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Jetsgo
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Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 4:10 am

In the US, we are free to pick and choose which auto insurance company insures our vehicles. We are also free to choose coverage limits, deductibles, and other optional coverages resulting in a very personalized policy. When we have an accident, we are free to choose the body shop. When we have an accident, we pay our deductible after which the insurance company pays up to the limit.

Why is it that our health insurance options are generally restricted to what our employers offer? Why must we select from a group of cookie cutter policies which can't be customized to our liking? Why do health insurance companies dictate where we can and can't be seen? Why do we have to pay a deductible and coinsurance?

Maybe this is an overly simplistic view of the world from my 25 year old eyes? However, as I get ready to bring a new one into the world and I view over my employers health insurance options, I simply get frustrated. The policies available to me are rather decent, but why can't I just sign up for whoever has the best rates/coverages for me? Yes, I know I can go the private route but that generally isn't cost effective...why?
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Pyrex
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 5:27 am

Quoting Jetsgo (Thread starter):
Why is it that our health insurance options are generally restricted to what our employers offer?

They are not. You can choose to buy individual insurance.

Quoting Jetsgo (Thread starter):
Why must we select from a group of cookie cutter policies which can't be customized to our liking?

Obamacare.

Quoting Jetsgo (Thread starter):
Why do we have to pay a deductible and coinsurance?

Because your auto insurance doesn't cover your oil change and your tires.

That was easy. Next!
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Mir
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 5:43 am

Quoting Pyrex (Reply 1):
Quoting Jetsgo (Thread starter):
Why must we select from a group of cookie cutter policies which can't be customized to our liking?

Obamacare.

That was true before Obamacare ever came around.

-Mir
7 billion, one nation, imagination...it's a beautiful day
 
Pyrex
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 6:13 am

Quoting Mir (Reply 2):
That was true before Obamacare ever came around.

It depended on your employer - I have the choice between several different carriers, and within each carrier I have several different options I can mix and match. Never felt I was lacking in choice. Of course, if I didn't like it, I could, as mentioned, buy health insurance myself (I know the IRS discriminates against individual health insurance - a big mistake that was not corrected with Obamacare).

Now with Obamacare I really won't be able to customize. If I want a policy with high deductible, I won't be able to buy it. If I want a policy that doesn't cover protection for recreational activities (contraception), tough luck.
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rabenschlag
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 8:36 am

I guess your employer has a say because she/he co-pays the insuranc fees so employers have b2b contracts wiith some insurers. If you pay all your insurance out of your pocket, I cannot see why you shoould not be able to choose whatever insurer you want. At least that is the way it works in Germany.

Keep in mind though that, depending on your medical precondition, insurers will not be willing to insure you at rates that you can afford. Free market health insurance is not for the poor and ill.

R.
 
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moo
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 9:23 am

The entire healthcare system in the US is severely in need of improvement, just on the cost basis alone - I've not looked at "Obamacare" in any depth to see what it offers, but the situation as of 2010 is just abysmal.

In 2010 (year picked because figures are unlikely to be revised), the UK spent £118.2Billion on the NHS, for a population of about 63Million persons.

Thats a per population head equivalent of £1906 or $2954.

In that same year, the US spent about $381Billion on Medicaid and about $509Billion on Medicare - both of which highly intersect with what the NHS provides, for a population of about 311.5Million persons.

Thats a per population head equivalent of $2858.

Except the US Medicare and Medicaid programmes don't cover 311.5Million persons - Medicaid covers roughly 50Million persons, and Medicare covers roughly the same number - theres about a 6Million person intersection between the two (persons that are enrolled in both), so, again roughly, the total number of beneficiaries for these federal and state programmes is around 94Million.

That makes it a per eligible head equivilent of $9469.

And you know which system I would rather have? The one I currently use - the NHS at $2954.

The US system is just very very badly run.

Sources:

http://www.gao.gov/highrisk/risks/insurance/medicaid_program.php
http://www.gao.gov/highrisk/agency/hhs/reforming-medicare-payments.php
http://www.kff.org/medicare/upload/7305-05.pdf
http://en.wikipedia.org/wiki/Medicaid
http://en.wikipedia.org/wiki/Medicare_(United_States)
https://www.google.co.uk/search?hl=en&q=US+population&meta=
 
Ken777
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 5:10 pm

Quoting Pyrex (Reply 3):
Now with Obamacare I really won't be able to customize. If I want a policy with high deductible, I won't be able to buy it. If I want a policy that doesn't cover protection for recreational activities (contraception), tough luck.

That depends on if your state establishes insurance markets that are called for in "ObamaCare" or if they simply wait until Obama is out of office - in 2013 or 2017.

The really queer part is that these insurance markets called for at a state level is focused on private insurance companies, not a public (government run) option. It would seem that the conservatives who are so supportive of private enterprise would be strongly supporting these state markets.

Quoting moo (Reply 5):
the US spent about $381Billion on Medicaid and about $509Billion on Medicare - both of which highly intersect with what the NHS provides, for a population of about 311.5Million persons

If you look at the Medicare spending it is important to recognize that those on Medicare make monthly premium payments and many of us also have a gap policy. That brings up a need to look not only the total payouts, but also the revenues received from FICA taxes ANY the various premiums paid for by those covered.

Medicaid is a totally different animal and it seems to me that the right wing states are failing to care for their citizens at a responsible level. Look at Texas and Oklahoma where right wing Governors look like they are rejecting federal funds to bring in more uninsured people into the program.

Reality is that the uninsured are a significant reason why our costs are so rapidly increasing. If you want to slow the growth then you need a Medicare for all, with private insurance then available at a fraction of the cots. THe Aussies can show how it is done.

Quoting Pyrex (Reply 3):
It depended on your employer - I have the choice between several different carriers, and within each carrier I have several different options I can mix and match.

