health insurance bill

[brin]

" I won't participate in this thread any further because I'm surprised it hasn't gotten shot down already for political reasons...this is precisely a political thread...which kind of "bill" does everyone think we are talking about."

arc - I think the owners and the moderators are smart enough to see you are the one trying to bring politics into this thread and thereby try to close the thread. This has little to do with politics but much to do with the health of our country. Try to lighten up !

 

[TonyKoehler]

Just wanted to see others thoughts on the new health insurance bill. Good or bad. If I want to retire at 62 and draw social security benifits at 65, will I be required to carry health insurance till retirement age, etc. . If so, what are the requirements and what if all insurance companys say you are uninsurable? Any thoughts?

Didn't read all the way through to start with, but the way I understand it, if you're 62 now, it won't affect your insurance until you're 66. They only start collecting revenue for the new bill now--they don't change/provide any benefits for 4 years! That's why they could claim that it saves money over 10 years! Collect revenue for 10 years and only pay benefits for 6. What business couldn't save money doing that?

 

[turbo36]

The title of this thread should read..

"I got mine, and I couldn't care less about any other American who has to die or suffer pain because they weren't as successful or lucky as me. Everyone could be a millionaire if they just wanted it bad enough"

Imagine...a bunch of bus drivers being millionaires and Snapon Tool salesman..the only reason they arent millionaires is that they just don't want it bad enough...therefore...why should we care if a catastrophic illness destroys their childrens future..

I got mine.

People have no clue as to what the bill actually entails and are making comments based on their perceptions of what pundits and chain emails are telling them to think, not reality. There is no rationing...there is no change to your insurance plan unless your employer decides to change it...but wait, that happens already...

You people afraid of rationing and an influx of people into the health care system..are these people that are laying dead and dying in the gutter, and you want them to stay out of your health care system so your "WAIT" time isnt impacted? You don't think that maybe there could be an expansion of jobs (if you believe your own rhetoric about an increase in patients). Fact is either these people don't need health care services or they do, and if they do...BY ALL THAT IS HOLY they should **** WELL GET IT. I dont care what their background is...Im not here to judge other human beings...thats GOD"S JOB...but many of you seem to be vying for that job. Many of you people sound like the people in the ER I work at that complain about their wait time on a upset stomach and someone in the next room is bleeding out, yet the upset stomach is the loudmouth screaming and carrying on about malpractice suits. Baby want their binky.

Cant have it both ways...hmmm...my opponent likes my ideas so he is wrong...or he likes his own ideas...still wrong...never mind that if he likes my ideas and is wrong, that makes ME wrong too...You cant talk about expanding an industry..creating extra demand for that same industry, and then complain about a declining job market in the same sentence and be considered credible in any way.


I won't participate in this thread any further because I'm surprised it hasn't gotten shot down already for political reasons...this is precisely a political thread...which kind of "bill" does everyone think we are talking about.

IBTL

You hit the nail on the head, many of those complaining about the new "socialist" health plan are already on the old "socialist" health plan ( Medicare, Medicaid, VA etc. etc) and they don't want that screwed up by adding others.

I don't know what the real solution is but as an employer the current system puts me at a great disadvantage compared to my global opponents. My third biggest expense is health care. If I moved my factory to China the wages I would pay would amount to less then my health care bill, how's that for reality?

 

[dave1949]

You hit the nail on the head, many of those complaining about the new "socialist" health plan are already on the old "socialist" health plan ( Medicare, Medicaid, VA etc. etc) and they don't want that screwed up by adding others.

I don't know what the real solution is but as an employer the current system puts me at a great disadvantage compared to my global opponents. My third biggest expense is health care. If I moved my factory to China the wages I would pay would amount to less then my health care bill, how's that for reality?

One thing I don't understand is the opinion support received for employer-sponsored/subsidized health insurance. Think about it, you are willing to allow your employer to decide for you how some part of your compensation will be spent; because you don't really have any other good options if you want to purchase health insurance. If that is/were the government, all heck is raised. Not a very consistent viewpoint.

One of the worst things that happened to health insurance was when employers began to subsidize it - in lieu of wages - back in the 1940's. It's no bargain to employers to deal with it, just headaches and administrative overhead. The fact that large employers have enough bargaining leverage to at least somewhat hold down rising costs means individuals and small businesses are automatically at a disadvantage in the market. There is no free lunch, what is not paid by one is paid by another.

