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June 16, 2009

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peter

I will continue to exercise and drink until the tests are conclusive.

Danube of Thought

Let's face it: the very essence of this push for universal coverage is to get it enacted before people understand what it entails and how it will affect them. None of its proponents is capable of telling the truth about any important feature of the thing.

And the oratorical vaseline being applied to the public option is beyond shameless. The very last thing Obama wants is for people to have a full understanding why it is being proposed, what it is intended to accomplish and what its inevitable result would be.

If I had to guess right now, I'd venture the hopeful thought that enough people are going to catch on in time to put a stop to this fraudulent scheme.

Thomas Collins

Wow. Moderate exercise and dietary habits are the way to go. Fifty years of study upon study have confirmed the Humphrey Bogart rule, namely, that as time goes by, the fundamental things apply.

By the way, when I am applying the corkscrew to a bottle of red wine, the last thing I am anticipating is life extension, unless life extension is defined as that lingering pleasant buzz one experiences from sipping a nice red wine!

jimmyk

Robert Samuelson of the WaPo is pissed off:

It's hard to know whether President Obama's health-care "reform" is naive, hypocritical or simply dishonest. Probably all three.

I don't agree with everything he says: He exaggerates the need for reform when he talks about growth in health care spending. Some of that may be attributable to insurance (and he correctly goes after Medicare), but a lot of it is due to demographics (more old folks) and to the fact that we have gotten wealthier (well, at least until recently), and wealthier people tend to want more and better care.

LUN (may require registration)

rse

Does anyone think it's a good thing that ABC is turning over it's programming next week to the White House and broadcasting from the WH on health care?

Will such an overt act finally get the attention of the middle or just bolster BO's unreasonable rhetoric on health care as being plausible and necessary?

Ignatz

--Oddly, a similar problem confounds the folks who insist that exercise promotes good health.--

And that CO2 causes global warming and that government spending produces jobs and that racism is the cause of ethnic underachievment and that gun control produces any effect on crime and that Joe Biden actually possesses a brain, ad infinitum, ad nauseum.

Rick Ballard

Emperor Ogabe I is gonna have to silence those CBO guys. Perhaps he should have David Letterman go after them in the opening monologue for the OBC/OBS News by Charles Gibson (kneeling in the Oval Office)?

It would be helpful to turn up a few EU/UK Kill Granny stories as this agitprop extravaganza gets underway. The cost shifting aspect is simply beyond the general comprehension capability of the muddle.

jimmyk

The cost shifting aspect is simply beyond the general comprehension capability of the muddle.

The other morning I overheard NPR (ok, ok) doing "man on the street" routines on the health plan. Quoth one genius: "They should include dental care, it's gotten so expensive!" Hey, my cable/internet bill has gotten really expensive, let's include that too!

On the other hand, BHO has gotten so blatant and extreme, more and more people are starting to get it, or at least I would like to think so.

Ignatz

--BO's unreasonable rhetoric on health care...

One of the prime examples being his assertion yesterday that he was for malpractice reform. He told the AMA this would not consist of limiting malpractice awards but instead would limit "defensive medicine".
Now presumably most doctors are smart enough to realize that you cannot do the latter without doing the former except by government coercion, but that presumption may be doubted by the fact that not one doctor threw his shoes at the idiot when he had the gall to say it.
This guy can say any incoherent or mutually exclusive thing and otherwise sane people nod their heads approvingly at his sagacity.

hit and run

Well, http://blogs.abcnews.com/politicalpunch/2009/06/after-cbo-analysis-white-house-distances-self-from-kennedy-bill.html>not so fast, don't blame Obama for this...

Kennedy?

Kennedy who?

"This is not the Administration’s bill," White House press secretary Robert Gibbs said in a statement following the Congressional Budget Office's analysis of Sen. Ted Kennedy's health care reform legislation, "and it's not even the final Senate Committee bill."

Both statements are true, though it's not clear who, if anyone, had been saying that the legislation drafted by the powerful chairman of the Senate Health Education Labor and Pension Committee constituted President Obama's bill.

So there, Kennedy!

Oh and this is fun, fun, fun. http://www.cbo.gov/doc.cfm?index=10310>First from the CBO director's blog:

...according to CBO's "preliminary assessment, enacting the proposal would result in a net increase in federal budget deficits of about $1.0 trillion over the 2010-2019 period."

Next, let's turn to Gibbs for the reaction:

Apparently responding to the CBO's numbers and the ensuing criticism of the Kennedy bill, Gibbs continued, saying "what is clear is what will happen if we let political posturing stand in the way of reform again: exploding deficits...

