Daria and CS

boxerfan · January 2012

FallinAgain:
I think Romney has some real problems, not the least of which is that he seems to be the GOP's John Kerry--no one really wants him but there's no one else they like better. Plus, he's robotic and dull, except when he gets pushed on an answer and becomes angry and snotty.

Plus, he's a flip flopper.

sparrowsocks · January 2012

I'm also a moderate with libertarian leanings. I will sign on to CS's post. I wish I had more time for these posts. Stupid work.

CaptainSerious · January 2012

FallinAgain:
I am finding it interesting, but not surprising, that our Repubs are all pro-gay marriage. I think I'd be much more open to voting for a Repub that was for gay marriage (see Huntsman). For me, that issue is the defining civil rights fight of our time and I cannot bring myself to vote for a candidate that wants to deny those rights anymore than I could ever vote for a candidate who believed in segregation or that women should not be allowed to vote. It's such a basic human dignity issue for me. I can't get past it.

To be fair, I used to prefer the idea of civil unions for gays and marriages for heteros, provided that they each entitled the couples to the exact same rights. I figured that solved everyone's issue, because it was only a matter of a different name; semantics. But then an advocate pointed out to me what I should have already realized: if the two were legislated in separate, but equal sections of law (or using the same section of law but a differentiating term), it opened the door for changes to be made in one section but not the other. So additional benefits could be given to hetero couples and not to gays or, similarly, taken away from one group but not the other. Just having two terms could lead to questions of why they were differentiated, because a distinction would have been carved out in the law. Separate but equal had been adjudicated once, and shown to be a pipe-dream. The only way to ensure the same rights for everyone is to allow the same institution: civil marriage.

CaptainSerious · January 2012

boxerfan:
CaptainSerious:

2. Healthcare reform - I don't think it should be required for small employers to provide health insurance to employees. I do think that basic health care should be available to everyone, but not necessarily through employers. I don't like when the government/insurance companies try to enforce lifestyle changes on the insured--encouraging healthy change is one thing, requiring it as a condition of coverage is not okay. I don't have any great answers, but I do think that the new law goes farther than I'm comfortable with.

How does the new law go farther than you're comfortable with?

I'm a contractor, so I am not offered health insurance as a benefit.

My H's company does not offer health insurance of any kind.

There is no individual insurance plan offered in the state of GA that would provide me the same level of coverage that I would be able to get through an employer offered plan, regardless of how much I am willing to pay.

Is that right?

As far as insurance companies enforcing lifestyle changes on the insured, this happens today for anyone that needs to get individual insurance. Lifestyle choices affect your premiums, as well as your ability to be insured at all. Those things are also affected by factors that you have absolutely no control over, such as family medical history and preexisting conditions. Aside from preexisting conditions, none of those things matter at all when you are participating in a group plan.

I don't necessarily think that all businesses should have to offer healthcare, but I think the same healthcare plans should be available to everyone, regardless of whether they're purchasing insurance as an individual, or through a group.

Doesn't the new law have requirements about lunches kids bring to school? Or did that not make it in? I think that goes to far.

I think a person should have the option of not being insured. I really do. I realize that this puts emergency doctors and hospitals in tough situations, but I think it should be a personal choice.

There is no individual insurance plan offered in the state of GA that would provide me the same level of coverage that I would be able to get through an employer offered plan, regardless of how much I am willing to pay.

Is that right?

No. Perhaps insurance companies should be required to make the same level of coverage available to all persons in a state (maybe even nationwide). Of course as private-pay, the cost would be higher (and possibly unattainable by some) than for a group.

I think that the reason for the high medical cost is malpractice insurance. It's why the Amish have entered an agreement with the local providers to pay cash and never sue...and why they have significantly lower rates than the rest of the country. So, the effective thing is to severely crack down on frivolous law suits through torte reform. But no one is willing to do that.

As far as insurance companies enforcing lifestyle changes on the insured, this happens today for anyone that needs to get individual insurance. Lifestyle choices affect your premiums, as well as your ability to be insured at all.

I see no problem with this. If a person makes a choice that can affect his health, and puts him at a statistically higher risk for needing extensive medical care down the line, he should pay more for his insurance that will have to pay for that care.

I don't really know what to do about pre-existing conditions. Like I said, I don't have all the answers, I just don't think this plan goes about it quite the right way.

