[Doofy]

Originally Posted by stupendousman 

First off, FedEx and UPS do not pay USPS fees for delivering to homes.

===========================================
United States Code 1725 Postage unpaid on deposited mail matter

Whoever knowingly and willfully deposits any mailable matter such as statements of accounts, circulars, sale bills, or other like matter, on which no postage has been paid, in any letter box established, approved, or accepted by the Postal Service for the receipt or delivery of mail matter on any mail route with intent to avoid payment of lawful postage thereon, shall for each such offense be fined under this title.

AMENDMENTS
1994 - Pub. L. 103-322 substituted "fined under this title" for "fined not more than $300". 1970 - Pub. L. 91-375 substituted "Postal Service" for "Postmaster General".

EFFECTIVE DATE OF 1970 AMENDMENT
Amendment by Pub. L. 91-375 effective within 1 year after Aug. 12, 1970, on date established therefor by Board of Governors of United States Postal Service and published by it in Federal Register, see section 15(a) of Pub. L. 91-375, set out as an Effective Date note preceding section 101 of Title 39, Postal Service.


Also,

DMM 508
3.1.3 Use for Mail

Except under 3.2.11, Newspaper Receptacle, the receptacles described in 3.1.1 may be used only for matter bearing postage. Other than as permitted by 3.2.10, Delivery of Unstamped Newspapers, or 3.2.11, no part of a mail receptacle may be used to deliver any matter not bearing postage, including items or matter placed upon, supported by, attached to, hung from, or inserted into a mail receptacle. Any mailable matter not bearing postage and found as described above is subject to the same postage as would be paid if it were carried by mail.

Wait. So your friend (who came around personally but missed you) can't pop a birthday/Christmas card (in envelope) into your mailbox without being guilty of an offence?

You don't even own your own mailbox in the land of the free?

You people need a revolution. Like, yesterday.

[ebuddy]

Originally Posted by msuper69 

Let me know the insurance company that will provide non-group health insurance for an insulin-dependent diabetic. Believe me I've tried and can't find one that will issue a policy at ANY price.

I'm sorry to hear this msuper69. It's situations like these that I think speak the loudest for health care reform. Is there not anyone in the country that will cover your situation or is this a matter of availability in your State?

It's surprising to me that even in your State there is no creative means of making coverage available to you even if it involves packaging a plan with a discount provision at least. We've got a long way to go.

[msuper69]

Originally Posted by ebuddy 

I'm sorry to hear this msuper69. It's situations like these that I think speak the loudest for health care reform. Is there not anyone in the country that will cover your situation or is this a matter of availability in your State?

It's surprising to me that even in your State there is no creative means of making coverage available to you even if it involves packaging a plan with a discount provision at least. We've got a long way to go.

No insurer will provide personal coverage for insulin-dependent diabetics. Believe me I've looked high and low. (they will if you get group insurance but that's only available at work and since I'm out of work I can't get it).

And the thing that really got me riled up was when I filled out an online application to Blue-Cross/Blue-Shield (about 3 or 4 pages worth of personal information) only for the last page to ask about pre-existing conditions. As soon as I clicked on Diabetes Mellitus and submitted the app, it came back immediately as "so sorry we can't help you due to a pre-existing condition" (or words to that effect). Why the he!! couldn't they just ask that first so I would have had to give them all that personal info?

[Chuckit]

Have you tried calling your state health department to see if they know of any options? A lot of places have some some sort of program to help high-risk patients get coverage.

[msuper69]

Originally Posted by Chuckit 

Have you tried calling your state health department to see if they know of any options? A lot of places have some some sort of program to help high-risk patients get coverage.

I seem to remember running into some kind of bureaucratic brick wall when I tried that route.

I'll give it another go.

Of course, if any of my current job leads comes through, I may be able to get coverage through work.

Thanks for the tip.

(What gets me is my diabetes is well-controlled as I'm pretty conscientious about the whole thing. A cigarette smoker/heavy drinker is a much worse risk than me).

[ebuddy]

Originally Posted by msuper69 

I seem to remember running into some kind of bureaucratic brick wall when I tried that route.

I'll give it another go.

Of course, if any of my current job leads comes through, I may be able to get coverage through work.

Thanks for the tip.

(What gets me is my diabetes is well-controlled as I'm pretty conscientious about the whole thing. A cigarette smoker/heavy drinker is a much worse risk than me).

Just found out that unfortunately you're in one of only four states in the country that do not have a mandate or insurance requirement for covering diabetics- they are Alabama, Idaho, North Dakota and Ohio. NCSL.org

To be clear; you should still pursue the advise given by Chuckit above.

I'm hoping some of the alternative proposals folks have been trying to get through Obama's "open door" since March can get some attention.

[hyteckit]

Pre-existing condition: Domestic violence

Domestic violence as pre-existing condition? 8 states still allow it | McClatchy

Mostly conservative states

[ebuddy]

The good news is there are 42 states that do not use domestic violence as a pre-existing condition. Mostly Conservative.

Let's get the market opened up across the country so we can end this madness.

[hyteckit]

Pre-existing condition: Donating your kidney to a family member


http://www.nytimes.com/2009/10/04/op...=1&ref=opinion

[hyteckit]

Pre-existing condition: 4 month old baby is too fat

Alex Lange Denied Health Care Coverage: "Your Baby Is Too Fat"

[Chuckit]

Originally Posted by hyteckit 

Pre-existing condition: 4 month old baby is too fat

Alex Lange Denied Health Care Coverage: "Your Baby Is Too Fat"

What a great example of the insurance industry doing something right.

Rocky Mountain Health Plans has now said it will cover Alex Lange, a baby they previously refused to give health insurance because of his weight.
"A recent situation in which we denied coverage to a heavy, yet healthy, infant brought to our
attention a flaw in our underwriting system for approving infants," says Steve ErkenBrack, president and CEO, Rocky Mountain Health Plans. "Because we are a small company dedicated to the people of Colorado, we are pleased to be in a position to act quickly. We have changed our policy, corrected our underwriting guidelines and are working to notify the parents of the infant who we earlier denied."

