Why would the Fed Gov’t want to put together a health plan when there are 1300 plans available in the USA? What can the Feds do that private enterprise can’t do? And if the Fed plan will be available to all, would that induce small businesses that supply health plans to drop them and tell their employees to go to the Feds? This seems like a duplication of what private enterprise can do at a price of One and a half Trillion Dollars that will need to be borrowed or taxes raised or both?
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President Bush and the Republicans spent way, way, way too much money, but when it comes to spending, they were bush leaguers — pun intended — compared to President Obama and the Democrats.
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2010-09-02 14:24
I think the idea is that those 1300 plans are great for us normally healthy folks, but they’re awful for the people who really need health coverage, like the lower-middle-class folks that don’t qualify for Medicaid and the chronically ill. We’re paying for their health care anyway, generally through unpaid bills for catastrophic care that jack up prices for everyone else (not to mention lost productivity from workers who come down with chronic illnesses that might have been managed or prevented if they had been able to visit the doctor regularly).
And I’m not sure it’s such a bad thing for small businesses to drop their health coverage. Or all businesses, for that matter. In fact, scrap the tax credit for businesses that provide health insurance and give it to individuals. One of the big problems with our health care system is the artificial coupling of health care to employment. Workers change jobs far more frequently than they used to, which means under our current system they have significant periods of time where they’re uninsured. Also, the true cost of health care is disguised somewhat for those whose health insurance is taken out of their paycheck automatically.
It’s funny you say that, Yorkshire. I was talking with some guys at my club about the same thing. If the feds want everyone covered all they need do is set up an “open group” policy with several insurers and subsidize the low cost premiums. It could be handeled just like Fleet Insurance is handled. But then the feds don’t get control over peoples lives (and deaths).
One of my drivers, who is a veteran, keeps saying that we have to “do something” about health care. I keep asking him, as an Air Force veteran, if he has ever seen a program taken over by the government that cost less.
Your friend the Air Force Vet should have answered, Medicare. Medicare spends less than 3% on administrative costs while the average private health insurance corporation spends close to 30%.
In the interest of disclosure here, I work for the Corps of Engineers and yes we have health care. For the plan I chose, and for this area there were a few dozen to choose from. The interesting thing is we can choose a plan that best fits our needs, or you can choose toopt out altogether. For those outside of the Fed system we do have to pay for our healthcare. The Feds will pay so much, and we pay the rest. I can honestly say, for I have to meet my needs, I do pay a considerable amount per month in the range of a luxury car payment. I do laugh when I hear two things: 1. We get it for free – NO we don’t, 2: Groups like the UAW gripe if they have to pay more than $25/week. I could only dream.
I see three different opinions and Jeff gave this some thought. I hate to say it, but I (I think the idea is that those 1300 plans are great for us normally healthy folks, but they’re awful for the people who really need health coverage, like the lower-middle-class folks that don’t qualify for Medicaid and the chronically ill.) fall somewhat in this group. I think I could qualify for some disability for where I am. (Dana can absolutely verify my condition) But I chose not to sit around thinking my condition is someone else’s problem, it’s mine. I could retire from work on disability, but I did the dumb thing of showing I could still do the work.
So in reading the three fine responses the next question comes up as to why is it the responsibility of the Federal Government to provide health insurance to 300million people?
What also just came to mind is for the relatively abled bodied, why should the Government pay for health insurance. But the flip side is there are those who may be uninsurable due to conditions not of their own making and life style, I probably could back insuring them.
So in reading the three fine responses the next question comes up as to why is it the responsibility of the Federal Government to provide health insurance to 300million people?
Given a choice between paying $700 in taxes or $1000 to a private company, which would you choose?
Yorkshire stated:
“But the flip side is there are those who may be uninsurable due to conditions not of their own making and life style, I probably could back insuring them.”
Understandable sentiment, problem is if health isnurance/health care becomes a “right” it becomes such for everyone (remember equal treatent under law) including, drug users, drunks, sky divers etc. Plus if the government runs it they will use it as a means to buy votes by including such things as implants, cosmetic surgery, sex changes, abortions (all terms), assisted suicides, hair implants, celulite reduction, sex addiction (chocoholic, shopping, kleptomania), and a million alphabet nonsense like ADD etc.
