65
   

IT'S TIME FOR UNIVERSAL HEALTH CARE

 
 
Advocate
 
  1  
Reply Fri 16 Feb, 2007 01:40 pm
Here is our private healthcare system at its best.



^2/16/07: The Health Care Racket

By PAUL KRUGMAN

Is the health insurance business a racket? Yes, literally -- or so say
two New York hospitals, which have filed a racketeering lawsuit against
UnitedHealth Group and several of its affiliates.

I don't know how the case will turn out. But whatever happens in court,
the lawsuit illustrates perfectly the dysfunctional nature of our health
insurance system, a system in which resources that could have been used
to pay for medical care are instead wasted in a zero-sum struggle over
who ends up with the bill.

The two hospitals accuse UnitedHealth of operating a "rogue business
plan" designed to avoid paying clients' medical bills. For example, the
suit alleges that patients were falsely told that Flushing Hospital was
"not a network provider" so UnitedHealth did not pay the full network
rate. UnitedHealth has already settled charges of misleading clients
about providers' status brought by New York's attorney general: the
company paid restitution to plan members, while attributing the problem
to computer errors.

The legal outcome will presumably turn on whether there was deception as
well as denial -- on whether it can be proved that UnitedHealth
deliberately misled plan members. But it's a fact that insurers spend a
lot of money looking for ways to reject insurance claims. And health
care providers, in turn, spend billions on "denial management,"
employing specialist firms -- including Ingenix, a subsidiary of, yes,
UnitedHealth -- to fight the insurers.

So it's an arms race between insurers, who deploy software and manpower
trying to find claims they can reject, and doctors and hospitals, who
deploy their own forces in an effort to outsmart or challenge the
insurers. And the cost of this arms race ends up being borne by the
public, in the form of higher health care prices and higher insurance
premiums.

Of course, rejecting claims is a clumsy way to deny coverage. The best
way for an insurer to avoid paying medical bills is to avoid selling
insurance to people who really need it. An insurance company can
accomplish this in two ways, through marketing that targets the healthy,
and through underwriting: rejecting the sick or charging them higher
premiums.

Like denial management, however, marketing and underwriting cost a lot
of money. McKinsey & Company, the consulting firm, recently released an
important report dissecting the reasons America spends so much more on
health care than other wealthy nations. One major factor is that we
spend $98 billion a year in excess administrative costs, with more than
half of the total accounted for by marketing and underwriting -- costs
that don't exist in single-payer systems.

And this is just part of the story. McKinsey's estimate of excess
administrative costs counts only the costs of insurers. It doesn't, as
the report concedes, include other "important consequences of the
multipayor system," like the extra costs imposed on providers. The sums
doctors pay to denial management specialists are just one example.

Incidentally, while insurers are very good at saying no to doctors,
hospitals and patients, they're not very good at saying no to more
powerful players. Drug companies, in particular, charge much higher
prices in the United States than they do in countries like Canada, where
the government health care system does the bargaining. McKinsey
estimates that the United States pays $66 billion a year in excess drug
costs, and overpays for medical devices like knee and hip implants, too.

To put these numbers in perspective: McKinsey estimates the cost of
providing full medical care to all of America's uninsured at $77 billion
a year. Either eliminating the excess administrative costs of private
health insurers, or paying what the rest of the world pays for drugs and
medical devices, would by itself more or less pay the cost of covering
all the uninsured. And that doesn't count the many other costs imposed
by the fragmentation of our health care system.

Which brings us back to the racketeering lawsuit. If UnitedHealth can be
shown to have broken the law -- and let's just say that this company,
which is America's second-largest health insurer, has a reputation for
playing even rougher than its competitors -- by all means, let's see
justice done. But the larger problem isn't the behavior of any
individual company. It's the ugly incentives provided by a system in
which giving care is punished, while denying it is rewarded.
---------------------------------------------------------------
0 Replies
 
Advocate
 
  1  
Reply Thu 22 Feb, 2007 11:49 am
Why are we keeping alive a private healthcare system that doesn't, and will not, work.


http://www.tompaine.com/articles/2007/02/22/saving_private_insurance.php
0 Replies
 
mysteryman
 
  1  
Reply Thu 22 Feb, 2007 01:52 pm
Advocate wrote:
Why are we keeping alive a private healthcare system that doesn't, and will not, work.


http://www.tompaine.com/articles/2007/02/22/saving_private_insurance.php



Because its better then a govt run system that cannot work.
0 Replies
 
Advocate
 
  1  
Reply Thu 22 Feb, 2007 02:10 pm
mm, you are ignoring the facts. The admin costs of Medicare, which is a government plan, are about a fifth of those of the most efficient private health insurance firm. Frankly, the best cure for the nation is to extend Medicare to everyone.

