You’re right, of course, and I agree with all your points. But I think the answer to that particular question is that the US health insurance system is so unbelievably screwed up, provider costs are so outrageous, and the whole system is so over-the-top overpriced, that the perception is that competition will allow consumers to choose the company that might screw them less than another, or might have a particular set of compromises that suit their particular health needs better, such as less extortionate deductibles or a better provider network. The perception is that if “choice” is good when selecting a car or a washing machine, then it must surely be good when it comes to choosing a health insurer.
This is of course completely wrong because the sole purpose of a health insurer is to pay your goddamned medical bills – beyond that, they add no value. The correctness of what you say is borne out in single-payer, which has the following insurance paradigm: if someone is sick, they get treated, unconditionally. Then the provider who treats them is paid in full, unconditionally, by the single-payer fund. It’s a very simple system, because it turns out that the algorithm of “paying your goddamned medical bills” is very straightforward if you’re not in the business of pumping up your profits by scrutinizing every claim to try to find a reason to deny it or cut corners on payouts.
This is such a stupid claim that it deserves special attention and derision.
Choosing a social policy of shared health insurance costs is not in any way challenging the validity of actuarial science. It’s choosing to value a principle other than mathematics and statistics in the effort to help individuals in spite of their obvious and undisputed differences in likelihood to require medical services.
Republicans are anti-science not because they choose a particular social policy that’s at odds with some scientific findings, but because they seem to misunderstand the very concept of science.
Try to imagine a mainstream Republican making a statement like: “Biological science has pretty well determined that evolution is the best explanation for diversity of life on the planet, but we still feel it’s important to educate our children about our socio-historical creation myths” or “There’s little doubt that anthropogenic climate change has occurred and will occur. However, we still feel that reducing fossil fuel usage or instituting taxes would cause greater short-term harm to our economy with few gains due to collective action problems.”
That was his closing statement by the way. As a member of the House Committee on Science. Not a question. Not a request to learn more. Just a proud statement that he didn’t know what the fuck he was talking about.
If you take the concept to its logical conclusion, you have single-payer. Does single-payer acknowledge actuarial science? Absolutely! It’s used to determine the health care budget, which then determines the required revenues. It’s actuarial science at its best because it deals with the entire population, a known quantity that is large enough to have predictable statistical characteristics.
The fact that actuarial science isn’t used to justify extortionate rates or deny someone insurance isn’t a problem, it’s the primary benefit. Rates in public health care systems are typically not risk-based at all, yet that’s one major reason that it costs everyone less than a private insurance system.
The ACA isn’t that, of course, but it’s taking baby steps in that direction, so of course the right-wingers are whining and shrieking about government overreach and the imminence of apocalyptic socialism.
And now maybe we can ask what sort of science the Republicans embrace. I’m thinking here of sciences like economics, biology, cosmology, and the perennial favorite, climate science! In Virgina, state Republicans have so embraced science that they’re dealing with rising sea levels [using the King Canute method](The funny thing is that the main chart of ECS probability distributions in the AR5 was graphed against a background showing 2 to 4.5 as the nominal probable range, and was changed to 1.5 to 4.5 just before final publication – that’s how arbitrary that determination is) of commanding the sea not to rise. Now that’s science!
If you purchased your own insurance, would your boss increase your salary by $12,200 per year?
Also, have you looked for insurance off the exchange? Private insurance was and is still available–you’re not limited to either employer-provided or the exchange. We buy our insurance (we’re self employed) on the private market–it was a better deal for us than the exchange (due in part by lowered rates, presumably to keep competative with the exchange).
Lastly, the seven grand didn’t magically disappear into the CEO’s pocket. One of the little-heralded but major improvements to the system is that the ACA limits insurance company’s non-medical spending to 20 percent of collected premiums (forgive if details on that are slightly off). On top of everything else we received a rebate check from our insurance company.
Hooray Obamacare!
I wonder what rates and buy-in would be like if the republicans weren’t so focused on being the ‘party of no’ and doing everything they could to make Obamacare harder to implement. Implementation isn’t without its organic issues, but just imagine what it woudl be like without the intentional sabotage. Shit, just think about the states that did their best to hide information–how many more people would have signed up?
Is your point that such a transgression wouldn’t technically be categorized as fraud? That would be splitting hairs, IMO. Because regardless of the particulars of a given state law, this is a significant sales practice abuse, and I’m not aware of a single state DOI that would NOT consider this cause for sanction and rescission. This would be a big deal and could get you fired at my firm.
It’d be a big deal if they knew that what they were saying was false, if they had data they weren’t showing you that contradicted their claims. Note the difference.
If I’m reading the thread correctly and you’re not talking about something else, then it’s very far from fraud and your job would be safe. Here’s what I’m seeing (emphasis mine):
[quote=“ITR_champion, post:60, topic:685021”]
Neither Pelosi nor Obama phrased what they said as predictions; they phrased what they said as simple, factual statements. **If I meet with an insurance company representative who promises that the price for a certain plan I’m signing up for will drop by $2,500, and it instead rises by a huge amount, that company would be in danger of prosecution for fraud. **
and
That’s a prediction on its face “I will sign.” The link he provides to say it’s a lie, one that includes terminology just for that, instead calls it a broken promise.
It would take an incredibly partisan view, one that would make even Rush blush, to say that it’s a lie because that would mean when he made the statement he actually wanted something different and knew he would be working towards something different.
