Obama speech to the kids.

the 3 strikes is BS!.. true while you don't want a Dr. to make mistakes, especially on you, one really needs to grasp reality. Can any of you bring me a carreer auto mechanic who has less than 3 repairs go wrong over his carreer?? How about a boat mechanic?? a plumber?? yet the human body is much more complicated than any of the above and for some reason Doctors are expected to achieve 100% success. add to that the fact that cars and boats don't fail to take their medication or follow directions....

And you need to add the fact that new proceedures are tried every day to see if they can save someone who just a few short years ago would have been allowed to pass away.

Tort reform needs just one simple rule added to it and all the issues go away. If the doctor/hospital cannot be proven, beyond a reasonable doubt, to be more than 50% at fault, you get nothing and are responsible for all litigation expenses for all involved.
 
Last edited:
we can all be thankful for how advanced our medicine are and well-trained the doctors are.

Current statistics say that 80% of all drug research and 70% of all new medical procedures and equipment are generated in the US. That is one thing that will for sure change if this health care legislation is passed.
 
And I do have to disagree with your home insurance analogy.

I should not have to pay more for my insurance just because you decide to build a large expensive house where a hurricane may hit it. Or in a flood plain, or on the San Andreas fault. Your problem, I didn't force you to live there.

By your analogy, you should pay part of my winter heating bill because I decided to live in Michigan.......Or maybe my travel bills because I have to go where it's warm every winter to keep from going nuts?????

Same with health care, I shouldn't have to pay more just because you drink heavily, use illegal drugs, and decide to be obese. (You gotta stop that by the way :sifone: ).

Or maybe I should be able to pay the exact same insurance costs as you for my car? Even though you drive a Volvo and have a perfect record...While I drive a Lambo and have 17 speeding tickets and 3 dui's??????

I managed a company in Oregon where all the employees lost their health insurance because of one guy. His first kid had a heriditary terrible disease, they decided to try again, so did the second, they decided to try again, so did the third. The cost to Blue Cross was over $550,000 per year for his family, they pulled coverage for the entire company, (140 employees), and we could not get insurance through any other company.

Once again, a lack personal responsibility costs everyone else.
 
Insurance companies are gambling entities, thas the nature of the buisness.

That just doesn't fly with me. Sure you can boil it down to similar analogies, but it just doesn't work that way.

Plus you know d@mn well if a bookie took that bet and lost, he'd friggin disappear in a heart beat. :D
 
Good points about house on a fault or Volvo/Lambo; I agree...

I managed a company in Oregon where all the employees lost their health insurance because of one guy. His first kid had a hereditary terrible disease, they decided to try again, so did the second, they decided to try again, so did the third. The cost to Blue Cross was over $550,000 per year for his family, they pulled coverage for the entire company, (140 employees), and we could not get insurance through any other company.

Once again, a lack personal responsibility costs everyone else.

What is the solution to some thing like this?

A guy on this site has a son that was born less than healthy (not sure what ills him and no disrespect towards this member what-so-ever!!!) that has cost him over $2M and that figure was from a while ago. All public info and if said member wants to out himself that is up to him.

Where is the line drawn? Asking in an ed-u-mah-kate me type way. I don't think it's right the one dude had 3 kids cost 140 their insurance but I don't know what the answer to some thing like that is either.
 
This stuff does cost money. But if I enter a contract, and as anyone with an insurance license knows, health insurance is a UNILATERAL contract. That means, both sides are not made whole. the insurance company is taking the open-ended risk. So if I enter a risk with the insurance company, or anyone, and the contract stipulates that they will pay in the event of a covered loss, I expect them to pay, period.

"Covered loss" absolutely yes. And we all know they like to do everything possible to not pay. So "we" have to be proactive and fight to make sure our doctors get paid so we can keep getting treatments.

But everybody who has entered the contract should also have read the fine print that says they can drop us at practically any time for almost any reason. That's the risk WE take in entering that contract. The expectation that anybody should continue to pay a losing bet is the same entitlement mentality that created Social Security, Medicare, welfare, etc.

I hope we can conduct some surgery and move these posts to an appropriate "healthcare" thread...:D
 
Good points about house on a fault or Volvo/Lambo; I agree...



What is the solution to some thing like this?

A guy on this site has a son that was born less than healthy (not sure what ills him and no disrespect towards this member what-so-ever!!!) that has cost him over $2M and that figure was from a while ago. All public info and if said member wants to out himself that is up to him.

Where is the line drawn? Asking in an ed-u-mah-kate me type way. I don't think it's right the one dude had 3 kids cost 140 their insurance but I don't know what the answer to some thing like that is either.

To me, first child no problem. We'd all choose to help as much as we could anyway. If there is a heriditary disease like that, no more children, sterilization at our expense. Sounds a little cruel, but so are the kid's lives, let alone the expense.
 
