patrick.net

Love that Swedish medical treatment. Man has to wait five months to get an appointment then they mistakenly amputate his penis! http://www.thelocal.se/31130/20101229/

elliemae says

But if you have a serious, progressive illness that requires labs, consults and chronic medications, it can cost $300 to $400/mo on top of the premiums just to treat it.

Ellie for any sinsible person that Anyone expects to pay up to if not more $1400 a month.
I think they can swing that quite comfortably, given the option.

Where's the added benefit, to pay tripple up front for care you don't even need???

IT would be far better suited in any kind of Savings account, and that way an even bigger guarantee they'll be able to afford any minor to mid level medical calamity.

You can actually Vacation in another country and under go serious operations, for 1/10th of what that operation would cost in America. And that's with a stay over in that country to recuperate before journeying home. And again the medicine paying out of pocket in the states would still be cheaper than any premium.

Tenouncetrout says

Federal Health Care System was the only SANE option. Every thing else was just a World Wide Joke of epic proportions.

I agree with all the rest, but it was not a Joke. It was a World Wide FRAUD of epic proportions. The whole reform was created by CEOs of major Health Insurers. In no way they would accept a Federal Health Care System.

winout says

Love that Swedish medical treatment. Man has to wait five months to get an appointment then they mistakenly amputate his penis! http://www.thelocal.se/31130/20101229/

Oh one story out of hundereds of Millions of medical patients in a socialist system in the world. In the meantime, our news papers are filled with "Malpractice" and "Neglegence" on a daily basis.

Just what is the point of these retorts? If ever in the history of "Anything is better than this" Liberal school of thought, Our insurance based medical system in this country, is a shinning example of that logic.
I mean on the scale of one to hundred,
Kerry vs. Bush was a 21.4 compared to this being a hundred.

michaelsch says

The reform actually reduces amount of health care existing facilities/personnel may provide by increasing huge administrative and regulatory overhead.

I find this unsupportable foo-fah.

But I agree that it's no surprise that premiums will be rising on the already-insured. That's what insurance pools are, once we admit millions who were excluded via adverse selection we're going to have to pay for them.

I also agree that KP is the big winner here and we may see health insurers start buying care facilities to get around the MLR stuff.

Getting more care for millions of people is a good first step. That premiums are supposed to be subsidized starting in 2012 or whatever does make this a fight that is going to be continued this decade.

The fight for reform is not over, it's just beginning.

michaelsch says

In no way they would accept a Federal Health Care System.

and neither would the American people, not in 1993 and not in 2010. We're too easily bamboozled. Seniors have largely already got their reforms, and most of the electorate that matters doesn't want government messing with what they have.

I'm willing to be proved wrong on this, but I think ACA was the best the system was able to vend in 2009-2010.

We'll see how it goes from here.

michaelsch says

The reform actually reduces amount of health care existing facilities/personnel may provide by increasing huge administrative and regulatory overhead.

You're saying additional insurance company paperwork costs are responsible for a 73% increase in my premium?

That's just obviously not true, or like Troy says "I find this unsupportable foo-fah."

The main problem with Obamacare is that the insurance companies blocked the public option.

Troy says

WPT has 10 million or so subscribers, so their overhead is $60/mo and their profit is $40/mo per subscriber.

So they have profits of $400 million dollars per month? Sucked out of customers who are trapped like rats in this evil system?

It's actually way higher than that, because that additional "overhead" cost of $600 million more per month no doubt includes the executive bonuses and private jets without which they could not provide their wonderful service...

But it still doesn't explain the 73% increase in premiums.

