Interesting Perspective on Pitfall of Obama-style Health Care

  1. 1
    The Massachusetts Health Mess
    Massachusetts shows how ObamaCare would really work.

    In a rational world, the prognosis for ObamaCare would wait on the evidence in Massachusetts, given that the commonwealth's 2006 program closely resembles what Democrats are trying to do in Washington. If the results were widely known, it might be dead on arrival.

    The Massachusetts law, which was championed by former GOP Governor Mitt Romney, imposed an individual mandate, requiring nearly all residents to buy health insurance or else pay a penalty....

    For 15 years Massachusetts has also imposed mandates known as guaranteed issue and community rating -- meaning that insurers must cover anyone who applies, regardless of health or pre-existing conditions, and also charge everyone the same premium (or close to it). Yet these mandates allow people to wait until they're sick, or just before they're about to incur major medical expenses, to buy insurance. This drives up costs for everyone else, which helps explain why small-group coverage in Massachusetts is so much more expensive than in most of the country. Mr. Romney argued -- as Democrats are arguing now -- that the individual mandate would make that problem disappear, since everyone is always supposed to be covered.

    ...a useful case study comes from the community-based health plan Harvard-Pilgrim. CEO Charlie Baker reports that his company has seen an "astonishing" uptick in people buying coverage for a few months at a time, running up high medical bills, and then dumping the policy after treatment is completed and paid for. Harvard-Pilgrim estimates that between April 2008 and March 2009, about 40% of its new enrollees stayed with it for fewer than five months and on average incurred about $2,400 per person in monthly medical expenses. That's about 600% higher than Harvard-Pilgrim would have otherwise expected.

    The individual mandate penalty for not having coverage is only about $900, so people seem to be gaming the Massachusetts system. "This is a problem," Mr. Baker writes on his blog, in the understatement of the year. "It is raising the prices paid by individuals and small businesses who are doing the right thing by purchasing twelve months of health insurance, and it's turning the whole notion of shared responsibility on its ear."

    ...he underestimates the extent to which it is rational for people to do this, considering the government-mandated incentives....The combination of guaranteed issue and community rating actively encourages parts of the healthier population to forgo coverage and thus blow up voluntary risk pools. No doubt our politicians will conclude that the solution is to raise the penalty for going uninsured, though it would be easier and more rational to let insurance markets function without mandates.

    full piece:http://online.wsj.com/article/SB124726287099225209.html
    lindarn likes this.

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  2. 10 Comments...

  3. 3
    I think the health care reform initiatives argued by Obama aren't really going to change much of anything. It's my hope, that the coming legislation is a stepping stone to single-payer. Single-payer would bypass the problems explained in the article.
    MedSurgeMess, herring_RN, and lindarn like this.
  4. 5
    I also have read numerous articles about the many problems of the MA system. This is why we would be much better off with a simple, universal single-payer system.
  5. 2
    So, I moved out of MA before the passage of this legislation. Does it include a state-owned insurance plan besides medicare/medicaid? Or were medicare/medicaid eligibility changed to include higher income people?

    If not, seems like a pretty critical difference.

    Feh ... same old story, IMHO ... competition is good ... except when it isn't.
    HM2VikingRN and herring_RN like this.
  6. 1
    MA residents ineligible for Medicare or Medicaid can buy insurance through the "Commonwealth Connector." Basically, the state subsidizes a bunch of plans. Premiums are based on your occupation, income, and family size.

    My biggest problem with the MA healthcare system is the fact that people without coverage are fined for it. What's the point? Companies that don't offer plans are fined $352 per employee per year, but there are a lot of loopholes. For instance, it doesn't apply to companies with fewer than 11 employees. A company can get around the fine if the only plan offered is extremely expensive, threadbare, or only available to 2 employees. It's much easier for companies to game the system than for individuals to game the system.
    herring_RN likes this.
  7. 3
    Please call your Rep & Senators to let them know they need to SLOW DOWN and get it right. What is at jeopardy is one of the best health care systems in the world. Chicago-style politics are being used to strong-arm this through before the public realizes the shortfalls. What are the issues? It does not reduce health care costs, it does not address current Medicare/-aid waste & fraud, it disallows future enrollment in a private plan, it mandates insurance, it does not address the excess cost due to illegals, it allows taxpayer funding for abortion, it does not address misuse or overuse of the health care system, and it includes excess UNION control. Check out Subtitle D of the House bill. It creates a 'Pipeline to nursing' which alters the career ladder to nursing, and includes training programs that would be jointly administered by the Health Care provider AND LABOR ORGANIZATIONS. It establishes a Health Advisory Board, of which 1 of 5 representatives must be a labor UNION representative. (Payback for the SEIU, maybe??).
    WAKE UP, NURSES -- AND CALL YOUR CONGRESSIONAL REPRESENTATIVES TODAY!! The ANA sold us out!
    K98, lindarn, and Jolie like this.
  8. 3
    Private insurance is a "for profit" venture. Always has been. It is not about "people."

