation of 300 million people and the GOP healthcare policy page is a single paragraph? The Dems are better but only just, long on rhetoric and short on actual facts, targets and costings. Compare that to similar pages for our Labor, Liberal and Green parties.

 

Like your Congress our Parliment is directly elected by the people to carry out the will of the people. However we elect parties and people based on the policies that they put before us and therefore elect people to put those policies into practice. The problem you have is that neither major party could find a coherent policy with a Ouija board and a star map. Without them putting forward exactly how a thing is going to work and exactly how it will be funded, the American electorate is constantly buying a pig in a poke.

 

Disliking how a piece of legislation was passed and being against the concept behind the new law are two very different things. You can be in favour of universal healthcare and also against the way the current law was passed. When it first came up I thought it wasn't done well. A huge piece of legislation, some thousands of pages I understand, with very little explanation of how it will work. Very much a case of "This new law will do what we say it will. Trust me, I'm a politician." And nobody in their right mind trusts a politician. The Dems would have been far better off putting it out for public discussion years ago where each part could be discussed openly and the electorate convinced. Obviously I agree with the Dems sentiment, since I support UHC, but I think the way they did it was very poor politically speaking.

 

This is where I am hardheaded. Maybe it's pride of country mixed with ideological principle, but hardheaded just the same.

 

First, your system goes against a majority of this country's principles because it is rather socialistic. Once government gets control of something you are left to their mercy. That is something people don't want here. Especially not with their healthcare.

 

Second, you already pay enough in taxes for healthcare. Then on top of that, you have to pay extra for an insurance to suppliment government coverage just to have some choice in the matter.

 

Third, your system controls price by rationing, which is dictated by a government body. Controling price and controling costs are two different things. Controling price can deminish value of product or service.

While controling cost can be implemented in a way that lowers price yet keeps value at a norm. Lets take perscription medication for example. Your system can ration what type of medication is available, which can lead to inefficiency and lowering choice option for those who can't afford an extra insurance to suppliment the government allowances.

 

 

Fourth, how can you prove to me that our quality of care is lower than yours? And before you use infant mortality rates or life expectancy, just know that I will argue that those numbers make an inadequate comparison, since they use the same criteria to compare completely different systems.

 

 

Fifth, why is it that private hospitals outperform public hospitals, hands down? Why ask for more of something that gets outperformed by what we already have a majority of? Now I'm not against looking for a way to help those that need help. I just don't like the ways that have been proposed.

 

Being hard headed due to pride or ideology is neither logical nor sensible. "Because I think so" is a childish and demeaning argument when coming from an adult. An adult should be able to reasonably express sensible reasons for their position on things. To take you points in order.

 

Firstly socialistic? Are you serious? Are the Interstate highway systems socialistic? The Military? The Federal Police? Universal healthcare is just something that is part and parcel of being part of a developed culture, like honest cops and uncorrupt courts. Or using another scale. In the most primitive of societies no care is given to those who need it, the old and infirm are left to die along the wayside. The more developed a society becomes the more it looks after those who cannot look after themselves. Note that a person who gets ill and can no longer get insurance due to "prexisting conditions" is exactly the same as a person with a congenital defect. Unless you're going to argue that people can choose to get cancer or not. So drop the "Socialism" schtick, it just doesn't fly. UHC is about what sort of society you want to live in, one with developed values or one still stuck in the paleolithic.

 

"Once government gets control of something you are left to their mercy." Bulldust. The government is paying a very large fortune for healthcare, are you saying that this spending should have no controls? Uncontrolled government spending is somehow a good idea? The thing here is that America is already spending far more per capita than anybody else, so how about some controls to make sure that you are getting value for money?

 

Secondly I can only assume you either didn't read or didn't understand my post. I have complete choice in which GP I go to see. I have complete choice in what tests I get done. The Doctors and surgeons who work in the public system are the same ones who work in the private system. The surgeon who removed my Thyroid works three clinics, one at the Royal Brisbane public hospital and two at private hospitals. By going public he sliced me up in the RBH, by being private I would have had the choice of being sliced up in a different hospital. Big deal. We go for very high standards of care down here and that makes choice irrelevent most of the time. Whether public or private, you're going to get sliced by one of the top 10 cutters in the State, does it really matter which one it is? The true "choice" that private insurance gives you is that you don't have to talk to the surgeons with lousy bedside manner. As the nurses all do the same training at the same facilities (and in our system the public hospitals are the teaching hospitals) I have complete confidence in their abilities and will get the same high standard of care regardless of which hospital I'm in.

 

Thirdly we don't control by rationing, but by the amount of the refund or subsidy. While it is true that parts are set by government body, this does not control the price at all. Taking a basic consult the "Prescribed Fee" is say $60 and the refund through Medicare is $45. The Doctor is free to charge whatever price he wants, he can charge $1,000 for a 15 minute consult if he wants, but the refund will still be only $45. Using the public system I have a choice, I can keep going to the wanker and get ripped off, or go to another Doctor. If I have private insurance it would pay for the "Gap" if I have that type of policy. If I choose to get ripped off and have the money to pay for it then I am free to so choose, otherwise I'm free to go somewhere else and get charged less. The government sets the refund, but the market sets the price of the service. I should add that many basic services are indexed and go up automatically with the CPI and all fees for services are constantly being reviewed.

