[pianotech] Medical costs (OT!) was:billing dilemma

Susan Kline skline at peak.org
Tue Nov 2 14:36:35 MDT 2010


Will, you bring up one of the fatal errors in how conventional health 
insurance worked before the health care bill passed (flawed as it is by 
corporate pressures from all sides).

An insurance pool, to work right, has to have the largest possible 
number of people in it. It should be affordable enough that many people 
pay in, but the catastrophes happen to only a few of them, so the system 
stays in the black. Insuring for a routine and expected expense is 
madness, because it balloons the costs to several times what they would 
be if people just paid out of pocket. I remember when dental insurance 
became common. Suddenly the fees for my dental care tripled, though I 
didn't do a single thing to cost the dentist a penny more than before.

What we need is not more insurance. We need more health, so that major 
medical costs only happen to a few people, instead of almost all of 
them. Plus we need efficiency, with doctors on salary. They should be 
forbidden to take kickbacks for prescribing drugs, as many now do. They 
should not be paid by the procedure, since this multiplies procedures, 
some of which are dangerous and most of which are expensive. They should 
be protected from needing expensive malpractice insurance. Instead of 
victims getting huge money settlements paid for by malpractice 
insurance, doctors who are truly incompetent should have their licenses 
revoked. There could be a public fund to reimburse victims, so that half 
the proceeds wouldn't line lawyers' pockets.

The "pre-existing condition" cherry picking just dumps huge segments of 
the population to fend for themselves. Often this is absolutely not 
their fault. Many of them work and take reasonable care of themselves 
and have money and are willing to fund their medical coverage, if it 
could be made efficient enough that the premiums weren't an invitation 
to bankruptcy. In the present situation, they can't find a way into the 
system.

What we have now is a hodge-podge of exceptions and ad-hoc ways of 
getting people treated when they are not in the shrinking pool of those 
privileged enough to be insured (through work for major companies, 
extreme wealth, or being young healthy and employed). You see the 
disconnect? Those who most need health care are the very ones closed out 
from obtaining it.

This is why every industrialized country (EVEN BRAZIL!!) has some form 
of universal coverage or a hybrid public-private setup. Adults were in 
charge. They saw that leaving people with no access to routine health 
care led to much higher expenses when they were in the final stages of 
fatal but preventable diseases. It was a lot cheaper and more humane 
just to be sure that everyone could get a certain basic amount of care.

We needed the public option really badly. But people fuming from Fox 
News "entertainment" (read "tissue of lies") brought guns to public 
meetings, screamed at the top of their lungs, and all the rest of it. 
Obama and the Democrats blinked.

Okay, one more point and I'll shut up about politics. I see people 
saying with fervor that they don't want to pay for the health care of 
people who have all sorts of bad habits, eat junk food, smoke, etc. 
Might I point out that they are already paying for it in the present 
system? Anyone can go to an emergency room and they have to be treated, 
though they have to go through the gauntlet of waiting in terrible 
conditions in the major city hospitals crowded with other uninsured 
people. (What are you advocating? Sending someone having a heart attack 
out to die on the sidewalk?) A universal system would provide a way that 
everyone would pay something, means-tested for the poorest, so that 
those people now  crowding and stressing the system could be treated 
early in a civilized uncrowded non-emergency setting, and they could 
help pay for their treatment.

On the other hand, people complain that no one should be forced to buy 
insurance. I am one of those who didn't buy insurance for thirty years, 
but if the system had been fair and equitable and efficient, I would 
have rushed to buy in. I don't imagine those who avoid being insured 
also avoid using the hospital when they have a medical crisis. If they 
had paid a little in for years before the crisis, the system might have 
been able to take care of them and still stay in the black.

We heard all these arguments before Medicare was passed. But then last 
year Fox News's campaign to derail the health care bill inspired the 
elderly at town hall meetings to shout that Obama "should keep his hands 
off our Medicare!!" You can't really have it both ways.

Susan Kline



On 11/2/2010 2:52 AM, William Truitt wrote:
>
> You make me ashamed of myself, Terry.  You are, of course, correct.  
> Health insurance is for 18 to 24 year old young women with no prior 
> medically disqualifying history (we'll overlook the medical crime of 
> being born just this once) (not for men in that age group, they get 
> drunk and fall off buildings) and the very wealthy.
>
> My prediction is that when the wealthy can't afford health insurance 
> either, they will become Nazi-Facist-Commie-Socialists too.
>
> Will
>
> *From:*pianotech-bounces at ptg.org [mailto:pianotech-bounces at ptg.org] 
> *On Behalf Of *Terry Farrell
> *Sent:* Monday, November 01, 2010 10:58 PM
> *To:* pianotech at ptg.org
> *Subject:* Re: [pianotech] Medical costs (OT!) was:billing dilemmawith 
> pitch raises
>
> Nice comments Will, but one glaring error:
>
> On Nov 1, 2010, at 10:16 PM, William Truitt wrote: "...this is how 
> private health insurance works also.  Everybody pays into a pool so 
> that the individuals who need to take from the system can get the care 
> they need when they need it, at least in theory."
>
> I would argue against this Will. In universal health insurance, 
> everybody pays into the pool via taxes. In private health insurance 
> only those who are healthy pay into the pool, unless of course, the 
> odd situation arises that the insurance company can't find a way to 
> disqualify someone who has a medical issue........
>
> Terry Farrell
>
>

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