You may now proceed to give us some personal anecdote that persuades you otherwise.
0 Replies
 
Thomas
 
  1  
Reply Thu 22 Feb, 2007 02:18 pm
mysteryman wrote:
Because its better then a govt run system that cannot work.

Why can't a government-run system work? Medicare, Medicaid, and the VA provide government-run healthcare systems. How do they not work? How do they work worse than the private part of the US health care system?
0 Replies
 
fishin
 
  1  
Reply Thu 22 Feb, 2007 03:27 pm
Advocate wrote:
mm, you are ignoring the facts. The admin costs of Medicare, which is a government plan, are about a fifth of those of the most efficient private health insurance firm. Frankly, the best cure for the nation is to extend Medicare to everyone.


Meidcare's administrative numbers only come in that low when you pretend that many of their costs don't exist. There are numerous hidden costs in Medicare's numbers that should be added to the actual payouts to come up with an accurate number for comparison. For one, Medicare pays out for claims but where does that money come from? There is no number in the Medicare cost system for collecting the taxes that are used to pay the bills but when you look at the private insurers their accounts recievables departments are included. Medicare also excludes the costs of a significant numbers of it's management employees and they buildings they occupy (the entire "Centers for Medicare
and Medicaid Services" are excluded).

In an apples-to-apples comparsion Medicare comes out in the exact same range as private insurers for overhead costs. They are within a percentage point or two of each other.
0 Replies
 
maporsche
 
  1  
Reply Thu 22 Feb, 2007 04:55 pm
Thomas wrote:
mysteryman wrote:
Because its better then a govt run system that cannot work.

Why can't a government-run system work? Medicare, Medicaid, and the VA provide government-run healthcare systems. How do they not work? How do they work worse than the private part of the US health care system?


because republicans would cut taxes, cut funding, and underfund the program.
0 Replies
 
Advocate
 
  1  
Reply Fri 23 Feb, 2007 12:01 pm
Fishin, I think you are dead wrong. Do you have any support for your statement? At least two studies support my view.
0 Replies
 
fishin
 
  1  
Reply Fri 23 Feb, 2007 12:03 pm
Advocate wrote:
Fishin, I think you are dead wrong. Do you have any support for your statement? At least two studies support my view.


http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf
http://www.ahipresearch.org/pdfs/Administrative_Costs_030705.pdf
http://www.examiner.com/a-564555~Is_Medicare_the_more_efficient_plan_.html

An additional item not mention in either of the two reports listed there is that Medicare is a joint Federal/State program. The Feds reimbursethe State's a portion of their costs for their administrative overhead but they don't cover all of it. Right now the state's get back anywhere between 50% and 75% of their costs from the Feds. Under this year's budget that drops to a flat 50% rate for all states.

But when Medicare reports their administrative costs they DON'T report the administrative costs that the states incurr to manage the program. They only look at their numbers.
0 Replies
 
Advocate
 
  1  
Reply Mon 26 Mar, 2007 09:30 am
I think that the issue of universal health care could be a big issue in the coming presidential race. The Dem candidates obviously believe this is so.