I just got my insurance raised AGAIN from Blue Shield of CA. It is unaffordable. I don't know what to do I was forced to switch to the lowest policy after the rate hike in Oct. My insurance has gone up over 100% since 2009, plus being a woman they increased my policy by 20%. raised it again, then said they were reducing it because of the gender bias and then raised it by 31.4% on top. It is shameful. I have panic attacks about my health care and how I can't afford it. The lower monthly high deducible policies are wolves in sheep's clothing. In the end you pay thousands more and are stuck with that policy than if you could afford to pay even 100 more a month by a 5000 difference. I have done the math. . It is a greedy system, and is structured to hurt the people who can't afford it the most. My wages aren't going up, I have to buy my own insurance, I work as a freelance person, and have tried to find a full time job in my field but they are limited and most do not offer benefits or have cut them. Everything is getting too expensive. I dread getting older, I turn 45 this year and again my insurance is going to go up by 100 or more a month. I can't make these ends meet and neither can the people I know. We all have 2-3 jobs and it barely covers it. I don't know who is getting the high paying salaries to keep up, but they aren't there anymore. A job that I interviewed for paid 75,000 2 years ago and now pays 35,000 with no benefits. Same job same heavy demanding workload. I am sorry to go off, but I can't believe my insurance is going up again. Also the underwriting is so evil if you have anything, I mean even a cold or god forbid told the doctor you were sad because someone died and they wrote the word Depressed or anxiety in your records they charge 75% above the the advertised rate for the same crappy coverage for 10 years.
I support Obama. At least he is trying to do something, it is out of control. I sit up at night and cry because of this health insurance nightmare, I pray if I get sick I just die so I don't go into financial ruin and be an indentured servant to this messed up system. I hate that I can't go to the doctor when I need to and if I do god forbid there is ANYTHING wrong I will be screwed because I can't afford to treat it and then can't afford the insurance. SHAMEFUL

Troy says

But I agree that it’s no surprise that premiums will be rising on the already-insured. That’s what insurance pools are, once we admit millions who were excluded via adverse selection we’re going to have to pay for them.

Woah, no, that's just the opposite of reality. "Adverse selection" means that only sick people want to buy insurance. Letting people buy insurance only when they want to means that we select for those with adverse health situations.

Adding the millions of others who don't have health issues right now means premiums should go down, not up. More people paying in, same few people are sick.

Tenouncetrout says

Sign up for Ruthy care, you’ll be amazed at the money you’ll save.

What's Ruthy Care? Doesn't show up in Google.

Got a URL for it?

Adding the millions of others who don’t have health issues right now means premiums should go down, not up. More people paying in, same few people are sick.

We haven't added them yet . . . the letter I got from BCBS telling me why my rates are going up 25% from $178 to $222:

ACA: BCBS says this is raising rates 1-5% now

Gender-neutral -- they say this is raising rates up to 17.7%.

ACA has the following changes for 2011:

Dependents up to age 26 now covered
Former lifetime limit of $5M removed
Preventative health care "free"
Pre-existing stuff for minors removed

I guess women have a lot higher health care costs than men . . .

I wouldn't be surprised if the health insurers were simply using Obama care as an excuse to raise rates. It's win-win for them: people will be POed at Obama and vote Republican - the party arguably favored by insurance companies - and in the meantime, the insurers enjoy higher premiums.

Any industry, being Health care, colleague education, housing, that have Gov subsidies prices go up.

These Gov tax subsidies are really Gov assisted robbery of citizen for the benefits of these industries.

Usually if people don't like something we refuse to buy that services and force the prices to go down.

But now even thought people don't like the health care price tag the Obama care will force people to buy that expensive things people hate.

absurd.

Tenouncetrout says

Sign up for Ruthy care, you’ll be amazed at the money you’ll save.

What’s Ruthy Care? Doesn’t show up in Google.
Got a URL for it?

Ruthy is my wife, she pays the Bills, she finds which Doctor we go to, and where we get our medicine. She's been pretty thrifty and effective. Still haven't managed to spend a full months worth of a $1400 monthly premium in the whole year. They've(wife and two daughters) been to the Doctor as many times as anyone else healthy with an insurance plan I know.

Me I don't go, if it aint broke don't fix it.

zongmike says

Obama care will force people to buy that expensive things people hate

you're not forced to buy anything under ACA. I forget, but something like $50/mo or 2% of income is the tax to induce you to get coverage.

I agree with your larger points that subsidies in education and housing are just making them more expensive, and the same thing will happen under ACA as tens of millions will enjoy subsidized health insurance.

This money will have to come out of taxes eventually. Or theoretically. Right now we're not too big on actually having taxes meet expenses for some reason.

