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Private insurers don’t offer many choices
Friday, July 24, 2009 | 2:04 a.m.
One of the biggest arguments against a public health plan option is the following: I want to choose my own doctor, and I don’t want a government bureaucrat making that decision.
But today, under our private health plans, your only choice is to pick a doctor who has negotiated costs with your carrier. Doctors who refuse to negotiate are excluded.
Another argument goes like this: I want my doctor to decide what type of test should be run instead of a government bureaucrat.
Today, however, a large number of tests recommended by doctors have to be preapproved by your insurance carrier. A private bureaucrat makes the decisions. Most likely that private bureaucrat will consider the profit motive.
When it comes to treatments, a private bureaucrat makes the decision whether your insurance covers such treatment. If this bureaucrat decides a cheaper treatment is just as effective, your carrier declines to pay for the treatment your doctor recommended.
Now consider this: Should you, for whatever reason, lose your coverage — you get laid off, your employer can no longer afford the premiums — and you have a preexisting condition, what are the chances of getting coverage from another company? In today’s market, getting a new policy with a preexisting condition, if not impossible, would be very expensive. The private bureaucracy considers stockholders before they consider your health.
Having a public health plan option would not introduce the bureaucracy into the mix because it already exists. I do hope your readers consider this before coming to a final decision on a public health plan option.
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"When it comes to treatments, a private bureaucrat makes the decision whether your insurance covers such treatment.If this bureaucrat decides a cheaper treatment is just as effective, your carrier declines to pay for the treatment your doctor recommended."
So Terry E. Peele is reducing the healthcare debate to choosing between a "private bureaucrat" and the "public bureaucrat".
By labelling the private insurer as a private bureaucrat you are infact point out why people are rejecting an Obama public plan. A government bureaucrat managed by a government manager and Congress.
One where Obama will pick whether you can take the red pill or the blue pill.
With the private insurer you have picked the plan that suits your needs. You can pick a basic plan or a broad plan. You can an HMO, PPO, etc.
I do not want to be forced into a plan like Medicare system where the care you get is based on the amount of money Congress puts into it every year and like in Texas only 38% of Doctors participate because of the pay scale for services.
Calling private insurer private bureaucrat is not going to win the debate.
On a different issue Terry E. Peele said "Now consider this: Should you, for whatever reason, lose your coverage -- you get laid off, your employer can no longer afford the premiums -- and you have a preexisting condition, what are the chances of getting coverage from another company?"
Now preexisting conditions and mandating buying a plan could be fixed by Harry Reid, Nancy Pelosi, and Obama today without the public plan baggage.
One problem with Future's argument. Most of us have to accept whatever healthcare plan our employer offers with whatever limitations it includes.
Silly Me, er...Uddebodda: I think it might probably be a common consensus here in America that after 12+ years of education and its HUGE expense...a physician is entitled to a perk or two including, but not limited to, a nice income.
Let me tell you I work for a local group here in town... there are no harder working people I know of. And, you seem to think in your socialistic fog that "helping people" precludes making a decent life for yourself. There are people who chose their careers because of the life it will afford them. Believe me not many people "aspire" to be ditch digger. Not to say that they aren't hard workers, they absolutely are, but without an education they likely will not advance professionally. But why hold it against the ones who did work hard and go the distance? Sounds a little ridiculous to me.
Frankly, I'd like to know what your beef is with doctors making a decent salary. It seems to offend you that the person who will be saving your sorry butt makes a decent living. Maybe the next time you need surgery you should let your doctor/surgeon know in advance that you think he is an overpaid, undeserving capitalistic jerk. Give him the opportunity to let someone else take care of you. I certainly wouldn't waste my time.
I think you have forgotten (again) that this is America...NOT SWEDEN.
And to the rest of you...I don't what insurance you all have, but being self-employed I had my own HMO policy with HPN. I have absolutely no complaints. NOT ONE! We had the best possible care through three surgeries. Is my family an isolated case, or does everyone here blogging have some insane disease/illness that exceeds medical monetary limitations? Generally speaking, most people I think are happy with their insurance aside from the common grumbles. But, if you take the opinion of the "few" who have issues, the system is lacking. I just don't see it.
