Saturday, February 27, 2010

Healthcare update

Many Americans watched the great health care square table summit, ostensibly to give Republicans a chance to give their input into a bill which Obama says is set in stone. It was defeatist and futile from the onset, but it gave me a chance to see how polarized the two parties are and how they just used the occasion to repeat their talking points. At least that is what I came away with from my hour or so watching of the non-event.

The Democrats talked about our moral responsibility to pass universal health care, and the Republicans talked about the equal need for fiscal responsibility. I personally think we need a big dose of both, not one or the other.

Some of you may suspect that I am not in favor of big government. I sort of like government by the people rather than government by the government. However, the deep need for some things have made me moderate my position for some big causes. Health care is one of those exceptions.

I have blogged about this before, and I made a list of the things I wanted. That list has been refined after a year of debate. Some things are still the same.

1. I want everyone to be covered. No exceptions.

2. I want everyone to participate in both the coverage and the payments for it.

3. "Everyone" means nobody gets to opt out or have their own special plan. Not even congress.

4. There must be one price for everyone. No special people and special low risk pools. One pool. Everyone is in that pool.

5. Every disease and injury is covered. Elective things like cosmetic surgery is not covered.

6. People who abuse the system go to jail.

One problem: the bill they came up with doesn't do this. Did we not say that congress would screw this up? Ha!

What do we do about insurance companies who now employ zillions of people?

Do we get to choose our own company still? (I don't want the government as my insurance company, friendly and compassionate and efficient as they are.)

Do we get to go across state lines to choose a company? Why would we want to if all charged the same and covered the same?

Where does the competition come from if all companies charge the same and cover the same?

How about all the people who don't have to pay because they made wrong life choices and don't have any money? I mean, are we going to do anything to make them go to work, or just pay their way? A lot of them are deserving and have nowhere to turn. But a lot of them just chose not to work as hard as others did or educated themselves. Will there be some justice there? Will they get to do some work for us one day a week? No? Not fair to them? Well, so be it.

A work in progress.


  1. You have one typo I picked out. Can you spot it? :) I like the O'Bummer photo.

  2. I agree with your points entirely. Ironic, isn't it? I would also like to add provisions to help people become doctors (as opposed to pushing out doctors riddled with half a million in debt), but also include provisions to change the fee for service structure. Otherwise, the price will continue to spiral up.

    I am also disappointed with the bills passed by both the house and the Senate. Some of the fine points after your checklist I may not agree 100%, but I don't think, fundamentally, we're on a different page on this topic.

  3. Universal Heath-care is in that state of non-being where we find Schrodinger's Cat, it is both dead and alive, both the best that it can be and the worst that it can be.

    Still, it is fun to talk about what color the cat will be, even if don't yet know that we are getting a cat.

    So if 'everyone' is should be given healthcare, how can you then say that the Undeserving Poor don't deserve to get healthcare?

    Our Right to Not Work and sit around collecting Welfare, Unemployment, and Social Security is why so many people want to move to America.

    What makes you think Healthcare will be treated differently than any other entitlement program?

  4. @Patchwork - That's patently absurd. :)

    @Stephanie B - I agree with you about incentives for doctors; forgiving some or all of their huge student loans in return for doing a certain amount of work (1 year for 1 year's college?)

    I was thinking though, what is the incentive for someone to want to become a doctor if the government sets the payment prices for each service rendered? I mean, how would doctors become rich in the brave new world of universal healthcare? A commendable desire to self-sacrifice one's life to care for the poor only goes so far in the motivation arena, and they can't ALL be plastic surgeons.

  5. Doctor's are salaried in many countries. And yet they're not short of them.

    Of course, they also have tort reform, which I also support.

  6. I support tort reform too. I forgot to mention that. And a 30-day season where you can shoot lawyers on sight.

    What country is that who is not short of doctors? Cuba? Can you substantiate that statement?

  7. Relative to here. Go to the WHO report on health care and you'll see we're not the top when it comes to doctor's per capita. We just cost like we are. Actually, I was surprised that we aren't.

