Post by: President-Elect Bob Noel on March 18, 2017, 04:11:56 PM
Note that the projected cost of the drug is $14,000 per year.
For now, let's ignore why the drug is that expensive.
My single-person health insurance costs about $9,000 per year.
A preventative treatment for a relatively common health problem costing more than current insurance plan rates. Hmmmm, what are the possibly results?
Even more common is the risk of the elderly developing Alzheimer's. What do we do if the miracle occurs and a cure for Alzheimer's is developed but it costs $50,000 per year?
Post by: Little Joe on March 18, 2017, 05:39:25 PM
Post by: nddons on March 18, 2017, 07:36:09 PM
As for the cholesterol drug, there are other drugs with similar results. And I think mine is now a generic. Love competition.
Post by: President-Elect Bob Noel on March 19, 2017, 05:20:16 AM
As for the cholesterol drug, there are other drugs with similar results. And I think mine is now a generic. Love competition.
Similar results? I don't think so, but what cholesterol drugs do you think give similar results (e.g., LDL as low as 19)?
Post by: Little Joe on March 19, 2017, 06:36:36 AM
The good thing about all this is that in order to lower my bad cholesterol without drugs, I have upped my exercise regimen and have lost some weight. Last year's retirement has made that a little easier.
Post by: Username on March 19, 2017, 08:15:35 AM
https://www.sciencedaily.com/releases/2011/05/110505142730.htm
Quote
"People often say, 'I want to get rid of all my bad (LDL) cholesterol,' but the fact is, if you did so, you would die," the Texas A&M professor adds. "Everyone needs a certain amount of both LDL and HDL in their bodies. We need to change this idea of LDL always being the evil thing -- we all need it, and we need it to do its job.
Post by: Little Joe on March 19, 2017, 09:51:13 AM
On the other hand, lowering or eliminating LDL may not be a good thing. LDL plays an important role in maintaining health. But it's been drilled into us that we must take drugs to lower LDL to make us healthy. The drugs themselves may be worse than the "cure". Yay drug company advertising!True, but that's like saying we need police, but who among us wants to live in a "police state"? Some is good. Too much is bad. Statin drugs have good and bad effects. For me, the bad outweigh the good. For others, maybe not.
https://www.sciencedaily.com/releases/2011/05/110505142730.htm
Post by: Username on March 19, 2017, 11:20:18 AM
Post by: DJTorrente on March 19, 2017, 02:07:22 PM
Against that backdrop, sloganeering like "Health Coverage is a RIGHT!" sounds rather silly, doesn't it? It sounds a lot like "PEOPLE HAVE A RIGHT TO GET FLEECED AT THE DOCTOR'S OFFICE". Which is particularly odd coming from dedicated leftist socialists who are prone to such outbursts.
Post by: PaulS on March 19, 2017, 03:26:17 PM
Post by: bflynn on March 19, 2017, 03:38:33 PM
Thus is the nature of Innovation and experimentation. Should the inventor of the miracle drug not be compensated so it can offset the cost of its innovation?
World wide there are estimated to be 1.5 billion people with high cholesterol, which makes the world market 22 trillion dollars per year.
It's reported to cost 2.5 billion to develop a new drug, amortized over all the failures.
Maybe the price has nothing to do with offsetting the cost of innovation.
Post by: bflynn on March 19, 2017, 03:42:17 PM
Before anyone says word one about public policy towards "health care" and/or "health care coverage" in America, honestly demands -- DEMANDS -- that you admit and acknowledge this one thing: Health insurance exists because the medical profession created it, and wants it to continue and grow. It exists because it permits individuals to pay various and sundry providers of health care goods and services more for their wares than those people would otherwise be willing or able to afford without it.
Against that backdrop, sloganeering like "Health Coverage is a RIGHT!" sounds rather silly, doesn't it? It sounds a lot like "PEOPLE HAVE A RIGHT TO GET FLEECED AT THE DOCTOR'S OFFICE". Which is particularly odd coming from dedicated leftist socialists who are prone to such outbursts.