Well said, indythinker, well said. I worked in the medical field for 5 yrs and chose to get out of it. My personal choice. I come from a family of various medical personnel. I say when open enrollment comes around each year, choose wisely. I only pay 90 a month for myself and son, my employer picks up the rest. BUT, I do have a high deductible. My choice fits my lifestyle and affordability. I have no complaints what-so-ever regarding my insurance carrier. The hardworking, ethical doctors are deserving of what they are paid.
Great letter Terri. You'll notice that the naysayers have no answers for the questions you raised, just criticism.
Choosing your doctor in todays system is so far from the truth it's absurd. Having a doctor make decisions about how to treat you is ridiculous. Some pencil pusher makes those decisions!
Gordon... Again, not sure I get where you are coming from. I think if you get bottom of the barrel insurance... you get what you pay for. I liken it to auto insurance. If you get basic insurance with, for arguments sake, no collision coverage...there is a chance that you will be in an ackward situation one day. However, if you make sure that you are adequately covered, chances are that in MOST cases you will be fine. I don't know what insurance you have that denies you the right to choose your physician. With HPN, it's a phone call. How simple is that? As far as being a "naysayer" who doesn't address the issue... Again, other than portability of insurance which think is a fine idea, but would require individual inurance, not employer based. What's wrong with that? Let me tell you that the only thing wrong with that is that American's are spoiled. No one wants to pay for their medical insurance. No one. No one wants to pay for auto insurance or life insurance, but we do because we need it. I wish that folks like yourself would realize that until the mentality of medical insurance changes, nothing will be right. I'm all for tax breaks for people to have insurance, and likewise I think it should be a mandatory law. And, for those who are below the line, federal subsidies, not unlike what they are getting now. By changing the attitude of insurance as an option, the next generation of Americans won't balk as it would have always been in place. Like having to wear a seatbelt. Remember how much flak there was over that? And now look... most people don't even think twice about it and do it willingly because it saves lives. Now imagine if you apply the same philosophy to medical coverage...
This whole nanny state business is for the birds. People need to be responsible for themselves and make better decisions. We do not need the US Govt. in charge of our medical care and frankly, the whole idea that they will have all my personal health info is a little too big brotherish for me. Think Gattaca!
indythinker: Please address pre-existing conditions, MS medications that cost $2,000 per month, elimination periods, and procedure denied, for starters. Then we'll go on to medical bankruptcy, bureaucrats choosing which drug is on their list from month to month, $1000 monthly insurance premiums, rising co-pays, benefits exceeded, etc, etc, etc.
Don't get sick!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
P.S. You call choosing from their list choosing your doctor? Talk about naive!
Gordon: You are talking about the smallest percentage of people who have these illnesses. No doubt that it is an issue. But I still maintain that the system needs tweaking, not a major overhaul. I am guessing that you think that insurance companies should be not-for- profit...and, you may be right. You know who DougDemocrat is as he has posted often enough about this very topic...he gets help from the Govt. and that's not enough. Apparently, that runs out too. So exactly what IS the answer? He has medical care, which he grumbles about nonstop as not being efficient, enough, etc. And I am not trying to be a jerk about it...I'm just asking the tough question. When is enough, enough?
As far as preexisting conditions... you are 100% right. I think that it is ridiculous especially in my case where I am dependent on daily thyroid medication. Yes, it comes up all the time EVEN THOUGH something ridiculous like 75% of all women will eventually need the same meds...it is a strike against me likely because mine was due to a mass. Believe me I get it!!! I also have son with hypertrophic cardiomyopathy. Do you know what that is? A death sentence. We have dealt with his insurance issues too. So, believe me I get it with a better understanding that you are giving me credit for. And, yet I still think that what we have is ultimately better than what we will have if BHO and his cronies get their way. And, I won't even address how much more $$$ there would be for legitimate American citizens if we weren't footing the bill for every illegal immigrant. I don't hear anyone complaining about that... and I wonder why.
"Please address pre-existing conditions, MS medications that cost $2,000 per month, elimination periods, and procedure denied, for starters."
Republicans and Democrats both want pre-existing condition covered by law.