HEALTH CARE -- PRESIDENTIAL CANDIDATES UNITE AROUND NEED FOR UNIVERSAL COVERAGE: On Saturday, the Center for American Progress Action Fund and the Service Employees International Union co-hosted the New Leadership of Health Care presidential forum. The candidates "united in pledging to provide universal health care to all Americans but differed over how quickly the changes could be achieved." Sen. Hillary Clinton (D-NY) said, "We need a movement. We need people to make this the number one voting issue in the '08 election." Clinton "assailed the health insurance industry and said she would prohibit insurers from denying coverage or charging much higher premiums to people with medical problems." Former Sen. John Edwards (D-NC) "was the only candidate who came to the forum having put forth a specific plan for universal coverage and said it would cost $90 billion to $120 billion a year." Speaking two days after he announced that his wife's breast cancer has returned, Edwards said, "It's not right that a woman has to go through--or anyone has to go through--this kind of struggle and have to worry about the medicine they need, the health care that they need. No American should have to worry about that." Sen. Barack Obama (D-IL) added, "The most important challenge is to build a political consensus around the need to solve this problem." Gov. Bill Richardson (D-NM) "offered a potpourri of ideas to achieve universal coverage, including tax credits to help people buy insurance and an option to let people ages 55 to 64 buy coverage through Medicare." Explaining how he proposed to provide universal health care, Sen. Christopher Dodd (D-CT) said, "If you get rid of tax cuts for top 2% of income earners, end this war in Iraq...we ought to provide the resources to really move in this direction." Rep. Dennis Kucinich (D-OH) "offered the most sweeping proposal, to create 'a universal, single-payer not-for-profit health care system providing Medicare for all.'" "Health care is a right, not a privilege," he said. Another candidate, former Sen. Mike Gravel (D-AK), called for "a universal single-payer plan." Alternet, The Politico, Blog for Our Future, and MyDD have round-ups of what each of the candidates said.
--AmericanProgressAction
0 Replies
 
PKB
 
  1  
Reply Mon 26 Mar, 2007 04:49 pm
Universal Healthcare
I'm not exactly sure about how I feel about the whole universal health care thing but there is one thing that I am 100% sure of and that is that all companies should provide their employees with health insurance, vision and dental to boot. Walmart is one of the biggest companies that is currently lobbying to have health insurance the responsibility of the employee because they "can't afford" to cover all of their employees and pay them the shi**y wages too. From what I understand, Walmart employees still have to fork over a portion of their wages to maintain coverage. That I don't have a problem with as long as it is reasonable.
$120 a week for a family to be covered is ridiculous!

Just my 2 cents.
0 Replies
 
mysteryman
 
  1  
Reply Mon 26 Mar, 2007 05:23 pm
Re: Universal Healthcare
PKB wrote:
I'm not exactly sure about how I feel about the whole universal health care thing but there is one thing that I am 100% sure of and that is that all companies should provide their employees with health insurance, vision and dental to boot. Walmart is one of the biggest companies that is currently lobbying to have health insurance the responsibility of the employee because they "can't afford" to cover all of their employees and pay them the shi**y wages too. From what I understand, Walmart employees still have to fork over a portion of their wages to maintain coverage. That I don't have a problem with as long as it is reasonable.
$120 a week for a family to be covered is ridiculous!

Just my 2 cents.


WHY?????
Why should companies be required to provide health insurance?
Or daycare,or college tuition reimbursement,or anything else?

When you hire on,you agree to get a salary of x for a weeks work,or a days work,however you get paid.
If you want more,go to another company.
0 Replies
 
maporsche
 
  1  
Reply Mon 26 Mar, 2007 06:22 pm
Re: Universal Healthcare
mysteryman wrote:
PKB wrote:
I'm not exactly sure about how I feel about the whole universal health care thing but there is one thing that I am 100% sure of and that is that all companies should provide their employees with health insurance, vision and dental to boot. Walmart is one of the biggest companies that is currently lobbying to have health insurance the responsibility of the employee because they "can't afford" to cover all of their employees and pay them the shi**y wages too. From what I understand, Walmart employees still have to fork over a portion of their wages to maintain coverage. That I don't have a problem with as long as it is reasonable.
$120 a week for a family to be covered is ridiculous!

Just my 2 cents.


WHY?????
Why should companies be required to provide health insurance?
Or daycare,or college tuition reimbursement,or anything else?

When you hire on,you agree to get a salary of x for a weeks work,or a days work,however you get paid.
If you want more,go to another company.


Because the people are wanting them too, and they will vote for politicians that write it into law. Within 10 years it will be federal law, I guarentee it (unless there is some drastic decrease in health care costs).