As long as costs continue to grow at the levels we have seen in this century your employer provided health care is at risk. It is already sufficiently hight to impact the number of US employees a company will have, and the wage/salary levels that employers will pay. Shifting those costs to a tax based system is far more effective in growing companies than most tax breaks I can think of.

Quoting Pyrex (Reply 3):
Now with Obamacare I really won't be able to customize.

Of course you ail and you will have better selections and pricing if the states work hard to build their state markets.

Quoting Rabenschlag (Reply 4):
Keep in mind though that, depending on your medical precondition, insurers will not be willing to insure you at rates that you can afford. Free market health insurance is not for the poor and ill.

We are rapidly moving to a point where insurance companies can take a blood sample and other generic materials to look for applicants who are at future risk for various health care costs. That should concern employees who believe they are "safe" from health insurance costs.
 
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Tugger
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 5:52 pm

Quoting Pyrex (Reply 3):
Now with Obamacare I really won't be able to customize. If I want a policy with high deductible, I won't be able to buy it. If I want a policy that doesn't cover protection for recreational activities (contraception), tough luck.

Then the Republican's should have fully participated in the discussions that went on for healthcare but unfortunately they were blocked from doing so by there own party stupidity/politics and various talking heads and blowhards that attacked anyone who even breathed that they may participate. Instead they were stuck with trying to press some lame "take or leave it" plan that was dead on arrival as they couldn't go anywhere meaningful from there. It was a truly sad situation and a missed opportunity.

Tugg
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PPVRA
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 6:27 pm

The simple, non detailed answer is because there is a massive amount of regulations int he health insurance market compared to the auto insurance market.

And it's not just Obamacare or even the Federal government - the states are every bit as much to blame as well.
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
fr8mech
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RE: Auto Insurance Vs Health Insurance

Thu Jul 26, 2012 6:51 pm

Quoting Jetsgo (Thread starter):
We are also free to choose coverage limits, deductibles, and other optional coverages resulting in a very personalized policy.


All states have a minimum level of automobile insurance required.

Quoting Jetsgo (Thread starter):
Why is it that our health insurance options are generally restricted to what our employers offer?


They are not. You are free to forgo your employer's insurance plan and buy one on your own.

Quoting Jetsgo (Thread starter):
Why must we select from a group of cookie cutter policies which can't be customized to our liking?


Because it is much easier and cheaper for your employer to provide you with set policies and coverages.

Quoting Jetsgo (Thread starter):
Why do health insurance companies dictate where we can and can't be seen?


Because that's the way the policy your employer bought is written. My policy (through my employer) is not written that way.

Quoting Jetsgo (Thread starter):
Why do we have to pay a deductible and coinsurance?


Because people go to the doctor for stupid, minor things. If you could claim all the routine and non-routine maintenance you do on your car to your auto insurance, you would also be paying deductibles/co-pays/co-insurance.

One of the main problems with our health care insurance issue is that we, as insured consumers are removed from the market. We generally do not care how much a procedure costs. Co-pays and deductibles help with that issue, but clearly, not enough.

I have a high deductible health insurance plan with a health savings plan. Trust me...I pay very close attention to my doctors' bills and am very selective as to when we go to the doctor.

Another fine thing would be to allow us to buy insurance across state lines. If I want a BC/BS policy offered in Texas, why shouldn't I be able to buy that insurance policy?
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Pyrex
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 5:14 am

Quoting moo (Reply 5):

I hope you enjoy the free medical research paid for by U.S. consumers. You are welcome.

Quoting Ken777 (Reply 6):
It is already sufficiently hight to impact the number of US employees a company will have

It is not the cost that is high, it is the arbitrary government regulations telling companies after how many employees they need to offer health insurance.

Quoting Ken777 (Reply 6):
We are rapidly moving to a point where insurance companies can take a blood sample and other generic materials to look for applicants who are at future risk for various health care costs.

Except they are expressly forbidden by law from doing that. There goes your canard.

Quoting tugger (Reply 7):
Instead they were stuck with trying to press some lame "take or leave it" plan that was dead on arrival as they couldn't go anywhere meaningful from there.

As opposed to a law that had to be passed before we could see what was on it?

Quoting PPVRA (Reply 8):

The simple, non detailed answer is because there is a massive amount of regulations int he health insurance market compared to the auto insurance market.

And the sad thing is the auto insurance market is already over-regulated as is...

Quoting fr8mech (Reply 9):
Another fine thing would be to allow us to buy insurance across state lines.

That would have been the single most effective way to bring down healthcare costs in the U.S. but somehow in 2,000 pages of Obamacare they couldn't find enough space for a single line of text allowing just that.
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Tugger
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 5:29 am

Quoting PPVRA (Reply 8):
The simple, non detailed answer is because there is a massive amount of regulations int he health insurance market compared to the auto insurance market.

And it's not just Obamacare or even the Federal government - the states are every bit as much to blame as well.

  

Quoting fr8mech (Reply 9):
Another fine thing would be to allow us to buy insurance across state lines. If I want a BC/BS policy offered in Texas, why shouldn't I be able to buy that insurance policy?

As long as it would meet the mins of your state I think it would be fine. However I don't think it would affect cost that much as PPVRA notes above, it is the state specific requirements that create a lot of the costs. It's not per se a bad thing, states should be allowed to set requirements as they and their citizens desire.

Quoting Pyrex (Reply 10):
As opposed to a law that had to be passed before we could see what was on it?

Absolutely! Yes.

Tugg
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. -W. Shatner
 
aa757first
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 5:50 am

Quoting Jetsgo (Thread starter):
Why do health insurance companies dictate where we can and can't be seen?