I had my rates rise 30% last year for myself wife and 1 year old daughter w/ Blue Shield. I filed a complaint in CA here: http://insurance.ca.gov/contact-us/0200-file-complaint/

BY LAW the insurance company needs to give you 30 (or 60 cant remember) days WRITTEN notice before raising rates. If that did not happen then they cannot raise your rates.

The end result was that I was reimbursed the difference by the insurance company in the months it took to file the complaint and await the review/ negotiation. However I was still owed $775 and B/ Shield have tried the same trick and raised the rate another 20% (again without written notice) so I about to file complaint #2.

Importantly, I kept paying the insurance the whole time until it was resolved. Being from the UK and having been treated there, Australia, Brazil, Singapore and Thailand I can honestly say that the US system is unfair and completely ran in favor of investors. They have no accountability as far as I can see, it is a scam.....

I agree w/ some of the above comments of US doctors suggesting treatments, medicines, procedures etc just to make a quick buck, not necessarily because they are the right thing to do.......

No other country in the world (I have lived in worked in about 15) has TV adverts telling you to "go and ask your doctor if $#@%^ is right for you" If you suffer from headache, nausea, wild erratic spasms, sleep walking or chronic anal discharge then maybe, just maybe......you took the wrong medicine that "your doctor" told you to take!!!

Mikejay says

I wouldn’t be surprised if the health insurers were simply using Obama care as an excuse to raise rates. It’s win-win for them: people will be POed at Obama and vote Republican - the party arguably favored by insurance companies - and in the meantime, the insurers enjoy higher premiums.

Thing is, everyone's getting these massive bills from the insurers, not from the government. Their costs have not gone up in the last year anything remotely like the increases they are imposing and anyone with half a brain can see that.

It's another huge example of corporate lobbyists influencing the government to let the corporations rape us in the name of the "free market" while angry dimwit Republicans go along with it.

When the banana Republicans finally get their wish and we are left with nothing but a banana republic, a few ultra-wealthy people will own everything. Everyone else will be their permanent peons. Entrepreneurship in America is already lower than most other countries, and the lack of health care independent from your job is a huge reason why:

http://noapparentmotive.org/blog/2010/12/17/health-insurance-and-entrepreneurship/

"Central planning doesn’t work. Free markets work. But as others observed above, we don’t have a free market. We have a hybrid where profits go to the private sector and costs go to the taxpayer. That won’t work. We have to get back to a true free market in health care, and that means eliminating government involvement except for the usual basic enforcement of contracts and so on."

What exactly does it mean to get back to a true free market in health care? When did we have a true free market in health care?

I completely agree with your description of privatization of profits, socialization of costs. But you seem to view this as a government takeover of health care. I view it as a health care takeover of government. The insurance companies, drug companies, hospitals, etc. are using the government as an instrument of plunder.

The cost graph Patrick has posted indicates the system is in a runaway condition. This is a positive feedback loop, i.e. the hotter it gets, the hotter it gets. As he extrapolated, it will quickly ratchet up to become unaffordable to everyone anyway.

repo4sale says

This is an example of why I “date women between 20-30″…. and why I refused to get married. 3 women in the past did not sign my Pre-Nuptial contract (very fortunate). I am looking for a “10 DNA surrogate”… $100-200k???? Must pass background & DNA analysis by my Dr. Present Net worth without Debt about $50-150m. 2020 goal is $1b. Need DNA child to transfer Estate to!

You just get increasingly odd - you do know that, right? I'm not surprised that you couldn't find anyone to sign your "contract." Have you tried Angela from "The Office?" She seems to be exactly what you're looking for.

Mikejay says

I wouldn’t be surprised if the health insurers were simply using Obama care as an excuse to raise rates. It’s win-win for them: people will be POed at Obama and vote Republican - the party arguably favored by insurance companies - and in the meantime, the insurers enjoy higher premiums.

Thing is, everyone’s getting these massive bills from the insurers, not from the government. Their costs have not gone up in the last year anything remotely like the increases they are imposing and anyone with half a brain can see that.
It’s another huge example of corporate lobbyists influencing the government to let the corporations rape us in the name of the “free market” while angry dimwit Republicans go along with it.
When the banana Republicans finally get their wish and we are left with nothing but a banana republic, a few ultra-wealthy people will own everything. Everyone else will be their permanent peons. Entrepreneurship in America is already lower than most other countries, and the lack of health care independent from your job is a huge reason why:
http://noapparentmotive.org/blog/2010/12/17/health-insurance-and-entrepreneurship/

Even the Mexicans are staying home now and many who have come "for a better life" have decided to pack up and go back to Mexico. Mexicans know what it's like to live in a 3rd. World Country. Americans are just starting to learn. Mexicans are smart enough not to get onto a sinking ship.