So in response to a CBO study of Kennedy's bill saying that it would ...explode deficits... Gibbs fires back that it is "political posturing" that would lead to ...exploding deficits...

Riiiiight.

Chris

DoT,
Spot on.

...the very essence of this push for universal coverage is to get it enacted before people understand what it entails and how it will affect them.

Of course the exact same thing applies to TARP, stimulus, auto (UAW) bail-out and on and on. I actually have some hope that this time the middle will stand up to their overlords and put a stop to it.

Old Lurker

There was talk (trial balloon?) last week about removing the cost scoring from the CBO altogether and moving it to OMB at the WH.

OT, but the same mindset...WaPo reports today that Mideast Czar Dennis Ross is being moved from State to the WH. Take THAT, Hilary.

matt

all this is turning into is a shell game to benefit Obama's cronies. Steal from Program A to fund, voila!, program B. Cut to trumpets sounding and Katie Couric in front of White House for big announcement and orgasm.

If there were any grown ups still in charge in corporate America, maybe they wiould get a clue, but the con has been going on so long and they are so deeply invested in fleecing the masses that once the rubes catch on they'll be on the first plane to Aruba.

Rick Ballard

"more and more people are starting to get it"

Jimmyk,

I hope so and I think that it may have started. It will only take about a 5-6% shift to strip away the (D)irty Fascist majority in '10. That's the biggest reason that their propagandists seem so desperate in their blatant attempts to elevate the unpalatable (crowning a cow Fashion Queen being the most humorous to date).

I support the reasoned approach to explaining the idiocy involved as well as highlighting the Kill Granny result. It's just that Kill Granny will catch more fish.

Jack is Back!

Brooksie writes:

You ran on a platform of hope and, boy, are you delivering. Every special interest in Washington lives in hope that they will get their pet idea incorporated into the final bill.

In the immortal words of Chuck Knox, head coach of the defunct L.A. Rams:

"Those who live in hope die in shit."

Jack is Back!

On a more serious note: Stu Varney at FBN calls the CBO report a "nuclear bomb". I disagree. No one let their assessment of the budget and its record deficits for years bother them in voting for the stimulus and other porkie trivials. Only the 'blue dogs' can keep us from this pending disaster. In a way, O was spot on that health care reform is a crisis - the way its going it is more important than Iran, IMHO. We need to kill this thing like Raid on an ant in order to bring some fiscal sanity and relief to our future.

clarice

Man, I really like Chuck Knox--Someone invite him here please.
I knew I'd find Hit on this thread though I figured it was the alcohol hook--instead he comes up with a brilliant jab at the rhetoricama

Paul Zrimsek

CBO's cost estimates make me want a drink. I figure I can always exercise next year, when it's mandatory.

MTF

Entertaining census analysis! There are three words you'd never thought you would see strung together, I'll bet. Anyway, the talkative BigLizard blog read the census exhibits on exactly who is not covered by health insurance, and it's not who you might think. One big group are the poor, 30% of the total 45.7 million not covered at the time of the census, but biggest group at 38.6% of the total seems to be in the $50,000 plus income category. Are those the so-called "in between jobs" uninsured? After Obamanation medical care passes, wouldn't those be the ones most likely caught up in the required coverage, leaving the poor as totally uninsured and unable to pay for care? This policy may turn out to be the biggest slam at the poor evah...

Original MikeS

One big group are the poor, 30% of the total 45.7 million not covered at the time of the census

Yes but, but, but, most of them (25% of the 45.7 million) are eligible to be covered by plans already in place. No need for any new laws or new coverage necessary for that 25%.

As you say, there is a very large group who probably could afford health insurance if they really wanted it.

Jack is Back!

Clarice,

Chuck also said that most of his quotes "aren't original".

He succeeded Tommy Prothro who smoked 3 packs of cigarettes a day along with 2 dozen Cokes. Even during the Ram's games on the sidelines. The locker room resembled a hospitality room at a convention it was so smoke filled. Ah, the good old days.

cathyf

Somehow we need to link this in to the foreclosure "bailout", because I think that it's simple enough for people to understand. So you started with some people who couldn't pay their mortgages and were facing foreclosure. So the government started a Program to kick in cash to restructure their mortgages so that they could pay them. But to get the cash they had to borrow money. Which raised interest rates and caused everybody with an adjustable-rate mortgage to have their payments soar. So now we've got a gazillion more people facing foreclosure and financial catastrophe. So, what was the purpose of that Program again? And next we're going to let that same "brain trust" tackle the problem of people without health insurance?

