Thank you Massachusetts!

[Guest050715-1]

Originally Posted by Rudyard K

What a joke!! One election is won and folks start talking about other’s wanting people to die..................

RK, thank you.

Ans! Shout it from the mountain top! Oh, bring on the mid-term elections!

I’m so not Republican or Democrat. If there was such an animal, I’d be a yellow dog Independent. And I’m all for nationalized healthcare, but these bills ain’t it. Hopefully it’s back to the drawing board. Maybe they will come back with something that isn’t / doesn’t burried under $300,000,000 given to a Louisiana senator, exemptions for certain states, bar humans from obtaining regulated insurance if they are illegal and include a tax on individuals if they can’t afford to pay for insurance.

I actually read that the Senate and House leaders are going to try to present something to the President before Brown can be sworn in.

The people have truly spoken. I never, ever, EVER thought I’d thank Massachusetts for delivering on something I politically agreed with.

[WTF]

Originally Posted by OliviaHoward

The people have truly spoken.

Olivia, Mass. does not speak for me!

[MrGiz]

I am not a Bush supporter... he spent/wasted way too much of OUR money!! Not just on wars.... but a long list of wasteful, useless, domestic give-away programs to individuals and corporations too! (although, it's Congress who approves the vast majority of all spending... not the Executive Branch!) (useless point, I know...)

I am certainly not an Obama supporter, either.... but all these lame excuse/comments about Bush, our past Idiot In Chief , infuriate me!! We have a current Idiot In Chief & Staff who has already out-spent, out-wasted, out-stolen , and out-lied the past IIC in his first year!!

The money belongs to us! How many ignorant, non-attention paying morons don't realize that? Trust me.... there are many!! Of them.... who do you think they may have voted for?

The number of uninsured in the USA has been reported to be between 30 and 50 million. Just for shits and giggles.... let's assume the number is 40 million.
The cost of giving everyone of them a standard yearly health care insurance plan worth $5K would come to $200 Billion. How much of that insurance coverage would actually be used? Not as much as many think.... most people never even use the current health care system... even when they are insured!!!

There is no question, that Insurance Companies are raping us to tears!! Health INSURANCE Reform is absolutely necessary.... not Health CARE Reform!!

If a system could be created where un-used premiums re-enter the pot every year.... and if Insurance Company Regulations are changed to include portability across state lines to force fair competition.... is it not reasonable to expect policy premiums might (at least) level off... if not decrease? Couple simplistic themes like that with other simplistic regulation changes like the elimination of "pre-existing condition" denials , physician's mal-practice legal & insurance reform , closer inspection and enforcement of fraud & waste..........

I realize the above comments are overly simple.... and many more changes are necessary..... but why can't our elected Congress come up with simpler / more reasonable, black & white , nuts & bolts , dollars & cents solutions which aren't covered up with 2000 pages of corruption , bribes , and theft by the useless 535 of them?

You want to know why? Because we are too stupid to kick their dishonest , corrupt asses out of office!! Yesterday's miracle in Massachusetts might be a step in the correct direction!

IT IS ALL OUR FAULT !!

Giz (is pissed!)

[otrdriver]

The breaks the union has lobbied for is to cover the union costs. The unions realise they cannot cover the costs in the future with the cadallic healthcare they have recieved over the years. For this reason the union WANTS single payer so that when or if the tax (remember no tax increase for low income workers) on cadallic plans takes efect the union can force their people over to single payer to make the PEOPLE pay for the union workers health care plans. Do your own reasearch and you will find that most union workers do not pay for healthcare nor do they have a co-pay when seeing a Dr. In addition thiese plans are paid for life by the employer. (sweet deal negiated long time ago by the unions)

As for Gov't Motors and Chrysler they are public companies or at least they were, Those of us know that if we make bad mistakes in our business we suck it up and re-organise or file BK. Now that the Gov't owns both of these companies Ford has posted record profits. The public is voting with their feet and now buying Ford not Gov't motors.