CaptainSerious · January 2012

FallinAgain:

Why do you think Huntsman cannot beat Obama? And why Romney has the best chance?

Honestly, I think Romney has the best chance because he was elected in MA, which is a very liberal state. He knows how to sell himself to the audience he's seeking, even if we have no idea what he really stands for.

WendyToo · January 2012

CaptainSerious:
FallinAgain:
I am finding it interesting, but not surprising, that our Repubs are all pro-gay marriage. I think I'd be much more open to voting for a Repub that was for gay marriage (see Huntsman). For me, that issue is the defining civil rights fight of our time and I cannot bring myself to vote for a candidate that wants to deny those rights anymore than I could ever vote for a candidate who believed in segregation or that women should not be allowed to vote. It's such a basic human dignity issue for me. I can't get past it.

To be fair, I used to prefer the idea of civil unions for gays and marriages for heteros, provided that they each entitled the couples to the exact same rights. I figured that solved everyone's issue, because it was only a matter of a different name; semantics. But then an advocate pointed out to me what I should have already realized: if the two were legislated in separate, but equal sections of law (or using the same section of law but a differentiating term), it opened the door for changes to be made in one section but not the other. So additional benefits could be given to hetero couples and not to gays or, similarly, taken away from one group but not the other. Just having two terms could lead to questions of why they were differentiated, because a distinction would have been carved out in the law. Separate but equal had been adjudicated once, and shown to be a pipe-dream. The only way to ensure the same rights for everyone is to allow the same institution: civil marriage.

See, this still comes across as superior to me and it bugs. Non-religious heteros would be eligible for marriage by your original plan, but not religious gay people because your interpretation of your religion says its bad?

boxerfan · January 2012

CaptainSerious:
Doesn't the new law have requirements about lunches kids bring to school? Or did that not make it in? I think that goes to far.

I've not heard or read anything about that requirement. Does anyone know if that's true? Given that they just ruled pizza as a vegetable for school lunch, I am wondering what possible requirements they could have in place for lunches brought from home.

CaptainSerious:

There is no individual insurance plan offered in the state of GA that would provide me the same level of coverage that I would be able to get through an employer offered plan, regardless of how much I am willing to pay.

Is that right?

No. Perhaps insurance companies should be required to make the same level of coverage available to all persons in a state (maybe even nationwide). Of course as private-pay, the cost would be higher (and possibly unattainable by some) than for a group.

Why should the cost per person be higher for an individual vs. a group member, assuming the benefits are the same?

CaptainSerious:
So, the effective thing is to severely crack down on frivolous law suits through torte reform. But no one is willing to do that.

Corporations have spent a lot of money on advertising and marketing to convince people that frivolous law suits are a big problem in this country. While torte reform may limit "frivolous" suits, it also protects corporations from legitimate law suits, to the detriment of the individual. I think the most widely mocked example of a lawsuit is the McDonalds hot coffee lawsuit. Have you ever really learned about that lawsuit? Because I don't actually think it was frivolous at all. The training manual provided by McDonalds corporation specified that coffee should be kept at a temperature that would cause severe burning if consumed. There were hundreds of complaints about people being burned by McDonalds coffee across the country in the years leading up to this suit, and McDonalds did nothing to adjust their practices. The woman received serious burns that required hospitalization, and multiple skin grafts. She tried to work with McDonalds outside of court to get them to pay her medical bills, and they refused to settle with her. This lawsuit was the only thing that actually made them revise their training manual, so that they were telling employees to keep the coffee at a safe temperature.

And still, that case is regularly held up as an example of why torte reform is needed in our country.

CaptainSerious:
I see no problem with this. If a person makes a choice that can affect his health, and puts him at a statistically higher risk for needing extensive medical care down the line, he should pay more for his insurance that will have to pay for that care.

I don't really have a problem with a person who makes bad choices having to pay more. My concern is that two individuals who make the exact same bad choice are treated differently based on whether or not they have an employer offered group plan available to them. Why should someone not be held accountable for their choices, simply because they are part of a group? In the end, those two people have the same statistical risk of needing extensive medical care.

Sorry, I hope you don't take this as arguing. I truly am interested to hear what you think about these things, and I appreciate you contributing to the discussion.

CaptainSerious · January 2012

WendyToo:

See, this still comes across as superior to me and it bugs. Non-religious heteros would be eligible for marriage by your original plan, but not religious gay people because your interpretation of your religion says its bad?

