Posted on 10/06/2009 11:22:10 AM PDT by ianschwartz
Karl Rove breaks down the price of health reform.
(Excerpt) Read more at realclearpolitics.com ...
I saw the 44% reduction in chemo radiation figure he was hawking.
If the elderly are suckered by Obama, they’re certainly going to pay big time for that mistake.
We are about to see one of the biggest heists in American history outside of the bank bailout. They will force everyone to buy insurance giving the insurance companies even more business and money than they make now. No savings for anyone just more profits for those involved. People had better wake up. Insurance isn’t the answer its the problem.
That may in fact be the outcome. I agree with your secondary premise too.
It’s simple.
Too many health care dollars are going to administrative organizations that will NEVER provide any medical service whatsoever.
Would anyone be stupid enough to buy food insurance, that would siphon off 15 to 30% of their food purchasing dollars? Would we want that for gasoline or anything else we buy?
That’s exactly what is happening when it comes to health care insurance.
Actual health care providers only get what is left over after the insurance companies take their cut.
The hundreds of billions of profits the insurance companies make each year, do not go to provide health care.
So, are you suggesting we should replace the Insurance Companies with a Government Agency?
As far as I know all Insurance companies are for profit, they have a VIG, just like any other business.
The only way to cut the insurance companies out is either to go straight out fee for service, just like any other product, you want it, you shop around and get it for the best price. (I recall my family doctor when I was a child accepted baked goods, vegetables, and one time a chicken as payment from those who could not pay) Or we are forced into a government agency one-size-better-fit-all insurance scheme where many die for lack of care or wait an eternity for treatment. This is what they want as it is a cure for Social Security and Medicare. More people die, less are around to collect, but they have spent their lives paying in and get nothing in return. This is the preferred way to go as it gives one party complete and total control over every single aspect of your life.
My fix for health care could involve hospital networks, and people making connections to them to purchase their health care directly through basic monthly payments.
I would like to see individual physicians and physician networks also available.
The network plan means that if you are in a city other than your home, you can still access an affiliated hospital or physician if you need to.
All health care dollars would then wind up in the hands of the provider, not a middle man before the provider ever got a dime.
I would also like to see personal savings accounts promoted so that people could basically self-insure. In the first ten years of their earning, they could build up an account with $10 thousand dollars or more. All services up to that fee could be paid out of your personal account. Thus the fees to network providers would be lower.
This account could also be used to self-insure for other things, such as auto insurance or even homeowners insurance. By creating your own pool of money instead of paying it out to insurance companies, you could reduce your insurance outlay drastically, and keep control of that money in your own account.
If you never used it, it would grow to help out with retirement or even be there to be disbursed are your direction upon your death.
Variances on these plans would get government out of health care.
I’m not a fan of Medicare because it means the government has it’s sticky fingers in the process. That is always a bad idea.
This is intended as a framework. I know it would need tweaking.
I believe there are ways to connect people to health care provider networks without them having to make massive outlays at one given point in time.
See my post above this. I think you’ll see what the foundation of my plan entails. As I stated there, I do think it would need tweaking, but I think it does provide a reasonable option.
There is still a role for health insurance - what was its original intended purpose.
It is not a conduit for all your health bills. It insures against financial catastrophe. Like all insurance it is a gamble - you gamble premiums against eventual claims.
While your food bills are predictable, a major medical catastrophe such as a car accident is not. It could bankrupt you. So, insuring against this can be a wise financial move - assuming of course you purchase the right product.
Your point is valid, but it is a result of the underlying problem: we have come to view health insurance as paying for all our medical needs. We should pay for most of them ourselves - and use the insurance for what it was intended.
I think there’s room for discussion on this. I’m not denying your premise entirely. I do want most of the health care dollars to actually get to the providers.
There’s something very unseemly about hundreds of billions in profits being realized by the insurance industry, when providers are barely scraping by.
There’s a tendency for people to see hospitals in the same light as oil companies and attorney’s. Hospitals have been pushed to the breaking point. They just can’t take any more of this, and the government’s big plan is to have the providers take less in payments. That has been the emphasis for the last twenty-five years.
Obama acts as if he just came up with the idea.
Thanks for your response.
I’m not sure if it was entirely clear to you what I was suggesting.
Instead of insurance companies siphoning HC dollars off the top, people would essentially insure directly with the providers. That way the funds would stay in the hands of providers.
I believe that would contribute to a more healthy health care industry.
I still don’t understand. Your hospital, doctor, etc. would become insurers also?
If so, you’ve only changed administrators and costs from one place to another.
Insurance companies sometimes incur losses and sometimes profits. It’s an actuarial enterprise and tries to predict and level risk bases. Doesn’t always work.
Insurance company profits are in line with similar services. They provide a service for a fee. Left to a free market, these would find their proper cost and value.
The biggest problem is the lack of free markets. Regulation on carriers is incredible. And the product has become a distortion, as I posted earlier. The price tag for medical costs is hidden and supply and demand all wacky.
My position is there is a proper role for medical insurance, just as there is for home-owners insurance for example.
