Health Care Reform

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halplm
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Post by halplm »

Primula Baggins wrote:Nobody is arguing that insurance is not a business. But money does flow from a lot of people to a few. That doesn't make insurance companies charities; that's just a simple fact about where the money comes from and where it goes.
Actually all the money flows to the company, the company pays for people's health care, it doesn't send them money. This is important because it is the service we are paying for rather than them just shuffling around money.
Profits are not evil. But health care systems that don't have to provide profits cost less.
This is not necessarily true, and it is also possible to get a greater profit while having a price less than an arbitrary amount. Profitability is not tied directly to the price of the product, it is merely one aspect.
No one is seriously saying there should be no profitable companies. People are saying that the current U.S. model is not the only one that works. Most of the other developed nations demonstrate this on a daily basis, providing good care for almost their entire populations for much less money than we pay in health care taxes plus private insurance premiums.
Well, now we're back to the question of how to change the system, because we all agree it should change.
How do you feel about entrepreneurs not being able to get health insurance, and thus not being able to carry out their plans? Does that help or hinder the American economic system?
Why are they not able to? What plans are they not carrying out?
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Post by yovargas »

vison wrote:
yovargas wrote:Though I think it's pretty fair to say that universal health charity is what a lot of people are looking for. :)
I disagree, yovargas. What people want is insurance.
The only way health care will ever be universal is through (forced) charity.
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Post by Voronwë the Faithful »

halplm wrote:
How do you feel about entrepreneurs not being able to get health insurance, and thus not being able to carry out their plans? Does that help or hinder the American economic system?
Why are they not able to? What plans are they not carrying out?
Because either the plans that are available to them are so prohibitively expensive that it makes their business plan impossible to follow, or they can't get any insurance at all because they have a pre-existing condition.
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Post by Whistler »

The only way health care will ever be universal is through (forced) charity.
There is no such thing.

There is something similar, but it's called robbery.
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Post by yovargas »

Indeed, Whistler, indeed.
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Post by vison »

yovargas wrote:
vison wrote:
yovargas wrote:Though I think it's pretty fair to say that universal health charity is what a lot of people are looking for. :)
I disagree, yovargas. What people want is insurance.
The only way health care will ever be universal is through (forced) charity.
Really? Well, yovargas, my medical insurance isn't "charity". I pay premiums as do almost all Canadians. A few people don't. Those people are treated "free". Just like, you know, in the USA? At public expense? Without ever having paid a premium?

I am not "forced" to buy medical insurance, but I would have to be several kinds of fool not to. There are those who don't, but of course, they get treated anyway. Just like, you know, in the USA? At public expense? Without ever having paid a premium?

The rest of the world is watching this in bemused amusement. The things most civil societies take for granted, and to your nation it is some kind of revolutionary idea.
Dig deeper.
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Post by yovargas »

I am aware that "forced charity" is very popular throughout the world. It's popularity doesn't make it any different than what it is.
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Post by vison »

yovargas wrote:I am aware that "forced charity" is very popular throughout the world. It's popularity doesn't make it any different than what it is.
What do you mean "forced charity"? That's an extremely strange term to me.

Do you regard it as "forced charity" when you pay taxes that support the schools, roads, bridges, military, police, fire, customs and excise, airports, and wharfs and docks? Is it "forced charity" to fund the operations of the federal/state/city/municipal governments?

It is NOT charity to fund a public health insurance system. It's, you know, INSURANCE. It works really well in many, many, many countries where people live really ordinary lives without having to worry about health insurance.

It's not charity, if you think YOU would be "giving your money" so "someone else could get something for nothing". You would be, just like me, paying premiums for health insurance. So my neighbours and I and all our fellow citizens have health insurance.

It's just bizarre. It really is. I thought the USA regarded itself as a Christian nation?
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Post by Voronwë the Faithful »

vison wrote:What do you mean "forced charity"? That's an extremely strange term to me.
To me, too. I don't really understand what is meant by that.
I thought the USA regarded itself as a Christian nation?
Nope. There may be a few people who think that way, who manage to attract a lot of attention to themselves, but most of us -- Christian, Jewish, Muslim, Athiest, Buddhist, Pagan, Hindu, etc. -- recognize that our strength is in our diversity and freedomof thought.
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Post by halplm »

Voronwë_the_Faithful wrote:
halplm wrote:
How do you feel about entrepreneurs not being able to get health insurance, and thus not being able to carry out their plans? Does that help or hinder the American economic system?
Why are they not able to? What plans are they not carrying out?
Because either the plans that are available to them are so prohibitively expensive that it makes their business plan impossible to follow, or they can't get any insurance at all because they have a pre-existing condition.
health insurance for business owners is not prohibitively expensive. I know, as I got it for my employees.

pre-existing conditions is an issue that needs to be adressed, there is no doubt.

The thing that baffles me, is that while everyone agrees the health care industry needs reform... anyone could possibly believe the government handling health care would in any way be better than what we have!

at the root of the issue seems to me to be the belief that companies operating for profit somehow wish to exploit their customers, while the government is benevolent in all aspects.

