Health care debate confirms this is not the Barack Obama we elected

[kg_veteran]

Originally Posted by Mavdog

if that were accurate, the accusation would be correct.

but that is not the case, insurance cos should act like a business, and they should do exactly what their business does...insure people against risk, and pay when their is a claim.

they should not be able to stop insuring people when the risk is realized. that is removing the downside of the policy they underwrote.

You're not making sense.

If I have health insurance in force when I become ill, the insurance company has to pay. Now, should they be allowed to raise premiums? Of course. Otherwise, how is it insurance?

that's not being a "charity", far from it. the premiums will be paid, and the coverage will be extended, and if there is a claim it should be paid.

I'm not sure what you're arguing here. Are you saying that insurance companies shouldn't be allowed to stop insuring people, that they shouldn't be allowed to raise premiums when a person gets sick, or what?

the false accusation that it is the "federal government..as an insurance/welfare company" is false. wrong. inaccurate. a lie.

the federal governemnt does not write a single policy.

Look, if you want everybody covered no matter what, that's going to result in a gigantic increase in costs. Unless you think that each individual patient is going to cover the cost of that increase through their premiums (which would be a ridiculous assumption), then I'm not sure why you're denying that the federal government would have to pick up the tab.

[92bDad]

Hey I've got an idea...why don't we get all conservatives to retire. 100% stop working...and let's let the liberals take care of the conservatives.

After all, since all the conservatives will no longer be earning an income, they won't have to pay a penny in taxes, and since the Liberals want to take care of everyone, they will get to do the work associated with taking care of poeple.

Both sides get what they want, we will all be happier...but who gets to sit on the death panel?

I say we appoint Mavdog, Underdog, Flaco, Murhpy, Mary and Alexamenos with Silksmoov getting the final veto power!!!

Anybody else interested in being on the death panel?

[DirkFTW]

Originally Posted by 92bDad

I say we appoint Mavdog, Underdog, Flaco, Murhpy, Mary and Alexamenos with Silksmoov getting the final veto power!!!

Only a racist would put Silk last on a list.

[Mavdog]

Originally Posted by kg_veteran

If you're going to put a person with a pre-existing condition into a pool with a healthy person, you're going to shift a good portion of the cost for the unhealthy person's care to the healthy person.

How is that going to save money and make health care more affordable again?

first, the person with a pre-existing condition many times WAS a member of the pool before their insurance lapsed. second when the insurance is universal there are many more healthy people than ill put into the pool, with the ratios remaining at worst level.

[QUOTE]Nonsense. Employer-based health insurance still represents the bulk of coverage in this country. When I say disconnected, I mean completely. Set up a system where people have the ability to purchase affordable coverage without getting it through their employer. Instead of giving the employer the deduction for the health insurance expense, give the employee the deduction.[/QUOTE}

you should get more informed on the stats...

•The percentage of all employers offering health insurance in the past eight years peaked in 2000 at 69% and has fallen steadily since, hitting 60% this year [2007], according to an annual survey of employers by the non-partisan Kaiser Family Foundation. Among small firms of three to nine workers, the percentage offering insurance has dropped even more — from 58% in 2001 to 45% this year.

http://www.usatoday.com/money/indust...cial-net_N.htm
http://www.nchc.org/facts/coverage.shtml

I agree on allowing the individual the same tax benefits provided to business, and that should help with the costs. that should be part of the package when coverage is universal.

[kg_veteran]

Originally Posted by Mavdog

first, the person with a pre-existing condition many times WAS a member of the pool before their insurance lapsed.

And, of course, if you disconnected health insurance from employment, that person would be able to stay with the plan they had if they so chose. The problem arises when you are on one group plan and are then forced to leave that plan because you are no longer employed by the same employer. If termination of employment didn't end coverage (after the COBRA period), then this wouldn't be an issue.

Thanks for agreeing with me.

second when the insurance is universal there are many more healthy people than ill put into the pool, with the ratios remaining at worst level.

And you expect those new people to cover their own costs? Really?

you should get more informed on the stats...

•The percentage of all employers offering health insurance in the past eight years peaked in 2000 at 69% and has fallen steadily since, hitting 60% this year [2007], according to an annual survey of employers by the non-partisan Kaiser Family Foundation. Among small firms of three to nine workers, the percentage offering insurance has dropped even more — from 58% in 2001 to 45% this year.

http://www.usatoday.com/money/indust...cial-net_N.htm
http://www.nchc.org/facts/coverage.shtml

This indicates that fewer employers are able to afford health insurance premiums, not that health insurance has been disconnected from employment. I'll repeat what I said: the bulk (majority) of people that are insured in this country receive their health insurance through their employer.

