OT: Anyone hear the NPR interview about the person getting dependant care coverage from parents

[bearishgurl]

[quote=meadandale][quote=bearishgurl][quote=enron_by_the_sea] . . . Like it or not – the future of our healthcare is HSA+HDHP and some bargaining with your favorite doctor.

I am in the 5th stage of Anger-Denial-Bargaining-Depression-Acceptance cycle of this issue. Most of the country seems to be in stages 2 and 3.[/quote]

enron, I don’t have an HSA, but have a high-deductible health plan (HDHP) which I used to think was “affordable.”[/quote]

If you have a HDHP it is likely an HSA qualifying plan…in which case you would be foolish not to take advantage of this and contribute pretax dollars to your HSA account that you can then use for any of your health related expenses. The annual max contribution is now almost $3k. If you have a plan with a deductible in the $3-4k range, one year of contributions gives you basically all the money you’d need to pay the deductible in the event you have a major health event (hospitalization, etc).[/quote]

enron, my carrier has two similar HSA-compatible plans to mine and I can “convert” to one if I wish. They are slightly more expensive (probably due to bookkeeping tasks with the HSA). When I recently got my 60-day notice of my 10/1/10 rate hike, I was told that I could change to an even higher-deductible plan to keep about the same rate as before, but, under the new health-care reform act, I was “grandfathered” into my old plan (6 yrs now) and if I left, there was no guarantee of ever getting the same deal back with the current benefits promised in my policy. They stated they reserved the right to change plan configurations for new plan applicants to meet the requirements of health care reform. It also said that if I stepped down to a lesser plan, if I wanted a better plan later, I would have to “requalify” at that time so they could “price me properly.”

The type of form letter I received was sent to ALL longtime individual policyholders with ALL US carriers.

I have a very low to non-existent tax rate, anyway, so the benefits of an HSA would probably be moot in my situation. Also, it wouldn’t take much out-of-pocket medical expense at all (over and above my premiums) to exceed 7.5% of my annual income, making nearly my entire deductible tax deductible :=)

[quote=equalizer]Simple fact to all questions on policy is that lobbyists wrote the bills and legally paid the Congress to pass the bills. Not hyberbole, c’est la vie.[/quote]

Yes, equalizer, insurance companies lobbied heavily for all the above provisions and more and Congress did not think they could get the bill to the President without their cooperation. I for one am very glad Congress didn’t provide (in the HCR Act) for the Federal goverment to “administer” or even try to contract “administration” of health plans. That would most certainly have been another horribly botched, mismanaged fiasco. Our “gubmint” is currently challenged in their attempts at navigating their way thru brown paper tunnels of their own making, as it is. Best to leave well-enough alone and let them focus on the messes they’ve already created :={

In the individual market, health care reform DOES NOT promise “affordable premiums” or premiums at a particular price point for an individual with pre-existing condition(s). It ONLY guarantees COVERAGE in an HDHP where they were previously denied. Even if a recent cancer survivor agrees to pay $1100-$1500 per month for their HDHP premium, insurance companies STILL do not want them, even at this rate level (6-8 months of brand-name chemotherapy can easily run north of $175K, not including doctor fees and any other treatment or surgery). The rest of us will STILL be required to (indirectly) supplement these new policyholders’ premiums (through frequent and systematic rate hikes), many of whom are now grabbing at ANY coverage available to them (because they CAN).

I can only surmise that in and after 2014, when people with pre-existing conditions might be entitled to more comprehensive and/or more affordable coverage, the individual rates for “healthier” people and groups will double or triple to make up the difference, forcing a lot of small businesses into the =<49 employee category to avoid paying the $2K per head fine for not offering medical plans to their workers.

[eavesdropper]

[quote=flu]Ok. My head is spinning. I guess the other question I have is. If what we really need is some sort of minimum universal health coverage then why the hell is everything still going through insurance companies???[/quote]

Why else? Money. Lots and lots of it. The insurance companies and their associated businesses clean up big time.

That’s one reason they didn’t lobby harder against kids staying on their parents’ health plans: young, traditionally healthy kids improve the risk pool. Parents pay premiums for them, but the chances of utilization of health services are low. Insurance companies know that kids without coverage have a list of roughly 300 things other than health insurance that they’d rather spend their limited funds on. It was different 7 or 8 years ago when employment of the young was high, and employers were paying most or all of a hefty “single” premium”. In today’s economy, it’s a reduced premium on a parent’s plan, or nothing at all.