 

With the medicines you're still thinking about it the wrong way. To use another example from me I recently gave up smoking. There is a product called Champix which is a prescription medicine and is subsidised. I go to the Dr and he makes a phone call and I get the Champix of $30 per course rather than $260. However I can only do this once per year. You might think of this as "rationing", but we think of it as not supporting wannabes. Any smoker will tell you that the most irritating person on the planet is the one who is "Giving up" and is constantly bludging smokes from others. If sonebody wishes to make "Giving up smoking" their lifestyle then that is their choice, it is not up to the rest of us to provide smokes and drugs to support their choice. If we didn't do it this way we would be constantly paying for people to have the Champix and they would continue smoking anyway. We're happy to give a hand up, but we aren't so big on hand outs.

 

This isn't to say that we don't have some silly things. We give heroin addicts free needles but not Diabetics. I've never been able to work that one out. Maybe if the Diabetics started leaving their used needles in playgrounds they would have some luck. I don't know.

 

Fourthly. Which is better is painfully obvious. What you need to realise is that people aren't arguing that American Doctors or nurses are worse than their counterparts overseas, but that the system is crap. Plus or minus 10% America is in the ballpark but it's not outcomes that are the problem.

 

Let's say you have 5 car factories all producing a four door sedan. the factories are all in first world nations so there isn't any "Asians work cheaply" argument. All the cars are similar in looks and performance and reliability, all those things. With me so far? Now let's look at the costs;

 

The German factory car costs $3465 to make.

The English factory car costs $2815 to make.

The French factory car costs $3420 to make.

The Canadian factory car costs $3673 to make.

The American factory car costs $6719 to make.

 

Now do you see the problem? The problem is not with the American car itself, but with how the factory that produces it is run. For the money spent the US should be delivering results far above what everybody else is but it is not. It isn't that your Drs and nurses are worse than everybody elses, it's that the system is sucking vast amounts of money away from the end user and you aren't getting value for money. You spend more than twice the per capita the English do and yet they have more hospital beds than you do. (39 per 10,000 population compared to 31.) Comparison Data.

 

Fifthly, down here they don't. The Prince Charles is one of the best heart hospitals in the country and is public. The Royal Brisbane, Royal Childrens and Royal Mothers are all top hospitals. Just because you don't call your State governments to account for how they spend or mis-spend health money doesn't mean the rest of us don't. I will gladly put my life in the hands of the staff of any public hospital in this country without fear.

[zapatos]

You can only go to war with a majority vote from congress.

Well, maybe on paper, but not in reality.

 

The United States has formally declared war against foreign nations five separate times, each upon prior request by the President of the United States. Four of those five declarations came after hostilities had begun.

 

After Congress repealed the Gulf of Tonkin Resolution in January 1971 and President Richard Nixon continued to wage war in Vietnam...

 

On at least 125 occasions, the President has acted without prior express military authorization from Congress.[13] These include instances in which the United States fought in Korea in 1950, the Philippine-American War from 1898–1903, in Nicaragua in 1927, as well as the NATO bombing campaign of Yugoslavia in 1999.

http://en.wikipedia.org/wiki/Declaration_of_war_by_the_United_States

[JustinW]

JohnB

what you get as "extras" for $57.40 per week from the Medibank Private company.

Man, I only pay 20$ a week for myself and my three children through my employee insurance. Of course we're probably dealing with a currency difference.

 

 

Disliking how a piece of legislation was passed and being against the concept behind the new law are two very different things.

They may be two different things, but they are two different things that a majority of Americans have in common in this particular case.

 

 

The Dems would have been far better off putting it out for public discussion years ago where each part could be discussed openly and the electorate convinced.

Agreed. For the simple fact that if they would have done it this way, it probably would have taken on more of a free market solution. It's not that the people don't want others to be covered. It's just that we don't want the government oversight in this matter to become so entrenched that there is no flexibility or choice. In my view the whole principle of a limited government is to avoid the tyranny that other nations have experienced throughout history. If someone would suggests that we have our own problems, you bet we do, but they are not problems that We The People cannot address.

 

 

Being hard headed due to pride or ideology is neither logical nor sensible.

It seems that some form their ideologies based on emotion. With healthcare they feel that it is unfair and downright cruel not to provide it to everyone. I personally, believe that feelings should start a person in a direction but the principles that constitute my ideology should set the standard. If we were to always make policy based on emotional reactions, policy making would turn into a rollercoaster ride. And it seems that the two ideologies at work today in US politics seem to either be one way or the other. One it seems would rather have the government take care of most problems, while the other side would rather limit the government to allow the people to come up with a solution. Any rational person can understand that these two things have to blend, but we tend to disagree to which side the blend should lean.

 

 

Firstly socialistic? Are you serious? Are the Interstate highway systems socialistic? The Military? The Federal Police?

