A Modest Proposal

#28
#28
615 Vol said:
2-5 is already available so unless it is mandated that people must have an HSA account than I don't see how anything is going to change there. Seeing you want less government than I couldn't see you supporting any mandate on HSA accounts.
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so options are already available, people choose not to use them but we need to make more options that they may/may not use that will cost billions of dollars?
 
#29
#29
volfanjustin said:
We would get paid a more.
We would own the policy, why do we rely on our employeer to provide our coverage?
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Because, at least in my case, I am happy with my coverage and because I contribute to a large pool, my premiums are low. I have several plans I can choose from based on my needs, and I pay a premium that is much lower than if I were to go out and get it on my own.

This system could work on a national level, and private insurance companies could make a lot of money doing it.
 
#30
#30
KB5252 said:
I think it would help people have more control over their policies, they can choose which company and policy they want for their needs.
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Why can't they do that anyway? I do. I work for a large company and I have several plans to choose from.
 
#31
#31
utvolpj said:
so options are already available, people choose not to use them but we need to make more options that they may/may not use that will cost billions of dollars?
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I'm not supporting the current plan by any means so the answer I would give you is no. I was asking what plan B would be and this was his answer. My point was that these options are already available and like you said people chose not to take them. My point in return is that although the plan on the table sucks there is nothing new out there that could improve the situation seeing that people don't already take advantage of some of these options.
 
#32
#32
rjd970 said:
Why can't they do that anyway? I do. I work for a large company and I have several plans to choose from.
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Most companies provide their employees with one or two insurance companies to choose from. Sure they offer a variety of policies but if every insurance company were competing equally for the business of all those seeking insurance it would surely open up competition and rates would decrease.

People would be able to choose their insurance based on which company suited their needs at the best rate, as it stands now they are limited to the carriers their employer does business with.
 
#33
#33
KB5252 said:
Most companies provide their employees with one or two insurance companies to choose from. Sure they offer a variety of policies but if every insurance company were competing equally for the business of all those seeking insurance it would surely open up competition and rates would decrease.

People would be able to choose their insurance based on which company suited their needs at the best rate, as it stands now they are limited to the carriers their employer does business with.
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I highly doubt that rates would reduce enough through competition to be even competitive to what I enjoy now through economies of scale....much less be equal to or better.

It is silly to think that free market competition would reduce rates that much.
 
#34
#34
volfanjustin said:
WE, don't. They insure themselves.
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Not under this bill.

The point goes back to where the money comes from, to insure the jobless (for whatever reason, they are that way). LG made the point that whatever is done, it needs to lower cost (which anybody would agree on). But as I see it, they would have to raise taxes to do this. So in one hand, you "may" get cheaper insurance, but with the other hand, you will pay in to make that happen.
 
#35
#35
rjd970 said:
I highly doubt that rates would reduce enough through competition to be even competitive to what I enjoy now through economies of scale....much less be equal to or better.

It is silly to think that free market competition would reduce rates that much.
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I didn't say this would be the cure all, I think it should be one small part of an overall plan to help with our health insurance problems.

True it may not help you in your situation because I would imagine that your employer pays a very significant amount of your plan for you. Many people have no problem going to the doctor for a runny nose because they know they will pay little out of pocket. Make people pay for their visits and they will likely avoid going to the doctor every time they cough.

It just seems to me that the problem with the cost of health care isn't due to one particular facet, it is a very complex problem with many different causes that will require the American people to change the way they think and act as far as health care goes. People need to see and feel the true cost of health care, having them responsible for their policies directly is just a small part of the plan.
 
#36
#36
rjd970 said:
I highly doubt that rates would reduce enough through competition to be even competitive to what I enjoy now through economies of scale....much less be equal to or better.

It is silly to think that free market competition would reduce rates that much.
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not really. In my industry there are purchasing groups that get together and buy at the same price my company does even though they are a fraction of our size.
 
#37
#37
KB5252 said:
I didn't say this would be the cure all, I think it should be one small part of an overall plan to help with our health insurance problems.

True it may not help you in your situation because I would imagine that your employer pays a very significant amount of your plan for you. Many people have no problem going to the doctor for a runny nose because they know they will pay little out of pocket. Make people pay for their visits and they will likely avoid going to the doctor every time they cough.

It just seems to me that the problem with the cost of health care isn't due to one particular facet, it is a very complex problem with many different causes that will require the American people to change the way they think and act as far as health care goes. People need to see and feel the true cost of health care, having them responsible for their policies directly is just a small part of the plan.
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And that gets to the heart of it. Doing this for everybody reduces cost across the board and allows companies to pay less for the same coverage. That is my whole point, if it works on a smaller scale it could work on a national scale. This is why I don't totally disagree with the national pool of private insurers people can choose from, with limited government oversight. As long as their isn't a single payer it could work.

And FWIW, even with great coverage, people don't go to the doctor for every runny nose. It is still a hassle to go, wait times are long, and most times the doctor can't do anything for you except tell you to "drink fluids and rest".

Personally, I go to the doctor MAYBE once a year, if that. The only time I have really used my insurance was a couple of years ago to get a surgery I needed and when we had our child last year.
 
#38
#38
rjd970 said:
I highly doubt that rates would reduce enough through competition to be even competitive to what I enjoy now through economies of scale....much less be equal to or better.

It is silly to think that free market competition would reduce rates that much.
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Of course not, only the government can.
 
#39
#39
utvolpj said:
not really. In my industry there are purchasing groups that get together and buy at the same price my company does even though they are a fraction of our size.
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Right, but they are grouping together, and still utilizing private insurers. If these purchasing groups disbanded and everybody went out and got single private plans from different companies they would be paying higher rates, even though it would be more "competitive".
 
