Maybe I am naive, but why can't insurance be non-profit? The whole idea of insurance is to spread the risk around, right? 10 people pay $100 a month each, one gets sick and makes a claim for $1,000. Voila! We have the money to cover him and the group is even! Instead, 10 people pay $500 a month each, one gets sick and the insurance company figures out how to only pay $200 of the $1000 (cause they are smarter and more powerful than the collective 10 people in the plan) and pockets the rest and Voila! the CEO gets another yacht.
You know where all that money goes, there are offices full of worthless people all across the country playing paper shuffling games. We have to pay those salaries!
manta - it means the company pays 100% of the premiums for individuals. partner/spouse/kid benefits are available but the company doesn't pay for them. besides the expense factor, it gets to be a fairness issue that's, quite frankly, too much of a headache to deal with. for example, if someone has a family and puts them on the plan, i'm in effect giving them an extra 7-8,000 per year that people who are single don't get. if i then have to pay those people extra in salary, then i'm just out huge amounts of money for such a small (5 FTE) people. it just doesn't work. maybe at a much larger or much more profitable place...
Really? And what are the Republicans all about? puppies and ice cream?
And for the record no Family Practice doc makes 300k a year....a specialist yes...that is a problem...but to say doctors make 300k is just idiotic.
Doctors in the USA also carry a HUGE debt load..something Japan, Canada, etc. don't have because they pay people to become doctors.
The system and issues are much more complex than anything that is being mentioned here. Single payer is what most FP's and GP's want...in excess of 80% of them...they hate dealing with the insurance companies as much if not more than patients.
Make it single payer system and it is. Without that no company will play the game with out the ability to make exponential returns endlessly into the future...bidness is bidness.
i don't know. i've got bennefits from variety of sources but i'd rather drink that spend time reading that rubbish...in fact, i'd rather drink than read this rubbish too...but i do know that i have money & that's all that really matters, isn't it?
"but anyway, manta just made the best argument on healthcare ive seen in any of these discussions"
Actually, he made a stereotypical argument.
Jon Stewart's argument... he cleverly set up Bill Kristol, and he clearly had that one loaded up prior to the interview. In reality, would anyone say that the health care provided to the military is a "system"? Were we to expand that "system" to cover all citizens, we'd have simply found one more way to bankrupt ourselves.
Kristol did not fare well on the show, but he made a point well worth noting here, and one that many of you have chosen to ignore -- and that's that the waste, corruption, and fraud within the current government run programs like Medicare/caid are largely repsonsible for the skyrocketing health care costs.
scribbles, obama is already *at* the middle. The left wants a single-payer system.
Sorry, outed, it seems I simply misread your statement -- I read it as you covered the family members and you couldn't do any less than that! Hence my confusion -- sorry about that.
Waste, fraud and corruption are present in private schemes.
One big difference is government operates (most of the time) on transparency.
Do you have any idea how expensive it is to publish data and reports every time you essentially fart? Government also has the issue of having to store every document indefinitely.
So, there's a huge cost in maintaining large repositories of information-- basically the government is legally bound to cover its tracks. Now, regulation has been making businesses try to do this for a while... but an insurance company is not obligated to you or required by law to file and save every single thing.
If they were... well, most companies would not be in business.
"that the waste, corruption, and fraud within the current government run programs like Medicare/caid are largely repsonsible for the skyrocketing health care costs."
Nope...you are ignorant and wrong. The rise of cost mainly sits on two fronts. One, the uninsured who end up having the ER as their only health option and in turn make premiums go up exponentially...which is why it would be more prudent for them to get a preventative healthcare so as to restrict the unnecessary visits of the ER.
Two, the Administrative cost of private insurance. Administrative costs of government care such as Medicaire pales in comparison. Private Insurance Administrative costs are going up while the coverage the are paying out is going down...they are making a killing...at the expense of the rest of us.
"the AMA and others have argued that health plans have kept a lid on costs because their market power allows them to unfairly dictate reimbursement terms to physicians."
The amount of waste in public health is minuscule in comparison. Just more corporate white washing of the truth that seems to work with those ignorant enough to believe in the government boogie man.
from the book, "Insurance companies that already offered medicare were spending 2 1/2 times more on Administrative overhead than the traditional medicare program ran b the government."
"the waste, corruption, and fraud within the current government run programs like Medicare/caid are largely repsonsible for the skyrocketing health care costs."
Yes, there is fraud in medicaire but even with that, it is still cheaper than for profit insurance by 33% since 1970.
I have a pretty basic "you're healthy and in your 20's" sort of blue cross blue shield plan. I pay close to $400 every three months. The deductible is pretty high but I get my annual exams paid for, up to $1500 in urgent care costs covered and all my prescriptions for free. There's also some a way you can have part of your gym memberships paid for if you go a certain number of times a month. Basically it pays for preventative care and in the event I get into a massive accident. For someone with no real pressing medical needs except for a month prescription it's pretty swell.
The medical-cost ratio -- also called the medical-loss ratio or medical-care ratio -- is the key number for health plans in terms of their level of profitability. That ratio, simply, is the percentage of dollars the companies spend on health care, including physician reimbursement.
Whereas 10 years ago many plans had medical-cost ratios in the high 80s or 90s, now the highest percentage among large, publicly traded health insurers is Health Net, at 83.9%. Aetna, which had a medical-cost ratio well into the 90s when CEO John Rowe, MD, took over in 2000, recorded a ratio of 76.9% in 2005, Dr. Rowe's final full year before his retirement. That was the lowest medical-cost ratio for the nation's largest publicly traded plans.
