They're simply power-grabbing liars and incompetents.

Why, again, should the people who brought you the Transportation Security Administration, the IRS, bring you "health care"?

They shouldn't. You should say what treatment you get. Doctors should be assured of being paid for services rendered. And "your fair share" of any health-care bill should never include the wages of people who do not provide any services to you.

Think about the word, "insurance". It's a good bet that whoever you're talking to, it doesn't mean the same thing to them that it does to you. It does not mean, "free".

If only there was a simple solution. Private insurance is not the answer. It's flawed by design. It's a business and like all businesses they want to take in more money than they let out. And there is no upper cap to the profit margin; the more, the better.

And if they can cut costs, they will. And if they can find loopholes to avoid paying out, they will. The bottom line is they're looking for ways to avoid paying. If they can deny services, find legal justification for not paying for a service, then that's what they'll do. Plus they pretty much have you over a barrel. You cannot, in the middle of finding out the hard way that your insurance sucks, suddenly switch companies, because anything you have already falls under "pre-existing condition."

Seems to me, though, that most of the complaints one could make about private insurance could be made about a government entity as well. So Patrick's right, no simple solution.

Glad you picked up on this.

Was listening to Bill Bennett on the radio this morning and a guest speaker described this as taking out another credit card, as the other one is maxed out, and then not putting it on the books where people can see it.

Wow! Don't trust this administration.

"It's a business and like all businesses they want to take in more money than they let out. And there is no upper cap to the profit margin; the more, the better."

/hands in air

/eyes rolling

Um, yeah? Why doesn't this inapposite point condemn essentially every single human activity? The food you eat? Grown by farmers with a profit motive. The clothes you wear? Profit motive. The education you received? Again, look at the *people* involved (those are who really give you what you have, not institutions) and what do you find? Profit motives! All of them (unless you were taught by nuns all your life).

I would note that this is hardly my insight. Smith raised in hundreds of years ago, noting how we depend on the butcher's self-interest, not his charity, for our meat.

But hey, if you think you can structure a health care system where capital sources, doctors, nurses, administrators, underwriters, and other vital economic inputs will work without profit motives, let us know. I seem to recall that being tried recently overseas, with suboptimal outcomes. Maybe you heard about those attempts?

If not, the locations are easy to find, just look for the mountains of skulls left behind. Those skulls belong millions who, oddly, never seemed to accept the idea that they should work for others without any expectation of maximizing profits from their labors.

When people self-righteously point out that someone is making profits---PROFITS!--from providing a service to another person in a freely-bargained circumstance, as if this will shock working adults, I usually can guess what will follow from that point in the post.

Spartee When people self-righteously point out that someone is making profits---PROFITS!--from providing a service to another person in a freely-bargained circumstance, as if this will shock working adults, I usually can guess what will follow from that point in the post.

Maybe you actually should have read the post, instead of assuming you knew what was there, to put any doubts you may have had to rest. No? Perhaps you're being self-righteous.

No one said anything was wrong with a business making a profit. But it when it comes to someone's healthcare, perhaps a business model is not the route to follow. Since the CEO's cushy mansion depends on making as much as he can, expenses have to cut and profits need to be maximized. If a business can avoid expenditures to save money, they will. Avoiding the best, and most expensive care in favor of a less reliable and less expensive treatment, finding loopholes to avoid paying, especially with that convenient catch-all, "pre-existing condition," etc. are ways to minimize costs.

Not particularly desirable for the consumer, who understandably wants the very best care when he gets sick.

By the way, services that are not provided with a profit motive doesn't mean doesn't mean that the personnel work for free. When the police investigated the mugging that took place last week, I don't think they sent the victim a bill.

If your house catches fire, you don't need to send the fire department away because you can't afford it.

But of course, those organizations, in addition to being subsidized by taxes, don't have CEOs with cushy offices on the twentieth floor of some huge office building, with three secretaries, a private masseuse and their own jacuzzi, and then go home at the end of the day to a sprawling mansion.

I have no issue with businesses making a profit. If you can start a business and make gazillions, more power to you. However, I would prefer that my health insurance not be handled by someone whose objective is to find some way to avoid paying out.

Patrick:

Not particularly desirable for the consumer, who understandably wants the very best care when he gets sick.

Why should a doctor be any different than a plumber? When I have a toilet installed, I expect the very best service. And I'm willing to pay for it.

