How Many States Alreday Offer Insurance for Pre X
- Thread starter bpenn9
- Start date
- 11,997
New York is GI too and the individual and family health insurance market is all but non-existant. Premiums are ridiculous, coverage sucks, and the group plans are very expensive. GI with no underwriting is not the answer to the problem. Addressing the cost of healthcare delivery would create the type of change I believe needs to happen.
- 2,908
- 11,997
Let me preface this by saying that I have mixed feelings about the government getting bigger with anything, let alone healthcare. Without writing a book, here are a few:
1. Expand funding for clinic models: Insurance is a method of financing healthcare, not delivering it. Skipping out on paying the insurance carriers and adding the cost of the man power to bill the insurance company and having the insurance company cut the checks, the government could expand funding for clinics and let americans have access to a Dr. visit with $5-$15 copay at the office. This wouldn't address the issues in the more rural areas, maybe adding a voucher for folks in rural areas could help bridge that gap, even the government self-insuring (if done correctly, which is a big if) the cost of the healthcare makes more sense. If we're going to do GI, than the government should pay the carriers an admin fee and pay the actual claims out of an operating fund.
2. Regulate the profits pharmaceutical companies: I'm not a fan of government intervention, but since they've helped the companies get this big they might as well be a part of helping America. I bought a drug from Canada from a pharmacy that was able to make a profit off of mailing me 100 pills for less than $95 with shipping. The same drug, for 30 pills, is over $140 even if I shop the different pharmacies. (btw- It's been a generic for two years). One way of lowering the cost of healthcare would be to limit the profits pharmaceutical companies can make off of drugs. If I can get a drug from canada for 20% of the cost here and that includes the cost of shipping AND the pharmacy making money off of it, then we're getting hustled in a major way.
3. Address the cost of obesity related health issues by taxing sugary and fattening foods. Again, I think this may be a bit extreme, but it probably would benefit americans in more than one way. Many people eat sugary and fattening foods simply because they are less expensive and easier to make than eating healthy, so this would work to some degree like a tariff by artificially inflating the price of being obese which would force americans to reconsider they're eating habits based on their wallets. I don't think it should be an excessive tax, but even a 10%-15% tax would at least make people stop and think about how badly they want to damage their health.
There are literally dozens of other ways of actually reducing the cost of healthcare delivery, but those are at least a few of them.
Copays create overutilization and drive up health care costs and health insurance premiums.
Profits are not the problem.
Canada limits the drugs that can be sold there and subsidizes the cost of the meds. Canadian taxpayers are paying for part of the cost of your Rx.
This works . . . to a point. As the price of cigarettes rose people stopped smoking.
But overeating, like smoking, has a root cause that goes beyond the wallet. Most overeating is caused by depression and/or stress. Until you address the root cause you really have done nothing.
If someone wants to make a REAL change, start in the areas that have the biggest impact on premiums AND the cost of health care.
Eliminating state & federal mandates will drop premiums 30% or more. In places like NY premiums would easily cut in half.
Eliminate copays . . . completely. That will have a bigger impact on utilization than anything else. This will also bring down premiums and the cost of health care.
Encourage utilization of PA's and NP's instead of docs. Most primary care dollars are wasted on using docs. Rather than having multiple PCP's in a large practice, use PA's to handle most exams. This can be done in many specialties as well.
Carrots work better than sticks. Encourage healthy lifestyle with reward for improved diet and exercise.
- 11,997
To some degree I agree with you, but you're looking at this from the wrong angle. The problem that congress is attempting to address it that folks making $8/hr with no health insurance do not have access to medical care. Let's say the folks are even making $12/hr, that's ~$2k/month, closer to $1,600 after taxes. Assuming they have a small apartment, a modest car to drive to work, and like having food to eat and clothes to wear all of that $1,600 is pretty well spoken for and then some. Especially if that person is trying to actually put even $100/month away in savings then they have a situation on their hands when they get sick and need to go to the doctor. Paying cash they're looking at spending ~$100 or more for an office visit which is more than they'll make after a day of working (especially if you're only looking at what they're actually able to keep after taxes).
I disagree and I think you're a knucklehead for even making that contention. The question was how to address the cost of healthcare and actually address those issues. There is absolutely no reason for drug companies to be making the profits they are when people aren't getting the medicine they need because of the cost. I'm not saying they can't make money, or even that they shouldn't be able to offset their r&d cost, but there is no reason for a drug to cost literally 500% more in the states than it does in Canada.
All we need is for things to work to a point. We do not need to completely gut the healthcare system overnight (well we do, but that's not a realistic solution). If we take enough steps in the right direction eventually we'll get things where we need them.