No! Not at all. My post is only addressing what the government should do. Each religion should do what it wants. So if a certain religion believes that gay people should be allowed to be married, they should marry gay people. I don't think the government should have any say in that.

If any couple gets married by a religion, but does not obtain a civil marriage license, they do not get any of the same rights as married couples. My post is only addressing what should happen to afford gay couples the same rights as civilly married couples.

WendyToo · January 2012

CaptainSerious:
WendyToo:

See, this still comes across as superior to me and it bugs. Non-religious heteros would be eligible for marriage by your original plan, but not religious gay people because your interpretation of your religion says its bad?

No! Not at all. My post is only addressing what the government should do. Each religion should do what it wants. So if a certain religion believes that gay people should be allowed to be married, they should marry gay people. I don't think the government should have any say in that.

If any couple gets married by a religion, but does not obtain a civil marriage license, they do not get any of the same rights as married couples. My post is only addressing what should happen to afford gay couples the same rights as civilly married couples.

So why Did you originally believe gays should be offered civil unions and heteros offered the option of marriage? Why would any distinction ever be necessary?

CaptainSerious · January 2012

Why should the cost per person be higher for an individual vs. a group member, assuming the benefits are the same?

As unfair as it is on the surface, it has to do with the fact that when insurance is bought as a group, the company is betting on the fact that while some of the people will need extensive care, others may barely use their benefits at all. The company offers group rates somewhere in the middle, in the hopes that all the costs will even out across the group. As an individual, you don't have this phenomenon working in your favor.

Maybe I used the wrong term when I cited "torte reform" here, because what I'm actually more focused on is all the times action is taken against a doctor because the patient died or the outcome wasn't as positive as expected/hoped. If you call up the medical board, you will find that any doctor who's been practicing for any amount of time will have countless actions brought against him, and usually they don't amount to anything. It's just grieving families looking for some way to direct their pain/anger, and believing that if their loved one died, it must be because the doctor did something wrong.

CaptainSerious · January 2012

WendyToo:
CaptainSerious:
WendyToo:

See, this still comes across as superior to me and it bugs. Non-religious heteros would be eligible for marriage by your original plan, but not religious gay people because your interpretation of your religion says its bad?

No! Not at all. My post is only addressing what the government should do. Each religion should do what it wants. So if a certain religion believes that gay people should be allowed to be married, they should marry gay people. I don't think the government should have any say in that.

If any couple gets married by a religion, but does not obtain a civil marriage license, they do not get any of the same rights as married couples. My post is only addressing what should happen to afford gay couples the same rights as civilly married couples.

So why Did you originally believe gays should be offered civil unions and heteros offered the option of marriage? Why would any distinction ever be necessary?

Only because there are a lot of social conservatives in this country who balk at the idea of gay marriage, and it seems there only real hang-up is that they don't want to see the term "marriage" applied to a relationship they see as fundamentally different to theirs. I think the line of thinking is backwards and generally stems from bigotry, but if it's the only thing standing in the way of affording gay couples the same rights, than maybe it wasn't a fight worth waging. Let the conservatives keep the "marriage" verbiage, and extend benefits to all couples equally. It seemed like a small compromise to make...until I realized what I posted above.

WendyToo · January 2012

CaptainSerious:
WendyToo:
CaptainSerious:
WendyToo:

See, this still comes across as superior to me and it bugs. Non-religious heteros would be eligible for marriage by your original plan, but not religious gay people because your interpretation of your religion says its bad?

No! Not at all. My post is only addressing what the government should do. Each religion should do what it wants. So if a certain religion believes that gay people should be allowed to be married, they should marry gay people. I don't think the government should have any say in that.

If any couple gets married by a religion, but does not obtain a civil marriage license, they do not get any of the same rights as married couples. My post is only addressing what should happen to afford gay couples the same rights as civilly married couples.

So why Did you originally believe gays should be offered civil unions and heteros offered the option of marriage? Why would any distinction ever be necessary?

Only because there are a lot of social conservatives in this country who balk at the idea of gay marriage, and it seems there only real hang-up is that they don't want to see the term "marriage" applied to a relationship they see as fundamentally different to theirs. I think the line of thinking is backwards and generally stems from bigotry, but if it's the only thing standing in the way of affording gay couples the same rights, than maybe it wasn't a fight worth waging. Let the conservatives keep the "marriage" verbiage, and extend benefits to all couples equally. It seemed like a small compromise to make...until I realized what I posted above.