In managed care, the insurance company forces providers to accept a certain payment amount. It's up to the provider to decide if they want to accept the reimbursement rate.

Quoting Jetsgo (Thread starter):
Why do we have to pay a deductible and coinsurance?

As said before, to discourage frivolous medical care. It has actually been proven effective at reducing the number of silly ER visits.

Quoting moo (Reply 5):

In 2010 (year picked because figures are unlikely to be revised), the UK spent £118.2Billion on the NHS, for a population of about 63Million persons.

Thats a per population head equivalent of £1906 or $2954.

In that same year, the US spent about $381Billion on Medicaid and about $509Billion on Medicare - both of which highly intersect with what the NHS provides, for a population of about 311.5Million persons.

Thats a per population head equivalent of $2858.

This is an awful comparison. The NHS covers all Briton. Medicare covers only old people, while Medicaid covers only poor people. Old and poor people are more likely to require expensive medical care. The U.S. system is expensive, but this is not an apples to apples comparison.
 
Mir
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 6:06 am

Quoting fr8mech (Reply 9):
Another fine thing would be to allow us to buy insurance across state lines. If I want a BC/BS policy offered in Texas, why shouldn't I be able to buy that insurance policy?

It wouldn't exist for you to buy. The healthcare companies would all run for whatever state bent over to let them rewrite the rules on what's required to be covered and what isn't. That state, in all probability, would not be Texas. Thus, no Texas-based policies would remain.

It's the same reason you can't get a credit card based in Texas - you're probably going to have to settle for South Dakota or Delaware.

-Mir
7 billion, one nation, imagination...it's a beautiful day
 
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moo
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 6:12 am

Quoting Pyrex (Reply 10):
I hope you enjoy the free medical research paid for by U.S. consumers. You are welcome.

Excuse me? What does that have to do with my cost comparison at all? Medicare and Medicaid costs are costs for patient care and support, they have nothing to do with medical research at all.

In 2010 the UK government spent £3.8Billion of public money on medical research.

And even so, the UK government doesn't just take drugs and pay nothing for them - we don't have a patent nullification program, so we pay the going market rate for treatments. The fact that a prescription here in the UK costs a person just $13 to fill per item is not the end cost, the NHS pays whatever the drug company invoices them.

So its hardly free.

Quoting aa757first (Reply 12):
This is an awful comparison. The NHS covers all Briton. Medicare covers only old people, while Medicaid covers only poor people. Old and poor people are more likely to require expensive medical care. The U.S. system is expensive, but this is not an apples to apples comparison.

Actually, that is what makes it an excellent comparison, because the NHS covers the poor and elderly as well as everyone else, and the NHS do it for basically the same money as it costs you to cover just the poor and elderly.

The point was that you are already paying either the equivalent per head of population (so all 311Million US citizens) or more (just the 94Million eligible for those services) as we do in the UK, and yet we in the UK have a fairly decent universal healthcare system while you do not.

By spending the equivalent amount of money, you should have an equivalent healthcare system - but yours only covers at best 1/3rd of your population, while the other 2/3rds are paying even more into the system themselves (or via their employers).

So why aren't you Americans baying for blood over your expensive, incomplete solution?

[Edited 2012-07-26 23:14:35]
 
fr8mech
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 11:39 am

Quoting Mir (Reply 13):
It wouldn't exist for you to buy. The healthcare companies would all run for whatever state bent over to let them rewrite the rules on what's required to be covered and what isn't. That state, in all probability, would not be Texas. Thus, no Texas-based policies would remain.


See Tugger's post about the policy being offered across state lines meeting the minimum requirements of the state the policy is being offered in.

For the record, I am opposed to minimum mandates. If I want a policy that covers certain things and excludes others, I would like the option to buy that policy. Put it this way: at this point in my life, I will not be having any more kids...why is my wife's 'potential' pregnancy covered (and being paid for)?

To carry the auto-insurance analogy a step...I can pay for 'full coverage', i.e. fire, theft, comprehensive, liability, etc. or I can pay for the minimum coverage (liability) or I can buy something in between. I don't appear to have that option because of state mandates. And, that pressures the price of the premium.
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flipdewaf
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 11:50 am

Quoting Pyrex (Reply 10):
I hope you enjoy the free medical research paid for by U.S. consumers. You are welcome.

I hope you enjoy the free medical research paid for by U.S.UK consumers taxpayers. You are welcome.

Fred
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Pyrex
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 12:15 pm

Quoting moo (Reply 14):
Excuse me? What does that have to do with my cost comparison at all? Medicare and Medicaid costs are costs for patient care and support, they have nothing to do with medical research at all.

Healthcare costs in the U.K. (or many other countries) tend to be lower because there is a monopsony by the State - since there is a single buyer for healthcare products, that buyer has a lot of market power to drive prices down. Drug companies, medical device companies, etc. know this and basically sell only to cover their marginal costs in countries like the U.K., Canada, etc. and make all their money in the only place they can sell their products at a market rate, the U.S. So when deciding to spend hundreds of millions of dollars in developing a new drug or medical device, the thought process is basically "how much money will I be able to make selling this in the U.S.?".

So yes, you are basically benefiting from free research paid for by U.S. consumers.
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Mir
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 12:24 pm

Quoting fr8mech (Reply 15):
See Tugger's post about the policy being offered across state lines meeting the minimum requirements of the state the policy is being offered in.

Would it, though? Or would the policies, as has been done with credit card rules, be regulated only by the state in which the company is based?

