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Realistic Health Insurance Provided By The Federal Government

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Everyone has health needs at some time or another. Having insurance to cover those needs reduces stress and worry about catastrophic events. Preventative medicine helps lower costs to everyone. The list of benefits of being covered for health is enormous and well-documented.

 

I think the federal government is the perfect place to handle a risk pool like health insurance. Not all insurance, just health insurance (not everyone drives cars or boats or owns homes). The for-profit angle of health insurance companies seems to run counter to what most people would want for themselves. After all, a for-profit insurer can crunch the numbers and decide you're just not worth dealing with any more.

 

Why can't a government program be modeled on the same structure as any of the most popular health insurers, with the exception that pre-existing conditions are covered as well. The profits a regular insurer makes should not only cover these extra treatments but also be given back to the members in the form of lower premiums. This means the government program could compete with the rest and everyone would be obligated to provide service that would entice more customers.

 

Quality should be the same; the doctors would remain unaffected. The government program might even be more popular with the doctors since they wouldn't be turning down as many claims (and doctors would absolutely flock to the program if it could pay on a Net 45 or 60 day basis). Is there any reason why this wouldn't work?

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Everyone has health needs at some time or another. Having insurance to cover those needs reduces stress and worry about catastrophic events. Preventative medicine helps lower costs to everyone. The list of benefits of being covered for health is enormous and well-documented.

 

I think the federal government is the perfect place to handle a risk pool like health insurance. Not all insurance, just health insurance (not everyone drives cars or boats or owns homes). The for-profit angle of health insurance companies seems to run counter to what most people would want for themselves. After all, a for-profit insurer can crunch the numbers and decide you're just not worth dealing with any more.

 

Why can't a government program be modeled on the same structure as any of the most popular health insurers, with the exception that pre-existing conditions are covered as well. The profits a regular insurer makes should not only cover these extra treatments but also be given back to the members in the form of lower premiums. This means the government program could compete with the rest and everyone would be obligated to provide service that would entice more customers.

 

Quality should be the same; the doctors would remain unaffected. The government program might even be more popular with the doctors since they wouldn't be turning down as many claims (and doctors would absolutely flock to the program if it could pay on a Net 45 or 60 day basis). Is there any reason why this wouldn't work?

 

So are you talking about a national insurance program, run by the federal government, into which everyone must pay? Similar to a universal health care system?

 

There are a lot of examples of different types of universal health care systems around the world. The only one I understand well enough to compare to the US system is the Canadian system, because, well, I'm Canadian. The system you are suggesting sounds pretty similar to the Canadian system, so I'm going to use that as my comparison to ask questions.

 

1) The Canadian system is organized provincially, but funded federally. That means each province has their own insurance program. I think that this might be a better way of organizing health care. Basically, you have "constitutionally" or "federal" laws regarding what types of health care must be provided, but the bureaucracy is more manageable and it seems easier to make improvements as needed at the state-level than at the federal level. For example, Ontario has made some improvements in efficiency over the last few years (without increasing costs) by changing up some procedures. But it also seems to me that the US federal government is far stronger than the state governments. Would the governments be willing to negotiate such a method of organization? What about the states? What about the constituents? Would you prefer a federally-organized or a state-organized national health insurance plan?

 

2) With a national insurance program, everyone pays in and everyone gets. How would constituents pay? Americans don't seem to like taxes much. Would they prefer to continue to pay a monthly insurance fee? What about people who can't afford the fee?

 

3) Would Americans want a tiered system, in which people could pay extra for private rooms, jumping the line, etc?

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So are you talking about a national insurance program, run by the federal government, into which everyone must pay? Similar to a universal health care system?

I'm talking about a health insurance program you could either get independently or through your employer, so it costs no more to people and employers than is currently being paid. No increased taxes.

 

There are a lot of examples of different types of universal health care systems around the world. The only one I understand well enough to compare to the US system is the Canadian system, because, well, I'm Canadian. The system you are suggesting sounds pretty similar to the Canadian system, so I'm going to use that as my comparison to ask questions.

 

1) The Canadian system is organized provincially, but funded federally. That means each province has their own insurance program. I think that this might be a better way of organizing health care. Basically, you have "constitutionally" or "federal" laws regarding what types of health care must be provided, but the bureaucracy is more manageable and it seems easier to make improvements as needed at the state-level than at the federal level. For example, Ontario has made some improvements in efficiency over the last few years (without increasing costs) by changing up some procedures. But it also seems to me that the US federal government is far stronger than the state governments. Would the governments be willing to negotiate such a method of organization? What about the states? What about the constituents? Would you prefer a federally-organized or a state-organized national health insurance plan?

If organizing it by state is deemed more cost-effective or more fair to varying cost-of-living structures, I wouldn't mind that. I'm sure there would be some federally-mandated rules, such as the not being turned down for pre-existing conditions clause.