[dude1394]

Nice...

http://article.nationalreview.com/?q...ZkZTMwN2YzNTg=

Buried in the 1,017 pages of the House Democrats’ health-care bill is a little-noticed provision that for the first time could give the government access to the checking or credit-card information of every American. Under section 163, which is entitled “Administrative Simplification,” the bill sets new “standards” for electronic transactions between individuals and their health-care providers.

According to section 163, the standards will “enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service . . . ” In addition, they will “enable electronic funds transfers, in order to allow automated reconciliation with related health care payment and remittance advice.”

[Mavdog]

Originally Posted by kg_veteran

And, of course, if you disconnected health insurance from employment, that person would be able to stay with the plan they had if they so chose. The problem arises when you are on one group plan and are then forced to leave that plan because you are no longer employed by the same employer. If termination of employment didn't end coverage (after the COBRA period), then this wouldn't be an issue.

Thanks for agreeing with me.

actually, this shows the extent to which the system needs reforming.

apparently you agree with me on this need.

And you expect those new people to cover their own costs? Really?

a pool of healthy and ill insured allows the combined premiums to cover the costs, that's the fundamental structure of insurance.

it works, has for a long time.

This indicates that fewer employers are able to afford health insurance premiums, not that health insurance has been disconnected from employment. I'll repeat what I said: the bulk (majority) of people that are insured in this country receive their health insurance through their employer.

but the rate of coverage is decreasing, didn't you see that in the articles?

actually it is both cost of coverage and the number providing coverage, as fewer and fewer people are employed by large cos and not provided lifelong job security. people move from job to job as well.

half of all workers are in small businesses, and a majority of workers do not work for large cos. the per cent covered by employer policies is declining, and declining at a greater rate.

that's why the system as it has been established in the past, based on employer provided coverage, must be reformed to adapt to this new environment.

so yes, we do need health care reform.

[Mavdog]

Originally Posted by dude1394

Nice...

http://article.nationalreview.com/?q...ZkZTMwN2YzNTg=

that's done today. check into a hospital and financial responsibility/coverage is the first item on their list.

[kg_veteran]

Originally Posted by Mavdog

actually, this shows the extent to which the system needs reforming.

apparently you agree with me on this need.

Well, duh! Have you been listening to anything I've said?

a pool of healthy and ill insured allows the combined premiums to cover the costs, that's the fundamental structure of insurance.

it works, has for a long time.

The difference is that REAL insurance adjusts for risks. That's why certain high-risk people are excluded.

Repeat after me: buying coverage for something that hasn't happened yet is insurance. Paying for coverage after the fact as if the event hasn't happened yet and requiring the rest of the people in the pool (or the government) to cover the costs is welfare.

If we're going to talk about giving coverage to people who already have uninsurable conditions, let's at least call a spade a spade.

but the rate of coverage is decreasing, didn't you see that in the articles?

actually it is both cost of coverage and the number providing coverage, as fewer and fewer people are employed by large cos and not provided lifelong job security. people move from job to job as well.

half of all workers are in small businesses, and a majority of workers do not work for large cos. the per cent covered by employer policies is declining, and declining at a greater rate.

that's why the system as it has been established in the past, based on employer provided coverage, must be reformed to adapt to this new environment.

so yes, we do need health care reform.

I think we agree on this. Health insurance should not be tied to employment.

[chumdawg]

Originally Posted by kg_veteran

The difference is that REAL insurance adjusts for risks. That's why certain high-risk people are excluded.

Repeat after me: buying coverage for something that hasn't happened yet is insurance. Paying for coverage after the fact as if the event hasn't happened yet and requiring the rest of the people in the pool (or the government) to cover the costs is welfare.

If we're going to talk about giving coverage to people who already have uninsurable conditions, let's at least call a spade a spade.

I think you are getting into some very grey area here. There are many things we could define as "welfare" if we were so inclined.

We could call police forces and military forces welfare, for example. Using your line of reasoning, we could imagine someone who says that the 9/11 attacks did not attack them personally. After all, it's a big country, and only so much of it could be reasonably said to be at threat. The farmer in Nebraska probably doesn't have to worry too much about a direct threat to his safety. So maybe he thinks, "Why the hell should I have to bear the cost of this war?"

[Flacolaco]

[chumdawg]

I think you misunderstand why we are having this discussion in the first place. We are having this discussion because health care is being characterized as a "right" by some, at least.

[kg_veteran]

Originally Posted by chumdawg

I think you are getting into some very grey area here. There are many things we could define as "welfare" if we were so inclined.

