Saturday, December 25, 2010

A Government Strong Enough To Give You Anything You Want...

...is strong enough to take away everything you have. For those of you who believe we need more and more regulation of our daily lives, is this what you had in mind?

PEJMAN YOUSEFZADEH: TSA: Crushing The Critics. “I don’t know what the point of this is, other than for the TSA to inform all of us that it does not like being shown up by mere airline pilots. . . . In a sane world, of course, higher-ups at the TSA, and at the Department of Homeland Security would be forced to answer for the huge security lapses documented in the pilot’s video. But we do not live in a sane world.”

Things aren’t any better at Kathleen Sebelius’ HHS.

14 comments:

mazenko said...

I, in no way, want more regulation of my "daily" life.

I do, however, seek more regulation of illicit business practices in banking, investing, and food production. I seek more regulation of a health insurance industry that seeks to make money only by balancing how many premiums they can accept while denying enough claims to remain mega-profitable. I seek more regulation and oversight of government contracting work out to the private sector - especially in military spending and responsibility.

The stand against "government regulation" is too innocuous to provide rational discussion of how much government we want. TR and Mark Twain were not wrong in the Gilded Age, and Elizabeth Warren is not wrong now.

MikeAT said...

Good afternoon Mike

1. I hope Santa was good to you and the family.

2. I will go where angles fear to tread, your brain. OK, to "stand against 'government regulation'" is too vague a statement in this discussion, to rephrased your innocuous statement. Then more specifically what regulations do you want on the health insurance industies? And what is your definition of mega-profits?

mazenko said...

Santa was good to us, and we enjoyed our Hannukah Festival of Lights, as well. Thanks you for your interest.

I approve of regulations that prevent a company from dropping patients for getting sick and making claims. Having asthma - which is so controlled as to be non-existent these days - I approve of regulations refusing access based on pre-existing conditions. Because of a recent, doctor-recommended preventive care procedure, I appreciate the Colorado regulation that gave me a co-pay, rather than a thousand dollar bill - especially for a provider who receives it as full profit because of their business model.

Most obviously, I approve of regulations that require clear, up-front pricing. After recently paying off a thousand dollars in urgent care bills for a few stitches, I disapprove of a business model that will initially refuse to name a price for a procedure, charge twice as much as they will take, and then agree to halve it when they realize they are billing an individual and not an insurance company. Thus, they admittedly were planning on gouging the insurance company. As the doctor said when I challenged the bill, "Why do you care what it costs? Just send it to your insurance."

Thus, I seek regulations from corrupt business practices. And, unless you are shielded by some great benefits coverage, you truly experience this "free market." My actual experience with this industry is what guides my ideas about necessary regulations. I'm not speaking hypothetically or ideologically.

skeneogden said...

Napolitano and Sebelius may not be listening now, but wait until they have to appear before Congressional committees chaired by Republicans investigating their malfeasance. That is one piece of political theater I don't want to miss.

MikeAT said...

This reminds me of a previous discussion we’ve had on campaign finance. And by your statements you’re not in a free market.

After recently paying off a thousand dollars in urgent care bills for a few stitches, …then agree to halve it when they realize they are billing an individual and not an insurance company. …

Part of a free market is having customers who are willing to shop around and pay less at other locations. We have conditioned people so much that they don’t care how much it cost because all they pay is the co-pay/deductable. Not to mention doctors used to know their patients and often would charge richer people more for what their services so they could charge poorer patients less. Now you have people going to the doctor for the slightest injury, justifying it by “I’m only paying 20 bucks”. One of the people who developed this scheme was Teddy Kennedy…it was called the Health Maintenance Organization.

I’ve lived in a “free market” health care system about 15 years ago and it wasn’t that bad. I went to a GP and paid him out of my pocket for things when needed (shocked the hell out of his staff when I actually paid his fifty dollar bill with three twenty dollar bills…they didn’t have cash to make change). I had a major medical plan through the university (I can’t remember if was 200 a semester or 200 a year…at most around 400 a year) that have me peace of mind. In case of a major illness or accident I was covered. But it encouraged me to shop around.

I think we’re in agreement that there should be more openness…but this will not come from Obamacare. BTY, you didn’t answer one question I asked. What is a fair profit for the medical care industry? Ten percent of the gross, five percent, twenty percent?

mazenko said...