    That's why private insurance won't work and that's why the costs of providing health care have reached the levels they are today.

    There are 46 million Americans that are living proof of why the private health care insurance industry is a failed model in the United States.

    That is 46 million Americans who don't have any form of "access" to health care in the most medically advanced country anywhere on the planet. Health care is broken in the United States and private insurance is the reason why.

    We have to create a universal health care system. It's the only option that works in reality. Yes, I admit it too has it's flaws, but it's better to wait in line for health care or treatment, than the idea of having no health care at all. That's where 46 million Americans stand at the moment - NO health care.

    Universal Health care is a "public" entity similar to our social security system. In addition, it's no more of a "socialist" entity than the social security system. Basically, It's just a public "safety net" administered by our government representatives and funded through public tax dollars etc. We can change internal policy if we want. We can also monitor how our money is spent and we can track how health care is being delivered to the public. (public accountability is created with Universal Health care) You can't do this with private insurance companies. They are private and profit motivated entities. Their primary objective is to profit from consumers and answer to it's shareholders. They couldn't care less if you are sick, are denied procedures and we have no control over them or when they should refuse such required services to us.

    Universal health care offers "everyone" health care as a basic "right" similar to the right you have to an education in the public education system. You cannot be refused health care. Everyone is covered regardless of pre-existing conditions, the employer you work for or otherwise. Healthcare isn't an optional luxury, it's a requirement. The difference in a universal system is you actually GET health care.... That's what people are really "expecting" from private insurance companies, but that's not what they are getting... EVEN when the are paying private insurance companies for it!! (There are literally 1000's of stories like this every single day and counting...)

    Some proponents suggest that universal health care would bear an added burden on taxpayers who don't always use it or need it but they fail to consider that when people have no private insurance plans, this actually costs taxpayers additional money too... (see link below)

    When something doesn't work. You need to change it. There's no point in placing a band aid on a major coronary artery as the solution to stop the bleeding.

    Americans are bleeding and 22,000 are dying every year because they have little, restricted or no "access" to health care. - Have we become a third world country?

    The link is to examine some facts pertaining what it actually costs taxpayers when people don't have private insurance. (Yes, like universal healthcare - that actually costs taxpayers money too...) That's why we might as well have a universal health care plan because taxpayers are going to burden the costs of the 46 million uninsured anyways.

    I feel 46 million uninsured Americans is a pretty compelling suggestion indicating the obvious fact that the private insurance industry has failed miserably in it's intentions. It simply doesn't work.

    http://www.nchc.org/facts/coverage.shtml

    My Best.
    Last edit by Patient_Care_Asst on Jul 26, '09
    lindarn, MedSurgeMess, and GCTMT like this.
  9. 0
    Please consider this....
    America is $$$$ BROKE $$$$ -- not the health care system.
    America CANNOT AFFORD UNIVERSAL HEALTH CARE.
    The argument that we MUST DO SOMETHING, & 'socialized medicine seems to work in other countries' is foolhardy.

    What do we have?
    - a health care system that the WORLD still looks to as the role model
    - a problem of payment for that world-class system

    That world-class health care system grew in a capitalistic system -- and will continue to thrive there.
    The cost to afford that Health care is a RESPONSIBILITY, not a right. Since the institution of Social security
    and Medicare/-aid ~75 years ago, some in our country have forgotten cause-and-effect.
    We manage to budget for food, home, cars, & gadgetry -- but somehow make the leap that the 'insurance company' or the 'government' will pay the bill if we get sick. WRONG.

    UNIVERSAL HEALTH CARE gives the individual the false-security that 'someone else' will pay.

    Like any other need in your life, the cost for health care should come FIRST out of YOUR pocket.
    NOT the collective pocket.

