Health care - administrative incompetence

[Gandalfs Beard]

No. The private sector is not shafting us. The whole system is set up to incentivize shafting us. That's what needs to change.

What the hell does that even mean?

Of COURSE the whole system is set up to incentivize shafting us, because PROFITS are the incentive. Eliminate the PROFITS and you eliminate the incentive to shaft.

You can't have it both ways. Either the Government Strictly Regulates and/or Nationalizes certain sectors of the economy to disincentivize (thanks for creating a new word by the way) the Profit Motivation, or it allows the so-called "Free Market" to shaft us.

You can't seem to make up your mind on this. First you claim the "Free Market" is God, then you claim that someone (I don't know who that someone would be in your Fairy Tale "Free Market" Universe) ought to set the health insurance industry straight.

GB

 

[bookitty]

But South Africa was ours at that stage. Did you check whether they were still British citizens/subjects?

Pretty much everything was yours at that stage. Which is probably why the descendants of English citizens who happened to be born in colonies do not have the same right to citizenship.

 

[bookitty]

Rolfe's mentioned this before but I just wouldn't be able to live in a society like that; how could I look a seriously ill neighbour or a friend in the eyes knowing what they are going to go through financially and not be able to help them to any significant degree? I suppose you have to be born and raised into it so that you can accept it as being OK.

Actually, it wasn't happening 10, even 5 years ago. You bought insurance with a set deductible and, if something happened, you paid the deductible and insurance took care of the rest. There were some treatments - experimental drugs, MRI's when they were new, cross-over elective - that might not be paid for or might need more paperwork. But, in general, it worked.

7 years ago, I paid $122 a month for very, very basic insurance. Pretty much catastrophic only with some breaks for preventive care (40% of doctor visit, discount on medicine.) Today, comparable insurance would cost me over $500. And, as I well know, there is little reason to think that $500 a month will buy me care if something happens.

 

[kellyb]

What the hell does that even mean?

Of COURSE the whole system is set up to incentivize shafting us, because PROFITS are the incentive. Eliminate the PROFITS and you eliminate the incentive to shaft.

You can't have it both ways. Either the Government Strictly Regulates and/or Nationalizes certain sectors of the economy to disincentivize (thanks for creating a new word by the way) the Profit Motivation, or it allows the so-called "Free Market" to shaft us.

You can't seem to make up your mind on this. First you claim the "Free Market" is God, then you claim that someone (I don't know who that someone would be in your Fairy Tale "Free Market" Universe) ought to set the health insurance industry straight.

GB

I don't think you understand the conservative mind.

The government is always the problem and can never be a solution.

Therefore, the government paying for the people on medicare and medicaid is what's shafting us.

If this makes no sense to you, pray to the "Invisible Hand" for more faith in the free market. Ask the Invisible Hand to renew your mind and heart as you read the scriptures at CATO.

 

[kellyb]

Actually, it wasn't happening 10, even 5 years ago. You bought insurance with a set deductible and, if something happened, you paid the deductible and insurance took care of the rest. There were some treatments - experimental drugs, MRI's when they were new, cross-over elective - that might not be paid for or might need more paperwork. But, in general, it worked.

7 years ago, I paid $122 a month for very, very basic insurance. Pretty much catastrophic only with some breaks for preventive care (40% of doctor visit, discount on medicine.) Today, comparable insurance would cost me over $500. And, as I well know, there is little reason to think that $500 a month will buy me care if something happens.

Yeah, things kind of went from "meh" to "OMFG WTFBBQ?" pretty recently.

 

[Gandalfs Beard]

I don't think you understand the conservative mind.

The government is always the problem and can never be a solution.

Therefore, the government paying for the people on medicare and medicaid is what's shafting us.

If this makes no sense to you, pray to the "Invisible Hand" for more faith in the free market. Ask the Invisible Hand to renew your mind and heart as you read the scriptures at CATO.

I know. I was being Rhetorical.

The "intellectuals" at the CATO Institute know that the "Free Market" is an abstraction that doesn't exist in reality, but it doesn't stop them from proselytizing to the True Believers.

GB

 

[xjx388]

Actually, it wasn't happening 10, even 5 years ago. You bought insurance with a set deductible and, if something happened, you paid the deductible and insurance took care of the rest. There were some treatments - experimental drugs, MRI's when they were new, cross-over elective - that might not be paid for or might need more paperwork. But, in general, it worked.

7 years ago, I paid $122 a month for very, very basic insurance. Pretty much catastrophic only with some breaks for preventive care (40% of doctor visit, discount on medicine.) Today, comparable insurance would cost me over $500. And, as I well know, there is little reason to think that $500 a month will buy me care if something happens.

