Cost of Health Care Continues to Rise

[whell]

Originally Posted by noonereal

so you have disqualified me from discussion because I am ill?

That is handy.

Was I disqualified when I paid over $15,000 a year for what amounted to catastrophic insurance for my daughter and I also?
You who has a vested interest in healthcare can discuss it objectively?

what a crock, a real Palin moment.

At what point did I "disqualify" you? I acknowledged that individuals bring their own experiences to the discussion which generate emotional responses. I simply suggested that emotionalism doesn't necessarily lead to constructive solutions.

Reading my posts rather than reacting to what you think my "agenda" might be could lead to a more productive discussion.

[whell]

I'll try this one more time. After re-reading my comments, I can see how they might have been misconstrued. As I stated, my object was not to "disqualify" participation from the discussion of any poster. However, if the remarks caused offense, my apologies.

We swerved into a discussion of the Canadian system due to a remark about the virtues of single payer. Its no secret that Canada, the UK, and other systems are now struggling under the weight of the rising cost of care. These are the same dynamics that pushed health care into the national debate in this country, and ultimately produced the PPACA earlier this year. It remains to be seen if this law will have intended impact.

Posts in these forums are great vehicles to share ideas and debate their relative merits. However, participants in these forums, my self included, are not all gifted writers. Well intended posts can be mis-construed and cause offence where none is intended. This thread seems to get contentious early, as two of my posts were immediately dismissed as "BS". I brought no ill will to this discussion, but it seems as if ill will was assumed by some. I have no ax to grind with anyone here, and certainly have no ax to grind on this topic, though I have some thoughts based on my experience. I've not been posting here long enough to develop any clear idea about anyone personally. The reverse is also true, however.

[Boreas]

Originally Posted by whell

We swerved into a discussion of the Canadian system due to a remark about the virtues of single payer.

"We" didn't. "You" did. If you felt that Finn's comments would be best responded to by introducing a document painting a rather jaundiced view of the Canadian system that's fine but you should be prepared to own it. Don't ascribe it to the collective "we". You are far too good a wordsmith to be ignorant of your framing here.

John

[whell]

Originally Posted by Boreas

"We" didn't. "You" did. If you felt that Finn's comments would be best responded to by introducing a document painting a rather jaundiced view of the Canadian system that's fine but you should be prepared to own it. Don't ascribe it to the collective "we". You are far too good a wordsmith to be ignorant of your framing here.

John

Yes, I did, to provide context for my comments. The document, I thought, was pretty balanced by the way. It covered both the best and least attractive aspects of the Canadian system. Which, by the way, is an example of single - payer. Which, was one way to respond to a sentiment that single payer should be an objective. I could have posted comments about the health system of just about any Western Social democracy, many of which are now trying to figure out how to continue to pay for their health care system. Many in this forum post comments without citations or reference to sources. I was trying to provide source material.

[noonereal]

Originally Posted by whell

This thread seems to get contentious early, as two of my posts were immediately dismissed as "BS". I brought no ill will to this discussion, but it seems as if ill will was assumed by some.

This is very inaccurate. My post was not dismissive I addressed each line of your post. How is that dismissive? You ignored all of it, that is dismissive. BTW it was one post not two.
Here is what it said:

"All tax codes are mess. This is not unique in healthcare.

Overall I'd say your post was a bunch of hooey.

Of course I am not in the industry. In fact once I became ill I lost all medical coverage so maybe I am unaware of the great healthcare industry."

(the word hooey was inserted for BS within minutes as I posted I was not sure how to spell hooey but it sure seemed to fit so I found out how and changed it)

If by contentious you mean "disagree" you are correct, other wise not so much. Anyway I will leave it alone unless more fact is altered.

Healthcare is a mess and pharmaceuticals are unethical at best.

[d-ray657]

I would suggest that an extremely important reform to the health care and health insurance industry, which did not survive the intense lobbying, is the repeal of the antitrust exemptions for those industries. (Wasn't health care a profession at one time, rather than an industry?) One needn't be a PHD in economics to conclude that price-fixing raises costs for most any product. When health care providers on one side, and insurance providers on the other side are able to engage in price fixing, the consumer loses.

Ironically, this would not be regulation, but an insistence that those industries actually operate in a competitive market. The libertarian Ron Paul, who opposes most all regulation, strongly advocates strict enforcement of anti-trust laws to prevent imbalanced operation of the market. In this market, consumers are essentially powerless and badly in need of help by someone with the authority and resources to stand up to the accumulated capital of the insurance companies.

By the way, the mish-mash of state regulation would be eliminated by a single payer plan, or by exclusive federal regulation of insurance. The multi-employer, self funded health and welfare plans (union sponsored) are regulated exclusively by the federal government under ERISA. As a rule, with no profit, no commissions, no dividends, minimal advertising, and no executive bonuses, those plans operate quite efficiently at delivering services to their beneficiaries, at a lower costs than the corporate insurance industry. Taking the greed out of the provision of health coverage seems to be a much better way of serving the consumer.

Regards,

D-Ray

[whell]

Originally Posted by d-ray657

I would suggest that an extremely important reform to the health care and health insurance industry, which did not survive the intense lobbying, is the repeal of the antitrust exemptions for those industries. (Wasn't health care a profession at one time, rather than an industry?) One needn't be a PHD in economics to conclude that price-fixing raises costs for most any product. When health care providers on one side, and insurance providers on the other side are able to engage in price fixing, the consumer loses.

