After posting the piece about Nurses traveling to Germany and reading the feedback. I would like to open up a debate on this BB about "Universal Health Care" or "Single Payor Systems"
In doing this I hope to learn more about each side of the issue. I do not want to turn this into a heated horrific debate that ends in belittling one another as some other charged topics have ended, but a genuine debate about the Pros and Cons of proposed "Universal Health Care or Single Payor systems" I believe we can all agree to debate and we can all learn things we might not otherwise have the time to research.
I am going to begin by placing an article that discusses the cons of Universal Health Care with some statistics, and if anyone is willing please come in and try to debate some of the key points this brings up. With stats not hyped up words or hot air. I am truly interested in seeing the different sides of this issue. This effects us all, and in order to make an informed decision we need to see "all" sides of the issue. Thanks in advance for participating.
Michele
I am going to have to post the article in several pieces because the bulletin board only will allow 3000 characters.So see the next posts.
Have you ever thought about changing jobs? If you have been paying for health insurance out of pocket for more than 12 months, it definately benefits you to change jobs and sign up for new insurance.
When insurance companies do a "search" to see if you have been receiving medical treatment THROUGH OTHER INSURANCE COMPANIES, it will show you haven't been receiving medical treatment for anything the entire time you have been paying out of pocket.
That's what I would do. You just fill out the benefits package along with the rest of the new hire paperwork, and Boom! in 30 to 90 days you have affordable insurance.
Sometimes you have to get creative.
I was a health insurance broker for 9+ years. It's not as simple as you stated above. What you have proposed is insurance fraud. This is a crime BTW. Try explaining that to the Board of Nursing when you want to get your RN license.
Don't fool yourself into thinking that there are short cuts or that you can beat the health insurance companies. Ninety percent of the time you would be wrong. FYI, a search of claims through other insurance companies (MIB) isn't the only tool insurance companies have. Most insurance fraud is caught through your medical records. Your medical records follow you and they are easy to find. Also, while HIPAA is Federal, insurance is regulated by each state. So the rules and regs in your state are different than others'.
jjoy. I understand what you are trying to say... where exactly do you draw the line then? How can you limit it to WIC, or? (yes, timothy, I realize your response with be "this is my point" ;-)). What about someone forced out of work to take care of a loved one? What about someone, who thru no fault of their own, has a debalitating illness and can no longer work? What exactly should a society's responsibilty be to ensure citizens are taken care of in situations of crisis, rather than left to fester on the streets? Yes yes, I know all about the evils of big governement, and about abuse potential of such things being provided. So, if you are a church goer, do you tithe 10% of your income and hound your church to provide for the needy? If your mother or child or spouse became ill, are you prepared to take care of them financially w/o a job or health insurance? What sacrifices are you making as an individual to ensure your or your loved ones or those people with misfortunes don't end up homeless living in a tent on the street? It's easy to say that having no social safety net forces us to make sure we take care of ourselves, but to be honest there are things that can happen that we never imagine that might just make that nearly impossible. I know from personal experience (illness), and altho I don't like Big Brother, I surely don't see anyone else, church or otherwise, stepping up to the plate to take care of the desperate...however they got that way.
I'll address both yours and jjoy's comments at the same time.
Contrary to popular belief in this thread, I don't consider myself to be a libertarian, but a conservative. I think most true conservatives have a small gov't, libertarian streak, but that doesn't mean that I completely agree with the total dimantle of gov't. It has a role to play, but that role is of an 'Uncle', and not a 'Daddy'. In fact, I think part of this mid-term election was due to conservatives being disgusted with a republican gov't that spends like drunken democrats.
Look, we are a rich nation. We SHOULD help those who are poor and on the margins. I never said otherwise. I even supported the concept of a universal system for catastrophic coverage. I supported the concept that the gov't should regulate healthcare insurance, in much the same vein that it does other types of insurance. I supported the concept that business shouldn't be able to dump the care of their workers onto the economy. I'm a huge fan of WIC, although, I think it's one key drawback is making bottle feeding a luxury. I think that, in order to bottle fed on WIC's (my) dime, a patient should have to jump through the hoops of getting a doctor to sign off on a medical need, but I digress. If you look at the other side of the coin, I'm not against medicare or social security, but I think both should be considered collective insurance policies and means tested. If you make more than 200k single/400k couple, congrats, you made the American dream, come back and see us if you ever actually need such help.