Soon Canada will be complaining about all of the immigrants coming from south of their border to work and seek out "a better life." Maybe they'll be kinder to us and refrain from the idiocy of building a fence in the middle of nowhere that keeps no one out.

michaelsch says

The reform actually reduces amount of health care existing facilities/personnel may provide by increasing huge administrative and regulatory overhead.

You’re saying additional insurance company paperwork costs are responsible for a 73% increase in my premium?
That’s just obviously not true, or like Troy says “I find this unsupportable foo-fah.”

It's not the insurance company paperwork. It's regulations compliance that creates that overhead.

The main problem with Obamacare is that the insurance companies blocked the public option.

No kidding. The bill was created by lobbyists from major insurances companies. They practically hijacked it. How would you expect public option?

Well, let me explain what I see myself. (BTW, I'm working for the biggest California Health Insurer and HMO.)

1. Health industry is an industry with finances similar to all other industries. Financing means getting loans and rolling over your debt.

2. The reform made available Government guarantees to large loans with extremely low interest rates. (much lower than inflation). Banks are still interesting in issuing these loans, since Government secures them, so banks create the whole amount out of thin air and get some interest for free. We talk about Billions, so even 1% interest is a lot of FREE money.

3. However, those guarantees are not automatic. You need to pass lots of compliance tests like HIPAA, SOX, etc., etc. to qualify. Most of these compliance requirements are not applicable to most of equipment, processes, and software used in Healthcare, (they are like 0 cholesterol in bricks.) but you still need to pass them. Passing them is very expensive. Today this is the major overhead for large H-C organizations and the major reason/excuse for increase in Your premium. Government fully recognizes cost increases caused by its regulations and allows insurers to pass the cost to You. I suspect they hope that after compliance work is finished the higher premiums will cover expenses to insure those currently uninsured.

4. The worst thing is that after you are certified, you can't make ANY change. Change becomes the worst nightmare of HealthCare management. You can't change outdated equipment, switch to better reagents, change software, implement fixes, etc., etc., etc. Health Care systems are very interdependent, change in one part often causes changes in information flows in other parts, so it's a big NO-NO on any level. As the result, everything we do turns less and less efficient. One would be amazed how quickly this works in Health Care.

As the result of 4., be ready to more sharp increases in premium.

Troy says

michaelsch says

The reform actually reduces amount of health care existing facilities/personnel may provide by increasing huge administrative and regulatory overhead.

I find this unsupportable foo-fah.

Please, take a look at my explanation above.

michaelsch says

In no way they would accept a Federal Health Care System.

and neither would the American people, not in 1993 and not in 2010. We’re too easily bamboozled. Seniors have largely already got their reforms, and most of the electorate that matters doesn’t want government messing with what they have.

I think American people are really brainwashed about things like Government Health Care System. I would say that on the one hand it is not the solution, on the other hand purely private Health Care does not work either. IMO, the solution would be some kind of combination of the two. Government Health Care System actually works nice for basic, routine care, like immunizations and anything that can be provided in a cookie-cutter approach. It does not work and never will for non-standard cases. So, Government Health Care System would be ideal most of the time, as long as everyone would understand he needs to save plus keep a good credit rating plus have very devote, caring relatives for the case of a severe medical emergency.

Of course, there are some problems with this. For example, how would you convince good doctors to work with Government Health Care System? The only way I can see is to allow private payments by patients to them. Today accepting such a payment is felony in USA.

michaelsch says

I think American people are really brainwashed about things like Government Health Care System. I would say that on the one hand it is not the solution, on the other hand purely private Health Care does not work either. IMO, the solution would be some kind of combination of the two. Government Health Care System actually works nice for basic, routine care, like immunizations and anything that can be provided in a cookie-cutter approach. It does not work and never will for non-standard cases. So, Government Health Care System would be ideal most of the time, as long as everyone would understand he needs to save plus keep a good credit rating plus have very devote, caring relatives for the case of a severe medical emergency.

