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Another Perspective
An Open Letter to My Congress People
Democratic opponents of Obamacare repeal need to face up to what government policy is doing to insurance costs.
Boulder, Colorado
Dear Senators Udall and Bennet, and Congressman Polis,
As you will soon be faced with a Republican-sponsored vote to repeal PPACA, also known as Obamacare, I’d like to offer you real-world evidence of the impact of government policy — primarily but not entirely federal policy — on the health insurance of a family you represent.
In the televised “Health Care Summit” last February (you remember, that was the meeting where Paul Ryan looked smarter, more prepared, and more presidential than Barack Obama did), President Obama said that the impact of his health insurance reform/assault would be that “The costs for families for the same type of coverage as they’re currently receiving would go down 14 to 20 percent.” Similarly, Senate Finance Committee Chairman Max Baucus seized on a narrow aspect of a CBO report to claim that “the vast majority of Americans will see lower premiums than they would if we don’t pass health reform.”
These gentlemen were both wrong — Obama spectacularly wrong — as of course they must be. After all, how could anyone claim that premiums would drop when government was piling cost after cost on the insurance companies and unwanted benefit after unwanted benefit on American health insurance buyers.
Thus, it was unwelcome but not surprising news when I learned that my health insurance premium for 2011 was jumping 17% from its 2010 levels. My insurance company, which I’m generally quite happy with, included a pretty color brochure trying to salve the overheating brows of many thousands of angry customers.
This information/propaganda included an explanation of government-required changes to the health insurance plan which increase the plan’s cost by adding “benefits” that I either don’t want or don’t need.
Some of these provisions are due to PPACA, including the ability to keep “children” on their parents’ health insurance plans until the age of 26 and the elimination of “lifetime dollar limits on essential health benefits.”
To be sure, it’s not only federal law which is raising my insurance costs. Democrats in Colorado have mandated that insurance policies cover maternity care and contraception. As you might guess, maternity coverage is extremely expensive. Given that I’ve already had a date with a scalpel, it’s extremely unlikely that my wife and I will have more children, so having to pay for insurance to cover child birth is an unnecessary burden.
As the key mental characteristic of “Progressives” is their belief that people are too stupid to make their own economic decisions, I expect you don’t understand that each of these provisions — indeed every provision of any insurance policy — should be the subject of negotiation between the insurance company and the insurance buyer. Yes, some people might want to keep their adult children on their policy and some people might want maternity coverage and some people might want unlimited potential insurance payouts, but many or most people don’t — at least not if there’s a cost.
The mandates of federal and state government are like requiring all Americans to buy a car with every possible option whereas most of us are OK with the base package, or something just above that, for much less money. As Frédéric Bastiat would pose it, Democrats have only focused on that which is seen, namely these “benefits” of coverage, while ignoring that which is unseen, namely that I now have less money available to send my children to a better school, to take a vacation, or even to pay my health insurance deductible.
As if all this isn’t enough, another provision of Obamacare makes it nearly impossible for me to change my family’s health insurance plan. If I try to change, we’re suddenly not “grandfathered” and are then funneled into the very limited and expensive choices remaining to us after Democrats shoved Obamacare down our throats. And even with a grandfathered plan, we only “may” be able to keep our plan after 2014, “when the market will function very differently and health care choices may be limited.”
We used to receive certain preventative medicine services without copayment (as the insurance company has determined that doing so saves them money in the long run), but — surprise, surprise — those provisions are somehow not grandfathered in. Of course they’re not, because the insurance company knows that you have made us their captive, all but unable to change policies or companies without running into the teeth of the growling Nanny State. We are now the insurance company’s prisoner, thanks to PPACA.
You may protest that not all of the huge increase in my health insurance premiums is due to Obamacare. While that’s true, the more important point is that the factors causing the rest of the increase are also due to government, in particular the many ways in which government prevents the functioning of a competitive market in health insurance.
You don’t allow interstate competition of health insurance, a key factor in keeping other forms of insurance, such as automobile insurance, more affordable and more responsive to customers. You tilt the playing field toward employer coverage, doing great disservice to the many self-employed and small businesses in this country. At the state level, mandates to cover everything from in vitro fertilization to hair transplants boost the cost of coverage for millions.
Soon, Obamacare will prevent insurance companies from denying coverage to people with pre-existing conditions. A brief conversation I had with my bank teller, who used to work for a large insurance company, might be instructive. When I asked her if someone who just found out he has cancer should be able to then apply for and receive health insurance coverage, she said “Of course! Everyone has the right to access health care.” After pointing out to her that everyone already does have that right and that it’s not dependent on insurance, I asked her whether someone who just wrecked his car should then be able to apply for and receive auto insurance coverage and use that to get a new car. Her response: “That’s illegal!” — followed by a clear explanation of why that wouldn’t be fair to existing policy holders. In short, sirs, forcing coverage of pre-existing conditions is not “insurance,” it’s welfare.
About the Author
Ross Kaminsky is a self-employed trader and investor and is a senior fellow of the Heartland Institute. He is the host of The Ross Kaminsky Show on Denver’s NewsRadio 850 KOA at 11 AM on most Sundays. You can reach Ross by e-mail at rossputin(at)rossputin(dot)com.
Letter to the Editor View all comments (99) | Leave a comment
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Bill Hussein O'Stalin| 1.6.11 @ 6:59AM
Your article is a great treatise on why health care costs have gone up and will continue to do so in the near and distant future.
The federal and state governments have all been busy engaging in central economic planning and all central economic planning fails for many of the reasons you note and several others.
Brian Mc| 1.6.11 @ 7:28AM
Whatever happened to the adage, "If the government tells you that they are 'here' to help, we are to run the other way"...?
"There is no such thing as a 'free lunch'."
"Those who would sacrifice their liberties to gain security deserve neither."
I'm sure that there are more quotes that apply here, but my coffee is getting cold..."submit".
Appleby| 1.6.11 @ 7:30AM
The myth about socialist medicine is that everybody will get Mayo Clinic treatment for no charge.
The reality is that most people will get third world clinic coverage for very high prices which will be paid to give the gamers and scammers Mayo Clinic coverage -- but not you.
SonOfSam| 1.6.11 @ 9:26AM
No one who voted for ObamaCare will ever have to be a part of it: they have their own separate healthcare programs. Its kind of like living in a gated community, with immunity from prosecution or accountability...oh wait, they have that too. This is why these ObamaNazi scum already understand perfectly damned right well that ObamaCare is going to raise costs: they DON'T GIVE A SHIT, SINCE IT WILL NOT AFFECT THEM.
I say, enough talk already, half of us need to bring the tar, the other half the feathers
PhilTheCapitalistPig| 1.6.11 @ 9:32AM
LMAO! Dittos, sir.
Intelligent Design| 1.6.11 @ 7:58AM
Just look at what RomneyCare has done to insurance costs in the Peoples Republic of Massachusetts! ObamaCare is already having the same result. Higher insurance premiums, higher costs for drugs, and ultimately a reduction in the quality and availability of medical care. We have the best health care in the world because of free enterprise and despite the government. But government is quickly reversing this success story. Repealing ObamaCare is only part of the solution. There was too much government interference in medicine even before ObamaCare. Private enterprise competition always results in higher quality, lower costs, more innovation, and more availability.