[spacefreak]

Originally Posted by hyteckit 

Health insurance is like mail-in coupons. They are always looking for ways to denied your claim.

Fortunately, there are over 1700 health insurance companies in the US, so if one is unsatisfied with their current carrier, they can seek out another policy w/ a different insurer (though government restrictions limit the number of available insurers per state). If that doesn't work out, they can walk into any hospital without fear of being denied care. Or, they can beg or borrow funds to pay for care.

If we had a single payer system, once the government says no dice to a procedure or medicine or treatment, that's the final word short of fleeing off to a different land. Like how people from all over the world flock here for care. One of the fastest growing industries in Canada is comprised of companies whose sole purpose is to locate hospitals in the US to treat Canadian citizens.

[hyteckit]

Originally Posted by spacefreak 

Fortunately, there are over 1700 health insurance companies in the US, so if one is unsatisfied with their current carrier, they can seek out another policy w/ a different insurer (though government restrictions limit the number of available insurers per state). If that doesn't work out, they can walk into any hospital without fear of being denied care. Or, they can beg or borrow funds to pay for care.

If we had a single payer system, once the government says no dice to a procedure or medicine or treatment, that's the final word short of fleeing off to a different land. Like how people from all over the world flock here for care. One of the fastest growing industries in Canada is comprised of companies whose sole purpose is to locate hospitals in the US to treat Canadian citizens.

Really? Tell that to the parents of Nataline Sarkisyan, who's health insurance CIGNA denied her claim, which lead to her death.

Nataline Sarkisyan's parents beg.
Nataline Sarkisyan's doctors beg.
Nataline Sarkisyan's parents then sued.

Having health insurance doesn't mean you won't be denied when you need it most.

When you are dying or dead, isn't really the best time to shop around for health insurance.

[besson3c]

The "oh, there are so many options" argument is bullshit. In many cities there is one health insurance monopoly, and one provider that the hospitals will accept, period.

You'd also think that the alleged poor quality of the Canadian health care system would have people disapproving of it in overwhelming numbers, when all polls show an incredible amount of support for it. Red America wants you to believe that Canadians hate their own system over Canada's own voices, and also to believe that when you take car accidents out of the way that the average life expectancy in America is comparable to Canada's (it isn't, even with this adjustment). Go figure.

[Chuckit]

And having the government be the insurer won't change any of that, except that the government can grant itself immunity from lawsuits if it feels like it. Personally, the government has never given me anything but headaches. Anybody who trusts the government more than an insurance company, please share whatever you are taking, because it sounds like good stuff.

[Chuckit]

Originally Posted by besson3c 

The "oh, there are so many options" argument is bullshit. In many cities there is one health insurance monopoly, and one provider that the hospitals will accept, period.

You'd also think that the alleged poor quality of the Canadian health care system would have people disapproving of it in overwhelming numbers, when all polls show an incredible amount of support for it. Red America wants you to believe that Canadians hate their own system over Canada's own voices, and also to believe that when you take car accidents out of the way that the average life expectancy in America is comparable to Canada's (it isn't, even with this adjustment). Go figure.

Which is why most non-liberals are in favor of knocking down this "in my city" business and opening up the healthcare field rather than locking it down further.

[hyteckit]

Originally Posted by Chuckit 

And having the government be the insurer won't change any of that, except that the government can grant itself immunity from lawsuits if it feels like it. Personally, the government has never given me anything but headaches. Anybody who trusts the government more than an insurance company, please share whatever you are taking, because it sounds like good stuff.

And you would trust our government for national defense over private companies?

Wouldn't you trust companies like Blackwater/Xe more?

Why don't we privatize national defense?

[Chuckit]

Originally Posted by hyteckit 

And you would trust our government for national defense over private companies?

Wouldn't you trust companies like Blackwater/Xe more?

Why don't we privatize national defense?

Because national defense and insurance are not remotely similar. Surely you can see that, right?

[CreepDogg]

Originally Posted by spacefreak 

Fortunately, there are over 1700 health insurance companies in the US, so if one is unsatisfied with their current carrier, they can seek out another policy w/ a different insurer (though government restrictions limit the number of available insurers per state).

Good luck with that. If one company denies you coverage for something, the other 1699 will now deny you because it's a pre-existing condition. They might cover you, but not for whatever you're actually sick with. What's their incentive, even in a perfectly competitive environment (which doesn't and won't exist when there's inelastic demand for care), to cover you in that situation?

If that doesn't work out, they can walk into any hospital without fear of being denied care. Or, they can beg or borrow funds to pay for care.

Which is always the most efficient way to get care when you're sick.

[CreepDogg]

Originally Posted by Chuckit 

And having the government be the insurer won't change any of that, except that the government can grant itself immunity from lawsuits if it feels like it. Personally, the government has never given me anything but headaches. Anybody who trusts the government more than an insurance company, please share whatever you are taking, because it sounds like good stuff.

Well, I'm for whoever is not seeking a profit off my misery. Yes, I know that's actually nobody, so the next best alternative is to try to pit private industry and government against each other (through regulation and what have you) for the benefit of the public. I'm looking for whatever best achieves that mix.

We know unabated private industry doesn't work - that's what we have now. We also know unabated government doesn't work. Those two working together is even worse. So - how can we best get them working against each other?

[Snow-i]

Originally Posted by CreepDogg 

We know unabated private industry doesn't work - that's what we have now. We also know unabated government doesn't work. Those two working together is even worse. So - how can we best get them working against each other?

What we have now is that mix. We surely don't have unabated private industry. We have state regulated monopolies that do not allow competition as would an "unabated" private industry. I agree with your sentiment, however your choice of vocabulary underscores a certain level of ignorance concerning the state of affairs today.

We also don't want the government primarily working against anything. We want them working for us. It might be a subtle difference to you but an important one nonetheless.

