Health Care Reform a Welcome Change

[vashti]

And I don't think you realize how much it would cost if you made insurance companies cover all that. They would definitely have to raise premiums or go bankrupt.

Shall we let people die then? People with asthma, epilepsy, type I diabetes, congenital heart defects, etc? (note that i am talking about conditions in which lifestyle cannot be blamed). How about the firemen who worked 9/11 and now have a lot of respiratory diseases? Should they be denied coverage?

And BTW - the insurance companies make PLENTY. I'm not worried about them losing out on their money.

[Sanctuary]

Shall we let people die then? People with asthma, epielpsy, type I diabetes, congenital heart defects, etc?

If a guy showed up at your door and said give me $20,000 or I'll die what would you do?

And BTW - the insurance companies make PLENTY. I'm not worried about them losing out on their money.

That's the blanket argument against big business isn't it. They make so much money that they can surely afford to do this or do that. How do you know this for sure? Have you seen their balance sheets?

[Mish]

Yes I agree that insurance companies seek to avoid payments and regulation should be enacted to change that.

But what about the paying customers that abuse the system when they go to the doctor for checkups everytime they think something is wrong. Or the guy that goes and gets a prescription filled out everytime he feels he has anything remotely related to an illness. Things like this cause unnecessary burden on the healthcare industry and create extra costs for insurance companies. If you wanna regulate the insurance companies who take advantage of people, then you should also regulate the people who take advantage of insurance companies.

I agree that the system should be regulated both ways. The only thing is there is an obvious uneven impact of insurance company misbehaving and a customer misbehaving. When a customer takes advantage of the system by as you say seeking checkups more often it creates more overhead for the company, something that can be fixed by maybe increasing the premium of that particular customer. When an insurance company takes advantage of the customer it completely obliterates and destroys people's lives. There is obviously a huge gap between the severity of the two impacts.

[Sanctuary]

I agree that the system should be regulated both ways. The only thing is there is an obvious uneven impact of insurance company misbehaving and a customer misbehaving. When a customer takes advantage of the system by as you say seeking checkups more often it creates more overhead for the company, something that can be fixed by maybe increasing the premium of that particular customer.

When a customer takes advantage of the system, it increases the future premiums of other customers in addition to that customer and not necessarily the premiums of that customer alone (geez that sounds verbose).

When an insurance company takes advantage of the customer it completely obliterates and destroys people's lives. There is obviously a huge gap between the severity of the two impacts.

I think you got me there but in the news articles I've read, I've never really come across a case where I felt that an insurance company denying coverage was truly unfair. Because most of those cases that I read, if insurance companies were to allow them, they would have to rework all their future calculations and raise premiums to counterbalance the incoming costs. They're gonna have a new set of angry customers that complain when their premiums skyrocket next year for no reason.

Insurance companies should do their best to provide coverage but I think there does reach a point where you have to put a price tag on what you're covering and think about the costs.

[IndiReloaded]

Actually, I do think most of the 'sweatshops' in Asia are fine. Child-labour is not fine, there are laws against that. Businesses that sell restricted technology are by definition breaking the law.

I don't see the parallel between insurance companies and businesses that engage in illegal activity.

You attack the insurance company because it worries about it's bottom line. I'm asking why can't it worry about it's bottom line? A business' goals should reflect the interests of it's shareholders. If it didn't, we'd have major problems.

You don't think that denying coverage in cases that Vash describes is unethical or illegal?

Well, if you want to take the business-first argument all the way--fine.

The US government can provide an alternate insurance option to Americans who don't like what private companies are offering. Competition being healthy for business and all that.

[vashti]

I understand (though don't agree) with your argument, Sanctuary. I agree that insurance companies have a right to profit, but to what extent at the expense of human life?

I have said before that I think the answer to fixing health care is to ration it after a certain age. I also think that people over 80 should automatically be made DNR/DNI status.

[Sanctuary]

You don't think that denying coverage in cases that Vash describes is unethical or illegal?

It's probably not illegal, but I do think it's unethical. This is where regulation comes in. Just don't go overboard and allow coverage for everything.

The US government can provide an alternate insurance option to Americans who don't like what private companies are offering. Competition being healthy for business and all that.

The government is unfair competition. It can do whatever it wants without really having to worry about profits/expenses. It also has insane leveraging
(borrowing) power.