Ken (Old Texican)| 1.6.11 @ 8:13AM
Folks,
Please read me very carefully. The whole point of this Obamacare is quietly spinning out.
It is merely an "interim step" on the way to nationalized healthcare.
Nothing more. Nothing less.
Thank you.
George True| 1.6.11 @ 8:42AM
Thank you Ross, for explaining so effectively the damage that Obamacare has already done to every American who currently has health insurance. The criminals in congress literally locked the Republicans out of the backrooms where this abomination was being created. They refused to listen to so much as a two minute explanation of why what they were proposing would cause what has now happened. It was abundantly obvious from the beginning that what they were proposing would cause a massive rise in costs for everyone. Anyone with any knowledge of how insurance works knew this. It was also obvious that they did not care, and they were going to do it anyway, and they did not care about the consequences.
I have been in the insurance industry for 22 years. There used to be a wide variety of plans available at every price point. As recently as five years ago, there were over 30 different health insurance companies that sold individual plans here in Arizona. And most of those companies had multiple plans, from "Cadillac" plans down to basic plans. There was also an abundance of HSA plans available that were downright inexpensive. For the last ten years I carried an HSA plan on myself that had a $10,000 deductible and cost $100 a month. (Wellness benefits were included and the deductible for accidents was $0.)
The real run-up in costs began in the late nineties after the federal government imposed HIPAA requirements on every health insurance plan. A lot of individual states exacerbated the problem by mandating that certain types of coverage be included on every plan. These were things like mental health benefits, wellness benefits, minimum lifetime maximum payouts, and in some states mandated maternity benefits and even prescription drug benefits. In other words, someone who did not need or want these benefits now had to pay for them anyway.
As a result, health care providers would milk policies for these payouts. I would hear ads on the radio all the time with the message, "Are you depressed? We can help. Come on in". Then if the person had health insurance, the provider would see how much mental health benefit their policy had, give the person exactly that amount of treatment, bill the insurance company for that amount, then kick the person out the door, pronouncing them "cured".
The Dems love to demonize insurance companies, but it has always been the health care providers, NOT the insurance companies, who are driving the costs of health care. The insurance companies are just the ones stuck with paying the grossly inflated bill.
A few years ago, a friend of mine in Las Vegas needed hernia surgery. At the time he was covered on his employer group plan. He only paid a $500 deductible, but the total charges billed to his group plan were $15,000. A year later I needed the same surgery. Since my plan had a $10,000 deductible, I shopped around for the best cash price. Five different providers here in Phoenix offered me prices ranging from $2500 to $3500.
A few months ago, my same friend needed hemmorhoid surgery. He had since lost his group plan, and was on an individual plan with a $5000 deductible. With insurance, the total price was going to be almost $10,000. But as a cash customer (not using his insurance) he got it done for a total of $1500 out of pocket.
The problem of pre-existing conditions is the one most often cited by Dems as the reason why the government has to get involved. But what they did not care to hear about is that in the last few years there were already a number of individual health plans in the marketplace that would cover almost all pre-existing conditions. If the individual can show proof of creditable coverage within the last 63 days, the pre-existing conditions are covered immediately. Otherwise there is a 12 month waiting period for coverage on the pre-existing condition. The outpatient benefits for doctors visits and diagnostic testing are limited. But the benefits for the big things, such as hospital and surgery are surprisingly good. And they are affordable, with the average cost for an individual between $200-$340 a month.
These plans are far from perfect, but they represented a huge step in the right direction, and they were a market driven response to a need. But the Dems conveniently ignored the fact that people with pre-existing conditions COULD get coverage, because it didn't fit their false narrative to the contrary.
Where there used to be over 30 plans available just five years ago, there are now only about seven or eight individual plans here in Arizona. Since the passage of Obamacare and the phase in of the mandated benefits and the mandated loss ratios, premiums have jumped anywhere from 20-40%. (My own HSA plan doubled in price.) There will be more such increases this year. Insurance companies are not gouging anyone, they are simply charging what they need to in order to comply with the new Obamacare regulations, and remain solvent.
An insurance company's overhead is fixed. So to comply with the new loss mandates, there is only one area where they can cut costs, and that is agent commissions. I took a 20% cut in commissions back in May of last year, and then had that reduced rate cut again by 50% a month ago. There will probably be further cuts this year. Some might say, "Good, those insurance agents are overpaid anyway". Well, not really. There is a lot of time and effort involved AFTER the sale shepherding an application through the underwriting process, and dealing with clients claims when they occur.
In my case I saw the handwriting on the wall several years ago and I shifted my focus almost entirely into life insurance and financial products. Health insurance had gotten to be too time consuming and too much hassle for not enough money. And that was BEFORE the commission cuts.
Over the years I always saw my role as a health insurance agent as helping my clients keep it affordable. I was the ultimate health policy wonk. I was constantly researching which companies offered the best rate for a given type of coverage. Frequently I would have my clients buy a basic plan with a high deductible, then purchase a separate accident policy, and a separate policy for something else. By mixing and matching, I could usually get them close to "cadillac" coverage for a Chevrolet price. Or get them Chevrolet coverage for a moped price.
I will still do this for my dwindling health insurance client base, but not for anyone new. And I wonder how many other agents like me are no longer in the business, and thus the public no longer has the benefit of their knowledge and experience, all due to Obamacare.
The true cost of this debacle is just beginning to be felt. It will only get worse over time.
PhilTheCapitalistPig| 1.6.11 @ 9:04AM
There was no REAL world evidence that people with Pre-Ex couldn't be covered. It was just a democratic talking point to get the bill passed. Just like children and polar bears with global warming. DO YOU WANT THESE CHILDREN TO DIE?!?!?!?!?
LOL! These pricks... If I can find a friend of mine an individual plan as a diabetic, and he can afford it easily working in the kitchen at a restuarant, I don't think the problem is THAT BAD with pre-ex..
Ken (Old Texican)| 1.6.11 @ 9:15AM
George,
Thank you for that. Solid analysis.
Ross Kaminsky | 1.6.11 @ 10:32AM
Fantastic comment, George. Do I have your permission to run it (giving credit to you) on my web site and another political blog here in Colorado?
George True| 1.6.11 @ 10:53AM
Ross: Certainly you have my permission!
Steve A| 1.6.11 @ 12:55PM
George, I have been a multi-line Ins. Agent for the past 11 years. We broker through a large Health carrier that offered a variety of plans. In the past year this carrier has eliminated child only policies & cut commissions.
I have a staff of 6 licensed sellers / service people. My first year cut on the product had been 20%. Due to the new 85/15 rule, they cut me to 5% first year. I have taken the product & carrier completely off the menu. I am unable to compensate employees to sell & service the product on a 5% commission.
