HealthCARE does not equal Health INSURANCE

soulsinging

scb wrote:

know1 wrote:

Furthermore, we'd all have a lot more money available if we didn't have to pay someone else to pay for our care.

While I totally agree with this statement and with the idea that we should do away with the health insurance industry, I still think single-payer is the way to go. While we would still have to pay some overhead, the overhead would be about 1/10th of what it is for private insurance. And, more importantly, the government is not a for-profit industry.

Perhaps, but if a lot of people are unwilling to even discuss a totally free government plan, there might be something to this idea. You could have a government plan with a graduated co-pay system that's kind of an inverse of the income tax perhaps. It removes incentives for government involvement in pricing, encourages competitive services and cost reduction among doctors and hospitals, ensures that everyone is covered, and everyone is going to save money via lower costs, less paperwork, guaranteed full coverage without benefit caps, and complete control over their choice of doctors and services.

Everyone is covered, the poor don't go without, but those that can afford direct care do make payment to ease the burden on the government, albeit at lower costs and with the guarantee that if something catastrophic happens they will not have their entire life wiped out by it.

decides2dream

scb wrote:

jlew24asu wrote:

the cost of high quality care is still expensive with or without the insurance industry.

As much as 30% of the money we pay to private insurance is spent on overhead rather than direct care. For Medicare, that cost is 2-3%.

indeed.
and isn't it better to have that 2-3%, so that we can encourage people to not just have 'insurance' for catastrophic healthcare....but ALSO to maintain their health through regular, preventative measures and check-ups? between cutting overhead, cutting out profit AND adding more preventatvie care....ALL these factors would greatly reduce our long-term healthcare costs, overall....financially and life longevity.

_

jlew24asu wrote:

the insurance industry doesn't set the price of healthcare, they set the price of premiums.

Here's an analogy: It's like the doctors are Pearl Jam and the insurance companies are Ticketmaster or, better yet, ticket scalpers. Sure, the band says how much they want to be paid for their services. But ultimately the customer must pay whatever cost Ticketmaster or the scalpers want to charge. If you sell your ticket for face value - the money you paid for it - you'll say the price was whatever Ticketmaster or the scalpers charged you, not the price originally set by Pearl Jam.

know1

scb wrote:

jlew24asu wrote:

the insurance industry doesn't set the price of healthcare, they set the price of premiums.

Here's an analogy: It's like the doctors are Pearl Jam and the insurance companies are Ticketmaster or, better yet, ticket scalpers. Sure, the band says how much they want to be paid for their services. But ultimately the customer must pay whatever cost Ticketmaster or the scalpers want to charge. If you sell your ticket for face value - the money you paid for it - you'll say the price was whatever Ticketmaster or the scalpers charged you, not the price originally set by Pearl Jam.

That's a clever analogy, but it's even way more than that.

The forgotten part of this is that for many people their employers are paying a large portion of their insurance premiums. That's money that the employer could be paying them.

This makes it more clear. What if we changed the system so that the employer actually gave you the money they spend on your insurance to you as salary and then you paid the insurance premium out of your pocket? It's exactly what's happening now it's just the employer is taking it out of your pay (or what they would be willing to pay you) prior to you getting it.

That's why I keep saying that we're all paying for it now.

soulsinging

know1 wrote:

scb wrote:

jlew24asu wrote:

the insurance industry doesn't set the price of healthcare, they set the price of premiums.

Here's an analogy: It's like the doctors are Pearl Jam and the insurance companies are Ticketmaster or, better yet, ticket scalpers. Sure, the band says how much they want to be paid for their services. But ultimately the customer must pay whatever cost Ticketmaster or the scalpers want to charge. If you sell your ticket for face value - the money you paid for it - you'll say the price was whatever Ticketmaster or the scalpers charged you, not the price originally set by Pearl Jam.

That's a clever analogy, but it's even way more than that.

The forgotten part of this is that for many people their employers are paying a large portion of their insurance premiums. That's money that the employer could be paying them.