See I see it as placating/condoning bigotry, which I dont think the government d do. At best, it's making a legal definition for what they say is a religious term (somehow belonging only to them?)

CaptainSerious · January 2012

Wendy, I don't necessarily disagree that it's placating, but as idealistic as I'd like to be, laws are made through compromise. I see it every day. The fact is, the country and elected Members of Congress are torn on this, almost exclusively because of the use of the term "marriage." Barring my new revelation that it just won't work, my initial impression was "why get held up by terminology, when the real issue is affording everyone the same rights?"

As far as it being a religious term, that's just not true, as much as some would like to claim it is. In our nation, marriage has been in both forms, a civil and a religious institution.

boxerfan · January 2012

CaptainSerious:
Why should the cost per person be higher for an individual vs. a group member, assuming the benefits are the same?

As unfair as it is on the surface, it has to do with the fact that when insurance is bought as a group, the company is betting on the fact that while some of the people will need extensive care, others may barely use their benefits at all. The company offers group rates somewhere in the middle, in the hopes that all the costs will even out across the group. As an individual, you don't have this phenomenon working in your favor.

I understand how group insurance rates are calculated. I just don't agree with the system. I don't think it's just unfair on the surface. I think it's truly unfair. I don't think there should be a different system used to evaluate a persons insurability/risk based on whether or not their employer chooses to offer health insurance.

You said earlier that all employers shouldn't have to offer health insurance. I'm fine with that, but I do think that there should be changes made to our current system that allow everyone access to the same benefits and level of care.

M has a heart condition, right? If he was 20, instead of 10, and he'd just graduated college (so he couldn't be on your plan anymore), he would most likely not qualify for any sort of individual insurance policy using todays evaluation system. If his employer (assuming he could get a job) didn't offer a group plan, he would be SOL. And as soon as he goes a day without coverage, that heart condition becomes a pre-existing condition, and no insurance company ever has to cover him for it in the future. I think that's really scary and wrong.

Everyone always rages about how terrible Obamacare is, but it makes some serious changes to the way pre-existing conditions are handled, and I think that is so important, and something that we really need in this country. I will be truly sad if it's repealed.

Two years ago on Thanksgiving my friend found out that she had breast cancer. About four months later, her HR department made an error when processing her payroll, which caused her to be accidentally unenrolled in her health insurance plan for a period of less than 24 hours. Today she is still fighting with them to cover her medical bills after that day, because they're calling her cancer a pre-existing condition. It's so fvcked up. That is just not right.

CaptainSerious:
Maybe I used the wrong term when I cited "torte reform" here, because what I'm actually more focused on is all the times action is taken against a doctor because the patient died or the outcome wasn't as positive as expected/hoped. If you call up the medical board, you will find that any doctor who's been practicing for any amount of time will have countless actions brought against him, and usually they don't amount to anything. It's just grieving families looking for some way to direct their pain/anger, and believing that if their loved one died, it must be because the doctor did something wrong.

What do you think should be done to prevent this from happening? Torte reform generally involves capping the amount of money that juries are allowed to award in lawsuits. So if a doctor or hospital truly does do something negligent, they can only be held accountable for a certain max dollar amount. It doesn't really do anything to prevent people from suing.

That's why many contracts that you sign today include binding arbitration clauses. Those generally say that no matter what happens, you can't sue a company. You can only go through binding arbitration with an arbitration company of their choosing. Those arbitration companies receive most of their revenue from the large corporations that they work with, and they will generally never work (or receive money) from the individual again. Guess who they generally tend to side with? And since it's arbitration, not court, they're free to rule any which way they please. And since it's binding, the individual has absolutely no recourse. Sweet deal, huh?

CaptainSerious · January 2012

Boxer, I already said that I don't know what I'd do about pre-existing conditions. I don't like the way they've been handled in the past. Perhaps, the insurance company should be required to cover the person anyway, sort-of like the assigned-risk driving pool. I'm not sure.

The thing is, insurance companies are businesses. They are in it to make a profit. And without them, the government (i.e., taxpayers) would have to pick up the tab. So something's gotta give, right? The thing that's driving up health care costs is litigation/actions brought against doctors. So that's where we should focus.

