Where's my fucking affordable health care, you fucking fuck? [lame]

The BBQ Pit
121

Why do you think this?

The government (funded by the citizens) supports services to keep us safe (defense, law enforcement), supports infrastructure, and educates us for 13 years… but health care doesn’t fall under the same category? I don’t get it. What is the difference?

We all pay for everyone’s education (whether we have kids or not), which is necessary and critical for the prosperity of our country. We pay for roads, whether or not we drive on them. Commerce and trade wouldn’t be possible without the infrastructure. These things are paid for by the government because they are necessary for the well-being of the whole of society. So everyone chips in, and everyone benefits. So on and so forth. So why shouldn’t we pay for one of the most fundamental and necessary things in life - health care? It seems so fundamental to me.

122

Fuck you. I work hard every day to design coverage that is comprehensive and affordable for working people. My industry is no more “greedy” than any other. If you don’t like the free market system, work to convince enough of the population of the superiority of your alternative to change it, or move to North Korea. There are no greedy corporations over there, I’m sure you’ll love it.

123

I always find it amusing, people who expect me to be impressed that they can compare their system favourably to North Korea.

124

What? Nobody is talking about libosuction or facelifts here! Nobody expects to have things that are not medically necessary - as defined by state statute - covered.

One of the issues I follow is state-mandated health insurance benefits. For example, as hard as it is to believe, states has to FORCE insurers, by law, to cover such necessary things as: cancer screening (mammograms, pap smears, colonoscopies); minimal hospital stays for new mothers; mental health treatment/medication; hearing aids; contraception; screening for osteoporosis; etc., ad nauseam. That’s right, folks! Insurers wouldn’t cover any of that on their own, the states had to pass laws to force the insurers to give their customers what they paid for.

Clearly, something as important as yearly pap smears and mammograms are medically necessary!

Who the heck ever said that nose jobs for cosmetic purposes are medically necessary?

Regarding the bariatric surgery - all the states have been introducing manadated benefits bills over the past couple of years trying to include obesity treatment (including bariatric surgert). BUT the laws are clear - only in medically necessary (life threatening) cases. Not for cosmetic purposes! The criteria are very stringent!

I’ve never heard of there being any issues about insurers covering dermatological issues (such as “pimple cream”)… but the issue of covering infertility is a really interesting one that could be debated ad nauseam. Again, practically every state has introduced infertility mandated benefits bills in recent years. But so far, most or none of them have passed. (I could look this up and see, just FYI).

125

Come on, Dave, don’t you feel bad for some of your clients? People who have to spend GINORMOUS portions of their income just for basic health coverage? Or not even basic coverage - many individual policies exclude mandated benefits, or have exclusionary clauses or modification riders which exclude certain conditions. And they are still paying crazy amounts.

Why are so many uninsured? BECAUSE MOST PEOPLE CANNOT AFFORD INDIVIDUAL HEALTH INSURANCE, yet they make too much to go on Medicaid. So they just go without. Why do so many small businesses not offer health insurance? Because small group coverage is unaffordable. So, years pass, teeth rot and fall out, cancer goes undetected, arteries clog, cholesterol rises, then they die needless deaths of preventable conditions. Nice, huh?

So Dave, somewhere, deep down inside, don’t you feel bad when a family has to pay more than their monthly mortgage payment for their monthly health insurance premium?

126

Cases in point:

http://www.consumerreports.org/main/detailv2.jsp?CONTENT<>cnt_id=160135&FOLDER<>folder_id=18151

Read all about the “strategies”… which basically means you’re paying a whole lot more for a whole lot less…

Read about the woman whose yearly premium got up $18,500 before her insurer cancelled her. I have read so many stories like this, they’re everywhere, and they are heartbreaking.

127

No health insurance plan I have ever been a subscriber to covered any of those things, as far as I am aware. From my limited experience, they stopped covering elective stuff years ago. Why would people assume that they can get all that shit if the government was running the show?

