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A friend said yesterday that she would rather pay the high health care premiums than try to figure out the issue as it was just so mind boggling complex. I know many here are in agreement with that feeling, even if they would rather keep the money. I'll try to keep the numbers simple, understandable, and interesting.

The question always arises as the number one question.  If we are to have universal health care, preferably single payer, how can we pay for it? Aren't we already having trouble paying for the entitlements we already give? The answer on how we pay is very simple.  We are already paying for it.  We just aren't getting it.

One of the things that private health insurance does is they work very hard to get sick people out of their system.  They don't even want people who are at risk of being sick. They are mostly successful at this.  The people they insure tend to be the young adult population who are fit enough to work full time.

The old get Medicare, paid for by taxes. Those in the riskiest line of work, war, get the Veteran's Administration, paid for by taxes. The poor get Medicaid, paid for by taxes.  Then we have those who are employed by the Federal Government, the States, the County, the towns. Their health insurance too, is paid for by taxes, although the tax money mostly goes towards the profits of the private health insurance companies. So tax money directly pays for medical care of the highest risk categories. We pay high profit to the insurance companies for the prime, low health risks of public employees.  Put all the people together whose health care is paid by tax dollars already and we've got about 60% of the population covered.

That means that private employers are paying for only four out of ten people who are insured in this nation.  Despite this, they are paying vastly increasing premiums, increasing far beyond the rate of inflation and they are paying these large sums mostly on the lowest risk population. Insurance companies are basing their premiums on the loss of  their investments in the stock market, not on the cost of providing health care. If the government collected the premiums on this population instead of the private health insurance companies, the first thing that would happen is that the costs would go down by 30% due to the excessive amount of money spent by the insurance companies on people hired to deny payments to those they insure. The second thing that would happen is we'd be adding premium money to government funds from the people most likely to pay more into the system than they take out.

As our system exists now, the private companies get to keep the profitable clients and the rest are picked up either by the government directly or indirectly, due to failure of the uninsured to be able to pay. The insurance companies, in their never ending greed, aren't willing to concede that they've had a system rigged to make them rich all these years, count their winnings and leave the table.  No, they want the system to continue forever, and are unconcerned with the fact that people are dying needlessly due to their greed. They will fight tooth and nail to keep their cherry picked clients and keep the profits for themselves rather than using this extra money to pay for additional coverage, benefits, or reduced premiums.

They seem to have made progress even with Obama, who has given the great insurance company giveaway when the government decided to pay 67% of COBRA fees rather than take the unemployed and put them on Medicare. Considering that, again, you are speaking of the healthiest, lowest risk population, the cost to the government of putting these people on Medicare might have mostly been nothing.  However, no matter how healthy they stay, the insurance companies are getting hundreds per month per person out of the COBRA subsidy.  And it is the taxpayer covering the bill.

Faced with increasing health care costs, some policies are becoming too expensive to use, with deductibles in the $10,000 range.  This means that the business is paying more, the employee is paying more, and yet they don't actually get health care.  Particularly preventative health care.  Doctors and hospitals are reporting that even insured people are coming in later in an illness and sicker. Costs of treating such patients can be exponentially more than if they had sought medical care earlier.

Another thing insurance companies do, and are allowed to do, is to tier their premium price to risk factors such as age or previous illness -- so that the premium for someone who is 60 is three times higher than the twenty something who works in the same office.  Guess what?  This motivates companies to fire or lay off their veteran employees to save money.  Age discrimination, anyone? And heaven help anyone who wants a job who has ever suffered a disability much less someone who is presently disabled.  They, too, will face discrimination in hiring despite the fact that such discrimination is against the law. This discrimination is supported and upheld by the private health insurance company premium rates. With universal health care, companies wouldn't feel forced to discriminate in their hiring or to fire loyal, long term employees. Business shouldn't have to chose between losing their ability to price their product competitively and having the best employees they can find due to our inability to realize that the private, unregulated health care experiment has proven a failure.

With the rise in employee contribution and deductibles, many who are employed and eligible for benefits no longer can afford health insurance.  Yet, they are still paying for health insurance for 60% of the population out of their payroll taxes. They get to pay for health insurance in which they are unable to participate.

We can pay for universal health care so easily with the money already being spent on health care, that we could cover everyone and even pay less than we do now.  Premiums, and even those on Medicare pay premiums, could be pegged to income so that families could pay far less than the average 25% of their income that they are paying now to get covered.  Doctors could put their resources into delivering medical care instead of personnel to deal with the endless reams of paperwork and fight for coverage for their patients from the insurance companies, which would bring down medical costs without reducing medical service.  The uninsured and the underinsured could get the treatment they need and preventative care, like physical examinations could catch illnesses while it is less expensive to treat. Your doctor could make the medical decisions about your treatment instead of some clerk in an insurance office.

The other cost of our present system where so many are denied treatment either by insurance companies, doctors, or themselves in an effort to save money is that a portion of the population walks around among us with infectious disease.  Disease doesn't limit itself to those without insurance. Even the wealthy and celebrities in this nation are threatened by the antibiotic resistant bacteria and other nasty illnesses that an untreated population can spread.