I don't know your individual situation, but I have a catastrophic plan for my family that costs less than $350/month.

 

[bookitty]

I don't know your individual situation, but I have a catastrophic plan for my family that costs less than $350/month.

You're married to a doctor, maybe you have access to insurance that the rest of us do not.

 

[Tatyana]

Is lapatinib given to people with breast cancer in the UK by the NHS? No. Why not? There's your answer.

No, here's your answer. It is being trialed, but not for end-stage breast cancer, to determine which breast cancer treatment is most effective.




http://www.nhs.uk/conditions/hercep...t00450892&condition=herceptin&pn=1&rec=0&ct=0

Docetaxel and Lapatinib With or Without Combination Chemotherapy or Docetaxel and Trastuzumab With Combination Chemotherapy in Treating Women With Locally Advanced, Inflammatory, or Resectable Breast Cancer

Recruitment status: Recruiting

Primary Sponsor: European Organization for Research and Treatment of Cancer
Recruitment countries: United Kingdom
Health condition studied: Breast Cancer

 

[Gandalfs Beard]

I don't know your individual situation, but I have a catastrophic plan for my family that costs less than $350/month.

And how does that help people who are struggling just to pay the rent/mortgage, car payments, pay their bills, and buy food and clothing?

And what if that "Catastrophic" plan has a High Deductible, a Cap, and exorbitant co-pays. And what if the "Catastrophic" Plan decides that you have "ore-existing" conditions, and either refuse access to the Plan, or charge $600 a month to cover your future needs as long as they have nothing to do with your "pre-existing conditions (as well as the high deductibles, co-pays and caps)? And how does that help to cover the costs of seeing a GP as needed? Oh, I forgot, you have a Doctor in the family, so why care about those that can't afford regular doctor visits?

I'm sure it works great for those that earn 50-60,000 a year or more.

GB

 

[xjx388]

What the hell does that even mean?

Of COURSE the whole system is set up to incentivize shafting us, because PROFITS are the incentive. Eliminate the PROFITS and you eliminate the incentive to shaft.

You can't have it both ways. Either the Government Strictly Regulates and/or Nationalizes certain sectors of the economy to disincentivize (thanks for creating a new word by the way) the Profit Motivation, or it allows the so-called "Free Market" to shaft us.

You can't seem to make up your mind on this. First you claim the "Free Market" is God, then you claim that someone (I don't know who that someone would be in your Fairy Tale "Free Market" Universe) ought to set the health insurance industry straight.

GB

The Free Market isn't God. It's just the most efficient way to distribute goods and services. It's about striking a balance between free market principles and the need to regulate. Look at Switzerland. They have regulations to ensure universal access but the actual provision of care is free-market based; doctors and insurance compete for patients.

We don't need the government to provide our healthcare; we need the government to ensure we all have access to healthcare.

 

[xjx388]

You're married to a doctor, maybe you have access to insurance that the rest of us do not.

Our employees have the same coverage at the same or lower prices. We contribute into their savings accounts as well as provide their catastrophic insurance. It's out there, but no one bothers to look. They'd rather whine about how unfair everything is.

I posted earlier a catastrophic plan for a family of four that would cost ~$260. I've attached a PDF. This was from ehealthinsurance.com. I'm sure there are conditions, etc. but it proves the point.

 

[xjx388]

And how does that help people who are struggling just to pay the rent/mortgage, car payments, pay their bills, and buy food and clothing?

And what if that "Catastrophic" plan has a High Deductible, a Cap, and exorbitant co-pays. And what if the "Catastrophic" Plan decides that you have "ore-existing" conditions, and either refuse access to the Plan, or charge $600 a month to cover your future needs as long as they have nothing to do with your "pre-existing conditions (as well as the high deductibles, co-pays and caps)? And how does that help to cover the costs of seeing a GP as needed? Oh, I forgot, you have a Doctor in the family, so why care about those that can't afford regular doctor visits?

I'm sure it works great for those that earn 50-60,000 a year or more.

GB

GB, despite what you may think, we have to pay to see the doctor just like everyone else. "Professional Courtesies" are illegal if the doc also accepts Medicare.

 

[kellyb]

The Free Market isn't God. It's just the most efficient way to distribute goods and services. It's about striking a balance between free market principles and the need to regulate. Look at Switzerland. They have regulations to ensure universal access but the actual provision of care is free-market based; doctors and insurance compete for patients.

We don't need the government to provide our healthcare; we need the government to ensure we all have access to healthcare.

http://www.nytimes.com/2009/10/01/health/policy/01swiss.html?pagewanted=all

. Swiss insurance companies offer the mandatory basic plan on a not-for-profit basis, although they are permitted to earn a profit on supplemental plans.