-Mir
7 billion, one nation, imagination...it's a beautiful day
 
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moo
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 12:51 pm

Quoting Pyrex (Reply 17):
Healthcare costs in the U.K. (or many other countries) tend to be lower because there is a monopsony by the State - since there is a single buyer for healthcare products, that buyer has a lot of market power to drive prices down. Drug companies, medical device companies, etc. know this and basically sell only to cover their marginal costs in countries like the U.K., Canada, etc. and make all their money in the only place they can sell their products at a market rate, the U.S. So when deciding to spend hundreds of millions of dollars in developing a new drug or medical device, the thought process is basically "how much money will I be able to make selling this in the U.S.?".

Except none of that bas any basis in reality. The NHS buys drugs and equipment on the open market at market rates.

Quoting Pyrex (Reply 17):
So yes, you are basically benefiting from free research paid for by U.S. consumers.

Only in fantasy land. Your fantasy land.

The US system is broken - there should be a single buyer for healthcare services, because having many different buyers is just idiocy and leads to the exact situation we have here where the US spends more and gets less.
 
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Moose135
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 1:43 pm

Quoting moo (Reply 14):
So why aren't you Americans baying for blood over your expensive, incomplete solution?

Some of us are...
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PPVRA
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 2:16 pm

Quoting moo (Reply 19):
The US system is broken - there should be a single buyer for healthcare services, because having many different buyers is just idiocy and leads to the exact situation we have here where the US spends more and gets less.

Funny thing about that is, Europeans pay more out of pocket than Americans. . .

Excessive reliance on third party payers, whether the govenrment or an insurer, is at the core of the problem. It's why auto insurance is cheap, and health is not.

[Edited 2012-07-27 07:18:10]
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
aa757first
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RE: Auto Insurance Vs Health Insurance

Fri Jul 27, 2012 11:04 pm

Quoting moo (Reply 14):
Actually, that is what makes it an excellent comparison, because the NHS covers the poor and elderly as well as everyone else, and the NHS do it for basically the same money as it costs you to cover just the poor and elderly.

No, it isn't. If you accept the premise that most people are fairly healthy, and given that the NHS covers everyone, most NHS members are healthy. Medicare only covers people over the age of 65 and old people tend to be much less healthy than young people. Medicaid covers only those who are poor and poor people tend to be less healthy than those who aren't poor. So the comparison isn't valid at all -- you're comparing the least healthy Americans to the average Briton.

It's true that the NHS is a more cost effective system than the US system as a whole, but this isn't proven by your unfair comparison.
 
Pyrex
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RE: Auto Insurance Vs Health Insurance

Sat Jul 28, 2012 12:56 am

Quoting moo (Reply 19):
Except none of that bas any basis in reality.

Go try buy some prescription drug in Detroit. Now cross the border and go buy that exact same drug in Windsor, Ontario. Now tell me who is paying for the medical research.

Quoting moo (Reply 19):
The US system is broken - there should be a single buyer for healthcare services, because having many different buyers is just idiocy and leads to the exact situation we have here where the US spends more and gets less.

Look, if you believe that people's life expectancy has peaked and that it doesn't make any sense to invest more money in medical research, so we might as well just make healthcare as affordable and accessible as possible, go right ahead, just say it. But at least have the intellectual honesty to admit the implications of what you are saying, and don't act all surprised every time "unintended consequences" (or as am extremely left wing professor of mine would say, reactions you were not smart enough to predict) happen.
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Ken777
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RE: Auto Insurance Vs Health Insurance

Sat Jul 28, 2012 2:15 am

Quoting PPVRA (Reply 8):

The simple, non detailed answer is because there is a massive amount of regulations int he health insurance market compared to the auto insurance market.

Just as well. The auto insurance companies can very easily write your car off if they want. Of course, health insurance companies can "decline to approve" tests or treatments. Basically treating you as an old car too expensive to treat.

Quoting fr8mech (Reply 9):
All states have a minimum level of automobile insurance required.

A core level of health care for everyone can be like that. Need a surgeon, you get who is available (maybe a resident) without a real choice of selection. You can also end up in an 8 - 12 bed ward instead of a private room. But you get health care you need.

Quoting fr8mech (Reply 9):
Because people go to the doctor for stupid, minor things

And far too many people wait too long before going to the Doctor, which is why some problems, like cancer, are far more expensive to treat. My bet is that the financial position of the patient is related to how often they see a doctor.

Quoting fr8mech (Reply 9):
Another fine thing would be to allow us to buy insurance across state lines.

That only works if you have federal oversight for the health insurance industry and some strict laws governing their approval or rejection of test/treatment requests.

We certainly don't need insurance being sold out of states without strict bad faith laws.

We would also need to shift tort law from the state to federal courts when there is a conflict as it is very problematic to let insurance companies hide behind state legislatives.

Quoting flipdewaf (Reply 16):
I hope you enjoy the free medical research paid for by UK taxpayers. You are welcome.

Fred

We have a really queer situation in hte US. Federal research dollars go to research (which is a good thing) and when a breakthrough (or important finding) is made there are papers published in journals like the NEJM.

The queer part? Asa tax payer you have to actually PAY to read the paper you financed with your tax dollars. Most Americans obviously won't bother, until they get hit with a nasty diagnosis. Then they get the shaft. Maybe we need to set up some very high windfall profit taxes on the fee.

UK medical research has been pretty outstanding. The most noticeable achievement in modern medical history is the total hip replacement. The top bone doc here went to the UK to learn the procedure and start hip replacements in TUL. That was close to 40 years ago, BTW.

Quoting aa757first (Reply 22):
If you accept the premise that most people are fairly healthy, and given that the NHS covers everyone, most NHS members are healthy.

But then you have to look at costs related to trauma care. Younger people do get into trouble learning to drive, etc. We also have a very large number of guns in this country and Second Amendment Trauma Care changes the equation - especially when it is the lower income, uninsured individuals shot.
 
PPVRA
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 1:38 am

Quoting Ken777 (Reply 24):
Of course, health insurance companies can "decline to approve" tests or treatments. Basically treating you as an old car too expensive to treat.