I understand why a large part of the population is against a single-payer system (although I believe that it’s the “boogeyman syndrome”: they’re more scared of things that don’t actually exist, but have been created by the PR flacks of insurance companies and opportunistic politicians). However, except for our country’s oldest citizens (75 & up), most of us grew up in the mindset that healthcare is something that we shouldn’t pay for directly; that’s what health insurance is for.

If you look at the traditional model of insurance, it was meant to ensure that if an unexpected illness or injury occurred, your family wouldn’t go broke paying for it. Look at life insurance or auto insurance or homeowners: all meant to cover the unexpected significant expense, not the routine maintenance items.

However, by the end of the 70s, several things had happened to upset the apple cart:

— We changed our pattern of consumption of health services significantly. Up thru the mid-sixties, people tended to their own illnesses, and those of their families. It’s completely different now: people are not just seeing a primary care doc much more frequently, but also specialists, and other health providers (physical therapists, nutritionists, dialysis techs, etc)

— We became a much more litigious society. Malpractice, personal injury, and class action lawsuits became a extraordinarily lucrative source of income for plaintiff’s lawyers, and sometimes even the patients. Successful cases are built on evidence, and nothing says “I am irreparably harmed” like lots and lots of health care-related bills. And then there are those multi-million dollar judgements. But the most expensive fallout from this change? Hospitals and health care providers are being incredibly proactive in practicing defensive medicine, resulting in the often-unnecessary ordering of tests, treatments, and consultations with specialists.

— We’ve become a society that believes we shouldn’t feel bad. Ever. Thanks to Hollywood tearjerkers, Lifetime movies, television medical heroes, reality shows, and the ever-helpful internet, we are bombarded from all sides with stories of complex medical conditions, the symptomatology of which closes matches what we’ve been feeling. So it’s off to the doctor, where, armed with knowledge gleaned from helpful drug company commercials, demands for the miraculous and instantaneous pharmaceutical cure are made. Hell, we don’t even want to deal with a mild cold – we take zinc the minute there’s a tickle in our noses, and keep a full and varied supply of antibiotics at the ready.

— We’ve made incredible advances in basic science research in the past thirty-five years. The development of sophisticated scientific instrumentation and equipment has led to discoveries in microbiology and biochemistry resulting in a new understanding of organisms and disease.

So the upshot is that the science behind health care has advanced, and we, as a society, take it for granted. We want to feel good all the time, we want to live forever, and we have no interest in how that happens or what it costs. The increase in employer-provided health benefits, and in the number of health-related entitlement programs have only aggravated the problem.

Years ago, people got sick, and they either got better or they died. It’s truly a wonderful thing that medical science has improved our chances of survival, but it’s come at a tremendous cost. There was a tremendous outcry against “death panels” during the health care reform debate, however health insurers have been making arbitrary decisions in life-and-death situations for years, and I didn’t ever see angry, over-the-top protests from the citizenry. In all likelihood, this is because most people aren’t in these types of situations until they reach an advanced age, so what the insurance companies are doing to others is not affecting them.

We either have to grow a pair, and out-and-out state that health care will not be available to those who can’t pay for it (and stop salving our consciences by insisting that everyone has access to it. They don’t. Period.) Or we have to decide that heath care is a right for everyone. For those in favor of the first option, just keep in mind that it could well be you or your children or your parents in the position of not being able to afford health care one day, and you’ll have to live with your decision at that point – don’t be turning “activist” overnight because you’re suddenly the ones affected.

To those in the second option camp, get your heads out of the sand and start educating yourself on what the actual costs of healthcare are. Study up on what the utilization trends are, and examine how you may be adding to the problem. Look at every insurance explanation of benefits that’s mailed to you, and compare it to what you’ve paid in premiums. Before you sign on with that lawyer, think about whether it’s actually malpractice, or if you’re just pissed because your surgeon wasn’t able to satisfy your vision of perky post-implant breasts.

If we allow things to continue the way things stand now, within 15 years only the very wealthy will be able to afford health care. Employers will continue passing on more and more of the costs on to their employees. And those depending on entitlement programs will find that their options are seriously reduced, or that the programs have been discontinued altogether.

If that happens, I’m fine with it. Not because I’m one of the fortunate wealthy. It’s because we’ve been in that position before as a nation, and yes, lots of people died, and many more suffered needlessly, and it affected our economic growth and national security.

