After 6 years obstructing Obama’s presidency, screaming “we have a plan, we have a plan!” they obviously did not. No idea.
No idea how to legislate
No idea how to govern.
This is the party that voted dozens of times to either cripple Obamacare via defunding measures, or outright repeal it, only to have literally zero tenable ideas on how to improve it, or replace it with something better. They control both houses of Congress and the Presidency and have been a complete embarrassment. McConnell knows he is running out of time, because once election season rolls around, nobody will dare pass a controversial bill. With continually tanking approval rating from the President, nobody will want to attach their name to anything that connects themselves to him.
Fortunately for Republicans, Democrats will capitulate at a moments notice for any morsel of compromise they can get out of the GOP. What we will assuredly end up with will be a Frankenbill trying to appease the sociopaths on the far-right, the greedy corporatists in both parties, and the handful of moderate Democrats in red states worried about their seats.
It will pass by 1 vote or a VP tie-breaker, and guaranteed it will suck for everyone, be less effective than Obamacare, and probably still result in much lower taxes for the rich, with a lower standard of care for everyone else. Fortunately, butchering this bill will be a temporary pain that results in single-payer or public option once Democrats regain congress and the Presidency.
Right on, Doug! I wonder if this is the SPECIFICCS Yogi was referring to all this time. Specifically, turning to the Democratic party for some ASSISTANCE.
I am still trying to figure out how 23 million will lose their coverage (over the next 10 years) when only 10 million are currently on obamacare.
Also, until the consumers are asked to shop for services, medical insurance will continue to be broken. In other words, if an MRI test carried a coinsurance payment by the consumer, they would shop around for a decent price for the service, and not just go where their Doc sends them (who may be getting a referral fee).
My physician always recommends I shop around to make sure my out-of-pocket expenses are kept as low as possible. So, what you are suggesting is already happening. In fact, most everyone I talk to shops before having major testing or surgeries. I also talk to my carrier to make sure all is approved. Are you saying you don’t? Do you want to be a part of your own solution or part of the problem?
You didn’t explain to Jack why Libitterals who lost the WH, didn’t recapture the House, and made no significant progress in recapturing the Senate, claim 23 million will LOSE THEIR COVERAGE (over the next 10 years). Try again to answer the question posed and to follow the ongoing dialog among informed adults! Ready, steady, …. GO!
Y’all are smart people..are you trying to help, or just call names?
Facts as I see them.
– High Tech Health Care Costs are exploding.
– Family of 2 40ish ACA Ins. is $2,000 / mo. That’ll break them.
– Interstate market will only homogenize rates nationwide. Not a Fix.
– Most everyone agrees some kind of preexcon Ins. is good.
– But proposal for separate fund for preexcon, has no limit on costs.
– Single-payer ends up w/ unlimited subsidized coverage for all.
– Essential to have a way to increase Rev, and/or reduce costs.
Are any above statements inaccurate? Any additional facts to add?
Maybe with facts on the Table, is there a solution? or just more Pol Hype?
Bill Price
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JUNE 28, 2017 AT 3:13 AM
Doug Fisher says:
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My 2 cents:
– High Tech Health Care Costs are exploding.
Agreed. Unfortunately, neither the House nor Senate bill address how to control costs. Ideas that have been floated forever like allowing cheap Canadian drugs (same or more rigorous testing standards than the FDA), encouraging and promoting selling insurance across state lines, and incentivizing prevention of diseases instead of treating catastrophic incidents in ERs are not present in this bill.
– Family of 2 40ish ACA Ins. is $2,000 / mo. That’ll break them.
I have never heard of premiums being anywhere close to this high. Please provide a resource or a link that supports this assertion. I am seeing a Kaiser Family Foundation link that shows less than half this amount in almost every state. But maybe I am wrong. I do agree that the premiums were still too high, though, even at half of your quoted amount. In those cases, people would probably opt to pay the year-end uninsured tax, instead, which capped out at 2.5% of income.
– Interstate market will only homogenize rates nationwide. Not a Fix.
Agreed.
– Most everyone agrees some kind of preexcon Ins. is good.
If we are going to be a fair and just society, YES. If we are going to let greed, avarice and a total lack of empathy take over, then no.
– But proposal for separate fund for preexcon, has no limit on costs.
You can’t rope every preexcon into a high-risk pool, because insurers won’t want to participate in those pools and the premiums would be ASTRONOMICAL for the participants. It would just be another ER visit, with astronomical costs that don’t go paid, because nobody can afford them, so the insureds end up taking more rate hikes for all types of services to pay for those without coverage. Else, the victim goes bankrupt and they and their families are irreversibly effected for years, if not decades.
– Single-payer ends up w/ unlimited subsidized coverage for all.
Correct. Everyone’s taxes go up, specifically the wealthy.
– Essential to have a way to increase Rev, and/or reduce costs.
Million dollar question here. Nobody seems to want to do either. Republicans won’t raise taxes, and neither side is interested in forcing rates down to reasonable amounts.
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JUNE 28, 2017 AT 6:00 PM
bill price says:
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Doug,
Your comments are constructive.
I’m tied up thru tomorrow, but will respond ASAP.
Thanks for seeking a productive analysis.
BP
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JUNE 29, 2017 AT 2:03 AM
Doug Fisher says:
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Thank you, I would welcome further analysis and disputation of any points. Perhaps we can learn more together and, even if we arrive at different answers due to differing ideologies. All things are edifying when done with true intent.
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JULY 5, 2017 AT 3:53 PM
bill price says:
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Doug,
( Sorry for Delay.. I work + live at beach so lots of family visits over 4th.)
To the Discussion of the unagreed ” Facts” :::::
– Family of 2 40ish ACA Ins. is $2,000 / mo. That’ll break them.
