Then I guess I don't see the problem. Criminals notwithstanding, mandating coverage is a proven workable system. I thought you were pointing out some difference between auto insurance and possible mandated health insurance.

Well perhaps you'd actually like to answer the real questions instead of bringing car insurance into it.
I've asked three times now.

I have insurance. Last time I got a sinus infection I called my doctors office and told them what was going on (sinus infection, visible swelling on my face). It was a Friday am and I didn't want to suffer all weekend but my doctor didn't want to see me or call in a prescription for antibiotics. She instructed me to go to the ER.

See if you have a local "urgent care" sort of place. It's like the ER without the battle. Saturday night people convinced me I might have strep, and my local place had me examined and cultured in 20 minutes for a $30 co-pay.

Paying for mandated health insurance is the problem.

But the assumption here is that their family doctor will take the federally funded health program. If the reimbursement is to low many doctors just will not see those patients, like they do now with Medicare/Medicaid.

Good idea... I think there's one right down the street. Although I have to say that Paoli's ER is lovely and battle free.

They have also been talking about rewarding doctors for preventative treatment on patients so they don't end up with more costly disease treatments later on. I think that is a great idea. If you can get a patient to quit smoking or lose weight, that should be an incentive for the doctor. Preventative medicine will help lower costs a LOT, IF we can shift the stinking thinking in this country.

I'm also hoping *fingers crossed* that somehow the whole issue of how food is grown in this country is brought into the debate. The movie Food, Inc. comes out this month, and that is a HUGE problem in this country that adds to health care costs. The food itself is unhealthy. Obesity is huge problem, and there are many problems that go along with that. Also, many people who aren't fat are still not FIT, and that means they are unhealthy and that also causes health problems.

Another thing that is a major problem is the cost of care in the last few months of life. We need to find a way to reduce those costs.

A couple of thoughts, I know someone said something about this earlier, but the cost of executive pay in the insurance industry is one reason why costs are so high. I imagine the reason why insurance companies turn down so many claims is because they have to in order to keep their executives living high on the hog. And so people who have been paying for insurance end up in bankruptcy or losing their life savings or their homes because their claims are denied. Add to that the cost of advertising, something the government doesn't have to do, and that is another way how costs would come down. (No inflated salaries, no advertising costs.)

Here is a list of a few executive salaries for 2006-7 (you know they are even higher now): ANNUAL COMPENSATION OF HEALTH INSURANCE COMPANY EXECUTIVES (2006 and 2007 figures):

• Ronald A. Williams, Chair/ CEO, Aetna Inc., $23,045,834
• H. Edward Hanway, Chair/ CEO, Cigna Corp, $30.16 million
• David B. Snow, Jr, Chair/ CEO, Medco Health, $21.76 million
• Michael B. MCallister, CEO, Humana Inc, $20.06 million
• Stephen J. Hemsley, CEO, UnitedHealth Group, $13,164,529
• Angela F. Braly, President/ CEO, Wellpoint, $9,094,771
• Dale B. Wolf, CEO, Coventry Health Care, $20.86 million
• Jay M. Gellert, President/ CEO, Health Net, $16.65 million
• William C. Van Faasen, Chairman, Blue Cross Blue Shield of Massachusetts, $3 million plus $16.4 million in retirement benefits
• Charlie Baker, President/ CEO, Harvard Pilgrim Health Care, $1.5 million
• James Roosevelt, Jr., CEO, Tufts Associated Health Plans, $1.3 million
• Cleve L. Killingsworth, President/CEO Blue Cross Blue Shield of Massachusetts, $3.6 million
• Raymond McCaskey, CEO, Health Care Service Corp (Blue Cross Blue Shield), $10.3 million
• Daniel P. McCartney, CEO, Healthcare Services Group, Inc, $ 1,061,513
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
http://www.slate.com/discuss/forums/post/2446099.aspx

(How many freaking CEOs does Blue Cross Blue Shield have anyway I wonder?)

