NYT: Coverage Now for Sick Children? Check Fine Print

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Insurance companies need to go, and that is that. They are what keeps the price of healthcare high. The downside is that when they go, doctor salaries may go down the tube.

Actually, insurance companies are not what keeps the price of health care high. What really keeps the cost of health care high and growing is new, expensive medical technology and increasing utilization of care.

To all of those talking nonsense about socialism and how bad this is for insurers: the intent of health reform is NOT to put the health insurers out of business. The bill mandates that millions of people purchase private insurance. On top of that, the federal government will now subsidize the purchase of their product.
 
"Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”

No Mr. Rockefeller, what is outrageous is that you & all the other politicians were in such a hurry to pass the damn bill without knowing exactly what was in it. I've got an idea, how about a new law that requires congress members to take and pass a comprehensive written test on the content of every bill that is to go into law before they can vote "yay" or "nay". Jesus, do they honestly expect to know what the hell they are passing when the bill is thousands of pages long?
 
First, I think we have to answer the question of "who is going to provide said services if these companies go under"? The answer to that usually solves the misunderstandings in these debates. Sure you say the whole insurance market wont tank, but look at the amount of people inured by these "monster businesses". ( I always find it odd that we use descriptive terms like "monster" for big companies like this) Thats a huge issue if they suddenly are uninsured. Of course I think that is part of the point for those wanting single payer in this country but thats a different discussion.

"Monster" was referring to the size of the business and nothing more. If invokes a different image, at worst it was a Freudian slip on my part vs me literally calling them "monsters" (although I will concede that that description was strongly implied by post overall). Still, unintentional.

Also, I'm sure you wouldn't be surprised to know that I am not opposed to a single payer--but I agree that is an entirely different discussion so no need to go into it further 😉

I dont however, hold insurance companies solely to blame and even if I did, dont think demonizing and causing them problems is going to really solve the kinds of issues that took my cousins life. There are ways to address chronic illness and insurance without a "one size fits all" federal law simply forcing things into effect without concern for "how" and its consequences. I dont want this situation for anyone, my worst enemy, but I dont think what we are discussing is really solving anything at all. Forcing out of business the major medical insurers is only going to magnify these kinds of issues, not solve them. Unless of course we are wanting to take up government run which I suspect is the core to these types of discussions.

I'm sorry you had to go through that situation. No, completely demonizing these companies isn't necessarily productive, but neither do I think that they should get a free pass for their actions. So I'm clear on it, my goal is equal access to a basic standard of healthcare. I believe health is a basic human right. I mention this because this is not the viewpoint of all who enter this debate necessarily (ie they may not view it to be a basic right, or that it should be based on income/work status/achievement, etc etc). If we're talking about completely different goals then of course we won't see eye to eye on this. Starmantis I'd like to hear what your goal is for the healthcare system as I think it would help me understand where you're coming from a little better.

Now, despite my openness to a government run option, I am not actually someone who wants to see major medical insurers go out of business. In fact, I agree with your previous that point that, ultimately, these business provide a crucial service. My argument is that the way they practice and pursue the bottom line is not commendable. Call me idealistic (check my username lol) but I think there is a way to strike a balance between profit and accountability/allowing for a basic standard of healthcare for people rich and poor alike. My problem with these companies are not that they are seeking a profit, but the manner in which they'll (often) disregard human lives (often of people at the bottom) to do it.

First, I think its disingenuous to label opposing viewpoints as "fear-mongering" and then say you would love to hear from others especially the opposing view points. Just saying.

You have misinterpreted. The "fear-mongering" label was not referring to those of opposing viewpoints as a whole. In that instance, I was referring to related posts which painted a quite dramatic picture, that this reform would basically send all insurance companies to grave and collapse the system. I find that position extremist, incendiary, and downright unfounded. And yes, for those who are able to have a responsible, reasonable, rational discussion about the topic who view the situation differently from me, I would love to hear from them on the matter rather than their alarmist counterparts.

