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Healthcare for All?
jcam
Posted: Thursday, July 23, 2009 2:01 AM
Joined: 15/08/2008
Posts: 11


The fierce national debate going on here in the States on universal healthcare has more than piqued my interest.  It’s also made me wonder how you; the yachting community of so many nationalities, feels about the current state of your “health”. 

 

Yes we in America have had medicare and medicade, but quite honestly, they are both systems that I merely see money taken out of my paycheck for and do not receive any benefit in return as I’m too young.  From those who it is meant to help, it seems as though we often hear voices of confusion or disappointment.

 

Being self employed, my wife and I pay for our healthcare.  We have seen steady and staggering increases in our premiums along with small print, multi-page notices of our reduction in benefits.  I’m sure yacht owners have seen the same in the benefits they try to afford their crews.

 

So here are my questions.  If you’re American, are you happy with the current system?  What do you believe to be the benefits/drawbacks of the current system? What do you think of this administration’s proposals?  How would you change it?

If you’re foreign, does your native country offer universal health care?  Do you use it (do you go home, or see a doctor here)?  Do you pay for it if when you’re abroad)?  What are the benefits/drawbacks of your countries system?

 

I don’t see the problem with letting government get involved in health care, on certain conditions.

 

For those who opt not to use it, they can’t be charged.

Government can not monopolize, over regulate, or take away the option of private health insurance.

 

Those are very broad statements I understand, but the best basic guidelines I can think of for the betterment of the state of healthcare.

 

If a government system meant cheaper healthcare with no possible excuse of having benefits/procedures denied (preexisting conditions/experimental procedures) but meant longer waits both at the ER and for treatments VS. more expensive private health care with shorter wait times and the possibility of having claims denied, which would you choose?


Anonymous
Posted: Thursday, July 23, 2009 7:17 AM

If you read what they have planned for you, you'll see that stopping it at all costs is the only option a reasonable person can come to. Concept and ideology, please meet the reality of 1984.

By all means, before you jump on board, just read it. All 1018 pages outlining the governments right to say who lives, who dies and when.

*Please Note that according to Politicians the following scam is a "work in progress." This means that changes to the text, omissions and exclusion can occur on the fly, at the whim of the perpetrators.



Page 16 if you have individual coverage before passage, you may keep it, but if you choose to drop it or it becomes unavailable you are not permitted to change to anything other than govt coverage

Pg 22 of the HC Bill MANDATES the Governmet will audit books of ALL EMPLOYERS that self insure!!

Pg 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments and benifits you get

Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED!!!

Pg 42 of HC Bill - The Health Choices Commissioner will choose your HC Benefits 4 you. You have no choice!

PG 50 Section 152 in HC bill - HC will be provided 2 ALL non US citizens, illegal or otherwise. (that's 15 million currently)

Pg 58HC Bill - Government will have real-time access to your finances & a National ID Healthcard will be issued!

Pg 59 HC Bill lines 21-24 Govt will have direct access to your bank account for electronic funds transfer

PG 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions and community orgs (ACORN).

Pg 72 Lines 8-14 Govt is creating an HC Exchange to bring private HC plans under Govt control.  (so much for allowing private alternatives)

PG 84 Sec 203 HC bill - Gov. mandates ALL benefit pkgs for priv HC plans in the Exchange (This would have been fun for Teddy Kennedy)

PG 85 Line 7 HC Bill - Specs for of Benefit Levels for Plans = The Govt will ration you Healthcare! (the compassion of the IRS and the service of the DMV!!!)

PG 91 Lines 4-7 HC Bill - Govt mandates linguistic approp svcs. Example - Translation for illegal aliens

Pg 95 HC Bill Lines 8-18 The Govt will use groups i.e., ACORN & Americorps 2 sign up indiv. for Govt HC plan (I suspect they will be provided free freshly starched brown shirts!!)

PG 85 Line 7 HC Bill - Specs of Benefit Levels for Plans. #AARP members - Your Health care WILL be rationed

PG 102 Lines 12-18 HC Bill - Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice  (say goodbye to medicare)

pg 124 lines 24-25 HC No company can sue GOVT on price fixing. No "judicial review" against Govt Monopoly

pg 127 Lines 1-16 HC Bill - The Govt will tell Doctors what they can make.

Pg 145 Line 15-17 An Employer MUST auto enroll employees into pub opt plan. NO CHOICE

Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.

Pg 149 Lines 16-24 ANY Employer with payroll 400k & above who does not provide pub opt. pays 8% tax on all payroll (on top of all other costs... just cut the staff 8% will take care of this problem)

pg 150 Lines 9-13 Biz with payroll between 251k & 400k who doesnt prov. pub. opt pays 2-6% tax on all payroll. (No problem, just make sure you don't pay over 400K - lay them off )

Pg 167 Lines 18-23 ANY individual who doesnt have acceptable HC accourding to Govt will be taxed 2.5% of insurance (Bye Bye HSA and MSAs!!)

Pg 170 Lines 1-3 HC Bill Any NONRESIDENT Alien is exempt from individual taxes. (Great, hire illegals, off the books and you don't have to pay - Americans will pay)

Pg 195 HC Bill -officers & employees of HC Admin (GOVT) will have access to ALL Americans finances and personal records.   (and you thought Bush was snooping???)

PG 203 Line 14-15 HC - "The tax imposed under this section shall not be treated as tax" (Yes, it says that)

Pg 239 Line 14-24 HC Bill Govt will reduce physician svcs 4 Medicaid. Seniors, low income, poor affected

Pg 241 Line 6-8 HC Bill - Doctors, doesn't matter what specialty you have, you'll all be paid the same --- Sure makes you want to spend those extra 5+ years learning brain surgery so they can help Senator Kennedy!!!

PG 253 Line 10-18 Govt sets value of Dr's time, prof judg, etc. Literally value of humans.

PG 265 Sec 1131Govt mandates & controls productivity for private HC industries

PG 268 Sec 1141 Fed Govt regulates rental & purchase of power driven wheelchairs

PG 272 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!

Page 280 Sec 1151 The Govt will penalize hospitals for what Govt deems preventable re admissions.

Pg 298 Lines 9-11 Drs, treat a patient during initial admission that results in a readmiss-Govt will penalize you. So keep everyone longer with more time to catch something deadly AT the hospital - over 200 patients die every day due to infections contracted in hospitals

Pg 317 L 13-20 OMG!! PROHIBITION on ownership/investment. Govt tells Drs. what/how much they can own. (and this is not socialism)

Pg 317-318 lines 21-25,1-3 PROHIBITION on expansion- Govt is mandating hospitals cannot expand - Sorry, no more room in our hospital - take this aspirin, your stroke should go away soon!!

pg 321 2-13 Hospitals have opportunity to apply for exception BUT community input required. Can you say ACORN?!!

Pg335 L 16-25 Pg 336-339 - Govt mandates establish of outcome based measures. HC the way they want - Rationing

Pg 341 Lines 3-9 Govt has authority to disqualify Medicare Adv Plans, HMOs, etc. Forcing people into Govt plan

Pg 354 Sec 1177 - Govt will RESTRICT enrollment of Special needs ppl! WTF.

Pg 379 Sec 1191 Govt creates more bureaucracy - Telehealth Advisory Committee. WOW!! HC by phone!!!

PG 425 Lines 4-12 Govt mandates Advance Care Planning Consultation. Think Senior Citizens end of life - WOW this Soylent Green really tastes GOOD!!!

Pg 425 Lines 17-19 Govt will instruct & consult regarding living wills, durable powers of atty. Mandatory!

PG 425 Lines 22-25, 426 Lines 1-3 Govt provides approved list of end of life resources, guiding you in death

PG 427 Lines 15-24 Govt mandates program for orders for end of life. The Govt has a say in how your life ends --- take a number please!!

Pg 429 Lines 1-9 An "adv. care planning consult" will be used frequently as patients health deteriorates....
PG 429 Lines 10-12 "adv. care consultation" may include an ORDER for end of life plans. We're going to have have so many Soylent colors to choose from!!!

Pg 429 Lines 13-25 - The govt will specify which Doctors can write an end of life order. (This is just plain silly!!! Dr Kevorkian can handle this at discount)

PG 430 Lines 11-15 The Govt will decide what level of treatment you will have at end of life.

Pg 469 - Community Based Home Medical Services=Non profit orgs. Hello, ACORN Medical Svcs here!!?

Page 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED ORG. 1 monthly payment two a community-based org. Like ACORN?