 

2) With a national insurance program, everyone pays in and everyone gets. How would constituents pay? Americans don't seem to like taxes much. Would they prefer to continue to pay a monthly insurance fee? What about people who can't afford the fee?

I think, at least in the beginning, this program would be available to all who could pay into it. I want it modeled as much like a for-profit health insurance company as possible, so no one could claim it wasn't as good. People who can't afford insurance might be able to afford this because I would hope the premiums would be lower due to it's not-for-profit structure. If they can't afford it, they can't afford it.

 

3) Would Americans want a tiered system, in which people could pay extra for private rooms, jumping the line, etc?

I don't see why more expensive private insurance companies can't service those customers. That's what I assume people who want private rooms and exclusive perks have now. I'm not looking to disturb that, I just want an alternative for the masses that is not profit oriented.

 

Before managed health care, insurance companies based your rates on the age at which you joined their program. Actuarial tables told them what to charge and if you joined young and stayed with the same insurer, your rates were pretty low your whole life. They had loyal customers because if you switched, you paid the rate at the age you switched. There was no mention of pre-existing conditions; the actuarial tables took that into account.

 

It was only when managed health care came about in the 70s that people stopped being loyal and started shopping around for better rates. For a while there was healthy competition, but when insurers realized they were making more money but losing customer loyalty, they came up with this idea of pre-existing conditions to scare people into staying with them. Have you ever tried to get a company you're no longer with to pay for something you had when you were with them? It's a nightmare and there's no good reason for it.

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There are a few things, imo, that should be out of the reach of pure capitalism. Minimal health insurance should NOT be for profit; one would think that this would be common sense for any moral individual (although, I do like the idea of added premiums for private rooms, internet, etc). Public education (both pre-college and college) should be out of reach of capitalism (a good tax-funded post-high school education system would increase revenue without raising taxes). And the printing of money should NEVER EVER be at the whim of private corporations like it is now (which has led to our monetary system being based on debt rather than value).

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United Health Group, is the largest US provider with over 70 Million people covered and employing about 87,000 full time workers, in all 50 States and territories. In their mix of plans, a person, family or business can provide insurance coverage from Catastrophic (commonly meaning very high deductible) to full coverage (commonly meaning lower deductibles and extended, with dental, eye care and so on) and in most States, under group policy, they can't even ask for pre-existing conditions when covering an employee and his/her family.

 

http://finance.yahoo.com/q/pr?s=UNH

 

By virtue of their policy holders and investors, they have a Market Cap of nearly 50B$, with reserve cash and assets on hand to cover most any major health care event, concerning only those involved. They as with most all larger providers or providers of any insurance, carry back up insurance, meaning they insure themselves from those potential events, Berkshire Hathaway being one major re-insurer. They do currently pay a dividend of 1.4% (.65/y) and have appreciated considerably, since starting out in 1990 as a penny stock.

 

http://finance.yahoo.com/q?s=UNH&ql=1

 

While there are hundreds of differences between how a Business/Corporation operates and a Government, IMO the major drivers are the incentive to MAKE A PROFIT and to successfully maintain and operated a service based organization and the continuity of management, driven by a concerned board of directors and CONSUMER participation.

 

Now for those of you here, thinking the Federal Government can in some manner replace the current providers (single payer system) for 310 Million Americans, here is a partial list of what your trying to eliminate....

 

 

The following health insurance companies/managed care organizations are shown with their overall Fortune 500 ranking as a US company (2008):

1. UnitedHealth Group - 25

2. WellPoint - 33

3. Aetna - 85

4. Humana - 98

5. Cigna - 141

6. Health Net - 179

7. Coventry Health Care - 266

8. Amerigroup - 555

9. Universal American - 669

10. Centene - 685[/Quote]

 

http://wiki.answers.com/Q/What_are_the_largest_health_insurance_companies_in_the_US

 

The above is meant to be informational, not confrontational and now to the threads premise;

 

I think the federal government is the perfect place to handle a risk pool like health insurance.[/Quote]

 

Phil; First the current program, called Obamacare, would have to be repealed or ruled unconstitutional by the courts, either possible and either could be after the current Government is voted out and my continuous problem with the Federal Government being involved with any State Obligation, IMO under the Constitution. THEN a plan to handle the "risk pool" can be addressed.

 

Since we have "risk pools" for many things, currently "flood insurance" is being talked about where the Federal will insure bad behavior, building on flood prone areas. Don't you think insurance companies that are already organized, have the experience, at a cost, would insure those risk factors, be it building in flood zones or pre-existing conditions, they all do anyway, today? Smokers to coal mine workers, can get private insurance.

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While there are hundreds of differences between how a Business/Corporation operates and a Government, IMO the major drivers are the incentive to MAKE A PROFIT and to successfully maintain and operated a service based organization and the continuity of management, driven by a concerned board of directors and CONSUMER participation.

