patrick.net

ChrisLA says

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WIKIPEDIA

Medical professionals are not paid high salaries by international standards. ..... Therefore, some prefer to work in different occupations, for example in the lucrative tourist industry where earnings can be much higher.

The San Francisco Chronicle, the Washington Post, and National Public Radio have all reported on Cuban doctors defecting to other countries.[52]

Black market healthcare

The difficulty in gaining access to certain medicines and treatments has led to healthcare playing an increasing role in Cuba's burgeoning black market economy, sometimes termed "sociolismo".

If one travels to Cuba you can quickly see that the Cuba government does NOT locals inside most tourist hotels.

Coffee is ready!

ljacobs says

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$87,000 RN in San Francisco, CA

Average RN salaries for job postings in San Francisco, CA are 20% higher than average RN salaries for job postings nationwide.

http://www.indeed.com/salary/q-RN-l-San-Francisco,-CA.html

You can also go to the SF HR dept site to get other numbers.

Many nurses make $100,000+ plus big benfits and OT.

Blue Cross is essentially non-profit, I don't know if Blue Shield is the same. The insurance companies are only reacting to the new health care law. If the government interferes with their business to the extent that they are no longer really insurance companies, they will have to raise our rates or be unable to cover anyone.
How much would your car insurance cost if you required them to sell a policy that will fix your car, and you buy it after you already crashed it? Oh, and your car insurance must also automatically cover anyone else who may be driving your car illegally without your knowledge, whether or not he has a license, etc.
Life insurance would probably be very expensive if your family wanted to buy it after you were already dead also.
The basic function of insurance is to spread risk of an event happening to you among a larger group, and paying when such an event happens. In life insurance, it's death. In medical events, the insurance companies have to calculate not jut how likely something is to happen to you, but how much it will cost to treat. If the government requires health insurance companies to cover more possible events, with more expensive claims, they must raise rates.
The government has prevented the insurance companies from being able to offer you to be OUT of the pool of sick people. Your insurance company was forced by the government to lump you together with the unhealthy people who are already sick.
My car insurance is ridiculously low. One reason is that if I had any speeding tickets, drunk driving or moving violations, etc. they would not have let me in their pool of insured drivers.

I guess a quick visit to a California hospital may be informative. These people are being treated and they have no insurance. The hospital treats them, then looks for someone to gouge so the hospital doesn't go bankrupt. I get crashed into and must go to the ER. The hospital will bill MY insurance company a big chunk of change to try to get me to cover those who came in all day with no insurance. Have you BEEN to a California hospital lately?
Providing medical care to millions of those who pay nothing, many of whom are here illegally, is expensive. The hospitals pass this cost onto those who have insurance.

I thought it was because we did need to use the insurance last year, but that’s not it. They even sent me their chart to show that my premium is the same as everyone else in my age and family category.
They’re just screwing everyone equally.

It's largely based on what group rate you can get. A friend works for a small company (fewer than 20 employees) and he pays over $800 a year for family coverage (although the out of pocket deductible is much lower then yours, something like 4k a year), the company I work for (about 300 employees) family coverage is something like $450 a month and the company my wife works for (3000+ employees in the medical field) pays about $100 a month for coverage to cover both of us.

So better rates are out there. My suggestion would be try to team up with other independent companies to obtain better rates. If you could get together maybe 100 small business owners together and form say the XYZ corp, with the total employees of XYZ corp around 300, your rates would get much better. All other finances would be separate, your just forming a corporation to get better medical benefit group rates.

This farmer co-op is just one example of what I'm talking about, I'm sure others exist, and if they don't there nothing stopping you from forming your own group.
http://www.choicesmagazine.org/magazine/article.php?article=101

Take a look at this:
https://www.greathealthplan.org

Great health plan?

If you go to the website looks like this is NOT health insurance, but a discount plan instead.

"team up with other independent companies" ? Not possible.

Above post looks like well disguised spam.

kimboslice says

Providing medical care to millions of those who pay nothing, many of whom are here illegally, is expensive. The hospitals pass this cost onto those who have insurance.

A friend of mine is an RN in an emergency room, and she frequently complains about all the money illegal immigrants are costing our system. Out of curiosity I did a little research to see if the statistics reflected her personal experience/views. This was several months ago, I don’t remember exact numbers, but it was a lot lower than I thought it would be based on what she was saying. I think it was around 2-3% (maybe less) if I am remembering correctly. This was only illegal and just in California (high level of illegals), not total uninsured that I was looking into.

A lot of this cost is because they come into the emergency room for anything, and I mean anything, and they do this because the emergency room is their only way of getting care.

Health Insurace Pro says

“team up with other independent companies” ? Not possible.
Above post looks like well disguised spam.