The simple cut-the-crap statistic is this: if you kill off health insurance, then we'll have 300 million uninsured Americans!

cathyf
One big group are the poor, 30% of the total 45.7 million not covered at the time of the census

Yes but, but, but, most of them (25% of the 45.7 million) are eligible to be covered by plans already in place.

If you think about it, those poor people who are eligible to be covered by plans in place are:

a) doing their admirable bit to cut unnecessary administrative costs by waiting until they get sick to sign up for the programs; and

b) they are covered, it's just that the bureaucratic systems don't have them registered yet.

Original MikeS

it's just that the bureaucratic systems don't have them registered yet.

Yep. In these tough times, it would probably be more reasonable to focus on getting the poorest people covered first. When the economy picks up, we could then discuss the people making over $75K and the people who are caught in the confusion between two different countries with different coverage options.

clarice

cathyf--I beg you to write about this. Beg. If nothing else your last two posts would make a super duper blog.

Extraneus

You go, cathyf. Great analogy.

Rick Ballard

OMS,

Why conflate care and coverage? The vote serfs receive care on demand now. Mandating that healthy 20-35 year old individuals pay premiums in order to alleviate the financial stress imposed upon health providers by government regulation (if you take a dime from Uncle Sugar then you must provide care to the vote serfs) will not improve the quality or increase the amount of health care furnished to the vote serfs as a fringe benefit for remaining in a Blue Hell. Michelle Obama or others of her ilk will see to that.

The demographics of those electing to not purchase coverage need to be sliced at least twice more (age and location) in order to understand the full dynamic of the decision. In many cases it is a completely rational choice based upon a very conservative risk/reward assessment.

maryrose

cathyf:
I echo Clarice's request. Let's get some sensible reporting about who is covered and which persons are opting out of coverage.

clarice

cathy--editoratamericanthinkerdotcom. Tell him I sent you.

Rick Ballard

Cathyf,

I'll join the chorus - write it up. I have a question for you. Do HMOs in Illinois set up their own facilities (Medical Office Buildings) as does Kaiser in California? I ask because a Kaiser MOB handles all treatment up to that requiring overnight stays. Kaiser's methods keep the counties' hands out of their clients wallets and purses by doing so - which increases the "deficit" incurred by the county on demand providers.

glasater

I posted this link in a previous thread but it really belongs on this one.

It is a video clip from Kudlow's show yesterday talking about how folks did move from HMO's to PPO's.

Karen Greenrose, AAPPO president/CEO is a very articulate woman both Kudlow and John Harwood were paying attention.

Harwood is interviewing Zero later today on CNBC and I hope he rephrases and asks him some questions and points that Greenrose posed.

Fresh Air

If it costs $1 trillion to ensure 12 million people for five years, how about we just give them a check for $90,000 or five checks of $18,000 and let them buy their own healthcare insurance? I mean, $1,200 a month ought to get your appendix removed. Right?

Worst administration in history.

Fresh Air

Ensure...insure. Whatever.

fdcol63

QUESTION:

Will Congress at least READ the Federal Universal Health Care Update (FUHC-U) reform bill before they vote on it?

ben

"I will continue to exercise and drink until the tests are conclusive."

Well, I think in order to "untangle" things I will stop exercising and keep drinking until the results are conclusive. If it turns out its drinking and not exercise that really helps I will feel like an ass for exercising all that time. If it turns out it's the exercise and not the drinking that helps I won't feel like an ass at all.

MayBee

Major Garret, Jake Tapper, Anne Compton, and April (?) just tried to pin Gibbs down for an explanation of how Obama can promise people they can keep their doctor if employers choose to drop private insurance for a public plan.
Gibbs said it was the Administration's belief that introducing a lower cost alternative (public) would cause the competition to lower their costs.
After a big roundabout discussion, Major Garret finally pointed out that private insurance companies wouldn't have an endless supply of tax dollars supporting the private insurers if they lower their prices and then.....

Lester whats his name complained about the number of questions the first two rows were getting.

ben

"Will Congress at least READ the Federal Universal Health Care Update (FUHC-U) reform bill before they vote on it?"

That's above their pay grade.

Original MikeS

In many cases it is a completely rational choice based upon a very conservative risk/reward assessment.

I absolutely agree. No insurance is a very reasonable choice for many people. Catastrophic only coverage is reasonable for many others.

As a political issue, I think that health care looses about 95% of its' steam when people realize that the most needy are already covered. (Even most illegal aliens are also covered back in their home countries.)

glasater

Someone mentioned that Zero hates the insurance companies because of his Mom.

fdcol63

I imagine that MOST of what drives Obama is related to parental / identity issues.