Who did HMO's market themselves to? Large employers, not individuals. That just added a cost layer with little to no benefit to the end consumers. I would like to see employers taken out of the health insurance equation. Put end consumers back in touch with the issues and let the market work it out.
Dave.

 

[canoetrpr]

My main point at the time with that statement was more to demonstrate that we are not necessarily bound to an employer for health insurance which is what it seemed to me canoetrpr was implying.

Lost, I didn't mean to imply that by my statement but upon re-reading my post I can see how it might have been seen that way. What I was trying to point out was that more so than any other industrialized country, health insurance is typically provided through the employer in the USA.

I understand that one of the principal reasons for this is that it is tax efficient to do it this way as the premiums can then be payed with pre tax dollars. Consequently a MUCH larger chunk of the general population gets their insurance this way than through an individual purchase.

I also expect that if you take up employment at many employers, you simply get the health benefits that come with the job. Are you able to opt out of them and get an increase in wage that is the fair market value of the health coverage you refuse?

The downside of the tax code encouraging this, is that you can't necessarily take your health insurance with you if you decide to leave.

I will fully admit that my understanding might be incorrect here so please correct me if this is the case.

Having one's own health insurance provided through / tied to his employer then becomes a reason for a person to stay under-employed due to the risk of losing coverage by moving to another employer (for pre-existing conditions - that may have developed while at the previous employer), of if things do not work out in a new job.

In my opinion this is a distortion to the labour market. Capitalism requires the free movement of both labour and capital to maximize the efficiency and productivity of resources in the economy.

One can debate about how much of a distortion this is and what exact impact it has on the American economy. My personal opinion is that it is significant and unreported and worse - it is hard to measure.

I have a number of friends, colleauges and family who claim that there are many occasions in the past when they hung onto a job primarily because of the health benefits it provided, a few others who decided not to quit their job, go back to school to change careers for the same reason, and one or two who might have considered starting a small business or become self employed.

Policy has to be assessed on a longer term perspective than one or two years. For freer movement of labour, it is better to encourage a health policy that results in insurance that is tied to the individual rather than to the place of employment.

 

[2manyrocks]

These are issues that are like the issues with employer retirement plans. Many of your rank and file employees rely on the employer to figure out what plan to get and then the employees participate. If left on their own, some employees wouldn't get health insurance any more than they would put aside money for retirement.

In theory, a employer should be able to drive a better bargain on health insurance than individual employees. In practice, I have seen the HR department fail to shop health insurance coverage and then everybody got hit with a huge premium increase in the next plan year because HR messed up and couldn't move the coverage elsewhere by the time they realized what was coming.

There are so many variables in how this actually plays out from individual to individual and company to company that I suppose the possible outcomes and opinions are endless for good reason.

 

[LostInTheWoods]

The title of this thread should read..

"I got mine, and I couldn't care less about any other American who has to die or suffer pain because they weren't as successful or lucky as me. Everyone could be a millionaire if they just wanted it bad enough"

This is a tired song that's been played all too often. "If you don't agree with me, then you must be ignorant, or racist, or just plain mean". If I can't provide facts that stand up to scrutiny, then *click* let the recording play...

Imagine...a bunch of bus drivers being millionaires and Snapon Tool salesman..the only reason they arent millionaires is that they just don't want it bad enough...therefore...why should we care if a catastrophic illness destroys their childrens future.

If I ever become a millionaire, I'll let you know if it changes my opinion. In the meantime, I'll still be showing up for work every morning.

I got mine.

Let's discuss just exactly how I "got mine".

I "got mine" by not relying on others to provide it for me. I "got mine" by taking out student loans to afford college. I "got mine" by working at least one, often two jobs while going to college, because student loans didn't cover all the bills, and weren't available once I entered graduate school. I "got mine" by working long hours, which turned into long days, that turned into long years filled with sacrifices. I "got mine" by following just one of many paths open to every single citizen of this country. I "got mine" by joining the National Guard during a time of war to do two things. One, help pay for those student loans. Two, to serve my country in a time of need. Which reminds me, the Guard and Reserves offer health insurance for both individuals and families that is very inexpensive. Yet another way someone can obtain insurance.