Current statistics say that 80% of all drug research and 70% of all new medical procedures and equipment are generated in the US. That is one thing that will for sure change if this health care legislation is passed.

A great deal, but I do not know the statistic, comes from public funding, university research and grants to private companies. That will continue. However, you are accurate in projecting the assumption that if pharma co profits are reduced, tehy may spend less on R&D.

We can't have everything. just like, we cannot have a public program like medicare installing new hips in 97 year old people. I'd hate to be in the situation but economically it's not viable.
 
And I do have to disagree with your home insurance analogy.

I should not have to pay more for my insurance just because you decide to build a large expensive house where a hurricane may hit it. Or in a flood plain, or on the San Andreas fault. Your problem, I didn't force you to live there.
Actually, the system doesn't work that way. By pooling all the states into one giant pool, the the negative impact of a catastrophic loss is muted. We've had giant floors in the mid-west, horredous blizzards up north, raging fire in California and hurricanes in the south. Surprisingly, the insurance co's lock down MASSIVE profits. However, when they introduced their creative accounting in the late 90's, all of a sudden they cannot make money and cry to the well-financed politicians.




By your analogy, you should pay part of my winter heating bill because I decided to live in Michigan
Not the same as insurance. Power companies cover a certain area, not the entire country. If they covered the entire country AND offered an intangible product that doesn't require power lines, production, storage, coveyance, etc, they could pool all states together and average the price. Now, when you have a winter blackout, your rate wouldn't have to go up alot. And in the Summer it wouldn't go down alot.

By the same token, if you get hit with chronic blackouts, they will likely raise your rate some, but not have to make up for all of the loss at once.

The problem with focused pooling, for the insureds, is the insurance company bean counters can mathematically justify how huge their risk is and get higher premiums. And people who dont understand the premise of what is happening will look at the simply math results and agree that it is not fair for the insurance co.
Meanwhile, the insurance co is using gold rakes to sweep in the money, then when there is a big loss, using that hoard of money to fight even paying you. So the idea of the unilateral contract become void when they use their power and influence to escape their part of the bargain.


Same with health care, I shouldn't have to pay more just because you drink heavily, use illegal drugs, and decide to be obese. (You gotta stop that by the way :sifone: ).
Hey, you're gonna lose alot of friends if you cast aspersions on the festively intoxicate heroin users on this site. :willy_nilly:


I managed a company in Oregon where all the employees lost their health insurance because of one guy. His first kid had a heriditary terrible disease, they decided to try again, so did the second, they decided to try again, so did the third. The cost to Blue Cross was over $550,000 per year for his family, they pulled coverage for the entire company, (140 employees), and we could not get insurance through any other company.

Once again, a lack personal responsibility costs everyone else.

I got nothing for that guy except: Stupid is as stupid does. But I assume they are loving parents and things just didn't work out for them health-wise.

At the same time, we can start a enw thread about the virtues of the government forcing anyone who is on the government cheese to be given the Norplant 5 Year Contraceptive. This is the clash between pro-lifers and anti-socialism. I firmly believe anyone on welfare should be required to get the contraceptive. If you cannot support yourself and the current litter you have, you should not be allowed to procreate until you are on your own. If you do get pregnant, you are off the gov't cheese.
 
What is the solution to some thing like this?

A guy on this site has a son that was born less than healthy (not sure what ills him and no disrespect towards this member what-so-ever!!!) that has cost him over $2M and that figure was from a while ago. All public info and if said member wants to out himself that is up to him.

Where is the line drawn? Asking in an ed-u-mah-kate me type way. I don't think it's right the one dude had 3 kids cost 140 their insurance but I don't know what the answer to some thing like that is either.

I don't know the answer per se, but if you pool enough people, there are going to be some that put money in and don't get much benefit. But at least they can put less in than they do now. And for the people who have high medical expenses, the pool covers it. Instead of the insurance company looking at each case, they insure everyone. When everyone is paying in a modest amount, there is more than enough to cover the expensive cases.

But to be effective, they must get tort reform, etc.

I see the real beneficiaries of a public option as the doctors and the insured. Whoc ares if the insurance co's make a huge profit or just a good profit. To everyone: Seriously, would you rather pay much higher premiums and get the same care from the same doctor? Or would you rather we go back to the basics: people get sick, they need medical attention. There are a few parts of our society (and economy) which can be detrimental to our societal growth if commoditized and set for the highest profit. Health insurance is one of them. Fuel and heating oils are another.
 
"Covered loss" absolutely yes. And we all know they like to do everything possible to not pay. So "we" have to be proactive and fight to make sure our doctors get paid so we can keep getting treatments.

But everybody who has entered the contract should also have read the fine print that says they can drop us at practically any time for almost any reason. That's the risk WE take in entering that contract. The expectation that anybody should continue to pay a losing bet is the same entitlement mentality that created Social Security, Medicare, welfare, etc.

