The US has the best health care in the world?

[Count Iblis]

45,000 Americans die each year due to lack of insurance:

http://www.bizjournals.com/baltimore/stories/2009/09/14/daily65.html

 

[WhoWee]

45,000 Americans die each year due to lack of insurance:

http://www.bizjournals.com/baltimore/stories/2009/09/14/daily65.html

How many die that have insurance?

The article says 46 million people are uninsured - that means only 1 out of 1,000 people without insurance are likely to die.

 

[mheslep]

45,000 Americans die each year due to lack of insurance:

http://www.bizjournals.com/baltimore/stories/2009/09/14/daily65.html

You misstated the bizjournal headline. Also:

..The study was released by Physicians for a National Health Program, an organization that favors a single-payer system.

However, the study’s authors concede that ... they did not validate their subjects’ insurance status.

:zzz:

Edit: link to the pre printed paper:
http://pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf

First line from this scientific paper:

The United States stands alone among industrialized nations in not providing health coverage to all of its citizens...

 

[mheslep]

Here's an example of why a consideration of the alternatives are important when slinging "people die!" claims around

People that die due to government healthcare (Medicaid):

summary from http://www.heritage.org/research/healthcare/bg2264.cfm#_ftnref31" :

a study published in the Journal of the American College of Cardiology examined outcomes from coronary artery bypass surgery and found that Medicaid status was independently associated with a worse 12-year mortality than for patients with other types of insurance. In fact, Medicaid enrollees had a 54 percent greater 12-year risk-adjusted mortality than patients enrolled in other types of insurance plans.

Original paper:
Operative and Late Coronary Artery Bypass Grafting Outcomes in Matched African-American Versus Caucasian Patients: Evidence of a Late Survival-Medicaid Association
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T18-4H6XKYC-4&_user=3938616&_coverDate=10%2F18%2F2005&_alid=1017029657&_rdoc=1&_fmt=high&_orig=search&_cdi=4884&_docanchor=&view=c&_ct=22&_acct=C000061828&_version=1&_urlVersion=0&_userid=3938616&md5=0d406bdb032a533728bb3618197a4139

[...]
Medicaid status and late CABG [coronary artery bypass surgery] outcomes. Race did not predict CABG outcomes, but Medicaid status, which is more than four-fold more frequent among African Americans, did with a 54% greater 12-year mortality (HR 1.54;p 0.0047)...

 

[WhoWee]

Watching the debate this week, I think health care reform is moving in the direction of Medicare Advantage programs. That is, Government regulated, mandated, and guaranteed - but privately insured.

This is the CMS rule book.
http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf

 

[rutherdbrown]

Each and every service has a price... and in US you can get best service if you are able to pay upto that extent.. Moreover, the one basic benefit for US to provide such facilities is that it has proper economy to buy latest and most advanced technology...

 

[mheslep]

New House Bill

Yesterday the US President spoke on the latest health care bill from the house, during which he again http://www.forbes.com/2009/10/29/health-care-remarks-business-washington-obama.html" :

The first thing I want to make clear is that if you're happy with the insurance plan you have right now; if the costs you're paying and the benefits you're getting are what you want them to be--then you can keep offering that same plan. Nobody will make you change it.

But as I read the http://docs.house.gov/rules/health/111_ahcaa.pdf" , it appears to have a fairly narrow view of 'keep', if it is possible at all. Under this bill there will only be two approaches allowed: insurance offered under the guidelines of the federally controlled insurance exchange, and existing insurance that is 'grandfathered in', the latter must be that to which the President referred.

To be grandfathered in, the insurance provider is very limited in its ability to change the plan in terms of benefits, conditions , or premiums. Now I know my plan (which I like) changes its benefits more or less every year (adds mental health, adds fertility, etc), bumps its premiums every other year or so. Under these restrictions, I can only imagine the provider would throw up its hands and move on to the exchange, especially given millions will be making moves in the heath market forcing major upheavals in health economics for some time until things stabilize. Likewise, if I have to change jobs then no more existing plan, and I'm on to the exchange.

A more accurate statement about this bill is that it may not immediately throw everyone onto the federal exchange, for a moment it may leave a few alone, but it clearly intends to force everyone on to the federal health exchange as quickly as possible.