Now that I "have mine", I'd just as soon not see it squandered on fraud and waste. That's a huge reason I question this bill. If its so fantastic, why did it require closed-door meetings and sweetheart deals after we were promised it would be out in the open? If they were discussing national defense, then yes, I could understand the need for secrecy. But private meetings about our healthcare?

People have no clue as to what the bill actually entails and are making comments based on their perceptions of what pundits and chain emails are telling them to think, not reality. There is no rationing...there is no change to your insurance plan unless your employer decides to change it...but wait, that happens already...

Then please, tell us what's in it that you support so strongly. What are you basing your comments on? What is the "reality" that we are not seeing? I'm not trying to be sarcastic. I'd really like more reasons to support this. I just don't see it.

You people afraid of rationing and an influx of people into the health care system..are these people that are laying dead and dying in the gutter, and you want them to stay out of your health care system so your "WAIT" time isnt impacted?

Think of all the people you know. All the people you see day in and day out. How many do you see "that are laying dead and dying in the gutter"?

There's oversimplification to make a point, then there's oversimplification that misses the point. No one who's "laying dead and dying in the gutter" is refused treatment. And we've already established there are numerous programs and agencies to assist those in need, even when things aren't quite so bad as your example. The current system is inadequate. It does need adjustment. That much I readily concede. But I think you're being a little extreme.

And do you reallybelieve the vast majority of people are more worried about their wait times than the proper care of patients and the proper means of changing healthcare to assist those patients?

Im not here to judge other human beings...thats GOD"S JOB...but many of you seem to be vying for that job.

Read Proverbs. Not for religious purposes, merely for some common sense sayings. Sort of like reading the little tidbits in Farmer's Almanac.

Proverbs 27:12 A prudent person foresees danger and takes precautions. The simpleton goes blindly on and suffers the consequences.

Proverbs 12:11 A hard worker has plenty of food, but a person who chases fantasies has no sense.

Proverbs 28:19 A hard worker has plenty of food, but a person who chases fantasies ends up in poverty.

Proverbs 13:16 Wise people think before they act; fools don't--and even brag about their foolishness.

Many of you people sound like the people in the ER I work at that complain about their wait time on a upset stomach and someone in the next room is bleeding out, yet the upset stomach is the loudmouth screaming and carrying on about malpractice suits. Baby want their binky.

Remind me again, who exactly is insensitive to others?

Cant have it both ways...hmmm...my opponent likes my ideas so he is wrong...or he likes his own ideas...still wrong...never mind that if he likes my ideas and is wrong, that makes ME wrong too...You cant talk about expanding an industry..creating extra demand for that same industry, and then complain about a declining job market in the same sentence and be considered credible in any way.

Um, I can't follow that at all. Consider my credibility shot.

I won't participate in this thread any further because... which kind of "bill" does everyone think we are talking about.

The one the OP mentions by name in the first line of his original post. It is no secret.

To the OP. Sorry if this thread has been derailed from its original intent. As you can see, I think most of us in the good 'ole USA really don't know exactly what to expect. Either how it will affect you in your current situation, or how it will affect the rest of us as we try to plan our lives. It has been fed to us as one feeds castor oil to a three-year-old. "Shut up and take this, its good for you".

Some posters running their own businesses have shown some support for this bill. I don't know their reasoning, but I also don't know the specifics of how this will play out for them. I remember that the US Chamber of Commerce wasn't a huge fan of the bill, so I was under the impression that if "the world's largest business federation representing the interests of more than 3 million businesses of all sizes, sectors, and regions..." was not for it, there might be issues.

When I read this, it seems as though the bill will be a mixed bag for business owners. Some good, some bad. I am not a business owner, so its hard for me to say.

The ChamberPost: Aftermath: New Realities for Businesses in the Wake of the Health Care Law

Trust me. I WANT to believe this will work. I WANT to believe this will help businesses. I WANT to believe it will help those who need help without making things worse. I want to believe it's the best thing for me, my neighbors, my co-workers, and for the future of my children. I want to believe everyone will end up a winner.

But there are always losers.


Respectfully,

Lost

 

[LostInTheWoods]

Lost, I didn't mean to imply that by my statement but upon re-reading my post I can see how it might have been seen that way. What I was trying to point out was that more so than any other industrialized country, health insurance is typically provided through the employer in the USA.