On that note, why should the government force companies to do anything. Why should they provide safe working enviornments, minimum wage, breaks and lunches, etc. Let them do whatever they want, and if the employees don't like it they can find some other job.
0 Replies
 
McGentrix
 
  1  
Reply Mon 26 Mar, 2007 06:31 pm
Huh. I chose my employer based on how it would benefit me and my family. If they did not offer healthcare, I would not have accepted the job I did. I expect others can do the same.

That is if they earned a high school diploma, put forth some kind of effort in learning a trade and showed some effort in looking for a job.
0 Replies
 
fishin
 
  1  
Reply Mon 26 Mar, 2007 07:20 pm
Re: Universal Healthcare
PKB wrote:
I'm not exactly sure about how I feel about the whole universal health care thing but there is one thing that I am 100% sure of and that is that all companies should provide their employees with health insurance, vision and dental to boot. Walmart is one of the biggest companies that is currently lobbying to have health insurance the responsibility of the employee because they "can't afford" to cover all of their employees and pay them the shi**y wages too. From what I understand, Walmart employees still have to fork over a portion of their wages to maintain coverage. That I don't have a problem with as long as it is reasonable.
$120 a week for a family to be covered is ridiculous!

Just my 2 cents.


And cars! And gas! Employers should be required to pay all of their employee's bills! Wheeee!
0 Replies
 
Advocate
 
  1  
Reply Tue 27 Mar, 2007 08:51 am
The funny thing is that more and more firms feel that universal healthcare is the way to go. Firms should not be burdened with this fast-growing expense, in which at least 30 percent of the healthcare cost is wasted due to the paperwork expense that falls on doctors. Also, the firms' business decisions are too often affected by healthcare coverage rather than selling a product or service at a profit.

Medicare has proven to be, by far, the most cost-efficient healthcare system in the country. Thus, it should be extended to cover all.
0 Replies
 
Advocate
 
  1  
Reply Tue 27 Mar, 2007 09:19 am
Gallop says that 69 percent of the public feels that the government has a role in providing healthcare coverage. There are similar high percentages relative to the people who feel that larger government is in the public's best interest.


^3/26/07: Emerging Republican Minority

By PAUL KRUGMAN

Remember how the 2004 election was supposed to have demonstrated,
once and for all, that conservatism was the future of American politics? I
do: early in 2005, some colleagues in the news media urged me, in effect,
to give up. "The election settled some things," I was told.

But at this point 2004 looks like an aberration, an election won with fear-
and-smear tactics that have passed their sell-by date. Republicans no
longer
have a perceived edge over Democrats on national security -- and without
that edge, they stand revealed as ideologues out of step with an
increasingly
liberal American public.

Right now the talk of the political chattering classes is a report from the
Pew Research Center showing a precipitous decline in Republican support.
In 2002 equal numbers of Americans identified themselves as Republicans
and Democrats, but since then the Democrats have opened up a 15-point
advantage.

Part of the Republican collapse surely reflects public disgust with the
Bush administration. The gap between the parties will probably get even
wider when -- not if -- more and worse tales of corruption and abuse of
power emerge.

But polling data on the issues, from Pew and elsewhere, suggest that
the G.O.P.'s problems lie as much with its ideology as with one man's
disastrous reign.

For the conservatives who run today's Republican Party are devoted,
above all, to the proposition that government is always the problem,
never the solution. For a while the American people seemed to agree;
but lately they've concluded that sometimes government is the solution, a
fter all, and they'd like to see more of it.

Consider, for example, the question of whether the government should
provide fewer services in order to cut spending, or provide more services
even if this requires higher spending. According to the American National
Election Studies, in 1994, the year the Republicans began their 12-year
control of Congress, those who favored smaller government had the edge,
by 36 to 27. By 2004, however, those in favor of bigger government had
a 43-to-20 lead.

And public opinion seems to have taken a particularly strong turn in
favor of universal health care. Gallup reports that 69 percent of the
public believes that ?it is the responsibility of the federal government
to make sure all Americans have health care coverage,-- up from 59
percent in 2000.