RichatUF

Maybee-

Gibbs said it was the Administration's belief that introducing a lower cost alternative (public) would cause the competition to lower their costs.

Ha. Good grief-these guys have a financials led economic crisis, a non-energy program which is causing gas prices to tick back up, a wishful thinking national security policy, and they want to go out and lead with their chin into a healthcare fight.

Fresh Air

Yep. Zero is a psychological basket case. Between hating his mother and loving his father (or the reverse), hating his own country, hating the British, hating his grandmother and (probably) resenting his wife, the guy is an emotional infant on the world stage with all the mental stability of Andrew Sullivan.

hit and run

ben:
Well, I think in order to "untangle" things I will stop exercising and keep drinking until the results are conclusive.

My studies have indicated that my health is only slightly impacted by this approach. My blood pressure is slightly elevated. Other than that, I got a clean bill of health from my doctor back in March.

Further, a more recent case study indicates that care should be taken in a regimen that includes exercise and drinking.

Two weekends ago we were at the lake with friends. We anchored up in a cove. After a few drinks and some swimming around the boat, I decided I should dive off the boat and see if I could reach the bottom.

I couldn't. But I did manage to go deep enough to get a perforated ear drum for my efforts.

Let that be a lesson to all the kids out there: drinking and exercise don't mix.

clarice

At least you weren't diving with a chainsaw in hand.

Extraneus

He's not the only one who hates insurance companies. It seems irrational, but this short video was pretty illuminating. Listen to the audience's blood-lust when she mentions them.

Video: The Public Plan Deception

The RNC should be showing this on TV.

Stephanie

Ummm.. Fresh... I think Sully might just be extraordinarily proud of the comparison.

Jack is Back!

When the federal government (Obama administration) can show me that they can turn around GM in 2 to 3 years time then I will start to listen to their grand plans on health (or as some wit wrote - my life). By the way, you know what's been missing in all this back and forth, this pros and cons, this debate? The role of unions in all this. I can tell you that right know I am with Aetna and my service provider is Mayo. Both are pretty efficient operations - bureaucratic, yes but a hell of a lot more productive than a health care system run by members of AFSME or SEIU or UAW.

BB Key

Today's WH briefing:
Gibbs told Lester that he does not know who Victor Davis Hanson is.

I think Gibbs was lying.

If he was not lying then he further disqualified himself as a credible WH spokesman.

PeterUK

"At least you weren't diving with a chainsaw in hand."

He would have,but it wouldn't start under water.

Pofarmer

Gibbs said it was the Administration's belief that introducing a lower cost alternative (public) would cause the competition to lower their costs.

Is there any proof that the govt is a lower cost way to do anything at all?

fdcol63

If Gibbs was truly ignorant of VDH's stature, intelligence, and academic credentials, then Gibbs is indeed too stupid and too ignorant to be ANY president's spokesman.

As Instapundit says sarcastically, "we're in the very best of hands."

MayBee

Is there any proof that the govt is a lower cost way to do anything at all?

Of course not. But what Gibbs meant was only that the cost of insurance premiums would be lower for the consumer (and possibly the businesses). Taxpayers or deficits would have to pick up the slack.
Private insurance companies can't compete with that.

I would call dibbs on Major Garret for pointing this out, but it would break Tappers heart.

glasater

There is competition among the insurance companies already.

And--there also is Safeway's Health Plan.

Years ago Golden Rule had terrific healthcare plan.

narciso

"best of all possible worlds",fd, he makes Scott McClellan seem like a genius, well I kid on that point.

cathyf

My family joined the first Illinois HMO when it was set up the late 70's. My parents are still there through medicare "gap" coverage. We certainly have had a positive enough experience to stay, obviously. Over 3 decades we experienced the HMO as a pure hmo clinic model, as more of a ppo model, run by the doctors, run by an insurance company, run by the hospitals. But there are no easy solutions, and the HMO model isn't one.

Porchlight

Bummer, hit. I had a perforated ear drum courtesy of an ear infection a couple years ago. It takes a while to get your hearing back but it does heal.

fdcol63

Scott McClellan, a genius. That's funny, narciso! LOL

fdcol63

People forget that there's a big philosphical different and approach between HMO's and insurance carriers.

HMO's are just what their name implies - health maintenance organizations. Thus, they do a better job at preventive care than do insurance companies. But, when something major or catastrophic comes up, they make things as hard as they can on the individual.

