Pay for Health insurance or you go to jail

[Gibonius]

Originally Posted by Trachei

Actually, I didn't think it was a good thing at all. It just made him look like more of a dumbass.

I can't see how it would make him look stupid...

[Trachei]

Originally Posted by Gibonius

I can't see how it would make him look stupid...

Because he was clowning on the MRI statistics and he got absolutely owned like a dumbass.

[Qwell]

Originally Posted by Gibonius

It's basically impossible to "shop around." Most places won't give you a price until the service is performed, and the prices vary wildly based on what insurance you have (and if you have insurance).

And most people pay 20%, some pay more. Plus deductible. 10% would be a sweet plan.

So shouldn't we try to solve that problem? The point Trechai is trying to make is that no one is asking "what does it cost?", they only ask "is it covered?". And by shifting to a government provided plan the issue would further be compounded. The doctor / patient relationship needs to change, and so does the "insurance provider" / "customer" relationship. The biggest problem with health insurance is the fact that it is tied to your employer instead of you, YOU are not your health insurances' customer, your employer is. Your provider doesn't need to worry about making you happy since it isn't up to you if you want to continue doing business with them. Your are also not the customer of your doctor because of this as well, and that needs to change.

The individual needs to see the real costs of their health care so they can better judge the value of their care. And they need to be able to "shop around" for not only insurance but for their doctors / care as well. THAT is the kind of reform we need, not pushing the "price" of health insurance onto the government.

[Gibonius]

Originally Posted by Qwell

So shouldn't we try to solve that problem? The point Trechai is trying to make is that no one is asking "what does it cost?", they only ask "is it covered?". And by shifting to a government provided plan the issue would further be compounded. The doctor / patient relationship needs to change, and so does the "insurance provider" / "customer" relationship. The biggest problem with health insurance is the fact that it is tied to your employer instead of you, YOU are not your health insurances' customer, your employer is. Your provider doesn't need to worry about making you happy since it isn't up to you if you want to continue doing business with them. Your are also not the customer of your doctor because of this as well, and that needs to change.

The individual needs to see the real costs of their health care so they can better judge the value of their care. And they need to be able to "shop around" for not only insurance but for their doctors / care as well. THAT is the kind of reform we need, not pushing the "price" of health insurance onto the government.

Oh, I agree with most of that. I'd add that the price difference between what insurance pays and what consumers pay is also a huge part of the problem, since it basically forces everyone to use insurance for all medical care or face a huge cost increase. My disagreement with Trachei is that I think it's useless to blame the consumer for a structural problem with the whole setup. Consumers have few options, they can't really shop around for providers, they can't realistically shop around for insurers, and they can't pay for care out of pocket without getting gouged.

The problem is, how do you fix any of that without getting the government involved? You're talking about basically rewriting an industry from the ground up.

The route I can envision: Make the government a significant payer in health care. Use that leverage to drive the insurance burden off of companies, and towards the government or individuals (depending on what prices are offered). Set consistent, but fair, prices for all customers. Once ordinary care becomes affordable out of pocket, switch most coverage over to a fee-for-service basis and leave the government in place with a high deductible plan.

I just don't see how you accomplish these goals without getting the government heavily involved in the market, either via massive regulation (and regulation is already massive and expensive) or directly.

[Qwell]

It would be a huge undertaking, but I think there are less intrusive ways to go about it. First things that need to happen is you have to give the tax benefits directly to the individual, currently you see no tax benefit for health insurance / care until you spend more than $2500 a year. You also need to allow health savings accounts to roll over for life, currently if I create a health savings account I will lose the money I put into it if I don't spend it by the end of the year. Possibly take away the tax benefit that a company gets by offering employees health insurance, or even mandate that they cannot offer it. Or change it so employers offer health insurance by simply contributing to an individuals health savings account / personal health insurance plan. This way regardless of employment status the individual retains all decision making in their health insurance plan, and the employer can simply offer to subsidize the individuals existing plan.

Also mandate the ability to buy health insurance across state lines, there are many states that forbid this to keep the "competition" for health insurance within their state, but this hurts the overall competitive benefit for the individual.

By giving the purchasing power / decision making back to the individual it will force the insurance industry to actually cater to the individual, and not a large company. They will have to care more about their single customer for fear of losing them to an insurance competitor the same way car insurance, title insurance, home insurance has to continue to fight for their customers.

[Trachei]

Wow, someone with intellect actually enters the topic. And on a side note, why are people complaining about revamping the system and how hard it would be?! Isn't that the fucking point of all this?! To change a broken system, not compound the problem? Why don't we fix it once and not have to bailout Medicare, Social Security, Government Care, Government dental, Government Nannies, Government Nursing homes, and so on. Prices are the RESULT of something, and as shown, it's not the result of insurers stealing your monies.