No, they can't. Unless you mandate things that have no business whatsoever being covered by insurance in the first place. Then, yes, the most bizarre things can happen when you try to force things that don't naturally go together, but you'd have nobody but yourself to blame for supporting those regs!
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
rfields5421
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 12:18 pm

Quoting Jetsgo (Thread starter):
Why is it that our health insurance options are generally restricted to what our employers offer?

Employers offer health insurance to attract workers. They pay a substantial portion of the cost of the health insurance in most companies - usually a greater share if the company is very large.

Quoting Jetsgo (Thread starter):
Yes, I know I can go the private route but that generally isn't cost effective...why?

That is your choice - and gives you the greatest flexability. But the reason it isn't cost effective is that your employer no longer provides most of the money necessary for the premiums.
 
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moo
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 1:05 pm

Quoting aa757first (Reply 22):
No, it isn't. If you accept the premise that most people are fairly healthy, and given that the NHS covers everyone, most NHS members are healthy. Medicare only covers people over the age of 65 and old people tend to be much less healthy than young people. Medicaid covers only those who are poor and poor people tend to be less healthy than those who aren't poor. So the comparison isn't valid at all -- you're comparing the least healthy Americans to the average Briton.

It's true that the NHS is a more cost effective system than the US system as a whole, but this isn't proven by your unfair comparison.

Unfair comparison? How?

Seriously, how is it an unfair comparison? I can't even begin to understand how you came to that ridiculous conclusion.

My comparison was in two ways:

1. Government spending on healthcare per head of general population. This gives a cost per head about the same for both the UK and the US.

2. Government spending on healthcare per head of covered population. This gives a cost per head three times as much for the US than the UK.

In both comparisons I am making the point that the *entire* UK population is covered for universal healthcare.

In both comparisons, the UK figures include the very exact same demographic which you say is "most people are fairly healthy".

And at the same time, in both comparisons the UK figures *also* include the very exact same demographic which you say is "old people tend to be much less healthy than young people".

And lastly, also at the very same time, in both comparisons the UK figures *even* include the third demographic which you say is " poor people tend to be less healthy than those who aren't poor".

For the very same amount PER HEAD OF POPULATION, we here in the UK manage to give healthcare FOR ALL, *including* the demographics you say are the least healthy.

We aren't talking in absolute costs, not at all as that certainly would not be a fair comparison, but you certainly should be able to give universal healthcare for EVERYONE on the same per general head of population basis that I gave here in point 1. That does not make it an unfair, invalid or poor comparison at all.

But you aren't - you are spending that per general head of population cost on just a few demographics. It doesn't matter that those demographics are the most sick - the averages in the per general head of population figures even it out.

You are taking what we spend per head of general population and spending it on a proportion of the general population. You are taking the same per general head of population cost that we spend, and not spending on the general population.

Thats got nothing to do with the demographic requiring more care, more money, or anything.

If we can provide universal healthcare for all of our general population for the same money that you already spend per general head of population (thats a direct, 1-to-1 comparison), then you should also be able to.

But you aren't. You are still required to spend more per person - why is that?
 
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moo
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 1:14 pm

Quoting Pyrex (Reply 23):
Now tell me who is paying for the medical research.

Are there no GlaxoSmithKlines of the world?

How about Bayer? None of them around?

I can count 41 drug and medical practice research companies in Cambridge, UK alone.

Quoting Pyrex (Reply 23):
if you believe that people's life expectancy has peaked and that it doesn't make any sense to invest more money in medical research

I'm sorry, but thats just more jingoistic nationalistic nonsense.

America is not the only country that does medical research.

I also suggest you read the following article if you want to know more in depth about how much per head of population the US and UK spend on medical research. You might be pleasantly surprised...

http://really.zonky.org/?p=556
 
PPVRA
Posts: 7878
Joined: Fri Nov 12, 2004 7:48 am

RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 2:59 pm

Quoting moo (Reply 28):
I'm sorry, but thats just more jingoistic nationalistic nonsense.

America is not the only country that does medical research.

I also suggest you read the following article if you want to know more in depth about how much per head of population the US and UK spend on medical research. You might be pleasantly surprised...

Just because UK pharmaceutical companies spend $12 billion in R&D does not mean it's all spent in the UK/EU! These are, after all, multinational companies - at least the largest ones.

FYI:

Quote:
The EC-sponsored Pammolli Report has identified that years of declining incentives for innovation have eroded Europe's research base to the point where America now surpasses Europe as the world centre for pharmaceutical R&D. Over the past decade, research investment in the United States has grown by a factor of ten, double the rate of Europe and Japan.

"The medicine chest of the world used to be Germany," said Dr. McKinnell. "Now, it's New York, New Jersey and Connecticut."

American pricing is set by market forces, allowing companies to determine a price that attracts buyers, gives the company a chance to recoup research costs, sustains investor confidence, and pays for future research. As a result, new medicines are available to patients shortly after regulatory approval.
http://www.prnewswire.co.uk/news-rel...-europe-governments-153987725.html

You can find lots of other articles on the subject, some even talking about a brain drain from the EU to the US in this field. Which should be unsurprising considering the article above.

[Edited 2012-08-01 08:05:12]
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
Kiwirob
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 3:17 pm

Quoting PPVRA (Reply 21):

Funny thing about that is, Europeans pay more out of pocket than Americans. . .

You need to back this statement up.

Quoting Pyrex (Reply 23):
Go try buy some prescription drug in Detroit. Now cross the border and go buy that exact same drug in Windsor, Ontario. Now tell me who is paying for the medical research.

Simple explanation in Canada the govt subsidises the prescriptions in the US they don't, that has nothing to do with who is paying for medical research.
 
