<p>I don’t view health care in the same way as I do a computer product or an entertainer.</p>
<p>“I don’t view health care in the same way as I do a computer product or an entertainer.”</p>
<p>why? It’s a product. Do you feel that the people who build houses should make money? What about food production? </p>
<p>I understand what your feeling, but honestly wouldn’t government workers get paid, wouldn’t directors make money? </p>
<p>The reason we have uber high compensation for medical ceo’s is our government both democratic and goper have allowed medical plans to merge over and over again. For some reason, they’ve looked the other way on both sides. Sure, you hear some occasional grousing to gain campain dollars, but really the regionalized players system is sliding into place from that 83 plan. </p>
<p>If the government takes hc over they will not reinvent the wheel, they will simply pass the operation off to a few regional players who will provide the service. It’s been in that process for the last 20+ years, a jocking for position to be a player… You’re going to end up with a big five, each with a section of the country and no choice. </p>
<p>I would be pressing for government to break up these giants and get back to lean and mean smaller companies. The smaller blues that are still nonprofits and not owned by majors pay a fairly reasonable compensation to their ceos.</p>
<p>Opie–by your definition, education is a product, too. Would you like to privatize it and have some (most) education dollars go to some CEO and stockholders, or would you like to keep the dollars in the education system, paying toward education–and teachers?</p>
<p>In a national health insurance system, the health care workers would get paid, just like they do now. Why pay a myriad of CEO’s and the overhead of a zillion different plans and the thousands of workers who must administrate them, when the money could stay in the actual, you know, care of health?</p>
<p>
So, the national plan would administer itself? The reality is that if you replaced private administrators with civil service employees you would get all the efficiencies that the rest of our government provides with employees who know that they really don’t have to work that hard to be assured lifetime employment.</p>
<p>Nobody in government would get paid over a billion dollars. There is a savings right there.</p>
<p>I agree we should break up these health care companies.</p>
<p>Insurance is one product the government can do as well as the private sector. Maybe better. It’s based on probabilty and probabilty doesn’t change whether the private sector does it or the public sector does it. The public sector doesn’t have to pay outlandish salaries and it doesn’t have to make money. The one thing the private sector does do better is innovation.</p>
<p>The private sector gets to cherry pick its customers and this can lead to either lower premiums for the rest of us, more profits for the firms or better salaries for the employees of the firms (Though those at the top seem to get that money). So that is an advantage of having the private sector do it.</p>
<p>Maybe.</p>
<p>The private sector is definitely not better for those that aren’t cherry picked.</p>
<p>Have relatives in Germany and in Poland, so I have experience under communism, democracy, and post German merger. Under communism, it was free in East Germany and Poland. However, the care was limited. The elderly weren’t deemed to be a drain on the exonomic system, so the sooner they died the better. Meds were limited to the young and “productive.” I know. My mother used to send her sister heart meds becasue she could not get them in Poland. She also sent dollars because she and other relatives could get things (meals in the hospital and some better nursing care) for dollars but not for zlotys. And those are just two examples of the “wonderful” socialized care one received back then. Fast forward to Democratic Poland. The system is basically bankrupt. People now have to pay into their insurance accounts. Not so free anymore. Better make sure you don’t have to go to work if your family member is incapable of doing for himself/herself in the hospital, because the nurses just deliver the food, but don’t feed - not enough time - too many patients - too few caregivers. You need to be there to take care of your own. You need to learn how to change sheets, too. My friends where I was staying watched her grandbaby. The baby had an ear infection. She called the doctor. Three month wait for an appointment, but if she was worried about the fact that the baby could go deaf, she could pay privately. It cost one months’ wages for the nurse (came one block to the house everyday with a shot) and doctor to treat the baby with antibiotics for a week. And they now pay premiums on top of this! In Germany, if you are self-employed, such as a vet, doctor, etc., you will pay HUGE amounts for medical insurance (thousands each month). The employer or self-employed pays in a huge amount and then the employee pays for it in taxes, too. And the system is so overburdened, that there are now restirictions, too, and everything is not free anymore. If you are an adult, you are now having to start paying a co-pay. Remember those days of free education? No longer. Cousin has to pay some tutition for college. That just started a couple years ago in Germany. Since the reunification, even with more people working and a huge tax rate, there just isn’t enough to keep covering all this. So as they are starting to back away from “socialized” medicine, we are heading for it? And look at Canada - it’s all free - if you can get the care - overburdened system with thousands coming to the States for treatment, or they might die while waiting to be seen by a doctor, and then how much longer once you are diagnosed? The concept is wonderful, but the application???</p>