BCBS is single Provider in NC. Rates have close to Doubled.
I had heard “Street Talk” of $2,000 premiums, but saw no facts. The Example > H&W, both work,wife hard working waitress volunteered comment of their premium over $2,000/ mo. in ’17. Again, that will break most families.
– But proposal for separate fund for preexcon, has no limit on costs.
– Essential to have a way to increase Rev, and/or reduce costs.
Basically , you agree….
Your response,, Pooling all Prexisting Conditions will break the pool, and agree that Taxes must be raised or costs cut.
I basically see 2 options:
1) Other unlimited Sources of Tax revenues on a wobbly economy. (But Unlimited high tech Health Care will break the economy.)
or
2) Increase revenues with increased premiums on Intentionally Unhealthy people or encourage Intentionally Unhealthy people to get healthy to reduce costs.
We have beat this issue of Intentionally Unhealthy people around a bit with no resolution.
IMO, there is no option. If there is no countervailant Increase in Revenue or strong motivation to Get Healthy, health care must ultimately be rationed or total taxes will overwhelme the Country.
Please note again, that I support Preexcon for individuals with genetic preexcon that try to live healthy lives. They deserve all the help we can give them. I ABSOLUTELY DO NOT support Preexcon coverage at basic Premium, for the guy that smokes 4 Packs a day.
Is there another solution?
Bill Price
PS: I recall the grade school election where one candate proposed a “pay as you go” plan. The opposition offered Free Ice cream for every one.
The Free Ice Cream Candidate won, but with no money, there was no Fee Ice Cream ( except probaly for the winner.)
No country can afford High Quality, Unlimited High tech Health Care.
In this instance, I will admit to calling names. We are just pointing out the fact that we have been mislead/lied to by the Republicans for 7+ years who said had this great plan ready for when they were in power.
While I enjoy debating different ideas to solve our health care/insurance problems, those in positions to make a difference do not care.
In my opinion, the only true solution is single payer health care.
I’m a R and fully agree that Congress has repeatedly said they had plan. Obviously they don’t.
Let’s see if this group can find an agreement, then try to sell it.
How do you see Single Payer staying solvent against Preexcon, unlimited high tech medicine.
BP
You asked, “How do you see Single Payer staying solvent against Preexcon, unlimited high tech medicine.” It would have the backing of the U.S. government.
There is no free market solution that can profitably address re-existing conditions, period. Especially if you do not mandate everyone have quality health insurance to spread out the risk.
In order for a free market health insurance to be profitable they would need to be allowed to underwrite each risk and price accordingly. That includes denying those with pre-existing conditions.
In addition, anyone seeking benefits, including the emergency room, would need to prove they either have health insurance to cover what it is they need or capital in reserve to cover the expenses. That is how it works in the rest of the insurance world. Try to file a homeowners, life or auto claim without coverage. Let me know how that works for you.
We need to totally rethink how we address health care/insurance. While there is no perfect system, Single Payer is the only option we have not tried that takes care of all citizens and maintains the compassion upon which this country is founded.
I disagree that there cannot be a free market solution to preexcon.
Not all preexcon’s are catastrophic. I have HBP and high cholesterol and it is managed quite inexpensively. Could it lead to heart disease or stroke? Of course! But that does not mean that it will.
Yes, health insurers need to underwrite better and it seems like they need better data analytics so that they can distinguish between a “good” preexcon and a “bad” one. Allowing underwriting will increase premiums for some and lower it for others. That is how real insurance works. The lower premiums will enable those that don’t buy because of affordability, to actually buy coverage, increasing the available premium to pay losses for the higher risks, which ultimately keep their costs down. It is done everyday in the P&C market and it works. Carriers are always thinking they can underwrite the business better than the next company, which drives costs lower as they try to increase market share.
The free market solution is the catastrophe coverage which needs to be defined by “cost” not preexcon. Once the cost reaches a certain level, the coverage switches to the Cat coverage. Every year is a new year and the primary coverage pays until the threshold is hit, then it goes back to the Cat coverage. Even serious preexcon situations have “dormant years” (i.e. a person with cancer goes into remission).
Single payer is not a good solution explained simply with two words – “Charlie Gard”. Whether you believe it or not, at some point, the “single payer” is going to play God and decide for the family that they do not want to provide the coverage. The excuse will be “it is in the patient’s best interest”, but that excuse is not for them to decide. It should be the patient’s decision because that is true freedom. The patient loses their right to pursue happiness, even if that happiness only will realistically last for only three months, it is still THEIR happiness.
I find it amazing that people complain about the insurance companies denying coverage and think that they are going to have a different experience in a single payer system. Isn’t the Charlie Gard case an example of the single payer denying to provide a potentially life saving procedure the same thing? They think it is humane to stop and let the kid die. That’s their opinion but NOT their decision to make.
We live in a sad, sad time when a human life can easily be discarded because of someone else’s opinion.
July 12, 2017 at 10:27 am
bill price says:
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Ron,
My concern is that ultimately, even the US Government can’t afford “Preexcon, unlimited high tech medicine.”
My proposal is to allow Preexcon, but charge Intentionally Unhealthy folks extra, unless they get healthy.
That either increases Revenue, or reduces Costs.
Do you believe in and Individual Responsibility and Choice?
Bill Price
July 12, 2017 at 10:37 am
Ron says:
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integrity matters,
While there are some pre-existing conditions are manageable, they are guaranteed to cost more money than someone who does not have such a condition. That needs to be factored into the premiums, correct?
Now, not only do you have to manage and, in many cases, suffer through having a pre-existing condition, you have to pay more money. What if you have a chronic condition that prevents or just limits your ability to work? Now you have reduced enjoyment of life, less earning potential AND higher premiums. Can we get any less compassionate?
