Help needed in argument with liberal about HMO's

n/a ^ | 07-03-03 | n/a

[Monster Zero]

Having a candid discussion with a liberal at work about what's wrong with health care. After being told that evil HMO's were the big problem, I stated that HMO's (I hate 'em too, btw)) were invented by Ted Kennedy and his crew back in the late 70's. He said, "well, Monster Zero, you've given me something to go look up."

[Monster Zero]

Rebuttal on the way, of course. Any useful information would be appreciated.

[Semper Paratus]

I had a similar arguement with a lib friend.
His claim is that HMO's are privatization of health care!

[Scenic Sounds]

If both of you hate HMO's, what's the argument going to be about?

[staytrue]

The big advances in health care has been advances in drug therapy. Drugs are expensive now, but all go off patent in 17 years. Problem solved.

[NYFriend]

What does he think that HMO's do that is bad? Inflate the cost of health insurance, inflate the cost of private pay health care, or deny peopel needed health care?

[CholeraJoe]

HMO Act of 1973

[m1911]

Google gave me a page from Institute for Health Freedom which says that ol' Sub Commander Ted was a sponsor of the '73 HMO act.

Also, it comments briefly on the root of the problem (IMO): "Today's workers are effectively coerced into HMOs because of federal tax policy established in the 1940s. Currently, health insurance is excluded from taxation if employers purchase it, but individually purchased insurance is not."

[Rodney King]

Ask him this: If you don't like HMO's which attempt to cut costs by exercising pricing power over doctors and pharmacies, and serve as gatekeepers to patient care to ensure that patients don't get unneeded treatment, then why would you possibly support government health care which is going to try to control costs by doing the exact same things? At least now, if you don't like your HMO you can go to another one. What will you do when the only HMO is the government?

[Reeses]

what's wrong with health care.

The lawyer mafia and the Lawyers Party, the Democrats, have driven up the price of healthcare. Now if there's a still birth it's almost a given the parents get $35 million, 1/3d of which goes to lawyers who then funnel money back to Democrat protectors. Of course that gets worked back into insurance costs and ultimately the consumer pays 3 times more than they used to.

[NYFriend]

It's true that employer provided insurance is a tax write-off, but there are insurance options that are alternatives to HMO's. Are we talking about the argument that all insurance is bad for the health care system? There is an argument to be made there. I disagree, but you could argue that any insurance 1) encourages over use of health care by removing the finacial responsibility for care from the patient; and 2) the market power of insurance companies allow them to negotiate health care fees that are too low and force providers to overcharge private pay patients to make up the differance, effectively using private pay to subsidize the insured's health care.

[Kaisersrsic]

I think you are wrong about the establishment of HMOs. I was under the impression that Kaiser Steel established the HMO that later became Kaiser Pemenente during WWII because of the tremendous increase in employees. The HMO Act of 1973 did not really establish HMO, but instead provided for federal rather than state-by-state regulation (similar to most employee benefits being governed by the Employee Retirement Income Securities Act, ERISA).

If you start with the understanding that neither you nor anyone else is entitled to free health care, HMOs become alot more attractive. Before run away regulation, they were thought to be an effective cost saving device that allowed employers to provide better health benefits at a lower price. If a person does not like their HMO, they should pay for a better plan. If an employer provided HMO is not what the person wants, they should ask the employer for more options or get a new job with "better" benefits.

[Monster Zero]

I hate HMO's because they interfere with and micromanage medical care in much the same way that HitleryCare would. He hates HMO's because they turn a profit. The argument started when we were discussing a coworker's upcoming surgery and I said something about "If people think that problem is going to be solved by the Government..." and that set him off.

[elbucko]

"Today's workers are effectively coerced into HMOs because of federal tax policy established in the 1940s.

Kaiser Industries began the US concept of a company HMO (not unlike the British coal companies) to insure levels of production by reducing absenteeism due to the unavailability of doctors in certain areas. Kaiser, as an HMO, was simply insuring a steady work force. They did not cover employees after retirement. HMO's have merit in places where there are no doctors or hospitals, but there is industrial activity, such as Kaisers gypsum mines in rural So. California.

HMO's are not the answer to the whole national health question. HMO's are the answer to a specific problem. The federal government is so involved in health care that it will never do what needs to be done, not socialize it or privatize it, but make it all, "non-profit".

