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bigfincat's Avatar

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I must warn people that Joe Lieberman's reluctance of a public option is expected. He was heavily supported by the insurance industry & would be very foolish to vote in direct opposition to them.

He is not acting ideologically as he may claim.
- November 4th, 2009, 09:22 pm
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[quote=saulgoode;787272]You spend $15,000 on healthcare?

I pay $50/mo per person on mine. My employer docs me about $100/mo on top of that.

I don't come out nearly to $15,000, even for a family of 4.

Why not?

Because I keep high, oh-sh.t style deductibles, and I limit my time seeking care.

In other words, I DO NOT seek treatment I neither need, nor can afford.

That's the problem. Those videos Dito put up say the same thing.

We're buying too many things we cannot afford. Quit being a nation of whiners, pay for your cr.ap, make the states stop monopolizing the industry, take away the fed gov't altogether, and let's be done with this problem.

I don't see what the big deal is, or why it's so complicated.

You limit your time seeking care? That must mean that you and your family members don't have serious illnesses. If one of yours got cancer, MS, was in a catastrophic accident, you are telling me that you wouldn't seek treatment for them if you couldn't pay for it out of pocket? How noble of you. One event is more than enough t o blow through even very high deductibles. And you would see how quick your company is to find a way to deny coverage for necessary, even life saving treatment.

I had an insurance company decide a year AFTER THEY PAID THE DOCTOR that $50k worth of treatment should not have been covered. Could you handle $50K in a single year for out of pocket expense? And where is the fault in getting treatment that the company had initially decided to pay for? Was that getting treatment I couldn't afford?

If your premiums are so low, it is a reflection, as you note, of what your employer offers. Not everybody gets the same options, or even more than a choice or two. You think the government shouldn't decide people's healthcare choices? Why should someone's employer have that power?

Your views are incredibly myopic. That's the nicest thing I can say.
- November 4th, 2009, 10:07 pm
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Woah, hold up. You can't just reform something. That's like saying "Everyone agrees we should fix that car" and leaving it there. You have to first know what's wrong with the car and then you have to figure out what actions will fix it. You can't just leave that part out or all you'll have is a broken car and probably a big bill while you spend time doing the wrong thing.

What exactly do we mean by health care reform? If we don't know than all we're arguing is ideology and not the issue. You have to delve into the connections and facts and not the intent as intent is useless without positive action.

First and foremost can we agree this has little to do with health care? Because all I see is stuff about how it's being paid for. The argument that our health care system is bad because it doesn't pay for expensive treatments only applies to health care if the care is being refused. If I go to an emergency room from a major car accident and have a metal rod poking through my chest the hospital is going to save my life even without me handing them an insurance card. As far as I know people are not denied necessary medical care in the United States.

Before the objections about "But they can't pay for it!" start coming up now we're talking about health insurance. Like car insurance you pay a certain fee and if you get into a car accident the company helps pay for the expenses of getting your car fixed or a new one. This is necessary because not all that many people have the disposable income to just buy a new car if theirs is damaged or destroyed.

This is also true of health care but the fact remains that you can get treatment without the finances to support it. It may have negative consequences but you aren't going to just drop dead at the hospital door because your check bounced.

So what we're talking about is health insurance reform. Can we start from there? I make this distinction because all this talk of how the UK and Cuba and the Moon's health care is better/worse than the U.S.'s is getting on my nerves. It's irrelevant to the discussion. We aren't talking about how well our hospitals work. We're talking about how well people can pay for the care we get. This discussion reminds me of someone talking about having the community pay for getting puppies their shots and anyone who says "Well, maybe we should have the owners pay for the shots?" is told they hate puppies. The "health care" debate is the same because anyone who disagrees with "reform" must want the poorer members of society to drop dead and penniless at the feet of our megacorporations. Please.

So what is our health insurance reform plan? To create a public option, right? Among other things (like an oversight committee)? The question shouldn't be the people want reform vs. those that don't want reform. The question should be will the proposed plan actually fix the problem it's trying to solve? That's the real question.

A public option gives employees the option to take a government plan instead of their employer's plan, correct? Sounds good. That way the employer doesn't have power over the employee based on their inability to give up health care. Is that the idea?

Except now the government has that power instead. And unlike an employer you have no method to fight back if the government plan is bad. In fact there's specific provisions to prevent prosecution of the government in relation to the public option. Our main "American" defense against abuse, litigation, is denied from the outset.

