What's So Great About Private Health Insurance?

[Velokid1]

Too many specialists. Not enough general practitioners.


neal

Narrowing your field of study to the tiniest of details is a great way to dodge actual study. I advised nearly 500 doctoral students and found that to be true of most people "specializing" in some obscure nook of their profession/field of study.

[glasseye]

I came across this article in The Denver Post which claims to debunk "Canadian Health Care Myths". Based on my experience with our health care system, It's accurate and unbiased.

http://www.denverpost.com/opinion/ci_12523427

[hambone]

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
to the war machine. Shame on you Obama. Were we suckered? Why is he playing so desperately to the middle when we need a leader that says "Damn popularity - I'm doing what's right - because it's the right thing to do." I don't see him really pushing many boundaries, and when he does he's shot down visciously.
We are spending too much money on weapons of death when that same money could be going to healing. Should be.
Ugh thanks Chi I didn't see that article befo.

[MeyerII]

What's so great about private health insurance?

The bloody battle in Congress over a 'public option' ignores the insurers' role in creating the nation's healthcare crisis and their efforts to throttle reform.

Michael Hiltzik LA Times
4:31 PM PDT, August 2, 2009

Throughout the heroic struggle in Congress to provide a "public option" in health insurance, one question never seems to get answered: Why are we so intent on protecting the private option?

The "public option," as followers of the debate know, is a government-sponsored health plan that would be available as an alternative to, and in competition with, the for-profit health insurance industry, otherwise known as the private option.

(Congress' own healthcare benefits are a public plan-Colin)

On Friday, the House Committee on Energy and Commerce narrowly passed a reform bill incorporating a public option resembling Medicare. It was a bloody fight among members of Congress, some of whom believe that the public option will give the government unwarranted power over healthcare, and all of whom enjoy government-provided healthcare that's a lot better than what most of us get.

But the battle is just beginning. After the committee vote, House Speaker Nancy Pelosi warned that the health insurance industry will conduct a "shock and awe" campaign to kill the public option when Congress returns from vacation in September and starts debating the measure. We can expect to be overwhelmed with an industry ad campaign worth millions of dollars (remember Harry and Louise?) exhorting us to write our lawmakers to preserve the American way of healthcare.

So it's proper to remind ourselves what that American way entails. For if the insurers have proved anything over the last 15 years as the health crisis has gathered speed like an avalanche roaring downhill, it's that they're part of the problem, not the solution.

The firms take billions of dollars out of the U.S. healthcare wallet as profits, while imposing enormous administrative costs on doctors, hospitals, employers and patients. They've introduced complexity into the system at every level. Your doctor has to fight them to get approval for the treatment he or she thinks is best for you. Your hospital has to fight them for approval for every day you're laid up. Then they have to fight them to get their bills paid, and you do too.

One Wendell Potter reminded a Senate committee in June that health insurance executives had assured Congress in 1993 they would work to secure universal medical coverage and end denials of coverage to people with pre-existing conditions. Then they moved heaven and earth to kill reform.

They've made the same promises now, Potter observed. But they're in an even better position to throttle reform. Mergers and acquisitions have turned the industry into a cartel of huge corporations.

"The industry is bigger, richer and stronger, and it has a much tighter grip on our healthcare system," he said. The last thing they want is a government program set up as their competition.

Potter knows the insurers' ways because he was a top executive in the industry for 20 years. But the hard numbers bear him out. The two largest insurers, WellPoint and UnitedHealth Group, each acquired 11 other insurers between 2000 and 2007. They now control a total of 67 million "covered lives" (that's customers in health insurance-speak).

This consolidation has produced functional monopolies in communities across America. The American Medical Assn. (itself no great fan of reform) found in a 2007 survey that in 76% of the country, defined as its major metropolitan statistical areas, one insurer had a share of 50% or more of the conventional insurance market. This phenomenon gives the companies enormous power to drive up premiums and maximize profits.

Why do we tolerate this? The industry loves to promote surveys indicating that most Americans are "satisfied" with their current health insurance -- 37% are "very satisfied" and 17% "extremely satisfied," according to one such study.

Yet these figures are misleading. Most people are satisfied with their current insurance because most people never have a complex encounter with the health insurance bureaucracy. Medical care generally follows the so-called 80-20 statistical pattern -- 20% of patients consume 80% of care. If your typical encounter is an annual checkup or treatment of the kids' sniffles, or even a serious but routine condition such as a heart attack, your experience is probably satisfactory.

But it's on the margins where the challenges exist. Anyone whose condition is even slightly out of the ordinary knows the sinking feeling of entering health insurance hell -- pre-authorizations, denials, appeals, and days, weeks, even months wasted waiting for resolution.