My Dad is pleased with his "Government Health Care System" (Tricare + Medicare). He figures he's received closing on a million dollars in medical treatment for angina, heart attack, multiple stents, an extremely rare liver cancer, lung problems, and various other indignities that come with getting to be 89 years old. Getting treatment at the Mayo Clinic which seems to have plenty of good doctors who "work with Government Health Care System".

michaelsch says

take a look at my explanation above.

Total health care costs are 20%+ of GDP. Regulations are not a major component of this.

I just read today that 60,000 general anesthesia procedures are done every day in this country, that's 20 million a year. Stupendous.

michaelsch says

how would you convince good doctors to work with Government Health Care System?

This is generally done by forcing doctors to choose between the government-supported system and private practice.

For doctors in Japan, they're kinda screwed because their language isolates them to the Japanese market and the government's domination over their practice.

For Canadian and UK doctors, they can escape to the US. My dermatologist is from Canada, practicing in nice & wealthy Los Altos.

oddhack says

michaelsch says

I think American people are really brainwashed about things like Government Health Care System. I would say that on the one hand it is not the solution, on the other hand purely private Health Care does not work either. IMO, the solution would be some kind of combination of the two. Government Health Care System actually works nice for basic, routine care, like immunizations and anything that can be provided in a cookie-cutter approach. It does not work and never will for non-standard cases. So, Government Health Care System would be ideal most of the time, as long as everyone would understand he needs to save plus keep a good credit rating plus have very devote, caring relatives for the case of a severe medical emergency.

My Dad is pleased with his “Government Health Care System” (Tricare + Medicare). He figures he’s received closing on a million dollars in medical treatment for angina, heart attack, multiple stents, an extremely rare liver cancer, lung problems, and various other indignities that come with getting to be 89 years old. Getting treatment at the Mayo Clinic which seems to have plenty of good doctors who “work with Government Health Care System”.

Good for your Dad.

I'm glad to learn that Government System may be able to cover much bigger part of Health Care than I thought.

This is an example of why I “date women between 20-30″…. and why I refused to get married. 3 women in the past did not sign my Pre-Nuptial contract (very fortunate). I am looking for a “10 DNA surrogate”… $100-200k???? Must pass background & DNA analysis by my Dr. Present Net worth without Debt about $50-150m. 2020 goal is $1b. Need DNA child to transfer Estate to!

Why post such a ugly response. This is a discussion about health care not about you trying to find some trophy baby momma for you to procreate with. Please be respectful.

Mikejay says

I wouldn’t be surprised if the health insurers were simply using Obama care as an excuse to raise rates

Bingo.

When the banana Republicans finally get their wish and we are left with nothing but a banana republic, a few ultra-wealthy people will own everything.

Exactly. Unfortunately, this country is chock full of banana Republicans. You know, the type that thinks that if only they didn't have to pay taxes they would all be rich.

justme says

You know, the type that thinks that if only they didn’t have to pay taxes they would all be rich

well, I'm half a tea-party type. We don't seem to be getting much value for our $6.7T/yr government.

It's not that I don't think we need all the services it provides, but in subsidizing so much it does also subsidize rent-seeking.

The government spent $3T more than it taxed over the past 2 years. That is about $1000/mo per household. Something is out of whack here and I don't see any return to equilibrium coming. Not without Soylent Green-style riots somewhere in the process.

UHC bumped ours by 25% - we are a childless couple in our 30s with no prior record of serious illnesses

^ they go by age not by previous health costs. Prior to ACA they could discriminate on sex, too, but that's now not permitted.

Troy says

well, I’m half a tea-party type. We don’t seem to be getting much value for our $6.7T/yr government.

I'd agree that we are not getting much value out of defense spending. Just endless war and killing.

As for Social Security and Medicare, we seem to be getting very good value, much better than through the private alternatives, 401k/WallSt and private health insurance.

Perhaps we can say the tea cup is half full.

One major problem: subsidies increase demand, not supply!

The government should be increasing supply of doctors, hospitals, machinery. Not increasing the number of dollars chasing a fixed amount of all that.