The concept of 'sink or swim' is silly and doesn't represent my viewpoint at all. Of course we should help those debilitated, I haven't addressed that because the mechanisms are already in place (medicaid/SSI) to do that and so, it is not at issue in a concept of where to go from here.
My point isn't sink or swim at all. My point is that we should throw those in need a lifejacket and not provide them a lifeboat in order to swim. See, in order to learn to swim, you have to actually be or have incentive to be, in the water, in the game.
In helping people, we should be helping them to be better people, and not simply disempowering them by meeting just enough of their needs so that the tip of their noses are only occasionally above water. That, in my opinion, is almost criminal: we aren't helping those in need by removing the incentives to be successful; we're just waterboarding them and patting ourselves on the back for our noble deeds.
But's it's more than that. I'm not against helping those in need, but I detest the concept that my aid should come at great personal sacrifice to the masses. I detest the concept that we should all devolve to the lowest common denominator. That not only steals the incentives for the poor and those on the margins, it steals incentive from everybody. This is why I harp on the communistic nature of this endeavor. Redistributions of wealth doesn't work. It never has. Why is simple: since incentive is the basic law of human economics, receiving things without effort is just not respected.
This is a basic problem in nursing as well: since many of us work by being 'called' instead of for the money, our employers can discount our earnings and, as a direct result, they simply don't respect us nearly as much. In fact, we, as nurses, have such a basic distrust of the respect that comes with real earning power, that we are distrustful of those nurses 'in it for the money'. That's what professionals do.
Now, translate that attitude across the spectrum with this notion that all Americans should be required to be 'called' and be required to do what amounts to charity work. What you end up with is a lack of respect for any work ethic. And that work ethic is what has made America a great nation. The lack of that work ethic is what made communism a failure. No, our nation won't become 'communist' tomorrow if we adopt universal healthcare. But, by my estimation, we are already 35% socialist and 65% capitalist. It's a continuum. The more we shift towards that socialist/communist agenda, the more the values that made this country great slip away.
But at it's basic point is this: I detest food stamps because it allows those that live on my charity to eat better than me. See, I have to comparison shop and make ends meet. I detest the abuses of medicaid because those on my dime use services that I must pay extensively to obtain. The concept that charity must be coerced and so pervasive that no real benefit is derived by being a member of the working class is detrimental, to both those that are in the working class, and those that beat the system because Uncle Daddy is there for them.
Many posters have spoken of balance. Any balance that depends upon the good graces of a working class while robbing them of the incentive to BE a working class is not a good balance.
I'm all for helping those in need. But, helping them avoid being successful is no help at all. And, it costs too much. Don't believe for a second that the costs I'm considering have to do with money.
Our current economic system is one that works, and works well for 85% of Americans. When you consider making changes to meet the needs of the other 15%, to make changes that fundamentally damages the working model for the many creates a system that, with each passing day, no longer has the economic or emotional capital to continue to help the few.
I was a health insurance broker for 9+ years. It's not as simple as you stated above. What you have proposed is insurance fraud. This is a crime BTW. Try explaining that to the Board of Nursing when you want to get your RN license.
Don't fool yourself into thinking that there are short cuts or that you can beat the health insurance companies. Ninety percent of the time you would be wrong. FYI, a search of claims through other insurance companies (MIB) isn't the only tool insurance companies have. Most insurance fraud is caught through your medical records. Your medical records follow you and they are easy to find. Also, while HIPAA is Federal, insurance is regulated by each state. So the rules and regs in your state are different than others'.
You don't have to answer questions that are not asked, and not every job I have had asked about pre-existing conditions. What they have asked is a list of insurance companies you have had in the last 12 months...well guess what...if you have been paying on your own the answer is NONE!
Medical records don't follow you...unless you request them to follow you. A doctor can't send a file anywhere unless I authorize it, and I have never had a reason to authorize it in my entire life. Each doctor I have ever seen has seen me for independent reasons. All they need to know is on the forms I fill out in the new patient paperwork.
You don't have to answer questions that are not asked, and not every job I have had asked about pre-existing conditions. What they have asked is a list of insurance companies you have had in the last 12 months...well guess what...if you have been paying on your own the answer is NONE!
THAT is 100% legal.
Who said anything about "answering questions that are not asked?" Coverage for pre-existing conditions is going to vary by state. Listing your previous companies if asked has more to do with continuous coverage and HIPAA regulation. Some of this info will apply to pre-existing coverage, some not. If your policy doesn't cover pre-exisiting conditions for one year for example - this is the case even if you didn't have coverage.
