Posted on 08/14/2009 8:26:25 AM PDT by St. Louis Conservative
We are now hearing this defense of ObamaCare: "why are you worried about government rationing? The insurance companies ration your care already!"
What is a good, effective rebuttal to that?
Amen “Constitutions Grandchild” for health czar !!
It isn’t rationing. I can not afford to eat steak every night. That doesn’t mean that steak is being rationed it means that I chose not to spend my money on steak. I pick the health insurance coverage that I want. I pay more than some because I want a particular type of coverage. I pay less than others. Just like my car insurance. I chose a particular deductible for collision that costs me more. That IS NOT rationing.
Second currently I can chose to make arrangements to pay out of pocket for care that I want that the insurance doesn’t cover. Based on the experience of those in Canada and Great Britain, good luck with that under Ocare
#12 is the correct answer.
Also, I have an HSA now. The required policy that comes with that has a high deductible and certain policy terms as to what is covered. Because of the HSA, I can put enough money in the HSA to cover most medical procedures the policy doesn’t cover, and pay for those procedures from the HSA funds.
There is an annual limit on how much I can put into an HSA, but if I need a procedure that costs more than the annual amount of my HSA contributions, I can use HSA contributions from more than one year to pay for medical expenses. That might not be enough for the most costly procedures, but can help a lot.
Under HR3200, I will not be allowed to have an HSA. Forbidden by law. Period.
They don’t. They have to provide the coverage described in the insurance contract. Also, if an insurance company refuses to pay for a covered treatment, you can sue them.
An insurance company might fight you on an item. But you, your doctor and your employer will pressure them. You will not be able to sue or effectively pressure the government.
Also, because an insurance company can’t control the health care facilities that are available, it can’t cause rationing based on supply. Once the government gets control, you won’t have as many MRI’s, specialists, etc. so rationing will occur due to inadequate supply. The government will authorize you for an MRI but oops, it takes 6 months to get one.
My wife is a cancer survivor. Chemo, surgery, deca scans, more chemo, x-rays, radiation, MRI’s, needle biopsies, steroids, multiple specialists, surgeons, prosthetics - the list is endless -
There NEVER has been a case of rationing of anything or anybody and she has seen specialists and had tests quickly for years. The only delay ever was the insurance company balking briefly on an MRI for a diagnostic test after x-rays and ultrasound and physical exams were already negative. The insurance company ultimately paid for teh MRI when the doctor pressed for it.
Final point (for now), without sufficient free market profit in teh system, treatments simply will not exist. My wife was saved by a cutting edge treatment which has turned her cancer from one of the worst to one of the better outcomes. That treatment is NOT allowed in Britain because it is “too expensive” so the women there die. Other such treatments will never be developed once pharma companies realize the government here will never authorize payment. But somehow the “evil” insurance companies do pay for it. Someday the treatment will come down in price as a generic. Under government control, it would never see the light of day.
Don’t believe the BS, private insurance may be imperfect but by definition it does not have the ability to “ration” a covered service. It must cover it.
HSA is my response. Personally, if individuals all had high deductable plans, they would “ration” their own care how they see fit. Healthcare isn’t free. I don’t think the insurance companies through corporate plans are the best either.
Apparently, in the late 80s when the HMOs were booming, there were horror stories, and I believe that that perception is still with a lot of people and used as an excuse.
Another answer is that the Insurance companies “subsidize” government plans right now. Medicare (etc) reimburse less than the cost of most hospital procedures, therefore, hospitals make that loss up through the insured. If insurance companies go away, who is going to pay this subsidy??? Taxes go up and the number of procedures goes down. If that is not a perverse system, I don’t know what is
Insurance companies don’t really ration. They have staff (usually RN’s) that approve or not - certain requests by doctors and hospitals. My sister works for Aenta and is a case manager RN. Hospital admits patient - she is sent case - reviews what is happening with the patient. Here’s an example: if the hospital requests an overnight stay for a sprained ankle when all that is really needed is an xray - crutches and an ace bandage - she would probably not approve the overnight stay unless the patient presented the need for constant attention for some negative reaction due to the injury like extremely elevated heart rate/BP. She’s told me herself, most of the requests are reasonable and she approves the majority of them. If they are blatently abusing the insurance company - those type of charges would not be approved.
The last thing we need are Obamacare Case Managers employed by the government telling us what they will approve.
Jake Tapper claimed this morning on Twitter that they ration it by denying coverage. That is simply not true. They provide coverage based on the contract they have with the insured. If you buy the coverage, they will pay. The notion that they are denying contractually covered claims is not a material problem in this country.
They could ration it by the benefits they will cover but in a competitive market someone else would and does step in to fill the need.
They could ration based on the size of their negotiated networks. For example, if they have a very high insured to doctor ratio, then there will access problems. However, again, the free market takes care of that. There is a constant balancing by the invisible hand. A case in point is the managed care backlash of the mid-90's.
