Did anyone just hear Shadegg on MJ re: healthcare just now?

[Skidmore]

I hate to say it but I agree with him on part of what he said. He was absolutely correct that the employer-based health insurance system needs to be broken up and insurance sold directly to all individuals. I posted a thread months ago in which I said essentially that eliminating this system would be true reform and many DUers agreed with me at the time. I also found it extremely telling when someone asked Shadegg why this hasn't been discussed as part of the debate and he forgot how to speak suddenly.

[Warpy]

1. That will work only when insurance companies are forced

to discard the "group" concept. As it stands, people who buy private insurance are all put into a "group plan" with everybody else buying insurance at the same time. As people within that arbitrary group get sick, the rates go up. Healthy people can drop out and join a new group with another insurer, leaving sicker and sicker people with nowhere to go and rapidly climbing rates. Eventually the rates are confiscatory and the last subscriber drops coverage. This is where a lot of the uninsured people in this country are coming from, the insurance death spiral.

It's a racket but insurance companies love it because it fits so well with those actuarial tables that tell them when we're no longer cost effective.

The idea of having insurance companies compete to get corporate business was a Republican idea and the group concept worked OK with that. It's just that any group plan is likely to see skyrocketing rates over time unless employers fire everyone who either gets sick or has that fiftieth birthday.

It's a great system for corporations including insurance corporations. It just stinks for the people who are trapped in it and it has to be stopped. Insurance companies have to be forced to rethink their business model. They won't do it on their own no matter how many of us they bankrupt and kill.

[Skidmore]

2. The group needs to be redefined as

the entire population of the US.

[City Lights]

4. Totally agree. nt

[Walk away]

3. Forty percent of Americans either have no insurance at all or are...

being screwed by insurance companies for the individual insurance they buy for themselves. It seem like a really bad idea to put the other %60 in the same situation without first providing a public option. Without a government option all Americans can get screwed together. It seem crazy to me.

[kenny blankenship]

5. That would necessitate basic healthcare be a NON-PROFIT operation for insurers

Almost no one can afford individual policies. And prices would have to be tightly regulated by the govt. to keep it from crippling the economy. That could work, but the Honorable Mr. Shadegg surely recognizes that maintaining such a proposal and even instituting it in the first place would represent MASSIVE intervention in the insurance market by the Federal government? Insurers' profits would be reduced even more under this scenario than they would be with the addition of a Public Option. I don't think they'd like exploring that idea very much.

But I'd be willing to explore it. This model of insurance works in Switzerland, although it's true they now have the highest insurance costs in Europe. It's worth thinking about, that is unless Shadegg simply means to throw all citizens on the mercy of the insurance mafia without the help of their employers or the government - in which case he should be put in jail. Because that's nothing but a plan to sentence countless Americans to early death, chronic suffering, and poverty.

[Skidmore]

6. Which is where we need to go.

The insurance industry should not be in the business of finance nor highrolling for profit. It should be in the business of helping people with their healthcare needs.

[ctaylors6]

7. very interesting

I'm not sure how they'd directly break up the employer-based system. They could certainly make all health payments by individuals deductible (eg premiums and even out of pocket paid by individuals) and that might go a long way to breaking up the system indirectly. I've seem some proposals to even the field by changing the tax law so employees have to include employer health payments in their compensation; that of course won't fly.

The employer-based system is of course a product of WW2 employment economics that has evolved. When so many more people were employed by large companies, it seemed great when Congress made employer health payments tax deductible to the employer and excluded from the employee's income. It wasn't until fairly recently in that evolution that individuals were able to deduct any part of their own payments (eg self-employed).

I've read that some economists believe very strongly that this system indirectly affects lack of cost containment. I think about $5 out of every $6 is spent on health care by someone other than the person receiving the care (insurance companies, employers, the government). Also, it's not clear where the ultimate cost is borne: does it reduce what employees might be paid if employers weren't paying for health care? are the costs passed on to consumers? does it reduce the return of the company? None of that is good.

Finally, this system that started out as a way to benefit workers has ended up hurting so many because of the lack of portability.

I hope that even if a comprehensive bill does not pass that they can remedy some very serious problems with a very short bill. (The shortest bill ever could say medicare for all, but I've given up on that kind of fix.)