Ironically, this would not be regulation, but an insistence that those industries actually operate in a competitive market. The libertarian Ron Paul, who opposes most all regulation, strongly advocates strict enforcement of anti-trust laws to prevent imbalanced operation of the market. In this market, consumers are essentially powerless and badly in need of help by someone with the authority and resources to stand up to the accumulated capital of the insurance companies.

I don't disagree with this. While we're at it, though, I suggest that we go all the way. Eliminate state - level regulations on health insurers as well, and allow health insurance to be sold across state lines. State mandates for health insurance can be a significant driver of health insurance costs. For example, in Illinois and other states, group health plans are required to carry a rider the covers fertility treatments. Why in the world should an entire group be required to pay extra premium for coverage that most of the members of the group will never use?

Originally Posted by d-ray657

By the way, the mish-mash of state regulation would be eliminated by a single payer plan, or by exclusive federal regulation of insurance. The multi-employer, self funded health and welfare plans (union sponsored) are regulated exclusively by the federal government under ERISA. As a rule, with no profit, no commissions, no dividends, minimal advertising, and no executive bonuses, those plans operate quite efficiently at delivering services to their beneficiaries, at a lower costs than the corporate insurance industry. Taking the greed out of the provision of health coverage seems to be a much better way of serving the consumer.

Regards,

D-Ray

If we eliminate the anti-trust exemption and reduce or eliminate state regs, and allow insurance to be sold across state lines, it would open up the whole market to significant competition. I'd suggest at that point you might see prices impacted in favor of the consumer, and more freedom to innovate insurance product design.

[merrylander]

Originally Posted by whell

I don't disagree with this. While we're at it, though, I suggest that we go all the way. Eliminate state - level regulations on health insurers as well, and allow health insurance to be sold across state lines. State mandates for health insurance can be a significant driver of health insurance costs. For example, in Illinois and other states, group health plans are required to carry a rider the covers fertility treatments. Why in the world should an entire group be required to pay extra premium for coverage that most of the members of the group will never use?


If we eliminate the anti-trust exemption and reduce or eliminate state regs, and allow insurance to be sold across state lines, it would open up the whole market to significant competition. I'd suggest at that point you might see prices impacted in favor of the consumer, and more freedom to innovate insurance product design.

So if we allow sale across statelines what will prevent, oh say Aetna, from establishing themselves in a state with little or no regulation and thus be free to screw people more than they currently do? I pick on Aetna because in my last employment they administered the health insurance. I retired at 73 so every time I submitted a claim after I reached 65 (Hell I was 69 when I started there.) some clerk would send it back saying that I should submit it to Medicare as they were my prime insurer. Then I would have to point them to the place in company litereature where it said they were prime for all employees regardless of age. They were not the sharpest knives in the drawer.

The voters in Illinois should have the fertility rites removed if that is how they feel.

[d-ray657]

Originally Posted by merrylander

So if we allow sale across statelines what will prevent, oh say Aetna, from establishing themselves in a state with little or no regulation and thus be free to screw people more than they currently do? I pick on Aetna because in my last employment they administered the health insurance. I retired at 73 so every time I submitted a claim after I reached 65 (Hell I was 69 when I started there.) some clerk would send it back saying that I should submit it to Medicare as they were my prime insurer. Then I would have to point them to the place in company litereature where it said they were prime for all employees regardless of age. They were not the sharpest knives in the drawer.

The voters in Illinois should have the fertility rites removed if that is how they feel.

Rob, what would prevent that is exclusive federal regulation of health insurance similar to the exclusive federal regulation of joint employer/union health and welfare funds. Under that scheme, the trust funds have delivered high quality coverage at lower prices than insurance. BTW, one feature of the joint funds is universal coverage. Employers make hourly contributions for all employees, regardless of age. Universal coverage is, of course, one of the major components of the new health care reform package.

To the extent that Whell agrees with the elimination of the anti-trust exemptions in the healthcare industry, and with a comprehensive exclusive federal federal regulatory program, I would agree with him on sale of insurance across state lines. The exclusive federal regulation would eliminate the incentive to go shopping for the best state regulations. It would also obliterate any argument that the exercise of federal regulation does not arise under the commerce clause.

Regard,

D-Ray

[finnbow]

Originally Posted by whell

If we eliminate the anti-trust exemption and reduce or eliminate state regs, and allow insurance to be sold across state lines, it would open up the whole market to significant competition. I'd suggest at that point you might see prices impacted in favor of the consumer, and more freedom to innovate insurance product design.

Sounds good on its face, but states aren't going to give up their rights with regard to regulation of the insurance industry. Constitutionally, insurance is one of those things that has remained outside of the purview of the Constitution's commerce clause (thus far anyway). It seems to be somewhat contradictory that conservatives are championing taking these powers away from the States. This presumes, of course, that they're sincere in this argument to begin with.

I don't buy the argument that competition between private insurance companies more than offsets the administrative costs of 50 sets of regulations, not to mention the differing coverage levels and forms each insurance company offers (not to mention the need for each of these insurance companies to earn a profit). I have a number of friends who are doctors and dentists and the one thing they universally detest about maintaining a practice is the administrative/billing/paperwork burdens imposed by the various insurance companies they deal with.