News The US has the best health care in the world?

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The discussion critiques the U.S. healthcare system, emphasizing its inefficiencies and the prioritization of profit over patient care. Personal anecdotes illustrate serious flaws, such as inadequate medical equipment and poor communication among healthcare staff, leading to distressing patient experiences. The conversation challenges the notion that the U.S. has the best healthcare, arguing that it often fails to provide timely and effective treatment, especially for those without adequate insurance. There is skepticism about government-run healthcare, with concerns that it may not resolve existing issues and could introduce new inefficiencies. Overall, the sentiment is that significant improvements are necessary for the healthcare system to genuinely serve the needs of patients.
  • #851
WhoWee said:
You stated, "The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. "

These are outrageous assertions.

Other than the fact that insurance company employees have testified confirming this, it is an obvious logical result of the incentive structure which our health care system is built on.

All the incentives for the Insurance companies are towards less care and more cost to the consumer. Less care means more death and financial ruin. There are most certainly people who are working towards the companies incentives, and there are most certainly people who's job is specific to this cause.
 
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  • #852
jreelawg said:
Other than the fact that insurance company employees have testified confirming this, it is an obvious logical result of the incentive structure which our health care system is built on.

All the incentives for the Insurance companies are towards less care and more cost to the consumer. Less care means more death and financial ruin. There are most certainly people who are working towards the companies incentives, and there are most certainly people who's job is specific to this cause.

You claim that it's a FACT that insurance company employees testified that ""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. ""

You need to support these outrageous comments.
 
  • #853
jreelawg said:
All the incentives for the Insurance companies are towards less care and more cost to the consumer. Less care means more death and financial ruin. There are most certainly people who are working towards the companies incentives, and there are most certainly people who's job is specific to this cause.
Think about what you are saying and apply it to home insurance, car insurance, life insurance. There's a reason these businesses all don't simply up and up the cost and never pay off. Why do you think that is?
 
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  • #854
"Potter also faulted insurance companies for being misleading both in advertising their policies to new customers and in communicating with existing policyholders.

More and more people, he said, are falling victim to "deceptive marketing practices" that encourage them to buy "what essentially is fake insurance," policies with high costs but surprisingly limited benefits.

Insurance companies continue to mislead consumers through "explanation of benefits" documents that note what payments the insurance company made and what's left for consumers to pay out of pocket, Potter said.

The documents, he said, are "notoriously incomprehensible."

"Insurers know that policyholders are so baffled by those notices they usually just ignore them or throw them away. And that's exactly the point," he said. "If they were more understandable, more consumers might realize that they are being ripped off."

.."They were no match for insurance companies who know exactly how to design and market plans whose gaping holes don't become apparent until it's much, much too late," she said.

http://abcnews.go.com/print?id=7911195

I guess this is where you come in Whowee
 
  • #855
jreelawg said:
"Potter also faulted insurance companies for being misleading both in advertising their policies to new customers and in communicating with existing policyholders.

More and more people, he said, are falling victim to "deceptive marketing practices" that encourage them to buy "what essentially is fake insurance," policies with high costs but surprisingly limited benefits.

Insurance companies continue to mislead consumers through "explanation of benefits" documents that note what payments the insurance company made and what's left for consumers to pay out of pocket, Potter said.

The documents, he said, are "notoriously incomprehensible."

"Insurers know that policyholders are so baffled by those notices they usually just ignore them or throw them away. And that's exactly the point," he said. "If they were more understandable, more consumers might realize that they are being ripped off."

.."They were no match for insurance companies who know exactly how to design and market plans whose gaping holes don't become apparent until it's much, much too late," she said.

http://abcnews.go.com/print?id=7911195

I guess this is where you come in Whowee

How exactly does this post support your statements of ""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. ""

Also, I don't understand your comment "I guess this is where you come in Whowee" what exactly are you attempting to say?
 
  • #856
WhoWee said:
How exactly does this post support your statements of ""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. ""

"Workers received high marks on performance reviews after policies were rescinded, documents show. The health insurer denies the practice is a factor in evaluations."

The documents show, for instance, that one Blue Cross employee earned a perfect score of "5" for "exceptional performance" on an evaluation that noted the employee's role in dropping thousands of policyholders and avoiding nearly $10 million worth of medical care.

"Blue Cross of California encouraged employees through performance evaluations to cancel the health insurance policies of individuals with expensive illnesses, Rep. Bart Stupak (D-Mich.) charged at the start of a congressional hearing today on the controversial practice known as rescission."