PG 489 Sec 1308 The Govt will cover Marriage & Family therapy. Which means they will insert Govt into your marriage


Pg 494-498 Govt will cover Mental Health Services including defining, creating, rationing those services... Crazy government workers --- that will fun to watch

Health care has problems, but do we really want the same people who ran Fannie and Freddie and now Government Motors running health care??


junior
Posted: Thursday, July 23, 2009 2:19 PM
Joined: 14/01/2009
Posts: 1026


The previous drooling anonymous poster sounds like the kind of person who keeps a couple loaded handguns in the back of his Hummer at all times...just in case. I would disregard his drivel and request that he board his Hummer and flee back to the safety of his mountain bunker. The Health care system in The US is broken, fragmented and far to expensive. Whole slices of society, young and old are excluded. I say give the President a crack at it. Concentrate on primary care, prescription drugs and full coverage for all citizens. Its possible...simply travel to France and watch it in action.
An Owner
Posted: Thursday, July 23, 2009 4:13 PM
Joined: 15/01/2009
Posts: 53


junior wrote:
The previous drooling anonymous poster sounds like the kind of person who keeps a couple loaded handguns in the back of his Hummer at all times...just in case. I would disregard his drivel and request that he board his Hummer and flee back to the safety of his mountain bunker. The Health care system in The US is broken, fragmented and far to expensive. Whole slices of society, young and old are excluded. I say give the President a crack at it. Concentrate on primary care, prescription drugs and full coverage for all citizens. Its possible...simply travel to France and watch it in action.







You would have me ignore a post that recommends that I read the bill, provides a link and highlights relevant inclusions that are in diametrically opposed to what the President is portraying as the relevant content to his plan?

Junior, your advise is, don't read it, ignore the content, follow blindly, just look at France! Then you enforce your position by insulting the poster?

Who's drooling?

junior
Posted: Thursday, July 23, 2009 6:10 PM
Joined: 14/01/2009
Posts: 1026


AN OWNER...SIR !! Holster your sidearm, shut down your generators , have one of your stewardess's fetch your reading glass's and reread the anonymous post. This poster does not understand how proposed legislation forms as a pork barrel wish list and then proceeds, under the guidance of enlightened legislators and the Executive branch, into workable policies . The life expectancy of an American trails that of all advanced states with socialize medicine. ALL OF THEM. The US ranks below all advanced states in infant mortality rates. The American healthcare system is biased , penalizing those who lack the financial power to secure proper coverage. Lack of primary and preventive health care is the number one cause...HANDGUNS are the second most important factor in Americas poor showing. Attack these two problems Mr Obama and I will gladly vote you into office again And icam...good to see that you are interested in sorting out this mess....Its the responsibilty of all us Americans to find a solution
kdhguard00
Posted: Thursday, July 23, 2009 6:50 PM
Joined: 16/09/2008
Posts: 31


Junior, I often appreciate what you have to say, but try not to stray from the topic. Let's not make this a broad personal attack. (I enjoy your sense of humor and only wish more people did too) An Owner, Junior's comment about France is true. While most yachts carry medical coverage for crewmembers, it is usually only accidental and generally only applies while carrying out ship's duties. As a result, most crewmembers have to pay out of pocket for other incidents or while between boats. You know what? It doesn't break the bank. I checked myself into a French Emergency room for a severe case of bronchitis and paid NOTHING! I have had 2 dental procedures in Spain and paid 60 euros each time. I was able to get by birth control pills in Turkey in about 20 minutes without a perscription. Does the US system allow ANYTHING to be done with out the insurance companies skimming their bit off the top? The advertisements we are seeing in the US at the moment showing Canadians begging us to not "allow the government to take away your right to private health coverage" is just blatant fear mongering. Our current system is an expensive profit making machine, and not what it could be.
junior
Posted: Thursday, July 23, 2009 8:00 PM
Joined: 14/01/2009
Posts: 1026


The concepts to get across are that it is your right as an American to benefit from a well conceived Health care system, overseen by civilized society and that it is in the countries best interests to have a healthy workforce with its industries free of the healthcare cost burden. This system should be straightforward to create simply because we can study the well proven European model and improve on its shortcomings. You will very soon face a barrage of negative publicity and scaremongering because changes to the present system will upset the status quo. Soon they will be telling you how much its going to cost. Just read that anonymous post.... YIKES !!! Don't fall for it. America is a vastly wealthy country that can and should be able to provide superior health coverage to its citizens. Remember...The decline in American manufacturing can be directly attributed to the massive employee health care costs which starved industry of future investment. Germany ,with its socialized medicine, dominates manufacturing. America has many talented lawmakers who can formulate a coherent strategy. Give them your support and push this issue thru.
Pascal
Posted: Thursday, July 23, 2009 9:51 PM
Joined: 23/11/2008
Posts: 42


"the well proven european model", "Germany with its socialized medicine dominates manufacturing"

wow junior, i dont' want to step as low as you with personal attacks but you got to get off whatever you're smoking...  maybe the hate for generators is affecting your judgment.. it's summer time and hot out there on the water with air con...

which model?  taxing people to death including a close to 50% payroll tax to finance healthcare and social security?

yeah, that works really well. just look at their average unemployment and average economic growth over the past 20 years...

the nr 1 issue here is cost. And what is driving cost so high?  liability. Solve the liability issue and you'll solve 90% of the health insurance problem.

Now with so many democrats / lawyers in charge in Washington, do you really think it's ever going to happen?  

dream on...



jcam
Posted: Thursday, July 23, 2009 11:08 PM
Joined: 15/08/2008
Posts: 11


My initial reaction to annonymous' posting (after I picked my jaw off the floor) was, "this can't possibly be true......can it?".  I applaud annonymous for doing something so few Americans bother to do, that is, read the legislation.  Annon brings up a host of terrifying prospects, many of which (I haven't read the whole bill) are taken out of context.  So Annon, while you have obviously studied this a great deal, you didn't exactly tell the truth.  One of, if not the most frightening points you brought up was the first. Upon further inspection, your conclusion is not what the bill is stipulating.  I've highlighted in green the contradiction. 

1 SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT

2 COVERAGE.

3 (a) GRANDFATHERED HEALTH INSURANCE COV

4 ERAGE DEFINED.—Subject to the succeeding provisions of

5 this section, for purposes of establishing acceptable cov

6 erage under this division, the term ‘‘grandfathered health

7 insurance coverage’’ means individual health insurance

8 coverage that is offered and in force and effect before the

9 first day of Y1 if the following conditions are met:

10 (1) LIMITATION ON NEW ENROLLMENT.—

11 (A) IN GENERAL.—Except as provided in

12 this paragraph, the individual health insurance

13 issuer offering such coverage does not enroll

14 any individual in such coverage if the first ef=

15 fective date of coverage is on or after the first

16 day of Y1.

17 (B) DEPENDENT COVERAGE PER

18 MITTED.—Subparagraph (A) shall not affect

19 the subsequent enrollment of a dependent of an

20 individual who is covered as of such first day.

21 (2) LIMITATION ON CHANGES IN TERMS OR

22 CONDITIONS.—Subject to paragraph (3) and except

23 as required by law, the issuer does not change any

24 of its terms or conditions, including benefits and

25 cost-sharing, from those in effect as of the day be

26 fore the first day of Y1.

17

1 (3) RESTRICTIONS ON PREMIUM INCREASES.—

2 The issuer cannot vary the percentage increase in

3 the premium for a risk group of enrollees in specific

4 grandfathered health insurance coverage without

5 changing the premium for all enrollees in the same

6 risk group at the same rate, as specified by the

7 Commissioner.

What's written in green sets the guideline to level the playing field going forward.  You did give great advice: READ IT.  As painstakingly dull as it is to read, all Americans should.  Find what you disagree with and contact your senators and representatives.  (August recess is coming up, so there's a good chance they'll be at their respective in state offices if not on vacation).  This is the point that Junior makes.  What you're reading here is not and will not be final law.  It's the beginning of one.  It's our duty as citizens to be informed, state our concerns, and seek the needed changes in the bill; to use our voices.