 

The incentive to make a profit is really the main problem with US health care, IMO. It's fine for doctors and other skilled workers to make a profit for providing the service, but the prices in US health care are so bloated because everyone's trying to take a cut. Hospitals are not there to improve people's health -- they're there to sell the most expensive medical care they can think of, whether you need it or not. Conversely, insurance companies are trying to make sure that they make a profit, sometimes at the expense of people who desperately need health care. I mean, doesn't it strike anyone as immoral to be earning money in the stockmarket because either a) someone was denied coverage that could've improved or extended their life, or b) someone overpaid for an unnecessary operation?

 

Healthcare would be less expensive and more oriented towards doing what is right for the patient (regardless of their income) if the insurance system and the hospitals were run as not-for-profit organizations.

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The incentive to make a profit is really the main problem with US health care, IMO. It's fine for doctors and other skilled workers to make a profit for providing the service, but the prices in US health care are so bloated because everyone's trying to take a cut. Hospitals are not there to improve people's health -- they're there to sell the most expensive medical care they can think of, whether you need it or not. Conversely, insurance companies are trying to make sure that they make a profit, sometimes at the expense of people who desperately need health care. [/Quote]

 

jeskill, since off topic I'll briefly respond to your comments. The price of US Healthcare is " so bloated", for a number of reasons, including primarily practicing defensive medicine, in the event of lawsuits, those lawsuits, the cost of insuring every person in the field and it might just be the best on the planet that 310 Million people can depend on. People working in "Hospitals" or more importantly working in the medical profession, have spent time being educated and practicing to care for others and somebody signs off on every single medication or treatment used, that was then FOR the patient. I would think, a reliable medical care system, would be the MOST appreciated by people who "desperately need health care". Frankly, I'm not sure US Government workers, who earn near twice the private sector worker (pay/perks/retirement packages) could show any more compassion.

 

I mean, doesn't it strike anyone as immoral to be earning money in the stockmarket because either a) someone was denied coverage that could've improved or extended their life, or b) someone overpaid for an unnecessary operation? [/Quote]

 

I appreciate your comments and opinions, but do you really think any member in the medical field, before acting, is concerned about profits or purposely perform operations for the profit? They all have co-workers and would be soon gone...For the record and to your arguments, PATIENT'S are more likely to be the cause for your scenario, then for medications.

 

As for immoral, under Obamacare, as I understand it, a person or family will be permitted to pay a fine (fraction of actual insurance cost), but when diagnosed or having health problems, can't be denied full coverage.

 

Healthcare would be less expensive and more oriented towards doing what is right for the patient (regardless of their income) if the insurance system and the hospitals were run as not-for-profit organizations. [/Quote]

 

Well, this is on topic and I'd like to hear your model for medical service, from a "not-for-profit organization"? Maybe the Red Cross, some religious or humanitarian operation could be implemented. Many are already in existence in the US, working from donations or the many Trust Funds, set up just for this, but I don't see how it could work for so many people.

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While there are hundreds of differences between how a Business/Corporation operates and a Government, IMO the major drivers are the incentive to MAKE A PROFIT and to successfully maintain and operated a service based organization and the continuity of management, driven by a concerned board of directors and CONSUMER participation.

So where does the corporation's primary loyalty lie? With maximizing the paying of claims, i.e. fulfilling the contract, or maximizing a profit? Because you can't do both at the same time. Delaying or denying a claim, or canceling the policy (rescission) reduces payouts and increases profits at the expense of the people who expect the insurance to cover them.

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jeskill, since off topic I'll briefly respond to your comments. The price of US Healthcare is " so bloated", for a number of reasons, including primarily practicing defensive medicine, in the event of lawsuits, those lawsuits, the cost of insuring every person in the field and it might just be the best on the planet that 310 Million people can depend on. People working in "Hospitals" or more importantly working in the medical profession, have spent time being educated and practicing to care for others and somebody signs off on every single medication or treatment used, that was then FOR the patient. I would think, a reliable medical care system, would be the MOST appreciated by people who "desperately need health care". Frankly, I'm not sure US Government workers, who earn near twice the private sector worker (pay/perks/retirement packages) could show any more compassion.

 

Are you saying that American insurance companies currently have compassion for the patients? I strongly disagree with that statement. Their job is to make a profit, not to hand out money. If you are saying that hospital/clinic workers have compassion, then I agree that most of them do. That's not the point, though. A government-managed health care system can employ private-sector experts (doctors, nurses) to do the job. For example, Ontario doctors are not government employees. They are private contractors that often own their own private businesses.

 

I appreciate your comments and opinions, but do you really think any member in the medical field, before acting, is concerned about profits or purposely perform operations for the profit?