[hyteckit]

Originally Posted by Chuckit 

Because national defense and insurance are not remotely similar. Surely you can see that, right?

I see more similarities than differences between health care and national defense.

Both really on an army of professionals to save and protect lives.
Doctors/Army protect us against terrorist/viruses that can kill us.

They are just combating a different type of terrorist. Humans versus viruses.


Besides. You trust the government?

As for being able to sue private health insurance companies, but not the government. Didn't you say you like the idea that we should limit lawsuits against health insurance companies? Now you like the idea that we can sue private health insurance companies because that would keep them in check?

So which is it? Yeah or nay for being able to sue private health insurance companies?

[CreepDogg]

Originally Posted by Snow-i 

What we have now is that mix. We surely don't have unabated private industry. We have state regulated monopolies that do not allow competition as would an "unabated" private industry.

Really? Who's regulating the actions of these companies? They certainly seem to be able to ration health care in any way they choose. They probably even have their own death panels.

How would the incentives be different if the separation by state would be eradicated? Instead of having Blue Cross in each state, I think we'd have one national Blue Cross with the same behaviors. They make money by cherry-picking their risk pool and denying coverage wherever they can get away with it. That would NOT change just because they could cross state lines.

We also don't want the government primarily working against anything. We want them working for us. It might be a subtle difference to you but an important one nonetheless.

Actually, yeah, I'd like the government working against injustice and profiteering, among other things. Bottom line is, it needs to be in a position to be an effective check and balance to what today is clearly a profiteering private industry.

I agree with your sentiment, however your choice of vocabulary underscores a certain level of ignorance concerning the state of affairs today.

Maybe so, in which case IMO it's a humility more on this forum should display. I get that it's a complex, nuanced issue, that there are no easy answers, and that I don't have all of them. If you want to claim you do, be my guest. I do know that what we have right now isn't working, that there's a fundamental problem with the incentives in the system, and that what's currently being bandied about will probably result in more of the same since nothing seems to be being done without the 'blessing' of the industry. So quite frankly, yeah, I think a little more hostility toward the status quo is in order.

[Snow-i]

Originally Posted by hyteckit 

I see more similarities than differences between health care and national defense.

One group kills people. The other saves people.

Both really on an army of professionals to save and protect lives.

One group travels to other land using massive weapons of destruction to acheive this, the other comes to your grandmother's house and prescribes her medicine. The similiarities are mounting.

Doctors/Army protect us against terrorist/viruses that can kill us.

No, doctors work to prevent it from becoming a threat and if such a threat does become prominent, the latter seizes control of the situation to prevent the destruction of our species and mitigate the loss of life, so that enough doctors can hopefully live long enough to develope a cure

They are just combating a different type of terrorist. Humans versus viruses.


Besides. You trust the government?

As for being able to sue private health insurance companies, but not the government. Didn't you say you like the idea that we should limit lawsuits against health insurance companies? Now you like the idea that we can sue private health insurance companies because that would keep them in check?

So which is it? Yeah or nay for being able to sue private health insurance companies?

Sue them for what? Under what circumstance? Under who's authority?

[hyteckit]

Originally Posted by Snow-i 

One group kills people. The other saves people.

Both kill terrorists/enemies to save human lives.

Originally Posted by Snow-i 

One group travels to other land using massive weapons of destruction to acheive this, the other comes to your grandmother's house and prescribes her medicine. The similiarities are mounting.

Different weapon for different task. How to kill the enemy/terrorist/virus.

Weapons of choice: Nuclear weapon for mass scale attack. guns for more precision. medicine for microscopic.

Originally Posted by Snow-i 

No, doctors work to prevent it from becoming a threat and if such a threat does become prominent, the latter seizes control of the situation to prevent the destruction of our species and mitigate the loss of life, so that enough doctors can hopefully live long enough to develope a cure

Both actively engage the enemy and prevents the enemy from spreading. Both try to contain the threat to human lives. Soldiers hope to eliminate terrorist. Doctors hope to eliminate terrorist/disease/viruses.


National defense against terrorist/viruses/enemies/diseases

[Snow-i]

Originally Posted by CreepDogg 

Really? Who's regulating the actions of these companies? They certainly seem to be able to ration health care in any way they choose. They probably even have their own death panels.

Hence the predicament we are in.

Competition and government are the two primary means that have been proposed to eradicate this predicament. Competition would have insurance companies that are unfair and underhanded meet fiscal doom, given the proper antitrust regulation. The government will just tax the living pants off of everyone and everything, just to throw this people in jail. Oh, and when they're doing it themselves...there is no check or balance.

How would the incentives be different if the separation by state would be eradicated? Instead of having Blue Cross in each state, I think we'd have one national Blue Cross with the same behaviors. They make money by cherry-picking their risk pool and denying coverage wherever they can get away with it. That would NOT change just because they could cross state lines.

Well, when you figure out that they're cherry picking then you just sign up with someone else. They then meet the fiscal angel of death, for which they are considered by the public to have a "pre-existing" condition for. No one can save them.

Actually, yeah, I'd like the government working against injustice and profiteering, among other things. Bottom line is, it needs to be in a position to be an effective check and balance to what today is clearly a profiteering private industry.

No, I don't want the government primarily working against those things. I was it to be clear that the government is working FOR us, and whatever that means. Its really the paradigm you choose to look through, as we are saying the same things. The distinction, IMO, has been lost today and is the basis of many of the problems we face.

Maybe so, in which case IMO it's a humility more on this forum should display. I get that it's a complex, nuanced issue, that there are no easy answers, and that I don't have all of them. If you want to claim you do, be my guest. I do know that what we have right now isn't working, that there's a fundamental problem with the incentives in the system, and that what's currently being bandied about will probably result in more of the same since nothing seems to be being done without the 'blessing' of the industry. So quite frankly, yeah, I think a little more hostility toward the status quo is in order.

I couldn't agree more. WHICH status quo we attack, well, thats the big question. Do i have all the answers? No. Could i do a better job? Maybe. A more honest one certainly...and thats what we really need.