You do not need a public plan to get that and in fact all the pre-existing conditions could end up in just the public plan.
Why is it that we cannot start with a simple healthcare bill that handles the bulk of the concerns most liberals and conservatives have - without a public plan -- it would pass
- Give everyone access to health insurance by, Health Insurance Exchanges and State co-operatives open to individuals and small employers, require coverage of pre-existing conditions on a new policy, prevent dropping coverage, and paid access to Medicare for early retirement.
- Subsidize coverage of people who are laid off (COBRA) and those that earn up to 2 times the poverty level (4 times is too high a threshold).
- Individual mandate - as a minimum everyone has a "minimal essential benefits - catastrophic" healthcare policy.
- Eliminated cost shifting where one plans pricing power gets a lower rate than other less powerful insurers. That is the cost of a red pill is the same for all.
- Impose tort reform
- Government investment in innovation and technology
- Automate Healthcare records
- Reduce corruption and eliminate billing scams
Before anyone tries to persuade their congressmen to pass the health care reform bill (H.R. 3200) I encourage you to try to read and understand the bill. It is comparable to reading the tax code. You are constantly instructed that the secretary shall, the secretary will, under direction of the secretary, etc. And, just as with the tax code, you are referenced to different paragraphs, sections, subsections et al. I do not believe any one of the congressmen or the president have any idea what is in the resolution. First, don't tell me I MUST have insurance; second, don't tell businesses they MUST provide insurance for their employees, and third, don't put the government in competition with the private sector. And, do not forget, should you not purchase insurance or provide insurance for your employees, you will pay, regardless. Yes, we need reform, but not what congress is pushing. There needs to be a happy medium. You cannot expect a hospital or physician in Los Angeles to accept the same fee as one in Pahrump. There are too many factors to consider and the president wants to rush it through. Hopefully this will not happen. You do realize this is being pursued for about 10% of the population.
indythinker/ Future: Some good ideas. Indythinker, I think you underestimate the number of people impacted by the limitations of the present system. In our middle class family of 4, (I hope we're still middle class), we have 1 with MS and uninsured due to loss of his job. What are his chances of ever getting insurance again? 1 underinsured with a pituitary tumor that must be monitored and she cannot afford to do so with her present farce of a policy. Think she can add coverage, HA!, and me with heart problems.
Many people face these same issues and it's getting worse every day by small businesses dropping coverage for their employees and others charging employees more for it. Higher co-pays for drugs and visits, etc. It's all BAD.
I have no problem with people earning over $280K paying more. They have benefitted greatly over the past number of years.
GrumpyLP: 10% my ass. 12,000 per day falling off the health insurance roles while insurance company profits skyrocket.
HEALTHCARE SHOULD NOT BE FOR PROFIT!!!!!!!!!!!!!!!!!!!!!!!
"Eliminated cost shifting where one plans pricing power gets a lower rate than other less powerful insurers. That is the cost of a red pill is the same for all."
We could have done that with Medicare Part D, but the Republican Congress specifically barred Medicare from doing what other insurers do: negotiate with drug companies for lower prices.
Congressional Republicans are more pro-big pharma than they are pro-insurance company.
Gordon: I don't even know what to say to that. I just can't believe that there are people out there who have no issue making one group pay for all of us. And I am certainly not in 280K+ group.
Maybe you are right and healthcare should not be for profit. But that begs the question, why stop there? What about utility companies? We already own insurance companies and now auto companies...where does it end? Or does it?
And, is your number of 12,000 per day due to insurance dropping them or them losing their jobs. I think there is a difference.
I feel for you and your family...like I do my son who is in the exact same boat. I was denied a 10K insurance rider on my life ins. policy for burial expenses that I had on all three of my kids for the one with HCM. Ironically, the one who might need it the most got short changed through no fault of his own. Do I blame the insurance company? I don't. It's their right to make that call, not mine.
There is no easy answer. Bottom line is we are headed down a slippery slope and this is only the beginning. I don't think the changes you want are what you are going to get...which is sad. Very sad. For all of us.