It's unfair to say that the president is seeking opposite legislation than what he has preached, as I'm not sure he's had the opportunity to fully review it yet if at all. (Is this the House version or the Senate version? Have they come to an agreement of what to send to the president?  No, Reid said today that they likely would not have anything before August recess) Pressure must be kept on the executive branch as well to make sure that government reach into our individual and private lives, but I really don't think that is Obama's MO.  The point; pay attention and stay involved. 


ablonde
Posted: Friday, July 24, 2009 12:13 AM
Joined: 24/08/2008
Posts: 8


It's really quite simple. I call it the "I'll have what he's having plan" and yes, if health insurance is a menu from which all American's get to have something, even if it's only an appetizer (infancy) or a dessert (when you're nearly dead), --- the revision of our "system" need merely mirror the benefits enjoyed by our federally elected officials (namely our Senators and members of Congress) since they are the ones who are meant to decide for the rest of us. So, as a taxpaying citizen of the United States of America I expect to enjoy the same level of health benefits enjoyed by my Senators and Congressman/woman. To achieve this level of universal coverage it will likely be necessary to change to a single payer national system such as the one that our federal employees have been enjoying for many years, I haven't heard many complaints from them, have you? And for all of you who proclaim that such a system will result in health care rationing, well, we already have health care rationing in this country. If you don't have health insurance you get no health care unless you're a baby or at the end of your life. And KD -- the likely reason you were not presented with a bill by the French was because they couldn't figure out how to generate one for you. If they had, it wouldn't have been anything close to what it would have run in the US. Oh, and the insurance you're referring to that covers crew only on board the vessel isn't health insurance at all, that's more like workmen's comp. A true health insurance policy covers you wherever you are but may be exempt if you go hang gliding (ex) check the fine print. This is why many crew prefer to contract their own policies and have the yacht reimburse them so that their policy remains with the crew person in between jobs. There are many great policies out there for reasonable rates since most crew people are young, fit, and healthy. And to everyone: be careful not to believe the propaganda style ads being broadcast in the States about how awful a single payer system would be. Find some people in Canada and ask them how much they had to pay when they had a baby and it was premature? Ask them about family members who have been seriously ill. In Canada it is unheard of for a family to go bankrupt over a medical crisis, it just doesn't happen. In the US it is the leading cause of bankruptcy, most of whom do have health insurance.
junior
Posted: Friday, July 24, 2009 9:37 AM
Joined: 14/01/2009
Posts: 1026


Yes indeed...just a sharp eyed reader kdhguard00 pointed out, scaremongering will dominate the discussion. First an anonymous poster spreads out a dozen heaps of floating sea grass for readers to cavitate on, then Pascal slips in the deadly FIFTY PERCENT TAX rate. Pascal ! Ahoy !!! Pull back on your throttles !!! Your pumping mud. Review the literature and the best guess cost analysis by healthcare economists concerning Obamas universal coverage plan is 1500 dollars per citizen. Not cheap...not 50 percent of your salary. The trademark of a civilized nation is how it looks after the welfare of its citizens. At present you have a system whereby a father with a diabetic child in Georgia looses his job and looses his family health cover. To cover the 1000 dollars per month in insulin this hardworking American citizen has been force to beg in front of the local church. Imagine the painful scenario an American faces.....When the economy turns south and you are made redundant you have two choices. Keep up with the family health insurance plan or keep up with the monthly mortgage payments. Many of the recent housing defaults in the US were caused by just such a Dickensonian scenario . Funding for universal health care , national health insurance is well within reach for American citizens.
Pascal
Posted: Friday, July 24, 2009 1:16 PM
Joined: 23/11/2008
Posts: 42


I guess the mud YOU stir prevented you from reading the entire sentence... I didn't mention a 50% income tax rate but close to 50% payroll tax in the europeean model you seem to admire.

Is there a problem with the current system? yes.  should medical care be so expensive?  hell no.

look at insurance rates for people who travel a lot, including those workign in this industry.  why are the premiums much higher if you live in the US?  this is the core of a problem. control the costs and the insurance will come down.

but the costs will never be controlled because Zerobama, Hellary and haf the crooks on capitol hills are lawyers.... adn the other half gets elected using campaign contributions from trial attorneys.

"Review the literature and the best guess cost analysis by healthcare economists concerning Obamas universal coverage plan is 1500 dollars per citizen."

do really believe cost estimates?  since when has the government ever done somethign on budget?  are you as naive as your screen name implies?

Gary P Carroll
Posted: Friday, July 24, 2009 2:22 PM
Joined: 14/10/2008
Posts: 13


Wow... If anyone would like to discuss this rationally without name-calling and political posturing I can discuss with you the dangers and pitfalls of a compulsory/mandatory system and how it can lead to cost increases and reduction of availability to care. How can I do this? I was the senior compliance officer for the government's health insurance commission for a jurisdiction that (against my and several notable global consulting company's recommendations) implemented just such a system in an effort to "fix" the healthcare system and all that ended up happening was adding tens of millions of dollars in debt to a government that can not afford it. Quality of care went down and more and more people were forced to fly to the US, receive care, and leave Medicaide with the bill. I'm all for giving the present administration a chance to "fix" the system - but what they are proposing is not a "fix" - it's a replacement that will be good for: doctors, hospitals, insurance companies and drug companies; but not necessarily for patients. Furthermore, it penalizes the wealthy, employers, and individuals who at present are not forced to purchase this particular "benefit." You can contact me and I'm happy to discuss this further but at the risk of being told to pack my handguns in my Hummer and head for my bunker I'll sign off for now.
jcam
Posted: Friday, July 24, 2009 3:16 PM
Joined: 15/08/2008
Posts: 11


Gary, I'd very much like to hear more of your input......  Here's a question though that I'm still not sure of the answer to.  Out of all the countries with universal health care, are there any where an individual may choose between state run and private plans?  If so, is there an "opt out" senerio in which individuals would not be charged if not using the state system?  I would guess no such system exists, but I'm not sure.  At present it seems as though this would be at least a start. 

Pascal, this isn't a "team red" vs "team blue" issue.  It's all of our problem.  As I add my healthcare costs that I purchase individually to my annual taxes, I'm already approaching 40%, and this shows no sign of slowing down.  So while healthcare costs are not technically a tax right now, they're a necessity that may as well be one.  (I can think of numerous ways I'd rather spend the money)


junior
Posted: Friday, July 24, 2009 3:33 PM
Joined: 14/01/2009
Posts: 1026


The healthcare issue is very very complex. For Dockwalk readers who wish to get to grips with many of the issues, swing over to the ....http://www.thehealthcareblog.com/the_health_care_blog/2009/03/a-brokers-lament-we-brought-this-on-ourselves.html much insightful information
Gary P Carroll
Posted: Friday, July 24, 2009 5:51 PM
Joined: 14/10/2008
Posts: 13


I'm not entirely sure how the system works in the UK or Canada, but I'm of the understanding that you do have a choice between government-sponsored plans and private plans. As far as choosing or opting out, I'm not sure. I defer to our British and Canadian friends on clarification on this point. In the jurisidiction in which I worked there was no "opt out" plan and every individual who didn't have it - and every employer who didn't provide it - was in contravention of the law and faced the ire of the penal provisions established within the law. What I think we can expect with regards to the present US plan(s) on the table is this: a lengthy debate period followed by a set amount of time that employers and individuals would have in order to comply with the law; after which fines/taxes would begin. This would be, in my opinion, a best-case scenario (other than scrapping the whole plan), because jumping from one problem into another one is not a solution. One of the largest expenses outside the cost of the acutal provision of the health care itself is the cost to establish, manage and oversee the government system from the standpoint of enrollment, billing, claims verification and consolidation, etc... and then also the cost to staff an agency that will be responsible for oversight and compliance of the law. Something tells me the present administration will pawn that off on the states - at great expense to the states - which will add yet another layer of expense onto already burgeoning proposed cost for this "universal plan." I still contend that the plans on the table are not a "fix" but rather a replacement. And instead of throwing the baby out with the bathwater I think items can be fixed first - but the new president, in an effort to try to reinforce his legacy, will not entertain any notion that is in any way inconsistent with a mandatory/compulsory plan; which is unfortunate.
junior
Posted: Friday, July 24, 2009 6:52 PM
Joined: 14/01/2009
Posts: 1026


Nobody has seriously proposed scrapping the system...they are trying to reform it and make it inclusive. Look at the example of Massachusetts. They instantly found with mandatory insurance that the weak link was not administration but the actual provision of health care to the millions on new, previously uninsured users. For to many years the US has failed to invest in health facilities. As soon as those citizens became eligible for health care...a basic human right...the system overloaded and collapsed. I have no doubt that the Obama plan with cost well in advance of estimates. Im also convinced that you cannot call yourself civilized unless as a society you provide health care for all. In the end the responsibility for administering this system must rely on you Gary...the private sector health insurance providers. I would like to see a cabinet level regulatory body who oversees and clarifies all the various products, fees and commisions that are for offered to the public.
jcam
Posted: Saturday, July 25, 2009 11:41 PM
Joined: 15/08/2008
Posts: 11


Thanks for the link Junior, it is very insightful. 

So it seems we've established a few things that drive up the costs of insurance.

