Former Health Care Executive: Michael Moore was Right (Sicko)

[billms]

Originally Posted by Edman85

By wanting to tax people for not electing to have health insurance. The purpose of health insurance is to protect against catastrophic costs from unexpected health bills. It doesn't make sense for people with enough saved to make health costs non-catastrophic to pay premiums on unnecesary health costs. We shouldn't penalize people for being good with money and saving wisely.

There is nothing inherent in the concept of insurance that implies catastrophic. I get car insurance and it covers my car when it gets dented in the parking lot. Similarly, there is nothing in the concept of insurance that implies unexpected - I've got life insurance but I expect to die.

Very few people that I am aware of view health insurance in the manner you describe.

[billms]

Originally Posted by Edman85

Those people you cite are acting irrationally.

Yes, they are. However, it is a sad fact that, from an economic point of view, people *always* act irrationally. It is irrational to expect them not to.

[DrWho17]

Originally Posted by Edman85

We need to free up health savings accounts and separate them from insurance so that people can have tax sheltered savings without an insurance plan.

We need to make sure that people who are recieving government health care are making healthy decisions. The moment they smoke a cigarette, they lose their coverage. Again, if they quit smoking and put that money away for later expenses, they can raise their deductable, lower their premium, and boom... health insurance is easier to afford!

We need to make sure that all 535 congressmen understand why health insurance exists in the first place before tackling this issue. I don't think they do, especially if they are mandating coverage.

Easy on the cigarettes (although I don't want healthcare coverage and my work forces me to take it).

[Melody]

Is the government going to be able to regulate ALL "unhealthy" behavior? Cease to cover those with a DWI or too many speeding tickets? Don't cover those who are found to be engaging in risky sexual behaviors? Addicts? No coverage for the obese?

[pfife]

Look @ Canada

[billms]

Originally Posted by Oblong

Especially one that has exactly 25 employees. Let's see, pay for health care for everyone, pay a $20,000 fine.... or let Tom go.

Bye Tom.

The proposal that came out of committee today - which the article relates to - says clearly that the first 25 are exempt. "or employers
subject to the assessment, the first 25 workers will be exempted."

So Tom is safe. And Johnny, number 26, is safe also unless his employer is a reactionary asshat who will fire him over $750 and the principle.

Am I safe in assuming this comfort to your concern does not change your overall opinion?

edit: linky http://help.senate.gov/Maj_press/2009_07_15_b.pdf

[billms]

Originally Posted by Melody

Is the government going to be able to regulate ALL "unhealthy" behavior? Cease to cover those with a DWI or too many speeding tickets? Don't cover those who are found to be engaging in risky sexual behaviors? Addicts? No coverage for the obese?

No, they are not. We have Roe v Wade, in part, to thank for that security.

[billms]

Originally Posted by pfife

Look @ Canada

can't see it - who do you think i am? sarah freaking palin?

[pfife]

Originally Posted by billms

can't see it - who do you think i am? sarah freaking palin?

That wasn't Palin, that was Tina Fey. Media bias!

[Edman85]

Originally Posted by DrWho17

Easy on the cigarettes (although I don't want healthcare coverage and my work forces me to take it).

If somebody claims to not be able to afford health insurance while they are spending $200 a month on cigarettes, I won't be easy on them.

[shabba4detroit]

Originally Posted by Edman85

If somebody claims to not be able to afford health insurance while they are spending $200 a month on cigarettes, I won't be easy on them.

If someone claims to not be able to afford health insurance while they are spending $150/m on cable/internet, I wouldn't be easy on them either.

[MrDeeds]

Originally Posted by shabba4detroit

If someone claims to not be able to afford health insurance while they are spending $150/m on cable/internet, I wouldn't be easy on them either.

$90 a month on IPhone or Blackberry

We could go on and on....Only in America can you be obese, own a car, have heat/AC, a cell phone, cable etc etc and STILL be considered below the poverty level.

[Edman85]

Originally Posted by shabba4detroit

If someone claims to not be able to afford health insurance while they are spending $150/m on cable/internet, I wouldn't be easy on them either.

Cable, I'd agree... Internet, these days is essential. Especially for the unemployed.

