Ending For-Profit Health Insurance

[sevfiv]

I have been reading as much as I can about health insurance/care and came across this article written by the Associate Dean of the Weill Medical College at Cornell University:

http://www.pnhp.org/news/2008/september/fo...t_health_in.php

What are your thoughts on this?

[MidtownCoog]

Do you want my thoughts on non-profit healthcare of Governemnt run healthcare?

Govt. waste is a fact of life, and I don't see how Govt. healthcare would be the exception to that rule.

[ricco67]

To be honest, I'd rather not have the government not get involved in health insurance. They would screw it up like they have in Canada and Britain.

Now for the us SUPPLEMENT our personal insurance....I'd be okay with that, particularly those that can't get insured because of "a previous condition" or whatever BS they call it.

[memebag]

What are your thoughts on this?

He's right. The rest of the industrialized world has figured out how to do this. We can benefit from their experience and pay less for better care. It will make the US a better place to live and do business.

[MidtownCoog]

Who says it'd be better? Canada and the UK systems are not.

When I used to spend time in London every week on the telly they had a show about how bad their care is.

If Hillary couldn't do it, nobody can. She's my man!

[TheNiche]

a new study by a team of Harvard researchers who report that 11.4 million of the nation

[sevfiv]

Do you want my thoughts on non-profit healthcare of Governemnt run healthcare?

Non-profit, government run - anything but for-profit (which is just...creepy to me).

I find it hard to believe that we are incapable of providing fair health resources to our citizens without waste, corruption, and inhumane qualities...but I have been unpleasantly surprised many times before

[memebag]

Who says it'd be better? Canada and the UK systems are not.

When I used to spend time in London every week on the telly they had a show about how bad their care is.

If Hillary couldn't do it, nobody can. She's my man!

Why would we limit our system to a copy of Canada or the UK? Watch Sick Around the World to see how it could be better.

[VicMan]

To be honest, I'd rather not have the government not get involved in health insurance. They would screw it up like they have in Canada and Britain.

Now for the us SUPPLEMENT our personal insurance....I'd be okay with that, particularly those that can't get insured because of "a previous condition" or whatever BS they call it.

Ricco67: 1. How did government screw up in Canada?

2. Please keep in mind that Canada's system is on a province by province basis; it would be like if Texas had a Texas Department of Health. Statements about Canada's health care statement are either true or false, depending on the province. See http://www.snopes.com/politics/medical/canada.asp

Edited September 5, 2008 by VicMan

[MidtownCoog]

Shareholder profits don't bother me much; profit is a motive to have an efficient organization with strict cost control proceedures.

Some of those nations have waiting lists for proceedures. What are they waiting for?

Agree. I just don't see the Govt. ever trying to work hard and employ continual service improvement for non-paying customers.

And wait lists are not just for procedures. Even simple things like CAT scans can take months.

[sheeats]

Agree. I just don't see the Govt. ever trying to work hard and employ continual service improvement for non-paying customers.

And wait lists are not just for procedures. Even simple things like CAT scans can take months.

QFT. My husband moved here from the UK six years ago, where he'd lived for the first 27 years of his life. He hated/still hates the UK healthcare system, both when he had private insurance (until he finished university, through his parents of course since it's so expensive) and when he had regular, state-run insurance. The way he tells it, there's no happy medium between the two -- which is what we have here.

If you can afford private insurance in the UK, then you're treated like royalty to almost embarassing extremes. But if you can't, or simply don't want to pay an exorbitant amount of money for it, then you're stuck with the government-run system, which is appalling. Months-long -- sometimes years-long -- waiting lists for even simple procedures, the government arbitrarily deciding piddly stupid things like whether or not you'll be allowed to have general anaesthetic during dental surgery, a shortage of qualified doctors (the good ones move here!), etc. My husband is thrilled with our healthcare system and talks endlessly about how much better it is over here.

Now, personally speaking, I'm in the for-profit healthcare business as a career. So you probably don't want my somewhat biased opinion on it.