W| 1.6.11 @ 3:54PM
Ge9rge, agree. One of the worst "medical provider" offenders is the chiropractors. Speaking from personal experience, they will tell a person he needs lifetime maintenance car, or two years at minimum. They bill and bill for useless treatment after an auto accident or work injury where there is insurance. I know most companies have limited coverage for chiropractors, but it should be restricted even more.
W| 1.6.11 @ 3:56PM
that is maintenance care.
Diane| 1.6.11 @ 4:22PM
I work for a provider and while I agree with most of what you said, one of your points is not correct. The INSURANCE COMPANY sets the amount that they will pay for each charge and it doesn't matter what the provider charges - $100 or $10,000 - the payment the physician receives will be the same. And the amount that he/she is paid is surprisingly small. My physicians charge $2000 for a delivery, but Medicaid pays less than $300! Would YOU deliver a baby for $300? We even had to refuse to accept patients with one kind of healthcare insurance because the insurance payments didn't even cover the cost of the procedure. Yes, there are wealthy physicians out there, but most are ordinary, struggling people like you and me. Insurance PROFITS are what drive up the cost of healthcare, not the physicians.
MikeD| 1.6.11 @ 8:59AM
Keeping adult (?) children on parent's policies is similar to extending unemployment benefits: it is a self fulfilling prophesy that increases costs. Most of the countries in Europe with extended unemploymen benefits have historically higher 'institutional' unemployment. Whether the politicians want to hear it or not, it is part of the make-up of certain people to wait to the very last minute (When benefits run out.) to look for a job.
It's the same thing with 26 year old kids on mom and dad's insurance. They'll wait as long as possible to get off the gravy train. This is just one more bit of evidence of the complete ignorance/stupidity (Pick one!) of democrats. The are simply not bright enough to understand 'dynamic' models of behavior. As an example, they have demonstrated a complete inability to understand the "Dynamic" model of tax rates and their effect on tax payer behavior. They're either stupid or evil. Since they have been so consistent so long, and many claim Ivy League educations, they MUST be brilliant. (Just ask them!) So, if it isn't stupidity, it must be their deep seeded evil in their hearts. (If they had one.)
SonOfSam| 1.6.11 @ 9:32AM
Keeping the "kids" on until age 26 is a damned shell game: all it does is shift costs from one employer to another. If they really wanted to help the younger crowd, they'd let them get a no-frills insurance which only covered the things that young people really need, and not have to pay for stuff that doesn't really apply to them.
Twenty years ago, when I was 26, I didn't need arthritis medication; now I do.
PhilTheCapitalistPig| 1.6.11 @ 9:01AM
Bravo, Ross! Bravo! Well done, sir. As an analyst for a very large insurance agency, I can attest that Ross has hit the nail on the head here, and he has driven the nail thru the back of the board.
NeilBJ| 1.6.11 @ 9:05AM
There is an interesting Constitutional conundrum regrarding Obamacare.
If it is illegal to sell insurance policies across state lines, then health insurance is out of reach of federal regulation, since there can be no interstate commerce in health insurance.
But then the law that prevents interstate commerce in health insurance is probably unconstitutional to begin with.
Of course, all this is moot since our legislators ignore the Constitution anyway.
Frisbee| 1.6.11 @ 6:09PM
If Boenher is honest, then at least Congress will stop ignoring the Constitution.
But the older and more real problem is that the Supreme Court ignores the Constitution. Congress needs to chastise the Supreme Court, and reverse several rulings such as
Roe v Wade: right to privacy does NOT trump the right to life.
Kelo vs New London: eminent domain is NOT validly invoked for private interests
PhilTheCapitalistPig| 1.6.11 @ 9:14AM
One last thing.. I will promise you this, if ObamaCare is not repealed, and Obama is re-elected, then you can kiss Employer paid benefits goodbye. Ken(Old Texican) is right. The Benefits are becoming entirely too expensive. Companies are having a hard time paying for them now. and the ONLY reason they are still offering them is that there is still hope that this can be repealed. I WILL PROMISE YOU THIS, the private benefits market will collapse if something isn't done. And what's left? That's right, the govt plan. Don't think this is being done by accident. Soft, slow tyranny is nothing more, nothing less than TYRANNY! If this class of incoming congressman don't walk the talk, it might be time to show up in DC with (modern-day) pitchforks...
Jack London| 1.6.11 @ 9:15AM
Our premiums more than doubled from about 1999-2008 - did anyone see theirs go down?
I guess selling health insurance from South Dakota like credit cards will make us all feel good.
SonOfSam| 1.6.11 @ 9:36AM
And I suppose that a trillion dollar government forcing you to buy healthcare coverage from a billion dollar insurance company will make premiums go down? Look, oh foolish one: if I own all the McDonalds in the country, and I get Congress to pass a law mandating that EVERYONE must eat at McDonalds at least once a day, the price of fries and Big Macs is going UP, not down.
But that's right, don't listen, just cover your eyes and ignore reality. Have another hit off the bong, dumbass
George True| 1.6.11 @ 10:04AM
"Our premiums more than doubled from about 1999 to 2008."
Why do you think that is, Jack? What do you think caused that?
I can assure you that health insurance companies are not making a greater profit margin than they were 10 years ago. Many of them have gotten out of health insurance altogether, concentrating on other lines of insurance with less risk and more profit.
So who is responsible for the increase in premiums, Jack? The health care providers, that's who. If you had read my comments above, you might understand that the providers are charging insurance companies five time more than they charge cash customers.
What makes you think a government takeover will bring down costs? Such a thing has never happened. Government involvement always raises costs. Why is it that the cost of virtually all other consumer goods and services has come down over time? (Hint: Because the government was NOT involved.) A $5000 flat screen TV seven or eight years ago is $500 today. A $2000 Toshiba laptop five years ago is $500 today. A $15,000 car ten years ago is still $15,000 today even with inflation, and it's a much better car. A $1500 Lasik eye surgery five or six years ago is now $500 per eye. And a $15,000 inguinal hernia surgery billed to insurance is $3000 to a cash customer.
The solution to bringing down health care costs is to get federal and state government completely OUT of it altogether.
Jack London| 1.6.11 @ 11:07AM
Yes George, I'm well aware that the cost drivers come from the providers. What you overlook though are obvious points.
The latest drugs and technology and would be even more ruthlessly marketed without government oversight. By the time 'prices come down over time' we're onto new things in medicine. In any case, comparing commodity type procedures like Lasik with what we are facing is just not on - much of healthcare is complex and multidisciplinary/factorial.
Then of course the one organisation able to bring down prices is the giant buyer - the government. Why do you think drugs cost less in Europe?
And an absolutely key point is overconsumption. We can get costs down now by a concerted education program and effectiveness drive. For example, we need to tell people that all those CT scans are not only unnecessary but harmful too. The list of overtreatment is endless.
George True| 1.6.11 @ 11:31AM
You refuse to see that which is right in front of your face. A government monopoly cannot possibly bring down costs. Again, such a thing has NEVER happened. It sounds good in theory, but in the real world it has never worked.
