Health Net Redux

[Guest]

Me: "My son has a 104 fever"

Doctor's office: "We can get him in around late May - or go stand in line like cattle at the free clinic."

That's single-payor.

On phone to doctor: "My son has a 104 fever."

Doctor's office: "Do you have insurance?"

Parent: "No. I can't afford it."

Doctor's office "Well, don't come here. Take him to the ER... and stand in line like cattle."

That's the current system.

If we do single payor right we will have a two--tier system where there will be private hospitals/clinics and doctors... just as there are private schools and tutors. If you have the money, you get "better" stuff.

The healthcare gravy train is slowing down guys, and when it runs out of steam the first people they are going to throw from that train are you and I. Don't say you were not warned. As for me, I'm getting off at the next station and renting a car. Sooner or later you will run out of track... but the open road goes on forever!

Al

 

[wildcat]

Maximum coverage in Ca for most carriers is 5 to 7 mill. Why not have plans with 500K max coverage, and offer if for a fraction of the current rates?

I have no idea what percentage of policyholders ever go above $500K, but I would think not many. $1000 ded, 4 office visit co-pays, 80/20 something like that.

Better than mini meds but not as much as the major meds.

Mandatory coverage. People who don't have much will buy the cheap, people with some assets will continue to buy the bigger plans.

 

[somarco]

The arbitrator is obviously rewarding someone excessively not because she suffered soooo much, but to punish the carrier for perceived misjustice in the overall retro review program

Carriers are always the deep pocket, bad guys. No doubt they need to review some of their practices. Backing GI & mandated coverage is a cop out.

Why not have plans with 500K max coverage, and offer if for a fraction of the current rates?

Setting lifetime max at $500k vs. $5M saves about 5% on premium. The bulk of claims paid are less than $1000.

percentage of policyholders ever go above $500K

About 2% of claims filed. Claims over $100k comprise 20% of the total dollar amount of claims paid.

Mandatory coverage doesn't work. Neither does GI.

 

[Crabcake Johnny]

Al, for don't need a single-payor system. We need states to adopt what Maryland's done:

Group if you have a job
Individual if you're self-employed - no coverage at work
Free care for the poor
Free care for children for families 200% of FPL
MHIP - GI affordable coverage for anyone with pre-ex.

The same struggling middle-class over-extended families who can't afford coverage now are the same families that can't afford the tax hike to pay for a universal healthcare system.

 

[moonlightandmargaritas]

I'm on record for a single-payor mandated system... Medicare for all of us. Let the private sector sell supplements. Al

Al, acknowledging that the current system is broke and needs a lot of work, let me ask you this...

Is there an example that you can cite where the government was able to provide something better and more economically efficient than private enterprise for profit?

I submit that if they could, there would be no UPS, FedEx or private schools.

 

[Crabcake Johnny]

When Medicare is going broke I think saying "Medicare for all" is a bad example.

 

[somarco]

Medicare's unfunded liability is $74 TRILLION.

Doesn't sound to me like it is working very well.

 

[Crabcake Johnny]

Not only is Medicare going broke, but seniors still have to purchase additional insurance if they don't want to go BK over medical bills. Horribly flawed program.

 

[moonlightandmargaritas]

Medicare's unfunded liability is $74 TRILLION.

Doesn't sound to me like it is working very well.

Private enterprise is driven by profit, which is partly a by-product of efficiency. Is it perfect, and are there abuses? Of course, nothing is...

On the other hand, we have government bureaucrats. They are NOT driven by profit and efficiency. They are driven by the power they think comes from bigger budgets, bigger "fiefdoms", etc. This leads to INefficiency.

I personally prefer the former.

 

[Crabcake Johnny]

Our past history has shown that when American really want something to change, it changes. I could point to the 100 things in this country that have changed dramatically do to protesting and a general public outcry but it would be a 1,000 page post.

Americans do not want universal health care. If we did we'd have it. Reporters and liberal news publications want universal health care. Polling people and asking if they are for or against free health care is like polling people and asking if they're for or against the gov't mailing everyone $5,000 a year: "New polls out today show Americans favor receiving $5,000 a year."

If you want me to prove my case we'll go back to 1993 when Bill was elected on a universal health care platform. Well...where did that go. It died quickly....not due to special interests but lack of overall support.