www.byzcath.org Forums General Discussions Town Hall You Will Lose Your Private Health Insurance

JOB:

I think the problem has become just exactly one expects from "health insurance." Originally, it was meant to provide people the opportunity to join pools of other people who subsidized each other for the cost of hsopital stays alone.

If I need it this year, you subsidize me; ditto for you next year when the situation is reversed.

The problem has become that everyone has come to expect their hospital insurance to cover their entire health-related costs. So we have dental, chiropractic, eye care, hearing, and those ads for "power chairs" that will cost you nothing out of pocket (even though they cost a small fortune). The idea has become so entrenched that people have come to believe that this is all free--if I'm covered at work, it seems to cost me nothing, though my employer figures it as part of the cost of having me as an employee.

The real problem with the whole health care payment system is that as government has gotten into the mix with ever-expanding regs and mandates for policies the whole has become more and more expensive. I managed our program in a small business some years ago and it got to the point where the annual raise was eliminated--nothing beyond a cost-of-living adjustment--because the money had to go to pay the ever-rising health insurance premiums. And we had no one using it!! When I left and COBRA set in, they offered me the same policy as an individual (and my family) at $1500+ per month, which was far beyond anything we could afford.

What scares people at the lower end of the scale is the fact that at minimum wage, there is no way they can afford this type of premium. At the same time, if carrying this insurance is mandated and there is nothing affordable, there is nothing more than a very burdensome fine.

I actually looked at health insurance for someone who could afford $300.00 per month. There was a $14K deductible per person per year (family plan). Then on the first $30K they paid only 20%. What it worked out to was that paying the premium actually did not benefit the family at all except to say that a very small portion of a catastrophic need was covered but the annual payment to be in that position was $3600.00. So when I took a look at my own recent heart attack, hospital stay, surgeon's fees, etc., it would have been to my advantage to simply pay the freight after I'd used the services because being in the insurance pool would have been of no benefit at all.

I think the bottom line in all this comes down to what should be covered and to what extent. I'd agree that we all need to have some sort of catastrophic coverage. But people ought to get back to paying for their own dental care, eyeglasses, hearing aids, power chairs, etc. These items all add to the cost shifting that goes on and makes so many procedures so expensive.

The real thing that no one has addressed is this: at what price will we, as a society, be willing to say we've paid enough. When we say we will pay only so much in a given year, then that means that once that level has been met, there will be no more and either procedures and services will not be given or some other formula will have to be developed so that the total moneis available last to the end of the year. Something like our sheriff's department. Once thee department hit their total budget for overtime, staffhad to be cut and various duties had to be put off except the bare minimum. That's rationing, no matter how ugly the word is or how people want to avoid it.

It's a little like people who come to my business. If a family is not willing to meet what it costs us to provide the services we have to offer, we have only limited choices. We can serve them and eat the cost of what we provide beyond what they pay; essentially asking the staff to subsidize their funeral. Or we can refuse to serve them and tell them to call someone else. Or we can gamble with our reputation and find substandard merchandise for them, risking a future disinterment where things are not what the courts would consider regular standards of practice to ahve been.

I don't have the answers to healt care financing, but I do know we have not yet had the discussion properly framed.

BOB

Helen,

I was merely stating that as absurd as the question sounded, unfortunately you were being serious.

I also wouldn't assume from one statement that was not directed towards content that I am ignorant of the proposed health care overhaul bills. I actually know quite a bit. There are some measures in the bill that would benefit many, but also have the potential to damage many. many seniors would benefit from reduced drug costs under the proposed law, especially those who do not have a drug plan under Medicare. But what do I know?

By the way, this is my only comment directed towards the Healthcare debate. I did not come to this forum to debate politics, there are other places for that. I just felt that I needed to defend myself against untrue accusations.

Peace in Christ,
Ed

Thanks for your reply Bob!!!

Let me take this one step at a time...



I couldn't agree more...insurance is to be a "safety net" I pay in and you pay in and its a pool of people doing the same to help each other when needed, in return I will be helped when needed. I agree that too much has become "expected"!



Believe me, I understand, when I was laid off last year COBRA was approximately $1,200 a month...quite pricy, especially for a family (wife and 3 children) when one has been laid off. However, with a pre-existing condition in the family, there was no other choice but to take it because if the plan is lost there is no other choice but no insurance at all...that meant any money that came in went to Health Insurance and Mortgage, with the little left for food...



Completely agree, once again, I believe it was in the house bill, although not sure what has occured with the senate bill, there is a "bare minimum catastrophic plan" which could be chosen. Which gets everyone into the pool which allows for elimination of pre-existing conditions clauses.

The American health care system is the worst possible health care system in the world--except for all the others. Try living under one for a while, and see.

As I keep saying - ours is not perfect - but if you are without private health insurance the care you will get on the NHS is second to none .

As I said earlier, this is not about health "care," but about health "payment."

I had a heart attack in February, had a trip to the emergency room, on to the cardiac cath lab, had a stent inserted, and was back home in two days. No one stopped the process because I had no insurance. I make monthly payments and will probably do so until I'm 83. No one can be turned away from medical care because of Hill-Burton and no one can be taken to judgment unless he fails to make a good faith effort to pay for the care he has received. My care was second to none, too.

