Health insurance premiums going up, thanks to new legislation

[....lybob]

The best part is letting people die is better for the bottom line.

 

PacifiCare thought so

[Pine Barrens Mafia]

Judging by the health care legislation, there's a "consensus" that macroeconomics no longer matters, so supply and demand is "scientifically" disproven.

 

If they had put a price cap on premiums, then it would have made more sense (it still would have sucked mind you, but it would have been logically consistent). But they didn't. So now, normal, healthy people will end up paying the price to insure the previously uninsurable. I hate what's becoming of this country, honestly.

[....lybob]

If they had put a price cap on premiums, then it would have made more sense (it still would have sucked mind you, but it would have been logically consistent). But they didn't. So now, normal, healthy people will end up paying the price to insure the previously uninsurable. I hate what's becoming of this country, honestly.

If anyone wanted to lower medical costs they could stop letting the AMA restrict the number of doctors trained and the number of foreign doctors allowed- they could let pharmaceuticals come in from Canada and Europe. what we really need though is a complete revamping of our medical system from the ground up.

[DC Tom]

If they had put a price cap on premiums, then it would have made more sense (it still would have sucked mind you, but it would have been logically consistent). But they didn't. So now, normal, healthy people will end up paying the price to insure the previously uninsurable. I hate what's becoming of this country, honestly.

 

My recollection is that the bill capped annual premium increases at a given percent. Still retarded, of course.

 

Retarded any way you cut it, really. Really stupid piece of legislation.

[birdog1960]

How do you argue with someone that denies the basic laws of supply and demand?

what the medical profiteers and even their opponents understand all too well is that there is and always will be more demand than supply in health care. one solution is to supply those who can pay the most. an alternative solution is to supply those who truly need the most and are most likely to benefit from applied resources. the former is what we've lived for decades. the latter is what compassionate, fair minded persons dream of and fight for. i'd be satisfied if we end up somewhere in between...which appears to be the short term resolution of the current administration....baby steps.

Edited September 11, 2010 by birdog1960

[IDBillzFan]

My recollection is that the bill capped annual premium increases at a given percent. Still retarded, of course.

 

Retarded any way you cut it, really. Really stupid piece of legislation.

Why do you say that? Do you hate black people? You must be one them there straight-up racists I heard tell about. Because only a racist would use the R word to describe a piece of legislation that was signed into law by a half a colored person.

 

I bet you hate mosques in NYC, too, don'tcha? And you probably want to light the match that burns a Quran, don't you?

 

Yeah, I knew it. You're all alike. Everyone one of you black-hating Quran-burning bigots.

Edited September 11, 2010 by LABillzFan

[Magox]

If anyone wanted to lower medical costs they could stop letting the AMA restrict the number of doctors trained and the number of foreign doctors allowed- they could let pharmaceuticals come in from Canada and Europe. what we really need though is a complete revamping of our medical system from the ground up.

Unfortunately the idiots up in Washington don't see it this way. THey'd rather focus on reforming those who pay for the coverage as opposed to controlling medical costs . You weren't here during the health insurance debate, this was my obsession and what you just pointed ot was what I was hammering away constantly.

[Alaska Darin]

If anyone wanted to lower medical costs they could stop letting the AMA restrict the number of doctors trained and the number of foreign doctors allowed- they could let pharmaceuticals come in from Canada and Europe. what we really need though is a complete revamping of our medical system from the ground up.

There truly doesn't seem to be ANY interest in reform - the reality is puppet politicians are simply gaining more control for special interests than the average guy and the partisan supporters of each party lap it up like the simpletons they are.

 

We had a pretty good debate here about health care leading up to the passage of this abortion of a bill. Your suggestions were the tip of the iceberg but they were certainly included. It shouldn't be of any surprise to the lucid that the first thing the current administration did was take economy of scale off the table regarding the pharmaceutical industry. They knew the money in that industry would flatten any chance of getting something done.

 

Had they gone for a series of smaller bills to address any number of things I think they'd have had an easy time getting them done and winning serious political points but the poorly crafted bulldozer legislation and the surrounding circus all but guarantees losing badly in November.

[OCinBuffalo]

If they had put a price cap on premiums, then it would have made more sense (it still would have sucked mind you, but it would have been logically consistent). But they didn't. So now, normal, healthy people will end up paying the price to insure the previously uninsurable. I hate what's becoming of this country, honestly.

1. It doesn't end there. Medicare/Medicaid are fundamentally based on the concept of people paying for other people who don't.

2. Price fixing inevitably leads to wage fixing...which in turn would lead to even less primary care docs, and we already don't have enough.

3. Believe me, there are literally trillions in cost that can be cut before we even get close to worrying about price caps. I find new ones every week. The real problem is: insurance companies aren't in charge of managing a provider's health care costs, or cutting them, but they are being treated as though they are. They simply pay the bill. They don't create it.