The 100 smartest people in Washington, DC are not one one-hundredth as smart as thousands of providers and insurance companies marketing their products to cost-conscious consumers, and tens of millions of consumers buying policies and services that best fit their individual needs.
Just like Lasik, all health care services are commodities. If real competition in the marketplace were allowed to take place, providers would be competing for our business, and we would be getting hernia surgeries for $3000 instead of $15,000. Then our insurance plans would revert to being just that - insurance. Do you really not understand that?
Imagine if, due to a truly free marketplace, health care costs came down just 30-50% over time. Imagine at the same time, insurance companies were not penalized in the form of mandated loss ratios for making good business decisions. Imagine that insurance companies were free to tailor health insurance plans to what people needed and wanted, instead of what was mandated by state and federal government. We would see health care providers making their services more efficient and streamlined, the better to attract their share of business in a truly competitive marketplace. Insurance companies would see losses decrease and profits increase. Like the health care providers, they would want to attract their share of business in a competitive environment, so they would begin offering even better benefits, or lowering premiums, or some combination of both. There would be an abundance of highly affordable policies that offered people what they NEED, if not necessarily everything they WANT. Like other forms of insurance, those who were willing and able to pay more could get richer coverage.
This is the only way costs will ever come down. Any government "solution" is pre-ordained to failure.
Jack London| 1.6.11 @ 12:32PM
Sorry George but this is mystical nonsense. As you well know there can never be a free market solution for seniors, so a massive part of healthcare insurance will be managed by government, which affects everything else. Second, private companies exist to make profits for shareholders and without regulation will simply leave unprofitable people without cover, as they have been. Third, dividing the population into ever more smaller pools of difference to cater for 'need' just adds enormous overheads and complexity and is simply never going to work.
And where does the magical supply of physicians come from that are going go work for lower fees? Who's going to pay to train the hospital residents? How do you get rare and less profitable parts of medicine catered for if profit is the only incentive?
Finally, let's look at some different examples. How would a woman with breast cancer buy a multidisciplinary cancer team over weeks and possibly years as a 'commodity' item? Likewise, someone with diabetes? People who can't travel far?
George True| 1.6.11 @ 1:54PM
"private companies....without regulation will simply leave unprofitable people without cover.."
So your solution is to saddle the insurance companies with so much risk, and with so much loss, that the only way they can remain solvent is to double or triple premiums for everyone else?? Wow, that's some solution, Jack.
"Dividing the population into ever more smaller pools of difference to cater for need just adds enormous overhead..."
You could not be more wrong. If insurance companies were allowed to offer stripped down policies that were affordable, it would cost them very little in extra overhead to do so, and people would buy them in droves. (Of course, the current mandated loss ratios would screw it all up.)
"Where does the magical supply of physicians come from?"..."Who's going to pay to train the hospital residents?"
The private sector, same as now. But your all-knowing, all-powerful government system will take most of the potential profit right out of it, and that is what will really diminish the supply of doctors. Even taking reduced fees for cash customers, there is still plenty of profit in it for doctors. But not if the government gets their way.
As mentioned earlier, there are already affordable plans out there for people with pre-existing conditions. No, they do not cover everything. But perhaps these people need to be carved out of everybody else's health plans, and put into these guaranteed issue plans. If the plans don't cover enough, then we can talk about a government funded high risk pool, or a government subsidy to the provider or health insurance company to provide additional coverage for those individuals. These are, in fact, some of the entirely workable solutions that the Republicans proposed, at the same time that the Dems were spouting the lie that the Repubs had no solutions.
You act like you are some kind of expert in health care and health insurance, but you really have no experience or in-depth knowledge at all in these areas. You have read a few magazine articles, and you buy into the socialist paradigm of Obamacare, and you thus deem yourself to be some kind of expert. In reality, you know less than nothing about these things, because pretty much everything you think you know just isn't so.
Steve A| 1.6.11 @ 2:20PM
George, I beg to differ on your opinion of Jack. He is an expert. He is able to correctly predict that if you take a person with no coverage & an enormously costly pre-existing condition, add a government mandate that an evil insurance company must take on the new risk & compensate for all of the inevitable treatment. Pay for this treatment from the reserve pool of funds that are collected from premiums. The net result is that everyone's cost would go down as ......oh, never mind. Perhaps I need to re do the math on that...
Jack London| 1.6.11 @ 3:02PM
What about the point about covering seniors George? Lost your tongue there.
"Stripped down policies' - you mean like those limited benefit plans that pay out a max $1000 a year? Why should anyone have less than decent coverage due to doing a job that you don't value?
You've not answered my other points about cancer care, and you've admitted that:
'we can talk about a government funded high risk pool, or a government subsidy to the provider or health insurance company to provide additional coverage for those individuals.'
Wow - real cool free market thinking.
And as a resident of Arizona I do hope you're writing to Jan Brewer to say you're disgusted that she's letting your neighbors die through lack of transplant funding. Don't leave it too long though - there's another 90 or so on death row. Or is that the free market?
George True| 1.6.11 @ 3:48PM
You continue to ignore the evidence, and then attempt to change the topic, like leftists usually do.
You never answered my question: Why do you think your premiums doubled over the last ten years? What do you think caused that?
Here's another question: What makes you think government can bring down the cost of anything? It never has before.
Here's yet another: Do you think mandating full coverage for pre-existing conditions and mandating 85% loss ratios is fair? I'm sure it's more than fair to the people who would most benefit from it, but do you think it is fair to triple the premium for healthy people? Is it fair to insurance companies who have done a good job of keeping costs and thus premiums low to mandate that they lose money from now on?
I did not say everybody would be best served by a stripped down policy, but many would be, if it meant it were more affordable. Different strokes for different folks. Why don't you want people to have a choice? Myself, I would rather have options, and not be forced to pay for coverages I don't want and would never use. By the way, I have never heard of a health plan that pays a maximum of $1000 a year, but I would certainly advise against such a plan if one existed. Another red herring, Jack? What about cancer care? All the plans I deal with cover it.
Conservatives have acknowledged all along that for the most seriously ill (who don't already qualify for Medicaid) there is a role for a government subsidized program. (You lambast me now for not being 100% free market? That's rich.) But there is a right way and a wrong way to do it. The 100% wrong way to do it is to screw everybody else's health plan in the process, which is what Obamacare does.
"What about the point covering seniors...?"
We are not talking about Medicare here. We are talking specifically about Obamacare. Way to shift the topic.
And as it so happens, I don't much care for Jan Brewer. She raised the state sales tax 15%, and enacted a 3% sales tax on groceries where there previously was none. As far as AHCCCS limiting transplants, here's a news flash for you. People on transplant waiting lists were dying before this happened. My understanding of it is they will no longer provide transplants where the likelihood of success is poor. Such as not transplanting livers into people who have Hepatitis C, and not doing non-family bone marrow transplants, which have an almost 100% failure rate.
But, if this really upsets you, they who are you so all gung ho in favor of Obamacare? Because too much medical need chasing too few dollars in Arizona's state-run Medicaid plan is just a microcosm of what you will see with Obamacare.