If we don’t go that route, I’m okay with that, too. But we have to be realistic, and let go of some of our unrealistic expectations. We have to engage in serious study of health care econometrics and bioethics, and stop terming it “death panels”. We have to start looking seriously at QUALITY of life, instead of simply looking at the length of it. We have to stop pissing and moaning about not being able to choose our own physicians, and we have to get real about providing painful and disabling 6-figure courses of “treatment” for 85 year-old patients.

You know, I appreciate that family members might be happy that the life of their 90 year-old father was saved by $300,000 worth of surgery, hospitalization, and rehab. I just question if their decision would have been the same had they been compelled to pony up 25% or 50% of the cost from their own personal funds.

[eavesdropper]

[quote=flu]Ok. My head is spinning. I guess the other question I have is. If what we really need is some sort of minimum universal health coverage then why the hell is everything still going through insurance companies???[/quote]

Why else? Money. Lots and lots of it. The insurance companies and their associated businesses clean up big time.

That’s one reason they didn’t lobby harder against kids staying on their parents’ health plans: young, traditionally healthy kids improve the risk pool. Parents pay premiums for them, but the chances of utilization of health services are low. Insurance companies know that kids without coverage have a list of roughly 300 things other than health insurance that they’d rather spend their limited funds on. It was different 7 or 8 years ago when employment of the young was high, and employers were paying most or all of a hefty “single” premium”. In today’s economy, it’s a reduced premium on a parent’s plan, or nothing at all.

I understand why a large part of the population is against a single-payer system (although I believe that it’s the “boogeyman syndrome”: they’re more scared of things that don’t actually exist, but have been created by the PR flacks of insurance companies and opportunistic politicians). However, except for our country’s oldest citizens (75 & up), most of us grew up in the mindset that healthcare is something that we shouldn’t pay for directly; that’s what health insurance is for.

If you look at the traditional model of insurance, it was meant to ensure that if an unexpected illness or injury occurred, your family wouldn’t go broke paying for it. Look at life insurance or auto insurance or homeowners: all meant to cover the unexpected significant expense, not the routine maintenance items.

However, by the end of the 70s, several things had happened to upset the apple cart:

— We changed our pattern of consumption of health services significantly. Up thru the mid-sixties, people tended to their own illnesses, and those of their families. It’s completely different now: people are not just seeing a primary care doc much more frequently, but also specialists, and other health providers (physical therapists, nutritionists, dialysis techs, etc)

— We became a much more litigious society. Malpractice, personal injury, and class action lawsuits became a extraordinarily lucrative source of income for plaintiff’s lawyers, and sometimes even the patients. Successful cases are built on evidence, and nothing says “I am irreparably harmed” like lots and lots of health care-related bills. And then there are those multi-million dollar judgements. But the most expensive fallout from this change? Hospitals and health care providers are being incredibly proactive in practicing defensive medicine, resulting in the often-unnecessary ordering of tests, treatments, and consultations with specialists.

— We’ve become a society that believes we shouldn’t feel bad. Ever. Thanks to Hollywood tearjerkers, Lifetime movies, television medical heroes, reality shows, and the ever-helpful internet, we are bombarded from all sides with stories of complex medical conditions, the symptomatology of which closes matches what we’ve been feeling. So it’s off to the doctor, where, armed with knowledge gleaned from helpful drug company commercials, demands for the miraculous and instantaneous pharmaceutical cure are made. Hell, we don’t even want to deal with a mild cold – we take zinc the minute there’s a tickle in our noses, and keep a full and varied supply of antibiotics at the ready.

— We’ve made incredible advances in basic science research in the past thirty-five years. The development of sophisticated scientific instrumentation and equipment has led to discoveries in microbiology and biochemistry resulting in a new understanding of organisms and disease.

So the upshot is that the science behind health care has advanced, and we, as a society, take it for granted. We want to feel good all the time, we want to live forever, and we have no interest in how that happens or what it costs. The increase in employer-provided health benefits, and in the number of health-related entitlement programs have only aggravated the problem.

Years ago, people got sick, and they either got better or they died. It’s truly a wonderful thing that medical science has improved our chances of survival, but it’s come at a tremendous cost. There was a tremendous outcry against “death panels” during the health care reform debate, however health insurers have been making arbitrary decisions in life-and-death situations for years, and I didn’t ever see angry, over-the-top protests from the citizenry. In all likelihood, this is because most people aren’t in these types of situations until they reach an advanced age, so what the insurance companies are doing to others is not affecting them.

