Allow Americans to purchase health insurance across state lines?

[saveliberty]

Nine hours or 554 miles from Houghton, Michigan to Detroit. You need healthcare in Detroit for a specific condition. See a problem?

 

[task0778]

Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders.

The Federal McCarran-Ferguson Act (1945) does not bar interstate sales of health insurance. The State chooses to allow outside entities or not, it is not a federal barrier to cross state line sales. The barriers are enacted by State legislatures.



>>>>

That's fine, I'm glad you're happy up there. However, there are Canadians saying that your system is in fiscal trouble. You have long wait times to see specialists or get certain medical tests. Costs are going up, and there aren't many options to fix that: raise your taxes or ration care. I don't think your HC system is the panacea that you claim it is.

I'm Belgian not Canadian but you might have a point. Taxes have been increasing and they have lifted the retirement age to 65 and that will probably go up more. I do not claim our system is perfect, nor do I claim it will stay how it is today in the future. I also realise that our system is not something that Americans would stand for. I've seen it in my wife, for years she had proverbial shivers when I said we had socialized healthcare. There is an irrational fear in a lot of Americans with the word socialism. It's considered an axiom that the government can not be as efficient as the free market. Our health care cost proof otherwise though. I've thought through why we are cheaper and it is a complex array of factors.

My apologies for confusing you with a Canadian poster. I suspect that there are many Europeans who are more receptive to socialist type polices than Americans are, no doubt having much of your continent destroyed in the last 2 world wars may have something to do with it. But when I look at the disaster that is the VA, which is gov't run HC for Vets, I get those proverbial shivers too. And I see that SP failed in Vermont and I'm thinking why the hell would anyone think that our gov't can manage HC for the entire country?

 

[WorldWatcher]

...and yet there it is in black and white for all to read. Wasn't even my source, I just actually read it. You may want to try that same thing.

Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders.

And it continues:

"A growing number of state legislators are interested in whether some states allow or facilitate the purchase of health insurance across state boundaries or from out-of-state regulated companies. NCSL's state health insurance research and tracking shows a gradually growing number of states (at least 21 as of December 2016) and state legislators considering this idea during the past eight years and continuing to the present (listed below).


States can already allow Health Insurance sales across state lines and 21 do so. That means, as I pointed out, the McCarran-Ferguson Action (1945) is not a Federal Barrier to cross state line insurance sales. The barriers exist because the States have barred out of state sales.


>>>>

 

[forkup]

My country is roughly the size of Maryland to give you an idea. But explain to me how the need to be healthy changes from state to state? I also want to point out that the fact you are reverting to name calling, as opposed to giving actual counterarguments leads me to believe you don't have any. I try to be respectful, and have a real conversation and it always frustrates me when people I try to talk to, feel that when they don't have anything substantial to say, do things like calling people sheep in the hopes I don't notice that they can't counter.

It was shorthand for you are being told what is best for you by the government. You should know that for yourself correct?

Climate and environment vary tremendously here. Don't you think that could effect what types of medical services might be needed in an area? Our population is much greater and distance is an issue too. All of these factor into a healthcare delivery system.

I can counter fine.

It is not shorthand, it is belittling the person you are arguing against in the hope that by belittling him you can belittle the argument. It's neither new nor nice as far as debating strategies go. You are claiming that the fact that their are bigger differences in environments and greater dispersal of the populace account for a more than doubling of health care costs per capita? You do understand that I'm talking averages here right? For your argument to work US citizens would have to be substantially sicker than the populace of one of the densest populated countries in the world. And transportation cost would have to add tremendously to the price of health care.

 

[NYcarbineer]

What is the Federal barrier then?

Usually it is ambiguous rules (thing is 2,000+ pages long), legal interpretations and determining risk properly for the insurance companies. Other federal laws influence it too, such as anti trust laws.

lol thank you Captain Vagary.

 

[forkup]

Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders.

The Federal McCarran-Ferguson Act (1945) does not bar interstate sales of health insurance. The State chooses to allow outside entities or not, it is not a federal barrier to cross state line sales. The barriers are enacted by State legislatures.