Health plans say they've been able to cut their medical-cost ratios through the use of technology and other means to allow for more judicious, health-effective spending. But the AMA and others have argued that health plans have kept a lid on costs because their market power allows them to unfairly dictate reimbursement terms to physicians.
And this was a couple of years ago. 23.1% overhead and profit margin on private insurance for AETNA
Government Performance Review and Results Act of 1993!
Also, there's also these things called General Accountability Office audits! They are really fun to use to threaten government entities with. That's how I got through college!
One of the biggest reasons for the Patriot Act is to keep people out of government offices. However, it's totally within your right to go into nearly any government office and read or xerox whatever you want. If they bar you from doing so, you can request it. If they fail to fulfill a request, you can sue them for money.
The annual salary of a beginning general practitioner would be averaging around $140,000 to $200,000. The annual salary for an experienced general practitioner would be around $210,000 to $320,000.
"waste, corruption, and fraud within the current government run programs like Medicare/caid are largely repsonsible for the skyrocketing health care costs."
Hahahahahahahahahahaha. Good try. 2/10 and citation needed.
From the New England Journal of Medicine (http://nejm.highwire.org/cgi/content/full/349/8/768)
Results - In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.
Conclusions - The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.
Health care costs are going to always be higher than in other countries until we get our unhealthy lifestyles in check. Also the "food" industry has to get out of bed with the health care industry. Becoming healthier individuals is something we all have control over. It should be a movement by the people.
And to answer the original posters question,
We pay (thru husbands job) about $350 a month for a family of four. Our copays are $20. Dental is super cheap (maybe $15 a month) and we have no copays. I think we pay 70% of the total cost of coverage. At my job (small firm) all employees are covered 100% and no coverage for families. Not sure if it makes a difference but we live in CT (insurance capital). We are also really healthy and have had no problems with coverage. At my husbands last job (in TN) we paid about $175 a month for similar coverage.
It's crazy how much cheaper family insurance is if you get it through your employer versus if you buy it on your own as a self-employed person, ala libertybelle, or for your very small firm, a la outed.
above you said that manta's argument, which i agreed with, was stereotypical. Id like to know why you think that is the case.
Presenting the fact that 78% of all bankruptcies due to medical bills are filed by those WHO HAD HEALTH INSURANCE should get everyone thinking... both left and right.
I dont think that particular fact lends credence to any one solution, but it is a shocking number that is probably higher than any of us would have guessed. The bottom line is that something must be done, the system as it is, is completely unacceptable.
First, id like to know if anyone disagrees with that last paragraph, and if so, why?
Next, id like to ask if you fear a rationing of care which might come with a public option. This is a legitimate concern, but doesnt seem to be a legitimate argument in my mind.
What is the raising of deductibles and premiums by insurance companies if not a rationing of care?
We hear every day how even people WITH health insurance delay necessary treatment because their deductibles are too high, or they are afraid the claim my cause them to be dropped.
the truth is this... health care is already rationed, by economic status in our case.
I think illegitimi was referring to my argument about not wanting my money to go to a corporation's profit margin when it could be going to my health, to my pocket, or to someone else's health. I don't think anyone's attempted to say anything yet in response to my other points.
The assertion that high health care costs are due to waste / fraud in medicare/medicaid makes no sense at all. I've been puzzling this one out and can't find any plausible logical connection. Is there any evidence to back this up? I would be interested to see it.
I sincerely doubt that the amount of money lost to waste and fraud in the medicare/medicaid system comes anywhere close to the amount of money lost to profit in the for-profit health care industry. That's not even counting the amount of waste/fraud in the health care industry itself.
Also, anyone here who thinks that the government does not have to be more transparent than private industry has clearly never worked on a government-funded construction project. If you've seen the amount of public documentation that has to be produced and reviewed and periodically presented to the public, and you've worked on private projects as well, there is no way you could say that government is opaque, certainly not with respect to private projects.
I'm your stereotypical early-twenties... just got out of grad school, no job, therefor no health plan. God forbid I get sick, there's nothing I can do about it. I would sure welcome universal healthcare right now.
Even when I was in a job with healthcare, I still couldn't afford to get sick. I was supposedly paid for by my firm, only needed to pay a $25 copay. But every time I went to the doctor, I'd end up with a bill of some $200 in charges that the insurance company deemed unnecessary or in excess of reasonable fees, that I had to pay out of pocket, and I didn't make enough to afford that. So what do I do? I don't go to the doctor. I don't take the medicine I should be for a thyroid condition, cause I can't afford it. Hello no preventative medicine!
i thought i had good health insurance with my firm. i have Aetna and pay a minimum 25% of it from my paycheck... the firm picks up the rest. i THOUGHT it was good... until I found out i was pregnant about 2 months ago.
being all crunch granola, i decided i wanted to go to a birthcenter instead of a hospital (i'm weary about all those drugs, vaccines, etc they try to pump you with in hospitals, amongst other things)... turns out there are only 2 in washington, dc because the insurance companies and doctors lobbying groups have run them out. so the birthcenter is "out of network"... which means i would have to cover 40% of the cost, however if i go to a hospital it is 100% covered. so to give you an idea, a typical hospital birth WITHOUT complications is between $8k-$13k... the birthcenter is $4k.
the insurance company would rather pay for me to go to a hospital and it costs them $8,500 than for me to go to a birthcenter where it would cost half.
whoever says you "wouldn't have a choice of doctors under a nationalized plan" please tell me where my choices are now?!?
p.s.= women's health & prenatal care is considered a pre-existing condition. my fetus is apparently pre-existing... so i can't be added to my significant other's policy.
on npr the other day they said only $0.07 of every dollar paid to every insurance company actually goes to real healthcare costs. the rest is a combination of lobbyists, overhead, and yes, corporate jets. which apparently were flown to DC to meet with Obama.