It’s a simple equation, really. A larger pool of subscribers means cheaper premiums and/or less out-of-pocket. Why the hell shouldn’t we attempt to spread the risk among the largest possible subscriber pool?

128

I mean, other than the fact that it would put a serious hurt on the insurance industry. Which many people will not exactly shed tears over.

129

Another point that should be made. There’s another villian and victim in this game - employers. People are uninsured because their employers don’t offer health coverage. Why do employers not offer health coverage? Because usually they are small companies, and it’s too expensive. So while we blame them for not providing the coverage, we also remember that they too are victims of the insurance industry…

…well most of them. Not giants like Wal-Mart, the biggest company in the US. Most of their employees are uninsured. It’s not like they couldn’t afford it, it’s just that they choose not to.

Well many states are coming up with creative ways to “encourage” employers to provide coverage. Dave, I am sure you are familiar with the recent bill from MD attempting to get Wal-Mart to cover its employees.

Why does the state care? Because all those uninsured people (working people, mind you) show up in emergency rooms, and the state (aka the taxpayers) have to pay those hospitals for the uncompensated care, or they end up on Medicaid, also courtesy of the taxpayers.

So many states are introducing “pay or play” bills. These measures some sort of penalty on employers that do not provide health insurance for their workers. This fee usually goes into a fund to reimburse Medicaid expenditures.

These penalties could include a fee, tax or assessment. Such as, requiring every employer to report how many employees they have who are uninsured, and they get a bill for it. Or instead of that, the state posts the list of deadbeat employers publicly for all to see. Another strategy is to require Medicaid recipients to report who their employer is so they can be charged or publicly embarassed.

Other pay or play bills mandate that the state can only contract with companies who provide health coverage. Want to pave roads or build a bridge? Well, your people better be covered or you’re not going to get the job.

I love it! I get so excited every time I see these bills (as well as all the insurance reform bills). So yeah, it can be fun to be a legislative researcher!

130

Oh I forgot one. A little bit nicer way to encourage employers to provide coverage is to give tax breaks or credits to the ones who provide health insurance.

131

You just don’t get it, do you? I absolutely do not feel bad about what I do, in fact I am quite proud of it. I work directly with all of those people you talked about earlier, “the self-employed, employees of small firms that don’t offer medical insurance, people between jobs, young adults moving off their parents’ policies, widowed or divorced people who have lost their spouse’s group coverage, and people who retire early and lose their group health coverage before they’re 65 and old enough for Medicare.”, and when I am able to get people coverage they couldn’t previously afford, or if I am able to save someone a significant amount of money on a policy, I feel pretty good about myself and about my profession

And yet at the same time you complain because rates are going up. Talk about blindness! If you paid any attention at all to my previous post, you would have noticed that that is exactly what I am talking about. When it comes to health insurance, people don’t want insurance, they want an entitlement. All of those things you listed should be the types of expenses that people pay for out of pocket. Insurance should be there to cover them if they get sick and to protect them against major loss if they need hospitalization or surgery or other major medical care. This is how every other type of insurance other than health works. If HI worked like that too, HI rates would be low, like they were 30 years ago. Instead, people demand more and more minor stuff be covered, they lobby their legislatures, mandates are passed, and then people complain bitterly as their rates go up and up. YOU CAN’T HAVE IT BOTH WAYS. Why this simple concept is beyond so many people baffles me. That’s why I like the way we do build policies. I lay it all out for the customer. You want this covered? It costs $X. You want that coved? $Y. That allows the individual consumer the opportunity to design their own plan. If they want all that extra stuff, great, they can pay for it and have it. If they don’t, they don’t have to. Choice. It’s a beautiful concept. Oh, and BTW, the risk is spreead over a pool of over a millon folks nationwide.

132

Because now it’s “free”. If you don’t understand that, you need a little more exposure to human naure. A government program that provides 1 free can of dog food a week per dog breeds puppies.