>>>>

That's fine, I'm glad you're happy up there. However, there are Canadians saying that your system is in fiscal trouble. You have long wait times to see specialists or get certain medical tests. Costs are going up, and there aren't many options to fix that: raise your taxes or ration care. I don't think your HC system is the panacea that you claim it is.

I'm Belgian not Canadian but you might have a point. Taxes have been increasing and they have lifted the retirement age to 65 and that will probably go up more. I do not claim our system is perfect, nor do I claim it will stay how it is today in the future. I also realise that our system is not something that Americans would stand for. I've seen it in my wife, for years she had proverbial shivers when I said we had socialized healthcare. There is an irrational fear in a lot of Americans with the word socialism. It's considered an axiom that the government can not be as efficient as the free market. Our health care cost proof otherwise though. I've thought through why we are cheaper and it is a complex array of factors.

My apologies for confusing you with a Canadian poster. I suspect that there are many Europeans who are more receptive to socialist type polices than Americans are, no doubt having much of your continent destroyed in the last 2 world wars may have something to do with it. But when I look at the disaster that is the VA, which is gov't run HC for Vets, I get those proverbial shivers too. And I see that SP failed in Vermont and I'm thinking why the hell would anyone think that our gov't can manage HC for the entire country?

The problem with these systems is that they are all half measures. I'll give you my amateur analyses why our system is cheaper. It's starts quite simply with education. Becoming a doctor in the US takes over 2 million provided you don't have a scholarship. Here it takes about 30000 euro. This is ballparking it here. This makes it that doctors don't have to charge as much because they don't have to pay back student loans. Our health insurance is mandatory. This has a couple of consequences. No need for advertising, no need for pharmacy techs calling health insurances to ask if they cover a medicine. It means about 20 people can service my town population 30000 plus for their health insurance needs. It means that the government has a vested interest in keeping the prices of medicines down. They for instance make it mandatory for doctors to prescribe generics over name brands. And most importantly the only people who have a for profit motive in the system, are to a small extent the doctors, and the pharmaceutical companies, both of which who are carefully monitored by the federal government to not price gouge.

 

[saveliberty]

What is the Federal barrier then?

Usually it is ambiguous rules (thing is 2,000+ pages long), legal interpretations and determining risk properly for the insurance companies. Other federal laws influence it too, such as anti trust laws.

lol thank you Captain Vagary.

Please enlighten me then.

 

[EdwardBaiamonte]

"Selling insurance across state lines is a vacuous idea, encrusted with myths.

we have international competition or globalization because more competition lowers price and raises quality. Its true for toothpaste and health care. Do you understand?

 

[saveliberty]

It is not shorthand, it is belittling the person you are arguing against in the hope that by belittling him you can belittle the argument. It's neither new nor nice as far as debating strategies go. You are claiming that the fact that their are bigger differences in environments and greater dispersal of the populace account for a more than doubling of health care costs per capita? You do understand that I'm talking averages here right? For your argument to work US citizens would have to be substantially sicker than the populace of one of the densest populated countries in the world. And transportation cost would have to add tremendously to the price of health care.

You presume health is the only factor, a false assumption. I suspect you are somewhat correct though. Health habits of Americans are not very good. I would be curious to know the per capita diabetes rate of both for example.

 

[Siete]

It’s such a perennial suggestion that when Len Nichols, a health policy professor at George Mason University and the author of a 2009 paper on the subject, was asked for comment, he said: “Are you kidding me? We’ve been through this about 30 decades ago.”

Selling insurance in a new region or state takes more than just getting a license and including all the locally required benefits. It also involves setting up favorable contracts with doctors and hospitals so that customers will be able to get access to health care. Establishing those networks of health care providers can be hard for new market entrants.

“The barriers to entry are not truly regulatory, they are financial and they are network,” said Sabrina Corlette, the director of the Georgetown University Health Policy Institute.

Neither America’s Health Insurance Plans, the lobbying group for most private insurers, nor the Blue Cross Blue Shield Association have endorsed such a plan when it has come before Congress.

sooooooooooooooo,

NO.

 

[forkup]

It is not shorthand, it is belittling the person you are arguing against in the hope that by belittling him you can belittle the argument. It's neither new nor nice as far as debating strategies go. You are claiming that the fact that their are bigger differences in environments and greater dispersal of the populace account for a more than doubling of health care costs per capita? You do understand that I'm talking averages here right? For your argument to work US citizens would have to be substantially sicker than the populace of one of the densest populated countries in the world. And transportation cost would have to add tremendously to the price of health care.