"In November 2007, The Times reported that insurer Health Net Inc. paid bonuses to employees based in part on their involvement in rescinding policyholders. "
Also, I don't understand your comment "I guess this is where you come in Whowee" what exactly are you attempting to say?

http://articles.latimes.com/2009/jun/17/business/fi-rescind17
 
  • #857
jreelawg said:

I read the article and I'll ask again

"How exactly does this post support your statements of ""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. """ also, "Also, I don't understand your comment "I guess this is where you come in Whowee" what exactly are you attempting to say?"

You haven't cited anything that supports your outrageous accusations of some insurance person being responsible for millions of deaths - please retract your nonsense and explain the "WhoWee" comment - again, please.
 
  • #858
WhoWee said:
I read the article and I'll ask again

"How exactly does this post support your statements of ""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. """ also, "Also, I don't understand your comment "I guess this is where you come in Whowee" what exactly are you attempting to say?"

You haven't cited anything that supports your outrageous accusations of some insurance person being responsible for millions of deaths - please retract your nonsense and explain the "WhoWee" comment - again, please.

I really meant people, obviously one person doesn't accomplish that much. Not one person. Everyone has their role, from the CEO, to the people who reviews claims, to the salesman. One sets em up another knocks em down. People ought to know what they are getting themselves into.
 
  • #859
jreelawg said:
I really meant people, obviously one person doesn't accomplish that much. Not one person. Everyone has their role, from the CEO, to the people who reviews claims, to the salesman. One sets em up another knocks em down. People ought to know what they are getting themselves into.

Again, support your claims. You said ""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. ""

Are you saying there's a giant conspiracy to commit murder? Or are you going to retract the nonsense?

Also, please explain this comment ""I guess this is where you come in Whowee"".
 
  • #860
Where do the doctors stand on health-care reform?

A RWJF survey summarized in the September 14, 2009 edition of the New England Journal of Medicine shows that 62.9 percent of physicians nationwide support proposals to expand health care coverage that include both public and private insurance options—where people under the age of 65 would have the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans. The survey shows that just 27.3 percent of physicians support a new program that does not include a public option and instead provides subsidies for low-income people to purchase private insurance. Only 9.6 percent of doctors nationwide support a system where a Medicare-like public program is created in lieu of any private insurance. A majority of physicians (58%) also support expanding Medicare eligibility to those between the ages of 55 and 64.

In every region of the country, a majority of physicians supported a combination of public and private options, as did physicians who identified themselves as primary care providers, surgeons, or other medical subspecialists. Among those who identified themselves as members of the American Medical Association, 62.2 percent favored both the public and private options.

The survey was conducted between June 25 and September 3, 2009 by Salomeh Keyhani, M.D., M.P.H., and Alex Federman, M.D., M.P.H., of the Mount Sinai School of Medicine in New York City. While the survey was conducted in several “waves” over a tumultuous summer for the health reform debate, no statistically significant differences were identified in physician responses throughout the summer.

http://www.rwjf.org/healthreform/quality/product.jsp?id=48408

It's clear that doctors want reform. Doctors want a public option, and they want people to be able to opt into Medicare. Doctors are care-givers, but most are also business people. It would be a good idea for people on the sidelines (who are often fed their "facts" by outsiders) to heed doctors who are on the front-lines of health-care. I have quite a number of friends who are in the medical profession, and I can't think of a single one who doesn't want significant health-insurance reform. They are being squeezed by the insurance companies and they are being forced to fight for payment of legitimate claims. Worst of all, they are often being told that they cannot order what they believe is the best treatments for their patients because the insurance companies refuse to pay for them.

Edit: Notice that if you add the almost 10% of doctors who want a public-only program to the 62+% that want a public plan to supplement private plans, you have over 70% of doctors supporting the creation of a broader public plan in one form or another. In my personal experience, I find that number to be a bit low, but that's probably because I live in a rural area where many of my friend's practices are small and administrative costs are brutal. Doctors who specialize in high-dollar elective procedures like cosmetic surgery, breast enhancements, etc are probably not highly motivated to support a public option because it would have little impact on their practices. Not a lot of them around here, though, so the study is probably accurate across a broad range of practices from GP to specialties.
 
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  • #861
WhoWee said:
Again, support your claims. You said ""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. ""

Are you saying there's a giant conspiracy to commit murder? Or are you going to retract the nonsense?

Also, please explain this comment ""I guess this is where you come in Whowee"".

"...and this particular act secured my reputation as a good medical director, and it insured my continued advancement in the ah, health care field. I went from making a few hundred dollars a week as a medical reviewer, to an escalating six figure income as a physician executive...I know how managed care maims and kills patients... and I am haunted by the thousands of pieces of paper in which I have written that deadly word, denied."

