Can Public Option Work?

[Care4all]

RABB,

this is for you, from an argument last week, that i meant to post for you....



Maine: 2 insurance companies control 88% of the market.

Missouri: 2 insurance companies control 79% of the market

North Dakota: 1 company control 89% of the market.

As stated before, 94% of the health insurance markets across the country ARE NOT COMPETITIVE MARKETS.

Did you know that the federal government has anti-trust (monopoly) law PROTECTION for health care insurance corporations? Insurance corporations CAN LEGALLY discuss AMONGST EACH OTHER, pricing, discuss coverage, discuss insurance limits, discuss “pre-existing conditions” and AGREE to NOT compete with each other, who will cover what territory and so forth.



The McCarran-Ferguson legislative bill was passed in 1945 when health insurance companies were a very small industry under the basis that there was no “interstate” insurance industry. It has been in place ever since and never updated. Other than Major League Baseball, NO OTHER INDUSTRY SECTOR enjoys this anti-monopoly PROTECTION.

Health care insurance: Did you know? | ItsYourTimes.com

i am still looking for a more reputable link....but i will find one, in time, and will post that when i do...

oh and i thought it was just the states that made them monopolies but it appears it is aq Federal Law?

 

[Care4all]

here Rabb....another article discussing the monopoly situation:

a clip from the article below...
Health insurance markets out of whack

The AMA is very concerned that federal regulators continue to turn a blind eye toward the reality that in much of the country health insurance markets are not competitive. Health insurers have amassed significant market power through mergers and acquisitions but have received minimal scrutiny. Mr. Botti himself can point to just one instance where the federal agencies have challenged a health insurer merger: the 1999 Aetna/Prudential merger.

In contrast, physicians have been placed under a far higher level of scrutiny than is warranted by their comparative economic strength in today’s market. In April 2002, the FTC announced its intention to "find and bring" cases against physicians. Between April 2002 and December 2004, it brought 21 complaints against physician entities. Of these, 20 entities decided to settle rather than engage in a protracted and financially devastating legal battle with the FTC. This scrutiny is misplaced given that physicians are by far the least consolidated component of the health insurance industry.

It is important to remember that physicians play a critical role as patient advocates in an environment where health insurers have limited accountability for decisions that impact patients. The physicians’ role as patient advocate can be undermined when they have no leverage in negotiating contracts with health insurers. The AMA has found that in much of the country physicians face a true David and Goliath battle when dealing with health insurers.

The AMA has been studying health insurance markets in-depth for the past four years based on the most credible, publicly-available data. Our recently-released Fourth Edition of Competition in Health Insurance: A Comprehensive Study of US Markets used the Herfindahl-Hirschman Index (HHI), part of the 1997 guidelines used by the FTC and DOJ in reviewing the competitive impact of mergers. Markets that exceed an HHI of 1,800 are considered "highly concentrated" by federal regulators.

Most alarmingly, our study found that for the combined HMO and PPO markets, 86 of the 92 metropolitan areas had an HHI that exceeded the federal threshold of 1800. In addition, the study found that in 87 of the 92 markets, a single insurer had a market share of 30 percent or greater and that in 34 of the markets, a single insurer had a market share of 50 percent or greater.

The findings need to be viewed in the context of the unprecedented consolidation of the health insurance market during the 1990s. Between 1995 and 2004, there were over 400 mergers involving health insurers and managed care organizations. A new merger wave is underway. The 2004 acquisition of WellPoint Health Networks, Inc., by Anthem, Inc., (now known as WellPoint, Inc.) created the largest health insurer in the country, providing coverage to 28 million Americans. UnitedHealth Group has acquired four insurance companies in the past year, adding nearly four million covered lives, bringing its total to 22 million.

 

[The Rabbi]

Good.
So getting gov't out of the insurance market is the fix, not letting them take over even more.
Right?

 

[Care4all]

Good.
So getting gov't out of the insurance market is the fix, not letting them take over even more.
Right?

leaving it the way it is now and not change anything, is bad....

and perhaps this bill overall, is bad.....

That's the best i can do for you at this time

 

[The Rabbi]

Good.
So getting gov't out of the insurance market is the fix, not letting them take over even more.
Right?

leaving it the way it is now and not change anything, is bad....

and perhaps this bill overall, is bad.....

That's the best i can do for you at this time

No this bill is the pits. It wont help people at all. It wont make insurance cheaper. It wont make health care better. It substitutes command economics for the market. It will be expensive for the gov't, expensive for health care providers, expensive for insurers, and expensive for the general public.
We can do better.