Insurance Company CEO Compensation 2006-2007
Insurance Company Chief Executive Officer (CEO)
2007 Total Compensation 2006 Total Compensation

Aetna Ronald A. Williams $23,045,834 / $19,802,476

Cigna H. Edward Hanway $25,839,777 / $21,014,486

Coventry Dale B. Wolf $14,869,823 / $13,034,126

Health Net Jay M. Gellert $3,686,230 / $6,066,913

Humana Michael B. McCallister $10,312,557 / $5,798,613

UnitedHealth Group Stephen J. Hemsley $13,164,529 / $15,549,028

WellPoint Angela Braly (2007)
Larry C. Glasscock (2006) $9,094,271 / $23,886,169
http://www.insurancecompanyrules.org...tion_2006_2007


I'm afraid this won't get done because Obama is cowtowing to the very same people who have held up health care reform for the past century. Really, if republicans and the AMA and insurance companies had such great ideas on how to fix it, how come they haven't done anything? In my opinion they shouldn't get to have any input. Now they are using scare tactics, just like they have in the past, crying socialism. It worked in the past. I PRAY it doesn't work now. If we don't get it done, then the system will spiral even worse out of control than it is now. People here love to say we have the best system in the world, and they're right, IF you have money, or if you're lucky enough to have good insurance form your job. but even if you have good insurance, it isn't a guarantee that you will get the care you need. They can always deny your claim. Which they do a lot more often that most people realize.

Personally, I think we should base our system on France's system. France has the best system in the world, while we are number 37.

They are still in the process of writing the legislation. That's probably why they haven't gotten back to you. There will be different proposals on the table, and by the time they finish, who knows what it will look like. I'm with Bill Maher on this. It's all well and good that Obama wants to be inclusive and reach across the aisle, but maybe he should be a little more like Bush in order to get certain things done. Like health care. Like energy.

... and therefore, the doctors income - no real incentive for them in that regard.
Just kill them sooner?
BS
Hmmm, really?
What makes you think that won't happen even more if/with Gov't oversight?
yeh - France - :headshake
Well if we don't know what it'll look like nor who it will cover nor IF it will cover everyone or just some or IF it will save money .... what exactly are we for?

I must say it was nice to hear in Obama say in his speech yesterday that if you are happy with your plan, or your doctor or your company ....you may keep them. Thats great, but at what cost? I just cannot see how this is not going to cost more than it already does and that means that I, as a productive employed citizen will be paying more. How much more is a major issue to me.

If we do it right, doctor's income could actually go up.

I didn't say that.

He is asking everyone to the table. Since the AMA and insurance companies have been the biggest opponents of health care reform over the past century, what could they possibly have to offer this time? They don't want a public option, but without a public option, there is no true reform.

http://abcnews.go.com/Health/Politic...7838800&page=1

Yes. REALLY. If republicans wanted to do it, they were just in power for years. They had their chance. All they are doing is trying to block true reform. Same with AMA and insurers. They have all had time to do it. Plenty of time. They haven't done it, because they aren't interested in true reform. They like the status quo.

I suppose it could, but the government isn't trying to make a profit, and that is the difference. insurance companies HAVE to make a HUGE profit in order to pay all the bloated executive salaries.

France does have the best health care system in the world, according to the WHO.
http://www.photius.com/rankings/healthranks.html

It should cover everyone. If it doesn't, Obama shouldn't sign it.

And you have to look at the cost if we DON'T reform health care. If we don't, it will take over, and the costs will continue escalating at an astronomical rate.

I really think it's a shame we aren't even debating a single payer system. I think a majority of people really want that.

One thing no one has brought up, is this is tied to wages. Wages have been stagnant for most people for decades, while rising for those at the top. Health care costs have risen dramatically more than wages. If wages had kept up, the problem wouldn't be as bad as it is. (It would still be a problem though.) No one wants to raise wages though. No one wants to do health care. So we have this problem, and we will continue to have it if nothing gets done, only it continue to get worse. It's the same with energy.

And gee, I'm sorry if you will have to pay more. I don't see how, unless you are above a certain income. There are plenty of productive citizens who are without insurance, through no fault of their own. It's just too damn expensive for some people. And some people had insurance, and still got screwed by their provider. So?

Forgive me, but I don't think you are sorry to hear that I'll have to pay more at all. It would seem that in your perfect world we'd all make about the same and have all the same benefits and the whole country would be full of "equality."
Would that be a majority of whom? People that have nothing and don't care what they get as long as it s given to them or a majority of those who have worked hard and earned all that they have?

The last thing I want is another bloated inefficient Gov't program with someone else other than me and my doctors having any more say in the care, treatment and/or health decisions of me and my family.

GIve it up. It is the same old mis-informed tired arguement.

What makes you think anyone other than your doctor would make those decisions? With insurance companies, pencil pushers make decisions about your health. They deny coverage. With Medicare they don't.

And sorry, but there are plenty of wealthy people who would like a single payer system as well. Or who don't mind paying more so that everyone is covered.

You are completely mis-informed. Medicare denies coverage on a daily basis. Like most insurance programs they require pre-approval and they are among the worst.