Again, I'm not really talking torte reform or capping awards. Perhaps a way to deal with it (similar to what the Amish have worked out) is that you get cheaper rates (from the medical provider/insurer, depending on if you are private pay or insured) if you promise not to bring action against the doctor except in extreme circumstances. I know it sounds unenforceable, but NJ already does this with car insurance. You waive your right to sue except in cases of death or certain serious injuries. Maybe something similar could be done for medical providers.

As for binding arbitration, I agree with you that it's a sham of a system. I think binding arbitration should be thrown out entirely, unless the consumer gets to pick the arbiter or some other serious protections are instituted.

boxerfan · January 2012

CaptainSerious:

The thing is, insurance companies are businesses. They are in it to make a profit. And without them, the government (i.e., taxpayers) would have to pick up the tab. So something's gotta give, right? The thing that's driving up health care costs is litigation/actions brought against doctors. So that's where we should focus.

Again, I'm not really talking torte reform or capping awards. Perhaps a way to deal with it (similar to what the Amish have worked out) is that you get cheaper rates (from the medical provider/insurer, depending on if you are private pay or insured) if you promise not to bring action against the doctor except in extreme circumstances. I know it sounds unenforceable, but NJ already does this with car insurance. You waive your right to sue except in cases of death or certain serious injuries. Maybe something similar could be done for medical providers.

As for binding arbitration, I agree with you that it's a sham of a system. I think binding arbitration should be thrown out entirely, unless the consumer gets to pick the arbiter or some other serious protections are instituted.

Sorry, I'll lay off the pre-existing conditions stuff. It just makes me angry and sad.

Insurance is most definitely a business, and one of the most profitable ones around. I think they spend a LOT of money trying to convince the general public that frivolous law suits are the reason that health care costs are so high. I'm sure that there are people out there who sue over nothing, but I don't believe that it's the majority of suits. Lawsuits are really expensive, and they don't really make much sense if you have no chance of winning.

I am pretty uncomfortable with the idea of waiving my right to sue. If a doctor or hospital is negligent in their care of a patient, I think they should be held accountable for that. I would be more comfortable with legislation that said the losing party of a lawsuit was responsible for the legal fees of both sides (which is often done via countersuit anyway), and that malpractice insurance premiums couldn't be raised if the dr/hospital wasn't found guilty of wrongdoing.

How does the NJ car insurance thing work? If an uninsured person smashes your car to bits because they're driving drunk, you have no recourse? Too bad, so sad, go buy a new car? Or claim it through your own insurance, and pay higher premiums for the next five years, even though you did nothing wrong?

CaptainSerious · January 2012

There's an option to be covered through your own insurance if an uninsured driver hits you. You opt in or out at the time you take the policy out, and if you are in, your premium's obviously higher, but you are covered. If not, you're out of luck. Premiums don't necessarily automatically go up for claiming in this type of situation.

And again, I'm not just talking lawsuits here. Complaints/Actions against a doctor through the medical board are far cheaper, but still require the doctor to take time and money to mount a defense.

CaptainSerious · January 2012

I would be more comfortable with legislation that said the losing party of a lawsuit was responsible for the legal fees of both sides (which is often done via countersuit anyway)

I'm okay with this until you consider that the average Joe may actually have a case but be out-lawyered by the medical professionals. Then to add insult to injury, he has to pay for those lawyers, too.

and that malpractice insurance premiums couldn't be raised if the dr/hospital wasn't found guilty of wrongdoing.

Again, it sounds good on the surface, but what about the doctor who isn't negligent but consistently takes risks or practices experimental medicine. He might get sued more than someone else and be exonerated, but shouldn't his premium be higher to off-set his risk/the fact that he's consistently having to go to court?

boxerfan · January 2012

CaptainSerious:

I'm okay with this until you consider that the average Joe may actually have a case but be out-lawyered by the medical professionals. Then to add insult to injury, he has to pay for those lawyers, too.

Is that worse than not being able to sue at all?

CaptainSerious:

Again, it sounds good on the surface, but what about the doctor who isn't negligent but consistently takes risks or practices experimental medicine. He might get sued more than someone else and be exonerated, but shouldn't his premium be higher to off-set his risk/the fact that he's consistently having to go to court?

If he's consistently exonerated, is his risk really greater?

CaptainSerious · January 2012

boxerfan:

Is that worse than not being able to sue at all?