Second, "IN TIME" is a serious issue in this discussion. The whole point of ramming this bill through was because we didn't have time. Because this is people's lives we are talking about and lives are ending all the time. So to say, it will work out "in time" is counterintuitive to the whole point of the quick action on the bill.

Here is why I view it not to be counterintuitive: I think by not changing the system, we would be losing more lives than we will as a result of the insurance system becoming "upset" as the reforms come into play. I'm saying that we can't waste one more day turning away the people who need it most (those with existing conditions, the poor, etc.) from health care. By work out "in time" I mean that in due time, companies will find their bottom lines again--they will just have to change they way they approach the pursuit of that bottom line, undoubtedly (which, as I've stated, I view to be necessary); but in the mean time, as the companies find new footing, people will be getting the care they need (whether the companies like it or not).

Unless of course the action was more about political gain than helping people, which is what I believe to this day.

Pretty cynical, but of course we'd all be kidding ourselves if we said that political gain didn't play a role. I just disagree that it was MORE about political gain than about fixing a very broken system. (Haven't gotten that jaded quite yet 🙂) You can disagree with the method, but I'm almost certain you wouldn't disagree that some change was in fact needed.

I reject the premise to this altogether. Nothing but this bill could change the "status quo" (to use the new Obama registered trademark phrase)? Seriously? I think its a false premise to say this is the only thing that could have "forced" changes in the "mode of operations" in the insurance market. There are a myriad of other ways to affect said mode of operations, not just this bill.

No one is saying that this is the "only thing" that could bring about changes in the mode of operations. But as I explained earlier, I view timing to be dire. Couple this with how far removed the goals of some of these companies are from improving the health of our population, pure and simple, I would argue that a bold move was needed.

Also, strong arm forcing of change is never as complete, or sustainable as compelling change.

I could not agree more! But knowing the culture and motives at some of these companies, realistically, who/what is strong enough to compel them to change? If humanizing/putting a face to some of these stories of loss or the reality of the raging healthcare disparity in our country doesn't budge them, seriously, what would? (I thought it was my job to see through rose-colored glasses 😛). Not much in my opinion. Not to mention that "compelling" change, while certainly the desirable option, would take a loooooong time; and actually, I view this reform as an important catalyst to bring about a more sustainable change myself.

I grew up in a very low income area, in fact I spent many of my formative years in a Ukrainian ghetto. Not many places in the US that can compare to that place, let me tell you. I disagree though that these kinds of experiences are what shape our beliefs or "bias" as some might say in these kinds of issues. Obviously we came to very different conclusions about it.

Obviously we do. For me, growing up in a place where getting health care (or even placing a priority on your individual health) was a luxury not everyone could afford, I find it depressing that people of low income have such low representation in the health care debate/politics of reform. You're not going to hear their opinions on it, but we do get to hear the booming perspective of the insurance industry on every issue. If these companies are maligned, I suspect it has more to do with the fact that they seem to drown out the voices of the everyday men and women to control agendas. The context in which I grew up in LARGELY impacted my views, but that's not to say living environment influences everyone to the same degree (as your story indicates). My point was that for me, it inclined me to see the situation a certain way.

I hope you are truly open, as you just heard from one opposing view. I also think using words like "defenders of these companies" is a little loaded. I dont think anyone is "defending" per se the insurance companies specifically, but opposing the way this bill has effected them.

This comes from the fact that, in my mind, opposing the reform is akin to opposing equality in access to (a basic standard of) healthcare for everyone. Since I doubt that that is seriously, SERIOUSLY the true intention of all those with opposing views on the bill, I guess what my greatest source of confusion about the other viewpoint is what exactly are you advocating as the alternative? In my mind, you ARE defending these companies (i.e.-they should not be "forced" into changing their ways, they will go under and/or lose massive profits as a result of this, it shouldn't be their responsibility to insure everyone/they should get to insure at they see fit). I'm sincere in wanting to understand. I don't "get" it--"it" being the argument against the stance that these companies need a force to intervene to get them to start serving the people (what I think their goal should be, but which I understand is hard to reconcile with the fact that they are for-profit as an end, vs human health necessarily as the end. Again, realize that I support a government option)

And in closing, let me just say, thank you for keeping this civil. I appreciate it.
 
