What value does the private health insurance industry bring to the U.S. healthcare system?

What Value Does Private Insurance Add to US Health?
by Donna Smith
Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.
November 17, 2010

Most Americans I know really don’t like to get ripped off. We don’t mind paying for something that is what we thought we were paying for. We just hate the feeling of having been taken. And boy, are we being taken en masse by the private health insurance industry.

Private health insurance is not a health product or provider. Private health insurance is a financial product.

So, would someone, anyone, please tell me what value the private health insurance industry brings to the U.S. healthcare system? Does private health insurance control costs? Clearly not. Does private health insurance assure better health outcomes? Clearly not. Does private health insurance prevent personal financial collapse? No.

And let’s keep asking one another and our elected officials: What value does private health insurance bring to the U.S. healthcare system? And until we get a sufficient answer, keep asking. If we never do get a sufficient answer, let’s do what the rest of the civilized world already does and find a progressively financed way to provide a single standard of high quality care for all. Let’s create value where none exists.

Read the full article at:

http://www.commondreams.org/view/2010/11/17-12

..that's probably it.

thing if they were working for the federal or state government.

You'd still need people to file claims, match payments, etc.

The only difference is that instead of working to deny people health care to make the CEO a big bonus, they would be working to help people get the health care they needed as part of the common good.

one band-aid towards your health. It doesn't provide health care. It only takes money from you and gives less to the physicians while skimming off the top.

deductible and preexisting conditions.
Honestly, they tell us lying cheating and stealing are American values. I absolutely hate our "healthcare system".

People come from Canada and all over the world to get health care they can't get in their countries with socialized medicine. And what they do get is rationed. I know these liberals will tell you that we have lower rates of mortality than many other countries, but that's because we have more violent crime. I mean, take out our fatal gunshot wounds and we'd be ahead of those other countries!

Besides, government can't do anything right! Didn't you know that?







:sarcasm:

And we already have access to a potentially bigger pile of money in the US government. They offer NOTHING of value. NOTHING.

The health insurance companies are nothing more than parasites. They are skimming billions of dollars that could be used for actual health care instead of big salaries and bonuses.

Millions of new government mandated customers.

We have to get the nomenclature right, else we'll be dismissed as irrelevant.
:rofl:
:thumbsup:

:)

you almost got it.

(Note: I know you were joking, but for clarity, it's actually the Health Insurance Portability and Accountability Act and it only specifically deals with the storage of personally identifiable information. What you're thinking of is the Patient Protection and Affordable Care Act (PPACA). :hi: )

Health Insurance Profit Assurance Act? Does that fit?:evilgrin:

One can never have too much confusion in a con as massive as this one.
:rofl:

that we get the name right.:evilgrin:






When we getting screwed like this, you at least want that.

In other contexts, that's called parasitism or even grand theft!

You can't just start up an insurance company without a ton of money already, because you have to meet claims before customers have paid enough to cover those costs.

No, they invest for a PROFIT on their investment, just like buying any stock, you expect to MAKE MONEY, not give it away.

True, for-profit corporations do not start up without capital from investors, be they a family, or stock-holders..

But none of the investor's money is put at risk if the insurance company collects premiums and pays out less in claims than the premiums they collected.

There is also something called "reinsurance" which is an insurance policy taken out buy insurance companies, pooling their excess risk, just so that the investors don't loose money on a heavy claims year on one particular insurance company.

The insurance industry in the USA is a very very profitable business!!!

That's the whole point. You pay claims and recoup the costs over time through premiums.

the insured. In fact, they collect more in premiums than they ever pay out.

That's why they are in the business, to make money, NOT to serve the people.

In fact, they collect more in premiums than they ever pay out.

In aggregate, over time, sure (otherwise they go out of business); just like Medicare has to take in more than it pays out. But for an individual claimant, if he gets sick the insurance pays out much more than that claimant ever paid in. Otherwise nobody would want insurance.

Oh, won't SOMEONE think of the executives?!

But the health insurance companies have morphed way past that, many years ago. Unfortunately, we're still stuck with them for at least the better part of this coming decade.

but even that was just an aberration while they got the industry under their thumbs.

But that was many decades ago, and the mega insurers either bought up, or ran their smaller competitors out of business.

I'm betting on some big shake ups in banking and health care.They have shown their hand. WE caught on.

I expect the Rethugs to repeal HCR before it ever gets a chance to get off the ground in 2014. Sure, they'll keep a bit of what has occurred already, but the weakness in this year's bill is that it front-loaded the pain, while back-loading most of the benefits.