#40
#40
rjd970 said:
And that gets to the heart of it. Doing this for everybody reduces cost across the board and allows companies to pay less for the same coverage. That is my whole point, if it works on a smaller scale it could work on a national scale. This is why I don't totally disagree with the national pool of private insurers people can choose from, with limited government oversight. As long as their isn't a single payer it could work.

And FWIW, even with great coverage, people don't go to the doctor for every runny nose. It is still a hassle to go, wait times are long, and most times the doctor can't do anything for you except tell you to "drink fluids and rest".

Personally, I go to the doctor MAYBE once a year, if that. The only time I have really used my insurance was a couple of years ago to get a surgery I needed and when we had our child last year.
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This happens way more often than you want to believe.

You appear to be a responsible consumer of healthcare. I wish more were.
 
#42
#42
rjd970 said:
Right, but they are grouping together, and still utilizing private insurers. If these purchasing groups disbanded and everybody went out and got single private plans from different companies they would be paying higher rates, even though it would be more "competitive".
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but what prevents people from doing this? An insurance company approached by a group of people wanting to buy from them is much more likely to give a break. Similar to how insurance companies give discounts if you insure multiple things with them
 
#44
#44
utvolpj said:
but what prevents people from doing this? An insurance company approached by a group of people wanting to buy from them is much more likely to give a break. Similar to how insurance companies give discounts if you insure multiple things with them
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Access. It works well in companies, especially large ones, because these plans are readily accessible. Is there an insurance plan offered by anybody that says "go get you and 50 of your friends" and we will offer you guys this rate, otherwise you get a higher personal rate".

Nationalizing an pool of private insurers where a government agency has limited oversight increases this access and creates better economies of scale. People can choose different plans from different providers. The free market is still working, albeit, in a created economic bubble. Not only does this reduce cost, but opens insurers to a bigger market.
 
#46
#46
rjd970 said:
Access. It works well in companies, especially large ones, because these plans are readily accessible. Is there an insurance plan offered by anybody that says "go get you and 50 of your friends" and we will offer you guys this rate, otherwise you get a higher personal rate".
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I believe the point is that it's not available yet. Allowing a more free market for insurance is one of the big points.

like volinbham said

reduce state mandated coverage to minimums and allow cross-state competition.
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#47
#47
Vbham is correct. Calling what most of us have "health insurance" is an absolute farce. We have healthcare payment plans.

My very first fix would be eliminating most outpatient drug coverage (or setting a high deductible). If people had to pay cash for meds drug companies would have to drop their charges. In the case of very costly outpatient drugs for chronic conditions or cancer treatment build a rider into the plan if necessary.

I'm convinced that the elephants and the donkeys have one goal now. Keep people borrowing and spending on consumer goods and services. I think this is why CEOs and Walmart are so anxious to jump on the bandwagon. After all, if people actually have to spend money on their health, they are less likely to buy anything from a Vizio to a Milky Way. Just my opinion.

For all the talk about ignorance and lifestyle, people are much more likely to take care of themselves when it hits them in the pocket book. The worst by product of a government plan will be ineffective wellness initiatives...unless we turn into a police state.
 
#48
#48
Lexvol said:
Vbham is correct. Calling what most of us have "health insurance" is an absolute farce. We have healthcare payment plans.

My very first fix would be eliminating most outpatient drug coverage (or setting a high deductible). If people had to pay cash for meds drug companies would have to drop their charges. In the case of very costly outpatient drugs for chronic conditions or cancer treatment build a rider into the plan if necessary.

I'm convinced that the elephants and the donkeys have one goal now. Keep people borrowing and spending on consumer goods and services. I think this is why CEOs and Walmart are so anxious to jump on the bandwagon. After all, if people actually have to spend money on their health, they are less likely to buy anything from a Vizio to a Milky Way. Just my opinion.

For all the talk about ignorance and lifestyle, people are much more likely to take care of themselves when it hits them in the pocket book. The worst by product of a government plan will be ineffective wellness initiatives...unless we turn into a police state.
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Reducing the scope of drugs that are covered will not go over well with the pharmaceuticals, and also stymie development of future drugs.

Its the old adage about why a single pill out of a prescription costs $20. Its not that it costs that to make that particular one, its that the first one they made of that drug cost them $1 billion.

If the system is not going to cover the cost, say, of a new arthritis drug, the R&D firms and the pharmaceuticals behind them have no incentive to develop new and potentially very beneficial things.

In the end, there are only three ways that seem to have direct promise of reducing costs: 1) regulate profits; 2) increase competition by injecting (no pun intended) a true competitior in the mix, likely in the form of the government option; or 3) dramatically scaling back what is covered.

#2 has been killed off. #3, you cannot imagine the political fallout of that.

In fact, don't know if anyone else has noticed that a lot of what you guys are talking about -- reducing mandated coverages, reducing coverage of medicines --- sounds a lot like systemic rationing to me.

What you are proposing is one big death panel.
 
#49
#49
there's a major reason why every single major drug in our lifetime has come from the united states and that is because we are the only country that PAYS for such innovation. amgen has cancer drugs that cost $20k a dose. it took them billions of dollars of reasearch. that drug doesnt' get created under say the canadian model.
 
#50
#50
lawgator1 said:
If the system is not going to cover the cost, say, of a new arthritis drug, the R&D firms and the pharmaceuticals behind them have no incentive to develop new and potentially very beneficial things.
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Sure they do. It's called competition in a free enterprise system... one of the biggest reasons the U.S. continues to advance in many areas.
 
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