1. Malpractice insurance: Doctors need it to be able to survive whether by a frivolous lawsuit, or a valid one.  Frivolous lawsuits seemingly outnumbering valid ones.  Malpractice insurance rates have steadily been rising for doctors, because not only does the insurance company have to be able to cover the risk, they need healthy profits for their shareholders to remain shareholders and to attract new investment. (perhaps a lawful cap on litigation is in order, as well as new paramaters for the definition of personal injury.  If you were a captain going into the ER with a severe laceration on your index finger and that finger was removed, should you be entitled to $5,000,000 or $500,000 in compensation if it was found out that the amputation was not necessary?  What if it didn't really affect your ability to perform your job?  What if it did? What if it happened in a country where no legal recourse was an option?  Once litigation was capped to reasonable numbers, cost of insurance could be regulated because risk would be reduced.

2. On the consumer side, it's much the same as above. If insurance companies were to act half as responsible as their advertising suggested, I'm a firm believer that 20-30% of lawyers would be out of business. Instead, insurance companies defer, delay, and ultimately do every thing they can to deny any claim that may even have a remote resemblance to what they would call quesitonable.  Insurance company employee compensation benefits reflect that. Fewer dollars paid out in claims = bigger bonus. Happy agent, happy shareholder (unless the shareholder is also the patient putting in the claim) If they do approve your claim, you can expect your premiums to skyrocket. And if you ever have to switch insurance companies, expect the next one to not even consider covering anything remotely associated to your past claim.  Part of the solution to this would be to not allow insurance companies such intrusive questionaires for new applicants.  Simply name, birthdate, sex.  Part of what the current bill is trying to do is limit what insurance companies can charge to various risk groups. While I'm not sure it's calling for enough, it's defenitly a step in the right direction. 

Pascal, I was thinking more about your tax issue.  A number of years ago I made a considerably different amount in personal income (and paid a considerably different amount of tax)  Now, I'm making a different amount (you guessed it, to the lower side) and pay a different amount in taxes (once again, to the lower side).  But instead of dropping, or even leveling off, ALL of my insurance products (home, life, windstorm, health, auto) have gone up. For health insurance,  I'd rather pay the higher taxes proportionate to income, (and know the rest of society did as well and had access to health care) regardless of whatever income level I ever achieve.  In our current status, Bono summed it up best; The rich stay healthy and the sick stay poor. 


Anonymous
Posted: Sunday, July 26, 2009 12:34 AM
Perhaps the problem is that the US health companies focus on making a profit rather than treating paople. Luckily I live in France where the focus is on helping people who need help. I'm in hospital and will be for a while. My back problem was aggrevated badly this afternoon whilst out surfing and I can't walk. I'm also in a shit load of pain. Nobody has asked me for any paperwork, nobody has asked me for money or asked me for pre-existing conditions. My insurance will cover everything. I'll be off work for several months, I'm in massive pain and off my tits on pain killers. Yet all the hospital wants to know is what they can do to help me. I gave someone my carte vitale an hour ago when a friend went to my house and brought me some things. That's going to cover everything. I forget the name of the philosopher who said "a society is judged by the way they treat their poor" but he was right. Healthcare is about making sure people get treatment, not about money. I hope you never find yourself where I am now but if you do, I hope you find yourself in a society that treats everyone equally, not more so than others. Its all acedemic until you need it. Long live socialist countries and their healthcare systems. Now if you don't mind I'll go back to focussing on the ceiling and giggling at the cartoons in my head.
Anonymous
Posted: Sunday, July 26, 2009 12:40 AM
Sorry for typos, bad grammar and missing words. But hey, morphine is GOOD.
Anonymous
Posted: Sunday, July 26, 2009 12:59 AM
Seems to me that this is a US only discussion. Obama plan, look to France, universal health care is socialism etc. Universal health care is actually stated as as a basic human right in the UN charter. That particular charter is even ratified by the US (being one of the founding nations and "inventor"), but seemingly not implemented. Methinks there is a lot of politics gone awry in the issue of health care, not to mention the right to bear arms, which has turned out to be a health issue, not a freedom issue.
junior
Posted: Sunday, July 26, 2009 9:13 AM
Joined: 14/01/2009
Posts: 1026


The unfortunate thing about the healthcare issue is the timing. The massive economic calamity that occurred in the US, combined with ill concieved foreign adventurism will drain the government and the taxpayer for a very long time. Obama inherited this mess and it will restrict his movement on health care reform. I feel the best we can hope for at present are small, incremental steps in the right direction so that future administrations can improve and perfect the system. The sophistication and inclusiveness of the French British or German model did not happen overnight and is constantly evolving. Obviously, investment in present public heath care facilities to accommodate the estimated 100 million new users, while simultaniously driving down the costs of healthcare is a very wise place to begin. Lets hope our legislators see clearly on this issue and move deliberatly.
jcam
Posted: Sunday, July 26, 2009 4:40 PM
Joined: 15/08/2008
Posts: 11


There are loads of statistics that can be researched on who.org (world health organization)

Here is one groups findings off those statistics in relation to overall ranking of health care system by country (first link) and expenditure on health care in relation to GDP (second link). 

http://www.photius.com/rankings/healthranks.html

http://www.photius.com/rankings/total_health_expenditure_as_pecent_of_gdp_2000_to_2005.html

Gary, are you at liberty to say which country you worked with?  It seems to me as though Kathleen Sebelius should pack her bags, book a flight to Paris, do a few months of fact finding and then make a formal report on Capitol Hill.  It woulden't be the first time the United States looked to France for a base platform on national policy.........


Anonymous
Posted: Monday, July 27, 2009 11:05 AM
Be careful what you wish for. Health care reform will have a overwhelmingly negative effect on the Superyacht industry. " In 1993 for every dollar paid in premium to the health insurers, 95 cents went back to the patients. Today that figure is down to 80%. The remaining 20% goes to bonuses to the executives and greedy investor. With an $1.800 billion health insurance industry, this overhang equates to $270 billion " In the early Nineties a health care executive drove a 40 ft yacht, with bag lunches and a beer cooler on weekends out of Ft Lauderdale, by 2009 this same executive commanded a 150ft super yacht entertaining worldwide. With the current generation of 200 ft yachts coming on line, we can only pray that politicians come to their senses, allow Health Care providers to stabilize profits at 25 percent and preserve the jobs of yachties, helicopter pilots, agents, bunker services and champagne merchants worldwide.
yachtone
Posted: Tuesday, July 28, 2009 2:46 PM
Joined: 27/07/2008
Posts: 96


Australia has an universal health care system, it is a no frills system & people who can afford it are encouraged to have "top up" insurance for hospital costs eg. private room with TV, WiFi , celebrity surgeon, premium catering etc.
             The cost of the Govt. medicare is 1.5% of TAXABLE income with DISCOUNTS for certain LOW INCOME people.
              The US system that makes employers pay for health insurance is as appropriate as the gold watch employees receive upon retirement, both are relics of a past world.

kdhguard00
Posted: Tuesday, July 28, 2009 5:09 PM
Joined: 16/09/2008
Posts: 31


Is that right? 1.5% seems more than reasonable to me!
Gary P Carroll
Posted: Tuesday, July 28, 2009 8:45 PM
Joined: 14/10/2008
Posts: 13