Jack London| 1.6.11 @ 4:42PM
A few points -
Obviously we have to have a mandate to make insurance work. That's what makes it fair.
Thanks for your acknowledgment of Medicare and government subsidy. This means that there is no 'free market' given the huge impact of Medicare (which by the way funds a lot of resident training).
Have a look at the 'plans' offered by Walmart and McDonalds to see how little they pay out.
Premiums have doubled largely because of runaway overuse of treatment - that's a point you've failed to address.
As for cutting docs' pay, people like you complain bitterly when Medicare prices are deemed low, yet you trumpet slashing costs by offering cash.
Even if 80% of current health plans are liked by people (and as I posted before, within this there are many actually unhappy about aspects), 20% of unhappy Americans is an awful lot of people. Far too many people have wasted too much of their lives (and some paid with their lives) doing battle with insurance companies.
By the way, who said:
'Of all the forms of injustice, inequality in health care is the most shocking and inhumane.'
And as for Arizona, who are you to say 1 week of life extra isn't priceless to that person? I take it you recall this argument about 'death panels'.
George True| 1.6.11 @ 4:46PM
Go to the end for my reply, because these narrow columns are getting way too long(in distance).
LeoInTheWoods| 1.6.11 @ 12:30PM
You overlook something that's plain as the nose on your face, too, Jack.
Government regulation/oversight is arbitrarily applied, creating an uneven playing field for anyone in competition, be they carriers or providers. Many companies are getting individual waivers from having to comply with Obamacare mandates. Why?
We should have learned a lesson from the results of Bill Clinton's waiver from PUHCA compliance for ENRON. Along with the perceived benefit of oversight and/or regulation, out politicians need to have lattitude taken away from them to prevent disaster.
George S| 1.6.11 @ 4:00PM
Government as the only buyer will not lower the cost of drugs without the supply of drugs being reduced; it would take a treatise on economics to prove it. In short, the government being the only buyer is, in effect, a monopsony. To put it simply, a free market business has a labor cost and a marginal product revenue. The cost of labor is the wage and the amount of labor performed. The marginal revenue of a product is the additional revenue with each unit of labor employed. The MRP decreases as each unit of labor is added because the margin is swallowed by the labor cost. To maximize profits, the wage and labor has to equal the demand of the product. Once that is reached, extra work or higher pay results in a loss, i.e., that tells the producer to stop hiring OR where to cap the wage.
To understand a monopsony, you have to understand that the cost of labor and the labor wages are two different things. The marginal cost of labor factors in overhead, benefits, taxes and regulatory costs and represents a higher cost to the employer than just salary. So a monopsony will maximize its profits not when supply meets demand but when the margin of selling one more product meets the cost of labor. Therefore, the worker eats his own cost with a lower salary or less hours worked. This is why monopsonies are inefficient -- the labor to produce additional products is curtailed (supply not meeting demand) and the worker gets less wages in proportion to the marginal revenue produced.
With the government as the only drug buyer, the drug companies are essentially monopsony workers. Since government has no marginal costs associated with making drugs, the marginal cost is steeper, thus maximizing "profits" at a much lower "wage" and "productivity". Which means that the drug companies are not going to be compensated to cover their costs and will work less (that is, drugs won't be coming off the assembly line as fast).
The monospony model is what progressive economists use to justify the minimum wage. They think that business are underpaying because they reach the marginal cost and keep the difference from worker's salaries. So increasing the wage by law would force businesses to pay at the demand equals supply rate. But they fail to realize that businesses are already doing that and that increasing the wage forces a cutback in labor to line up with (if you're still with me) the marginal product rate.
Jack London| 1.6.11 @ 5:02PM
I appreciate the tutorial - no really as I hated the econ I had to do in college. But I do know a fair amount about sales and marketing. What's missing here is that buyers have to justify the prices they pay in terms of value, more so than ever now. Bigger entities can usually negotiate bigger discounts because they are buying more, or they may deem the value to have a ceiling (which I believe is the much derided NICE model in the UK). Except from what I've read it works - drug companies have dropped prices to meet the government buyers in the UK and Europe, or offered deals. The marginal cost of running out some more drugs is tiny - so it's surely in the companies interest to supply more not less to increase sales.
And I doubt you're going to tell me that the drug companies are hurting, given the massive amounts they spend on marketing.
George True| 1.6.11 @ 6:57PM
He just explained to you why it won't work, you acknowledged that he knows more about it than you, but you then declare that it WILL work? Even without knowing anything about it, you still have all the answers. Gosh, I wish we were all as smart as you.
Old White Guy| 1.6.11 @ 5:51PM
"Why do you think drugs cost less in Europe?" Well I think they cost less because they were developed and tested in America, and the American consumer bears the cost of the newest products. The pharmaceutical companies need to expand their market in order to make a profit on a drug which might have cost billions to develop, so they also market to other countries. Also, a number of the latest drugs are not available in other countries - too expensive for nationalized insurance.
PhilTheCapitalistPig| 1.6.11 @ 9:22AM
RE: Jack London
Remember, Financial decisions are made proactively by insurance companies, so even though the bill hadn't taken effect in fiscal year 2009, they still knew it was coming. That's why we're seeing 40-50% increases over the last two years. Premiums are nothing more than a reflection of costs for the group. I am POSITIVE that the last two years huge increases are a result of ObamaCare.
Here's a couple of quicktips though to keep your group's insurance cost down.
1) stay away from urgent care centers/ ER as much a possible. Always go to your (In-Network) regular doctor.
2) Always use generic medications when it is possible.
These two things alone could lead to a decrease in premiums next year if not many people in your group are aware of this.
Conrad Spiracy| 1.6.11 @ 10:13AM
Phil,
You are correct that costs have gone up prior to implementation, but do you know why? The costs have not yet hit, so there is not yet an impact to the bottom line.
The reason is that monstrosity that you can call the Sarbanes-Oxley Act of 2002, SarbOx, or SOX. That act alone, by many analysts estimates, cost corporations over $2.5 B in the first year of regulation. Costs have only skyrocketed since.
SOX requires that, if a company sees a future impact to their bottom line, they must put that on their Balance Sheet in "THE QUARTER IN WHICH IT IS DISCOVERED" not the quarter in which it is realized. When ObamaScare was signed, hundreds of companies had to report their losses, including insurance companies, and so to remain solvent, costs HAD to rise.
As an IT Risk Manager and Certified Information Systems Auditor for a major financial corporation, I can say that the rising costs prior to the disaster are only a harbinger.
Con Spiracy
EXCELSIOR!
Conrad Spiracy| 1.6.11 @ 10:16AM
pp2:
Costs for SOX compliance have only skyrocketed since.
PhilTheCapitalistPig| 1.6.11 @ 10:29AM
I'm perfectly fine with SOX regs.. In fact I think its important that Accounting regs are in place so that companies don't account for profits that will hypothetically take place 20 years down the road in order to drive up stock prices.