We either have to grow a pair, and out-and-out state that health care will not be available to those who can’t pay for it (and stop salving our consciences by insisting that everyone has access to it. They don’t. Period.) Or we have to decide that heath care is a right for everyone. For those in favor of the first option, just keep in mind that it could well be you or your children or your parents in the position of not being able to afford health care one day, and you’ll have to live with your decision at that point – don’t be turning “activist” overnight because you’re suddenly the ones affected.

To those in the second option camp, get your heads out of the sand and start educating yourself on what the actual costs of healthcare are. Study up on what the utilization trends are, and examine how you may be adding to the problem. Look at every insurance explanation of benefits that’s mailed to you, and compare it to what you’ve paid in premiums. Before you sign on with that lawyer, think about whether it’s actually malpractice, or if you’re just pissed because your surgeon wasn’t able to satisfy your vision of perky post-implant breasts.

If we allow things to continue the way things stand now, within 15 years only the very wealthy will be able to afford health care. Employers will continue passing on more and more of the costs on to their employees. And those depending on entitlement programs will find that their options are seriously reduced, or that the programs have been discontinued altogether.

If that happens, I’m fine with it. Not because I’m one of the fortunate wealthy. It’s because we’ve been in that position before as a nation, and yes, lots of people died, and many more suffered needlessly, and it affected our economic growth and national security.

If we don’t go that route, I’m okay with that, too. But we have to be realistic, and let go of some of our unrealistic expectations. We have to engage in serious study of health care econometrics and bioethics, and stop terming it “death panels”. We have to start looking seriously at QUALITY of life, instead of simply looking at the length of it. We have to stop pissing and moaning about not being able to choose our own physicians, and we have to get real about providing painful and disabling 6-figure courses of “treatment” for 85 year-old patients.

You know, I appreciate that family members might be happy that the life of their 90 year-old father was saved by $300,000 worth of surgery, hospitalization, and rehab. I just question if their decision would have been the same had they been compelled to pony up 25% or 50% of the cost from their own personal funds.

[eavesdropper]

[quote=flu]Ok. My head is spinning. I guess the other question I have is. If what we really need is some sort of minimum universal health coverage then why the hell is everything still going through insurance companies???[/quote]

Why else? Money. Lots and lots of it. The insurance companies and their associated businesses clean up big time.

That’s one reason they didn’t lobby harder against kids staying on their parents’ health plans: young, traditionally healthy kids improve the risk pool. Parents pay premiums for them, but the chances of utilization of health services are low. Insurance companies know that kids without coverage have a list of roughly 300 things other than health insurance that they’d rather spend their limited funds on. It was different 7 or 8 years ago when employment of the young was high, and employers were paying most or all of a hefty “single” premium”. In today’s economy, it’s a reduced premium on a parent’s plan, or nothing at all.

I understand why a large part of the population is against a single-payer system (although I believe that it’s the “boogeyman syndrome”: they’re more scared of things that don’t actually exist, but have been created by the PR flacks of insurance companies and opportunistic politicians). However, except for our country’s oldest citizens (75 & up), most of us grew up in the mindset that healthcare is something that we shouldn’t pay for directly; that’s what health insurance is for.

If you look at the traditional model of insurance, it was meant to ensure that if an unexpected illness or injury occurred, your family wouldn’t go broke paying for it. Look at life insurance or auto insurance or homeowners: all meant to cover the unexpected significant expense, not the routine maintenance items.

However, by the end of the 70s, several things had happened to upset the apple cart:

— We changed our pattern of consumption of health services significantly. Up thru the mid-sixties, people tended to their own illnesses, and those of their families. It’s completely different now: people are not just seeing a primary care doc much more frequently, but also specialists, and other health providers (physical therapists, nutritionists, dialysis techs, etc)

— We became a much more litigious society. Malpractice, personal injury, and class action lawsuits became a extraordinarily lucrative source of income for plaintiff’s lawyers, and sometimes even the patients. Successful cases are built on evidence, and nothing says “I am irreparably harmed” like lots and lots of health care-related bills. And then there are those multi-million dollar judgements. But the most expensive fallout from this change? Hospitals and health care providers are being incredibly proactive in practicing defensive medicine, resulting in the often-unnecessary ordering of tests, treatments, and consultations with specialists.