As I mentioned in my previous post, we cannot compare health insurance to other lines, unless, as I said, you deny care until coverage is verified. Do you want to live in a world like that?
As I have stated multiple times, there is no perfect system.
Regarding Charlie Gard, the UK has Socialized Health Care, not Single Payer. Do you know the difference between Single Payer and Socialized Health Care? With Single Payer, private insurance companies would be making the decisions, not the government. With Single Payer, the government would collect premiums, in the form of taxes, and pay the private insurance companies. In addition, they would still be in charge of regulations and auditing the insurance companies. The government’s involvement would end there.
In my opinion, it is an even sadder world if we let sick people go without care and even die because they cannot afford to pay when we have more than enough resources in this great country to take care of all of our citizens. Many claim we are a Christian nation. Can we please start acting like it?
July 12, 2017 at 1:30 pm
integrity matters says:
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Ron, Thanks for your reply.
Regarding your question about manageable preexcon being factored into the costs. Yes they do, but that is where better data analytics and underwriting become more important. The cost of an insurance company paying for the preventive care for any preexcon should be significantly less than the alternative of them paying for a surgery later. There should be enough data to actuarially determine the costs and impact of those exposures.
You said “Now, not only do you have to manage and, in many cases, suffer through having a pre-existing condition, you have to pay more money. What if you have a chronic condition that prevents or just limits your ability to work? Now you have reduced enjoyment of life, less earning potential AND higher premiums. Can we get any less compassionate?” Forgive me for sounding less compassionate, but, isn’t what you described…”life”? Stuff happens and no insurance (or entitlement, for that matter) is going to provide a Utopian fix for what happens in life. Are you saying that the government should now purchase disability policies for those that cannot work due to their chronic condition? Where does it ever end?
You said “As I mentioned in my previous post, we cannot compare health insurance to other lines, unless, as I said, you deny care until coverage is verified. Do you want to live in a world like that?” We are going to have to “agree to disagree” on this point. Why does it have change from what takes place today? I’ve been to the ER twice this year and neither time did they ask me what my limit was? The patient is still ultimately responsible for payment. If there was a “Cat” coverage purchased, that insurance card could be presented. If I am a person that develops a condition or that has a preexcon, is it not my personal responsibility to seek and obtain coverage to protect myself? Yes, I know it would be difficult to buy AFTER the condition is discovered, which is all the more reason why people need to be educated to buy it while they are healthy. The problem today is that there has been too much “hand holding” by the govt and creating the expectation that the govt will be a “savior” and fix everything. This country got along for almost two hundred years on the premise that people are responsible for their own actions and situations. When catastrophic needs arose, the community (family, friends, churches, etc) stepped up and supported those needing help, not the govt.
Regarding single payer vs. socialized healthcare, I think it is naïve to assume that the govt’s “auditing” procedures would not include a “utilization” review. Do you not think the gov’t is going to set “parameters” for what the insurance companies pay, both the amount for specific services and for what types of services? Do you really think cutting edge, unproven procedures will be covered? Isn’t the health provider going to have to call to see if it is covered?
What is more important, personal responsibility and liberty (freedom to choose) or personal irresponsibility and dictatorship?
Our current entitlements and Obamacare have already proven that the latter does not work and is not sustainable over a long period of time. I am not saying that people that truly need help shouldn’t be given help. It is all of responsibility to do that, via a hand up, not a handout. We have done this for over 200 years as a Christian nation, but there are increased forces from those that do not believe in God that want to continually try to remove God from our country. Could that be a reason why some are less compassionate than others? The human race throughout history has tried to put themselves above (or on equal ground) with God and it’s impossible.
Christians (and this nation) continues to “love their neighbor” despite the ridicule and opposition more than any other country. It’s hard to act like a Christian nation when the govt can’t portray themselves as a Christian nation for fear of the ACLU and atheists.
July 12, 2017 at 2:52 pm
Ron says:
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integrity matters,
Thank you for the honest and respectful debate.
You said, “Forgive me for sounding less compassionate, but, isn’t what you described…”life”? Stuff happens and no insurance (or entitlement, for that matter) is going to provide a Utopian fix for what happens in life.” I would have no problem using this philosophy for those who have put themselves into a tough position due to poor decisions. However, until you can find a way to separate those whose medical conditions are due to intentional poor decisions and those who have conditions that are hereditary or environmental (ex. inner cities where healthy food is sparse, expense or both), how do you tell someone that they need to pay more because of their ancestry or where they were born?
This is not a Utopian fix. The idea behind Single Payer is to create the largest pool to spread the risk. Is that not the goal of insurance? People and corporations will pay more in taxes to pay for this. Heck, let’s levy a sin tax on alcohol, cigarettes, junk/processed foods, soda, etc. to help pay for it. We could even legalize marijuana and add a tax that too. That way, those who do make poor decisions, do pay more. To go even further, if you can determine that someone requires care solely because of a poor decision, they need to pay a special deductible to cover or defer some of the costs.
I agree with a lot you are saying and understand your and anyone else’s reluctance to bring the government into anything more. However, the free market had their chance to reform health care to provide affordable solutions for people with pre-existing conditions and either refused because it would be less profitable or failed. I am going with the former.
This is another industry where, if the private sector is either unwilling or unable to come up with a solution to help the people, the government is the only other option.
You asked, “What is more important, personal responsibility and liberty (freedom to choose) or personal irresponsibility and dictatorship?” If I had to choose, I would say the former. However, those are not the only options. Our country has prospered applying parts of all, but dictatorship. More importantly, I have yet to meet anyone who believes in true freedom and liberty.
