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M&K's Retrievers
03-19-2010, 02:28 PM
1.)Look for insurance companies to start marketing a new accident/emergency medical policy to cover those individuals who opt out of mandated coverage and pay the fine instead. The plan will provide gap coverage for accidents and initial expenses incurred for illness until full coverage can be obtained with no pre-existing condition limitation after a medical condition is diagnosed. The plan will probably have a fairly low maximum of $25,000 or so. It will probably be available on a group basis as well. The premium for this type of coverage plus the fine will pale in comparison to current coverage.
2.) The number of uninsureds will double to 60,000,000 as individuals and employers will drop existing plans and elect to pay the fines instead. Employers have never wanted to provide coverage and what better time than now to drop it. The employer fine will be way cheaper and with unemployment this high there is no need to offer perks to get good employees.
3.) The influx of uninsurables getting coverage without the offset of healthy individuals participation will be catastrophic for insurance companies forcing many to exit the market. Hello Uncle Sam Mutual.

To quote another poster "we live in Cuba now"

Gerry Clinchy
03-20-2010, 05:01 PM
You might say that this ends up being "Medicare" for all ages. The private insurors then come up with the plans to cover the "gaps" ... and the costs for the govt portion & the private portion will continue to increase ... since there have been very few provisions for how to control costs and still have doctors earn a decent income for the responsibility they shoulder.

The way this plan is being put together, it will lead down the road to the govt running health care simply because it will become unaffordable, unsustainable without govt subsidy. Ironically, as seen in the UK, everybody gets "some" care until they get too old to be viable candidates for treatment ... except the very wealthy, who can go to another country to get the best care.

All of that may very well get a modicum of care to those who are at the lowest socio-economic levels, along with some higher up who cannot afford insurance (or can't get it right now). However, a higher-income end of society may still hock their homes and assets to purchase care outside of the US when it's a matter of life and death, like the fellow from Canada ... he had enough $ to have a condo in Miami, & also had enough $ to purchase the medical care he felt was critical to his health.

There just ain't no free lunch.

Terry Britton
03-21-2010, 11:18 AM
I still don't get why this bill in current form is so urgent and "needed". I also don't understand why they don't want to look at Industrial Engineering solutions of streamlining processes, eliminating paperwork, doing triage in emergency rooms and turning the non-emergencies away, and also doing illegal alien checks as well on those being covered. Why not sue the governments of illegal aliens to recoup the costs of treating their citizens?

Why create a mandatory government option when we already have one in many states? Oklahoma has Soonercare already for those who qualify.

YardleyLabs
03-21-2010, 01:00 PM
I still don't get why this bill in current form is so urgent and "needed". I also don't understand why they don't want to look at Industrial Engineering solutions of streamlining processes, eliminating paperwork, doing triage in emergency rooms and turning the non-emergencies away, and also doing illegal alien checks as well on those being covered. Why not sue the governments of illegal aliens to recoup the costs of treating their citizens?

Why create a mandatory government option when we already have one in many states? Oklahoma has Soonercare already for those who qualify.
The "urgency" over the health care bills is the same as the "urgency" over tax cuts, social security changes, and even the invasion of Iraq under Bush. There are only certain times when it is possible to mobilize the political support needed to make major changes. Either you make the changes when you can or you recognize that you next chance may be many years later. The sole reason for delaying now is not to get a "better" bill but to get either no bill or a bill that does nothing substantive at all. or even something that simply gives more tax benefits to those that already have coverage while doing nothing for those that do not.

With respect to efficiency issues, a lot has already been done and more will be. I do not think that government is very good at promoting improvements in efficiency. The private sector is much better as companies compete for profit. However, in health care it is important to make sure the rules of the game encourage competition. Today they do not. For example, Medicare is explicitly prohibited from negotiating drug prices either directly or through management of the formulary for covered drugs. Therefore, whatever price a manufacturer chooses to charge will be paid in full as long as they can get physicians to write the prescriptions. It's no wonder that tens of thousands are spent each year on direct marketing of drugs to doctors. For drugs that are essentially elective, the focus shifts to spending hundreds of millions in direct to consumer advertising to stimulate demand for something that will cost almost nothing to the consumer but a bundle to the insurance company. When the insurance company charges a higher deductible for these drugs, what happens? The drug companies pay the deductible for the consumer arguing, in the words of one executive, that they believed it was wrong for consumers to have to base their choice of drug on price. If, by contrast, Medicare classified drugs as being therapeutic equivalents and charged consumers a co-pay equal to the difference between the lowest cost drug and the drug actually used, you would see the power of market competition immediately.

On the information efficiency side, the Federal government has actually spearheaded some efforts to try to push both for increased used of electronic medical records so that results of tests can be shared across different providers (funding was part of the stimulus bill) and for uniform standards for third party electronic billing and reimbursement.