[CreepDogg]

Originally Posted by Snow-i 

Sue them for what? Under what circumstance? Under who's authority?

So you're saying you oppose health insurers having accountability for their decisions on granting care?

[Snow-i]

Originally Posted by hyteckit 

Both kill terrorists/enemies to save human lives.

Lets add a another variable into the mix. Exterminators..

Your analogy.

"All 3 kill terrorist/enemies/spiders to save human lives."



"Different weapon for different task. How to kill the enemy/terrorist/virus/spider.

Weapons of choice: Nuclear weapon for mass scale attack. guns for more precision. medicine for microscopic. Can of raid for spiders.




All three actively engage the enemy and prevents the enemy from spreading. Both try to contain the threat to human lives. Soldiers hope to eliminate terrorist. Doctors hope to eliminate terrorist/disease/viruses. Exterminators hope to kill poisonous spiders.


National defense against terrorist/viruses/enemies/diseases/spiders"


Your analogy is so general that it is academically and pragmatically WORTHLESS.

"Spiders are bad. And so are terrorists. I don't like viruses" Lets socialize all of them!

[Snow-i]

Originally Posted by CreepDogg 

So you're saying you oppose health insurers having accountability for their decisions on granting care?

No, I'm asking!

[CreepDogg]

Originally Posted by Snow-i 

Hence the predicament we are in.

Competition and government are the two primary means that have been proposed to eradicate this predicament. Competition would have insurance companies that are unfair and underhanded meet fiscal doom, given the proper antitrust regulation.

Depends on how 'unfair' and 'underhanded' are defined. And what regulation falls under the umbrella of 'antitrust'? I also think insurers, whoever they are, need to be accountable for their decisions, and there is some form of speedy appeal.

This is, by definition, an imperfect market. You don't know what you're insurer is or isn't going to cover until you need it. And when you need care, you need it. The time you actually need coverage is not the time you can shop around. Not to mention, insurers don't have very clear parameters on what's covered and what's not (as evidenced by the number of decisions that are made at claim time). So - that's another regulation that would be needed to enhance competition - clear information up front from each insurer about what they will and won't cover.

Insurance companies won't like that. The people would. See how government and industry might have to work against each other to make this work best in our interest?

Well, when you figure out that they're cherry picking then you just sign up with someone else. They then meet the fiscal angel of death, for which they are considered by the public to have a "pre-existing" condition for. No one can save them.

See above. Good luck signing up with someone else once you've been cherry-picked out of another (absent regulation that says they have to take you and/or clear information up front that your cherry wouldn't be picked).

No, I don't want the government primarily working against those things. I was it to be clear that the government is working FOR us, and whatever that means. Its really the paradigm you choose to look through, as we are saying the same things. The distinction, IMO, has been lost today and is the basis of many of the problems we face.

Fine, except I'll add that sometimes working FOR us means working AGAINST those things. It's not binary.

I couldn't agree more. WHICH status quo we attack, well, thats the big question. Do i have all the answers? No. Could i do a better job? Maybe. A more honest one certainly...and thats what we really need.

Well, I don't have all the answers - but some thoughts on WHICH status quo(s) we attack? Sure...

- Denial of care for pre-existing conditions, particularly behavior that goes searching for ANY possible condition upon a claim
- Decisions being made at the time of claim, rather than the time the policy is selected (I realize this wouldn't be 100% eliminated but needs to be cut down if there's any hope for competition)
- Ties to insurance from employers with few equivalent-cost options for individuals
- High levels of overhead for providers, administrators, and insurers
- Lack of accountability of insurers for making care decisions

The ideal is care decisions are made between the doctor and patient. Of course, there has to be a 'within reason' qualifier to this, but there need to be some much clearer lines drawn on what that means. There are a zillion things in medicine that I don't understand, so I don't have all the answers on how that's done, but that should be the goal.

[hyteckit]

Originally Posted by Snow-i 

Lets add a another variable into the mix. Exterminators..

Your analogy.

"All 3 kill terrorist/enemies/spiders to save human lives."



"Different weapon for different task. How to kill the enemy/terrorist/virus/spider.

Weapons of choice: Nuclear weapon for mass scale attack. guns for more precision. medicine for microscopic. Can of raid for spiders.




All three actively engage the enemy and prevents the enemy from spreading. Both try to contain the threat to human lives. Soldiers hope to eliminate terrorist. Doctors hope to eliminate terrorist/disease/viruses. Exterminators hope to kill poisonous spiders.


National defense against terrorist/viruses/enemies/diseases/spiders"


Your analogy is so general that it is academically and pragmatically WORTHLESS.

"Spiders are bad. And so are terrorists. I don't like viruses" Lets socialize all of them!

If giant spiders become a major threat to hundreds of thousands of human lives per year, then we would need an army of "exterminators".

If zombies are a major threat to hundreds of thousands of human lives, then we would need an army of "zombie killers".

If vampires are a major threat to hundreds of thousands of human lives, then we would need an army of "vampire killers".

If fires are a major threat to hundreds of thousands of human lives, then we would need an army of "firefighters".

If gangs, criminals, burglars are a major threat to hundreds of thousands of human lives, then we would need an army of "policemen".

Socialize soldiers, firefighters, policemen? No way!


However, the threat to hundreds of thousands of lives is not there, so we don't need an army of "exterminators", "zombie killers", or "vampire killers". When they become a threat, there will be a need to socialize them to save human lives.


Right now, terrorist and diseases are a major threat to hundreds of thousands or millions of human lives a year, so we need a army of soldiers and doctors the fight the threat to human lives.

[Snow-i]

Originally Posted by hyteckit 

If giant spiders become a major threat to hundreds of thousands of human lives per year, then we would need an army of "exterminators".

If zombies are a major threat to hundreds of thousands of human lives, then we would need an army of "zombie killers".

If vampires are a major threat to hundreds of thousands of human lives, then we would need an army of "vampire killers".

If fires are a major threat to hundreds of thousands of human lives, then we would need an army of "firefighters".