Second, be proactive about the birth if you do end up at a hospital., The most important thing is to have a GOOD OB who you TRUST. If you don't want drugs, you can absolutely decline to have them, and you can AND SHOULD write up a birth plan before hand and discuss it with your SO, your practitioner AND the partners that practitioner has on call in case she isn't available for the birth. Bring it to the hospital and have your SO there to be your advocate.
You might also consider hiring a dula: if you can save money by going to a hospital, which the insurance will pay for, you can maybe afford to hire a dula, who will be your experienced, calm, logical advocate during the birth process and will make sure you don't just get bullied into a decision you don't want to make.
I'll also say that my OB was a woman in a practice of women and at EVERY step in the birth they asked me how I felt about this or that suggestion they had - I ended up C-section but absolutely did not in any way feel coerced into it and am totally confident that it was the right choice. I've had one or two experiences in my life with doctors I felt weren't listening to me; I never went back to them.
Email me if you want to talk further, or check out the A Great Adventure thread, where we talk vigorously and in depth about every dang aspect of pregnancy you can imagine!
I actually have a reference for a good dula in the DC area. As an aside. Email me if you're interested, +i.
I'm so tired of the "you will have someone standing between you and your doctor!!!" scare tactics. We already HAVE someone standing between us and our doctors, and that someone is currently beholden to no one except the bottom line. That's the scariest thought of all.
Rationalist, I also have had to pay out of pocket for supposedly "covered" medical expenses. I had checked with both the doctor AND the insurance company ahead of time, being careful to ask for and note the exact verbiage the doctor would use in processing the claim. I was assured by all concerned that the procedure would be covered, although nobody would actually go on record for that. Went ahead with the procedure under these assurances, and then 4 weeks later BAM! $400 bill. I called over and over to protest it and was told "we never know what it's going to cost until your doctor processes the claim. We can't tell you in advance what the cost will be. Your doctor must have used some other terminology." I checked all this with the doctor, too. Nobody took responsibility.
I am an educated, mature woman who has had plenty of experience dealing with these things. I run projects in which I get quotes from people for services and then when the services are performed, they ask for the amount quoted. I hear a lot about how you can manage your health care costs if only you're pro-active, and "make the right choice" and "talk to your doctor and check it with your insurance company" etc etc etc. This is bullshit. I did all of this and still have ended up paying for things that I was told would be covered (and that are listed in my plan as being covered). How on earth am I supposed to feel like I'm in control, with this "system"? It's complete bullshit.
America - where your hospital stay while giving birth costs $10,000 and you get a week off work to be with your new baby.
How can other countries spend less on healthcare AND offer a reasonable maternity leave? Oh yeah - by not letting for-profit insurance companies 'manage' your health(care).
It's hard for me to wrap my head around the absurdity of all that. It's laughable, really.
like the theory goes most people don't change their minds in face of opposition but see confirmation of existing beliefs and of stereotypes of the "other", regardless of facts and logic...
make, Dustin, etc. -- you're all providing links to substantiate your arguments and crowning yourselves logical, reasonable, and, apparently, correct. Do you suppose it's just barely possible that "facts" can be presented as needed to drive any argument?
I'm saying maybe look a little further. Couple of you are "hahahaha"-ing about my statement that EXTENSIVE waste and outright fraud runs rampant in government programs. Hm... well, you'll find agreement on a website as liberal as archinect. But give that posture of yours a whirl in any other context. Perhaps you might reach as far as, say, offline, even...
Anway, you want me to provide data to substantiate what I've said thus far about government program waste and fraud? Well don't take my word for any it. Pick any of the goverment programs. Google "medicare fraud" for crying out loud... how many links are there? A bazillion or two? Yes, some are garbage, to be sure. But all of them? Are every one of those links devoid of the "facts and logic" you claim to require? Are all of those articles written without respect to any statistically correct information? Are they all "biased"? Did Bush, Fox News and Palin corrupt every one of them?
Hardly.
Yet a bunch of you are moving forward as if that were the case.
my facebook quiz says i am moderate liberal so i guess i am expected to think little of bushfoxnewsandpalin. it is their own fault however. while they may not have corrupted the world, they sure did make it hard to take anything they have anything to do with seriously. bushfoxnewsandpalin gotta be on some kinda funky drugs, way they talkin most times. whooooo-doggy but they can get weird as shoot-heck.
ok, i've given this a little more thought and the nuance of my opposition to "universal" health care in america has less to do with any ideals about free-markets than it does with a supreme distrust of anything mandated at a federal gov level within the united states.
that is to say, that i would be far more willing to consider government healthcare if it was administered at a state level rather than a federal level. those of you who are suspicious of my opinions as being representative of a partisan political perspective are missing the point that i've been critical of excecutive administrations for literally my entire life. as far as i'm concerned Obama has been nothing more than an intellectually charismatic but nonetheless willing participant in a continual centralization of power that has been quietly in play thoughout our lifetimes (stretching through the administrations of Bush II, Clinton, Bush !, Reagan, Carter...maybe not Carter, Ford, Nixon, etc) in fact, Obama has been exceptionally good at it thus far during his term.
it's not so much national healthcare that is scary...but the idea of a national healthcare datebase that should have the average american concerned. do you really want to trust this information to the same handful of people who so brutally managed to consolidate wall street in just the past year alone? have you considered the implications of a firm like goldman sachs to further manipulate markets if they had direct access to the health data of nearly every american?
the current circumstance of privatized healthcare in america is not ideal...but at least their are some competitive market-place self interests that keep health insurance companies honest (and i use that term only in the loosest sense).