Jcam - It was the Cayman Islands. I think what needs to be said here is simple: it is a noble cause to want to fix the health care system in the US - but implementing a new system does not fix it. The problems with the current system aren't economic; they are systemic flaws that manifest themselves in ways that lead to higher costs... and as we all know governments are notoriously poor at solving quandries such as these because a government's first response to problems is "How much money will it take to fix the problem?" The systemic problems need to be fixed before any new plans are implemented - something the democrats seem unwilling to address with their republican counterparts. Once the problems are addressed THEN move on to modifications of provision of care. The democrats are putting the cart in front of the horse on this one because they're too blinded by their own concept to see that they have an amazing opportunity to usher in changes to the existing system that will go farther in healing a diseased health care system than any misguided and poorly planned system of universal healthcare.
Anonymous
Posted: Tuesday, July 28, 2009 10:15 PM
http://open.salon.com/blog/blue_roses/2009/07/27/the_cost_of_5_days_of_health_care_in_canada_compared_to_us JULY 27, 2009 10:34AM THE COST OF 5 DAYS OF HEALTH CARE IN CANADA compared to US "As the current bombardment of misinformation being shared about Canada's universal health care system heats up, I feel the need to speak up." By Kimberley (A Canadian) Co-contributor, Linda (Blue Roses)(US Citizen living in Texas) Tue at 8:01 am Thank you Linda for providing the estimated comparison costs for the US. If anyone has information on costs for the unknown items, please let me know. Kimberley, The figures I've given you for the United States are actual bills that have been incurred for me and/or my son since 2003. The costs fluctuate from state-to-state according to Google Searches. I know that there is a delicate sense of American pride, and I have a real Canadian propensity to not want to brag or dictate, but I've watched so many of my friends suffer needlessly, physically and financially as a result of not having adequate health services. I am not talking only of those with no health insurance, but also of those who pay hundreds of dollars a month for coverage. People who have to sell cars and household items just to pay premiums. People who consider high risk alternatives in order to treat themselves. People who all too often have to choose between groceries or a visit to the doctor. People who manage to get care, only to lose everything they've worked a lifetime to achieve. People who have to just go home and wait for their life to end because they can't afford the treatment they need to sustain their life. People who die too early. People who live with pain. From where I sit way up North, Americans have been conditioned to fear and hate the word socialism and all if its derivatives. I have come to the conclusion that inciting fear and distrust serves people of a certain economic stature well and provides a distinct disservice to the rest, while pitting human beings against other human beings for nothing more than varied ideological perspectives. So, without further adieu, based solely on facts alone, let me share with you the real cost of the past five days of living in a country that has the all-too-often-feared reality of socialized medicine. This covers the services my son, myself and my father and his wife have had over the past 5 days. I consider this pretty typical. My father has a chronic illness, my step mother accidentally fell from standing on a chair and broke her leg, my son is getting fitted for his first hearing aid and I've had routine care. CDA: 3 Dialysis sessions $0 US: Physical Therapy @ 3 X wk $300.00 (dialysis costs in the US are estimated at $144 to 172 per session) CDA: Dietitian services $0 US HealthCare Premiums per month for 2: $250.00 ($3000.00 annually) CDA: Paramedic services $0 US: (Charged $350.00 in addition to Ambulance Services) CDA: Emergency surgery $0 US: Shoulder Surgery $37,000.00 billed Severe hand burns from firecrackers: $5000.00 (2003) CDA: 5 day hospital stay $0 US: 2 day hospital stay Pediatric ICU $12,000.00 (2002) CDA: Regular Dr's visit $0 US: Co-pay $35.00/Drs fee $250.00 CDA: Specialist Dr's visit $0 US: Co-pay $35.00/Specialist fee $350.00 plus CDA: Extensive lab work $0 US: Lab tests/Blood tests for Diabetes (3) $150.00+ CDA: CT scan $0 US: $450 - $2000 CDA: X-rays $0 US: $200.00 minimum, MRI: $3000.00 to $5,000.00 per CDA: Hearing aid fitting $0 US: Glasses Exam $150.00 CDA: Hearing aid (for child) $0 US: Glasses (adult) $450.00+ CDA: Blood transfusion $0 US: Orthopedic Boot/short $450.00 billed CDA: 45 minute ambulance ride $50 (with 80% to be reimbursed) US: Ambulance Service $350.00 (2003) CDA: Prescription $20 (with 80% to be reimbursed) US: Rx copay $10.00 to 25.00 CDA: Travel to dialysis $0 US: patient covers complete cost ------------------------------------------------- CDA: Grand total (after reimbursement) $14 for 4 people US: Approx. $71,000.00 for 2. In addition my father, because he's blind receives an abundance of additional services, and technical supports to assist in maintaining his Independence. Contrary to the fear-mongering ads appearing now on television, there were no waits, no one piled up in the hallway of hospitals awaiting substandard care. I have family members in the health profession and they all have more than adequate salaries that support a high standard of living and neither I, nor anyone I am personally aware of has ever had to wait for emergency, life saving health care. The only waits that I have seen have been for elective procedures. I can't and won't tell you what is best for you or your country, but I felt it was important to give you the correct information that seems to be elusive on the airwaves of American television. In my humble opinion, you deserve so much better than what you are currently getting. Health care should not be an option, but a right -- available equitably to all, and wellness should never be attached to an economic scale. Demand better, you are entitled.
Gary P Carroll
Posted: Wednesday, July 29, 2009 1:31 PM
Joined: 14/10/2008
Posts: 13


Anonymous - There are success stories and failures in any system, and the pricing of services varies not only from country to country, but as well from hospital to hospital and from region to region. I've had numerous successes with my health plans including a surgical procedure that ran nearly $55,000 US for which I paid an admission co-pay of $750, and some small co-pays for post-surgical meds. What's more, one year of post-surgical follow-up care and PT was paid for as well. US health plan, US provider, US hospital. What's more, my neurosurgeon and his hospital were not in the network, so I requested from my insurer that they cover the procedure and all related charges at the in-network level of benefits - and they agreed. After about six months I actually received a cheque from the insurer in the amount of $250 because they mistakenly over-charged me. All too often we hear only of the bad/negative aspects of US-based private insurers because people who pay for and use their health plans as a matter of routine do so, well... as a matter of routine - as they should. "Socialised" health care is not perfect; nor is the privatized system - but what needs to be understood is this: simply initiating a "universal" healthcare plan in the US will not cure the disease so much as it will treat the symptom. Economists and the Congressional Budget Office have said that a governments-sponsored plan will cost much more than initial projections of $1.5trillion over the next 10 years. No one can disagree that the system needs repair, but adding a layer of governmental beauracracy to the mix - along with trillions of dollars of expenses, penalties, fines and taxes - is not the solution. If the US is to have an effective system of universal healthcare then the US needs to move toward that type of system with well-thought-out and deliberate steps instead of rushing into an unknown and untested system without proper planning. For while other nations may be reaping the benefits of successful government-sponsored plans, the US government could cause more damage than good if they do too much, too soon. My experience with this type of system being implemented without long-term planning supports the notion that a lack of planning will disenfranchise supporters of the plan, medical providers and insurers - and it will add exorbitant expenses to the plan. Proper planning prevents poor performance. The current plan is being blocked by fiscally conservative democrats and republicans which tells me that lawmakers do not believe it will work effectively, efficiently and affordably. Couple that with obama back-tracking, looking for consessions, and now using terms like "could possibly lower costs" and "may potentially lead to more choice" and it appears that even he isn't 100% sold on the current plan in its present form. Everyone needs to slow down, take a deep breath, cool their jets and spend all the time necessary to understand how health insurance works, what causes the high rates, etc... and get the plan right - THEN send it to the floor for a vote. Regardless, affordable plans ARE out there and insurance companies offer an abundance of choices to suit most every person's needs; so don't believe the hype that health insurance isn't affordable or you don't have choices. If you don't believe me, contact me or Anita Warwick and we'll be glad to show you all sorts of options for everyone including US citizens, non-US citizens, US citizens living outside the US and non-US citizens living in the US.
AndyP79
Posted: Wednesday, July 29, 2009 4:29 PM
Joined: 13/06/2009
Posts: 42


I agree that we need a complete overhaul to the system. How to go about it is the question. Myself, I would rather see things like frivolous lawsuits against doctors who PRACTICE what they do be banned. I would like to see things like name brand meds allowed to be made generically sooner. How about funding more clinics, and educating people about using them instead of the ER. How about making to where the insurance companies can't tell you which doctor you can see? There are a million ways to go about it. But, if I am going to be told I don't have a choice, that I have to have my taxes raised, then I don't want to pay a single cent when I walk into the hospital. If everyone so deserves to have health care, then how about making the whole thing tax sponsered. When we break a hand, or foot on the boat, why should I have to pay anything or show any card. If they really care, and want everyone to have equal coverage, then give us equal coverage. If illegal immigrants, and the poor get health care for free, why not the rest of us. Just make employer coverage not available. Then I can get a raise from the company to cover the extra taxes. Then I can just go to a clinic to get the flu shot, or the ER for an accident. Use the money to make sure people have access to the right place for their injury or illness. But the other side to that people will say, is then the quality of research will go down, people won't want to be doctors or nurses, but those that really want to help people, will still do it. If we are going to socialize medicine, lets actually do it and not have plans for different people. One thing though, which the government is not so good at, is getting rid of all the old rules. Make sure Medicaid and Medicare, and all the other programs that provide for things today, are null and void. Why would they need to be around. Let the hospitals and the politicians fight over how to get paid, instead of continuing to dump it on us. If they can't do all this, and make it truely a universal thing, then just leave it alone, until they can come up with something better. Like magic wands to make the boo-boo's go away! Sorry, couldn't help but make a smart ass response to all of it, right?

An Owner
Posted: Wednesday, July 29, 2009 9:13 PM
Joined: 15/01/2009
Posts: 53


AndyP79 wrote:
I agree that we need a complete overhaul to the system.











We don't need a complete overhaul to the system. All that really needs to be done is to return competition to the insurance industry and take them off the government dole. There was absolutely no problem with insurance or our heath care system until the insurance industry got in bed with government and HMO's were born. Now the insurance industry is subsidized by government. You can't sue them, you can't get a competitive plan as an individual, and they can jack your premiums at will.