If gangs, criminals, burglars are a major threat to hundreds of thousands of human lives, then we would need an army of "policemen".

Socialize soldiers, firefighters, policemen? No way!


However, the threat to hundreds of thousands of lives is not there, so we don't need an army of "exterminators", "zombie killers", or "vampire killers". When they become a threat, there will be a need to socialize them to save human lives.


Right now, terrorist and diseases are a major threat to hundreds of thousands or millions of human lives a year, so we need a army of soldiers and doctors the fight the threat to human lives.

You apparently missed the crux of my point. Your analogy for defending your ideals for how to go about solving these issues is utterly worthless. The writing on the wall is that your arguments lack logical and rational substance, in case you missed it.

[hyteckit]

Originally Posted by Snow-i 

You apparently missed the crux of my point. Your analogy for defending your ideals for how to go about solving these issues is utterly worthless. The writing on the wall is that your arguments lack logical and rational substance, in case you missed it.

Cause you have no point and your arguments are weak.

National Defense:
Army
Navy
Air Force
Marines
National Guard
Doctors

If needed when hundreds of thousands of lives might be at stake:
Vampire Killers
Spider Killers
Zombie Killers
Cyber Warriors
Starship Troopers

[Snow-i]

Originally Posted by CreepDogg 

Depends on how 'unfair' and 'underhanded' are defined. And what regulation falls under the umbrella of 'antitrust'? I also think insurers, whoever they are, need to be accountable for their decisions, and there is some form of speedy appeal.

Agreed!

This is, by definition, an imperfect market. You don't know what you're insurer is or isn't going to cover until you need it. And when you need care, you need it. The time you actually need coverage is not the time you can shop around. Not to mention, insurers don't have very clear parameters on what's covered and what's not (as evidenced by the number of decisions that are made at claim time). So - that's another regulation that would be needed to enhance competition - clear information up front from each insurer about what they will and won't cover.

Agreed!

Insurance companies won't like that. The people would. See how government and industry might have to work against each other to make this work best in our interest?

Insurance companies will at that point be forced to compete honestly. Will they like it? Probably not, but it would be an equal playing field where, in time, customers would vote with their dollars. The best carriers would excel to popularity and therefore prosperity. A quick and speedy appeal process mandated by the gov't could easily mitigate unfair denials in the meantime, given it is setup properly to avoid abuse and exploitation.

In other words. Agreed!

See above. Good luck signing up with someone else once you've been cherry-picked out of another (absent regulation that says they have to take you and/or clear information up front that your cherry wouldn't be picked).

Given your regulation and a field with plenty of business minded insurers who wish to prosper, I'd say we're on to something!

"We'll take you no matter what" is a pretty big marketing slogan for any insurance company. That part the market will take care of.

Fine, except I'll add that sometimes working FOR us means working AGAINST those things. It's not binary.

Agreed!

Well, I don't have all the answers - but some thoughts on WHICH status quo(s) we attack? Sure...

Okay!

- Denial of care for pre-existing conditions, particularly behavior that goes searching for ANY possible condition upon a claim

Agreed!

- Decisions being made at the time of claim, rather than the time the policy is selected (I realize this wouldn't be 100% eliminated but needs to be cut down if there's any hope for competition)

Agreed!

- Ties to insurance from employers with few equivalent-cost options for individuals

Agreed!

- High levels of overhead for providers, administrators, and insurers

Agreed!

- Lack of accountability of insurers for making care decisions

Agreed!

The ideal is care decisions are made between the doctor and patient. Of course, there has to be a 'within reason' qualifier to this, but there need to be some much clearer lines drawn on what that means. There are a zillion things in medicine that I don't understand, so I don't have all the answers on how that's done, but that should be the goal.

Agreed![quote]

Same page here...I'd say.

[CreepDogg]

Originally Posted by Snow-i 

Agreed!

Glad we're in agreement on a lot of things, but part of my point is that we have a challenge ahead of us to build any semblance of competition in the market. Because of the way demand for care works, it's inherently anti-competitive.

Insurance companies will at that point be forced to compete honestly. Will they like it? Probably not, but it would be an equal playing field where, in time, customers would vote with their dollars. The best carriers would excel to popularity and therefore prosperity. A quick and speedy appeal process mandated by the gov't could easily mitigate unfair denials in the meantime, given it is setup properly to avoid abuse and exploitation.

The biggest problem with this is the statement 'in time'. When? Who dies in the meantime while we figure it out? And, when it gets there, what in medicine will change to alter the playing field? This is not a market like big-screen TVs where long-run competition will weed things out perfectly.

Don't get me wrong, I love markets. When they work, they work really well. There are some things that are well suited to competition. There are others that, left alone, gravitate to monopolistic/oligopolistic/monopsonistic behavior. I think health care falls into the latter, so to make it work, one way or another, government's gotta get involved in more and different ways. It's just a matter of how and where.

"We'll take you no matter what" is a pretty big marketing slogan for any insurance company. That part the market will take care of.

Maybe. It's also an expensive proposition - eating into profits and/or possibly creating a loss! So that means that coverage will be MORE expensive. If an insurance company takes on more risk, someone has to pay for that risk. Which, by the definition of insurance, means everyone in the risk pool.

So - they could do that. Or they could offer cheaper coverage with conditions. It really depends on what their customers will buy. The latter is what happened the last time we tried this. So unless something forces them to do otherwise, we'll get right back to where we are today, if you believe past results are the best predictor of future behavior.

Point is, claiming that we can achieve a high level of competition in the health insurance industry is just as much a red herring as it is to claim that a single payer system will cover everything for everyone forever. They each have their advantages and disadvantages (not that those are the only 2 possibilities - there's a whole continuum in between).

[ebuddy]

I see a lot of fallacious arguments going on in here to be quite honest.

- There are no shortage of anecdotes for whatever horror story you'd like to tell be it victimization to private insurance, Medicare, Medicaid, or no insurance. The "Aunt Millies" play well to the simpleton, but really only go so far as they exist in all forms of insurance, in all countries.

