Yeah, I’m kind of bitter. It is hard to watch people get sucked into perception management games while having their pockets picked. Is anyone really paying attention to anything? Anyone?
For myself, I currently pay $433.92 per month to Cover Colorado, the state-run insurance agency for people rejected by private insurers. In our crazy system, the private jackals got first crack at us, and only then did we qualify for a government program. It’s better than anything in the new Colorado Insurance Exchange. Cover Colorado will go out of business next April. That sucks.
In 18 months, I’m on Medicare, and will wave a single-finger bye-bye to the American health insurance game.
The Exchange now offers a variety of plans, but reality is that they are all the same plan. Companies do not compete. They can’t. Private health insurance by its very nature must limit our access to the health care system while extracting maximum rent from us. Investors demand no less. Any competitive advantage gained from making our access to the system easier ends up attracting unprofitable clients. Consequently, all plans offer the same benefits in different wrappers. It can be no other way.
Here’s a typical plan for a young person I just read about: $208/month, $7,500 deductible, out-of-pocket maximum of $2,400 for non-ER visits, overall out-of-pocket not specified.
As I read that, this person must spend $9,996-$12,396 per year before the insurance company spends $1. If that is a typical young person, there is not $10,000 in the bank. As this person is already paying $208 per month for coverage, it is unlikely that she’ll be visiting a doctor for anything, as that $2,400 is put there to discourage such activity.
So in essence, that policy offers catastrophic insurance only, with a need to borrow at least $7,500 up front if anything serious happens. If there are any conditions that can be treated prior to becoming emergent, she’ll not find out about it, as she’ll not be visiting a doctor. She does have right to an annual physical at policy expense, but if that physical uncovers a condition that needs treatment, again, this person is looking at borrowing the money to pay for coverage, and that will not happen.
That is an insurance company dream: Under-insurance and people forced to buy their products. I cringe to think of the bashes and orgies in insurance company offices when this bill passed. It’s a monstrous gift to private industry at citizen expense.
It only dawned on me recently that the urgency of “health care reform” was the inevitability of single payer. California had passed it twice, in 2006 and 2008, and third time would have been the charm. Obama/Baucus/Fowler stepped in and stopped single payer in its tracks. How long can Obamacare last? I do not know. Given the low level of public education regarding insurance, I fear quite a while.
But here is a prediction: Not too many people who do not have insurance will be buying insurance. The coverage is crap, the costs too high for a nation where most people are just barely scraping by – who are in fact in debt and without savings. This cow had already been milked by the credit card companies and the 2007-08 crash (with another hovering like a hawk). Obama managed to stave off reform, but the walls must fall.
Bill Maher said in his recent closing comedic remarks that California would lead the nation to single payer. He’s entertaining and funny as hell but also kind of dumb, and doesn’t realize that California can’t do anything now without Washington’s consent. But I think that once this program falls on its face, as it must, that California may show us the way, just as Saskatchewan did for Canada.
Bring on Tommy Douglas! Give us a political leader with some courage. Right now, we got nuthin’.
Piece of Mindful 
The Clintons should not go unmentioned. There is a fork in the road, way back there, somewhere, long forgotten. They led us all like livestock to slaughter. I’m betting on Vermont. California may surprise us all, but it’s a very complicated place.
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Well, your math is incomprehensible here. It appears that you took the deductible from my CURRENT plan and added it to the deductibles from the plan I’ll get under Obamacare. But hey, that’s your MO at the moment. That being said, you’re not totally wrong – it’s not a great plan. But, instead of using my Facebook feed, you can go to any one of the exchanges that opened today and have some fun plugging some numbers. That way, you won’t screw up the math in your next post.
Also, remember that your typical young person is mostly going to go in for office visits, and more often than not they’ll utilize diagnostic care that is prohibitively expensive (ever had a CAT scan?) – these things are not covered by basic plans today, meaning that most people just put off care when they need it, and more often than not forego insurance altogether.