This makes it more clear. What if we changed the system so that the employer actually gave you the money they spend on your insurance to you as salary and then you paid the insurance premium out of your pocket? It's exactly what's happening now it's just the employer is taking it out of your pay (or what they would be willing to pay you) prior to you getting it.

That's why I keep saying that we're all paying for it now.

That's where lobbying and special interests come into play. They know if people aren't essentially forced into a plan, they won't buy one because their costs are utterly absurd. So they get legislation passed to make it easier for them to hook people... a direct cash infusion right from the employer that deprives most consumers of any really meaningful choice of insurance or doctors. They offer themselves as a security to doctors to ensure they get paid, then dictate prices to them. And then they turn around and get legislation passed that allows them to take their premiums right from your check to ensure that they get paid regardless of whether or not they're doing a good job or providing you the services they say they will. Does anyone know of an industry that is allowed to garnish wages that's not government owned? I think there's one student loan company that can do this, but that's to recover on debts, not simply take their costs direct from your check before even the government gets it.

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know1 wrote:

scb wrote:

jlew24asu wrote:

the insurance industry doesn't set the price of healthcare, they set the price of premiums.

Here's an analogy: It's like the doctors are Pearl Jam and the insurance companies are Ticketmaster or, better yet, ticket scalpers. Sure, the band says how much they want to be paid for their services. But ultimately the customer must pay whatever cost Ticketmaster or the scalpers want to charge. If you sell your ticket for face value - the money you paid for it - you'll say the price was whatever Ticketmaster or the scalpers charged you, not the price originally set by Pearl Jam.

That's a clever analogy, but it's even way more than that.

The forgotten part of this is that for many people their employers are paying a large portion of their insurance premiums. That's money that the employer could be paying them.

This makes it more clear. What if we changed the system so that the employer actually gave you the money they spend on your insurance to you as salary and then you paid the insurance premium out of your pocket? It's exactly what's happening now it's just the employer is taking it out of your pay (or what they would be willing to pay you) prior to you getting it.

That's why I keep saying that we're all paying for it now.

Another part left out of my analogy is the part where, if it were 100% analogous, Ticketmaster would dictate to Pearl Jam that they won't pay the the band the full price they're charging for the tickets.

The part that confuses me about your plan (probably 'cuz I'm not fully awake yet) is that you're talking about still paying insurance premiums but you want to do away with the insurance companies. Really, you still want to keep them around for major event, I think you said, right? So how would we reap all the benefits of doing away with insurance companies if we don't really do away with them? Sorry, my brain's not on straight right now.

Also, although I see your point about employers paying premium money to employees who then pay it to insurance companies, the problems I see with that plan are:
1. The money would be taxed when it comes in your paycheck, whereas I don't believe it's taxed now, correct?
2. The employers might not really give you the money they would otherwise have spent on your health insurance.
3. The people might use the money for other things instead of for buying insurance.

decides2dream

know1 wrote:

scb wrote:

jlew24asu wrote:

the insurance industry doesn't set the price of healthcare, they set the price of premiums.

Here's an analogy: It's like the doctors are Pearl Jam and the insurance companies are Ticketmaster or, better yet, ticket scalpers. Sure, the band says how much they want to be paid for their services. But ultimately the customer must pay whatever cost Ticketmaster or the scalpers want to charge. If you sell your ticket for face value - the money you paid for it - you'll say the price was whatever Ticketmaster or the scalpers charged you, not the price originally set by Pearl Jam.

That's a clever analogy, but it's even way more than that.

The forgotten part of this is that for many people their employers are paying a large portion of their insurance premiums. That's money that the employer could be paying them.

This makes it more clear. What if we changed the system so that the employer actually gave you the money they spend on your insurance to you as salary and then you paid the insurance premium out of your pocket? It's exactly what's happening now it's just the employer is taking it out of your pay (or what they would be willing to pay you) prior to you getting it.