No, I don't agree with that. Hospitals started a prepayment plan in the 20s, but that was not insurance, it was paying for services in advance. It was a teacher's group that first started paying for their employee's health care via an insurance plan...because they wanted the teachers at work, not at home sick. It was started by employers.
Post by: DJTorrente on March 20, 2017, 04:43:26 AM
But put that aside, and just work through the logic. Think about the mechanics of the medical market with and without insurance. Absent widespread (employer-based) health insurance, would individuals save an amount equal to their premiums each year to be available for medical expenses? Some might; still others might save generally, but not as much and/or not dedicated only to health expenses; most will save little or nothing and attempt to cash flow their needs. This would greatly reduce the medical industry's pricing power.
Now, even for those who saved the full measure, once that individual pool of money is exhausted, would doctors have any ability to access the saved funds of others (outside perhaps immediate family members) in order to pay for extraordinary care? The insurance model necessarily means that funds from those who don't need services are used to pay for those who do. Ergo, doctors/hospitals/pharma can charge more to those who do need it, and those people have a resource from which to pay the amount charged.
Listen, I'm a capitalist. I'm not necessarily ascribing a sinister motive to any of this or putting red horns on your neighborhood family doctor. But if we are going to seriously discuss any attempt to "fix" the system, aka, provide health care services to people who can't otherwise afford it, or more generally reduce the cost of health care overall ('bend the cost curve'), then pursuing a model that is designed and operates to increase cost doesn't seem logical, does it?
Post by: Anthony on March 20, 2017, 06:19:09 AM
Against that backdrop, sloganeering like "Health Coverage is a RIGHT!" sounds rather silly, doesn't it? It sounds a lot like "PEOPLE HAVE A RIGHT TO GET FLEECED AT THE DOCTOR'S OFFICE". Which is particularly odd coming from dedicated leftist socialists who are prone to such outbursts.
Look at two of the many areas in which the government is very involved. Healthcare insurance, and college tuition loans. Look at the rate of cost increases over the years due to this involvement. Yes, costs for healthcare were going up before Obamacare, but government so regulated health insurance that it created a market that could not work as competitively, or effectively as it should. Trump, and Congress needs to change that.
Both Bernie Sanders, and then Hillary (to out Bernie, Bernie) ran on "free" college, and continuing Obamacare, or perhaps even going to single payer (government run, and paid for healthcare). Both would further lead us to higher deficits, debt, and much higher costs. It would also make the quality of care suffer, and rationed.
Post by: President in Exile YOLT on March 20, 2017, 07:47:05 AM
Although I often use the Google-Wiki combination for a quick primer on issues, it is not authoritative. The full Wiki article on US health insurance describes medical accident insurance offered in the 1850's.What percentage of the fabled "highest per capita cost in the developed world" of healthcare is related to defensive medicine and malpractice premiums? I say start with major tort reform. Next, mandatory fee visibility (not the "negotiated" number) for everything from open heart surgery to the price of an aspirin. Everything else will follow.
But put that aside, and just work through the logic. Think about the mechanics of the medical market with and without insurance. Absent widespread (employer-based) health insurance, would individuals save an amount equal to their premiums each year to be available for medical expenses? Some might; still others might save generally, but not as much and/or not dedicated only to health expenses; most will save little or nothing and attempt to cash flow their needs. This would greatly reduce the medical industry's pricing power.
Now, even for those who saved the full measure, once that individual pool of money is exhausted, would doctors have any ability to access the saved funds of others (outside perhaps immediate family members) in order to pay for extraordinary care? The insurance model necessarily means that funds from those who don't need services are used to pay for those who do. Ergo, doctors/hospitals/pharma can charge more to those who do need it, and those people have a resource from which to pay the amount charged.