What I don't like is when Bureaucrats in washington write legislation to revamp an entire industry when they don't have a clue how it works. If they do know how it works, then they are intentionally destroying the private market with these mandates. And to be perfectly honest, I believe that is the case.
What is causing costs to skyrocket is primarily the 80%/85% mandatory loss ratios on small/large group plans. Insurance Carriers don't have the option to lose money on accounts anymore. Its either make too much, and return the excess profit to the group, or make a profit that is deemed exceptable by the dicks in DC. It used to be that insurance companies would lose money on groups and make money on others. In the long haul, it balances out. This is the concept of subsidizing the sick, and thats how insurance has always worked, but not anymore thanks to people running the U.S.S.A.
PhilTheCapitalistPig| 1.6.11 @ 10:31AM
*acceptable not *exceptable
jgo| 1.6.11 @ 10:02AM
Why not save us from 3 in one stroke and repeal Obamacare, Medicare and Medicaid at the same time?... and balance the federal budget in the bargain.
PhilTheCapitalistPig| 1.6.11 @ 10:30AM
LOL! Some say I'm a dreamer... but now I KNOW I'm not the only one. :D
Goldwater Girl| 1.6.11 @ 10:16AM
I have managed employer-sponsored health plans for the last 20 years, and I can tell you, there is nothing in the HCR bill that addresses the actual cost of healthcare. In fact, I would argue that governnment mandates are a huge driver of the healthcare trends we see. This is not going to change with Obamacare, in fact, they add more mandated benefits. The Democrat congress approached this bill with the base assumption that the main problem with healthcare costs is the obscene profits made by Insurance companies. I call BS on that one. If this were true, why is it that self-funded plans experience the same claim trends as fully-insured plans? Health insurance was never meant to be a maintenance plan, but rather to protect you from the financial risk of a catastrophic illness/accident. When HMO's came on the scene in the 80's, in order to lure members, they offered low copays for all services. This eventually led to the same benefit expectation on the traditional PPO plans. If you really want to have an impact on healthcare spend, then we need complete transparency with provider costs, the ability to compare prices and health outcomes(this is possible), and force everyone into a high deductible health plan, where people have skin in the game. If you know that you are going to be responsible for the first $5000 in healthcare costs, you are going to spend more wisely, and you will also take better care of yourself. The health plans available now are the equivalent of buying auto insurance that covers oil changes and car washes. Would you file an auto or homeowners claim for $100?? Why do you expect that a health insurance plan should pay for everything?
PhilTheCapitalistPig| 1.6.11 @ 10:22AM
Bravo, Goldwater Girl. You just smacked that one right out of the park!
Frisbee| 1.6.11 @ 6:20PM
Great insights GoldwaterGirl:
How much cost goes into the doctors' malpractice insurance, which I assume has been affected by the trend in rising punitive damage awards?
Myself, I think that punishment should be punishment (incarceration, the lash, whatever). With big cash punishments, sure somebody is punished, but the problem is also that somebody is rewarded (the lawyers). The punitive damage culture has fueled an industry of trial lawyers.
Mimi| 1.7.11 @ 7:22AM
We need to go "BACK" to hospital only plans! Al the rest of health-care would be "MARKET" prices....The cost would go way down. The care in 1979 was better than now,,ie quicker diagnosis etc. The care in the 50's was cheaper and better...and rarely did people have so called HEALTH-INSURANCE ie bill for 5 days at a maternity hospital ( for mom and baby) was about $110.00 . What would happen if EVERY person in the country quit their HEALTH-INSURANCE on the same day and at the same hour?. In the 50's people earned 5-8 thousand a year.... the local Dr. up the street charged 5 bucks ! We should go "OUT OF POCKET"
A. C. Santore| 1.6.11 @ 10:17AM
Thank you, Mr. Kaminsky.
I hope you don't mind that I FAXed your letter (full credit to you and AmSpect, of course) to my Progressive Senator.
No, correction, he's definitely not "MY" Senator. I don't know whose Senator he is, but he's not "MY" Senator. He's never voted for anything of any importance that was good for me and the people.
I have no doubt that he will not read it, so it's not even a matter of "hope springing eternal." It's a matter of doing what I can, even if it's just banging my head against the wall.
Again.
Pete| 1.6.11 @ 10:36AM
The stooges in Colorado could care less what the people think as they are progressive radicals, and, like the Mocha Messiah, see themselves as rulers and not representatives. What's more, they don't have to fear elections either based on this past November. Between incorrigible front range hippies, daily arrivals from failed state CA (hell bent on harvesting what's left of our prosperity organs), and a voter fraud infrastructure that stole the recent senate election overnight, what's to worry about? I hope Texas doesn't get too overcrowded as the liberal locusts from the coasts start to invade other formerly prosperous places.
Ross Kaminsky | 1.6.11 @ 10:39AM
To all who have commented on my article (so far), I just want to offer an early morning "thank you."
When I wrote the piece, I actually said to my AmSpec editor (Wlady) that while I didn't necessarily think it was my best writing, I thought that it made a point that would resonate with "real people". I meant that I aimed to be writing a real-world story rather than philosophy (such as my recent piece about positive versus negative rights.) Thus, I was a little worried that you guys wouldn't enjoy this note since you might be used to something different from me and in part because I'm personally a little skeptical of the "open letter" format.
So, your thoughtful and appreciative comments have really made my day.
All the best,
Ross K
Chris| 1.6.11 @ 1:28PM
I enjoy all your columns Mr. Kaminsky. However I would like to make two observations. First, you forgot tort reform, which would save hundreds of billions per year. And secondly, I admire your good faith letter, but the Democrats (in particular Obama and his cohorts) are not operating in good faith. The healthcare reform has nothing to do with healthcare or reform. It is but a step on the long road to full socialism, which is what I believe is the real goal of Obamacare. If I am wrong, please enlighten me as to how Obamacare could in any way improve healthcare. It's not about health for the ignorant masses, it's about control of the ignorant masses...
Frisbee| 1.6.11 @ 6:24PM
Ross: Thanks for the article, and for joining us in the comments. You should have your surgery reversed (whether it's covered or not).
DLM| 1.6.11 @ 11:52AM
We always appreciate your writings Ross, for those of us here in the Boulder area, it may be worth buying you a cold brew sometime as a thank you...
Pete| 1.6.11 @ 11:58AM
Amen. I am in.
Ross Kaminsky | 1.6.11 @ 8:53PM
I'm in too!
let's work out the details.
my e-mail is rossputin(at)rossputin(dot) com
Ross Kaminsky | 1.6.11 @ 8:53PM
I'm in too!
let's work out the details.
my e-mail is rossputin(at)rossputin(dot) com
Peggie| 1.6.11 @ 12:44PM
This is a great article! It's chock-full of common sense!
David| 1.6.11 @ 1:52PM
Good job Goldwater Girl. Whenever a government places mandates on those who own things and create jobs, you get less of it, lower quality, and things get more expensive.
I recall in the mid 70's when the federal government mandated that over a 3 year period all restaurants would have to pay time and a half for hourly employees more than 40 hours per week.