If you check the numbers of un-insured most are the young low income that either don't feel they need insurance or cannot afford. Now if every state resident was able to purchase medical insurance from any of these companies the private sector would see med insurance cost drop due to competion. BUT the Gov't will not allow cross state line competion. (i.e. Calif 1300 companies offer health insurance in the USA, only 3 available in the state of Calif.)

[pjorourke]

Originally Posted by MrGiz

The number of uninsured in the USA has been reported to be between 30 and 50 million. Just for shits and giggles.... let's assume the number is 40 million.
The cost of giving everyone of them a standard yearly health care insurance plan worth $5K would come to $200 Billion. How much of that insurance coverage would actually be used? Not as much as many think.... most people never even use the current health care system... even when they are insured!!!

There is no question, that Insurance Companies are raping us to tears!! Health INSURANCE Reform is absolutely necessary.... not Health CARE Reform!!

If a system could be created where un-used premiums re-enter the pot every year.... and if Insurance Company Regulations are changed to include portability across state lines to force fair competition.... is it not reasonable to expect policy premiums might (at least) level off... if not decrease? Couple simplistic themes like that with other simplistic regulation changes like the elimination of "pre-existing condition" denials , physician's mal-practice legal & insurance reform , closer inspection and enforcement of fraud & waste..........

No offense Giz, but I'm giving you the award for the most ignorance professed on this subject today. I like you, but your comments indicate that you have no concept of insurance whatsoever. Where do I begin?

How about here "The cost of giving everyone of them a standard yearly health care insurance plan worth $5K would come to $200 Billion. How much of that insurance coverage would actually be used?" Well probably $5,000 per head -- if the plans are worth $5,000 then thats the average cost. Somebody cost $100,000, someone cost $1 million, some cost $20,000, some cost $5,000, lots cost $2,000 and a bunch cost nothing. But total costs divided by total number of people = $5,000 less a profit margin. The definition of an average means that the "money goes back in the pot".

Yeah, lets talk about those fat profit margins. The people screwing us are folks like Budweiser (now InBev) with an average profit margin of about 26%. That means that out of every dollar they take in, 26 cents is profit. Health insurance margins? Well that industry ranked #86 -- about 3% of revenue. So in your example above, that is $150 per head. Yeah, they are screwing us big time.

Okay, maybe the stupid pills were wearing off at the end of your post, because you actually started to make sense. Some things that would actually "bend the cost curve down" include:

1) Interstate sale of insurance -- not to protect us from insurance cartels, although thats part of it, but to protect us from state legislatures that mandate specific coverage to benefit special interests (e.g., chiropractic, holistic healers, etc.) Not that there is anything wrong with these things -- they do benefit people, but making everybody buy them is like saying that every car must have a GPS system. Sure, nobody would get lost, but lots of people couldn't afford a car (sound familiar). I've heard estimates that ancillary coverages like this add 15% to the typical policy.

2) Malpractice reform -- not so much the cost of damages (including pain & suffering & lost income) to the injured -- thats a pretty small number -- maybe 1-2% of annual health care costs. No, the big issue there is the defensive medicine that docs practice as a result of the Machiavellian scheme for paying for malpractice costs. With deductibles on malpractice policies, docs pick up a fixed dollar per claim -- that can be as much as $100,000. Docs make good money, but not enough that they are immune to those costs. So they have a choice -- run every test under the sun (btw, they make more money by doing that) or take a chance that they missed something. Guess what happens. A better approach would be to institutionalize these costs and get rid of shitty docs.