[pfife]

Originally Posted by MrDeeds

$90 a month on IPhone or Blackberry

If I had to wager, from this statement, I'd wager you don't have an iphone....

[billms]

i'll second that

[Melody]

Originally Posted by Edman85

Cable, I'd agree... Internet, these days is essential. Especially for the unemployed.

Don't know about up there, but down here you can use the internet for free at the library or check your e-mail free with purchase of a cup of coffee at most McDonalds.

[pfife]

Originally Posted by billms

i'll second that

1 month and 5 days until I can upgrade. I'm not counting though.

My wife has an iphone, and its one of the greatest pieces of tech ever.

[billms]

shhh... if she's running 3.0 and uses a laptop much (i find my self in airports a few times a month) she can turn on tethering without jailbreaking the phone - pm me if interested in the link - works real slick

[pfife]

:X

[Edman85]

Originally Posted by billms

There is nothing inherent in the concept of insurance that implies catastrophic. I get car insurance and it covers my car when it gets dented in the parking lot.

Right, but you are losing money on that deal. If all you had the car insurance for was to cover parking lot dents, you are paying more for your premiums than you would to fix the dent without insurance.

Therefore, the only reason insurance is purchased in the first place is to avoid catastrophic costs... (Except car insurance, which is legally required)

[MrDeeds]

Originally Posted by MrDeeds

$90 a month on IPhone or Blackberry

We could go on and on....Only in America can you be obese, own a car, have heat/AC, a cell phone, cable etc etc and STILL be considered below the poverty level.

Nope, have a Blackberry and it's about $90 a mth including everything including the ladies crappy pink razor.

[billms]

Originally Posted by Edman85

Right, but you are losing money on that deal. If all you had the car insurance for was to cover parking lot dents, you are paying more for your premiums than you would to fix the dent without insurance.

Therefore, the only reason insurance is purchased in the first place is to avoid catastrophic costs... (Except car insurance, which is legally required)

Really, the idea that the only reason people purchase insurance (other than laws) just not true. There are plenty of examples to counter that. People purchase insurance for repairs. They buy separate insurance for rentals if the repairs take too long.

Maybe they lose money on the deal - maybe they don't. In most cases they do - thats the nature of insurance. But not all. However, as i said before, nobody actions rationally most of the time let alone all of the time. Expecting them to - or building public policy based on that - is a bad idea.

[Buddha]

Originally Posted by Edman85

Right, but you are losing money on that deal. If all you had the car insurance for was to cover parking lot dents, you are paying more for your premiums than you would to fix the dent without insurance.

Therefore, the only reason insurance is purchased in the first place is to avoid catastrophic costs... (Except car insurance, which is legally required)

what about liability insurance? Or inland marine insurance? Or cargo insurance?

You buy insurance to protect yourself from liability or injury. And good insurance is really ****ing expensive.

I don't see the point you're trying to make about this "you only buy insurance to cover catastrophic losses" bit. Especially when you basically describe a catastrophic loss as anything not covered by what you have in the bank. Which could be anything from an infection to a root canal to four fillings in your teeth to a broken leg to regular medication that people need (which, without insurance, would be ex-****ing-spensive). And if you are defining catastrophic in that fashion, then you're using a really loose definition of catastrophic.

And another thing, with the way insurance works nowadays, even the coverage for things you can't pay for results in you not going broke (given the deductible's and the lack of 100% coverage).

If all of this is a backhanded way for you to try to argue that people should be saving more money and to pay for their health care needs, I don't see it. Health care is so expensive that most people wouldn't be able to pay for it and afford other things like homes and home insurance, etc. etc.

[Buddha]

Originally Posted by billms

Really, the idea that the only reason people purchase insurance (other than laws) just not true. There are plenty of examples to counter that. People purchase insurance for repairs. They buy separate insurance for rentals if the repairs take too long.

Maybe they lose money on the deal - maybe they don't. In most cases they do - thats the nature of insurance. But not all. However, as i said before, nobody actions rationally most of the time let alone all of the time. Expecting them to - or building public policy based on that - is a bad idea.