PPVRA
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 3:51 pm

Quoting KiwiRob (Reply 30):
Quoting PPVRA (Reply 21):

Funny thing about that is, Europeans pay more out of pocket than Americans. . .

You need to back this statement up.

Page 36 of the following report:

http://tinyurl.com/brbu9z7
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
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Tugger
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 4:43 pm

Quoting PPVRA (Reply 31):
Page 36 of the following report:

Point taken and noted. I think some people misinterpreted your original statement to mean the Europeans Pay more overall for healthcare. That is obviously not the case, but it is important that the consumer pay more directly for what they benefit directly from. However the European consumer has more cash available to pay directly as they pay half of what we pay here in the USA for similar (or worse) healthcare.

You are actually making even a better case for reformed healthcare, and even single payer systems that require "personal responsibility" and said responsibility is imposed or mandated.

Tugg
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. -W. Shatner
 
PITingres
Posts: 1010
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 7:35 pm

Quoting rfields5421 (Reply 26):

Quoting Jetsgo (Thread starter):
Yes, I know I can go the private route but that generally isn't cost effective...why?

That is your choice - and gives you the greatest flexability. But the reason it isn't cost effective is that your employer no longer provides most of the money necessary for the premiums.

That is certainly a reason, but very far from the only reason. Group coverage is simply cheaper than individual coverage for equivalent coverage levels; and that's making the rash and largely false assumption that equivalent coverages are even available. (In my experience, close equivalents are simply not available to the individual at any price.)

The specifics are going to vary depending on what your employer has managed to negotiate with their provider, but in general even if your employer gave back 100% of what they pay for your health coverage, you would be unable to find anything like it at anywhere near the same price individually.

The reality of the situation for the vast majority of corporate employees is that, although

Quoting fr8mech (Reply 9):
You are free to forgo your employer's insurance plan and buy one on your own.

you are also free to drive down the street and throw cash out the window, which amounts to pretty much the same thing.
Fly, you fools! Fly!
 
Ken777
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 9:54 pm

Quoting Pyrex (Reply 23):
Look, if you believe that people's life expectancy has peaked and that it doesn't make any sense to invest more money in medical research, so we might as well just make healthcare as affordable and accessible as possible, go right ahead,

Investing in medical research isn't always to extend life expectancy.

Look at investments in fighting cancer. Major efforts and achievements have been made at places like St. Jude. Children go there and the goal is to cure them while they are kids - not worrying about their health when they are in their 70s or 80s.

Breast cancer? Lots of funds on research and it hits younger women. Can be very rough for younger women. One friend lost a daughter at 27 from it. No worries there about old age.

Then there are the traditional illnesses that kill all ages.

In terms of making health care affordable without impacting research try ensuring every treatment and test is paid for at some level. That requires a medicare for all system for core care. Core care might mean a 12 bed ward instead of a private room, an intern or resident instead of the most expensive surgeon in the city.

Reality is that our medical costs have been jacked up to pay for those who can't. Take away that huge justification for high prices and you are able to pull costs DOWN. Amazing. That also means that private insurance can be significantly lower. Using Australia as a comparison employers and individuals can see private insurance prices falling 80%. That's based on comparisons when I was paying in both countries, and the Aussie policy was a far better policy.

Quoting PPVRA (Reply 25):
No, they can't.

If they can't then why does your doctor have to call 1-800-MOMMY-MAY-I? to get AUTHORIZATION for a test or treatment?

Quoting rfields5421 (Reply 26):
Employers offer health insurance to attract workers. They pay a substantial portion of the cost of the health insurance in most companies - usually a greater share if the company is very large.

Unfortunately that has been used to establish a tax free ride for people in the program. Companies deduct the cost of that insurance and the employer doesn't have to pay taxes on that income. If you look at the total money involved at the national level it's pretty clear where this tax free ride has impacted our national debt.

Reality is simple. We cannot afford that tax free ride any longer. Cut out the deduction or pay taxes on the income value of your "free" insurance.
 
PPVRA
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RE: Auto Insurance Vs Health Insurance

Wed Aug 01, 2012 11:26 pm

Quoting Ken777 (Reply 34):
If they can't then why does your doctor have to call 1-800-MOMMY-MAY-I? to get AUTHORIZATION for a test or treatment?

The answer to that is in the part of my statement you didn't quote.
"If goods do not cross borders, soldiers will" - Frederic Bastiat
 
PITingres
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RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 12:50 am

Quoting PPVRA (Reply 35):
The answer to that is in the part of my statement you didn't quote.

I sure didn't see any answer, but I suspect a mis-communication here. The doctor does not under any circumstances HAVE to get approval from an insurer for any procedure whatsoever, at least not in the US as far as I know; he or she has the option to take the (high) risk of not being paid. However, of course, many patients are simply unable to pay cash out of pocket for any significant procedure, and most doctors want to be doctors, not financiers or bill collectors. The doctor needs approval for billing purposes, not permission to do the procedure per se.
Fly, you fools! Fly!
 
Pyrex
Posts: 4080
Joined: Thu Aug 25, 2005 7:24 am

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 12:51 am

Quoting moo (Reply 28):
Are there no GlaxoSmithKlines of the world?

How about Bayer? None of them around?

There are, but even those make the majority of their earnings in the U.S. market (and so make investment decisions on what new drugs to research accordingly).

Quoting moo (Reply 28):
I can count 41 drug and medical practice research companies in Cambridge, UK alone.

And what percentage of the earnings (or the earnings potential, in the case of start-ups) comes from the U.s. market?

Quoting moo (Reply 28):
America is not the only country that does medical research.

No, they just pay for the majority of it through higher healthcare prices. The actual research is done wherever you can find people with a brain.