Really? Who are those? Hollywood talking heads?

I don't think Medicare is going to let someone die of cancer when there is treatment available. You certainly don't hear stories about people going into bankruptcy or losing their home and life savings because Medicare wouldn't treat them. You DO hear those stories about private insurance.

I hardly think Donnie Deutsch or Warren Buffet are Hollywood talking heads, and I've heard both of them say that. In fact, Donnie Deutsche said the other day on Morning Joe the best way to pay for health care would be to get the top 100,000 people to pay an additional $100,000 in taxes.

I just want the bottom 60% to pay thier fair share.

What is their "fair" share?
When you make BILLIONS of dollars you can certainly afford to pay a LOT more %-wise than if you are living paycheck to paycheck. Honestly, what do you think those people do with all that money? They can never spend it all. Since this country (and the people of this country) helped them become successful, they should certainly return the favor by investing back into this country, and those citizens. But they don't. They screw us by taking jobs overseas to cheaper labor markets, and they move their offices offshore so they get out of paying taxes, and they get subsidies from the government to offset things that, really, THEY should be paying for, not our taxes, and they quit paying for benefits for their employees, and all the other tricks of the trade they use to get out of giving back.

And you know, if wages had kept up with the cost of living, this wouldn't be as much of an issue as it is. But they haven't. Millions of people today are living on LESS than people lived on during the 70s. Pathetic. And we expect them to be able to afford isurance?

"A billion here, a billion there, sooner or later it adds up to real money."
- Everett Dirksen

Ummmmmmmmmmmmmm.... I no longer give a shit. Everyone needs to feel the pain. Everyone needs to pay.

It's not the doctor's responsibility to take care of your body, it's *yours*. We need to given *you* an incentive to stay healthy -- by making you pay for your own health.

It's physically impossible. If it costs less to extend your life, then you will live longer .. which increases the costs. It either costs an infinite amount of money to keep you alive, or someone must declare it's time for you to die. Who do you trust with that responsibility?

You're just trolling now. Capitalism is founded on people keeping what they earn. If you don't like it, you're free to attack capitalism. But don't go posting this crap pretending it has anything to do with health care.

That would be me. And I thank him for it.

Now I'm confused. You want the government to take over health care, yet you admit they have no clue how to run it. What exactly are you arguing?

I'll take that bet: $100,000*100,000 = $10 billion. There are a quarter billion people in the states, so that gives us .. $40 per person per year. Problem solved.

I recommend you read that link, it's quite informative. Especially this gem:

So the WHO posted a questionable report, then just gave up altogether. But wait, why does a page on "photius.com" have a "geography.org" header? Maybe we should visit the actual press release. Sure enough, near the top, they report that the US is number 37. But if you keep reading ...

US is first, France is missing.

France and US are both missing.

Let's see if Google can tell us what's so great about France. How about this one?

How much health care could you buy for 20% of your income? If you put that in a 401K, you think it might cover your retirement? Boy, I bet those doctors are well paid.

Yikes. Well, how about this one:

That's not so bad. Unless it's on top of the 20% social security tax. Just one more:

While the US system may be troubled, but France is certainly not the utopia you make it out to be.

This rubs our noses in the underperformance of the welfare state, and in its costliness -- for those of us who weren't with it enough to know already.

Socialism does not work; socialized medicine does not work. Reject both, for ever. Vote out anybody caught trying to vote it in. The Democrats are sowing the seeds of their own destruction.

At Bitman: :notworthy: :thumb:

How much is that per the estimated 46 million uninsured?

Think how much more we could save if male vanity drugs like Viagra weren't paid for (I would be willing to offset this savings by PAYING for birth control pills.)

I don't know about your area, but down here you can get BCP at the public health department and a pretty big discount.

Someone whose profit potential is not increased by my death.

Insurance companies pay their shareholders out of the money they take in as premiums, but don't pay out in claims. And they are primarily beholden to their shareholders.

They complain that they couldn't compete with a program with no profit motive. That sounds like a plus to me.

YOu can get VIAGRA for FREE from Medicare.

Makes sense, huh? It shows that old pasty men are in charge. Always will be.

Now excuse me, I have to go buy a 10 dollar box of tampons. :lol:

Good job of posting some excellent links Bitman. Lotta good info there.
Hope you don't wait over a year to post again.

And who would that be? Your immediate family would love to keep you around, but the rest of us would rather use the space you take up for ourselves.

*You* are the only person who can make that decision correctly, and you can only make it if you directly control your own health.