3) Tax Code Bias -- Health insurance paid by an employer is tax free in this country. If I pay you say $50,000 in cash, lets say the taxes all in with FICA and the rest is maybe 25% or $12,500. Now if instead, I pay you cash of $40,000 and $10,000 worth of health insurance, your taxes are only $10,000. You have the same total value of income, but less taxes. Dang, I need health insurance, I'll take that deal (see posts above re unions and tax breaks). But damn, if I'm getting that much money in health insurance, I better use it. Can anyone spell demand pull inflation? I saw a cool graph recently, that I can't find at the moment, which showed the growth trend in health care costs relative to the share of the costs paid out of pocket. Its dropped from maybe 40% in the 50's to 10% today. Anyone know what costs have done?

4) Pre-existing conditions are a problem that I agree the insurance industry has totally fucked up. The reason for pre-existing is really to protect the other policy holders (see margin discussion above). If there were 1000 people in Giz's $5,000 insurance pool and you let someone in that had a pending $1,000,000 claim, that would increase everyone else's premium by about 20% (now $6 million in costs divided by 1,000 people.) There have to be better solutions that allow more portability of coverage and the ability to change carriers, without contaminating insurance pools by letting people sit out until they think they need it. That "free riding" costs other policy holders a lot of money.

Anyways, I hope you didnt take offense Giz, nothing personal, your post just touched me off. As DG will note, this exceeds my monthly quota of words in one post. I'm now reverting to one-liners.

[otrdriver]

Gizz sorry guess we are both on same page on this our posts hit together.

We need smaller Gov't, Let's go back to the Constitution as was written in 1776.
Most of the public does not understand that every attack on the Constitution has been from the Progressive Party. (In case some of don't know the Dem's and Rep's have been high jacked by the Progressive Party) Now for all the younger crowd out there, The Progressive movement started with Woodrow Wilson, he was a president and pushed by FDR he was also a president. The Progressive Party praises some of the wonderful(sic) leaders from around the world such as Polpot, Stalin, Hitler, Castro, Chaevez, Chei, these people killed MILLIONS of people while they were in office. and IMO the present party in power is not far off from the same scheme. If they get the pos healthcare reform they want the Gov't will tell you when, where, and how you can live, what you can eat. (now they want to control salt and sugar in food) I think I can figure that out on my own.

my .02

Oh: those that feel they don't like living here in the US, Don't change my country move to the country that has everything you want here. I will help make your moving plans and make sure you get to the airport on time. I have lived in 10 countries and out of them all the USofA Is the Best. If it wasn't why are people illegally coming here?

[discreetgent]

Originally Posted by otrdriver

Oh: those that feel they don't like living here in the US, Don't change my country move to the country that has everything you want here. I will help make your moving plans and make sure you get to the airport on time. I have lived in 10 countries and out of them all the USofA Is the Best. If it wasn't why are people illegally coming here?

Were you suggesting that Lonesome Dove move to Russia?

[atlcomedy]

Originally Posted by pjorourke

3) Tax Code Bias -- Health insurance paid by an employer is tax free in this country. If I pay you say $50,000 in cash, lets say the taxes all in with FICA and the rest is maybe 25% or $12,500. Now if instead, I pay you cash of $40,000 and $10,000 worth of health insurance, your taxes are only $10,000. You have the same total value of income, but less taxes. Dang, I need health insurance, I'll take that deal (see posts above re unions and tax breaks). But damn, if I'm getting that much money in health insurance, I better use it. Can anyone spell demand pull inflation? I saw a cool graph recently, that I can't find at the moment, which showed the growth trend in health care costs relative to the share of the costs paid out of pocket. Its dropped from maybe 40% in the 50's to 10% today. Anyone know what costs have done?

Great post

Your #3 is labeled "Tax Code Bias" & you do a good job a laying out what it is, but the real fundamental problem with healthcare in general is the later part, that Americans are not directly paying for the services/care they are getting. Your 40% to 10% graph. Sure there are copays but from a personal cash flow standpoint, call it the "checkbook perspective," healthcare becomes a nearly free good. There are a number of other issues out there that a big & real, but until you address this one, you don't fix healthcare, at best you move things around and confuse the issue.