In contrast, insurance companies are betting that you DON'T get sick or need their service. They don't care about preventive care because they're intended to pay for those covered items AFTER care is needed. Which is why they don't pay for many physicals, tests, cleanings, and other preventive services.

It would be great if we could have thebest of BOTH in some kind of hybrid system, but definitely not one run by the Federal government! LOL

bad

Ibama's marriage to Michelle makes him very susceptable to the lure of Sharia.

Danube of Thought

Keep in mind that a policy that pays for routine, recurring services isn't "insurance" at all. It's simply a prepaid medical plan, and most of its proponents insist that someone else do the paying.

If auto insurance covered oil changes, tire replacements and gasoline, those premiums would go off the charts as well.

Pofarmer

Of course not. But what Gibbs meant was only that the cost of insurance premiums would be lower for the consumer (and possibly the businesses). Taxpayers or deficits would have to pick up the slack.

Well, yeah, there's the rub. It's not "cheaper". It might cost me less, but someone, somewhere, is making up the difference with his tax dollars. I wonder, can Obama get to the point where the entire budget is deficit spending?

sylvia

One thing I think people are not realizing is that some people make a conscious choice to avoid health insurance because they don't want a paper trail. For instance, if you are a person who changes jobs a lot or are self-employed and move from state to state, the one thing you want to avoid is a permanent record of a pre-condition stain. Once that gets on your record, you are barred for life from getting good coverage.

So it is best to pay cash for all tests and procedures because one day those tests might give you a bad result, and if health insurance pays for that test, that bad result will forever be on your record, and you will never be able to change your insurance company again. In fact I read that it is better to get sick with no health insurance than health insurance sometimes in terms of bankruptcy laws. If we do away with the pre-condition clause, or make it more reasonable, that black market will disappear.

Rick Ballard

"I wonder, can Obama get to the point where the entire budget is deficit spending?"

Sure he can. Zimbabwe has done it for years and years. I was recently reading a Credentialed Moron (whose name I have blissfully forgotten) make the argument that high inflation and high unemployment cannot coexist. Apparently his education had not taken him as far as the Weimar Republic, let alone Zimbabwe or Venezuela.

[Typhuspad is having a small fit at the moment - pardon me (or curse Typhuspad) if this double posts]

sylvia

Well I don't get why it necessarily has to cost all that much. There are a lot of people willing to pay a reasonable amount to get a reasonable amount of coverage, such as catastrophic coverage. Like the figures said, a lot of people without coverage are not all poor. If you offer a good benefit, many people will sign up themselves for it and pay for it themselves. For instance, I looked it up and you can get a $10,000 deductible for about $100 a month now with private insurance. A lot of the uninsured could afford that now.

But like I said, a lot of people don't want a paper trail. Take away the pre-condition clause, and people will start signing up. Also a lot of people are lazy and they are gamblers. Put forth some sort of tax penalty if you don't pay for your insurance, and people will sign up for it. And also, get those $100 prices down just a little, to maybe $80 a month, and more people will start signing up. A carrot and stick approach should work. I don't think it has to be that expensive.

Mary

Syvia,

Don't forget that with a high deductible plan you are eligible for a health savings account and can deduct the contribution to that from your income. The money in the account can grow tax free if you do not need to use it. For 2009 the contribution is $3000 for an individual. If a person is healthy in the fourth year that $10,000 deductible has been fully funded. It is also possible to use that money to cover other expenses like dental care.

cathyf
Keep in mind that a policy that pays for routine, recurring services isn't "insurance" at all. It's simply a prepaid medical plan, and most of its proponents insist that someone else do the paying.
Yeah, but the problem is that some routine/recurring expenses are substitutes for catastrophic expenses. For example, for a diabetic the insurance company would prefer to pay for the meter and test papers rather than have the diabetic have less close control over sugars and need limb amputation and have heart attacks. So the cost-minimizing insurance company has a rational incentive to pay for the testing supplies.

There are substitution effects that no one even tries to capture. For example if you have a seizure disorder there is a substitution relationship between the meds which prevent you from having seizures and your car insurance.

There are also cross-subsidy effects where people value the "routine" care more than it costs, and are willing to pay higher premiums which then make up for the fact that they are unwilling to pay the fair value for catastrohic coverage.

But probably the most important value is that health care is full of things which have high fixed costs and low marginal costs. Everything from drugs -- where the first pill costs the $20 billion R&D costs and every pill after that costs the 50-cent production costs -- to ER rooms which still have to be opened and staffed even though no one is there. So health care is rife with price discrimination. And it also involves services that you have to have lots of expertise to even know what it is you are getting, and so the typical patient has no way of knowing if something is a good price or not.