Some years ago, my COBRA offering was almost the entire amount of my disability income so, though I haven't liked it, I have not been able to find affordable insurance ever since. And the programs that provide for catastrophic coverage are like those I outlined above--what is paid into the pool is simply money lost. I do have my funeral prepaid, though.

BOB

Bob:
Hill-Burton only applies to emergency life saving care and the follow-on care it requires (such as post-op recovery time). They don't have to provide you hypertension meds, just make certain you don't die immediately, and send you home.

I received the emergency care and made it home. I have paid for my own meds and physician care all my life because small business health insurance plans that I've been under have never provided for meds or any regular physician. But I'm still not eleigible for Hill-Burton act to make the care I received free. I earn just over the limit.

BOB

When my husband and I were first married insurance coverage was for those times when you were hospitalized and needed extended care in hospital. Thus the name hospitalization. In my opinion this is what we should go back to. If we paid for our everyday items ourselves the cost would go down. Its like a credit card instead of cash. Cash is usually taken more care of. You can touch it, see it and keep it. That credit card is something we expect to have value and mostly unseen. Like the little guy that wanted a hamburger today for a dollar tomorrow. Many of us want something for nothing and just do not understand that someone must pay for what we receive.
Charity soul be something we give to the needy and if the needy can work for their benefits all the better. I firmly believe that we rob the poor and needy of their dignity when the government just gives them what they want and need. Dignity to many is also important.
So make sure you provide for those in need and allow them to have their dignity also.

Kathleen:
until we stop the proliferation of civil medical malpractice lawsuits with exhorbitant awards, we will see doctors either saving up large sums in anticipation of same, or paying slightly less but still large to insurance carriers for malpractice, and passing that cost on to patients and insurance companies.

Hence why I'm in favor of a 4-prong approach, one that will not add much regulatory cost, but will reduce the cost to doctors (and thus what is reasonable):

1) Ban civil malpractice suits
2) make all malpractice suits criminal, with mandatory federal level restitution by forfeiture of assets as part of sentencing, along with jail time.
3) ban malpractice insurance (including for paying attorneys)
4) ban cash-only malpractice settlements and sealed malpractice settlements

The higher standard in criminal courts means having to show cause before filing, AND a lower rate of erroneous conviction.

Cash-only settlements are the bane of professional licensure; likewise sealed settlements; they amount to legalizing blackmail of doctors. Further, due to insurance, they result in denial of access to information about past performance of the doctor.

Banning malpractice insurance also incentivizes more cautious medical care and better informed consent.

The harsher punishment of criminal cases (most docs actually lose nothing personal when they settle a malpractice case; they might have a rise in malpractice insurance costs) incentivizes not committing actionable malpractice. Go to jail, lose your house & car, have your family rendered homeless... for serious malpractice, indeed those are fair and just, for serious malpractice is akin to attempted homicide.

Heck, the US needs to instigate a grand jury process for civil suits... filter out the frivolous before trial discovery...

I do not think all malpractice suits should be criminal, because criminal law requires proof of either (criminal intent) or (b) criminal negligence, both of which are difficult to prove and may not apply in cases where real malpractice has occurred as a result of innocent yet avoidable errors.

I am also opposed to the abolition of malpractice insurance, which exists for almost all professions, including (ironically) the legal profession. Without insurance, most doctors will simply leave the profession.

There are only three reforms needed to malpractice law: first, abolition of punitive damages (as opposed to compensatory damages; second, abolition of contingency fees (i.e., lawyers taking on cases in return for a percentage of the settlement--though abolition of compensatory damages would probably also eliminate contingency fees); and third, institution of a "loser pays" rule covering litigation costs. This would serve to minimize frivolous suits, court hopping and outrageous punitive awards that have been driving up malpractice premiums as well as the cost of medical care generally.

Loser pays hasn't slowed civil suits at all; it merely upped the settlement rates.

Because it hasn't been linked to the abolition of contingency fees. Look at it this way: a law firm takes on a civil litigation at a 33% contingency--if the settlement is a million dollars, then they collect $333,333.33. If they lose, they are out of pocket their own costs (my experience working with law firms is these are usually overstated by a factor of two or three, so that most of their loss is on paper, plus the court costs of the other side--probably still not as much as their potential fees if they win. The plaintiff, if he loses, is not out of pocket at all. If he wins, he gets $666,666.67. No wonder civil suits continue unabated. For the plaintiff, it's heads I win, tails you lose. For the plaintiff bar, the risks are minimal if they do their homework, choose their cases with a modicum of care, and cherry pick the jurisdictions in which they file suit.

If you abolish lawsuits taken on by attorneys on a contigency basis, you eliminate the ability of the poor to seek legal recourse, except through suits taken on a pro bono basis. For this reason, I am strongly opposed to the abolition of lawsuits taken on a contigency basis.

Not so. There are pro bono services, plus the Legal Services Corporation. With punitive damages off the table, you remove the jackpot element from the equation, and the number of lawsuits will fall dramatically, as the more frivolous suits are abandoned.