I support national health care, most westernized countries have it, and it boggles my mind that the richest nation on earth doesn't have one. DD
Makes one wonder are we the most heartless? greediest? Selfish country in the world as well? Rocket River
State employees in Texas have a defined benefit plan, with many options within it. When you retire, you can keep your state health insurance, and continue keeping your children and spouse on your policy, regardless of "pre-existing conditions," in this case, conditions that existed prior to retirement, like a spouse who's diabetic, for example. You have the option of using an HMO, a PPO (which we use, but I believe is more expensive), and some other options I don't feel like looking up. State retirees draw a pension based on years of service, combined with age, in something (hope I have this right) called the rule of 80. If you worked for the state for 30 years, and are 50, you could retire with benefits immediately when age and service equals 80, if you want to. Your pension is based on your highest 3 years of salary with the state, which is usually, but not always, your last three years of service. The state offered incentives the last few years (they no longer do) to those employees who qualified for retirement if they would go ahead and retire... a bonus equal to about 20-25% of the last annual salary. The idea was to get highly paid, experienced state employees out of the workforce, and replace them with cheaper, less experienced, and often inexperienced workers straight out of college, in many cases. To the state's astonishment, huge numbers of state employees, many in vital positions requiring extensive experience, took advantage of the incentives to retire. State employees had gotten little in the way of raises for years, while co-pays and other expenses related to their benefits became larger, reducing what had always been a big incentive to remain with the state when you could make more in the private sector... the benefits. Some folks I know very, very well retired at 50, having begun their career with the state, while going to college, at age, lets say, 19, and then were begged by their agency to continue working for them after retirement. With benefits being paid by their retirement package, their salary after a month or two of being "out of work," if at 80-90% of what they were making prior to retirement, equaled that of pre-retirement income due to not having deductions taken from their salaries. Just a little info for those who might have been curious. Keep D&D Civil.
Insurance companies should not have been in it in the first place. Cohen, might actually be able to play a worthwhile role in a single payer National Health Care sytem like we need and they have in Canada. At this point as I understand it, he spends a fair amount of time trying to miminimize costs or compare various plans -- all of which are overpriced due to the ineffciencies of for profit insurance schemes. There would certainly be a role for consultants or MBA types to try to increase the efficiency of even a single payer government system in which you have eliminated the wasteful insurance company middle man and the poor consumer does not have to pay additional so that stock holders and upper management can make a lot of money. A similar concept is the plight of the poor utility payers in Harris County. You have Green Mountain, Reliant etc. etc. to choose from and you could hire someone to tell you which one is cheapest. OR you could go to San Antonio or even Austin where there is one municipal owned? comapny which is cheaper than any of the myriad companies to choose from in Houston. There was an interesting article about the inefficiency in terms of cost of the Houston companies, albeit private enterprise. I suppose like the insurance company bureaucracies you could argue that in post industrial USA you need to create paperwork jobs for insurance company clerrks by the tens and probably hundreds of thousands.