 

No. As you've already stated, unnecessary operations occur due to defensive medicine. I'm going to be honest and say that I don't know much about American tort laws regarding defensive medicine. My intuition is that defensive medicine is less of a problem in a universal health care system because the patient or insurance company is less likely to sue to obtain money they didn't spend in the first place. It would be interesting to see some more educated thoughts on that.

 

The "bloating" that occurs due to the higher administrative costs of dealing with many insurance companies would also be eliminated with a state-wide / federal insurance system, btw.

 

Well, this is on topic and I'd like to hear your model for medical service, from a "not-for-profit organization"? Maybe the Red Cross, some religious or humanitarian operation could be implemented. Many are already in existence in the US, working from donations or the many Trust Funds, set up just for this, but I don't see how it could work for so many people.

 

OK. Bear in mind I'm an ecologist, not an economist :). A not for profit is simply a business that (as I'm sure you know) doesn't issue stock shares or doesn't distribute surplus profits to owners or shareholders. Releasing the insurance company or hospital from the need to constantly increase their profit margin and focusing their goals on keeping the insurance system or hospital in the black while maintaining good service would allow for a more sustainable system that just needs to be maintained, and doesn't necessarily need to grow. The concept of hospitals, state-run insurance systems being run as not-for-profit stems from a value system that believes basic health care service should be a human right.

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So where does the corporation's primary loyalty lie? With maximizing the paying of claims, i.e. fulfilling the contract, or maximizing a profit? Because you can't do both at the same time. Delaying or denying a claim, or canceling the policy (rescission) reduces payouts and increases profits at the expense of the people who expect the insurance to cover them. [/Quote]

 

swansont; The primary loyalty is always to the consumer/customer. To many complaints, law suits, including rescission's, will dry up institutional or private investment, long before cutting dividends.

 

The real question, already answered, is that TODAY, Government already denies more service request than the private sector, but why? Politicians already know, between Medicare/Medicaid and all the other programs catering to the vulnerable (poor/aged/children), they need the Insurance base, somewhere around 150 Million, to pay those cost.

 

To reemphasize a point made earlier, there are 180 major health insurance companies in the US, each with very different policies for any individual or group employee policy, that polling indicates people are happy with and unless somehow a plan can be devised for State Control, I would prefer House District, "one size fits all" is just not going to work. Here's a list of insurers by State and their ranking in each State.

 

http://health.usnews.com/health-plans/illinois

 

Are you saying that American insurance companies currently have compassion for the patients? I strongly disagree with that statement. Their job is to make a profit, not to hand out money.[/Quote]

 

jeskill; There purpose ("job") is to collect money from as many people as they can, that want to hedge against the cost of future medical service. It's a statistical/average calculation, that has served, MILLIONS Americans (trying to emphasize ONE difference between Canada and the US*) for generations. People that grow food, in hopes someone will consume that food, ALSO hope to make a profit, would you also Nationalize Agriculture or is food less important than Health Care?

 

No. As you've already stated, unnecessary operations occur due to defensive medicine. I'm going to be honest and say that I don't know much about American tort laws regarding defensive medicine.[/Quote]

 

Except for what's interpreted in the US Constitution (IMO Nothing) or National Laws/Regulation found Constitutional, each State controls acceptable limits (if any) for actual damages (harm done) or punitive damages, usually awarded to a victim to punish the accused and it varies greatly. Our problem is ANYBODY can sue any medical person, without a monetary risk, looser pays nothing in most all States, if not all.

 

My intuition is that defensive medicine is less of a problem in a universal health care system because the patient or insurance company is less likely to sue to obtain money they didn't spend in the first place. It would be interesting to see some more educated thoughts on that. [/Quote]

 

I don't know how my thoughts are thought of, or do I really care, but it would be same problem, unless it's somehow all under the Federal or with massive HC Tort Reform, which won't happen anytime soon. It's very difficult to sue Government, but any other entity would probably have more problems, with increased traffic, alone.

 

The concept of hospitals, state-run insurance systems being run as not-for-profit stems from a value system that believes basic health care service should be a human right. [/Quote]

 

To my knowledge, nobody in the US can be denied HC service today, regardless where their from or said another way, are turned away left to die on the streets, the common analogy. I don't think US States are in any better shape to handle HC, than the Federal or capable of making Doctor/Patient decisions which can't be allowed under any National Program.

I do have some idea's, for improvement through State Governments (or Districts as in School Districts), under some kind of Insurance Cooperation, other infrastructure and Medical doctors cooperation....for another time.

 

*The population of Canada about 34 Million,

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swansont; The primary loyalty is always to the consumer/customer. To many complaints, law suits, including rescission's, will dry up institutional or private investment, long before cutting dividends.

 

Then why are there acts of delay or denial of claims and cancellation of policies?

 

Complaints and lawsuits won't dry up investment if there's still a profit to be made.