Listen, I'm a capitalist. I'm not necessarily ascribing a sinister motive to any of this or putting red horns on your neighborhood family doctor. But if we are going to seriously discuss any attempt to "fix" the system, aka, provide health care services to people who can't otherwise afford it, or more generally reduce the cost of health care overall ('bend the cost curve'), then pursuing a model that is designed and operates to increase cost doesn't seem logical, does it?
Post by: President-Elect Bob Noel on March 20, 2017, 09:33:38 AM
What percentage of the fabled "highest per capita cost in the developed world" of healthcare is related to defensive medicine and malpractice premiums? I say start with major tort reform. Next, mandatory fee visibility (not the "negotiated" number) for everything from open heart surgery to the price of an aspirin. Everything else will follow.
don't forget the cost of paperwork. How many people are in a doctor's office? My PCP has 3 people. Years ago, my family's GP had 1.
Post by: bflynn on March 20, 2017, 12:35:29 PM
But if we are going to seriously discuss any attempt to "fix" the system, aka, provide health care services to people who can't otherwise afford it, or more generally reduce the cost of health care overall ('bend the cost curve'), then pursuing a model that is designed and operates to increase cost doesn't seem logical, does it?
Bingo.
But let me suggest another thing to think about - however much you and I and the government pay for health care must support everyone who works in the healthcare industry. THAT is the price of healthcare. That means I don't just pay my doctor. I pay his nurses, his billing coordinator, record keepers, the insurance company, the drug reps, HIS insurance...everything that he has to pay for, I have to pay for.
Now extend that out to everyone in the field.
That is why health care is expensive.
Post by: asechrest on March 20, 2017, 01:22:56 PM
So if it isn't insurance, what is it? I'm not sure, but I do know that it serves to obfuscate and allow to be obfuscated the true cost of care. And, together with the fact that there are limited players in the health "insurance" market, it prevents the capitalist approach from working if in fact it could work.
Post by: nddons on March 20, 2017, 01:34:48 PM
My opinion is that health "insurance" fails the simple tests that would confirm that it is an insurance product. Parts of it qualify as insurance, but not the whole of it. And, in fact, it has become less of an insurance product than it used to be, by increasing out of pocket costs for the unknowns, and decreasing out of pocket costs for the known.And what law put the nail in the coffin of health insurance as insurance?
So if it isn't insurance, what is it? I'm not sure, but I do know that it serves to obfuscate and allow to be obfuscated the true cost of care. And, together with the fact that there are limited players in the health "insurance" market, it prevents the capitalist approach from working if in fact it could work.
People used to be able to buy catastrophic health insurance. They would pay for most healthcare costs out of pocket, with the catastrophic coverage coming into play when the shit hits the fan.
No longer. Thank you, government.
Post by: Jim Logajan on March 20, 2017, 01:40:43 PM
So if it isn't insurance, what is it?
It's a forced redistribution of wealth. But it is for the greater good, so there.
Post by: asechrest on March 20, 2017, 01:59:49 PM
Post by: DJTorrente on March 20, 2017, 02:06:34 PM
My opinion is that health "insurance" fails the simple tests that would confirm that it is an insurance product.
You can't (profitably) insure against an inevitable occurrence. "Obamacare" style health insurance as currently mandated is as bad a deal as whole life insurance; and I thought most people above room temp IQ know what a bad deal that is (for the subscriber -- people who sell it LOVE the stuff).
Post by: Little Joe on March 20, 2017, 02:41:06 PM
Seems to me it's actually the worst of both worlds. It's some strange middle between a fully capitalist approach and a full single-payer approach, without the benefits of either, and which does nothing to ameliorate the increase and obfuscation of cost of care.I have been saying that since I first heard the details of the ACA.
Post by: President-Elect Bob Noel on March 20, 2017, 02:41:13 PM
Seems to me it's actually the worst of both worlds. It's some strange middle between a fully capitalist approach and a full single-payer approach, without the benefits of either, and which does nothing to ameliorate the increase and obfuscation of cost of care.
Why would anyone be surprised that the Federal government would make a massive fuster cluck of the whole thing?