We could call police forces and military forces welfare, for example.

I think there's a clear difference. I don't know many people who would deny that one of the basic roles of government is to maintain the safety of its citizens and defend them against foreign enemies.

[Mavdog]

Originally Posted by kg_veteran

The difference is that REAL insurance adjusts for risks. That's why certain high-risk people are excluded.

Repeat after me: buying coverage for something that hasn't happened yet is insurance. Paying for coverage after the fact as if the event hasn't happened yet and requiring the rest of the people in the pool (or the government) to cover the costs is welfare.

If we're going to talk about giving coverage to people who already have uninsurable conditions, let's at least call a spade a spade.

first, are you saying that we should "exclude...high risk people" from being able to get health insurance?

the idea is to not have the scenario of people's coverage lapse, the situation that creates the term "pre-existing condition".

if a person is continually covered, the term is an oxymoron.

paying for coverage and having the ability to use it when the need arises is what insurance is there for. keep everyone in the pool.

you're a smart guy, why can't you grasp this?

[alexamenos]

He does get it -- he's three steps ahead of you and waiting for you to catch up.

What you're describing is not an insurance program, it's a socialist redistribution welfare scheme. It's fine and dandy if you want a socialist redistribution welfare scheme, but administering socialist redistribution schemes isn't what insurance companies do.

[kg_veteran]

Originally Posted by alexamenos

He does get it -- he's three steps ahead of you and waiting for you to catch up.

What you're describing is not an insurance program, it's a socialist redistribution welfare scheme. It's fine and dandy if you want a socialist redistribution welfare scheme, but administering socialist redistribution schemes isn't what insurance companies do.

Exactly. Welfare isn't what insurance companies do.

BTW, Mavdog, if you think that insurance companies are going to operate at a loss just because the government tells them that they can't deny anyone coverage, I think you're in for a rude awakening. The reality is that if you mandate coverage for everyone, for everything, you're going to eventually run all the private insurers out of the market.

And then you'll have the single-payer system.

[kg_veteran]

Commentary
Obama's Ailing Popularity
Todd J. Zywicki, 08.21.09, 12:01 AM ET

President Obama took to the stump this week to respond to criticisms of his health care plan. But he now confronts an even deeper problem, one that threatens not only the success of Obamacare, but his presidency itself. Since the beginning of his term, Obama's personal popularity has exceeded that of his policies--a gap that was obviously unsustainable. Yet the final resolution remained unclear: Would his personality make his policies more popular, or would his policies drag down his personal likeability?


As the health care debate unfolds, we are seeing something we could not have predicted just weeks ago. President Obama's popularity is eroding--fast.



This week the Rasmussen poll of likely voters found the president's approval rating dipping below 50% for the first time. This is not only due to Obama's unpopular health reform program (although that may explain some of it). It is also because of the process he has used to push his signature initiative--a process that reeks of arrogance, deception and bullying.


This was unexpected: Even those who weren't crazy about the president's policies generally liked and respected the man. He seemed to be even-tempered, honest and somewhat earnest. He came across as reflective and open to debate, listening and persuasion.


This Obama has disappeared in the past few weeks while the health care debate has unfolded. Rather than open, he comes across as a sarcastic and lecturing professor. Rather than honest, he has seemed duplicitous and slick. Rather than careful and measured, his plan appeared rushed and extreme.


Voters were willing to forgive haste and sloppiness in ramming through a pork-laden economic stimulus bill that only loosely splattered on the target. To many, the financial crisis and rising unemployment justified a kitchen-sink approach. Sure, there would be waste, many voters acknowledged, but better to do too much than too little. After all, what was a few billion dollars when the economy itself seemed near collapse? Washington's urgency and inattention to the details of the legislation seemed appropriate leadership in a time of crisis. And most recognized that the Congress, not Obama, was to blame for the less appetizing ingredients in the stimulus crock pot.


These traits are less acceptable in the context of health care reform; this is a systemic, generational change, and it affects our health and medical care. Haste is irresponsible and reckless when the stakes are so high, and the need for urgency comparatively weak. The Rasmussen poll finds that a clear majority of Americans are more concerned that health reform be done right rather than enacting the hastily constructed proposal currently on the table.



The refrain of a health care system in "crisis" is not just overwrought, but obviously untrue for most Americans whose personal experience is of a health insurance system that works pretty well, albeit with some inconvenience, most of the time and provides state-of-the-art care, albeit inefficiently, almost all of the time. We are not creating a one-time obligation, but a fundamental entitlement that will be with us indefinitely.