 

[toomuchtime_]

yes, it may not save money for the consumer INITIALLY.

But how about answering my MAJOR POINT correcting YOU on the 400% of poverty claim that the public insurance option is what pays for this....

As i said, WITHOUT THE PUBLIC OPTION, your taxes will still go to pay for the health insurance of those making 400% of poverty.

do you accept this or still deny this PP?

There is no reason to believe the public option contained in the current House bill will ever reduce costs to the consumer, so again, that being the case, according to the CBO, why would you want a public option?

As for your MAJOR POINT, that's a discussion you were having with some one else.

yeah, i see NOW that i was responding to you toomuchtime instead of Plymouth, MY MISTAKE!

I think the congress should take seriously what the CBO is saying about this and i do appreciate the information....but they TOO should appreciate the CBO's report as well and do something to change it...change or tweak some things in their plan for this option that will not have the same results with CBO, and reduce costs....the plan hasn;t been passed and is not static....congress should be reacting to CBO's scoring and make the changes necessary to price it better, send it back to CBO to score and see how it comes out...

And for goodness sakes, if the public insurance option is not in this bill, DO NOT MAKE HEALTH INSURANCE MANDATORY! make the insurance companies compete for the extra customers, not hand them to them on a silver platter.

The individual mandate is a terrible idea with or without a public option. It is, in effect, a tax on healthy people to pay for the health care of sick people. If we as a people want to have these reforms, principally insurance for people with pre existing conditions, then we as a people should pay for it and not shift the entire burden of these costs on to one segment of the population.

Get the individual mandate out of the bill and get rid of the requirement that sick people be accepted at standard rates. Instead provide sliding scale subsidies to people with pre existing conditions based on income and wealth - we don't need to subsidize high risk insurance premiums for some one who earns $500,000 as the present bills do - and pay for it with a surcharge on income tax so that whatever you would ordinarily pay will be increased by a factor of 1.0X (X is a variable that will be whatever is needed to cover the projected costs of the sliding scale subsidy for the following year).

The income tax is our most progressive tax. It is what we as a people have decided is the right way to share the financial burden of running this country. If we are unwilling to pay the bill for insuring sick people in this way, then we don't really want this reform.

 

[AVG-JOE]

Interesing link/report. Thank you Rabb. so, a good chunk is in preventative medicine, and minor sickness and savings could be had if we let the market work....how long do you think it would take for the market forces to lower prices? 3 years? 5 years? 10 years? it does take competition to work down the prices and 'supply' as well...

and if it is going to work, (which it should), WHY would we leave out an area that is more than 50% of these costs off the table to reform or the chopping block? the catastrophic or hospitaliazation insurance plans?

Well, when AT&T was broken up how long did it take for rates to drop? I think it was within 6 months.
I don't understand your second paragraph as it isn't English.

why still buy catestrophic insurance? isn't that just keeping prices higher as well, because market forces can not work? why not eliminate the middle man there?

Part of the problem lies in the name... "Insurance"

When you're in your 30's with a mortgage and 2.2 kids to raise, you buy life 'insurance' hoping you never have to use it, but glad your spouse won't loose the house if you kiss a bus.

When you drive a car you buy collision 'insurance' hoping you never have to use it.

You 'insure' your house and your business against fire, hoping you never have to use it.

Health 'insurance' is the only insurance product sold that the customers and the underwriters both know full and well that use and claims will begin before the ink on the signature line is dry.

What we need is a maintenance program for physicals, pap smears and the occasional boo-boo sold separately from the 'insurance' we need for if our kid gets leukemia.

 

[AVG-JOE]

I dont understand that.
Health insurance is there to pay for things that you cannot afford to pay for. Catastrophic insurance would seem to be one of those things. Maybe the main one.

'Insurance' can NOT make things more affordable - it is a pool of funds used to spread risk over a group of people or a span of time.

If you can't afford something in the first place, how can hiring a million dollar insurance executive to do the paperwork for you possibly make it more affordable?

Hiring a bureaucracy to track health care payments will only work if everyone understands that it is an additional expenditure that is worth the cost because it helps spread the cost of an unexpected bad day over time (pay premiums starting when you're 20 so there is medical money available when you're 70) or over a group (I'll help cover your broken leg today, 'cause I know your premiums will help cover my ulcer next summer).

 

[AVG-JOE]

My dad retired from the military after 22 years also and us kids were covered till we were 18. I don't think of the military as a public option. This is something owed all the men and women that serve this country.