4. By far, the largest creator of empty, ineffective/inefficient, and/or useless costs in health care is the State and Federal government. Their regulatory mechanisms are patently retarded, so is their reimbursement structure. Managing these processes add 30-40% to provider's budgets, solve nothing, can't stop fraud, require legions of government employees to manage, and...have yet to improve quality of care/save lives. They don't solve problems, and they create new ones.

5. Finally, the elephant in the room is Medicare. Medicare, not insurance companies, sets the price of everything...because they are the largest "insurance company" by far. If Medicare agrees to pay $2000 for a procedure, every other insurance company will get in line behind that and pay a little less or more, largely depending on how many doctors they can marshal to a hospital.

 

You want to cut cost? You have to start with Medicare's contractual agreements and the ridiculous government agencies that regulate health care. Their results = get fired everywhere else. But, nobody wants to accept and deal with the obvious. Health care needs to be regulated to be sure. But, it should be done by people who have a clue how quality assurance actually works, not health care Ph.D's/government employees = amateurs.

If anyone wanted to lower medical costs they could stop letting the AMA restrict the number of doctors trained and the number of foreign doctors allowed- they could let pharmaceuticals come in from Canada and Europe. what we really need though is a complete revamping of our medical system from the ground up.

Absolutely. Are we to assume that you have taken up the cause of supply side economics? Because, deregulation and investment in the supply of primary docs are certainly not Keynesian policies.

what the medical profiteers and even their opponents understand all too well is that there is and always will be more demand than supply in health care. one solution is to supply those who can pay the most. an alternative solution is to supply those who truly need the most and are most likely to benefit from applied resources. the former is what we've lived for decades. the latter is what compassionate, fair minded persons dream of and fight for. i'd be satisfied if we end up somewhere in between...which appears to be the short term resolution of the current administration....baby steps.

And what about those who "truly need the most" who are "truly responsible" for their own predicament? Are you telling me that 20 years of being willfully obese, and developing diabetes as a result = free health care...because now it is "needed"?

 

I can accept a "preventative maintenance" argument and/or anything pediatric. I cannot accept "you get to live like a douche, and it's my job to cover your health care cost". I can accept "you get to live like a douche, provided you pay for your own health care". Otherwise, this is just one more "give away free schit for votes" program, and you can spare me the phony moral superiority. There's nothing moral about stealing money from some people and giving it to other people who piss it away.

[Chef Jim]

what the medical profiteers and even their opponents understand all too well is that there is and always will be more demand than supply in health care. one solution is to supply those who can pay the most. an alternative solution is to supply those who truly need the most and are most likely to benefit from applied resources. the former is what we've lived for decades. the latter is what compassionate, fair minded persons dream of and fight for. i'd be satisfied if we end up somewhere in between...which appears to be the short term resolution of the current administration....baby steps.

 

Baby steps? Are you serious?

[birdog1960]

 

 

And what about those who "truly need the most" who are "truly responsible" for their own predicament? Are you telling me that 20 years of being willfully obese, and developing diabetes as a result = free health care...because now it is "needed"?

 

I can accept a "preventative maintenance" argument and/or anything pediatric. I cannot accept "you get to live like a douche, and it's my job to cover your health care cost". I can accept "you get to live like a douche, provided you pay for your own health care". Otherwise, this is just one more "give away free schit for votes" program, and you can spare me the phony moral superiority. There's nothing moral about stealing money from some people and giving it to other people who piss it away.

and what then of the other side of the coin: the wealthy drug addict radio broadcaster who needs a cochlear or penile implant, the rockstar that needs a new liver but keeps drinking, the executive who had a bypass but keeps smoking? if they can afford "good" private insurance and maybe much more out of pocket, they get what they "need". many more examples out there...ask our resident gas passer how many 80+ year olds with 5 or less years life expectancy he's put to sleep for joint replacements. how old was barbara bush when she got her recent bypass? what's her life expectancy with and without it? how many bone marrow transplants are done on patients with negligible 1 or 5 year survival rates? if you really want to save money in the system, these are the questions that need asking and answering, even for thse with wealth as the difference between demand and supply widens while more costly and effective interventions prolong life.. people currently without "good" insurance are rarely (or at least much less frequently) offered these interventions which may be well and proper if lifestyle conditions are not met. yet, fat, poor diabetics often don't get regular care til they develop chest pain and coronary artery disease, in our current system. when a fat, poor 50 yo arrives at an er with chest pain, would you advocate refusing care? a poor alcoholic would already be refused a liver transplant until he abstained from alcohol for a protracted period. most would consider this reasonable as do i but it such judgements should be universally applied when they result in life or death for the patient. they aren't in our current system.