The answer to both questions is the same.

and as long you followed their rules you didn't get hurt.

But you can follow all the rules your health insurer has and they'll still decide not to pay your claim.

But it's is your own fault if they won't pay for a transplant or your chemotherapy if you didn't tell them you had an ingrown toenail 25 years ago.

What are people thinking? PRE-EXISTING means it happened to you before you existed! :-)

a gambling house, all rolled into one giant bogus "service" that provides no actual medical or healing "service"

Think about this 23% of every dollar given to private insurance goes to paperwork/redtape bullcrap

Medicare -- (est) 5% goes to paperwork/redtape...

Which allows those providers to recoup the losses they take from Medicaid. It also in the past has helped bring down health care costs, though that feedback loop seems to be more or less broken lately for a long list of reasons. It also provides us with a wider range of options for level of care vs. cost than we would have with a government-run system (eg, they still have private supplemental insurance in France and here with Medicare for that reason).

It's more or less an article of faith here that for profit health care work = evil, but I'm not personally convinced that the fact that a portion of the economy is generating profit is necessarily evil (though I don't think anyone would say the system as it is now isn't broken in many fundamental ways).

Also, mine at least does some administrative work I value; today my health insurance company texted me to remind me to get a flu shot and telling me where I can go to get it without a copay. And the gym discount, nutrition planning guides, etc. are nice too.

Leave profit where it belongs--with consumer goods, not public goods.

Hospitals and doctors practices being treated as profit centers are, IMHO, the real reason we can't afford it.

Nearly every public good is provisioned by a for-profit enterprise, though: Ross Perot made his money processing Social Security claims, after all.

your health insurance company employs and pays more people over half a million dollars than you have physicians, who, generally, earn LESS than $500,000 for a year of actual work in providing care to people.

Find out what percentage of your health care dollar is paid out in claims. Some states and now the feds require those figures to be released yearly. If it is less than 95%, there is no value to your health insurance company, other than to take your money and give it to themselves. A single payer system could operate on less than 5% administrative costs.

your health insurance company employs and pays more people over half a million dollars than you have physicians

Which doesn't mean anything without a comparison of how many insured people are paying in to the company vs. how many patients the physician sees.

Find out what percentage of your health care dollar is paid out in claims. Some states and now the feds require those figures to be released yearly. If it is less than 95%, there is no value to your health insurance company

That would only be true if I were just receiving the level of care provided by Medicare parts A & B, which is not very much and has a $1000 deductible (and, if you haven't paid in over the course of your career, an $800 monthly premium). I luckily have a much better plan than Medicare, one provided, btw, by a not-for-profit corporation.

Have you seen the McAllen, TX vs. El Paso, TX study?

Also, I'd remind you respectfully that the fact that I don't agree with you doesn't mean I haven't done research on the subject.

has destroyed the quality of patient care in this country. That was the first domino that fell in this horror story we call our health care system. There is no way to, morally, justify the diversion of $129,000,000 to a CEO's salary that could have been used to provide care.

Yes, it is evil. Pure evil. And a few perks here and there doesn't change that.

Couldn't any salary of anyone in the hospital have been used for health care?

For instance, without nurses, there's no reason to be in a hospital. However, staffing for nurses has been cut to dangerous levels over the years putting patients at risk and driving nurses out of the field. Salaries for nurses, who provide one of the major reasons for patients to be there, have also been driven down further complicating shortages while executive salaries skyrocketed.

I saw not one thing the profit motive added to the hospital system after the for profit takeover except more misery and danger for patients and fewer resources for staff trying to care for patients.

were exactly poverty stricken back then. But they didn't make enough to balance the budget of a small nation.

My nurse's union is under NNU. Donna Smith, you make me proud.
:toast:

Personally, I prefer a single payer system. However, my insurance is phenomenal. Granted, I am a union member. So, we get excellent coverage. Our union negotiated such coverage. It is far better than what I would get in any single payer system in any nation I am aware of. However, that's because I'm damn lucky. Private insurance means that many people will get fucked over.

Your employer switches companies, and if your doc isn't on the new company's preferred provider list, you are SOL. In single payer countries, people can go to any doctor they want (though that isn't particularly meaningful in thinly populate areas, any more than it is here).

If single payer gave you less than what your union is getting for you now, every single version of it that I've seen sxplicitly states that you are entitled to negotiate for (or buy on your own), any extra bells and whistles that aren't offered.

and I can also buy seperate stuff... if I want (why would I).

