What do you think of Obama's health care plan?

your position reflects your profession.

you are not gonna like me when this is all done, i can tell.

(i think i should mention so the group knows, he's in insurance)


good night.

So what? If you think his argument is flawed because of his profession then you should be able to point out the flaws in the argument itself. Otherwise this is a classic ad hominem, you attack the messenger instead of the message and add nothing to the discussion.

I think his argument reflects the fact that he defends the insurance companies he works for, and will come back with more comprehensive, well thought out reasoning when it is that.

your nothing may not be my nothing, robert.

i'll post elsewhere.

Yeah - this just seems illogical to me and I can't see how it can or will ever be implemented.

Tying the concept of universal healthcare so intimately to insurance companies (or any for- profit industry) seems to me to be just more of the same old/same old.

And how is it not going to cost anything? Again, logic dictates that, at least initially, it will cost someone something.
To say it won't- sets off alarm bells in my mind that something (such as a cost/benefit analysis) is being fudged to look better than it is.

I wish he'd been more straightforward. People need to realize that if they want a universal healthcare system that is equally available to all citizens, regardless of age, gender or medical/disease history - it CANNOT work the same as it always has for anyone - except those people who are willing to pay a premium for private care.
Is it more important to people to know that everyone in the country has healthcare available- or is it more important for people to know that they and their own will be taken care of and let everyone else find some way to take care of themselves?

I think that's the speech that should be made, and then the people will have to answer.

Because I can tell you here, in England, under the NHS schedule of preventive care- I've had one pap smear in five years. In the US, I would have had five - one a year. Here in England, I've never had a mammogram under the NHS schedule of preventive care. In the US - I had two in three years (both perfectly normal - this was just to establish a baseline against which to read future mammograms for issues that might arise), and I'd have had one every couple of years after that as precaution- and this would not be my choice - this would have been prescribed by my doctor.
So I don't have the preventive care in England that I would have had in the US. But I don't mind that, because I know that the trade off is that EVERY woman gets a level of preventive care and guaranteed treatment as opposed to some women getting VERY GOOD preventive care and treatment and others having NO CHANCE for any.
It's a trade off I'm happy to make.

No, I find this disappointing. And I can't fathom how it can possibly work.
It seems to me that it will just lead to more embroilment in bureaucratic wrangling and refinement in the language of legalese (as it pertains to health and disease)...

And if you think the argument is thusly flawed, then you should be able to find fault with the argument itself, instead of the messenger.



This isn't some subjective difference of opinion. It's just simple logic. Don't take my word for it, here's wikipedia on the subject:

Finn I'm interested in hearing what conclusions you draw from this argument. If making these customer protections kills the profitability of insurers what then do you propose? That we do nothing at all?

I have a very different conclusion: that this is all the more an argument for a public option. If profit is incompatible with the coverage and consumer protections we want, then profit is what should get the boot.

Well written, as always. There's much there I would like to comment on, but it's a little late for me to be making good sense. I will say that there are elements of the plan, as I understand it, that I might decide are useful and good for the country as a whole. Those elements are certainly not going to be fair to everyone, and this is something that isn't being communicated to the general public.

Nods. That's where I go too. I don't see a way to reconcile the two. But I'm open to suggestions.

Whether or not I like you has nothing to do with your contribution to this thread.

I imagaine you think you have "outted" me.

Yes, my business is related to insurance, but most likely not in the way you imagine.

I do know insurance though --- do you?

No, I do not suggest we do nothing at all.

How can we reduce the cost of healthcare and health insurance?

Allow competition across state lines.

Why is this not part of ObamaCare?

Because very extensive and very powerful bureaucracies have been established in every state (and particularly the Blue ones) to regulate insurance. Breaking down artificial barriers to insurance commerce will interfere with the machines of state insurance departments.

Implement medical malpractice tort reform that caps non-economic damages.

A primer on tort actions: Plaintiffs (the persons alleging that they have been harmed) sue for "Special" and "General" damages. Special damages are out of pocket expenses: the cost of their medical care, their lost wages etc. These are, theoretically, easily proven damages: a doctor botches your operation and you need to spend $150,000 in additional medical costs to repair the screw-up. While you are at it, you are out of work for 6 months and so lose $25,000 in wages. There are other elements of Special damages but for our purposes you have special damages in the amount of $175,000.

Think about this. If not for the doctor's mistake, you would not have had to spend an additional $150,000 or lose $25,000 in pay, and so if it was his fault, it's only fair that he reimburse you for these amounts.

