Just three more days until Massachusetts mandatory health care goes into effect. Health insurance for everyone, whether they want it or not.
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Just three more days until Massachusetts mandatory health care goes into effect. Health insurance for everyone, whether they want it or not.
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What the heck is going on up there?
Have we given Mass. over to the Canadiens?
;)
well they all want it. Sometimes they just do not realize it. Once they end up in the hospital with a $10k bill, they will be grateful.
I am curious to how this will all play out. What will happen to those who have to go to the ER, but did not purchase health insurance? Obviously they will still be treated, but will they be fined for not purchasing health insurance? What will happen if they continue to refuse to purchase health insurance? Jail? Time will tell.
How much more do you have to pay for manditory insurance? Will it be way over priced like manditory car insurance?
Mass is putting in place a system that has some inate flaws, but is something we all need to consider. The US and South Africa are the only developed nations on this planet without some basic minimum coverage for all citizens. Or do we provide converage......? In reality we do, it is called the Emergency Department (ED). Americans have real concerns when it comes to receiving treatment in the emergency department of any hospital in the country. Long waits, and inadequate staff and space to meet the needs are common. Why? We require any facility to provide treatment to the uninsured through the ED. The significance of that is simply the fact that it costs you and I (the average taxpayer) 10 times to see that patient in the ED what it would cost to provide treatment in a clinic or doc's office. Why not provide some basic coverage? It will be cheaper in the end. OK....I am ready. Some will now flame me for endorsing "socialized" health care. So be it, but keep in mind we need to seek cheapest alternative to what we have now, which is simply not efficient. Our current system is based on employers paying the bulk of insurance premiums. If you read the literature, you realize that is rapidly changing. Large corporate structures constantly seeking a larger bottom line are placing more of that burden on workers (called cost-sharing). Illegal aliens are causing tremendous problems in California, where some large EDs had to close due to the flow of red ink caused by treating the uninsured. Some may think they are illegal and we should not treat them, but the law will not let us turn them away, and in reality as a compassionate society, we must provide at least some care to stabilize those in need, in my opinion.
Oh well, I could go on about this forever. I, like Mr. Baker, feel initially like it is a slap in the face to "require" insurance. But the truth be known, it may be something that is needed for all of us to more effectively and efficiently provide coverage to those uninsured. Keep in mind there is about 15% of the population without coverage (approx. 47 million). 10-12 million are illegals. Many cannot get coverage due to existing conditions, but a large number (10+ million) chose not to seek coverage and buy that new car instead. You and I pay for them when the time comes. This issue is confusing to the so-called experts, so to most of us on Optiboard it is even more so, but keep in mind we must do something to stem this continually-rising tide of health care costs. This may be a first step towrds that goal, or may not work at all. We'll soon see.
Probably. Any oligopoly will be higher pricedOriginally Posted by gemstone
Unfortunately, when companies own hospitals, it will not be competitive and will never be competitive.
Hmm. I could post my large 30 page paper on this topic..
Here is a snippet:
US health care spending should be more effective. In 2005, health care spending reached $2 trillion, or $6700 per person. This total represents 16% of the gross domestic product of the United States. It was projected that in the next decade, that amount will double to $4 trillion in 2015 and represent 20% of the gross domestic product. The United States spends more money on health care than other nation in the world, and we still have nearly 47 million Americans that are uninsured. Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 in Germany, 9.7 percent in Canada and 9.5% in France according to the Organization of Economic Cooperation and Development. These countries also provide health insurance to ALL of their citizens.
All of this money has failed to grant the United States top health status. The US ranks 42 in life expectancy, 41 in infant mortality, and rank 37 in terms of overall satisfaction with the health care system. The United States spends more than any other nation in the world, yet the citizenry is receiving less quality care and is more dissatisfied than the populace of any other industrialized nation.
Thirty four percent of Americans believe that the nation’s health care system needs to be scrapped and reformed. Most Americans that are insured have the coverage provided by an employer. The average cost of an employer purchased health care plan was $11,500 per family or $4200 for single coverage. Workers contributed over 25% of the costs for the plans. Since the year 2000, employment-based health insurance premiums have gone up 87% compared to cumulative inflation of 18% and wage growth of 20% for the same period. So while the average American is making 20% more than 7 years ago, they are bringing home less money due to the costs of insurance.