Dr. Linda Peeno MD testifies in front of congress

http://www.youtube.com/watch?v=DoqpPwvUoP0&feature=related
 
  • #862
I've disclosed previously that I'm a licensed insurance broker/agent. I am appointed with MULTIPLE insurance companies. Accordingly, I know hundreds of licensed agents around the country.

PLEASE NOTE - THIS POST IS NOT INTENDED TO DEFEND INSURANCE COMPANIES.

I can honestly make the following statement. Every insurance agent I know, is trained to fight for their clients when there is a problem with coverage. It is in the best interest of the agent to get claims paid - and in a timely manner. Individual health insurance sales are driven by referrals.

Most agents work on a commission only basis. Therefore it's also in the agent's best interest to sell the best coverage possible. Unfortunately, everyone can not afford the best coverage and everyone is not fully insurable.

Agents that take the money and run, and put people into the wrong coverage, don't last in the industry.

At the same time, people don't always tell the absolute truth on their applications. Every prescription you've ever had filled is on a national database.
http://www.mib.com/
If someone lies to obtain coverage, they are taking a very big risk. Instead, applicants need to tell the truth and select from the coverages that are available and in their price range.

I agree that we need reform in the health care industry. There are thousands of items to address and can not be over-simplified.

However, the first place I would start is with standardization of insurance coverage across all 50 states. Then (I've posted this before) the best Government option would be to fund a high risk pool that would guarantee acceptance of all pre-existing conditions.

These 2 steps alone would remove obstacles, reduce premiums (due to administrative and legal savings) and expand coverage to millions of currently uninsured or under-insured people.

Again, we need to remove politics from the debate and approach reform with a problem solving mind set.
 
  • #863
jreelawg said:
"...and this particular act secured my reputation as a good medical director, and it insured my continued advancement in the ah, health care field. I went from making a few hundred dollars a week as a medical reviewer, to an escalating six figure income as a physician executive...I know how managed care maims and kills patients... and I am haunted by the thousands of pieces of paper in which I have written that deadly word, denied."

Dr. Linda Peeno MD testifies in front of congress

http://www.youtube.com/watch?v=DoqpPwvUoP0&feature=related

You still haven't supported your claims that

""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. ""

Please retract the nonsense.
 
  • #864
WhoWee said:
You still haven't supported your claims that

""The person who reviews the claims makes more money denying people. Ultimately being responsible for killing millions of people." as well as "A whole lot of health insurance employees, really have no role in the health care system except to maximize death and bankruptcy of the sick. ""

Please retract the nonsense.

If they want to be rated well, and have the opportunity to move up, and get paid more, then they deny as many people as they can (translated save the company as much money as possible) This is how the incentives go. My initial interpretation may be coming on a little strong, and I know that there are probably differences between different insurance companies in policy. In some cases my interpretation is correct, and in some, not so much.

It seams clear that a persons evaluated performance would have a lot to do with wether a person advances, gets a raise, or gets fired. Whether or not in all cases the financial incentive to the employee is directly and officially based on rescinded coverage, rescinding care is commonly practiced, and saves the company money. Whether the reward for an employee's performance is spelled out, or whether the employee simply knows based on common sense that their performance is a factor in the success of their career and pay, the direction is towards dropping as many people as possible to save money. Obviously this results in the deaths, and financial ruin of their customers.
 
  • #865
Hans de Vries said:
This is an authoritative study on cancer survival rates and the US does very well actually:

http://v1.theglobeandmail.com/v5/content/pdf/CONCORD.pdf

On the other hand, the US has a higher percentage of it's population diagnosed with
cancer, twice that of France and four times that of Japan. My feeling is that the US
does more in preventive scanning resulting in earlier diagnosis, increasing the survival
rates, but that would need to be substantiated.


Regards, Hans.
Yes, ...five continents... reported in Lancet Oncology too:
http://www.thelancet.com/journals/lanonc/article/PIIS1470204508701797/abstract?iseop=true
 
  • #866
mheslep said:
Yes, ...five continents... reported in Lancet Oncology too:
http://www.thelancet.com/journals/lanonc/article/PIIS1470204508701797/abstract?iseop=true
It is indeed fairly well known that the US does slightly better than western Europe on cancer. The link does not explains why, and it has already been pointed out that Europeans tend to smoke more for instance. But above all, the article points slight differences between US, Australia, Japan, and Europe for instance, while large differences with Bresil, the UK, Algeria, or Danemark for instance with prostate.