Pg 91

1 SEC. 202. PROTECTING THE CHOICE TO KEEP CURRENT
2 COVERAGE.
3 (a) GRANDFATHERED HEALTH INSURANCE COV4
ERAGE DEFINED.—Subject to the succeeding provisions of
5 this section, for purposes of establishing acceptable cov
6 erage under this division, the term ‘‘grandfathered health
7 insurance coverage’’ means individual health insurance
8 coverage that is offered and in force and effect before the
9 first day of Y1 if the following conditions are met:
10 (1) LIMITATION ON NEW ENROLLMENT.—
11 (A) IN GENERAL.—Except as provided in
12 this paragraph, the individual health insurance
13 issuer offering such coverage does not enroll
14 any individual in such coverage if the first ef
15 fective date of coverage is on or after the first
16 day of Y1.
...
21 (2) LIMITATION ON CHANGES IN TERMS OR
22 CONDITIONS.—Subject to paragraph (3) and except
23 as required by law, the issuer does not change any
24 of its terms or conditions, including benefits and
25 cost-sharing, from those in effect as of the day be
26 fore the first day of Y1.

1 (3) RESTRICTIONS ON PREMIUM INCREASES.—
2 The issuer cannot vary the percentage increase in
3 the premium for a risk group of enrollees in specific
4 grandfathered health insurance coverage without
5 changing the premium for all enrollees in the same
6 risk group at the same rate, as specified by the
7 Commissioner.

... [pg 94]

1 (c) LIMITATION ON INDIVIDUAL HEALTH INSURANCE
2 COVERAGE.—
3 (1) IN GENERAL.—Individual health insurance
4 coverage that is not grandfathered health insurance
5 coverage under subsection (a) may only be offered
6 on or after the first day of Y1

 

[turbo]

Under these restrictions, I can only imagine the provider would throw up its hands and move on to the exchange, especially given millions will be making moves in the heath market forcing major upheavals in health economics for some time until things stabilize.

Do you think that the insurance companies will abandon the lucrative insurance industry? Is it possible that they might work to become (gasp!) competitive and stop doubling their premiums every 6 years or so? The breathless predictions of collapse of our health-care system if reform is initiated are getting really tedious. I guess if my father owned Cigna, I could jump on board to protect my villas in southern France and my yachts...

 

[mheslep]

Do you think that the insurance companies will abandon the lucrative insurance industry?

Who said anything about abandoning in the industry? I said they will all be forced on the exchange. Do you have any comment on the validity of the President's statement yesterday?

 

[WhoWee]

This is one response from the insurance industry. This letter has been forwarded by thousands of agents to members of Congress this week. Please read the entire letter before posting.

"I am a health insurance agent and also a citizen of your district. I am writing to express my objections to a government run insurance program ("public plan") under consideration as part of health reform legislation. I am also very concerned for my customers and the buying public that the proposed legislation does not adequately address the issue of affordability. The bills I have read do very little to nothing to bend the cost curve for either public or private health plans.

The foundation of any effort to improve the health care system must include measures to control the costs of medical care. The current House and Senate legislation has as its primary focus the financing of medical services only (i.e., insurance). Even the public/government plan will make coverage more expensive as providers who are underpaid by the government shift that loss to the private sector insureds. The legislation simply fails to achieve the bipartisan goal of controlling health care costs.

I urge you to oppose the government-run plan and focus instead on reducing costs by instituting medical malpractice reform, eliminating unnecessary medical procedures, simplifying and standardizing administrative processes, focusing on wellness/prevention, and on a variety of other options -- all of which have been discussed at some point in the debate but were never included in the bills.

Although I have heard the rhetoric from many sources, at the "street level", I can tell you there is no way that any insurance company can "compete" with the government payor. Most private insurers do not have the ability to dictate pricing to providers. Maybe the largest 3 or 4 insurers do, and of course the government does. This is a significant advantage for the few, and will cause significant harm to all others. Instead of creating more competition, you are causing less.

Why does the government believe it can run a large health insurance program, and be successful at it? The current federal insurance plan -- Medicare -- has a $38 trillion deficit. And the deficit is at this exorbitant level even with the government paying much less for medical services than private insurers do. If the federal government was regulated the same as a private insurer, it would be placed into liquidation. This current health reform is supposed to be self-sustaining -- Medicare also was supposed to be.

Our government cannot afford to start yet another entitlement program with impossible spending levels. There are simply too many red flags in government run health insurance.

I am asking you to pause and step back for a moment, and remember that there is an enormous amount of necessary and non-controversial reform that could be implemented quickly and without a public plan. Let's begin with that. The economy is in terrible shape. Please work on passing realistic legislation without a government plan. Taxpayers don't need and can't afford that expense. We elect our Congressmen to represent our interests in Washington, not to act irresponsibly and make us fearful about our continuing ability to buy affordable health coverage.