And that's among people with affordable employer-paid insurance, an ever-shrinking cohort. The percentage of small and medium-sized businesses offering health coverage to employees shriveled to 38% from 67% between 1995 and 2008, according to the National Small Business Assn. Without reform, the number will continue to plummet. Meanwhile, people employed by big companies that offer a health plan are within a layoff notice of losing coverage for themselves or their families, joining America's 46 million uninsured.

Their only alternative right now is the individual market, where insurers scrutinize applicants' medical histories, looking for reasons to turn them down or charge them exorbitant premiums. Have hay fever, asthma, a cholesterol pill prescription? Are you a woman of child-bearing age? You're virtually uninsurable at an affordable cost.

Even if you're accepted, your carrier reserves the right to cancel your policy retroactively if it finds that you left even a tiny condition from years back off your application.

The public option may be your lifeline -- if it's enacted.

Signs of the industry's mobilization against the public option are everywhere. I don't claim clairvoyance for having predicted this development back in March; given the industry's record on reform, a child could have done so.

You've heard of the Blue Dog Democrats, those mostly rural conservatives who blocked a summertime vote on reform legislation on Capitol Hill? According to the Center for Public Integrity, the biggest backer of the Blue Dogs’ political action committee is the healthcare industry, which is on the path to pumping a total of $1.2 million into the PAC's maw in the current 2009-10 election cycle.

The there's the advocacy group called the Campaign for an American Solution, which describes itself as "a grass-roots effort . . . to build support for workable healthcare reform." The organization owns up to being an "initiative" of America’s Health Insurance Plans, or AHIP, the industry's chief lobbying arm. Unless I've missed a radical change in lawn and garden horticulture, you can't get much further from the grass roots than to be a creation of the industry with the biggest stake in the debate.

Despite all this, America's health insurance plans, which helped create our dysfunctional world, are deferred to as though they're a disinterested party. AHIP subtitled one of its policy papers "A Vision for Reform." But are the insurers now, and have they ever been, anything other than a roadblock?

I've always known where I've stood on this issue, but have generally refrained from weighing in on it due to the general level of debate. The cries of "Socialism!" get somewhat watered down after being applied to damn near every piece of legislation introduced by the "other side", and the only true antidote to the Glen Becks of the world is clearly outside of our reach - namely, a decent education an a smidgeon of compassion.

Nevertheless, I found myself with two things that seem to come my way in combination very rarely these days, that being a little free time and a bottle of 15 year-old Scotch. So my reponse to the blatherings in the SEWR, reprinted here:

Ever thought about how the current healthcare system in the US came to be? I heard part of this on the radio while on the way back to my office and went back on the web to find it because I thought it was pretty interesting.

If you want to understand how to fix today's health insurance system, you'd be smart to look first at how it was born. How did Americans end up with a system in which employers pay for our health insurance? After all, they don't pay for our groceries or our gas.

It turns out there never was any central logic at work.

Give it a read. It is short, but sheds a little bit of light on how we got to where we are: marketing.


It seems that an alarming number of you choose to simply spout off your general political outlook (over and over and over again, sadly) yet choose to ignore several inconvenient issues that don't seem to get discussed nearly often enough.

1) Worker health insurance puts US businesses at a competitive disadvantage. The pairing of large company jobs and health insurance never should have happened.

2) Partly because of the above, far too many people do not have health insurance. After adjusting for age and sex, the percentage of uninsured persons interviewed between January and March 2008 was 30.4% Hispanic, 9.9% non-Hispanic white, and 17.0% non-Hispanic black. And no, Lee, it is not because all of these people are lazy, regardless of what you choose to believe. These are actual, real people. People that you might already know. They're not just numbers. They could be your children or grandkids someday.

3) The real problem with people being uninsured is the cost to the system, of course, but the underlying problem there is that these people aren't getting preventative care and have to wait until it turns into an expensive emergency room visit. It is arguable that adding these people to some kind of decent regular health care is cheaper than what we have now.

4) There are administration costs and profit that necessarily need to come out of the system. Rather than go back in to help, resources basically go into mansions and yachts. And you damn well better believe that every penny that can possibly be extracted is being extracted. If you believe otherwise, you have learned nothing from the economic collapse of 2008. Richard Branson - a wealthy businessman himself - recently said something to the effect that an organization solely dedicated to extracting profit without regard to the welfare of the people it services resembles more a criminal enterprise than a business enterprise. And the health insurance comanies have it pretty good right now - mostly only having to insure relatively healthy, well-off people while the rest are welcome to an untimely death, seemingly. Pretty good deal for them, I'd say.

5) Healthcare really ought not to be a commodity solely for those that can afford it. It is life itself that we are talking about here. It frightens me that people who consider themselves to be religious can think otherwise. But it doesn't terribly surprise me. The fact that others can trivialize it into anti-socialistic rhetoric saddens me.




I swear, if somebody found a way to politicize toothpaste and was able to play on the fears of the gullible, they'd make a minty mint. Maybe I should get to work on that. Then I'd never have to worry about healthcare again.