This is in response to Rhythmdvl as well. I was reacting to the assertion regarding this statement: “If I meet with an insurance company representative who promises that the price for a certain plan I’m signing up for will drop by $2,500, and it instead rises by a huge amount, that company would be in danger of prosecution for fraud.” That statement is extremely problematic in the insurance business. This is an enormously regulated industry, and even marginally ambiguous statements are a no-no. An unequivocal statement like this is right out. There is typically lots of disclosure required, which the applicant must acknowledge in writing, and no literature or brochure–or anything–is permitted without approval by the Compliance department. If a statement like this was made, followed by an increase in premiums, that would be a big deal even if the rep had no data to contradict his claim and was pretty certain of it.
You can’t say stuff like this unless it is accurate, and anything that’s uncertain needs to be strenuously emphasized as an uncertainty. You can’t create an impression of certainty, even if you never outright say it’s a certainty. While there may be gray areas, DOIs err on the side of the consumer. Take it from me, it’s a real pain in the ass and reps need to be very careful how they position something.
If your point is that Obama never made such an unequivocal statement, I don’t know if that’s true or not. But IMO, the “sell job” of ACA certainly would have been a sales practice no-no, creating an overall impression that no one would have to lose their existing coverage if they liked it, premiums would most typically be lower, etc. In our business, statements like “the cost of a typical family’s premium will be reduced” would in all likelihood be struck by the Compliance area, and even if it wasn’t it would be followed by bold disclosure that the applicant should not rely on this and could well have higher premiums.
Just reacting to Snowboarder Bo’s post and sharing my experience. I also acknowledge that the president is not subject to the rules and law mentioned when discussing proposed legislation. Which is a good thing for him, because he’d have been dinged by the appropriate regulatory body.
I guess the answer is incremental change: first came science, then came medical marijuana, then, etc.
Best I understand, more people are getting covered, the fuedal linking of employment and healthcare is weakening, it’s generally cheaper, and the upward trend towards 20% of GDP will turn around. Maybe that’s not bad for a start.
If the sky doesn’t fall in or communists don’t overrun DC, more incremental steps might be taken in time.
Because of how ingrained it’s been - how it’s been associated with almost a national ideology - I’d guess change is a generations-long project.
Speaking as someone that lives there and actually has such a policy via his employer:
The most interesting part of it is that the vast, vast majority are offered by employers as perks. People very rarely choose to purchase it, it is just there when you get a job. I’ve been at my currently employer for over a year and have never once actually used my insurance, despite being a type-1 diabetic. I don’t even have the card with the phone number on it (it came up in discussion the other day with a workmate that was using it to get a free physio session - a session which via the state would cost a MASSIVE 100 SEK per session up to a maximum of 1100 SEK/year, a value that covers all non-dental healthcare costs).
So in essence I wouldn’t read too much into the amount of policies. What is of more interest is the amount of private companies providing services under contract for the local authorities. Capio is one such company, they actually run S:t Görans hospital where I go for my regular diabetes checkups. I’m torn with this, the service has not suffered (although there appears to be issues with the sharing of medical records with non-Capio hospitals, at least there was when my girlfriend was there last year) but the knowledge that ultimately they are responsible to shareholders makes me uncomfortable.
Apparently they are currently the only such hospital in Sweden, but there are other services run by Capio in Sweden:
This line of argument gives me flashbacks to around eight years ago. Everyone knew, by then, that almost everything President Bush and his Administration had told us in order to justify his war in Iraq was false. He said Saddam had lots WMDs, but Saddam had none. He said Saddam was trying to acquire uranium, while Saddam wasn’t. He said Saddam was collaborating with Al Queda, which was untrue. He said that the war would cost two billion dollars, and the cost ended up being in the trillions. He said that the war wouldn’t last more than six months, but it lasted many years. Yet a few of his defenders insisted that Bush never lied to us. Yes, he said some things that turned out to be untrue, but can you prove that he knew they were untrue when he said them? Obviously we can’t prove what he was thinking, absent mind-reading capabilities. We can say that the President and his Administration were either lying through their teeth or dumb enough to believe their own propaganda. We can’t prove that it’s the first rather than the second. And the same is true for the current Administration and its health care law.
You really think it’s comparable? Really? There’s lots of evidence that all of the Bush gang were lying, Rumsfeld and Cheney in particular, but I don’t even want to go down that rathole. What I would ask is if anyone could possibly think that the self-serving criminal gang of former members of the Project for a New American Century who had drafted plans for US hegemony in the Middle East before Bush was even elected and subsequently became senior members of his administration could possibly be compared to Obama’s interest in improving the state of health care for the common good. Unless you believe that killing thousands of Americans in an unnecessary war and tens of thousands of Iraqis is morally equivalent to trying to bring health care to the poor and needy and impose some regulation on health insurers to prevent coverage denials and lousy policies.
Sure–and if you care to do an advanced search, you’ll see I made a highly legalistic argument way back then that said the only smoking-gun-time he lied involved a false statement he made about yellowcake. He might not have known the statement was false when he made it, but it was, and he made the statement as part of an effort to deceive the public.
The difference, of course, is that now we know for sure that there were no significant WMDs in Iraq. If you think it’s time to call the game on Obamacare, well, I have a great metaphor/American Pie reference, but I probably shouldn’t use it in this forum, so I’ll just say I think you’re a bit on the early side :).