Quoting KiwiRob (Reply 30):

Simple explanation in Canada the govt subsidises the prescriptions in the US they don't, that has nothing to do with who is paying for medical research.

That is not the reason - I am talking about total revenue for the pharma company, whatever is paid by the government plus whatever is paid by private insurance and the patients themselves. On a per unit basis, it is still much cheaper in Canada (or most other countries outside of the U.S.).

Quoting Ken777 (Reply 34):
Investing in medical research isn't always to extend life expectancy.

Look at investments in fighting cancer. Major efforts and achievements have been made at places like St. Jude. Children go there and the goal is to cure them while they are kids - not worrying about their health when they are in their 70s or 80s.

The first statement is true but the example you give contradicts that - solving juvenile cancer does increase the average life expectancy, since this is usually measured by the average amount of time a children is expected to live if they survive their first year (given higher mortality, this statistic is usually excluded from life expectancy and included in infant mortality) and includes all types of deaths including accidental (sometimes even war). So if you manage to prevent a kid from dying of cancer at age 8 you are still increasing the average life expectancy of the population even if that same kid dies on a motorbike accident when they are 21.
Read this very carefully, I shall write this only once!
 
fr8mech
Posts: 6714
Joined: Mon Sep 26, 2005 9:00 am

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 2:52 am

Quoting Ken777 (Reply 34):
If they can't then why does your doctor have to call 1-800-MOMMY-MAY-I? to get AUTHORIZATION for a test or treatment?


It all depends on the policy and type of plan you have. My plan does not require pre-approval or authorization for any procedure the doctor deems medically necessary. Other plans available to folks at my workplace do require pre-authorization. I have a high deductible plan with an HSA, they do not. It's a choice.

I guess the insurance company feels that if I'm spending more of my money, I will make smarter, more informed choices. The corollary being: the insurance company feels that if you are spending more of their money, you won't be as careful.

Quoting PITingres (Reply 33):
you are also free to drive down the street and throw cash out the window, which amounts to pretty much the same thing.

True, but the OP was asking why he didn't have a choice in the matter, and I pointed out that he did.
When seconds count...the police are minutes away.
 
User avatar
moo
Posts: 4169
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RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 8:40 am

Quoting Pyrex (Reply 37):

What rubbish and nationalistic crap, you aren't even worth discussing with.
 
Pyrex
Posts: 4080
Joined: Thu Aug 25, 2005 7:24 am

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 12:05 pm

Quoting moo (Reply 39):

So what exactly of what I said is wrong? Are drugs not more expensive in the U.S. than anywhere else in the world?
Read this very carefully, I shall write this only once!
 
Kiwirob
Posts: 10145
Joined: Mon Jun 13, 2005 2:16 pm

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 1:19 pm

Quoting Pyrex (Reply 40):
So what exactly of what I said is wrong? Are drugs not more expensive in the U.S. than anywhere else in the world?

The consumer/end user pays more but I'm sure that's because other countries governments subsidise perscriptions, I don't believe that the actual cost of the drugs is higher in the US than any other country, if this is incorrect show me proof that I'm wrong.
 
Ken777
Posts: 9101
Joined: Thu Mar 11, 2004 5:39 am

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 4:13 pm

Quoting KiwiRob (Reply 41):
The consumer/end user pays more but I'm sure that's because other countries governments subsidise perscriptions, I don't believe that the actual cost of the drugs is higher in the US than any other country, if this is incorrect show me proof that I'm wrong.

I believe that consumers to pay more in the US. We even had the pharma industry basically write the Part D Medicare plan that made it illegal for the government to negotiate the price of drugs. Other countries (and our own VA) have no problem negotiating prices.

We also block prescription from Canada and Mexico in order to keep prices inflated here.

And, another interesting twist. When a highly profitable drug goes of patent and some company starts producing a generic version, the company who had the patent will frequently buy the generic maker in order to close down competition.

So, yes, we do pay more than other countries. The increased price is built into your health insurance and, if you have nanny care from your employer, it puts downward pressure on your salary or wage.
 
fr8mech
Posts: 6714
Joined: Mon Sep 26, 2005 9:00 am

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 7:30 pm

Quoting Ken777 (Reply 42):
So, yes, we do pay more than other countries. The increased price is built into your health insurance and, if you have nanny care from your employer, it puts downward pressure on your salary or wage.

I don't see my salary being offset by my benefits as a problem. I work for a compensation package. My salary, my benefits, my pension, my 401K are all part of my compensation.

Oh, and, assuming your model is accurate, when we have nanny care from the government, it will put upward pressure on our taxes.

[Edited 2012-08-02 12:32:48]

[Edited 2012-08-02 12:34:25]
When seconds count...the police are minutes away.
 
User avatar
Tugger
Posts: 6146
Joined: Tue Apr 18, 2006 8:38 am

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 8:15 pm

Quoting KiwiRob (Reply 41):
I'm sure that's because other countries governments subsidise perscriptions,

Actually most don't subsidize them as much as negotiate with the drug companies and basically say "If you want to sell into our market you will charge us XXX (or provide XXX discount, or whatever)". This is what the USA Medicare prescription drug benefit was specifically blocked form doing because the big pharma companies lobbied friends in congress to not hurt their cash cow (i.e. the USA consumer). There is nothing wrong with using your market power to drive prices down. And there is nothing wrong if the USA did the same as other countries.

Quoting fr8mech (Reply 43):
Oh, and, assuming your model is accurate, when we have nanny care from the government, it will put upward pressure on our taxes.

Unlikely. Costs will go down if the package is structured properly. Just as it has in every other country with a national health care plan. Ultimately if Republican's get involved and work with those across the aisle we can have an excellent low cost plan.

Tugg

[Edited 2012-08-02 13:54:03]
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. -W. Shatner
 
fr8mech
Posts: 6714
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RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 8:58 pm

Quoting tugger (Reply 44):
Unlikely. Costs will go down if the package is structured properly.