[jm1fd]

Any kind of government program would also have immense overhead--larger still on account of government unions. And if it were any kind of program resembling Medicare, it'd be rife with fraud and poor quality of care. Shareholder profits don't bother me much; profit is a motive to have an efficient organization with strict cost control proceedures.

The insurance companies may be wonderfully efficient but the hospitals and doctor's offices who deal with these companies are forced to waste huge amounts of time and money conforming to differing requirements of HUNDREDS of different insurance carriers.

It wouldn't be a bad idea for the government to step in and make all the insurance carriers and all the providers adopt a single standard. That would eliminate a lot of waste right there.

[ricco67]

Ricco67: 1. How did government screw up in Canada?

2. Please keep in mind that Canada's system is on a province by province basis; it would be like if Texas had a Texas Department of Health. Statements about Canada's health care statement are either true or false, depending on the province. See http://www.snopes.com/politics/medical/canada.asp

Because I knew someone who lived in canada who had to go through hoops to get a procedure done.

I'll see if I can explain it properly:

He needed a procedure done (nothing critical, but not something you'd want to wait on).

Turns out he had to be on a waiting done for this particular procedure to be one since the money "for that procedure" (i.e. Ration) was used it. meaning he would have to wait for the next year to do it, however, he could have it done in ANOTHER province because they still have money for THAT procedure. As it was explained to me, he can have the procedure done, but they (the province) has to trade "money" from his home province. It required quite a bit of paperwork and eventually travel to that location to have the procedure done.

So basically, if you need knee replacement done and you live in the Quebec Province, you better get your procedure done before all "knee replacements" money is used up. If you can't do that, then you have to go to Manitoba where the procedure isn't as common and have it done there, but since you're not a resident of that province, they have to get money from Quebec to "Reimburse" them.

The next procedure he had done, he just said to hell with it flew to the US, paid for the procedure in cash and flew back home.

Britain is just as bad or worse;

I had a friend who had to WAIT to remove a painful tooth. I think she waited for 4 days or so to get the procedure done.

If she had the money, she could have done it the same day.

[plumber2]

The union I once belonged to has it's own health and welfare benefit that includes medical incurance. The employee pays for this in their negotiated hourly rate. The government insurance could be funded the same way, with insurance companies bidding for the opportunity to be a provider. The government would only be involved in the up front part, with the providers operating just like they do now.

However, I am aware that some of the posters on this site are oppossed to anything that unions have made work.

[TheNiche]

The insurance companies may be wonderfully efficient but the hospitals and doctor's offices who deal with these companies are forced to waste huge amounts of time and money conforming to differing requirements of HUNDREDS of different insurance carriers.

It wouldn't be a bad idea for the government to step in and make all the insurance carriers and all the providers adopt a single standard. That would eliminate a lot of waste right there.

I could get on board with that. It probably wouldn't take much government coercion, either. Some form of industry self-regulation (excluded from cartel status) would probably be readily embraced. And certainly they'd rather that than have to deal with government bureaucrats telling them what to do.

[MidtownCoog]

It wouldn't be a bad idea for the government to step in and make all the insurance carriers and all the providers adopt a single standard. That would eliminate a lot of waste right there.

Not a bad idea. Expensive to implement but could pay for itself.

[TheNiche]

Non-profit, government run - anything but for-profit (which is just...creepy to me).

I find it hard to believe that we are incapable of providing fair health resources to our citizens without waste, corruption, and inhumane qualities...but I have been unpleasantly surprised many times before

Non-profit healthcare really is the best. The doctors are allowed greater discretion, and therefore the non-profits tend to attract better staff. And the idea is ultimately that top notch treatment can result in huge sums that are donated or left to them in wills. ...the non-profit hospice care that my grandfather received was exemplary of this. My grandmother distrusts everyone and every company, but she LOVED them and gave them all of my grandfather's privately-owned equipment after he passed.

I think that there is a place for private healthcare in the system, though. No one size fits all.