we may dream of a national healthcare system run by the governmnent (with "by the people, for the people, of the people" interest at stake) but the reality is that as soon as the federally gov can wrestle control of health care/information from the current competitve marketplace the fed gov will very quietly turn around and outsource this responsibility to a private company. it's a very high stakes game of winner-takes-all. inevitably that winner will be the nasty & most cheating group of people who are already involved in the industry. they will win big. everybody else (including consumers) will lose.
this post is too long...i'm drunk & i doubt that any you morons will read it. thanks! :)
ha ha...nice jump. bush and palin may be retards. but you have to appreciate the honesty of foxnews.
that is to say that murdoch makes no illusions about the fact that he is after ratings (money making!!!) and if that means telling people exactly what they want to hear...then so be it. they don't deny that. it's just remarkable that som many people seem to interpret that forthrightness as synonymous with journalistic credibility. but given the alternatives, i'm not sure fox news are any dumber than the rest of america.
But I would go even further to say that while I have some trust in federal programs... I hate government at a state level.
I think there should be more government involvement at a city-countryside level.
The reason I say this is because I think state borders are absurd. Should northern Californians bear the healthcare costs of southern California's atrocious air quality?
I mean that's a pretty poor comparison but I think states can be heavily divided politically, economically and socially.
"the current circumstance of privatized healthcare in america is not ideal...but at least their are some competitive market-place self interests that keep health insurance companies honest (and i use that term only in the loosest sense)."
You mean where they up their profit rating by cutting out sick people and killing them or bankrupting them?
If the market was really competitive, it would be easy to start an insurance company and there would be competition to drive the price down. Instead, there are high barriers to entry and we have the Detroit version of health insurance with huge costs, runaway premiums and cutting off of health coverage when needed most.
Why are we the only industrialized nation that thinks it make sense?
Orochi - because American has been brain washed that anything that has the Gov't involved is socialism.
American's think we all should be able to do whatever we want without any concern for anyone else, anything else, without any concern for the future, etc. "Free markets" will supply what is needed, etc.
I think it is a combination of greed, selfishness and naivete.
That said, I am not liking the talk about higher taxes on the "rich" to pay for the health care. What is "rich" is too subjective. 250k per year was a good start/general point, but that is not "rich", imho.
We need a more staggered system of taxes. Someone making a million a year, 10 million or 100 million a year are substantially different and should be taxed as such.
Here's an ignorant question: A common comment in this debate is "The poor need access to affordable health insurance".
Don't the poor (and everyone) need access to affordable health care? Does insurance actually have to be a part of the delivery of health care at all?
puddles said above that if everyone like me stopped buying health insurance, the companies offering it would have to revamp to get me to buy it - free market, right? But what if I could just go to a doctor and buy the health services I wanted? People do this in some ways now, that's what concierge service in the healthcare industry is.
Insurance is gambling and preying on the fear of something bad happening. I don't have a problem with paying for the things I want, including healthcare - the problem is, I can't, as an individual, currently afford to pay for hundreds of thousands of dollars of cancer treatment or post-car crash surgery if I needed it.
I guess I'm saying, as I've said above, I don't think people should get things for "free", and I don't think people should have to live in fear of being destroyed (either financially or physically) by a freak occurrence. But isn't there a way to combine those two things into a healthcare system?
Illegitimi....[etc]: You're presenting a red herring. The burden of proof is on you, my friend. I've backed myself up with facts, but you're choosing not to accept them because they're online. The article I linked to is from the NEW ENGLAND JOURNAL OF MEDICINE. Give me your address and I'll send you a copy, if you want a hard copy so badly.
Grrrrrr. Not enough coffee yet today.
Let's say that the American private system works in that the care you get (if approved) is good. The article that jump linked to about the Canadian woman who went to the US for care brings up some interesting questions. I said this earlier - we have problems with our system up here, including what I see as long wait times. The woman in the article chose to mortgage her house to get the $100,000 she needed to pay for her treatment. Great for her. But the only thing I own is a $500 car and a fridge full of condiments. I couldn't afford insurance, so what would I do if I got sick or injured? I have no collateral. Would I die?
The Canadian system would treat me even if I was homeless. As a taxpayer, I agree with this. I'll make it very clear here: I'D RATHER MY TAXES GO TO MAKING SURE PEOPLE STAY HEALTHY AND PRODUCTIVE, than pay for private insurance.
The fact is, and I hate to bring it up again - that universal healthcare in my country costs about 2/3 less than private healthcare in the US. Up here, we aren't paying for advertising or large administrative overhead, or for profits for insurance executives. You've been scared into believing our dirty socialist/commie system doesn't work, when in fact the US is the ONLY... I repeat... ONLY first-world country without universal healthcare.
Are you covered by health insurance from (or not)? How much does it cost?
Maybe I am naive, but why can't insurance be non-profit? The whole idea of insurance is to spread the risk around, right? 10 people pay $100 a month each, one gets sick and makes a claim for $1,000. Voila! We have the money to cover him and the group is even! Instead, 10 people pay $500 a month each, one gets sick and the insurance company figures out how to only pay $200 of the $1000 (cause they are smarter and more powerful than the collective 10 people in the plan) and pockets the rest and Voila! the CEO gets another yacht.
You know where all that money goes, there are offices full of worthless people all across the country playing paper shuffling games. We have to pay those salaries!
manta - it means the company pays 100% of the premiums for individuals. partner/spouse/kid benefits are available but the company doesn't pay for them. besides the expense factor, it gets to be a fairness issue that's, quite frankly, too much of a headache to deal with. for example, if someone has a family and puts them on the plan, i'm in effect giving them an extra 7-8,000 per year that people who are single don't get. if i then have to pay those people extra in salary, then i'm just out huge amounts of money for such a small (5 FTE) people. it just doesn't work. maybe at a much larger or much more profitable place...
