At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.” Skip to next paragraph Fred R. Conrad/The New York Times Paul Krugman It’s a funny story — but it illustrates the extent to which health reform must climb a wall of misinformation. It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance. And that government involvement is the only reason our system works at all. The key thing you need to know about health care is that it depends crucially on insurance. You don’t know when or whether you’ll need treatment — but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential. Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend. And in their efforts to avoid “medical losses,” the industry term for paying medical bills, insurers spend much of the money taken in through premiums not on medical treatment, but on “underwriting” — screening out people likely to make insurance claims. In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care. Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention. Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance. Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees. And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market. So here’s the bottom line: if you currently have decent health insurance, thank the government. It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays. Which brings us to the current debate over reform. Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage. Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That’s not radical; it’s as American as, well, Medicare
Medicare and Medicaid are financial disasters. This program won't be any different. Our country's financial condition simply can't tolerate the burden that this healthcare bill will impose on it. Healthcare is too important to have government administrators involved as middlemen and screwing everything up. The potential for abuse is through the roof.
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<a href="http://ihasahotdog.com/2009/07/30/im-sorry-i-dont-mean-to-stare-its-just/"><img src="http://ihasahotdog.wordpress.com/files/2009/07/funny-dog-pictures-stupid-magnitude.jpg" alt="funny pictures of dogs with captions" title="funny-dog-pictures-stupid-magnitude" width="430" height="500" class="mine_4744561" /></a><br />see more <a href="http://ihasahotdog.com">dog and puppy pictures</a> Posted a second time because you deserve it. Address the points in the article or STFU.
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D&D is in fine form today. BTW, I do not agree with Krugman. http://www.nber.org/papers/w12504.pdf (research paper on community rating) "Overall, our results suggest that the effect of regulation is to produce a slight increase in the proportion uninsured, as increases in low risk uninsureds more than offset decreases in high risk uninsureds." And from marginalrevolution.com: The Uninsured: Adverse Selection Problem or Distribution Problem? Alex Tabarrok In his recent post on health care and insurance Paul Krugman writes: [Insurance companies] try to avoid covering people who are actually likely to need care. If insurance companies do avoid covering people who are "likely to need care," this suggests that the uninsured are unhealthy. But 60% of the uninsured are in excellent health (Table 10) (In fact, overall the uninsured are only slightly less healthy than the insured). To be sure, this doesn't mean that being uninsured is not a problem but, contra Paul, it does mean that insurance companies would be willing to cover most of the uninsured at the same rates as the insured if the uninsured could or would pay those rates. In Paul's story there is a market failure, in the latter story health insurance is expensive and some people don't buy it. The difference matters because the wrong diagnosis will almost surely lead to the wrong treatment.
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Medicare and Medicaid cover old people, Old people get sick a lot and tend not to be profitable to cover. Without the government many would not have coverage. So how do you propose private companies implement Medicare?
I liked this show. One of the major cornerstones of Stossel's conclusions is that we need more competition. I totally agree. A public option for insurance could very well cause for-profit insurance companies to lower prices and cover more. We need more competition, we need to allow people to buy insurance across state lines, but we also need an option that isn't in it for profit just so that the insurance companies have some pressure to improve their prices and services.
I'll respond based on the fact that your country club view of life and rigid conservative ideology have actually led you to believe what you said. Private medicine is bankrupting this country. The administrative costs far exceed that of Medicare or the VA system. Maybe this will help. If you and your alleged corporate employer pay a combined $1,000 per month for your family's health care policy it is not more efficient for you or the country as a whole if the same level of health care could be provided for $500 per month in tax money paid jointly by you and your employer. Your bumper sticker level ideology of the "gubmint is always bad; coproations are always good and efficient" shared by Reagan (he had Alzheimer's what is your excuse?) is wearing thin and you and the rest of the country club set will eventually have to provide some figures to back up your claims. "Gubmint bad", the darkies, the homos, the terrorists will take your stuff and way of life won't always cut it.
"In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care." There it is in a nutshell alot that is wrong with 'private' insurance Rocket River
Percentage of Gross Domestic Product (GDP) Spent on Health Care --- Selected Countries, 2006 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5813a5.htm?s_cid=mm5813a5_x I think in dollar figures the amount the US wastes on the bureaucracy, inefficiency, and the general waste of the current US system is in neighbourhood of $1 trillion. In order to completely cut that out you’d have to scrap your current system entirely and go to some variation of a single payer government run system that almost every other every other country on this list uses. Obama's hybrid system may be the best you can do right now given your current situation, however. See also the updated 2009 info: http://www.oecd.org/dataoecd/46/2/38980580.pdf
I remember when I had a job with the State of Wisconsin. They offered life insurance which gave the same payout with lower premiums. It was completely unsubsidiezed by the state. It made no profit for fat cat CEO' and passive investors, no advertizing costs etc. No private insurance company could compete. Conceivably you could make some sort of argument that in a post industrial society we need make work for insurance industry execs, clerks, advertisers, physical givers etc. Much insurance is a no brainer concept in which nothing is created. The whole idea of rugged risk taking individuals who thus somehow justify multi-million dollar salaries is not even arguable.
Throw those figures up against quality of care and you got yourself some damning evidence right there.