Post by: DJTorrente on March 21, 2017, 05:44:36 AM
Nothing "good" (broadly speaking, there are certainly isolated winners and losers) usually comes from governments trying to remake markets into what some people wish that they would be.
Post by: Anthony on March 21, 2017, 05:53:17 AM
Obamacare was designed to fail. After it did, the "only" option left would be single-payer.
Nothing "good" (broadly speaking, there are certainly isolated winners and losers) usually comes from governments trying to remake markets into what some people wish that they would be.
It was designed to give further control of 1/6 of the economy over to the globalists/progressives (government). These are people that like to control, and tinker with everything in the name of "the public good". The public good is better served by letting the markets do what they do best, and provide an auxiliary safety net for those that need it.
Post by: Number7 on March 21, 2017, 05:54:59 AM
Then Donald Trump came along and refused to play the game as per the script, making democrat politicians mad and all the pathetic, little snowflakes frightened.
The only deviation from the script came from voters, which obviously made all liberals mad because they thought it was all a done deal and that voters would simply do what they were told, like all good liberals do.
Post by: asechrest on March 21, 2017, 08:42:15 AM
It was designed to give further control of 1/6 of the economy over to the globalists/progressives (government). These are people that like to control, and tinker with everything in the name of "the public good". The public good is better served by letting the markets do what they do best, and provide an auxiliary safety net for those that need it.
In fairness, "the markets" didn't work vis a vis healthcare even before Obamacare was implemented. The structure of it prevents a capitalist approach. We need to change a bunch of things outside of Obamacare.
Post by: PaulS on March 21, 2017, 10:30:57 AM
Post by: Anthony on March 21, 2017, 10:45:08 AM
In fairness, that's because the government has been monkeying with health insurance for years. Thank Ted Kennedy for the HMO legislation.
Exactly. The government regulations restricted most of the market forces, especially only allowing them to compete within each state. This occurred well before Obamacare. Anytime when the governmet gets overly involved we have these types of market failures whether it be insurance, home mortgages, college tuition, etc. Government over reach = FAILURE.
Post by: bflynn on March 21, 2017, 03:22:39 PM
And what law put the nail in the coffin of health insurance as insurance?
People used to be able to buy catastrophic health insurance. They would pay for most healthcare costs out of pocket, with the catastrophic coverage coming into play when the shit hits the fan.
No longer. Thank you, government.
I'd like you to expound on that last part. It seems that you're blaming the government for the expense of health care, but do you understand why?
Hint, it's not interstate competition. It isn't mandated insurance, although that certainly did not help. There are more core issues at play, things that aren't the fault of either party specifically, but do you know what they are?
Post by: Little Joe on March 21, 2017, 03:51:39 PM
I'd like you to expound on that last part. It seems that you're blaming the government for the expense of health care, but do you understand why?It's a good thing you said "they", because there are many reasons.
Hint, it's not interstate competition. It isn't mandated insurance, although that certainly did not help. There are more core issues at play, things that aren't the fault of either party specifically, but do you know what they are?
But medical insurance itself is assuredly one of the prime reasons. Just consider how few people complain when the insurance company pays x$'s for an aspirin. I say "x$'s" because when I was a kid, the insurance company paid $1.00 per aspirin. That was over 40 years ago. My parents didn't complain to anyone but family because insurance paid for it. If my family had to pay the bill, there is no way they could get away with that.
Post by: Gary on March 21, 2017, 04:41:07 PM
My opinion is that health "insurance" fails the simple tests that would confirm that it is an insurance product. Parts of it qualify as insurance, but not the whole of it. And, in fact, it has become less of an insurance product than it used to be, by increasing out of pocket costs for the unknowns, and decreasing out of pocket costs for the known.
So if it isn't insurance, what is it? I'm not sure, but I do know that it serves to obfuscate and allow to be obfuscated the true cost of care. And, together with the fact that there are limited players in the health "insurance" market, it prevents the capitalist approach from working if in fact it could work.