As the costs of insurance continue to rise, the number of uninsured also rises. The large uninsured population not only affects the individuals and their families, but society as a whole. Roughly $35 billion dollars was spent in 2001 for uncompensated care. This figure includes money to hospitals that receive a disproportionate share of uninsured patients, money for public expenditures for grants, and direct service programs, and the value of free or reduced cost care provided physician volunteers.
The Institute of Medicine estimates that the US loses 65-130 BILLION a year in lost health capital. The shorter life spans and poorer health mean more people being placed on Disability roles, and throwing more families into poverty. All of these costs are typically borne by the taxpayers.
As was stated above, we pay more than any other country yet receive less quality of care... while only covering a fraction of our populace..
And if you view the plans from other countries, there are many markets and thriving private sector plans. Mandated insurance or even universal coverage doesn't have to mean everyone on medicare. There are voucher systems, a mix of public and private plans, and safety net programs.
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
I believe that there will actually be more competition. The mandatory coverage isn't a rule saying you have to be covered by our federal or our "contracted" insurance provider. The idea is that to be fair, everyone has to contribute to the system to try and keep costs per person down.
In fact, I believe this will create a system similar to the medicare advantage plans where since there is a mandate, everyone will try to get into the fray for the potential increase in "covered lives". The main way to compete is through offering more services at a more reasonable/reduced cost.
The AHRQ (Agency for Healthcare Research and Quality), The NCQA (National Committee for Quality Assurance) and the AHIP (America's Health Insurance Plans) all provide information on insurance costs, the quality of various plans, and how to choose the right plan for you.
http://www.washingtonpost.com/wp-dyn...040401937.htmlAll residents will have to provide details about their health insurance policy on their state income tax returns in 2008. Those who do not have insurance would first lose their personal state tax exemption, perhaps worth $150, and later face penalties equal to half the cost of the cheapest policy they should have bought. That might work out to $1,200 per year, officials said. Those who cannot find an affordable plan could obtain a waiver.
Enforcement of the requirement will not be done by hospitals, officials said: They will treat uninsured patients as before
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
This is a Free Nation! That means we don't like words like MANDITORY!
For Anything.
Every year the only state with no personal income tax* sends critically ill or injured children to Massachusetts for care. If they are uninsured guess who picks up the bill (hint-It's NOT N.H.) How fair is that???
I agree with Mr McDonald well written post. One way or another we're paying. The system is broken and something new needs to be tried.
* Don't ask New Hampshirites how much their property tax is. They even tax your view!
Like a mandatory tax that pays for the army, President and Congress income, prisons, roads, plumbing, sewage and water maintenance, ect?
So do you complain about mandated car insurance?
Or since you just signed up for Medicare, you already have a mandated insurance. When you start collecting Social Security, you are automatically forced to sign up for Medicare which will convienently take their premium from your SS check...
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
The high price , yes.
IMO, One of the biggest reasons health care cost are so high IS health insurance. The benefits go up and the Drs and hospitals say "MORE FOR US, YIPEE!" Better health insurance means higher cost. It has upset the natural balance of competition. Hey! I will take better coverage when I can get it too. I am just saying it is not the fix all solution to the problem that certain politicians would have you think. (Shameful thing is, they know it isn't, but keep making promises.) It will be intresting to see how things pan out in Mass.
I completely disagree. The idea just like in car insurance, homeowner's insurance, disability etc is to spread the risk across a larger population. Health Insurance operates the same way.
The fact of the matter is that it isn't doctors getting rich from the insurance. The same way those of us who deal with vision insurance aren't getting rich from it. The insurer is who typically makes the money.
While the insurance system as it currently exists does cause an increase in costs (administrative costs, certain technology costs, etc) it isn't the sole blame. Fees act just like the prices in stores. As theft, or the amount of goods/services rise without compensation, the rest of the group pays higher rates to counter act it. So part of the reason our insurance is rising, is to help cover those who aren't covered. The fed then has to kick in even more money to help trauma centers and other facilities in more impoverished areas stay open, and we pay even more in taxes... We are paying it already through other means..
The fight over health insurance has been going on for the better part of a century. Unfortunately most people lack the means or control to put enough funds into a health savings account or other means to pay the full cost of any non routine care they may need.
