Let me repeat this one more time...

[WCGreen]

When it comes to Health Care Reform, you have to take the middle guy out, you have to take the insurance industry's profit motivation or else there will never be equal and fair access to health care in this country.

It's ridiculous that some snot nosed entry level insurance clerk has power over how people are medically treated. The answer on their end, "I was only following orders"...

Sound familiar?

It's absurd that we have to tip toe around the insurance industry when everyone knows they are only in it for the money. If they weren't, they wouldn't be performing their responsibilities to their shareholders.

Get the Insurance Industry out, I say, out damn spot...

[CaliforniaPeggy]

1. Oh, it certainly sounds familiar, all right...

I have been lucky enough to not have had to deal with that circumstance...

But many people I know haven't been so fortunate...

We need to get the insurance industry (and there's a misnomer if I ever heard one) out of the mix...

Good luck with that...

K&R

[cliffordu]

2. K&R, times thirty.

Get the profit out of cancer treatment.

[Just-plain-Kathy]

22. ...and then they'll find a cure.

[John Q. Citizen]

3. i second that!

[Greyhound]

4. It is the only way, period.

As long as this leech is allowed to bleed us we will never heal. Literally everybody from the doctors to the patients suffer from this parasite.

It is the cause of our illness.
:kick: & R

[The Doctor.]

5. What if I cracked the formula that would put insurance companies out of business

practically overnight?

I believe I have, and so long as there's no single-payer universal reform anytime soon; it'll work. Obviously, with the insurance industry's lobbying power, UHC isn't going to happen for some time. Meanwhile, if they go out of business, they lose their lobbying power, and UHC would merge seamlessly with the formula.

So how would anyone else go about implementing such a thing?

[sammythecat]

25. I have no idea for the implementation,

but I sure would like to hear about your idea.

15 hours later and no one seems to be curious when someone says they know how to put the insurance companies out of business. That's curious in itself.

[The Doctor.]

34. Yeah, I thought that was funny too.

My first thought is that no one takes any such assertion seriously.

Here's the thing; obviously I'm not interested in giving away all the key details, but let's just say that no one in their right mind would chose orthodox insurance over this formula once they spent 15 seconds looking it over.

The problem here is manifold;

1) Finding investors who want to make more money than God without giving away or losing control of the formula.

2) Working out a few key details about the insurance industry.

3) Deciding which of two ways to go with the model (assuming things pan out).

4) Overcoming my distinct lack of resources to accomplish these things.

5) Not be taken seriously enough to get 'suicided' by the insurance industry until it's all underway. (To all you insurance industry people... nothing to see here... I'm just a wacky CT nut around here... seriees.)


That's the problem... being taken seriously without the wrong people taking me seriously.

Anyone know if Michael Moore likes to entertain various Earth-shattering ideas?

[gilpo]

29. do tell, Dr Eldritch.

This pilgrim is interested.

[lonestarnot]

42. Will it take care of big pharma too?

[The Doctor.]

46. One terrifying behemoth at a time, thanks.

;)

[lonestarnot]

61. I will be waiting for the day you share! Sounds very interesting!

:applause:

[HughMoran]

56. Does it involve weapons?

Because if the insurance companies keep fucking with people's lives, they might get a lesson in "going postal".

[The Doctor.]

62. No.

That would accomplish nothing, of course.

But that doesn't mean it isn't fun to think about!

[Norrin Radd]

6. kr

[canetoad]

7. I clicked this thread

expecting a nice talk on tautology.

[grantcart]

8. There is a very objective reason for this

Companies are formed to return a positive profit on investment.

Companies compete against each other and in many cases the market is the best way for companies to vie for resources and customers.

In emerging products and services, companies can compete with each other by adding innovation and improving technology, and phones are a classic example of this.

In the health field however the industry the insurance industry has matured to a final stage. While a new medicine or treatment might, theoretically, revolutionize patient response, that would be shared equally by all insurance companies.

When companies compete in a mature industry they can only compete by cost reduction. In the health industry that can only be achieved by cherry picking clients or by denying benefits.

