And State provision is different from this how?
Oh yeah, I forgot, people in government are the good guys, right?
If you have taken any basic economics courses, and you have any understanding of the basics of why market economies are efficient, ask yourself how rational economic actors can act in when they generally lack the following:
- Information about the marketplace, the quality and pricing of services offered by competitors
- Ability to choose from multiple providers, including the time and freedom needed to do so
- Immediate consequences for choosing a provider that is more or less price-efficient
Typically, someone who needs significant medical treatment has no idea which hospitals or doctors are going to provide the best overall value, little ability to pick anyway and believes a third party will pick up the bill. The invisible hand doesn’t have much of a chance here.
Regulation has its own set of problems. However, the issue we’re discussing is why healthcare costs so much. Our system is not what anyone would call a model of how price efficiency works.
The point is that market failure problems can be just as bad, if not worse, with a single, monopoly provider (you seem economically informed so I won’t explain why the term “market failure” also applies to state provision of goods, in economics terms). (And this is different again from the kinds of problems that typically accompany regulation, which are larded over the top of that.)
Even with the point about quality, if you look at a single state provision, it actually tends to be just as variable in quality regionally as it is might be between market providers - i.e. your average punter has no more assurance of quality wherever they happen to live, under a state system, than they would be if they picked a provider on the market at random.
State provision/mandate is an illusory (vote buying) solution to a problem of market failure that could probably be solved better by other means. It’s something for useful idiots to bray about, but not something to be seriously considered.
So any realistic system that is both effective and efficient has to be some kind of mixture of market provision and regulation. The question is what’s the right kind of mixture.
Now, was the system before Obamacare a free market system? No, it was always a mixture of market provision and state regulation. But was it the right kind of mixture?
For example, what economic sense is there in 60% of employees receiving their health insurance via employers, rather than shopping for their own and having it be portable as a matter of course? Did the practice arise solely as a market-driven result of employers trying to offer something attractive to employees?
Not sure if rhetorical, but I head that was exactly the reason it came about. Wages were regulated during WWII, so companies could only compete with benefit packages. Health care was a very attractive package.
That’s kind of the opposite of solely market-driven, though. Companies couldn’t compete on wages because of regulation, so they competed on benefit plans, and now we’re in a really silly position where most people’s health benefits aren’t portable between two companies in the same building, much less across state lines.
State providers lack a profit motive. So while the health care customer might lack information and the ability to choose in both private and public system, at least the state provider doesn’t have an actual financial incentive to exploit the customer.
When I read this, I feel you are just another idiot, if it was working, it would be by now, but I’ve found without heavy heavy regulation, the capitalist venture is a sick twisted morbid reality where where people like you think you are just temporary down on your luck. Ofcourse the people who got heavily over treated before will bitch, but atleast more people will have to rely less on luck in life.
When I read this, I feel you are just another idiot, if it was working, it would be by now, but I’ve found without heavy heavy regulation, the capitalist venture is a sick twisted morbid reality where where people like you think you are just temporary down on your luck. Ofcourse the people who got heavily over treated before will bitch, but atleast more people will have to rely less on luck in life.
If what was working? “You’ve found” - in what culture have you lived in which the market wasn’t regulated by the State?
I suspect most people do not like the idea that their healthcare is tied to their job, and is therefore at risk if they get fired, quit or their employer just decides it’s too pricey. But there’s no lobbying organization or PAC throwing money at the issue, so it’s not something that ever gained ground on its own.
Maybe there’s no desire to exploit the customer, but there is a definite desire to protect their fund, as anyone who has ever dealt with the Social Security disability system can attest.
It is regulated in democratic states of some function because the alternative is immoral. Normally the politicians who support this are either crooks or ignorant of the consequences, we got them here in Norway too.
Man has never been well off with letting a force of nature wash through us like the marked capitalism is, it is a dumb beast that needs severe regulation to even be manageable, unless you want back to the days of robber barons…
We are far better served with having a democratic led government do the regulations than we ever will be with whoever runs corporations.
Sorry about the harshness, I should probably not post with 39c in feber.
First, my pet peeve against the car insurance analogy. This is brought up all too often to defend the gov’t regulation to purchase insurance from a private business, but it is completely inaccurate. The choice to own and operate a motor vehicle is exactly that, a choice. Imagine the outcry if gov’t required everyone to carry car insurance on the off chance they find themselves behind the wheel. Its absurd! The second point is that a great majority of car accidents involve other people and property. If 100% of all car accidents only resulted in harm or damage to the responsible driver or thier property, no one would care if insurance was required. But because accidents involve other people and most people don’t have the available resources to cover the liability on thier own, insurance for cars becomes necessary.
But you are correct in thinking that to cover the expanded cost of pre-existing conditions and even expanding the lifetime spending caps insurance companies must either raise their rates or get more people into the pool. The question isn’t whether to legislate the purchase of insurance but how it should be done. This is essentially the problem the Republican party had with the topic all along. They thought the 2008 election was a debate on whether we needed a change to insurance or not. It never occured to them that this was no longer a should we or shouldn’t we debate, but rather how do we do it.
The exchanges were a great starting point. If the rates were to go down with more people enrolled then shouldn’t there have been one national pool instead of allowing for individual states to create multiple exchanges? More people in the pool equals lower rates. I also think that breaking down the barriers between state lines would have gone a long way to create more competition. The gov’t could have still regulated minimum requirements for insurance so there was as baseline for everyone.