And how is this public option superior to other insurance systems? It certainly doesn't decrease bureaucracy; it creates a need for new government departments to enforce the new set of laws, new government paperwork (*cough* the same guys who wrote IRS forms *cough*), new federally protected jobs...weren't we trying to reduce federal spending? Wasn't the whole point of this reform to get money back in the hands of the American people? All this money has to come from somewhere. While we seem to think of the federal budget as being bottomless the bottom is just really far down...ten trillion dollars down. This is not sustainable. And we do NOT want to hit that bottom.

I'll leave you with one final thought...I'm in the Marine Corps. When I signed my initial paperwork I was contracted a GI Bill kicker, an extra $350 a month while attending school. It was in writing, copied, signed, and promised in my original government contract.

It took me a year and a half after completing boot camp to finally get that money. I had to fight both the VA and DoD every step of the way, ignore being told several times that I didn't qualify for the kicker even though it was in my contract, and fight tooth and nail to finally get my money (which was back-paid).

This is how the federal government operates. And you expect them to treat you fairly for health insurance?

...

Jacquesne
- November 4th, 2009, 11:36 pm
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let me put it this way:

i'm type 1 diabetic. it has nothing to do with things a person might have power over - like being fat (which i'm not and never have been). the prevailing theory is you get hit by some virus and that's that.

ok. so if my diabetes causes me to go to the emergency room, ER is gonna treat me. they're not gonna let me die because i don't have insurance - i.e. the money to pay. they're gonna treat me, yell at me for "not taking care of my diabetes", then slap me with a bill. that's the law.

the way this plays out is that i never get the care i need, i don't get to die, parts of me will be amputated one by one over a period of years, and the debt will just rack up and up and up.

that's the law.
- November 5th, 2009, 12:22 am
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lil_lamb wrote :
let me put it this way:

i'm type 1 diabetic. it has nothing to do with things a person might have power over - like being fat (which i'm not and never have been). the prevailing theory is you get hit by some virus and that's that.

ok. so if my diabetes causes me to go to the emergency room, ER is gonna treat me. they're not gonna let me die because i don't have insurance - i.e. the money to pay. they're gonna treat me, yell at me for "not taking care of my diabetes", then slap me with a bill. that's the law.

the way this plays out is that i never get the care i need, i don't get to die, parts of me will be amputated one by one over a period of years, and the debt will just rack up and up and up.

that's the law.
Yet some people think that access to emergency rooms means that everyone has access to "necessary care".

Of course, sick people can keep selling everything they own until they are driven into homelessness and bankruptcy to pay for all that care that isn't "necessary", and will last a little longer if they are still well enough to work some, but when they get sick and broke enough maybe they can get medical care (medicaid) plus housing and food courtesy of the state. That would be a great outcome.
- November 5th, 2009, 12:37 am
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OK, so we are agreeing that health insurance and not health care is the problem? Because again we're talking about financial issues.

So now that we're on the same page I do agree that our current insurance system has several glaring flaws. First and foremost is the "preexisting condition" system.

I understand that preexisting conditions cost insurance companies more money in general than someone without such conditions. Type 1 diabetes, for example, is a lifelong disease that has no known cure and is likely genetic (although it could also be viral or based on the autoimmune system). Either way there are plenty of preexisting conditions people have no control over; losing a leg from a car accident or being born with Down syndrome (although the latter interestingly reduces a person's chance of cancer while sometimes increasing risk of organ failure and epilepsy) for example.

In my opinion the government's job is not to remove competition from the market but facilitate it and prevent abuse. Preventing abuse, however, doesn't mean "government takeover."

So make preexisting medical conditions something that can't be discriminated the same way race, religion, sexual orientation, etc. can't be discriminated against now. Will this increase costs for insurance companies (and therefore consumers) across the board? Yes. At the risk of sounding socialist...so what? Just because you believe in a free market doesn't mean you believe people should get abused in it and someone being pushed into poverty because of medical bills hurts our economy. We lose a potentially productive member of the society by saving a relatively small amount (which is probably all going to CEO bonuses anyway but I digress).

We'd save money if we prohibited all minorities from having health insurance, too, but I imagine that wouldn't be very popular (or remotely moral). At some point you have to look at something and say "Isn't the whole point of health insurance to pay for the medical expenses of those who need it?"