The waiver of right to sue would be an option. If you chose to waive your right, you get cheaper premiums. I know that sounds like I coerced option, but it works in NJ. Car insurance rates here are notoriously high, but I still know average people who have chosen not to waive their right.

Also, you can still sue in certain egregious cases. I'm not sure how they should be defined for medical insurance, but I'm confident someone in the field could come up with something that would work.

boxerfan:

If he's consistently exonerated, is his risk really greater?

Yes, if the insurance has to pay for his defense each time.

boxerfan · January 2012

CaptainSerious:
The waiver of right to sue would be an option. If you chose to waive your right, you get cheaper premiums. I know that sounds like I coerced option, but it works in NJ. Car insurance rates here are notoriously high, but I still know average people who have chosen not to waive their right.

Also, you can still sue in certain egregious cases. I'm not sure how they should be defined for medical insurance, but I'm confident someone in the field could come up with something that would work.

I still don't really understand how the NJ car insurance thing works. Can you explain it?

CaptainSerious:
boxerfan:

If he's consistently exonerated, is his risk really greater?

Yes, if the insurance has to pay for his defense each time.

The insurance company wouldn't have to pay for his defense if the losing party was responsible for legal fees. That's why I think those two ideas should go together.

I hear you about the issues with being out-lawyered, and I don't really have a good answer for that. I think it's all a big cycle of corporations charging exorbitant prices for things (health care, insurance, legal fees, etc.) to make record profits, until everything just spirals completely out of control, and there's no way that an average person can compete. I do think that at some point the government needs to step in and start to legislate in these industries to make sure that people can still have access to the things that they need. If that means that I end up paying more in taxes in the end, I'm ok with that.

CaptainSerious · January 2012

When you sign up for car insurance in NJ, you can opt to waive your right to sue, unless there's been a death or certain other serious injury. If you do, your rates are lower. This document, starting at page 12, explains it: http://www.state.nj.us/dobi/division_consumers/pdf/autoguide02.pdf. The same document explains how the Uninsured/Underinsured Motorist Coverage works.

I do agree that it's an out-of-control cycle of increasing costs. I'm not sure it's just because of profits. I admit a lot of my conviction on this is the fact that the Amish carved out such a great deal for themselves just by promising not to sue. Although, I just searched some articles and found that they, too, are now facing increasing costs and are having a harder time paying their medical costs.

FallinAgain · January 2012

I think that everyone should get a civil union from the govt. I disagree that the word "marriage" is the hang-up. Most republicans, including most of the ones running for president, don't support civil unions for gay people either. I cannot get past that.

I call BS on the argument that "frivolous lawsuits" are the reason for high healthcare costs. It gives the candidates convenient strawmen in the guise of the greedy shyster lawyer. People SHOULD be able to sue doctors who eff up. There should be a redress against people who violate their duties to you. People should not have to give up future access to that redress in order to afford medical care. Things like recovery caps only serve to damage the people who have been most grievously injured by medical professionals. And frankly, the argument is based on the assumption that the court system is a failure and that juries are stupid. The courts are, in fact, quite good at dismissing frivolous lawsuits.

If we want less lawsuits, we probably need to look at redefining what constitutes the "standard of care." I do think doctors over-prescribe and over-test (especially) for fear of being sued. The medical associations need to better set what constitutes appropriate care. That's a hard question because you want good doctors to feel they can use their best judgment.

CaliopeSpidrman · January 2012

Boxer watched Hot Coffee recently. In that, didn't they make the point that insurance companies are charging more and more for malpractice insurance, but paying out less and less? So in reality, those "frivolous lawsuits" everyone grumbles about aren't actually causing health care rates to go up. More like insurance company greed.

noisy_penguin · January 2012

Insurance itself is one of the reasons health care costs so much. For every doctor there are at least four people handling insurance paperwork. Four people's salaries to figure out what the fucck they need to do to get insurance to cover a claim, and then to fight with the insurance company. Someone needs to pay for those people's salaries.

People always ask, "Do we want a bureaucrat standing in the way of me and my doctor?" And yes, I would rather a nonprofit, governmental lazy ass bureaucrat be in charge than a for profit business that is out to make sure they can make as much money as possible off people who are sick, injured, and dying by denying their claims.