— We’ve become a society that believes we shouldn’t feel bad. Ever. Thanks to Hollywood tearjerkers, Lifetime movies, television medical heroes, reality shows, and the ever-helpful internet, we are bombarded from all sides with stories of complex medical conditions, the symptomatology of which closes matches what we’ve been feeling. So it’s off to the doctor, where, armed with knowledge gleaned from helpful drug company commercials, demands for the miraculous and instantaneous pharmaceutical cure are made. Hell, we don’t even want to deal with a mild cold – we take zinc the minute there’s a tickle in our noses, and keep a full and varied supply of antibiotics at the ready.

— We’ve made incredible advances in basic science research in the past thirty-five years. The development of sophisticated scientific instrumentation and equipment has led to discoveries in microbiology and biochemistry resulting in a new understanding of organisms and disease.

So the upshot is that the science behind health care has advanced, and we, as a society, take it for granted. We want to feel good all the time, we want to live forever, and we have no interest in how that happens or what it costs. The increase in employer-provided health benefits, and in the number of health-related entitlement programs have only aggravated the problem.

Years ago, people got sick, and they either got better or they died. It’s truly a wonderful thing that medical science has improved our chances of survival, but it’s come at a tremendous cost. There was a tremendous outcry against “death panels” during the health care reform debate, however health insurers have been making arbitrary decisions in life-and-death situations for years, and I didn’t ever see angry, over-the-top protests from the citizenry. In all likelihood, this is because most people aren’t in these types of situations until they reach an advanced age, so what the insurance companies are doing to others is not affecting them.

We either have to grow a pair, and out-and-out state that health care will not be available to those who can’t pay for it (and stop salving our consciences by insisting that everyone has access to it. They don’t. Period.) Or we have to decide that heath care is a right for everyone. For those in favor of the first option, just keep in mind that it could well be you or your children or your parents in the position of not being able to afford health care one day, and you’ll have to live with your decision at that point – don’t be turning “activist” overnight because you’re suddenly the ones affected.

To those in the second option camp, get your heads out of the sand and start educating yourself on what the actual costs of healthcare are. Study up on what the utilization trends are, and examine how you may be adding to the problem. Look at every insurance explanation of benefits that’s mailed to you, and compare it to what you’ve paid in premiums. Before you sign on with that lawyer, think about whether it’s actually malpractice, or if you’re just pissed because your surgeon wasn’t able to satisfy your vision of perky post-implant breasts.

If we allow things to continue the way things stand now, within 15 years only the very wealthy will be able to afford health care. Employers will continue passing on more and more of the costs on to their employees. And those depending on entitlement programs will find that their options are seriously reduced, or that the programs have been discontinued altogether.

If that happens, I’m fine with it. Not because I’m one of the fortunate wealthy. It’s because we’ve been in that position before as a nation, and yes, lots of people died, and many more suffered needlessly, and it affected our economic growth and national security.

If we don’t go that route, I’m okay with that, too. But we have to be realistic, and let go of some of our unrealistic expectations. We have to engage in serious study of health care econometrics and bioethics, and stop terming it “death panels”. We have to start looking seriously at QUALITY of life, instead of simply looking at the length of it. We have to stop pissing and moaning about not being able to choose our own physicians, and we have to get real about providing painful and disabling 6-figure courses of “treatment” for 85 year-old patients.

You know, I appreciate that family members might be happy that the life of their 90 year-old father was saved by $300,000 worth of surgery, hospitalization, and rehab. I just question if their decision would have been the same had they been compelled to pony up 25% or 50% of the cost from their own personal funds.

[eavesdropper]

[quote=flu]Ok. My head is spinning. I guess the other question I have is. If what we really need is some sort of minimum universal health coverage then why the hell is everything still going through insurance companies???[/quote]

Why else? Money. Lots and lots of it. The insurance companies and their associated businesses clean up big time.

That’s one reason they didn’t lobby harder against kids staying on their parents’ health plans: young, traditionally healthy kids improve the risk pool. Parents pay premiums for them, but the chances of utilization of health services are low. Insurance companies know that kids without coverage have a list of roughly 300 things other than health insurance that they’d rather spend their limited funds on. It was different 7 or 8 years ago when employment of the young was high, and employers were paying most or all of a hefty “single” premium”. In today’s economy, it’s a reduced premium on a parent’s plan, or nothing at all.