Every day, a few thousand among us declare bankruptcy due to medical bills. These bankruptcies aren't just disaster for those declaring it.  They mean that those who sold them merchandise won't get paid for it.  That the home on your block becomes foreclosed due to medical bills and drives down the value of your home. That their pets end in shelters or on the street due to the fact that few rentals will take pets. Yet, few among us would choose our homes or pets over the life of someone we love. But in order to keep the profits, our private health insurers would rather say no to those who are ill.  They even call payments for medical care "medical loss"  So few businesses call the delivery of a product they sold a "loss" but that is the attitude of the private insurers.

If the attitude of the insurers reminds you of the attitude of the bankers with their incentive bonuses, you and I are in agreement.  I say, the hell with them.  Let's have universal, single payer health insurance now.  After all, we've paid enough for it.  Call your representatives and let them know that you are a health care voter.  Better yet, take out a pen and scrawl an old fashioned snail mail to them.  It doesn't have to be long.  Representatives think handwritten messages represent far more voters than the phone call or e mail. The private health insurers have raised lots of money to make lots of noise fighting universal, public health care.  We have to make even more noise if we want to get good, affordable health care.

Originally posted to SusanL143 on Fri Apr 10, 2009 at 07:44 AM PDT.

Poll

Is universal health care

0%2 votes
0%4 votes
3%15 votes
73%367 votes
3%15 votes
0%1 votes
13%66 votes
0%3 votes
3%16 votes
1%7 votes

| 496 votes | Vote | Results

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Comment Preferences

  •  Insurance IS socialism, more or less. (13+ / 0-)

    Why not put it in the hands of people that AREN'T trying to make as much money off of us as possible while not caring at all whether we get the health care we need?  I mean, could gov't-run insurance be more expensive or work even worse than what we have now?  I don't think so.

    Leave it all on the road. Make the Republican Party small enough to drown in a bathtub.

    by janmtairy on Fri Apr 10, 2009 at 07:58:15 AM PDT

    •  Oh, Yes It Can! (1+ / 0-)
      Recommended by:
      SusanL143

      Please, give me one example of a Government running anything efficiently.

      "And so, my fellow Americans: Ask not what your country can do for you - ask what you can do for your country." -JFK

      by RyanBTC on Fri Apr 10, 2009 at 08:49:48 AM PDT

      [ Parent ]

      •  Canadian health care (8+ / 0-)

        It's more efficient than our system, and our system is getting worse by the day.

        By the way, the Postal Service was privatized in 1971.  Happy with it since?

        •  I don't know... (1+ / 0-)
          Recommended by:
          SusanL143

          1.) An awful lot of Canadians come to the U.S. for healthcare, and there aren't any Americans going the other way.

          2.) If the Postal Service is private (which it isn't) where can I buy shares of it's stock?

          "And so, my fellow Americans: Ask not what your country can do for you - ask what you can do for your country." -JFK

          by RyanBTC on Fri Apr 10, 2009 at 09:24:07 AM PDT

          [ Parent ]

          •  You can't buy shares in private companies. (6+ / 0-)

            You can only buy shares in PUBLIC companies.

            "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

            by Brooke In Seattle on Fri Apr 10, 2009 at 09:35:48 AM PDT

            [ Parent ]

          •  Then why do Canadians buy healthcare insurance (3+ / 0-)
            Recommended by:
            gogol, caul, SusanL143

            if they're visiting the United States?

            If tax cuts create jobs, then why aren't the Bush tax cuts that are still in effect creating jobs?

            by gooderservice on Fri Apr 10, 2009 at 08:35:11 PM PDT

            [ Parent ]

            •  Canadian system (3+ / 0-)
              Recommended by:
              radarlady, neroden, SusanL143
              Simple, our system will only pay the amount that a procedure would cost in Canada, which for a variety of reasons, is quite a bit lower then it is in the US.

              I was shocked when I found out American hospitals often have whole buildings dedicated to accounting, handling insurance claims and billing.  A Canadian hospitals accounting department on the other hand could be contained in a medium sized one room office.  

              They for the most part get paid by one entity (the local provincial government), a good chunk of their budget is allocated well in advance to cover the basic costs of maintenance and utilities, and they don't have to build a lot of room for defaults on debt into their fee structure.  Insurance costs tend to be lower as well, since Canadian judges are a bit more wary of awarding huge amounts in damages in lawsuits, though that hasn't prevented Obstetrics insurance from going through the roof (this isn't a purely Canadian problem.. it's the nature of the field).

              And finally the actual doctors fees are set according to a government schedule (which varies from province to province).  This is why the Canadian Medical Association routinely tries to push for an American style market driven system.  And why in the past quite a few Canadian trained doctors moved to the US (a trend that has actually reversed in the last decade or so).  For what it's worth, while a doctor in Canada isn't going to earn quite as much as they could in the US, if they are Canadian, and got their education in a Canadian university they didn't pay nearly as much for their training, and don't leave Uni nearly as deeply in debt.