Mike, you've missed most of my points. The stitches were out of pocket, and I was not shielded by my co-pay. I have different insurance for me and my family, so I clearly shop around and am not naively and frivolously consuming health care without knowledge of price. However, emergencies like stitches don't allow for a lot of shopping - but guess what? I did. And this was the best deal - no real competition for an industry in collusion.

I have an HSA for the family and pay out of pocket just like you claim you did. Not a big deal for office visits. How long did you live in the "free market"? Did you face a cancer scare? How but some necessary surgery? Maybe something that didn't quite meet your $8000 deductible, but was certainly enough to cripple your savings if it happened twice ... or a few times if you have kids? I doubt you're talking about situations like that. Because when I was young and single, I did the pay for service as well.

Being older and having kids changes things. Have you "shopped around" while your child has a broken limb which you paid out of pocket for? How about a child with hemophelia? Any experience with that one? Any chronic conditions? By the way, the HMO model and the business model employed by companies like Kaiser was actively pushed by Richard Nixon.

I haven't answered your mega-profits just as you haven't commented on the corruption in need of regulation. Is the gouging of the insurance company a reasonable concern? Are the providers so pure of heart that they can be trusted to not screw people? Or just not enough people that they end up sued.

Mega-profits are a problem when the company posts "record profits" while paying out "record low" claims, all the while claiming they need to keep raising premiums on people who have not consumed any health care. They claim their costs are going up, when actually they are going down. And then investigations reveal they are simply making up in premiums money that they lost - not through payouts - but through their own investments in a down market. That's what I'm talking about.

That probably needs some regulation. That's why it might be necessary for the companies to have to justify to an insurance commissioner why they are raising premiums. If they can show medical losses, it's one thing. If it's because they lost at the track, that ought to be at least disclosed, if not prohibited.

MikeAT said...

The Congressional hearing I want to see:

"Ms Pelosi, you realy enjoyed riding around in that taxpayer provided 747...let's see if you really used it for official business..."

mazenko said...

What?

No logical answer so the Pelosi straw man? Or maybe that came before my comment.

Anyway, I'm not a huge fan or defender of the health care act, which I think was overkill. However, I'm not for dismantling something that 80% of is approved by 80% of Americans. There's a lot of good and necessary regulation and "free market" solutions in that bill.

So, don't go "Obama-care Pelosi-scare" on me. Just talk about problems with the regulations and analysis of business model I offered.

Darren said...

I challenge your 80% number, as I read today that 60% support repeal.

mazenko said...

Depends on your source - and I'm not saying 80% support the law. But the 80% of the law is supported by 80% of Americans. Key issues like pre-existing conditions, not dropping sick patients, justifying rate increases, central exchanges for consumers, etc. are supported by nearly all Americans.

MikeAT said...

1/2

“What?

No logical answer so the Pelosi straw man? Or maybe that came before my comment.”

Maybe I was too nuanced with that…let me be very specific. I was making a comment in agreement with the point Skeneogden made on Napolitano and Sebelius having to actually answer questions to a skeptical congress.

“Anyway, I'm not a huge fan or defender of the health care act, which I think was overkill. However, I'm not for dismantling something that 80% of is approved by 80% of Americans. …"

Again Mike I don’t know where you get these numbers but there are, to put it politely, wrong as the day is long. But unlike you I will show you were I get my numbers. From Rasmussen poling (not exactly a right wing propaganda arm) a survey of 1000 likely voters conducted 12/26/10, do you want to repeal Obamacare:

Answer: 60% favor repeal, of which 49% Strongly Favor repeal of the plan.

http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/health_care_law

"There's a lot of good and necessary regulation and "free market" solutions in that bill.”

Let’s try this again. SPECIFICALLY what are the good and necessary regulation and "free market" solutions in that bill.”

"So, don't go "Obama-care Pelosi-scare" on me. Just talk about problems with the regulations and analysis of business model I offered."

Again Mike, read a little more in the post and you may get the point it wasn’t directed towards you…

“Mike, you've missed most of my points. The stitches were out of pocket, and I was not shielded by my co-pay. …And this was the best deal – “

I thought I was agreeing with your point there is an “I don’t care how much it cost I’m not paying for it…” attitude out there. And that will lead to increased consumption which will lead to higher prices if you don’t do something to increase the quantity of health care. Now some of the things Obamacare did do:

- Under the authority of the Interstate Commerce Clause they took down the barriers from insurance companies from offering insurance all over the country, therefore increasing the quantity and completion which of insurance offered which always decreases cost…oh wait, they didn’t do that. They said they could tell John Q Public “You must buy insurance or you will pay a fine (before the court cases)” or pay an additional “tax” (what they called it to the judge in the court cases).

