<p>I keep reading how efficient the private sector is compared to the public sector. I don’t think people are that efficient anywhere. </p>
<p>At the Gallup healthcare conference a few days ago, Gallup talked about start ups. Before the financial crisis, 500,000 companies a year started new businesses in this country. 400,000 companies would go bust. Since the financial crisis, 400,000 start ups are created a year. 500,000 go bust. </p>
<p>I am a capitalist. I did make my living in the financial markets. I like the markets. I don’t have my head up my butt. Companies in the private sector have to make money or they wilter away and die. That adds a cost to the consumer.</p>
<p>If a company is 10 percent more efficient than the government but has profits that exceed 11 percent of sales, the consumer pays more. Not less.</p>
<p>If the insurance companies provided such a great service and kept costs down, why do so many of the largest companies in the US self insure? </p>
<p>Why do we tolerate paying more for less in this country? Many of the drugs that are developed in this country, many of the medical devices that are used, are no better than what we had 10 or 20 years ago. They cost more though. Prettier packaging. Higher costs. We are animals. The glitter catches our eyes…and we pay.</p>
<p>Yes. Really. Smoking is a huge driver of health care costs too, bigger than obesity. Age is of course a driver of health care costs as well. </p>
<p>The US is not less healthy that other countries. That’s not the explanation of our higher health care costs. The explanation can be seen in dstark’s link: we pay more for the same thing. We pay more for the same drugs. We pay more for the same procedures. We just pay more.</p>
<p>We pay more, but we don’t get better results. The US has a third-world level of maternal mortality (women dying in childbirth). In Sweden, 4 women die per 100,000 live births. In Canada, 12 women die per 100,000 births (not great). In the US, 21 women die per 100,000 live births (a scandal and an outrage).</p>
<p>You’re assuming the big insurers followed the law. In real life, until ACA, insurers continued to practice [url=<a href=“Stock Portfolio & Tracker - Yahoo Finance”>Stock Portfolio & Tracker - Yahoo Finance]rescission[/url</a>]. Sure, it was illegal. And sure, they sometimes paid fines and court judgments as a result. But those costs were insignificant compared to the money they saved by not paying the claims on certain subscribers. As they saw it, when they broke the law and “simply dumped” subscribers with expensive illnesses, that was a smart business decision which benefited their shareholders.</p>
<p>But more common than outright rescission was the practice – which has been described several times – of herding subscribers with expensive illnesses into certain plans and then attempting to price those subscribers out, while keeping healthy (profitable) subscribers in lower-cost plans. That is also “dumping.”</p>
<p>Well, ACA is a law so if the problem is mean companies not following the law then a new law that funnels taxpayer money into those mean companies is a bizarre solution. imho. </p>
<p>Flossy, I agree, but the reality is they have ginormous political power, so they had to be bribed into behaving themselves (personally, I think throwing a few of the defiantly criminal CEOs in jail would have also worked). But this speaks to the fundamental problem with our insurance system which has profit-conscious private corporations as its centerpiece. There will ALWAYS be a conflict between shareholders and subscribers. Anything that is good for the subscriber – paying a claim, e.g. – is automatically bad for the shareholders. And vice versa: anything that is good for the shareholder – outrageous premium increases, rescinding sick people – is bad for the subscriber. It is a built-in conflict of interest. The only way to resolve it was to throw millions of healthy subscribers their way in exchange for a promise to treat the sick subscribers with some decency.</p>
<p>I find it bizarre that there are people that work very hard so millions of people dont get health insurance… Imho.</p>
<p>Flossy, how are you personally negatively affected by ACA? There are posters that benefit by ACA. Personally benefit. Right here. Real people.You have communicated with them. You are giving these people the finger. Policies affect real people. You are giving real people the finger. You would give my daughters the finger. My daughters are such great people. They are like Mary Tyler Moore’s character on her show. They light up a room when they enter. You tell them too bad. Bad luck. It was bad luck. But you would put a knife in them.</p>
<p>Why? How are you personally hurt by ACA?