              As a side note, even our most conservative politicians are leery of doing more then tinkering with the current system.  Any party that tried to get rid of it would get tossed out on their heads ASAP.

              As for choice of doctors.. here your choice is only limited by how far you feel like travelling and whether the doctor you want is currently accepting patients.  Lots of doctors are simply too busy to see anybody new.

          •  where's your proof of that myth? (2+ / 0-)
            Recommended by:
            gooderservice, SusanL143

            don't everybody gang up on the troll all at once...

          •  Canadians that I worked with in Ohio (4+ / 0-)
            Recommended by:
            neroden, gooderservice, Thassa, SusanL143

            would took the child and headed for Canada in the eventuality of any serious illness.
            In South Carolina, employees of Michelin often send  sick family members back to France for any serious problems, and both sets of people have excellent employer paid health insurance.

          •  the US postal system (0+ / 0-)

            IS privately run. And private operation of anything does not guaranetee better quality service.
            This diary is one of the best ever. Anyone who takes issue with universal health care should read it. It really lays it out.

      •  Medicare (10+ / 0-)

        is a stellar example.  One of its few problems is that the private sector providers are always trying to steal extra payments through fraud of one form or another.

        •  I've been on Medicare for a few years now, (9+ / 0-)

          and I'm very happy with my insurance plan this year. I pay no premium above the standard $87/month whatever payment to Medicare deducted from my disability check. I have no deductible, no caps. My prescription coverage is (finally) very good, and the plan covers dental & chiropractic. The company issuing my plan takes care of all the paperwork.

          So it's not like the insurance companies disappear; they still offer plans and administrate them, and, presumably, make a profit from someone like me, who has pretty high upkeep. Their whining, and that which they stir up among the masses of OMGSocialism, is simply to make people believe that they have a higher bargaining point to start at when the change actually comes.

          It's not just a zip code, it's an attitude.

          by sboucher on Fri Apr 10, 2009 at 08:42:29 PM PDT

          [ Parent ]

      •  Social Security, Ryan... (13+ / 0-)

        Every month social security checks make it safely to recipients. Contrary to popular belief the SS fund is also still solvent and - barring more raiding by greedy Neocons - should remain solvent for many years to come.

        I defy the tyranny of precedent. I cannot afford the luxury of a closed mind. I go for anything new that might improve the past. ~ Clara Barton

        by AuroraDawn on Fri Apr 10, 2009 at 08:30:16 PM PDT

        [ Parent ]

      •  There is inefficiency in every big organization (6+ / 0-)

        be it a government or a public or private company.  That's life.  It is what it is.

        If tax cuts create jobs, then why aren't the Bush tax cuts that are still in effect creating jobs?

        by gooderservice on Fri Apr 10, 2009 at 08:36:21 PM PDT

        [ Parent ]

        •  Inefficiency in normal times means there is some (2+ / 0-)
          Recommended by:
          JeffW, SusanL143

          slack available to cope with emergencies.  If an organization has to evacuate their building for two hours because of (for example) a gas leak, unless they were a little inefficient before they will not have the extra capacity to catch up afterward.

          Renewable energy brings national security.

          by Calamity Jean on Sat Apr 11, 2009 at 02:15:25 AM PDT

          [ Parent ]

      •  The Swedish health care system ... (8+ / 0-)

        would be another example. It consistently ranks among the best in the world. Everyone in Sweden, even visiting tourists, are allowed access to medical care equal to that of native born Swedes. And the care provided is top notch. My cousin was injured there once, he was treated immediately, and very well. No lines that lasted for months. The French health care system is also very well-run. It is considered by some (and not just those in France) to be THE best health care system in the world.

        I defy the tyranny of precedent. I cannot afford the luxury of a closed mind. I go for anything new that might improve the past. ~ Clara Barton

        by AuroraDawn on Fri Apr 10, 2009 at 08:36:22 PM PDT

        [ Parent ]

      •  Medicare (6+ / 0-)

        Medicare is amazing, pure and simple. We were paying over $9K for crappy $2K deductible private insurance that an increasing number of doctors wouldn't accept, even though it is a big name. Now, we're paying ~$1K per year for Medicare that all of his doctors accept, that pays them promptly within 21 days with streamlined paperwork. The doctors love it.

        And, at less than 4% overhead, it's the best thing this country ever did. Now we jsut need to make it available for everyone. I'd join in a hot minute.

        And since when do corporations tell we the people we can't use the power of our numbers? We can be the most amazing co-op.

        "The survival value of intelligence is that it allows us to extinct a bad idea, before the idea extincts us." -- Karl Popper

        by eyeswideopen on Fri Apr 10, 2009 at 10:18:49 PM PDT

        [ Parent ]

      •  Even the perennial whipping boy, the post office (5+ / 0-)
        Recommended by:
        Bluehawk, joy221, craiger, Mike08, SusanL143

        delivers my letter for 42 cents, anywhere in America, in two days.

        Can't get that from FedEx or UPS.