133

Well I do commend you for this, but isn’t it heartbreaking when a hard-working family has to give up important benefits and still pay a huge percentage of their income for incomplete coverage? Isn’t is sad that a family has to pay as much as their mortgage or rent for bare-bones coverage? To me, it’s heartbreaking…

Dave! Come on! People should pay out of pocket for yearly pap smears and colonoscopies and mammograms and cholesterol checks? If that was the case, many or most of the “working poor” would opt not to get these done. They would choose to make the rent or put food on the table - things that are immediate needs.

Then what happens? They don’t get preventative health care and screening, and something that could have been caught early and dealt with inexpensively becomes a death sentence. And yep, you guessed it, it actually becomes MORE expensive to deal with in the end.

How is this a good idea?

You’re saying we chould just go around, waiting for the heart attack, or the lump in the breast to grow big enough to detect, or the bloody stools… why, because we have coverage for a “major loss?” We’ll just deal with it once it gets serious or “major”?

Heh, well news flash! By the time you need the coverage, it’s probably already too late!

Dave! Damn! Most of the most common causes of death, such as cancers and heart disease, are totally preventable with regular screenings and preventative care! And it’s much less expensive to provide preventative medicine that it is to to treat a major health catastrophe!

I. CANNOT. BELIEVE. YOU. DO. NOT. GET. THIS!!!

It may cost $100 a year for a 15-minute gynecological exam and pap smear. And maybe another hundred or two for a mammogram once you’re of a certain age. I guarantee you that amount over a lifetime is MUCH CHEAPER than if you were to wait until you were sick and have major surgery or cancer treatment!

It may cost $500 a year to cover cholesterol screening and cholesterol-reducing medication. But I guarantee you that is a lot cheaper over a lifetime than a triple bypass!

AND most importantly… those amounts are a lot cheaper than DEATH!

So go ahead, tell your wife not to go in for her yearly exam… don’t take your son in for teeth cleanings twice a year. I know you all ain’t rich, you could probably use that money for your rent or to fix your car or something. So, go ahead. Don’t complain when your wife ends up with a tumor the size of a baseball and it’s too late to save her.

134

OK, I lied. I’m back. The reason I’m back is to allow that you have a bit of a point there - but only a bit and you have to allow for exceptions.

I do not agree with you that all the things nyctea scandiaca listed should be out of pocket (I mean, c’mon! Letting a mother have one night in the hospital after giving birth? What should be out of pocket about that? Anyway…), you are, in general, right with that one. I don’t expect my car insurance to cover my oil changes; I don’t expect my renter’s insurance to cover the battery in my smoke alarm. So, OK, I can agree that routine maintenance of my body should be paid for by me, with my insurance kicking in when I get lung cancer or have a stroke.

But what if I had three kids and had a stroke? Suddenly, I’m living on long-term disability. Suddenly, I cannot afford their routine maintenance. Who’s going to pay to vaccinate them? Who going to pay to take out the appendix of the oldest son? Who’s going to pay to rehabilitate me from my stroke?

You and me, that’s who. One way or another. Why don’t we just sit down together and figure out what is the best way, the cheapest way consistent with good care, the most moral way, to ensure that all citizens of this country get the medical care they need when they need it?

135

One more thought…

Sigh. Such is the fate of America’s working poor. Another example of what is terribly wrong with this country.

136

Well how about this: let’s not let it get to that point. Take care of yourself, get routine checkups and preventative care, and it is likely you would never have the stroke in the first place.

When you first start experiencing the headaches and blurred vision, you can go to the doctor, and not have to choose between your mortgage and the cost of an MRI scan.* The problem is caught and fixed, you recover and return to being a productive member of society, contributing to the pool and everyone’s happy and healthy.