The entire idea of a "rational" person is ridiculous. It's invented by economists to come up with some baseline for them to test their theories.

[billms]

Exactly. Its a useful and interesting model - and simplifies *some* problems to make them tractable. But its never the real world.

[MrDeeds]

Originally Posted by MrDeeds

$90 a month on IPhone or Blackberry

We could go on and on....Only in America can you be obese, own a car, have heat/AC, a cell phone, cable etc etc and STILL be considered below the poverty level.

Poor in Colorado may get free phones - The Denver Post

Poor in Colorado may get free phones
TracFone Wireless wants to give cellphones to Coloradans who receive public assistance.
By David Migoya
The Denver Post
Posted: 07/15/2009 01:00:00 AM MDT


Thousands of low-income Coloradans reliant on public assistance could get a free cellphone under a plan before the state Public Utilities Commission.

If approved, the plan by TracFone Wireless in Miami would make Colorado the 17th state it has settled into with free cell service for the indigent, a form of wireless welfare that proponents say taps into one of the last untapped markets for the telecom technology.

"Our hope is to have it up and running by September," said Jose Fuentes, TracFone's director of government relations. "Historically, it's a very underutilized service, and we'd like that to change."

The program is a twist on Lifeline, a long-standing federal subsidy that provides low-income families with a break on their land-line telephone bill in order to ensure emergency 911 service.

In Colorado, it's called LITAP — the Low Income Telephone Assistance Program — and is available to anyone receiving aid from any of six welfare funds: Colorado Works Assistance (TANF), Supplemental Security Income, LEAP, Aid to Needy Disabled, the Old Age Pension Fund and Aid to the Blind.

Statewide, about 65 percent of those eligible participated in Lifeline last year.

The money — more than $800 million in subsidies were paid last year for low-income phone service across the country — comes from the Universal Service Fund, a tax on all telephone lines. Of that amount, Coloradans received nearly $3.2 million in low-income subsidies.

TracFone's subsidized program, called Safelink Wireless, gives users at least 68 minutes of free cell service each month — in Colorado, it would be 83 minutes — and unlimited access to 911 service even if the minutes are used up.

Users also get a free Motorola phone worth $50, according to the company's PUC filing. As long as subscribers are on the welfare rolls, they get the phone subsidy.

TracFone is best known as one of the country's biggest pay-as-you-go phone services, and Safelink subscribers can purchase additional minutes on the government-paid cellphone, Fuentes said.

"Historically, we've attracted those who don't have the means to afford a monthly billing for a land phone or don't want to be tied to a long-term cell contract," Fuentes said.

The idea is to convert Safelink users to regular cell customers as they are weaned from the public dole.

Critics question the cellphone idea, mostly pointing to malfunctions or user error that could create a problem in an emergency.

[Edman85]

Originally Posted by Buddha

what about liability insurance? Or inland marine insurance? Or cargo insurance?

You buy insurance to protect yourself from liability or injury. And good insurance is really ****ing expensive.

I don't see the point you're trying to make about this "you only buy insurance to cover catastrophic losses" bit. Especially when you basically describe a catastrophic loss as anything not covered by what you have in the bank. Which could be anything from an infection to a root canal to four fillings in your teeth to a broken leg to regular medication that people need (which, without insurance, would be ex-****ing-spensive). And if you are defining catastrophic in that fashion, then you're using a really loose definition of catastrophic.

And another thing, with the way insurance works nowadays, even the coverage for things you can't pay for results in you not going broke (given the deductible's and the lack of 100% coverage).

If all of this is a backhanded way for you to try to argue that people should be saving more money and to pay for their health care needs, I don't see it. Health care is so expensive that most people wouldn't be able to pay for it and afford other things like homes and home insurance, etc. etc.

It's not backhanded at all... All I'm doing is pointing out why insurance is purchased in the first place. It's not, or at least it shouldn't be, purchased at (I'll ball park it, it depends on your plan, #of dependents, etc.) $2,000 per year to save $50 on a doctor's visit... You are paying that money just in case you have to pay 6 digits for that heart attack. (p.s. This is why Dental Insurance is typically a ripoff. Crunch the numbers before getting that $10 per pay period being taken out of your paycheck)

Understanding the core reason why health insurance is purchased should be the foundation of any debate! Not anecdotal "Well, this happened to me! I had to wait in line in Canada! Oh I got bad care in the US!" ******** that this has been reduced to.