 Stop the taxpayer subsides and guarenteeing them all a piece of the pie and see just how fast policy prices drop when they're hunting for business. See how fast those that do not complete get left by the wayside.

Offer individuals a 5 or 10 thousand dollar tax credit to get their own insurance and companies will be climbing all over themselves to get the business. You'll be shocked to see just how close to the exact dollar amount an insurance company will come to your credit.  Deductables will disappear again (no such thing until HMO's came along) and family care will return to a fraction of what they can rape you for without the taxpayer subsidy and cover of the psudo governmental agency. Taking competition out of an industry is the quickest way to turn it into the runaway monster that it has become.

For the elderly Medicare, and for the sick, lame and lazy there is Medicaid. They are more than sufficient to support these folks abiet at a loss, but that is where socieital responsibility ends. As it stands now, your congress and your President wish to raid these, to pay for their power grab.

Of course, this so call health care plan before congress now has nothing to do with this goal. That mess is nothing but a huge socialist move to nationalize all of health care under government control. Anyone who doesn't read this bill and see exactly what it is going to do to you, deserves exactly what it offers. The government dictation of what health care you can recive, not your doctor. This bill literally tells you that if you are on the government plan, your health care will be rationed. It goes so far as to even dictate that education for heathcare services be designated to show preference to "minority and underprivildged" designees without even defining exactly who that might be. Can anyone say, unconstitutional?

It tells you that you can choose to keep the plan that you have. What it doesn't tell you is that it is literally guarenteed that your employer can and will change you to the government plan and there is absolutely nothing you can do about it. Why? Because it also doesn't tell you that your private insurance company will have no choice but to be systematically converted to an approved government healthcare provider, under government regulation, because they can't compete with a governmental agency that is undercutting them and at the very same time telling them how much they can charge.


This bill doesn't add competition, it doesn't offer choice and it doesn't "level the playing field. It swallows the playing field. It allows government to control every aspect of your life, who lives, who dies and when. It lets them into not only your living room, but your bank account as well, and there isn't a damn thing you can do about it.

Like our fearless leader said, "Maybe you don't need the surgery, maybe just the pain pill instead." Get ready for it. No dialysis for you after 65. It isn't cost effective. No pace maker for you. You're too old for it to be cost worthy. We will however be more than happy to send our community orgainzation out to provide you with end of life counseling.

Think about it long and hard before you jump on this bandwagon. It is a bad deal for everyone.


It's all your's now Junior. Insults, slander and malicious comments, let them rain.


Gary P Carroll
Posted: Thursday, July 30, 2009 9:33 AM
Joined: 14/10/2008
Posts: 13


Good general points An Owner. The last thing a government-sponsored "universal" plan will do is create competition. It will remove competition by removing incentives for insurers to compete as the insurers know that everyone must have it and not everyone will qualify for the alleged low cost government option that - at this point - may or may not come to pass. Couple that with lawmakers being unsure - still - as to how the government plan will work, what benefits it will contain and how "affordable" it actually will be and it's easy to see that this government plan is not well thought out. The government is planning to offer affordable access to health care - and they're going about it the wrong way. I still contend that until the system is repaired no entity will succeed with a universal plan that is good for anyone, and we will pay the price which will be significantly more than the trillion dollar pricetag currently on the table. Also... there are so many affordable health insurance options out there if people just spend time looking for them. I am 42, I have had three major surgeries and I have never had trouble getting health insurance. I pay $186 per month for a comprehensive plan with a major US health insurance company and I have no pre-existing condition exclusions. I call that "affordable" - especially given the fact that my health insurance company could be on the hook for $4,000,000 in benefits. It would take me 1,700 years of paying premiums to equal the amount my health insurer is on the hook for from day one.
Anonymous
Posted: Thursday, July 30, 2009 9:53 AM
The point surely is about treating people, not making money or creating competition?
Anonymous
Posted: Thursday, July 30, 2009 12:03 PM
Tweaking the existing system in the US will not really provide universal health care. As long as it is hinged on the employers and personal economic strength, a large portion of the population will continue without sufficient means to acquire proper health care when needed, especially in a recession. In the end it's about "can you and/your employer afford it or not"! And people go through different phases in life. Starting a family in a very insecure job market means that you as a private person must compromise, you go for the cheapest. Insurers will as part of the business concept try to keep expenses down (otherwise they are not running their business right), your employers as well if you have one. Later in life perhaps you have the financial security and savings to upgrade considerably. But you really need it when you are younger, with toddlers in the house etc. More over health problems in a younger age tends to manifest themselves with graver implications and required costly medical attention later in life. So for society as a whole that is bad economics. Most western European countries statistically outdo the US in many of the parameters that indicate level of health care. Tax rates are higher in Europe, but for people of low income (bottom third) tax rates are significantly reduced, some countries down single digit percentage. To pay 130-140 eur a month for health insurance would be an outrage in f.ex France or Spain, where the average starting salary for a professional would be in the region of 12-1800 eur a month. It would also be an outrage for small companies and enterprises to cover that amount monthly. These two countries have arguably the best health care systems in the world today (of larger countries) and consistently ranks top ten on international rankings . They are not without problems, in no way perfect, private insurers and private health care is available to those who wish to pay for it, but they seem to yield far better results for the general health of the population. I have no doubt that the US system provides the very best that world has to offer in health care, if you have sufficient coverage. I think the US is overdue with regard to health reforms if it wants to close the gap on WHO rankings. Besides it is a basic democracy question. As long as the system perpetuates the "have's" and the "have not's" there will be "health segregation", two very distinct segments of the population. Socializing health care is actually a good preventer of class struggle if one likes ideological terminology.
Gary P Carroll
Posted: Thursday, July 30, 2009 12:33 PM
Joined: 14/10/2008
Posts: 13


How many "Anonymous" are there?? We'd all like to think that this idea of universal health care in the US is about treating people, but it's not. It's about money. It's about how to drive costs down so we CAN treat more people. It's about making the system more efficient so we can afford to add 50,000,000 patients to the system. It's about finding ways to offset the potential for abuse and overutilization by patients who currently don't have it who will - once they get it - over utilize the plan. It's about how to deal with those who have pre-existing conditions who - once they get it - will incur significant costs by over-utilization AND by generating higher claims. It's not about treating people - its about "how can we afford to treat the people?" Simply by implementing a universal plan will not, in and of itself, create an automatic and affordable healthcare system. You can't compare the US with France or Spain or Germany - even, to a certain degree, the UK. Those systems are different. Could the US move in that direction? Sure. Will obama's plan do that for the US? No. When you do something major like this you don't just do it. When the US went to the moon, they didn't point a missle at the moon and light it. They spent years and years developing rockets and developing systems and sending capsules into orbit... and THEN once they had their systems in place, they went for the moon. Along the way there were problems and setbacks, but once they worked out the problems they were able to land on the moon. Health care should be treated the same way because this will cost the US significantly more than putting a few guys on the moon; and if we screw it up because we move to quickly then we do nothing more than set ourselves back even further - which costs more money while failing to meet the objective of insuring up to 90% of those people currently without helath coverage. Is this plan about treating people? No. This is all about money.
Anonymous
Posted: Thursday, July 30, 2009 2:41 PM

Yes, let's all get this right.  It is about the money and Gary is part of it.  He is an insurance broker.  This plan impacts his commission.  Putting "more government" in healthcare would simply replace the massive bohemouth that the health sector has become.  And let's get it straight about the moon.  They made a timeline of 10 years and delivered on that promise.  That was the moon!  This is hardly the same, let's get real.  Why isn't it obvious that removing the profit-hungry middle man, or at least limiting that gorging, is the right thing to do?