If we want to go into the slight differences we would have to look at variances by population and location for instance.

So we conclude that the US health care is good enough ? It seems to me, it remains to explain why the US does a couple percent better while spending 50% more.
 
  • #867
humanino said:
So we conclude that the US health care is good enough ? It seems to me, it remains to explain why the US does a couple percent better while spending 50% more.

I think it would be more enlightening to compare treatment-by-treatment costs than total costs. Having lived in both Europe and the US, and having recently the unpleasant experience of watching relatives linger and die, I can tell you that one difference is that in the US there are heroic efforts to extend the life of dying patients a month or two. This can't come cheap.

Comparing like-with-like seems to me to be more valuable than comparing aggregates.
 
  • #868
jreelawg said:
If they want to be rated well, and have the opportunity to move up, and get paid more, then they deny as many people as they can (translated save the company as much money as possible) This is how the incentives go. My initial interpretation may be coming on a little strong, and I know that there are probably differences between different insurance companies in policy. In some cases my interpretation is correct, and in some, not so much.

It seams clear that a persons evaluated performance would have a lot to do with wether a person advances, gets a raise, or gets fired. Whether or not in all cases the financial incentive to the employee is directly and officially based on rescinded coverage, rescinding care is commonly practiced, and saves the company money. Whether the reward for an employee's performance is spelled out, or whether the employee simply knows based on common sense that their performance is a factor in the success of their career and pay, the direction is towards dropping as many people as possible to save money. Obviously this results in the deaths, and financial ruin of their customers.

This sounds to me like a lot of guessin' and supposin' but not a lot of evidence. I think I agree with WhoWee that it would be good for you to provide some facts in support of your opinion.

I did provide one fact a zillion messages ago. The two biggest health insurance companies have profits of about 4%. So if people are being denied coverage that they deserve and have paid for so that the insurance companies can make a profit, we know that this can be at most 4% of the total. More than that, the problem isn't that insurance companies are making too much profit, it's that health insurance is underpriced.
 
  • #869
Vanadium 50 said:
I did provide one fact a zillion messages ago. The two biggest health insurance companies have profits of about 4%. So if people are being denied coverage that they deserve and have paid for so that the insurance companies can make a profit, we know that this can be at most 4% of the total. More than that, the problem isn't that insurance companies are making too much profit, it's that health insurance is underpriced.
As an answer to this fact, I quoted mutual organization in the US providing health care insurance roughly 30% cheaper. Interestingly, this is in line with the US system being 50% more expensive than the European one. It is possible that, even with similar profits, services cost less with better organization, and above all, health costs are reduced if routine checkups are covered or possibly imposed. Those are just two examples where indeed, we do not compare "like-with-like" but we really change the philosophy of the system.
 
  • #870
turbo-1 said:
That is standard operating procedure for health insurance companies. I have told you that (as the former IT guy for a large medical practice) as has Adrenaline (doctor in private practice). If you choose not to believe us, fine, but don't argue that it doesn't happen because it does, constantly.
I have never claimed that fraud didn't happen. I said the issue wasn't in dispute here. It takes two to constitute a disagreement, so the fact that you have mentioned fraud doesn't make it an issue in dispute.

In fact I have pointed out that claiming that insurance companies are all alike (as you have done) helps the bad companies get by with it.

And do any of the current proposals address the issue of fraudulently denied claims, anyway? Why should they, it's already illegal in every state.
 
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  • #871
Vanadium 50 said:
The two biggest health insurance companies have profits of about 4%.
One thing that many people seem to just not understand about economics is that in any (relatively) unregulated industry, higher profits result in products being both cheaper and higher quality for consumers, and vice versa.

"Excess" profits result from inadequate competition, and lure competition into the market, again benefiting consumers.

This just doesn't happen so much when there are regulatory barriers to entry into the market, like with health insurance. The result of the regulation is higher prices and an inferior product.
 
  • #872
humanino said:
...
and it has already been pointed out that Europeans tend to smoke more for instance.
That's about how many people contract cancer - out of the of the reach of most medical reforms; the Concord/Lancet study above is about effectiveness of the medical treatment on people that have cancer - two very different things.
...So we conclude that the US health care is good enough ?
We have hundreds of posts in this thread with almost universal agreement that US health care is _not_ good enough and has major flaws. The point is that it also has major strengths, such as the quality of oncological care demonstrated above, and we would like not to wreck that in the process of reforming the system.
 