Canoetrpr,

I suspect what you say is true. Its mostly conjecture on my part, but from what I understand of the healthcare delivery in most other nations, I agree.

I understand that one of the principal reasons for this is that it is tax efficient to do it this way as the premiums can then be payed with pre tax dollars. Consequently a MUCH larger chunk of the general population gets their insurance this way than through an individual purchase.

LOL, we Americans (by that I mean the US "Americans") are a crafty bunch when it comes to trying get get as much mileage out of our greenbacks before the tax man reaches in.

That's not to say we're all clueless. We KNOW taxes are necessary. I believe everyone should pay taxes. And not because I'm crying about "how come I have to pay them and he doesn't". I think everyone needs to have an investment in their country. They need a tangible way to "feel" that investment. And your tax burden should be directly tied to the deficit ... deficit goes up, your taxes go up. Deficit goes down, your taxes go down. Then we'd see an electorate responsive to the masses.

I also expect that if you take up employment at many employers, you simply get the health benefits that come with the job. Are you able to opt out of them and get an increase in wage that is the fair market value of the health coverage you refuse?

I have been employed at several places in my life that offered health insurance. I every case, I was able to elect to not participate. I don't know if that is true in all instances.

In some instances, the employer would offer some monetary compensation to those who chose to forego the insurance. But not always. And I have no way of knowing if it would be for the true market value.

...you can't necessarily take your health insurance with you if you decide to leave.

Very true.

Having one's own health insurance provided through / tied to his employer then becomes a reason for a person to stay under-employed due to the risk of losing coverage by moving to another employer (for pre-existing conditions - that may have developed while at the previous employer), of if things do not work out in a new job.

In my opinion this is a distortion to the labour market. Capitalism requires the free movement of both labour and capital to maximize the efficiency and productivity of resources in the economy.

There's a reason the USA is known as The Land of Opportunity. You can always leave your job and take a risk. And you do need to compare health insurance between the two employers (or what you can get for yourself if staring your own business).

The preexisting problem issue is one that certainly needs to be fixed. Does it impact the free movement of labor (US spelling )? I don't know. That is an answer I'd leave to economists. I would agree that it would be difficult to measure.

For freer movement of labour, it is better to encourage a health policy that results in insurance that is tied to the individual rather than to the place of employment.

I believe that most things should be tied to the individual, but that's a soapbox I'll stay off of for a while.

Part of the problem is that the individual will lose his first choice, and that is whether or not he even wants insurance. *apologetically climbs down from soapbox*

As for tying it to the individual, I looked at the summary on the healthreform.gov website. I don't see where it will necessarily be tied to the individual under the new plan. I could have easily missed something, though.

I did see this about pre-existing conditions:

HELP FOR UNINSURED AMERICANS WITH PRE-EXISTING CONDITIONS UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)猶rovides access to affordable insurance for Americans who are uninsured because of a pre‐existing condition through a temporary subsidized high‐risk pool. Effective in 2010.

I see no info on just how "affordable" it will be, or what happens after the "temporary" pool disappears.

I'd really like to draw on your experiences in Canada. Have you had much interaction with the healthcare system there? Does it resemble what is in our new bill? Are you happy with certain aspects? Unhappy?


Respectfully,

Lost

 

[brin]

Do any of you remember back prior to about the late 1970's when you got insurance from your employer it was only for a major injury or illness requiring hospitalization and or surgery. The insurance did not cover Doctor visits, drugs , tests or lab work..just covered major problems and back then we all paid that out of our pocket and then if you had to go to the hospital you paid the first 20% and insurance paid the rest...How did we stray so far ? and how can we get back to a patient/consumer driven price camparing market ?

 

[LostInTheWoods]

Do any of you remember back prior to about the late 1970's when you got insurance from your employer it was only for a major injury or illness requiring hospitalization and or surgery. The insurance did not cover Doctor visits, drugs , tests or lab work..just covered major problems and back then we all paid that out of our pocket and then if you had to go to the hospital you paid the first 20% and insurance paid the rest...How did we stray so far ? and how can we get back to a patient/consumer driven price camparing market ?

Brin, I think those days are gone, for a variety of reasons. The new medical technology we have now is great, but it costs tons of money to both own and operate.