[Doc]

and what then of the other side of the coin: the wealthy drug addict radio broadcaster who needs a cochlear or penile implant, the rockstar that needs a new liver but keeps drinking, the executive who had a bypass but keeps smoking? if they can afford "good" private insurance and maybe much more out of pocket, they get what they "need". many more examples out there...ask our resident gas passer how many 80+ year olds with 5 or less years life expectancy he's put to sleep for joint replacements. how old was barbara bush when she got her recent bypass? what's her life expectancy with and without it? how many bone marrow transplants are done on patients with negligible 1 or 5 year survival rates? if you really want to save money in the system, these are the questions that need asking and answering, even for thse with wealth as the difference between demand and supply widens while more costly and effective interventions prolong life.. people currently without "good" insurance are rarely (or at least much less frequently) offered these interventions which may be well and proper if lifestyle conditions are not met. yet, fat, poor diabetics often don't get regular care til they develop chest pain and coronary artery disease, in our current system. when a fat, poor 50 yo arrives at an er with chest pain, would you advocate refusing care? a poor alcoholic would already be refused a liver transplant until he abstained from alcohol for a protracted period. most would consider this reasonable as do i but it such judgements should be universally applied when they result in life or death for the patient. they aren't in our current system.

What do you envision happening under Obamacare? That everyone on it will get all the services that private insurance patients currently/will get? Or even that they'll get the services that Medicare and Medicaid patients currently get? Nope. They'll restrict access to care, using "evidence-based medicine" to deny those with poor 5-year survival/productivity rates. While private insurance patients will continue to get better care, because they're paying more for their services.

[birdog1960]

What do you envision happening under Obamacare? That everyone on it will get all the services that private insurance patients currently/will get? Or even that they'll get the services that Medicare and Medicaid patients currently get? Nope. They'll restrict access to care, using "evidence-based medicine" to deny those with poor 5-year survival/productivity rates. While private insurance patients will continue to get better care, because they're paying more for their services.

baby steps...single payer was not politically feasable this go round. yes, there will always be haves and have nots but it will be better when the disadvantaged (think the minimum wage worker with 2 jobs and no insurance) gets basic care and seeks it early when it can do the most good. should that person have coverage for the treatment of cosmetic skin lesions or elective repair of droopy eyelids? Nope but it should cover counseling for smoking cessation and proper diet recs.. should he be eligible for dialysis if needed after 65? 70? 80? should he be a candidate for a bypass at 80? at 60 if he smokes? don't know but i think these questions should be open to debate if we want to avoid the cost of health care becoming 25-30% of gdp. and the same rules decided on for the disadvantaged should hold for the advantaged but they never will. the golden rule is just too strong in the US and that will never change. a reasonable person grudgibgly accepts this. btw, doesn't it make more sense to make decisions like this or on more simple but important questions (eg duration of antibiotic treatment for strep throat) based on evidence rather than anecdote and tradition? how can you possibly argue otherwise?

[Doc]

baby steps...single payer was not politically feasable this go round. yes, there will always be haves and have nots but it will be better when the disadvantaged (think the minimum wage worker with 2 jobs and no insurance) gets basic care and seeks it early when it can do the most good. should that person have coverage for the treatment of cosmetic skin lesions or elective repair of droopy eyelids? Nope but it should cover counseling for smoking cessation and proper diet recs.. should he be eligible for dialysis if needed after 65? 70? 80? should he be a candidate for a bypass at 80? at 60 if he smokes? don't know but i think these questions should be open to debate if we want to avoid the cost of health care becoming 25-30% of gdp. and the same rules decided on for the disadvantaged should hold for the advantaged but they never will. the golden rule is just too strong in the US and that will never change. a reasonable person grudgibgly accepts this. btw, doesn't it make more sense to make decisions like this or on more simple but important questions (eg duration of antibiotic treatment for strep throat) based on evidence rather than anecdote and tradition? how can you possibly argue otherwise?

I can argue otherwise because "evidence-based practice" is another way of saying "rationing of care." Only instead of big, bad insurance companies denying you care, it's the government. And we all know how easy it is to argue with the government to get something done.

 

Another way I can argue otherwise is that cancer survival rates will drop, like they do in countries with socialized medicine. And costs will continue to go up, also as they do there, as they try and figure out the "baby steps" in vain. While the disparity between haves and have nots increases with the rich getting private insurance and the poorer (meaning middle-to-lower middle class and below) getting government insurance. Yet people will still abuse their bodies, doctors will still face frivolous lawsuits, and everyone who cut their deal with Barry will still be raking in the dough while practitioners, who spent good portions of their lives studying to get where they are, spent hundreds of thousands in the process, and who have ALL the liability, continue to get squeezed out.