Suddenly every medical item becomes a right. And instead of people being judged as patients they will be treated as constituants.
Understandable sentiment, problem is if health isnurance/health care becomes a “right” it becomes such for everyone (remember equal treatent under law) including, drug users, drunks, sky divers etc. Plus if the government runs it they will use it as a means to buy votes by including such things as implants, cosmetic surgery, sex changes, abortions (all terms), assisted suicides, hair implants, celulite reduction, sex addiction (chocoholic, shopping, kleptomania), and a million alphabet nonsense like ADD etc.
Suddenly every medical item becomes a right. And instead of people being judged as patients they will be treated as constituants.
Except, of course, in every place that has it, where it doesn’t.
Here’s the one thing that such a plan can do that the others cannot. In order to participate in this plan, you will have to have a chip for identity.
Is anyone aware of Dr. George Watson from Kansas? He has a working model of the solution to health care. Hear him speak at the Independence Day Tea Party in Grand Island, Ne. July 4th. For information, go to taxdayteaparty.com and look it up.
Yorkshire wrote:
Yorkshire’s new gravatar, with the gingerbread man with the right leg snapped off, is illustrative. Here’s how a real man shovels the snow:
A free lunch may seem tasty but it is seldom worth the true cost.
Look at the per-pupil cost of most of our public schools. De we get our money’s worth?
Give Government a monopoly and they will fight competition with force.
How many packages do people send by parcel post?
Put a motor and some snow treads on that chair and you could make some extra money.
Dave A: “Your friend the Air Force Vet should have answered, Medicare.
Medicare spends less than 3% on administrative costs while the average private health insurance corporation spends close to 30%.”
That is correct!
Unfortunately, I am amazed at how few people understand anything about how Medicare works and how successful it is, and how it can serve as a model for a single payer plan to cover all Americans.
Medicare is expensive, because it covers only the elderly who have far more medical expenses than younger people.
So the real solution is to have a single payer plan like Medicare that covers every citizen, independent of pre-existing conditions, and requires every citizen to pay a modest premium. Per capita, the cost would then have to be much less than Medicare.
Medicare covers basic health care, including chronic conditions. For coverage of extraordinary services, such as transplants, supplemental coverage is required, and costs an additional premium.
In Medicare, seniors pay a premium, it has a deductible each year, and there is a co-pay, so in that respect it is not unlike private insurance, except, the premium is considerably lower.
Besides, single payer has been tested and works well, as in Medicare for seniors, and as single payer for all in almost all other developed countries.
Finally, note where the opposition to single payer comes from, from those who make a lot of money from the system we now have, like doctors (the AMA), like other medical service providers, and like insurance companies. These people deserve adequate compensation, but not such that costs inflate at double digit rates while our incomes stagnate. This situation is non-sustainable.
Another of my posts “awaits moderation”! How can I avoid this, Dana?
jcw:
Put a motor and some snow treads on that chair and you could make some extra money.
I have a four wheel, but not four wheel drive scooter. Last winter in a light snow I was hold a shovel and pushing it, and about a month ago I needed a little bit of dirt moved, so I did similar and became a front end loader.
A side note on the scooter. Although my health insurance, an HMO, has paid for practically everything, they would only finance a little three wheel scooter for inside the house. I needed outside access and a three wheeler would tip over on a hill. So, I bout the four wheeler myself.
Dave wrote:
It should also be noted that Medicare dramatically underpays the costs of treating Medicare patients. In 2006, Medicare patients costs hospitals an aggregate $225.1 billion to treat, but total Medicare reimbursements to hospitals for those patients was only $205.7 billion, an operating loss of $19.4 billion, or 9.4%. Medicaid was much, much worse.
The chart is mine, but the source data can be found here, on Chart #5. (It is a .pdf document, which is why I couldn’t just use the original chart.)
If we went to a 100% Medicare system, the obvious assumption is that hospitals would be underpaid for all patients, and we’d have a system in which everyone had medical care coverage, and all of the health care providers had gone broke, so there was none available!
In theory, going to a single-payer system would reduce administrative costs: everyone is eligible, so the process of getting decisions whether someone is eligible goes down dramatically. Pre-existing conditions problems go away, because everyone is eligible, period.
But the government will have to pay more, much more than it is now, or health care providers will go out of business.