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There are a few things, imo, that should be out of the reach of pure capitalism. Minimal health insurance should NOT be for profit; one would think that this would be common sense for any moral individual (although, I do like the idea of added premiums for private rooms, internet, etc). Public education (both pre-college and college) should be out of reach of capitalism (a good tax-funded post-high school education system would increase revenue without raising taxes). And the printing of money should NEVER EVER be at the whim of private corporations like it is now (which has led to our monetary system being based on debt rather than value).

I agree with most of this, and would add the interstate highway system. Not that it's a problem now, but I think it should be on a list of things better not privatized. And I'd love to put the public utilities back in the hands of the municipalities, or perhaps the states. But we digress....

 

United Health Group, is the largest US provider with over 70 Million people covered and employing about 87,000 full time workers, in all 50 States and territories. In their mix of plans, a person, family or business can provide insurance coverage from Catastrophic (commonly meaning very high deductible) to full coverage (commonly meaning lower deductibles and extended, with dental, eye care and so on) and in most States, under group policy, they can't even ask for pre-existing conditions when covering an employee and his/her family.

But they can if the coverage isn't through an employer. And the fact that they can in ANY circumstance is unreasonable. How long will it be before they can deny cancer coverage because you've used antiperspirants containing aluminum?

 

By virtue of their policy holders and investors, they have a Market Cap of nearly 50B$, with reserve cash and assets on hand to cover most any major health care event, concerning only those involved. They as with most all larger providers or providers of any insurance, carry back up insurance, meaning they insure themselves from those potential events, Berkshire Hathaway being one major re-insurer. They do currently pay a dividend of 1.4% (.65/y) and have appreciated considerably, since starting out in 1990 as a penny stock.

OK. Meaning I, as an individual, have to play roulette with my health, trying to decide what kind of ill-health bet I should cover at any given time. An insurance program that isn't run for profit wouldn't care if you already had a problem. It's insurance for your health, something that is relatively difficult to predict on an individual basis, but is fairly reliable statistically when applied to a society of hundreds of millions.

 

Phil; First the current program, called Obamacare, would have to be repealed or ruled unconstitutional by the courts, either possible and either could be after the current Government is voted out and my continuous problem with the Federal Government being involved with any State Obligation, IMO under the Constitution. THEN a plan to handle the "risk pool" can be addressed.

It's only called Obamacare by those who don't like it or the president. It's an attempt to link the two as bad ideas. And yes, the current health care reform isn't what I'm asking for here, so yes, it would need to be repealed.

 

Since we have "risk pools" for many things, currently "flood insurance" is being talked about where the Federal will insure bad behavior, building on flood prone areas. Don't you think insurance companies that are already organized, have the experience, at a cost, would insure those risk factors, be it building in flood zones or pre-existing conditions, they all do anyway, today? Smokers to coal mine workers, can get private insurance.

I'm not going to follow the red herring swimming into the flood zone. I will simply repeat that I would prefer my risk-pool clear and clean of for-profit motives. There is nothing about the for-profit motive that makes a risk-pool safer, better or more efficient. The opposite is true, in fact, when health care is what the pool is for

 

Frankly, I'm not sure US Government workers, who earn near twice the private sector worker (pay/perks/retirement packages) could show any more compassion.

Government and union workers set the bar for what the rest of us make. Without their competitive compensation, we would all be making less. But that's off-topic.

 

So where does the corporation's primary loyalty lie? With maximizing the paying of claims, i.e. fulfilling the contract, or maximizing a profit? Because you can't do both at the same time. Delaying or denying a claim, or canceling the policy (rescission) reduces payouts and increases profits at the expense of the people who expect the insurance to cover them.

And when that expectation is unfulfilled, all insurance gets a bad name. This is a big reason why some people avoid it, or don't consider it essential.

 

swansont; The primary loyalty is always to the consumer/customer. To many complaints, law suits, including rescission's, will dry up institutional or private investment, long before cutting dividends.

The CEOs don't think so. They pilot the corporation, and their primary loyalty is to the board of directors who represent the stockholders.

 

The real question, already answered, is that TODAY, Government already denies more service request than the private sector, but why? Politicians already know, between Medicare/Medicaid and all the other programs catering to the vulnerable (poor/aged/children), they need the Insurance base, somewhere around 150 Million, to pay those cost.

Medicare gets scammed much more than private insurers. Double billings, fraudulent claims, non-existent or deceased patients. And when you add in all the patients who were dropped from coverage (2.7M in 2008, and those don't get counted as "denied claims"), then YOUR claim is denied. Medicare does NOT deny more service requests, and it never drops coverage to legitimate patients.

 

To reemphasize a point made earlier, there are 180 major health insurance companies in the US, each with very different policies for any individual or group employee policy, that polling indicates people are happy with and unless somehow a plan can be devised for State Control, I would prefer House District, "one size fits all" is just not going to work.