I understand why a large part of the population is against a single-payer system (although I believe that it’s the “boogeyman syndrome”: they’re more scared of things that don’t actually exist, but have been created by the PR flacks of insurance companies and opportunistic politicians). However, except for our country’s oldest citizens (75 & up), most of us grew up in the mindset that healthcare is something that we shouldn’t pay for directly; that’s what health insurance is for.

If you look at the traditional model of insurance, it was meant to ensure that if an unexpected illness or injury occurred, your family wouldn’t go broke paying for it. Look at life insurance or auto insurance or homeowners: all meant to cover the unexpected significant expense, not the routine maintenance items.

However, by the end of the 70s, several things had happened to upset the apple cart:

— We changed our pattern of consumption of health services significantly. Up thru the mid-sixties, people tended to their own illnesses, and those of their families. It’s completely different now: people are not just seeing a primary care doc much more frequently, but also specialists, and other health providers (physical therapists, nutritionists, dialysis techs, etc)

— We became a much more litigious society. Malpractice, personal injury, and class action lawsuits became a extraordinarily lucrative source of income for plaintiff’s lawyers, and sometimes even the patients. Successful cases are built on evidence, and nothing says “I am irreparably harmed” like lots and lots of health care-related bills. And then there are those multi-million dollar judgements. But the most expensive fallout from this change? Hospitals and health care providers are being incredibly proactive in practicing defensive medicine, resulting in the often-unnecessary ordering of tests, treatments, and consultations with specialists.

— We’ve become a society that believes we shouldn’t feel bad. Ever. Thanks to Hollywood tearjerkers, Lifetime movies, television medical heroes, reality shows, and the ever-helpful internet, we are bombarded from all sides with stories of complex medical conditions, the symptomatology of which closes matches what we’ve been feeling. So it’s off to the doctor, where, armed with knowledge gleaned from helpful drug company commercials, demands for the miraculous and instantaneous pharmaceutical cure are made. Hell, we don’t even want to deal with a mild cold – we take zinc the minute there’s a tickle in our noses, and keep a full and varied supply of antibiotics at the ready.

— We’ve made incredible advances in basic science research in the past thirty-five years. The development of sophisticated scientific instrumentation and equipment has led to discoveries in microbiology and biochemistry resulting in a new understanding of organisms and disease.

So the upshot is that the science behind health care has advanced, and we, as a society, take it for granted. We want to feel good all the time, we want to live forever, and we have no interest in how that happens or what it costs. The increase in employer-provided health benefits, and in the number of health-related entitlement programs have only aggravated the problem.

Years ago, people got sick, and they either got better or they died. It’s truly a wonderful thing that medical science has improved our chances of survival, but it’s come at a tremendous cost. There was a tremendous outcry against “death panels” during the health care reform debate, however health insurers have been making arbitrary decisions in life-and-death situations for years, and I didn’t ever see angry, over-the-top protests from the citizenry. In all likelihood, this is because most people aren’t in these types of situations until they reach an advanced age, so what the insurance companies are doing to others is not affecting them.

We either have to grow a pair, and out-and-out state that health care will not be available to those who can’t pay for it (and stop salving our consciences by insisting that everyone has access to it. They don’t. Period.) Or we have to decide that heath care is a right for everyone. For those in favor of the first option, just keep in mind that it could well be you or your children or your parents in the position of not being able to afford health care one day, and you’ll have to live with your decision at that point – don’t be turning “activist” overnight because you’re suddenly the ones affected.

To those in the second option camp, get your heads out of the sand and start educating yourself on what the actual costs of healthcare are. Study up on what the utilization trends are, and examine how you may be adding to the problem. Look at every insurance explanation of benefits that’s mailed to you, and compare it to what you’ve paid in premiums. Before you sign on with that lawyer, think about whether it’s actually malpractice, or if you’re just pissed because your surgeon wasn’t able to satisfy your vision of perky post-implant breasts.

If we allow things to continue the way things stand now, within 15 years only the very wealthy will be able to afford health care. Employers will continue passing on more and more of the costs on to their employees. And those depending on entitlement programs will find that their options are seriously reduced, or that the programs have been discontinued altogether.

If that happens, I’m fine with it. Not because I’m one of the fortunate wealthy. It’s because we’ve been in that position before as a nation, and yes, lots of people died, and many more suffered needlessly, and it affected our economic growth and national security.

If we don’t go that route, I’m okay with that, too. But we have to be realistic, and let go of some of our unrealistic expectations. We have to engage in serious study of health care econometrics and bioethics, and stop terming it “death panels”. We have to start looking seriously at QUALITY of life, instead of simply looking at the length of it. We have to stop pissing and moaning about not being able to choose our own physicians, and we have to get real about providing painful and disabling 6-figure courses of “treatment” for 85 year-old patients.

