My wife called for a doctor visit yesterday. They will see her in about 3 weeks. Nope, no waiting times in America. I had a specialist to see a mole on my back. The appointment was for 3 months later.
I disagree. Under a PPO plan (and POS, and Indemnity), you have the choice of any provider, but you will get reimbursed at a higher percentage if you use the provider’s network. 69% of people (in 2002…most recent easy-to-find cite) had choice of any provider. Under HMOs, you generally have to stick to the network, but your PCP can refer you outside if deemed necessary.
From http://www.doityourself.com/stry/ara_thedifferencebet
“National survey data from Mercer Human Resources Consulting shows that in 2002, 49 percent of employees in the United States were enrolled in PPO plans. In the same year, 31 percent of employees were enrolled in HMOs, 14 percent in so-called “POS” plans, and 6 percent in indemnity plans with no provider network.”
Saying it’s a small sample doesn’t make it so.
gonzomax…go to an Urgent Care Center. One of the benefits of a free-market healthcare system is a multiplicity of choices. UC centers straddle the line between ERs and PCPs.
-Cem
Just to take the edge off your zealotry, I’d be pretty surprised if the US set up a direct-competition situation. In the wake of our economic bender (and during our tenuous recovery), I’d be shocked if Obama kneecapped the entire industry.
Maybe it was your puny attempt instead of the evil DOI. Try write more good.
-Cem
I’ve found a more satisfying way. I take advantage of every benefit I am allowed under the terms of the policy, whether I need it or not. Mrs. Fear is entitled to $500 annually for a “hair prosthetic device”; this year I’m trying to get her to go for the Marilyn Monroe model.
“Happy Birth-day, Mister Presi-dent!”
You must live in a state that appoints rather than elects your insurance commissioner. Do note that “puny attempts” will not get action however.
Since they are now competing with a public health insurance provider (Medicare), and the private Medicare plans were selling well when I left the biz in 2007, I’d say it’s kinda doubtful that they will be driven out of business.
Excellent example of why I don’t want to be on the same policy as millions of my fellow countrymen… :rolleyes:
Not all doctors accept Kaiser, or Prudential, or United, or Blue Cross Blue Shield… so how is this different from private insurance? Or did you really not know that fact, that private insurance DOES limit your choice of doctor?
Of course, it is always your option to go to whoever you please if you don’t mind paying entirely out of pocket. But few people can afford that option.
Why don’t you try this, curlcoat - instead of making assumptions, such as “you probably worked for a GP’s office” you ask me “what sort of medical facility did you work at?” because, once again, your assumption is WRONG. I did not work for a GP’s office. At all. I didn’t work for a surgeon either so if there is a chornic problem for billing for them I’d be unaware of it. If there is then it should be fixed, whether that problem arises in private industry or a government problem.
I’m sorry - are you having trouble keeping up? I combine multiple posts into one answer, would it work better for you if I broke them up into separate posts?
I want him to be able to receive the medical care he needs, without which he WILL die in a short period of time! Is that SO unreasonable?
PRISONERS, people on death row, are guaranteed that much - why are honest citizens left hanging?
I want society to provide a safety net for EVERYONE, not just me and mine. I don’t want anyone to die in this country because they simply didn’t have enough money to pay the doctor (obviously, people die every day because we will never be able to cure everything, that’s not what I’m having an issue with). You act like I’m asking for a handout without any expectation that I, too do my part. Which is crap, lady - I pay my taxes, I have always paid my taxes. When I earned more money I paid more taxes than I do now. When I again earn more money I will continue to pay every penny of tax I owe (and since I have neither children nor real estate I do pay a higher percentage of my income in taxes than many people at my income level regardless of how much I earn). I don’t have a problem for helping to pay for my neighbor or the person in the next county or even YOU - so long as the burden is spread in a manner I deem fair. I acknowledge that what you and I think is fair may be two entirely different things but you still come across as a cold, heartless, nasty person who doesn’t give a shit if other people are suffering or dying as long as YOU get to clutch every last one of your pennies to yourself.
I don’t think it is at all unfair that you have insurance - what I think is unfair is that other people don’t have insurance. Or they have inadequate insurance. I care that other people are suffering even when I’m not, apparently you don’t give two shits about other people.
Really? I thought you have a problem with taxpayer money being used to buy medical insurance. Make up your mind - do you have an issue with this or not?
So you’re OK if people suffer and die as a consequence? That doesn’t bother you at all?