Govt employees?? Well thats a whole other kettle of fish in my book. These folks have gold plated benefits and retirement all payed for by the taxpayers. They along with Congress will be exempt from the public system if it passes. I wonder why that is?? Mayby the public system will suck big time and these Govt employees are better than the average taxpayer??? If the public option is so great how come the Govt employees, Congress aren't front and center to partake of the marvels of the public system???? Anyone got an answer for that one??

I work for the federal government - non military. I was hired fairly recently, so I do NOT have a 'cushy' job.

Health coverage for my wife and I costs about $500 per month. I have to assume that if I was buying my coverage outside my place of employment, my paycheck would be about that much more, but my official payroll contribution is $170.

It looks cheap because my wife and I are pretty healthy and we chose a plan that has substantial co-payments for routine stuff and good coverage for heart attacks and cancer, over more expensive plans more suited to young families with snot-nosed little petrie dishes running through the house.

The only real difference between working for the rest of you and working for just one of you is that I have 3 companies, each with a couple of plans, to choose from instead of just 1, due to the size of the 'group' that federal employees represent.

The days of the cushy federal job began to be grandfathered out in 1984. The sooner we vote out the deadwood hired to congress before 1984, the sooner our leadership will have a vested, personal interest in fixing things like Medicare and Social Security.

 

[AVG-JOE]

Frankly I cannot understand how anyone can advocate borrowing vast sums of tax money knowing the track record for Govt. programs like healthcare then expect this one to be any different and suddenly bring down the costs of healthcare for everyone through coverage mandates without addressing overall costs. Someone has to pay for this eventually and if you choose to call it a tax or Value Add whatever the American people will pay for it. It will not effect service delivery, nor will effect cost in the least little bit. How do you expect cost to come down when costs are not the mitigating factor being addressed in the bill but rather coverage. Perhaps the best way to provide coverage for those that need and want it, is to make it available at such a price point that people are willing to purchase it. Here is the main falacy in this so called "public option" it assume's that by mandating coverage on everyone you mitigate costs by bringing in healthy young people too offset those with pre-existing condition that will flood the system. The problem with that is that these young people 18-29 will have to be able to purchase this healthcare at such a reduced cost to make it appealing vs. paying the penalty imposed for not having the insurance. The current penalty is 2.5% vs. 1200.00 to 1500.00 a year for low cost basic insurance. So if your a young person and are faced with paying a 300.00 dollar penalty that can be offset by deductions or paying 1500.00 a year for healthcare what do you think they will do? So your left with a system that brings in those that need it most with little of the offsets and no costs being addressed, and in the end you have accomplished nothing other than to create a new department in the Govt. to push this nation even faster into bankruptcy when healthcare reform can be addressed with the application of reform measures without massive spending.

Does everyone understand that if the extreme happens and the government mandates a tax to cover the health care of all, we won't have to buy insurance anymore?

For me, I already pay $500 per month in health care 'taxes'........ that's for me and my bride, so multiply $250 per month by the 80% of us who are working in the worst of economies and you have quite a shit-pile of money to invest in a health care without raising taxes one single penny.

It isn't a question of raising or lowering 'taxes', it's all about finding a cheaper bureaucracy to track the nations sensitive health and financial data.

 

[AVG-JOE]

i think the cost of medicare....(exclude new prescription drug plan) is less expensive than what it would be for seniors having to buy private insurance at this time in their life, because medical prices are capped through regulation.

IT WAS a Gifthorse to the insurance industry by our government removing those who are sickest from the pool of people insurance companies cover.

our health insurance costs would be much, much higher if seniors were part of the Pool of people in our plans...

Ya hit the nail on the head, Care. The dirty, but profitable, secret in health insurance is the concept of collecting premiums from us while we are young, healthy and making few claims if any, only to dump us on to the tax payers via Medicare when we hit 65 and begin to need the coverage.

Lobbying our representatives in government for profit is a practice that needs to end.

 

[AVG-JOE]

This is one of those decisions, if we go with it, from which there is no turning back. Once we introduce a public option, it's here to stay. That doesn't mean we shouldn't do it, but again, I'd like to be absolutely certain that it's necessary before I support taking the leap.

And considering the complete unwillingness of anyone, here or publicly, to address this question sincerely, I'm pretty much left with no alternative but to oppose it. I simply do not see a need.

If you need a car, you probably don't need a Mustang GT, but it's nice to have options.

If considered on it's own merit, the public 'option' should be just that, an option.