For good or bad, there are an ever-increasing number of government regulations (long before the new healthcare bill) influencing the delivery of medicine that require both time and money to comply with.

And not to beat a dead horse, but I doubt docs back in the good 'ol days spent such a large portion of their income on malpractice premiums, transcriptionists, billing clerks, secretaries, fax machines, copy machines, etc, etc. Then, of course, you have so many employees, you need an office manager.

Even the 80/20 policies, where you pay twenty percent can be a pretty big impact to your finances these days. 20% of $50,000 for a major hospitalization is gonna hurt.

 

[brin]

Brin, I think those days are gone, for a variety of reasons. The new medical technology we have now is great, but it costs tons of money to both own and operate.

For good or bad, there are an ever-increasing number of government regulations (long before the new healthcare bill) influencing the delivery of medicine that require both time and money to comply with.

And not to beat a dead horse, but I doubt docs back in the good 'ol days spent such a large portion of their income on malpractice premiums, transcriptionists, billing clerks, secretaries, fax machines, copy machines, etc, etc. Then, of course, you have so many employees, you need an office manager.

Even the 80/20 policies, where you pay twenty percent can be a pretty big impact to your finances these days. 20% of $50,000 for a major hospitalization is gonna hurt.

Lost - I think you are right I think those days are gone....For ever and I just wonder how many other things we have cherished are gone for ever as well..

 

[ultrarunner]

Do any of you remember back prior to about the late 1970's when you got insurance from your employer it was only for a major injury or illness requiring hospitalization and or surgery. The insurance did not cover Doctor visits, drugs , tests or lab work..just covered major problems and back then we all paid that out of our pocket and then if you had to go to the hospital you paid the first 20% and insurance paid the rest...How did we stray so far ? and how can we get back to a patient/consumer driven price camparing market ?

Yes... I remember it being called major hospitalization...

Growing up in a family without Health Insurance and now working in the medical field I can see how far expectations have shifted.

It was standard for physicians to take 3 installments for service... doctors didn't take credit cards like they do now. In fact... all of the Doctors I know were very good at working out financial arrangements... our family Doctor got labor for a new patio from one patient.

The 80/20 rule has worked well for years... the original intent of most "Plans" was to inure against catastrophic loss and even those that didn't have coverage had the option to have their bills settled in a Bankruptcy Court.

Few actually take the time to find out or negotiate their Hospital Bills ahead of time... is it any wondered why costs have escalated?

 

[brin]

ultrarunner...thanks you jarred my memory...It was indeed called " Major Medical " wasn't it and it worked fine and then they began to add mandatory coverage for this & that which many folks did not even want and then they added the co pays for everything and it took the patient out of the negotiating for price equation...notice health care is about the only thing none of us bargain for the best price on...we never know what it will cost. I have even asked the Doctor - How much will that cost..and they say...Don't worry it is covered by insurance...Hey that is not the point ...I want to know. The whole system is screwed up and the new health care bill does not fix it..it only makes it worse..No where in the new bill does it control health care costs.

 

[sweettractors]

ultrarunner...thanks you jarred my memory...It was indeed called " Major Medical " wasn't it and it worked fine and then they began to add mandatory coverage for this & that which many folks did not even want and then they added the co pays for everything and it took the patient out of the negotiating for price equation...notice health care is about the only thing none of us bargain for the best price on...we never know what it will cost. I have even asked the Doctor - How much will that cost..and they say...Don't worry it is covered by insurance...Hey that is not the point ...I want to know. The whole system is screwed up and the new health care bill does not fix it..it only makes it worse..No where in the new bill does it control health care costs.

When 60% of the public did not want this budget buster bill and still does not support it after it has been signed into law, what can the majority do to correct this problem? I don't like being run over, and I am not dumb enough to think that this bill address some of the most important cost containment issues, like Tort reform, and Union members, Senators and Congressman getting sweetheart deals for their states or lobbiests. Ken Sweet

 

[brin]

When 60% of the public did not want this budget buster bill and still does not support it after it has been signed into law, what can the majority do to correct this problem? I don't like being run over, and I am not dumb enough to think that this bill address some of the most important cost containment issues, like Tort reform, and Union members, Senators and Congressman getting sweetheart deals for their states or lobbiests. Ken Sweet

" what can the majority do to correct this problem? "

Ken - To me it's like an out of control machine at this point..I would say all we can do is pray and pray hard.