It DOES offer choice. In single payer, you can get any color you want, as long as its black. And I'm not talking about single payer as proposed in the US. Read what I said. I am referring to other nation's single payer. I am not aware of any nation on earth that offers better coverage than I have. I prefer single payer as a policy matter, not because*i* would benefit.

My doctor was not one that one. If you actually can choose your doctor, you are in a very small elite minority.

With single payer, you can see any doctor you want, and you can buy extra bells and whistles not coverd by single payer (or your employer can). Those are the only choices that matter. Any other "choice" is nothing but a guess as to whether you will successfully be able to fuck over really sick people or not, and should flat out not be allowed.

If a doctor doesn't want to sign on to the government's single player plan, the government can't MAKE him. Pretty much all the dr's WILL, but it's still their choice. And my point goes further. In a single payer plan, let's use france for example, you generally can't choose plans. My plan for instance covers a bunch of stuff without cost to me, that France doesn't. Other plans don't. People can choose more or less inclusive plans, and pay accordingly.

I can choose my doctor as long as he is a preferred provider for my plan. If he's not a preferred provider, I only get partial (vs. 100%) coverage. Another plan (the one I don't have) has far less doctors, one of the reasons I did NOT choose that plan. Again, there is more choice.

Again, it doesn't do the cause of single payer any good to pretend it is something that it is not. In ANY plan, there is a limiter on what you can get. Given no single payer plan, there are going to be far more choices in what plan you can choose, just like you can choose an employer partially based on what plan they offer, and/or choose better or worse private insurance.

One of the reasons I chose my employer was because I knew they offered a great plan(s). I specifically did not choose another one, because they offered inferior coverage.

health care plans lumped together as "Single-payer"...

I also SERIOUSLY doubt that there's any coverage you have in your private plan that isn't covered, and probably covered better by the best health care in the world in France...

Do you get house calls? They do in Paris...

your employer. Most employees have NO choice of they type of insurence they get, even of whether or not they want it. Many plans provide lists of care providers, but outside that list again there is no choice.
The present non-system also gives employers great control over the lives of workers and one more threat to hold over our heads.


mark

an expensive one at that..

And IF proponents of single-payer would respect that one individual right, they would already have the single-payer plan they beg for.

is, they'd have a lot more credibility.

how great some opinions of it sound, how much money some think it will save or how much more "fair" some opinions think it would be, if it does not allow freedom of choice, they will be against it.

You dismiss their credibility ONLY because you do not respect their belief in freedom of choice and THAT is why it has been so difficult.

That's the thing, single-payer is by it's very nature ONE SINGLE PAYER of insurance. Canada offers a variety of supplemental plans that cover things that the provincial plans don't, but basic medical services are paid by the government.

I can't argue "freedom of choice" (a pretty but ultimately meaningless slogan) in this context. It doesn't apply to the issue at all.

the ability to choose if they want to pay for insurance or care and the ability to choose the insurance or care they desire.
It is NOT paid by the government, it is paid by a mandated tax on the people and such a tax is directly opposite of freedom of choice.

We have to work with them and build up support, not force it onto them. We've seen what happens when we do that.

This is basic insurance theory. For single-payer to work, and cover things like pre-existing conditions, everyone must be in the insured group in order to spread the risk adequately. This is why HCR requires all people to carry insurance, otherwise you'd just get people waiting until they got sick to seek insurance (adverse selection).

"It is NOT paid by the government, it is paid by a mandated tax on the people and such a tax is directly opposite of freedom of choice."

Um, yes the cost of care is paid by the government. It's as much a premium as it is a tax, the insured seeks care wherever they want (you know, freedom of choice in choosing a provider of care), and the government pays the cost of that care.

It's really quite simple: in single-payer, there's one insurer, and that's the government. It's really not that radical a concept.

Um, yes the cost of care is paid by the government. It's as much a premium as it is a tax, the insured seeks care wherever they want (you know, freedom of choice in choosing a provider of care), and the government pays the cost of that care.

If you're talking about Medicare rather than single payer in the abstract, the cost is paid by a dedicated payroll tax and supplemented by a trust fund containing past surpluses from that tax. People who have not had Medicare-deducted employment and want Medicare coverage do pay a premium, to the tune of $800 per month or so.

If you're talking about single payer in the abstract, then who and how that's paid for is up for grabs, and one of the biggest hurdles it faces is how exactly to pay for it. Nobody can seem to agree with each other on that, and also nobody knows how well the health care system could stand providing all its services at the rates it currently gets from Medicare. I'm personally dead-set against a single payer system that does not have a dedicated revenue stream (it would become a Federal Medicaid otherwise, with all the problems associated with that).

