(10-29-2018, 03:22 PM)mikesez Wrote: [ -> ] (10-29-2018, 03:00 PM)flsprtsgod Wrote: [ -> ]I do believe we should have a safety net of some sort, there is definitely a place and interest for us to protect the vulnerable and thereby protect the public health. We still absolutely do not have a health care problem, we have a health care financing problem, and that kind of problem only gets worse when the government gets involved. The best way for this to imprvoe is to realign the market incentives to create a robust individual market and allow the private sector to provide for all customers, not just large groups, but that will never be the intentions of the government.
What you just described is literally what the Obamacare health care marketplace does for anybody who earns 133% of poverty level or higher. It creates an individual market for health care where the private sector is the only player.
The market incentives were realigned such that none of the insurers get to look at pre exisiting conditions, and very few conditions could be excluded.
It did all this while making minimal changes to large group employer coverage and Medicare.
Your last sentence makes everything before it irrelevant.
(10-29-2018, 08:15 PM)flsprtsgod Wrote: [ -> ] (10-29-2018, 03:22 PM)mikesez Wrote: [ -> ]What you just described is literally what the Obamacare health care marketplace does for anybody who earns 133% of poverty level or higher. It creates an individual market for health care where the private sector is the only player.
The market incentives were realigned such that none of the insurers get to look at pre existing conditions, and very few conditions could be excluded.
It did all this while making minimal changes to large group employer coverage and Medicare.
Your last sentence makes everything before it irrelevant.
Why?
Are you trying to say that you would have supported a health care bill that was more ambitious and didn't just try to target one population for help, and instead to treated everybody the same?
If you’re going to force people to get insurance and force companies to cover high risk people, why not just cut out the middle man and go directly after healthcare costs? If everyone got the negotiated prices that insurance companies got, people would be able to pay for their own healthcare as they need it, instead of paying thousands to another company for the privilege of paying even more for services.
(10-29-2018, 09:01 PM)mikesez Wrote: [ -> ] (10-29-2018, 08:15 PM)flsprtsgod Wrote: [ -> ]Your last sentence makes everything before it irrelevant.
Why?
Are you trying to say that you would have supported a health care bill that was more ambitious and didn't just try to target one population for help, and instead to treated everybody the same?
I want an individual market, that means a healthcare bill that doesn't "help" anyone.
(10-29-2018, 09:50 PM)flsprtsgod Wrote: [ -> ] (10-29-2018, 09:01 PM)mikesez Wrote: [ -> ]Why?
Are you trying to say that you would have supported a health care bill that was more ambitious and didn't just try to target one population for help, and instead to treated everybody the same?
I want an individual market, that means a healthcare bill that doesn't "help" anyone.
I want an individual Market too, but without government "help" how will people who have documented pre-existing conditions ever be able to participate in that market?
(10-29-2018, 09:24 PM)Bchbunnie4 Wrote: [ -> ]If you’re going to force people to get insurance and force companies to cover high risk people, why not just cut out the middle man and go directly after healthcare costs? If everyone got the negotiated prices that insurance companies got, people would be able to pay for their own healthcare as they need it, instead of paying thousands to another company for the privilege of paying even more for services.
I like how you're thinking.
(10-29-2018, 09:24 PM)Bchbunnie4 Wrote: [ -> ]If you’re going to force people to get insurance and force companies to cover high risk people, why not just cut out the middle man and go directly after healthcare costs? If everyone got the negotiated prices that insurance companies got, people would be able to pay for their own healthcare as they need it, instead of paying thousands to another company for the privilege of paying even more for services.
There are some docs trying to go this route along with a more extreme office healthcare "escrow" account. Either way, the difficulty is that everyone wants a piece of the pie. Big pharma is the [BLEEP] in every scenario!
(10-30-2018, 07:23 AM)mikesez Wrote: [ -> ] (10-29-2018, 09:50 PM)flsprtsgod Wrote: [ -> ]I want an individual market, that means a healthcare bill that doesn't "help" anyone.
I want an individual Market too, but without government "help" how will people who have documented pre-existing conditions ever be able to participate in that market?
Go to doctor, open wallet, pay bill. Health "insurance" is fraudulent on its face. Insurance isn't for certain events, and the need for health care financing is not one of life's uncertainties.
(10-30-2018, 12:32 PM)flsprtsgod Wrote: [ -> ] (10-30-2018, 07:23 AM)mikesez Wrote: [ -> ]I want an individual Market too, but without government "help" how will people who have documented pre-existing conditions ever be able to participate in that market?