Your comments sting people who need health insurance and were having trouble getting it or affording it. This isnt a game for some people. We are talking about their quality of life. </p>
<p>Personally, my family is paying roughly 150-dollars more because of ACA. Didn’t you say you were paying $800.00 more? For some people $800.00 is a house payment. That is not affordable. I realize there are winners and losers. Attacking me for raising a question that even LasMa agreed with while we have posters linking YouTube videos of violins in response to real stories of suffering doesn’t exactly scream empathy. It screams politics.</p>
<p>This is much bigger than you and me. And, I fully expect all of our costs to continue to rise. Maybe, until we are all subsidized. But, we are also paying those subsidies in other ways. The whole point of healthcare is that it’s personal. This particular scheme has wildly varying impacts depending on random factors like where you happen to live. It’s not enough to say more people have insurance cards so it’s all good. If that was the case a mass mailing of government issued insurance cards would have done the trick. But, the 5 people left on this thread are not open to any negative news so, whatever. It’s just yawn, another sick person with a big problem. Or a liar. Sigh. </p>
Really good stuff, dstark, but in a discussion about healthcare, one of the most regulated markets imaginable, I can’t see that it matters a whit.</p>
<p>Add another 1% of costs, heck add two or three, and you’ll still be crippled with defending the merits of bureaucratic innovation… ROTFL… against the evil profit model.</p>
<p>CF: Those that have been ‘doing the right thing’ by carrying insurance since the get go have always been subsidizing the non- insured. Remember - cost shifting??? So, those that have been bearing the burden of their own insurance (the supposed healthy) have by default been subsidizing the uninsured (the supposed unhealthy) all along. The insurance rate increases were substantiated by the increasing cost of health care… a large portion of which was the cost of the uninsured using the system. One of the big selling points of the ACA was that it was to spread the cost of caring for the uninsured (ER visits etc) so that the burden was carried more equitably. However, once we passed the bill and saw what was in the bill, the ACA simply demands more subsidizing by those that have already been doing the majority of the subsidizing all along. I do get it, really truly I do. </p>
<p>[fquote]There’s a large racial component to the problem, one that all the spending in the world won’t bring down to Sweden’s rate. Or Canada’s.
[/quote]
</p>
<p>Really? I can’t begin to understand why this would be the case. Other countries have black and brown women living in them, and yet other developed countries somehow manage to provide adequate prenatal and maternity care to all the pregnant women living in their countries. The US maternal mortality rate for black women is a shocking 35 per 100,000. </p>
<p>CF: additional insight…We (H and I ) are a small group and as such have been involved with subsidizing the unhealthy in our group for 10 years. We know a number of other small groups consisting of H and W and maybe an employed kiddle. There is our neighbor the painter whose wife runs the office, my friend whose husband runs a computer repair business, friends where H and W are the sole proprietors of small businesses…ALL of us have been voluntarily paying higher premiums to be in a group and will lose our group status under ACA. All of us will be forced into higher premium, smaller network non-subsidized policies. The would be ALL of US that have already for years and years and years been subsidizing and subsidizing and subsidizing the uninsured, the unhealthy the uninvolved. But yes, again… I SO get it…that’s okay, that’s morally right and it is our obligation. Yes, I get it.</p>
<p>But that is equally true for those who have been doing the right thing, but who have paid two or three or four times as much as you did because they had pre-existing conditions. You now have to pay more, but the responsible people RIGHT IN THIS THREAD who also had insurance, but who were unlucky enough to have family members who got sick, are now paying less.</p>
<p>Do please let go of the idea that maintaining continuous coverage was enough to keep one’s insurance premiums down if one got an expensive disease. If you don’t believe us, ask some of your friends who had private insurance and who got sick. You’ll hear the same story.</p>
<p>Because the problem was identical in small-group insurance. A small company would offer insurance, ok fine, but one premature baby was enough to make insurance unaffordable for that company ever afterwards.</p>
<p>Each individual small group (H and W or spouse and spouse) was aggregated into a larger group. There was the a group of property owners, managers, trades people (electrician, painters) etc. So they took the small parts and grouped them into bigger parts. This way, one premature baby among a group of 100s or 1000s was a non - issue. THAT system worked. THAT system is being dismantled.</p>
<p>Let’s ignore the lifestyle choices of Swedish blacks and just focus on their percentage of the total population. It must be comparable to that of the US, since you’ve suggested we’ve thrown ours under the bus with our unconcern.</p>
<p>What is your point here? That it’s ok if some women die in pregnancy at a rate of 35 per 100,000, because they are black? If your point is that black women are at higher risk for pregnancy complications than white women, I already disproved it for you.</p>