Does anyone really think that Paul Ryan's Vouchers-for-Medicare plan can work? Ask the insurance industry which companies want to offer health insurance to the over age 65 demographic. This is from
Benjy Sarlin at Talking Points Memo.Unlike the Affordable Care Act, which mandated that millions of young and healthy Americans purchase insurance with government subsidies, the Paul Ryan plan would instead bring the oldest, sickest, and least profitable demographic to the table. And with the CBO projecting that the average senior would be on the hook for over two-thirds of their health care costs within just 10 years of the plan's adoption -- a proportion that is projected to worsen in the long run --- the government subsidies backing them up may not bring in enough profitable customers to make things worthwhile.
"If reimbursement rates are too low to provide basic benefits, they'll tell the government, 'You do it,'" one insurance lobbyist told TPM. "I don't think they can require they lose money, they'd just pull out."
Dan Boston, a veteran lobbyist for health care providers and co-owner of Health Policy Source, said in an interview with TPM that he was taking a "wait and see" approach on the GOP budget before judging its value. (The American Hospital Association opposes the plan). But he cautioned that a major concern would be whether hospitals and private insurers would be left on the hook for low-income seniors eligible for both Medicare and Medicaid, who could run up significant costs with little hope of ever paying them off.
"I think everyone is going to be looking at the viability of the funding," he said.
Any so-called insurance company that tried to offer policies to the Medicare demographic would not last two years.
Ryan's plan is a perfect example of the crap that Republicans and much of the MSM call
thoughtful and
innovative. Ann Rand would have loved this stuff.
[Cross-posted at
Whiskey, Tango, Foxtrot - over.]
Labels: Health Insurance, Medicare, Paul Ryan, Republicans
A major reason for getting health insurance is so that you can have access to health care regardless of your employment status. That's important because is the case of severe illness, you may not be able to work so insurance is essential. The second reason is to protect your personal wealth from the unexpected and, in the case of many severe illnesses, extremely high costs of health care. So when you get laid off, one of the first things you need to do is get individual health care in the individual insurance market.
Consumer reports has recently investigate the health insurance offered in the private health insurance market for people who do not have employer-connected insurance. What they have found is that the private health insurance market offers policies which are either unaffordably expensive or which are so riddled with co-pays and limitations that they leave the insured on the hook for a great deal of the cost of health care which would have been covered by good employer or government insurance policies.
Here is the beginning of
the report from Consumer Reports:
Hazardous health plans
Coverage gaps can leave you in big trouble
Many people who believe they have adequate health insurance actually have coverage so riddled with loopholes, limits, exclusions, and gotchas that it won’t come close to covering their expenses if they fall seriously ill, a Consumer Reports investigation has found.
At issue are so-called individual plans that consumers get on their own when, say, they’ve been laid off from a job but are too young for Medicare or too "affluent" for Medicaid. An estimated 14,000 Americans a day lose their job-based coverage, and many might be considering individual insurance for the first time in their lives.
But increasingly, individual insurance is a nightmare for consumers: more costly than the equivalent job-based coverage, and for those in less-than-perfect health, unaffordable at best and unavailable at worst. Moreover, the lack of effective consumer protections in most states allows insurers to sell plans with "affordable" premiums whose skimpy coverage can leave people who get very sick with the added burden of ruinous medical debt.
The rest is quite worth reading so click through.
You may remember that the private insurance market was John McCain's and the Republican party's
solution to the rising costs of health care. As this CR study shows, that may get you into the door of a hospital in the case of a major emergency, but it won't cover the costs. If it does, you are broke from paying the premiums before you got sick and you'll very likely be bankrupt when you get out in either case.
The rational solution to this is mandated universal health care financed by the federal government. It needs to be federal because both people and illnesses easily move anywhere in the nation. The problem is national so the solution needs to be national. Also, as medicare and medicaid have proven, they can pay out benefits with an administrative cost less than 10%, while the very best private insurers have an administrative cost of 25% or more. Much of that cost is caused by the fact that the private insurer has to make sure that they do not insure unhealthy individuals and also do not pay for care for individuals who are not paying for their insurance to the insurance company who pays for he services.
Mandated universal health care will lower some of the costs for the federal government because a lot of the administrative expense is involved in just making sure that uninsured and ineligible individuals are covered for health care. That would also lower costs for private insurers, as they could always determine how the individual was covered before they accepted them. The federal government, by dint of its size, also can negotiate the lowest costs for medications and health services. In Germany the similar solution is federally financed and state administered.
