View Poll Results: Do you think no more preexisting conditions is right or wrong?

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Thread: Do you think no more preexisting conditions is right or wrong?

  1. #111
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    Kandahar's Avatar
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    Re: Do you think no more preexisting conditions is right or wrong?

    Quote Originally Posted by cpwill View Post
    i think you meant even more unsustainable.

    but yes; it's going to come crashing down.

    which, mind you, was the intent all along; they're going to use the crash to push for single-payer via the halfway point of a public option.

    only problem is, if this thing crashes with Republicans in charge of the House, they are screwed, and the only option left is market liberalization. woops.
    I'm curious as to what you mean by "market liberalization." The health care industry, by its very nature, is not friendly to competition. Individual insurers work out agreements with individual hospitals, which is a recipe for patchwork policies and horrendous inefficiency. It also dissuades universal documentation; why should hospitals want to make it easy for rivals to steal their patients? Laissez-faire policies also means that it will be more difficult to compare and contrast the effectiveness of one hospital (or insurer) with another, as those statistics won't be published at all. And, of course, it traps workers at their jobs because they cannot leave without losing their health insurance; this reduces social mobility and discourages people from pursuing careers at which they can excel.

    "Market liberalization" should be about encouraging competition...not about eliminating government just because you don't like government. If the laissez-faire approach actually encouraged competition and efficiency, then I think most people would support it. But that's simply not the case in health care.
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  2. #112
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    Re: Do you think no more preexisting conditions is right or wrong?

    Quote Originally Posted by Kandahar View Post
    I'm curious as to what you mean by "market liberalization."
    drop the state barriers. stop distorting the market by pushing people into employer-provided health insurance with a heavy third-party-payment model (which, as you point out, effectively traps people at their jobs). move to high-deductible plans that don't cover non-insurable events like regular checkups (that's like asking auto insurance to cover your oil change). and so forth.

    The health care industry, by its very nature, is not friendly to competition.
    large entities are never friendly to competition. McDonalds does not appreciate the superior taste of the Whopper, and agribusiness looks at being foited off of their subsidies and back onto the market as an absolute horror.

    And, of course, it traps workers at their jobs because they cannot leave without losing their health insurance; this reduces social mobility and discourages people from pursuing careers at which they can excel.
    actually it is the current emphasis on employer-provided health insurance which produces this. liberalization would involve at the least giving individuals and businesses the same tax incentives for purchasing health insurance. McCain suggested this in the 2008 campaign; the Obama camp, of course, said it meant he wanted people to lose coverage

    "Market liberalization" should be about encouraging competition...not about eliminating government just because you don't like government. If the laissez-faire approach actually encouraged competition and efficiency, then I think most people would support it. But that's simply not the case in health care.
    really?


    When I was elected governor of Indiana five years ago, I asked that a consumer-directed health insurance option, or Health Savings Account (HSA), be added to the conventional plans then available to state employees. I thought this additional choice might work well for at least a few of my co-workers, and in the first year some 4% of us signed up for it.

    In Indiana's HSA, the state deposits $2,750 per year into an account controlled by the employee, out of which he pays all his health bills. Indiana covers the premium for the plan. The intent is that participants will become more cost-conscious and careful about overpayment or overutilization.

    Unused funds in the account—to date some $30 million or about $2,000 per employee and growing fast—are the worker's permanent property. For the very small number of employees (about 6% last year) who use their entire account balance, the state shares further health costs up to an out-of-pocket maximum of $8,000, after which the employee is completely protected.

    The HSA option has proven highly popular. This year, over 70% of our 30,000 Indiana state workers chose it, by far the highest in public-sector America. Due to the rejection of these plans by government unions, the average use of HSAs in the public sector across the country is just 2%.

    What we, and independent health-care experts at Mercer Consulting, have found is that individually owned and directed health-care coverage has a startlingly positive effect on costs for both employees and the state. What follows is a summary of our experience:

    State employees enrolled in the consumer-driven plan will save more than $8 million in 2010 compared to their coworkers in the old-fashioned preferred provider organization (PPO) alternative. In the second straight year in which we've been forced to skip salary increases, workers switching to the HSA are adding thousands of dollars to their take-home pay. (Even if an employee had health issues and incurred the maximum out-of-pocket expenses, he would still be hundreds of dollars ahead.) HSA customers seem highly satisfied; only 3% have opted to switch back to the PPO.

    The state is saving, too. In a time of severe budgetary stress, Indiana will save at least $20 million in 2010 because of our high HSA enrollment. Mercer calculates the state's total costs are being reduced by 11% solely due to the HSA option...

    It turns out that, when someone is spending his own money alone for routine expenses, he is far more likely to ask the questions he would ask if purchasing any other good or service: "Is there a generic version of that drug?" "Didn't I take that same test just recently?" "Where can I get the colonoscopy at the best price?"

    By contrast, the prevalent model of health plans in this country in effect signals individuals they can buy health care on someone else's credit card. A fast-food meal costs most Americans more out of pocket than a visit to the doctor. What seems free will always be overconsumed, compared to the choices a normal consumer would make. Hence our plan's immense savings.