Most employers offered insurance to thier employees. If the gov’t wanted to put the greater burden on the employers (presumably those with the means to provide insurance) then they should not have engineered as many outs. All employes, part time or full time, should be covered. If your business is too small you should be allowed to participate on the exchange rather than through private companies. If there is a tax penalty for non compliance it should be greater than the cost to cover your employees.
The problem is that the exchanges are cheaper than private insurance, but my employer covers a greater portion of my insurance than I pay. MY out of pocket is 3x lower than the exchange rate for my family, even though the overall cost is 2-3x higher (since my employer covers that balance). If I am forced out of my employer’s plan, then MY out of pocket goes up, and my coverage goes down. Thats a lose-lose for me. But my employer pays less in tax penalties than it costs them to cover me, thats a win for them. And the difference in the tax penalty and what they were spending to cover me before? They get to keep that as part of their profit. It would be different if they passed that on to me as income but they won’t.
Another option is the idea of vouchers. I know a lot of democrats cringe at the sound of it, but think about it. We want every American to buy insurance. If we levvy an “insurance” tax on employers and not require them to cover employees and instead of offering universal single payer system; we could then offer every American a voucher for the basic insurance plan. People could then choose to apply that coverage to a better plan and pay the difference themselves. Some people will still have better coverage but everyone has the option for it. We could eliminate things like the VA plans, Medicare and Medicaid. They would be redundant if basic plans were available to everyone. The funds from those programs would go to help fund the vouchers along with insurance tax against employers. If a person chose not to buy insurance that is their chocie but they could not cash that voucher in to use the money for something else. This increases the ammount of people available to the pool to nearly 100% so rates should also go down, but still allows private insurance to be the primary provider and people would have choices in thier provider and portability between employers.
I am curious about how pre-existing conditions are viewd by some others in the healthcare industry. Its been explained to me by my own provider that its not as clear cut as some people would believe and that makes me think that in some way pre-existing conditions have been available before the ACA took effect. Please let me explain:
If I am unisnured and I get sick (say diabetes) then when I get insurance, that would be looked at as a pre-existing condition and not be covered. The basic reasoning for this, as I understand it, is to eleviate costs associated with something when I have not spent any money with the provider on premiums etc. I think this is reasonable and understandable for them to cover costs when I wasn’t insured ahead of time with them. However, If I’m insured with Company A and get sick, then move to Company B, it is still the same basic situation. Company B never earned any of my money to cover the expenses before, but because I was insured with Company A this isn’t really called a pre-existing condition but it still gets covered.
So my thoughts are that with this happening all the time, aren’t pre-existing conditions already covered, to some extent. Would opening up all pre-existing conditions really be such a financial hit above what they already are for insurance companies?
Of course I do realize the fear that people might drop their insurance and wait to get sick and I think that is a valid concern, but doesn’t that seem like the same type of concern that conservatives spoke out about when referencing all the employers that would drop coverage if they had the chance?
Why does basic needs have to be that complicated?
Probably because everyone has different basic needs. Not everyone has the same body parts or suffers from the same ailments. Basic coverage could be considered any normal preventative care from a yearly physical to required medications for chronic conditions like diabetes, high blood pressure etc. Some people will argue that other items like abortion and birthcontrol are women’s health issues and to some degrees they are right and in other areas they are wrong. But those are completely other debates. I have it on pretty good authority that a lot of lawyers and politicians don’t need cardiovascular coverage because well… tin man.
I kid, I kid.
Graphics cards, it a jungle, both Nvidia and Radeon has profited well on releasing tons of versions of in reality the same stuff, its a jungle and very hard to know what you are buying…
Same goes for phone suppliers, powers suppliers… it makes more sense to confuse the customer and rob them than it ever does to be fair to them. We released the power companies to the free market a few year ago, and our consumer watch dogs say the market now is confusing, and full of misleading info, making it VERY hard to judge what you are actually getting.
These things, you can live without, but to have -this- happen to your very basic need of health, that’s shameful and immoral.
I’m not sure if I can completely agree with you on that. Things like energy, gas, electricity and water are basic needs for our quality of life. People talk about health benefits as a right and I’m personally torn. Health care is provided by other people. Is it really MY right to force someone else to take care of me? If we lost utility companies, I could still go out and “forage” I could get a generator or solar panels and live off the grid. I could find a river and claim my water rights near it. But I can’t cure myself of most diseases. I would argue that healthcare is a cooperative effort.
it may be considered a right by virtue that we agree to live in a society where the exchange of healthcare is an assumption but i’m not sure its an actual right.
Healthcare as a ‘right’ is just a societal discussion of whether we want to ensure everyone has it. It’s no different from whether children and the elderly have a right to not starve to death (food stamps, social security), whether kids have a right to school (publicly funded school systems), or whether the very poor or, again the elderly, have a right to healthcare (medicaid and medicare). It’s a question of what minimum level of support we want to ensure everyone here has.
There’s a substantial portion of the country moving in the “Eff them, I got mine” direction (note, I am not accusing you of being in this group). I find them to be reprehensible, lacking in fundamental empathy and human decency. Some of the commends JPindard mentioned at the beginning of this post provide examples.
Most employer-sponsored health plans offer “continuation of coverage” provisions which ensure that you will continue to have coverage for pre-existing conditions so long as they were covered (i.e. not pre-existing) under your previous plan. Insurers have to offer these provisions, or else they would not be able to entice employers to switch their coverage.