In effect when you make your monthly payment to the hospital, it goes toward the bottom line.
When you pay it to the insurance company, it goes to their bottom line.
Insurance profit margin vs hospital operating income
The hospital would hardly need to add any infrastructure to facilitate this. The health care insurance industry would cease to exist. You don’t see the value in that?
That’s okay. We see it different, but I’m not perfect. Who knows...
But what should your monthly payment be? And what is it for?
To work for the hospital it would need to know your age, where you live, previous history and so on and so on.. In other words it would have to perform actuarial and risk analysis. If it does this properly, then you, and others in the risk pool aren't over-charged and the hospital is not operating at a loss. The hospital makes, from your monthly payments, enough to cover its expenses plus - get this - a profit.
Hospitals get to make profit also right? It's performing two services here: medical and actuarial risk management. This requires professionals, just like doctors are professionals, and the hospital should make a profit on both.
I don't think you are against profit. I think you are missing the fact that there is a real service with a real risk - someone has to do this to a high level of competence and deserves the same reward as any other service provider.
Insurance carriers should get paid for their risk - that's what they do - some years they lose money, some years they don't. They need to be used properly for an true insurance system to work. I think what you are missing here is the value of insurance, in all its forms. It is paid a fee to spread risk properly; it's a real profession with a real value.
The health care insurance industry would cease to exist.
No, it's just moved in-house to a different profit center, likely the same professionals would work there instead of at Aetna.
You don’t see the value in that?
I don't see the benefit in losing a service I'd like to purchase: Insurance against financial catastrophe due to unforeseen medical costs. I'm willing to pay for that.
The problem, IMHO, is we have transformed medical insurance which was designed to insure against financial ruin into a monthly payment that pays for all our medical needs. Your system does not change that.
And one major problem with this view of medical insurance is the price tag gets lost. You pay your premium and then your medical is "free." You don't price shop, there's no price competition.
My alternative would be bigger and better HSAs, tax free accounts that build up and roll over to pay for the great majority of medical during your life: broken arms, check ups, flu, birth, etc. etc. Plus high deductible, catastrophic insurance - no regulation on what has to be covered, you pick it; competing across state lines; tax deductible for personal buyers as well as employers.
The money you save on premiums goes into your HSA - it's a "premium" that doesn't get wasted if you don't use it.
Plus allowing small employers, neighborhoods, whatever, to combine risk pools to bring down premiums further.
Sorry for the length.. and I do appreciate the discussion and chance to rant my opinionated rant. best regards..
There are many not for profit hospitals in this nation. I don’t know what the breakdown is by percentage, but I would wager it’s huge. All government hospitals are not for profit. All religious hospitals are not for profit. There are other varieties as well, all plowing their profits back into the business.
What this means is that equipment, infrastructure, and R&D benefit. Some of these institutions are also teaching institutions.
I think you’ve got the idea that some fat cat physicians are going to get rich instead of insurance executives. That’s not the case. These institutions already have accounts receivable people. They’re not going to go out and hire lots more workers. I wouldn’t be surprised to see some hired on, but not that many.
As for actuarials, you’d be surprised the detail hospitals accumulate in order to keep on top of things. They know what risks they face, believe me. They’re the ones struggling to keep the doors open.
The insurance companies have been pegging a number they will pay for certain services, and hospitals have been barely scraping by, while the insurance companies claim profits.
Nah, I’m sorry, I understand where you are coming from, but I’m not sympathetic to the insurance industry in this sector. In others yes.
You and I agree on the catastrophic nature aspect of reasoned insurance. We agree that people should only have coverage that protects them against fiscal ruination. That can be achieved paying directly to health care providers too.
I appreciate the give and take too.
Well the Senate sure could use the idea, looks pretty good to me. Of course I remember when Docs still accepted chickens :)
Mmmm mmmmm Mmmmm
Chickens!
LOL
Rush has his own version of Mmmm mmmmm Mmmmm, I subscribe to his web cast. :)
So do I, and his tweaking of the left with that Rush Hudson Limbaugh sound track is an absolute riot.
We’re not going to have Rush forever. I started archiving his program about four months ago. I’ve got the ditto-cam and the sound files.
One day I’ll be listening to them when he’s no longer on the air. It will be a sad time when I do.
Over the years, I’ve listened to Rush only on occasion. His mind is very active, and he generally gets it better than any other personality.
He’s a great guy.
No. I hope they all get rich as long as it is honestly and in a fair, free competitive market.
I'm not going to join any bandwagon against profit or the evil insurance industry.
And if hospitals want to go into the insurance business, fine. In fact, they can do so now and offer the very programs you outline. I'm convinced they would not address the core problem, but there's nothing illegal about it. Removing the "profit" would do little to decrease the fundamental cost problems. But hospitals can go for it, it's not illegal.
What I'm proposing, however, is illegal now. Remove these barriers and I would be able to choose a competitive catastrophic plan, tax-free, with a tax-free HSA to pay for my non-catastrophic bills.
Others could waste their premiums on policies that cover every doctor visit, broken bone or hangnail if they wish and insurers could offer smart and dumb policies in a free market.
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