You're moving the goalposts. I asked for a not-for-profit alternative run by the federal government. People who want "different sizes" are free to choose them. I'm only suggesting a not-for-profit competitor.

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Frankly, I'm not sure US Government workers, who earn near twice the private sector worker (pay/perks/retirement packages) could show any more compassion.

You should really compare this to insurance company employees. I don't think there are a lot of people flipping burgers etc. for eight bucks an hour in either insurance or the government. In fact, I had a colleague (PhD in mathematics) who left the government to go work for an insurance company some years back, because he couldn't raise a family on what he was making. Actuarial research/modeling paid him about a third more than what he was making doing R&D for the government.

 

The oft-repeated mantra that government workers are overpaid is based on cooked books and cherry-picked statistics. I hope that I make more than someone who doesn't have my credentials, regardless of whether I work for the government, and I'm pretty sure the handful of people who do work similar to mine in industry make more than I do. Comparing my pay & benefits to some "average worker" is just plain dishonest.

 

People that grow food, in hopes someone will consume that food, ALSO hope to make a profit, would you also Nationalize Agriculture or is food less important than Health Care?

 

Government subsidies do not count, I suppose?

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People that grow food, in hopes someone will consume that food, ALSO hope to make a profit, would you also Nationalize Agriculture or is food less important than Health Care?

Food is a consumable product. It's perfect as a for-profit commodity. No one is going to cancel your food while you're still willing to pay for it. No more red herrings, please.

 

And the goalpost is health insurance, not "Health Care".

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I'm not sure that the two can be separated. Reduced to basics health insurance is paying a small amount each year so that when you need to you can make a large claim and pay the medical bills. Health care or any "Universal" government system is exactly the same but on a larger scale. Instead of "premiums" you pay a "tax", but the basics are the same.

 

As a simple example I've just had the rest of my thyroid out. This meant a 3 day stay at a top hospital and two operations. (It would have only been one but I suffered breathing problems the first night and they decided to go back in and check that everything was okay. It was.)

 

As a private patient with private insurance I would have had choice of surgeons and a private room rather than a ward. At the end of the stay I would have been presented the bill and given it to my insurance company for payment because that is what I pay my premiums for.

 

However I went in under our "Universal" system as a public patient. I got a top line surgeon. (Like us non medical plebs could actually work out before the fact who is or is not a good surgeon anyway.) I finished up in my own room. On the way out I had to pay for my medications Thyroxcine and aspirin, a total cost of some $44. Aside from that there is no cost because I've been paying the premiums in my taxes.

 

I really cannot understand the antipathy of many people to "taxes". Call it a premium or call it a tax it is the same thing, a price you pay for a service. Pay $500 per year to an insurance company or $500 per year in tax you get exactly the same product, your bills paid when you go to hospital.

 

For example;

I'm talking about a health insurance program you could either get independently or through your employer, so it costs no more to people and employers than is currently being paid. No increased taxes.

 

I don't get this. Pay your current insurer, pay some new insurer or pay neither but pay more tax. The result is exactly the same from the POV of cost to the consumer. Quibbling about semantics around a health issue is counterproductive.

 

The whole point of health insurance is to pay a small amount on a regular basis so that you recieve "free" (as in no extra cost to you) health care when you need it. Why should it matter a tinkers damn whether you pay it as a "premium" to an insurer or as a "tax" to the government? The difference is ideologically and not factually based.

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I'm not sure that the two can be separated. Reduced to basics health insurance is paying a small amount each year so that when you need to you can make a large claim and pay the medical bills. Health care or any "Universal" government system is exactly the same but on a larger scale. Instead of "premiums" you pay a "tax", but the basics are the same.

 

As a simple example I've just had the rest of my thyroid out. This meant a 3 day stay at a top hospital and two operations. (It would have only been one but I suffered breathing problems the first night and they decided to go back in and check that everything was okay. It was.)

 

As a private patient with private insurance I would have had choice of surgeons and a private room rather than a ward. At the end of the stay I would have been presented the bill and given it to my insurance company for payment because that is what I pay my premiums for.

 

However I went in under our "Universal" system as a public patient. I got a top line surgeon. (Like us non medical plebs could actually work out before the fact who is or is not a good surgeon anyway.) I finished up in my own room. On the way out I had to pay for my medications Thyroxcine and aspirin, a total cost of some $44. Aside from that there is no cost because I've been paying the premiums in my taxes.

 

I really cannot understand the antipathy of many people to "taxes". Call it a premium or call it a tax it is the same thing, a price you pay for a service. Pay $500 per year to an insurance company or $500 per year in tax you get exactly the same product, your bills paid when you go to hospital.

 

For example;

 

 

I don't get this. Pay your current insurer, pay some new insurer or pay neither but pay more tax. The result is exactly the same from the POV of cost to the consumer. Quibbling about semantics around a health issue is counterproductive.