For that reason all developed countries have taken the insurance company out of the equation. Germany for example has a system where everyone pays the same percentage 8% for employees and 8% for employers. The actual approval of benefits are done with 5-6 large not for profit companies administering the same basic definition of benefits which is established by the state. There is no government bureacracy involved.

Moreover the actual delivery medical services is left unrestricted and doctors are free to incorporate and compete in being able to provide the actual services in the most efficient system. Of course if the patients don't like that they are free to go to someone who is more patient friendly.

Everyone is only in it for the money. The insurance company simply shouldn't be apart of the equation.

I believe that Obama's intention is to support expansion of medicare and not for profit alternatives and force the insurance companies to compete. As they have the added expense of 'profit' they will not be able to.

[exboyfil]

10. I like the German system and it probably is the best model for

our country (superior to the English system) because I really don't see making all the health care providers government employees.

The German percentage of wages continues to creep up over time so where do you think it will ultimately end up?

If we can get to 16% of our wages for health care, then we will be doing great. It currently stands at 24%.

Cost containment will always be an issue. The Germans handle it by paying their doctors a certain amount irrespective of how many patients they see (NPR did a story on this awhile ago). Germany also aggressively negotiates with drug companies (like Canada) which works well in the short term, but may have lasting long term consequences for drug development.

A testament to the German system is that high earners can opt out of the system, but many (if not most) elect not to.

Just because an entity is non-profit does not mean that it will not have the same functional difficulties as a for profit. Ultimately the dollars come from the wage percentage, and, as costs creep up (elderly population demanding more services on the same wage basis) you will have the same motivations as what drives for profit insurance companies. The only difference is that the state insurers will be answering to a a different stakeholder (not the stockholders). The compensation for the guys at the top that can manage the non-profit insurance company will still be set by the company's needs and the market for his/her skills.

[eridani]

17. Of course private insurance will be able to compete--they cherry pick

No sick people or pre-existing conditions allowed. That's how they make their profit goals. Also being subsidized by the government as in Medicare Advantage.

[grantcart]

18. Obama has already announced that he is going to pass legislation

against eliminating pre-existing conditions. (Ambinder indicates today that health care is not going to be put on the back burner even with the current economic crises).


But I disagree with the idea that they would be able to compete because in the end people will realize that non profits have no incentive to deny benefits.


As fewer people pick 'for profit' insurance companies their costs per client will increase and they will slide further down on the slope of economies of scale.

[eridani]

49. There is a problem here with assuming what people will realize

You are forgetting that most people will never get expensively sick. The only way you find out about whether claims get denied is to get seriously sick. All the people in SiCKO were people who HAD INSUEANCE. Their tendency, if covered by employers, is to not think about the absurdly complicated mess that private insurance is.

Also, it doesn't matter in the slightest if pre-existing conditions are eliminated if insurers are allowed to triple the premiums of people who are already sick.

[eridani]

50. I think you are making unwarranted assumptions about what currently healthy people will realize

You are forgetting that most people will never get expensively sick. The only way you find out about whether claims get denied is to get seriously sick. All the people in SiCKO were people who HAD INSUEANCE. Their tendency, if covered by employers, is to not think about the absurdly complicated mess that private insurance is.

Also, it doesn't matter in the slightest if pre-existing conditions are eliminated if insurers are allowed to triple the premiums of people who are already sick.

[exboyfil]

9. I agree that Single Payer Universal Health Care is the way to go

but lets not kid ourselves about what will ultimately happen in a government run and managed system. The need to control costs will remain irrespective of who is making the ultimate decision (whether a glorified clerk or a government employee).

You can look at England for examples (the best one was the guy who was told he had to lose sight in one eye before they would pay for the drug to stop his condition from worsening).

Lots of folks in England pay for their care in India instead of going through the English system. Why do you think that happens?

Even Canada with its Universal system has back up insurance that can be purchased to pay for additional things (and possibly improved service and response).

England has stand alone clinics outside of the NHS - why do you think they exist?