Sounds great, doesn't it? Sure - make the owners pay the less educated and lowest income earners time and a half. But, it didn't work that way. Most of those workers at the time worked 6 days at 10 hours a day, or 60 hours per week. I recall as a teenager living at home working side-by-side with grown men with families who were more than happy to work 60 hours per week. They had decent cars, lived in decent housing, put good food on the table, could buy their children new (although discount store) clothes when needed, etc. Despite living paycheck-to-paycheck, they were HAPPY.
So, the first year of the fed government's gift of overtime to the poor, the fed demanded that time and a half be paid after 48 hours; the second year it was after 44 hours; and the third year it went down to 40 hours.
What were restaurant owners to do? They hired mininmum wage workers pick up the extra 20 hours that the more well-paid cooks had been working. While the owners were happy to let the better paid cooks who worked 60 hours, much of it by doing easy prep work (chopping salad, breading fish, etc.) were not going to pay the better paid cooks time and a half for that extra 20 hours.
I watched as those fine men received about a 20% paycut in wages the first year of the fed's grand plan to help them, and after the 3 years had were earning 33% less than they had when the fed had butted-out and allowed them and their employers to work and pay them for 60 hours a week. Once happy men were now miserable and struggling to provide for their families - and all because of the fed's GOOD INTENTIONS.
As has been noted, "when the government comes along saying they are here to help" - it ain't so.
Frisbee| 1.6.11 @ 6:45PM
David: very interesting insights. I happen to like rules like mandatory overtime, but it should not be the Fed doing it.
Intelligent Design| 1.6.11 @ 3:42PM
The real agenda of Obama and his fellow Demo Socialists is to make as many people as possible dependent on the government for medical care (and many other things). Their goal is socialism, as in the Union of Soviet Socialist Republics, aka USSR or CCCP in Russian.
What we need is complete privatization of health care, which is exactly the opposite of the direction the Demo Socialists have taken us. Free market competition and individuals taking responsibility for their own health care are essential. We don't have a health care crisis, but we do have a health crisis. More than 50% of all people receiving medical care at any given moment are doing so because they have abused their own bodies with cigarettes, over-eating and poor diet, drug and alcohol abuse, and lack of exercise. Who should pay for their care? The taxpayers, not.
Frisbee| 1.6.11 @ 6:47PM
Yes, it was definitely mostly a power grab. Obama doesn't care what works or doesn't - as long as the FedGuv takes over.
ONTIME| 1.6.11 @ 3:48PM
Everyone remember the mud flap with Yosimite Sam on it? Well the real Republicans and Conservatives with the help of the Tea Party need to stand-up to all this nation wrecking policy and agenda and say what scowling Sam says, "BACK OFF SUCKER!"
wbheff| 1.6.11 @ 3:55PM
For "Jack London" who asked, "Why do you think drugs cost less in Europe?" I respond with another question, Why do you think so few new drugs are developed in Europe?
Jack London| 1.6.11 @ 4:48PM
Interesting point. The way I see Europe is a lot of countries most of which are much smaller than the US, which has a number of large federal institutions that fund a lot of research (NCI, NIH, DoD etc). As a single market, the US is also obviously a massive target, but we consume way too many drugs here and a lot of the new ones developed by pharma either are marginally effective or me-toos chasing the big diseases while others get almost totally ignored.
George True| 1.6.11 @ 5:55PM
If you were running a pharmaceutical company, and you were contemplating spending tens of millions of dollars developing a new drug that could help 30,000 people or one that could help 3 million people, what would you do?
Jack London| 1.6.11 @ 6:21PM
Well right. But we may not need another me too drug marketed to hell and back. That's where your free market falls flat on its butt.
George True| 1.6.11 @ 7:01PM
The free market produced every drug known to mankind. I am not aware of a single one that was produced by government.
Jack London| 1.7.11 @ 10:53AM
No - many drugs have also been developed in academic and institutional settings.
And the point, which you ignore, is that the 'free market' is likely to produce many drugs we don't need, rather than ones we do.
Redstateboy| 1.6.11 @ 4:15PM
If anyone is dumb enough (and this would seem to be a majority of the Democrat base) that 1 Party - the Democrat Party - could produce a 2013 page Law that would lower overall Healthcare costs; then they are obviously too stupid to vote.
Frisbee| 1.6.11 @ 6:49PM
Ha!! LOL! A 2000 page document of cost lowering regulations! Well said Redstateboy.
Redstateboy| 1.6.11 @ 4:19PM
on occasion you do see Liber-uls posting comments on TAS but you Never see them posting when a topic is written employing irrefutible facts, logic and common sense.
George True| 1.6.11 @ 5:43PM
In response to Jack London's last comments about a third of the way up:
Medicare and Obamacare are entirely different issues. Yes they are linked, and yes, Obamacare will rob Medicare of 100 Billion dollars a year in benefits to subsidize Obamacare. But they are still separate issues. The issue we are discussing here today is Obamacare.
How much or how little group health plans offered by WalMart or McDonalds pay out is irrelevant to our discussion. But I can guarantee you that with Obamacare, such plans will cost more and pay out less as time goes on. It cannot be any other way. Eventually, such companies may decide not to offer a group plan anymore. So much for "If you like your current plan you can keep it". That promise is only good until it gets so expensive either you can't afford to put your family on it or the company decides to cancel it.
"Premiums have doubled because of runaway overuse of treatment."
That is ONE of the reasons. And one of the main reasons for over utilization is doctors practicing defense medicine. And Obamacare did not address tort reform. And the reason the Dems did not want to address tort reform is because trial lawyers did not want it and they are a main Dem constituency. Politics as usual, Jack.
Other reasons for the run up in premiums are inflation of the dollar (32% over the last ten years) and increased cost shifting providers inflating prices billed to insurance to make up for underpayments elsewhere). Neither of these is the fault of insurance companies.
Your suggestion that it is just fine to jeopardize the quality, affordability, and ultimately the availability of 80% of people in order to satisfy the 20% who are not happy is unconscionable.
"Of all the forms of injustice, inequality of health care is the most shocking and inhumane."
Really, Jack? Really??? I can think of a number of other things that happen all the time in this country that are far more inhumane. Innocent people being falsely prosecuted and imprisoned is pretty high on my list. The government driving entire industries out of business and causing grown men in their 50's and 60's to no longer be able to feed their families is right up there too. Inequality of health care, in the grand scheme of things, is not that high up on the list.
Besides, your implication that poor people in this country don't have access to world class health care is false on its face. As part of my work with prison ministries, I helped a woman in her 50's who was released from prison in late 2009 get back on her feet. She did not qualify for disability because she had never worked in her life. She needed valve replacement heart surgery and a lung surgery and she needed it right away. She got the surgery from a truly world-class surgeon, and a month later got the lung surgery. All told, well over $100,000 worth of care, and nobody ever even asked her to pay a dime.