This program at minimum would cover catastrophic medical costs, the costs of chronic health problems like diabetes, high blood pressure, and perhaps the wide-spread causes of illness like obesity. I'd like to see it pay for universal dental care, also, since untreated dental problems cause a lot of other health problems like heart trouble and such. Services above and beyond those items like chiropractic care as well as vitamin therapy and alternative medicines which are not well researched could then be covered by private health insurance or by fee for service.
If the government offered this alongside private insurance plans through employers and private insurance, then the difference in cost between the private insurance and the government would have the majority of people move to the government plan because they got equal health care at significantly lower costs and with a lot less hassle and surprise bills or denials of service.
Health care providers (operating as private contractors) would all understand the rules of the major health care financer and be able to focus on providing medical care instead of having to hire three or four medical insurance clerks to deal with differing insurance regulations and with fighting with insurance companies to get various services covered for their patients. Appeals for denials of services would be public record and available to the press, unlike similar "appeals" to private insurers, so the public could be made aware of unfair financing practices. Note the several private health insurers in California were sued for waiting until someone got expensively sick, then going back and determining ways to cancel their policies and merely refund their premiums instead of paying benefits. This unfair process (which is probably widespread) only comes out against a private insurer after expensive and lengthy law suits, and then only if the currently declining media covers it. A government appeals process can be made separate from the issue of making a profit, unlike for private insurers.
Most average workers simply want access to needed health care for themselves and their families. Middle class workers want medical care access and protection of their family wealth, such as their home and retirement funding. Only a universal health care mandate properly designed will provide that. It clearly is not here for a great many people right now, and what is happening to the auto workers demonstrates how uncertain even employer-provided health care is.
Addendum 10:39 CDT
Here is a link to a story of how the employer insurance is abused by employers.
Fired Zales worker recovers. My thanks to the commenter "anonymous" who left this link as a comment to my April 10th post on
Social Security and Medicare Notes.
Labels: Health Care System, Health Insurance, National Health Insurance
Karen Tumulty of Time Magazine moderated and covered the debate about health care held in Las Vegas last week. All the current candidates for President, Republican and Democrat both, were invited. No Republican accepted, while all the Democrats except Joe Biden accepted and showed up. The health care forum was held at the University of Nevada in Las Vegas on March 24, 2007.
Every Democrat in the 2008 presidential field has promised to provide health coverage to all the estimated 47 million Americans who lack it and to curb costs that have sent premiums soaring four times as fast as wages. On March 24, seven candidates showed up for a health-care forum that I moderated in Las Vegas, sponsored by the University of Nevada, Las Vegas, the Service Employees International Union, and the Center for American Progress Action Fund. [Snip]
There was no disagreement over the need to fix health care, only over how fast it could be done. New Mexico Governor Bill Richardson said he could accomplish it in his first year in the White House; New York Senator Clinton said it might take until the end of her second term; everyone else was somewhere in between. There was some dispute over whether reforming the nation's health-care system would require new taxes. Former North Carolina Senator John Edwards said it would; Richardson said it wouldn't; others were equivocal.
So why does it appear that this is the year of healthcare reform?
...the problems of high cost and inadequate coverage have gotten a lot worse since Clinton's plan crashed and burned. As employer-provided insurance has become skimpier and skimpier, the problem has turned nearly every American into an "expert" on health care with ideas on how to fix it. For another, the corporations that were Clinton's chief adversaries in 1994 are now among the loudest voices clamoring for something to be done about health-care costs. In the meantime, some states--among them, Massachusetts, California, Maine and Vermont--are moving ahead to guarantee all their citizens coverage.
But while health care for all is now a popular slogan, Edwards is the only candidate offering a plan that would actually get to universal coverage. His proposal is much like a model that is being tried or considered in several states and that includes a combination of features. For example, it requires employers who don't insure their workers to pay into a fund for the uninsured, and individuals who don't get coverage from their employers to buy it, and provides subsidies for those who can't afford the premiums.
The two largest problems that seem to be recognized by Democrats are that access to health insurance is declining, while health care itself (and the insurance that often pays for it) is increasing at a rate far above the rate of inflation.