Insurance companies aren't allowed by the government to make any profit on basic plans. Clearly, this is the free market at work.

The Swiss government does not “ration care” — that populist bogeyman in the American debate — but it does keep down overall spending by regulating drug prices and fees for lab tests and medical devices.

More proof of how the free market keeps care affordable.

The Swiss government also provides direct cash subsidies to people if health insurance equals more than 8 percent of personal income, and about 35 to 40 percent of households get some form of subsidy

What was that you said about government not being needed to provide health care?

 

[kellyb]

GB, despite what you may think, we have to pay to see the doctor just like everyone else. "Professional Courtesies" are illegal if the doc also accepts Medicare.

What's your family's deductible again?

 

[Architect]

How easily you forget reports like this one. Or this one. Or this one. Oh, and don't forget this one. That ought to be enough to get you started.

My goodness, reading comprehension certainly isn't your strong point:

The first article you cite, from the IEA healthcare unit, is 10 years old and prior to major increases in NHS funding. You have been told this already. Incidentally the IEA is on the right wing free-market fringe, so forgive me for not counting it as an impartial authority on the matter.

The second article you cite is from the Times, in 2008. It deals specifically with the n(for example) in the Scottish NHS. Interestingly, it goes on to set out the appeal mechanisms and notes that (for example) nearly all of those in Mid Essex were then given the requested treatment.

That this was held up as a scandal in one of the leading UK papers speaks volumes. As I recall, you have been challenged to show that US healthcare insurers provide these medicines as a matter of course. You have failed to do so. So really, not a compelling case there either.

The third source you direct us to is from a letters column in the Guardian and appears to be written by some big names. Alas, it provides no data on evidencial sources whatsoever. Bit hard, therefore, to judge whether it's an accurate reflection or not.

The final article you refer to is from 1999. The last time I looked, that was some 11 years ago. The headline looks very compelling until you read the report and discover that the group complaining about lack of access to these drugs is "sponsored by 10 pharmaceutical companies". Well, that makes them absolutely neutral then, eh?

So is that the best you can do XJX? Let me remind you: half the cost, every single permanent resident covered, comparable clinical outcomes.

 

[kellyb]

Our employees have the same coverage at the same or lower prices. We contribute into their savings accounts as well as provide their catastrophic insurance. It's out there, but no one bothers to look. They'd rather whine about how unfair everything is.

I posted earlier a catastrophic plan for a family of four that would cost ~$260. I've attached a PDF. This was from ehealthinsurance.com. I'm sure there are conditions, etc. but it proves the point.

Oh, you only need about $20K to access it? And the annual out of pocket limit is another $20K?

How can a person making minimum wage afford this?

 

[bookitty]

Our employees have the same coverage at the same or lower prices. We contribute into their savings accounts as well as provide their catastrophic insurance. It's out there, but no one bothers to look. They'd rather whine about how unfair everything is.

I posted earlier a catastrophic plan for a family of four that would cost ~$260. I've attached a PDF. This was from ehealthinsurance.com. I'm sure there are conditions, etc. but it proves the point.

You're in Texas, I am in California. Seems there's a difference. It might have to do with all those under/non insured people who are currently abusing the system or relying on government aid. Just like you said they should.

And for the record, I have spent HOURS trying to find affordable insurance. I've researched every company and numerous self-insured options including co-ops and the groups that have been started up for free-lancers. So no, it's not that I would "rather just whine" but thank you so much for the insinuation.

 

[kellyb]

You're in Texas, I am in California. Seems there's a difference. It might have to do with all those under/non insured people who are currently abusing the system or relying on government aid. Just like you said they should.

And for the record, I have spent HOURS trying to find affordable insurance. I've researched every company and numerous self-insured options including co-ops and the groups that have been started up for free-lancers. So no, it's not that I would "rather just whine" but thank you so much for the insinuation.

You have to have FORTY THOUSAND DOLLARS laying around for that plan to make sense. The deductible alone is TWENTY THOUSAND DOLLARS for a family.

 

[bookitty]

You have to have FORTY THOUSAND DOLLARS laying around for that plan to make sense. The deductible alone is TWENTY THOUSAND DOLLARS for a family.

And at $20,000 for the deductible, it makes more sense to put what I would spend on health insurance into a short-term CD that I can access at need. The interest isn't great, probably wouldn't even keep up with inflation over the long term, but it's better than handing the "fruits of my labors" over to some corporation that will use it to fund the auditors who will deny me coverage if I need it.