I would agree with this. Over the last 40-50 years, various bits and pieces were added on as far as insurance requirements, government regulation and individual needs. None of them fit well together.
Post by: Gary on March 21, 2017, 04:44:53 PM
It's a good thing you said "they", because there are many reasons.
Very true! It is convenient to blame "the government" but it is far, far more complex than that. We ourselves, as potential patients are part of the problem.
Post by: EppyGA - White Christian Domestic Terrorist on March 21, 2017, 07:07:53 PM
On top of that they took the debt to unheard of levels and put the country on the edge of collapsing financially, a key tenant of taking over. Once they could topple the economy there would be no stopping the socialistic utopia the desire from moving forward. The collapse of Obamacare would have been key to helping collapse the economy. Once they could get there who would be able to stop them? They would just go out and tell their base that they need control over everything to get the country going again and the snowflake millennials would just roll over as well as the Hispanics and progressives.
Trump has really impacted that plan at this point and must be resisted at all costs. If he succeeds at doing the things he has talked about the Democrats can hang it up.
They need to get this healthcare thing right though. If they pass something and premiums and deductibles do not start to come down the Republicans will be pilloried and the midterms could be a blood bath. How are you going to beat a Democrat who simply has to say that his Republican opponent voted for a bill that has increased your premiums and deductibles.
Post by: nddons on March 21, 2017, 08:44:53 PM
I'd like you to expound on that last part. It seems that you're blaming the government for the expense of health care, but do you understand why?No, genius. I'm not playing your word game because you think I meant something that I didn't.
Hint, it's not interstate competition. It isn't mandated insurance, although that certainly did not help. There are more core issues at play, things that aren't the fault of either party specifically, but do you know what they are?
I'm blaming the government, through Obamacare, that made logical, sane, affordable health insurance policies illegal. An entire market - catastrophic insurance - disappeared. Same with a la cart policies. Illegal.
Post by: bflynn on March 22, 2017, 02:12:39 AM
No, genius. I'm not playing your word game because you think I meant something that I didn't.
I'm blaming the government, through Obamacare, that made logical, sane, affordable health insurance policies illegal. An entire market - catastrophic insurance - disappeared. Same with a la cart policies. Illegal.
Although Obamacare made costs worse, i was asking if you recognize WHY health care costs are high? The answer you just gave tells me no.
Post by: bflynn on March 22, 2017, 02:25:22 AM
Very true! It is convenient to blame "the government" but it is far, far more complex than that. We ourselves, as potential patients are part of the problem.
We as the patients have some input to the price through demand, but not as much as you might think.
There are three major elements that affect price - supply, demand and costs. Diversity of policies is a supply issue, whether that is different kinds of policies, interstate competition or even access to different doctors. How we as patients use the system is a demand issues, how much we go to see a doctor, using urgent care over emergency room and choosing lower costing services.
I am convinced that cost is the major factor driving the price of health care today. It is expensive because stratificiation makes it expensive. You just cannot have so many companies in an industry and not have costs go up. Every layer adds their costs and profit to the pile and passes it onto the next layer.
We could afford our healthcare without our government, if it weren't for our government.
Post by: Gary on March 22, 2017, 07:27:41 AM
We as the patients have some input to the price through demand, but not as much as you might think.
Certainly as a consumer of health care services we do have input as to pricing. But unlike a good or service that we routinely purchase, health care isn't a good example of a "free market" where consumers can shop around to determine the best price/value. We as a society in general are becoming more sedentary, older, more obese and voluntarily partake in activities such as smoking, drunk driving, and eating high sugar/fat diets. All of this leads to greater use of health care.
There are three major elements that affect price - supply, demand and costs. Diversity of policies is a supply issue, whether that is different kinds of policies, interstate competition or even access to different doctors. How we as patients use the system is a demand issues, how much we go to see a doctor, using urgent care over emergency room and choosing lower costing services.
No disagreement there except for the interstate competition, that already occurs.