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  • #873
It's not just that by preventative screening leading to earlier treatment you have better survival chance. There is also the issue of prostate cancer in older men. Some percentage of men who die, have prostate cancer at the time of death, without the cancer being a factor in their death. Such cases go undetected in Europe while in the US, due to screening, they contribute to the cancer surviving rate statistics. I think that the incidence of non lethal prostate cancer is 10% or more in old men.

In the US, you also have a far larger incidence of easily treatable skin cancer compared to Europe.
 
  • #874
Rangel is disappointed - where's the tax on the rich?:-p
http://www.ny1.com/content/top_stories/105791/rangel-raises-concerns-over-health-care-funding/Default.aspx
...and not enough for the poor?:rolleyes:
 
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  • #875
On a serious note, details of the Max Baucus Bill are drawing criticism.
http://online.wsj.com/article/SB125303845553412855.html

""This is not like shaving off things, this is reducing coverage for poor and working people," House Ways and Means Chairman Charles Rangel (D., N.Y.) said Monday. Mr. Rangel is an architect of the $1 trillion House health-care bill, which provides more generous subsidies.

Some Senate Democrats are voicing similar concerns. Sen. Jay Rockefeller (D., W.Va.) on Monday said there was "no way I can vote for the package" without changes. Sen. Debbie Stabenow (D., Mich.) vowed to seek additional subsidies, or possibly a new tax break, aimed at helping working families, when the bill comes before committee. "Fundamentally, we're doing this for American families, and we need to make sure this is affordable," she said.

The Baucus bill would provide federal subsidies to individuals and families with incomes as high as 300% of the federal poverty line. For people whose incomes fall between 300% and 400% of the poverty line, the bill would cap premiums at 13% of income.

Critics complain the 13% cap is too high and would impose unreasonable costs on middle-income family budgets. But Finance Committee aides argue that tens of millions of Americans would still benefit from the cap.
Opinion

The Senate Is Ready to Act on Health Care

Mr. Baucus said that because his bill would expand insurance coverage for Americans, "middle-class families are going to be much better off than they currently are." In an op-ed published Wednesday in The Wall Street Journal, Mr. Baucus said the "current system is simply unsustainable," and noted his bill would help small businesses and families stressed by the rapid growth in health costs. "The status quo is no longer an option," he said.

Republicans, meanwhile, have been seeking other changes to the bill. In private negotiations led by Mr. Baucus, Sen. Charles Grassley (R., Iowa) made a push this week to drop the proposed mandate requiring individuals to buy insurance. Instead, he has proposed creating a new "reinsurance pool" to help spread the risks associated with high-cost patients.

In a statement released late Tuesday, Mr. Grassley complained the Senate Democratic leadership is imposing an "artificial deadline" on the bipartisan talks led by Mr. Baucus, but vowed to "continue to work with" the chairman.

Health Care for America Now, a liberal advocacy group, estimates that a family of four earning $77,175 a year could pay as much as $10,033 a year for health insurance under Sen. Baucus's proposal. That is about $2,000 a year more than they would pay under a health bill passed through the Senate's Health, Education, Labor and Pensions Committee, as well as under two of the three bills passed through House committees.

Mr. Baucus's bill would also place higher caps than other versions on the amount consumers would pay for out-of-pocket health-care expenses. It would allow insurance companies to charge older customers premiums that are as much as five times as high as those for younger customers, a provision sought by insurance companies. The other bills would restrict them from charging older customers more than twice as much."

It sounds like the debate has just begun. The cap will have to increase with Obama's mandate of no lifetime maximum payout and no pre-existing conditions.

This is especially true when you consider the average cost of an employer paid policy is $13,000 per year.
http://www.google.com/hostednews/ap/article/ALeqM5hMAlWaPqqHfYA1aKXHRs7xjmXQMgD9ANTRAG0

"Health insurance premiums rose modestly in 2009

By TOM MURPHY (AP) – 8 hours ago

The cost of employer-sponsored health insurance rose modestly again this year, but researchers predict a return to bigger increases that may eventually produce crippling premiums if left unchecked.

Meanwhile, more workers with single coverage are facing high-deductible plans that make them pay $1,000 or more out of pocket before coverage starts, according to a report released Tuesday by the Kaiser Family Foundation and the Health Research and Educational Trust, a nonprofit research organization affiliated with the American Hospital Association.

The average annual premium — the amount charged for a fully insured policy — rose 5 percent for the third straight year to surpass $13,000 for employer-sponsored family health coverage.

Employers picked up about 74 percent of that cost, while workers paid the rest. Single coverage remained relatively flat at an average of $4,824, with employers paying 84 percent.