Finally, the town hall confrontations across America have shown a political class that brazenly refuses to read--much less master--the details of the legislation, an irresponsible arrogance that was tolerated when it came to the stimulus legislation but which voters are much less willing to accept when there is no need for panic.


There is a growing perception of condescension surrounding the selling of the White House's health care plan. Common

sense tells us the government cannot simultaneously expand coverage and reduce costs. The government cannot dramatically inflate demand for health care services and eliminate market mechanisms for allocating them without devising some way of rationing supply and demand through political means. To suggest otherwise, as the White House has, is not just misleading but insulting. And the American people don't like to have their intelligence insulted.


The phony sense of crisis, the inattention to the details and the transparent dishonesty of many of the claims have made voters question not only the program but the president. What does Obama have to hide? Why won't he level with us? The discovery that there are hidden, controversial provisions in the plan has sparked rumors about imaginary provisions. Denouncing the false concerns as "lies," as the White House has done, doesn't redeem the apparent effort to obfuscate certain details of the plan. And the now-abandoned request of loyalists to report "suspicious communications" to the White House did nothing to assuage voters' distrust.


It is this distrust, more than anything, that is eroding Obama's popularity. Voters no longer see him as a grown-up, straight-shooter and basically good guy who is trying to do his best, but as a political opportunist taking advantage of their charity and trust.


George W. Bush had a long way to fall after the terrorist attacks of Sept. 11, 2001, when the American people trusted him to use his power responsibly to do what needed to be done to wage the war on terror. But he abused this mandate to justify policies that had little to do with keeping us safe. The American people eventually came to feel like they had been suckered by a president who took advantage of their goodwill, and they turned on him with a vengeance. Is Barack Obama in the same position, post-financial crisis?


White House Chief of Staff Rahm Emmanuel famously announced his desire not to squander a good crisis. But Americans recognize that the health care system, while troubled, is not in crisis. Nor, as President Obama might soon discover the hard way, is global climate change a crisis for which voters will tolerate job-killing legislation enacted through slap-dash decision-making and irresponsible haste. Unless Obama quickly recognizes that voters know the difference between an authentic and inauthentic crisis, the success of his health care overhaul--and perhaps his presidency itself--is in jeopardy.


Todd J. Zywicki is a professor at George Mason University School of Law and a senior scholar at Mercatus Center.

[Mavdog]

Originally Posted by alexamenos

He does get it -- he's three steps ahead of you and waiting for you to catch up.

What you're describing is not an insurance program, it's a socialist redistribution welfare scheme. It's fine and dandy if you want a socialist redistribution welfare scheme, but administering socialist redistribution schemes isn't what insurance companies do.

ah yes, the "socialist redistribution welfare scheme" mantra. apparently you are part of the cabal of nay sayers whose goal is to repeat the phrase enough times expecting people will be blind enough to believe it.

the boogeyman of "socialism". it's so scary!

people pay a premium, and they get coverage in case of a claim. if you believe that is a "socialist redistribution welfare scheme", then we've got a bunch of "socialist redistribution schemes" in operation today masquerading as insurance companies.

you're wrong. very, very wrong.

[Mavdog]

Originally Posted by kg_veteran

Exactly. Welfare isn't what insurance companies do.

right, and that is why insurers aren't "socialist welfare schemes".

BTW, Mavdog, if you think that insurance companies are going to operate at a loss just because the government tells them that they can't deny anyone coverage, I think you're in for a rude awakening. The reality is that if you mandate coverage for everyone, for everything, you're going to eventually run all the private insurers out of the market.

And then you'll have the single-payer system.

and if they operate with a profit because they correctly approximate their losses with appropriate premiums, the population will be better off, the industry will be better off, and the government won't be in the insurance business.

the risk associated with pool of insured won't materially change, and the actuarial tables will be valid and reliable.

and just like we have now, there will be competition in the marketplace.

[dalmations202]

Originally Posted by Mavdog

a pool of healthy and ill insured allows the combined premiums to cover the costs, that's the fundamental structure of insurance.

it works, has for a long time.

Actually it doesn't work, and it never has worked exactly properly. It is like social security -- it is written to make some people some money, help a few at the expense of the many, and then eventually die from the inability to provide.

it works as long as there is more people putting into it, than are taking from it and there is serious inflation.

There is only a finite amount of money coming in and with insurance and social security for that matter -- you not just need the money to cover the cost of what you are insuring, now you are actually paying the wages of people to keep track of the money. When they can't reach the money needed to cover the wage earners -- then they fold unless someone like the government can vote to reallocate other money from the people to make sure the wage earners are getting paid.

