Tag Archives: Financial Services

why a non-profit public option is important..

This was brought up on the MucheDumbre forum today in regards to a government involvement in healthcare..

Essentially, that is my problem with all of this. I already have a problem with the FDA and AMA being owned by drug companies, why make the problem bigger?

If this is how you feel, that private companies already have too many fingers in the political arena and are turning policy in their favor, then the only option for you is the public option.

As it stands now all healthcare options are  owned,regulated,price marked and everything else relating to  them by the for-profit health insurance companies. Your doctor doesn’t decide his fee, Cigna,Aetna,BCBS decide what and if they will pay him.It is the insurance company who decides what they will pay, who they will pay, where they will pay.. who can get their product and  who can keep their product even after paying for it for decades. Without a public option, the way it is now will look like the ‘better’ way in 5 years..

Think about it for  second… A not-for-profit public option that would be self-sufficient and rely on the premiums it collects, going from the Government to the healthcare provider(i.e.. doctor,clinic,hospital)  is  a direct line to the ones doing the service. Yet, this has been deemed evil,socialistic,freedom robbing and bad because it is the government who is collecting the money and giving it out to the providers…

The other alternative is that we subsidized[pay for] not just the >5% who would chose a public option but all 45 million uninsured American with a credit that comes from private and public funds{i.e. taxpayers} . The difference is  that the money goes directly to the insurance company where they take their 30% cut and then decide whether to pay the doctors/hospitals the rest. It is a mainline from your wallet into the wallets of the same types you say you are against, the private companies- NOT the doctors and hospitals proving your care.

Somehow the government  paying the insurance company with taxpayer’s money instead of the provider being paid with the fees that those in the option have paid for is the better option for some. How it’s  better or less socialist for the government to subsidize the insurance companies is something I haven’t had explained to me even though I keep asking,but let’s keep moving.

Not only will the government subsidize the insurance company, but without regulation or something in the market competing with them, the insurance companies can get their ‘asking price’ for any policy they offer, meaning they can start charging the government whatever they want for the healthcare the government is buying from them..while still retaining the right to decide how much they will reimburse the doctors,hospitals or if they even will reimburse them.

What is being asked for here to control this is the choice of a public option, for  less than 5% of the uninsured in the United States .   Less than 5% of those uninsured now, not 20% of the entire population, 50% all of the United States of America, but >5% of the 18% who are without insurance..

I’m not being a smart-ass.. but read that again before moving on…

“Let me be clear — it would only be an option for those who don’t have insurance,” he said.

“No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates,

we believe that less than 5 percent of Americans would

sign up.”-Obama health speech before congress

we’re talking millions of people yes,  but single digit millions.

The not-for-profit public  option will force these unregulated companies to atleast keep their fees reasonable. It won’t put them out of business, the creation of any reform will ensure 45 million more people buy their product. That’s not taking money away from them… that is a windfall of fat cash coming their direction.

The not-for-profit public option will force these companies to own up to their contracts and actually pay out more claims, because to deny someone coverage because of a preexisting condition will become illegal.  It will force them to become a better product than they are right now, because  right now the ‘free market’ is allowing them to have all the marbles whether those be taxpayers marbles or private marbles. It is allowing them to collect whatever amount of money they want while choosing when and who to pay it out to. You purchased your insurance plan to cover your medical costs, you didn’t  purchase it so they company you chose could have complete autonomy to do with your money as they saw fit and thus leaving you responsible for the doctor bill at the same time.

Again, read this again. You pay the insurance company to cover your health care costs.. if they deem your claim unworthy, you are still responsible for the payment  to the doctor/clinic or hospital who treated you. So now you have paid the insurance company to keep your money and the doctor to treat you. Seriously people, if you just want to send your money to someone while still being responsible for your bills, I’ll be glad to accept it instead.



To put it simply, there are only two choices here.. .We either pay the insurance companies to insure the uninsured and thus, paying their fee for doing this  or we pay the doctors directly to treat the uninsured. If you don’t like big Pharma being involved in the politics and decision making, then you can’t be against something that  takes big insurance out of the politics and decision making on people lives.