Serious as a heart attack. Interstate highways are not socialistic because they are not mandating that you buy a product to so others can use that highway. The equivalent to that analogy would be the government mandating that you buy poor people a vehicle so can they can use those highways. The military has nothing to do with either one. A country will be conquered in short order without a military. What about the federal police. Didn't I say something earlier about efficiency and convenience? The big cry for this healthcare reform was that those on the left felt that it was everyones RIGHT to have healthcare. Police protection is not a right. So again it can fall back to efficiency and convenience.

 

 

The government is paying a very large fortune for healthcare, are you saying that this spending should have no controls?

I'm not saying that. I am saying that those controls should be decided by the people through their elected representatives rather than some government bureaucracy. Name one US bureaucracy that runs efficiently and doesn't get worse as time goes by. By it's very nature, the longer it exists the more it's goal becomes about political survival rather than efficiency.

 

Not to mention those polititions could have done something about this large fortune that they are spending. But instead of addressing the problems behind the spending, they would rather create a crisis that supports their ideology in order to drive the government in the direction that they preffer. Look up how much waste is estimated to be in our medicaid, medicare, social security, and food stamp programs. Add to that the huge amounts of fraud that those programs are eat up with and tell me if that doesn't seem like it should have been the firstt thing to deal with. Instead this fight is more ideological than about the actual problem, at least where spending is conscerned. Like I've stated before. I agree with the sentiment, but disagree with the solutions proposed. From a political viewpoint it goes against the principles that most Americans have stood for in the past.

 

 

Whether public or private, you're going to get sliced by one of the top 10 cutters in the State, does it really matter which one it is?

So you're saying that ten doctors cover a whole state? I'm not sure what you're point is with this paragragh. It sounds about like everything is roses over there in Oz. Could it be that wonderfully glorious?

 

 

The true "choice" that private insurance gives you is that you don't have to talk to the surgeons with lousy bedside manner. As the nurses all do the same training at the same facilities (and in our system the public hospitals are the teaching hospitals) I have complete confidence in their abilities and will get the same high standard of care regardless of which hospital I'm in.

So people pay over 54$ a week so they can go to a doctor who speaks them nicer? What about people who are in an accident that requires cosmetic surgery. Is that covered? Or do those people left with half a face if they don't have private insurance. Is optical covered? Dental?

 

Thirdly we don't control by rationing, but by the amount of the refund or subsidy.

Really? Then what's up with the PBS list? Is that not considered rationing by limiting access to medications? Anything that is not a PBS item, the patient has to pay in full, as far as I understand. Ambulance service isn't covered. Only most Primary Care treatment which implies that some are not. Clinical treatments which are not deemed necessary are not covered. Which implies that there is a governing body that dictates what is and isn't. (which is a major part of my argument against) And medical costs incurred overseas. Which doesn't make sense to me. If it is so God-Awfull and morally right that everyone should have care, then it seems like a contradiction to leave those hanging that are just out of the country at the time. Doesn't it?

 

If sonebody wishes to make "Giving up smoking" their lifestyle then that is their choice, it is not up to the rest of us to provide smokes and drugs to support their choice. If we didn't do it this way we would be constantly paying for people to have the Champix and they would continue smoking anyway. We're happy to give a hand up, but we aren't so big on hand outs.

I see this differently. You have the option not to give those people smokes. It is your choice to do it or not. But instead of standing up for your choice not to give a bum a smoke and making them take responsibility for themselves, you let the government mandate that you pay for their perscription, eliminating their own responsibility when most will ultimately still bem smokes from people. So looking at the big picture, what did that really solve? And would the comfort of not having to give someone a smoke be worth going against my principles? To me it wouldn't.

 

 

We give heroin addicts free needles but not Diabetics.

We do this in places too. It is meant to keep down diseases spread through the sharing of needles, but I'm not sure how much of an impact it has had.

 

 

The German factory car costs $3465 to make.

The English factory car costs $2815 to make.

The French factory car costs $3420 to make.

The Canadian factory car costs $3673 to make.

The American factory car costs $6719 to make.

I can see this point, BUT(and it's a big but) there are a few things that make this understandable. America makes a lot more per capita than most other countries. Even devided up into states, the individual states make more per capita than most other countries. In a free market system that is not regulated to control cost, one can spend their money however they wish. Anyone who is ever gotten a raise at work knows that the more you make the more you spend. Is this not true? Now, if that is true then why wouldn't it also be the same with healthcare? Another point to this is that without restriction there can be more amenities in a product or service. Over in Oz country you can see this with some of the private services that are not covered by the public system. These types of services are covered by our private insurance, they just add to the cost(value=comfort in this case). You get where I'm going with this? And all of this considered I still didn't add waste and fraud. Which is one of my biggest pet peaves about our system, because no one seems to want to do anything about it.

 

Are these not plausable and acceptable reasons for the higher costs? And I'm not against the lowering of costs. I think it should be one of our biggest priorities, but not at the risk of going against our principles of limited government and individual freedom and responsibilty.

 

Fifthly, down here they don't.

Then why are waiting times longer for public hospitals? Nurse:patient ratios are higher in public hospitals, which weighs on cleanliness and efficiency. And private hospitals have more amenities and better sights (you can't say that comfort level doesn't weigh on a ptients . I also read something awhile back on birth conditions being better in private hospitals, but that is more of a specific, which can go both ways once specific outcomes are taken into consideration.