The 2009 increases represent much smaller growth than just a few years ago. Premiums increased anywhere from 10 percent to 13 percent from 2000 to 2004."

How can a 13% cap possibly work - when the median household income is less than $60,000?
[URL]http://quickfacts.census.gov/qfd/states/00000.html

13% of $60,000 is only $7,800 - who is going to pay the difference $13,000 - $7,800 = $6,200 a 47% difference? Is Obama going to be able to cut out 47% of the cost? The numbers don't compute.
 
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  • #877
  • #878
Count Iblis said:
45,000 Americans die each year due to lack of insurance:

http://www.bizjournals.com/baltimore/stories/2009/09/14/daily65.html
You misstated the bizjournal headline. Also:
..The study was released by Physicians for a National Health Program, an organization that favors a single-payer system.

However, the study’s authors concede that ... they did not validate their subjects’ insurance status.
:zzz:

Edit: link to the pre printed paper:
http://pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf

First line from this scientific paper:
The United States stands alone among industrialized nations in not providing health coverage to all of its citizens...
 
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  • #879
Here's an example of why a consideration of the alternatives are important when slinging "people die!" claims around

People that die due to government healthcare (Medicaid):

summary from http://www.heritage.org/research/healthcare/bg2264.cfm#_ftnref31" :
a study published in the Journal of the American College of Cardiology examined outcomes from coronary artery bypass surgery and found that Medicaid status was independently associated with a worse 12-year mortality than for patients with other types of insurance. In fact, Medicaid enrollees had a 54 percent greater 12-year risk-adjusted mortality than patients enrolled in other types of insurance plans.

Original paper:
Operative and Late Coronary Artery Bypass Grafting Outcomes in Matched African-American Versus Caucasian Patients: Evidence of a Late Survival-Medicaid Association
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T18-4H6XKYC-4&_user=3938616&_coverDate=10%2F18%2F2005&_alid=1017029657&_rdoc=1&_fmt=high&_orig=search&_cdi=4884&_docanchor=&view=c&_ct=22&_acct=C000061828&_version=1&_urlVersion=0&_userid=3938616&md5=0d406bdb032a533728bb3618197a4139

[...]
Medicaid status and late CABG [coronary artery bypass surgery] outcomes. Race did not predict CABG outcomes, but Medicaid status, which is more than four-fold more frequent among African Americans, did with a 54% greater 12-year mortality (HR 1.54;p 0.0047)...
 
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  • #880
Watching the debate this week, I think health care reform is moving in the direction of Medicare Advantage programs. That is, Government regulated, mandated, and guaranteed - but privately insured.

This is the CMS rule book.
http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf
 
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  • #881
Each and every service has a price... and in US you can get best service if you are able to pay upto that extent.. Moreover, the one basic benefit for US to provide such facilities is that it has proper economy to buy latest and most advanced technology...
 
  • #882
New House Bill

Yesterday the US President spoke on the latest health care bill from the house, during which he again http://www.forbes.com/2009/10/29/health-care-remarks-business-washington-obama.html" :
Obama said:
The first thing I want to make clear is that if you're happy with the insurance plan you have right now; if the costs you're paying and the benefits you're getting are what you want them to be--then you can keep offering that same plan. Nobody will make you change it.

But as I read the http://docs.house.gov/rules/health/111_ahcaa.pdf" , it appears to have a fairly narrow view of 'keep', if it is possible at all. Under this bill there will only be two approaches allowed: insurance offered under the guidelines of the federally controlled insurance exchange, and existing insurance that is 'grandfathered in', the latter must be that to which the President referred.

To be grandfathered in, the insurance provider is very limited in its ability to change the plan in terms of benefits, conditions , or premiums. Now I know my plan (which I like) changes its benefits more or less every year (adds mental health, adds fertility, etc), bumps its premiums every other year or so. Under these restrictions, I can only imagine the provider would throw up its hands and move on to the exchange, especially given millions will be making moves in the heath market forcing major upheavals in health economics for some time until things stabilize. Likewise, if I have to change jobs then no more existing plan, and I'm on to the exchange.

A more accurate statement about this bill is that it may not immediately throw everyone onto the federal exchange, for a moment it may leave a few alone, but it clearly intends to force everyone on to the federal health exchange as quickly as possible.