- This notion that "just one more provider" (the government) is going to pop in and become the panacea for all our health care woes is simply naive. While they manage upwards of 46% of our health care in this country already, they've not proven they can manage care even in their specified segments more effectively than the private insurance market for their much more broad base. Not to mention of course the fact that this half of our system is insolvent and unsustainable just as most nationalized systems today. Newsflash, just as many of you are talking about claims denials, etc... these all exist under the government-managed plans.

- Free/ultra-cheap health care creates frivolous usage. It has been demonstrated time and again. As long as your employer or the government is picking up the tab, you're not watching your expenditures.

- This notion that private insurers have somehow functioned unabated by the government or by regulation is laughable. It is a complex package of tax policy and regulation that has created the state-by-state monopolies we're all complaining about here.

- To besson3c; if you remove accidental death (death not contingent upon your health care system or "quality of care") the US is in fact #1 for life expectancy sir. #1. I know this flies in the face of all the horrible things you've heard about the US system and how the profit motive kicks little puppy dogs and all that, but sanity is going to have to rely on substantive data. Not little got'cha one-liners about "life-expectancy" with no regard for varying demographics.

We need government reform before we need insurance reform. Of course the powerful insurance lobby is going to play the game in order to up their lot, but they're playing the game designed for them by your representatives. Instead of 50 small insurance monopolies, many are arguing for one large one under the Federal banner that we'll get to watch move back towards privatization in 10 years. You want cheaper insurance? Competition? Portability? Accessibility and accountability?

• Instead of spending over a trillion dollars of your offspring's money, firing up the printing presses at the reserve, or increasing your taxes to cover a portion of the uninsured, toppling the entire system for just one more insurer; open the national market of thousands of already-existant insurers.
• Go online to Consumer reports or any other number of consumer advocacies (sure to grow with a national insurance market) to read about how well or how poorly your insurer performs. Horror stories of coverage denials is not going to win patronage. Trust me.
• Ensure your state is competing for a national insurance charter that enables an insurer to operate under one set of regulations, offering coverage nationally and encourages us to aggressively shop for care.
• Push for HSAs and HSA-compatible plans.
• Push for the ability of any government subsidy to the poor for health insurance be in the form of a Health Savings Account and allow it to roll over from one plan-year to the next.
• Push for your legislators to end the 1945 McCarran-Ferguson Act that gives states the authority to regulate the “business of insurance” and exempts Insurers from federal antitrust laws.
• Push for each of us to receive the tax benefit afforded our employers enabling them to produce cadillac plans instead of cadillac pay.
• These among a wealth of other options exist, but are not on the table anywhere. I've noticed as long as the "public option" is on the table, we argue "public VS private" with very little by way of ideals that contain costs, increase affordability, and accountability. Eliminate the "public option" talk. It only muddies the waters of common sense.

[CreepDogg]

Originally Posted by ebuddy 

- There are no shortage of anecdotes for whatever horror story you'd like to tell be it victimization to private insurance, Medicare, Medicaid, or no insurance. The "Aunt Millies" play well to the simpleton, but really only go so far as they exist in all forms of insurance, in all countries.

Yes. Every institution has a limited (in some way) pool of resources to distribute. This will not change no matter who's running the show. The question is in how they distribute - what claims get covered and who gets admittance to the risk pool.

- This notion that "just one more provider" (the government) is going to pop in and become the panacea for all our health care woes is simply naive.

That depends on how different the product of 'one more provider' is from the products currently on the market, no? I agree it's no panacea, but 'just one provider' certainly could make an impact in the marketplace.

- Free/ultra-cheap health care creates frivolous usage. It has been demonstrated time and again. As long as your employer or the government is picking up the tab, you're not watching your expenditures.

Which is why we need transparency on what is/isn't covered. Insurance companies today choose to cover a lot of preventive care, often at a higher level than other care. They certainly don't do this out of altruism, so some level of usage must have a positive impact on overall health and the cost of care.

- This notion that private insurers have somehow functioned unabated by the government or by regulation is laughable. It is a complex package of tax policy and regulation that has created the state-by-state monopolies we're all complaining about here.

Laughable? Really? You say right above that they hold monopolies. That in itself demonstrates to me that there hasn't been much resistance. Is it possible that policy has helped them along that path? Sure. But don't tell me they would have welcomed competitors with open arms had the government 'just gotten out of the way'.

The bottom line is, if you want competition, the government is going to have to regulate the hell out of the industry in order to force it. It's pretty clear what happens in this market when they're left to their own devices.

We need government reform before we need insurance reform.

We need both.

Of course the powerful insurance lobby is going to play the game in order to up their lot, but they're playing the game designed for them by your representatives. Instead of 50 small insurance monopolies, many are arguing for one large one under the Federal banner that we'll get to watch move back towards privatization in 10 years.

Eliminating the state barriers will result in what happened with the phone companies. If you have Blue Cross Arizona and Blue Cross New Mexico today (I don't know if they're actually in those states, but work with me...), they'll merge to form Blue Cross Southwest. Then Blue Cross Southwest will merge with Blue Cross Northwest and Blue Cross Texas. Then that will merge with Blue Cross East to get one national monolith. Aetna and UHC will do the same. And we'll have the same level of competition we have today in the states. Unless some external force stops that and forces competitive behavior. That force won't be consumers - they need health care, so they'll buy whatever they can get, as they do today.

You want cheaper insurance? Competition? Portability? Accessibility and accountability?

Yes. Deregulation and an assumption that companies will naturally 'compete' will not get there.

* Instead of spending over a trillion dollars of your offspring's money, firing up the printing presses at the reserve, or increasing your taxes to cover a portion of the uninsured, toppling the entire system for just one more insurer; open the national market of thousands of already-existant insurers.

Who, as said, will quickly merge and behave in the way that maximizes profits.