Germany pays their doctors a certain amount of dollars irrespective of how many patients which they see. Many take Holidays at the end of the quarter because of this (so they don't work for "free"). Also German doctors make 2/3s what U.S. doctors make.

Many developed foreign countries pay far less for prescriptions than the U.S. does. Canada basically tells our drug companies what they are willing to pay through the PMPRB, and, if the producer does not agree, then the drug is not available in Canada. Most producers agree because the price is greater than the marginal cost to make the drugs.

I am firmly in favor of single payer monopsony for negotiating all medical services (drugs, primary health care, specialists, and hospitals), but we should recognize the impact of this approach (less drug development etc).

What has convinced me is my own health care through my employer. My employer and I pay $12,000 per year for a family plan that has a $5,000 deductible. Except for paying for yearly physicals (total cost no more than $500 for a family of four), UHC does not have to spend a dime until the $17,000 figure is reached. For this I get the exposure of no portability in the event I lose my job.

I can't imagine dealing with a government bureaucrat will be any worse than an UHC representative. Just remember that the motivations for both will be the same (cost containment).

[Merlot]

36. A big difference between "cost containment" and profit for shareholders.

[OneBlueSky]

11. absolutely . . . the percentage of our healthcare dollar spent on non-healthcare items . . .

(like corporate profits, executive salaries, bonuses and perks, advertising and marketing, etc.) ranges from a quarter to a third . . . and I wouldn't be at all surprised if it were even higher . . .

that's all money that could be going to the provision of healthcare and/or to knocking down some outrageous costs . . . or to filling the Medicare Part D donut hole (which won't even exist if we adopt a true single payer system, without the middle man) . . .

on edit: one more thing . . . while we are operating under the existing system, allowing the government to negotiate drug prices for those enrolled in Part D programs would save consumers billions of dollars . . .

[WCGreen]

12. It is that high if not hire...

[CaliforniaPeggy]

13. Kick!

:kick:

[tavalon]

14. Nurse here

Fuck, yeah, get the blood sucking insurance ticks out, out, out!!!@!!

[The Doctor.]

15. How?

Seriously...

[liberaltrucker]

58. Single payer, Doc

I've discussed this issue with my Republican physician during the poking and prodding.
I think I've finally convinced him than eliminating layer upon layer of insurance
paperwork and filing one simple claim to one payer is MUCH more efficient.

[tavalon]

60. I don't think we can get rid of them

Not because they are necessary but they are too big and strong to let us take them down.

I don't have an answer for you.

[jtrockville]

16. I'll repeat my mantra too: Health INSURANCE prevents health CARE

It's as simple as that.

[tbyg52]

19. For-profit healthcare should be an oxymoron. nt

[FiveGoodMen]

31. For-profit healthcare should be a crime

(for the confused: getting paid for what you do is compensation, not profit)

[tbyg52]

63. Word. nt

[stuntcat]

20. it's HEALTH

The thing that should belong to EVERY citizen. It drives me crazy how much of a business health is, all about profits, it makes me ashamed of my country.

[Mike 03]

21. You got it, man. Say it loud, and say it over and over and over.

Kick and rec. This is one of those posts I wish I could Sky-Write over Washington D.C.

[Still Sensible]

23. I long for a single payer system, but

it is probably a political reality that we'll have to get universal insurance coverage as an interim step. I do fear that ultimately single payer could simply replace bad decision making corporate pencil pushers with bad decision making government bureaucrats.

[wolfgangmo]

24. This is my story...I wrote it after the latest Nancy Gregg column...

... I'm so tired.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=132x8093345#8094918

[Catamount]

26. K&R

Send all your ideas to Change.gov. and they will be heeded!

[Kajsa]

27. Yes! Healthcare is just that,

it should not be based on profit margins.

:(

[Kitty Herder]

28. K&R We have to keep repeating it until the Congress and the President finally understand. nt

[rhett o rick]

30. Yeah we give Congress words and the insurance industry gives em cash. Not a fair fight. nm

[Kitty Herder]

33. You're right about that.

Maybe all those who believe in national, single-payer healthcare should make a pact not to vote for any one, for any office, under any circumstances, who does not explicitly support the same. Since the majority does want that, it might just work.