That's why I keep saying that we're all paying for it now.

of course we pay for it all now, i don't think anyone disputes that.
i also know you are a believer in taking charge of your own life and saving, and being smart, etc. i do agree...no question...but the thing of it is....what about those who currently have no insurance? where's the extra $$$ in their paycheck to put towards their healthcare? or yea...what about the guy who chooses to spend that extra $$$ on OTHER things, not on their own medical care...and then down the road becomes ill and becomes a burden on the system? or do we now adopt a SOL idea that it's your own fault and you can just be sick? again, all of this is the reason i think it's wise to take it directly from your income/paycheck and why it is also wise to fund preventative care. i still don't honestly know why you are against funding this since it is the best way of keeping costs lower, overall. preventative care costs a heckuva LOT less than say cancer treatments, surgery, etc. preventative care actually helps to....prevent....disease. and/or at least, catch it early, more options...for the life, and for cost-effectiveness. it truly just makes financial sense to have good incentives in place to encourage all to utlize preventative annual care.

know1

scb wrote:

Another part left out of my analogy is the part where, if it were 100% analogous, Ticketmaster would dictate to Pearl Jam that they won't pay the the band the full price they're charging for the tickets.

The part that confuses me about your plan (probably 'cuz I'm not fully awake yet) is that you're talking about still paying insurance premiums but you want to do away with the insurance companies. Really, you still want to keep them around for major event, I think you said, right? So how would we reap all the benefits of doing away with insurance companies if we don't really do away with them? Sorry, my brain's not on straight right now.

Also, although I see your point about employers paying premium money to employees who then pay it to insurance companies, the problems I see with that plan are:
1. The money would be taxed when it comes in your paycheck, whereas I don't believe it's taxed now, correct?
2. The employers might not really give you the money they would otherwise have spent on your health insurance.
3. The people might use the money for other things instead of for buying insurance.

You know, I'm not sure about even having the insurance companies for the catastrophic either, but I do recognize that something would need to be in place. Maybe low interest unsecured loans?

My example about employers giving the money to employees was not something I'm advocating as a solution. I was trying to open people's eyes to the fact that they are already paying for their own health insurance.

cincybearcat

scb wrote:

And, more importantly, the government is not a for-profit industry.

That's debatable...they're only "non-profit" because they spend everything they take. Not to mention the campaign donations people get for makng things happen. I don't think you could say they are non-profit with a straight face.

know1

decides2dream wrote:

of course we pay for it all now, i don't think anyone disputes that.
i also know you are a believer in taking charge of your own life and saving, and being smart, etc. i do agree...no question...but the thing of it is....what about those who currently have no insurance? where's the extra $$$ in their paycheck to put towards their healthcare? or yea...what about the guy who chooses to spend that extra $$$ on OTHER things, not on their own medical care...and then down the road becomes ill and becomes a burden on the system? or do we now adopt a SOL idea that it's your own fault and you can just be sick? again, all of this is the reason i think it's wise to take it directly from your income/paycheck and why it is also wise to fund preventative care. i still don't honestly know why you are against funding this since it is the best way of keeping costs lower, overall. preventative care costs a heckuva LOT less than say cancer treatments, surgery, etc. preventative care actually helps to....prevent....disease. and/or at least, catch it early, more options...for the life, and for cost-effectiveness. it truly just makes financial sense to have good incentives in place to encourage all to utlize preventative annual care.

Not the total answer to your questions, but in THEORY, everyone should have more money available to them through lower costs of goods and services and higher wages if the employers weren't burdened with paying for health insurance. That money just doesn't come from thin air. If the employers are paying it, they are making it up with lower salaries and higher prices so in the end we're all paying for it anyway.

I also truly believe that the cost of health care will go lower if we introduce the concept of the patient as customer and the ability to find their doctor of choice on the basis of service, expertise AND PRICE.

I don't have an answer to how we force people to be responsible enough to take care of their own medical situations and, NO, I do not believe we should deny them care if they "can't" pay.

_

know1 wrote:

I don't have an answer to how we force people to be responsible enough to take care of their own medical situations and, NO, I do not believe we should deny them care if they "can't" pay.