President Obama’s big speech the other day was notable because he said that he would not attempt to clamp down on medical malpractice litigation. Since that would involve both federal and state law changes, he is limited in his authority there. But the costs of malpractice insurance drive up the cost of medical care tremendously. Not only does the insurance add large costs, but additional “defensive medicine” procedures keep getting done.
Dana asked:
if he has ever seen a program taken over by the government that cost less.
I can think of one project conducted by the Delaware Prison sytem where the cost of a new wing of the prison cost less. There was a construction superintendent that was in jail. There was alsoa new building to be built there. The Super talked the Prison Officials into letting him supervise a crew of inmates to build the building. The Super’s thinking was he was in jail fair and square, but he missed doing the work, and he could also provide vocational training for inmates in real time. The Prison actually agreed on the terms if one inmate walks off, the whole project was off. They finished the prison.
Actually Yorkshire, that was a government program taken over by the inmates.
“Why would the Fed Gov’t want to put together a health plan when there are 1300 plans available in the USA? What can the Feds do that private enterprise can’t do? ”
Force you to buy.
Dana says: “It should also be noted that Medicare dramatically underpays the costs of treating Medicare patients.”
“Dramatically” you say, Dana? Your table does not support your characterization.
The assumption made by your analysis is that Hospital charges for services are reasonable. Your table refutes that, indicating that the operating margin for “Commercial” patients, that is non-Medicare/Medicaid, is 23.1%. That is simply outrageous! Thus hospitals are overcharging, and Medicare is justified to cut back on their reimbursement. This is an important indicator of how broken our system is, with these outrageous overcharges.
Have you ever reviewed an itemized hospital bill, Dana? What did you think of it? Anyway, again, your table tells the story.
Dana goes on to say: “But the costs of malpractice insurance drive up the cost of medical care tremendously.”
Tremendously, Dana? I hear this statement from you folks on the right all the time, but I have never ever seen it substantiated. Therefore, I don’t know whether or not to believe it!
Now I have another post awaiting moderation. What is going on with your blog, Dana? You pride yourself on not censoring anyone, yet these delays are a form of censorship. That said, my moderated posts are finally posted.
Perry,
I’m curious what countries Obama was referring to in his speech the other day where he said single-payer health insurance was working. Could you please tell me what countries those are? You seem to know a lot about this and are in favor of a single-payer system and I seek as much information pro/con that I can make a rational decision whether it makes sense (not what gov’t or media say it is). Also, could you please let me know what percent of the population in those countries are satisfied or very happy with the quality of care they receive? Lastly, it would be appreciated to know if there is any kind of rationing that occurs in these countries’ single-payer systems.
Thank you in advance for answers you can provide.
Perry wrote:
I’d call a 9.4% operating margin loss pretty dramatic; you won’t stay in business very long that way.
Hospitals have to have that kind of margin, or they’d go out of business: commercial pay patients are, in effect, subsidizing all other patients. Please note that, overall, hospitals in 2006 had an operating profit margin of 3.8%. That’s a very low profit margin.
Let’s assume that hospitals should make a 4% profit margin. (And that’s very low; a one year certificate of deposit has a current nationwide average return of 2.03%, and that is a no-risk investment.) Using the chart numbers above, we could reduce private insurance expenditures to $229.4 billion, a savings of $57.7 billion. But Medicare expenses would have to be increased $28.4 billion, to $234.1 billion, or 13.8%. Medicaid expenditures would have to be raised $14 billion, to $86.6 billion, a 19.3% increase. “Other government and self-pay” would have to be raised $15.3 billion (a 30.4% increase), for hospitals to make a 4% profit across the range.
Hospitals have to make money, or they go out of business; it is as simple as that.
I’m curious what countries Obama was referring to in his speech the other day where he said single-payer health insurance was working. Could you please tell me what countries those are? You seem to know a lot about this and are in favor of a single-payer system and I seek as much information pro/con that I can make a rational decision whether it makes sense (not what gov’t or media say it is).
The best place to start would be OECD comparisons of the health systems as a unbiased comparative source. A large library may have some of these.
See, on the US and health, this, for example:
(And that’s very low; a one year certificate of deposit has a current nationwide average return of 2.03%, and that is a no-risk investment.)
Maybe.
Maybe not.
Oh, and by the way, Dana – ooooooops.