 

[Chuck52]

Boys, take a deep breath and relax. You might want to check your numbers...remember that just because all the people you talk with on a regular basis, and the news sources you believe, say you are the majority, it may not be true. Selective photography can make small crowds look huge and vice versa, and poll numbers can be cited to support just about anything, and change quickly to boot. If your opinions really do reflect majority opinion, you can vote in various November elections and try to be happy with the results. On the other hand, since most of you proclaim loudly to support the Constitution, if you aren't happy with what turns out to really be the majority opinion, you do have some recourse, but mainly you'll have to live with the election results just the way those of us who were less than happy with previous elections did.

Chuck

 

[2manyrocks]

This talk about majority opinion reminds me of Mark Twain's observation that most people only think they think.

also reminded of a saying that there should be another box on each ballot that says, "none of the above."

It's not just the health care system, but the days of being to get by without having to run in a marathon economic rat race appear to be about gone.

 

[canoetrpr]

Lost, you are a gentleman to debate/discuss with. Too many people get lost in all the rhetoric and are unwilling to debate the actual issues.

Most people seem to like the fact that the health care bill disallows the use of pre-existing conditions to deny coverage. I think it would be fair to say that most think this is the best part of the bill.

The requirement to purchase healthcare (individual mandate) is least liked as it takes away the freedom for one to have the individual freedom to decide whether they would like to have it or not.

What I don't think has been communicated effectively is that you cannot have one without the other - not without bankrupting the insurance companies. If insurance companies are no longer allowed to deny coverage for pre-existing conditions, then there is no point for any one to get insurance until they actually get sick enough to need it. It is much cheaper to pay for regular doctors visits, the odd treatment and so on. When you need insurance is when you have a condition that is going to cost a lot of money.

They only way to ensure that individuals don't have an incentive to do this. (get insurance only once they have an expensive to treat condition) is to have an individual mandate that requires everyone to have insurance. Not having this would effectively bankrupt all private insurance companies.

On the whole business of policies that start moving the provision of health insurance away from employer to individual... I think that your health care bill does some but not too much. My understanding is that it attempts to equalize the tax treatment of premiums so that the same deductions are available regardless of whether you choose to get your health insurance through your employer or on your own. If I understand this correctly then this ought to start the process of employers providing higher wages in lieu of health coverage. I think this is an area that they could have / should have done a lot more in, along with tort reform.

We have a very very different health care system in Canada from what you have in America. It is completely a single payer system, otherwise known as 'socialist' There is only a public healthcare system that is funded out of a combination of general tax revenues and specific contributions done by all employers. Each province administers its own public health insurance system. Doctors, X ray clinics, pathology labs etc. are private operations which simply bill the province's health insurance when you need their services. In Ontario, the public insurance is called OHIP (Ontario Health Insurance Plan).

Hospitals are not privately owned (for the most part) but are administered not-for-profit.

One very key difference between our systems is that in Canada you cannot as a patient decide to go see a specialist. You must be referred by your family doctor. Consequently, in Canada the ratio of of GPs to specialists is 3:1. This is the case for other first world nations for the most part. It is the reverse in America.

Your current health care legislation, in my opinion, does not move you towards the kind of system that we have. Despite the rhetoric, we've got a socialist system here (and it has its flaws but it isn't half bad) and I've got a pretty good idea of what one looks like. I'd say Obama's policy with no public option, elimination of pre-existing conditions and the individual mandate is very much a middle of the road capitalist way to approach the problem. It is more like Germany's than anywhere else, with the exception that they have a public option in addition to private insurance.

Wrt. rationing - everyone better get used to this - no matter where you live. We are living longer and we tend to consume far far more healthcare as we get older. Medical science is getting better and better as well. Nothing is going to stop these two trends. So either health care services re going to be rationed and we are not all going to get that billion dollar pill that will allow us to add three months to our life, or the entire economy is simply going to be health services, and we are all going to give each other checkups. Everybody might as well start having a rational conversation about this.