The rest of your post was a rag on capitalism, which is not relevant here. I'm happy to grant insurance companies all the profit they can make, but only where health insurance is the right thing to do, and only where these companies can compete.

Thanks but I've got a greedy reason for posting. I'm genuinely curious as to why the only two options I hear about are corporate insurance and national insurance. Personal responsibility is the only way to keep costs under control; any kind of government plan is fundamentally broken. Yet many other countries have some form of socialism, so I wonder -- What am I missing?

Over here (Australia) we have both options. Many people have private health insurance, but there's also a pretty good public system. When I say pretty good, that's in comparison to some other systems out there. For people with private insurance, there are tax breaks, although that's all about to change by the looks of things. Anyway, we'll see how it goes, but for now we have both.

Because there is an inherent understanding around the world that medicine is a different beast. If someone wrecks their car and has no insurance, boo hoo for them we say, now you have no car. You must suffer the consequences of your actions, and rightly so. If someone is hurt and has no insurance, as a society we (and most others) say we can't simply let them die for their mistakes, those consequences are too great for what is essentially a sin of greed (not wanting to shell out for insurance--and I know people will jump in and say "it's not that they don't want to, they just can't afford it; but unless they're completely homeless and unemployed, the reality is they could "afford" it, just at a drastically reduced standard of living that understandably no one wants to endure.)

It is a reality that we are going to end up providing at least a base level of care for the people who choose not to take personal responsibility. So many countries have decided to remove the choice from their hands, and force "responsibility" on them in the form of mandated programs and taxes. Is that a better system than we have? I don't know, I've never experienced a socialized program, and really what everyone wonders in these scenarios is "will it be better for me?" As a middle-class family who already shells out a pretty decent but not absurd amount for our coverage, I suspect our personal situation is going to stay pretty much the same no matter what the system is. It's the people at either extreme who will feel the effects of it.

What if wrecking their car involves injuring not only themselves, but also other people and their property?
Conversely, if someone decides to engage in risky behaviors - they are not hurting others - they are only hurting themselves.

Don't worry. There's no plan that will affect the ability of the wealthy to self-finance their own treatment. But if I'm on a health plan, I'd trust a government beaurocrat over a health insurance company.

I wasn't ragging on capitalism; jut pointing out that there are some areas where market pressure isn't in the right direction.

That's precisely why the government mandates auto liability insurance. You have your choice of private companies, but other than that it is a direct example of enforced socialism.

I agree that is why auto insurance is mandated - not so much the socialism part though. Also, I don't think that transfers to Health insurance though.

On the contrary most government run single payer(governemnt run) plans DO NOT allow for opt outs or selectively going outside the plan to your own doctor. They control by making it illegal for the Doctor to treat outside the plan sometimes and continue to participate in the plan for the balance of his practice.

Lets not get distracted by the thousands of pages of details that are in these proposals. There is only one thing to consider. If the real objective is to control costs-and I believe that is NOT the real objective-then we need to look at the federal governments track record of 'controlling costs': medicare/medicaid costs 100's of percent higher than initially projected; education spending out of control for declining performance, $800 toilet seats and $140 screws, etc.

Or on a larger scale the overall success of centrally controlled governments at providing a decent quality of life for their citizenry- USSR, Communist China, North Korea, Iran, and how many others.

Bottom line --with the 'awful' healthcare system we have here-you can count on one hand the number of people leaving the US to get better health care elsewhere. And those are invariably for experimental treatments. And when residents of only those moderately socialist places like France, Scandinavia, Canada-with their government run programs need superior care, they come here.

First, I don't know about "most", but it is definitely not the case for all single-payer plans.

Second, there is no single payer plan being proposed for the US.

Are doctors who accept medicare allowed to treat medicare participants outside of medicare? NO!. Same in England, Canada, etc. And those are the systems advocates here look to as models of government plans.

In fact, they ARE proposing a single-payer in practice. By artificially creating a lower rate schedule people will opt for lower direct out of pocket and eventually dry up private carriers.

If they thought they could get the votes for an openly stated single-payer plan they would go right for it, because the outcome will not provide lower overall costs-its impossible when the government runs things-they would go right for it. But the words 'single paper' scare people too much so they put it in the details while denying it publicly.