Maybe this election will bring some effort to find some solutions.
Labels: 2008 Election, Health Insurance, Universal Healthcare
The LA Times just published this story:
Blue Cross of California systematically violates state law when it cancels health insurance policyholders after they get pregnant or sick, making no attempt to determine whether the consumers did anything to merit such harsh treatment, a scathing investigation by state regulators has found.
As a result of its unprecedented investigation, the Department of Managed Health Care today fined Blue Cross $1 million. The department's findings also expose the company, the state's largest health insurer, to legal liability in dozens of lawsuits filed by consumers who allege their policies were illegally canceled, subjecting them to substantial hardships.
When I need the benefits of my health insurance, I need it at the time I am sick (or the pregnant woman needs it when pregnant and when giving birth.) Even if the insurance company is
caught denying benefits illegally, as most are not, then they don't get sued or fined until a long time after the benefits are actually needed.
A private health insurer has one purpose. That is to make money. They are not there to help pay for your health care. They are there to collect payments on your health insurance policy and pay out as little as possible. They can make a lot of money as long as they receive the payments and don't pay the benefits. It doesn't matter to them if you don't use the benefits because you are healthy, or because they deny your policy when the benefits should have been paid. It just matters that they get richer if they do not pay out the benefits on your health insurance.
The government does not have a profit motive. The covered benefits are paid when they are needed. If they aren't, then the government is carefully watched by large numbers of people who want to catch them out. Clearly we cannot say the same for even the very best of the private insurance companies. Blue Cross/Blue Shield has usually been the very best.
The health care industry should be working to keep people healthy or make them well. They should not be working to get rich themselves. (And most aren't.) But as long as we have private health insurance companies trying to skim off the healthiest of the rate payers, health care will cost too much for those who can pay for the insurance, while leaving a lot of people out - often unexpectedly as the customers of Blue Cross in California found.
This is one more very strong argument for single-payer national health care.
Labels: Blue Cross, Crime, Health Insurance, National Health Insurance
Quinnipiac reports (Feb 22, 2007)
a national poll that says:
By a 64 - 31 percent margin, American voters say, "It's the government's responsibility to make sure everyone in the United States has adequate health care," according to a Quinnipiac University national poll released today.
Democrats support this position 81 - 15 percent, as do independent voters, 67 - 28 percent, but Republicans oppose it 55 - 41 percent, the independent Quinnipiac (KWIN- uh-pe-ack) University poll finds.
American voters also say, 53 - 42 percent, that they would be willing to pay more in federal taxes to provide health care to all Americans. Democrats back higher taxes 70 - 26 percent, along with independent voters, 56 - 39 percent. Republicans oppose paying higher taxes for health care 63 - 32 percent.
If we are all paying taxes (instead of having the price of health care deducted from our salaries)we would have universal national single-payer insurance.
Health care providers could put clinics and emergency rooms where the people had more illnesses, rather than where they had more money. Everyone would have the same rules for their insurance, so the community would develop knowledge of what was covered and what was not covered. Hospitals and other health care providers could simply provide care and know they were going to be paid, rather than first checking the patient's wallet for an insurance card. HMO networks would disappear. A patient could choose any licensed healthcare provider. The cost of trying to collect fees from people who don't have the money would be taken off the hospitals, and the numbers of patients driven into bankruptcy by medical bills would be sharply reduced.
Then there is the massive benefit that would be given to the automotive companies. They would not have to include $1700 in the price of every car for health care. Yet the much simplified administration (a single set of claims procedures and no insurance companies trying to find reasons not to pay claims) would more than cover the cost of this system.
And anyone who has had to decide which Medicare or Medicare Part D plan to choose would find the stress sharply reduced. There would not be a set of critical or potentially critical insurance decisions to make just because you are age 65.
The savings in administration would very likely more than cover the cost of covering everyone, so the increase in taxes would be accompanied by a decrease in insurance payments. [The employers would probably get that cost savings, but wages and salaries would not be reduced because health insurance was so expensive to them.]
The American people are ready for universal healthcare. It is only the insurance companies and their bought-and-paid-for politicians who are holding things up. This is a solution to a lot of American problems that should be implemented as soon as the lost war in Iraq is liquidated and Bush/Cjeney leave the national political scene.
[H/T to
TPM Cafe.]
Labels: Health Insurance, single-payer, taxes