What is wrong with giving the overwhelming majority of the people a choice of what is out there?  That’s all, a choice.

I found a quote from Bill Moyers on another blog that said

“we should be treating health as a condition, not a commodity.”

I can’t imagine it being put into simpler terms.

If you are wondering just how much around the fingers of the insurance CEO’s the politicians have wrapped themselves, there are calls for ‘tort reform’.  This will in essence regulate how much money a lawyer can be paid for his services. Why are we so against providers of the actual services being reimbursed for their product and so much in favor of the companies who offer no other service than to hold our money and decide who or if they will pay with it. If the doctors and lawyers charge too much, isn’t one of the tenents of ‘free market capitalism’ that they will be weeded out as their competitors  offered the same for less?  Isn’t government imposing the will of   a select few companies, who service is solely to pay these doctors and lawyers the money you gave them, isn’t imposing those companies will over the will of the ones doing  the service you hired them for,  more detrimental to  the idea of Capitalism?

****UPDATE****

sometimes a good video says it all…




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My reply to lil mike

ekg here…what you’re about to read is  what lil Mike and I do, this is where we are in our comfort zone and where we excel. It’s long, it’s tedious, but the final result is an all out information explosive.. We have done this kind of exchange for years on muchedumbre.com. When we started ‘blogging’, we forgot that which made us great… the quote/reply debate, because it’s hard to get into that sort of debate in a ‘blog-comment’ section..

well, not anymore…

Here is my rebuttal to Lil Mike’s

Public Option? -> Only Option

Feel free to join in the debate in the comment sections.

..

” But one thing is clear, if it’s going to be reform in any way that Obama and the far left of the Democratic Party care about, it’s got to have the “Public Option.”  Right now the administration is having it both ways.  On the one hand it’s saying that it has no intention of driving private insurers out of business, but on the other hand, reassuring Congressional Democrats that the President is still committed to having a public option as part of his vision of health care reform.

Why the Public Option?  The formal answer was included in Obama’s letter to Senators Kennedy and Baucus:

“I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”

Competition?  There are approximately 1300 health insurance providers in the US.  Really, will 1301 really make the difference and suddenly lead to “a better range of choices, make the health care market more competitive, and keep insurance companies honest?”  That’s all it would take, just one more provider?  The idea is so ridiculous that you would have to be a White House journalist to buy it.”

Ok, will one more provider really make a difference? Absofuckinglutley!  Yes, 1300 companies offering the same shitty product would actually have to offer a better option if a bigger and better player came on to the scene. Your debate isn’t whether the Government can offer a product that will make the other companies provide a better choice, your argument is… Should the Government offer that product at all.. So let’s not play games with throwing in all this other stuff..

“What makes the public option the crown jewel of any health care reform plan?  It’s the camel’s nose under the tent for single payer government healthcare.  No, this isn’t just Republican scare-mongering.  I can hardly imagine any other conclusion for the insistence on a government healthcare plan.  And it’s easy to see how it would happen.  The logic is this:  One of the keys of health care reform is an individual mandate, but you can’t very well have one if people cannot afford to buy health insurance, so you have to provide an option for people too poor to pay.  Enter the public option.  An analysis of several public option scenarios shows that premiums could be 30 to 40 percent less than comparable private plans.  That of course hinges on the government paying reimbursement rates comparable to Medicare, which are 70-80 percent of what private insurers pay.”

I read your Lewin Group PDF analysis it was interesting.. until I Googled them and found out that..

Lewin Group is) part of Ingenix, which is owned by United Healthcare Group, the insurance behemoth that has been buying up insurance companies left and right, expanding its reach into just about every segment of the health-insurance market. Its flagship, UnitedHealthcare, helps make it the largest health insurer in the country. It’s a safe bet that United is not too keen on a public plan that might shrink its business.

Now I don’t find them credible in this discussion..Sorry about that but seriously, you wouldn’t allow me to use Rahm’s notes as actual unbiased data would you?But let’s address this ‘fear-mongering’ warpath scream of “Single Payer Healthcare-Oh My”..  Why is it that every time a Democrat tries to do anything you Pub’s start screaming ‘Government take-over!” “Government Control” “States Right!” and“Give me Liberty” , when after 8 years of massive Government abuse, Lenin-ish intrustion, insane Government spending,  and obscene Government entitlements there was nothing but the sound-bite of “If you’re not with the President, you are with the terrorists” to anyone who raised a fart of a question?