        Your turn:

        Give me an example of any large company running anything efficiently. My personal contention, from years of observation, is that any organization larger than 50 people is inherently inefficient.

        Fry, don't be a hero! It's not covered by our health plan!

        by elfling on Fri Apr 10, 2009 at 10:24:37 PM PDT

        [ Parent ]

      •  Medicare, e.g. (3+ / 0-)
        Recommended by:
        craiger, Mike08, SusanL143

        3% overhead vs. 16% for private insurers (apples to apples).  Touche!

      •  Check out the effeciency of the VA health care (1+ / 0-)
        Recommended by:
        SusanL143

        system.
        According to the Dartmoth Health Policy Study quoted in the book Overtreated, they have better outcomes at a lower cost with an older sicker population.

      •  Medicare and Medicaid (1+ / 0-)
        Recommended by:
        SusanL143

        work great for me and for millions of others.

    •  It doesn't (15+ / 0-)

      My Mom gets Medicare, and when that runs out, my stepfather's policies pick her up. Medicare pays for stuff, no questions asked, under clearly defined rules. My step-father's health insurance? No way. The regulations change constantly, so one month, my Mom's medications will cost $60, the next, $600. It was the same when I was in the federal civil service. I had Blue Cross Blue Shield through the Federal Employees plan, and my benefits, co-pays, etc. were straightforward and unquestioned. My husband was on Blue Cross through his company, and they gave him endless fits.

      Taking the money employers and employees pay for health insurance, combining it with the Medicare, Medicaid, and VA funds, then creating an insurance pool based on the entire US population will be cheaper and provide better coverage than the piecemeal system we have right now. The only difference is, a few ex-insurance executives will be a tiny bit poorer.

      Boo-bloody-hoo.

      Radarlady

    •  Sorry, didn't mean to jump your tip jar. (4+ / 0-)

      I waited awhile but not quite long enough!

      Leave it all on the road. Make the Republican Party small enough to drown in a bathtub.

      by janmtairy on Fri Apr 10, 2009 at 08:10:01 AM PDT

      [ Parent ]

    •  Really awesome diary, Susan. (3+ / 0-)
      Recommended by:
      joy221, Mike08, SusanL143

      Thanks for putting all that together, and in a very readable way. Insurance IS boring, but when I read some people's comments, about Medicare, I want to get on single-payer this instant. Being self-employed, I pay over $6000/year in premiums (for 1 person) and still only have 60-80% coverage for most items, plus co-pay and deductible. And I do put off treatment, especially dental for which I have an additional insurance that pays practically only for cleaning & check-ups, not for actual dental work! Totally sucks.

    •  Not yet mentioned in your diary: (3+ / 0-)
      Recommended by:
      joy221, Mike08, SusanL143

      taxpayers subsidize private insurance for self-employed people, since some of it is tax-deductable. That also amounts to the government paying money directly to the insurance companies that they could put towards single-payer.

      •  Indeed (0+ / 0-)

        The federal government would come out ahead by allowing my daughter to enroll in SCHIP rather than leaving her on my private, tax deductible plan.

        Fry, don't be a hero! It's not covered by our health plan!

        by elfling on Sat Apr 11, 2009 at 11:10:21 AM PDT

        [ Parent ]

  •  Brilliant Exposition; I'd Known That PER CAPITA (12+ / 0-)

    we were already paying for it, overall.

    But I'd never thought to break it down as you do, pointing out that at least two of the highest risk groups (military and the aged) are covered, and at least a fraction of the high-risk poor also covered.

    Way back in the 1970's the axiom I heard was that 80% of your lifetime health costs would be spent on the disease that finally kills you, generally during the final 6 months of life.

    I don't know what the stats are today, but they can't be wildly different, and that huge-cost population is as you say largely on medicare already.

    And yes, I lost my technology career under Clinton not Bush, for attempting to exceed 50 in the work place. And this was state government employment.

    So if I benefit from no medical advances and merely follow my family's last-century lifespan, I will end up living over half my life unemployable.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Fri Apr 10, 2009 at 08:08:32 AM PDT

    •  I have been unemployed for a much shorter time (4+ / 0-)
      Recommended by:
      radarlady, joy221, maxzj05, SusanL143

      but why don't we start a company to employee older tech workers?
      Starting a company is usually a crap shoot, but and one needs a sound revenue model, and sound accounting, but we should have the experience and skills to do the research  and find a viable business to keep all of us whitecaps productively workings if we really got together and put our minds to it.  

      •  I really like that idea! (1+ / 0-)
        Recommended by:
        SusanL143

        Of course, all our profits would be eaten up by health care premiums, but it would be a blast anyhow.

        •  Not necessarily (2+ / 0-)
          Recommended by:
          maxzj05, SusanL143

          What if the company only employed workers aged 65+ already covered by Medicare Part A.  The company could then pay about $96 per month to reimburse their employees for Medicare Part B.  The company would have the essential equivalent of what all Canadian companies have -- almost free single payer health insurance.