    The Indiana experience confirms what common sense already tells us: A system built on "cost-plus" reimbursement (i.e., the more a physician does, the more he or she gets paid) coupled with "free" to the purchaser consumption, is a machine perfectly designed to overconsume and overspend. It will never be controlled by top-down balloon-squeezing by insurance companies or the government. There will be no meaningful cost control until we are all cost controllers in our own right.
    Last edited by cpwill; 12-24-10 at 01:02 PM.

  3. #113
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    Re: Do you think no more preexisting conditions is right or wrong?

    Quote Originally Posted by cpwill View Post
    drop the state barriers. stop distorting the market by pushing people into employer-provided health insurance with a heavy third-party-payment model (which, as you point out, effectively traps people at their jobs). move to high-deductible plans that don't cover non-insurable events like regular checkups (that's like asking auto insurance to cover your oil change). and so forth.
    I havent read through this whole thread so I apologize in advance on anything I may misunderstand or missed while im addressing your ideas.

    I agree with dropping state barriers
    Do not agree with high deductible plans at all because thats clearly worse unless the deductible is determined by some live style? yes the daily drinking, smoking, drug user that hobbies include swimming with sharks should pay more the the clean as a whistle, fitness teacher that doesnt do any drugs at all.

    also car insurance is a TERRIBLE example and nothing more than a "talking point" in my opinion. It simply isnt a equal example nor does it make sense. People are not cars nor is health insurance like car insurance in the example you picked. (oil changes) Insurance should absolutely help with check-ups and it BENEFITS them to do so

    Car insurance is "typically" only for accidents not for general health of the car.
    if you wreck the insurance company sweeps in
    if I fall down the steps the insurance company sweeps in
    those are the same

    BUT

    if you car starts knocking or missing or the oil gets thick
    the insurance company doesnt give a damn because they dont cover wear and tear or the engine/tranny in most cases. If your engine (heart, lungs etc) blows up they dont care

    but if my heart starts beating irregular, or my blood is thin etc
    the insurance company does and should sweep in, this way they pay for my meds to fix this instead of my heart and lung surgery AND my meds

    oil checks dont effect car insurance, check ups DIRECTLY effect health care.
    I know 20 people off the top of my head if their check ups would cost to much they just simply wouldnt get them and wait to their problem made them go or the ambulance was picking them up.

    I know another 20 people that put off check ups until coverage starts again and or have BIGGER problems, this goes for dental and eye care also.

    Quote Originally Posted by cpwill View Post
    It turns out that, when someone is spending his own money alone for routine expenses, he is far more likely to ask the questions he would ask if purchasing any other good or service: "Is there a generic version of that drug?" "Didn't I take that same test just recently?" "Where can I get the colonoscopy at the best price?"

    By contrast, the prevalent model of health plans in this country in effect signals individuals they can buy health care on someone else's credit card. A fast-food meal costs most Americans more out of pocket than a visit to the doctor. What seems free will always be overconsumed, compared to the choices a normal consumer would make. Hence our plan's immense savings.
    or they simply wont get the check ups, or they will get the cheapest procedure or meds possible that may be sub par. Then they will need MORE healthcare cause they were misdiagnosed, thought to be cured and not or simply the less, cheaper treatment wasnt good enough. Or again maybe just push off those meds or procedure off until its worse or too late.

    Quote Originally Posted by cpwill View Post
    The Indiana experience confirms what common sense already tells us: A system built on "cost-plus" reimbursement (i.e., the more a physician does, the more he or she gets paid) coupled with "free" to the purchaser consumption, is a machine perfectly designed to overconsume and overspend. It will never be controlled by top-down balloon-squeezing by insurance companies or the government. There will be no meaningful cost control until we are all cost controllers in our own right.
    you make very good points, it all was logical and made sense besides the car insurance example which was just silly but with that aside you arent looking at reality. Actually I take that back you ARE looking at reality (cost wise) but you are totally ignoring the reality of what a lot of people will simple do or react to by paying doctor visits/check-ups, high premiums etc that are 50$ a pop or procedure that cost to much or even a ankle brace that cost a 100$ . They simply wont get it, will push it off and make things worse. Some of this will be poor judgment and some of it will simply be they cant afford it so they will risk it until they can afford it or insurance now covers it.

    I know people the wont go to the emergency room right now because of what it costs because they fear the co pay or fear they wont be admitted and will have to pay, then they are either forced to go later when things are worse or calling the ambulance to get them because things are a lot worse.

    again I do agree with you on many points, we need some type of checks and balances so people arent going to check ups once a week for nonsense and people dont go to the ER for splinters but there is two sides of the coin and one side you are frankly ignoring. Its the power of money in BOTH directions, yes if everything is free people will abuse it but if everything costs to much people get abused or neglected. The FEAR of being broke is more immediate and smack in the face than you MAYBE having a health problem or that you DO have a health problem but the person feels fine. People often blow those things off easier than an empty pocket, empty bank account, empty fridge or notices of utilities being shut off or you house or car being taken.

    Just saying I think you are thinking very one dimensional(and its an IMPORTANT dimension) but theres a couple dimensions to it and the system has to be somewhere in the middle.


    and on a joking note

    maybe something we can still from car companies is "Vanishing deductible" every good/regular check up you have or positive live decision you make, quitting smoking, changing diet, stop drinking, exercising your out of pocket cost goes down

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