But now, Oh My God! We’re killing health care…!! We’re taxing people too much..!! Businesses will crumble..!!

really?

Did you know that Bush’s medicare proposal was…

…aimed to inject market forces into Medicare by encouraging beneficiaries to enroll in government-subsidized private health plans that would compete directly with the traditional government-run, fee-for-service program. The drug benefit would be the chief inducement for seniors to make the switch to private plans.

Maybe I missed it, but were there Fox News sponsored Tea-parties for that?

Something else I just found out (by the way, this is why Mike and I do this so well… during our hunt for facts we often find other facts that come in handy in other debates) “The Patriot Act and Department of Homeland Security was the brainchild of one William Jefferson Clinton.” Sure the website is a little nutty and over the top in it’s ‘doomsday’ opinions, and in all seriousness I shouldn’t link it because you will use it against me, but what the hell.. it pretty much spells out everything I’m saying about what the Pubs were happy to do with a Pub leader and shit themselves when it’s a Democrat doing the same thing. Best of all, it does it with the same chicken-little hyperbole you guys are using now..

In short, Bush’s encouragement to beneficiaries to enroll out of their private plans and into the government plan didn’t bring about “Single-Payer Storm troopers” and neither will President Obama’s. But if… if it did, once again you can thank Bush for that ummm…camel nose under the tent… since he started the ball rolling… 😉

Of course I loathe the ‘It’s Bush’s fault” argument.. It was fun for a few years there, but now it’s just old,crusty and only garners a slight roll of the eyes… The problem is, there are just so many fucking things that are his fault and you Pubs are just now finding that out because Obama is following in his footsteps on alot of them. So as loathsome as it is to say.. it’s still applicable.

Moving on…


“So one of the ways the Obama plan controls costs is just by paying the doctors and hospitals less.  I’m sure that will make a great incentive for people to go into the medical field.  And who wouldn’t want to be taxed to subsidize their competitor?”

President Obama will pay doctors less and therefore who would ever go into the med field.. An addendum to this argument is the.. “we will become a 3rd world health care system because there will be no incentives (money) for research”… OK 1st, we already are below many 3rd world countries when it comes to our health care and as for the rest? Well,  I can think of one disease that if it wasn’t for the French, not only would we still be calling it GRID, who knows when someone would have been able to isolate the AIDS retrovirus. Hell, it was a German who discovered that HPV was the leading cause in cervical cancer…

As for being paid less? When did we lose that ‘country doctor’ mentality of people becoming a doctor to help people? Was it around the same time insurance companies first started popping up? I’d really love to see a study on the correlation of the emergence of insurance companies and their control and doctors treating people less because it’s what they dream of doing and more to try and become a million by the time they are 30.

In short, I don’t know what President Obama’s plans on the pay scale for doctors and hospitals is. I know that right now we spend more money on administration costs than just about anything else. Medicare proves that you only need to spend 2% on admin costs and still function admirably.. $230 billion a year is spent in California alone on administration costs, Obama’s plan cost less than 1/2 that for the entire country.. so why those  massive saving would not trickle down throughout the system is beyond me.  To me, it would seem that if $25 from every $100 doctor visit that went to insurance administration now, was cut to $2, the doctor would be seeing a hell of alot better of a return.

“First, the same analysis shows that depending on the premium rate for the public option, 119 million people could lose their private health insurance…If the public plan has lower premiums, what do they care what rate their doctor gets paid at?  Others would find themselves dumped.  Why would companies want the expense of maintaining their own health insurance coverage when a public plan can offer lower premiums?”


I addressed this somewhat above when I brought Bush’s plan to get people off the private rolls and onto the public ones  to your attention already, but that’s not my argument against it, a bad plan is a bad plan no matter who the President is, something the Republican  religion doesn’t like to admit..My argument is this… I believe you are wrong.. those insurance companies will be forced to compete with the new plan.. they will have to offer something else, whether it be a lower premium or more coverage or an annual trip to Bermuda..whatever.. I mean do you seriously think they’ll just keel over and die? Hell no, they’ll find something that their competitor doesn’t have and offer it..