Your insurance company does have the legal ability to obtain your medical records in order to process claims.
You have hit on my pet-peeve which is applying your own experience to everyone else. This is why I mentioned that insurance is regulated by state and that health insurance regulatation varies significantly by state. The regulations are quite complex. I can't do them justice in a thread like this. I won't even try. But it is correct to say that what you proposed is naive. It is insurance fraud. It is usually caught.
Who said anything about "answering questions that are not asked?" Coverage for pre-existing conditions is going to vary by state. Listing your previous companies if asked has more to do with continuous coverage and HIPAA regulation. Some of this info will apply to pre-existing coverage, some not. If your policy doesn't cover pre-exisiting conditions for one year for example - this is the case even if you didn't have coverage.
Your insurance company does have the legal ability to obtain your medical records in order to process claims.
You have hit on my pet-peeve which is applying your own experience to everyone else. This is why I mentioned that insurance is regulated by state and that health insurance regulatation varies significantly by state. The regulations are quite complex. I can't do them justice in a thread like this. I won't even try. But it is correct to say that what you proposed is naive. It is insurance fraud. It is usually caught.
It's not insurance fraud, I challenge you to show me a statute in ANY state that requires you by law to hand over your entire medical history in your healthcare career? ANY state, go ahead, pick one.
I never said my own experience applying to everyone else. I have held more than one job in more than one state, and they don't ALWAYS ask about pre-existing conditions....if it is not asked, are you saying that it's insurance fraud to not VOLUNTARILY hand over the information?
That's bull.
Are you saying it's insurance fraud anytime you visit a new doctor to not call every doctor you have ever seen in your life and forward all of your records to your new doctor immediately? I challenge you to find a state, again, ANY state, that requires that.
What I am proposing is not insurance fraud...insurance fraud is FALSIFYING INFORMATION THAT IS SPECIFICALLY ASKED FOR.
I challenge you to cite one case in any state where someone was convicted and jailed for insurance fraud for not VOLUNTERING A MEDICAL HISTORY WHEN THE INITIAL APPLICATION DID NOT ASK FOR SUCH INFORMATION.
Asking for an insured to list all of their insurance companies in the last year is NOT the same as asking for pre-existing conditions.
It's not insurance fraud, I challenge you to show me a statute in ANY state that requires you by law to hand over your entire medical history in your healthcare career? ANY state, go ahead, pick one.
I never said my own experience applying to everyone else. I have held more than one job in more than one state, and they don't ALWAYS ask about pre-existing conditions....if it is not asked, are you saying that it's insurance fraud to not VOLUNTARILY hand over the information?
That's bull.
Are you saying it's insurance fraud anytime you visit a new doctor to not call every doctor you have ever seen in your life and forward all of your records to your new doctor immediately? I challenge you to find a state, again, ANY state, that requires that.
What I am proposing is not insurance fraud...insurance fraud is FALSIFYING INFORMATION THAT IS SPECIFICALLY ASKED FOR.
I challenge you to cite one case in any state where someone was convicted and jailed for insurance fraud for not VOLUNTERING A MEDICAL HISTORY WHEN THE INITIAL APPLICATION DID NOT ASK FOR SUCH INFORMATION.
Asking for an insured to list all of their insurance companies in the last year is NOT the same as asking for pre-existing conditions.
Again, one case, any state.
Don't get your knickers in a knot. I was referring to withholding pre-existing health information when asked. Some employer goup health insurance enrollment forms ask for this in some states; some do not. I'll explain more in my next post.
Don't get your knickers in a knot. I was referring to withholding pre-existing health information when asked. Some employer goup health insurance enrollment forms ask for this in some states; some do not. I'll explain more in my next post.
See, that's the problem you didn't read my post...nowhere did I say she should lie in an application. You pulled that accusation out of thin air.
So please don't put words in my mouth, or rather, in my posts, when I never said anything of the sort.
Have you ever thought about changing jobs? If you have been paying for health insurance out of pocket for more than 12 months, it definately benefits you to change jobs and sign up for new insurance.
When insurance companies do a "search" to see if you have been receiving medical treatment THROUGH OTHER INSURANCE COMPANIES, it will show you haven't been receiving medical treatment for anything the entire time you have been paying out of pocket.