HealthNet denied claims from my hospital stay to the tune of over $10,000. Granted, this is a drop in the hat to the $400,000+ cost of my stay, but we could afford $10,000 about as well as we could afford $400,000, and their denial was pure bullshiit, claiming that a procedure that my doctors wanted done at a different hospital was an outpatient, elective procedure, though I was sent to and from the other hospital in an ambulance and was under care the entire time. Every action I took, for well over a year, was denied and they sent me to a collections agency. It wasn't until my employer, a large entity that had recently made HealthNet their sole healthcare provider, stepped in that they backed down. If I didn't work where I worked I have no doubt that I'd have been fuccked.

And of course, when I tried to get private insurance after leaving my job, I was denied reasonable coverage because of my pre-existing gallstone pancreatitis condition, something I cannot ever get again because I DO NOT HAVE A FUCCKING GALL BLADDER.

My mom lost her state health insurance because one of the kids in her daycare was no longer eligible for DSHS help, and because she was no longer working with enough DSHS kids, she didn't qualify. She can't get reasonable health insurance because she had open heart surgery as a child. Her heart condition is gone, has never been an issue in the 50+ years since she had surgery, and yet here she is, being charged $700+ a month for coverage that's so terrible she still pays 40% for care after she reaches her absurd deductible.

Our healthcare system is fuccked. People should not be making money on gambling with people's lives. They just shouldn't. It's wrong. I know systems in England and Canada are also flawed, but I'd much rather have theirs than I would ours.

salimoo · January 2012

CaptainSerious:
No. Perhaps insurance companies should be required to make the same level of coverage available to all persons in a state (maybe even nationwide). Of course as private-pay, the cost would be higher (and possibly unattainable by some) than for a group.

How is this different than how it is pretty much anywhere, minus those excluded due to pre-existing conditions, which is being fixed soon? Why do only those with financial means (whether on their own or by virtue of having a job) get to have insurance?

FallinAgain · January 2012

noisy_penguin:
Insurance itself is one of the reasons health care costs so much. For every doctor there are at least four people handling insurance paperwork. Four people's salaries to figure out what the fucck they need to do to get insurance to cover a claim, and then to fight with the insurance company. Someone needs to pay for those people's salaries.
People always ask, "Do we want a bureaucrat standing in the way of me and my doctor?" And yes, I would rather a nonprofit, governmental lazy ass bureaucrat be in charge than a for profit business that is out to make sure they can make as much money as possible off people who are sick, injured, and dying by denying their claims.
HealthNet denied claims from my hospital stay to the tune of over $10,000. Granted, this is a drop in the hat to the $400,000+ cost of my stay, but we could afford $10,000 about as well as we could afford $400,000, and their denial was pure bullshiit, claiming that a procedure that my doctors wanted done at a different hospital was an outpatient, elective procedure, though I was sent to and from the other hospital in an ambulance and was under care the entire time. Every action I took, for well over a year, was denied and they sent me to a collections agency. It wasn't until my employer, a large entity that had recently made HealthNet their sole healthcare provider, stepped in that they backed down. If I didn't work where I worked I have no doubt that I'd have been fuccked.
And of course, when I tried to get private insurance after leaving my job, I was denied reasonable coverage because of my pre-existing gallstone pancreatitis condition, something I cannot ever get again because I DO NOT HAVE A FUCCKING GALL BLADDER.
My mom lost her state health insurance because one of the kids in her daycare was no longer eligible for DSHS help, and because she was no longer working with enough DSHS kids, she didn't qualify. She can't get reasonable health insurance because she had open heart surgery as a child. Her heart condition is gone, has never been an issue in the 50+ years since she had surgery, and yet here she is, being charged $700+ a month for coverage that's so terrible she still pays 40% for care after she reaches her absurd deductible.
Our healthcare system is fuccked. People should not be making money on gambling with people's lives. They just shouldn't. It's wrong. I know systems in England and Canada are also flawed, but I'd much rather have theirs than I would ours.

Yep. Yep. Yep. The whole "death panel" rhetoric was so ridiculous. If you don't think there's already someone looking at your grandmother's and your medical requests and deciding whether the life saving treatment will be covered, you are very naive. The only question is do you want that someone to work for the government or for a company whose purpose is to make as much profit as possible.

pdxmouse · January 2012

Oh, sure, have a non-arguing, arguing, political thread buried under a page when I have hardly any computer time right now.

Bastards.