Back in the 90’s I was fired for being pregnant, lost my insurance(not that I had prenatal anyway), and was forced to go on Medicaid. HMO’s were exploding at that time and you were forced to pick either an HMO or straight medicaid. There was many HMO’s to chose from  and they all pretty much offered the same plans as each other and medicaid but since there was competition, the HMO’s decided to offer other incentives to get people to enroll in their plan. It was piddly shit like  children vitamins each month with this one, free contacts with that one, free vitamins,contacts and bubble gum with the other..(ok, not really on the bubble gum.. but you get the point).. the catch was you had to use their doctors,their hospitals and their pharmacies. Or you could stick with medicaid and go with pretty much whoever you wanted. I liked my doctor and she took medicaid so I chose that path. So when you tell me that a government sponsored plan will not only force people out of their private plan but will force private plans to close up shop and move away.. I laugh! These companies want to succeed today just as much as they want to succeed tomorrow and they will find a way to entice employers to keep paying them.. Whether that be free vitamins or a free trip to Bora-Bora for the employer who signs up the most employees onto their plan.Most, if not all, will adapt and  survive… and those that don’t? Well, you don’t mind when they fall in a full capitalistic society do you?

So why is a Public plan the only option? Because without it there is no change.. With it there is a crack in the monopoly-like hold insurance companies have on this country and it’s leaders. They have never had to worry about regulation and competition before and now they are throwing out all the buzz words that make  conservative hard.. “Socialism”..”Government sponsored”..”Government entitlement”… and to that I say Pshaw! Look what the debate has already done for health care… before a person was actually denied  treatment for her cancer because her insurance company said an outbreak of pimples in her past constituted a ‘pre-existing conditions’.Pimples!  But now all of a sudden insurance companies are screaming that sure,  they can get rid of the pre-existing conditions clause. The debate alone is forcing other companies to offer more benefits at a lower cost to women in some states.. The debate alone is changing health care for the better.. If the debate is cleaning up health care and the conglomerate-do-as-they-please  hold on health care that the insurance companies have.. then I am encouraged as to what an actual Public Plan will be able to do.

So, the cost factor? One state already pays 1 and 1/2 times more for just the administrative costs than the public plan for an entire country.

The reduction of doctor’s fee and hospital costs? The savings from the decrease in administration costs should increase what the medical providers see.

The loss of research and cutting edge medicine? You walk into the  Pasteur Institute and tell them they’re a 2nd tier institute.

Socialism? Please.. George Socialist Bush!

The loss of a free market? No, more like the opening of a closed market and forcing it to become competitive to survive..

Yes… Public Option? is the only Option

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Forget the flying car we were promised and just give us healthcare!

Why do we need health care reform?

Robin Beaton found out last June she had an aggressive form of breast cancer and needed surgery — immediately.

Her insurance carrier precertified her for a double mastectomy and hospital stay. But three days before the operation, the insurance company called and told her they had red-flagged her chart and she would not be able to have her surgery.

The reason? In May 2008, Beaton had visited a dermatologist for acne. A word written on her chart was interpreted to mean precancerous, so the insurance company decided to launch an investigation into her medical history.

Even after the dermatologist talked with the insurance company, telling them ‘This is a misunderstanding. This is not precancerous. All she has is acne.”and begging them not to cancel her, they still rescinded  her coverage.

What kind of country allows this to go on day after day after day.  I won’t ask why Charles Manson has a dental plan while 45 millions American’s can’t even afford to go to the doctor,  that would be ignored like it always is. So I am phrasing it in a monetary way since money seems to be the only thing some people understand.

Why do criminals have better health coverage than the people who actually pay for coverage?

Why do the people who can make a difference think that this couldn’t be their daughter’s story? Is it because they’ve got more money than most small countries so it doesn’t matter if their insurance covers them or not?

It must be.

Until something like this happens to the wife, daughter, grandson or someone in the immediate family of those who can actually change this arcane system we call ‘health care’, these kinds of stories will grow.


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