    The insurance company is not 'the problem'.
    Americans didn't have medical insurance policies 100 years ago.
    But as our demand for more sophisticated care has risen, so has the cost for the care.
    So first we got Hospitalization insurance to help pay, then Catastrophic insurance, then Doctor visit insurance.
    But the more the 'insurance' coverage rose, the further we got away from the cause-and-effect.
    SOMEONE has to pay, every penny.

    And now hospitals provide health care to 100% of anyone who walks through the door.
    100% of any legal or illegal person can come to an ED in America. WE HAVE ACCESS!
    So who pays??? The people with insurance have had to pay for the non-pay clients.
    So rates go up. Decisions are made for 'how to pay', 'who to exclude' -- hence,
    the evolution of 'pre-existing conditions'.
    But as rates go up --- don't forget WHO made those rates go up. THE NON-PAYING PATIENTS.

    So let's go back to how it used to be.
    The individual pays his own bills.
    No government 'handouts'. No insurance company.
    THE INDIVIDUAL is responsible for THE INDIVIDUAL.
    Simple. I will take responsibility for my own life.
    I will pay for my own health care needs.

    That sounds radical, doesn't it.
    But isn't that what has brought America to the achievements that it now enjoys?

    Just consider it.....

    (I pose this not as 'the solution' -- but in all the arguments about health care,
    it is helpful to go back in history and remember how we got to this problem.
    Then address the problem.)

    Respectfully...WORKINGWOMANINTN
  10. 1
    Quote from WORKINGWOMANINTN
    Please consider this....

    America is $$$$ BROKE $$$$ -- not the health care system.
    America CANNOT AFFORD UNIVERSAL HEALTH CARE.

    The argument that we MUST DO SOMETHING, & 'socialized medicine seems to work in other countries' is foolhardy.

    America cannot afford to do nothing about it either... It costs taxpayers money either way you choose. Additionally, this is more than just a "money" issue., it's a "people" issue.

    The insurance company is not 'the problem'.

    The Insurance companies are the very reason why health care costs have skyrocketed and accurately explains the reason why 46 million Americans can no longer afford access to heath care.

    And now hospitals provide health care to 100% of anyone who walks through the door.
    100% of any legal or illegal person can come to an ED in America. WE HAVE ACCESS!
    So who pays??? The people with insurance have had to pay for the non-pay clients.

    Exactly. We pay either way. Taxpayers are already footing the bill for the uninsured. Another reason to propose a universal health care system instead.

    So let's go back to how it used to be.
    The individual pays his own bills.
    No government 'handouts'. No insurance company.
    THE INDIVIDUAL is responsible for THE INDIVIDUAL.
    Simple. I will take responsibility for my own life.
    I will pay for my own health care needs.

    Well that's fine if you are rich and make a 7 figure income. But I don't know many Americans who can afford $40,000 out of their own pocket to pay for a medical procedure.

    When something doesn't work out for the general population, you don't continue doing things the same way as the solution to the problem.

    That sounds radical, doesn't it.
    But isn't that what has brought America to the achievements that it now enjoys?

    46 uninsured Americans is not an "achievement," but rather it's a national crisis.

    Just consider it.....

    (I pose this not as 'the solution' -- but in all the arguments about health care,
    it is helpful to go back in history and remember how we got to this problem.
    Then address the problem.)

    Private insurance companies and "profiteers" is how we got into this problem. How else do you explain why an Aspirin costs $10 on a US hospital bill and yet over the border an Aspirin doesn't cost that much in comparison in the universal health care system? (Public accountability for the associated costs of delivering health care to the public is the reason - not something you get with private "for profit" insurance companies.)

    Healthcare is broken in the United States. Private insurance is not working anymore. You only need to direct your attention to the 46 million Americans as a proven testament to that fact.

    Respectfully...WORKINGWOMANINTN
    My Best.
    Last edit by Patient_Care_Asst on Jul 27, '09
    GCTMT likes this.
  11. 0
    Obviously we disagree... but that's OK.
    We need to understand all sides.

    You want to adopt Universal health care in the USA
    due to the "46MM uninsured".

    I think Universal health care will give individuals a false-security
    that "someone else" will pay, and so the system will be mis-used,
    the root cause of the problem will not be addressed, and the end
    result will be overall deterioration in health care.

    What is your perspective on HR 3200? Doesn't it seem too bureaucratic
    and unwieldy??


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