<p>I agree that the health care is a big problem here in the US. The lack thereof, that is. However, having experience some of the “free” care in Europe and Asia, I can see why many Americans are loath to give up what they currently have. Particularly those who have health care. The problem we have right now is that health care is tied into what your employer has, that those who have employers with poor or no coverage are really up the creek. When my husband went on his own, we found that the cost of health care was very, very expensive, but we were still much better off than if he did not have a business. Try to get health care as an individual–I looked to see what was available on that basis as opposed to company, and found only one paltry offering that would have been woefully inadequate in a major health crisis, and expensive to boot. We were fortunate that our income could accomodate a large premium, though it hurt, but there are families that just do not have that kind of leeway in finances. And if you do have a catastrophic medical problem, you can end up in terrible straits if you run over limits or lifetime coverage. I know folks who are in this situation. They have had to put their child on Medicaid, and those are the lucky ones whose states and situations even allow that option. If you are privy to these stories you realize that our healthcare situation is scandalously inadequate for most families who end up with expensive health problems. </p>
<p>On the other hand, you see many British, Canadian, other foreigners in the waiting room who had to pass the tin cup around to get their kids here for treatment because some options we have here are not available in those countries or their kids would not last for the wait to get that care there. I have experience in this because I have a child with a medical issues that has cost millions in care. I belong to a medical listserve that has tales of financial woe from inadequate insurance and they would break hearts of stone as we are talking about children who can be treated and possibly cured, but devastate the family finances in the treatment. So, yes, we have the resources that many of these “free” care countries do not, but our price for them ruins many families who need to avail themselves of this care. I cannot come with a solution to continue and better our level of care, and yet expand it so that it is not such a financial burden, unless we devote a lot more money to healthcare. And I am talking about A LOT more.</p>
<p>FF–one plan means a fraction of the complexity in administering it. Every doctors office I know of employs people whose job is just to negotiate the complex requirements and allowances of each of the many plans their patients belong to. Additionally, each doctor spends hours a day on the phone with insurance plans figuring out what care they can give their patients, and trying to get permission for what they feel is necessary care that is not being covered (one of the main reasons my H left medicine.)</p>
<p>And no billion dollar salaries or stockholder profits means less money leaving the system for non-medical purposes.</p>
<p>Additionally, the leading cause of bankruptcy in the US is medical bills-and most of these involve people who actually do have coverage—it’s nice for those of you with Cadillac plans, but millions of Americans have plans that force them to be, as Cpt says, passing the cup for help paying.</p>
<p>“Opie–by your definition, education is a product, too. Would you like to privatize it and have some (most) education dollars go to some CEO and stockholders, or would you like to keep the dollars in the education system, paying toward education–and teachers?”</p>
<p>They call them principals and superintendents and assistant supers and so on… so no, not all education dollars end up educating anybody. Bad example, try again. And acually there is public and private education. If we could ever agree on what basic healthcare actually is ( like porn, it is in the eye of the beholder) and then allow for people to supplement their healthcare with additional bennies fine… the problem is What is basic healthcare? Should it include chiropratic, dentistry, vision, aroma theraphy and so on?</p>
<p>Decades ago I sat in our state’s capital listening to speakers make recs for what basic health care IS… 
We all laughed a bit when the people who support pryamids testified to the healing powers, but then sobered up when the next group wanted crystals as a covered expense. All of these people were serious and convienced that these methods should be covered. </p>
<p>The result of this formation of what basic healthcare IS,was most of the insurance carriers just simply stopped selling plans in the state. It wasn’t till a few years ago that they came back. </p>
<p>Here again is our problem with UHC, what is really basic? Sounds simple till you get detailed… been there seen that </p>
<p>" Why pay a myriad of CEO’s and the overhead of a zillion different plans and the thousands of workers who must administrate them, when the money could stay in the actual, you know, care of health?"</p>
<p>The problem really is paying a few ceo’s zillions, not the other way round. The thousands of workers? administrate? you mean the people who process claims? where would they go? You still need em and more of them. </p>
<p>“stay in the actual, you know, care of health?”"</p>
<p>What is that? is it the electricity to power the equipment, the beds, the chairs, what is the actual care of health? is it the janitor that keeps the operating room sanitary? the office person who keeps records? The cafeteria worker who helps feed staff? </p>
<p>What is the actual care of health?</p>
<p>“What is the actual care of health?”</p>
<p>Well, it is obviously important to pay CEOs hundreds of millions, make sure lobbyists pay our representatives thousands (they are paid off so cheaply), make sure millions are uninsured, millions more underinsured and struggling to pay other medical costs, that many services aren’t insurable, and that costs go up 3 times the inflation rate for years and years.</p>