You presume health is the only factor, a false assumption. I suspect you are somewhat correct though. Health habits of Americans are not very good. I would be curious to know the per capita diabetes rate of both for example.

I'm guessing you are talking about the difference in obesity rates. The World Factbook — Central Intelligence Agency Your obesity rates are 11 percent higher. So that to you warrants a doubling of health care costs per capita? Nicely played btw, obvious cherry picking of data but nicely done nonetheless. I'll see your obesity and I'll raise you cigarette consumption.List of countries by cigarette consumption per capita - Wikipedia, we smoke about twice as many cigarettes then Americans . My point is you can point to this stat and that stat and it doesn't change the simple fact that, the American Health care system is less efficient, more expensive and less effective than my government run program.

 

[EdwardBaiamonte]

It’s such a perennial suggestion that when Len Nichols, a health policy professor at George Mason University and the author of a 2009 paper on the subject, was asked for comment, he said: “Are you kidding me? We’ve been through this about 30 decades ago.”

Selling insurance in a new region or state takes more than just getting a license and including all the locally required benefits. It also involves setting up favorable contracts with doctors and hospitals so that customers will be able to get access to health care. Establishing those networks of health care providers can be hard for new market entrants.

“The barriers to entry are not truly regulatory, they are financial and they are network,” said Sabrina Corlette, the director of the Georgetown University Health Policy Institute.

Neither America’s Health Insurance Plans, the lobbying group for most private insurers, nor the Blue Cross Blue Shield Association have endorsed such a plan when it has come before Congress.

sooooooooooooooo,

NO.

so maybe we further limit health insurance to counties rather than states. That way each county could innovate on its own and set its own standards????

 

[EdwardBaiamonte]

Ours is roughly half as expensive as your system.

there are 5 reasons most countries have cheaper health care than the USA:
1) they are poorer so cant afford to pay what America pays
2) they have more efficient socialist health care than USA's convoluted redundant twisted piecemeal system.
3) America invents health care and pays for the most of the world's products( 70% of recent health care patents) while Europe just copies from us or buys from us. Take that away and Europe and it drops from 70% of our standard of living to 40%.
4) Europeans are far more health conscious and healthy than Americans so require less care
5) Europeans pay far less for end of life care while America, valuing life so much more, spend 70% of all health care dollars.

If American switches to capitalism our prices would drop 80%.

 

[Siete]

It’s such a perennial suggestion that when Len Nichols, a health policy professor at George Mason University and the author of a 2009 paper on the subject, was asked for comment, he said: “Are you kidding me? We’ve been through this about 30 decades ago.”

Selling insurance in a new region or state takes more than just getting a license and including all the locally required benefits. It also involves setting up favorable contracts with doctors and hospitals so that customers will be able to get access to health care. Establishing those networks of health care providers can be hard for new market entrants.

“The barriers to entry are not truly regulatory, they are financial and they are network,” said Sabrina Corlette, the director of the Georgetown University Health Policy Institute.

Neither America’s Health Insurance Plans, the lobbying group for most private insurers, nor the Blue Cross Blue Shield Association have endorsed such a plan when it has come before Congress.

sooooooooooooooo,

NO.

so maybe we further limit health insurance to counties rather than states. That way each county could innovate on its own and set its own standards????

you could but thats counter productive if keeping the program less complicated matters ... more complicated usually = more expensive

 

[EdwardBaiamonte]

It’s such a perennial suggestion that when Len Nichols, a health policy professor at George Mason University and the author of a 2009 paper on the subject, was asked for comment, he said: “Are you kidding me? We’ve been through this about 30 decades ago.”

Selling insurance in a new region or state takes more than just getting a license and including all the locally required benefits. It also involves setting up favorable contracts with doctors and hospitals so that customers will be able to get access to health care. Establishing those networks of health care providers can be hard for new market entrants.

“The barriers to entry are not truly regulatory, they are financial and they are network,” said Sabrina Corlette, the director of the Georgetown University Health Policy Institute.