Since I'm a regular poster, with hundreds of postings and comments it's unlikely my post is well disguised spam. So for the "Team up with other independent companies" comment, I ask why not? If you could contract 50 or even 100 small local businesses in your area and form a co-op for the purpose of insuring there employees at a lower cost. So you approach a health insurance company and say we have 500 employees, what rate you going to give us? Instead of "not possible" perhaps you can enlighten us Why it's not possible.

TechGromit says

Health Insurace Pro says

“team up with other independent companies” ? Not possible.
Above post looks like well disguised spam.

Since I’m a regular poster, with hundreds of postings and comments it’s unlikely my post is well disguised spam.

I don't know perhaps you have been a "sleeper" spammer, slowly building credibility waiting for the right topic to arise just to slip in some subtle spam.

Ahhhh... just kidding, reading someones post history is a good way to detect spam.

Just got a call today from some astroturf group in Pennsylvania that wanted my signature for recalling Obamacare. Not gonna happen.

Thanks. Obamacare is definitely flawed, but compared to the Republican plan of "death for everyone who failed to get rich" it looks pretty good.

Thanks. Obamacare is definitely flawed, but compared to the Republican plan of “death for everyone who failed to get rich” it looks pretty good.

Common let's be fair, they are not going to let the non-rich just die. First they will bleed them and their families for every cent they can driving them into bankruptcy or debt slavery. Then they will let them die.

And, yes as horribly disappointed as I am in Obamacare it is better than the Republican plan.

You still do not get it.

The only effect of Obama insurance reform (in no way it's about healthcare but about insurance) is the carte blanche to insurance companies to gauge their prices.

This reform was created by Health Insurance CEOs. Their first goal was to kill public option. (Mission accomplished). Second was to milk the public for as much money as possible. This is done in many ways: raising premiums, increasing deductibles and reducing services, outsourcing everything possible and impossible to India, reducing salaries and benefits (have you heard about recent reduction of salaries to Kaiser Permanente nurses and strikes in LA?)

However, the most important is getting practically free loans guaranteed by Federal Government. That's what enables them to not care about the patients. It's very simple, since the end of 2009 they really do not need you. They need to be government compiant, (HIPPA, SOX etc.). In this case they get Government guaranteed loans with rates way below inflation. Banks are happy, they need no securities to create these loans and still get some interest on zero investment. Executives have their fat bonuses funded. Who needs patients, nurses, labs, even doctors? Even more so, those are dangerous, they may want to do something. They may want to change some processes, equipment, software. That would force another proof of compliance. "No, thank you, all we need are happy government not any crap like patient care."

That's all direct result of Obama reform.

With private health care poor people usually get some care. There are religious organizations, true non-profit clinics, altruistic doctors etc. The most important, there is no shortage of available care.

Obamareform creates a deficit of healthcare. Anything in short supply comes at a premium. Both insurance premium and lower quality premium.

As the result of Obama reform health care has to become unaffordable to working class (even those who are blind enough to consider themselves still in middle class).

No wonder, when services are scarce, they are affordable to rich only.

michaelsch says

With private health care poor people usually get some care. There are religious organizations, true non-profit clinics, altruistic doctors etc. The most important, there is no shortage of available care.

ideology-driven bullshit.

Troy says

michaelsch says

With private health care poor people usually get some care. There are religious organizations, true non-profit clinics, altruistic doctors etc. The most important, there is no shortage of available care.

ideology-driven bullshit.
“Nessuna soluzione . . . nessun problema!„

Very strong argument. Could you pls specify what's the ideology.

On the matter, I remember how in 80th most of my friends had no health insurance, but were able to get treatment when needed.

From 1991 to 2000 I held no health insurance. Paid $50 for private doctors visits as needed. Did not need much more than that.

I was a software contractor, my wife was a PHD student at UCLA. She had a UCLA health plan, but it did not cover the family. We checked that in case of emergency UCLA Med. Ctr. would admit us. Payments would be nogotiated later on.

The only issue I had was once when my son needed physical exams for some kind of sporting activity.

Called a private clinic, we agreed on something like $60. Later on I got a bill for several handreds, with a bunch of tests listed (apparently some of them not done at all and some completely unnecessary.)

Had to write a nasty letter to them. Have not heard from them since.

michaelsch says

Could you pls specify what’s the ideology.

your laissez faire bullshit about "poor" people "usually" getting the medical care they need as private, uninsured consumers. This is just hand-waving generalities.

This medical care goes far far beyond $60 office visits, as you will find out as you grow older and or encounter a serious health care need.

The reality is that every other first-world nation on the planet has a much better health care system now, with per-capita prices less than half ours for prenatal to grave universal coverage.

The only way to get there is by breaking the cartels controlling supply for one, and putting single payer cost controls run by the state.

ACA is only a small step in that direction, but by having taxpayers pay subsidies for the middle class we (aka the state) will be buying a seat at the cost-control -- actually, profit-control -- table eventually.

