Health Care a Right?

[Ladyhawk]

I got laid off, and put on COBRA (California's mandated 'laid off' medical insurance, for a mere $430 a month - and this is what they charged EVERYONE who was laid off).

Just so you know, Evil, COBRA is a national mandate; stepchild of another employee benefit law: ERISA.


Get your own insurance BEFORE you're laid off. And DO NOT let the company pay for it, or it'll end up getting SNAFU'd into "COBRA", which is about 5x~8x normal health insurance rates AFTER you are laid off.

Actually, that's not true. COBRA mandates that an employer can charge no more than 102% of the actual group premium that he/she pays for that employee. The 2% covers the employers admin costs. Insurance premiums outside of COBRA provisions are FAR higher... I worked this industry for years; believe me, I know.

Yeah, it's not a "right", but then again, driving isn't a "right", either. See how well you can live in most of America without a driver's license.

Valid points all, EvilD, but consider this. Unnecessary pre-dx tests and lawsuits, coupled with people who treat their insurance card like a Visa and pharmaceutical companies who price-fix amongst themselves, contribute greatly to the high cost. Employers don't 'make out' on COBRA. In fact, many are forcing participatory contributions from their employees (translate: charging them) and dropping their level of coverage because they simply can't afford it. COBRA, ironically, was the government's attempt at providing health insurance for unemployed people. And, you can personally attest to how well that is working. What makes anyone think socialized medicine would fare better?

 

[Tmy]

I hate when malpractice suits are blamed for health care costs. i think thats just an excuse forthsoe who jusyt wantto limit liablilty (and increase profits) for medical firms.

There are far more auto accident lawsuits (frivolous and otherwise) yet car insurance is manageable.

I doubt id make even a dent in costs if you outlawed malpractice suits.

 

[RandFan]

The problem with Health Care is that were fighting on the wrong front. We're trying to get everyone insured and not trying to control the costs that make insurance so expensive. Lobbysist make sure that aint going to happen.

A bit simplistic. There is no secret to the problem of health care. When a 3rd party collects premiums and then distributes payments then there is no incentive on the consumer to budget his or her medical consumption and no incentive on the provider to control costs.

Take the food shopping analogy. My budget for my family for 1 month is $XXX.xx I always clip coupons, shop at multiple stores, look for bargains and avoid going to the store when I am hungry. If I run out of money before I run out of month I buy hamburger instead of steak. Generic brands instead of premium ones. Why? Because I am motivated to do so.

This dynamic has created an incredible selection and assortment of goods and services. The desire of the producer to make a profit is balanced with the desire of the consumer to get quality products at a low price.

But what if I and all of my neighbors gave that $XXX.xx to a third party who paid the grocery store and I was allowed to go as often as I wanted to the store and get what ever I wanted?

Simple economics and simple mathematics. I would always purchase the best products for myself and my family (as would my neighbors) and the best products would for ever rise faster than the rate of inflation.

 

[Zero]

I hate when malpractice suits are blamed for health care costs. i think thats just an excuse forthsoe who jusyt wantto limit liablilty (and increase profits) for medical firms.

There are far more auto accident lawsuits (frivolous and otherwise) yet car insurance is manageable.

I doubt id make even a dent in costs if you outlawed malpractice suits.

It is one of those popular lies. While individual jury awards may be high, overall lawsuit payments haven't increased in relation to the increases in health care costs. It is just a scam to justify increased insurance profits.

 

[Ladyhawk]

It is one of those popular lies. While individual jury awards may be high, overall lawsuit payments haven't increased in relation to the increases in health care costs. It is just a scam to justify increased insurance profits.

Respectfully disagree. It isn't just the individual lawsuits, folks. It's the risk of lawsuits. To wit; ask any doctor what his malpractice liability insurance is costing him. Look at the number of OB/GYN practitioners who have dropped obstetrics from their practice because they couldn't afford the insurance. As a result, those who can afford their insurance are over prescribing medical tests to ensure that their examinations were as 'thorough' as possible to avoid malpractice threats. Further, people are living longer and we're delivering premature babies at 3 - 4 months.

Anyone who honestly doesn't believe that our lawsuit-happy society is increasing the costs of every service and good in this country is living with their head poked in the sand...

 

[Tmy]

Take the food shopping analogy. My budget for my family for 1 month is $XXX.xx I always clip coupons, shop at multiple stores, look for bargains and avoid going to the store when I am hungry. If I run out of money before I run out of month I buy hamburger instead of steak. Generic brands instead of premium ones. Why? Because I am motivated to do so.

Problem. In food shopping you have options. You can eat ramen or you can eat steak. But If I NEED presciption X , I cant just decide to take asprin as a substitute. I need drug X. Generic drugs are not available in every case and even if they are they are still expensive.

Remember this is stuff that people NEED to live. I think the govt should regulate prescripts more. Like they so with utilities, and other basics.

 

[Ladyhawk]

There are far more auto accident lawsuits (frivolous and otherwise) yet car insurance is manageable.

I doubt id make even a dent in costs if you outlawed malpractice suits.