  8. @Stephanie B - Well, if we are not on top when it comes to number of doctors, it seems we would need more doctors. What am I missing? We will attract these new doctors with government scale salaries? I've lost you. And you think doctors are being paid too much?

  9. There are a number of factors in healthcare. One is overhead to deal with 900 insurers all have different forms and different protocols and charges and all having different ways of trying to back out of paying. Most doctor offices have half their staff (if not more) devoted to insurance. That's money that could either not be spent or spent on, I don't know, nurses. In other words, a huge amount of overhead.

    More overhead goes into malpractice insurance, which could be reduced with tort reforms. Additionally, reducing the debt burden could go a long way to (a) encouraging GPs (which we're short on)and (b) eliminating the need to make money quick.

    I think doctors are entitled to make a good living. It's hard work, it takes a great deal of training. They are specialists and need to keep informed to stay on top of it.

    I'd also much rather pay doctors for keeping people well than on a fee for service plan. There has to be a way to do it; it's done that way in many places all over the world. And they still have doctors.

    Other countries, whether using a single payer system or using many private companies like Switzerland or Japan, have managed to make healthcare far more affordable and still provide doctors with a good living, probably more so in Switzerland than Japan.

  10. @Stephanie B - I am having trouble keeping up with your font of misinformation. Here are the only health insurance companyies I could find that do business in the USA, search as I might. And even this includes companies like AFLAC which aren't health insurance companies. Would you please post a list of the other 700 companies you say are here? Thanks.

    Part One:

    AEGON USA, Inc
    Aetna, Inc
    Affinity Health Plan
    AF&L Insurance Company
    Alameda Alliance for Health
    American Family Mutual Insurance Company
    American Fidelity Assurance Company
    American Medical Security, Inc
    American Re Healthcare
    American Republic Insurance Company
    American Specialty Health Incorporated
    AmeriChoice Health Services, Inc
    Amerigroup Corporation
    AON Corporation Group
    Arkansas BlueCross Blue Shield
    Assurant Health
    Assurant Employee Benefits
    Atlantis Health Plan
    AultCare Corporation
    AvMed Health Plan
    Bankers Life and Casualty Company
    BC/BS of Florida
    BC/BS of Georgia
    BCE Emergis, eHealth U.S.
    Berkshire Life Insurance Company of America
    Blue Care Network of Michigan
    Blue Cross and Blue Shield of Georgia
    Blue Cross and Blue Shield of Illinois
    Blue Cross & Blue Shield of Louisiana
    Blue Cross and Blue Shield of MN
    Blue Cross and Blue Shield of Montana
    Blue Cross and Blue Shield of New Mexico
    Blue Cross Blue Shield of MA
    Blue Cross Blue Shield of NC
    BlueCross BlueShield of North Dakota
    BlueCross BlueShield of Texas
    BlueCross BlueShield of Vermont
    Blue Cross of California
    Blue Cross of Idaho
    Blue Cross of Northeastern Pennsylvania
    Blue Shield of California
    Bluegrass Family Health, Inc
    Botsford Health Plan
    Capital Blue Cross
    Health Plan News
    CarePlus Health Plan
    CENTENE Corp
    Center Care
    Central Reserve Life Insurance Company
    Central States Health & Life Company of Omaha
    CHA Health
    CHCS Services, Inc
    Chartered Health Plan
    Chinese Community Health Plan
    CIGNA Health Care
    Combined Insurance Company of America
    Commercial Travelers Mutual Insurance Company
    Commonwealth Health Corporation
    Community Health Network of Connecticut
    Community Health Plan-LA County Dept.
    Community Health Plan of Washington
    ConnectiCare, Inc
    Conseco, Inc
    Continental General Insurance Company
    Cox Health Systems HMO
    Dental Benefit Providers, Inc
    Denver Health Medical Plan
    Destiny Health, Inc
    Disability RMS
    Elder Health, Inc
    Empire Blue Cross and Blue Shield
    Employers Dental Services, Inc
    ENCOMPASS Health Management Systems
    Fallon Community Health Plan
    Family Health Partners
    Federated Insurance Companies
    First Health Group Corporation
    Geisinger Health Plans
    General & Cologne Life Re of America
    Great-West Healthcare
    Group Health Cooperative
    Group Health Cooperative of SC Wisconsin
    Group Health Incorporated
    Guarantee Trust Life Insurance Company
    Guardian Life Insurance Company of America
    Gundersen Lutheran Health Plan Inc
    Harvard Pilgim Health Care
    Harvard University Health Services
    Health Alliance Plan
    Health First Health Plan, Inc
    Health Net
    Health New England
    Health Partners – Philadelphia
    Health Plan of Michigan
    Health Plan of Nevada
    Health Plan of San Mateo
    Health Plus PHSP, Inc
    HealthPlus of Michigan
    Healthyroads, Inc
    Highmark Blue Cross Blue Shield
    HIP Health Plans
    Hometown Health Plan
    Horizon BC/BS of New Jersey
    Humana, Inc
    IHC Health Plans, Inc
    Illinois Mutual Life Insurance Company
    Independence Blue Cross, Philadelphia, PA
    Independent Health
    Inter Valley Health Plan
    JHA, Inc
    Kaiser Permanente
    Keystone Mercy Health Plan, Inc
    L.A. Care
    Legacy Health Plan
    LifeCare Assurance Company
    LifePlans, Inc
    The Lifetime Healthcare Companies
    Long Term Care Group, Inc
    Lovelace Sandia Health System/Lovelace Health Plan
    Lumenos, Inc