Troy says

The reality is that every other first-world nation on the planet has a much better health care system now, with per-capita prices less than half ours for prenatal to grave universal coverage.

The only way to get there is by breaking the cartels controlling supply for one, and putting single payer cost controls run by the state.

ACA is only a small step in that direction, but by having taxpayers pay subsidies for the middle class we (aka the state) will be buying a seat at the cost-control — actually, profit-control — table eventually.

Who is ACA?

The reality is that what reform we got was writen with the goal to kill any chance of a single payor system. Or even of a limited version of it they call public option. It was writen by Health Insurance execs. Because of it we won't have any chance of any public option in lifetime of the current generation.

As a side effect, the government gets incredible level of control on how health care is done without taking on any responsibility. As the result, health care providing organizations must concentrate on government relations rather than on health care.

As one directly involved in health processes that serve more than 2.5 million people in S. Cal. i'm directly witnessing devastating effects of the reform on actual services. As of today it mostly affects costs, however, it's clear that the quality is to deteriorate over the next several years.

I'm not saying this from any ideological position. In fact I would like to have a state single payor system in USA, even though there are large differences between Europe and USA that may make such a system much less efficient here. Anyways I agree that a single payor care is the least evil of our options.

Again, the purpose of the current reform is to kill a chance of such a system, rather than bridging to it.

APOCALYPSEFUCK says

No hospital in America will let you into the parking lot without insurance that they know they can bill successfully.

Kind of a new argument to me.

I don't know how it is today, but in the 90th at least some university hospitals accepted uninsured patient and negotiated payments later on.
Of course you needed to live quite close to one, which was expensive.

The main argument I heard when telling people I held no health insurance was: "yes, but do you really want to be treated by an intern instead of an experienced doctor, or by a dental school student instead of a real dentist."
It could make some sense, however KP family doctors are hardly better than UCLA interns and are allowed much less time per a patient visit.

Most private hospitals accept uninsured patients in emergency rooms even today. Visiting an emergency room is not a fun, but may save you in a severe situation.

Austinhousingbubble says

Of course I’m shopping for other insurance via http://www.healthcare.gov/ but so far none of the others seem to be much cheaper.

Another reason for this is the antitrust exemption the insurance industry enjoys. The House passed a bill to eliminate it, but whether you’ll hear anything more about it is doubtful.

Bingo. Anti trust pure and simple. These guys were making 28 percent profit. Now they are trying to make 28 percent profit while offering a lot more coverage as mandated by Congress. (No lifetimes and all that jazz.) Thanks Congress and Obama administration for this piss poor excuse for reform. This was completely forseeable and precisely why we need real reform including a public option.

Oh and by the way. I have cured myself of allergies/asthma/fibrocystic breast disease through natural means.

Try the water cure. www.watercure2.org.

All the information is there for free.

Water, sea salt, magnesium (I use magnesium oil), potassium (fruits and veggies), iodine (I use lugols solution.)

The Drs will tell you there is nothing you can do but take expensive pharmaceuticals. They are misinformed. I now no longer require any pharmaceuticals on a daily basis. Have not taken antibiotics in a year. Before that I took them 4-6 times a year for chronic sinus infection.

I will share my knowledge with all who ask. I hope everyone would get better like me. Healthcare costs would go down for everyone.

The only discussion should be how to eliminate the middle man, and not give out free medical care to anyone.

Healthcare is not a right, it is a product sold by free people. You have no right to anyone's product, no matter your need.

Socialism is a failure, more socialism will not work, it adds way too much friction to the system.

Your philosophy is corrupt, who made you God to decide how health companies should function? They owe you nothing. They own their products.

If Blue cross wants to charge $1 million per year then tough, they have the right to charge whatever they want, who are you to demand anything? Do not buy their product. Go to any doctor and pay in cash.

John Spikes says

Socialism is a failure, more socialism will not work, it adds way too much friction to the system.

Your philosophy is corrupt, who made you God to decide how health companies should function? They owe you nothing. They own their products.

Right! Why should anyone be able to use the government to rob you of everything you ever worked for?

But that's exactly what you are supporting.

Corporate control of your life is a TAX.

John Spikes says

Socialism is a failure, more socialism will not work, it adds way too much friction to the system.

tell it to the Swedes, Norwegians, Denmark people, and Germans.

your ideological thinking is very reality-challenged.

RENTS are what destroy any system in the end, capitalist or socialist.

The eurosocialism of the Nordic countries is actually just a mixed economy, taking the things that work from both sides of the debate, and leaving the things that don't, like private capture of rents created by public goods that our current system here in the US suffers from.

Free-market ideology was BS 50 years ago when Goldwater was espousing it and it's demonstrably still BS today.