Whoson is basically correct. If that plan makes it through the legislative process. The question remains will the historically powerful lobby of the health care insurance industry have the strenght to convince Congress to vote against it? This process of introducing the "alternative' government plan may encourage companies who currently provide insurance to their employees to drop it. The costs of such insurance for private companies is second only to payroll. Will the companies continue to pay for it or in more recent discussion allow employees to be taxed on it? What will be the penalty for those companies that drop their plans and let the people just go and apply for the government sponsored plan? Obama floated this during the election. No one knows. And given the previous process of how things have been ramrodded through Congress without having the time to read all of the details in massive bills we may never know til it is to late. The fallout will be felt in all sectors.

You are giving $1000+ a year to your car insurance company to pay for someone else's car wreck. You will get no refund when you stop driving, even if you've never had a wreck in your life. How is that not socialism?

Because when State Farm gives us a bad deal we can switch to Progressive.

And that's one of the biggest problems with the health care industry, that I've bitched about specifically before. The advent of employer-provided healthcare killed any real competition between the insurance companies--you just have to go with whoever your employer chooses. If anything, your employer should contribute to your health savings fund on your behalf, but you should have control of which insurance company you choose. That one tiny change right there would fix HUGE numbers of problems.

I agree, to a great extent, but unfortunately corporations are often the only ones big enough to negotiate good deals with the insurance companies, and (I think) it's harder for them to kick people out of the corporate plan than it is for them to boot sick individuals.

Why can't the Gov't repeal the law that doesn't allow them to do so. That in itself would ... oh nevermind.

Very true. And that fits the capitalistic model. Volume pricing will always get a better deal than you can get on your own.

True, but they can charge you higher premiums based on your individual case to offset the standard and set fee the employer pays for your insurance. The employer certainly is not going to pay more. And each year the insurance company can and does increase premiums to the employee with little change or in many cases less coverage.

For a side by side comparison of all the plans floating around congress, select all in each of the two boxes. It will come up as a PDF file.

http://www.kff.org/healthreform/sidebyside.cfm

You mean everyone but the uber rich, right? Because you always defend them, no matter how wrong they are.

Bull shit. They should pay the same percentage as I have to pay, 33%. Eveyone should pay the same.

I disagree. I think the more money you have, the higher a percentage you should pay. I know we will NEVER agree on this subject though, so I'm dropping it now.

Good, but don't post bull shit that I support the uber rich. They, and you, and everyone else should pay the same percentage, what ever that is...

I don't understand your point ... You support a plan where only the wealthy can choose their only treatment, while the middle class is stuck with the federal standard treatment? I'd prefer a system where everyone can choose their treatment.

This automotive comparison really doesn't work. The government mandates liability insurance, which covers your damage to other people's property. Comprehensive insurance covers damage to your own property, and is totally optional. Health insurance is like comprehensive. And yes, I really believe it should be optional.

No, you're paying $1000/yr for your own wrecks. I pay $350/yr for mine. It might be a kind of socialism, but it's arguable -- only people with cars pay car insurance. Conversely, people who have no children still pay for public schools.

No, it's not true at all. Negotiation may be able to get a good deal (depending on the skill and drive of the negotiators) but only competition can get the best price. (And there's no guarantee the government negotiators will be any good.)

And wait, there's another gaping hole in this meme -- Who is this single seller we're having such a hard time getting good prices from?

One more thing -- The USA is already running an annual deficit. Every dollar a health plan would require must come from at least one extra dollar in taxes.

Me too, but I don't expect medical care to be free any time soon. The next closest thing would be single payer, which is a non-starter at this point. So my choices are going to be made through a health plan of some sort. And if someone is going to be in charge of deciding what treatments I can get, I don't want it to be someone who gets to keep any money they don't use to pay for my treatment.

That is the system we already have. If you pay for insurance that is what you get now. Same in an HMO. Same for any plan the Federal government is going to offer.

Yes, yes, yes, and probably not.

We don't know yet exactly what the government plan is going to be, but I don't think it is a big stretch to hope that it isn't going to be paying shareholders out of the money they don't spend on medical costs.

No, they will be paying for it out of our taxes. And if you think this is going to be better I have bridge in Arizona to sell you.

The Federal plan will be paying shareholders? So they'll have both tax funding and investors? Like I said, nobody knows what it will look like at this point, but IMHO that's unlikely.

Meaning the share holders, us the US public, you know the portion that pays income tax, will be paying for it.

And the latest news is that the major hospital associations will be chipping in a huge portion in savings for the federal plan as well. Guess who is going to pay for thier missing bit? All the rest of those who pay for their health care now, not the portion who get it for free, as they do now. Guess what, costs are not going to go up for the rest of those who pay. You think the CEO's and hospitals are just going to cut their profits? Don't count on that. They will be protected under any new plan.