 

 

I will gladly put my life in the hands of the staff of any public hospital in this country without fear.

It's good to see someone express pride for their own country. Here lately I've heard too many bashing something great.

 

 

Zapatos,

 

Well, maybe on paper, but not in reality.

Oh okay. I'm back in my fantasy world again. Even those that were not officially passed by congress had their approval. If they didn't those actions could have easily been defunded. And I assert that that is what would have happened if they didn't. My point was that a president doesn't dictate to the public, but rather the other way around in an indirect way.

[JohnB]

Again, some fair comments.

 

Man, I only pay 20$ a week for myself and my three children through my employee insurance. Of course we're probably dealing with a currency difference.

 

Actually our dollar is worth slightly more than yours ATM. You say "Employee Insurance" which implies a company is paying some of the premium, how much is the company paying? And if you weren't part of a company fund, what would you be paying? Let's compare apples to apples here.

 

Serious as a heart attack. Interstate highways are not socialistic because...

 

This could just be a difference in how we view things. Healthcare is not viewed as a right or privilige, it's something basic in an advanced society. It's a service, nothing more. From our POV it is no more socialist than having a gov dept making rules about impurities in food. A service that government supplies to its people is a basic standard of food quality and food handling rules. To us, basic healthcare is the same it's just a service gov provides.

 

I should add that Queensland was run by a bloke called Joh Bjelke-Petersen for some decades while our "free" hospitals were expanded. Indeed one of the arguments against the Australian system was that we already had a working system so why should we pay more for something we already get? To call anything associated with this man "socialist" is to make you look a fool in the eyes of every Australian. The idea is simply ludicrous, so I suggest the "socialist" doesn't mean what you seem to think it means.

 

I'm not saying that. I am saying that those controls should be decided by the people through their elected representatives rather than some government bureaucracy. Name one US bureaucracy that runs efficiently and doesn't get worse as time goes by. By it's very nature, the longer it exists the more it's goal becomes about political survival rather than efficiency.

 

The laws that govern how a system is run are voted on by the elected representatives of the people. Do you think our system came about because some shiny bums in Canberra thought it would be a good idea for expanding their department? It was legislation, introduced and voted on in Parliment that brought it about. All major changes have been fought at the ballot box. If you have a problem with bloated beauracracies then I suggest that you put pressure on your elected representatives to actually do something about it. As a point, Federal Healthcare down here runs at about 3% administration costs for the country but this isn't an accident.

 

We aren't as nice as you are to politicians that don't do their job. Have a look at the Queensland Election results from last month. Until the 24th the ALP held some 56 seats out of 89, they now hold 7. The ALP Federal Government is absolutely sh*tting itself about what is going to happen to them.

 

Your politicians are not scared of their voters and they bloody well should be. Looking at the Texas Wiki page it looks like you're not too kind to the Dems, bu the electorate should now be saying to the GOP "Get your act in gear or next time your numbers will be so low as to make the Dems look like a major win." If the pressure was on and half the sitting members looking at losing the next election, you bet your arse they will do as they are told.

 

So you're saying that ten doctors cover a whole state? I'm not sure what you're point is with this paragragh. It sounds about like everything is roses over there in Oz. Could it be that wonderfully glorious?

 

It's not glorious, but it does work quite well. We have far fewer surgeons covering the State than you do. Queensland is roughly twice the size of Texas and has a population of about 3 million. The point is this, since all surgeons have to meet standards what does it really matter who does the cutting? Put it another way, since all paramedics are qualified paramedics does it really matter which one drives you to the hospital? My view is a continuation of the same principle.

 

So people pay over 54$ a week so they can go to a doctor who speaks them nicer? What about people who are in an accident that requires cosmetic surgery. Is that covered? Or do those people left with half a face if they don't have private insurance. Is optical covered? Dental?

 

I've already mentioned optical and dental, so I have to wonder if you are actually reading my posts and comprehending them. The extra $54 gets you a private room (which I always found boring) and a variety of other things that can be found at the link I gave. Cosmetic surgery is a sticking point and one we are constantly considering. What we've done is split it into "Cosmetic" and "Reconstructive" for the start. Surgery to repair damage after an accident is deemed "Reconstructive" and is covered by the public system. Where we are getting problems is with the psychologists buying in now. They're arguing that a girl with a "B" cup might feel "inferior" to a girl with a larger bust and therefore breast augmentation surgery is not "Cosmetic" but has a therapeutic benefit. This argument is being expanded to cover just about any part of a persons anatomy that they might feel "bad" about being fixed as a theraputic situation. Eyebrow plucking, hair regrowth, gender changes, everything is up for grabs at the moment.

 

But the point is that we do talk about things and decide what we will authorise our governments to pay for as a general thing. The Obama system wasn't put out there and publicly discussed anywhere near enough.

 

Really? Then what's up with the PBS list? Is that not considered rationing by limiting access to medications? Anything that is not a PBS item, the patient has to pay in full, as far as I understand. Ambulance service isn't covered. Only most Primary Care treatment which implies that some are not. Clinical treatments which are not deemed necessary are not covered.