[TexasVines]

lets end all malpractice lawsuits that are filed for profit first

if profit is bad then lawyers profiting off of people having mistakes made in medical procedures should be evil

[west20th]

lets end all malpractice lawsuits that are filed for profit first

if profit is bad then lawyers profiting off of people having mistakes made in medical procedures should be evil

That pretty much has been done in Texas. Of course that was only a half assed solution. Nothing was done to deny licenses to the small minority of incompetent DRs. that drew most of the malpractice suits.

[Zippy]

Let's end for-profit trial lawyers! Maybe the rest will fall into place...

[Overseas]

I have been reading as much as I can about health insurance/care and came across this article written by the Associate Dean of the Weill Medical College at Cornell University:

http://www.pnhp.org/news/2008/september/fo...t_health_in.php

What are your thoughts on this?

First, let's dismiss the argument that we don't ration health care/have waiting lists in the US- we just do it by how much money you have. We have 45 million people without insurance - that's who are on the wait lists for care in this country. Every system rations health care. It is just that every other modern industrialized nation has made the determination that health care should be rationed on a different - and, to be honest, more equitable basis.

Every other nation has also decided that people should not be bankrupted because they become ill. They also are generally uncomfortable with the determination of whether your care will be paid for being made by a company which has a direct financial interest in not paying for that care. And there is a recognition that with health coverage, you really can't have true competition (e.g., if you don't like the level of service you get, you can't go somewhere else - that would usually entail changing jobs and/or trying to get a new insurance company to cover you at the exact moment when you are ill and need the coverage). These points are really only issues in a health care system where coverage is primarily private.

On a macro level, the UK used to spend something like 6% of GDP on health care, and with life expectancies exceeding the US, and survival rates for major illnesses generally comparable to that of the US. On an economic analysis level, they did seem to make the right choice. In comparison, the US spends close to 15% of GDP - and considering a baby born in Cuba has a better statistical chance of living to its first birthday than one born in the US (Cuba, for heaven's sake!) we don't seem to be spending our money perhaps as wisely as we could.

However, the UK was really trying to get health care on the cheap (and as a former resident of London, it was noticeable). While survival rates were generally comparable, they were well behind in certain areas (cancer, especially). They have increased spending up to closer to 9% of GDP, I believe - which is close to the European average to address that.

We also need to differentiate between the provision of health care by the government, and the provision of health insurance by the government (e.g., the actual health care providers are not government run). In the UK, the National Health Service actually runs the hosptials, employs the doctors, etc - it is truly socialized medicine (although since Thatcher started some reforms, a certain level of private health care has developed). I don't believe anywhere else is quite so socialized as the UK, though everywhere obviously has certain degrees of government provided health care (look at Ben Taub and the VA here, for instance).

The UK is pretty unique - few places have the full socialized medicine as they do. Most everywhere else has something something like Medicare here - government provided basic insurance with some private insurance in addition, and a mix of private and government provided health care. I believe that Canada, however, has been quite strict on not allowing too many private insurance providers, and also tries to centrally plan the provision of health care as well.

My sense - and I may be wrong - is that wait lists generally develop not because the coverage won't cover you for your hip replacement surgery or chemotherapy, but because there isn't the capacity to actually provide the services. And when the capacity is solely provided by the government, that seems to be where things really break down.

I think that Australia, where I currently live, has a good balance of goverment and private, and is something the US might want to look for ideas. They have what they call Medicare, which is the government provided insurance that everyone has. You may also have private insurance, which provides for certain extra coverage, and can help you avoid wait lists. If you earn over a certain income, you are actually taxed at a higher rate (and extra 1% of your income) if you do not have private insurance.

Hospitals are a mixture of private and public - although I think the private are mainly non-profit. And the public hospitals have a private "wing" where coverage is provided for those with private insurance. It is a real mix.

There doesn't appear to be the same service delivery issues you do wtih the UK - this is one area where a bit of competition might seems to work, perhaps because you can pick a different hospital or doctor more easily - especially if your insurance will cover anywhere you go. There are still wait lists, but (based on personal stories and media coverage at least), they don't seem to be as problematic as in the UK.