"Obama is all about fear"
Really? And what are the Republicans all about? puppies and ice cream?
And for the record no Family Practice doc makes 300k a year....a specialist yes...that is a problem...but to say doctors make 300k is just idiotic.
Doctors in the USA also carry a HUGE debt load..something Japan, Canada, etc. don't have because they pay people to become doctors.
The system and issues are much more complex than anything that is being mentioned here. Single payer is what most FP's and GP's want...in excess of 80% of them...they hate dealing with the insurance companies as much if not more than patients.
"but why can't insurance be non-profit"
Make it single payer system and it is. Without that no company will play the game with out the ability to make exponential returns endlessly into the future...bidness is bidness.
obama will own you
obama will own you
obmama will own you
and obama will own you...too
and you
and you
and you.
Do you have insurance?
i don't know. i've got bennefits from variety of sources but i'd rather drink that spend time reading that rubbish...in fact, i'd rather drink than read this rubbish too...but i do know that i have money & that's all that really matters, isn't it?
"but anyway, manta just made the best argument on healthcare ive seen in any of these discussions"
Actually, he made a stereotypical argument.
Jon Stewart's argument... he cleverly set up Bill Kristol, and he clearly had that one loaded up prior to the interview. In reality, would anyone say that the health care provided to the military is a "system"? Were we to expand that "system" to cover all citizens, we'd have simply found one more way to bankrupt ourselves.
Kristol did not fare well on the show, but he made a point well worth noting here, and one that many of you have chosen to ignore -- and that's that the waste, corruption, and fraud within the current government run programs like Medicare/caid are largely repsonsible for the skyrocketing health care costs.
scribbles, obama is already *at* the middle. The left wants a single-payer system.
Sorry, outed, it seems I simply misread your statement -- I read it as you covered the family members and you couldn't do any less than that! Hence my confusion -- sorry about that.
Waste, fraud and corruption are present in private schemes.
One big difference is government operates (most of the time) on transparency.
Do you have any idea how expensive it is to publish data and reports every time you essentially fart? Government also has the issue of having to store every document indefinitely.
So, there's a huge cost in maintaining large repositories of information-- basically the government is legally bound to cover its tracks. Now, regulation has been making businesses try to do this for a while... but an insurance company is not obligated to you or required by law to file and save every single thing.
If they were... well, most companies would not be in business.
"that the waste, corruption, and fraud within the current government run programs like Medicare/caid are largely repsonsible for the skyrocketing health care costs."
Nope...you are ignorant and wrong. The rise of cost mainly sits on two fronts. One, the uninsured who end up having the ER as their only health option and in turn make premiums go up exponentially...which is why it would be more prudent for them to get a preventative healthcare so as to restrict the unnecessary visits of the ER.
Two, the Administrative cost of private insurance. Administrative costs of government care such as Medicaire pales in comparison. Private Insurance Administrative costs are going up while the coverage the are paying out is going down...they are making a killing...at the expense of the rest of us.
http://www.ama-assn.org/amednews/2006/03/06/bisd0306.htm
"the AMA and others have argued that health plans have kept a lid on costs because their market power allows them to unfairly dictate reimbursement terms to physicians."
The amount of waste in public health is minuscule in comparison. Just more corporate white washing of the truth that seems to work with those ignorant enough to believe in the government boogie man.
Money Driven Medicine
http://books.google.com/books?id=pOfrTRPgv_kC&printsec=frontcover#v=onepage&q=&f=false
from the book, "Insurance companies that already offered medicare were spending 2 1/2 times more on Administrative overhead than the traditional medicare program ran b the government."
And if that is not enough Bill Moyer does a great interview with Wendell Potter an recent ex-industry insider who speaks truth to the issue.
http://www.pbs.org/moyers/journal/07312009/watch.html
Yes, there is fraud in medicaire but even with that, it is still cheaper than for profit insurance by 33% since 1970.
Here are the figures:
http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf
I have a pretty basic "you're healthy and in your 20's" sort of blue cross blue shield plan. I pay close to $400 every three months. The deductible is pretty high but I get my annual exams paid for, up to $1500 in urgent care costs covered and all my prescriptions for free. There's also some a way you can have part of your gym memberships paid for if you go a certain number of times a month. Basically it pays for preventative care and in the event I get into a massive accident. For someone with no real pressing medical needs except for a month prescription it's pretty swell.
From the AMA:
The medical-cost ratio -- also called the medical-loss ratio or medical-care ratio -- is the key number for health plans in terms of their level of profitability. That ratio, simply, is the percentage of dollars the companies spend on health care, including physician reimbursement.
Whereas 10 years ago many plans had medical-cost ratios in the high 80s or 90s, now the highest percentage among large, publicly traded health insurers is Health Net, at 83.9%. Aetna, which had a medical-cost ratio well into the 90s when CEO John Rowe, MD, took over in 2000, recorded a ratio of 76.9% in 2005, Dr. Rowe's final full year before his retirement. That was the lowest medical-cost ratio for the nation's largest publicly traded plans.
Health plans say they've been able to cut their medical-cost ratios through the use of technology and other means to allow for more judicious, health-effective spending. But the AMA and others have argued that health plans have kept a lid on costs because their market power allows them to unfairly dictate reimbursement terms to physicians.
And this was a couple of years ago. 23.1% overhead and profit margin on private insurance for AETNA
http://www.ama-assn.org/amednews/2006/03/06/bisd0306.htm
"One big difference is government operates (most of the time) on transparency."
Honestly, what planet are you from?
Government Performance Review and Results Act of 1993!