Anyways, I don’t necessarily disagree with a lot of what you say here. It’s a big question how many people will buy insurance. This whole thing could be a disaster. I don’t think it’s a cornucopia – but my hope is that more people will be covered and that the insurance they’ll be carrying is better.
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I had to go back and re-read it. You don’t say what your current deductible is, but the wording makes it seem to be $7,500. Further, I did not see where you had written more behind the fold, and further, hid the post as it was making me angry. I also deleted my longer comments, knowing that people skip right over them anyway.
At any rate, I understand arithmetic quite well, and how to calculate true out-of-pocket exposure: Minimum = premiums. Maximum = premiums + deductibles + co-pays + insurance-stated max out-of-pocket + uncovered expenses, the latter in your case including $2,400 in office visits.
Most people your age are exposed to accidents, and not office visits, which tend to tilt heavily towards seniors. Auto accidents tend to be covered by the driver-at-fault’s insurer, so health care policies don’t cover them. Other exposures are on-the-job, and those are covered by workers’ compensation, so there too there is no health insurance company exposure. So your highest exposure is an accident not involving autos (if you’re not at fault).
or on-the job injury.(Tired.) If you get sick and have to be hospitalized, your insurance will kick in, and then, if you follow the math above, you will be able to calculate your personal exposure. If you do not have money in the bank to cover that exposure, you are under-insured.Your post on FB merely stated the obvious, that insurance represents shared risk. There are also covered diagnostics and an annual physical. But if something is diagnosed or exposed by those procedures, you are again faced with out-of-pocket concerns.
I happen to understand insurance – health, auto, gpl thoroughly. I know that baseball teams insure themselves for the salaries of high-value players in case they are lost to injury. Football teams cannot do this, as the cost is prohibitive in a high-injury sport, and so do not offer guaranteed contracts. In health insurance, I understand that it should not exist as a private concern because it cannot operate without shielding itself from medical loss payments. So consumers must suffer. Health insurance is a government function. I also understand politics, and know that Obama acted as he did because AHIP saw the writing on the wall, that single payer was inevitable, and wanted to forestall reform. I knew that the bill was industry-written, and that the protracted “debate” was scripted to a predetermined outcome, and that Obama, who often does not fight for things, fought for this bill because he knew that he would not be reelected if he did not deliver.
So don’t lecture me. I had an early morning due to that damned company up in Montana, and am cranky.
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Oh yeah, and I spent the morning on the insurance exchange. It’s terrible. I decided to keep my current policy, even knowing that on the day it expires, nothing is covered including ongoing expenses. Then I plan to go bare until Medicare kicks in. I might be penalized, but the ACA bill makes it virtually impossible for IRS to collect the penalty. Trust me. I know stuff.
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Now that I think of it, I cannot do that as if something expensive happens Hassie is liable as well as me on our joint assets. Oops.
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I had that thought as well. You can actually retro-actively sign up until the end of March, so you’ll be able to risk it until then if you really want to.
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Cover Colorado is in force until then. I’ll sign up for something effective April.
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Its all about perception management.
“In discussions with former KGB and GRU officers you will run across two apparently contradictory statements. Sometimes you will hear them say that the former USSR is still run by Communists, suggesting that the rulers there believe in Communism. On the other hand, they will tell you to forget about the Communist label; that the rulers of the USSR never really believed in Communist ideology, which was a deception used to manipulate large numbers of unintelligent people.
Former KGB Lt. Col. Victor Kalashnikov recently wrote several paragraphs on this subject, and it is worth presenting. Kalashnikov’s key point is that Communism is strategy, not ideology. Useful idiots believe in Communist dogma, while Communist strategists do not.”-J.R. Nyqist
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You just discovered this?
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Consider the scope of it.
Useful Idiots believe in Single Payer dogma, while socialists (cocoon commies) do not.
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That’s very muddled thinking, my friend. You’re repeating an ancient meme from the early days of the Cold War, that communism in Russia was merely an extreme form of socialism. It was totalitarianism, for sure, and they called themselves socialists, but it was a military dictatorship more than any ideology, just as your quote demonstrates.