* Go online to Consumer reports or any other number of consumer advocacies (sure to grow with a national insurance market) to read about how well or how poorly your insurer performs. Horror stories of coverage denials is not going to win patronage. Trust me.

Nor will it lose it, if everyone is doing it and they continue to obfuscate their coverage criteria.

* Ensure your state is competing for a national insurance charter that enables an insurer to operate under one set of regulations, offering coverage nationally and encourages us to aggressively shop for care.

A good start, depending on what behaviors that one set of regulations creates and enforces.

* Push for HSAs and HSA-compatible plans.

Another good start. FWIW, I'm already in one.

* Push for the ability of any government subsidy to the poor for health insurance be in the form of a Health Savings Account and allow it to roll over from one plan-year to the next.

OK, that's nice for day-to-day care, but what about catastrophic coverage that a corresponding HDHP would cover?

* Push for your legislators to end the 1945 McCarran-Ferguson Act that gives states the authority to regulate the “business of insurance” and exempts Insurers from federal antitrust laws.
* Push for each of us to receive the tax benefit afforded our employers enabling them to produce cadillac plans instead of cadillac pay.
* These among a wealth of other options exist, but are not on the table anywhere.

More good starts.

I've noticed as long as the "public option" is on the table, we argue "public VS private" with very little by way of ideals that contain costs, increase affordability, and accountability. Eliminate the "public option" talk. It only muddies the waters of common sense.

Because there's going to have to be 'public' intervention one way or another. Say what you want, but there are not a lot of forces regulating the specific behavior of the insurance industry today. They have taken advantage of the system to create monopolies (as you said yourself), and we've seen what happens when they're left to their own devices.

Talking about a 'public option' in and of itself does not muddy the waters of common sense. It's disingenuous if one were to claim there aren't costs associated with a 'public option' - there are. So let's talk about those costs freely and determine if it's worth it - if that strategy would get us the health care distribution mechanism we want. And yes, if there are other options to be considered, let's put them on the table. But just as government is no panacea, neither is free market competition, because the market for health care is anything but 'free'. So let's stop pretending that either panacea exists.

[Snow-i]

Originally Posted by hyteckit 

Cause you have no point and your arguments are weak.

National Defense:
Army
Navy
Air Force
Marines
National Guard
Doctors

If needed when hundreds of thousands of lives might be at stake:
Vampire Killers
Spider Killers
Zombie Killers
Cyber Warriors
Starship Troopers

????????

[Snow-i]

Originally Posted by hyteckit 

Cause you have no point and your arguments are weak.

National Defense:
Army
Navy
Air Force
Marines
National Guard
Doctors

If needed when hundreds of thousands of lives might be at stake:
Vampire Killers
Spider Killers
Zombie Killers
Cyber Warriors
Starship Troopers

I'm sorry but your "arguments" are absolutely laughable. I trust that others can see the value in your "army of doctors and spider-killers" proposal, so there is no reason to encourage you.

Have a good one!

[CRASH HARDDRIVE]

And so we've reached the culmination of the left's desperate attempts at comparing socialized healthcare to the military...

Vampires and Zombie killers.

[hyteckit]

Originally Posted by CRASH HARDDRIVE 

And so we've reached the culmination of the left's desperate attempts at comparing socialized healthcare to the military...

Vampires and Zombie killers.

Wow. Did you really missed the obvious joke about the likeliness of needing spider killers, vampire killers, and zombie killers because spiders, vampires, and zombies aren't likely a real threat to hundreds of thousands of human lives.

No surprise there.

[besson3c]

Crash: I guess I missed the memo where hyteckit represents all of the left? Who cares anyway, we all have opinions, how you want to categorize them is pretty irrelevant.

[hyteckit]

I don't know why we have socialize

1. Firefighters
2. Policeman
3. Border Patrol <-- Useless
4. Air Force
5. Navy
6. Marines
7. National Guard
8. Coast Guard
9. DEA <-- Useless
10. CIA <-- Useless


Drugs? We need a socialize agency to fight drugs?
Fires? We need a socialize agency to fight fire?

Man. What's next? An agency to fight spiders? Vampires? Zombies?

1. Spider Killers
2. Vampire Killers
3. Zombie Killers


I say get rid of all socialism and privatize all national security.

[ebuddy]

Originally Posted by CreepDogg 

Yes. Every institution has a limited (in some way) pool of resources to distribute. This will not change no matter who's running the show. The question is in how they distribute - what claims get covered and who gets admittance to the risk pool.

... and what that pool's premiums will look like, how to pay for it, who to pay for it, and how to sustain it. In other words, the very same questions we have under the status quo. The government is proposing to "run the show" while the economy is still trying to recover from extremely high unemployment and a condition that was repeatedly compared to the great depression. By the way, the show won't start 'til 2015, but the "how to pay for it" and the "who to pay for it" questions get answered upon passage. Answers like a 40% tax on "cadillac plans", somehow half a trillion in "waste, fraud, and abuse" cost shavings from Medicare (because remember, they're promising they won't touch your coverage), and a wealth of other punitive measures against employers and yes, penalties against the uninsured and underinsured, etc...

There are a lot of questions to be sure.

That depends on how different the product of 'one more provider' is from the products currently on the market, no? I agree it's no panacea, but 'just one provider' certainly could make an impact in the marketplace.

Not as much as 1300 providers IMO. I'd also add, not nearly as costly to the majority of the country and not nearly as contentious a measure. I think the one thing that the multiple proposals running through the house and senate have in common is that they upset the currently insured. (the "good" of our system) I'm simply not biting on the "this plan will not require you to change your coverage" political speak.

Which is why we need transparency on what is/isn't covered. Insurance companies today choose to cover a lot of preventive care, often at a higher level than other care. They certainly don't do this out of altruism, so some level of usage must have a positive impact on overall health and the cost of care.

Agreed. I do not however believe a public option is necessary to accomplish this transparency nor do I believe the government is any more altruistic.

Laughable? Really? You say right above that they hold monopolies. That in itself demonstrates to me that there hasn't been much resistance. Is it possible that policy has helped them along that path? Sure. But don't tell me they would have welcomed competitors with open arms had the government 'just gotten out of the way'.