Anyway, if I'm not going to argue, because we're not arguing, at all, even a little, let Ms Mouse tell you a story of why she's a tax and spend liberal who doesn't believe in tort reform.

Two years ago my dad was hit by a young woman running a light while he was riding a motorcycle. He doesn't remember the impact, but apparently he hit headfirst and flipped over the hood of the car. He was unconscious for a few minutes and broke his leg and back. He was very lucky. He was extremely lucky that he was taken to OHSU's hospital and that the three-day stay wasn't all that expensive (I think $60k).

The young woman who hit him was 18 and late for work. Her policy pays out a max of $100,000, the minimum you have to carry in our state. She lives with her parents in a small house in a small town. She has no assets and honestly, she made a mistake. My dad has decent auto insurance, but I guess coverage in Oregon doesn't allow you to "double dip" so you don't get benefits beyond what the other party pays out. Auto accidents don't fall under health insurance benefits either.

My parents didn't want to take her to court and ruin her life. Not much point in it either, they didn't have any way to pay. Their biggest concern wasn't being compensated for pain and suffering, their biggest concern was that he'd need back surgery, he needed rehabilitative care, and who knows if he'd need more expensive care down the road as his joints and bones age, and exacerbate whatever problems the injury caused. Health insurance could continue to deny claims years later, because it's another party's responsibility, even if the settlement is long gone.

If we had universal health care in this country, my parents wouldn't have thought twice about suing. I know there's people who file because they're pissed, or they want theirs, or whatever greedy bogeyman you want to drag out, but most people I know, most people I've heard about even, sue for injuries because they're terrified of future health care costs.

I've talked to physicians who have told me that they're not afraid someone will sue to be vindictive, but that they're pretty sure that most suits are filed because that's the only way to cover health bills, especially long-term care. An FNP I know told me she wishes there was a way to get insurance payouts without having to find fault. She used an example I'm pretty sure was from real life: a baby born brain-damaged after a hard delivery. A c-section would have avoided the damage, but the readings were mostly in normal bounds, so what was the midwife supposed to do, insist on a slice-and-dice for what was usually blips? But that baby is going to need substantial, ongoing, potentially lifelong care because no one caught what was happening. What are the parents supposed to do, but sue? Anger might play a role, but it's fear that's driving them to the lawyer's.

Not that things would be honky-dory forever if we just embraced single-payer, but that we can't even get to addressing some of the causes for spiraling costs, fear and suspicion until we have at least a basic right to health care. There's no way, not only do too many people fall through the cracks, but too many people are afraid of those cracks to look out for anyone but themselves. I don't see how we can blame them, seeing how clear it is that no one is willing to look out for them. How can we ask anyone to look out for the greater good on this issue when only some benefit, and even then, only so long as their luck holds?

pdxmouse · January 2012

salimoo:
CaptainSerious:
No. Perhaps insurance companies should be required to make the same level of coverage available to all persons in a state (maybe even nationwide). Of course as private-pay, the cost would be higher (and possibly unattainable by some) than for a group.
How is this different than how it is pretty much anywhere, minus those excluded due to pre-existing conditions, which is being fixed soon? Why do only those with financial means (whether on their own or by virtue of having a job) get to have insurance?

Also, why is the risk pool parceled out in tiny chunks, group or individual? If the group pays less because they average out those who need extensive care with those who skate by with the occasional wellness check, how is that different than the broader pool everyone is paying into that averages out globally? Isn't that the justification for insurance in the first place; that the more people pay in, the more risk is spread out? I don't see why the employer should be the magic gateway when the pool is theoretically everyone who joins the plan.

Now, it's true that people who buy individual insurance tend to be sicker and use it more, but that wouldn't be true if everyone were required to have insurance. It certainly wouldn't be the case if we had single-payer.

boxerfan · January 2012

So, the nj car insurance thing - are you waiving your right to sue your own insurance company? The other drivers insurance? The other driver individually? Say Papa Mouse lived in nj and chose that option. He needed surgery not covered by the at fault party's insurance, and couldn't afford it himself, even though he personally had adequate coverage. What would happen? Bankruptcy for Papa Mouse? A lifetime of uncovered medical bills that he could do nothing about?

If people in nj can't be sued, why would they ever take out a policy that covered more than the bare minimum for liability? And what incentive does the insurance have to approve even a legitimate claim, if they can't be sued?

Daria and CS

Re: Daria and CS

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