[Pete]

Also, it comments briefly on the root of the problem (IMO): "Today's workers are effectively coerced into HMOs because of federal tax policy established in the 1940s. Currently, health insurance is excluded from taxation if employers purchase it, but individually purchased insurance is not."

The reason for that was the wage freezes during World War II. Businesses needed other perks to attract workers. Group health insurance was such a perk. It makes sense that it is excluded from taxation if one considers that it is a business expense.

Everyone loves to say they hate HMO's and, in fact, there has been a 'Managed Care' backlash in the late 1990's. You should start to see new products coming out now, such as 'Consumer Driven Health Plans'.

Before bashing the HMO's, it is worthwhile to consider the cost of healthcare WITHOUT insurance. The HMO's may have some hoops but that is only because we, the public, have given them the responsibility of financing our health care AND accepting the risk. Ask anybody if they would like to go to any doctor any time and they will say 'Yes'. Ask them if they are willing to pay for it and they say 'No'. Some people have become so disconnected from the cost that they think health care is free when you have insurance. Getting the consumer back into the financial side (so they can consider the economics) is one step we need to take in order to improve our health care system.

Another major problem is our society's view of death. Two things have happened simultaneously in the last 30 years. We have become more secular and medical science has made huge advancements [the latter means more potential treatments at a higher cost and longer life expectancy with progressively more expense health care requirements]. The end result is the expectation that doctors should keep you alive no matter what (because this life is all there is) and that they actually can (because of all the wizz-bang medicine). With most people disconnected from the financing, the economic cost is lost in the equation. Inpatient hospital health care in the last 30 days of life accounts for a disproportionately high percentage of total health care cost.

Another fact that most people don't know is that 5% of the people incur 50% of the cost in a given year. (Which 5% will it be next year is the question - and that is why we have insurance)

[m1911]

Google came up with this one from the Citizens Council on Health Care too - it seems to give a detailed, albeit one-sided, view of the development of HMOs.

[NYFriend]

First, it's true that HMO's turn a profit at the expense of providers, such as hospitals. My insurance company makes alot of money off me. I don't need much health care. One day I probably will. I'm paying for piece of mind. My wife goes the doctor more frequently. She gets her money worth for sure, of course our employer picks up a bigger portion of our health insurance costs than we do.

I hate trial lawyers because they turn a profit. You and your friend are coming from different places. Drop the argument. Neither of you will win. As far as your problem with HMO's, it all comes down to choice. I pay more for my insurance, a PPO, than I would for the HMO option my employer offers. I don't need prior approvals for anything. I also chose to pay more.

[NYFriend]

First, it's true that HMO's turn a profit at the expense of providers, such as hospitals. My insurance company makes alot of money off me. I don't need much health care. One day I probably will. I'm paying for piece of mind. My wife goes the doctor more frequently. She gets her money worth for sure, of course our employer picks up a bigger portion of our health insurance costs than we do.

I hate trial lawyers because they turn a profit. You and your friend are coming from different places. Drop the argument. Neither of you will win. As far as your problem with HMO's, it all comes down to choice. I pay more for my insurance, a PPO, than I would for the HMO option my employer offers. I don't need prior approvals for anything. I also chose to pay more.

[pabianice]

The issue is so clear: There is not enough money in the world to provide everyone with the best medical care available.

Now, how difficult is that to understand?

[big bad easter bunny]

Didn't liberals invent HMO's?

[OhMike]

First of all, a worthwhile discussion on this (or any other topic) would call for intelligence and logic. You might get lucky and find the former in a liberal, but I doubt you'll find a liberal who can practice the latter.

Why waste your time? I am in the healthcare industry. I've been a consultant at a major firm specializing in healthcare. One might charitably say that I am an expert in the field. Yet, here's what I know: Most people are so woefully ignorant on this subject, so misguided, and so much ruled by an illogical wish to live forever and to get something free, that there's very little point in discussing the subject.

The basic liberal's take on healthcare amounts to this: Me want live always. HMO bad. Insurance companies bad. Me good. Me want free stuff. Gimme a new liver.

Save yourself the aggravation, and use your time more constructively. Go punch a liberal in the eye. -OhMike