So instead of a government option just have a "no discrimination" reform where preexisting conditions pay the same amount as everyone else and calculate from there. One problem down.

Problem two...one of the reasons our medical costs are so high compared to the rest of the world isn't because of greedy capitalism but because doctors have to pay big bucks for a team of lawyers in their back pocket. Basically if anything goes wrong with a medical procedure and it could possibly have been from a mistake on the doctor's part he's going to get sued for more than the combined cost of everyone's medical bills for that day in the whole hospital. That requires it's own form of insurance and adds layers upon layers of cost to medicine. Every step has to be documented and completely unnecessary tests must be performed just to cover doctor bums. Why do I need my pulse taken when I go in for a runny nose? Why do I need to let them know about a broken ankle or childhood asthma if I'm going in for a headache? These things take time, money, people to keep track of, etc.

I understand their purpose but forcing doctors to have to act like Dexter after a crime, making sure they cover everything, is a drain on our system. I once had a doctor glance at my ankle and tell me it was sprained but then had to go and get an X-Ray which confirmed exactly what he told me. How much did that X-Ray cost? But if it had been broken or something I could have sued him for malpractice. So he was forced to do it.

We need to cut down on excessive litigation in this country, not just for health care but overall. Get rid of imbalances in the insurance system, get rid of some of the excessive costs required of the health care industry, and you get less expensive health care and correspondingly less stingy insurance companies.

I'm all about fixing problems but let's fix the right ones.

Jacquesne
- November 5th, 2009, 09:35 am
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The funny thing is ... If one actually crunches the numbers and looks at insurance and medical bills logically ... It is generally undeniable that a high deductible plan is the way to go ...

Woman, age 43 and 2 kids in FL ... High deductible plan puts her at 179 a month ... If it hits the fan, the insurance company covers EVERYTHING after 10k in medical expenses for the family for the year ... At which point she sets up an easy payment plan with the hospital to pay the bill over 2-3 years or so ...
Now people will say that is highway robbery! And that nothing higher than a $1000 deductible with a copay for doctor visits is acceptable ... So now we are at $467 a month and a $25 copay for doctor visits ... Which is a $2000 deductible for the family and a $4000 maximum after deductible ...

So lets break this down a bit real quick ... Doctor visit under the high deductible plan (to be called Plan A, and the other to be called Plan B) is ~$70 compared to $25 on Plan B, a difference of $45 ... But there is a premium difference of $288 a month ... So that three person family would have to go to the doctor 6 times a month to break even on the difference alone ... Let's say it hits the fan and there's a $200k hospital bill ... Under Plan A, we are looking at $10k + $2148 (insurance premiums) = $12,148 in bills for the year ... Under Plan B, we are looking at $2000 (deductible) + ($4000 maximum) + $5604 (premiums) = $11,604 in bills for the year.
Wow! Isn't that amazing! So having great coverage saves me $480 on a bad year and costs me $3,456 on a good year. Lets look at the cost/benefit analysis then real quick ... Average person goes to the hospital once every 10 years ... 3 people, so a visit ever ~3 years ... Over the course of 10 years I would have saved $1,440 and paid an extra $20,736 ...

You know ... I think I might just take the gamble that I will pay an extra $480 over the course of the year with the possible payout of saving $3,456 over the course of the year ... It is just simple math.
- November 5th, 2009, 09:48 am
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on a side note: since we're talking the U.S., why is it folks talk about the government like it's a different from its people? "government for the people, by the people."

in any case, one of the things that drives our costs seriously up is a non-uniform system.

p.s.: rand - i'm making a career switch. to do so, i took a job as a cashier in a grocery. i was making the same as my supervisors, for whom this grocery was a career. $12 an hour.

the store was incredible in that it paid the full premium for health care insurance, including dental and vision. i never in my whole life before that had such a deal, and i never had dental or vision - not even at 5x that wage.

but i digress. my point is, at $12 an hour no one could ever get $467 together in the lump sum necessary to pay for health insurance... not and still have a place to live, food to eat, and a car to get to work in the first place. (and let me say, a lot of people at the store commuted over 45 minutes to get to this store.)

p.p.s.: "genetic" in the case of type 1 diabetes means, in the theory, that the virus hits you and effects your genetic workings in such a way that your immune system is set off to destroy your insulin-producing beta cells. it's not "genetic" in the sense that if your mom and dad have brown eyes, you will have brown eyes too. less than 10% of type 1 diabetics have any family history of it.