I am convinced that cost is the major factor driving the price of health care today. It is expensive because stratificiation makes it expensive. You just cannot have so many companies in an industry and not have costs go up. Every layer adds their costs and profit to the pile and passes it onto the next layer.
The actual cost of healthcare is indeed a major driver. That cost has been rising well before Obamacare. I'm with you on the complexity and the different firms involved. I live in PA, headquarters is in TX. My healthcare "insurance" (we self-insure) is provided by Aetna, managed by Hewitt, with Meridian as the payer, also involved are companies called AON, JIFF and Quantum Health. Each of those firms get their cut somewhere along the line.
A good article as to why costs are what they are is here:
http://khn.org/news/health-care-costs/
We could afford our healthcare without our government, if it weren't for our government.
Not at all convinced of that.
Post by: Anthony on March 22, 2017, 07:36:51 AM
Post by: President-Elect Bob Noel on March 22, 2017, 09:12:05 AM
We as a society in general are becoming more sedentary, older, more obese and voluntarily partake in activities such as smoking, drunk driving, and eating high sugar/fat diets. All of this leads to greater use of health care.
and yet the are a large number of people that gnash their teeth over high health care costs and want to force the federal government to provide free health insurance.
(btw - being more sedentary and more obese are also voluntary)
Post by: Little Joe on March 22, 2017, 10:48:52 AM
One of us is wrong. AFAIK, there is no interstate competition for medical insurance.
No disagreement there except for the interstate competition, that already occurs.
There may be interstate competition in the hiring of the best doctors and nurses, or the purchase of supplies and equipment. But there is no interstate competition for health insurance products. Living in Florida, I cannot purchase a plan that my cousin in Virginia can, and vice versa.
Post by: Jim Logajan on March 22, 2017, 11:33:37 AM
One of us is wrong. AFAIK, there is no interstate competition for medical insurance.
There may be interstate competition in the hiring of the best doctors and nurses, or the purchase of supplies and equipment. But there is no interstate competition for health insurance products. Living in Florida, I cannot purchase a plan that my cousin in Virginia can, and vice versa.
With respect to health insurance, this page may prove useful (I quote only from the first paragraph; the rest of the page should be read for more info):
http://www.ncsl.org/research/health/out-of-state-health-insurance-purchases.aspx (http://www.ncsl.org/research/health/out-of-state-health-insurance-purchases.aspx)
"Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders. Large employers who self-insure are exempt from these state regulations. The result has been a patchwork of 50 different sets of state regulations; the cost for an insurer licensed in one state to enter another state market is often high."
Post by: nddons on March 22, 2017, 12:47:16 PM
Although Obamacare made costs worse, i was asking if you recognize WHY health care costs are high? The answer you just gave tells me no.If I gave a shit about healthcare COSTS in my post, I would tell you. My post was solely about government interference in the insurance industry, making affordable policies illegal.
Pay attention.
Post by: asechrest on March 22, 2017, 03:01:21 PM
Certainly as a consumer of health care services we do have input as to pricing. But unlike a good or service that we routinely purchase, health care isn't a good example of a "free market" where consumers can shop around to determine the best price/value. We as a society in general are becoming more sedentary, older, more obese and voluntarily partake in activities such as smoking, drunk driving, and eating high sugar/fat diets. All of this leads to greater use of health care.
I wonder, why do you think health care could not be subject to market forces? Granted, it's been structured so that market forces are of little effect, but I don't see what would prevent healthcare providers from competing on price and service just like any other business. As it stands now, most places wouldn't know the price of their services even if you asked, at least not if it's running through health insurance. We'll never have market force at work in a system that purposely obfuscates cost.
Interesting story: some time ago I had some imaging done on my neck and spine for numbness in my hands (still persists). I had a relatively high deductible health insurance plan through my employer. My neurologist referred me to the imagine place, but gave me a tip - find out what my out of pocket cost would be using health insurance, and then find out what the cash price would be at the imaging center. Through health insurance: $500+. Cash price: $250.