I have heard a lot of good praises for Medicare here in Florida, I would be happy if we scrapped the whole bucket of lobby-brewed 'reform' and just made Medicare A & B available to me as an option for a fair premium. If it were offered for less than private companies currently charge and the coverage were adequate, why not?

 

[Ame®icano]

This is one of those decisions, if we go with it, from which there is no turning back. Once we introduce a public option, it's here to stay. That doesn't mean we shouldn't do it, but again, I'd like to be absolutely certain that it's necessary before I support taking the leap.

And considering the complete unwillingness of anyone, here or publicly, to address this question sincerely, I'm pretty much left with no alternative but to oppose it. I simply do not see a need.

If you need a car, you probably don't need a Mustang GT, but it's nice to have options.

If considered on it's own merit, the public 'option' should be just that, an option.

I have heard a lot of good praises for Medicare here in Florida, I would be happy if we scrapped the whole bucket of lobby-brewed 'reform' and just made Medicare A & B available to me as an option for a fair premium. If it were offered for less than private companies currently charge and the coverage were adequate, why not?

Why would I buy FIAT 500 from the Government Motors for the price of Mustang GT when I can buy Mustang GT directly from Ford Company for the same price?

 

[Intense]

Frankly I cannot understand how anyone can advocate borrowing vast sums of tax money knowing the track record for Govt. programs like healthcare then expect this one to be any different and suddenly bring down the costs of healthcare for everyone through coverage mandates without addressing overall costs. Someone has to pay for this eventually and if you choose to call it a tax or Value Add whatever the American people will pay for it. It will not effect service delivery, nor will effect cost in the least little bit. How do you expect cost to come down when costs are not the mitigating factor being addressed in the bill but rather coverage. Perhaps the best way to provide coverage for those that need and want it, is to make it available at such a price point that people are willing to purchase it. Here is the main falacy in this so called "public option" it assume's that by mandating coverage on everyone you mitigate costs by bringing in healthy young people too offset those with pre-existing condition that will flood the system. The problem with that is that these young people 18-29 will have to be able to purchase this healthcare at such a reduced cost to make it appealing vs. paying the penalty imposed for not having the insurance. The current penalty is 2.5% vs. 1200.00 to 1500.00 a year for low cost basic insurance. So if your a young person and are faced with paying a 300.00 dollar penalty that can be offset by deductions or paying 1500.00 a year for healthcare what do you think they will do? So your left with a system that brings in those that need it most with little of the offsets and no costs being addressed, and in the end you have accomplished nothing other than to create a new department in the Govt. to push this nation even faster into bankruptcy when healthcare reform can be addressed with the application of reform measures without massive spending.

Does everyone understand that if the extreme happens and the government mandates a tax to cover the health care of all, we won't have to buy insurance anymore?

For me, I already pay $500 per month in health care 'taxes'........ that's for me and my bride, so multiply $250 per month by the 80% of us who are working in the worst of economies and you have quite a shit-pile of money to invest in a health care without raising taxes one single penny.

It isn't a question of raising or lowering 'taxes', it's all about finding a cheaper bureaucracy to track the nations sensitive health and financial data.

Listen to Yourself. "A Cheaper Bureaucracy!!!"

 

[AVG-JOE]

This is one of those decisions, if we go with it, from which there is no turning back. Once we introduce a public option, it's here to stay. That doesn't mean we shouldn't do it, but again, I'd like to be absolutely certain that it's necessary before I support taking the leap.

And considering the complete unwillingness of anyone, here or publicly, to address this question sincerely, I'm pretty much left with no alternative but to oppose it. I simply do not see a need.

If you need a car, you probably don't need a Mustang GT, but it's nice to have options.

If considered on it's own merit, the public 'option' should be just that, an option.

I have heard a lot of good praises for Medicare here in Florida, I would be happy if we scrapped the whole bucket of lobby-brewed 'reform' and just made Medicare A & B available to me as an option for a fair premium. If it were offered for less than private companies currently charge and the coverage were adequate, why not?

Why would I buy FIAT 500 from the Government Motors for the price of Mustang GT when I can buy Mustang GT directly from Ford Company for the same price?

That sir, is is a question that you must decide in the privacy of your own mind for yourself.

But isn't it nice to have options?​

 

[AVG-JOE]

Does everyone understand that if the extreme happens and the government mandates a tax to cover the health care of all, we won't have to buy insurance anymore?

For me, I already pay $500 per month in health care 'taxes'........ that's for me and my bride, so multiply $250 per month by the 80% of us who are working in the worst of economies and you have quite a shit-pile of money to invest in a health care without raising taxes one single penny.