Last edited by lil_lamb; November 5th, 2009 at 10:42 am.
- November 5th, 2009, 09:56 am
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lil_lamb wrote :
but i digress. my point is, at $12 an hour no one could ever get $467 together in the lump sum necessary to pay for health insurance... not and still have a place to live, food to eat, and a car to get to work in the first place. (and let me say, a lot of people at the store commuted over 45 minutes to get to this store.)
That's exactly right. And the Plan A vs. Plan B math doesn't mean much if you have a serious or chronic illness that runs you that $10K plus in out of pocket expenses year after year. Even at above average wages, it breaks you financially. I am speaking from personal experience as well as that of several loved ones. You should not have to lose everything you have worked for over a lifetime, or if you have the misfortune to become ill at a young age never be able to afford an independent quality life, paying medical bills.

The other problem is that once you show up on an insurance company's radar, the definition of "necessary care" changes very quickly. It is no longer what you and your doctor think, but what the insurance company decides it wants to pay for. I have a file full of "letters of medical necessity" that didn't mean diddly to my so-called insurers, so in effect my deductible doubled, tripled or more as a result of "non covered" expenses. My father died after he was denied a transplant. Do people think you can just show up in an emergency room to get such things because it is "necessary care"?

Every med malpractice judgment awarded in a year combined is a drop in the bucket of the total costs of doctors and "the system". Doing away with the ability to sue won't change a thing. Moreover, the reason such judgments become necessary, apart from deterring bad practices, is that the social safety net in this country is wholly inadequate. If you need maintenance care, devices, and can't work enough to afford food and a decent place to live, you are crap out of luck. Do you think you get to walk into an ER and get procedures to try to make you whole again once a doctor has screwed up? You will get enough (maybe) to discharge you alive, but you will be scarred, maimed and who knows what. I would invite anyone who thinks otherwise to seek out a dozen or so actual people who have lived this process and find out what it is like.
- November 5th, 2009, 10:27 am
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You limit your time seeking care? That must mean that you and your family members don't have serious illnesses. If one of yours got cancer, MS, was in a catastrophic accident, you are telling me that you wouldn't seek treatment for them if you couldn't pay for it out of pocket? How noble of you. One event is more than enough to blow through even very high deductibles. And you would see how quick your company is to find a way to deny coverage for necessary, even life saving treatment.

I had an insurance company decide a year AFTER THEY PAID THE DOCTOR that $50k worth of treatment should not have been covered. Could you handle $50K in a single year for out of pocket expense? And where is the fault in getting treatment that the company had initially decided to pay for? Was that getting treatment I couldn't afford?

If your premiums are so low, it is a reflection, as you note, of what your employer offers. Not everybody gets the same options, or even more than a choice or two. You think the government shouldn't decide people's healthcare choices? Why should someone's employer have that power?

Your views are incredibly myopic. That's the nicest thing I can say.
I busted my shoulder a few years ago. I used my insurance to have it repaired. It was an "elective" surgery, since it was not life-threatening, so not everything was covered (about half).

I wound up paying about $4,000 out-of-pocket, and I'm on pain every minute of every day. Workouts are excruciating.

And if I hadn't had the money, guess what? I wouldn't have had the surgery!

Wow... how's that for a concept! Only buy what I can afford. Weird, I know.

As for cancer and the other stuff, THAT'S why I have insurance!

You hit the nail on the head!

I need something to cover a catastrophic condition. Amputation. Paralysis. Long-term care following an accident or illness.

I do NOT have insurance so I can wipe my nose, or so I can get stitches when I bang my head.

Yes, I could cover $50,000 in expenses. Otherwise, I wouldn't get the treatment. Yes, it might mean I'd die. So it goes. Nobody guarantees you or your child the right to $100,000 in oncology visits, sorry.

You want that sorta guarantee, you'd better get to work and save your money, like a big boy.

Insurance is there for the big stuff, and for big stuff only. It's not there for broken arms and scraped knees.

My motto for insurance is this: Lose big, win big.

I have high deductibles on everything. It just makes sense.


- Saul
- November 5th, 2009, 10:47 am
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