Single payer (and socialism) are in practice everywhere, and they work. Evidence speaks!
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Muddled thinking? No, a very timely comparison. Bolsheviks enjoyed the very best in health care, much like the premium insurance packages of our federal legislators.
Do the ruling classes wait in line for hip replacements in the SP countries you so admire?
I think not.
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The Bolsheviks were a manifestation of their time. the Russians were devastated by the First World War, and reeling, withdrew from it. In that weakened state they were vulnerable to internal rebellion. The Bolsheviks, unable to control such a large country, were quickly undone by well-financed internal machinations. World War II, which again devastated Russia (most of its manufacturing base destroyed, 26 million killed), left it vulnerable and encircled. Just as Pol Pot came to power in human tragedy, so too did what we called the “Communists, a mere military dictatorship. Tyrants capitalize on tragedy. That’s all your Nyqist is saying.
That has nothing to do with single payer, a successful medical model used throughout the world. That’s why I say your thinking is muddled. It’s mot mixing apples and oranges – it’s mixing of European history and the evolution of health care models.
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Mark, open your mind. Our Senators/Bolsheviks have exempted themselves from Ocare.
Ruling classes are all the same, whether SP Care or any other laws or restrictions, they’re for the little people and you useful idiots.
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Oh, and Nyqist rages on.
Nyquist quotes Lenin: “Communism is nothing more than the scientific management of human affairs.”
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I could easily have this debate with you, but you would vamoose and reappear again later, unaffected by argument or evidence.
Give me your reckoning of single payer, the private insurance system, Russian history. Do so without links, plagiarism, or parroting. Do not blame your fingers for inability to do so.
Otherwise, I’m done.
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I’m redoing some corrals while the the weather is nice so my responses will be spotty.
I’m not here to talk Russian history, the original theme of your post was “perception management” and my response was that we are being “managed” like Lenin and the Bolsheviks.
I threw in Single Payer after seeing the absolute train wreck that Ocare is and the fact that SP like Medicare, Indian HC, Veterans HC, will experience the same glitches and delays.
Useful Idiots with simple minds offer simple solutions. Sure, we’re to believe that England, Canada and others have great systems, decent survival rates, no delays but who’s” reporting the numbers. You can’t believe the government on 911/JFK/Boston/…etc. but you’d believe a National Health system saying all is well? I see visions of the “hockey stick graphs” every time some back water country says it’s infant survival rate is double ours.
Ya took the bait on Cuba and Sicko, but when smuggled cameras went to the people’s hospitals they told a different story. I’d link if it was worth it.
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Very difficult to deal with a black/white thinker. There are no gradations in your mind, no room for a little of something. This was Rand too. The world outside your mind and inside are in diametric opposition.
I have no illusions about the Soviets, but also know that American propaganda about them post World War II was nonsense, done to justify our own agenda. Their system under Stalin very much depended on national security and a threat from without to justify repression within, spying, torture, prisons. Just like the current US. The difference however is that the threat they faced was real – encirclement by the west, while what we face, terrorism, is fake, or at least home-generated.
The statistics on health care were based on UN WHO studies, and measured outcomes only. Michael Moore did not play into it at all, I’m pretty sure. When that study came out, the US made sure of two things – that the word be spread that it was biased, and that WHO never do another study. You’ve had your perceptions managed. And please, when you talk of Cuba, use the phrase “under illegal embargo.” (What the hell scares the US that they still enforce that atrocity?)
Regarding “government,” you must distinguish between that and the National Security State, which came into being in 1947 and planted the seeds of our current CIA and NSA, the sources of 911/JFK/Boston etc. The republic ended in 1947, but legitimate government functions do carry on within the country.
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Swede. Swede? Sweeeeeede??? Done with the corral?
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Its raining today, but that’s not the reason I bailed.
Anytime you use UN/WHO/IPCC/NASA as truth seekers my eyes glass over.