Originally Posted by Rudyard K

Any idiot can come up with ideas to save lives. ...
Figuring out how to do these things in a fiscally responsible manner, where it saves the most lives? Well that is a tougher trick. But nevertheless, it sounds so much more noble to stand on a soapbox telling everyone you want to save lives…and imply that if another doesn’t agree with your methodology that they must be for killing people.

.

Government entities in general do a very poor job of what in the business world is often called "portfolio management" or making choices when there are resource constraints.

Of course people want to save lives...have good roads...safe neighborhoods...good schools...maybe even a free session with a Diamond once a week for everyone. In isolation all of these things sound good, but we can't afford to do them all....

Originally Posted by Egrbvr

I for one don't think Brown's election was all about healthcare reform. I believe it was about the way it is being handled...BCD. Pelosi, Reed and Barney Frank, et al, project that they know better than all Americans .

I believe as scared as many Americans are on the actual impacts of any overhaul, more than that they are pissed off with how its been handled, "the process."

[MrGiz]

PJ..... have you ever heard of an Insurance GROUP , consisting of 40 million people? Think outside of the boxes you are used to! That's what it's going to take to fix the current Klusterphuck!!

I didn't define anything.... only presented birthing ideas..... have you heard of any from the GOVERNMENT?

Giz

P.S. - If there is one industry which I wouldn't mind seeing re-structured by the paying populace..... it's the Insurance Industry!! I can dream of ways it can be re-structured.... without the GOVERNMENT operating it! I'm not a beer drinker.... so I couldn't care much less about BUD..... somebody's gotta pay for the Superbowl commercials!

[pjorourke]

Originally Posted by atlcomedy

Your #3 is labeled "Tax Code Bias" & you do a good job a laying out what it is, but the real fundamental problem with healthcare in general is the later part, that Americans are not directly paying for the services/care they are getting. Your 40% to 10% graph. Sure there are copays but from a personal cash flow standpoint, call it the "checkbook perspective," healthcare becomes a nearly free good. There are a number of other issues out there that a big & real, but until you address this one, you don't fix healthcare, at best you move things around and confuse the issue.

That is the root cause. The problem really started when Medicare totally fucked up the medical economic system. More than 50% of the prices were set by fiat -- not the market. Surprise, surprise, strange and irrational things happened.

I have heard health care described (accurately I think) as going to a grocery store where someone load your cart with whatever they want (the docs) and then when you get to the checkout stand, someone else has to pay. Why would anyone expect rational behavior in that environment.

[pjorourke]

Originally Posted by MrGiz

PJ..... have you ever heard of an Insurance GROUP , consisting of 40 million people?

I assume you are referring to my reference to pre-existing. Well a group of 40 million wouldn't change the effect I noted, just the effect one person could have on rates for the other. Of course with 40 million in a group (i.e., roughly the size of all UnitedHealth Care's insureds) there would be LOTS of those free-riders showing up so the effect wouldn't be as diminished as you think.

[atlcomedy]

Originally Posted by pjorourke

I have heard health care described (accurately I think) as going to a grocery store where someone load your cart with whatever they want (the docs) and then when you get to the checkout stand, someone else has to pay. Why would anyone expect rational behavior in that environment.

Kinda sounds like sending my GF to Saks with my charge card to see her "personal shopper"

[guest051510-1]

Originally Posted by atlcomedy

...
Of course people want to save lives...have good roads...safe neighborhoods...good schools...maybe even a free session with a Diamond once a week for everyone. In isolation all of these things sound good, but we can't afford to do them all....

Well something has to give. I would say forget the good roads and schools, but keep the weekly Diamond dates.

[netman]

Originally Posted by Ansley

Scott Brown won the Massachusetts race!

Oooo.. Ansley's a hottie and, I am assuming, a Republican. I like.

[Guest083011]

Originally Posted by Nicolette Bordeauxva

but keep the weekly Diamond dates.

Word! Hear, hear! I'm in! I'll vote for that.