You said, “It’s hard to act like a Christian nation when the govt can’t portray themselves as a Christian nation for fear of the ACLU and atheists.” I have never heard the ACLU or any atheist be against anyone acting like a Christian. They, as is the Constitution, against the forcing of a religion upon the people. There is a significant difference.
I am not sure why you think being less compassionate will bring this country closer to God.
July 7, 2017 at 4:01 pm
Agent says:
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Bill, looks like you spent a lot of time with your post. Are you getting any work done for your employer? By the way, Single Payer would make Oblamacare look cheap by comparison.
Agent,
I work for myself, and I’m not happy with me ( but nothing new there.)
I asked Ron how he sees single payer staying solvent with unlimited preexcon high tech medicine?
Nonetheless, I have a Niece that has juvenile diabetes and she lives as healthy a life as absolutely possible, and couldn’t get ins. with preexcon. What I don’t understand is why a person that smokes 4 packs a day should have same rates as she, or anyone else living a healthy life.
BP
Yep, you got me, because I work at 8:09 pm on a Friday…or 4:47pm on a Saturday for that matter.
Having Agent calling out some dude he doesn’t know is asinine. At least we can tell that you are special when we call you out.
Remember:
-100% Disingenuous
-Imbecile
or
-Zombie Fly – ready to regurgitate any right wing talking point without regards to truth or tact.
Which one are you going to be today? Or are you going to start whining that liberals don’t want to kill people out of bloodlust again?
July 11, 2017 at 2:08 pm
Bill Price says:
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Doug,,
I’m a Contractor, Developer and every-things always my fault.
Do you have any comments to my post?
( A note: I started building on NC Coast in 1970. Received letters for all my employees from BCBS urging Employer Paid Health Insurance. I responded that if Health Care was free, the System would go broke. The Pres. of BCBS wrote me saying I didn’t know what I was talking about. IMO, we’re getting close.)
Bill Price
You, of all people, are actually criticizing someone for the amount of time they spent on IJ?!?! Wow. At least he had something to say…your posts are typically worth little except to you and Yogi.
I’m OK with repeal & REPLACE failing if the REPEAL occurs shortly thereafter, followed by regulatory action to enable greater competition across state lines, re-establishment of high risk pools, and a few other things included in HEALTH CARE SPPECIFICCS.
I’d like to add three important points to this discussion.
1) The major reason the Repeal and Replace has not been passed already is because there are some Republicans that actually have integrity and care about what they want to pass. Simply changing a few items in Obamacare is not going to fix the systemic or endemic problems.
2) IJ and the rest of the media reporting on these bills continue to FALSELY report that “X” amount of people are going to LOSE coverage. Medicaid is not being taken away AND people will have the choice to purchase coverage or not. They only LOSE coverage if they make the decision to not buy coverage.
3) In addition to the many good points made, lowering costs through increased competition will help achieve the overall goal.
Thanks, IM. In addition to point 3, I’d add that increased supply of medical providers and drug mfrs will increase competition and temper cost increases. Pertinent to that is the licensing across state lines and the med mal tort law reforms proposed as separate actions from ‘pure repeal’.
The latest stats and reports from credible sources that I’ve been following show drug costs driving the huge increase in med care costs. Some proposals have untested, possible solutions to that issue, and include ideas used ‘up north’.
One thing people haven’t figured out yet is how to deal with adverse selection and prexers. The proposal that may soon be PARTIALLY revealed by McConnell deals effectively with BOTH, and is included in the memory key HEALTH CARE SPPECIFICCS. Stay tuned!
IM
The money has to come from somewhere.
If we open up tax sources to fund insurance doesn’t that simply obscure the Cost and provide More and More tax revenue to ultimate insolvency?
Also, interstate sales only homogenizes the costs. Some go up, some go down with rates being equalized nationwide.
If we don’t fix the system now, we drown.
BP
Bear: Thanks and I agree with your additional comments.
Regarding the preexcon situation, in my humble opinion, they should (and can) be handled within normal health care coverage, IF:
1) There is a reasonable price adjustment/deductible that is affordable to the patient and “helps” the insurance carrier for the specific condition, AND
2) There is a catastrophic plan (aka: reinsurance pool) in place to spread the risk of ANY health condition (preexcon or newly developed) that exceeds a certain cost to the health insurance carrier. This would have to be actuarially determined so that the price point below and above the CAT Health plan is affordable.
Each health insurance carrier could offer the coverage to their insureds. If it is reasonable priced (1-5% of health premiums), the participation should be higher.
This could work with any type of underlying health plan, including the high deductible HSA plans.
Many health care plans have unlimited upsides to them today, which is costly and a big risk to the carriers. If that was capped with a limit,
1) it should lower the “primary” care coverage for the majority of people, and
2) people could buy excess coverage that fits their budget.
Depending upon how the numbers work out, I might even be in favor of “mandating” a minimum $1MM cat coverage for a fixed minimum premium. People could buy more as they deemed necessary for their specific situation.
I want to add that it is possible that the “Cat” coverage could even work for people that are on Govt Medicare or Medicaid. I’m sure there would be numerous reinsurers that would love to get the infusion of Govt cash to cover the individuals under those plans.
This would also lower the cost of those programs to the taxpayers.
That indeed is one of the aspects of the revised plan being considered. However, the reinsurers you mention are defined much more broadly than is typically the case. I can’t reveal anything else, at this point. I’m not allowed, and I’mnot privy to the art of the ‘reinsurance’ deal.
After 6 years obstructing Obama’s presidency, screaming “we have a plan, we have a plan!” they obviously did not. No idea.
No idea how to legislate
No idea how to govern.
