Health Insurance 44

[tbonebanjo]

I was just wondering how many companies still have good insurance and how many have gone the way of Obamacare. I am in a small MEP firm in Maryland. Our health insurance just changed, our premiums went up and our coverage went way down. I have maximum out of pocket expenses of $12,500 per year, $4000 deductable per person, tnen start the copay schedules. Should I start looking for other employment or are all companies being affected this way?

 

[rconnor]

Yes, I do agree beej. But your next point is a straw man.

But first a question, to help me understand your position more clearly. Which best describes your position:
1) Theoretically (ignoring the “money-in-government” problem), a “free-market” healthcare system is better than a universal healthcare system.
2) While theoretically a universal healthcare system is better, the corporate influence over the government in the US would make it worse than a “free-market” system in practice.
3) While theoretically a universal healthcare system is better, the corporate influence over the government in the US would prevent the transition to a universal healthcare system in the US. Therefore, the “free-market” system is the next best alternative.

If #1, then see all my previous posts. I really don’t want to go into the practical application of universal healthcare until after you agree that it is a superior system. If not, then we can continue to argue the merits of both systems.

If #2, then we can continue. We both agree that corporate influence on government is a major problem. This affects the healthcare system in the US greatly as, in the current system, healthcare is primarily ran by private, for-profit corporations. This gives them the incentive to lobby for their interests (i.e. more profits). If you take away the private, for-profit nature of the healthcare system you inherently solve that problem. There is no need for corporate corruption when there are no for-profit corporations. This is why universal healthcare works so nicely in other countries.

Your solution, the “free-market” system, minimizes or completely removes any ability for regulation. This too would remove the need for lobbyists, as corporations are allowed to do whatever they want but that is not a good thing. So you’ve identified the problem being corporate influence over government and your solution is to give all the power to the corporations and let the people fend for themselves.

If #3, then I agree with you much more than #1 or #2. However, I don’t feel it would be impossible. Difficult? Yes. Despite how bad the issue of money-in-politics is, if the voice of the people is loud enough, the government will listen. Remember that any candidate needs both money, which comes from corporations, and votes, which still comes from the people, to be in power. The first step is getting more people to understand the benefits of universal healthcare and squash some of the rumours. There is a lot of misinformation out there, usually stemming from the very lobby groups that you agree are the core of the problem. The more advocates you have for it, the more likely the government is willing to listen. Furthermore, even if a "free-market" system is in the best interest of the people and not corporations (which I completely disagree with), would it not face the exact same issues?

There is also a very interesting campaign that is attempting to develop a super-PAC to end all super-PACs. The Mayday Campaign is trying to raise money to fund candidates that are committed to push for reform to the way campaigns are financed.

 

[beej67]

But first a question, to help me understand your position more clearly. Which best describes your position:
1) Theoretically (ignoring the “money-in-government” problem), a “free-market” healthcare system is better than a universal healthcare system.
2) While theoretically a universal healthcare system is better, the corporate influence over the government in the US would make it worse than a “free-market” system in practice.
3) While theoretically a universal healthcare system is better, the corporate influence over the government in the US would prevent the transition to a universal healthcare system in the US. Therefore, the “free-market” system is the next best alternative.

4a) Free market principles don't work if you can't shop for stuff, so universal care makes complete sense for emergency services, in much the same way that it makes sense for fire protection and police protection. You will get no argument from me on that.

4b) The structure of the US health care system legacy, going all the way back, was one where health care providers made a solemn vow to "spare no expense," and their zeal was only counter balanced by the end recipient deciding to keep his own costs down, since they came out of his pocket.

4c) Shared cost pools, be they private or public, unravel that counter balance, leaving the legacy of our system to run wild. This is the seed of the rot. Sparing no expense is nice, and sharing costs is nice, but you mix those two together and the thing explodes.

4d) "Single Payer," as presented by the Blues, means nothing more than "Everyone Gets Medicare," or equivalently "Everyone shares their costs with taxes instead of premiums." It does not change the system, and the system is the problem. It is purely re-skinning the rotten banana.

Mr. Connor, you still, still, have not shown how re-skinning the banana gets rid of the rot. Now, lets punch through the rest of your post.

If #1, then see all my previous posts. I really don’t want to go into the practical application of universal healthcare until after you agree that it is a superior system.

I think it's vastly superior for car wrecks, where I cannot shop for an ambulance. I think it's vastly inferior for headaches, where I can absolutely shop for Aspirin. I think blind zeal in one system being better for all types of healthcare over another is dangerous and not a particularly intelligent way to approach the problem.