  11. Part Two

    Managed Health, Inc
    Martin’s Point Health Care
    M-CARE, Ann Arbor, MI
    MedAmerica Insurance Company
    Medica Health Plan
    Memphis Managed Care Corp.
    Metropolitan Health Plan
    Mount Carmel Health Plan
    MultiPlan, Inc
    Munich American Reassurance Company
    Mutual of Omaha Insurance Company
    MVP Health Plan
    Nationwide Health Plan
    Neighborhood Health Plan
    Network Health Plan
    New West Health Services
    New York Life Insurance Company
    Olympic Health Management Systems, Inc
    OSF Health Plans
    Oxford Health Plans
    Pacific Life Insurance Company
    PacifiCare Health Systems
    Parkland Community Health Plan
    Penn Treaty American Corporation
    Peoples Benefit Life Insurance Company
    Peoples Health Network
    Physicians Health Plan of Northern Indiana
    Physicians Mutual Insurance Company
    PHP Companies d/b/a Cariten Healthcare
    Preferred Care Partners
    Preferred Plus of Kansas
    Presbyterian Health Plan
    Prevea Health Plan, Inc
    PrimeWest Health Systems
    Principal Financial Group
    Private Healthcare Systems, Inc (PHCS)
    Providence Health Plans
    ProviDRs Care Network
    QualChoice of Arkansas
    Regence BlueCross BlueShield of Utah
    Regence Blue Shield
    Regence BlueShield of Idaho
    The Regence Group
    Rocky Mountain Health Plans
    Sagamore Health Network, Inc
    SCAN Health Plan
    Scott & White Health Plan
    Sentara Healthcare
    Sentry Insurance Group
    Sierra Health Services
    Southeastern Indiana Health Organization
    State Farm Insurance Companies
    Stonebridge Life Insurance Company
    Sun Health MediSun, Inc
    Teachers Protective Mutual Life Insurance Company
    Transamerica Life Insurance Company
    Tufts Health Plan
    Trustmark Insurance Company
    UCare Minnesota
    UNICARE Life & Health Insurance Company
    United HealthCare
    United Teacher Associates Insurance Company
    UnitedHealth Group
    Univera Healthcare
    UPMC Health Plan
    USAA Insurance
    USAA Life Insurance Company
    ViaHealth Managed Care Services
    Vytra Health Plans
    WellCare Health Plans
    WellPoint Health Networks Inc
    WINHealth Partners
    Woodmen of the World Life Insurance Society
    Yale University Health Services
    Zurich North America

  12. You aren't counting some of them 50 times are you?

  13. You didn't get your 900 figure from your global warming stats site I hope. :)

  14. Did I say 900? I'm meant umpteen.

    (Like you've never seen hyperbole before! Or used it!)



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