 

[dave1949]

Do any of you remember back prior to about the late 1970's when you got insurance from your employer it was only for a major injury or illness requiring hospitalization and or surgery. The insurance did not cover Doctor visits, drugs , tests or lab work..just covered major problems and back then we all paid that out of our pocket and then if you had to go to the hospital you paid the first 20% and insurance paid the rest...How did we stray so far ? and how can we get back to a patient/consumer driven price camparing market ?

You do pay out of pocket now - until you have reached your annual per person/family deductible level - which varies by policy.

When you combine the deductible with the amount you pay in premiums, that adds up to significant health care out of pocket spending before further costs are reimbursed by the insurance company.

No matter how it is sliced and diced, the sum of: not covered by insurance spending + co-pay + deductible + self-payed premiums + employer-paid premiums (if applicable) amounts are your out of pocket expenses for health care.

If your and/or your family's total annual health care costs exceed that sum, you actually had health care expenses that were paid by other members in your insurance pool.
Dave.

 

[dave1949]

Lost, you are a gentleman to debate/discuss with. Too many people get lost in all the rhetoric and are unwilling to debate the actual issues.

Most people seem to like the fact that the health care bill disallows the use of pre-existing conditions to deny coverage. I think it would be fair to say that most think this is the best part of the bill.

The requirement to purchase healthcare (individual mandate) is least liked as it takes away the freedom for one to have the individual freedom to decide whether they would like to have it or not.

What I don't think has been communicated effectively is that you cannot have one without the other - not without bankrupting the insurance companies. If insurance companies are no longer allowed to deny coverage for pre-existing conditions, then there is no point for any one to get insurance until they actually get sick enough to need it. It is much cheaper to pay for regular doctors visits, the odd treatment and so on. When you need insurance is when you have a condition that is going to cost a lot of money.

They only way to ensure that individuals don't have an incentive to do this. (get insurance only once they have an expensive to treat condition) is to have an individual mandate that requires everyone to have insurance. Not having this would effectively bankrupt all private insurance companies.

On the whole business of policies that start moving the provision of health insurance away from employer to individual... I think that your health care bill does some but not too much. My understanding is that it attempts to equalize the tax treatment of premiums so that the same deductions are available regardless of whether you choose to get your health insurance through your employer or on your own. If I understand this correctly then this ought to start the process of employers providing higher wages in lieu of health coverage. I think this is an area that they could have / should have done a lot more in, along with tort reform.

We have a very very different health care system in Canada from what you have in America. It is completely a single payer system, otherwise known as 'socialist' There is only a public healthcare system that is funded out of a combination of general tax revenues and specific contributions done by all employers. Each province administers its own public health insurance system. Doctors, X ray clinics, pathology labs etc. are private operations which simply bill the province's health insurance when you need their services. In Ontario, the public insurance is called OHIP (Ontario Health Insurance Plan).

Hospitals are not privately owned (for the most part) but are administered not-for-profit.

One very key difference between our systems is that in Canada you cannot as a patient decide to go see a specialist. You must be referred by your family doctor. Consequently, in Canada the ratio of of GPs to specialists is 3:1. This is the case for other first world nations for the most part. It is the reverse in America.

Your current health care legislation, in my opinion, does not move you towards the kind of system that we have. Despite the rhetoric, we've got a socialist system here (and it has its flaws but it isn't half bad) and I've got a pretty good idea of what one looks like. I'd say Obama's policy with no public option, elimination of pre-existing conditions and the individual mandate is very much a middle of the road capitalist way to approach the problem. It is more like Germany's than anywhere else, with the exception that they have a public option in addition to private insurance.

Wrt. rationing - everyone better get used to this - no matter where you live. We are living longer and we tend to consume far far more healthcare as we get older. Medical science is getting better and better as well. Nothing is going to stop these two trends. So either health care services re going to be rationed and we are not all going to get that billion dollar pill that will allow us to add three months to our life, or the entire economy is simply going to be health services, and we are all going to give each other checkups. Everybody might as well start having a rational conversation about this.

Thank you CanoeTrpr, that is a rational presentation of the topic.

It's a shame many USA folks do not keep up with other countries news and systems. There is a dearth of factual international news. A smidgen in a newspaper or TV as it relates to wars, etc. Very little about issues that tell us how it is to actually live in another country. We tend to be very USA-centric and the cultural isolation that results is not good. In the absence of facts and actual knowledge, demagoguery rules.
Dave.