Having an insurance company act as your agent in purchasing routine care can be an excellent choice. And that's the way HSAs work, btw. It works just like if you have insurance: You have some medical bills, and the provider(s) submit the bills to the insurance company that administers the HSA. They put the bills through exactly the same (seemingly-random) payment reducer that they stick it through for their non-HSA customers, and send you some completely opaque documentation. Then, when they get around to it, the insurance company sends payment. If you have an HSA and you are below your deductible, they take the money out of your HSA, while if you have made your deductible then they send insurance company money.

cathyf

sylvia, the feds fixed the pre-existing condition problem starting July 1, 1997.

And yes, it is a textbook example of a case where everyone -- including the insurance companies -- was better off when the insurance companies were forced to do something that they could only do if all of the other insurance companies were forced to do it, too.

sylvia

Yes that helps somewhat Mary for some people. Don't forget though, that a lot of people, especially the people who fall into the uninsured category, don't pay much in terms of income taxes anyway. A person working a part time job at Wal Mart will not care much if he or she gets a health deductible because they hardly pay any taxes now. Then there are those known self employed income tax dodgers, like say waitresses and bartenders. That's why there might have to be a penalty instead, which could go towards a health fund.

I say make a penalty, and just like a mortgage deductions, where you have the insurance companies sending in the info on you independently. And to make it more palatable, you could call it a tax "deduction" that you can get if you have insurance, even though it's really a penalty added on for those who don't.

I think every American should have at least catastrophic insurance at a low price. So put a small tax on people who don't have it, or employers who don't offer it, and use that tax to fund cheaper rates for catastrophic, get it down to maybe $50 a month. For the really poor, get some means tested insurance. And take away the pre-condition clause. I don't think it should end up being that expensive or hard to do.

sylvia

"sylvia, the feds fixed the pre-existing condition problem starting July 1, 1997."

That's news to me. Then why did I have to fill out all that pre-existing condition stuff when I signed up for Blue Cross?

sylvia

Oh and by the way, as to obesity and health, I would again refer to the mini-series John Adams again. I noticed that John Adams was made fun of for being overweight. They teased him by calling him "His Rotundity", and they say that was one reason he was not as well known historically because he wasn't as attractive and stately looking. However His Rotundity was the oldest living US President, he lived till 90, which was really great for those days, so it looks like Adams had the last laugh. I think that's a sign right there that obesity is over-rated in terms of health problems.

Pofarmer

I think every American should have at least catastrophic insurance at a low price.

It's available right now, today, you don't have to wait.

Mary

Sylvia,

We have HSA's for mom,dad & son (still in school). One of our sons is a musician with high deductble insurance. He spent 5 days in hospital last year in NYC. The doctor is taking $100.00 a month until his bill is paid. We could pay it for him but he has declined our help. But he has started contributing to the HSA as well. His total bill was around $25,000. The total cost of the insurance, contribution and payment to his physician is less than his car payment and because he is not making a lot of money it does not help on his taxes. But if it happens again he will not have to pay out of current income. So an HSA helps even the low income insured budget their share of medical costs.

Melinda Romanoff

Po-

You've got mail.

Sorry, just digging out from the manure pile that slid on me, that's also known as "work".

Back in a bit, I'm chef this evening, dinner for one.

Jim Rhoads a/k/a vjnjagvet

Betsy's Page has a quote from John Steele Gordon which is particularly good on the government healthcare issue:

Why not have the federal government demonstrate that it can provide adequate health care to American Indians, a promise it hasn’t kept for 222 years? Then demonstrate it can provide adequate health care to veterans, a promise it hasn’t kept for 79 years. Then demonstrate that it can reform and efficiently run the health insurance system called Medicare, which it has been been making a dog’s breakfast of for the last 44 years. And then, and only then, take over all of American health care.

Or even better, why not have the mainstream media do its job for once and vigorously investigate the federal government’s actual track record in regard to health care? It’s not an impressive résumé for someone applying to run the whole show. Indeed, it’s a more-than-two-hundred-year record of failure, inadequate funding, bureaucratic indifference, and broken promises.

These facts should be memorized by all think-tanks, lobbyists, and the rest of us individual opponents of federal health care.

I will listen to what others say, but I am convinced the only reason I am alive today is because I chose not to use the VA health care benefits and to use the private system instead.

Involuntary (aka mandatory) national health care would be very expensive, and very ineffective.

