Health care increasingly out of reach for millions of Americans

[Rebecca Jo 1,962]

If you want insurance that you can afford then we need to go back to COST. You want insurance companies to pay every single claim, then tell people AND doctors to stop abusing the system. There's a cause and effect for everything. Insurance companies don't make their money off of premiums they collect. They generally (most of them anyway) pay out more than they take in from actual premiums. They invest the premiums and help them grow so they can A) pay for the healthcare and B) turn somewhat of a profit which is very small in comparison to any other industry.

Until congress addresses the issue of actual cost and doesn't play politics, we're all doomed. They hand us over to the insurance companies and at the same time screw the insurance companies over by making them have actions that send their costs through the roof. At the same exact time they prop up Big Pharma guaranteeing high costs for prescriptions and screwing over the public even more.

We can't win. The Washington lobby on health care is extreme and not to the extent that your average insurance company has any type of benefit as some would make it out to be. The American Medical Association and Big Pharma have done more harm to the American populace in the past 30 years than imaginable. We need more doctors, more specialists, etc.. However thanks to the AMA we aren't going to see that anytime soon. There's a huge supply and demand issues with doctors in many areas and a lot of that is thanks to lobbying from the AMA. Amusingly enough, the AMA only makes up 18% of all doctors, which says A LOT, especially when you look at the influence on Obamacare. Lobbying works and its VERY prevalent in the Democratic party despite what the leftist jerk offs will have you believe. Democrats aren't the only ones to blame here though as Republicans have had options for years, just never taking advantage of their situations. Well, they did, just not in ways that necessarily help the American people.

As long as both parties work for lobbyists and corporate America, nothing will change in health care. We can argue about who should pay what and who should help who, but at the end of the day until costs are actually focused on; everyone is screwed and will continue to be for a very long time.

"Until Congress addresses the issue of actual cost.............................."

Are you saying the government should fix prices?

[james&olya 1,121]

"Until Congress addresses the issue of actual cost.............................."

Are you saying the government should fix prices?

[Rebecca Jo 1,962]

It was an honest question......what are you laughing at?

Or are you laughing because you think I "scored a point"?

Edited May 14, 2012 by Rebecca Jo

[Obama 2012 1,714]

"Until Congress addresses the issue of actual cost.............................."

Are you saying the government should fix prices?

Not it at all. However the government can fix many of the things that attribute to rising 'costs.' - Mandates, technology, TRIAL LAWYERS, etc.

[Rebecca Jo 1,962]

Not it at all. However the government can fix many of the things that attribute to rising 'costs.' - Mandates, technology, TRIAL LAWYERS, etc.

Mandate what?

Provide the technology?

Marc, anyway you slice it, you are looking for government intervention.

Edited May 14, 2012 by Rebecca Jo

[mawilson 2,133]

Don't laugh.

Seriously think about it.

1. We don't want to mandate health insurance companies to pay for "little things".

2. If there is no mandate, then the free market insurance industry decides to not pay for these "little things".

3. Doctors and clinics aren't getting whopping fees from insurance companies for these "little things".

4. So the free market should take over, and the cost of these "little things" falls into a range where the average person can afford them.

Yes or no?

Absolutely, yes! When we rely on insurance for everything and don't consider the actual

costs of most procedures, the medical industry has little incentive to decrease costs.

To give you a specific example of the 'free market' in action, insurance doesn't cover

plastic surgery or Lasik eye surgery. Because these procedures are not covered by

insurance plans, the doctors who perform it must compete for business. Unsurprisingly,

the costs have remained stable or even decreased!

The cost of Lasik has decreased 70% (!) since its inception, whereas general healthcare

costs have increased at more than double the rate of inflation.

[Rebecca Jo 1,962]

Absolutely, yes! When we rely on insurance for everything and don't consider the actual

costs of most procedures, the medical industry has little incentive to decrease costs.

To give you a specific example of the 'free market' in action, insurance doesn't cover

plastic surgery or Lasik eye surgery. Because these procedures are not covered by

insurance plans, the doctors who perform it must compete for business. Unsurprisingly,

the costs have remained stable or even decreased!

The cost of Lasik has decreased 70% (!) since its inception, whereas general healthcare

costs have increased at more than double the rate of inflation.

But..................Lasik isn't in demand as much as say ............ a BMP work-up. Or an x-ray.

[mawilson 2,133]

But..................Lasik isn't in demand as much as say ............ a BMP work-up. Or an x-ray.

True, but...

All I know is some preventive care can be affordable. For instance, the cheap BMP I mentioned above actually exists. Here's how I know:

Previously when my husband had insurance, we would get all his routine blood work done at the hospital. They would bill his insurance and it wouldn't be covered until we hit the $1000 deductible. The tests (of which the BMP was one) came to $330. So we were always making payments to the hospital for blood work.

