The discussion has become somewhat misdirected. The point I was trying to make is that the incurred costs that the uninsured often end up not paying are born by someone. The argument for mandated health insurance is not a lot different than mandated auto insurance. It enlarges the pool of participants and includes those who will not necessarily need services (but might) which tends to lower everyone's ante. Controlled costs and profitability on the part of HMO's and insurers is also necessary. Obama didn't go far enough in my view in that area. Transitioning to a heavier emphasis on primary care rather than specialties is another problem in figuring out how to actually provide services to everyone. The topic is clearly complex and won't be resolved by us in this forum. I think the discussion has run its course as has election day and it's time to get the list back on track. So I will gracefully bow out of any further discussion on the subject, at least in this particular forum. Good luck and good health to all. David Love www.davidlovepianos.com From: Mike Spalding [mailto:mike.spalding1 at frontier.com] Sent: Wednesday, November 03, 2010 5:19 AM To: davidlovepianos at comcast.net; pianotech at ptg.org Subject: Re: [pianotech] Medical costs (OT!) was:billing dilemma That part was paid by the same people who pay the part the insurance companies don't pay. Look at any EOB (explanation of benefits) from the insurance companies - there's the amount billed, then the discounted amount the insurance company has negotiated (bullied) with the provider. In the case of hospital surgery bills, the discounted amount can be as little as 1/3 the original amount billed. Don't attack Susan for doing, in a small way, what every insurance company does in a very big way. Mike On 11/2/2010 4:05 PM, David Love wrote: Susan: Just one question. When you negotiated that hospital bill down to 30k who paid the part you couldn't pay? David Love www.davidlovepianos.com _____ From: Susan Kline <mailto:skline at peak.org> <skline at peak.org> Sender: pianotech-bounces at ptg.org Date: Tue, 02 Nov 2010 13:36:35 -0700 To: <mailto:pianotech at ptg.org> <pianotech at ptg.org> ReplyTo: pianotech at ptg.org Subject: Re: [pianotech] Medical costs (OT!) was:billing dilemma 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 -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://ptg.org/pipermail/pianotech.php/attachments/20101103/536fca9f/attachment-0001.htm>
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