Pg 91
House health bill Oct 29 said:
1 SEC. 202. PROTECTING THE CHOICE TO KEEP CURRENT
2 COVERAGE.
3 (a) GRANDFATHERED HEALTH INSURANCE COV4
ERAGE DEFINED.—Subject to the succeeding provisions of
5 this section, for purposes of establishing acceptable cov
6 erage under this division, the term ‘‘grandfathered health
7 insurance coverage’’ means individual health insurance
8 coverage that is offered and in force and effect before the
9 first day of Y1 if the following conditions are met:
10 (1) LIMITATION ON NEW ENROLLMENT.—
11 (A) IN GENERAL.—Except as provided in
12 this paragraph, the individual health insurance
13 issuer offering such coverage does not enroll
14 any individual in such coverage if the first ef
15 fective date of coverage is on or after the first
16 day of Y1.
...
21 (2) LIMITATION ON CHANGES IN TERMS OR
22 CONDITIONS.—Subject to paragraph (3) and except
23 as required by law, the issuer does not change any
24 of its terms or conditions, including benefits and
25 cost-sharing, from those in effect as of the day be
26 fore the first day of Y1.

1 (3) RESTRICTIONS ON PREMIUM INCREASES.—
2 The issuer cannot vary the percentage increase in
3 the premium for a risk group of enrollees in specific
4 grandfathered health insurance coverage without
5 changing the premium for all enrollees in the same
6 risk group at the same rate, as specified by the
7 Commissioner.
... [pg 94]
1 (c) LIMITATION ON INDIVIDUAL HEALTH INSURANCE
2 COVERAGE.—
3 (1) IN GENERAL.—Individual health insurance
4 coverage that is not grandfathered health insurance
5 coverage under subsection (a) may only be offered
6 on or after the first day of Y1
 
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  • #883


mheslep said:
Under these restrictions, I can only imagine the provider would throw up its hands and move on to the exchange, especially given millions will be making moves in the heath market forcing major upheavals in health economics for some time until things stabilize.
Do you think that the insurance companies will abandon the lucrative insurance industry? Is it possible that they might work to become (gasp!) competitive and stop doubling their premiums every 6 years or so? The breathless predictions of collapse of our health-care system if reform is initiated are getting really tedious. I guess if my father owned Cigna, I could jump on board to protect my villas in southern France and my yachts...
 
  • #884


turbo-1 said:
Do you think that the insurance companies will abandon the lucrative insurance industry?
Who said anything about abandoning in the industry? I said they will all be forced on the exchange. Do you have any comment on the validity of the President's statement yesterday?
 
  • #885
This is one response from the insurance industry. This letter has been forwarded by thousands of agents to members of Congress this week. Please read the entire letter before posting.

"I am a health insurance agent and also a citizen of your district. I am writing to express my objections to a government run insurance program ("public plan") under consideration as part of health reform legislation. I am also very concerned for my customers and the buying public that the proposed legislation does not adequately address the issue of affordability. The bills I have read do very little to nothing to bend the cost curve for either public or private health plans.

The foundation of any effort to improve the health care system must include measures to control the costs of medical care. The current House and Senate legislation has as its primary focus the financing of medical services only (i.e., insurance). Even the public/government plan will make coverage more expensive as providers who are underpaid by the government shift that loss to the private sector insureds. The legislation simply fails to achieve the bipartisan goal of controlling health care costs.

I urge you to oppose the government-run plan and focus instead on reducing costs by instituting medical malpractice reform, eliminating unnecessary medical procedures, simplifying and standardizing administrative processes, focusing on wellness/prevention, and on a variety of other options -- all of which have been discussed at some point in the debate but were never included in the bills.

Although I have heard the rhetoric from many sources, at the "street level", I can tell you there is no way that any insurance company can "compete" with the government payor. Most private insurers do not have the ability to dictate pricing to providers. Maybe the largest 3 or 4 insurers do, and of course the government does. This is a significant advantage for the few, and will cause significant harm to all others. Instead of creating more competition, you are causing less.

Why does the government believe it can run a large health insurance program, and be successful at it? The current federal insurance plan -- Medicare -- has a $38 trillion deficit. And the deficit is at this exorbitant level even with the government paying much less for medical services than private insurers do. If the federal government was regulated the same as a private insurer, it would be placed into liquidation. This current health reform is supposed to be self-sustaining -- Medicare also was supposed to be.

Our government cannot afford to start yet another entitlement program with impossible spending levels. There are simply too many red flags in government run health insurance.

I am asking you to pause and step back for a moment, and remember that there is an enormous amount of necessary and non-controversial reform that could be implemented quickly and without a public plan. Let's begin with that. The economy is in terrible shape. Please work on passing realistic legislation without a government plan. Taxpayers don't need and can't afford that expense. We elect our Congressmen to represent our interests in Washington, not to act irresponsibly and make us fearful about our continuing ability to buy affordable health coverage.