With delivery prices as high as they are, no matter how we choose to insure the population it's going to end up being tremendously expensive.

I'm talking about how an individual citizen has his or her care paid for. You're talking about how much medical care actually costs. And we are in complete agreement that without attempt to control the cost of care, single-payer would bankrupt itself pretty quickly.

I actually favor a sort of HMO model for a single-payer system: specialist referrals are required as sort of a gatekeeper. For instance, you don't necessarily need an MRI for a broken ankle, an X-ray is fine and much cheaper. Also, unlike Canada, I'd propose some sort of small token copay for services, like $5 or $10, that could keep people from seeking unnecessary care but not punitive enough to make people prolong care they might need out of a concern for cost. (My Canadian wife strongly disagrees with me on this)

Secondly, preventive care and encouraging healthy lifestyles should be a major priority for any single-payer system. Providing incentives to quit smoking, lose weight, get regular checkups, etc. could do quite a bit to reduce the need for more expensive care down the road.

I'd also ban direct marketing of pharmaceuticals, since this just encourages people to doctor-shop until they can get the flashy new drug that they saw a cool commercial for. Doctors should be making that decision, not your average person with little to no medical training.

Nobody can deny the possible benefits of such a program if it is run correctly.
What I said is that it takes away freedom of choice and some people do not like that being taken from them. Especially when that choice is taken from themselves and given to the government.

"everyone must be in the insured group in order to spread the risk adequately"
Yes, but not everybody wants that insured group chosen for them, something single-payer would do.

"It's as much a premium as it is a tax"
No, it is not. It is a tax. You have a choice when it comes to paying a premium.

"the insured seeks care wherever they want"
Only if that care is in the govt's "network." Those seeking alternative methods would be forced to pay for care twice.

"It's really quite simple: in single-payer, there's one insurer, and that's the government"
And this one sentence makes it quite simple to see why single-payer limits freedom of choice.

No matter how much we support such plans, we cannot force them onto people and just expect them to be sheep and accept them. That is why the country is in the position it is in now.

There is no "government network," unless you mean that the government won't pay for people to seek care from nonsense like homeopaths. Personally, I don't mind that, as I don't want my tax dollars being used to pay for witch doctors. Otherwise, you can seek care from any licensed medical professional you like, unlike we have now under for-profit private health insurance.

And single-payer isn't "forcing" anything on people anymore than SS and Medicare is "forced" on people. Quibbling over whether it's a "premium" or a "tax" is a distraction. And it's cheaper, more streamlined, and would probably provide better health outcomes than our current for-profit insurance system if done correctly.

on edit: it should also be noted that Canada's system is ultimately run by the individual provinces. Their plans have to meet certain minimum requirements set by the federal government, but what is covered and how it's covered it otherwise determined by the province. If we replicated that system here, blue states like NY could have a slightly higher tax/premium to provide a better plan than those rugged individualist teabaggers in Texas who would gladly vote to bankrupt their own system. Sounds fair to me.

Right now, we choose who, what and how much our money goes to. Under single-payer, we will not be able to choose.
No matter how you spin it, if you have a choice and then lose that choice, freedom of choice has been taken away.

The fact that you do not mind government determining what kind of care you will receive, (as long as you're tax dollars are used how you personally think, I'm sure) is another reason why they do not want single-payer.

SS and Medicare are mandated taxes, you have no choice in paying them or not. If you are paying for something against your will, you are being forced to pay it.

Again, cheaper, streamlined, hopes of being better and whether you and I think it is good, is NOT why people do not want a single-payer plan.

I have looked at that some and I think you are correct with it possibly being used here. I believe it could be a good starting point in showing people how beneficial such a plan could be and that govt is capable of running it. If those two things are accomplished, then the people may embrace the plan and that would take us forward alot faster than forcing it upon them and telling them to just get used to it.

is a licensed medical provider. The provincial governments in Canada has zero say in determining what kind of care you receive (other than not paying for homeopathy, crystals, prayer, etc.) It's actually a much less restrictive system than our for-profit insurance system here in the US.

In both Canada and in the US under Medicare, standards and levels of care (both minimum and maximum) are defined by the government; Canada is a bit better than Medicare at preventing very expensive tests, but both do it to some extent. And claims are routinely denied in both cases (Medicare actually denies claims at a higher rate than any private insurance company).

wait times before care can be received (this is entirely dependent upon hospital availability, and in Toronto, for instance, they regularly contract with Buffalo hospitals if services are unavailable in Canada) or "death panels."