Why are you unwilling to pay the doctor to make you well? Do you feel that your health is so important that you have a right to hold a gun to my head and force me to pay for your care?

When the police investigated the mugging that took place last week, I don't think they sent the victim a bill.

You've obviously never paid property taxes.

But of course, those organizations, in addition to being subsidized by taxes, don't have CEOs with cushy offices on the twentieth floor of some huge office building, with three secretaries, a private masseuse and their own jacuzzi, and then go home at the end of the day to a sprawling mansion.

And in the end, it's always the same for the leftist: class envy.

However, I would prefer that my health insurance not be handled by someone whose objective is to find some way to avoid paying out.

And who might that be? It sure as fuck isn't going to be the government.

Like I said, you have no moral quandary at all about holding a gun to my head and demanding I pay for your health care.

If a business can avoid expenditures to save money, they will. Avoiding the best, and most expensive care in favor of a less reliable and less expensive treatment, finding loopholes to avoid paying, especially with that convenient catch-all, "pre-existing condition," etc. are ways to minimize costs.

Or...they could find a way to deliver even better care less expensively and, as a result, increase demand and gain share on the competition.

Businesses that cut expenses don't necessarily have to cut the level of service provided. Outsourcing office functions (HR, payroll, accounting) have saved businesses millions of dollars without negative impact on the level of service provided.

Implementing Business Intelligence systems have improved record-keeping as well as enabled companies to develop customized products based upon usage rates.

Businesses in competitive markets that reduce service levels without reducing costs often find themselves losing customers (and money). A truly competitive health insurance market would be no different.

To create a more competitive health insurance market, enable companies to offer coverage across state boundaries and truly compete with each other. Untether health insurance from employers to create truly portable coverage (and thus incent companies to work to keep me as a customer).

Some regulation may still be needed. But let that regulation be a guidepost, not a hitching post.

If Wal-Mart can offer $4 prescriptions and cell phone companies can profitably provide service in the Third World, then insurance companies can find ways to offer affordable coverage for pre-existing conditions - but not if the government tells them what that coverage will be and how much it will cost.

Competitive markets drive businesses to find new ways to deliver better services at lower costs.

Governments don't...whether providing that service directly or heavily regulating the private providers.

If your house catches fire, you don't need to send the fire department away because you can't afford it.

And yet many communities are closing fire stations and furloughing firefighters to reduce costs.

But of course, those organizations, in addition to being subsidized by taxes, don't have CEOs with cushy offices on the twentieth floor of some huge office building, with three secretaries, a private masseuse and their own jacuzzi, and then go home at the end of the day to a sprawling mansion.

Ever seen the mayor's office in your town?

Ever tried to call the mayor? Getting through the layers of receptionists and secretaries can be tough.

Ever seen the mayor's mansion in your town?

I find it curious (and highly suspect) that this whole health care reform debate isn't even seriously considering tort reform. Could it be, perhaps, that the malpractice lawyers are in bed with Congress?

One of the biggest expenses in healthcare today is malpractice insurance, because of out-of-control lawsuits.

the other Beth,

Exactly. Let's be realistic. A majority of those in congress are lawyers. So they aren't going to upset the gravy train.

The sue happy in our country need to be told to STFU, and stop wasting everyone's time. And if they continue to file bogus claims, they need to be banned from filing (Juridictions can bar someone from filing in that particular juridiction).

However, I would prefer that my health insurance not be handled by someone whose objective is to find some way to avoid paying out.

Posted by: Patrick at October 21, 2009 8:04 AM
-------------

And what will be the government's objective when running healthcare? Payola out to their benefactors and purely politcal reasons, not whats best for the patient. Whats going to happen when the "other party" gets in? Who will you go to when you get denied service or shoddy service? You think there won't be as high or higher difficulty getting compensation in the courts? Why is the bureaucrat so inherently more trust worthy than insurance company worker/executive? They're not in it for the money? Nah, just the fat gov. bennies, the union contract that makes it near impossible to fire them and they'll have budget concerns and pressures just as a business would, just far more leeway due to gov. just printing more money if needed.

Fun fact, medicare requires the insurance companies to pay providers within 30 days of bill submission. How long does medicare get to pay out the insurance folks? 5-6 months. Government efficiency for ya.