Please do what is right for your constituents, stop spending billions of dollars on measures that have little impact, and take all the time needed to make sure that health care reform is done in the right way."
 
  • #886
Under health insurance reform, we will put an end to the days when an insurance company could use a worker's illness to justify jacking up premiums. We'll crack down on excessive overhead charges by setting strong standards on how much of your premiums can go toward administrative costs and requiring insurers to give you a refund if they violate those standards. It will be against the law for insurance companies to deny you coverage because of a pre-existing condition. And it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most.

They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. If you get your insurance through your employer, we'll change the cutoff on how old your kids can be to remain on your plan--we'll raise it to 26 years old. We'll place a limit on how much you can be charged for out-of-pocket expenses. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies-

In a nutshell, those seem to be the restrictions that will be placed on insurance providers.

There seem to be two issues. The first, addressed above, is Insurance reform. The second, less mentioned, is Health or Care reform. I think these two are being interchanged and confused.
 
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  • #887
WhoWee said:
This is one response from the insurance industry. This letter has been forwarded by thousands of agents to members of Congress this week. Please read the entire letter before posting.
Generally speaking: it might facilitate the discussion if you pull out the 2-3 concise points you consider salient; either that, or provide an extraordinary reason for us to read the entire text.
 
  • #888
mheslep said:
Generally speaking: it might facilitate the discussion if you pull out the 2-3 concise points you consider salient; either that, or provide an extraordinary reason for us to read the entire text.

Actually, I think you've just highlighted the main problem with the debate. Everyone wants 2 - 3 talking points and an avoidance of the details.
 
  • #889
No, OR provide the reason to read all the detail you provided. WhoWee millions of people write letters to Congress. We can't all read everything. Some context and and background is required to pick and choose what to read. Why is your page important? Why is it believable?
 
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  • #890
WhoWee said:
Actually, I think you've just highlighted the main problem with the debate. Everyone wants 2 - 3 talking points and an avoidance of the details.
As someone who has read the details of the current proposal, I have to agree with mheslep. A good way to keep people from reading a post is to make it long.

It's the long posts that are avoided, not important details, and in the absence of a particular reason to believe a longer post is important, most of us just assume that it's an inefficient use of time to read it.

That being said, the letter you posted was worth reading, so it was an exception to the rule.
 
  • #891
Alfi said:
In a nutshell, those seem to be the restrictions that will be placed on insurance providers.
And consumers. Those "restrictions" are placed on all of us. We will be "restricted" to either buying an expensive comprehensive health care plan that meets the new standards, or nothing at all.

It's not like those "Cadillac" policies aren't already available, we just aren't forced to buy them yet.
 
  • #892
From the Insurance agent's letter
Although I have heard the rhetoric from many sources, at the "street level", I can tell you there is no way that any insurance company can "compete" with the government payor.
Do they compete without the restrictions that are proposed?
Would the restrictions alone work without a 'government payor'?
Street level knowledge might be questionable.
 
  • #893
mheslep said:
No, OR provide the reason to read all the detail you provided. WhoWee millions of people right letters to Congress. We can't all read everything. Some context and and background is required to pick and choose what to read. Why is your page important? Why is it believable?

This letter was written by the CEO of a large insurance company and made available to the agent network to send to their respective political representatives. My intent was to make a factual post, rather than pick and choose from the content.

If you really want to know my personal thoughts, please read the next few lines. Health care reform is needed. Any solution based upon the Medicare model is a mistake. An exhaustive review of the system - using a problem solving technique (scientific method) is needed before any additional legislation is enacted.
 
  • #894
I find it fascinating that the proponents of maintaining the status quo choose to ignore the WHO's ranking of our medical system in favor of theoretical arguments against socialism, gov't bureaucracy and anecdotal reports of long que times in Canada.

I think that in itself is quite telling.
 
  • #895
mihna said:
I find it fascinating that the proponents of maintaining the status quo choose to ignore the WHO's ranking of our medical system in favor of theoretical arguments against socialism, gov't bureaucracy and anecdotal reports of long que times in Canada.

I think that in itself is quite telling.

Welcome to PF.

Can you please elaborate?
 
  • #896
mihna said:
I find it fascinating that the proponents of maintaining the status quo choose to ignore the WHO's ranking of our medical system in favor of theoretical arguments against socialism, gov't bureaucracy and anecdotal reports of long que times in Canada.

I think that in itself is quite telling.
I think it's quite telling that you think opponents of the current proposals are "proponents of maintaining the status quo".

Do you have something to contribute other than snide comments?
 

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