Also, there's also these things called General Accountability Office audits! They are really fun to use to threaten government entities with. That's how I got through college!
One of the biggest reasons for the Patriot Act is to keep people out of government offices. However, it's totally within your right to go into nearly any government office and read or xerox whatever you want. If they bar you from doing so, you can request it. If they fail to fulfill a request, you can sue them for money.
HUR DUR.
lrn2govern,plzkthx.
Let's get back to facts and figures...
Yes, someone corrected me on GP salaries.
http://wiki.answers.com/Q/What_is_the_annual_salary_of_a_general_practitioner
The annual salary of a beginning general practitioner would be averaging around $140,000 to $200,000. The annual salary for an experienced general practitioner would be around $210,000 to $320,000.
Imagine if Architects made that much?
Payscale has it lower which makes more sense.
http://www.payscale.com/research/US/Job=Family_or_General_Practitioner/Salary
I think the $320k is for guys who own a practice and have other doctors working for them. That's where the money is.
"waste, corruption, and fraud within the current government run programs like Medicare/caid are largely repsonsible for the skyrocketing health care costs."
Hahahahahahahahahahaha. Good try. 2/10 and citation needed.
From the New England Journal of Medicine (http://nejm.highwire.org/cgi/content/full/349/8/768)
Results - In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.
Conclusions - The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.
Health care costs are going to always be higher than in other countries until we get our unhealthy lifestyles in check. Also the "food" industry has to get out of bed with the health care industry. Becoming healthier individuals is something we all have control over. It should be a movement by the people.
And to answer the original posters question,
We pay (thru husbands job) about $350 a month for a family of four. Our copays are $20. Dental is super cheap (maybe $15 a month) and we have no copays. I think we pay 70% of the total cost of coverage. At my job (small firm) all employees are covered 100% and no coverage for families. Not sure if it makes a difference but we live in CT (insurance capital). We are also really healthy and have had no problems with coverage. At my husbands last job (in TN) we paid about $175 a month for similar coverage.
It's crazy how much cheaper family insurance is if you get it through your employer versus if you buy it on your own as a self-employed person, ala libertybelle, or for your very small firm, a la outed.
Illegitiminoncarborundum ;
above you said that manta's argument, which i agreed with, was stereotypical. Id like to know why you think that is the case.
Presenting the fact that 78% of all bankruptcies due to medical bills are filed by those WHO HAD HEALTH INSURANCE should get everyone thinking... both left and right.
I dont think that particular fact lends credence to any one solution, but it is a shocking number that is probably higher than any of us would have guessed. The bottom line is that something must be done, the system as it is, is completely unacceptable.
First, id like to know if anyone disagrees with that last paragraph, and if so, why?
Next, id like to ask if you fear a rationing of care which might come with a public option. This is a legitimate concern, but doesnt seem to be a legitimate argument in my mind.
What is the raising of deductibles and premiums by insurance companies if not a rationing of care?
We hear every day how even people WITH health insurance delay necessary treatment because their deductibles are too high, or they are afraid the claim my cause them to be dropped.
the truth is this... health care is already rationed, by economic status in our case.
my brain isnt working well right now... maybe someone who understands what im saying can better articulate it...
I think illegitimi was referring to my argument about not wanting my money to go to a corporation's profit margin when it could be going to my health, to my pocket, or to someone else's health. I don't think anyone's attempted to say anything yet in response to my other points.
The assertion that high health care costs are due to waste / fraud in medicare/medicaid makes no sense at all. I've been puzzling this one out and can't find any plausible logical connection. Is there any evidence to back this up? I would be interested to see it.
I sincerely doubt that the amount of money lost to waste and fraud in the medicare/medicaid system comes anywhere close to the amount of money lost to profit in the for-profit health care industry. That's not even counting the amount of waste/fraud in the health care industry itself.
Also, anyone here who thinks that the government does not have to be more transparent than private industry has clearly never worked on a government-funded construction project. If you've seen the amount of public documentation that has to be produced and reviewed and periodically presented to the public, and you've worked on private projects as well, there is no way you could say that government is opaque, certainly not with respect to private projects.
"I've been puzzling this one out and can't find any plausible logical connection. Is there any evidence to back this up"
See this.No, there isn't.
http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf
Medicare's overhead is about 3%
http://www.thehealthcareblog.com/the_health_care_blog/2004/10/policy_medicare.html
Sure, there's waste just like there's waste in our $500 billion defense budget but it can be cut out.
I'm your stereotypical early-twenties... just got out of grad school, no job, therefor no health plan. God forbid I get sick, there's nothing I can do about it. I would sure welcome universal healthcare right now.
Even when I was in a job with healthcare, I still couldn't afford to get sick. I was supposedly paid for by my firm, only needed to pay a $25 copay. But every time I went to the doctor, I'd end up with a bill of some $200 in charges that the insurance company deemed unnecessary or in excess of reasonable fees, that I had to pay out of pocket, and I didn't make enough to afford that. So what do I do? I don't go to the doctor. I don't take the medicine I should be for a thyroid condition, cause I can't afford it. Hello no preventative medicine!
Rationalist,
Where do you live?
i thought i had good health insurance with my firm. i have Aetna and pay a minimum 25% of it from my paycheck... the firm picks up the rest. i THOUGHT it was good... until I found out i was pregnant about 2 months ago.
being all crunch granola, i decided i wanted to go to a birthcenter instead of a hospital (i'm weary about all those drugs, vaccines, etc they try to pump you with in hospitals, amongst other things)... turns out there are only 2 in washington, dc because the insurance companies and doctors lobbying groups have run them out. so the birthcenter is "out of network"... which means i would have to cover 40% of the cost, however if i go to a hospital it is 100% covered. so to give you an idea, a typical hospital birth WITHOUT complications is between $8k-$13k... the birthcenter is $4k.
the insurance company would rather pay for me to go to a hospital and it costs them $8,500 than for me to go to a birthcenter where it would cost half.
whoever says you "wouldn't have a choice of doctors under a nationalized plan" please tell me where my choices are now?!?
p.s.= women's health & prenatal care is considered a pre-existing condition. my fetus is apparently pre-existing... so i can't be added to my significant other's policy.