Congrats to Patrick and those advocating for reform. I know, a drop in the bucket, but a moral victory nonetheless.
Blue Shield to cap profits at 2 percent

SF ace, How could you be cynical about a non profit where the chief executive pulled in $4.6 million last year? Clearly, he's fearful of the state insurance commissioner being given authority to regulate his ATM machine business.

Many US Employers to Drop Health Benefits: McKinsey
http://www.cnbc.com/id/43312215

Not good...

The biggest failure of Obama is he didn't implement a single payer system, now we are all gonna get screwed.

This is exactly why we need single payer. If medical providers can't charge people different amounts for the same service, then insurance companies cannot hold people captive.

90% of the reason people buy insurance is just for the group bargaining power. You get billed a lot more if you don't have insurance.

Plus if single-payer existed, anyone could start up an insurance company and compete against big insurance since the prices would be the same. A well written software system could put all the big insurance companies out of business. After all, it's all well-known math and if an insurance pool reaches a critical size, it's essentially zero-risk.

All I can say is, there are so many moron Americans out there that it is almost comical watching them constantly, consistently voting for something entirely against their self interest. Take single payer for example.

A typically rational voter with $20M net worth, probably should vote it down (but even Donna Dubinsky had difficulty getting her individual insurance and complained openly). Most Americans are just poor slobs teetering on the verge of bankruptcy, and if they are sick, they are almost assured of financial ruins, yet they want to vote it down, because they don't want so-called socialism, I am just amazed and amused by their stupidity.

If I were someone making $80K, completely dependent on employer for medical insurance, hell, I would vote with both hands and feet for single payer. Most Americans don't even have a decent insurance plan with their employers for god's sake. Who cares if it is socialism or communism, you can cal it fascism and I will vote for it.

Where else do you find a bunch of morons who always get brainwashed to vote against their self interest? Only in America.

I would love to see the following options available to me for an individual policy:

Fixed premium that increases only with CPI or equivalent.

Deductible that increases with age, predetermined.

Multi-year contract that allows this locked-in rate for X years.

We can lock in on just about every other kind of contract, and the whole point of insurance is to protect us from the financial unknowns of medical cost. Yet, the costs are still unknown, now, when an insurer can take such giant arbitrary leaps in price.

pianist says

Yet, the costs are still unknown, now, when an insurer can take such giant arbitrary leaps in price.

We need insurance against insurance cost increases!

We need insurance against insurance cost increases!

Ala the CATO "Health-status insurance" white paper?

pianist says

I would love to see the following options available to me for an individual policy:

Fixed premium that increases only with CPI or equivalent.

Single payer. IF there is only one payer, that one payer can to a great degree set the price. Providers can try another country where they will be paid less if they have a problem with it.

"But the government can never do anythng right."

People are so fricking gullible.

pianist says

Fixed premium that increases only with CPI or equivalent.

You would also have to exclude yourself from any newer more expensive medical treatments in the future for this to work. That might be a little tricky if you got sick with something that couldn't be cured when you signed your policy but is curable later for a higher cost.

OO says

I am just amazed and amused by their stupidity.

The stupidity is induced by decades of failed education system and embedded distortion of American political system. All those who believe in Dem/Rep opposition are nothing by stupid. There is practically no differences between them.

(Well, in recent history Dems mostly care about financial capital, while Reps care about all major corporations, but this practically does not matter to 99% of people.)

Praising Obama reform is nothing but stupidity. The guy actually had opportunity to reform healthcare, he rather opted to create a reform that only insures profits of owners and top executives of insurance companies. Worst of all his reform kills ANY chance of any meaningful healthcare reform for decades to go. He deserves the worst punishment for this. (If only there was any remotely better candidate to vote for.)

So private insurance rates for individuals are totally unrealistic. People group together (small companies, etc) to get leverage to negotiate lower terms. I imagine the larger the group, the better the terms. SO - why not create a corporation including all (or maybe just 99%) of US citizens, then see what BS BS comes up with?

That's the same as saying this: If I hold a gun to your head and charge you $1 million to remain alive, tough, I have the right to charge whatever I want. Who are you to demand anything? Do not live, just die.

No one is holding a gun to your head though....

Yes, the insurance companies are holding a gun to my head, and yours.

Everyone eventually needs medical care.

John Spikes says

You have no right to anyone's product, no matter your need.

Sorry, buddy, but you do.

This here, boy, is the United States of America, and we do have rights. Obviously you have no idea how Health Care works, or how much of it already comes from the government.

We have a right to participate in that system of Health Care, provided by our government, but we are barred from getting that access.

All any one has asked for is access to the same Health Insurance Congress people enjoy.

Yes, the insurance companies are holding a gun to my head, and yours.

Everyone eventually needs medical care.

We are the ones to blame, for this silly concept that we can't have medical care, without "insurance"