Let's put aside the fact that in many states you will get to collect these amounts even if you have your own form of insurance that assures the costs are not actually out of your pocket. In essence, you can profit from your loss, but the notion that the guilty party pay for your extra costs certainly seems fair.

Now we move to General Damages: Your pain and suffering.

OK, not only did you lose money you should not have, but you've had to suffer. What's the value of pain and suffering?

There are no convenient tables that can tell us what the pain of a broken arm might be worth. It's all up to what a jury thinks such suffering is worth.

Who serves on our juries?

Most of the people we would want to serve on our juries make every effort to avoid service and so we are usually left with people who have nothing better to do: The Jerry Springer viewership. A representative sample of America? I hope not.

In any case, these folks get to decide what your pain and suffering is worth. Do you think they are most likely to be conservative or liberal in their evaluations?

Then comes Punitive Damages for which the sky is almost the limit.

Punitive damages are supposed to punish misfeasors in such a way that they will think long and hard about screwing up again. If a multi-national company that records profits in the billions is forced to pay $650,000 to a plaintiff for an act of negligence, it's not unreasonable to think that the company will shrug of that amount as a cost of doing business, and so it makes sense to award punitive damages when it can be shown that the defendant was grossly or intentionally negligent. In other words they knew or should have known that their actions would cause harms but decided that their profit was more important. It's a way to punish the truly Bad Guys in a manner that will actually hurt them, and it's a good provision of the law.

The problem is that punitive damages are awarded far more often than they are called for because jurors act on emotion.

Doctors are not (as much as we would like to believe they are) perfect and they will make mistakes, but at the same time, no action of a doctor can be relied upon to be effective 100% of the times. Sometimes bad things happen and no one made an obvious mistake.

So if you go in for surgery and the doctor tells you up front that there is a 20% chance of facial paralysis, if you wake up from anesthesia and are unable to smile, does it follow that the doctor owes you money or deserves to be punished?

Insurance works when insurers can predict losses. When they can predict losses they can establish prices that are not only competitive but profitable (Let's not forget, they are in business to make a profit).

When the extent of a loss is unpredictable and uncapped, insurers are at a tremendous disadvantage.

Thousands of babies are born deformed or damaged every year. Is each and every one of these tragic events the fault of the OB-GYN? Of course not, but almost every one of these tragic events results in a law suit and a settlement if not a verdict, and so Malpractice Insurers are not insuring against negligence, they are insuring against imperfection.

As a result, the average med mal premium for an OB-GYN is over $200,000 a year. And guess what? Most Med Mal Insurers are losing money!

As a result, is it any wonder that doctors go far beyond what is medically necessary to cover their asses? Ever wonder why the percentage of Cesarean births has increased dramatically over the last 30 years? Every wonder why no matter how minor your complaint might be, your doctor will order an MRI or a CT scan?

Here's the solution:

Do not allow plaintiffs to collect twice on special damages. If, however, they have distinct insurance that reimburses them for their costs, they should only be able to collect, from the defendant, those costs which someone else has not paid.

Cap general damages. It should be that hard to come up with a table that defines the amount of monetary compensation certain injuries can recover, and put a limit on the most the worst injury might. Here's a very effective test of our tort system:

You break your leg and receive $300,000. If you think it was "worth it" to break you leg, or you think that it wouldn't be so bad to break your leg in the future, you were paid too much. This is the case for the majority of plaintiffs.

You are supposed to come out of the process whole, not enriched.

Obviate the need for doctors to practice "defensive medicine" and we can significantly reduce the cost of healthcare and health insurance.

Why is this not part of ObamaCare?

Because the Democrats are, in large measure, the creatures of the Trial Bar. Not, necessarily, because they love to see plaintiffs get big bucks (although there are plenty on that score), but because the Trail Bar has made, literally, billions of dollars suing tobacco companies, asbestos companies et al and is more than willing to spend large shares on influencing the government to insure they can make further billions.

If you abhor the influence of Big Business on American politics than you must abhor the influence of the Trial Bar or stand revealed as a hypocrite.

Enough for now.

No, I do not suggest we do nothing at all.

How can we reduce the cost of healthcare and health insurance?

Allow competition across state lines.

Why is this not part of ObamaCare?

Because very extensive and very powerful bureaucracies have been established in every state (and particularly the Blue ones) to regulate insurance. Breaking down artificial barriers to insurance commerce will interfere with the machines of state insurance departments.