I think this would be a HUGE issue. With no health insurance at all - private or government - we would have many people who - because they are irresponsible, broke, just think they're too healthy to worry about it, etc. -won't be prepared to pay for their medical bills. Who will pay for it then? I think we will, and I think this would happen to a MUCH greater extent than it does now.

know1

scb wrote:

know1 wrote:

I don't have an answer to how we force people to be responsible enough to take care of their own medical situations and, NO, I do not believe we should deny them care if they "can't" pay.

I think this would be a HUGE issue. With no health insurance at all - private or government - we would have many people who - because they are irresponsible, broke, just think they're too healthy to worry about it, etc. -won't be prepared to pay for their medical bills. Who will pay for it then? I think we will, and I think this would happen to a MUCH greater extent than it does now.

I guess they could just file bankruptcy like all of the people who do now who can't afford their bills - medical or otherwise. It may not be that much different than it is now.

_

know1 wrote:

scb wrote:

know1 wrote:

I don't have an answer to how we force people to be responsible enough to take care of their own medical situations and, NO, I do not believe we should deny them care if they "can't" pay.

I think this would be a HUGE issue. With no health insurance at all - private or government - we would have many people who - because they are irresponsible, broke, just think they're too healthy to worry about it, etc. -won't be prepared to pay for their medical bills. Who will pay for it then? I think we will, and I think this would happen to a MUCH greater extent than it does now.

I guess they could just file bankruptcy like all of the people who do now who can't afford their bills - medical or otherwise. It may not be that much different than it is now.

The problem is that the taxpayers and hospital systems pay for it when this happens. And, like I said, I think it would happen a LOT more under this plan.

decides2dream

know1 wrote:

decides2dream wrote:

of course we pay for it all now, i don't think anyone disputes that.
i also know you are a believer in taking charge of your own life and saving, and being smart, etc. i do agree...no question...but the thing of it is....what about those who currently have no insurance? where's the extra $$$ in their paycheck to put towards their healthcare? or yea...what about the guy who chooses to spend that extra $$$ on OTHER things, not on their own medical care...and then down the road becomes ill and becomes a burden on the system? or do we now adopt a SOL idea that it's your own fault and you can just be sick? again, all of this is the reason i think it's wise to take it directly from your income/paycheck and why it is also wise to fund preventative care. i still don't honestly know why you are against funding this since it is the best way of keeping costs lower, overall. preventative care costs a heckuva LOT less than say cancer treatments, surgery, etc. preventative care actually helps to....prevent....disease. and/or at least, catch it early, more options...for the life, and for cost-effectiveness. it truly just makes financial sense to have good incentives in place to encourage all to utlize preventative annual care.

Not the total answer to your questions, but in THEORY, everyone should have more money available to them through lower costs of goods and services and higher wages if the employers weren't burdened with paying for health insurance. That money just doesn't come from thin air. If the employers are paying it, they are making it up with lower salaries and higher prices so in the end we're all paying for it anyway.

I also truly believe that the cost of health care will go lower if we introduce the concept of the patient as customer and the ability to find their doctor of choice on the basis of service, expertise AND PRICE.

I don't have an answer to how we force people to be responsible enough to take care of their own medical situations and, NO, I do not believe we should deny them care if they "can't" pay.

believe me, i DO see merits to your system ideas....but that last part is a BIGGIE as to why, ultimately, i don't quite see it. now if that somehow could be addressed, we might be onto something.


and the issue of those currently w/o employee sponsored healthcare, again...they are still left without any extra funds for healthcare. hell, if we ALL had healthcare thru our employers, coupled with medicare for those in extreme situations, i am sure we'd still discuss quality of care and insurance denials....but i doubt as MANy would be looking for a new system and/or overhaul. that's the thing, those w/o now but employed...they still will see no more extra added $$$ in their paychecks, and even IF healthcare costs were lowered, they'd still have to take it all out of their current rate of pay, and for many, that would not be enough....and once again, preventative care would fall by the wayside.