IMHO, on the contrary, companies operating for profit want to maximize what they can provide for their customers such that they can maximize their market share and thus profit... while the government only wishes to maximize the number of people dependent on them to consolidate power and maximize the number of votes those in power can get in the next election.

eh, I'm too tired to make sense...
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Post by Pearly Di »

yovargas wrote:The only way health care will ever be universal is through (forced) charity.
Of course, I live in the UK, and we have had a National Health Service for over 60 years. I don't regard paying my taxes to help fund this as 'forced charity'. ;) Anymore than I resent my taxes going towards the things that Vison listed ... schools, roads, bridges, military, police, fire, customs and excise, airports, etc.

I'd never heard the term 'socialised medicine' until I met American people on messageboards, and the term puzzled me mightily, I can tell you. :blackeye: It sounded vaguely insulting, although I wasn't sure quite why. :scratch:

http://www.nhs.uk/NHSEngland/aboutnhs/Pages/About.aspx

There are some things I do question my taxes going towards ... inevitably. Our NHS isn't one of them.

I am not posting this to say that America should be like Britain.

Merely to say that on another continent -- or island, rather -- the view looks very different.
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Post by sauronsfinger »

from Halplm
health insurance for business owners is not prohibitively expensive. I know, as I got it for my employees.
Your experience years ago seems to be contrary to testimony before Congress, personal accounts in various forms of the media, and studies on the subject. For many business owners, it is indeed prohibitively expensive and they have loudly said so many times in many places.
pre-existing conditions is an issue that needs to be adressed, there is no doubt.
And the only way to do that is to put everyone in the same pool so to spread the risk and cost of insuring and covering those who will cost much more because of those conditions. To merely say that a private company must cover them is only to invite the company charging rates that are so high that few with some pre-existing conditions could afford them.
The thing that baffles me, is that while everyone agrees the health care industry needs reform... anyone could possibly believe the government handling health care would in any way be better than what we have!
Surveys should that people on government programs like Medicare have a higher rate of satisfactions with that program that those with private insurers. The administrtive costs for government run health programs is much lower than private companies. So why should this baffle you or anyone else? The facts are there which clearly demonstrate this.

here is the proof
www.nationaljournal.com/njonline/mp_20090629_2600.php
Among those insured through Medicare, however, "the Medicare program" (68 percent) scores nearly as high. Among those with private insurance, "your health insurance company" earns much less trust (48 percent).

Perhaps that result is just about perceptions of corporate interests and not about patient experience?

We can test that question with data from a set of surveys known as the Consumer Assessment of Healthcare Providers and Systems. CAHPS is an initiative of the Department of Health and Human Services that developed a standardized survey questionnaire used by virtually all health insurance plans -- public and private -- to assess patient satisfaction. Most private insurers use the CAHPS questionnaire and disclose the data to the National Committee for Quality Assurance in order to receive their accreditation. So thanks to CAHPS, we have a massive collection of data comparisons of how patients experience and rate Medicare, Medicaid and private insurance.

Those comparisons show the depth of Medicare's popularity. According to a national CAHPS survey conducted by the Centers for Medicare and Medicaid Services in 2007, 56 percent of enrollees in traditional fee-for-service Medicare give their "health plan" a rating of 9 or 10 on a 0-10 scale. Similarly, 60 percent of seniors enrolled in Medicare Managed Care rated their plans a 9 or 10. But according to the CAHPS surveys compiled by HHS, only 40 percent of Americans enrolled in private health insurance gave their plans a 9 or 10 rating.
People have a higher rate of satisfaction with government run health insurance programs than they do with private for profit ones.
at the root of the issue seems to me to be the belief that companies operating for profit somehow wish to exploit their customers, while the government is benevolent in all aspects.
I think you have hit the nail upon the head with the first part of your statement. At the root of this is the issue of belief. We can discuss all the facts we want to and we can crunch the numbers and we can listen to a legion of people tell us their horrible experiences with the medical health industry. But the issue of belief will still be there on both sides and facts, statistics and numbers will not change some opinions if they are fixed and set in ideology.

There is no shortage of information and stories from many people who have indeed been exploited by private insurers all in the name of profit. Just yesterday I posted the facts right here about staggering increases in profits from ten major private insurance companies at a time when the rest of the nation is in recession and the real incomes of real people are declining. The drive for profits is part and parcel of a private company. It is their sole reason for existing.
IMHO, on the contrary, companies operating for profit want to maximize what they can provide for their customers such that they can maximize their market share and thus profit... while the government only wishes to maximize the number of people dependent on them to consolidate power and maximize the number of votes those in power can get in the next election.
No. Companies want to maximize profit. Period. The customers, the product, the entire process is but a means to an end. If they can do that by maximizing customer service, then they might do that as you suggest. If they can do that by having a minimal level of customer service, then they will do that. If they have to cut services to increase profit, they will do that. If they have to remove some customers from services because they are regarded as too expensive and a danger to high profits, then they will do that also. If they have to increase rates and prices in the quest for higher profits, then they will do that also. And if they have to decrease customer services while increasing rates and prices in the quest for increased profits, they will and have done that also.

