Tuesday, March 02, 2010

"Nobody does health care this way"

One complaint I hear about the current health care bill is, "nobody does health care this way!" i.e. with mandates and private insurance companies. Problem is, that's not true. Switzerland, for example, has an individual mandate -- you must buy private health insurance that meets minimum requirements. In Germany, you pay payroll tax to the state insurance fund and are either assigned an insurer by your employer or choose one yourself, and the State has an insurance fund for those who aren't employed. In the Netherlands, long-term major medical is provided by the government, but for all other care people are mandated to buy private health insurance. So yes, there's folks out there doing health insurance this way.

Do I like the current health care proposal? Not really. I'd prefer simply extending Medicare eligibility to 0 years of age and raising payroll taxes by the 5% needed to pay for that, it'd be much cheaper and we wouldn't have to put a new program into place, we already have Medicare and know how it works. But I like the alternative -- no health care because I'm entering a time of life where I'm going to have to work contract due to "grey hair syndrome" which renders me unemployable as a full-time employee in the computer industry and ineligible for private health insurance due to pre-existing conditions -- even less. In the end, it's a choice between mediocre and horrific. I choose mediocre, thank you.

-- Badtux the Pragmatic Penguin


  1. I think there's a missing "don't" in the sentence, "I like the alternative.."

    Thanks for all the logical thinking. It's relatively rare these days...

  2. Yogi - Jump to the end of the sentence. The "even less" makes it all clear.

    Tux - I stumbled over that sentence, too. You might consider an edit.


  3. Consider it an IQ test ;-). I do sometimes edit my posts but usually don't give a shit, way I figure my readers got what they paid for (what, they didn't pay anything to read my prose? Exactly!). Yeah, I'm a cranky evil penguin today...

    - Badtux the Evil Penguin

  4. I don't know about evil, but CRANKY!

    I'd offer you some single malt if you weren't 2000 miles away.


  5. Don't think Medicare for Everyone will cover cranky but it is marginally better than nothing, especially if you are on your own without an employer.

    BTW, TR Reid covers all the details of health care around the world in his book, Healing America. There are a variety of models for providing universal health care. The US model is good for reminding other nations how much better their systems are.

  6. I should read my comment before I post. I meant to say Medicare for Everyone would be great but the current reform is marginally better than nothing.

  7. I would say "marginally" better is an understatement of large proportions -- simply ending the pre-existing conditions bit will be a huge improvement for significant numbers of people -- but you're right, it's a mediocre reform watered down way below what could have been. Siiiiigh!

    - Badtux the Mediocrity Penguin

  8. However, with the individual mandate and the lack of a public option what is to stop insurance companies from jacking up their premiums, copays, and deductables to compensate for the people that they cannot drop because of preexisting conditions or recisions knowing full well that you have to buy their crappy plans or face a yearly tax penalty?

  9. Ooops, my bad.

    I'll wipe the drool off now.

    Yogi, paid in full

  10. However, with the individual mandate and the lack of a public option what is to stop insurance companies from jacking up their premiums, copays, and deductables ...

    Nothing. And, unfortunately, that's the way it needs to be due to the politics of this country.

    Obama and the Dems (FINALLY!) are actually using the P.R. that the insurance companies have handed them, this time with 6 companies that are jacking up premiums by double digits on individual policy holders. When they screw over even more people, they will provide more fodder.

    Private insurance companies failing to provide affordable insurance (which the GOP claims they'll do sooooooo well) is the door to a real public option. Unfortunately, a lot of people will get hurt in the process, not that the likes of Jim Bunning or any other Republican would give a s**t.

  11. Well, there is also the option of regulation -- setting a loss claim ratio below which insurers are not allowed to go on insurance that meets the minimum requirements of the bill. That's not a perfect solution, and I agree there are a lot better ones, but (shrug). It is what it is. This appears to be all we can get through the current political system, and while mediocre it's still better than the current setup, so...

    - Badtux the Pragmatic Penguin

  12. The current proposed law, which will probably be rammed through, is a fascist prop to the insurance company maggots. Speaking from the Left, I want to see it fail.

    Only, the insurance companies and their minions in Congrifts secretly WANT it to go through, because they'll have more people forced to pay them, and will get government subsidies to cover the cost of some poor people getting "health insurance." It will keep the money flowing to these maggot corporations for another year or two, at which point the collapse will be on and there will be no medical system left in North Mexico anyway.

    I sure am glad I have my choice of TWO countries to live in with socialist medical systems! I'm not worried about my adoptive countries leaving me to die neglected because I'm old and less economically productive. Good luck in the United States of Hobbes, y'all.

  13. Bukko, private insurance only covers 35% of health care in the USA. Of that, individual insurance, the coverage actually regulated by the new bill (employer-provided coverage is already under different regulations) only covers 3.5% of health care in the USA. So the current bill is a tiny, tiny change in the current system that will make no difference to most people -- but a *huge* difference to those of us who shortly will not qualify for employer-provided health insurance and could not get health insurance at any price without this bill due to "pre-existing conditions".

    If the bill was as much a subsidy for health insurers as you imply, health insurers wouldn't be fighting it tooth and nail. But they are. They very, very, very much do not want to provide health insurance coverage to older sicker people. They only want to provide health insurance to young healthy people, because that's where the profits are.

    And yeah, profits of some of these insurers are obscene. But that's not the primary cause of the high cost of health insurance premiums. The primary cause of the high cost of health insurance premiums is, as I've previously pointed out, caused by the high cost of treatment for life-threatening illnesses. When a doctor can tell you, "your money or your life", there is literally no amount of money where you as an individual will balk, even if you are entirely impoverished for the remainder of your life as a result. Insurers end up getting the bill for that... and doing some evil shit as a result to try to get their expenses down, but the evil shit is because providers are saying "your money or your life", not because the insurers actually set out to be evil.

    In short: You're looking at the wrong culprit if you're looking at why U.S. healthcare is so inefficient and expensive. If you add up the entire medical loss ratios of all insurers (difference between premiums and claims), only 7% of health care costs are caused by that. You need to look up the food chain if you want the real culprits...

    - Badtux the Healthcare Economics Penguin


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