The government, on the other hand, has the power of law to ration care with no check or balance that exists in the free market. Further, and more troubling, is the fact that the number of health care providers will decrease in a government system. We already see this in the number of doctors who accept Medicare. That means severe access issues and results in the 6 month waiting times for an MRI you hear about in Canada.
Now it gets really scary. A large proportion of the health care dollar is spent in the last 6 months of life. That is why you are hearing so much about "end of life" issues in the regs. In order to reduce costs, they have to deal with those costs. In socialized medicine countries like Canada and the UK, they simply deny care based on age. That is just fact. That is how the manage the cost.
So how does the current system manage that cost? It doesn't. We pay for it because we have decided as a society that we WANT to pay for it. That is the bottom line.
To the extent the current system has problems, let's identify and tackle each one. Keep in mind, though, that there are a whole bunch of people working in the current system who are trying to solve these problems every day with the goal of providing better service at a better price. The idea that a bunch of big fat cats are lying around get rich off the system may help get legislation through but it is not reality.
Care is rationed by reality,you cannot spend infinite amounts. The question is whether you want the government doing the rationing by dictat. You can always change your insurance company if you dont like their rationing criteria. Not so in a socialized system.
Bingo. You get the Gold Star for the day.
Utter nonsense.
That's like saying that supermarkets ration food because they charge for it. Would you say that's how they parasitically live off our hunger?
Every company rations something. McDonald’s doesn’t do Lobster. Mercedes doesn’t build economy cars. Boeing doesn’t make corporate jets. Harvard rations it’s incoming seats.
There is two types of rations. Bureaucratic/government ordered, and private companies with price rationing.
If government is so good, why don’t they build their own pharmaceutical plats, run by unions, controlled by politicians?
Why don’t they?
Because they would be three times expensive, late and with lower quality. Same with bandages, needles, etc.
But, some how, the same people that couldn’t run a band aid factory, are competent o run all of health care.
Yeah, right.
In addition to the previous responses, you can still opt to get what you need. Under the government program, you won’t have the option to get care at all if some bureaucrat decides you’re not worthy.
You are exactly right. Many insurance carriers have relented when they are sued for denying what they called experimental treatments.
Has anyone read the bill to see what recourse there will be, if any, for denial of treatment under the government’s plan?
Not as difficult as it used to be. It is generally universal that if you can show continued coverage, any pre-existing conditions are covered.
If my Insuance company denies a claim for a procedure, I can go out and pay for that procedure myself and get it.
Under Obamacare there will be no option to go outside the system for a procedure. Denied a procedure and you are SOL.
1. You, or your employer, are free to choose a plan that fits your needs better.
2. Because of that freedom, the insurance companies have to be sensitive to the demands of the purchaser.
3. The insurance companies remain obligated to provide the level of care asserted in the contract, regardless of whatever fiscal pressures may evolve; the government changes its coverage policies by changing statutes.
4. The 11th amendment protects the government from being sued over the deleterious consequences of its decisions.
5. The 11th amendment doesn’t protect “downstream” agents, but: A private healthcare provider which is sued must either lose income, or raise rates or cuts benefits and thus become less competitive; the government simply raises taxes or cuts services.
6. If people are outraged enough by the practices of insurance companies, they can turn to smaller, more responsive governments to force improvements; they cannot do so with nationalized health care.
7. To a private insurer, many patients are income sources, many are “loss leaders.” To the government, all citizens are loss leaders.
insurance companies don’t ration. they provide(maybe not without a fight) what you contacted for. You can also pay more or less for greater or lesser coverage. You thus have an option. Thats free market.
Now some employers pay all or some of the cost of insurance,depending on their ability but essentially,its part of a pay package. What you and your fellow employees produce,how productive you are will determine how much the company pays and how good your coverage will be. Now lets play pretend. Say your company covers 1000 workers and their families where all the workers are contributing to the companies well being. Now lets pretend that the company is mandated by the govt to cover 1000 more people and their families that just happen to live within a 5 mile radius of your workplace.
You’re working as hard as you can as are your fellow employees. Your company is already paying plenty for insurance. So whats going to happen? Yep,your company will opt for coverage at half the price. For half the price you’ll get half the services.
What you see here is insurance companies are not rationing health care. Costs ration healthcare. When the govt picks up people not paying taxes into the healthcare system,their total cost will go up,your healthcare will go down.
Nothing in the health care plan is done to increase supply. In fact, the government will lower the reimbursement for many procedures and treatments causing supply to decrease. The choice becomes to ration the resource through waiting months or years for treatment or to have bureaucrats decide who is eligible to receive the treatment.
Insurance companies limit the demand through higher premiums for the preferred provider plans, HMO approval processes for treatments, and copay requirements. If they offer a plan that covers everything with no limits or copay then the premiums are set very high to compensate for the risk. The government option tries to spread risk but does little or nothing to limit demand except through rationing.
“Prove it!”
” Boeing doesn’t make corporate jets.”
They actually do: The Boeing Business Jet. (BBJ)
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