And I also already said I'd expect cost-control measures to be in place, like not paying for an MRI for a broken ankle, but that's not really the same thing as the government "controlling" what type of treatment you receive, like requiring step therapy for drugs or requiring referrals to specialists.

Kind of a big thorn for those not wanting to give up their freedom of choice and you're support of govt dictating what care you can and cannot have doesn't help in convincing them otherwise. Its been taken out of context and used against single-payer pretty effectively and has been a good tool for the right.
No sense in trying to work with each other. Much better to fight.

I can't tell if you're playing devil's advocate or if this is actually what you believe, but the last option is the assumption I've been operating on throughout this subthread. Am I incorrect?

I meant to say fight with 'them' or work with 'them.' Not that we were.

I actually support a laxed type of single-payer, but I support freedom of choice more so a voluntary participation single-payer system on a state level is what I hope for. Yes, I would sign up for it and have taxes withheld, but I do not believe my neighbors should be forced to do the same. Theory being that once they could see the effectiveness of such a plan, they would also sign up.

Getting them to embrace the idea would be a hell of a lot easier than fighting them on the idea.

Unless you wanted to exclude people in perpetuity that refused to sign up initially. See what I said about adverse selection. Maybe as part of a baby step towards a totally single-payer system, but not as an end in itself.

but I have no problem with people living with the consequences of their own actions and decisions. Would only work to the benefit of a single-payer type plan anyways.

Why should health care be any different? The only choice that most people care about is their ability to choose providers, and that's precisely the choice that your employer and their limited choice of insurers will NOT allow.

you choose where you live. Don't like any of the things you mentioned? You can choose to move to ones you do like or that have none.

Just so they realize that anyone travelling to another state to get health care will have liens put on everything they own if they don't pay.

States will eventually adopt some form of heavily cost-controlled centrally-administered system (no doubt either supplemented or actually provisioned by coalitions of private insurers). Honestly I think that's a better level to take care of health care at than nationally.

Insurance companies?

Other than freedom to have no access to health care, what freedom of choice do you think would be missing under single payer?

Unless you have an indemnity plan now your freedom to choose doctors and hospitals is constrained by the relationship between your health care plan and the provider through network arrangements, so that can't be it.

We could not choose to not have health insurance and spend our money on what we believe is in our own best interest.
We could not choose the plan of my choice, unless we are able to pay for two policies.
We could not choose the doctor of my choice, unless we are able to pay for two policies.
We could not choose to pay on an as-needed basis.

Yes, those choices are slowly being taken from us today (a left wing plan according to those on the right) but they are all choices we ALL have right now and people are not going to give them up without a fight.
I would rather work towards the goal and have it accepted instead of forcing people to accept it against their will.

Unlike the for-profit insurance system in this country. Worrying about this shows a lack of understanding of what single-payer actually is.

As for people choosing to be uninsured, see what I said in my previous post about adverse selection.

Well, it's a little more complex than that, but basically you can't provide a covered medical service for a covered individual but bill him for it privately, even if both the doctor and the patient would prefer that.

I think that's a step American society will not be ready to take for a long time.

entirely dependent upon income, like in the US. Since the vast majority of Americans seek care entirely through private insurance, I don't see why this would be a huge issue.

Choosing not to have health insurance -- yeah, you're right about that one.

Choosing the plan of your choice -- how many plans can you choose from now? If you're talking about plans offered through an employer, understand that your choices have already been severely constrained by the company. I can promise you that I was offered totally different choices by my employers and if every plan is better than your employer's, tough for you because you don't have the right to choose my plans.

Choosing the doctor of your choice -- nothing about single payer would require that. In fact, unless you have an indemnity plan now, your choice of doctors has been limited to whatever network has been set up as part of your PPO or HMO.

I have no idea what paying on an as-needed basis mean other than the same as your first point, going without insurance altogether. I'll guess that the incentive for that is that you don't have enough money to pay for other, more immediate needs. That's a valid concern for many people, but what will you do when you or a family member gets in a car accident or comes down with a serious but survivable condition? If you were in a country with a single payer system, the health care would happen without anyone asking you how you plan to pay for it.

But let's refer again to those health care plans you can choose from now. If you've ever had to use it for hospitalization you know that there are weeks or months of follow up with bills and insurance statements. Bear in mind that a large percent of the cost of your care now is the cost of pushing that paper around. Under single payer that paperwork would practically disappear because all of the billing goes to one place. That should also mean that costs go down, and what we pay for single payer will be less than the private insurance plans we have now.