 

The whole point of health insurance is to pay a small amount on a regular basis so that you recieve "free" (as in no extra cost to you) health care when you need it. Why should it matter a tinkers damn whether you pay it as a "premium" to an insurer or as a "tax" to the government? The difference is ideologically and not factually based.

My point is that a government health insurance program should be less expensive than a private carrier because they don't have to make x% profit to satisfy investors. The result is NOT exactly the same.

 

We currently have a system in place that deducts your private carrier premiums from your paychecks. Americans accept this so I proposed we use this system instead of calling it a new "health tax". Currently, the Republicans are screaming about taxes so it would make it difficult to add new ones.

 

The other reason I proposed it this way was so the national insurance was an option to compete against higher priced private insurance. If it's a tax, everyone has to pay and we might as well abolish private health insurance. I didn't think that would sit well, and would definitely be used as a (rather convincing) slippery slope argument against government interference in commerce. This way, if it put private carriers out of business, it would be due to competition rather than government fiat.

 

Bottom line is, well, the bottom line. A government sponsored risk pool for health insurance should simply cost less because they don't need the kinds of profit a private carrier does. I feel health insurance is unique in this aspect. I'm not proposing all insurance be handled this way, just health insurance, because we really can't put a price tag on the health of a nation.

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If it's a tax, everyone has to pay and we might as well abolish private health insurance.

 

Here is the problem I think. We have the tax and private health insurance companies. People view it as an "all or nothing" proposition when it isn't.

 

The tax is used to cover everybody for the basics. You get surgery and stay in a ward. You are treated by the roster doctor or surgeon, that sort of thing and you stay in the "Public" or government hospitals. Private cover gets you a private room in a private hospital (or a private room in a public hospital) and the doctor or surgeon of your choice. And please don't make the mistake of thinking that public or government hospitals are worse than private ones. All doctors and nurses meet the same standards of training as do the hospitals themselves. Doctors and surgeons divide their time (I don't the details of how) between the private and public hospitals so it's not like the idiots work the public system.

 

As has been pointed out before in threads on health, the US federal government is already spending 3 times as much per capita than other nations for healthcare. The problem is not lack of money, the problem is the system itself and until people get past this knee jerk reaction to governments and taxes and actually look at the system and the issues involved then you will continue to spend far too much money for a p*ss poor system.

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Here is the problem I think. We have the tax and private health insurance companies. People view it as an "all or nothing" proposition when it isn't.

Ah, I see. This is the socialized medicine approach that privatized US medicine lobbies have been spinning as Communistic Satan-worshipping pedophilia terrorism that will give us ebola and force us to speak French.

 

As has been pointed out before in threads on health, the US federal government is already spending 3 times as much per capita than other nations for healthcare. The problem is not lack of money, the problem is the system itself and until people get past this knee jerk reaction to governments and taxes and actually look at the system and the issues involved then you will continue to spend far too much money for a p*ss poor system.

I'm fairly certain that the other 200% is going into the pockets of the insurance providers and the pharmaceutical corps. A repeal of the law that prohibits Medicare from negotiating prescription drug prices will help the latter, and I thought having the government compete as a risk pool for insurance would help the former.

 

We seem to have too many politicians listening to too many corporate interests. To be fair, the people aren't as on top of things as they should be, so the pols pay attention to the corporations who have the money and influence to keep them in office. Career politicians would listen to the people if the people talked louder than the corporations, but we just don't band together the way we should. And when we do band together, it's in two nice, neat little piles that are easy to manipulate.

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Ah, I see. This is the socialized medicine approach that privatized US medicine lobbies have been spinning as Communistic Satan-worshipping pedophilia terrorism that will give us ebola and force us to speak French.

 

Oui. :D

 

I have to agree with the rest. The existence of a law that says the largest purchaser of pharmaceuticals in the nation cannot negotiate bulk discounts is ludicrous. TBH I would put it as so far from the "National Interest" as to be almost treasonous.

 

While Americans are admirably individualistic there is the downside that if a lobby can get something associated with the word "socialist" then there will be a large percentage of the population immediately against whatever it is, regardless of truth. In this respect you are easily fooled and mislead.

 

I've argued here before and will say it again. Partisanship is killing you. Any statement by either a Republican or Democrat will immediately polarise at least 60% of the people, 30% accepting the statement as ineffable truth and 30% believing it an outright lie. Party loyalty is one thing, outright political blindness is quite another. A good example of this is how the climate debate divided politically in America. When "An Inconvenient Truth" came out a section of the population accepted it immediately as "truth", not because of facts or arguments or science, but because Al Gore said so. "Al Gore is a Democrat and is therefore honest and pure and wouldn't lie to people so it must be true". Another section of the populace immediately went the other way for no better reason than "Al Gore is a Democrat and they are all lying b*stards who could stand in the shade of a corkscrew, so it must be false". Both of these groups are wrong and show how partisanship makes decent sized segments of the American population easily controllable.