          •  Graebeards, Inc. (0+ / 0-)

            I already have a company, Graebeards, Inc.

            I formed it when I retired from Silicon Valley over ten years ago.  I figured if I wanted to do any consulting it would provide a corporate structure for any contracting work.  Nothing ever came of it, other than it still exists.

            It will probably remain dormant.  But I am intrigued by the thought of a technology consulting company consisting of only people over the age of 65.  Hundreds of years of experience.  I have 50 years myself, having started as a Computer Programmer in January of 1959.

            Two areas that I am interested in are Green Technology (Van Jones was very impressive) and Universal Health Care, with Green being top priority.

            "If nominated, I will not run; if elected, I will not serve; if impeached, I will not leave" -Anon

            by Graebeard on Sat Apr 11, 2009 at 08:31:17 AM PDT

            [ Parent ]

  •  Well, here's the issue (IMHO) (7+ / 0-)

    It seems to me that the biggest obstacle in any kind of reform of the health care system are those employed people who have fairly decent health care coverage through a private employer.  I think that studies show that this group is pretty satisfied with their health care coverage.  Just from talking to a lot of these people, they are convinced that they, personally are going to pay more (or at least the same) and that they are going to get less -- in terms of government "rationing" of care, of waits for elective procedure, etc.  Yes, we already have "rationing" of care in the sense that those without insurance don't get care, but that defect actually helps those who have good employer-provided coverage, because today's "rationing" is in their favor.  

    I haven't seen any serious calcuations from a non-partisan, non-biased (on either side) source demonstrating that costs for these people are going to go down, in terms of costs to their employers, etc., or that their level of care is going to get better.  I'd love to see one if you have it.  

    Yes, we can talk about what "we" are spending overall, as a society, on health care costs.  But that is not as meaningful to these people -- those with the good, employer provided plans -- as what it is going to do to them, personally.  And right now, those I talk to are worried that they, personally, will be negatively affected in the name of providing coverage to those who don't have it.  

    •  Cost control (6+ / 0-)

      The irony of our system is that all the countries that already socialized their systems have lower costs, but that's because they did it before the corruption set in.  Once medical care becomes a corporate property, you see what we've seen from the military-industrial complex: profitable diagnoses (exaggerated threats), the proliferation of specialists to raise fees and reduce competition (we have how many Special Forces now?), conflicts of interest (who finances the think-tanks that tell us what weapons we need?), and a cult of expertise that intimidates common-sense objectors into silence.

      There's no fixing the military or American health care because the key personnel were promoted based on their loyalty to its corrupt premises.  The doctors believe what they say, the insurance adjusters believe they're the good guys, and the employers (like GM) have somehow come to believe that they're better off with the system that's bankrupting them than with a system based on taxing them as rich individuals.

      •  To many, cost control (2+ / 0-)
        Recommended by:
        maxzj05, SusanL143

        means that somebody other than the patient is going to decide that some medical services aren't necessary or can wait.  

        I understand that there may be some administrative savings.  But, I also understand that one big complaint people have right now is that coverage is often denied for many things.  If "we" stop denying "coverage" (depending on how you define the term) in any kind of significant way, then the demand for services will clearly go up, and that increases some costs.  I've seen no good, reliable, hard numbers predicting what that balance is going to be, along with the assumptions (for example, is there any limit to elective services? any limit on so-called "heroic" measures at the end of life? what assumptions are being made to get the "cost control"?)

        If you want to win over people who have decent health coverage now, just using terms like "cost control" doesn't cut it, without explaining example where costs will be cut, and whehter that will be enought to offset increased demand/use of medical services. If you want to point to countries that have socialized medicine already, then some will point to examples where there are longer waits than people with decent coverage experience here, and examples where services that are optional, but are covered by a good health insurance policy here, are denied to people in those countries.  

        Yes, you can make the argument that, in countries with socialized medecine, more people are "covered" at a lower overall expense to the country as a whole.  That is often meaningless to an individual that has decent employer provided coverage now and wants to know, before they lend support, how exactly this is going to affect "me."  

        •  those who are employed (6+ / 0-)

          are very naive about their own coverage-specifically about how fast they will be out of a job if they get a catastrophic illness with any kind of complications.

          I'd love to know how to get thru their blanket of denial.

        •  Many people with private insurance (2+ / 0-)
          Recommended by:
          Mike08, SusanL143

          are already experiencing the whole cost control thing, as soon as they are hurt or sick.

          What makes it worse is that there are literally thousands of different rules to live by. You, nor your doctor, cannot really know what the insurance company will do. Just having a standardized set of rules will itself cut a lot of costs and a lot of frustration. If you know something won't be covered, you can work out another strategy from the beginning instead of submitting bills - or fake bills - and waiting 4 months to see what code comes back.

          Fry, don't be a hero! It's not covered by our health plan!

          by elfling on Fri Apr 10, 2009 at 10:33:40 PM PDT

          [ Parent ]

    •  coffeetalk, it seems we are approaching (2+ / 0-)
      Recommended by:
      Mike08, SusanL143

      a point where those comfortably ensconced in an employer provided plan is seriously shrinking.  Their satisfaction with the status quo will not carry as a significant weight in the discussion as the shameful neglect of the majority.