If we say that profit is good and desirable for a private company, then why do we shrink from the reality of how those profits are achieved in many cases? This is not theory in a college textbook. This is reality that impacts the lives of hundreds of millions of people. The theory of how business is suppose to work means nothing next to the reality of how it does work and impacts the lives and deaths of actual real people.
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Post by yovargas »

Voronwë_the_Faithful wrote:
vison wrote:What do you mean "forced charity"? That's an extremely strange term to me.
To me, too. I don't really understand what is meant by that.
I'm avoiding getting into more libertarian debate type stuff here but the idea, whether you think it's good or not, is simple: something like universal health care can't happen without charity (eg. subsidies) and the government can't give subsidies without using force (because it's not a person's choice to give or not). Therefore - forced charity (a phrase I swear I stole from vison in a different but similar context but can't find from where or when :P).
We can argue the merits of doing such things but I don't see how one can argue that in plain terms that's what happens.
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Primula Baggins
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Post by Primula Baggins »

IMHO, on the contrary, companies operating for profit want to maximize what they can provide for their customers such that they can maximize their market share and thus profit
In many states, the private insurance market is dominated by one or two insurers, who don't need to do anything for the sake of market share. And at the individual level, people who get their insurance through their employers often have little choice or no choice. There is no free market.
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Post by sauronsfinger »

Yovargas - you have a solid point there. But I have to agree with both Vison and Voronwë. I do feel that there are words that are intentionally used because they have meaning and are intended to pack a punch. One can talk about the need for taxes to foster a better community for all citizens or one can talk about the forced confiscation of ones own money for the use of others. The same concept, expressed in two very different ways, conveys two very opposite messages.

A term such as "forced charity" - in my opinion - is a loaded term that is intentionally crafted to convey a negative meaning. It intentionally takes a term that is traditionally negative - force or coercion - and pairs it with a positive term that is almost always a voluntary action that is positive. The result is something which is intentionally jarring and makes a statement that such an action is indeed a contradiction in terms and is thus not something very good.
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Post by Maria »

You have to want to do it or it isn't charity. I don't think there is such a thing as forced charity. The force negates the charitable part.
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Post by anthriel »

Frelga wrote:Sorry to point back to the discussion of a couple days ago, but I had no time earlier and I did promise to Anthy, so here's the link to that blog post (that's right, just a blog post, I don't know who the frell the author is) on The Next Right I quoted: http://thenextright.com/jon-henke/repub ... are-reform

And I see I was mistaken, the first idea was not tort reform, it was this:
Eliminate Medicare/Medicaid and replace it with Megan McArdle's suggestion: "catastrophic federal insurance for those whose medical bills exceed 15-20% of gross income".
I know this is very much out of sequence, but I wanted to thank Frelga for taking the time to find this link. I almost don't care what it says as long as it is not some "official" Republican plan. Sounds like it's not.

Thank the stars for that. :)
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Post by Inanna »

Voronwë_the_Faithful wrote:
I thought the USA regarded itself as a Christian nation?
Nope. There may be a few people who think that way, who manage to attract a lot of attention to themselves, but most of us -- Christian, Jewish, Muslim, Athiest, Buddhist, Pagan, Hindu, etc. -- recognize that our strength is in our diversity and freedomof thought.
Thank you, V.
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Post by Ellienor »

No. Companies want to maximize profit. Period. The customers, the product, the entire process is but a means to an end. If they can do that by maximizing customer service, then they might do that as you suggest. If they can do that by having a minimal level of customer service, then they will do that. If they have to cut services to increase profit, they will do that. If they have to remove some customers from services because they are regarded as too expensive and a danger to high profits, then they will do that also. If they have to increase rates and prices in the quest for higher profits, then they will do that also. And if they have to decrease customer services while increasing rates and prices in the quest for increased profits, they will and have done that also.
SF, that is spot-on. Companies want to increase profits; there are a variety of ways to do so. Many of them involve decreasing competitition so they can charge more money. :P The antitrust laws came into being because of this. And you should see the time, effort and money that companies shovel into obtaining patents, because they are legal monopolies. :P

Governments are accountable to their people in a democracy. If Medicare sucked, the bums would be voted out of office until a new set that promised reform would go in.

Weirdly, somehow there is a political belief out there that contributing to the common welfare (as explicitly stated in the Constitution) impedes their "liberty." :P
We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.
And if you think I didn't resent having to pay for Bush's war with my taxes, you'd be dead wrong. So, conservatives paying for healthcare is justice done, IMHO. ;)
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Post by halplm »

Primula Baggins wrote:
IMHO, on the contrary, companies operating for profit want to maximize what they can provide for their customers such that they can maximize their market share and thus profit
In many states, the private insurance market is dominated by one or two insurers, who don't need to do anything for the sake of market share. And at the individual level, people who get their insurance through their employers often have little choice or no choice. There is no free market.
You are correct, and that is because of government regulation.

SF, indeed, companies are out for a profit, which brings us back to the point I was making yesterday.

The way you guys are viewing how insurance companies work, makes insurance companies look bad for profiting, as it's "taking away" from all our health care.

The way I view how insurance companies work, the profiting means their doing their job better than they were before.
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