And yes... a movement to promote personal fiscal responsibility would go a long way toward providing a free market alternative to health insurance, which is too expensive. That and a healthier collective lifestyle.

[sub rosa]

Originally Posted by Edman85

It's not, or at least it shouldn't be, purchased at (I'll ball park it, it depends on your plan, #of dependents, etc.) $2,000 per year to save $50 on a doctor's visit...

you had it right at the beginning of your sentence - it's not purchased to save a few bucks on a doctor's visit. at least not by anybody i know or have ever known.

Originally Posted by Edman85

And yes... a movement to promote personal fiscal responsibility would go a long way toward providing a free market alternative to health insurance, which is too expensive. That and a healthier collective lifestyle.

right, if we could all just play by the rules (or just be smarter!) we wouldn't need police or judges or marriage counsleors etc. it's nice to think about, but is it really a practical idea?

[Edman85]

Originally Posted by sub rosa

you had it right at the beginning of your sentence - it's not purchased to save a few bucks on a doctor's visit. at least not by anybody i know or have ever known.

That's not what was said earlier in this thread!

People purchase insurance for repairs. They buy separate insurance for rentals if the repairs take too long.

I get car insurance and it covers my car when it gets dented in the parking lot. Similarly, there is nothing in the concept of insurance that implies unexpected - I've got life insurance but I expect to die.

b) to make health care more affordable for those who can afford the insurance. many people use their insurance plans for legitimate health care costs other than "catastrophic costs" (routine checkups, prescription drugs, preventative care, etc. etc.).

Each of these cases are people paying extra for insurance on things that aren't that expensive and are less expensive than the extra premiums they are paying (Granted, $10 co-pays are nice, but they are a rip off if that's all you use your insurance on). Rental reimbursement is one of the biggest ripoffs out there...

This is the kind of thing I'm saying. If we can work together as a society to stop empowering the insurance companies with our ignorance, they can stop bullying us around.

[Edman85]

On another note, this debate has clearly (at least to me) exposed that the whole purpose of Universal Health Care is not to improve the health care system, but to redistribute wealth. Clear as day...

[sub rosa]

buzzwords! redistribution of wealth! communism! obama's a socialist!

i redistributed some wealth tonight - i had two belgian beers at a restaurant. i paid with my "debit" visa card and tipped the waitress 20%. now she'll hand a portion of that tip over to the feds to pay farmers not to grow crops.

[sinister porpoise]

Originally Posted by Edman85

On another note, this debate has clearly (at least to me) exposed that the whole purpose of Universal Health Care is not to improve the health care system, but to redistribute wealth. Clear as day...

Consider visiting a psychiatrist

[Who is the Drizzle?]

Originally Posted by Edman85

That's not what was said earlier in this thread!








Each of these cases are people paying extra for insurance on things that aren't that expensive and are less expensive than the extra premiums they are paying (Granted, $10 co-pays are nice, but they are a rip off if that's all you use your insurance on). Rental reimbursement is one of the biggest ripoffs out there...

This is the kind of thing I'm saying. If we can work together as a society to stop empowering the insurance companies with our ignorance, they can stop bullying us around.

I agree with this, if people are expecting the health equivalent of rental insurance or payment for every ding on their car, that'd be asinine. If you've got a cold, a sprained ankle, or any other superficial common occurrence the human race has been dealing with well for the last several thousand years, deal with it. Any national health insurance should really only deal with necessary surgeries, treatment for serious diseases, and proven preventative check-ups. I don't want Joe Idiot going to the free doc to get antibiotics for his flu virus just because he can and it's free. Just because some people act stupid or freak out over nothing, doesn't mean the government should plan on paying for it.

[Who is the Drizzle?]

Originally Posted by Edman85

On another note, this debate has clearly (at least to me) exposed that the whole purpose of Universal Health Care is not to improve the health care system, but to redistribute wealth. Clear as day...