    •  I meet fewer and fewer of those people now (3+ / 0-)
      Recommended by:
      neroden, Mike08, SusanL143

      and when I do, I ask them what will happen to them if they lose their job, or if they have an auto accident and cannot work for a year.

      And people are also recognizing auxiliary risk: that is, maybe I'm insured, but what if my 25 year old child can't buy insurance? What if my college-aged child wants to take a semester break from school and has a preexisting condition? What if my 40 something child loses a job, and loses insurance for the grandkids? Sandra Day O'Connor has an uninsurable grandchild. If it can happen to her, it can happen to anyone.

      Fry, don't be a hero! It's not covered by our health plan!

      by elfling on Fri Apr 10, 2009 at 10:29:42 PM PDT

      [ Parent ]

    •  Even with so called "Good Insurance" (5+ / 0-)
      Recommended by:
      Matilda, neroden, maxzj05, Mike08, SusanL143

      a $530.00 per month payment and
      deductables and co-pays and uncovered meds amounted to about $8500.00 last year, and that was just for a case of sinusitis.

      No, people with insurance are NOT happy. We knew that in the event of serious illness the 1st round would be will be with the insurance company.

      •  That is crappy insurance (1+ / 0-)
        Recommended by:
        SusanL143

        My out of pocket is limited to $1500...

        I love my doctor, dentist and my kid's eye doctor.

        I pay $11 for meds.

        So, perhaps I am the only one on this board, but I am pretty happy with my insurance.

        My dream would be for everyone in the US to be as happy with their medical care as I am with mine...

        The goal is great coverage for all. I think we get there by opening up medicare.

        •  As a low income person with a disability (1+ / 0-)
          Recommended by:
          SusanL143

          my coverage with Medicare and Medicaid is pretty much FREE!  Prescriptions cost me $1.00!  But I believe that for people with higher incomes Medicare is $87.00 per month and prescription copays are still very low.  The government is not out to make a profit so of course everything cost less.  Service is still by the same doctors that people with private insurance pay much more to see.  It's a fantastic system for the consumer.

    •  I have to disagree with you there. (1+ / 0-)
      Recommended by:
      SusanL143

      My husband works for a company that provides full coverage health insurance, dental and optical.

      At first, they offered 2 plans. One was an HMO, the other was traditional medical where you chose your doctor and hospital.

      The HMO had no deductible, but they kept raising the deductible on the traditional insurance. Most people with families couldn't afford it anymore and were forced to switch to the HMO. My family lost the doctor we loved and who had delivered my 2 youngest sons.

      Once most of the employees went to the HMO, the HMO began to require a deductible.

      Gradually, even the HMO became more and more expensive, and because the company was trying to cut costs wherever it could, they began to switch us around to different HMOs. All the while, our deductible and prescription drug copay climbed higher and higher. Our deductible for an emergency room visit went from 10 dollars 10 years ago to 150 dollars today.

      Finally, because of the costs, my husband's company went to Cigna and is basically insuring us itself.

      This is very expensive for the company and I worry all the time about when the cost of health care will finally break them and they move out of the US.

    •  Those who think they'll get less (1+ / 0-)
      Recommended by:
      SusanL143

      with a government system are falling for the insurance industry hype.  Having Medicare and Medicaid, I've received a number of treatments and medications and I've never been denied or had to wait for anything.  It's a great system that in my case, provides great care.

  •  We aren't paying for it... (2+ / 0-)
    Recommended by:
    radarlady, SusanL143

    If we are to have universal health care, preferably single payer, how can we pay for it? Aren't we already having trouble paying for the entitlements we already give? The answer on how we pay is very simple.  We are already paying for it.  We just aren't getting it.

    You almost swerved into the truth.

    We are borrowing the money, pretending that the costs aren't there. No one is paying for any of it.

    Yet.

    I am glad I do not have children...

    "And so, my fellow Americans: Ask not what your country can do for you - ask what you can do for your country." -JFK

    by RyanBTC on Fri Apr 10, 2009 at 08:48:00 AM PDT

  •  We do actually collect and pay out money (3+ / 0-)
    Recommended by:
    gogol, sberel, Mike08

    It isn't all borrowed.  The Iraq war money was borrowed.  The bail out and stimulus money is borrowed, we are in huge national debt.  But -- we also collect taxes and fees in huge quantity every year.  People and employers pay real money, right out of their paycheck for insurance premiums.  Social Security gets a cut of everyone's pay check. There is real money being spent that is earned not borrowed.  Lots of it.