  • Be real, people. The working poor, the very people who are uninsured, they don’t have a lot of cash on hand. Do you know how much it would cost out-of-pocket to be seen by a neurologist, or to have an MRI? There’s no way a family living paycheck to paycheck could afford that. So, in this scenario, most of the time the person is going to not be able to afford the doctor visit to detect the swollen blood vessel in his brain. He’s doomed - doomed for being poor.

And that FUCKING SUCKS.

137

Shit, here’s a good anecdote.

I have a good job and make well above the poverty level. However, even I would struggle big time if I didn’t have health insurance.

For example, recently I developed a really bad uniary tract infection. I was literally peeing pure blood and blood clots. I have never felt such pain in my life. I had to go to one of those urgent care centers. Before being seen they needed to see my proof of insurance. If I didn’t have insurance, I would have had to pay out-of-pocket, on the spot.

The whole visit and the medication cost more than $200. To be quite honest, if I hadn’t had insurance, I would not have been able to afford the treatment. You know what can happen if a UTI that bad goes untreated? It moves into your kidneys, and can shut them down in a matter of hours, and you can die.

You may say, well that is an example of a “catastrophic” illness. Perhaps, BUT most individual policies have huge deductibles - thousands of dollars. I certainly could not afford to pay that much. So I guess I would have been screwed, huh?

I guess people like that just deserve what they get, huh? Too bad for them if they can’t get a job at a company that provides health benefits!

138

Oh, and just to make it very clear, what do you think would have been more expensive… the $200 for an urgent care visit and a prescription? OR the amount it would cost if it went untreated, I had to go to the emergency room, my kidneys failed, and I had to be on dialysys for life or get a transplant? You think the insurer would rather pay for all that instead of “nipping it in the bud” early, for much cheaper?

This concept defies logic.

139

No Dave, you don’t get it. Other industrialized countries with socialized medicine pay less per capita and have better basic care, and moreover basic care for everyone. Some expensive diagnostic procedures sometimes get a bit of a short shrift, it’s true, but the problems are generally manageable. Socialized medicine does not result in of your lurid imaginings of catastrophe. You can look it up. It does, however, eliminate most of the crap that nyctea scandiaca is talking about. You can look that up too. I realize that Americans have been brainwashed into thinking that universal health care is equivalent to Stalinism by the pharma and insurance lobbies, but this message board is supposed to be about fighting ignorance, not perpetuating it.

I mean really, what does it tell you, that in every industrialized nation with universal health care it is political suicide to talk about moving to a US-style system of health care delivery. Is the rest of the western world engaged in mass irrationality? Or do we just know something you don’t?

140

The problem is that none of the choices you can offer under the present system offer as much benefit for as little cost as a UHC plan can.

Bootleggers during Prohibition in the U.S. probably felt pretty good about themselves, too. They were filling a need and offering their customers choices, as well. You want bathtub gin? It costs $X. You want watered-down beer? It costs $Y. You want the very best smuggled liquor, you can pay for it and have it. If you don’t, you don’t have to. Choice. Beautiful concept.

Still, in most of the developed world, everybody who needed (or wanted) it had access to tipple of equal or better quality, at substantially lower costs – and fewer people died because of a less-than-ideal system.

What policy do you offer that compares well cost-wise with the coverage offered under socialized systems, and provides the best standard of care, while extending coverage to those who can’t actually pay for it?

Choice is good – and people can choose to change the system. Privatised health insurance offers a middling deal for those with enough money to throw at it, and a raw deal for everyone else.

Of course socialising U.S. Health Care is something that insurers and gung-ho capitalists would hate to see. Nobody likes anything that has a negative impact on their bottom line, or goes againt their ideology. Bootleggers and teetotalers probably were probably pretty sore about the 21st amendment, too. Sure, some people will lose a nice revenue stream, and some people will be offended on principle-- but on balance, it’s all to the greater good.

NB: I am not suggesting a moral equivalence between insurers and gangsters. The analogy only speaks to the costs/benefits issue.