That's what I would do. You just fill out the benefits package along with the rest of the new hire paperwork, and Boom! in 30 to 90 days you have affordable insurance.
Sometimes you have to get creative.
This is what I was referring to. Your post implies that if you didn't have other insurance paying out on your pre-existing conditions - that the new insurance company wouldn't know and would cover the pre-existing condition. This is incorrect. I took your post above to imply "don't tell them if they ask." "Sometimes you have to get creative." If I was incorrect, then never mind.
In this situation, your medical records catch you. What I meant by "your medical records follow you" is that the trail of your records is easy for the insurance company to pick up. Usually the claim they receive gives clues of other physicians they can send for records from. Sometimes they just request records from all hospitals within a certain radius of your home. One record leads to another which usually reveals your pre-existing condition. Your new insurance company will audit your medical records if they start seeing claims in the first 12 months if pre-existing conditions are excluded. The forms you sign when you enroll in your coverage give the company the right to get your medical records. The permission to treat and conditions of admission forms you sign for all medical care allow the providers to release your medical records upon request from your insurance company.
Insurance companies have huge departments called SIUs. This is short for Special Investigation Units. They investigate claims which may be denied if you don't have coverage for pre-existing conditions. These folks are quite good. All they need is your name, DOB, and SSN. They can and will find and get your medical records just from this info. This is done in many many ways.
I'm stepping out of this topic now. You seem to think you know more than me - and I this was my industry for almost ten years - I have had multi-state broker licenses for years. ok.
This is what I was referring to. Your post implies that if you didn't have other insurance paying out on your pre-existing conditions - that the new insurance company wouldn't know and would cover the pre-existing condition. This is incorrect. I took your post above to imply "don't tell them if they ask." "Sometimes you have to get creative." If I was incorrect, then never mind.
In this situation, your medical records catch you. Your new insurance company will audit your medical records if they start seeing claims in the first 12 months if pre-existing conditions are excluded. The forms you sign when you enroll in your coverage give the company the right to get your medical records. The permission to treat and conditions of admission forms you sign for all medical care allow the providers to release your medical records upon request from your insurance company.
Insurance companies have huge departments called SIUs. This is short for Special Investigation Units. They investigate claims which may be denied if you don't have coverage for pre-existing conditions. These folks are quite good. All they need is your name, DOB, and SSN. They can and will find and get your medical records just from this info. This is done in many many ways.
I'm stepping out of this topic now. You seem to think you know more than me - and I this was my industry for almost ten years - I have had multi-state broker licenses for years. ok.
Yeah, you were incorrect.
I suggested she changed jobs because not all insurance companies ask about pre-existing conditions, and she can review the benefit information in advance and find out. Sometimes I have been asked for pre-existing conditions and strangely, MOST of the time I haven't ....it's the names of the insurance companies that they are looking for in the last 12 months.
If you have changed doctors and you have been paying out of pocket for the last 12 months and no insurance company has been billed, I would be quite curious to see how they can search a non-existent data-base.
I don't fear "conspiracy theory" people. Health insurance companies take your money and then find every way possible not to pay anything back out and will leave someone to die in a gutter in the process of doing it.
You know after reading this post I am seriously scared for all of you as well as the rest of America.
Apparently the liberal media has influenced most of you with their half truths and bias reports that you all actually think you will benifit from a universal healthcare system.
I can sit here and back up my opinion for days with articles, quotes and such but I see that Timothy has attempted to do just that and hit a brick wall. I see no point anymore. I will just pray for yall and the country.
Just like social security, I will save up my spare pennies in case I need them in the future. I know I wont rely on the government to feed, house, and take care of me. If there is a national healthcare system implemented in this country, Im pretty sure my saved money will be needed some day when Im told I will have to wait 6 months for a surgery that is needed to save my life. Thank God for mutual funds.
Multicollinearity, BSN, RN
3,119 Posts
I was a health insurance broker for 9+ years. It's not as simple as you stated above. What you have proposed is insurance fraud. This is a crime BTW. Try explaining that to the Board of Nursing when you want to get your RN license.
Don't fool yourself into thinking that there are short cuts or that you can beat the health insurance companies. Ninety percent of the time you would be wrong. FYI, a search of claims through other insurance companies (MIB) isn't the only tool insurance companies have. Most insurance fraud is caught through your medical records. Your medical records follow you and they are easy to find. Also, while HIPAA is Federal, insurance is regulated by each state. So the rules and regs in your state are different than others'.