As far as the Arizona transplant situation, there's your death panels for you. You libs are the ones who screamed that no such thing would happen. But when there is no money, such things will indeed happen, with a state run program. Obamacare is just Arizonacare writ large. Death panels as far as the eye can see. You likee?
Jack London| 1.6.11 @ 6:15PM
I'm out for dinner now but briefly:
- Tort reform has been shown it will make only a small impact
- We are not just discussing Obamacare as the questions are about the entire system.
- a system that's failing millions of Americans (eg 20%) is not a worthwhile system
- Martin Luther King was speaking at an international medical convention. You can imagine that in Africa many poor people die for lack of care. You should also be aware that the US has the worst inequality of the West - eg: 'A woman who lives in the South Bronx region of New York City, where the population is 95% Black or Hispanic, and very low income, has a 20 times greater chance of dying of the complications of diabetes than a woman living in the higher income Upper East Side of Manhattan.'
http://www.ncbi.nlm.nih.gov/pm.....MC2464852/
- An anecdote of one does not extend to a population of 310 million
- George - are you seriously telling me that private insurers would take on these transplant patients?
W| 1.7.11 @ 12:03AM
Tort reform would definetely lower the cost of malpractice insurance which should lower medical fees, and reduce tests done solely to "cover your ass." If you want a real life example of tort reform, look at the lawsuits for personal injuries against governmental units, such as cities, counties, states,etc. The laws of every state limit the amount of damages for pain and suffering, usually to$250,000 or $500,000. That limit was set because the taxpayers pay for those awards, and the limits are set to keep costs down and not have tax increases to pay awards. The same or similar limits in malpractice lawsuits are reasonable, they are reasonable for the government because the taxpayers ultimately pay the bill. In the private sector, the awards are paid by insurance companies that then raise premiums to pay the awards. Again, we who work and pay taxes and insurance premiums pay.
Tackspitter| 1.6.11 @ 6:45PM
Ross the obvious question is will they read even your letter?
Ross Kaminsky | 1.6.11 @ 8:54PM
Rep. Polis will definitely read it because he's a friend of mine. Another friend of mine knows Sen. Udall, so I hope he'll read it. I doubt Bennet will read it but so what... ;-)
George True| 1.6.11 @ 6:49PM
Tort reform in and of itself would indeed make only a relatively small difference. But the point you are missing is doctors no longer having to practice defensive medicine as a result of tort reform would save tens of billions every year.
You are once again taking the discussion down the rabbit hole by bringing up a claim that MLK made some 50 years ago. I question whether it was true then or is true now, but in any case it is irrelevant to our discussion.
Next, private insurers do indeed cover transplants for their insureds. As for the people in Arizona who may be denied a transplant because the Arizona state run Medicaid program is out of money...again, there's your government run program for you. I read an article about the people who are having to make the decisions about who will and will not get a transplant. I would not want to be one of the people having to make such a decision.
Again, there is a real life example of a death panel that is making life or death decisions right now as we speak. And this is what you want for the entire nation? Because just as surely as the sun will rise tomorrow, this will be the end result of socialized medicine. What makes you think it will be otherwise?
Jack London| 1.7.11 @ 11:33AM
The cost of defensive medicine is overblown.
'The total cost of medical malpractice-related costs to the health care system, including defensive medicine, is about $55.6 billion per year, or about 2.4 percent of annual health care spending. Defensive medicine is about 80 percent of that total, the researchers found.'
http://www.npr.org/blogs/healt.....-after-all
Your refusal to discuss health inequalities essentially invalidates anything you say as this is the issue that underpins the entire reform agenda.
Private insurers are not going to take on uninsured people on transplant lists George. If we don't fund their procedures, who will? That's an America free market death panel if we don't.
George True| 1.7.11 @ 9:47PM
For the third time: If you don't like transplant patients being denied then why are you so gung ho for Obamacare? Under Obamacare, transplants are just one of many life-saving and life-extending procedures that will routinely be denied. That is the nature of a government run program. Again, death panels as far as the eye can see. Whatsa matta, you no likee?
Jack London| 1.8.11 @ 12:31PM
'death panels as far as the eye can see'
And I thought you were more sensible. Shame.
Frisbee| 1.6.11 @ 6:54PM
"But the point you are missing is doctors no longer having to practice defensive medicine as a result of tort reform would save tens of billions every year."
Well said George.
Nite| 1.6.11 @ 9:55PM
The liver transplants in Arizona were to be for individuals with Hepatitis C. You get a poor outcome for individuals with that disease. Now as for Obamacare, businesses are dropping employee health insurance right and left. My son-in-law lost his while my daughter was pregnant. I have had a difficult time finding a primary physician who would take Medicare and it is about to get much worse. Medicare is being gutted and the funds the money transferred to Medicaid. The states will go broke because they will have to pick up the tab for all the extra people put on Medicaid. I agree with a previous poster, that the US will go from having the best healthcare in the world to that of a third world country. Obamacare has got to go!
Oldefarte| 1.6.11 @ 10:19PM
As I spent thirty five years in the insurance business, I can easily say that this healtcare legislation most certainly was, is and forever will be WELFARE. the previously thirty million UNINSURED individuals were the sole purpose of this legislation, and it was absolutely not the intent to improve, lower the costs of, etc of health insurance. If the latter was desired, then elimination of medical malpractice lawsuits, enabling purchase of health insurance across state lines, computerization of the medical profession, etc would have solved the problems. Since the trail lawyers associations are one of the largest political contributors to the Democratic Party, and since most of all legislators in government have a law degree and are therefore beholden to the ABA's and the Democratic Party, therefore lawsuit reform is, was nor ever will be a consideration for healthcare insurance reform and improvement!!!!!!!!!
Negro X| 1.6.11 @ 11:18PM
Health care is the UK is just great.
http://www.americanthinker.com.....cover.html
Carol Vicic| 1.7.11 @ 10:40AM
Ross:
Great letter to the same Democrats I am stuck with.
Udall, Obama's newly elected Obama's bootlicker Bennett and Polis will never vote to repeal Obamacare.
They are revolutionaries and proved it with their words and votes.
Nice try.
gilbert | 1.8.11 @ 7:46PM
Great Letter. What about this:
Wickard v. Filburn 317 US 111 (1942) – A farmer wanted to grow wheat for his chickens but because the government imposed limits on wheat production, the farmer was growing more than permitted. Supreme Court ruled in favor of the government. Furthermore, in Gonzalez v. Raich 545 US 1 (2005) interprets the Constitution as giving Congress vast regulatory authority over interstate commerce. Conservative Justices Scalia and Kennedy set this precedent. Add the “liberals” Kagan, Sotomayor, Breyer, and Ginsburg – “Obamacare” gets 6-3 or the more likely 5-4 upholding “Obamacare.”
What can and will the people do? It is not up to us, it's up to the Supreme Court.
sex toys | 7.4.11 @ 1:08AM
Health care is the UK is just great.
Adidas | 8.11.11 @ 5:57AM
is good
العاب بنات | 4.10.12 @ 12:25PM
No - many drugs have also been developed in academic and institutional settings.