 

Concerning lobbyists. I think a major difference is that in the US it appears that lobbyists drive government policies, whereas down here they seek to modify them. Down here the partys publish their policies and the lobbyists then try to get modifications to get the best deal for their industry, but in the US there is a dearth of actual policies coming from the parties.

 

Compare these Health policy pages;

 

Republicans: http://www.gop.com/index.php/issues/issues/ You might have to flip through to find their one paragraph "policy" statement.

Democrats: http://www.democrats.org/issues/health_care Much better, aside from the complaints about the GOP, but is mainly about what they've done or tried to do and very little about what they intend to do or how it will work.

 

Now the three major players in Australia;

Labor; http://www.alp.org.au/agenda/health-reform/ Sets out intentions, targets and spending as well as links to more detailed policies in specialised areas.

Liberal/National: http://www.liberal.org.au/Issues/Health.aspx A general page with links to detailed .pdfs giving targets, intentions and funding.

Greens: http://greens.org.au/policies/care-for-people/health A detailed page listing all the targets and intentions. (There is no mention of how to fund things as the greens have all the economic abilities of a house brick. They may not know how to pay for it, but at least you know what they want.)

 

From my POV neither party in the US actually has a policy on anything. It's all wishy washy, airy fairy, if then maybe, pie in sky dreaming rubbish. There are no targets, no statements of intent, no way at all to hold the political party to its word, no way at all to decide whether a party is or is not achieving its policy goals. Is it any wonder that the lobbyists are providing policy? It sure isn't coming from the parties.

 

And the American people are letting both parties get away with it.

Edited by JohnB

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While Americans are admirably individualistic there is the downside that if a lobby can get something associated with the word "socialist" then there will be a large percentage of the population immediately against whatever it is, regardless of truth. In this respect you are easily fooled and mislead.

We have a lot of pre-spun words like that. "Conservative" and "liberal" are the most ludicrous to me. You might think you know what they mean but I guarantee you they have 312M different definitions over here.

 

 

I've argued here before and will say it again. Partisanship is killing you. Any statement by either a Republican or Democrat will immediately polarise at least 60% of the people, 30% accepting the statement as ineffable truth and 30% believing it an outright lie. Party loyalty is one thing, outright political blindness is quite another. A good example of this is how the climate debate divided politically in America. When "An Inconvenient Truth" came out a section of the population accepted it immediately as "truth", not because of facts or arguments or science, but because Al Gore said so. "Al Gore is a Democrat and is therefore honest and pure and wouldn't lie to people so it must be true". Another section of the populace immediately went the other way for no better reason than "Al Gore is a Democrat and they are all lying b*stards who could stand in the shade of a corkscrew, so it must be false". Both of these groups are wrong and show how partisanship makes decent sized segments of the American population easily controllable.

 

Concerning lobbyists. I think a major difference is that in the US it appears that lobbyists drive government policies, whereas down here they seek to modify them. Down here the partys publish their policies and the lobbyists then try to get modifications to get the best deal for their industry, but in the US there is a dearth of actual policies coming from the parties.

 

Compare these Health policy pages;

 

Republicans: http://www.gop.com/index.php/issues/issues/ You might have to flip through to find their one paragraph "policy" statement.

Democrats: http://www.democrats.org/issues/health_care Much better, aside from the complaints about the GOP, but is mainly about what they've done or tried to do and very little about what they intend to do or how it will work.

 

Now the three major players in Australia;

Labor; http://www.alp.org.au/agenda/health-reform/ Sets out intentions, targets and spending as well as links to more detailed policies in specialised areas.

Liberal/National: http://www.liberal.org.au/Issues/Health.aspx A general page with links to detailed .pdfs giving targets, intentions and funding.

Greens: http://greens.org.au/policies/care-for-people/health A detailed page listing all the targets and intentions. (There is no mention of how to fund things as the greens have all the economic abilities of a house brick. They may not know how to pay for it, but at least you know what they want.)

 

From my POV neither party in the US actually has a policy on anything. It's all wishy washy, airy fairy, if then maybe, pie in sky dreaming rubbish. There are no targets, no statements of intent, no way at all to hold the political party to its word, no way at all to decide whether a party is or is not achieving its policy goals. Is it any wonder that the lobbyists are providing policy? It sure isn't coming from the parties.

 

And the American people are letting both parties get away with it.

You're absolutely right, JohnB. Most Democrats have no idea what their representatives are really voting for, and they're often not voting the way their platform would dictate. Republicans seem to be divided into at least four groups, only one of which really sticks to their platform. The result is a nation divided in two, with a whole lot more common ground than their partisan ideologies will let them admit.

 

We're addicted to convenience, and those who know us best can spin up sound bytes that convince us it would be too hard to fight it. It's our fault for forgetting that the people have the power to make them stop.

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