And insurance companies and health care providers do seem to compete on providing better services in Australia - you get private rooms here with insurance, and the insurance companies compete on how many extras they'll provide (which they can do as the main bulk of an expense is picked up by Medicare). Many of the main hospitals are run by the states, but they don't have a complete monopoly.

Australia's system of involving publc and private seems to insure (pardon the pun) that everyone is covered, wait lists don't seem to be huge issue, people who want more or quicker coverage can purchase it, and that the provision of health care isn't caught up in as many bottlenecks.

Apologies for the long reply...

[TexasVines]

That pretty much has been done in Texas. Of course that was only a half assed solution. Nothing was done to deny licenses to the small minority of incompetent DRs. that drew most of the malpractice suits.

but it has brought in a flood of new doctors

and as for the poster above me......does more "equitable" mean that those who work and can afford to pay have to suffer like those who do not work and/or refuse to provide insurance for themselves.......it is really equitable to provide the same to everyone regardless of what they try and provide for themselves.......some people have nicer cars with warranties on them....some have old clunkers with no warranty....should we adjust that "inequality" as well

[memebag]

but it has brought in a flood of new doctors

and as for the poster above me......does more "equitable" mean that those who work and can afford to pay have to suffer like those who do not work and/or refuse to provide insurance for themselves.......it is really equitable to provide the same to everyone regardless of what they try and provide for themselves.......some people have nicer cars with warranties on them....some have old clunkers with no warranty....should we adjust that "inequality" as well

Did you read the post? The Australian health care system has private doctors, private insurance, and all the other luxuries you want to spend your hard earned cash on.

[TexasVines]

Did you read the post? The Australian health care system has private doctors, private insurance, and all the other luxuries you want to spend your hard earned cash on.

what makes Australia any different than what the USA has now......with the exception that people in the USA end up with an unenforceable blemish on their credit record that will not prevent them from getting credit for any consumer good they wish

also as for the tort reform not getting rid of bad doctors.....it seems lil johnny edwards and his lawsuits did not get rid of them either.....it just made insurance more expensive for all the good doctors

[RedScare]

Let's end for-profit trial lawyers! Maybe the rest will fall into place...

Would that be similar to ending prison time for murderers to stop murder?

If not, why not?

[TexasVines]

Would that be similar to ending prison time for murderers to stop murder?

If not, why not?

perhaps one of the dumbest comparisons I have ever seen on the internet

[memebag]

what makes Australia any different than what the USA has now...

Then internet is full of answers to your question. There you will find that Australians spend about 9% of their GDP on health care, while we pay about 15%.

[MidtownCoog]

So the Aussies have expaned Ben Taub?

Nice.

[RedScare]

One of the biggest problems with the US system is that the government attempts to escape the issue by claiming the employers provide insurance, and we'll help make it easier for them to do so. But, then there is no requirement for employers to provide coverage. This leaves huge numbers of working uninsured...the ones that expanded SCHIP was supposed to cover...and premiums to expensive for the low wage workers to afford. Let's face it, if you only have money for shelter or insurance, we all know which one we have to buy.

To achieve full coverage, one of two things must occur. Either the government steps in with insurance (or help with premiums) or employers must be required to provide insurance. Since small businesses would be squeezed hard by an insurance requirement, and many would simply go black market, paying empoyees in cash, a more equitable solution would be to expand Medicaid/Medicare. In this way, all citizens are covered, not just those lucky enough to work for big corporations.

But even this plan will not work if insurance companies are allowed to dictate who gets covered and who doesn't. Minimum standards of coverage and care should be enacted to achieve a basic level of expected healthcare. Obviously, those who desire higher standards of care may purchase supplemental coverage on their own. Companies can still offer higher coverage as perks. But, a base level is established for all. Hopefully, that standard would focus on prevention, rather than just cure.

[RedScare]

However, I am aware that some of the posters on this site are oppossed to anything that unions have made work.

Not anymore. Many posters on this board are getting ready to vote a United Steel Workers member into the Vice President's house. Now, unions are good.