When Barack Obama was asked during the recent ABC-TV "health care reform" infomercial whether he would enroll HIS family in a government health care plan the President IGNORED the question. Also, on the matter of health care reform, Senator Ted Kennedy (D-MA) included a provision in his "Kennedy Health Care Plan" EXEMPTING members of Congress and their families from the program. Thus, Democrats feel a government health care plan is good enough for YOU, but not for them or their families. Democrats are the most despicable type of phonies, but fortunately, most of the American public is (FINALLY) realizing the fact.
News,
yep, just like their cushy retirement plan. If u want MEANINGFUL reform of the social security system, dispose of the congressional pension system and make them rely on social security like so many americans.
more government, "do as I say, not as I do"
News report are "House Speaker Nancy Pelosi has set the legislative throttle at full-speed-ahead as she plans to bring health care reform to a floor vote by the August recess, a move that could inflame tensions in the Democratic party and imperil the bill's passage since fiscally conservative Democrats say they're still not satisfied."
Multiple sources with the Democratic Blue Dog Coalition, the group of fiscally conservative Democrats who have been holding up the bill in the only House committee yet to vote on it, said Friday they still don't have a deal -- despite Pelosi's insistence that she's got the votes.
"We don't have a deal yet," a senior Democratic Blue Dog source said. "Negotiations continue," said another. A third said no details of a pact have been worked out.
Democratic leaders are considering bypassing the House Energy and Commerce Committee, merging the bills that have passed out of two other House committees and bringing that to the floor.
This would avert the trouble of granting concessions to the Democrat Blue Dogs, who hold several seats on the Energy and Commerce Committee.
Aside from cost and the public plan, two other key issues Democrat Blue Dogs have is coverage of illegals and abortion.
I asked Harry Reid via email if he intends to drop his current health insurance plan for the one he will propose for the rest of us. He replied that he and the rest of congress definitely will not. They will be keeping the plan they have now.
So you think they will be improving our health care system with whatever they put forth? If so, you are beyond naive, you're just plain stupid.
"So you think they will be improving our health care system with whatever they put forth?"
What's the GOP's alternative? Where's their plan?
The House Minority Leader promised they would unveil a plan this week, but then changed his mind.
Barack Obama and liberal Democrats' "health care reform" plan is DEAD! Does anyone remember during the mid-1980's the Coca Cola company made the worst decision in corporate history when they removed the tried-and-true, old formula Coke and replaced the product with the "new Coke" - that raidly became a dismal failure? The Coke executives had to restore the old formula under a new name ("Classic Coca Cola") and nobody ever heard of "new Coke" again. Well, the Democrats' health plan IS the "new Coke" and will be abandoned and forgotten by the end of the year.
"12,000 per day falling off the health insurance roles while insurance company profits skyrocket."
If true, the insurance companies will be without customers, and profits will evaporate.
I don't understand how Americans can be so selfish toward their neighbors.
And it sickens me that those with healthcare are perfectly content to sit on the sidelines and say "don't reform healthcare because it works for me." I understand that many people are "happy" with what little healthcare they have now and do not want it changed. And I understand that they are perfectly content to let those without insurance die just because the uninsured are not as fortunate as those with insurance who can receive proper care.
But there is not one good reason to keep the current system. We can do better for our fellow citizens than the rest of the developed world does for theirs. We can create a plan that works for Americans!
To start, America has to treat healthcare as a fundamental right and must stop thinking of it as a privilege for only those who can afford it.
Dr. Jeremy Spinks had this to say on the subject in an article he wrote:
"I used to believe that healthcare was a privilege, but what I have come to discover is that when healthcare is treated as a privilege, only the privileged receive it."
I see UNLV has instituted liberal brainwashing....Healthcare is a privelidge not a right. I am diabetic and understand how much this stuff does cost, but it is MY responsibility to take care of myself, not yours or anyone elses. The only positive thing with Barack Insane(sorry Hussein) Obama's proposed health plan is that it is dead. Once everyday Americans have time to have this 1000+ page bill deciphered for them, it will wake them up to the scam it is. And with the messiahs remarks towards police officers, he has become the greatest racial divider since who can remember when, he just limited his presidency to 4 years. Thank God for that!!!! The truth of who he really is, is starting to come out in public for all the brainwashed to see..
