I just realized the insurance companies don't want to allow healthy people to not be in their pool

[dkf]

"Mr. Obama has started to answer these questions. At a town hall-style meeting in Elyria, Ohio, he explained, for instance, why it is difficult if not impossible to force insurers to cover everyone, including people with pre-existing medical conditions, without also requiring everyone — healthy or not — to obtain insurance and join the risk pool."

http://prescriptions.blogs.nytimes.com/2010/02/03/to-the-right-the-left-tough-questions-now-for-democrats/#more-20037

Looks like the deal is that if we want to legislate insurance companies to take in people with preexisting conditions, we also need to make sure they have a large supply of young healthy people.

This is probably a deal that was made.

It explains why we will not have access to a public option.

[glowing]

1. Essentially, medicare for all would create the largest pool of people for

30% less if you don't reform the systems of health care delivery... Actually, with lot's of healthy young people, the health care problem would right itself... We are not like some other countries where the population of young is disproportionate to that old (shrinking pop).

[dkf]

4. Yes, that is obvious to us, but apparently Obama doesn't feel like taking on this argument.

I'm beginning to think that the Senate bill IS what he wants. He may not want to announce that though, because the base prefers the House bill.

[Warren Stupidity]

5. That is true, but it would require a major tax increase.

Everyone would have to pay in. On the upside, assuming a payroll tax model, employer/employee tax payments would likely be lower than what employers and employees with work based coverage currently pay.

[glowing]

13. I would think it would be modeled on a pay scale. If you are making min. wage,

your portion would be a lot less... similar as it is now.. The more you make the more you pay. I'm thinking they could def. do better than our current rate for a family plan. I'm also thinking that all those young people who need a dr. once a year is going to really offset the numbers. AND Dr.s shouldn't worry about making money.. Everyone covered.. plenty of people willing to call and make an appt.

[Warren Stupidity]

15. That would be a payroll or income tax based system

as used in many countries. Works fine. The point being that all systems require universal participation: as in everyone pays in.

[glowing]

17. Yes, but as soon as its enacted and it works.. and no paperwork other than your

name and social is needed, and every single American would be happy as pigs in ... Tell a older person who gets medicare they won't be receiving it anymore and they will brain you. Bold action that is intelligent is just doing so.

[Warren Stupidity]

19. Our party leadership lost its way many decades ago.

They have no vision. It seems for them it is all about getting along and not rocking the boat.

edit: typo

[glowing]

22. Is it time to walk the convention accross the street?

[Warren Stupidity]

24. I can't join a hard right populist movement.

But I certainly understand the populist sentiment. The government in washington is sick, paralyzed and hopelessly corrupt. And it is patently obvious that neither party is interested in changing much of anything.

[glowing]

25. No way I could join those idiots... But many regular Americans would

clamor towards a progressive candidate.. Like when Grayson speaks or Weiner.

[Vincardog]

29. The 'major tax increase' would accompany the ELIMINATION of the fastest rising expense in our countr...

The net result would be average people taking home MORE money and being MUCH more financially secure.

[Warren Stupidity]

32. I believe that is exactly what I wrote.

However the professional paid liars would frame it as what it would appear to be on paper superficially: a tax increase and a large one. The fact that net costs would be lower for employers and employees currently covered by the private insurance scam would be ignored.

[Warren Stupidity]

2. That is the only way a universal private insurance system can work

and be affordable. It is also the only way a universal public system can work and be affordable. They both require that the healthy pay in along with the sick. If you have some other plan that does not require universal participation and that can provide affordable coverage for everyone who needs it, please do share your plan.

[dkf]

6. Umm, it only works if the particular pool of that particular insurance company gets

equal representation.

If one company gets all the older sick people and another company gets all the young well people then one of these companies will fail.

Insurance companies need the young healthy people to go with them, NOT with a public option. Which is my point exactly.

[Warren Stupidity]

16. Why would the old sick people choose the more expensive private insurance?

I know you think you have some valid point here, but other than the obvious: no exclusions requires universal participation, I really don't get what it is.

The insurance companies are opposed to a public non-profit plan because it would lower their profits, not because only healthy people would use the public plan, but because it would be less expensive than their plans.

[Armstead]

18. Eggs Ackley

A better affordable public plan may not be as good for them, but much better for people.would be better for people. Let the insurance companies either compete with that or focus on cars and homes instead.

[dkf]

21. Well how will the government option enrollment be set up?

Seems to me it makes sense to do a sign up with your taxes, when you figure out if you are being penalized or not and what your subsidy is.

The point is, the health insurance companies need a guarantee they will get picked by these young people. They cannot give the Govt the opportunity to get them instead.

[Warren Stupidity]

23. No insult intended but you are grasping at straws while avoiding the obvious.

The obvious: a public non-profit plan would offer equal or better service at a lower price.
The straw: for some reason only healthy young people would choose the public option.

The insurance companies killed the public option because it would eat their profits by offering equal or better service at a lower price to anyone qualified to choose the public plan. There was nothing proposed that would have funneled only young healthy people into the public plan.

[dkf]

26. Its not that most older sicker people will go to the private plan, but its

where the young people are going that counts.

