Hi there everyone -
I have time for a quick note - one that I've been thinking about for a couple of days - one I'd like to get your opinions on.
So - what do you think the purpose of insurance companies are? And do you think they should be making money off of sickness and disease???
I was thinking about it. I think that the government has been providing them with a windfall.
If the government runs Medicare, then all people over 65 are covered under Medicare. If the indigent and disabled people of the country are covered under Medicaid, then the government pays for their health care as well. If you're in the military, your health insurance is covered by the VA or Tri-care - so if you were disabled while in the military, the government pays for your medical care.
Now on the flip side, if you have insurance with a private insurance company, and you're not sick or don't really use your insurance much - they keep you as a client. But if you get sick, they drop your coverage. If you meet your lifetime maximums, they don't pay any of your bills. They don't pay your medical bills until you reach your yearly deductibles, cost-sharing and co-pays. And if you have a pre-existing medical condition, you can't get insurance.
How much sense does this make to everyone???? We, or our employers buy insurance just in case we get sick, right???? Then what are the private insurance companies insuring if they aren't insuring us against sickness and disease?
And why are we all afraid of the government providing or running an insurance exchange or public option???? It sure seems like the government is the only one that is actually insuring the sick. I think I've concluded that Medicare, Medicaid, VA, Tri-care - all these government run programs have been a gift to the insurance companies. So while they are off making billions of dollars off of us - until we're sick - then we're all actually footing the bills of the sick. Because it's our tax dollars that are paying for the government run medical programs.
So what's up with all that? In closing, we're paying for insurance we don't need or use through the private insurance companies - plus we're actually paying for everyone else - including ourselves again - when we get sick. So we (the employers and the employees) are actually paying health care premiums, plus the cost of the government run programs (through taxes) - as well as the uncompensated care of the uninsured.
Sure doesn't seem right to me - how about to you??
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As much as i would like to hammer the insurance industry i think we need to clarify some definitions in order to have an honest discussion. One word that needs a definition is the word sick. Most insurance companies do not and cannot drop you if you have general illness or sickness so saying that they will not cover you if you're sick is not exactly accurate. What we would need to do is look at the stated causes of dropping insurance and see if this is an actual problem and, if so, who does it affect. I know thousands of people with chronic diseases that have insurance. Also, we would need to know how they handle those cases of disease which brings us to the complicated evaluation and decision practices of determining risk. There are some regulations on risk determination individually and in a geographic area or for a specified population. In other words, insurance companies calculate the number of people with chronic diseases and those at higher risk for disease and compare them with how many people they have paying premiums that do not have disease currently and those who are at lower risk for developing disease so that they can use the money that those who are disease free to pay for those who have disease and to pay for capital expenditures, profits, etc. One of my concerns about the insurance industry is that they end up siphoning billions from the healthcare industry in order to pay for the cost of doing business, cash reserves, profits, administration, etc. I can't help but wonder if this money could be better used and totally disagree that the government can find a better alternative. It is government regulations, after all, that prevent insurance companies from offering their product/service in a truly open marketplace. Currently, insurance companies are restricted to certain geographic locations and many cannot sell across state lines. to be continued
ReplyDeleteContinued....The fear about the so called public option in the current health care reform proposals is centered on the theory that if the government competitively competes with private insurance, it has a dominant and overbearing position with which the insurance companies cannot compete. This will eventually, if not immediately, lead to the collapse of the insurance industry leaving only 1 payer-the US Government. The reason for this is that the federal government is the single taxing authority at the federal level and since they are levying taxes and regulating the system they have an unfair and uncompetitive position. The federal government has no incentive to reduce waste and costs through the competitive marketplace because they will always outperform any private company since they collect taxes and do not have to pay any kind of business tax that they do. This raises the bottom line for the insurance company through the addition of a non-productive fee that the federal government simply doesn't have to pay. Therefore, the federal government can pay better salaries and pull talent out of the marketplace and offer cheaper products/services while not necessarily improving the provision of healthcare.
ReplyDeleteThe government run option: One of the common phrases i hear about a single payer system is that the government is already running medicare, medicaid and VA/tricare so it must not be all that bad. I can understand where this thought process comes from but in reality the benefits are far from certain. Have we forgotten the problems at VA medical centers and Walter Reed MC not too long ago?? How about the fact that medicare is projected to be bankrupt in a few years?? Do you feel comfortable with this happening to everyone if we were on a single payer system?? If a single payer system was in force there would be no options if that system went bankrupt. I tend to agree that it would be nice if everyone just had these benefits and the problems would go away but i am not particularly comfortable with. So the question is that if the current system is not working and the single payer system is not desirable and uncertain, why not try a truly free market place...de-regulate and see what true competition can do??? I don't know if this is the right path but i think it's worth looking at since we have many models of free marketplace working to reduce waste and provide desirable products and services. Certainly, every system has it's downside but i think we are most familiar and comfortable with the free market way of providing services. The government does do some things well but the original purpose of the government was never intended to take care of us rather, it is designed to protects us from all enemies, foreign and domestic. I would rather preserve and enhance our free society rather than continue the march towards socialism and the inevitable all powerful government which taxes us to death, dictates what it will allow us to do and attempts to controls individuals and their destinies. i think we have enough examples of this happening in history to know that we wouldn't want that to happen here.
That's how i see it for now
Lupold, PA-C
I agree with alot you say - it is kind of scary that the more government gets involved with every day business activities, the worse it could become - but on the other hand, the insurance and banking institutions are out of control as well. There's no reason there should be such a disparity between the rich in this country and the middle and lower classes. There's no reason a company should be paying billions of dollars to some of their executives while they are laying off regular employees and cutting benefits.
ReplyDeleteAnd there is no reason that we are the last industrialized nation that doesn't cover all our citizens with health insurance. Our domestic companies just can not compete globally with the other countries that don't spend this kind of money on healthcare.
I don't agree with further de-regulation, it will only make it worse. The economy was far better when there was more regulation - things started to fall apart during the Reagan era - when they started to de-regulate and has only gotten much worse with further deregulation. Too bad they failed the withdrawal test.
You should take a listen to Paul Krugman - the nobel laureate economist who does a breakdown of what has happened with the economy and deregulation. Big business just can not be trusted - it's all about greed. No one can be happy without a huge profit.
But I do agree - I don't know if the government can do it any better - but I do know they control costs a bit better, the costs have went up a little bit slower than the private industries' have. There's a lot broken.
And I truly believe the figures that are fact-based about the number of americans who are going bankrupt because of their medical bills. Care is being rationed - people are dying while they're waiting, and the insurance companies bureaucrats are standing between the people and their doctors already. Personally and financially, I'm not really effected - I have a great job and insurance - but as a nurse, I see these horrible things happening to patients. It kind of makes me sick - on pretty much a daily basis.
One last thought - if there is an insurance exchange, technically companies will be able to cross state lines - they just have to follow the rules so that consumers are protected. And no matter what system you're speaking of, there will be guidelines for spreading out the wealth - so to speak - risk pooling and geographical guidelines. Those items are already in all the bills I've read.
I actually feel personally that there are a few things in the world that shouldn't be for profit - health, education, prison systems and military defense. I believe our taxes should pay for these basic needs because a lot of companies and their CEOs take advantage of the vulnerable. And I'd pay more taxes to just have these 4 things provided to everyone.
But I like your feedback and appreciate your opinion. You've come a long way since I knew you as a cocky little EMT. lol