"We're talking about directly putting price tags on human well-being, directly stripping a human life down to numbers and figures."

A human life, sorry to say, will always have an inherent value. The question is who is going to pay for that price tag. Your view is to force other people to pay for a cost that the government sets. My view is that a person's worth is based upon their production and ability to aid a society, which is decided from the free market. We will always disagree on that point.

Agreed. I have respect for that stance because although I do COMPLETELY disagree, your reasoning is sound/makes sense to me. My goal is seriously not judgement--I'm just honestly trying to understand where the other side is coming from on this. Thanks for that.

👍
 
It's all just a race to the bottom.

Anywhere they think they can squeeze costs, they will. Ultimately, the problem is that demand for the very best and costly care is outstripping supply.

👍

Doesn't matter what sort of system we have, we have to address that problem first.
 
Insurance companies are going to do crazy well though (assuming the mandate holds through).

Everyone in the US has to buy from them, so all they have to do is set their prices to whatever level lets them make a profit. If I wasn't a broke med student I'd seriously be investing.
 
Actually, insurance companies are not what keeps the price of health care high. What really keeps the cost of health care high and growing is new, expensive medical technology and increasing utilization of care.

To all of those talking nonsense about socialism and how bad this is for insurers: the intent of health reform is NOT to put the health insurers out of business. The bill mandates that millions of people purchase private insurance. On top of that, the federal government will now subsidize the purchase of their product.

Let's not forget that physicians are people, too. They drive up the cost of health care by ordering/performing unnecessary test/ procedures, because that's how they get paid. This forces insurance companies to pay out more, increasing premiums, etc. Patients are to blame as well. They demand CAT scans, expensive drugs, and hospitalization for minor injuries, fueled by threats of litigation.

My opinion: Insurance companies aren't perfect, but they're a scapegoat. True health care reform would require a national paradigm shift; most patients will have to be more frugal, drug companies to cool it with the TV advertising, DME companies to stop targeting the elderly on medicare for DME they don't really need, and physicians to admit their part in contributing to this mess, that they are indeed fallible and sometimes self-motivated, and be willing to accept less pay.

Happening anytime soon? No way. Let the private sector control health insurance? I find it morally repugnant to let the "bottom line" trump our right to adequate health.

I liken the current bill to putting new wood floors and fresh wallpaper in a house infested with termites. Yeah, it may function for a while, but ultimately the walls will crumble and the whole house will need to be demolished and rebuilt.
 
Let's not forget that physicians are people, too. They drive up the cost of health care by ordering/performing unnecessary test/ procedures, because that's how they get paid. This forces insurance companies to pay out more, increasing premiums, etc.
Actually, I don't think that's true. I believe the Stark Law prohibits physicians from increasing their revenue from Medicare patients just by ordering more tests. Maybe someone better versed in this can clarify? I feel like the majority of overtesting is done in a CYA manner rather than with greedy intent.
 
Actually, I don't think that's true. I believe the Stark Law prohibits physicians from increasing their revenue from Medicare patients just by ordering more tests. Maybe someone better versed in this can clarify? I feel like the majority of overtesting is done in a CYA manner rather than with greedy intent.

Well, not exactly. The Stark and anti-kickback laws are in place to prevent conflicts of interest -- e.g., to stop physicians from referring to hospitals, imaging centers, labs, etc, that they have a financial stake in. If a physician's practice has an in-house MRI, for example, there's nothing in place to prevent them from increasing revenue by performing unnecessary imaging.

Of course, patients drive over-utilization too. Part of the reason that physician practice might have in-house imaging is because every time patients come in with knee pain, they expect an MRI.
 
Yup.

And for the record, I couldn't give less of a crap about insurance companies taking a hit from this. I care about the families of sick kids who shouldn't have to worry about possible 6-figure medical bills on top of their child's illness.

Save it for your personal statement. 🙄
 
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