Yes laughable because the insurers hold state-by-state monopolies as crafted by our representatives; representatives beholden to special interest. Certainly businesses do not want competition, but they generally can't control this aspect of market nature without the type of relationship they've developed with government. Without government, competition is a forgone conclusion. The profit motive.

The bottom line is, if you want competition, the government is going to have to regulate the hell out of the industry in order to force it. It's pretty clear what happens in this market when they're left to their own devices.

The devices of the select-few chosen by our government to be winners of course. I don't see this as a problem of the market nor do I believe the government has any more a track record of integrity. Again, the "public option" only brings up these, IMO fallacious black or white, we/they arguments when in reality what we should be fighting here is a marriage of Corporation and Government. They need a divorce. That divorce starts at legislation that makes it illegal for legislators to bargain with insurers and repealing antiquated legislation that shields the "winners" from accountability.

We need both.

Starting with those who craft the rules we're all expected to play by.

Eliminating the state barriers will result in what happened with the phone companies.

You say this of the phone companies (broken up under antitrust legislation) as an analogy to what would occur with insurers (insulated from antitrust legislation) without providing the phone company examples. The divestiture resulted in AT&T breaking into 7 operators losing a great deal of market share to new competitors like MCI and Sprint among a wealth of no names and up and comings.

If you have Blue Cross Arizona and Blue Cross New Mexico today (I don't know if they're actually in those states, but work with me...), they'll merge to form Blue Cross Southwest. Then Blue Cross Southwest will merge with Blue Cross Northwest and Blue Cross Texas. Then that will merge with Blue Cross East to get one national monolith. Aetna and UHC will do the same. And we'll have the same level of competition we have today in the states. Unless some external force stops that and forces competitive behavior. That force won't be consumers - they need health care, so they'll buy whatever they can get, as they do today.

It's interesting to me that you're concerned of a corporate monolith citing the limited recourse of the consumer without acknowledging that a government option would simply create a different monolith affording the consumer no recourse at all. You frame this debate as if the government is subservient to these corporate monolith's power when the only power they wield is money. There are several reasons why I believe reform begins at the government. Antitrust legislation already exists, it needs to be enforced. It is not being enforced because it would be just as hostile to campaign coffers as it would be to their donors. The Securities and Exchange Commission for example already has the power to supplement or preempt state corporate law to regulate national securities markets, why then can they not apply similar jurisdiction over rogue states or rogue insurers? Of course they can. I'm not against oversight and regulation. I'm against unnecessarily burdensome regulation tilted towards generating revenue for a different monolith; the government. When the government enters the insurance market on such a broad scale, they create a substantial conflict of interest with we, the people IMO. The only ones to survive under the proposals I'm seeing are the corporate monoliths and government.

Yes. Deregulation and an assumption that companies will naturally 'compete' will not get there.

Of course not. (not directed necessarily at you) Proponents of a public option often frame the debate as if this is all the opponents have. i.e. "the party of 'no'". There is a method of achieving competition and a balance to regulation of course.

Who, as said, will quickly merge and behave in the way that maximizes profits.

Isn't this just saying "no"? In other words, it seems the above is founded in the following;
- an assumption that the government is not also interested in revenue generation
- a government monopoly is somehow different than a corporate monopoly
- profits are bad
- profit is the life's blood of corporation therefore corporations are bad
- human nature is exclusive to the private sector

If you have insurers looking for charter states, states competing for charters, insurers competing for consumers all under a wide-open national market with antitrust enforcement and market oversight, you will see an increase in coverage options, affordability, and accessibility while naturally eliminating much of the need for lobbyists. This, without spending a dime in additional taxpayer money... starting tomorrow. I have a lot more faith in the profit motive of a company in need of consumers and employees than I do a government that supposedly cares for me, but can't really tell me how.

Nor will it lose it, if everyone is doing it and they continue to obfuscate their coverage criteria.

I disagree with this. I think it's just saying "no" or worse, FUD. I don't think we're miles apart though. At the very least, you and I agree on a great many things that are (to my knowledge) not in any of the health care reform proposals. Things like;

[Charters] A good start, depending on what behaviors that one set of regulations creates and enforces.

[HSAs and compatible plans] Another good start. FWIW, I'm already in one.

[End antitrust exemptions] More good starts.

OK, that's nice for day-to-day care, but what about catastrophic coverage that a corresponding HDHP would cover?

Money from the subsidies can be used for HDHP premiums. We still want the poor to work and their employers should also be able to contribute to their employees' HSAs. I of course would anticipate an increase in accessibility and affordability out of the gate.

Because there's going to have to be 'public' intervention one way or another. Say what you want, but there are not a lot of forces regulating the specific behavior of the insurance industry today. They have taken advantage of the system to create monopolies (as you said yourself), and we've seen what happens when they're left to their own devices.

See all above.

Talking about a 'public option' in and of itself does not muddy the waters of common sense. It's disingenuous if one were to claim there aren't costs associated with a 'public option' - there are. So let's talk about those costs freely and determine if it's worth it - if that strategy would get us the health care distribution mechanism we want. And yes, if there are other options to be considered, let's put them on the table. But just as government is no panacea, neither is free market competition, because the market for health care is anything but 'free'. So let's stop pretending that either panacea exists.

Do you really believe the "free" in "free market" means cost free? We're not pretending anything I hope. We're talking about "good places to start" when none of those exist in the current proposals. I maintain the reason for this is because the debate has been exhausted by the "public option" arguments.

[hyteckit]

Poor kids. They just can't get a break. First they are too fat. Now they are too skinning to get health insurance.

Aislin Bates: Colorado Toddler Denied Health Insurance For Being Underweight

Does the media have to get involve in order for these health insurance companies to reconsider?

[hyteckit]

Women can't get a break either.

Rape, a pre-existing condition.

Rape Victim's Choice: Risk AIDS or Health Insurance?