Keep trying to pull rank. Not buyin it. Insulting again. Is it ignorant to just insist on pulling rank. Agreed by the way on the actuarial basis for life insurance. Good management and the "waste" i.e unnecessary cost to consumers by the need to make a profit is not offset by any alleged effciency. Good management i.e., the perecnet spent on administrative overhead is necessary in both medical insurance and life insurance and social security, so you see there is a connection. Not a bad idea. All of the single payer national health care systems cost less and do more. I like the history. Can we conjecture somehow we can reconfigure the inefifcient private sytem. I guess so, or at least create doubt as that bocks change. As the history shows and you detail many complicated schemes have gone awry trying to reform the system to keep insurance comapnies involved. Agreed and the profit motive is powerful, which you seem not to deny at time. The more they pervert, the more money they make. It seems wise to get rid of this perverse motivation. In fact it i diffcult to undo the perverted motivation of the for profite system of health care, so why reinvent the wheel unless you have a stake in the profit part of the prevailing system. We can agree on this. Also an attempt by the profit makers in the present screwed up system to hang on and prevent what other advanced countries have. Quality is important. So it cost especially if you don't have any.. Again another unwieldy attempt to reinvent the wheel and make American safe for insurance companies, down the drain.. By the way many ordinary Americans know about managed care and "capitation", which doctor freinds complain about, which leads to you doctor not giving the greatest care of spending time with you. MOre unwieldy attempts to protect the status quo. Again why invent the wheel. Keep every thing complex or allege it to be so essentailly prop up the status quo. (BTW I am not alleging necesariy that this is your motve just that your perspective seems to be limited by the infor from the industry supporters. So a lot of the HMO's are inept, but let us have a theory that they can be made excellent and then we can use this theory to avoid change. P A study by researchers at Harvard Medical School and Public Citizen to be published in Friday’s International Journal of Health Services finds that health care bureaucracy last year cost the United States $399.4 billion. The study estimates that national health insurance (NHI) could save at least $286 billion annually on paperwork, enough to cover all of the uninsured and to provide full prescription drug coverage for everyone in the United States. http://www.citizen.org/pressroom/release.cfm?ID=1623
Well Hiliary's plan was overly complicated as she tried to keep the insurnace company middle men involved for she feared taking on their powerful lobby. In the end despit all her attempts to placate the lobby, they led the charge to defeat her plan and maintain the status quo, which has continued to this day. At least Hiliary's plan would have covered many of the working class GOPers who prefer to vote on the basis of God, guns and gays. As we have seen with the recently botched prescription drug plan, and the various failed plans above enumerated by Cohen, if you keep the insurers involved they manage to subvert the plan and turn it into an expensive profit center for themselves.
But to be fair, a single-payer national health insurance system would be an economic disaster. Literally, putting a multi-billion dollar industry out of business would be an economic nightmare and I have trouble seeing how a fair transition could occur. (The same would apply for something like a Flat Tax because it would put the accounting business out of a job) My idea of a solution is a little different. The solution would be to make health insurance mandatory like auto insurance. The government could pool people together to negotiate lower insurance prices. The system would be two-tiered. Those who can afford health insurance would buy it from private companies with the assistance of the government in terms of negotiating a lower price, while those who couldn't afford it would have the government help pay for it and subsidize part or all of the costs depending on one's income level. This system would preserve the private insurance industry and help eliminate the painful transition that a single-payer system would cause. Furthermore, it would avoid the rationing of health care that has become endemic to countries with a national health insurance plan. Also, a single-payer system is so large that it would be open to massive fraud and poor spending along with the gigantic bureaucracy it would surely create. See Medicare for the type of fraud that this could create. On the other hand, my two-tiered system would still leave insurance companies in place and avoid a lot of the fraud issues that occur with gigantic government programs. Also, I think its much more politically feasible since it avoids much of the big government aspect of such a program while creating a safety net for those who can't afford health care. Also, it utilizes one of government's most important abilities which is the ability to negotiate on the behalf of health care recipients.
Well the need for paper pushers in a post industrial society whether needed or not is a problem. How is this different from downsizing or off shoring which never bother the typical corporate fat cats? Just requiring it is simplistic. So do you put people in jail like you do with auto insurance? Aren't they suffering enough now without health care and now you want to put them in jail, too? Facetious, I know, but don't you see a problem? l. As far as I know going to Medicare was no more wrenching than many of the various HMO schemes Cohen described above. Many of the standing in line problems are somewhat exaggerated by those desperate to keep profitting off the status quo. In addition remember that many of these programs spend a so much lower percent of GDP than we do and just spending more would eliminate most if not all the problems. How about the waste in corporate programs. Don't forget gross figures showing the enormous percentage we now spend on paperwork (See harvard study above). My idea is Medicare for all. If you are wealthy enough you can buy extra insurance. This is essentially what seniors now have in this country. You can choose your own doctor. Americans are familiar with this from their family members, so it should not be so disruptive as you fear. I believe that is the way it works in countires with national health care. If you are wealthy you can purchase more or different medical care.