You know, I appreciate that family members might be happy that the life of their 90 year-old father was saved by $300,000 worth of surgery, hospitalization, and rehab. I just question if their decision would have been the same had they been compelled to pony up 25% or 50% of the cost from their own personal funds.

[eavesdropper]

[quote=flu]Ok. My head is spinning. I guess the other question I have is. If what we really need is some sort of minimum universal health coverage then why the hell is everything still going through insurance companies???[/quote]

Why else? Money. Lots and lots of it. The insurance companies and their associated businesses clean up big time.

That’s one reason they didn’t lobby harder against kids staying on their parents’ health plans: young, traditionally healthy kids improve the risk pool. Parents pay premiums for them, but the chances of utilization of health services are low. Insurance companies know that kids without coverage have a list of roughly 300 things other than health insurance that they’d rather spend their limited funds on. It was different 7 or 8 years ago when employment of the young was high, and employers were paying most or all of a hefty “single” premium”. In today’s economy, it’s a reduced premium on a parent’s plan, or nothing at all.

I understand why a large part of the population is against a single-payer system (although I believe that it’s the “boogeyman syndrome”: they’re more scared of things that don’t actually exist, but have been created by the PR flacks of insurance companies and opportunistic politicians). However, except for our country’s oldest citizens (75 & up), most of us grew up in the mindset that healthcare is something that we shouldn’t pay for directly; that’s what health insurance is for.

If you look at the traditional model of insurance, it was meant to ensure that if an unexpected illness or injury occurred, your family wouldn’t go broke paying for it. Look at life insurance or auto insurance or homeowners: all meant to cover the unexpected significant expense, not the routine maintenance items.

However, by the end of the 70s, several things had happened to upset the apple cart:

— We changed our pattern of consumption of health services significantly. Up thru the mid-sixties, people tended to their own illnesses, and those of their families. It’s completely different now: people are not just seeing a primary care doc much more frequently, but also specialists, and other health providers (physical therapists, nutritionists, dialysis techs, etc)

— We became a much more litigious society. Malpractice, personal injury, and class action lawsuits became a extraordinarily lucrative source of income for plaintiff’s lawyers, and sometimes even the patients. Successful cases are built on evidence, and nothing says “I am irreparably harmed” like lots and lots of health care-related bills. And then there are those multi-million dollar judgements. But the most expensive fallout from this change? Hospitals and health care providers are being incredibly proactive in practicing defensive medicine, resulting in the often-unnecessary ordering of tests, treatments, and consultations with specialists.

— We’ve become a society that believes we shouldn’t feel bad. Ever. Thanks to Hollywood tearjerkers, Lifetime movies, television medical heroes, reality shows, and the ever-helpful internet, we are bombarded from all sides with stories of complex medical conditions, the symptomatology of which closes matches what we’ve been feeling. So it’s off to the doctor, where, armed with knowledge gleaned from helpful drug company commercials, demands for the miraculous and instantaneous pharmaceutical cure are made. Hell, we don’t even want to deal with a mild cold – we take zinc the minute there’s a tickle in our noses, and keep a full and varied supply of antibiotics at the ready.

— We’ve made incredible advances in basic science research in the past thirty-five years. The development of sophisticated scientific instrumentation and equipment has led to discoveries in microbiology and biochemistry resulting in a new understanding of organisms and disease.

So the upshot is that the science behind health care has advanced, and we, as a society, take it for granted. We want to feel good all the time, we want to live forever, and we have no interest in how that happens or what it costs. The increase in employer-provided health benefits, and in the number of health-related entitlement programs have only aggravated the problem.

Years ago, people got sick, and they either got better or they died. It’s truly a wonderful thing that medical science has improved our chances of survival, but it’s come at a tremendous cost. There was a tremendous outcry against “death panels” during the health care reform debate, however health insurers have been making arbitrary decisions in life-and-death situations for years, and I didn’t ever see angry, over-the-top protests from the citizenry. In all likelihood, this is because most people aren’t in these types of situations until they reach an advanced age, so what the insurance companies are doing to others is not affecting them.