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Oh. I see. I thought you just didn’t have any chops.
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No adult person is forced to do any of this. Why Ecuador? http://abcnews.go.com/Travel/americans-find-retirement-paradise-ecuador/story?id=19187268
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Thanks! Join us there.
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Si. Y tambien, ya puedo hablar espanol como un Ecuadoriano! Pero, desafortunadomente, tengo neitos aqui. No puedo moverme. Tengo qur qedarme aqui y luchar contra los fascistas. Es mi future. Me gusta mas me patria. Eligio quedarme aqui luchando. La vida es corta, y la murte larg. No hay otro remedio.
Have someone translate this for you Americanos.
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Well, the coverage I’m getting is basically a little better than the coverage I have now – which is much better than catastrophic coverage. I’ve had my share of health issues this year (as a 30th birthday present), and had about $5,000 in medical expenses. Because most of that was spent trying to figure out what was wrong with me, insurance paid for all of it but $150. Not too bad. Obamacare essentially does away with catastrophic coverage as we know it today, and the “bronze” plans are essentially the plan I have today. Also, subsidies.
Anyways, I’m not lecturing you, and we’ve had this discussion before. I don’t think all of this is great, but if it insures a few million more people, than good. And I think it’s better than what we have going now. You disagree, so be it.
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Say that I am cheap and decide not to carry insurance, and go on that way for many years until one day I find out I have lung cancer. At that time I go to an insurance company and apply for a policy. They tell me they will not issue me one because I have a “preexisting condition,” lung cancer. That is logical and proper. Not carrying insurance until you think you need it is called a “moral hazard.” I should not get a policy, and should die.
The insurance companies turned moral hazard on its head, and decided they would not cover anyone outside of large groups* who might have certain conditions in the future. When one company did that, all of the others, including not-for-profits, had to follow suit. Otherwise, the people with those illnesses would flock to those companies, and they would be out of business. That’s why so many people 50 and older could not get insurance.
that is the “preexisting condition regime.” I’m told it is over, but I do not think so, as perverse incentives have not changed – companies still don’t want to cover sick people.
So they moved the goal posts. Here’s what they did: They wrote ACA so that you had to buy a policy, but changed the policies so that office visits are not covered. In so doing, and they know this, they discouraged people already burdened by premiums, co-insurance and co-pays from seeing doctors for anything except major concerns, the old ER routine.
It is slightly better now, and I do not know the future, but I will not be surprised if we have millions of uninsured in the middle – people who don’t qualify for subsidies and can’t afford the high prices and who would rather pay the penalty. And, with those who do buy the policies, this would be the low-income groups who are a conduit for the subsidies, there will still be bankruptcies and collection agencies hounding them for uncovered expenses. The policies they get, if “bronze,” will not be very good.
_________
*By the way, not well understood, but businesses in essence do the screening for insurance companies with group policies, as they tend to hire healthy
Leopoldopeople and not sick ones, younger ones and not old ones.LikeLike
The whole point of the mandate under Obamacare is that insurance companies are now required to cover you as soon as you apply. So yes, you can apply when you get lung cancer, and they will be forced to take you. You don’t believe that, and maybe you’re right. We will see.
Also, office visits are indeed covered other than a small copay. Don’t know where you got that.
As for that chunk of people who won’t qualify for subsidies, it shouldn’t be that many. For me as a single person, I’d have to make $44,000 a year or so to not qualify for any help. Still, the estimates range from about 10-25 million who will still be uninsured when all is said and done, especially now that 25 states have opted out of the Medicaid expansion. Hopefully that changes.
That’s not too good – not too good at all. But better.
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Maybe the FEMA camps are for sick people who won’t pay the fine/tax or can’t afford the premiums, and not for starving masses arrested in food or fuel riots after all. Prisons are “infrastructure,” right? Making America safe from sick people and government resisters may have to wait for the next Bush president. Obama kind of has his hands full.
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http://www.counterpunch.org/2013/10/01/the-complications-of-obamacare/
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