Personally, I can choose from any of the 5 plans I have looked into. 2 are from employers and I can choose if their plan, which you said are severely constrained and I agree, and choose if either are one I want.

Yes, the doctor must be in the network. But I am able to choose different doctors until I find the one I like and if I don't, I can find another plan with a doctor I do like. I absolutely acknowledge that is not an easy thing to do, but there are many people who would rather keep that choice.

Paying on an as-needed basis is nothing more than paying for the office visit instead of the co-pays and premiums. Car accidents and catastrophic events can be covered with other policies.

I know how a single-payer system works and I do not deny its possible merits. I know its possible that admin savings would lower prices. I doubt it though.
We were discussing the main obstacle to getting such a system here, individual rights and freedoms.

Nothing about single payer precludes choosing your own physicians. For that matter, single payer doesn't require that you even see a physician.

I'm still struggling to understand why some people think this is a violation of individual rights or freedoms unless these are the same people who think mandatory car insurance and seat belt laws are violations too, and that paying into retirement via Social Security should be optional.

A good single-payer plan would be paid for with a tax, just like SS but alot more. That is a mandated tax that must be paid and most people will not be able to afford to pay that tax AND pay for a supplemental plan. They have no choice but to use the plan they are forced to support and not use the plan of their choice.
I believe convincing them it is a better plan would be alot more effective than forcing them to accept what we see as the better plan.

coverage for the price. Frankly, most people have little choice in plans other than deductible levels, and higher deductibles are a disincentive to seeking preventative care which ultimately will cost them more or shorten their lives.

I agree that there should be a better effort to convince people of the benefits of never having to worry again about seeking basic medical care vs. preserving "choices" that will not offer them a better deal for the price especially since any single payer plan would address the hardships on lower income workers.

People in single payer countries may complain about their health care options but most shudder in fear at the thought of having our health care options.

51 million Americans have no "freedom" when it comes to visiting a doctor.
The insurance premium (or paying cash for service) is unaffordable for millions of us.

I am one of the 51 million. I have been to the doctor twice since 1979.

For me, the American health care system is an unaccessible abstraction with no rights or freedoms at all.

like fire and police services and public schools. Health care is a public good.

Presumably, we are citizens of a republic where the "res publica" is an important principle. We all have a stake in it.

That's the whole "freedom of choice" loss he's lamenting.

I never heard of a republic that would do such a thing...

He's saying a single payer system has less freedom of choice than the current system in some important ways, because of the argument you yourself eloquently articulated three posts up.

EDIT: Is it "eloquence" if you're writing? I'm not sure, but will leave it be.

We could not choose to not have health insurance and spend our money on what we believe is in our own best interest.
We could not choose the plan of my choice, unless we are able to pay for two policies.
We could not choose the doctor of my choice, unless we are able to pay for two policies.
We could not choose to pay on an as-needed basis.

His first assertion would allow people to choose not to treat an illness and winds up with the public purse paying for the later, more acute and expensive care. The only alternative I presume is that he gets to die (ini his own best interests) rather than rely on any form of public assistance.

His second assertion has been successfully shot down by several other posters here. Saying something is true again and again does not make it true.

Ditto for his third assertion.

His fourth assertion falls of its own weight for the reasons I describe for the first one.

Now ask yourself: why doesn't he apply the same logic to say, publicly supported Fire Departments? Why can't I just put aside a little dough to pay for putting out a house fire that I might have someday? I think you know the answer to that one...

Freedom of choice would be being able to choose or not choose to have insurance AND the willingness to live with that decision. It would be like it used to be: no "public purse" in the hands of govt control.

The second and third have NOT been shot down even once.

The fourth falls ONLY if one refuses to acknowledge individual freedom of choice.

I apologize for not seeing you're question about fire depts, police depts etc... and answering sooner. But the answer really is quite simple: We exercise that freedom of choice every day when we choose to live in a certain area over another. You choose which fire dept, police dept, school district and property taxes you want to pay when you choose to live where you do. You can also choose to live off the grid so to say, and not pay for any of them.
Comparing such taxes to a mandated tax is apples to oranges.

For example, some of your taxes go to pay for schools and teacher's salaries. If you don't have children in the system or used private schools, then you got very little direct benefit - but you still paid into the system. You can't "opt out" because you just don't feel like paying. Hell, if I could do that, I'd never direct my taxes to pay for any of the Iraqi War.