Given that the US is either the 3rd largest country in the world in regards to population it’s nigh impossible to find an equally populous country with which to compare. Did you just say we’re too big to implement such a plan?
Not that that is entirely without merit - which is why some UHC proposals suggest doing this on a STATE level, as the US states ARE comparable in population to countries that have had UHC for decades. Canada, as just one example, has UHC on a province-level basis. Given that the US states do operate independently on social welfare issues already (unemployment, Medicaid, etc.) this should be doable.
Is the problem that your friends don’t grumble, or that you have a shortage of friends?
This is a particularly bizarre idea of curlcoat’s in that Blue Cross Blue Shield already administers healthcare for 95-100 million people already, equivalent to the 11th most populous nation on Earth. That would seem to put to rest the notion that you somehow can’t administer healthcare for more than 60 million people. As Blue Cross also claims one of the lowest administrative overheads of private health insurance that would also seem to imply one can get efficiencies and savings from economy of scale as well.
Indeed.
Yes, but if the insurance company is not breaking the law such “threats” will do nothing. Nor can you change how a private company is run. On the other hand, if you don’t like what government is doing your vote does have the potential to change things to something you like better.
What is your take on the latest proposal here:
Does that meet your definition of fairness? If so, how?
So how did you resist the AIG bailout? It was a government handout if ever there was.
It is one possible solution, and justifiable if you take the stance that the wealthy have a greater stake in maintaining society as a whole since they benefit from a stable society. I do not feel it is an ideal solution, I think we can do better. However, even at 45% the top tax rate is still lower than that imposed in many other countries on the wealthy, so clearly it will not bring on Armageddon. I understand that no one enjoys paying taxes but I do believe progressive taxation can be an effective means of funding government. Failure to bring in adequate taxation in relation to government expenditures really is why California is such a basket case these days, and I attribute to the greed of people who refuse to pay the bills (via their taxes) for actually running their state while also refusing to cut programs. Either you cut programs or you raise taxes. If you refuse to do either you wind up paying people via IOU’s, which no one will accept because they know damn well they’ll never be paid.
However, I’d prefer a tax specifically tagged as for health care (much as we separate out SS and the like). It would still rise as income increases as some of those below middle class may not be able to fully subsidize their actual costs (others, such as the young and healthy just starting out in life, will initially pay in more than they take out, but if they live long enough they’ll recoup that down the road) but at some point it stops rising. Where, exactly, that point would be would have to be calculated by someone with more information and more adept than I am, but there are thousands of experienced actuaries with experience in health insurance matters that should be completely up to the task. This would be a progressive tax, but the wealthy have an interest in both reducing costs (by treating people earlier, when it’s cheaper) and avoiding civil unrest (which could happen if people are dying because they can’t access care but their neighbors can). Arguing against this is like bitching that the rich pay for an unfair share of police, fire, sewers, roads, etc. because their overall tax rate is higher. I have no doubt some people argue this.
A flat tax for the purposes of funding healthcare might also be deemed fair, although I’d have concerns about the impact on the lowest socio-economic levels. You don’t want to tax people to the point they can’t afford food or housing, that is self-defeating (see later and more expensive treatment and potential civil unrest). I’d consider it a tolerable compromise on funding.
The most important point is that in order to be fair EVERYONE has to be in the risk pool. You might choose to purchase additional coverage but you can not opt out and skip the taxes. I realize there are healthy people who claim they have no need of health insurance but they are not immune to accidents or contagious ailments and thus are at risk whether they admit it or not. Yes, this means those who don’t utilize services subsidize those who do but that is how insurance works! As proper medical care can restore the ill and injured to sufficient health and ability (in most although not all cases) that means those folks go back to paying taxes and their share of the medical costs, as opposed to our current system that leaves people bankrupt, suffering, unemployed, and an economic drain on society when they don’t have to be. Even where a person is permanently disabled it is STILL cheaper to provide adequate medical maintenance rather than to be in a cycle of crisis > expensive treatment > unaffordable care > crisis > rinse and repeat. It is a tenet of insurance that the larger the risk pool the lower everyone’s individual risk - the third most populous nation in the world (that’s us!) will have one hell of a large risk pool which means everyone’s risk should be significantly lower than at present, regardless of their current health status.
I answered this further up in the thread. As the HMO (particularly the capitated version) is becoming less common, out-of-network options (think like an Out-of-network PPO benefits) are becoming more common. PPO, POS, and Indemnity plans all allow OON utilization (and if I remember that link I posted earlier…roughly 69% of total national membership is in one of those three types…as of 2002. I woudl expect the 2009 numbers to be higher).
