The random political thoughts thread (Part Deux)

[alphabassettgrrl]

Originally Posted by Betty

So - I'm all for not slowing down. Give me access to staying alive thank you very much.

I'm with you. I don't have insurance, either, in large part because it costs so dang much, and doesn't cover anything anyway. So I can spend a lot of money for useless "coverage."

Originally Posted by scaeagles

what I think what frustrates me in this whole national debate is the way the insurance industry is viewed. They came into existance to make a profit, so I don't know why they are slammed for trying to do so.

I guess I don't mind if their profits were reasonable, but they're ENORMOUS, and based on how much they can keep down the claims costs. Which means denial of care. They deny things that seem perfectly logical, and needed, and the conversation is along the lines of "if they really care they'll resubmit it." This is really wrong.

[Ghoulish Delight]

Just for the record, I don't imagine that there are people at insurance companies wringing their hands thinking, "Muuahahaha, whom can I deny coverage to this week to earn my bonus?"

They are not evil people. The decisions they make are not evil. They are prudent. They are rational and reasonable business models. They are the right decisions to make to make the numbers come out right. It just happens that some of those numbers represent money saved by not allowing real human beings access to medical care that can save their lives. When they cut costs to appease their stockholders and maintain their profits, someone down the line is put at risk of death.

Yes, it works for the vast majority of people who are lucky enough to have it. I'm one of those people. But just because I happen to be in the majority for the system was designed to benefit doesn't change that fact that it's a system that does so by treating people's lives as a commodity to be invested in and traded for profit, and I find that appalling. People's lives should not be measured by how much money they can afford to spend, and it is my belief that a government should do what it can to ensure that its citizens are on equal footing when it comes to access to that which protects their lives.

[BarTopDancer]

Here's a good example of an insurance company wasting money:

When claritin, zyrtec and some other allergy drugs showed up on the market not all of them were covered equally. My doctor gave me samples of each and told me to let her know which one worked best and she'd write me a script for it.

I tried them and determined that zyrtec was the best. I went to fill my script and was told that my insurance would not cover it unless I first had a prescription and tried all the other allergy medication out there, including nasal spray which I cannot take at all. So instead of covering zyrtec, which I knew worked I they would pay for 4 or 5 other prescriptions that I knew wouldn't work or I wouldn't even take before just covering the one that did work.

My doc, who is awesome, went to the insurance company and got them to over-ride it. Thankfully.

[mousepod]

I also think that there's a misconception about the cost of medical care with insurance. After my emergency visit to the hospital last week (that included one night's stay), my bill for the deductible + co-pay + my percentage of daily charge was close to $1000. That doesn't include lab fees, which I'm sure will be costly as well.

And I'm covered under what's considered to be a good insurance plan.

[Tom]

I believe as well that many of those who are currently happy with their health insurance will become less happy if cost increases are not controlled soon.

My premiums are about 2.5 times what they were 15 months ago (and I can't change providers due to a pre-existing condition). Right now, I can still afford to pay them, but I won't be able to if they continue in that direction, and I think a lot of people could see themselves similarly priced out of their current insurance in the not-too-far-off future.

[Ghoulish Delight]

Originally Posted by BarTopDancer

Here's a good example of an insurance company wasting money:
...

Actually, they're trying to save money. That Zyrtec prescription could very well cost the insurance company 10, 15, 20 times as much as any of the other brands or generics. So even if they make you go through 4 or 5 other ones and you still end up with Zyrtec, the cost to make you go through that is a drop in the bucket compared to what they stand to save in the long run on the gamble that you'd be happy with one of the other ones. If even 5% of people choose the cheaper drug after that process, they'll have made their money back on those 4 or 5 trial prescriptions they gave to everyone by the time that 5% has come back for the 3rd refill of the cheaper drug.

And anyone can come in and claim they've tried all the others, so yes, it would take a call from the doctor to get around that.

But to me, the fact that this wasn't a waste of money is even worse. This isn't an example of an insurance company throwing money away. It's an example of a very smart business practice, a cost-saving measure that takes very little for them to implement and can save them millions in the long run. But it's at the expense of patient experience and adequate access to benefits.

It's a relatively minor inconvenience. And, in all honesty, probably something a socialized system (assuming medical providers remain privatized) would also engage in to some degree. But it's a good example of how profit-motive from an insurer puts their bottom line, not the health of patients, first.

[wendybeth]

Originally Posted by mousepod

I also think that there's a misconception about the cost of medical care with insurance. After my emergency visit to the hospital last week (that included one night's stay), my bill for the deductible + co-pay + my percentage of daily charge was close to $1000. That doesn't include lab fees, which I'm sure will be costly as well.

And I'm covered under what's considered to be a good insurance plan.

Many of the people who wind up filing for bankruptcy due to medical bills have insurance. Even the best plans do not pay for everything, and oftentimes insurers will come back months later and decide they don't want to pay for a procedure or meds they previously approved.

[lashbear]

You may remember I had a Tenodesis last year (the re-attachment of my Bicep muscle in my right arm). The Out-of pocket cost to me after my medical insurance and the Government medicare paid all their bits was still $1200 - because the Government sets the rebate levels and the AMA sets their "Standard scheduled Fees" and nary the twain shall meet.

At least they threw in that packet of pain-killers. They were fun.

[Alex]

While on conference calls today I've been bouncing around ideas in my head for how I'd re-do the election of the president if granted such power (I'm odd).

The idea I've been swirling around is this:

President is elected (whether using current electoral college model or not) to initial four year term.

After four years, rather than an all out election, the president is subjected to a national vote of confidence. Everybody just votes on "Should Bob continue to be president?"

If majority (though I've been thinking of supermajority requirements too) says yes then repeat every two years until majority no longer say yes. No term limit on office.

If majority says no then full blown presidential election is held 1 year later, current president is not eligible.

Cycle starts over.

Office of vice president is eliminated. In case of presidential death/incapacitation next in line holds office until full presidential election to be held at next scheduled vote of confidence (successor eligible for office).



Assuming all of this for the sake of argument, I'd be interested to know on anything thoughts on repercussions from such a system?

[Strangler Lewis]

1) We have enough of a problem with sabotaging the president with an eye towards an election that's four years off. Making these votes of confidence every two years would probably worsen that. Unless . . .

2) There was a supermajority requirement for a "no" vote. This would overcome our cultural tendency to throw the bums out because it feels good to do it. Also, it might require members of Congress to find a way to work with the president because he's going to be there for a while.