If you do have the ability to pay a large portion of potential healthcare costs, then maybe a HDHP plan is right for you. Pay very little a month ($60-70 a month for a healthy 30something) and be prepared to spend about $5500 before having the insurance kick in with a 70/30 type idemity plan..
Most people Americans can not afford to do so.
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
Is that you, Hillary?
In addition to your reference to the ER as a component of critical care, US hospitals have always provided free care for emergency or life threatening/altering conditions to anyone who presents either through the ER or a physician referral.
Two examples, an optician friend worked in a optical practice that did not provide health insurance. He had a few years before depleted his savings on medical care for his wife. He woke one evening with chest pains, dialed 911 and a few days later had CABG surgery. Total cost of care was $400,000.00. The surgeon and anesthesiologists waived their fee and the State provided some funds to the hospital.
A friends mom was diagnosed with CA and was put on Medicaid where she received wonderful compassionate care for the remainder of her days.
Personally, I am a Shriner and we operate orthopedic and burn hospitals throughout the country at a cost of over 7 billion a year which is all raised through private contributions. We take no money from the patient or the government. How about St. Jude Hospital and the many other private philanthropies that fulfill the role of thy brothers keeper. Why has this model of private funding been supplanted by the belief that "it's the guvmints job"?
Why has the expensive ER become the primary point of entry into health care? Because whether you have insurance or not it's about the only place that you can get to see someone after hours or on a weekend. If everyone has health insurance the ER will be an even busier place. But, what about private walk in clinics? Why not allow APRN's to practice independently?
The American health care system is the most compassionate in the world and up to this point, the best. I am concerned over its future under increasing government control.
Could you itemize that?
I have always believed that for me and my family the cost of health insurance outweighed the value. I have never carried insurance and paid out of pocket for all things medical for my family. Including pre and post natal care.
If mandatory healthcare insurance were to be fair then IMO it should be regulated and profits restricted (like power companies) or better yet - not for profit.
Please attach it if possible. I for one would like to see it. Thanks
Yes, I will send you an email ASAP
The ER will not be a busier place. Urgent care centers, Minute Clinics and the like can take care of most after hours illnesses and at a much more reasonable rate.
As was stated above, many people seek ER services cause they can not be turned away regardless of ability to pay. The problem becomes multi-fold.. people don't seek routine and primary care for their "minor" issues. Turns out those minor issues were signals of systemic disorders such as diabetes and hypertension. The amount of time it took from the beginning signals and the time of diagnosis means a much more acute patient and more costly procedures are needed to "Rescue" the patient. Leading to increased hospital stays, surgerys that may have been prevented, and slew of other potentially avoidable treatment had the patient been placed on the proper meds and educated on their condition when the body first manifested itself.
The lack of primary care leads to more ER visits, duplicated services, and delays in proper diagnosis and treatment due to the lack of communication flowing between providers. Having a clearing house so to speak for that information will make sure that whoever is treating you will have the most accurate information while reducing the cost of healthcare overall.
Most people when they do have insurance will get seen by a non-ER entity for those little "inconsiquential" sysmptoms. Thus eleviating a lot of the ER madness for things that could have been treated by a primary care provider..
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
Having lived and worked in both NH and MA I am quite familiar with this situation. First of all Massachusetts has world class hospitals and if you have a sick child thats where you want him to go. Hopefully the situation is changing and care will be more equal throughout the country.
It might not be fair but, Massachusetts or any other state would pay for a critically ill child's care without a thought. We are a compassionate nation.
Actually we have had a vicious cycle in all the insurance, auto and medical industry. Insurance has in many cases (less now) paid 80% of. So most practioners raised prices to 120% so that 80% was now 100%.
This all went O.K. until someone realized that: If I raise another 20% I would get more money. In a regular situation this would work it out with competion. But in a "Mandatory" and "regulated" insurance agency this was fine, because the more they could show thier costs to be the higher they could get regulating agencies to allow them to raise rates.
With govenment services there was occaionally curtailed as on catarac surgery was twice. But for the most part it has become a never ending cycle.
However most states do not have "Mandatory Automobile Insurance", only Liability and this is optional if you can post satisfactory bond. Translation if you got $100,000.00 you don't have to have insurance.
Chip
One solutionwould be to totally outlaw health insurance. It'd hurt for a couple years but then things would get real competitive.
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