The main force driving this shift to the left is probably rising income
inequality. According to Pew, there has recently been a sharp increase
in the percentage of Americans who agree with the statement that "the
rich get richer while the poor get poorer." Interestingly, the big increase
in disgruntlement over rising inequality has come among the relatively
well off -- those making more than $75,000 a year.

Indeed, even the relatively well off have good reason to feel left behind
in today's economy, because the big income gains have been going to a t
iny, super-rich minority. It's not surprising, under those circumstances,
that most people favor a stronger safety net -- which they might need --
even at the expense of higher taxes, much of which could be paid by the
ever-
richer elite.

And in the case of health care, there's also the fact that the traditional
system of employer-based coverage is gradually disintegrating. It's no
wonder, then, that a bit of socialized medicine is looking good to most
Americans.

So what does this say about the political outlook? It's difficult to make
predictions, especially about the future. But at this point it looks as if
we're seeing an emerging Republican minority.

After all, Democratic priorities -- in particular, on health care, where
John Edwards has set the standard for all the candidates with a specific
proposal to finance universal coverage with higher taxes on the rich --
seem to be more or less in line with what the public wants.

Republicans, on the other hand, are still wallowing in nostalgia --
nostalgia for the days when people thought they were heroic terrorism-
fighters, nostalgia for the days when lots of Americans hated Big
Government.

Many Republicans still imagine that what their party needs is a return
to the conservative legacy of Ronald Reagan. It will probably take quite
a while in the political wilderness before they take on board the
message of Arnold Schwarzenegger's comeback in California -- which is
that what they really need is a return to the moderate legacy of Dwight
Eisenhower.
-------------------------------------------------------------------
0 Replies
 
Advocate
 
  1  
Reply Tue 27 Mar, 2007 10:37 am
People are avoiding opening their own businesses due to a dearth of healthcare options for the self-employed.

http://www.latimes.com/business/la-fi-insure27mar27,0,4490954.story?coll=la-home-headlines
0 Replies
 
ehBeth
 
  1  
Reply Wed 28 Mar, 2007 11:02 am
The Young Invincibles ... New York Mag

Quote:
They're young and healthy, and insurance is expensive. As long as they don't catch the flu, slip on the ice, crash a bike, snowboard into a tree, rupture an appendix, or get hit by a bus, everything will be fine. Right?


lots of interesting stuff in the article

this >>> is what I found craziest-making
Quote:
"And then," said Ondrejcak, "I got the bills."

They came separately, over the course of a week. The most damaging expenses were for his overnight stays: $16,608.76 for his first, $16,223.61 for the second. Then came the surgeon's bill ($1,665.50), the anesthesiologist's ($1,014), the two ER physicians ($605), the blood clinic ($551), and the post-op clinic ($592.04). A staggering $37,259.91 in total, a sum far higher than the prenegotiated rates the hospital would have charged an insurer. "That's one of the unfortunate ironies," says Cunningham. "The same people who don't have insurance because they can't afford it are charged much higher rates than someone with insurance."


Ironic. mmm yeah. Ironic.


~~~~~~

Quote:
0 Replies
 
blueflame1
 
  1  
Reply Sat 31 Mar, 2007 10:08 am
Texas Governor Perry took Merck money before mandating cervical vaccine David Edwards and Mike Sheehan
Published: Thursday February 22, 2007

Texas Gov. Rick Perry (R) says that it's just a coincidence that he and eight other lawmakers received donations of $5,000 each from Merck lobbyists just a few days before mandating the drug giant's HPV cervical cancer vaccine for all females in Texas ages 12 and up.

"There's been a lot of pressure about the implications of vaccinating young girls against sexually-transmitted diseases," says CNN's Ali Velshi in the video below, "some people thinking that that encourages promiscuity at that age."

He reports though that "this thing is coming undone by word, rumor and report of connection between Rick Perry's office and Merck."

The main lobbyist for Merck previously worked as Chief of Staff for Gov. Rick Perry. Several other states are considering making the vaccine mandatory, thanks in part to Merck's aggressive lobbying.

CNN's coverage can be viewed below. The Associated Press offered further details at this link.

http://www.rawstory.com//news/2007/TX_Gov._Perry_took_Merck_money_0222.html
0 Replies
 
 

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