Neither America’s Health Insurance Plans, the lobbying group for most private insurers, nor the Blue Cross Blue Shield Association have endorsed such a plan when it has come before Congress.

sooooooooooooooo,

NO.

so maybe we further limit health insurance to counties rather than states. That way each county could innovate on its own and set its own standards????

you could but thats counter productive if keeping the program less complicated matters ... more complicated usually = more expensive

but issue is whether you want global competition or just let each state or town have its own control of the health care industry within its borders.

 

[forkup]

Ours is roughly half as expensive as your system.

there are 5 reasons most countries have cheaper health care than the USA:
1) they are poorer so cant afford to pay what America pays
2) they have more efficient socialist health care than USA's convoluted redundant twisted piecemeal system.
3) America invents health care and pays for the most of the world's products( 70% of recent health care patents) while Europe just copies from us or buys from us. Take that away and Europe and it drops from 70% of our standard of living to 40%.
4) Europeans are far more health conscious and healthy than Americans so require less care
5) Europeans pay far less for end of life care while America, valuing life so much more, spend 70% of all health care dollars.

If American switches to capitalism our prices would drop 80%.

1) Obviously not applicable for Belgium but a valid point
2) True I think I already addressed this on the previous page
3) Bit confusing. If Europe both copies and buys the US isn't the only one paying. I think what you are trying to say is that the US is the main developer of new medicines. Even if that's true. Europe still has to buy those drugs, unless you are claiming that big pharma gives them away it would have no effect on health care costs. Btw Belgian universities are on the cutting edge of several medical fields, Cancer and Alzheimer research springs to mind.
4) See my point above, we smoke twice as many cigarettes than Americans, so debatable.
5) As someone who lost a grandmother who had end of life care, both deny and even resent the implication that Europeans don't value life and loved ones as much as Americans do.
- Don't know what you mean by your last point. Capitalistic is the only way I can describe your health care system.

 

[EdwardBaiamonte]

. If Europe both copies and buys the US isn't the only one paying. I think what you are trying to say is that the US is the main developer of new medicines. Even if that's true. Europe still as to buy those drugs, unless you are claiming that big pharma gives them away it would have no effect on health care costs.

not just drugs but everything: devices, procedures and basic research. America creates the word's health care and does all the research.Once I asked a women at Yale if she bothers to check to see if her research was being done in another country too. She said no it was all done here. She was from Italy. THe best in Europe come here. America created the world after WW2 so Europe could be lazy and socialist. Does Europe want to become capitalist so it has the spirit of invention too or does it just buy cheaply from us and enjoy its wine and cheese? We know what Europe is made of. Our drug companies charge all countries according to their ability to pay. America pays most of course.

 

[EdwardBaiamonte]

. Capitalistic is the only way I can describe your health care system.

wow thats totally 100% misinformed!!!!! Medicaid VA Medicare Schip tricare clinics are all as far from capitalism as you can possibly get. No wonder why nothing you say makes sense!!! Where to begin with you???

 

[EdwardBaiamonte]

5) As someone who lost a grandmother who had end of life care, both deny and even resent the implication that Europeans don't value life and loved ones as much as Americans do.

Over 40 percent of patients who die with cancer are admitted to the intensive care unit (ICU) in the last six months of life, which is more than twice that of any other country in the study. Similarly, 39 percent of American patients dying with cancer received at least one chemotherapy treatment in the last six months of life more than any other country in the study.-

 

[Care4all]

Your article notes that it is essentially illegal to sell across state lines in most of the states. You fail

any insurance company can sell insurance in any State, as long as they meet the State Insurance commission's rules and regs....

and unless the insurance company in Colorado as an example, has a lot of customers in Maine buying their insurance out of Colorado, they would have no means to operate in my State.

Insurance companies develop their policies with IN-NETWORK, and OUT OF NETWORK costs, and without a bunch of customers with a bunch of doctors and hospitals willing to participate in this plan, the plan will never be created.

Thy negotiate their prices within their chosen network, by how large of a group thy have in their plan.....

I DO NOT UNDERSTAND how this crossing state lines to sell insurance policies would even work if only 10 people in th whole State of Maine want to buy the Insurance plan sold in Colorado....???

Can you explain how the savings from crossing State lines is suppose to work?