If they raise the top tax rates to what the house was talking about.....I don't think that's their goal really, but that's what it'd be going towards.

Of course even a flat tax redistributes wealth by definition. I don't have a problem with it. I do have a problem with taxes being raised drastically and the budget still being nowhere closed to balanced.

[Melody]

The cost saving measure I'd like to see is a few of our prescription drugs becoming available from the pharmacy without a doctor's visit. It's ridiculous that medications that I've been using for years (most notably Axert, a migraine medication) requires an $80 office visit (of which I pay about $15) every six months. All they do is have the nurse take my blood pressure and the doctor writes a scrip. The pharmacy has a free blood pressure machine. I should just be able to take the result to the pharmacist and get my pills. You can get imitrix (a very similar drug) in the UK this way.

[belcherboy]

Originally Posted by Who is the Drizzle?

I agree with this, if people are expecting the health equivalent of rental insurance or payment for every ding on their car, that'd be asinine. If you've got a cold, a sprained ankle, or any other superficial common occurrence the human race has been dealing with well for the last several thousand years, deal with it. Any national health insurance should really only deal with necessary surgeries, treatment for serious diseases, and proven preventative check-ups. I don't want Joe Idiot going to the free doc to get antibiotics for his flu virus just because he can and it's free. Just because some people act stupid or freak out over nothing, doesn't mean the government should plan on paying for it.

If we are going to UHC (and I think we are), I'd like to see a plan where people have to pay for anything under a couple of hundred dollars, or maybe pay a $50 fee every time they see a doctor (maybe give them 2-3 free visits a year per person). Those who are at the poverty line or below could get a special exemption/more free visits, and you could cap what anyone pays at $1500 a person or $3000 a family (maybe even exempt kids from it). I'm just throwing numbers out there, but I know my insurance is much cheaper because I have co-pays.

I know when I worked with the homeless, one of my jobs was to keep them from going to the ER because they would have something trivial wrong with them (a cough, a runny nose, an aching joint, etc). Under UHC, I would hate to see a large chunk of people swamping the ER or Urgent Care, because it is free. If you put a minimum fee on it, I think it would deter that behavior.

[Melody]

You can already go to one of those retail clinics in places like Walgreens or Walmart for around $60 or less.

[billms]

Originally Posted by Edman85

That and a healthier collective lifestyle.

So you are in favor of forced health standards as well, Comrade?

I hate you commies!

[billms]

Originally Posted by belcherboy

If we are going to UHC (and I think we are), I'd like to see a plan where people have to pay for anything under a couple of hundred dollars, or maybe pay a $50 fee every time they see a doctor (maybe give them 2-3 free visits a year per person). Those who are at the poverty line or below could get a special exemption/more free visits, and you could cap what anyone pays at $1500 a person or $3000 a family (maybe even exempt kids from it). I'm just throwing numbers out there, but I know my insurance is much cheaper because I have co-pays.

I know when I worked with the homeless, one of my jobs was to keep them from going to the ER because they would have something trivial wrong with them (a cough, a runny nose, an aching joint, etc). Under UHC, I would hate to see a large chunk of people swamping the ER or Urgent Care, because it is free. If you put a minimum fee on it, I think it would deter that behavior.

One of the clear major benefits of a national health care is that it would almost totally end that practice by making available clinics and primary care much more accessible to people.

The question of co-pays as a means of reducing trivial health visits has been studied - in act a study at RAND was one of the main justifications for most plans going this route many years ago. Since then the co-pays have increased well beyond the amounts that showed efficacy and are now used to make money. I would hate to go back to the old days where policy decisions were made because they "seemed right" to us rather than studying the problem and trying to measure what should work and then track its efficacy.

[billms]

Originally Posted by Edman85

On another note, this debate has clearly (at least to me) exposed that the whole purpose of Universal Health Care is not to improve the health care system, but to redistribute wealth. Clear as day...

please elaborate - who is now receiving the wealth?

and why would anybody set "redistributing wealth", in the abstract, as a goal? i don't see the rational appeal - i've never met anybody who woke up and said "what we need to do to make things better is redistribute wealth".