Anonymous
Posted: Thursday, July 30, 2009 4:04 PM
Gary, effectively YOU are the problem. It is about money however it should not be. Universal health care means healthcare professionals (that means the ones that treat people not bean counters and 10%ers) just treat people as and when they need it and to the best of their ability. THEY control the system not vice versa. If you have a vested interest in a subject you should disclose that interest. My vested interest is my health. I pay 37 Euro/month for a no questions asked and no, I mean ZERO restriction policy. What you earlier describe is ridiculous.
Gary P Carroll
Posted: Thursday, July 30, 2009 5:20 PM
Joined: 14/10/2008
Posts: 13


I LOVE this debate! Thanks "Anonymous" (if that is your REAL name) - thanks for supporting my point on the moon analogy. I'm all for a 10-year timeline on implementing a universal healthcare plan. And you're right - I am a broker. But I'm a broker who is all for a universal system; just not one as ill-conceived and expensive as this one. I"m also a broker who sells yacht insurance and offers health insurance as an ancillary service (please call 954.604.2888 for a quote!) and I work for my health insurance clients to find them the best deals at the lowest premiums: and I'm sure all TWO of my health insurance clients appreciate this. Little-known fact about me: I don't even write my own health insurance, so it doesn't actually affect my commission that much at all. I pay more for health insurance in a month ($186) than I make in health insurance commissions in a year, so while I'm - as you say - a "part of it," I'm a very small "part of it." And so no one else has to assume to know me so well I'll take a moment and give you some context for my comments and opinions on this issue that are based not in emotion or conjecture but rather in experience. I spent 16 years in the health insurance industry and I saw a plan come and go that promised employers and individuals that the government intervening on their behalf with regards to health insurance would provide choice, access and availability to affordable care. It failed in two years due to a lack of planning and due to the fact that the added layer of compliance added expense for which the health insurance company had to bill. From an agent's perspective, the care was substandard, the plans were very limited and often more expensive than plans that were richer in benefits and already available. My health insurance experience also has included a number of years in a senior-level compliance position with a government that implemented a compulsory/mandatory plan; effectively adding "more government" in an attempt to "replace the massive behemoth..." or whatever you said. It's been nearly 10 years and the plan has done little more than criminalize non-compliance; stagnate the health insurance industry; increase the debt of government hospitals and clinincs; forced hospitals and providers to increase the standard fees (called UCR fees here in the us - google it) which increased bills to insurance companies and balance bills to patients; increase the government's debt due to required increases in funding the government plan; forced more than a few businesses to close due to the increased cost of mandatory employer participation; etc... After nearly ten years of this plan there are now - percentage-wise - more people without healthcare than had it when it was a "benefit" and not a "compulsory condition of residence and/or employment." First of all: Putting more government in healthcare will NOT automatically, as you say, "replace the massive behemoth that the health sector has become." Putting more (keyword MORE) government in healthcare will exascerbate the systemic problems. I've seen it happen. I warned a government that it could happen if they didn't take more time and implement a more viable plan and guess what - that government is now sucking wind because their healthcare system has added nearly $50million of additional total debt to their already debt-ridden system - debt they are, at this point, unable to pay down by borrowing money. Hmmmm... wherever will they get the money? Furthermore, the government healthcare option reduced access to care and slashed benefits. The government oversight added millions to the budget and triggered addtional routine multi-million dollar emergency subsidies in order to maintain operational viability. But it DID have an upside. It did encourage people to fly to Miami, receive treatment there and leave US hospitals (usually Baptist or Jackson Memorial) holding the bag with no other option than to file claims under Medicaid and write the rest off as bad debt. This is one of the problems with the US system that needs to be addressed - unless we take "universal health care" to mean we're going to treat every freaking person in the universe!! The last case I worked resulted in Medicaid paying $380,000 of a $435,000 claim for a pre-mature baby and an additional $88,000 for the mother - everything else was written off by Baptist Hospital in Miami as bad debt. Does the current plan address this? Of course it does - it allows for it to continue. And systemic problems such as these will continue to flourish in the president's plan. We have a down economy coupled with an expansive government that will have to hire tens of thousands of people to manage the plan at an unGodly cost and the plan hasn't addressed any concerns regarding repairing the systemic problems (or inherent vice) that lead to runaway expenses BEFORE hundreds of billions of dollars are spent on a prototypical and untested plan. I don't want to be "a part of" that. History lesson: Yeah... all we'll do is pop over to the Middle East, find the weapons of mass destrutction and head home. We'll be done in a few months... Poor plans lead to poor execution lead to poor (and expensive) results. I would, however, LOVE to be a part of a universal plan supported by an industry that was consistent and efficient working in concert with a governmental plan backed by solid policy and oversight along with viable fiscal policy. I mean come on - as an insurance agent I'm thinking 50,000,000 additional potential premium-paying, commission-generating clients in a mandatory and compulsory plan? I'd gladly be a part of that
Gary P Carroll
Posted: Thursday, July 30, 2009 5:36 PM
Joined: 14/10/2008
Posts: 13


I'm sorry about not posting my "vested interest." I thought perhaps avoiding the "Anonymous" monkier by actually posting my name, picture, link to my DW page with my business and contact info on it, etc... would be sufficient. My mistake.
Anonymous
Posted: Thursday, July 30, 2009 7:21 PM

I'm just blown away that Gary pays $186 a month for health insurance. No wonder you are not in a hurry to fix the system, Gary, what a bargain. If you have a spouse and kids, try about $1,500 a month. $18,000 a year is what my family pays.

 

And heaven forbid we get sick outside of our home base, as all doctors, hospitals and urgent care centers outside our state are considered 'out of network' and are not covered at all on this policy that costs $18,000 a year! I can only hope we get sick outside of the country because we can afford the 32 euros the doc visit in Spain costs as opposed to the $258 bill from the urgent care center in Virginia.

 

And by 'overutilize the system' do you mean people like my sister's neighbor who discovered a suspicious mole but was reluctant to go to the doctor because he didn't have health insurance? He's dead now, didn't make it to forty. And we call ourselves a civilized country.


Anonymous
Posted: Thursday, July 30, 2009 8:21 PM
Communism has been proved wrong but hell, the US version of Capitalism sure isn't doing too well right now. Seems to me that the extremes in both directions are a mistake and that the middle ground on both sides of the divide or a combination of the too might work.
Gary P Carroll
Posted: Thursday, July 30, 2009 9:29 PM
Joined: 14/10/2008
Posts: 13


Okay... here comes the hard sell. Yeah, $186 is nice. Just think if you and your wife and kids (assuming a total of 4 persons) each paid $186 a month like I do you could save about $9,000 per year. What would you do with an extra $9,000/year? My only two health clients have global benefits, are husband and wife, and pay about $5,200/year total for both. So, if both of their kids were in their 40s like these two are, they still pay $7,600 less than you and your family. Something doesn't add up. I’ve been in the insurance industry for 18 years with 16 being spent in the health insurance industry and I can say this with a reasonable amount of certainty: There’s a reason you’re paying $18,000/year. And whatever that reason is, your agent makes 10% and perhaps 15% commission - and $18,000 with no national network and no international benefits is the best he/she can do? Now I’m really curious. You have two options: First: You can continue to complain or; 2) You can call me because I'm happy to discuss options for you to investigate. Heck - I'll even counsel you, provide you options AND refer you to someone else who can sell it to you. I'll send you to the person who writes my insurance and she can do it. (That's right - I truly do NOT write my own health insurance.) I can't promise you anything but who knows... I might actually be able to work with you and your family and use my "vested interest" to help you find a carrier like mine that has a network of more than 450,000 doctors so that if you got sick outside your state you could still utilize in-network benefits. And that same insurance company might also reimburse foreign providers at the in-network rate so the next time you're in Spain next you'd have options. And they might charge less than $18,000 / year. I love a challenge and I love beating up on insurance companies to benefit my clients... and I have a number of yacht clients who can back that statement up. I'm an agent which means I am a client advocate NOT an insurance company advocate. My duty is to the participant/patient/client and not to the insurance company. If you’re working directly with a company or a captive agent, their loyalty is to the company – my loyalty is to the client. Sorry to hear about your sister's neighbor. It’s always sad to hear news like that and it’s troubling to think that this person used not being able to afford insurance as an excuse to not go to the doctor – and it quite possibly cost him his life. Using the excuse of "I can't afford it" to avoid dealing with a health issue is not only foolish, but potentially deadly. Doctor’s offices and hospitals will work with patients and set up billing to meet a patient’s needs – all you have to do is ask. And if you think it can’t be done, you’re wrong. I handled more than 300 settlements for patients from the Cayman Islands receiving care in the US from private doctors and from hospitals like Baptist and Jackson Memorial. The frequency of this process inspired Baptist to actually set up an office in the Cayman Islands to work with patients before they head off for treatment. It’s good for the patient because they know they’re getting care and it’s good for the hospital because they know they stand a higher-than-average chance of getting paid. Obviously this post is a bit brash and a bit tongue-in-cheek, but people need to know they have options and that insurance companies will be as “evil” as you let them be. But the most important thing you can do is arm yourself with knowledge – which is where an agent should come in. A good agent will work with you to guide you through the BS and help you choose the proper product – and I’m willing to do that. Can I help? Who knows... but I am always willing to try. 954.604.2888 gary-p-carroll@cyacht.net
Anonymous
Posted: Friday, July 31, 2009 12:21 AM
186 bucks a month! And that's a bargain? In my country it is max you can pay pro annum, if you go over that sum in medication or other health care services the the govt takes the bill, and it is one of the few European countries where you actually have to fork out some money to talk to somebody in a white frock . I pay 30 pct income tax (not doing to bad, upper mid percentile tax bracket, every conceivable deduction played and there are certainly more I haven't tried or heard of yet!). I pay nothing if my legs fall off on holiday in Orlando, Fl. or Alma Ata, Kashakstan. Repatriation guaranteed, they'll even give me drinks on the plane back. I just flash my EU health card (strong funding guaranteed!) My employer pays 14.1 pct in payroll tax. You pay this every month, even when you are not sick? Your insurer should give you a car or something! You are being bamboozeled!!!
Gary P Carroll
Posted: Friday, July 31, 2009 12:26 PM
Joined: 14/10/2008
Posts: 13