And, as a better educated society helps society as a whole, so does a healthier one.

The rest of your statements don't make sense. Most Americans don't choose their plans, now, their employer does. You don't choose your doctor, now, your insurance company does. There's very little "choice" left in our health care system, now... unless you're rich and, even then, a serious illness could wipe you out financially.

Look at Germany. They have socialized medicine and socialized education. They have high labor union membership and representation on boards of private companies. They have higher taxes than we have.

Now, the results: they are a major exporter and we are not. They are healthier and have a better educated work force than we do. They have a thriving entrepreneurial sector and ours is lacking steam.

Let's look at Germany and ask "Why not us?"

In other words - we want our services for no taxes and our meat cheap.

they really have no other function.


mark

I've been commenting in here forever that insurance provides zero value. They don't deliver single microgram, microsecond, or microliter of health care. They skim off the top and middle, and leave the "insured" fighting for the drops at the bottom.

Stop begging them to behave, pols. Make them defend their very existance. Make them state their actual purpose.

.. I believe it is about nothing but JOBS. Our current system is wasteful, unfair, downright byzantine at times but it keeps millions employed in a country that has nothing but service jobs left.

Of course you could say pretty much the same thing about advertising and any number of other fields.

America sold out its manufacturing base, its REAL source of wealth back in the early 90s to China so a few industrialists could get rich. That event marked the beginning of our decline and we're still declining. Health care or nothing else will get fixed as long as we have "free trade".

and both stem from their fiduciary responsibilities to their shareholders.

they push to keep the medical care costs down.

On the "help" side of the ledger they
- the try to hold costs down by paying "fair" (a relative term) amounts in compensation to doctors, hospitals and pharmacies
- actively work to minimize fraud

on the "hinder" side of the ledger, you pile up things like:

- too much of a "cut" for providing this service
- denying claims in an effort to bolster their bottom line
- ditto for excluding pre-existing conditions

Could/can the government provide the same service? like anything the government does, it is better in some areas and worse in others. The feds can knock out or minimize the both sides of the ledger but with varying degrees of success and failure.

the feds could definitely do a better job on the hinder side of the ledger but probably not do as well on the help side

... they'd be gunning for the pharmaceutical companies.

But the insurance companies only care about one thing, and that's the size of the revenue stream that they can siphon profits off of. Bigger stream, more expensive "product," more profits. Reduced stream, less expensive "product," less profits.

The insurance companies are literally holding our health for ransom.

as well as the post office and, best of all, a handful of jobs paying over $100 million per year, for the head grifters of each of the companies.

and their executives, shareholders, etc.

Nothing beyond that.

It's about capitalist economics, not human service.

For how long and for what?

Everyone needs high quality health care now!

Under this health insurance industry bill we won't get that now and we won't get it anytime in the foreseeable future.

The point people are making is that the health insurance industry bill is not and will not solve our health care problems.

Why is that?

Because the health insurance and big pharma industry lobbyists wrote the fricken legislation!

And the remain the key players in our health care system while not contributing anything to improving our health care.

They continue to stand between us and high quality health care for all.

Each day, 273 people die due to lack of health care in the U.S.; that's 100,000 deaths per year.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

We don't need the GingrichCare of mandated, unregulated, for-profit insurance that is still too expensive, only pays parts of medical bills, denies claims, bankrupts and kills people.

Republinazi '93 plan:

"Subtitle F: Universal Coverage - Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005."

"Any proposal that sticks with our current dependence on for-profit private insurers ... will not be sustainable. And the new law will not get us to universal coverage ...." -- T.R. Reid, The Healing of America

Private "health" insurance is a leech on the system bleeding precious dollars, energy and time away from health care and toward entities that contribute nothing to health care, whether it's toward a fractured insurance bureaucracy with a thousand hoops for medical staff to jump through, gamblers, aka; shareholders or redundant salary and bonuses paid to themselves.

This privatized, for profit health insurance system is dysfunctional, illogical and forcing the American People to reward this industry is a travesty in its' own right.

Thanks for the thread, Better Believe It.

NONE!

Not to say that completely socialized medicine couldn't employ more people more stably, but if there's anything good to say about private insurers, it's that they keep some people working.

What a way to make a living.

What makes you think this is a problem only with private insurance?

Are they unnecessary, duplicative or just suspiciously fraudulent?

If they ARE true, do we not have democratic means to repair the problem? Wouldn't it be our duty as citizens to do whatever possible to remedy the situation?

