New health care bill

[WRXtranceformed]

Just to clarify the preexisting condition thing....If I have carrier A through employer A any sickness I have during that time can be considered a preexisting condition when I move on to employer B with carrier B.

When I was about to change jobs I needed to go to the doctor and I thought this was how it worked. So I talked to an insurance rep and was assured that policies are written such that as long as you had insurance at the time of sickness then ongoing/future care for the same condition will be covered with the new insurance. (and it was)
This is why when you sign up for new health insurance they ask you about your previous policy and when it expired etc.

This is sometimes the case with employer-based insurance policies. The reason why is that an insurance company can then spread the risk of that individual being hospitalized for that condition out over the premiums of all of the company's employees, or mitigate the risk. If that same person who had coverage for that preexisting condition gets laid off and can't afford COBRA or their own health insurance individually (as many people have over the past few years) or if they retire without extended benefits, that is a completely different story. What Adam said about his aunt is very common. There's a difference between having knee surgery and an insurance company willing to cover future knee problems and having pancreatic cancer or a heart stint and the same company willing to provide you coverage at all.

I have seen a 32 year old 1099'd male denied health care because he had high blood pressure. I'll say it again because I've seen it first hand, you guys with strong employer and / or government supported health care just don't understand what it's like for a lot of people who aren't as fortunate.

[CaptainHenreh]

I'll say it again because I've seen it first hand, you guys with strong employer and / or government supported health care just don't understand what it's like for a lot of people who aren't as fortunate.

You say that like it matters. Nobody here is saying that our health care system is just fine and dandy as it is. We all agree that there needs to be some change.

But what you're saying smacks of class-ism, and offends me. The implication that I simply "don't understand" because our current situations are more advantageous than others -- it's horseshit. It's not that I want people to have to choose between putting food on the table and getting healthy. Far from it! But I don't think the government A: has the right to dictate these terms, and B: knows their ass from a hole in the ground as to what is actually broken with our health care system. This bill is just a shitty band-aid solution slapped on a terminal wound.

Problem: People with preexisting conditions are being denied health insurance.
Best Solution: Explore why this is the case, and work with insurance companies to ensure that this is no longer a financial dead end for them (no pun intended).
Government Solution: REGULATE!

Problem: People can't afford health insurance, because premiums are too high unless their employer negotiates their rate for them.
Best Solution: Find a way to empower the individual to make their own decisions. Allow cross-state buy in, end ridiculous by-state regulation.
Government Solution: REGULATE! (If you can't afford health insurance, we'll just tax someone else and give it to you until you can!)

Problem: Medical Costs are spiraling out of control, exceeding insurance spending caps
Best Solution: Find out what the base causes of these cost increases are...and how to eliminate them. Costs should go *down* over time, not up...why is the medical field so different, and how can we change it?
Government Solution: REGULATE! (No more caps! You have to treat someone until they are dead!)

It's a bunch of ill-thought-out bullshit and the fact that some of you refuse to see it because "there is some good things in this bill" makes me want to :vomit: Talk about not seeing the forest for the trees. If I gave you a slice of blueberry pie and then punched you in the face, would you thank me for solving your pie shortage problem?

[Kaan]

mmmm pie!

[WRXtranceformed]

Blueberry pie sounds so good right now!!

[CaptainHenreh]

[CaptainHenreh]

[WRXtranceformed]

At least punch me in the dick so I can enjoy the pie while I'm doubled over on the floor.

[Apoc]

You would want a dude to touch your dick... you no shirt car washing homo.

I'll take the pie. Rex hits like a girl.

[.RJ]

So should we tax tatoos as well?

Why not, we tax everything else?

Our effective tax rate is still relatively low compared to other places that you'd want to live in, but I guess thats going away.

[WRXtranceformed]

You would want a dude to touch your dick... you no shirt car washing homo.

I'll take the pie. Rex hits like a girl.

Facebook stalker!!!!!!

[CaptainHenreh]

The pie is a metaphor, people. There is no pie.