Implement medical malpractice tort reform that caps non-economic damages.

A primer on tort actions: Plaintiffs (the persons alleging that they have been harmed) sue for "Special" and "General" damages. Special damages are out of pocket expenses: the cost of their medical care, their lost wages etc. These are, theoretically, easily proven damages: a doctor botches your operation and you need to spend $150,000 in additional medical costs to repair the screw-up. While you are at it, you are out of work for 6 months and so lose $25,000 in wages. There are other elements of Special damages but for our purposes you have special damages in the amount of $175,000.

Think about this. If not for the doctor's mistake, you would not have had to spend an additional $150,000 or lose $25,000 in pay, and so if it was his fault, it's only fair that he reimburse you for these amounts.

Let's put aside the fact that in many states you will get to collect these amounts even if you have your own form of insurance that assures the costs are not actually out of your pocket. In essence, you can profit from your loss, but the notion that the guilty party pay for your extra costs certainly seems fair.

Now we move to General Damages: Your pain and suffering.

OK, not only did you lose money you should not have, but you've had to suffer. What's the value of pain and suffering?

There are no convenient tables that can tell us what the pain of a broken arm might be worth. It's all up to what a jury thinks such suffering is worth.

Who serves on our juries?

Most of the people we would want to serve on our juries make every effort to avoid service and so we are usually left with people who have nothing better to do: The Jerry Springer viewership. A representative sample of America? I hope not.

In any case, these folks get to decide what your pain and suffering is worth. Do you think they are most likely to be conservative or liberal in their evaluations?

Then comes Punitive Damages for which the sky is almost the limit.

Punitive damages are supposed to punish misfeasors in such a way that they will think long and hard about screwing up again. If a multi-national company that records profits in the billions is forced to pay $650,000 to a plaintiff for an act of negligence, it's not unreasonable to think that the company will shrug of that amount as a cost of doing business, and so it makes sense to award punitive damages when it can be shown that the defendant was grossly or intentionally negligent. In other words they knew or should have known that their actions would cause harms but decided that their profit was more important. It's a way to punish the truly Bad Guys in a manner that will actually hurt them, and it's a good provision of the law.

The problem is that punitive damages are awarded far more often than they are called for because jurors act on emotion.

Doctors are not (as much as we would like to believe they are) perfect and they will make mistakes, but at the same time, no action of a doctor can be relied upon to be effective 100% of the times. Sometimes bad things happen and no one made an obvious mistake.

So if you go in for surgery and the doctor tells you up front that there is a 20% chance of facial paralysis, if you wake up from anesthesia and are unable to smile, does it follow that the doctor owes you money or deserves to be punished?

Insurance works when insurers can predict losses. When they can predict losses they can establish prices that are not only competitive but profitable (Let's not forget, they are in business to make a profit).

When the extent of a loss is unpredictable and uncapped, insurers are at a tremendous disadvantage.

Thousands of babies are born deformed or damaged every year. Is each and every one of these tragic events the fault of the OB-GYN? Of course not, but almost every one of these tragic events results in a law suit and a settlement if not a verdict, and so Malpractice Insurers are not insuring against negligence, they are insuring against imperfection.

As a result, the average med mal premium for an OB-GYN is over $200,000 a year. And guess what? Most Med Mal Insurers are losing money!

As a result, is it any wonder that doctors go far beyond what is medically necessary to cover their asses? Ever wonder why the percentage of Cesarean births has increased dramatically over the last 30 years? Every wonder why no matter how minor your complaint might be, your doctor will order an MRI or a CT scan?

Here's the solution:

Do not allow plaintiffs to collect twice on special damages. If, however, they have distinct insurance that reimburses them for their costs, they should only be able to collect, from the defendant, those costs which someone else has not paid.

Cap general damages. It should be that hard to come up with a table that defines the amount of monetary compensation certain injuries can recover, and put a limit on the most the worst injury might. Here's a very effective test of our tort system:

You break your leg and receive $300,000. If you think it was "worth it" to break you leg, or you think that it wouldn't be so bad to break your leg in the future, you were paid too much. This is the case for the majority of plaintiffs.

You are supposed to come out of the process whole, not enriched.

Obviate the need for doctors to practice "defensive medicine" and we can significantly reduce the cost of healthcare and health insurance.

Why is this not part of ObamaCare?