If #2, then we can continue. We both agree that corporate influence on government is a major problem. This affects the healthcare system in the US greatly as, in the current system, healthcare is primarily ran by private, for-profit corporations. This gives them the incentive to lobby for their interests (i.e. more profits). If you take away the private, for-profit nature of the healthcare system you inherently solve that problem. There is no need for corporate corruption when there are no for-profit corporations.

Woah there buddy. The AMA is a lobby. Every little professional subgroup (The American Osteopathic College of Proctology, etc) is a lobby. Note how they, in the link above, recommend expensive procedures instead of cheap ones even though they're a "nonprofit?" Medicare coverage is affected by lobbyists. Device manufacturers are never going to be non-profit. Drug companies are never going to be non-profit. The "Band-Aid" company is never going to be a non-profit. You could turn all hospitals into nonprofits and not change the fundamental problem at all. They still have to hire doctors, who's artificial scarcity is effectively lobbied by the AMA.

Plus, your idea of what qualifies as 'nonprofit' doesn't really jive with reality. In reality, nonprofits lobby like heck. Teachers unions are nonprofit, and lobby like crazy. Churches are nonprofit, and lobby like crazy. The NCAA is nonprofit, and they fly around in private jets that would put the guys at Citibank and Blue Cross to shame.

Also, who exactly do you think you're going to convert 'nonprofit' as part of your solution? The MRI machine manufacturers? The MRI Technicians Of America lobby? The colleges who train the MRI technicians?

Your solution, the “free-market” system, minimizes or completely removes any ability for regulation. This too would remove the need for lobbyists, as corporations are allowed to do whatever they want but that is not a good thing. So you’ve identified the problem being corporate influence over government and your solution is to give all the power to the corporations and let the people fend for themselves.

The primary reason why doctors can't compete with big corporations is because of the regulation. This is something that's fundamentally amiss with Blue thought. (There's plenty that's fundamentally amiss with Red thought too, btw, but that's not really the subject at hand) The Blues think "corporation bad" and then want to regulate the corporation, but what they fail to see is all they're doing is entrenching that corporation's market share. In a marketplace, I can choose the better solution for me. Regulation is about eliminating choice, and preventing innovation from displacing the market share of the big corporations.

I had a very close friend, an MD, who was so sick of the health care model in this country he decided he was going to quit his practice and start a direct doctor-to-patient company, predicated entirely on house calls. He'd show up with a van, to your house, do all your checkups, see you when you were sick, etc etc. The business model was flawless, because the doctors aren't actually making a lot of the money they're charging either - it all gets sucked up into the machine. But in order for his company to work, he had to charge cash. And nobody wanted to pay cash, because they had already paid their premium. They were on the shared pool, so they wanted him to get his pay from the shared pool. Which would have ruined his whole business model. "Everyone on Medicare" would do the same thing. The high efficiency system he brewed up would continue to be rubbed out in favor of the giant corporations that can figure out how the heck to be paid by Medicare.

I think the free market would work flawlessly for routine care, if people weren't paying premiums, because then they could take that money and shop for it. I think it would work flawlessly for your kids getting sick. I think it would work flawlessly for most of the things that we have now. Cash for services would be cheaper. Even up to and including things like broken bones and MRIs. The only thing it doesn't work well for is cancer and car wrecks. It flat sucks on car wrecks, and honestly when faced with "Chemo or die" choices, it doesn't really work then either.

My position is closest to (3) of yours above, but with the caveat that some stuff is absolutely cheaper if you're buying it with cash, in our country, where we have built everything from the ground up to work that way. And our problem is a cost problem.

If you want to make our system work:
1) get rid of all these "mandates"
2) single-payer the emergency hospitals,
3) up the HSA cap, and let people cover all their routine care, OTC medications, etc through it
4) let pharmacists issue prescriptions without a doctor, buyer-beware
5) Allow "limit of liability" clauses for all medical procedures
6) let all doctors self insure for malpractice insurance, by simply holding cash in escrow based on the volume of procedures they do per year, based on the liability limit
7) force all doctors, hospitals, etc, to publish their damn rates for procedures

That would give you de-facto tort reform without having to actually get into the details of it, would insulate us from the "oh god I got in a car wreck and now I'm bankrupt" factor, and it would restore the original cost controls that used to work in our system back into our system. It wouldn't be impossible to get there from here. The moment folks start trying to go to the sort of system you're talking about, rconnor, they'll be putting us all on the VA plan. And we know how single-provider healthcare works here in the USA. It kills Army vets.

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