The problem is, how do you fix any of that without getting the government involved? You're talking about basically rewriting an industry from the ground up.

The same way we broke up standard oil. We have insurance companies that control entire markets with one insurer. Obviously this has created a non-competitive environment. This could be fixed 10x easier than trying to stuff government care down our throat.

If a company controls too much of the market, let the government SELL a plan on an actual profit basis through normal business. If it can't be competitive what does that tell you. Second, state regulators could order break-ups for current insurers if they control entire markets.

Also, as Qwell stated about state lines, why are there barriers? If a company in Arizona is kicking ass, why can't they easily offer coverage in California? I'm not versed on this topic, but if they can't, it's fucking retarded.

Lastly, we need to find a way to end the provider stranglehold on expenses. Just by listening to Obama, he has no intention of changing that system whatsoever. Remember, "keep your doctor!" "Keep your plan!" "We're just offering another insurer subsidized by every American!". That changes nothing.

[Trachei]

Originally Posted by Qwell

So shouldn't we try to solve that problem? The point Trechai is trying to make is that no one is asking "what does it cost?", they only ask "is it covered?". And by shifting to a government provided plan the issue would further be compounded. The doctor / patient relationship needs to change, and so does the "insurance provider" / "customer" relationship. The biggest problem with health insurance is the fact that it is tied to your employer instead of you, YOU are not your health insurances' customer, your employer is. Your provider doesn't need to worry about making you happy since it isn't up to you if you want to continue doing business with them. Your are also not the customer of your doctor because of this as well, and that needs to change.

The individual needs to see the real costs of their health care so they can better judge the value of their care. And they need to be able to "shop around" for not only insurance but for their doctors / care as well. THAT is the kind of reform we need, not pushing the "price" of health insurance onto the government.

I could just imagine how consumer's actions would change if all the prices were posted up front like at McDonald's. They might start to wonder why the doctor keeps racking up these expensive tests and treatments that are unnecessary. I don't even know why this isn't a state regulation already. McDonalds is required to post facts about its food, why the hell can doctors just get away with billing you later without having lists of their fees in easy to read locations beforehand.

[Gibonius]

Originally Posted by Qwell

First things that need to happen is you have to give the tax benefits directly to the individual, currently you see no tax benefit for health insurance / care until you spend more than $2500 a year.

You have to spend more than that in many cases, since only expenses over 7.5% of income are deductible. I agree that making expenses tax deductible would be a good idea though.

You also need to allow health savings accounts to roll over for life, currently if I create a health savings account I will lose the money I put into it if I don't spend it by the end of the year. Possibly take away the tax benefit that a company gets by offering employees health insurance, or even mandate that they cannot offer it. Or change it so employers offer health insurance by simply contributing to an individuals health savings account / personal health insurance plan. This way regardless of employment status the individual retains all decision making in their health insurance plan, and the employer can simply offer to subsidize the individuals existing plan.

Good ideas.

Also mandate the ability to buy health insurance across state lines, there are many states that forbid this to keep the "competition" for health insurance within their state, but this hurts the overall competitive benefit for the individual.

This would require some nationwide regulation on insurance policies (which is a good idea anyway). It would also have the side benefit of making coverage more portable, which is a good thing.

By giving the purchasing power / decision making back to the individual it will force the insurance industry to actually cater to the individual, and not a large company. They will have to care more about their single customer for fear of losing them to an insurance competitor the same way car insurance, title insurance, home insurance has to continue to fight for their customers.

Sure. Currently the purchasers of insurance are the companies, and they want to get just enough coverage to keep their employees from rebelling at the lowest price. Employees, who aren't paying for the plans, want the maximum coverage and don't care about the price.

[Gibonius]

Originally Posted by Trachei

Prices are the RESULT of something, and as shown, it's not the result of insurers stealing your monies.

I've been saying for quite awhile that the fault is not all on the insurers.

The same way we broke up standard oil. We have insurance companies that control entire markets with one insurer. Obviously this has created a non-competitive environment. This could be fixed 10x easier than trying to stuff government care down our throat.

I think the problem is more related to the insurance/provider model, not the competition between companies. Policy averages are pretty consistent across state borders, it's not like one state has figured out the right formula for cheap insurance.

Also, as Qwell stated about state lines, why are there barriers? If a company in Arizona is kicking ass, why can't they easily offer coverage in California? I'm not versed on this topic, but if they can't, it's fucking retarded.

There's nothing preventing any company from operating in any particular state (and many are nationwide already). The issue is that regulations differ state to state. Arizona has some of the most lax regulations in the country, so if an insurer is based there, they may not want to issue policies that meet the stricter standards in California.