[Apoc]

I demand pie.

[G.Irish]

Problem: People with preexisting conditions are being denied health insurance.
Best Solution: Explore why this is the case, and work with insurance companies to ensure that this is no longer a financial dead end for them (no pun intended).
Government Solution: REGULATE!

I don't see how your best solution could possibly work. An insurance company's job is to make profit. To best way to make profit from insurance is to have people pay premiums but file as few claims as possible. Someone with a pre-existing condition is much more likely to file claims and cost you money, so it would give you more profit to just deny them. It is always going to be a financial dead end to them. Insurance companies would ideally want people who never get sick to pay premiums so that their only costs are administrative. You can't change that fact without some sort of artificial manipulation.

Problem: Medical Costs are spiraling out of control, exceeding insurance spending caps
Best Solution: Find out what the base causes of these cost increases are...and how to eliminate them. Costs should go *down* over time, not up...why is the medical field so different, and how can we change it?
Government Solution: REGULATE! (No more caps! You have to treat someone until they are dead!)

Well one of the largest costs to the medical field comes from malpractice suits and to fix that you'd require tort reform.

I agree that costs should be coming down for medical care for a lot of reasons but the market is slow, very slow in solving that problem. Competition in medical care just isn't direct enough to drive efficiency up as quickly as other industries. It's not like people can shop around to find the best hospital/clinic/private practice at the best price. Maybe insurance companies could do that as a way to provide better care at a lower cost but to date I haven't heard of that

Bottom line is that a health insurance companies goals lie directly at odds with the goal of a sick person to get well. The only way insurance companies' and customers' interests line up is in preventitive medicine.

[CaptainHenreh]

Problem: People with preexisting conditions are being denied health insurance.
Best Solution: Explore why this is the case, and work with insurance companies to ensure that this is no longer a financial dead end for them (no pun intended).
Government Solution: REGULATE!

I don't see how your best solution could possibly work. An insurance company's job is to make profit. To best way to make profit from insurance is to have people pay premiums but file as few claims as possible. Someone with a pre-existing condition is much more likely to file claims and cost you money, so it would give you more profit to just deny them. It is always going to be a financial dead end to them. Insurance companies would ideally want people who never get sick to pay premiums so that their only costs are administrative. You can't change that fact without some sort of artificial manipulation.

Didn't say it would be easy. But while you can't change that fact without some sort of artificial manipulation, the answer isn't to say 'You MUST treat these people, no matter what, no matter the cost, end of story, period.' You can't "total" a person, which is one of the reasons that the 'insurance' model is so broken.

I agree that costs should be coming down for medical care for a lot of reasons but the market is slow, very slow in solving that problem. Competition in medical care just isn't direct enough to drive efficiency up as quickly as other industries. It's not like people can shop around to find the best hospital/clinic/private practice at the best price. Maybe insurance companies could do that as a way to provide better care at a lower cost but to date I haven't heard of that

Well, why isn't there more competition? I love pointing to the auto insurance here, because when it was deregulated, and insurance companies could compete across states, prices went down while quality went up. When was the last time you saw Blue Cross Blue Shield advertise on TV for your services? And yet I see commercials all the time for State Farm, Progressive, Allstate, etc. If they're not competing, then there is either collusion or some kind of obstacle set in place by the government to competition...otherwise the Hand would solve this problem.

Bottom line is that a health insurance companies goals lie directly at odds with the goal of a sick person to get well. The only way insurance companies' and customers' interests line up is in preventitive medicine.

True, but again, that's why this legislation is crap. It's 100% at odds with what a health insurance company does. (Make Money). What happens when they "go under"? I'll answer my own question: The .Gov will bail them out and we'll have de facto single payer.

[WRXtranceformed]

There is quite a lot of competition among health and life insurers. Probably the reason why not a lot of them advertise on TV is that most of their sales process is directed toward big businesses and not individuals. Big businesses (and some individuals like me) use brokers to shop the market to find what the best deals are. That helps control costs, but not by a lot. Health insurance is expensive no matter how you look at it.