This is the party that voted dozens of times to either cripple Obamacare via defunding measures, or outright repeal it, only to have literally zero tenable ideas on how to improve it, or replace it with something better. They control both houses of Congress and the Presidency and have been a complete embarrassment. McConnell knows he is running out of time, because once election season rolls around, nobody will dare pass a controversial bill. With continually tanking approval rating from the President, nobody will want to attach their name to anything that connects themselves to him.
Fortunately for Republicans, Democrats will capitulate at a moments notice for any morsel of compromise they can get out of the GOP. What we will assuredly end up with will be a Frankenbill trying to appease the sociopaths on the far-right, the greedy corporatists in both parties, and the handful of moderate Democrats in red states worried about their seats.
It will pass by 1 vote or a VP tie-breaker, and guaranteed it will suck for everyone, be less effective than Obamacare, and probably still result in much lower taxes for the rich, with a lower standard of care for everyone else. Fortunately, butchering this bill will be a temporary pain that results in single-payer or public option once Democrats regain congress and the Presidency.
Tired of all that winning yet?
Doug Fisher,
Hit the nail right on the head.
Thank you for not leaving anything for me to add.
Right on, Doug! I wonder if this is the SPECIFICCS Yogi was referring to all this time. Specifically, turning to the Democratic party for some ASSISTANCE.
I am still trying to figure out how 23 million will lose their coverage (over the next 10 years) when only 10 million are currently on obamacare.
Also, until the consumers are asked to shop for services, medical insurance will continue to be broken. In other words, if an MRI test carried a coinsurance payment by the consumer, they would shop around for a decent price for the service, and not just go where their Doc sends them (who may be getting a referral fee).
My physician always recommends I shop around to make sure my out-of-pocket expenses are kept as low as possible. So, what you are suggesting is already happening. In fact, most everyone I talk to shops before having major testing or surgeries. I also talk to my carrier to make sure all is approved. Are you saying you don’t? Do you want to be a part of your own solution or part of the problem?
You didn’t explain to Jack why Libitterals who lost the WH, didn’t recapture the House, and made no significant progress in recapturing the Senate, claim 23 million will LOSE THEIR COVERAGE (over the next 10 years). Try again to answer the question posed and to follow the ongoing dialog among informed adults! Ready, steady, …. GO!
Who screamed “we have a plan” for 6 years? Names and states they represent, please. Ready, steady, …. GO!
After your list, explain why such foolish optimism would persist for 6 yrs when Obama would veto any such plans? Ready, steady, …. GO!
Doug and Ron.
To Continue previous analysis.
bill price says:
Y’all are smart people..are you trying to help, or just call names?
Facts as I see them.
– High Tech Health Care Costs are exploding.
– Family of 2 40ish ACA Ins. is $2,000 / mo. That’ll break them.
– Interstate market will only homogenize rates nationwide. Not a Fix.
– Most everyone agrees some kind of preexcon Ins. is good.
– But proposal for separate fund for preexcon, has no limit on costs.
– Single-payer ends up w/ unlimited subsidized coverage for all.
– Essential to have a way to increase Rev, and/or reduce costs.
Are any above statements inaccurate? Any additional facts to add?
Maybe with facts on the Table, is there a solution? or just more Pol Hype?
Bill Price
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JUNE 28, 2017 AT 3:13 AM
Doug Fisher says:
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My 2 cents:
– High Tech Health Care Costs are exploding.
Agreed. Unfortunately, neither the House nor Senate bill address how to control costs. Ideas that have been floated forever like allowing cheap Canadian drugs (same or more rigorous testing standards than the FDA), encouraging and promoting selling insurance across state lines, and incentivizing prevention of diseases instead of treating catastrophic incidents in ERs are not present in this bill.
– Family of 2 40ish ACA Ins. is $2,000 / mo. That’ll break them.
I have never heard of premiums being anywhere close to this high. Please provide a resource or a link that supports this assertion. I am seeing a Kaiser Family Foundation link that shows less than half this amount in almost every state. But maybe I am wrong. I do agree that the premiums were still too high, though, even at half of your quoted amount. In those cases, people would probably opt to pay the year-end uninsured tax, instead, which capped out at 2.5% of income.
– Interstate market will only homogenize rates nationwide. Not a Fix.
Agreed.
– Most everyone agrees some kind of preexcon Ins. is good.
If we are going to be a fair and just society, YES. If we are going to let greed, avarice and a total lack of empathy take over, then no.
– But proposal for separate fund for preexcon, has no limit on costs.
You can’t rope every preexcon into a high-risk pool, because insurers won’t want to participate in those pools and the premiums would be ASTRONOMICAL for the participants. It would just be another ER visit, with astronomical costs that don’t go paid, because nobody can afford them, so the insureds end up taking more rate hikes for all types of services to pay for those without coverage. Else, the victim goes bankrupt and they and their families are irreversibly effected for years, if not decades.
– Single-payer ends up w/ unlimited subsidized coverage for all.
Correct. Everyone’s taxes go up, specifically the wealthy.
– Essential to have a way to increase Rev, and/or reduce costs.
Million dollar question here. Nobody seems to want to do either. Republicans won’t raise taxes, and neither side is interested in forcing rates down to reasonable amounts.
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JUNE 28, 2017 AT 6:00 PM
bill price says:
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Doug,
Your comments are constructive.
I’m tied up thru tomorrow, but will respond ASAP.
Thanks for seeking a productive analysis.
BP
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JUNE 29, 2017 AT 2:03 AM
Doug Fisher says:
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Thank you, I would welcome further analysis and disputation of any points. Perhaps we can learn more together and, even if we arrive at different answers due to differing ideologies. All things are edifying when done with true intent.
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JULY 5, 2017 AT 3:53 PM
bill price says:
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Doug,
( Sorry for Delay.. I work + live at beach so lots of family visits over 4th.)
