<p>Not just the admin overhead. </p>
<p>[JS</a> Online: High cost of high tech](<a href=“http://www.jsonline.com/story/index.aspx?id=733327]JS”>http://www.jsonline.com/story/index.aspx?id=733327)</p>
<p>Overall, healthcare is the least computerized of all the major industries. Most doctors and hospitals don’t use computerized health records; even though, they are widely available.</p>
<p>[Bloomberg.com:</a> Special Report](<a href=“Bloomberg Politics - Bloomberg”>Bloomberg Politics - Bloomberg)</p>
<p>[Bloomberg.com:</a> Special Report](<a href=“Bloomberg Politics - Bloomberg”>Bloomberg Politics - Bloomberg)</p>
<p>“Overall, healthcare is the least computerized of all the major industries”</p>
<p>not really about office computers, but moreso about diagnostic equipment. </p>
<p>What studies have shown is if they have it, they will use it. If they own it, they will use it a lot. 
Not every ankle injury requires an MRI, but if you have one, you’re more inclined to use the higher cost equipment. For a couple reasons… first if you “own” the higher cost equipment, you get paid for it’s use. Second, when cross examined in malpractice and the attorny asks “did you use every means available for your diagnosis?” what ya gonna say? Preventative practice sometimes means prevent the malpractice claim.</p>
<p>Health care is expensive because our system is geared to 80-100 million people having intermittent coverage, or none at all. Given this reality, it is in the best interest of any individual insurer to deny or delay care in the hope that the individual will no longer be on their dime when the care ends up being delivered. They have underwriters who make hefty salaries figuring out in good actuarial fashion how much care can be delayed or denied before it comes back to bite them. But for the system as a whole, it means that if/when individuals actually have coverage and manage to receive care, it is often for serious conditions that might have been avoided (and which may now require the use of the big machines.)</p>
<p>“But for the system as a whole, it means that if/when individuals actually have coverage and manage to receive care, it is often for serious conditions that might have been avoided (and which may now require the use of the big machines.)”</p>
<p>er, no. most plans have very good preventive aspects in their plan designs. Actually actuarially they know someone who is paying a couple hundred dollars a month for coverage that incurs a $600,000 claim is not good math. </p>
<p>You also live in a guaranteed issue state where individuals can’t be singled out for claims and if they have prior coverage they can wing walk. So, let’s say a state employee creates some very large claims under one plan. Then at open enrollment, they simply switch plans and walk away. Pre-existing isn’t an issue. So I don’t think your arguement holds much liquid. It is actually eaiser for a person in your state to hang a large claim on a insurer and move on to another, than it is for the insurer to drop the person. </p>
<p>Can you look at your own plan summary and tell us what percentage of preventative is covered? more than likely it will be 100% or 80% waiving the deductible. In most of the plans in WA you can’t get much better than 100% towards preventative. Even with that level of coverage (100%), does everybody partake? er no…</p>
<p>I can tell you that, of the plans that have been offered to me over the past 15 years, 12 of them stopped coverage after three years. Some of them re-emerged several years later to offer coverage again, and some of those quit again after three years, after the build up of denials and delays became untenable.</p>
<p>As for those with “intermittent coverage”, approximately 30% of all Americans, the build-up in service demand can be staggering.</p>
<p>But one of the reasons my single-payor plans works as well as it does is that once folks get on it, unless they move to the private sector, they never leave. I know of dozens and dozens of folks who have switch to the single-payor option, and not a single one who has gone the other way. The reason for that is simple: the premium is much cheaper (no underwriting, profit, advertising/marketing, and patients don’t jump in and out), the quality is higher (proven in continuing customer satisfaction surveys), the much wider choice of providers, and there is no waiting list unless you choose to be on one, because you can change providers anytime you want.</p>
<p>Ask Dick Cheney whether he’d prefer Aetna over CheneyCare.</p>
<p>“I can tell you that, of the plans that have been offered to me over the past 15 years, 12 of them stopped coverage after three years. Some of them re-emerged several years later to offer coverage again, and some of those quit again after three years, after the build up of denials and delays became untenable.”</p>
<p>Have you worked for the state of wa all that time? If so, your statement isn’t necessarily so. It isn’t that the carriers stopped coverage, it was more than likely another underbid for the WA employees account. What you are describing is a claims cycle well known in the WA insurance biz. First year, “congratulations, you picked up the state employees.” Third year, “the state employees claims are at such a point that we have to charge XXX” State says bye. Another company “gets” the business… the cycle continues.