As they say in some parts of the country: sump'n ain't right.
Post by: EppyGA - White Christian Domestic Terrorist on March 22, 2017, 03:38:19 PM
Post by: PaulS on March 22, 2017, 03:39:36 PM
Bottom line.......if they pass a bill and after it goes into effect premiums and deductibles do not go down the Democrats will regain the House in 2018.
I seriously doubt that.
Post by: EppyGA - White Christian Domestic Terrorist on March 22, 2017, 03:41:52 PM
I seriously doubt that.
So you think folks will be fine with premiums and deductibles rising as long as it isn't Obamacare making it happen?
Post by: PaulS on March 22, 2017, 04:56:15 PM
So you think folks will be fine with premiums and deductibles rising as long as it isn't Obamacare making it happen?
I think rising insurance rates are a fact of life, I think we can only hope for the slope of the rise to decrease. My hope is that the plans are restructured to allow insurance where you pay for your own routine care and insurance kicks in for hospitalization. This is where savings could be realized in my opinion. I would also like to see competition opened up across state lines to break up the mini monopolies.
I haven't bothered to look for the details of this plan Ryan is trying to push through, nor do I know if they are available. But I am concerned that what he proposes doesn't go far enough. I don't buy that there will be a phase 2 and 3 of this, I think they need to get it done now, buy now I mean that there will be one bill signed through and that will be it, it better be a good one. I don't buy the pressure that has been applied to get this done quickly, nor do I buy that if this fails to get votes it is over. It's tough to discern what is truth and what is moonbat driven hysteria. My hope is that Trump gets on top of this. We shall see.
Post by: President in Exile YOLT on March 22, 2017, 05:20:48 PM
Through health insurance: $500+. Cash price: $250.It's usually the other way around.
Post by: asechrest on March 22, 2017, 08:11:06 PM
It's usually the other way around.
Recently, not so much.
Post by: bflynn on March 23, 2017, 05:07:13 AM
Bottom line.......if they pass a bill and after it goes into effect premiums and deductibles do not go down the Democrats will regain the House in 2018.
Extremely unlikely to happen. The demographics mean the republicans have a huge advantage in winning congressional districts.
Post by: bflynn on March 23, 2017, 05:12:26 AM
I think rising insurance rates are a fact of life, I think we can only hope for the slope of the rise to decrease. My hope is that the plans are restructured to allow insurance where you pay for your own routine care and insurance kicks in for hospitalization. This is where savings could be realized in my opinion. I would also like to see competition opened up across state lines to break up the mini monopolies.
I haven't bothered to look for the details of this plan Ryan is trying to push through, nor do I know if they are available. But I am concerned that what he proposes doesn't go far enough. I don't buy that there will be a phase 2 and 3 of this, I think they need to get it done now, buy now I mean that there will be one bill signed through and that will be it, it better be a good one. I don't buy the pressure that has been applied to get this done quickly, nor do I buy that if this fails to get votes it is over. It's tough to discern what is truth and what is moonbat driven hysteria. My hope is that Trump gets on top of this. We shall see.
Insurance rates are up, but not necessarily for good. If changes were made which reduced the costs to service providers then insurance rates would go down because half the care costs would go down.
Not surprisingly, these issues all revolve around government interference
- bad tort law
- mandated policy purchasing
- mandated coverage
- mandated record keeping requirements
- mandated reporting requirements.
If the government got out of the way, doctors would solve the cost problem.
Post by: Anthony on March 23, 2017, 07:50:24 AM
Insurance rates are up, but not necessarily for good. If changes were made which reduced the costs to service providers then insurance rates would go down because half the care costs would go down.
Not surprisingly, these issues all revolve around government interference
- bad tort law
- mandated policy purchasing
- mandated coverage
- mandated record keeping requirements
- mandated reporting requirements.
If the government got out of the way, doctors would solve the cost problem.