To the Discussion of the unagreed ” Facts” :::::
– Family of 2 40ish ACA Ins. is $2,000 / mo. That’ll break them.
BCBS is single Provider in NC. Rates have close to Doubled.
I had heard “Street Talk” of $2,000 premiums, but saw no facts. The Example > H&W, both work,wife hard working waitress volunteered comment of their premium over $2,000/ mo. in ’17. Again, that will break most families.
– But proposal for separate fund for preexcon, has no limit on costs.
– Essential to have a way to increase Rev, and/or reduce costs.
Basically , you agree….
Your response,, Pooling all Prexisting Conditions will break the pool, and agree that Taxes must be raised or costs cut.
I basically see 2 options:
1) Other unlimited Sources of Tax revenues on a wobbly economy. (But Unlimited high tech Health Care will break the economy.)
or
2) Increase revenues with increased premiums on Intentionally Unhealthy people or encourage Intentionally Unhealthy people to get healthy to reduce costs.
We have beat this issue of Intentionally Unhealthy people around a bit with no resolution.
IMO, there is no option. If there is no countervailant Increase in Revenue or strong motivation to Get Healthy, health care must ultimately be rationed or total taxes will overwhelme the Country.
Please note again, that I support Preexcon for individuals with genetic preexcon that try to live healthy lives. They deserve all the help we can give them. I ABSOLUTELY DO NOT support Preexcon coverage at basic Premium, for the guy that smokes 4 Packs a day.
Is there another solution?
Bill Price
PS: I recall the grade school election where one candate proposed a “pay as you go” plan. The opposition offered Free Ice cream for every one.
The Free Ice Cream Candidate won, but with no money, there was no Fee Ice Cream ( except probaly for the winner.)
No country can afford High Quality, Unlimited High tech Health Care.
Bill Price,
In this instance, I will admit to calling names. We are just pointing out the fact that we have been mislead/lied to by the Republicans for 7+ years who said had this great plan ready for when they were in power.
While I enjoy debating different ideas to solve our health care/insurance problems, those in positions to make a difference do not care.
In my opinion, the only true solution is single payer health care.
I’m a R and fully agree that Congress has repeatedly said they had plan. Obviously they don’t.
Let’s see if this group can find an agreement, then try to sell it.
How do you see Single Payer staying solvent against Preexcon, unlimited high tech medicine.
BP
Bill Price,
You asked, “How do you see Single Payer staying solvent against Preexcon, unlimited high tech medicine.” It would have the backing of the U.S. government.
There is no free market solution that can profitably address re-existing conditions, period. Especially if you do not mandate everyone have quality health insurance to spread out the risk.
In order for a free market health insurance to be profitable they would need to be allowed to underwrite each risk and price accordingly. That includes denying those with pre-existing conditions.
In addition, anyone seeking benefits, including the emergency room, would need to prove they either have health insurance to cover what it is they need or capital in reserve to cover the expenses. That is how it works in the rest of the insurance world. Try to file a homeowners, life or auto claim without coverage. Let me know how that works for you.
We need to totally rethink how we address health care/insurance. While there is no perfect system, Single Payer is the only option we have not tried that takes care of all citizens and maintains the compassion upon which this country is founded.
Ron –
I disagree that there cannot be a free market solution to preexcon.
Not all preexcon’s are catastrophic. I have HBP and high cholesterol and it is managed quite inexpensively. Could it lead to heart disease or stroke? Of course! But that does not mean that it will.
Yes, health insurers need to underwrite better and it seems like they need better data analytics so that they can distinguish between a “good” preexcon and a “bad” one. Allowing underwriting will increase premiums for some and lower it for others. That is how real insurance works. The lower premiums will enable those that don’t buy because of affordability, to actually buy coverage, increasing the available premium to pay losses for the higher risks, which ultimately keep their costs down. It is done everyday in the P&C market and it works. Carriers are always thinking they can underwrite the business better than the next company, which drives costs lower as they try to increase market share.
The free market solution is the catastrophe coverage which needs to be defined by “cost” not preexcon. Once the cost reaches a certain level, the coverage switches to the Cat coverage. Every year is a new year and the primary coverage pays until the threshold is hit, then it goes back to the Cat coverage. Even serious preexcon situations have “dormant years” (i.e. a person with cancer goes into remission).
Single payer is not a good solution explained simply with two words – “Charlie Gard”. Whether you believe it or not, at some point, the “single payer” is going to play God and decide for the family that they do not want to provide the coverage. The excuse will be “it is in the patient’s best interest”, but that excuse is not for them to decide. It should be the patient’s decision because that is true freedom. The patient loses their right to pursue happiness, even if that happiness only will realistically last for only three months, it is still THEIR happiness.
I find it amazing that people complain about the insurance companies denying coverage and think that they are going to have a different experience in a single payer system. Isn’t the Charlie Gard case an example of the single payer denying to provide a potentially life saving procedure the same thing? They think it is humane to stop and let the kid die. That’s their opinion but NOT their decision to make.
We live in a sad, sad time when a human life can easily be discarded because of someone else’s opinion.
Ron,
My concern is that ultimately, even the US Government can’t afford “Preexcon, unlimited high tech medicine.”
My proposal is to allow Preexcon, but charge Intentionally Unhealthy folks extra, unless they get healthy.
That either increases Revenue, or reduces Costs.
Do you believe in and Individual Responsibility and Choice?
Bill Price
integrity matters,
While there are some pre-existing conditions are manageable, they are guaranteed to cost more money than someone who does not have such a condition. That needs to be factored into the premiums, correct?
Now, not only do you have to manage and, in many cases, suffer through having a pre-existing condition, you have to pay more money. What if you have a chronic condition that prevents or just limits your ability to work? Now you have reduced enjoyment of life, less earning potential AND higher premiums. Can we get any less compassionate?