[Sanctuary]

I understand (though don't agree) with your argument, Sanctuary. I agree taht insurance companies have a right to profit, but to what extent at the expense of human life?

I have said before that I think the answer to fixing health care is to ration it after a certain age. I also think that people over 80 should automatically be made DNR/DNI status.

I guess we agree to disagree. lol

As much as people don't want to admit it, there is a dollar value that we have to put on human life because we have to ration it somehow. Even if healthcare was completely free, some people would still not be able to get it simply because we don't have enough doctors for that. What we need is more people like you Vash, that work in the healthcare industry.

I've half-jokingly propositioned before that the answer to fixing health care is to do what the Eskimos do - send old people (who can't afford healthcare and provide no utility to the world) off on floating icebergs.

Take a look at healthcare costs after Medicare was implemented; you expand healthcare, you will make costs rise even more.

[lovesjoyajm]

I also think that people over 80 should automatically be made DNR/DNI status.

That is WAY too harsh for my taste.

Anyway, I admit I am not a fountain of knowledge on the health care issue, but there is just as much corruption and waste on the health CARE side as on the health INSURANCE side. An equal amount of effort and resources need to go to reforming the practices in hospitals, by doctors and other practitioners, as to turning to a more socialist system of coverage. (I'm talking about avoiding unnecessary testing and standardized progressions of treatment.) Perhaps that way, the quality of care won't take as sharp a nosedive when the public option is introduced.

[vashti]

That is WAY too harsh for my taste.

Really? Because there is nothing worse than doing chest compressions on little old people whose bones snap so easily... they very rarely recover well, and it is such a violent way to end a life that has already surpassed the average life expectancy. If people actually saw for themselves how brutal it is, they'd let their loved ones die peacefully.

I might waver on my DNI stance, depending on long term prognosis, though.

[Sanctuary]

That is WAY too harsh for my taste.

Anyway, I admit I am not a fountain of knowledge on the health care issue, but there is just as much corruption and waste on the health CARE side as on the health INSURANCE side. An equal amount of effort and resources need to go to reforming the practices in hospitals, by doctors and other practitioners, as to turning to a more socialist system of coverage. (I'm talking about avoiding unnecessary testing and standardized progressions of treatment.) Perhaps that way, the quality of care won't take as sharp a nosedive when the public option is introduced.

This is true.

But one of the reasons that there's so much waste also has to do with our laws.

Doctors run an insane amount of tests because if they don't and the patient gets sick they can get sued on the grounds that they didn't exercise due diligence.

Also, doctors run insane tests because it makes the hospital money and it costs the patients next to nothing. Who fronts the bill? The insurance company of course.

And then the insurance company raises premiums to cover it's costs.

It's hard to say what is a frivolous lawsuit and what isn't though. Where exactly is the line between a doctor giving you his utmost duty of care and a doctor that makes an innocent mistake (which might cost you your life)?

[vashti]

Also, doctors run insane tests because it makes the hospital money and it costs the patients next to nothing. Who fronts the bill? The insurance company of course. That's abuse.

Really? Have you got some sort of stats to support this point of view? I mean, I see doctors order stupid stuff all the time, but it has always been a CYA situation - not for hospital profit.

[Sanctuary]

Really? Have you got some sort of stats to support this point of view? I mean, I see doctors order stupid stuff all the time, but it has always been a CYA situation - not for hospital profit.

It happens in clinics where the doctors have a personal profit to gain from doing this but no I don't have stats to support this view lol. I don't think the chief of medicine or the hospital administration would be against such a thing though.

What is CYA? I'm not familiar with medical acronyms.

[lovesjoyajm]

Really? Because there is nothing worse than doing chest compressions on little old people whose bones snap so easily... they very rarely recover well, and it is such a violent way to end a life that has already surpassed the average life expectancy. If people actually saw for themselves how brutal it is, they'd let their loved ones die peacefully.

I might waver on my DNI stance, depending on long term prognosis, though.

It's a gut reaction because my grandmother is almost 80 and enjoys life, stays active, and is healthy. I see your point though.

Also, what's CYA?

[vashti]

hah! CYA = cover your ass. It's not a medical term. :-D

Sanctuary - hospitals ALSO have an interest in not being sued...