Insurance is and always has been a scam of prying on peoples fears. Well this might happen, so I'll send this cash to someone else to hold on to -- just in case it might happen to me someday. Get enough people sending you money and it becomes big business -- which actually goes nowhere.

It is nothing but peace of mind for the mass majority of people.

[alexamenos]

Originally Posted by Mavdog

people pay a premium, and they get coverage in case of a claim. if you believe that is a "socialist redistribution welfare scheme", then we've got a bunch of "socialist redistribution schemes" in operation today masquerading as insurance companies.

There's a very big difference between socialist redistribution schemes and insurance companies.

What insurance companies do first and foremost is discriminate. They discriminate between healthy and unhealthy, between the old and the young, between those with and those without medical conditions.

As I read your comments, I invariably get the impression that you believe discrimination by insurance companies is a problem to be solved.

The 'fix' as you suggest seems to involve a great deal of central planning by the state in order to arrive at a system where each pays according to his ability and receives according to his needs. The reason I call this a socialist redistribution scheme is not to hype some bogeyman, but instead because it's the most accurate description I can think of.

[alexamenos]

Originally Posted by dalmations202

Insurance is and always has been a scam of prying on peoples fears.

Insurance is a very legitimate and valuable business. In a nutshell it's about paying someone else to bear the cost in the event something bad happens. If the bad thing happens, your covered, if it doesn't happen the insurance company walks away with premium. It's a fair deal.

[Flacolaco]

Originally Posted by alexamenos

Insurance is a very legitimate and valuable business. In a nutshell it's about paying someone else to bear the cost in the event something bad happens. If the bad thing happens, your covered, if it doesn't happen the insurance company walks away with premium. It's a fair deal.

This insurance stuff sounds great! But unfortunately, I've heard I probably can't get it, or do anything else, without help from the government.

[alexamenos]

I think the government regulates insurance kind of like the mob regulates gambling -- it's not so much about protecting the consumers' interest as it is about taking something off the top.

[Mavdog]

Originally Posted by alexamenos

There's a very big difference between socialist redistribution schemes and insurance companies.

What insurance companies do first and foremost is discriminate. They discriminate between healthy and unhealthy, between the old and the young, between those with and those without medical conditions.

As I read your comments, I invariably come to the impression that discrimination by insurance companies is a problem to be solved.

The 'fix' as you suggest seems to involve a great deal of central planning by the state in order to arrive at a system where each pays according to his ability and receives according to his needs. The reason I call this a socialist redistribution scheme is not to hype some bogeyman, but instead because it's the most accurate description I can think of.

insurance companies don't "discriminate", they use data to correctly assign risk.

this is not that difficult to do, and there are instances where the data (actuarial tables) end up in error. that's when the insurers lose money, and if they do this repeatedly the insurer goes out of business.

the insurer understands that when a health insurance policy is issued, they will eventually need to pay a claim. there is really no such thing as an insured person who never gets ill, everybody at some point in time will be afflicted.

the insured does not "pay according to their ability", they pay according to the risk pool they are a part of.

in the case of the universal coverage, the risk pool is expanded about 20% over the current amount. this addition to the pool of those covered will include higher and lower risk insured, pretty much parallel to what is currently covered.

people will pay a premium just like they do today, a premium that is aligned with the risk tables. those tables won't show a material change.

no socialism involved.

[alexamenos]

Originally Posted by Mavdog

insurance companies don't "discriminate", they use data to correctly assign risk.

Based on the data they discriminate. (Ideally) those with higher risk factors wind up in higher premium pools, blah blah blah.....

And it's entirely reasonable that a 48 year old fat alcoholic smoker should have to pay more for coverage than a 24 year yoga instructor on a rabbit food diet, right?

[Dirkadirkastan]

Originally Posted by dalmations202

Actually it doesn't work, and it never has worked exactly properly. It is like social security -- it is written to make some people some money, help a few at the expense of the many, and then eventually die from the inability to provide.

it works as long as there is more people putting into it, than are taking from it and there is serious inflation.

There is only a finite amount of money coming in and with insurance and social security for that matter -- you not just need the money to cover the cost of what you are insuring, now you are actually paying the wages of people to keep track of the money. When they can't reach the money needed to cover the wage earners -- then they fold unless someone like the government can vote to reallocate other money from the people to make sure the wage earners are getting paid.

Insurance is and always has been a scam of prying on peoples fears. Well this might happen, so I'll send this cash to someone else to hold on to -- just in case it might happen to me someday. Get enough people sending you money and it becomes big business -- which actually goes nowhere.

It is nothing but peace of mind for the mass majority of people.

