"healthcare idea with mileage"

[wisteria]

http://www.johnkerry.com/news/articles/newsarticle.html?id=83

Original Editorial in the Boston Globe


PROBABLY wasn't anything George W. Bush had much interest in hearing -- but Nancy Pelosi and Harry Reid should sit up and take notice.

Last week, the chiefs of Ford, General Motors, and Chrysler went to Washington to meet with the president, the vice president, and various administration officials about the auto industry's woes.

Among their complaints: The heavy healthcare costs they shoulder are hindering their ability to compete.

And what did they suggest by way of a solution? Something John Kerry proposed during his presidential campaign: a reinsurance arrangement to pay for chronic or catastrophic healthcare costs, thereby effectively taking those cases out of private health-insurance plans.


Take that Repubs and media talking heads that claimed that Kerry had no plans in 04. The guy is too far ahead of everyone else. Actually, that is a good thing. Now we need to get people's attention.

[Joe Chi Minh]

1. Kerry was also talking about the paramount need for renewable

energy resources at the Democratic Convention in 2002 - which, in my ignorance, sounded quite odd to me at the time.

[pooja]

2. would this be like a regular insurance and then a subsidy fund

through one Gov't agency for catestrophic events...
Also, I thought that diebetes and heart disease were #1 medical drain anyway.. How about companies giving their employees and extra 3 to 4 hrs a week to go to a gym.

[DocSavage]

3. The company only provides

insurance for the worker. If there is a family, well, let the breadwinner take care of it. This is the hard way for a company to reduce medical costs.

[sui generis]

4. I think it's an utterly wrong unspeakably bad idea

but I'll give it a shot.

When you create a criteria based "high risk" pool in insurance that the government has to reinsure, it is reinsured by budget. So the first cuts to budget mean that people in those pools get chopped out of them or are prevented from partaking as they languish on a waiting list in a "no man's" land.

Being in an insurance risk group does not conflict with HIPAA protections, so merely belonging to that group or ever having been assigned to that group can be made a matter of public record.

It's a horrible idea on many many levels. So these risk groups are built not just of people with long term chronic problems, but anyone over the age of say, 55. Or anyone who has ever had cancer once in their life, including not just cancer but a negative biopsy for cancer.

Or better, somebody who may have had a new patella put in, or an inguinal, hiatal, abdominal repair procedure, or anyone who's been diagnosed with high blood pressure.

It's a frakking stupid idea, and it shows that Kerry is NOT in touch on this topic.

If you want to reduce healthcare costs, stop splitting people up along artifial lines of risk groups and state and federal budgets. You have to negotiate with pharma (90% of the cost), period, first, middle and last. If you fail to do that you might as well just send them a nice big fat check from the government. You have to remove risk group limitations, reregulate health insurance and manage our nation's health from a preventative perspective rather than a reactive perspective.

You have to do and say some tough things, such as, the most basic health of our nation is not to be profiteered from in its administration. It is to be administered. Now that leaves plenty of room for making a profit on elective healthcare, on supplemental insurance that can be risk based, and on pharma with extended patents and re-regulated generics.

But the Kerry idea is half baked and lame and lacks foresight or understanding.

[wisteria]

5. I liked the idea. However, why don't you contact him and explain your position. n/t

[sui generis]

6. It's not a position

It's reality in Texas already, and it's not working. Or rather, it's working out great for the everyone in the money supply chain except the co-insureds who have to ante up double to quadruple the premiums of the next lowest risk group, and cannot acquire new single insurance on their own because of the risk group designation, and have as long as 18 months of pre-existing exclusions when they do qualify on an employer's plan.

I wish that Kerry would stop saying the first thing that occurs to him. I know he means well, but even consulting with anyone but an insurance company he would have come to this conclusion. It's not the conclusion that matters but how he arrived at it.

And I can assure you that the insurance companies would happily support this plan - it means that they don't have to change a thing or lose a penny and that they can further tighten their risk-group exclusions to basically only insure people who will never need it except for an emergency such as a car accident.

I think that rather than being miffed that someone disagrees on DU, that we all, each of us contact him and say why it's not enough, and why it's a gimme to the insurance companies. Otherwise, people like me but with smaller more evil hearts will happily wave goodbye to anyone who might run the risk of raising MY premiums and continue to keep our tax cuts while the rest of the people who need healthcare the most continue to have the least access to it.