Don't know where you live, TMY, but my auto insurance goes up every single year. I live in a safe neighborhood and honestly couldn't tell you the last time I even had a traffic ticket....

 

[boooeee]

I think questions like "Is health care a right?", or "Is everybody entitled to a liveable wage?" miss the point. I think you could find agreement across the political spectrum that people should earn a liveable wage and should have access to quality healthcare. The fundamental (and often ignored) question is to what extent these goals can be achieved by active governmental intervention.

These are different questions than do we have the right to freedom of speech or religion. The government's role in ensuring those rights is, for the most part, to just keep their nose out of it. Providing health care as a right entails just the opposite. So, after we are all in agreement that health care is a right, we come to the infinitely more important question - How is the government going to ensure that right for its citizens?

 

[Zero]

Respectfully disagree. It isn't just the individual lawsuits, folks. It's the risk of lawsuits. To wit; ask any doctor what his malpractice liability insurance is costing him. Look at the number of OB/GYN practitioners who have dropped obstetrics from their practice because they couldn't afford the insurance. As a result, those who can afford their insurance are over prescribing medical tests to ensure that their examinations were as 'thorough' as possible to avoid malpractice threats. Further, people are living longer and we're delivering premature.

Anyone who honestly doesn't believe that our lawsuit-happy society is increasing the costs of every service and good in this country is living with their head poked in the sand...

See, you are just making that up. It has little to do with lawsuits, and plenty to do with insurance companies wanting to increase their profits. Lawsuits aren't costing the insurance companies any more today(as a percentage of costs) than they were 5 or ten years ago; in fact, for some of them the percentage may have gone down. However, by fear-mongering and raising costs, the insurance companies have created the false impression that it is lawsuits that make the premiums go up, and not simple corporate greed.

I am not saying that the doctors aren't getting screwed; I'm saying that the insurance companies are screwing them under false pretenses.

According to the National Association of Insurance Commissioners, the number of new medical malpractice claims declined by about four percent between 1995 and 2000. There were 90,212 claims filed in 1995; 84,741 in 1996; 85,613 in 1997; 86,211 in 1998; 89,311 in 1999; and 86,480 in 2000.
While medical costs have increased by 113 percent since 1987, the amount spent on medical malpractice insurance has increased by just 52 percent over that time

 

[Ladyhawk]

See, you are just making that up. It has little to do with lawsuits, and plenty to do with insurance companies wanting to increase their profits. Lawsuits aren't costing the insurance companies any more today(as a percentage of costs) than they were 5 or ten years ago; in fact, for some of them the percentage may have gone down. However, by fear-mongering and raising costs, the insurance companies have created the false impression that it is lawsuits that make the premiums go up, and not simple corporate greed.

I am not saying that the doctors aren't getting screwed; I'm saying that the insurance companies are screwing them under false pretenses.

With all due respect, Zero, I don't make anything up. Impolite of you to assume so. As I've mentioned before, I've got 10+ years experience in the healthcare industry. I worked the risk management side of the fence and with self-funded health plans. I've seen the actuarial stats and how increased utilization and legal action have impacted premiums charged by reinsurers and insurance companies. This is not made up. It's quite real.

I'll agree that many insurance companies probably play those numbers more to their favor. On this we can agree. But, you can't tell me that you haven't seen some of the ridiculous awards awareded to morons who contributed to their own health problems more than any doctor. Come on, for Chrissake, you've got smokers suing the tobacco companies. How ridiculous is that! And, who, do you think is paying for those lawsuits and awards?

Self-funded plans by the way, are just that. The employer contributes the $ to the account to pay every claim. The only additional insurance he carries is 'reinsurance' in the event that a single claim or group of claims exceeds a stated $ amount. While the reinsurance rate may not significantly rise every year (although there were staggering increases from 1986 - 1991) utlization $ (actual claims expense) typically does increase every year.

My overall point is: the blame does not solely rest on the shoulders of the insurers.

Respectfully,
LH

 

[Zero]

 

[RandFan]

Problem. In food shopping you have options. You can eat ramen or you can eat steak. But If I NEED presciption X , I cant just decide to take asprin as a substitute. I need drug X. Generic drugs are not available in every case and even if they are they are still expensive.

Remember this is stuff that people NEED to live. I think the govt should regulate prescripts more. Like they so with utilities, and other basics.

Yes, but that is not the point. Tens of millions of people don't need to go to the doctor for every little ache and pain.

Doctors don't need to run every diagnostic test for every ailment.

My Mother-in-laws doctor talked her into an eye lid procedure. Do "I need it she asked?" "Since it is not yet affecting your eye sight then not really" was the reply. "But you might need it in the future and since the insurance will pay for it if I say it is a medical necessity then we might as well do it now. Besides it will make you look younger"

She got the procedure. I asked her if she would have gotten it if she would have had to pay for it out of pocket. Her answer NO!

 

[Tmy]

Don't know where you live, TMY, but my auto insurance goes up every single year. I live in a safe neighborhood and honestly couldn't tell you the last time I even had a traffic ticket....