+i,
Did you see that in 2005, Aetna led the industry with 23.9% taken out for profits and overhead?
on npr the other day they said only $0.07 of every dollar paid to every insurance company actually goes to real healthcare costs. the rest is a combination of lobbyists, overhead, and yes, corporate jets. which apparently were flown to DC to meet with Obama.
<long aside>
First, +i, CONGRATULATIONS! It's exciting.
Second, be proactive about the birth if you do end up at a hospital., The most important thing is to have a GOOD OB who you TRUST. If you don't want drugs, you can absolutely decline to have them, and you can AND SHOULD write up a birth plan before hand and discuss it with your SO, your practitioner AND the partners that practitioner has on call in case she isn't available for the birth. Bring it to the hospital and have your SO there to be your advocate.
You might also consider hiring a dula: if you can save money by going to a hospital, which the insurance will pay for, you can maybe afford to hire a dula, who will be your experienced, calm, logical advocate during the birth process and will make sure you don't just get bullied into a decision you don't want to make.
I'll also say that my OB was a woman in a practice of women and at EVERY step in the birth they asked me how I felt about this or that suggestion they had - I ended up C-section but absolutely did not in any way feel coerced into it and am totally confident that it was the right choice. I've had one or two experiences in my life with doctors I felt weren't listening to me; I never went back to them.
Email me if you want to talk further, or check out the A Great Adventure thread, where we talk vigorously and in depth about every dang aspect of pregnancy you can imagine!
<end aside>
I actually have a reference for a good dula in the DC area. As an aside. Email me if you're interested, +i.
I'm so tired of the "you will have someone standing between you and your doctor!!!" scare tactics. We already HAVE someone standing between us and our doctors, and that someone is currently beholden to no one except the bottom line. That's the scariest thought of all.
Rationalist, I also have had to pay out of pocket for supposedly "covered" medical expenses. I had checked with both the doctor AND the insurance company ahead of time, being careful to ask for and note the exact verbiage the doctor would use in processing the claim. I was assured by all concerned that the procedure would be covered, although nobody would actually go on record for that. Went ahead with the procedure under these assurances, and then 4 weeks later BAM! $400 bill. I called over and over to protest it and was told "we never know what it's going to cost until your doctor processes the claim. We can't tell you in advance what the cost will be. Your doctor must have used some other terminology." I checked all this with the doctor, too. Nobody took responsibility.
I am an educated, mature woman who has had plenty of experience dealing with these things. I run projects in which I get quotes from people for services and then when the services are performed, they ask for the amount quoted. I hear a lot about how you can manage your health care costs if only you're pro-active, and "make the right choice" and "talk to your doctor and check it with your insurance company" etc etc etc. This is bullshit. I did all of this and still have ended up paying for things that I was told would be covered (and that are listed in my plan as being covered). How on earth am I supposed to feel like I'm in control, with this "system"? It's complete bullshit.
make, I've lived in Phoenix, LA, and Seattle. Shitty healthcare all around.
America - where your hospital stay while giving birth costs $10,000 and you get a week off work to be with your new baby.
How can other countries spend less on healthcare AND offer a reasonable maternity leave? Oh yeah - by not letting for-profit insurance companies 'manage' your health(care).
It's hard for me to wrap my head around the absurdity of all that. It's laughable, really.
thanks liberty bell and mantaray. i'll email you!
like the theory goes most people don't change their minds in face of opposition but see confirmation of existing beliefs and of stereotypes of the "other", regardless of facts and logic...
make, Dustin, etc. -- you're all providing links to substantiate your arguments and crowning yourselves logical, reasonable, and, apparently, correct. Do you suppose it's just barely possible that "facts" can be presented as needed to drive any argument?
I'm saying maybe look a little further. Couple of you are "hahahaha"-ing about my statement that EXTENSIVE waste and outright fraud runs rampant in government programs. Hm... well, you'll find agreement on a website as liberal as archinect. But give that posture of yours a whirl in any other context. Perhaps you might reach as far as, say, offline, even...
Anway, you want me to provide data to substantiate what I've said thus far about government program waste and fraud? Well don't take my word for any it. Pick any of the goverment programs. Google "medicare fraud" for crying out loud... how many links are there? A bazillion or two? Yes, some are garbage, to be sure. But all of them? Are every one of those links devoid of the "facts and logic" you claim to require? Are all of those articles written without respect to any statistically correct information? Are they all "biased"? Did Bush, Fox News and Palin corrupt every one of them?
Hardly.