But if they were to increase supply, the medical industry would hate them for forcing healthcare prices down.

Troy says

michaelsch says

how would you convince good doctors to work with Government Health Care System?

This is generally done by forcing doctors to choose between the government-supported system and private practice.
For doctors in Japan, they’re kinda screwed because their language isolates them to the Japanese market and the government’s domination over their practice.
For Canadian and UK doctors, they can escape to the US. My dermatologist is from Canada, practicing in nice & wealthy Los Altos.

Bs. Most (not all) of the public health care systems around the world are a combination of public and private. The government public health system takes care of basic health care and people who can't afford private insurance. Everyone who wants to is free to purchase private insurance and see doctors in the private sector. The doctors work for the public system and run their private practices in addition. Why would someone use the same doctor as a private instead of public? Shorter waits, procedures not covered in the public sector, use of a private hospital for a start.

bob2356 says

The doctors work for the public system and run their private practices in addition

AFAIK the debate in Canada is allowing a parallel private *insurance* system. All Canadian practices are private, but the insurance is single-payer.

http://medicare.ca/main/the-facts/the-myth-of-the-european-model

mn_mark says

Going to an all-government health care system would just be jumping out of the frying pan and into the fire. Think about it: if it was actually more efficient for the government to run the nation’s healthcare as a centralized bureaucracy, then it would be more efficient for the government to manage all of the goods and services society needs: food, shelter, clothing, transportation, entertainment, education, everything.

mn_mark says

Socialist health care systems are already collapsing around the world. Look at the problems with Britain’s. We do not need to go that route…it will be worse than what we have now and will cost even more - the cost will simply be hidden in your taxes and interest rates rather than coming as a premium bill from an insurer. We need to get back to a real free market in health care.

Rubbish. We have and always will have a socialized system that pays for a huge percentage of the most expensive care. This is medicare and medicaid. These should be tweaked and expanded to replace private health insurance.

Think about it, the government pays for the really expensive stuff, the end of life care (or at least most of it) and for "coverage" of all the people who probably will need very little health care we go the insurance route. So let's see, that means that a significant part of the relatively fixed costs of a national system for payment to providers is already in place. And yet we have all of these little entities tripping over themselves complicating things for everyone and gouging the consumer in the process.

As Patrick said, it is corruption, plain and simple. Your argument simply doesn't fly. You can't deny all the countries that get it right.

michaelsch says

how would you convince good doctors to work with Government Health Care System?

How many heart specialists don't accept Medicare ? Virtually all doctors would have to go with 'Medicare for all' if we had it.

oddhack says

My Dad is pleased with his “Government Health Care System” (Tricare + Medicare). He figures he’s received closing on a million dollars in medical treatment for angina, heart attack, multiple stents, an extremely rare liver cancer, lung problems, and various other indignities that come with getting to be 89 years old. Getting treatment at the Mayo Clinic which seems to have plenty of good doctors who “work with Government Health Care System”.

Exactly.

There is one problem that I never hear people talking about, and that is our economy. If health care is 16% of GDP and we "fix" our system cutting the cost say by 50% (for the sake of the example), doesn't that mean that our GDP takes an 8% hit ?

Given how things already are, maybe we can't handle fixing our health care system. You could think of our health care system as a permanent built in "stimulus" to our service oriented economy. Dang, I knew I should have gone in to health care.

marcus says

“fix” our system cutting the cost say by 50% (for the sake of the example), doesn’t that mean that our GDP takes an 8% hit

Yes, GDP is income and if health professionals and their suppliers are making half what they do now there will be less income in the national account.

However, this lost income to them becomes more discretionary income for everyone else. The extra money we'd have would start chasing other life expenses (foremost, higher rents and land values of course).

To avoid just having home prices rise in response we would have to raise taxes, like reverse the 2% cut to FICA (stupidest thing we've done EVER).

The USGOV has spent $3T more than it took in over the past two years. This is a very curious development and I don't really have any idea what's going to happen in response, to either us continuing this rate of borrowing, increasing it, or throttling it down. It all seems bad.

Also, medicine is largely wealth preservation not creation. There is an element of the http://en.wikipedia.org/wiki/Parable_of_the_broken_window to it.