Danube of Thought

If you remain uninsured until a problem arises, I cannot imagine why you would expect anyone to "insure" you against the risk of that problem arising. You are not seeking insurance; you are simply asking others to pay for remedies you already know are required. Whatever that is, it is not insurance. In CA at least, for many years it has been unlawful for an insurer to cancel a policy because an insured condition has arisen. But if you choose not to seek insurance until you need care, go cry on somebody else's shoulder.

Stephanie

You are not seeking insurance; you are simply asking others to pay for remedies you already know are required.

Ding ding ding... winner.

And that is the nut isn't it? Why get insurance when you can get a 72" big screen TV for that same $249 a month...of course the TV won't cure your cancer.... but it sure makes your friends envious.

cathyf
Involuntary (aka mandatory) national health care would be very expensive, and very ineffective.
The only alternative to mandatory health care would be to make it illegal to provide free health care to anyone. If you don't buy health insurance, then you get whatever care you can pay for, and when you run out of money you die. You are allowed to provide care to your own minor children, and you are certainly allowed to pay someone else's health insurance premiums, but other than that, charity care is illegal.
Danube of Thought

Cathyf, in your example it's not clear to me whether the diabetic was insured at the time of diagnosis, or was diabetic at the time he sought insurance--two very different circumstances.

If the former, then whether he gets "routine" procedures at the insurer's expense, or some less routine ones, is a matter of his agreement with the insurer and whatever they may negotiate among themselves.

If it's the latter case, then again my point is that the patient would simply not be seeking anything properly describable as insureance. He is seeking to have other people pay for the costs of an already existing problem.

Danube of Thought

Amazing--no sooner do I unload my last two posts when I stumble across the LUN item at American Thinker, which makes my point much more clearly than I was able to do.

I certainly recommend it to everyone interested in this discussion.

sylvia

What you are all not getting is not so much that people are trying to avoid paying for insurance, it's that people are trying to avoid getting locked into a job or a state, because once they see you have something, even semi-minor, you are stuck forever. You want to keep no paper trail and only sign up when you really really need it, and with no paper trail then you can sign up with full coverage. In fact I knew people who had health insurance and paid for their own tests out of pocket at different doctors in case the tests came up with a bad result, because that way they could preserve their job mobility.

Yeah it's cheating but it's happening, and the rest of the people are paying for it. Playing fast and lose with pre-conditions from the insurance companies is cheating too in my opinion. Much better to eliminate the pre-condition clause and get the people enrolled so you can at least get some money out of them.

And perhps CathyF's point is that today people have to be accepted with pre-conditions, but you have to wait often a year to be covered for that condition. For anything life threatening, a year is too long, and might as well be forever.

sylvia

Just as an example. Let's say you have a job with health coverage and get some routine tests done and that say you have high cholesterol. Then you switch jobs and are offered another health plan. During that first year at your new job, you suffer a heart attack. The new insurer can say that your heart attack was a pre-existing condition due to your risk factors and you are not covered. That leaves you with hundreds of thousands of medical bills for that year. Not something you want to happen.

cathyf

No, sylvia, that only happens if you let your insurance lapse between jobs. And no, they don't let you purchase homeowners insurance after your house is already on fire, either.

All those things you describe happened before July 1, 1997 -- you had people who had a child who had an organ transplant, and those people could never change jobs. Insurance companies wanted to be able to cover people's pre-existing conditions -- or, more precisely, the insurance companies' customers wanted them to cover pre-existing conditions so that they could hire the people that they wanted. But no insurance company could afford to be the only insurance company who did this. Every insurance company has a group of people that they are paying bills for with expensive, chronic conditions. That's the whole point of insurance -- collect money from a huge number of people, and then when a few random members of your risk pool develop expensive health conditions you use the money to treat them. So if every company has these folks, but only one company will take on the folks from a different company, then its obvious what would happen: people could come in to that one company's plan, but they could not leave. So the one company would collect more and more of the people with the pre-existing conditions, while all of the other companies would be able to get rid of them. So the one company would have to raise their premiums while the other companies could afford to lower theirs. Which would allow the customers who didn't have any employees/dependents with expensive conditions to save money by switching insurance companies away from the one. And eventually the one company would collapse into bankruptcy. Which, among other things, would leave all of their collected people with the pre-existing conditions with no insurance and no way to get any.

So the rather obvious solution was to pass a law which requires all insurance companies to take each other's customers and cover their pre-existing conditions. So that, over time, the number of people with pre-existing conditions coming into any plan equals the number of people moving out. This was a huge win for everyone in that insurance companies added a feature to their products which was highly valued by their customers yet cost the insurance companies virtually nothing. Without the law, the cost would have been basically infinite, so no insurance company could afford, at any price, to be the only one to take on pre-existing conditions.