As I mentioned in my previous post, we cannot compare health insurance to other lines, unless, as I said, you deny care until coverage is verified. Do you want to live in a world like that?
As I have stated multiple times, there is no perfect system.
Regarding Charlie Gard, the UK has Socialized Health Care, not Single Payer. Do you know the difference between Single Payer and Socialized Health Care? With Single Payer, private insurance companies would be making the decisions, not the government. With Single Payer, the government would collect premiums, in the form of taxes, and pay the private insurance companies. In addition, they would still be in charge of regulations and auditing the insurance companies. The government’s involvement would end there.
In my opinion, it is an even sadder world if we let sick people go without care and even die because they cannot afford to pay when we have more than enough resources in this great country to take care of all of our citizens. Many claim we are a Christian nation. Can we please start acting like it?
Ron, Thanks for your reply.
Regarding your question about manageable preexcon being factored into the costs. Yes they do, but that is where better data analytics and underwriting become more important. The cost of an insurance company paying for the preventive care for any preexcon should be significantly less than the alternative of them paying for a surgery later. There should be enough data to actuarially determine the costs and impact of those exposures.
You said “Now, not only do you have to manage and, in many cases, suffer through having a pre-existing condition, you have to pay more money. What if you have a chronic condition that prevents or just limits your ability to work? Now you have reduced enjoyment of life, less earning potential AND higher premiums. Can we get any less compassionate?” Forgive me for sounding less compassionate, but, isn’t what you described…”life”? Stuff happens and no insurance (or entitlement, for that matter) is going to provide a Utopian fix for what happens in life. Are you saying that the government should now purchase disability policies for those that cannot work due to their chronic condition? Where does it ever end?
You said “As I mentioned in my previous post, we cannot compare health insurance to other lines, unless, as I said, you deny care until coverage is verified. Do you want to live in a world like that?” We are going to have to “agree to disagree” on this point. Why does it have change from what takes place today? I’ve been to the ER twice this year and neither time did they ask me what my limit was? The patient is still ultimately responsible for payment. If there was a “Cat” coverage purchased, that insurance card could be presented. If I am a person that develops a condition or that has a preexcon, is it not my personal responsibility to seek and obtain coverage to protect myself? Yes, I know it would be difficult to buy AFTER the condition is discovered, which is all the more reason why people need to be educated to buy it while they are healthy. The problem today is that there has been too much “hand holding” by the govt and creating the expectation that the govt will be a “savior” and fix everything. This country got along for almost two hundred years on the premise that people are responsible for their own actions and situations. When catastrophic needs arose, the community (family, friends, churches, etc) stepped up and supported those needing help, not the govt.
Regarding single payer vs. socialized healthcare, I think it is naïve to assume that the govt’s “auditing” procedures would not include a “utilization” review. Do you not think the gov’t is going to set “parameters” for what the insurance companies pay, both the amount for specific services and for what types of services? Do you really think cutting edge, unproven procedures will be covered? Isn’t the health provider going to have to call to see if it is covered?
What is more important, personal responsibility and liberty (freedom to choose) or personal irresponsibility and dictatorship?
Our current entitlements and Obamacare have already proven that the latter does not work and is not sustainable over a long period of time. I am not saying that people that truly need help shouldn’t be given help. It is all of responsibility to do that, via a hand up, not a handout. We have done this for over 200 years as a Christian nation, but there are increased forces from those that do not believe in God that want to continually try to remove God from our country. Could that be a reason why some are less compassionate than others? The human race throughout history has tried to put themselves above (or on equal ground) with God and it’s impossible.
Christians (and this nation) continues to “love their neighbor” despite the ridicule and opposition more than any other country. It’s hard to act like a Christian nation when the govt can’t portray themselves as a Christian nation for fear of the ACLU and atheists.
integrity matters,
Thank you for the honest and respectful debate.
You said, “Forgive me for sounding less compassionate, but, isn’t what you described…”life”? Stuff happens and no insurance (or entitlement, for that matter) is going to provide a Utopian fix for what happens in life.” I would have no problem using this philosophy for those who have put themselves into a tough position due to poor decisions. However, until you can find a way to separate those whose medical conditions are due to intentional poor decisions and those who have conditions that are hereditary or environmental (ex. inner cities where healthy food is sparse, expense or both), how do you tell someone that they need to pay more because of their ancestry or where they were born?
This is not a Utopian fix. The idea behind Single Payer is to create the largest pool to spread the risk. Is that not the goal of insurance? People and corporations will pay more in taxes to pay for this. Heck, let’s levy a sin tax on alcohol, cigarettes, junk/processed foods, soda, etc. to help pay for it. We could even legalize marijuana and add a tax that too. That way, those who do make poor decisions, do pay more. To go even further, if you can determine that someone requires care solely because of a poor decision, they need to pay a special deductible to cover or defer some of the costs.
I agree with a lot you are saying and understand your and anyone else’s reluctance to bring the government into anything more. However, the free market had their chance to reform health care to provide affordable solutions for people with pre-existing conditions and either refused because it would be less profitable or failed. I am going with the former.
This is another industry where, if the private sector is either unwilling or unable to come up with a solution to help the people, the government is the only other option.
You asked, “What is more important, personal responsibility and liberty (freedom to choose) or personal irresponsibility and dictatorship?” If I had to choose, I would say the former. However, those are not the only options. Our country has prospered applying parts of all, but dictatorship. More importantly, I have yet to meet anyone who believes in true freedom and liberty.