According to this: http://www.associatedcontent.com/article/2572409/top_5_reasons_for_medicare_claim_denial.html

(Caveat: I make no claims for the accuracy of this, and it's full of weasel words like "probably" and "sources say", but this seems reasonable)

The top five reasons for Medicare claims denials are:

1. Provider error
2. Procedure judged medically unnecessary
3. Provider not enrolled
4. Medicare judged itself to be the secondary payer
5. Contractor error

Again, for whatever that's worth.

And #4 doesn't mean the care doesn't get paid for and the insured is on the hook for it, it just means that the other insurer ends up paying primary instead of Medicare. So the care eventually gets paid for. :shrug:

an Improved and Enhanced Medicare for All is what we're asking for.

As one on Medicare, thanks to the corporate dominated bullshit that passes for a political process in this country, current Medicare has been laden with many of the for-profit insurance evils like co-pays and deductibles, etc. that private insurance has pioneered.

We need a national tax on those who can afford it to pay for health care for all!

We need a restructuring of the H.C. delivery system away from huge corporate concentrations of for-profit "medical centers" to a decentralized delivery of primarily preventive care!

The entire profit-based system of Sick Care in USAmerica is deformed and a deterrent to good health (as is the freakin' capitalist economic system that it's based on - but that's another thread)...

And first and foremost we need a NATIONAL decision, like that that most of the industrialized world has already made, that Health Care is a Human Right -- NOT a commodity or privilege to be reserved for the affluent or rich.


PS: Read the article again. NONE of those 5 reasons are because of the Medicare concept or have any bearing on the idea of single-payer. They are all (understandable) errors made by providers or, mainly, errors made by the for-profit leeches that are allowed to pollute the Medicare idea...

Are they unnecessary, duplicative or just suspiciously fraudulent?

If they ARE true, do we not have democratic means to repair the problem? Wouldn't it be our duty as citizens to do whatever possible to remedy the situation?

but slavery

but keep coming up with the same answer. Nothing but serving as a middle man to cash in on the American people.

living off the health care services industry.

Some health insurance companies are on record as paying out LESS THAN 50% OF WHAT THEY COLLECT IN PREMIUMS!!!!

MONEY OFF OF SICKNESS AND DEATH.

But despite of my own personal situation, I still would give it all up if it meant single payer for all Americans.

a functioning section of the economy. That is to say, they employ people and pay them. But yes, it's a system based in part on theft. Some 25% goes to profits for bloated senior management pay and stockholder dividends.

What might be better would be a non-profit system financed by bonds (much like muni's).

It's really a question of how we view the world. Should healthcare be considered a social good which works for everybody and can still be quite profitable and pay excellent incomes to those who work in it, or the system we have now which only seems to work well for Rush Limbaugh?

the concept that health care should carry a penalty. Needing healthcare is a bad thing that costs money. Insurance maintains the gateway to healthcare and they are then they authority - government is relieved of that responsibility.

They do not do that by being generous with medical expenses. Raise rates and cut expenses, deny treatments, and do whatever it takes to make lots and lots of $$$ for shareholders, high paid Company officials, and friendly politicians willing to trade their votes for gold. Nothing more, nothing less.

That would be $7200 we pay per countryman, subtract $3000 that Europe pays per countryman(and that covers everyone for everything over there), that gives 4200 times 300-million Americans, or 1.26 trillion dollars per year. Add, another quarter trillion to include that despite calculating this for all 300-million of us, 50-million out of that don't get health care, so, really, about 1.5T$, negative 1.5T$ that insurance companies bring U.S.

extract the most money for the least service possible. IOW, to steal the money for themselves that, otherwise, would go towards providing health care for the citizens of this country.

Er, um, nothing.

Except maybe a totally unnecessary 20% overhead.

The ONLY gauge worth recognizing for the health of the USAmerikan Empire...

War and war profiteering pump up the GDP... Bombs and bullets are GREAT for the GDP...

Peace is BAD for the GDP...

MacMansions in the hills for the affluent are GREAT for the GDP...

Low income, right-sized housing is lousy for the GDP...

Burning fossil fuels, fouling the air and water, increasing greenhouse gasses emitted is great for the GDP...

Waste is great for the GDP...

Powering down, right-sizing one's life, buying less and more durable goods are VERY BAD for the GDP...

In the vampire capitalist system only those things that "increase the size of the pie" are valued. Conservation and living within nature's limits are deadly to the system.

Connect the dots...Follow the Money...