And so say I. I sense that I may have struck a chord over there, as nobody so far has even responded with as much as a "neener-neener".

My original plan was to spend the day offing the Scotch and attending to routine tasks too mundane from my patience. I may decide, instead, to be annoying on the internet for the rest of the evening. "But my dear Meyer, how is this any different than all of the other times you are on the internet?", you may well ask.

Well ... Good Scotch for one! Is that not enough?

 

[Amskeptic]

Good Scotch! Is that not enough?

No. It is time to knock heads. If we allow irrational blowhards to think for a second that they have an audience, well guess what? like any four year old who told a funny in front of the guests, these morons will continue to blabble senselessly. I cannot believe the level of irrational idiocy that has permeated the news. We have work to do in this country, it is serious work, yet we are distracted by thoughtless strident nitwits who truly know not what they speak of. Obama & Co. had better toughen up. If the mid-term elections show too much of a shift, not only is his challenging agenda weakened, but the multiple-front solutions required to save the Republic will be dealt a mortal blow.
Colin

[Elwood]

Colin as I sit here watching the autum sunset on the golden oaks and feel the warmth of the beautifull day coming to a end, I was thinking " Gosh I have not heard what Rush has said latly"

My blood pressure has receeded and I feel darn optimistic about our country and the world as a whole.

What do you think we should be doing? I truly care and value your opinion.

[Elwood]

Colin as I sit here watching the autum sunset on the golden oaks and feel the warmth of the beautifull day coming to a end, I was thinking " Gosh I have not heard what Rush has said latly"

My blood pressure has receeded and I feel darn optimistic about our country and the world as a whole.

What do you think we should be doing? I truly care and value your opinion.

Colin my timing is way off today, just read about your gas cap and changed plans, we can take this up another time.

Be safe and happy,

Love Barb

[Amskeptic]

What do you think we should be doing? I truly care and value your opinion.

Well, it took a couple of generations for us to get in this pickle.

I do not "blame" the people in government, like Congresspersons and White House denizens, they are doing what they can in the current system of Pay To Play.

I think we have to write our representatives, and we have to talk amongst ourselves and chat it up with strangers too, and we have to put out a decent argument using the power of our informed convictions to actually enlighten others.

I think we both can agree that that if two people are having a discussion within earshot, the person with the facts and open heart will win us observers over. That is why I happily dust it up in here occasionally. The person I am debating is not likely to change his/her mind on the spot, but a lurker/reader might very well consider things in a new way and pass it on down the line. We all citizens have to push the national dialogue one conversation at a time. Viral works.

As Obama would say, "let me be perfectly clear," we are screwed if we don't change the current lobbying cash system.
Colin

[BellePlaine]

What do you guys make of your House vote this weekend? Are you loving it?

[hambone]

I hate the polarization. Makes me think of Jr. High.
Adults running the show no less.......

[RussellK]

What do you guys make of your House vote this weekend? Are you loving it?

have you renounced your citizenship? Its your house too. I'm disappointed that some parts of the Republican plan are missing and am hopeful that the final version will include those ingredients. Honestly by focusing exclusively on the insurance component of healthcare we are missing an opportunity to get this right.

[BellePlaine]

What do you guys make of your House vote this weekend? Are you loving it?

have you renounced your citizenship? Its your house too.

Haha! I was thinking moving to Switzerland because no one knows the name of their President.

Actually, I was hoping to learn more about the bill from you guys. I know that it has the public option, can't be denied for pre-existing conditions, a fine/fee if you don't have insurance, they are not paying for abortions. Costs something like 1.2 trillion over 10 years (although I could be wrong).

[RussellK]

I was really hoping we could shop out of our state for insurance and have the ability to form groups. Looks like there was no compromise for that. The other thing I was hoping for was a change in how the pricing is established. And that is just on the insurance side of the equation. We really needed to look at the entire healthcare system if we want to get a handle on cost. Its really hard to get behind something when you still don't know what its going to cost.

[ruckman101]

What do you guys make of your House vote this weekend? Are you loving it?

have you renounced your citizenship? Its your house too. I'm disappointed that some parts of the Republican plan are missing and am hopeful that the final version will include those ingredients. Honestly by focusing exclusively on the insurance component of healthcare we are missing an opportunity to get this right.

Republicans had a plan? First I've heard, other than obstruction.

neal

[RussellK]

What do you guys make of your House vote this weekend? Are you loving it?

have you renounced your citizenship? Its your house too. I'm disappointed that some parts of the Republican plan are missing and am hopeful that the final version will include those ingredients. Honestly by focusing exclusively on the insurance component of healthcare we are missing an opportunity to get this right.

Republicans had a plan? First I've heard, other than obstruction.

neal

heh. Can you explain why I find Joe Lieberman so annoying. The guy just gets under my skin and the damned media is always clamoring to hear what he thinks.