"I am diabetic and understand how much this stuff does cost, but it is MY responsibility to take care of myself, not yours or anyone elses."
Hope you don't have a maximum cap on benefits or ever lose your insurance (either through rescission or job loss), because if that happens you're pretty well sunk in the private market since now you'll be tagged with a "pre-existing condition".
Darth:
So you have a pre-existing condition and you're okay with the insurance companies charging you more because of it because it was YOUR FAULT that you got diabetes? You would rather pay more for yourself than to have a level laying field for all?
Also, there's no final bill yet so I don't know how you're criticizing something that isn't in existence.
Finally, it's sad that you feel that someone who is old, or a child doesn't deserve health care because they can't provide for themselves.
A child is the responsibility of the parents. Not me, not you or anyone else. my parents chose to have me, and made the sacrifices necessary to take care of me. They were poor, yet didn't take a government handout to take care of me or my siblings. I hate when people use the "This is for the children" bs. If you can't afford them, don't have them. They are not my responsibility. As for the old who can't take care of themselves, again, that is the problem of their family. It is also a self problem, why did they not prepare for what was to come. being old doesn't happen overnight. financial planning is again an individuals responsibility. it may sound harsh to you DD or UNLV, but reality is that. The best quote I ever heard is "faliure to plan, is planning to fail". I know you will counter, how can children plan... it's not the children it's their parents responsibility. A level playing field for all, hmm? who will determine what is level? and no I don't. If I cost more in benefits then someone else, I should pay more. Was diabetes my fault, was cancer or anything someone elses fault? some cases yes some no. But if I cost more to cover, than I should pay more proportionately. Also, I think if someone chooses the mcd's diet, or smoking, or drinking, illegal drug use, unprotected promiscuity, etc.. and those bad choices turn into costly medical problems, they also should pay more or not have coverage at all as they chose to gamble with their health and lost.
and here is a copy of the senate bill which is only 615 pages
http://help.senate.gov/BAI09A84_xml.pdf
I'll say this once for all the dim-witted, entitlement-savoring LIBERALS on this page - the US Constitution did not intend for government to pay for an individual's home, health care, abortion, job or other life occurrences. The phrase..."the PURSUIT of happiness" does not guarantee that you will be happy. Government's ONLY responsibility is to protect citizens from physical harm either domestic or foreign. We've seen the government's incompetence in that area as demonstrated by their failures on 9-11 and Hurricane Katrina. Individuals must protect themselves and cease expecting government to care for their lives. Whatever happened to individual responsibility in this once-GREAT nation? That has been relegated to near obscurity by LIBERALS and their doctrines of entitlement programs and governmental paternalism.
Uddeboda - Get real - it's ALWAYS about money! Or, are you sufficiently altruistic to be willing to work for LESS than your worth? The naivete of LIBERALS is stunning! Maybe, Barack Obama should take a drastic pay cut too since he has done NOTHING to solve ANY of our nation's problems in the six months since he took the oath of office. LIBERALS always want others to make sacrifices with less pay and more taxes but not themselves (remember Tim "tax-cheat" Geithner and Tom Daschle among others).
I could make an excellent LIBERAL as I can spend OTHER people's money all day long and then, watch someone else work as I collect government entitlements.
Now, make your lame comments on this post as I always enjoy hearing from my fans! LOL...
"Was diabetes my fault, was cancer or anything someone elses fault? some cases yes some no."
And right there is the "blame the victim" defense hiding in the language of "individual responsibility".
If you got cancer, it's your own fault. Never mind if you never had any indication of it, never engaged in behavior to increase your risk, or were extremely young when it happened. Wham, bam, thank you ma'am...next case.
So, would it be hypocritical for you to believe the government to help those who got sick through no fault of their own? Or in the name of fairness, should they have to suffer with the high-risk takers?
And News, for what I hope is the last time, I. DON'T. WANT. A. HANDOUT. I want HELP - I am willing to pay as much as I can for the medicine I need, but I'm not Daddy Warbucks. I work two jobs to pay my bills, but they are no-benefit positions. I am trying to find something better, but in case you haven't noticed I'm competing with about 150 people per open position.
