Posted on 05/06/2017 7:21:19 AM PDT by RoosterRedux
Now that the Obamacare replacement bill has passed the House and is moving on to the more centrist Senate, the real debate begins. What is the true purpose of health insurance, and what is our government’s goal in ensuring we have it?
I learn from my patients every day about the benefits, limitations and contradictions of their health insurance. One charming 60-year-old with severe seasonal allergies insists on seeing me every few weeks this time of year, even though I tell her she doesn’t need to — her antihistamines and nasal spray treatment rarely changes. But she worries that her allergies could be hiding an infection, so I investigate her sinuses, throat, lungs and ears. I reassure her, and her insurance (which she buys through New York’s Obamacare exchange) covers the bill.
If she was responsible for more than a small co-payment for these visits, I’m sure I would see her less often.
We pride ourselves on being a compassionate society, and insurance companies use this to manipulate us into sharing the costs of other people’s excessive health care. Meanwhile, 5 percent of Americans generate more than 50 percent of health care expenses. Why shouldn’t a patient who continues to see me unnecessarily pay more? Continue reading the main story
Advertisement Continue reading the main story
The government’s job is to maintain public health and safety. It should ensure that insurance plans include mandatory benefits like emergency, epidemic, vaccine and addiction coverage. The Republican bill would let states apply for waivers to define these benefits differently; it would be a big mistake to drop such coverage entirely. But Obamacare went well beyond these essentials, by mandating an overstuffed prix fixe meal filled with benefits like maternity and mental health coverage...
(Excerpt) Read more at nytimes.com ...
Ping.
I wonder how many subscribers will cancel over this editorial?
The best case would be if the law allowed folks to pick and choose what they want covered.
“allowed folks to pick and choose what they want covered”
I’d like lung cancer covered at ~$12/month.
Alas, if customers could pick the covered risks they would normally have to pay almost full price since most of their risks would be covered.
What is more feasible is to allow insurers to offer risk packages of their choosing. You would pick the risk package most to your liking.
I’m a low-income person.
I simply can’t pay to cover the pre-existing conditions of a person making $35,000/year.
My risk is about $50/month.
Insurers might choose to offer me coverage at say $150/month that would met my actual medical risks.
To offer me a $250/month “subsidy” on a $500/month PPACA-level package has me overpaying above market-level pricing by $100/month.
I can barely afford to pay $100/month out-of-pocket.
To ask me to pay $250/month after a “subsidy” is simply unaffordable for me.
Don’t offer me a subsidized lease on a Obama-class Cadillac when all I can afford is local bus fare.
As a low-income person, I live a life without many things and services that might benefit me. It’s just the way it is.
Dr Marc Siegel is one of the FoxNews guest ‘expert’ docs.
I totally agree with this statement but I don't see what this has to do with either the ACA or the proposed replacement.
The only aspect of this that might be mandated by law is that a doctor visit for allergies has to be covered. The amount of the co-pay is completely determined by a negotiation between the insurance company and the buyer of the policy. There's nothing keeping the insurance company from charging a $500 co-pay other than the market.
In addition to limiting the menu of essential benefits, the House bill would let states create high-risk pools for patients with pre-existing conditions who had let their insurance coverage lapse, and who could then be charged premiums more in keeping with their health care needs. This is the only way to make insurance affordable for most consumers; pre-existing conditions will continue to drive up premiums if everyone is compelled to pay the same price.
These risk-pool premiums can and should be subsidized by the government.
If you don't find a way to reduce the cost of treating these conditions all you're doing is shifting the cost from insurance policy holders to the general tax base. People may pay less in premiums but they'll make up for it in higher taxes - and we'll lose visibility of our true healthcare costs.
That $100.00 (+/-) is what's lining the pockets of the politicians/lobbyists and insurance cos. :(
Any surgeon who listens to the continual complaints of a 94 year old with arthritis and heart disease and performs back surgery four months before the patient dies a natural death, should have a black mark on his healthcare record. This happened in our family.There are thousands of these medically unnecessary, hugely expensive operations done each year. The nation will soon be financially insolvent because of such practices.
“It should ensure that insurance plans include mandatory benefits like emergency, epidemic, vaccine and addiction coverage.”
I’m 58-years old and have never been an ER patient.
To mandate vaccine coverage is to ensure vaccines will become expensive.
As for addiction coverage, just make buprenorphine/naloxone prescriptions automatically renewable.
There should be no government insurance mandates.
Insurers must be free to design and offer coverage.
Giving insurers full power to design coverage affordable for me is what I want.
If you want better coverage than what I can afford, then buy it.
Don’t deny me a chance to have coverage in case an SUV motorist fractures my pelvis.
I wanna know why health care prices are not posted on their website or in their office, like my auto mechanic does.
I believe my mother’s 30 year abuse of medicare alone broke the system.
If you don't find a way to reduce the cost of treating these conditions all you're doing is shifting the cost from insurance policy holders to the general tax base. People may pay less in premiums but they'll make up for it in higher taxes
And the high risk-pool funds themselves should not be subsidized by the government...but that is not the big deal.
HRP premiums need not be a lot higher than standard risk pool rates, but HRP patients should pay more, since they have very high claims loads.
The reason governments should not fund pools once they are established, is that future RATs can easily defund them and wreak havoc upon those people depending on them. Usually the average for HRP patients in the pool is about three years...either they get better...or succumb to their malady.
No mandates please.
Creeping mandates and leaping drug prices enabled by those mandates is how we got into this mess.
Government has failed low-income Floridians like me for decades.
Government should not ensure by well-intentioned mandates that health care coverage is unaffordable to low-income people like me.
Aetna and Blue Cross know their business and their customers. Let the market system work.
Based upon your homepage you are deeply into
the medical/insurance coverage arena......
Good news, here's a great policy that only costs you $100 a month.
(the bad news is, it doesn't cover a damn thing, but you won't find that out until you try to use it)
Now don't forget to pay your premiums.
Meanwhile, 5 percent of Americans generate more than 50 percent of health care expenses. Why shouldn’t a patient who continues to see me unnecessarily pay more? Continue reading the main story
...
Is it the same 5% year after year?
“I wanna know why health care prices are not posted on their website or in their office, like my auto mechanic does.”
There are tens of thousands of services and products.
Most catalogs of medical procedure names are copyrighted.
As fare as I know, only the German OPS system is public domain.
https://www.dimdi.de/static/en/klassi/ops/
What I suggest is Medicare multiple pricing. This would be one number, not tens of thousands.
“I wanna know why health care prices are not posted on their website or in their office, like my auto mechanic does.”
No Doctor or Hosp can do that, because everyone is charged a different price for everything!
A Medicaid patients insurer (The State) is billed $50 for a Doctor visit that a Medicare patient pays $100 for.
A BCBC patient’s insurer pays $150 for the same visit.
A patient that has no Ins. at all might pay $75 for paying in cash.
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