 

What on Earth are you talking about? Why would you expect something called the "Pharmaceutical Benefits Scheme" to have anything to do with the ambulance service? The PBS is about subsidised pharmaceuticals and nothing else. And as I've said before, we pay a levy on our power bills and get "free" ambulance access anyway.

 

With the smoking drugs it's a case of "Sure, we'll help pay for the drugs to help you quit. But we'll only do it once per year". To keep paying for the things would be like allowing the person to continue to bum smokes. "Giving up smoking" is an intention, not a lifestyle and we support good intentions but not lifestyles.

 

I can see this point, BUT(and it's a big but) there are a few things that make this understandable. America makes a lot more per capita than most other countries. Even devided up into states, the individual states make more per capita than most other countries. In a free market system that is not regulated to control cost, one can spend their money however they wish. Anyone who is ever gotten a raise at work knows that the more you make the more you spend. Is this not true? Now, if that is true then why wouldn't it also be the same with healthcare? Another point to this is that without restriction there can be more amenities in a product or service. Over in Oz country you can see this with some of the private services that are not covered by the public system. These types of services are covered by our private insurance, they just add to the cost(value=comfort in this case). You get where I'm going with this? And all of this considered I still didn't add waste and fraud. Which is one of my biggest pet peaves about our system, because no one seems to want to do anything about it.

 

Your doctors and nurse aren't paid more than ours, so why does a hospital bed cost twice as much per day? Look up the payscales, your people aren't being paid more than everybody elses, so where is all the money goingto? As to "more amenities" you generally have less doctors, nurses and hospital beds per 10,000 people than the rest of the developed world.

 

You also seem to be labouring under the miscomprehension that "Universal Health Care" is supposed to cover everything when it isn't. The point of the Australian system is to provide timely and affordable basic healthcare to all citizens. If you want more than the basics, then you can buy private insurance or not, your choice. I don't have private insurance but this doesn't mean I dip out. It means that when I do to the dentists I simply pay the bill out of my own pocket and I pay full price for my glasses. Neither of these is a financial burden to me.

 

And to put a reality spin on things, 6 months ago when I had a tooth out, a molar, it cost me about $350 all up. What would your bill be?

 

Then why are waiting times longer for public hospitals?

 

Because they have to treat everybody and private hospitals don't. Duh! But seriously the waiting times are more due to lack of qualified surgeons etc that anything else. It doesn't matter how many ORs a hospital has if it doesn't have the staff to operate them 24/7.

 

Nurse:patient ratios are higher in public hospitals, which weighs on cleanliness and efficiency. And private hospitals have more amenities and better sights (you can't say that comfort level doesn't weigh on a ptients . I also read something awhile back on birth conditions being better in private hospitals, but that is more of a specific, which can go both ways once specific outcomes are taken into consideration.

 

How about some links to back these stories up?

 

The thing I don't get is this, why you are arguing against. Your current system doesn't cover everybody for the basics and costs some $2 trillion per year and you have God knows how many people every year going bankrupt due to health costs. If you bit the bullet and forced the change to our system you would have one that costs $1 trillion, covers everybody and nobody would be going bankrupt. How is this not a good idea???

 

Edit to add.

 

In general the "Freedom of Choice" under private insurance is a fantasy. We the general public don't know enough to make a true choice. If your kid is rushed to hospital with a burst appendix are you going to ask for the CVs of the various available surgeons and make a "choice"? Of course not, you'll be bloody thankful that there was a surgeon and OR available. The closest you'll come to a choice is picking which specialist from the three or four your GP advises and even then it will probably be your GPs preferred choice anyway. So what "Freedom of choice" is there really? Just the freedom to choose the view from the ward window and that's about it.

Edited April 22, 2012 by JohnB

[iNow]

JohnB

Man, I only pay 20$ a week for myself and my three children through my employee insurance. Of course we're probably dealing with a currency difference.

Your experience is an outlier, Justin. For the past decade, or so, I've worked for a few fairly large international corporations, and my payments per week for coverage with family have been closer to $40-50.

 

---

JohnB - As always, some really solid posts and presented in a personal first-person manner on this topic.

[JustinW]

JohnB,

 

Actually our dollar is worth slightly more than yours ATM. You say "Employee Insurance" which implies a company is paying some of the premium, how much is the company paying? And if you weren't part of a company fund, what would you be paying? Let's compare apples to apples here.

 

I honestly have to say that I don't know. I imagine that it's probably pretty spendy considering the type of insurance it is, and have no doubt that private insurance over there is cheaper when comparing apples to apples. I kinda thought that was what I was doing when comparing out-of-pocket to out-of-pocket expense.

 

As for not being in a company fund, I had to drop my wife off the plan this last quarter. Something to do with the new health reform law went into affect, which inturn caused insurance companies to raise their premiums. I was paying about 500$ a month when my wife was included, then it jumped to over 800$ a month this past quarter. Once I dropped my wife it went down to 80$ a month. I still haven't made sense out of why married women cost so much more than single women, or what exactly about Obama's new reform law affected these insurance companies so bad. But what I do know is that this scenario coupled with what will happen if the supreme court doesn't overturn the purchase mandate, that this reform will hurt people more than help at least, (at the very least), until the transition is completed. My confidence in that is minimal as well.