[Catherine Vincent]

32. I agree.

You ever noticed in large cities the amount of dialysis clinics? They are needed but it's a for profit organization.

[Jokinomx]

35. Right On....

My Dr. ordered a colonoscopy when I turned fifty. My Father passed because of colon cancer. My insurance company refused to pay for the screening because I didn't have any symptoms.

I have had insurance companies not pay for covered services... stating that my primary physician didn't "refer" me for therapy after having two broken fingers and a severe infection in because of creek water entering my compound fractured finger.

I could go on.... and on...

:toast:

[Sarah Ibarruri]

37. I agree. Remove the insurance industries. They failed at managing health care nt

[bonito]

38. And while we're at it damn it

Lets get big pharma out of the FDA, they build nothing but a box for health care professionals to operate within.

Our doctors are under their dictatorship, they can only operate within those walls of imprisonment, chained, confined, and frightened to operate outside it.

In essence they ultimately work for the benefit of big pharma and not for the patient.

[BlooInBloo]

39. Convince me you have even a vague idea of what the economic role played by middlemen is...

and I'll be happy to listen.

(I fully appreciate that DUers will take this as an endorsement of the status quo, which it obviously is not to any literate person.)

[bonito]

44. How about making a comprehensive statement for starters n/t

[bertman]

40. Rec and kick.

[lonestarnot]

41. That would take care of that, but what about big pharma?

[Laelth]

43. Hear, hear! But undoubtedly they will want a "seat" at the table.

They are very powerful. They will not give up this cash cow freely.

We will have to take it from them by force.

:dem:

-Laelth

[harmonicon]

45. sounds good to me

Shit, without insurance, I went to a hospital in the Czech Republic the other week. X-rays, doctor consultation, crap treatment, and crutches came to about $150. What would that have been in the US without insurance? 5 grand?

[Raster]

47. Insurance companies = parasites.

Any questions?

[lwcon]

48. K&R

[Canuckistanian]

51. We have no "middlemen" in Canada

Our health care is paid by the government. It is not RUN by the government. DOCTORS AND HOSPITALS run our health care.

The extra we pay in taxes is dwarfed by the amount the average American citizen pays for Health Care insurance monthly.

And we can never be turned down, refused treatment or have to fight over the price of our treatment. It doesn't matter if I have a job, or if I'm a billionaire. I get the same care.

Health care is not an issue to me.

Nor should it be for you.

[trthnd4jstc]

52. If I am successful in my several enterprises, I will start a non-profit, mutual, insurance company.

I have a friend that went over it, and it is remarkably easy to start your own insurance company, assuming that you can get at least 100,000 plus shareholders, which I believe is completely possible.

[garybeck]

53. but what about all those jobs????

just playing devil's advocate

[defendandprotect]

54. Insurance companies OWN legislators who could change this . . .

[1]

55. well, yeah wcgreen... but how do you do that?

a very similar argument, how do you remove all of the accounting firms from the tax issue. taxation in america is run by tax corporations.

huge corporations down to the smallest. that contribute huge dollars to each and every politician.

health care in america is run by insurance companies. huge corporations down to the smallest. that contribute huge dollars to each and every politician.


you want, what? all of a sudden for this to all be eliminated?

heh.

you might want that. but your representatives don't want that.



do you see the problem here?

[liberaltrucker]

57. You know all too well, Chris

You've lived it. Now, if only the goddamned politicians could figure it out!
They say "Why should a government bureaucrat come between you and your doctor"?
HELL, a fucking INSURANCE COMPANY bureaucrat second-guesses MY doctor every
fucking visit. Example: I take a med for my ailment. Drug company parcels it
out in 37.5, 70, 150, 300, and 600 mg doses. My doctor determines that 370 mg
is the right dose for me. Result? My insurance carrier denies combining 2
scripts into one. Double deductible. Double co-pay. :wtf: is wrong with this
picture?

[AtomicKitten]

59. I completely agree. n/t