Sandy,

The following externalities prevent our insurance system from working in the
case of healthca

1. Forced coverage - you cannot buy insurance to cover what you want.
Regulations force coverage and non coverage based on state politics


And, the insurance companies in the regulated areas are virtually guarnateed a
profit at or above a certain percentage. The insurance companies have little
incentive to be efficient or take actions to ensure that fraud is not wide
spread.

2. Medicare is hard to compete with. Competing with the government is just
silly, and most businesses don't want to try it.


You don't compete with Medicare but you need to also understand that Medicare
is a cash cow for many companies who are given huge and lucrative contracts to
manage the medicare program in each state and a butt screw for the healthcare
industry who must operate under government imposed price controls, paperwork
burdens that none of us would accept, and is lucky to collect 50% of what they
bill.

3. Subsidy of employer based coverage through the tax code. This is the
big one, and most important one here. You cannot get health insurance
because you cannot buy a cradle to grave policy. Your employment situation
forces you into groups based on job stays and inevitably forces changes in
policy throughout your life. Instead, you go from dependent of your
parents employment group or groups, to possibly a student group, to then a
number of employment groups, and then are put in the medicare group. At
each change serious government involvement and inefficiency prevent your
making any choices of importance, taking the market out of the situation,
and driving up costs in ridiculous ways.


As far as the insurance companies are concerned, don't blame it all on the
government. The insurance companies have a very vested interest in making damn
sure that you don't have a cradle to grave policy. You can also blame the
insurance companies for making it more difficult for older workers to find
jobs. They have some not so subtle ways of discouraging small companies from
hiring older, supposedly higher risk employees.

So, you could, if you had paid into a policy for your entire life, have
built up enough reserve for at least one stint of heroic medicine to extend
your life. This could easily be done for the amount that most workers pay
into the system now. Also, if you paid more directly, and were more
financially involved in price quality decisions for your care your health
cost would be much reduced. Instead, you likely have ZERO involvement even
though you are the best person to police it on the scene.


True to a limited degree but not entirely.

4. State licensing. The licensing system is overly burdensome, driving up
costs


You got that one right!

5. Tort. Defensive medicine is used because you cannot be allowed as a
patient to make decisions based on reasonable outcome expectancies. Also,
because you have no financial involvement, you just get ALL the tests.
Failure to give a test should not be automatic negligence if its not called
for the presented systems, unfortunately, juries expect doctors to be
perfect.


Now there is a catch-22 of our current system that has the healthcare industry
by the preverbial balls. No, you don't just get ALL the tests, in fact if
tests are run that are NOT indicated by the diagnosis, you are not going to get
paid for them and may find yourself going to jail. On the opposite side, if
you don't perform the tests that might have caught a treatable condition, you
will find yourself facing a malpractice lawsuit.

Doctors are people, their staff consists of people, and people sometimes make
mistakes. Nobody, that I know of, is perfect and beyond mistakes. Add to our
imperfections, the inability to disassemble the human machine and spec the
parts to a blueprint, and you are guaranteed that not all diagnosis will be
accurate. The medical industry is working hard to try and overcome these
limitations but it is expensive and will be a long time reaching the goals.

6. Reverse price competition. Instead of competing on price and value, the
present system is a strange maze of over and under payment negotiated
without any of the real customers being involved in the negotiation at all.


I agree, except on the negotiation part. Too often there is NO negotiation,
just imposed rules that often can't be understood even by those who write them.
I would challenge you to intrepret the rules for CPT coding and billing.

7. Inability to refuse care. Emergency rooms cannot turn you away for any
reason at all. While inability to pay is likely a good restriction, how
about we tell you that you are not eligible due to lack of need - GOODBYE.

That can't be determined without spending time, money, and physician resources
to determine the "need". Catch-22!

Or, when you pester the ER all the time, and never pay, we send you away for
consistent REFUSAL to pay.


It does not fit to our liberal mentality.

8. Cost shifting of socialist systems from countries with government
healthcare to the US. These systems will begin to fail the day the US
forces the pharmaceutical companies into the same situation they force our
doctors into. Namely, you must charge the US government covered patients
the lowest price you charge anyone, or we throw you in jail. Now, progress
in healthcare will virtually cease.


Ah, you do show some knowledge of this point. Good.

Sorry Sandy, I am not out in any field on this. I am just unwilling to look
at the present system and accept it. It sucks. Really, the system we have
is outside the stadium and it started with job based health insurance.

I would argue that one with you, I feel it started with the Mediare program and
state Medicaid has inflicted additional injury to the system. The advent of
the HMO's was the final nail in the coffen.

Socialist healthcare will not improve the system in the US for anyone except
the working poor and stupid. 80% of us will suffer.


It won't improve the system for anyone. PERIOD! The working poor and stupid
already have better access to healthcare than many of the working middleclass.

Your question assumes that someone would have no insurance until after they
found they had cancer. Of course, no one will sell it to you then. That
would be stupid, and wouldn't work. But wait, that's what we have now.
Once you spend ALL your money, then you get Uncle Sugar to pay. Thus
rewarding lack of financial responsibility.


On this we both agree and disagree. I have been self-employed for over 25
years. I bought a good health insurance policy but over that period of time,
the costs and coverages of that policy changed. The coverage had to be
constantly dropped with a higher and higher deductable untili it became just
major medical only. The costs thought, even with dropping coverage rose to
over $1500 per month. Alternatives were not existant, nobody would consider
coverage for less. I finally had to drop out when they wanted to increase
premiums to $1800 per month. That was five years ago and I have no idea what
they would want to charge today.

Lastly, your link does not support your statement, and is hardly conclusive
at all. No findings were made on quality of care. Also, healthcare is
definitely NOT the largest contributor life expectancy. Sanitation, life
style, diet, and climate would all beat out health care. Your doctor can
add a year or two on average. Better living and genes can add decades.


As far as the quality of the healthcare system in the US, it stands second to
none. That can easily be seen if you visit any of the major medical centers in
the US and check out the patient population for the number of foreign patients
who come here for treatment. If our life expectancy is lower, it can be
directly attributed to diet and life style.



"Sandy" wrote in message
...

"Dude" wrote in message
...
.

Just how does one save up for radical cancer therapy after you retire
and
don't have company health insurance. No insurance company is going to
insure you and if you do find insurance you can say goodbye to your
nest
egg
that you have been saving for all your life. Oh yeah, you get to sell
your
house and give it to a doctor. What a great way to grow old. Just
when
you've finished working all your life, and through the luck of the
draw,
you
get to lose everything you own to the health industry. But, at least
you
have your life, such that it is, living in a rental at a trailer park.



One can buy his own insurance. The fact that you cannot get a decent
policy
is largely due to government interference in insurance.

Dude, you're a little out in right field on this one. What do you think
insurance is going to cost you after you have retired and had a bout with
cancer? Either way it's going to cost you your house and everything you
have worked for all your life. This is where countries with socialized
medicine have it over the US. People live longer and pay less for medical
care than in the US. Have a read.



http://news.sympatico.msn.ca/Health/...tentid=5535dfd
d962443b6b5408385f11556ec&show=False&number=0&show byline=False&subtitle=&abc=ab






Bob Reed
www.kisbuild.r-a-reed-assoc.com (KIS Builders Site)
KIS Cruiser in progress...Slow but steady progress....

"Ladies and Gentlemen, take my advice,
pull down your pants and Slide on the Ice!"
(M.A.S.H. Sidney Freedman)