If we like an idea, we should be prepared to say why. Or why not.

[Selatius]

9. The problem is the insurance industry's heavy fragmentation and bureaucratic waste

Each company has its own little ways of doing things, and the result is inconsistent health care, and it disenfranchises the poor for the fact that costly duplication of activities leads to higher operating costs, which is usually simply passed onto consumers. On top of that, many of them neglect infrastructure improvements in favor of short-term dividends, and the result is a paperwork intensive organization that hasn't yet discovered the computer.

I favor John Conyer's Expanded and Improved Medicare for All Act of 2005, but the bill is currently languishing in committee. Hopefully, it sees the light of day when the Dems take over.

[sui generis]

10. administrative costs are really a straw man though

again - something that the real monsters lurking under the bed are happy to tell you we need to do something about.

The biggest costs are clearly the actual healthcare costs themselves. "Reasonable and Customary" takes on entirely new meanings when it is reasonable and customary for your doctor to charge an "emergency visit" R&C and "emergency treatment" R&C for taking your appointment in under two weeks, nevermind the ACTUAL healthcare that was utilized (a prescription for two aspirin and a glass of water, etc.). I give this as an example because recently I had got a stomach bug and thought a shot in the ass and some Cipro (standard eval) would be the the fastest way to not miss work. I had an appointment after three days and went in and my shot in the glute, the Rx (writing it, not paying for it), and the ten minute appointment with a PA cost $700 dollars on my insurance. And this doctor is a friend of mine. All the R&C was paid, but they submitted a bunch of extraneous crap for which R&C got paid, and this is monitored by a private insurer, and not the government.

When you look at things like Restasis (for dry eye treatment) that cost as much on the formulary as AIDS and cancer drugs and typically have six month prescription regimens, something is seriously badly wrong.

We MUST have negotiating power with big Pharma - they're killing all of us by keeping the cost of healthcare artificially inflated, and they're killing the least medically risk-tolerant, the elderly and chronically ill, the fastest by limiting access to necessary healthcare altogether.

Quite frankly, they've had their day. It's time to put our national health above the rights of a company to make astonishing profits. Nobody wants to nationalize or socialize these guys, but we need pricing regulation, medical school cost management (if we really value our doctors and healthcare professionals), and in turn we need to be able to cross incentivize pharma by extending their patents and keeping re-regulation away from elective healthcare - i.e., cosmetic procedures, etc.

It is complicated and it can be done, but we're going to have to discount the ideas we hear from both HMO adminstrative organizations and from Pharma and healthcare providers as being solutions that they perceive will continue to benefit them financially at the expense of our national healthcare.

We have to innovate.

[SoCalDem]

7. "Reinsurance plan" Hah!

All they want to do is to dump the people who are the sickest and need it the most, into a "special group".. Think PBGC (pensions)..and you KNOW what will happen..

Look...

EVERYONE IS GONNA GET SOMETHING, SOMEDAY.

We are all in this together.

Everyone in the US should be in one BIG OLE group to cut down the costs.

we just need to make up our minds what we ARE..

are we all a bunch of Libertairan "Me-Me-Meees"
or are we a nation of "WE's" you know as in WE the people??

We need to remove health care from the "private sector" and turn those hospitals back into not-for-profit

Pay the doctors and researchers well

Quit subsidizing pharma or demand that they provide lifesaving meds at COST.. (The enhancing drugs are a different story)

Healthcare should not be in the hands of an employer. Why give them that much power over their employees? They already control how much a person will earn, what their hours are, when they can go to lunch, take vacations etc. Why give them literal LIFE & DEATH power too?

Private sector is fine for "stuff"...clothes, cars, gadgets, toys..

but it's NOT fine for necessities like

health care
energy

[Gwerlain]

8. Reinsurance is not the answer...

for many reasons that others have brought to light in this thread. What we need, and what we have needed for a very long time, is national health care. "Private" healthcare insurance has failed, miserably, utterly, totally, and without any redeeming consequences. Just like Iraq. It's time to admit it and terminate it.

Wanna know what GM, Ford, and Chrysler, along with all the other large corporations, and all the technology corporations, in this country would REALLY like, and would already have if they controlled the government as much as the foil-hat crowd likes to believe they do? National healthcare. So they wouldn't have to pay for it.