<p>“Additionally, the leading cause of bankruptcy in the US is medical bills”</p>
<p>So should people buy disability or income insurance? </p>
<p>We are the goofiest folks when it comes to logically taking care of our responsibilities… I need a new couch, not life insurance. I want a fast car, not income insurance. I want to travel, not buy health insurance…</p>
<p>The only thing a single payor system would do is take before you do… that is the one advantage a tax over a premium offers, the lack of choice… everybody pays. </p>
<p>I admit for some that would be of great benefit. Not everyone who lacks insurance lacks the ability to pay for it. Sometimes they have the means, but lack the desire to own insurance… </p>
<p>Instead we listen to book pushers who create this illusion that if you follow what their book says you’re set… no need, no need… </p>
<p>gar ask your H who was the worst payor to deal with in HC. 9 out of 10 places are going to say the government, not private insurers… They aren’t better at paying claims, just the opposite. I have several medical professional accounts whom are owed millions by the feds, out more than 12 months for services provided… meanwhile they have payroll to meet. Maybe your H specality didn’t have much govt interaction. I guarantee you those that do aren’t all that pleased with uncle bucks ability to pay quickly either…</p>
<p>“struggling to pay other medical costs, that many services aren’t insurable, and that costs go up 3 times the inflation rate for years and years.”</p>
<p>But are you certain that the government won’t say no? are you sure there won’t be a cost that people will struggle to pay? Are you sure that costs won’t go up? </p>
<p>The reason I disagree is the solutions being offered are feel good for the momment things with absolutely no concept of what tomorrow brings… sort of like Iraq… yea, we kicked their butts… now we can’t leave and what does it cost?? </p>
<p>No body and I mean nobody is addressing claims. Sure I hate joe ceo as much as you do, it’s obsene what they make. But with about 40% of our health care dollars being spent on treating preventable conditions and ceo making up less than a half of a half of a half percent of the billions in cost, Which honestly is going to have a better impact on saving hc? </p>
<p>Yea, we canned ole joe ceo, here is your 25 cents savings. Oh, more folks used the “free” MRI machine for body scans and we have to increase taxes 2% to cover, not a problem is it?</p>
<p>There’s yet to be an honest politican out there to tell us the truth about hc in America, that if we really want to change it, we must change our habits completely to start reducing the certainities back to propabilities. To truly fix healthcare, we need to fix us from craddle to grave… </p>
<p>We won’t address the true causes because it means pointing the finger at ourselves. When was the last time you saw anybody take into account their actions in the situation?</p>
<p>I am a former federal and city government employee, and I can tell you I would never want to put my life and health in the hands of government employees. In general, there is little incentive to do your best or work efficiently. There is governmental immunity from liability, pay raises are determined by strict guidelines, and it is almost impossible to get fired. Is this the type of employee you want providing your medical care? I know I don’t.</p>
<p>Opie, most of us have no idea how deficient our insurance is until we hit a medical catastrophe. We had a B/C B/S plan that was considered great, and the literature accompanying it extolled it. It had a huge deductible, but great coverage thereafter. Supposedly the more doctors/hospitals than anything else in network because out of network had double that deductible. </p>
<p>Well, we had a major injury occur to one of the kids that behooved us to get surgery immediately for best chance of recovery and full use of body part involved. Nothing in-network was available–in fact he lay in the hospital on ivs for a couple of days waiting for a slot, before I checked him out and got him immediately to a doctor who took care of the problem ASAP. We owe $6K for that alone, not to mention other costs. Yeah, we can absorb it, but I know many families who would not. Plus we underwent 3 insurance company changes one year which meant 3 deductibles had to be met. </p>
<p>That is one of the reasons we are now behind the financial 8 ball for colleges. Lots of unexpected medical costs. And now that we are high risk for medical problems, we have to plan accordingly and colleges that we had hoped to be able to afford, and should according to our income and finances, are not good choices. We have to put health issues first. When you live through something like this, you realize how hard hit in the financial dept, health care be. It frightens me terrible. If anything happens to my husband, I don’t know what we would do for health care coverage.</p>
<p>Keep talking. I was going to get DS med insurance today (signatures obtained and checkbook in pocket) in preparation when he comes off our insurance 12/31. I can hold off a couple of more days.</p>
<p>Medicare is not considered to be a cheap insurance option. It is expensive for everyone involved. Part A’s deductible starts over it you are out of the hospital for 60 days. For Part B, you pay not only a monthly premium, but a 20% coinsurance. Part D has two deductibles and a monthly premium.<br>
For health care providers, you have to go through hurdles to get reimbursed by medicare/medicade. If you don’t participate in certain programs, they’ll decrease your reimbursement by a certain percent. The average reimbursement time is close to 4 months. Private insurers normally pay within a month.