Yet a bunch of you are moving forward as if that were the case.
my facebook quiz says i am moderate liberal so i guess i am expected to think little of bushfoxnewsandpalin. it is their own fault however. while they may not have corrupted the world, they sure did make it hard to take anything they have anything to do with seriously. bushfoxnewsandpalin gotta be on some kinda funky drugs, way they talkin most times. whooooo-doggy but they can get weird as shoot-heck.
ok, i've given this a little more thought and the nuance of my opposition to "universal" health care in america has less to do with any ideals about free-markets than it does with a supreme distrust of anything mandated at a federal gov level within the united states.
that is to say, that i would be far more willing to consider government healthcare if it was administered at a state level rather than a federal level. those of you who are suspicious of my opinions as being representative of a partisan political perspective are missing the point that i've been critical of excecutive administrations for literally my entire life. as far as i'm concerned Obama has been nothing more than an intellectually charismatic but nonetheless willing participant in a continual centralization of power that has been quietly in play thoughout our lifetimes (stretching through the administrations of Bush II, Clinton, Bush !, Reagan, Carter...maybe not Carter, Ford, Nixon, etc) in fact, Obama has been exceptionally good at it thus far during his term.
it's not so much national healthcare that is scary...but the idea of a national healthcare datebase that should have the average american concerned. do you really want to trust this information to the same handful of people who so brutally managed to consolidate wall street in just the past year alone? have you considered the implications of a firm like goldman sachs to further manipulate markets if they had direct access to the health data of nearly every american?
the current circumstance of privatized healthcare in america is not ideal...but at least their are some competitive market-place self interests that keep health insurance companies honest (and i use that term only in the loosest sense).
we may dream of a national healthcare system run by the governmnent (with "by the people, for the people, of the people" interest at stake) but the reality is that as soon as the federally gov can wrestle control of health care/information from the current competitve marketplace the fed gov will very quietly turn around and outsource this responsibility to a private company. it's a very high stakes game of winner-takes-all. inevitably that winner will be the nasty & most cheating group of people who are already involved in the industry. they will win big. everybody else (including consumers) will lose.
this post is too long...i'm drunk & i doubt that any you morons will read it. thanks! :)
cheers!!
puddles
ha ha...nice jump. bush and palin may be retards. but you have to appreciate the honesty of foxnews.
that is to say that murdoch makes no illusions about the fact that he is after ratings (money making!!!) and if that means telling people exactly what they want to hear...then so be it. they don't deny that. it's just remarkable that som many people seem to interpret that forthrightness as synonymous with journalistic credibility. but given the alternatives, i'm not sure fox news are any dumber than the rest of america.
I kind of agree/disagree with puddles.
But I would go even further to say that while I have some trust in federal programs... I hate government at a state level.
I think there should be more government involvement at a city-countryside level.
The reason I say this is because I think state borders are absurd. Should northern Californians bear the healthcare costs of southern California's atrocious air quality?
I mean that's a pretty poor comparison but I think states can be heavily divided politically, economically and socially.
"the current circumstance of privatized healthcare in america is not ideal...but at least their are some competitive market-place self interests that keep health insurance companies honest (and i use that term only in the loosest sense)."
You mean where they up their profit rating by cutting out sick people and killing them or bankrupting them?
If the market was really competitive, it would be easy to start an insurance company and there would be competition to drive the price down. Instead, there are high barriers to entry and we have the Detroit version of health insurance with huge costs, runaway premiums and cutting off of health coverage when needed most.
Why are we the only industrialized nation that thinks it make sense?
Orochi - because American has been brain washed that anything that has the Gov't involved is socialism.
American's think we all should be able to do whatever we want without any concern for anyone else, anything else, without any concern for the future, etc. "Free markets" will supply what is needed, etc.
I think it is a combination of greed, selfishness and naivete.
That said, I am not liking the talk about higher taxes on the "rich" to pay for the health care. What is "rich" is too subjective. 250k per year was a good start/general point, but that is not "rich", imho.
We need a more staggered system of taxes. Someone making a million a year, 10 million or 100 million a year are substantially different and should be taxed as such.
Here's an ignorant question: A common comment in this debate is "The poor need access to affordable health insurance".
Don't the poor (and everyone) need access to affordable health care? Does insurance actually have to be a part of the delivery of health care at all?
puddles said above that if everyone like me stopped buying health insurance, the companies offering it would have to revamp to get me to buy it - free market, right? But what if I could just go to a doctor and buy the health services I wanted? People do this in some ways now, that's what concierge service in the healthcare industry is.
Insurance is gambling and preying on the fear of something bad happening. I don't have a problem with paying for the things I want, including healthcare - the problem is, I can't, as an individual, currently afford to pay for hundreds of thousands of dollars of cancer treatment or post-car crash surgery if I needed it.
I guess I'm saying, as I've said above, I don't think people should get things for "free", and I don't think people should have to live in fear of being destroyed (either financially or physically) by a freak occurrence. But isn't there a way to combine those two things into a healthcare system?
Illegitimi....[etc]: You're presenting a red herring. The burden of proof is on you, my friend. I've backed myself up with facts, but you're choosing not to accept them because they're online. The article I linked to is from the NEW ENGLAND JOURNAL OF MEDICINE. Give me your address and I'll send you a copy, if you want a hard copy so badly.
Grrrrrr. Not enough coffee yet today.
Let's say that the American private system works in that the care you get (if approved) is good. The article that jump linked to about the Canadian woman who went to the US for care brings up some interesting questions. I said this earlier - we have problems with our system up here, including what I see as long wait times. The woman in the article chose to mortgage her house to get the $100,000 she needed to pay for her treatment. Great for her. But the only thing I own is a $500 car and a fridge full of condiments. I couldn't afford insurance, so what would I do if I got sick or injured? I have no collateral. Would I die?
The Canadian system would treat me even if I was homeless. As a taxpayer, I agree with this. I'll make it very clear here: I'D RATHER MY TAXES GO TO MAKING SURE PEOPLE STAY HEALTHY AND PRODUCTIVE, than pay for private insurance.
The fact is, and I hate to bring it up again - that universal healthcare in my country costs about 2/3 less than private healthcare in the US. Up here, we aren't paying for advertising or large administrative overhead, or for profits for insurance executives. You've been scared into believing our dirty socialist/commie system doesn't work, when in fact the US is the ONLY... I repeat... ONLY first-world country without universal healthcare.
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