[Warren Stupidity]

27. Actually the way it was structured hardly anyone at all was allowed in.

The only people who were even going to be allowed to choose the public plan were those who did not have an employer based plan. You would have to establish that these people were entirely 'the young' to have even a glimmer of a point. They aren't as far as I know, but they may be slightly more young than those covered by employer plans. As it is you have conceded that "its not that most older sicker people will go to the private plan", so the now dead public plan would in fact have a share of the high cost clients. Young people working for companies that offer insurance would be in private plans under the dead public option plans proposed.

As I said you are grasping at straws here when the obvious reason why the insurance industry killed the public option is entirely sufficient as an explanation: even the crippled versions offered would eat their profits by offering equal or better for less.

[HughMoran]

12. Of course

One way or the other, healthy young people need to contribute to the system.

[Pirate Smile]

3. If you bring in sicker people without bringing in many more healthy people then insurance

premiums would skyrocket. It is called the insurance death spiral. It is just a basic requirement or else the system will not work. It isn't an insurance company conspiracy. Insurance is basically a risk pool. If you make the risk pool sicker then premiums go up because the insurance companies have to pay out more. You counteract that by having more people who are not sick paying in premiums every month. Of course, the healthy people also never know when illness, disease or injury will hit them.

All the other countries that have universal health insurance do the same thing.

[dkf]

10. Exactlly, which is why Obama can't allow young healthy people to flock to a public option.

For instance, adverse selection says sick people will seek health insurance and young healthy people won't.

Unless it is offered through an employer, I really don't think a typical young person will price and research different plans. I bet a lot would simply opt for a public option.

And if there is an automatic enrollment of people who do not seek health insurance in a public option when they do their taxes, this could result in even more young people in the public option.

[Armstead]

20. Other countries either have a public plan or control rates and terms

They don't say "Insurers can charge anything they want and you have to buy it."

[billybob537]

7. Imagine the hundreds of billions in profit

The insurance industry takes off the top every year actually being spent on health care.
Now how much are they willing to spend to make sure that doesn't happen.
That is what we're up against.

[AllentownJake]

8. Insurance is the stupidest way to deal with Health Care

Think about all the other things Insurance is used for, than think about the number of claims filed for those things.

Property (how often do you file a claim), Life (If you die more than once, I want to talk to you), Automobile (if you keep getting into accidents eventually your premiums become to a point where you have to stop driving)

Now lets look at Health Insurance. You will have to file claims, several times a year, and that is if you are healthy, let alone what happens if you get sick.

Honestly, high claim volume and guaranteed increasing claim payments (the older you get, the more you need to see doctors).

They lost me when they moved to Health Insurance Reform, from Health Care reform.

[brand404]

9. Remind me again what the point of Insurance companies are?

Just go Single Payer and be done with this mess. It is clear that WA is not for the interesto f the people as it is open for those who donate generously to their campaigns....if there is money to be made the votes will always go in that direction.

[Captain Hilts]

11. Single payer and govt.-based health ins. run the same way. You need EVERYONE in, not just old/sick.

[dkf]

14. And you can't have the sick all in one place and the healthy in another.

If more young healthy people went to the public option out of plain old laziness or cluelessness, the private insurance companies would suffer by being forced to take on older sicker people.

It all depends how people will find their health care option.

[Turbineguy]

28. That's how insurance works.

The insurance company gamble you stay well. You gamble that you get sick. If you stay well, the insurance company wins. If you get sick the insurance company still wins because they deny your claims.

[sandnsea]

30. That was discussed months ago

In fact, at the time, the fear was that sick people would be shoved off into the pubic option and insurance would only take healthy people who didn't need health care. Funny how the story is now flipped around. Either way to attack the plan I guess.

But it's not the reason we don't have a public option. We don't have a public option because a handful of Democrats think they won't get elected if they support a "government takeover" of health care. And that's because the DNC, local Democrats and we the people did a horrible job of countering the noise machine in a whopping FOUR states.

[Honeycombe8]

31. That's obvious and no secret. It's been discussed for a year now. And makes sense, of course.

If ins. cos. ONLY had customers that were ill, they would soon cease to do business. They are in business to make a profit. They need healthy people who use fewer dollars than they pay for premiums in order to make money. Same thing for auto insurance companies, life insurance companies, etc.

There's nothing wrong with that. But I DO have a problem with a mandate to buy their insurance, when the consumer has NO OTHER CHOICE.

Auto insurance is NOT like health insurance. One can't get medical treatment without health ins. (one can still drive a car w/o auto insurance, although it's against the law and you're taking your chances). Health insurance is necessary, sooner or later, for everyone (many people don't need auto insurance - they may not drive or have a car, use public transportation, etc.) If a person can't get auto insurance, there may be alternative (get a ride from a friend; use public transportation; walk or ride a bike to work; etc.), while there is no alternative to health insurance. Health insurance is a life or death matter. Health insurance is WAY more expensive than auto insurance (like 12 times more expensive or more), making health insurance mandates a much more critical issue of contention. Just to name a few differences.

[blueworld]

33. Wouldn't they then seek out the healthy on their own???? n/t