We either have to grow a pair, and out-and-out state that health care will not be available to those who can’t pay for it (and stop salving our consciences by insisting that everyone has access to it. They don’t. Period.) Or we have to decide that heath care is a right for everyone. For those in favor of the first option, just keep in mind that it could well be you or your children or your parents in the position of not being able to afford health care one day, and you’ll have to live with your decision at that point – don’t be turning “activist” overnight because you’re suddenly the ones affected.

To those in the second option camp, get your heads out of the sand and start educating yourself on what the actual costs of healthcare are. Study up on what the utilization trends are, and examine how you may be adding to the problem. Look at every insurance explanation of benefits that’s mailed to you, and compare it to what you’ve paid in premiums. Before you sign on with that lawyer, think about whether it’s actually malpractice, or if you’re just pissed because your surgeon wasn’t able to satisfy your vision of perky post-implant breasts.

If we allow things to continue the way things stand now, within 15 years only the very wealthy will be able to afford health care. Employers will continue passing on more and more of the costs on to their employees. And those depending on entitlement programs will find that their options are seriously reduced, or that the programs have been discontinued altogether.

If that happens, I’m fine with it. Not because I’m one of the fortunate wealthy. It’s because we’ve been in that position before as a nation, and yes, lots of people died, and many more suffered needlessly, and it affected our economic growth and national security.

If we don’t go that route, I’m okay with that, too. But we have to be realistic, and let go of some of our unrealistic expectations. We have to engage in serious study of health care econometrics and bioethics, and stop terming it “death panels”. We have to start looking seriously at QUALITY of life, instead of simply looking at the length of it. We have to stop pissing and moaning about not being able to choose our own physicians, and we have to get real about providing painful and disabling 6-figure courses of “treatment” for 85 year-old patients.

You know, I appreciate that family members might be happy that the life of their 90 year-old father was saved by $300,000 worth of surgery, hospitalization, and rehab. I just question if their decision would have been the same had they been compelled to pony up 25% or 50% of the cost from their own personal funds.

[Aecetia]

eaves,
We all know the answer to that one. I just heard a local ad bragging about doing some new type of heart surgery they did on a 90 year old man and how successful it was. His is an inspirational story; he survived the Bataan Death March, however, it does give you pause to think. I am not suggesting death panels, I was merely thinking about what you just wrote, would the family have made the same decision if they had to pay a percentage of the cost from their own personal funds? That is a great question. I do not have the answer other than most people do not have that kind of money to pay for their medical procedures.

[Aecetia]

eaves,
We all know the answer to that one. I just heard a local ad bragging about doing some new type of heart surgery they did on a 90 year old man and how successful it was. His is an inspirational story; he survived the Bataan Death March, however, it does give you pause to think. I am not suggesting death panels, I was merely thinking about what you just wrote, would the family have made the same decision if they had to pay a percentage of the cost from their own personal funds? That is a great question. I do not have the answer other than most people do not have that kind of money to pay for their medical procedures.

[Aecetia]

eaves,
We all know the answer to that one. I just heard a local ad bragging about doing some new type of heart surgery they did on a 90 year old man and how successful it was. His is an inspirational story; he survived the Bataan Death March, however, it does give you pause to think. I am not suggesting death panels, I was merely thinking about what you just wrote, would the family have made the same decision if they had to pay a percentage of the cost from their own personal funds? That is a great question. I do not have the answer other than most people do not have that kind of money to pay for their medical procedures.

[Aecetia]

eaves,
We all know the answer to that one. I just heard a local ad bragging about doing some new type of heart surgery they did on a 90 year old man and how successful it was. His is an inspirational story; he survived the Bataan Death March, however, it does give you pause to think. I am not suggesting death panels, I was merely thinking about what you just wrote, would the family have made the same decision if they had to pay a percentage of the cost from their own personal funds? That is a great question. I do not have the answer other than most people do not have that kind of money to pay for their medical procedures.

[Aecetia]

eaves,
We all know the answer to that one. I just heard a local ad bragging about doing some new type of heart surgery they did on a 90 year old man and how successful it was. His is an inspirational story; he survived the Bataan Death March, however, it does give you pause to think. I am not suggesting death panels, I was merely thinking about what you just wrote, would the family have made the same decision if they had to pay a percentage of the cost from their own personal funds? That is a great question. I do not have the answer other than most people do not have that kind of money to pay for their medical procedures.

[afx114]

Good post eavesdropper. EOM

[afx114]

Good post eavesdropper. EOM

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Good post eavesdropper. EOM

[afx114]

Good post eavesdropper. EOM

[Author]

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