Go to doctor, open wallet, pay bill. Health "insurance" is fraudulent on its face. Insurance isn't for certain events, and the need for health care financing is not one of life's uncertainties.
If you get ten random people in a group, four of the ten will have a cancer diagnosis at some point in their life. But no one knows which four. So that is one of life's uncertainties. Are you trying to say that all of the ten people should be saving up money as if a cancer diagnosis is coming?
(10-30-2018, 12:46 PM)mikesez Wrote: [ -> ] (10-30-2018, 12:32 PM)flsprtsgod Wrote: [ -> ]Go to doctor, open wallet, pay bill. Health "insurance" is fraudulent on its face. Insurance isn't for certain events, and the need for health care financing is not one of life's uncertainties.
If you get ten random people in a group, four of the ten will have a cancer diagnosis at some point in their life. But no one knows which four. So that is one of life's uncertainties. Are you trying to say that all of the ten people should be saving up money as if a cancer diagnosis is coming?
You have to admit that life planning should be a big part of it. Most live daily depending on ideal situations with no backup plan because it's not convenient. Sadly, those same people get smashed when you take out one the the pillars like job security, running automobile, and housing. There does need to be a certain level of personal responsibility. There are options outside of the insurance companies and those options get better looking as insurance companies cap their services.
(10-30-2018, 12:46 PM)mikesez Wrote: [ -> ] (10-30-2018, 12:32 PM)flsprtsgod Wrote: [ -> ]Go to doctor, open wallet, pay bill. Health "insurance" is fraudulent on its face. Insurance isn't for certain events, and the need for health care financing is not one of life's uncertainties.
If you get ten random people in a group, four of the ten will have a cancer diagnosis at some point in their life. But no one knows which four. So that is one of life's uncertainties. Are you trying to say that all of the ten people should be saving up money as if a cancer diagnosis is coming?
Yes, savings for many things should happen but aren't. I also believe that the individual market that we both want should be the primary mechanism for catastrophic coverage and the like, not employer or group based coverage for every possible health need no matter how routine. Especially with the history of failure of HMOs, Capitation, Managed Care, and just about every other planned and controlled finance scheme to draw on to make it better.
(10-30-2018, 09:56 PM)MalabarJag Wrote: [ -> ] (10-30-2018, 12:46 PM)mikesez Wrote: [ -> ]If you get ten random people in a group, four of the ten will have a cancer diagnosis at some point in their life. But no one knows which four. So that is one of life's uncertainties. Are you trying to say that all of the ten people should be saving up money as if a cancer diagnosis is coming?
That's exactly what insurance should cover, catastrophic events.
Right now health 'insurance' pays for routine office visits. This is comparable to having car insurance cover oil changes, or home insurance covering lawn mowing.
If patients were billed directly for routine visits they would become a lot cheaper because people would shop for better prices. With the current health 'insurance' method there's no incentive for one doctor to charge less than any other doctor.
That's a legitimate complaint and I used to say things like that in these conversations.
It makes sense. It is plausible. But the evidence isn't there to say that this is our actual problem.
First, doctors do compete to see who will get on which plan and not all plans reimburse all doctors the same. I would not call it patient centered, but if there is a doctor that patients prefer, they do get some leverage in the negotiations with insurers.
Second, the cure to this problem is worse. It has been demonstrated over and over that the high deductible plans cause people to wait too long to get treatment and needlessly risk their lives. It's been demonstrated that they make us significantly less healthy without singificantly reducing overall health spending.
(10-30-2018, 09:56 PM)MalabarJag Wrote: [ -> ] (10-30-2018, 12:46 PM)mikesez Wrote: [ -> ]If you get ten random people in a group, four of the ten will have a cancer diagnosis at some point in their life. But no one knows which four. So that is one of life's uncertainties. Are you trying to say that all of the ten people should be saving up money as if a cancer diagnosis is coming?
That's exactly what insurance should cover, catastrophic events.
Right now health 'insurance' pays for routine office visits. This is comparable to having car insurance cover oil changes, or home insurance covering lawn mowing.
If patients were billed directly for routine visits they would become a lot cheaper because people would shop for better prices. With the current health 'insurance' method there's no incentive for one doctor to charge less than any other doctor.
Bingo. I've said this all along about health insurance.
(10-30-2018, 10:16 PM)mikesez Wrote: [ -> ] (10-30-2018, 09:56 PM)MalabarJag Wrote: [ -> ]That's exactly what insurance should cover, catastrophic events.