Government is grossly inefficient. How can you possible say that we will add millions to the insurance rolls and not increase our taxes? The bureaucracy required to run this thing will be bloated and a source mismanagement and outright fraud.

Taxes will go up, they have to. You can not create a new massive government program without raising taxes, unless you plan to aggressively cut other programs to offset the cost...and we know that will never happen.

Sorry, the key to reducing healthcare access costs is to allow the free market to do its thing. We need to link the cost of healthcare to the consumer and work to back the insurance companies out of routine medical care. Insurance should be used for, what it was in the past...major medical issues. If you want to buy a plan for routine maintenance, than you need to pay more. This cookie cutter approach, with state and, now, federal mandates just drive up costs with no added utility.

The polls show that Americans want this thing gone.
When seconds count...the police are minutes away.
 
User avatar
Tugger
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RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 9:05 pm

Quoting fr8mech (Reply 45):
Government is grossly inefficient. How can you possible say that we will add millions to the insurance rolls and not increase our taxes? The bureaucracy required to run this thing will be bloated and a source mismanagement and outright fraud.

Medicare has burden rate of about 2-7% (depending on which data you are looking at, even the highest put it at about 14% at worst). That is vastly lower than any private insurance system (which typically has a burden of 20%-30%).

The health insurance industry employs about 300,000 people, the entire HHS (Health & Human Svs) agency employs about 65,000. The Medicare section employs under 5,000. http://www.hhs.gov/about/whatwedo.html/

It is not a bloated or out of control agency.

Quoting fr8mech (Reply 45):

The polls show that Americans want this thing gone.
Quoting fr8mech (Reply 45):
Taxes will go up, they have to. You can not create a new massive government program without raising taxes, unless you plan to aggressively cut other programs to offset the cost...and we know that will never happen.

Yes and no. Yes, you may move something into what is called a tax that was previously borne as a commercial expense. No they don't increase the overall cost to the consumer. In fact nowhere in the world in the cost higher that what we have here. That does show that government managed systems can and often ARE lower in cost.

Quoting fr8mech (Reply 45):
, the key to reducing healthcare access costs is to allow the free market to do its thing. We need to link the cost of healthcare to the consumer

This I agree with. Fully.

Quoting fr8mech (Reply 45):
The polls show that Americans want this thing gone.

No, they want good affordable healthcare that they can access when they need it. Unfortunately it has been a full time occupation of an entire party to poison public opinion against it instead of working to actually craft something that both sides can agree to and will benefit the citizens of the USA. Just work and fix the damn thing.

Tugg

[Edited 2012-08-02 14:15:52]
I don’t know that I am unafraid to be myself, but it is hard to be somebody else. -W. Shatner
 
Ken777
Posts: 9101
Joined: Thu Mar 11, 2004 5:39 am

RE: Auto Insurance Vs Health Insurance

Thu Aug 02, 2012 9:24 pm

Quoting fr8mech (Reply 43):
I work for a compensation package. My salary, my benefits, my pension, my 401K are all part of my compensation.

And if an employer can cut his nanny care costs by, say, 80%, then your package has rtoom for growth, or your employer can use the funds to grow the business & make your position even more stable.

Quoting fr8mech (Reply 43):
Oh, and, assuming your model is accurate, when we have nanny care from the government, it will put upward pressure on our taxes.

And when you think about it there are some significant benefits to that. If your company has a rough year then their income based nanny tax is lowered, or eliminated. Far better than having to make "adjustments" in tough years, like cutting jobs or R&D investments, etc. When I lived in Australia my employers never had to include nanny costs in their budgets, or in their P&L.

So let's assume some company, especially one competing internationally, can get rid of that cost when competing. They are more competitive and generate more sales and more profits. Hard to complain about paying taxes on the profits when the shift allows them to generate more profits. That's an approach that supports private enterprise far more than politicians pushing for employer based nanny care.
 
fr8mech
Posts: 6714
Joined: Mon Sep 26, 2005 9:00 am

RE: Auto Insurance Vs Health Insurance

Fri Aug 03, 2012 1:03 am

Quoting Ken777 (Reply 47):
can cut his nanny care costs by, say, 80%
Quoting Ken777 (Reply 47):
can get rid of that cost


The cost doesn't go away...it is shifted. It goes into the increase in taxes that the same corporation will pay in order for the government to take over the nanny care.

All things being equal (my most favorite economic term), given a choice between the government handling my insurance and the for-profit corporation I work for handling it...I opt for the corporation.

Quoting tugger (Reply 46):
Just work and fix the damn thing.


Every attempt made to repeal it and replace (granted more repealing than replacing) has been rebuffed by The Senate.

Quoting tugger (Reply 46):
It is not a bloated or out of control agency.

What happens when millions more are added to the rolls? We already know the IRS (yes, the IRS) needs to hire 18,000 more agents (by the way, how many support staff need to be added to support the additional agents?). Do you really think HHS isn't going to grow into some out-of-control monster (like the EPA) when it will have the statuatory authority to touch every person in the US?

Just about 3 more months until election day and a mere 154 days until the new congress is seated and 172 days until the door knob hits President Obama in the ass.
When seconds count...the police are minutes away.
 
pilotsmoe
Posts: 241
Joined: Sat May 07, 2005 5:21 am

RE: Auto Insurance Vs Health Insurance

Fri Aug 03, 2012 1:59 am

Quoting fr8mech (Reply 48):
Just about 3 more months until election day and a mere 154 days until the new congress is seated and 172 days until the door knob hits President Obama in the ass.

You mean 3 months until Obama gets re-elected   It's gonna be pretty close, but I don't think Romney has a chance.

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