 

It's a service, nothing more. From our POV it is no more socialist than having a gov dept making rules about impurities in food. A service that government supplies to its people is a basic standard of food quality and food handling rules. To us, basic healthcare is the same it's just a service gov provides.

The government might regulate unsafe food, but they already regulate unsafe medical practice. The government doesn't mandate that you buy a certain food or ristrict certain foods to cut costs. That WOULD be socialistic, would it not? So I don't believe that basic services are socialistic in the way that I see your healthcare system or the one that is trying to be implimented here.

 

But the point is that we do talk about things and decide what we will authorise our governments to pay for as a general thing. The Obama system wasn't put out there and publicly discussed anywhere near enough.

There's a reason for that. It's because they knew that once it was publicly discussed, that it would have been rejected as it was in the 90's.

 

What on Earth are you talking about? Why would you expect something called the "Pharmaceutical Benefits Scheme" to have anything to do with the ambulance service? The PBS is about subsidised pharmaceuticals and nothing else. And as I've said before, we pay a levy on our power bills and get "free" ambulance access anyway.

I didn't say anything about the PBS being connected with ambulance services. I was listing off things that are not covered by your government system. You said that the government doesn't ration. I gave a list of things they do ration.

I said that the government only allows people to have medications that are on the PBS list. The cost of those that are not is charged in full to the patient.

 

Most primary care treatment is covered, which MOST, implies that all are not. Rationing?

Clinical treatments which are not deemed necessary are not covered. Which implies that there is a governing body that dictates what is and isn't. Rationing?

And medical costs incurred overseas are not covered, which is rationing and what I feel is a conflict of the whole idea behind a universal system.

So that was my point in listing those items, not to in anyway link PBS with ambulatory services.

 

The laws that govern how a system is run are voted on by the elected representatives of the people.

Hence, what I said about pollitical survival. Political survival can be detrimental to the very nature of an institution. I don't like the idea of voluntarily opening that perverbial can of worms.

 

Your politicians are not scared of their voters and they bloody well should be. Looking at the Texas Wiki page it looks like you're not too kind to the Dems, bu the electorate should now be saying to the GOP "Get your act in gear or next time your numbers will be so low as to make the Dems look like a major win." If the pressure was on and half the sitting members looking at losing the next election, you bet your arse they will do as they are told.

I agree to an extent. The Repubs are sitting pretty for a couple of different reasons. I think that most of all it is because US Dems are connected to this Liberal socialist movement. Texas, being majorily conservative generally gets people to automatically oppose them. Another reason is that, although there have been some misdeeds by the conservative side of the arena, during the recent resession Texas felt less of an impact than most of the other states. This was attributed to conservatism rather than liberalism. So I can see where a conservative might not have any reason to fear losing their job. With the majority of Texans considering themselves conservative, the idea of switching to Liberal Socialism isn't to even be considered. Kinda like a dirty word.

 

 

It's not glorious, but it does work quite well. We have far fewer surgeons covering the State than you do. Queensland is roughly twice the size of Texas and has a population of about 3 million. The point is this, since all surgeons have to meet standards what does it really matter who does the cutting? Put it another way, since all paramedics are qualified paramedics does it really matter which one drives you to the hospital? My view is a continuation of the same principle.

I think I see what you're saying here, but am not sure that I would pick that over a competitive structure that we see in a free market. When two different surgeons compete for higher pay. That higher pay is a direct reflection of quality of work. Or at least in theory. When government gets involved it tends to change the game a bit.

 

I've already mentioned optical and dental, so I have to wonder if you are actually reading my posts and comprehending them.

 

And this is what it said about dental and optical.Surgical removal of wisdom teeth

(for hospital charges only), and Major eye surgery - including cataract & lens-related services.

 

So the dental is only hospital related for one specific procedure, and the optical is about the same. Most dental and optical still isn't covered that I can see. So what did I miss here?

 

With the smoking drugs it's a case of "Sure, we'll help pay for the drugs to help you quit. But we'll only do it once per year". To keep paying for the things would be like allowing the person to continue to bum smokes. "Giving up smoking" is an intention, not a lifestyle and we support good intentions but not lifestyles.

Ahhh, good intentions. I hate to get off subject, but something came to mind when I read this. I forgot who said it, but I once heard someone say that the most evilest of acts come from one man's good intentions. Whether those intentions were misguided or not, an evil act can always be nailed down to someone's good intention. That probably has no relevance in this case, but I thought I would share it anyway.

 

 

And to put a reality spin on things, 6 months ago when I had a tooth out, a molar, it cost me about $350 all up. What would your bill be?

I had a friend get one pulled out about 2 years ago for 80$. I just asked another friend of mine, who said that he had one pulled in the next town over, and it was a little more than 150$. So price may have went up in recent years, but still fairly inexpensive compared to alot of places.

 

You also seem to be labouring under the miscomprehension that "Universal Health Care" is supposed to cover everything when it isn't. The point of the Australian system is to provide timely and affordable basic healthcare to all citizens.

I can also understand this. But I'm trying to get an idea of what you pay:what you get, compared to what we pay:what we get.

 

 

Because they have to treat everybody and private hospitals don't. Duh! But seriously the waiting times are more due to lack of qualified surgeons etc that anything else. It doesn't matter how many ORs a hospital has if it doesn't have the staff to operate them 24/7.