Please do what is right for your constituents, stop spending billions of dollars on measures that have little impact, and take all the time needed to make sure that health care reform is done in the right way."

 

[Alfi]

Under health insurance reform, we will put an end to the days when an insurance company could use a worker's illness to justify jacking up premiums. We'll crack down on excessive overhead charges by setting strong standards on how much of your premiums can go toward administrative costs and requiring insurers to give you a refund if they violate those standards. It will be against the law for insurance companies to deny you coverage because of a pre-existing condition. And it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most.

They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. If you get your insurance through your employer, we'll change the cutoff on how old your kids can be to remain on your plan--we'll raise it to 26 years old. We'll place a limit on how much you can be charged for out-of-pocket expenses. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies-

In a nutshell, those seem to be the restrictions that will be placed on insurance providers.

There seem to be two issues. The first, addressed above, is Insurance reform. The second, less mentioned, is Health or Care reform. I think these two are being interchanged and confused.

 

[mheslep]

This is one response from the insurance industry. This letter has been forwarded by thousands of agents to members of Congress this week. Please read the entire letter before posting.

Generally speaking: it might facilitate the discussion if you pull out the 2-3 concise points you consider salient; either that, or provide an extraordinary reason for us to read the entire text.

 

[WhoWee]

Generally speaking: it might facilitate the discussion if you pull out the 2-3 concise points you consider salient; either that, or provide an extraordinary reason for us to read the entire text.

Actually, I think you've just highlighted the main problem with the debate. Everyone wants 2 - 3 talking points and an avoidance of the details.

 

[mheslep]

No, OR provide the reason to read all the detail you provided. WhoWee millions of people write letters to Congress. We can't all read everything. Some context and and background is required to pick and choose what to read. Why is your page important? Why is it believable?

 

[Al68]

Actually, I think you've just highlighted the main problem with the debate. Everyone wants 2 - 3 talking points and an avoidance of the details.

As someone who has read the details of the current proposal, I have to agree with mheslep. A good way to keep people from reading a post is to make it long.

It's the long posts that are avoided, not important details, and in the absence of a particular reason to believe a longer post is important, most of us just assume that it's an inefficient use of time to read it.

That being said, the letter you posted was worth reading, so it was an exception to the rule.

 

[Al68]

In a nutshell, those seem to be the restrictions that will be placed on insurance providers.

And consumers. Those "restrictions" are placed on all of us. We will be "restricted" to either buying an expensive comprehensive health care plan that meets the new standards, or nothing at all.

It's not like those "Cadillac" policies aren't already available, we just aren't forced to buy them yet.

 

[Alfi]

From the Insurance agent's letter

Although I have heard the rhetoric from many sources, at the "street level", I can tell you there is no way that any insurance company can "compete" with the government payor.

Do they compete without the restrictions that are proposed?
Would the restrictions alone work without a 'government payor'?
Street level knowledge might be questionable.

 

[WhoWee]

No, OR provide the reason to read all the detail you provided. WhoWee millions of people right letters to Congress. We can't all read everything. Some context and and background is required to pick and choose what to read. Why is your page important? Why is it believable?

This letter was written by the CEO of a large insurance company and made available to the agent network to send to their respective political representatives. My intent was to make a factual post, rather than pick and choose from the content.

If you really want to know my personal thoughts, please read the next few lines. Health care reform is needed. Any solution based upon the Medicare model is a mistake. An exhaustive review of the system - using a problem solving technique (scientific method) is needed before any additional legislation is enacted.

 

[mihna]

I find it fascinating that the proponents of maintaining the status quo choose to ignore the WHO's ranking of our medical system in favor of theoretical arguments against socialism, gov't bureaucracy and anecdotal reports of long que times in Canada.

I think that in itself is quite telling.

 

[WhoWee]

I find it fascinating that the proponents of maintaining the status quo choose to ignore the WHO's ranking of our medical system in favor of theoretical arguments against socialism, gov't bureaucracy and anecdotal reports of long que times in Canada.

I think that in itself is quite telling.

Welcome to PF.

Can you please elaborate?

 

[Al68]

I find it fascinating that the proponents of maintaining the status quo choose to ignore the WHO's ranking of our medical system in favor of theoretical arguments against socialism, gov't bureaucracy and anecdotal reports of long que times in Canada.

I think that in itself is quite telling.

I think it's quite telling that you think opponents of the current proposals are "proponents of maintaining the status quo".

Do you have something to contribute other than snide comments?