 

Yes, how could I argue otherwise?

[Alaska Darin]

Yes, how could I argue otherwise?

Ignoring all the while the things that actually make health care more expensive here...

[birdog1960]

I can argue otherwise because "evidence-based practice" is another way of saying "rationing of care." Only instead of big, bad insurance companies denying you care, it's the government. And we all know how easy it is to argue with the government to get something done.

 

Another way I can argue otherwise is that cancer survival rates will drop, like they do in countries with socialized medicine. And costs will continue to go up, also as they do there, as they try and figure out the "baby steps" in vain. While the disparity between haves and have nots increases with the rich getting private insurance and the poorer (meaning middle-to-lower middle class and below) getting government insurance. Yet people will still abuse their bodies, doctors will still face frivolous lawsuits, and everyone who cut their deal with Barry will still be raking in the dough while practitioners, who spent good portions of their lives studying to get where they are, spent hundreds of thousands in the process, and who have ALL the liability, continue to get squeezed out.

 

Yes, how could I argue otherwise?

was any of your training publicly subsidized? we all know the true cost of medical education is much more than most public med schools charge. did you get any government low interest loans? did you go to a public med school? hell, even if you did your residency at georgetown, it was subsidized by medicare dollars...so shouldn't there be some payback to the public? and because people will still abuse their bodies (and people who don't will still get dreadful illnesses) should we not at least attempt to make a difference? some people do stop smoking and/or lose weight at least in part due to the encouragement of their doctors. some drug addicts and alcoholics quit. some arrogant, "invincibles" change their risky behaviors (well, rarely, i grant you). if we continue our vain search for immortality and permanent youth with the outrageous costs associated it will be the upper middle class and below getting government insurance as no one but the rich will be able to afford private insurance. rationing happens now and will continue but hopefully a more studied, rational approach can be agreed upon.

 

Ignoring all the while the things that actually make health care more expensive here...

about 1/3 of all medicare dollars are spent in the last month of life. how am i ignoring that? most are either ignoring it or avoiding it. it's the elephant in the room and will only get worse with improved but more expensive heroic interventions.

[Doc]

was any of your training publicly subsidized? we all know the true cost of medical education is much more than most public med schools charge. did you get any government low interest loans? did you go to a public med school? hell, even if you did your residency at georgetown, it was subsidized by medicare dollars...so shouldn't there be some payback to the public? and because people will still abuse their bodies (and people who don't will still get dreadful illnesses) should we not at least attempt to make a difference? some people do stop smoking and/or lose weight at least in part due to the encouragement of their doctors. some drug addicts and alcoholics quit. some arrogant, "invincibles" change their risky behaviors (well, rarely, i grant you). if we continue our vain search for immortality and permanent youth with the outrageous costs associated it will be the upper middle class and below getting government insurance as no one but the rich will be able to afford private insurance. rationing happens now and will continue but hopefully a more studied, rational approach can be agreed upon.

LOL! As if doctors are the only ones who have been subsidized! Not that me getting 1/3 of private insurance rates for the poor and elderly isn't "payback" enough. I'd like to see ANY other place where a poor or elderly person would get a 66% discount, nevermind when their lives are in ones hands.

 

No one needs a doctor to tell them to lose weight, eat better, exercise, stop smoking/doing drugs, and engaging in high risk activities. They know the dangers, but choose to do it. The only way to "make a difference" is potentially by legislating/regulating behavior, but even that doesn't work, and it has its own inherent costs and loss of freedoms. While denying care is ethically wrong, and isn't made better just because the government is the one deciding it, not private insurance companies.

[birdog1960]

While denying care is ethically wrong, and isn't made better just because the government is the one deciding it, not private insurance companies.

and denying care on the basis of insurance coverage is ethical...happens thousands of times every day.

[birdog1960]

 

No one needs a doctor to tell them to lose weight, eat better, exercise, stop smoking/doing drugs, and engaging in high risk activities.

had to wait til i got to my office to find a reference (there are several actually): bmj online DOI:10.1136/bmj.39503.582396.25 "effects on smoking quit rate of telling patients their lung age". since you seem anti evidence based it probably won't sway you, however...just hold on to all those unfounded beliefs and keep telling yourself you know better based on personal observation

[Doc]

had to wait til i got to my office to find a reference (there are several actually): bmj online DOI:10.1136/bmj.39503.582396.25 "effects on smoking quit rate of telling patients their lung age". since you seem anti evidence based it probably won't sway you, however...just hold on to all those unfounded beliefs and keep telling yourself you know better based on personal observation

Again, patients don't NEED to hear it from a doctor. It might make more of an impact coming from one, but people know what they're doing. And the percentage of patients who listen is still too small to create meaningful change, hence the need to legislate behavior.