I hope we can conduct some surgery and move these posts to an appropriate "healthcare" thread...:D

They can elect to not renew us. But to drop us as we are sick or decline coverage for a covered item is not part of the unilateral contract.

And on the proactive part, we, as a people, cannot be proactive enough against the giant insurance industry and their lobbyists. We cannot rely on the insurance company to take the simple message of our disgust and decide to reform their practices.

With a public option, the insurance co's will have a competitor in the market with lower prices. It may not offer as good of coverage, but they will need to offer something better to justify their premiums.

Think about public and private school. Private is regarded as a better program, but it costs more and the people who 'have', cna decide to use the private system. The private school cheery pick the students and toss them out if they want at any time.

However, everyone else can go the public school option, get a good education and have a better chance at making it somewhere in life. They may not get the best teacher, but they can get 'learned'. :sifone:
 
Agreed, but it is currently expected. Plus transplants, etc.

Very true. But that would be for the people who have the resources to get it. If you cannot afford the private policy, which many cannot now, then they don't get it. Instead, they get a warm and fuzzy morphine drip and a monthly visit to the Japanese Spa for a happy ending. (I added that for the fun of it.)
 
Surprisingly, the insurance co's lock down MASSIVE profits.

I keep wondering where you get this? The insurance companies which posted huge profits are only those which had huge investments during the stock markets boom years. Every publically traded insurance company has had declining profits over the last two years. It's kinda like the story everyone told about huge profits at Exxon, yeah they were huge, but not once were they 10% of sales, which is the standard for every business on the planet.

Will a Public Option Hurt Insurance Company Profits? Insurers' Profits Are So Slim, It Would Be Hard for Health Care Reform to Whittle Them Further

Wall Street Journal

http://online.wsj.com/article/SB124947013703607453.html

Returns on assets, a key measure of profitability, are typically pretty modest too. According to analysis by FactSet, WellPoint's ROA has averaged 5.8% over the past five years, Aetna's, 4.2%. Those were, remember, supposedly boom years. UnitedHealth was higher, at 9.6%, but fell to 6.4% in 2008. These are reasonable, but hardly spectacular, results. By comparison, Wal-Mart averaged a 9.2% return on its assets and Dell, Inc. 12.4%.
 
The far Right Republicans and religious leaders would fight that. It's another logical decision, but too much emotion.

Get to the truth, they cannot buy votes with that logic....


Root political cause and effect......buy votes, get elected, buy votes, get re-elected..........
 
We are ignoring a major part of the problem. . . the doctors and hospitals charge outrageous amounts for the procedures. So when the insurance model makes calculations, they base it off the big numbers.We need to drill down the costs in the system. Doctors can charge less for the procedures if they aren't at risk of paying out big settlements AND paying HUGE premiums to malpractice policies. But it's also the hospital costs that are too high. $20 for a Tylenol because a nurse gave it to you is nuts. but therein is the embedded liability charge.

I don't think the entire litigation part of the system is bad. Just as knowing a cop could be around the corner might keep some kid from hotrodding and causing a big wreck. So too does the lawyer keep balance in the system. HOWEVER, everyone must realize doctors, much as they may disagree :sifone:, are not Gods. They make mistakes. procedures have probabilities and sometimes you are on the losing end of the probability. Suck it up and deal with it. But if the doctor cuts off the wrong leg or performs while under the influence of drugs, there's liability you must be able to sue for.

Back to it, I don't pretend to have all the answers, but the health insurance market has been hit with an obscene amount of inflation for years, and we are merely deebating how to pay the high expenses. Drill down the costs and most insurance models are profitable. Doctors made huge money in the 70's, 80's, 90'[s and today. They wont take big paycuts because they already only get reimbursed 10-30%. So if the fixed cost is 30% of current top price, set that for everyone. And let the government negotiate their rates on pharma, etc.

I still cannot believe the party of capitalism and free market actually support the pharm companies who lobby to restrict the power of. . . free market!
 
Concentration of Health Spending


While discussions about the costs of health care often focus
on the average amount spent per person, spending on
health services is actually quite skewed. About ten percent
of people account for 63% of spending on health services;
21% of health spending is for only 1% of the population. At
the other end of the spectrum, the one-half of the
population with the lowest health spending accounts for just
over 3% of spending.4



80/20 rule I always talk about.
 
The amounts people pay out-of-pocket for health
care depend on several factors, including the
quality of their health insurance (if any) and the
type and amount of services they use. For people
with health care expenses, the average share of
total health care costs that are paid out-of-pocket
was 33% in 2006. Because many insurance plans
have limits on out-of-pocket expenses, people
who have high health total spending have relatively
low out-of-pocket shares; e.g., the 1% of people
with the highest health spending in 2006 (total
costs more than $41,580) on average paid 7% of
their costs out-of-pocket.
 
Back
Top