Asking people to pull themselves up by their bootstraps often requires that they have boots first.
DouglasDemocrat - I'm sorry for your cancer problem. I do not have an issue with someone that is struggling to pay a mortgage, medical care or their child's education. Such a person has made a personal effort to succeed, but circumstances (i.e the economy, etc.) has not been favorable to his situation. But, I do have a MAJOR problem with MANY liberals that voted for Barack Obama simply on the basis of what he could give them withoput their making any effort on their own. In other words, such individuals are part of the "gimme. gimme, gimme" culture and do NOT deserve any handout or help with their "problem." Our nation is on the precipice of financial failure and Barack Obama, Congressional Democrats and many of his supporters don't give a DAMN as long as they can continue to pass cost-prohibitive legislation that will benefit their particular constituency(e.g., NEA, ACORN, SEIU, ACLU, Planned Parenthood, etc.). The expensive legislative proposals must end - our nation is bankrupt! We're printing and borrowing money without ever having any means to pay back the debt. Several years from now, when the dollar becomes WORTHLESS, inflation will rise to levels that will surpass those of the late 1970's . When you're paying FIVE DOLLARS or more for a loaf of bread, remember this year, when our President and the Democrat Congress went on a "hog-wild" spending spree with money our treasury does NOT possess!
"We're printing and borrowing money without ever having any means to pay back the debt."
Did you have this problem when President Bush became the first President in American history to cut taxes while fighting a war?
In case you forgot, just about all the spending on Iraq and Afghanistan has been "off the books" through "emergency supplemental appropriations". And I can guarantee that pretty much the entire "War On Terror" has been fought on the government credit card.
And BTW - I don't have cancer. I have kidney problems. I was just using cancer as an example because it's an easier thing for some to wrap their head around.
I still don't understand your argument that the government shouldn't provide healthcare for those that can't afford it.
I know you hate thinking about the children, the mentally retarded, the indigent, the mentally ill, and seniors, but they are all Americans and deserve to be treated like human beings like everyone else. Even if they can't afford it themselves.
There's no reason why healthcare should be a fundamental right on the same level as having access to primary education. Maybe the reason is that insurance companies need to make a profit on sickness and they can't do that if everyone is insured?
I totally agree American's need to take better care of themselves, but I'm not going to force someone to eat better or jump on a treadmill. The government isn't going to force that either.
DougD:
If a drug company could develop a therapy that would heal you, but it would cost one trillion dollars, would you want the 350 million U.S. citizens to cover that cost for you? That would be about $8,500 per person.
Sorry, make that $3,000 per person.
"If a drug company could develop a therapy that would heal you, but it would cost one trillion dollars, would you want the 350 million U.S. citizens to cover that cost for you?"
What is WITH you and the nonsensical hypotheticals?
Reductio ad absurdum isn't meant to be a style of argument. Any company that develops a treatment that NO HUMAN BEING could possibly afford even with insurance doesn't deserve to be in business.
Now, try to develop a reasonable and rational argument instead of pie-in-the-sky absurdities.
"What is WITH you and the nonsensical hypotheticals?"
You are the one spewing nonsense, because you know nothing about economics. There are millions of people with life-threatening problems like yours, and society doesn't have the resources to take care of all of them. So either you pay for your own care, or take your chances with bureaucratic rationing.
"You are the one spewing nonsense, because you know nothing about economics."
You make up an utterly ridiculous scenario (that no person could ever meet), and then when I call you on it you claim I'm the one spewing nonsense?
I'm not making it up, and it isn't ridiculous. It's reality. And you are wallowing in nonsense to think the world owes you anything. Stop feeling sorry for yourself. Learn something about economics. Be a man.
"I'm not making it up, and it isn't ridiculous."
Show me someone on this planet that has a trillion dollars.
You like economics? What kind of business model would rely on providing a service no one can afford? Answer: one that isn't going to be in business very long.
Please don't be dense. My question was, if a therapy cost a trillion dollars, not whether an individual has that much. Should society spend that much to save you?
"Should society spend that much to save you?"
I'm not being dense. It's an absurd scenario, and the fact that you can't see that means you're the one who's dense.