[Scape]

Tapeworm sums up exactly what the current setup for the insurance companies does to a T. They corner markets in states so that they are the only provider and charge obscene rates and because there is no regulation what so ever, what one hospital charges in one state does not meet the billing format of an insurance provider in another state so you end up with hundreds of different billing standards for very basic procedures. Thus making online e-forms next to impossible to standardize and making treatment hazardous if indexing this info for ongoing treatment and retarding modernization of the industry as a whole. It also causes duplication of tests and exploratory procedures that are almost always completely unnecessary but open up a pandora's box of risks. Furthermore, this complicates health history searches so much that it is frequently impossible to get conclusive results. Making possible psychotic interactions from drugs that would otherwise be preventable with a routine check. Multi-doctoring for drug abuse is a real problem and the insurance industry in the US has only exacerbated this problem.

[N_Fiddledog]

Wasn't one of the things the Republicans wanted in their bill the freedom to buy insurance across state lines? Wouldn't that have been a way to go?

In this new Democrat bill weren't different states allowed to swing their own deals if they agreed to sign the bill? Is that better?

[CommanderSock]

I am stunned at his effectiveness.

If this bill goes through it goes to show he is a guy who can get things done. Like it or not, its the way it has been for the last year. Its certainly not pretty, but like a battering ram, highly effective.

This is a political chess player. He's been knocking pawns off 3 years and going.

[Scape]

N_Fiddledog wrote:

Wasn't one of the things the Republicans wanted in their bill the freedom to buy insurance across state lines? Wouldn't that have been a way to go?

The major problem with that being that you would be forcing consumers back to the very providers in those states that have been dominating for decades now. Their systems have matured and metastasized like a cancer. To say you can have competition is one thing but to be able to provide effective, timely and safe service is another. Some of these providers by be big time players in some states but would be totally out of their league if they were to suddenly take on clams nation wide. At best they would be adequate at regional coverage but few if any would be up to task on a national level without a serious retooling. Only the VA and the Medicare are designed from the ground up to take that level of service on.

[Kjorteo]

Ultimately, I'd like the health care system to be a lot more progressive than what we see in the Senate bill or will undoubtedly see in the compromise (the House bill minus the Stupak-Pitts amendment was good,) but I recognize the potential, perhaps even necessity of doing things in baby steps. If some sort of bill final bill passes and becomes law, then we have a foundation which can be improved upon later--health care reform can itself be reformed later. The reason it's so important (and why Obama is more or less telling Congress to just get him something that at least vaguely resembles some sort of bill so he can sign it) is that after how contentious and exhausting this whole debate has been, if it fails now, it would close the door on trying to do anything to the system again for a very long time, if ever again--think Canadian Constitutional amendment debates.

[martin14]

Scape wrote:

N_Fiddledog wrote:

Wasn't one of the things the Republicans wanted in their bill the freedom to buy insurance across state lines? Wouldn't that have been a way to go?

The major problem with that being that you would be forcing consumers back to the very providers in those states that have been dominating for decades now. Their systems have matured and metastasized like a cancer. To say you can have competition is one thing but to be able to provide effective, timely and safe service is another. Some of these providers by be big time players in some states but would be totally out of their league if they were to suddenly take on clams nation wide. At best they would be adequate at regional coverage but few if any would be up to task on a national level without a serious retooling. Only the VA and the Medicare are designed from the ground up to take that level of service on.

hmm, that sounds an awful lot like the American banking system,
and we all know what happened with that.

Or the airline industry.

[Lemmy]

martin14 wrote:

hmm, that sounds an awful lot like the American banking system,
and we all know what happened with that.

Or the airline industry.

Excellent examples, banking and airlines: two industries that require extensive regulation for safety and efficiency.

[Psudo]

Scape wrote:

Some of these providers by be big time players in some states but would be totally out of their league if they were to suddenly take on clams nation wide. At best they would be adequate at regional coverage but few if any would be up to task on a national level without a serious retooling.

If you're worried about the market getting flooded with incompetent insurance providers, the competition could be phased in. Perhaps allow insurance companies to sell directly over the border to neighboring states for starters, wait 10 years, and see if insurance companies have adapted enough to open them up nationally. If they see future incentives coming, they have all the more motivation to retool to be nationally competitive.

Kjorteo wrote:

I recognize the potential, perhaps even necessity of doing things in baby steps. If some sort of bill final bill passes and becomes law, then we have a foundation which can be improved upon later--health care reform can itself be reformed later.

When Republicans arguments against "socialist" health care reform are criticized as slippery-slope fallacies, they can point to arguments like this which completely validate the argument.

Lemmy wrote:

Excellent examples, banking and airlines: two industries that require extensive regulation for safety and efficiency.

Why? Aren't news stories of plane crashes and abusive security enough to convince people to switch airlines? Aren't bank failures, lousy service, or abusive customer fees enough to chase savers to other institutions?

I'm fine with regulation forcing business to follow rules they wouldn't otherwise, but I can't imagine how businesses in any industry can stay in business if they're killing off customers in horrific displays that the sensational news media would just love to expose. It's not like tobacco companies, which only kills people gradually over years or decades of subtle health failures; it's the flaming death of scores or hundreds. You can't miss it. It seems like the kind of thing companies have to handle themselves if they want to continue existing.

Banking cheats are subtler, but people are more sensitive about their money. I can see more reason for banking regulation, but not a ton more.