That Khalid Sheikh Muhammad would lie is hardly surprising. That some of the information he gave was real and actionable has been told by the people who did the work, and found some of the information to be accurate in their work.
timajin:
Perry,
I’m curious what countries Obama was referring to in his speech the other day where he said single-payer health insurance was working. Could you please tell me what countries those are? You seem to know a lot about this and are in favor of a single-payer system and I seek as much information pro/con that I can make a rational decision whether it makes sense (not what gov’t or media say it is). Also, could you please let me know what percent of the population in those countries are satisfied or very happy with the quality of care they receive? Lastly, it would be appreciated to know if there is any kind of rationing that occurs in these countries’ single-payer systems.
Thank you in advance for answers you can provide.
I was very surprised to hear this yesterday on the radio, but the National Healthcare system in France seems to be working. The reason given is France has a co-pay system rather than for free.
JohnC.:
Yorkshire stated:
“But the flip side is there are those who may be uninsurable due to conditions not of their own making and life style, I probably could back insuring them.”
Understandable sentiment, problem is if health isnurance/health care becomes a “right” it becomes such for everyone (remember equal treatent under law) including, drug users, drunks, sky divers etc. Plus if the government runs it they will use it as a means to buy votes by including such things as implants, cosmetic surgery, sex changes, abortions (all terms), assisted suicides, hair implants, celulite reduction, sex addiction (chocoholic, shopping, kleptomania), and a million alphabet nonsense like ADD etc.
Suddenly every medical item becomes a right. And instead of people being judged as patients they will be treated as constituants.
John, I see a flip side to the flip side. People will no longer be people, but actuarial tables. You have a certain type cancer, the table says 60-40 non-survivablity rate, no treatment because the investment in money may not pay off. You smoke and have a heart condition – self inflicted disease, therefore you are denied treatment since it was your fault. Obese and joint problems – again self inflicted disease.
Tables say on average 50,000 joint replacements a year, well, you’re 50,001 and it’s July so wait your turn next year.
I can see more mischief played by the Gov’t in health insurance than health insurance companies. But when you have a crappy insurer, you have 1,299 more to check out. If the Gummint is the only game in town, where do you go?
timajin, good questions! I’ve just noted your request, and don’t have time to give you a decent answer until Saturday at the earliest.
Now I understand it perfectly. BO’s Chicago doctor doesn’t like the plan at all. If the president’s own doctor can’t support it, why should we?
http://www.forbes.com/2009/06/18/obama-doctor-knocks-obamacare-business-healthcare-obamas-doctor.html
Obese and joint problems – again self inflicted disease.
What about AIDS? How many cases of this are not self-inflicted?
David Horowitz was still in his radical phase when when he mused that the goings on in so called ‘bath houses’ might be more of a factor in the spread of the disease than anything being promulgated by the Reagan Administration. Horowitz was denounced by the Left for his thought crime.
The current Horowitz would be the last to agree that our healthcare provision in this country is a hodgepodge and a disgrace:
“When it comes to treating veterans, we’re Britain or Cuba. For Americans over the age of 65 on Medicare, we’re Canada. For working Americans who get insurance on the job, we’re Germany.
For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you’re sick enough to be admitted to the emergency ward at the public hospital.
The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it’s fairer and cheaper, too.”
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html
No honorable American can be proud of this, as we are behind most other developed countries, costing much more per capita, and delivering much less in healthcare, per capita.
Timajin, in response to your request, to which Phoenician has already amply responded, let me put you onto a discussion with references that just appeared today by Cassandra on Delaware Liberal:
http://www.delawareliberal.net/2009/06/21/comment-rescue-why-not-single-payer/
The links that Cassandra gives in her piece are excellent summaries of the various single-payer and universal healthcare coverage that are practiced by various developed nations globally. So I hope your questions on single-payer are answered there. Also, if you google “single payer healthcare”, you will come to a Wikipedia which has a great discussion on single payer.
All plans in other nations cover at least 95% of their population, and at a per capita cost far less than our own. Several of them offer the public option approach currently under consideration by our House, and vehemently opposed by the Repubs and some Dems too.
I fear that the vested moneyed interests and their powerful lobbyists in Washington will try again to obstruct, negating a healthcare delivery system that we need so badly, and one which will save us tons of money down the road. I hope I am wrong.