It is not uncommon for health care providers to receive reimbursement for less than true cost. That is why doctors limit the number of medicare patients they cover. Many hospitals view medicare/medicade patients as partial charity cases.</p>
<p>“we had a major injury occur to one of the kids that behooved us to get surgery immediately for best chance of recovery and full use of body part involved. Nothing in-network was available–in fact he lay in the hospital on ivs for a couple of days waiting for a slot, before I checked him out and got him immediately to a doctor who took care of the problem ASAP”</p>
<p>what state are you in? Emergency should be handled the same across the board, most plans are specific in that regard. Your’s is the classic definition of emergency. </p>
<p>The blues normally have a reciprocal agreement amongst each other. My kid shatted his ankel in a lax game a couple years back out of network and state. They picked it up as if it were in our town. We spent about $4,000 towards a $40,000 bill. His rx and treatments outside our state were treated as instate for copays and fees.</p>
<p>if you want you can pm me with who your carrier is, I should be able to find their policies towards emergencies pretty easily. </p>
<p>The blues were intended to be the nations healthcare basic plans. They were supposed to be nonprofit orgs. In many states however, they have been purchased by the UHcares and such without so much as a peep from government. At least in WA, our insurance commiss shot down the attempt by our bc provider to go private… as it benefited nobody here. There plan was to become a regional player… that word keeps poping up…</p>
<p>cptofthehouse,
An underlying theme of this is that there is no free lunch. Someone still has to pay for the healthcare and Opie makes a very good case that the effect of bringing all insurance into the government would be to just transfer all (or at least the most significant component) of the cost to the government. This means higher taxes to provide the same amount of coverage. However, the the objective would not be just the same amount of coverage but rather to include everyone that currently is uninsured. While a noble objective this will have the net effet of increasing taxes even more. </p>
<p>So, while you may not be happy with the $6,000 cost for the (hopefully) one-time event, would you rather pay higher taxes for life? Also, what happens if the government decides that they can’t afford all of the facilities to provide an immediate operation like you were able to find with private insurance and, like in most single-payer countries, has to ration health care? Instead of having the option to get the immediate surgery, you may be forced to wait your turn. Something to think about.</p>
<p>“Keep talking. I was going to get DS med insurance today (signatures obtained and checkbook in pocket) in preparation when he comes off our insurance 12/31. I can hold off a couple of more days”</p>
<p>Check with your plan to be certain, many states are moving to age 25 with our without school for dependents. The key thing beining whose tax form does he show up on?</p>
<p>Whomever you go with, check and see with your state’s department of insurance to see if they are licensed to do business in your state and the person selling to you should be licensed as well. Always check. Always.</p>
<p>If the plan or company is not registered with your OIC, don’t buy it, it is likely a sham and you have little to no recourse if there is a problem. </p>
<p>Get your note pad out and play what if as you go through the plan summaries. Make sure you understand what your maximum liability would be in and out of service areas. In some cases you may have a $5,000 max cap for your expenses for the year’s claims and out of net, unlimited. </p>
<p>But it all starts with checking company and agent out with the oic to see if complaints are filed or if either is licensed.</p>