And you don't think that competition would drive employment. A hospital employee here in the US has benifits to consider when making a choice on where to work. Do your hospital employees get offered any benifits?

 

 

Your current system doesn't cover everybody for the basics and costs some $2 trillion per year and you have God knows how many people every year going bankrupt due to health costs.

Can you show me that a majority of these people actually paid medical costs? If I went broke, and wanted to play a system that is easily playable, I would file for brankruptsy and list it as being due to medical costs. Hell, I can do that right now if I wanted to, but I won't. My own father did that back in the early 90's when his restaraunt went under. And he never paid a dime towards medical. He used the bill from one of my surgeries as a reason. All you have to do is show that you owe, not that you've actually paid anything. So it's a little hard for me to believe that all of these people went bankrupt paying their medical bills.

 

 

If you bit the bullet and forced the change to our system you would have one that costs $1 trillion, covers everybody and nobody would be going bankrupt. How is this not a good idea???

Where does it show that Obama's new reform will actually cut costs? I've heard people say it, but it has since been debunked by a lot of folks.

 

In general the "Freedom of Choice" under private insurance is a fantasy. We the general public don't know enough to make a true choice.

I get what you're saying. But right now there is no one stopping those in the general public, that do know, from making a decision. Also I tend to think that it a persons responsibility to LEARN enough to make a sound decision.

 

iNow,

 

Your experience is an outlier, Justin. For the past decade, or so, I've worked for a few fairly large international corporations, and my payments per week for coverage with family have been closer to $40-50.

Yes, and I was paying closer to $125 a week. With my wife off the policy it is now about $20 a week. What gives? You can blame it on the insurance company, but I would rather think that there was a reason behind it, and not just the greed of insurance companies.

[CharonY]

As for not being in a company fund, I had to drop my wife off the plan this last quarter. Something to do with the new health reform law went into affect, which inturn caused insurance companies to raise their premiums. I was paying about 500$ a month when my wife was included, then it jumped to over 800$ a month this past quarter. Once I dropped my wife it went down to 80$ a month.

 

Is it possible that this is due to a change in coverage? It depends on what you got before, but under the new provisions preventive care is supposed to be covered without co-pays and deductibles.

Also they are not allowed to have annual or lifetime caps. Starting 2014 the companies are not allowed to have higher premiums for men than for women (which may be the case for the describe scenario). Maybe they just want to gauge some money as long as they can?

[JustinW]

CharonY,

 

Is it possible that this is due to a change in coverage?

Naw. We still carry the same company, and the package name and benifits are still the same.

 

It depends on what you got before, but under the new provisions preventive care is supposed to be covered without co-pays and deductibles

This right here would be one hell of a reason for an insurance company to raise their premiums. What percentage of testing and treatment would you say is preventative? ALOT, that's how much. This reform is turning out to hurt more than it helps from what I can see so far.

 

Maybe they just want to gauge some money as long as they can?

See, this had popped up in my mind, but I dismissed it due to the competitive nature of the market. If one company's rates skyrocket, you know others will take advantage of this to gain customers. Since no others were taking advantage of this, I just assumed that there was a legitimate reason for the insurance company to raise premiums so high. The agent who came in to discuss the plan said "that she didn't know the exact part of the law that went into affect that caused it, but that she knew it had something to do with it". Whatever that means. Oh, and never fear about the wifey. I found her a policy that was around $134 a month. Though it's not quite as good, it still covers the basics till something better comes along, and it's a whole lot better than $800 a month.

[Phi for All]

Yes, and I was paying closer to $125 a week. With my wife off the policy it is now about $20 a week. What gives? You can blame it on the insurance company, but I would rather think that there was a reason behind it, and not just the greed of insurance companies.

Even when you remove obstetric care from the equation, gender rating against women shows that women are charged more for medical insurance than their male counterparts across the board using some really stupid metrics, like increased likelihood of domestic violence. In many states, it's not uncommon for a non-smoking woman to pay significantly more than a man who smokes. No matter what we'd like to think, there doesn't seem to be any justifiable reasons other than greed. The Affordable Care Act has banned the practice of gender rating.

[JustinW]

Phi,

 

so you're just chalking it up to greed rather than sound business practice? One set price for all would also mean higher premiums.

[Phi for All]

so you're just chalking it up to greed rather than sound business practice?

How is it a "sound" business practice to charge more for women just because it's easy to make people think it's justified? If you remove the obstetric costs, women are still being charged more for health insurance for the same coverage. The reasons given by the insurance carriers have been proven to be bullshit (like pointing to cities with high instances of domestic violence and then applying that to women everywhere). That's why the Affordable Care Act is not allowing the exploitation to continue.

 

One set price for all would also mean higher premiums.

Only if you as a consumer and a citizen allow it. And it looks like, even though you seemed to object to the higher costs before I commented, you are now convinced the insurance companies are justified in continuing the practice. I don't mean this as a personal attack, but it seems to me like on the one hand you defend the free market, and on the other you think it's acceptable to allow discrimination if standing up for your wife means paying more. Aren't you the guy who asked, "What gives?"