The price of milk goes up too.

If you live a healthier life, does you health insurance costs drop?

As for cars, they are getting alot more expensive. A fender bender will cost thousands to fix! ( I readthis story how theives are stealin headlights from the new Audis cause they can fetch $3000 for them. FOR HEADLIGHTS!!!)

Even with all the car accidents and dopey lawsiuts from TV lawyers I can still afford the monthly premium. My years car insurance = one month of the my works family plan health ins premium. thats insane. Good thing my employer picks up the cost.

 

[Ladyhawk]

The price of milk goes up too.

If you live a healthier life, does you health insurance costs drop?

As an individual, probably not. That's my point. Those "few" lawsuits that result in millions of dollars do affect insurance costs. Therefore, it takes more and more of us to keep utilization down in order to level off. On the optimistic side, that could happen since people are far more health conscious than 20 years ago. My fitness club is packed most of the time and it's open 24/7. Fewer people are smoking. More of us are diet conscious. We're slowly becoming more educated about generic vs brand name Rx's, cholesterol, etc. Who knows? Maybe we'll get to a point when we don't need health insurance anymore...you know.....when we've evolved back into single-cell lifeforms.....

 

[Tmy]

I understand peopel abusing the medical system for every ache but what about drug costs???


Why are scripts so expensive? People will drive to Canada to buy their pills!!! Generics are still pricey. Does it all tie back to R+D?!??

I often buy my retired parents meds cause they cant afford copays (which can be steep depending on the drug) on a fixed income. I cant see how they can afford the stuff on their own. Its a shame too cause poeple need these meds.

 

[Ladyhawk]

I understand peopel abusing the medical system for every ache but what about drug costs??? Why are scripts so expensive? People will drive to Canada to buy their pills!!! Generics are still pricey. Does it all tie back to R+D?!??

To be fair, continued R & D does impose significant costs. But, as I've alluded to in previous postings, RX needs to be a seperate discussion....not enough competition....price-fixing...the like.

I often buy my retired parents meds cause they cant afford copays (which can be steep depending on the drug) on a fixed income. I cant see how they can afford the stuff on their own. Its a shame too cause poeple need these meds.

First, TMY, kudos to you for helping your parents out! Frankly, if I had the power to mandate any one type of coverage, it would be for prescriptions. Many senior citizens are not severely physically disabled but suffer from Alzheimer's, arthritis, osteoporosis...serious, debilitating conditions that rob them of the ability to perform everyday things. Robs their quality of life, if you will. Not every senior needs a hip replacement but almost all of them need some form of medication just to get through a day...

 

[Tmy]

Well lets discuss RX Drugs.

You dont have the same abuse problems like in med treatment but the costs are just as out of control. For the most part people dont really like taking meds, they often come with side effects. If doctors are over prescibing then that has to do with the med comunitys internal controls. If more n more people are on meds, shouldnt the costs decrease??

 

[Shane Costello]

Originally posted by BillyTK:
Of course health care is a right—btw, does it have to be written in your Constitution for something to be recognised as a right?—it's a logical extension of personal sovereignty, and this is something that the British health care system is predicated on.

Ah, let me play Devil's Advocate: Did George Best have a right to a new liver?

 

[Ladyhawk]

Well lets discuss RX Drugs.

You dont have the same abuse problems like in med treatment but the costs are just as out of control. For the most part people dont really like taking meds, they often come with side effects. If doctors are over prescibing then that has to do with the med comunitys internal controls. If more n more people are on meds, shouldnt the costs decrease??

True. And, yes, it would seem that with any other commodity, increased demand drives down price...EXCEPT...Rx drugs. Why? I can't claim to know but there doesn't seem to be as many competitors in the Rx business. You can find 1000 general practitioners in a 10 mile radius, but how many pharmaceutical companies are there? Point being, there is no incentive to compete. It's my belief that they collectively price-fix the market. I have absolutely no proof to back this up. Just conjecture on my part.

 

[Segnosaur]

Why are scripts so expensive? People will drive to Canada to buy their pills!!! Generics are still pricey. Does it all tie back to R+D?!??

The costs of bringing a new drug to market is very high. (On the radio, I heard that it can reach $1 billion.)

A little googling gave me the following: (Note: these links are pro-business so may be a bit biased)

From: http://www.businessengine.com/solutions/pharmaceuticals.html Typically, only 3 of 10 approved drugs recover average research and development costs, and the average time to market for new drugs has stretched to 12 years

From: http://www.forbes.com/business/newswire/2003/12/08/rtr1173648.html : ... it now costs pharmaceutical companies nearly $1.7 billion to bring a new drug to market. That figure includes not only the price tag for discovery, development and launch, or advertising and marketing, of a drug, but also factors in the cost of failed prospective drugs that never make it to market.... Only one new compound now reaches the market for every 13 discovered and placed in preclinical trials

Now, I'm not saying that drug companies are poor or deserve our sympathy, or that some medicines aren't over prescribed. But yes, R&D is expensive.