This is a canonical example of an externality whose existence cost everyone money and no one benefitted from it. And a canonical example of the state using the force of law to internalize the externality, and by making everyone better off, actually create wealth.

Of course this only works for allowing the people to move from one insurance company to another. The people who gambled that they were young and healthy and probably wouldn't get something like diabetes, or a seizure disorder, or MS, or RA, etc. -- well, they made their choice when they decided that they had more important ways to spend their money than to pay insurance premiums. Just like the homeowner who decided to let his homeowner's policy lapse, and is now standing on the sidewalk watching his house burn. We might have more or less sympathy for the homeowner (soon to be pile-of-ashes owner) depending upon why he decided to opt out of his insurance, but once his house is already on fire we can't let him in to our insurance pool without destroying it.

sylvia

I don't know where you are getting your information from CathyF. The pre-condition clause is alive and well. You look up the info up on that health insurance site, is it esurance?, and they list right there the waiting periods. And I also know this because I've had many discussions about it with my Blue Cross representative.

You are right that each company is forced to accept anyone, however their waiting periods for pre-conditions vary, but they tend to be a year. And I believe there is no time limit for the year clause. For instance if your condition happens to appear 10 years after you are covered, you are not covered for that condition for one year after that condition appears. My representative told me a story of a young man who broke his ankle in the past. Then later on, years later, he developed arthritus in his leg. He was not covered for that because they said breaking his ankle was a pre-condition for it. She also said that if you ever went to the doctor in the past for a flu and then developed a flu later on, maybe having to be hospitalized for it, you would not be covered for that during that year. And this was only a couple years ago we had this discussion so this was recently.

sylvia

And to add on, remember that quote that's out there that's something like, if the bank loans you a thousand dollars and you don't pay it back, it's your problem. But if the bank loans you a billion dollars and you don't pay it back, it's the bank's problem.

The difference between your house burning down and health insurance is that if your house burns down without insurance, no one is forced to give you any money for it. If you have a health emergency without insurance, everyone is forced to pay for it. And recovery of debts is very often minimal. So we are paying for it anyway. And people are gaming the system.

So either we just let uninsured people die in the emergency rooms or we might as well be realistic and drop the pre-condition clause because it's not saving any money and causing more problems than it's worth.

cathyf

sylvia, I've filled out all of that paperwork, too. Your new insurance company must cover pre-existing conditions if those conditions were covered by your previous insurance as long as you did not let your previous insurance lapse before starting with your new insurance. The paperwork is very specific: prove that you have had continuous coverage, or, if you can't, prove that it wasn't a pre-existing condition. If you were covered, it's trivial -- fill in the name of your previous company and policy number and send it back.

cathyf
The difference between your house burning down and health insurance is that if your house burns down without insurance, no one is forced to give you any money for it.
No, but a pretty close analogy is that you buy a house on the coast which is under sea level, decide that you have better things to spend your money on than flood insurance, and then your house gets flooded by the storm surge from a hurricane. It's happened, multiple times, and I've been forced to pay for it.

Which is why the flood insurance program doesn't work. If the government is going to bail out the freeloaders equal to the premium-payers, then paying premiums is for chumps. In order for insurance to be possible for the people who want to pay for it, it must be true that the people who refuse to pay premiums suffer by not being covered.

sylvia

Yeah I'm not sure about that. I'll have to look that up. Yes definitely you are not covered if you lapsed. If you were covered, I'm not sure if they cannot wiggle out of it somehow. For instance, can they say that since the condition was not covered by the previous insurance company, that it won't be covered later? Let's say you have high cholesterol before, but you never received any treatment for it. Can the new insurance company say since it was not "covered" before, it's an uncovered pre-condition? I don't know, I know they will do whatver they can to get out of it.

But either way, a lot of people let their health insurance lapse between jobs, often because the premiums increase. So that is still a problem in an industry say where there are a lot of layoffs.

sylvia

"In order for insurance to be possible for the people who want to pay for it, it must be true that the people who refuse to pay premiums suffer by not being covered."

I agree. But it seems we have made a choice as a society to treat people in emergency rooms and ask questions later. And it is very easy to hide your health problems by paying cash. So unless we refuse treatment, or establish some sort of gestapo like tactics tracking everyone's health, there is no way to prevent the gaming, and some young healthy people may consider other people chumps for paying health insurance. So since that is the reality, what's the point of the pre-conditions. People who don't want to gamble, won't. People who do want to gamble, will. The pre-condition clause doesn't do anything.

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