When he lost his insurance, we found out through friends that a large physicians group in our town has a lab that does affordable basic tests. We started going there while Wes was uninsured. We could get all the same tests done (that the hospital were doing) for about $35. In fact, we went there last weeks (even though he is insured now) because paying the low rate was less hassle than going through the big lab corporation his insurance requires.

And the BMP was #15 of the $53 we paid.

[james&olya 1,121]

It was an honest question......what are you laughing at?

Or are you laughing because you think I "scored a point"?

I'm sorry, definitely the 2nd!

[Mr. Big Dog 10,747]

To give you a specific example of the 'free market' in action, insurance doesn't cover

... Lasik eye surgery.

Really? My plan does. Not 100% but it does cover I think 50% - which puts it right into the same range as my dental plan coverage for major dental work. Of course, the 50% coverage isn't all. You start at a lower rate because of the rates the insurance company has negotiated with network providers. Now, I erased the plastic surgery from the quote but you and I both know that many plastic surgery procedures are indeed covered by most standard medical insurance plans. What's not covered is elective plastic surgery. And that is because it's, well, not exactly medically necessary.

[Rebecca Jo 1,962]

True, but...

I'm sorry but I don't understand.

[Mr. Big Dog 10,747]

I'm sorry but I don't understand.

I think his point is that consumers (here, you and your hubby) are able to get procedures done for less if you have to worry about the cost - i.e. if you don't have insurance covering it. Some truth to that. I used to have regular medical insurance with fixed co-pays for doc visits. Didn't matter to me whether I took my daughter to the after-hour care at her pediatrician's office from a cost point of view. Same co-pay applied. Insurance shelled out more for it, though. Now that I have a HD plan and pay the HD out of an HSA, I rather take her in during regular hours - costs me half as much.

Edited May 14, 2012 by Mr. Big Dog

[james&olya 1,121]

One of the biggest problems in health care now is that some procedures are being 'sold' to the public already in spite of their questionable value. This would only get worse in the sort of 'free' market some envision. Health care consumers are not in a very good position to judge the value of different treatments. Providers are also compromised by significant conflict of interest. Cardio-thoracic surgeons have a huge interest in perpetuating the idea that coronary bypass surgery is the best treatment for narrowed coronary arteries, even though much less costly stenting is often the treatment of choice. Parents are often convinced their children need tympanostomy tubes to prevent potentially hearing deficit causing episodes of otitis media in spite of research showing that after the age of 2 the risk of hearing damage is much greater from the tubes than from the otitis they prevent. The list goes on and on. The current system has distorted the patient/doctor relationship and too often the patient gets what is good for the provider rather than the patient. Making the market even more 'free' will increase the potential for these abuses. Unless everyone gets their own medical degree the 'free' market just does not work well for most health-care decision making.

[james&olya 1,121]

I think his point is that consumers (here, you and your hubby) are able to get procedures done for less if you have to worry about the cost - i.e. if you don't have insurance covering it. Some truth to that. I used to have regular medical insurance with fixed co-pays for doc visits. Didn't matter to me whether I took my daughter to the after-hour care at her pediatrician's office from a cost point of view. Same co-pay applied. Insurance shelled out more for it, though. Now that I have a HD plan and pay the HD out of an HSA, I rather take her in during regular hours - costs me half as much.

You hit a good point! Any system will be used more responsibly if there is some incentive to discourage irresponsible utilization. It is observed often where I work that patients with no financial incentive otherwise will grossly abuse the system. Calling for an ambulance for insomnia! Coming to the ER to get meds filled because they couldn't be bothered to get the prescription they already had filled in a pharmacy! Etc.! I have often thought that medicaid would save a large amount of money if they required a time of service co-pay of $2 for a doctor's office visit, $10 for the ER, and $20 for an ambulance. The money raised would be insignificant but the money saved from more responsible utilization would be impressive. Just an idea!

[Rebecca Jo 1,962]

You hit a good point! Any system will be used more responsibly if there is some incentive to discourage irresponsible utilization. It is observed often where I work that patients with no financial incentive otherwise will grossly abuse the system. Calling for an ambulance for insomnia! Coming to the ER to get meds filled because they couldn't be bothered to get the prescription they already had filled in a pharmacy! Etc.! I have often thought that medicaid would save a large amount of money if they required a time of service co-pay of $2 for a doctor's office visit, $10 for the ER, and $20 for an ambulance. The money raised would be insignificant but the money saved from more responsible utilization would be impressive. Just an idea!

My husband's insurance does this already.

There is a $75 co-pay for an ER visit. It's going up to $350 with the new plan year.

However, the co-pay is waived if the patient is admitted to the hospital.