There are ways to reform insurance that will still leave gov't outside the Doctor/Patient relationship, it's just that these ideas are not open to debate and were never on the table. Insurance is a way to pool resources to protect against catastrophic events, yet, most policies have to, by law, cover non-catastrophic events that, in effect, have resulted in people not having to take personal responsibility for routine procedures which have a negative effect on cost containment. The insurance reform now being "debated" is nothing but a bait and switch to ultimately fund only the gov't option that will come with truly draconian health laws.

For those you who argue against profits for insurance companies, do you know what the actual profit margins are for insurance? I heard an interesting fact on the news last week... it seems that the profit margins are only 3.5 to 4 percent.... this hardly makes them oppressors of the little man...Tech companies have a profit margin of 20% if you need a frame of reference.... or more importantly... perspective...

"Like I said, you have no moral quandary at all about holding a gun to my head and demanding I pay for your health care."

Yes, precisely. And if you still refused, you will be shot and left for dead.

The paramedic, who responded to your 911 call, realized that you need an immediate surgery on your head and it is going to cost about $100,000.

He is going to ask you,
"Brian, do you have $100,000?"
"No."
"Then, do you have a health insurance?"
"No."
'Then, do you have a life insurance?"
"Yes."
"OK, then. Please change the beneficiary to me, then I will start to work on your CPR. Please sign here, Where the hell is my pen? Wait a minute. I left in the car. I will be right back."

At this point, Brian, you wish you had a gun to point at his fucking head.

The other Beth @ "One of the biggest expenses in healthcare today is malpractice insurance, because of out-of-control lawsuits."

Not at all true. Tort claims account for only a couple of percentage points of the big picture. Doctors' "defensive" medicine (which just happens to make them a bunch of extra money) costs are a bigger, although still relatively small, part of the picture.

And, if you look at the reseach, you find that the vast majority of medical malpractice is never made the subject of a claim -- the patient suffers, and the doctor/hospital just move on.

Looking for an easy scapegoat, it appears to me.

> you have no moral quandary at all
> about holding a gun to my head and
> demanding I pay for your health care.

So you're saying eventually, we'll get our money?

"For those you who argue against profits for insurance companies, do you know what the actual profit margins are for insurance?"

Profits are clearly not what is expensive about the current situation. There is not just "one" creditor with hand out for your dollar. There are hundreds of people "between" you and your doctor. This is the result of the attempt to spread costs to people who have not incurred it - typical of all insurance - combined with attempts to deny that any such thing happens.

Right now, you pay first, and for others, in order to get a chance to bill those others for lots of routine stuff which can and should cost less.

Why should you not have a deductible? Why should you NOT be held liable for your own poor judgment? Why should you not be the one deciding what level of care you get?

The only way to make that happen is for you to pay. If you don't pay, you don't get a say. That's a fact, and that's why Grandpa is going to get too old to waste a Federally-provided hospital bed on.

There is no "Easy Fix" here folks. Too bad that the idiots we have elected (and re-elected ad nauseum) would rather just ram some p.o.s. legislation through so that they can say that "something" was done on their watch under the tutelage of Barack Obama.

What happened to the campaign promises of cooperation with conservatives? Or the promise of transparency? Are there ANY honest, diligent, politicians not "on the take" by special interest groups?

We are so fucked...

Brian writes: Like I said, you have no moral quandary at all about holding a gun to my head and demanding I pay for your health care.

You already do. I get my care at the VA. Thanks very much for my recent cancer surgery by the way. Turned out to be a false alarm, but you can't be too careful, you know.

That piece of trivia aside, your complaint is a little like saying, "You have no moral quandary at all about holding a gun to my head and demanding that I pay for your services from the police and the fire department.

You already do. I get my care at the VA. Thanks very much for my recent cancer surgery by the way. Turned out to be a false alarm, but you can't be too careful, you know.

You and I both know that veterans are a special case. But nice try exploiting an edge case to prove your larger point. Too bad it failed.

That piece of trivia aside, your complaint is a little like saying, "You have no moral quandary at all about holding a gun to my head and demanding that I pay for your services from the police and the fire department.

Not at all. If you start your own house on fire, you are going to prison. If you call the cops every time you hear a noise in the basement, you'll get fined for it, and possibly arrested.

But if you live a life of reckless abandon, you expect someone else to pick up the tab?

The government already has too much power. And you want to give it more. That says an awful lot about you, and none of it good.