Healthcare... America and the rest

[Scot Dutchy]

I am glad I live where I do. I need my health insurance and so does my wife. The insurance here will go up next year by a max of €10 a month. Those families receiving any form of benefit the rise will be paid by the Social Department.

[Tero]

Insurance companies have no interest in staying in Obamacare markets, so Hillary will have to push through a public option within about 2 years
http://mobile.reuters.com/article/BigSt ... SKCN12I103

[Brian Peacock]

The US could learn a lot from the Dutch system.
Then again, so could many - including the UK.

[Scot Dutchy]

The US could learn a lot from the Dutch system.
Then again, so could many - including the UK.

While not being 100% (which system is?) it is hitting constantly 96% and it does work.

[Tero]

Obamacare was designed as a compromise that would take care of a group that was not getting healthcare through work. Such as my hair cutters. One is on her parents' insurance, the rest have Obamacare.

It was to include insurance companies. They chose to have separate offices handling the Obamacare side. It was such a small pool compared to their corporate clients, they decided not to bother. Save on office staff.

The healthcare industry has one size services and tries to overcharge where possible. Medicare staff are on to this, but do not catch all the errors.

HMOs could bring down prices as the same people provide services and insurance. But people quickly caught on: they just deny service. The dead patients won't need service, so just delay the useless service.

And Trump has a plan? No. He would let people buy plans across state lines. But it just shuffles the problem a bit and helps very few. It still lets insurance to dump plans where they are not making a big profit.

[Tero]

Why we are heading to a single payer...but not Canadian..plan under Hillary.

The U.S. ranks so poorly on health outcomes partly because it is the only advanced industrialized economy that has not provided health care to everyone, a situation that persists even after the passage of the Affordable Care Act. Not having health insurance adversely affects access to health care, which in turn affects mortality and morbidity.

Although this is an unusually large increase, the Kaiser Family Foundation reports that in the last decade, employee premiums have increased more rapidly than total health insurance costs as employers—using a combination of increasing premiums, deductibles, and copayments—have relentlessly shifted health care costs to their workers.

The Affordable Care Act mandated that health insurers had to spend at least 80% of their collected premiums on medical care. The very inclusion of that provision implies that at least some health insurers had overhead rates in excess of 20%. All of this seems expensive and wasteful, and it is.

Kaiser and Mayo have run the HMO model decently

Without a separate insurance company intermediary, Kaiser saves money, which it then uses to offer lower health insurance rates. For instance, for 2015, the total cost (Stanford’s portion plus my contributions) of purchasing the Blue Shield-administered plan in which my wife and I participate is 39.7% higher than the cost of getting health insurance through Kaiser Permanente. Although many factors might explain this huge difference in price, the simplification of access and the reduction of administrative overhead is a big part of the story

Obamacare left it to the insurers. It could have dictated one set of paperwork fro all.

Their updated estimate, once again published in The New England Journal of Medicine, found that administration accounted for about 31% of health care spending and that more than 27% of all of the people employed in health care worked in administrative and clerical occupations.

This large administrative expense is not surprising. It costs money for health care providers to deal with multiple insurers, each with its own protocols, forms, and requirements.

Save money where you can as the patient has no lawyer for every visit

Not really. First of all, health insurance companies often improperly reject claims and deny coverage. As just one example, a recently reported audit of Medicare Advantage plans conducted by the Center for Medicare and Medicaid services found that “in 61 percent of audits, insurers ‘inappropriately rejected claims’ for prescription drugs” and “in more than half of all audits, ‘beneficiaries and providers did not receive an adequate or accurate rationale for the denial’ of coverage when insurers refused to provide or pay for care.”

The Insurance companies went along but now the plan is too much even for corporate clients )same rules). Dump it

Another news report noted that America’s Health Insurance Plans, an industry association representing the health insurance industry, funneled more than $100 million through the U.S. Chamber of Commerce in an effort to defeat Obamacare. Consulting a database of reported lobbying expenditures (which understates the money spent attempting to influence policy) reveals that in 2013, some $154 million was spent by insurance lobbyists. The two biggest spenders were Blue Cross/Blue Shield and America’s Health Insurance Plans.

http://fortune.com/2014/10/20/health-insurance-future/

Summary: it's not socialism. Socialism would have provided so so care for all.