Because the Democrats are, in large measure, the creatures of the Trial Bar. Not, necessarily, because they love to see plaintiffs get big bucks (although there are plenty on that score), but because the Trail Bar has made, literally, billions of dollars suing tobacco companies, asbestos companies et al and is more than willing to spend large shares on influencing the government to insure they can make further billions.

If you abhor the influence of Big Business on American politics than you must abhor the influence of the Trial Bar or stand revealed as a hypocrite.

Much more to come, but enough for now.

I'll be waiting. This is useful.

I can certainly see how allowing competition across state lines could reduce the cost of health insurance, but not how it would reduce the actual cost of care. Further, I'm somewhat wary about allowing competition across state lines as I still have a bad taste in my mouth about the last time we did that -- with credit card companies. You would essentially be allowing insurance companies to sell insurance from the least regulated states to people whose states mandate consumer protections, bypassing those protections. But assuming we did this and it did reduce costs, would it increase coverage? Would we be doing anything about the people who right now cannot get insurance or who lose their coverage once they get sick or whose insurance is not adequate to cover their medical costs?

Reduce the cost of health insurance and you will reduce the cost of health care, but who cares? The aim of ObamaCare is not to make healthcare inexpensive enough for anyone without insurance to afford, it is to allow everyone to access health insurance.

The cost of healthcare only comes into play when Obama has to deal with how he will provide everyone with health insurance and not increase the deficit, and this is a farce because he fully accepts that his plan will increase the deficit. He's just trying to figure out to bullshit the American people about how it will not.

There are some ways to reasonably reduce the cost of healthcare:

First and foremost is to obviate the need for defensive medicine by implementing medical malpractice reform.

Convert written records to a digital form. This won't produce the level of savings that proponents of ObamaCare claim, but it will help costs and improve healthcare delivery.

Take a relative small portion of the billions of dollars ObamaCare will cost and spend it on national advancements of healthcare. It would cost the government far less to pay for an MRI machine in every hospital than to create a public healthcare option.

If we insist on nationalizing some aspect of healthcare, and we want to reduce costs and improve care, let the government take over the R&D for drugs. Once they find an effective drug they can place in on the auction block to pharma companies. Whatever they receive will help finance additional R&D and by bearing the R&D costs, they will eliminate the argument for Pharma to charge such high prices for their drugs.

These are but a few suggestions that are limited in scope but promise high returns. Does it really make sense for the government to assume responsibility and control of the entire mess?

As for selling insurance across state lines, it's already happening and no one in the P&C industry gets away with arguing they are based in one state and therefore the regulations of that state should govern the transactions in any other state. It simply doesn't happen, but if you still are goosey about insurers picking and chooseing state regulations, create a federal regulatory agency and kill the state insurance departments.

Any insurance company that writes in all, or most of, the 50 states would be happy to have a single regulatory agency with which to deal, and by being able to focus on a single set of regulations rather than 50 different sets, could save operating costs that can be passed on to their customers.

The markets can take care of all of these problems with minimal governmental involvement if government will allow them to do so.

I thought it was the cost that was preventing the access, but what do I know.


I accept it too. I think we should cut elsewhere to balance the budget but I don't see why this bill itself all of a sudden has to be deficit neutral.


Why is this first and foremost? What makes it the first priority? Do we have some sense that it would make that big of an impact on costs of health insurance? There's been quite a discussion on the Conservatives thread and to date there's been no evidence to show that it effects premiums other than malpractice premiums. I know the theory is there that it will eventually effect health insurance premiums, but if this is to be the first priority it would seem that more than theory should be present.


Ok. But why is this a government endeavor? (I don't mean to ask these questions in a combative way -- I'm genuinely interested.)


Interesting.


Another interesting proposal. I was under the impression that we already fund quite a bit of the research, but you're suggesting that we actually nationalize drug R&D entirely. Might be a good idea.


Depends on which government and what you mean by entire mess. I hadn't considered a foray into drug manufacturing before you mentioned it.


So, two questions then. One, if it's already happening then why are they crowing about being able to sell across state lines? And two, are you really arguing for another federal regulatory agency (big surprise in itself) that takes power away from the states?


I suppose that's a pretty good argument, not that it doesn't still surprise me.


I don't know, what you describe above doesn't sound minimal to me. I'm not completely adverse to the idea that government involvement in the past has had some hand in the problems we have now. But I think it's been more along the lines of protecting the big insurance companies from market forces.