You still think we're talking about insurance and we're not. It's cheaper to pay cash for a car than take out a loan yet most people take out a loan because they can't afford to pay for it all at once. The government forcing everyone to get health insurance is not "healthcare reform", it's mandating that this country finance the cost of their healthcare in the most expensive way.
Eliminating copays is not the solution to help America access they healthcare they need. Undoubtedly it would lower premiums, but again, health insurance is not the solution to solving this countries problems with respect to helping it's citizens access the healthcare they need.
I disagree with the savings of this idea, but this is more the type of change we need to address. We need to address the actual cost of healthcare, not just effectively force everyone to "take out a loan" on it to use the earlier example of the car loan.
Another point you and I will have to agree to disagree on. The carrot of better health isn't enough of an incentive as it sits now, so what exactly do you do to encourage it? Some carriers give insureds cash back (bcbs in NY as well as MVP) or discounts on their premiums for things like going to the gym and discounts on premiums for health surveys and the like. I see that as only adding another layer of cost and buearacracy to the healthcare "system" and I don't see it as nearly enough of a motivation to win over the people that are really driving up the cost of healthcare. I don't have the numbers in front of me, but individuals with 5 or more chronic conditions which account for abotu 3% of the population (medicare numbers) account for something to the tune of 65% of the cost of healthcare in their group. It's not the folks with one or two chronic conditions, it's folks with 5 or more! The way they usually get there is a lifetime of bad decisions. Again, I don't think we need to solve that problem overnight, but some form of a tax on their dietary choices would curb their choices. The other end of that is in theory the tax could be used to address the cost of the additional extra healthcare they'll need which would minimize the net financial impact of their obesity.
- 2,908
True but they also negotiate a better price with the drug companies. Not so much here.
- 11,997
Exactly! What they do is price fixing. The price fixing here works in reverse. In order to get this so called "healthcare reform" Obama had to make deals with the drug companies and assure them their best interests would be protected. I'm all for letting folks make a profit, but to some degree the cost of drugs seems like extortion. Most people take drugs because they need them, whether the drug is $1/pill or $15/pill, they have to take it. If it costs ten cents to make and the drug companies are making a reasonably profit at selling it for $1/pill, even $5 seems criminal. I understand that r&d costs time and money, but after the r&d cost they're making fortunes off of what I consider taking advantage of people who need the drugs. Again, I'm all for them making a profit on it, but if someone needs it in order to stay healthy or keep breathing, they shouldn't be making these type of profits if it's at the expense of keeping some of those who need the drugs from getting them.
Just because they (and you) say it doesn't make it true. Show me one minimum wage worker that does not have access to taxpayer and charity funded free clinics or Medicaid.
No argument here, but the cost of health care goes hand in hand with the cost of health insurance. For all the political rhetoric about health care reform there is virtually nothing in the legislation that addresses the cost of health care.
Bring down the cost of care and utilization, and premiums drop. Eliminate mandates and the bottom falls out of health insurance premiums.
Do that and everyone is happy.
And once more, no, I am not confusing health care with health insurance. I have beat that drum longer than almost anyone. The things you suggest to tweak the cost of health care will have a minimal effect on the cost of care and almost negligible effect on health insurance.
The govt answer is to pay the docs less.
Yeah, that will work.
Actually, it does work.
Actuarial studies prove that incentives built in to plan design and cash rewards for healthy lifestyle (diet, exercise, stop smoking) all have a dramatically better result than penalizing "bad" behavior.
Price controls don't work. Anyone around during the Nixon era of wage & price controls will know it does nothing to fix the real issue.
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Apparently with the Democrats while an attack on the unborn may seem relentless and corrupt to some through the public funding of abortions, the dem's attack on children does not stop there;
from Reuters this morning;
"The rejected Republican amendments included proposals to deny erectile dysfunction drugs to sex offenders.......etc. etc.
The Senate's approval of even one of the amendments also would have sent the entire package back to the House, and Democratic senators had vowed to prevent that."
Nothing more than yesterday's cow dung...
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hey MedicarePlanSolutions
I suppose it would cut out the middleman and save us all a bunch of money if the govt simply would run every thing.
from Reuters this morning;
"The rejected Republican amendments included proposals to deny erectile dysfunction drugs to sex offenders.......etc. etc.
The Senate's approval of even one of the amendments also would have sent the entire package back to the House, and Democratic senators had vowed to prevent that."
Nothing more than yesterday's cow dung...
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hey MedicarePlanSolutions
I suppose it would cut out the middleman and save us all a bunch of money if the govt simply would run every thing.
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