  •  all ins. paid by the consumer (9+ / 0-)

    every dollar you spend anywhere all people in the supply and distribution chain that have coverage ... the cost is added to the products you buy , as much as 20 cents on the dollar of every consumer good purchased in America pays for some form of insurance be it workmans comp {whose greatest liability is healthcare} and liability ins.{again greatest expense is health care related} and the actual health plans of the phone companies the cable companies the trucking companies , the manufactures , the farmers all lawyers and doctors , pharmaceutical industry , health care related workers as well as the retail outlets from goods to groceries every govt. entity police , fire , ambulance , politicians every parade every fireworks display all insured for liability {again potential medical expense is the greatest risk covered}} , the costs seem hidden out of sight out of mind , but all the expense is added to the bottom line paid for by you the consumer , oh did I forget the financial industry automobile insurance professional sports , energy ... and the list goes on ... yes you are all paying for it , and yet 50 million of you are left holding the bag and another 100 million have worthless insurance but we are all paying for it ... other countries may seem to have higher taxes but in truth we have the highest taxes with the smallest return in the industrialized world hidden , neatly tucked in to the price of everything , again we are already paying for it  

  •  My rep is Diana DeGette (5+ / 0-)

    and in conversation with friends of mine this week ( they went to see her re ovarian cancer advocacy) she said she was so glad we weren't asking for universal health care since it just wasn't an option right now.

    hogwash. I'm going out of town, and she'll be getting a letter from me when I get back. NOT leadership.

  •  Personal investment is but just one example (5+ / 0-)

    of why we need single payer coverage now.

    After paying 50 to 75 thousand for healthcare premiums over about 15 years, and not needing any major medical procedures, treatments or tests, looking back I realize that I wasted my money.  (I was self-employed with private healthcare insurance.)

    Why should that have been a waste?

    That money, if it had to be that high (and it didn't) should have and could have gone into a governmental healthcare pot.  THEN, if I lost my business, I wouldn't lose my healthcare coverage... I could utilize the money I paid into the pot.

    I'm probably not making my point very well, but if you pay years and years for healthcare insurance, lose your business and your healthcare insurance, you've lost tens of thousands of dollars.  

    The cost isn't so high for other insurances, i.e., car and home.  The percentage of premiums per year for car and home versus healthcare compared to income is minuscule.  (We all need some healthcare at some point; some more and some less.  We all don't have car accidents nor are all our homes burglarized or sustain a fire.)

    Another thing:  People who are self-employed not only pay for their own healthcare insurance, but pay double (2.9%) of their earnings into Medicare.
    Whereas if your employer provides a portion of your healthcare, the employee only pays 1.45% of their income into Medicare.

    There needs to be a sliding scale of sorts where we all have deducted from our paychecks (or pay into if you're self-employed) a set amount of money per week the minute you start employment in your life.   It's worked well for Social Security and it can work well for healthcare coverage for all.

    Who in their right mind thinks it's perfectly fine for a group of people to take your money every week/month, keep 30 to 40%, and then make payouts when you need a medical service.  That's crazy.  It's crazy that system has been allowed to go on for so many years.

    If tax cuts create jobs, then why aren't the Bush tax cuts that are still in effect creating jobs?

    by gooderservice on Fri Apr 10, 2009 at 08:52:59 PM PDT

  •  How many people do you have to pay when you (6+ / 0-)

    get sick?

    You pay your internist.

    You need an x-ray?  You pay not just the radiologist, but you pay for the facilities which house the equipment.  Same for MRI, CAT scan, et cetera.

    Need to see a specialist?  You pay that doctor, too.

    Need to be hospitalized?  You pay the hospital for the use of the facilities, and if any of the doctors you see (probably most of them) aren't hospital employees, you get a bill from them, too.

    Go to the ER?  Well, many ERs subcontract their doctors.  So you get a bill from the hospital and you get a bill from the company who employs the ER doctors.

    You get an x-ray in ER?  Well, you pay for the equipment and then you pay for the radiologist to read your x-ray.

    Need a blood workup?  You pay for the person to extract your blood, you pay for the lab to test your blood, and you pay your doctor for the visit when he/she tells you the results of the blood work.

    Now... all those people mentioned above that are paid, they deserve it.  They're doing a job and should be compensated for it.

    Health insurance companies?  There is no damn good reason why they should pocket 30 to 40% of the money you pay them to pay the above-mentioned people.

    Sure, there should be some administrative expense to handle payments... kind of like Medicare -- NO PROFIT.

    If anyone thinks that a profit over and above the medical providers or facility providers is reasonable, well... that makes me mad as hell.

    If tax cuts create jobs, then why aren't the Bush tax cuts that are still in effect creating jobs?

    by gooderservice on Fri Apr 10, 2009 at 09:02:22 PM PDT

  •  I'm a former benefits mgr and never heard of this (1+ / 0-)
    Recommended by:
    SusanL143

    You say the following:

    Another thing insurance companies do, and are allowed to do, is to tier their premium price to risk factors such as age or previous illness -- so that the premium for someone who is 60 is three times higher than the twenty something who works in the same office.  Guess what?  This motivates companies to fire or lay off their veteran employees to save money.  

    I never, ever heard of this for group health plans. The premium is the same for all employees. That's the benefit of a group - the risk is spread across the entire group.