Insurance works because the sum of a bunch of random variables has a more predictable effect than just one of the random variables. Roll a fair die once, and you could get anything from a 1 to a 6. Roll the die 1,000 times, and you'll most certainly average around 3.5.

A client may not have any clue what they will need to pay in the case of an emergency, because the variance is so high. But an insurance company is willing to shoulder the burden, because it knows pretty accurately what it will likely be paying over 1,000 policies. An insurance policy allows the individual consumer to convert the risk into the same predictable loss that the insurance company experiences overall.

The insurance companies make their money by investing the money earned up front, not just wild overcharging.

[dalmations202]

Originally Posted by alexamenos

Insurance is a very legitimate and valuable business. In a nutshell it's about paying someone else to bear the cost in the event something bad happens. If the bad thing happens, your covered, if it doesn't happen the insurance company walks away with premium. It's a fair deal.

Not the point. It is totally about sleeping at night, without worry.

Why worry, I have paid into this big MONEY TREE that will save me IF something happens.

Of course, I will also pay many other peoples salaries to keep track of the FAIRNESS of who has paid what and who gets what.

You call it a fair deal. I call it prying on fears of what if's.

With that said, of course I have insurance.

[alexamenos]

Originally Posted by Dirkadirkastan

Insurance works because the sum of a bunch of random variables has a more predictable effect than just one of the random variables. Roll a fair die once, and you could get anything from a 1 to a 6. Roll the die 1,000 times, and you'll most certainly average around 3.5.

A client may not have any clue what they will need to pay in the case of an emergency, because the variance is so high. But an insurance company is willing to shoulder the burden, because it knows pretty accurately what it will likely be paying over 1,000 policies. An insurance policy allows the individual consumer to convert the risk into the same predictable loss that the insurance company experiences overall.

The insurance companies make their money by investing the money earned up front, not just wild overcharging.

very well stated...

From the consumer's perspective, the most desirable thing (that is also reasonable) is to be placed in a pool with people with similar risk profiles.

The 24 year old yoga instructor doesn't want to be pooled with fat smokers, because the average risk of that pool will be higher than her risk...she'd effectively be subsidizing the fat smokers.

The fat smokers would like to be pooled together with the yoga instructor, but they won't be able to as long as the yoga instructor has some measure of freedom in her choice of insurance plans. The best they can hope for is not to be pooled with the hemophiliac heroin addicts.

At the end of the day, a person can't escape the cost of their own health care any more than they can escape the cost of maintaining their car...their own habits and their genetic fortune or misfortune just comes with the territory.

[dalmations202]

It is still Vegas though.

The avg person pays in way more $$$ than they will ever receive from the insuring company (if not the insuring company would be out of business).

The insurance company is Vegas. You hope to hit it big (if you need it), so you keep pumping in the $$$$.

In the end, the average person who is insured sleeps better at night, and has paid much money to someone else to manage their money -- just in case something might happen.

[aquaadverse]

Originally Posted by Mavdog

insurance companies don't "discriminate", they use data to correctly assign risk.

this is not that difficult to do, and there are instances where the data (actuarial tables) end up in error. that's when the insurers lose money, and if they do this repeatedly the insurer goes out of business.

the insurer understands that when a health insurance policy is issued, they will eventually need to pay a claim. there is really no such thing as an insured person who never gets ill, everybody at some point in time will be afflicted.

the insured does not "pay according to their ability", they pay according to the risk pool they are a part of.

in the case of the universal coverage, the risk pool is expanded about 20% over the current amount. this addition to the pool of those covered will include higher and lower risk insured, pretty much parallel to what is currently covered.

people will pay a premium just like they do today, a premium that is aligned with the risk tables. those tables won't show a material change.

no socialism involved.

The big fly in the ointment is assuming all this takes place in a vacuum. It's assuming that the insurer just picks a premium, that they dictate all the costs involved. The strategy for the last couple of weeks for the administration has been to pile on the insurers. That simply extending coverage to everyone is the answer.

The kick in the teeth is the reality that much of the cost is simply paying the bill presented to them for payment. Simply saying "we'll pay this amount for this service" and the rest of the system just snaps to and adjusts is a fallacy. It's backwards. It's why Doctors are opting out of taking new Medicare patients.

It's not a coverage or access problem, but that's the main thrust of the proposed solution. There is a huge amount of what and very little how.

It's similar to what we saw here in Florida after the rash of hurricanes over the last decade. Insurers were dropping property coverage and the State's solution was to create a pool of last resort since no mortgages are written without it.