I’ve seen it for a couple decades. First year pats on the back, third year claims are so bad we have to adjust premiums… </p>
<p>“But one of the reasons my single-payor plans works as well as it does is that once folks get on it, unless they move to the private sector, they never leave. I know of dozens and dozens of folks who have switch to the single-payor option, and not a single one who has gone the other way. The reason for that is simple: the premium is much cheaper (no underwriting, profit, advertising/marketing, and patients don’t jump in and out), the quality is higher (proven in continuing customer satisfaction surveys), the much wider choice of providers, and there is no waiting list unless you choose to be on one, because you can change providers anytime you want.” </p>
<p>You don’t have a single payor plan, you are under a tax payer susidized health plan offered. Please disclose the Cobra rates, rather than the employee premium as the cobra rates are the true reflection of the cost per person of the plan. What you pay for your portion is just the employee side. </p>
<p>And your plan is subject to the same conditions of any plan that insures a group. If or when claims rise above premiums collected, price will go up or the plan will go away. Just like before you’ll get to leave and go elsewhere within the state’s healthcare offerings if you find a better deal. You could drive a million in claims and walk with no obligation for the cost. no? It’s how it works here, as long as you have a place to wing walk to. Take away the other plane, well then you have to pay for what you incur. Sure you want that option?</p>
<p>“You don’t have a single payor plan, you are under a tax payer susidized health plan offered.”</p>
<p>I have a single-payor plan which is subsidized at EXACTLY THE SAME RATE as the other plans offered. The percentage paid by the state is set by law. If claims rise or fall, price rises and falls. It has for a decade. But always lower than the private plans, for reasons already stated. </p>
<p>And, unlike the other plans, it doesn’t experience the 3-year claims cycle of lousy care, followed by no care at all. That’s the general principle which combined with “intermittent coverage” for 80-100 million Americans, as to why “health care costs so much”.</p>
<p>“It isn’t that the carriers stopped coverage, it was more than likely another underbid for the WA employees account.”</p>
<p>Not true. We have the data. In fact, the Health Care Authority would LOVE to offer more choices. Just ain’t happening anymore. My offerings have gone from 9-10 to three over the past decade and a half.</p>
<p>Plus, we have collectively stopped dying of cheap-to-treat infectious diseases, and are increasingly becoming ill from diseases more expensive to treat. Baby boomers will live longer and longer, making their health care ever more expensive.</p>
<p>mini,</p>
<p>What’s the cobra rate? </p>
<p>then list what you pay. </p>
<p>“Not true. We have the data. In fact, the Health Care Authority would LOVE to offer more choices. Just ain’t happening anymore. My offerings have gone from 9-10 to three over the past decade and a half.”</p>
<p>Gee, and why do you think that is? </p>
<p>I sell the stuff and yes, you are absolutely correct… choice has gone down. We are a guarantee issue state. Groups 2-50 don’t answer any individual health questions and are pooled. Pre ex only applies if you haven’t had prior coverage. Every individual is Guaranteed some sort of health coverage to buy in this state. That is also why some national carriers don’t sell here, they cannot underwrite competitively so they choose not to. </p>
<p>We still have both blues and your personal favorite group health. All do a good job. Group death is still trying to get the market to forget how they were 20 years ago. </p>
<p>You’d have more choices if WA didn’t have the mandates they’ve installed. WA is pretty much a “cherry pick” free state, except for a few carriers. Yes, there are some bad ones, but Mike K does a pretty good job from their end. </p>
<p>Am I disappointed in the mandates? not really. It would be nice to have more offerings, but on the other hand the blues and group death all pay their claims with little hassle. In the old days some of the “cheap” plans needed alot of baby sitting, glad to see them go.</p>
<p>I checked WA employees benefit plans.</p>
<p>You are getting a great deal for the UMP (good design) for $28 a month employee rate and $87 for family (2008 rates). That is great for you, someone did some great contract work for you.</p>
<p>The Cobra rates for the same plan are $416.94 for an employee and $1126.15 for a family. Less 2% of course. Mini, pretty much for the plan design that’s an average rate. Nothing special. Your cost savings come from very good labor talks, not the health plan.</p>
<p>by the way, your dental rates are to the local market as well. ;)</p>
<p>“But one of the reasons my single-payor plans works as well as it does is that once folks get on it, unless they move to the private sector, they never leave. I know of dozens and dozens of folks who have switch to the single-payor option, and not a single one who has gone the other way. The reason for that is simple: the premium is much cheaper (no underwriting, profit, advertising/marketing, and patients don’t jump in and out), the quality is higher (proven in continuing customer satisfaction surveys), the much wider choice of providers, and there is no waiting list unless you choose to be on one, because you can change providers anytime you want.”</p>
<p>How are you defining a “single payor plan”?</p>
<p>"Aos Assurance Co., a Barbados-based start-up company, is offering malpractice policies for American medical tourists, working with Atlanta-based Crawford & Co. as a claims adjuster. The insurance pays settlements for malpractice without involving foreign courts or lawyers, said Paul Laverty, a former insurance consultant who co-founded the start-up company.</p>
<p>Malpractice Coverage</p>
<p>An American traveling abroad for medical care, for example, could purchase a $500 policy from Aos that would pay up to $100,000 in case of malpractice on a surgical procedure or spend $2,430 for coverage up to $1 million. Group programs could run from less than a dollar to $5 a month per employee, Laverty said."</p>
<p>This may be the answer for tort reform, and also make malpractice insurance companies even richer. </p>
<p>Why can’t we have that model here where the PATIENT pays the malpractice premiums instead of doctors, and there are $100,000 or $1 million caps depending on how much of a premium the pateint pays. This is great! Just send all of the high risk patients and procedures to Mexico or Singapore, and the price of medical care in the US will plummet. Actually, all of Southern California’s high risk patients could be shipped right from SoCal ERs to Mexico for procedures. But they will have to pay their malpractice premiums first or waive their rights to a trial if they think there is malpractice. </p>
<p>Takes a huge burden off of the US. This is NAFTA how it was intended!</p>
<p>This actually is the best news about malpractice reform that I have heard in a while. Go for it!</p>