I’m fairly sure (anecdotally) that more docs refuse to take Medicaid and Medicare than are excluded from the more robust networks.
-Cem
Not to get too nitpicky, but I’d take anything listed as germane to BCBS with a grain of salt. Two factors…their massive network discounts (in the 80’s, it was almost a rite of passage for a doc to sign up in a BCBS network as soon as he grabbed his diploma), and their NFP status combine to give them an internal “flexibility” in creating Admin Cost exhibits and/or Network Discount exhibits.
Not bashing them…just a slightly different animal.
-Cem
I have a problem (forget about the fact I work for an insurance company) with a tax-funded UHC plan. What I think you’re missing here (and it will be HUGELY relevant in about 5-10 years) is that a big chunk of our population will be taking a big step down in their income, and therefore, tax burden. When the Boomers and their sense of entitlement start retiring en masse, your UHC plan’s utilization will skyrocket, and the funding will bottom out. Terrible idea.
Also, what about those that choose not to work, live on welfare, and don’t have taxable income? You may live in a Utopia…I live in Chicago, and I know there are Welfare hogs out there. Is it a moral good to provide UHC to people who choose not to work (and thereby avoid taxes)?
This is a terrible time to inplement a UHC plan. Boomers will gut it almost before it has a chance to get rolling. You and your children will be taxed out the wazoo for debts to the UHC system due to ageing populations. Boomers who have retired and live on 401(k) proceeds and SSN will avoid your progressive tax as well.
Oh…and think of the outcry recently about future generations being on the hook for our spending now. Do we really want to make that worse?
Thoughts?
-Cem
How do the wealthy have a greater stake? Doesn’t eveyone benefit from a stable society?
Agreed on cutting programs. What you don’t do is create massive new entitlement programs like UHC.
Using the threat of civil unrest due to lack of UHC is the silliest argument yet.
Agreed, a flat tax would be fair. What would not be fair is what the House Dems are proposing, namely raising taxes on the few to provide services to the many. Where have we heard that little song and dance number before?
So I ask , is there a reasonable argument to be made that taxing the few at 45%, while almost half the population pays 0%, if somehow “fair”?
When the boomers retire they’ll go onto Medicare if we DON’T have UHC - so how would having UHC be any different? UHC won’t cause that problem, that problem will occur regardless and will have to be solved either way.
As it stands now, people on welfare DO have tax-payer paid healthcare - it’s called Medicaid. You are ALREADY paying for them. Can we get everyone to understand this? You are already paying for the “welfare hogs” right now
Right now, the biggest chunk of people who are uninsured actually work for a living - either they forego health insurance (for whatever reason) or can not obtain health insurance (for whatever reason).
And they wouldn’t “gut” Medicare? You don’t seem to realize that whether we have UHC or not shortly the taxpayers WILL be paying for the baby boomers.
Again with the assumptions - where did I ever say I have children? Can everyone stop assuming so much about other posters?
No they won’t - progressive tax applies to EVERYONE, including retired people with incomes sufficiently high as to pay taxes - which is the vast majority. The better you save for your retirement the more taxes you will have to pay. Oddly enough, this seems to discourage no one from funding their 401(k)s or other investments.
Yes, but the rich have more to lose - more money, more property, etc.
You can create ANY program you like provided you pay for it. Cutting programs is not the ONLY solution to government debt and finances.
No? You think people wouldn’t riot over a matter of life and death? Hell, they riot over sports events, how can you discount the possibility of them rioting over something that really matters?
That is why I don’t particularly like what you linked to. The progressive tax should start much lower… just above poverty line, or at 150% of poverty (which is still a pretty modest income), then scale up from there. Just dunning the rich won’t work well because the rich whine so much. Everyone (except those truly destitute) should pay into the system at least to some degree.
First of all, I’m not at all convinced that half that population pays NO taxes, or even no income taxes. I’m sitting here with an income that is under the poverty line and I still pay some Federal income tax and I am required to pay state taxes quarterly. I realize some people have trouble believing that, but I have no real tax shelters (no mortgage, no kids, and so forth) so I, too, pay taxes.
Second, that group that would be paying 45% is a teeny fraction - even IF half the people in the US really don’t pay income tax (which I don’t believe) then the vast majority of the remainder will be paying between 1% and 45% - the tax rate does not go from 0 to 45 as soon as you step a penny over the dividing line.