The exposure for the State quickly ballooned far past the level of reserves to liability Florida required of insurance companies. They tried to remedy the situation by first raising the premiums to the legal limit because private insurers couldn't compete under the States own requirements. The next step was to require homeowners to accept any private offering, even if it was more expensive. Insurers were just leaving the market despite nothing in the law requiring them to do so.

You could keep what you had, except what you had was no longer available. The problem was finally brought under control using the Vegas technique of laying off the risk by capping the amount insurers had to pay and the State paying the rest. Yes, the government was subsidizing insurance policies.

The second was to change the requirements. They raised the allowable deductible amounts and let insurers separate hurricane damage from the other liability so I have to get storm damage past 5% of the insured home value before it kicks in, and mandating insurers give discounts for storm shutters and other preventative measures. The State also beefed up building codes to keep the market attractive for insurers. There's no doubt the insurance companies had some predatory and unethical practices and the builders were lax in making code compliance. Extending access to coverage did nothing to change the real issue.

If they had started with those measures to control costs first, it's unlikely they would have needed to provide coverage, or had to do it to the extent they did. Simply extending coverage was not the answer because it was an affordability issue. If that patterned had continued there would have been a single insurer because they would have needed to grab the less risky policies to balance the high risk ones and the private sector companies that were left were unable to compete since the State wasn't adhering to the same requirements the insurers legally had to follow.

[Dirkadirkastan]

Originally Posted by dalmations202

It is still Vegas though.

The avg person pays in way more $$$ than they will ever receive from the insuring company (if not the insuring company would be out of business).

The insurance company is Vegas. You hope to hit it big (if you need it), so you keep pumping in the $$$$.

In the end, the average person who is insured sleeps better at night, and has paid much money to someone else to manage their money -- just in case something might happen.

No, it's the opposite of Vegas.

In Vegas, if you spend the money, then you assume the risk of whatever the slot machine decides to give you. You either lose a little or gain a lot. The only course of action that allows you to know your result beforehand is just walk out and not spend any money.

With insurance, the risk is taken when you don't have it. You either save a little or lose a lot. Paying the premium steadies the possibilities and the risk factor is removed.

Hoping you'll get away without needing insurance is a gamble much closer to representing Vegas than buying a policy.

[dalmations202]

Originally Posted by Dirkadirkastan

No, it's the opposite of Vegas.

In Vegas, if you spend the money, then you assume the risk of whatever the slot machine decides to give you. You either lose a little or gain a lot. The only course of action that allows you to know your result beforehand is just walk out and not spend any money.

With insurance, the risk is taken when you don't have it. You either save a little or lose a lot. Paying the premium steadies the possibilities and the risk factor is removed.

Hoping you'll get away without needing insurance is a gamble much closer to representing Vegas than buying a policy.

So what you are saying is that you are pouring money into something you hope to never use.

[Dirkadirkastan]

You speak as if that makes it a bad thing.

[dalmations202]

Originally Posted by Dirkadirkastan

You speak as if that makes it a bad thing.

Depends on how you look at it.

If you consider Money to be a tool and not all powerful then yes, it is a bad thing.

If I work all day long, I want something for what I worked for.

Why would I work and work for nothing?


With that said, I would work and work to make sure that my house doesn't catch fire or be flooded, etc --- even though it might still happen. So why would I do it -- so I could sleep and stop worrying about it. Exactly like why I have insurance.

Most likely I and most people would be better off monetarily if I would take the same amount of money each paycheck and put it in a savings account, and then get catastrophic insurance policy. I don't though because 1) I am lazy 2) employer pays a portion of my plan 3) I like sleep.

[Dirkadirkastan]

Originally Posted by dalmations202

Depends on how you look at it.

If you consider Money to be a tool and not all powerful then yes, it is a bad thing.

If I work all day long, I want something for what I worked for.

Why would I work and work for nothing?


With that said, I would work and work to make sure that my house doesn't catch fire or be flooded, etc --- even though it might still happen. So why would I do it -- so I could sleep and stop worrying about it. Exactly like why I have insurance.

I think you're overreacting to the whole sense of security thing. It looks like you're saying that a product's ability to give a consumer a sense of security negatively impacts its profitability, while I believe it has no impact whatsoever.

Most likely I and most people would be better off monetarily if I would take the same amount of money each paycheck and put it in a savings account, and then get catastrophic insurance policy. I don't though because 1) I am lazy 2) employer pays a portion of my plan 3) I like sleep.

Even if most people would be slightly better off without insurance, that doesn't make it a bad investment.

Say we were to play a game with a fair die. If you roll a 1, 2, 3, 4, or 5, then I give you $5. If you roll a 6, you give me $100.