Bamboozled? Naaaah. I'm quite happy to pay for my health care. We both pay for our health plan - just in my case, I'm the one writing the cheque and I'm the one allowed to deduct premiums and other health care expenses which helps reduce my tax liability. Individuals and corporations can utilize a number of tax-advantaged methods to reduce taxable income by paying for insurance and other medical expense with pre-tax dollars.
Anonymous
Posted: Friday, July 31, 2009 3:13 PM

HI,

I'm the anonymous that pays $1,500 a month. The reason for the high premiums is the family plan. How it works is if you have 1 child or 20, you pay the same amount, Yes, crazy, but that's just the rules every insurance company go by. We would LOVE to pay 4x $186, but we're not four men in our 30s. Premiums vary by age and gender and it's impossible to find premiums for a woman of childbearing age under $500 a month (for a good plan that pays all med bills, not one with a $5,000 deductible). It just costs about twice as much a month to insure a woman who could possibly have a child (which would cost the insurance company about 10 grand, but if you were paying out of pocket, more like $20,000).  

 

And yes, we have the more expensive plan but with a couple small children we end up at the doctors a lot, and I have no patience for the 70/30 plans and outrageous out-of-pocket expenses, on top of already too-high premiums. Our plan means we pay just a reasonable co-pay and no more bills follow.

 

We're not getting bamboozled, I'm afraid, as we've been with three or four different plans over the last ten years. This is actually one of the better plans...my point was it's incredibly expensive and cost prohibitive to most Americans. Decent health care should never be cost-prohibitive to a majority of a nation's citizens.


Anonymous
Posted: Friday, July 31, 2009 3:26 PM
Perhaps you have a sweet deal, compared with other US citizens, and it certainly seems so! Compared to most European countries you are being slowly bled (by private companies, not the state, which makes it even more unpalatable). I mean that US citizens in general are being bamboozeled by the health insurance racket. With your sweet deal you and your family of four will have effectively forked over in excess of 161 000 USD by the time your kids are 18. You and your wife would have forked over in excess of 300 000 USD by the time you reach 67. Not to mention if some in your family gets a chronic condition, then 186 bucks/month/person is no longer valid. As I understand from other pundits, the norm is actually twice that. In eighteen years you would have a second house, man! And not a dime i mortgage to boot. How can a blue collar family actually manage that without going broke or bonkers in a recession?Still think you are not being bamboozeled?? Europeans have started civil wars and armed revolutions over less!
Gary P Carroll
Posted: Friday, July 31, 2009 5:41 PM
Joined: 14/10/2008
Posts: 13


Consider this - if I get $4million sick my insurance company pays $4million. At $186/month it would take me 1,792 years to equal the amount they would pay out tomorrow if I got sick. That's about 1,700 years longer than I'm planning on living. PLUS, as a business-owner, I get a deduction AND I can defer pre-tax dollars into a HSA to pay for my annual health care which further reduces my personal taxable income. You pay taxes that pay for your health care - I pay taxes that are net of what I pay for health care. Either way you slice it - we both pay for our health care. I spend about $300 month on groceries, but if I stop eating by the time I'm 65 I could save nearly $100,000 (I suppose the grocery store racket has me bamboozled). I spend $150/month on utilities, so by the time I'm 65 - if I go without electricity or water - I could save another $50,000. I guess the power and water people have me bamboozled too. There are certain items I consider staples as they have value to me. Health insurance is one of them. I figure I've probably spent $40,000 over my lifetime on insurance and I know for sure based upon my three surgeries that I've incurred more than $200,000 in claims from those three instances alone; not to mention the routine visits, emergency room visits, medications, etc... Does that mean I have the health insurance companies bamboozled? I've spent $40,000 in premiums and insurance companies have paid out $200,000 in claims. Bamboozled? I'm okay with it. But if it's a choice between having an extra $40,000 and not being "bamboozled" or being alive - tell me who I owe and label me "The Alive Bamboozled Guy."
Gary P Carroll
Posted: Friday, July 31, 2009 6:02 PM
Joined: 14/10/2008
Posts: 13


Anonymous $1,500 / month person. I'm aware of the rating basis for insurance companies. Like I said earlier - call me if you like and I'm happy to discuss this further. I just ran a proposal (42yr/old male; 35 yr old female; one son and one daughter aged 10) on a PPO plan with a $500 deductible, $20 doc co-pay, dental benefit, optional maternity... all for $950 per month. I just showed you a potential savings of $550/month or $6,600/year (35%) and that was the first place I looked. I don't even sell health insurance full-time so I might actually have to look in a couple of other places to get more data to possibly offer you more choices from your $18,000/year plan. I think our other anonymous friend might say you're getting "bamboozled" by your current carrier - but I'd never say that. Call if you want me to look for you some more.
Anonymous
Posted: Saturday, August 1, 2009 8:46 AM
Consider this: If I get 4 mill usd sick, I pay nothing. It will take me no time "to pay" for 1792 years. I do however pay regular tax which a part from health care, also pays for schools, roads, general infrastructure, university education for my kids, social services, free dental care for my kids, and more. You say you own your own company and thus have elaborate schemes for deductibles. 50 million Americans do not have health insurance. Many more are not thrifty health insurance entrepeneurs like your self. They pay through their noses to have the same coverage. The way you describe how you and people of your "class echelon" can maximize health plans and pay less is a big part of the problem, because its all about you, individually. You regard health care as something that should cater to those who pay, not as a service to society as a whole. One thing is your personal health, another thing is universal health care which cater to society. To up the general level of health in a society is very good for the economy. Employers do not go broke because they have to fork out for laid off workers or benefits to early retirements. A big part of Detroit's demise was due to such arrangements with auto workers unions etc. You simply don't get it. Universal health care is a shift from "me and mine" to "us". I think it must be considered a leap of faith for fiercely individual Americans, but health reform in the end is about democracy, human rights and a big chunk of money. Funnel private funds through a govt run health care system has nothing to do with robbing people of the right to choose, nor is it socialism. It's actually the only working model today that can provide decent health care for the population as a whole.
Gary P Carroll
Posted: Saturday, August 1, 2009 11:01 AM
Joined: 14/10/2008
Posts: 13


Well, I'm glad you understand that your taxes pay for your health care which means you understand that there is no such thing as "FREE" care. No matter who you are - rich or poor - if you receive care someone is getting billed. Either the patient, the insurance company or the government. So let's do away with the term "FREE" health care. There is no such thing as "free"health care. Second: utilizing deductions in accordance with the Internal Revenue Code is not an elaborate scheme and has nothing to do with, what did you call it... "class echelon" - whatever that means. Millions of people each year file income taxes and utilize thousands of deductions allowed by the US tax code in order to reduce their tax liability. Businesses AND individuals are allowed to utilize these tax deductions to reduce their tax liability. These same individuals continue to pay taxes that pay for things like roads, schools and other infrastructure. If you have a 401(k) or a SEP or an IRA or any sort of tax-deffered plan you are participating in yet another tax-advantaged plan allowed by the IRS and the tax code. These aren't elaborate schemes. Furthermore, health insurance companies themselves offer to administer IRC Section125 plans, HSA, MSA and FSA that help participants pay for medical expenses with pre-tax dollars that not only reduce an individual's/family's tax liability but can also reduce a business owner's expenses and tax liabilities as well. The government created these programs and fully supports their use - and their use would continue to benefit folks even with a universal health care system because even with a universal health care system people will still be paying premiums for their health care and they still will be looking for ways to reduce their tax liability. Understand this: This proposed system in NO WAY will mean "free" health care. Insurance companies will still charge premiums, people will still pay premiums and cost shares, doctors will still bill, etc... and until the systemic problems are fixed costs will continue to go up. It's simply that the government will now be in the game by taxing folks to attempt to create their own system that will - in the words of obama himself - "possibly" create more choice and "possibly" lower costs to people in a certain "class echelon" - the 45million people without care. AGAIN I say: I support a "universal" healthcare system - just not this one because it doesn't address repairing the systemic problems that lead to systemic abuses that lead to high costs. Nor does it offer a viable, sustainable and affordable government option. Read the 1018 page document and then get back to me.
 
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