[Tero]

(American) Health Care Is Expensive

The cost of medical care and drugs is high, and increasing. While increased prices for EpiPens and other drugs have grabbed headlines, overall health expenditures have grown at lower rates in recent years (around 5 percent a year) but the Kaiser Family Foundation says there's evidence these numbers could again increase.

New medical treatments and drugs, especially for conditions like cancer, are especially pricey. As more sick people have insurance, they can get more expensive treatments that previously they could not afford or paid out of pocket. These expensive procedures can drive up premiums for the entire pool of insurance customers.

http://abcnews.go.com/Health/health-car ... d=43047190

[Tero]

Why do we want insurance companies in health care at all? Private clinics could continue with cash customers.

The CEO of Blue Cross, a nonprofit, makes tens of millions.

Aetna charges its mistakes to customers:
The Maryland Insurance Commissioner ordered five Maryland health plans to pay a total of $1.4 million in penalties for failing to comply with the state's claims payment practices; Aetna was cited twice and ordered to pay the largest fine of $850,000.

[Tero]

I am sitting waiting for a senior class in GM foods. Looking at the other lectures, there is a class on the wonders of modern medicine. In the US, it struck me, there is a market for all this. At whatever the cost!

[Scot Dutchy]

Here is what we have:

[Tero]

Gingrich and Paul Ryan assigned to destroy Medicare.
http://www.foxnews.com/health/2016/11/1 ... -plan.html

It will go as I predicted.
http://karireport.blogspot.com/2016/11/ ... rhaul.html
You will pay most of it out of pocket. Insurance companies do not want aby old people. They don't due fast enough and death panels are out I guess. Palin started that.

[Tero]

Trump Hillary Giuliani and even Bob Dylan are never going to be without healthcare:
https://www.msn.com/en-us/news/us/in-am ... ar-AAkqAKj

[Tero]

How do other counties get around the mandate?
Germany:
Tax all employers

WHAT THE CHANGES MEAN
From January 2011, employers have to pay 15.5 per cent of their income towards healthcare. (The previous rate was 14.9 per cent). This is a huge proportion of income by comparison with other countries, but it should be remembered that the cover is for cradle-to-grave service.
But the 15.5 per cent employers’ rate is fixed in law and frozen long term. The sums raised are ultimately distributed among scores of state registered health insurers, many quite small and trade-union based. The idea is that by freezing the employers’ income-related contribution rate, the onus falls on insurers to cope with future cost rises. Insurers will either increase premiums – arguably the most likely scenario – or slash overheads and tighten efficiency.

Health insurance is compulsory for the whole population in Germany. Salaried workers and employees below the relatively high income threshold of almost 50,000 Euros per year are automatically enrolled into one of currently around 130 public non-profit "sickness funds" at common rates for all members, and is paid for with joint employer-employee contributions. Provider payment is negotiated in complex corporatist social bargaining among specified self-governed bodies (e.g. physicians' associations) at the level of federal states (Länder). The sickness funds are mandated to provide a unique and broad benefit package and cannot refuse membership or otherwise discriminate on an actuarial basis. Social welfare beneficiaries are also enrolled in statutory health insurance, and municipalities pay contributions on behalf of them.

Regular salaried employees must have public health insurance. Only public officers, self-employed people and employees with a large income, above c. €50,000.00 per year (adjusted yearly), may join the private system.

In the Public system the premium

is set by the Federal Ministry of Health based on a fixed set of covered services as described in the German Social Law (Sozialgesetzbuch – SGB), which limits those services to "economically viable, sufficient, necessary and meaningful services"
is not dependent on an individual's health condition, but a percentage (currently 15.5%, 7.3% of which is covered by the employer) of salaried income.
includes family members of any family members, or "registered member" ( Familienversicherung – i.e., husband/wife and children are free)
is a "pay as you go" system – there is no saving for an individual's higher health costs with rising age or existing conditions.

https://en.wikipedia.org/wiki/Healthcare_in_Germany

[Feck]

I'm waiting for someone to explain what is wrong with "GM" .

[Tero]

Good question. You have to read a book. But most of the resistance is the same as vaccinations etc. Not based on facts.

The book:
https://www.amazon.com/GMO-Myths-Truths ... =gmo+foods