You said, “It’s hard to act like a Christian nation when the govt can’t portray themselves as a Christian nation for fear of the ACLU and atheists.” I have never heard the ACLU or any atheist be against anyone acting like a Christian. They, as is the Constitution, against the forcing of a religion upon the people. There is a significant difference.
I am not sure why you think being less compassionate will bring this country closer to God.
Bill, looks like you spent a lot of time with your post. Are you getting any work done for your employer? By the way, Single Payer would make Oblamacare look cheap by comparison.
Agent,
I work for myself, and I’m not happy with me ( but nothing new there.)
I asked Ron how he sees single payer staying solvent with unlimited preexcon high tech medicine?
Nonetheless, I have a Niece that has juvenile diabetes and she lives as healthy a life as absolutely possible, and couldn’t get ins. with preexcon. What I don’t understand is why a person that smokes 4 packs a day should have same rates as she, or anyone else living a healthy life.
BP
I have seen a lot of crappy posts out of you, but this may be the worst.
You don’t know this guy, as far as I know. He could be an agency principal, a private contractor, a CEO, etc.
You must not be getting work done for your employer, and are now embarrassed that you were called out for it.
Yep, you got me, because I work at 8:09 pm on a Friday…or 4:47pm on a Saturday for that matter.
Having Agent calling out some dude he doesn’t know is asinine. At least we can tell that you are special when we call you out.
Remember:
-100% Disingenuous
-Imbecile
or
-Zombie Fly – ready to regurgitate any right wing talking point without regards to truth or tact.
Which one are you going to be today? Or are you going to start whining that liberals don’t want to kill people out of bloodlust again?
Doug,,
I’m a Contractor, Developer and every-things always my fault.
Do you have any comments to my post?
( A note: I started building on NC Coast in 1970. Received letters for all my employees from BCBS urging Employer Paid Health Insurance. I responded that if Health Care was free, the System would go broke. The Pres. of BCBS wrote me saying I didn’t know what I was talking about. IMO, we’re getting close.)
Bill Price
You, of all people, are actually criticizing someone for the amount of time they spent on IJ?!?! Wow. At least he had something to say…your posts are typically worth little except to you and Yogi.
I’m OK with repeal & REPLACE failing if the REPEAL occurs shortly thereafter, followed by regulatory action to enable greater competition across state lines, re-establishment of high risk pools, and a few other things included in HEALTH CARE SPPECIFICCS.
REPEAL, and DON’T replace with ACA-lite.
Bill/Ron & Doug:
I’d like to add three important points to this discussion.
1) The major reason the Repeal and Replace has not been passed already is because there are some Republicans that actually have integrity and care about what they want to pass. Simply changing a few items in Obamacare is not going to fix the systemic or endemic problems.
2) IJ and the rest of the media reporting on these bills continue to FALSELY report that “X” amount of people are going to LOSE coverage. Medicaid is not being taken away AND people will have the choice to purchase coverage or not. They only LOSE coverage if they make the decision to not buy coverage.
3) In addition to the many good points made, lowering costs through increased competition will help achieve the overall goal.
Thanks, IM. In addition to point 3, I’d add that increased supply of medical providers and drug mfrs will increase competition and temper cost increases. Pertinent to that is the licensing across state lines and the med mal tort law reforms proposed as separate actions from ‘pure repeal’.
The latest stats and reports from credible sources that I’ve been following show drug costs driving the huge increase in med care costs. Some proposals have untested, possible solutions to that issue, and include ideas used ‘up north’.
One thing people haven’t figured out yet is how to deal with adverse selection and prexers. The proposal that may soon be PARTIALLY revealed by McConnell deals effectively with BOTH, and is included in the memory key HEALTH CARE SPPECIFICCS. Stay tuned!
IM
The money has to come from somewhere.
If we open up tax sources to fund insurance doesn’t that simply obscure the Cost and provide More and More tax revenue to ultimate insolvency?
Also, interstate sales only homogenizes the costs. Some go up, some go down with rates being equalized nationwide.
If we don’t fix the system now, we drown.
BP
Bear: Thanks and I agree with your additional comments.
Regarding the preexcon situation, in my humble opinion, they should (and can) be handled within normal health care coverage, IF:
1) There is a reasonable price adjustment/deductible that is affordable to the patient and “helps” the insurance carrier for the specific condition, AND
2) There is a catastrophic plan (aka: reinsurance pool) in place to spread the risk of ANY health condition (preexcon or newly developed) that exceeds a certain cost to the health insurance carrier. This would have to be actuarially determined so that the price point below and above the CAT Health plan is affordable.
Each health insurance carrier could offer the coverage to their insureds. If it is reasonable priced (1-5% of health premiums), the participation should be higher.
This could work with any type of underlying health plan, including the high deductible HSA plans.
Many health care plans have unlimited upsides to them today, which is costly and a big risk to the carriers. If that was capped with a limit,
1) it should lower the “primary” care coverage for the majority of people, and
2) people could buy excess coverage that fits their budget.
Depending upon how the numbers work out, I might even be in favor of “mandating” a minimum $1MM cat coverage for a fixed minimum premium. People could buy more as they deemed necessary for their specific situation.
I want to add that it is possible that the “Cat” coverage could even work for people that are on Govt Medicare or Medicaid. I’m sure there would be numerous reinsurers that would love to get the infusion of Govt cash to cover the individuals under those plans.
This would also lower the cost of those programs to the taxpayers.
That indeed is one of the aspects of the revised plan being considered. However, the reinsurers you mention are defined much more broadly than is typically the case. I can’t reveal anything else, at this point. I’m not allowed, and I’mnot privy to the art of the ‘reinsurance’ deal.
Thank you integrity for your well thought out post. It won’t register with the Progressives, but it was good.
Why not cut to the chase and follow the Russian health care plan. Russia, are you listening???