It isn't a question of raising or lowering 'taxes', it's all about finding a cheaper bureaucracy to track the nations sensitive health and financial data.

Listen to Yourself. "A Cheaper Bureaucracy!!!"

Yeah, a cheaper bureaucracy. What do you think companies like Blue Cross are? It's not like they actually make something to sell... They track data and payments!

Here's an example: The largest insurance company on the planet, Social Security, runs at an efficiency of just 1.2%, meaning for every dollar of your FICA 'premium', only one and two-tenths of a penny goes toward overhead and administration.

Blue Cross, by comparison runs at about 22% - for them 22 pennies out of every dollar must go to overhead.

As bureaucracies go, some run more efficiently than others..... True, Social Security is kind of an unfair comparison because they don't have million dollar executives and profit-demanding shareholders to feed, but they do have The President for a boss and Congress as their board of directors. That has to add a few tenths of a penny to the overhead.

 

[Missourian]

Listen to Yourself. "A Cheaper Bureaucracy!!!"

Yeah, a cheaper bureaucracy. What do you think companies like Blue Cross are? It's not like they actually make something to sell... They track data and payments!

Here's an example: The largest insurance company on the planet, Social Security, runs at an efficiency of just 1.2%, meaning for every dollar of your FICA 'premium', only one and two-tenths of a penny goes toward overhead and administration.

Blue Cross, by comparison runs at about 22% - for them 22 pennies out of every dollar must go to overhead.

As bureaucracies go, some run more efficiently than others..... True, Social Security is kind of an unfair comparison because they don't have million dollar executives and profit-demanding shareholders to feed, but they do have The President for a boss and Congress as their board of directors. That has to add a few tenths of a penny to the overhead.

Social Security will be broke by 2041...that doesn't sound very efficient.

(AP) The trust fund for Social Security will go broke in 2041 — a year earlier than previously estimated — the trustees reported Wednesday. Trustees also said that Medicare, the giant health care program for the elderly and disabled, faces insolvency in 2020.

Social Security Broke In 2041? - CBS News
​

 

[The Rabbi]

Well, when AT&T was broken up how long did it take for rates to drop? I think it was within 6 months.
I don't understand your second paragraph as it isn't English.

why still buy catestrophic insurance? isn't that just keeping prices higher as well, because market forces can not work? why not eliminate the middle man there?

Part of the problem lies in the name... "Insurance"

When you're in your 30's with a mortgage and 2.2 kids to raise, you buy life 'insurance' hoping you never have to use it, but glad your spouse won't loose the house if you kiss a bus.

When you drive a car you buy collision 'insurance' hoping you never have to use it.

You 'insure' your house and your business against fire, hoping you never have to use it.

Health 'insurance' is the only insurance product sold that the customers and the underwriters both know full and well that use and claims will begin before the ink on the signature line is dry.

What we need is a maintenance program for physicals, pap smears and the occasional boo-boo sold separately from the 'insurance' we need for if our kid gets leukemia.

Not so.
Do you understand how insurance works? It works by statistics and probability. All of that gets priced into the policy, or more accurately the policy pool.
You can insure against any event as long as you have good historical data to predict its probability.
btw, I had health insurance for probably 20+ years before I made claim one on it. I never got sick and had a routine visit to the doctor probably every 5 years.

 

[The Rabbi]

I dont understand that.
Health insurance is there to pay for things that you cannot afford to pay for. Catastrophic insurance would seem to be one of those things. Maybe the main one.

'Insurance' can NOT make things more affordable - it is a pool of funds used to spread risk over a group of people or a span of time.

If you can't afford something in the first place, how can hiring a million dollar insurance executive to do the paperwork for you possibly make it more affordable?

Hiring a bureaucracy to track health care payments will only work if everyone understands that it is an additional expenditure that is worth the cost because it helps spread the cost of an unexpected bad day over time (pay premiums starting when you're 20 so there is medical money available when you're 70) or over a group (I'll help cover your broken leg today, 'cause I know your premiums will help cover my ulcer next summer).

You clearly do not understand what insurance is and how it operates. I'd suggest some basic research on the topic before you go blundering off again.

 

[Claudette]

Well CAre. I would have to see that in writing to believe it. If its true. You can just bet your boots they will have the cards stacked so they will still get their great benefits payed for by me and you. You could probably make book on that.

AT one of the Town Hall meetings one of those same Congresswomen was asked about why she was exempt. Her answer was that she and all of us would have the choice to keep what we have or use the public option. She, of course, would keep her gold plated bene's.

No. I would have to see proof of that Care.