I agree to an extent. As you say it is not just the doctors driving up costs. I have two cousins, both physicians in NJ (sucks to be them :) ), anyway my aunt, their Mom, had a stroke. One of my cousin docs acted as her patient advocate. Now remember, she's and M.D., and also associated with the hospital where my aunt was admitted. She told me horror stories of trying to get straight answers, cut through bureaucracy, and insurance issues. A lot of it WAS the hospital, but I am sure most of it was probably forced upon the hospital, docs, nurses, etc. If a doc can't navigate the system satisfactorily, then how can a layman?
Post by: Gary on March 23, 2017, 04:10:22 PM
With respect to health insurance, this page may prove useful (I quote only from the first paragraph; the rest of the page should be read for more info):
http://www.ncsl.org/research/health/out-of-state-health-insurance-purchases.aspx (http://www.ncsl.org/research/health/out-of-state-health-insurance-purchases.aspx)
"Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders. Large employers who self-insure are exempt from these state regulations. The result has been a patchwork of 50 different sets of state regulations; the cost for an insurer licensed in one state to enter another state market is often high."
Excellent reference, thanks for finding that, learned something new. Settles the question of self-insuring and state lines.
Did note that five states allow for insurance from out of state. Have never seen any data, but if premiums are lower and/or benefits better in those states, that would be a strong argument that selling across state lines is a good thing. Unfortunately, the article also states that not a single insurance company has taken advantage of that ability. Sounds good on the surface and worthy of further investigation. That being said the NAIC wasn't very optomistic.
http://www.naic.org/documents/topics_interstate_sales_myths.pdf
Post by: President-Elect Bob Noel on March 23, 2017, 04:25:02 PM
Did note that five states allow for insurance from out of state. Have never seen any data, but if premiums are lower and/or benefits better in those states, that would be a strong argument that selling across state lines is a good thing. Unfortunately, the article also states that not a single insurance company has taken advantage of that ability. Sounds good on the surface and worthy of further investigation.
I can imagine several reasons why insurances companies have not taken advantage of that ability.
One reason could simply be avoiding the quagmire and land mines associated with the myriad of state regulations.
But not to worry, the Federal Government will step in and improve the situation that they f'd up in the first place.
....That being said the NAIC wasn't very optomistic.
http://www.naic.org/documents/topics_interstate_sales_myths.pdf
That summary pdf smacks of a singular bias.
The very first myth and "reality" is horse manure.
plus the claim that "Allowing insurance to be sold across state lines would eliminate the ability of insurance regulators to assist consumers." is another load of nonsense.
Who is dumb enough to believe that complete nonsense?
Post by: bflynn on March 31, 2017, 06:30:18 PM
So you think folks will be fine with premiums and deductibles rising as long as it isn't Obamacare making it happen?
I have to agree with him - I don't think Democrats will take control because of demographics. Too many districts are slanted too far to the Republican side for them to lose control. They might lose seats, but they won't lose that many. Only about 20 seats out of 435 are balanced/competitive. Democrats would need to take 30 seats over to take control.
Post by: DJTorrente on April 01, 2017, 10:58:55 AM
So you think folks will be fine with premiums and deductibles rising as long as it isn't Obamacare making it happen?
I hate to quote myself, but I've already stated at least one reason I fear premiums are never coming down.
At least one problem that Obamacare caused and repeal can't fix is that the insurers have been shown a new high water mark of how much the public will pay for their product. Think about market dynamics -- what does a seller charge? As much as the market will bear. Well, Obamacare -- through lavish minimum benefits provisions; prohibition on rejection for pre-existing conditions; forced community rating price structure -- placed insurers in a position where they raised their premiums higher than they ever dared before. By and large, the public paid it. That's a one-way ratchet, and they are never going to forget it. If I was with a large health insurer (Humana, Oxford, American Health, etc.) I would be thanking Gaia for putting Obama in office every day until I died.
Plus, add in that Government has a piss poor record of success in long-term market manipulation. Their history looks more like a junkie going to further extremes to repeat the same results.