[Lemmy]

Psudo wrote:

Why? Aren't news stories of plane crashes and abusive security enough to convince people to switch airlines? Aren't bank failures, lousy service, or abusive customer fees enough to chase savers to other institutions?

Because when banks and airlines fuck up, people die or lose their life's savings. Airlines, in a competitive industry, are perpetually in the red. The Canadian airline industry is a natural monopoly, and, despite the prices, is preferred to a competitive industry. When airlines are unprofitable, crashes happen. If you want to see want deregulated travel looks like, check out the Indian railway industry or the Philipino ferry system. Would you travel on either?

When banks fail, the entire economy gets thrown in the shitter. That is needless suffering that can easily be avoided with a little simple regulation.

Psudo wrote:

I'm fine with regulation forcing business to follow rules they wouldn't otherwise, but I can't imagine how businesses in any industry can stay in business if they're killing off customers in horrific displays that the sensational news media would just love to expose. It's not like tobacco companies, which only kills people gradually over years or decades of subtle health failures; it's the flaming death of scores or hundreds. You can't miss it. It seems like the kind of thing companies have to handle themselves if they want to continue existing.

Again, regulation creates the same results, without the pain. The strength and regulation of the Canadian banking industry was THE PRIMARY reason why Canada has suffered much less than the USA over the past two years of economic turmoil. I'll stake my professional credibility as an economist on that last statement.

[BartSimpson]

Lemmy wrote:

The Canadian airline industry is a natural monopoly

And that's a good thing?

[Lemmy]

BartSimpson wrote:

Lemmy wrote:

The Canadian airline industry is a natural monopoly

And that's a good thing?

Why are you rolling your eyes? It's neither good nor bad. It is what it is. When an industry is a natural monopoly, it's better to have one provider that can provide than 2 that will fail. First year economics, dude.

[Scape]

Psudo wrote:

Scape wrote:

Some of these providers by be big time players in some states but would be totally out of their league if they were to suddenly take on clams nation wide. At best they would be adequate at regional coverage but few if any would be up to task on a national level without a serious retooling.

If you're worried about the market getting flooded with incompetent insurance providers, the competition could be phased in. Perhaps allow insurance companies to sell directly over the border to neighboring states for starters, wait 10 years, and see if insurance companies have adapted enough to open them up nationally. If they see future incentives coming, they have all the more motivation to retool to be nationally competitive.

The problem is you have only 9 years at current rate before over half of all US incomes will be spent on healthcare. Some HAS to be done and the system in place now was a 'good enough' prospect but no idea about what the future of healthcare would be because it was always differed to future generations to solve.


More Is less

Listen to this show done by This American Life, very well done explains why costs are sky rocketing.

Someone else's money

This one shows how the system was created and where it is headed.

Paying Doctors

Planet money they explains how the price indexes was set high by doctors in order to get them to sign on, that fire hose of costs has never been shut off.

[Psudo]

Lemmy reasons that banks and airlines should be regulated because the consequences of their failures are extreme: deaths and bankruptcies. This is true. But do regulations prevent the frequency and severity of those failures? Not necessarily. The increased security at airports since 9/11 obviously reduced efficiency, yet didn't stop Richard Reid, the Shoe Bomber. Rather, it was an attentive flight attendant who noticed suspicious activity. Now we all have to take off our shoes to fly (more inefficiency) and al Qaeda is surely investigating some new trick we aren't yet screening for (which will be stopped or not by attentive attendants rather than regulation).

Obviously, regulation is not always beneficial. Instead, effective regulation should be optimized for the specific situation. Is it impossible for the best regulatory system for a situation to ever be "none at all"? I see no reason it's impossible. So, if it is truly impossible, why? Or, if you accept my reasoning, how do we tell good regulation from bad regulation?

One way to tell is to try it and see. Single-payer and public option health insurance have both been tried at the state and federal level in the United States. The US federal Medicare and Medicaid programs are nearing bankruptcy. The Massachusetts, California (Medical), and Oregon state public option programs are also facing severe financial problems. The US Veterans Administration single-payer health care system is better. Gov. Schwarzenegger vetoed California's proposed single-payer system, citing government budget inability to cope with the additional costs.

This is not to say the health care is more expensive under a single-payer system, but that the governments are responsible for more health care costs than under their current systems where private groups pay for more of it. More government costs either means more inflation or more taxes, both of which are economic costs that must be weighed against any potential benefits.

According to these examples of single-payer health care attempts by the US state and federal governments, and given the weak economic and federal budget situations already being faced, the US federal government probably cannot afford a national single-payer or public option health care program.

Given these examples, I can think of only two reasons to continue to support public option health care reform in the USA: 1) you believe the improvement to health care is worth the cost (and perhaps any cost), or 2) you believe that additional regulation is always better. The second I disputed above. The first is a judgment call, and you're free to whatever judgment you'd like, but I dramatically disagree; if nothing else, I personally would see no improvement to my health, as I am already fully healthy. I have nothing to gain and everything to lose. In disagreeing, you're telling me that people like me do not politically or morally matter, which argument is itself morally and politically repugnant.

[N_Fiddledog]

This blog post says some stuff I didn't know before...

http://hotair.com/archives/2010/01/02/v ... alth-care/

Apparently the Japanese have a system like the one the Americans are moving towards. You have a government plan, but private plans are available.

It appears to work providing you have the bucks or (and), influence to make it do so. If not, maybe not so much.