That's a bad investment for you, and analogous to the potential risk someone takes on when not buying insurance. However, most people who play it once will come out ahead. The probability and magnitude of loss outweigh the probability and magnitude of gain, even if the probability of gain is significantly higher than the probability of loss.

The point is, this has nothing to do with emotions. Insurance is a mathematically profitable endeavor for both sides. This is possible due to the accumulation of risk and the time value of money.

[DirkFTW]

No Maine Miracle Cure
Another state 'public option' that failed.

Want a preview of ObamaCare in action? Sneak a look at what has happened in Maine. In 2003, the state to great fanfare enacted its own version of universal health care. Democratic Governor John Baldacci signed the plan into law with a bevy of familiar promises. By 2009, it would cover all of Maine's approximately 128,000 uninsured citizens. System-wide controls on hospital and physician costs would hold down insurance premiums. There would be no tax increases. The program was going to provide insurance for everyone and save businesses and patients money at the same time.

After five years, fiscal realities as brutal as the waves that crash along Maine's famous coastline have hit the insurance plan. The system that was supposed to save money has cost taxpayers $155 million and is still rising.

Here's how the program was supposed to work. Two government programs would cover the uninsured. First the legislature greatly expanded MaineCare, the state's Medicaid program. Today Maine families with incomes of up to $44,000 a year are eligible; 22% of the population is now in Medicaid, roughly twice the national average.

Then the state created a "public option" known as DirigoChoice. (Dirigo is the state motto, meaning "I Lead.") This plan would compete with private plans such as Blue Cross. To entice lower income Mainers to enroll, it offered taxpayer-subsidized premiums. The plan's original funding source was $50 million of federal stimulus money the state got in 2003. Over time, the plan was to be "paid for by savings in the health-care system." This is precisely the promise of ObamaCare. Maine saved by squeezing payments to hospitals and physicians.

The program flew off track fast. At its peak in 2006, only about 15,000 people had enrolled in the DirigoChoice program. That number has dropped to below 10,000, according to the state's own reporting. About two-thirds of those who enrolled already had insurance, which they dropped in favor of the public option and its subsidies. Instead of 128,000 uninsured in the program today, the actual number is just 3,400. Despite the giant expansions in Maine's Medicaid program and the new, subsidized public choice option, the number of uninsured in the state today is only slightly lower that in 2004 when the program began.

Why did this happen? Among the biggest reasons is a severe adverse selection problem: The sickest, most expensive patients crowded into DirigoChoice, unbalancing its insurance pool and raising costs. That made it unattractive for healthier and lower-risk enrollees. And as a result, few low-income Mainers have been able to afford the premiums, even at subsidized rates.

This problem was exacerbated because since the early 1990s Maine has required insurers to adhere to community rating and guaranteed issue, which requires that insurers cover anyone who applies, regardless of their health condition and at a uniform premium. These rules—which are in the Obama plan—have relentlessly driven up insurance costs in Maine, especially for healthy people.

The Maine Heritage Policy Center, which has tracked the plan closely, points out that largely because of these insurance rules, a healthy male in Maine who is 30 and single pays a monthly premium of $762 in the individual market; next door in New Hampshire he pays $222 a month. The Granite State doesn't have community rating and guaranteed issue.

One proposal to get people into the DirigoChoice system is to reduce the premiums, presumably to give the uninsured a larger incentive to join. But that would explode the program's costs when it already can't pay its bills. A program that was supposed to save money by reducing health-care waste and inefficiencies has seen a 74% increase in premiums. But even those inflated payments can't keep the program out of the red.

Last year, DirigoCare was so desperate for cash that the legislature broke its original promise of no tax hikes and proposed an infusion of funds through a beer, wine and soda tax, similar to what has been floated to pay for the Obama plan. Maine voters rejected these taxes by two to one. Then this year the legislature passed a 2% tax on paid health insurance claims. Taxing paid insurance claims sounds a tad churlish, but the previous funding formula was so complicated that it was costing the state $1 million a year in lawsuits.

Unlike the federal government, Maine has a balanced budget requirement. So out of fiscal necessity, the state has now capped the enrollment in the program and allowed no new entrants. Now there is a waiting list. DirigoChoice has become yet another expensive, failed experiment in government-run health care, alongside similar fiascoes in Massachusetts and Tennessee.

Not everyone sees it this way. Noting the similarities between the Maine program and the Congressional initiative, Karynlee Harrington, the executive director of the Dirigo Health Agency, boasted recently: "DirigoChoice is consistent with what we think the definition of a public health option is." It certainly is.

Link

Maybe if it were about 300 times bigger, it would work!