[JustinW]

Hello Phi, hope the trip went well.

 

How is it a "sound" business practice to charge more for women just because it's easy to make people think it's justified? If you remove the obstetric costs, women are still being charged more for health insurance for the same coverage. The reasons given by the insurance carriers have been proven to be bullshit (like pointing to cities with high instances of domestic violence and then applying that to women everywhere). That's why the Affordable Care Act is not allowing the exploitation to continue.

I mostly agree with you on this to a certain extent. What I was trying to get across was that not all of the charges based on differences are BS. I agree that they can get out of hand when justifying some charges, but a cost analysis should still apply when comparing gender, race, location, etc... Things like domestic violence, and I'm sure there are others, I think are going above and beyond a fair cost analysis. And it's these types of things that give these companies a bad name and spur along outrage throughout the public to give people an excuse to do away with the whole system. So I believe that these companies should look at differences when doing a cost analysis, (that's only good business), but I think they should be aware not to cross a line between good business and squeezing consumers.

 

 

Only if you as a consumer and a citizen allow it.

And I agree here too once I think about it. This is where free market competition should give the consumer more freedom. But how this certain area of the market has developed, the consumer has nowhere else to turn. This I believe is the biggest problem with our healthcare system. And don't get me wrong, even though I believe this is a big problem, I still don't agree with the changes that are trying to be made. I think we should open up the market to better benifit the consumer. We can do this by focusing on not just one area, but multiple areas at once that drive costs.

 

 

And it looks like, even though you seemed to object to the higher costs before I commented, you are now convinced the insurance companies are justified in continuing the practice.

No, as I explained above, I was commenting on the fact that it's not as cut and dry as you made it seem. A cost analysis needs to take every factor into consideration, but it is those that would take the high end and apply it across the board that are disingenuous. I know if I owned a business that I wouldn't focus on maximizing profit ABOVE quality of consumer relations. And I have a feeling that that is the exact reason that we are in the pickle that we're in these days.

 

 

I don't mean this as a personal attack, but it seems to me like on the one hand you defend the free market, and on the other you think it's acceptable to allow discrimination if standing up for your wife means paying more.

With the amount of conversations we've had over the past several months, I can't imagine your character as malicious. So it would have to be pretty harsh before I would consider anything you say as a personal attack.

 

I can see how you could be confused on my take of these types of situations. It's not that I flip flop on these topics. It's that I'm not just an all or nothing kind of person. I will always stand up for free market capitalism. Does this mean that I can't think that certain things are wrong about it? NO. But it seems that any time I express some thoughts about something that is wrong with it, people say "Aha", or "you think one thing one minute then another thing the next". I don't see why you can't see the problems in a system without wanting to scrap the whole thing. Then people that want to replace this kind of system with another seem to totally ignore the things that are wrong with the system that they champion. It makes no kinda sense to me.

 

And I did ask what gives. I also implied that it was a direct result of Obama's healthcare reform law, but no one seems to want to give an answer to that. I can see this reform hurting before it helps on a couple of different levels, but again, no one seems to give a damn about that either just as long as the end result is government control.

[zapatos]

I thought the following was an interesting article. Looks like an Indian company sees profit to be had in reaching out to America's underinsured.

 

Ascension Health Alliance executives say their joint venture to build a $2 billion "health city" in the Cayman Islands with an India-based hospital group will bring high-quality, low-cost medicine to the Caribbean and South America.

 

"We’re not considering this a medical tourism facility. That’s not the intent at all," said Anthony Tersigni, president and chief executive of Edmundson-based Ascension Health Alliance, which runs the nation’s largest Catholic and nonprofit health system. "I’m not sure we’re going to have U.S. patients at the Caymans."

 

But the system’s for-profit partner, Narayana Hrudayalaya Hospitals in India, has cast the project in sharply different terms. For years, Narayana’s founder, Dr. Devi Prasad Shetty, has promoted the idea of building an offshore medical center to serve primarily American patients who cannot afford health care in the United States.

 

"Cayman Islands is an hour flight from the U.S., and we intend to offer cost-effective treatment for the citizens of the U.S. and also (those) who are under-insured," Shetty said in Narayana news release in October.

 

...

 

Read more: http://www.stltoday.com/business/local/ascension-health-plans-billion-cayman-health-city-project/article_cbe07d56-8d91-11e1-85c9-001a4bcf6878.html#ixzz1tBC2nZA4'>http://www.stltoday.com/business/local/ascension-health-plans-billion-cayman-health-city-project/article_cbe07d56-8d91-11e1-85c9-001a4bcf6878.html#ixzz1tBC2nZA4

http://www.stltoday.com/business/local/ascension-health-plans-billion-cayman-health-city-project/article_cbe07d56-8d91-11e1-85c9-001a4bcf6878.html

[JustinW]

I too ran into an interesting article today that supports my take on fraud and how much it actually affects our spending and availability.

 

http://usnews.msnbc.msn.com/_news/2012/05/02/11504338-feds-unveil-allegations-of-450-million-in-medicare-fraud-schemes?lite

 

 

And keep in mind that without even covering patient abuses this type of fraud alone is estimated to cost taxpayers upwards of 160 billion dollars a year.