    Now if the demographics of your group skews older, the claims may be higher resulting in higher premiums but those higher premiums apply to everyone. But if your demographics skews in the lower age range, your claims experience may still be high because this is the prime age for having children.

    A company can charge a higher premium co-pay for a smoker for example or even offer co-pay reductions as a incentive for meeting certain health milestones as part of a wellness program.

    A premium may differ because of geographic location because medical costs are higher or lower. For example, the premium for our employees in Central Pennsylvania was lower than it was for employees in Northern New Jersey.

    The only premium rates I've ever seen are single, 2-person, and family. Never have I seen anything age related for active employees or based on prior illnesses. It would be illegal.

    For retired employees we had a separate plan supplementing Medicare and that premium was different than for active employees.

    •  Every state has different rules (4+ / 0-)
      Recommended by:
      Bluehawk, neroden, Mike08, SusanL143

      In California, group policies are rated by age. On my plan, a 60+ year old pays about 350% of the rate for a 20-29 year old.

      One high risk employee cannot have just his policy uprated; instead, a surcharge is applied to the group policy as a whole. Thus, hiring one 50-something guy with a previous heart attack not only brings his premium as part of his compensation cost, but can raise the price for the entire group by 10%. In an organization of 20 people paying an average $7000 per individual, that's an extra $14,000 a year.

      Each state also has different rules for individual plans, so we're looking at over 100 (including DC and territories) different sets of regulations today.

      Fry, don't be a hero! It's not covered by our health plan!

      by elfling on Fri Apr 10, 2009 at 10:21:23 PM PDT

      [ Parent ]

      •  Maybe I misunderstood (1+ / 0-)
        Recommended by:
        SusanL143

        Of course, demographics are used in underwriting. Age, gender, family composition (# of single, 2 person, family)even zip code as well as claims experience go into the underwriting but I've still never seen a different premium charged for different age groups or based on current or prior health conditions.

        Perhaps I misunderstood what the diarist was saying. I took it to be that there were different premiums based on age and/or health status within a single company.

  •  This looks like a good place (3+ / 0-)
    Recommended by:
    neroden, Mike08, SusanL143

    to take my new sig out for a spin:

    I can't go to the doctor.

    by VictorLaszlo on Fri Apr 10, 2009 at 10:45:25 PM PDT

  •  A recent example (4+ / 0-)
    Recommended by:
    elfling, neroden, maxzj05, SusanL143

    My daughter recently went to the doctor. She's on my health plan, but the insurance payment was addressed to her. She was livid when she read it. $276 for an office visit that consisted of ten minutes with the doctor and no diagnostics. The plan covered $117, the provider write-off was about the same, and our cost was a $10 copay.

    I find it hard to believe an office call is now $276. I also feel kind of foolish for not reading the insurance payment forms that come when I go to the doctor. Between the two of us we go to the doctor about three times a year-so I really haven't paid too much attention.

    But what worries me is does that mean if she didn't have insurance, if she needed to see a Dr. it would have been $276? Or is that just an obscene shell game they play so that we are essentially paying for universal healthcare already?

  •  As a nurse (2+ / 0-)
    Recommended by:
    Mike08, SusanL143

    I've been trying to make these same points to folks for years. If  we supply a diabetic with the testing supplies and medications needed to control their blood sugar levels and assure them access to routine preventative care, it is MUCH less expensive in the long run, than having to foot the bill for the dialysis treatments, kidney transplants, coronary bypass surgery and amputations they will need later without this care. Not to mention the social services they'll require when they lose their vision.

    If a child with asthma has access to the meds, respiratory treatments and inhalers needed to keep their airways open, chances are better that we won't have to pay for an extended ICU stay when he needs to be on a respirator.

    High blood pressure meds= cheaper than caring for debilitating stroke.

    Statin drugs and preventative care= cheaper than open heart surgery.

    I could go on and on. And for each of these cases we'd have an individual who could remain in the workforce being a productive member of society rather than becoming a drain on the system.  

    I'm so weary of these strawman arguments about how countries with socialized medicine have such poor care. Its simply not true. I recommend watching SiCKO. The people of France and other European countries sound pretty helathy and happy to me.

  •  Lets put on a show! (0+ / 0-)

    Well, not a show but I couldn't resist using that line from the Garland/Rooney movies.  Let's write a letter!

    Your wonderful, thoughtful comments that make me realize why I am grateful for Daily Kos. It brings together terrific people. The comments were so good that I think, between what was suggested and what I wrote, we have the basis for a letter that could go to newspapers around the nation.  It just needs refining, shortening, and serious editing. Anyone willing to help?

    Long ago I carried on a campaign to throw out some politicians who were stealing from our local museum. They were political bosses and the people who had to fire them were politicians they had put into office. I discovered that politicians read and care about those local papers even more than an article in a big national. The articles in the small, local papers turned their votes.

    We could make the difference between a politician voting yes or no for universal care with such a clear, well written letter and lots of people all over to send it into their communities. Anyone willing to help?  I'll write a diary on it soon and see if we can't come up with a finished, simple and forceful letter for Universal Healthcare now.

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