Right now health 'insurance' pays for routine office visits. This is comparable to having car insurance cover oil changes, or home insurance covering lawn mowing.
If patients were billed directly for routine visits they would become a lot cheaper because people would shop for better prices. With the current health 'insurance' method there's no incentive for one doctor to charge less than any other doctor.
That's a legitimate complaint and I used to say things like that in these conversations.
It makes sense. It is plausible. But the evidence isn't there to say that this is our actual problem.
First, doctors do compete to see who will get on which plan and not all plans reimburse all doctors the same. I would not call it patient centered, but if there is a doctor that patients prefer, they do get some leverage in the negotiations with insurers.
Second, the cure to this problem is worse. It has been demonstrated over and over that the high deductible plans cause people to wait too long to get treatment and needlessly risk their lives. It's been demonstrated that they make us significantly less healthy without singificantly reducing overall health spending.
So I join us in condemning the ACA and it's syrocketting deductibles?
(11-03-2018, 12:28 PM)jj82284 Wrote: [ -> ] (10-30-2018, 10:16 PM)mikesez Wrote: [ -> ]That's a legitimate complaint and I used to say things like that in these conversations.
It makes sense. It is plausible. But the evidence isn't there to say that this is our actual problem.
First, doctors do compete to see who will get on which plan and not all plans reimburse all doctors the same. I would not call it patient centered, but if there is a doctor that patients prefer, they do get some leverage in the negotiations with insurers.
Second, the cure to this problem is worse. It has been demonstrated over and over that the high deductible plans cause people to wait too long to get treatment and needlessly risk their lives. It's been demonstrated that they make us significantly less healthy without singificantly reducing overall health spending.
So I join us in condemning the ACA and it's syrocketting deductibles?
The ACA has very little to do with deductibles.
The bronze, silver, gold, grading is just about over all costs distributions and there are ways to achieve each grade with high and with low deductibles.
high-deductible plans were becoming a bigger part of the marketplace already. people are interested in high-deductible plan simply because the lower premium is the only premium they can afford.
The overall health system is just too expensive. Too many Middle Men.
(11-03-2018, 01:31 PM)mikesez Wrote: [ -> ] (11-03-2018, 12:28 PM)jj82284 Wrote: [ -> ]So I join us in condemning the ACA and it's syrocketting deductibles?
The ACA has very little to do with deductibles.
The bronze, silver, gold, grading is just about over all costs distributions and there are ways to achieve each grade with high and with low deductibles.
high-deductible plans were becoming a bigger part of the marketplace already. people are interested in high-deductible plan simply because the lower premium is the only premium they can afford.
The overall health system is just too expensive. Too many Middle Men.
ofcourse it does. Essentially, we eliminated rating for pre-existing conditions, merged pools like maternity and mental health and eliminated lifetime caps for insurance. That all sounds great, just like a dry aged ribeye sounds great. IT just costs more. In this case, that cost was passed onto the consumer in the form of higher premiums and exponentially high deductibles that are invariably leading to the kind of rationing you lamented above.
We should have learned by now that 2000 pages of bureaucracy don't reduce costs or increase resources. It just results in an increase in the cost of compliance and a reduction in the number of producers and thus options for consumers.
The market has always had a solution to making healthcare more affordable. Doctors could self insure for the lower level care and pair that with catastrophic coverage for the heart transplant/cancer diagnosis etc. etc. etc. There are practices emerging across the country that charge $50 bucks a month per adult for unlimited visits and service and have the same discounts on prescription drugs that we all get through our insurance programs. Why aren't these more prevalent? Because in the previous 10's of thousands of pages of Washington crap attempted price controls etc. etc. etc. they made medical associations more difficult to set up, and basically enshrined group health coverage because of tax treatment (and as a way around post WWII wage controls).
So what's the solution? Have Washington stop trying to HELP like a two year old with a chainsaw trying to fix their mothers broken toe. Let producers develop products that work for consumers. You'd think that the absolute horror show of the VA would serve as a cautionary tale about the government running healthcare, but people still believe in fairy tales.
(11-03-2018, 12:01 PM)flsprtsgod Wrote: [ -> ] (11-03-2018, 11:33 AM)Jagwired Wrote: [ -> ]https://www.foxnews.com/us/gillum-intern...epublicans
Gillum intern arrested in Florida for throwing chocolate milk at College Republicans
Shocked the intern was arrested. That sort of behavior is usually condoned on behalf of Democrats.
Like sending pipe-bombs to Democrats is condoned by Nationalists?