[G.Irish]

I don't see how your best solution could possibly work. An insurance company's job is to make profit. To best way to make profit from insurance is to have people pay premiums but file as few claims as possible. Someone with a pre-existing condition is much more likely to file claims and cost you money, so it would give you more profit to just deny them. It is always going to be a financial dead end to them. Insurance companies would ideally want people who never get sick to pay premiums so that their only costs are administrative. You can't change that fact without some sort of artificial manipulation.

Didn't say it would be easy. But while you can't change that fact without some sort of artificial manipulation, the answer isn't to say 'You MUST treat these people, no matter what, no matter the cost, end of story, period.' You can't "total" a person, which is one of the reasons that the 'insurance' model is so broken.

I'd agree that the "treat at all costs" approach is probably not the right approach. But at the end of the day you're still talking about some sort of government intervention or regulation if you want to solve the pre-existing conditions problem.

I agree that costs should be coming down for medical care for a lot of reasons but the market is slow, very slow in solving that problem. Competition in medical care just isn't direct enough to drive efficiency up as quickly as other industries. It's not like people can shop around to find the best hospital/clinic/private practice at the best price. Maybe insurance companies could do that as a way to provide better care at a lower cost but to date I haven't heard of that

Well, why isn't there more competition? I love pointing to the auto insurance here, because when it was deregulated, and insurance companies could compete across states, prices went down while quality went up. When was the last time you saw Blue Cross Blue Shield advertise on TV for your services? And yet I see commercials all the time for State Farm, Progressive, Allstate, etc. If they're not competing, then there is either collusion or some kind of obstacle set in place by the government to competition...otherwise the Hand would solve this problem.

Health insurance should have to compete, that's a no brainer.

What I was talking about was the costs at the hospital and individual medical office level. There is a lot of inefficiency in the healthcare industry now because they're not particularly driven to become more efficient. People don't shop hospitals against each other or compare costs (I want the Charlottesville chopper to pick me up, they're $50 less per mile). And again, there's the whole malpractice litigation issue.

Bottom line is that a health insurance companies goals lie directly at odds with the goal of a sick person to get well. The only way insurance companies' and customers' interests line up is in preventitive medicine.

True, but again, that's why this legislation is crap. It's 100% at odds with what a health insurance company does. (Make Money). What happens when they "go under"? I'll answer my own question: The .Gov will bail them out and we'll have de facto single payer.

I guess some people would answer that with, 'people shouldn't have to die so someone else can make profits'. It'd be a losing argument to put a rich health insurance exec against someone's dying child and say that the kid has to die so he can hit his numbers for the quarter. Now granted I don't think that health insurance companies can't be profitable while still providing good healthcare but the fact is that putting money vs life is always going to be an ugly and uncomfortable issue.

[Kaan]

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watch it all live right now...

[HAULN-SS]

I think a lot of those costs baloon because doctors like to experiment too much. I had an uncle who died a few years ago, and hours before death, the doctor says to the family "Let's try this shot, it's worked (like 2 times) before..maybe it will work..but it's $14,000" and sure enough, they said give it a shot, and it did nothing whatsoever. That kind of crap needs to stop. People get desperate, even when the person really is "totalled" and doctors definitely take advantage of that.

[.RJ]

I think a lot of those costs baloon because doctors like to experiment too much

I wouldnt call it experimenting, but you are right, too much $$ is spent in the last 6 months of life trying to keep them alive rather than worrying about the quality of life for the amount of time they have left. Everyone is going to die, no way around that.

[JohnC]

I think a lot of those costs baloon because doctors like to experiment too much

I wouldnt call it experimenting, but you are right, too much $$ is spent in the last 6 months of life trying to keep them alive rather than worrying about the quality of life for the amount of time they have left. Everyone is going to die, no way around that.

I agree, and I think that's less a health care issue and more a societal one. Don't fear the reaper...