- Well they did limit trial lawyers punitive damages like Texas did to lower the cost of medical mal-practice insurance…oh wait, that was left out of the final bill…must have fallen out of page 2919. But case in point…then Governor George Bush reformed liability for doctors, limiting punitive damaged (not actual loses but the stuff the lawyers get rich off of) to 750K. Our medical malpractice rates are 40% lower than the national average and doctors are moving to this state. Can’t be said of New York or California.

“no real competition for an industry in collusion.”

Agreed…and we need to change that. Some things to do it…limits on medical malpractice, allow Physician’s assistants to handle more routine things like your stitches. It takes a Masters to be a PA but you can do a lot of the work of an MD. Have people actually pay for more routine visits and leave the insurance for the more important stuff will again lead to people shopping around.

MikeAT said...

2/3

"I have an HSA for the family … Because when I was young and single, I did the pay for service as well. "

Well you claim you have a HSA so I’ll go with the planning assumption that is accurate. Yes, I did have a policy through the university. The first 1000 was on me, 1001-10000 is 80%, 20% me and 10001 to 1000000 was 90% insurance.

"And I guess you had no scare in that time…like cancer or such."

I will let you in on a little secret. I had an MS scare in during the holidays in 95. And my personal physician checked me out and when I asked him how much he shook my hand and said “Merry Christmas Mike”. Something you don’t get much of these days. BTY where did you get the 8000 deductible?

“Being older and having kids changes things. Have you "shopped around" while your child has a broken limb which you paid out of pocket for? “

No but I did go to an all night clinic when my step daughter was sick with a stomach virus and couldn’t hold down water. Almost 700 bucks I didn’t need just as the holiday shopping season was starting but gladly paid it.

“How about a child with hemophelia? Any experience with that one? “

I take it you mean Hemophilia, the inability of the blood to clot quickly. Not personally but I have some good friends who’s seven year old has it and they got insurance for their son. Granted they pay extra but it’s good coverage.

“Any chronic conditions?”

A little secret Mike. I was diagnosed with Multiple Sclerosis in 1998. Since then HMO Blue has paid over 15K a year in treatment. And get this Mike. That haven't cancelled my policy or doubled the premiums. A major reason is I'm in a group policy and that spreads the risk out amoung a lot of people. I think that's the basic concept of insurance...all the people (higher risk and lower risk) put their money into one place (i.e. an insurance company) and when needed it's there. And I thank God I have it. But in discussion with my neurologist I asked if I lost my coverage if I had any options. The doctor told me of programs Biogen has to help people of limited means…and my injections are almost 10K a year. Gee, I have a chronic illness and I have options that do not involve going broke. That was a long time before B Hussein Obama was known as anything more than a state senator from Chicago who loved to say “present”.

MikeAT said...

1/3

“ By the way, the HMO model and the business model employed by companies like Kaiser was actively pushed by Richard Nixon.”

Mike, you’re not helping your argument by invoking Richard “R” Nixon. Let’s see, establishing the EPA, taking us off the gold standard, signing off on HMOs…his domestic policy was kinda liberal. But he was the stereotypical Rockefeller Republican.

“I haven't answered your mega-profits just as you haven't commented on the corruption in need of regulation. …sued. “

I asked a specific question. And I agree the system needs reform, not necessary regulation. I think I’ve thrown out some ways to start reforming medicine in this country with my sarcastic commentary on Obamacare. But you’re just throwing out cliché’s about “record profits” and “record low” claims. Exactly what the hell are you talking about and what are your sources other than the ideas created between your ears? And so we are the same sheet of music what, as a percentage of the gross, is too much profit for a company like HMO Blue to make? 1%?...5%?...10%...20%...what?

“…And then investigations reveal they are simply making up in premiums money that they lost - not through payouts - but through their own investments in a down market. That's what I'm talking about. “

What investigations? And of what company (companies)? BTY Mike welcome to the real world. They need that money (from investments, premiums, etc) to pay out claims. It’s not like the take the money you pay for your insurance and they put it into a can and when you need ten grand for the tonsils to be removed (that’s what B Hussein Obama said a doctor makes to needlessly take out a kid’s tonsils so it must be true) they take out 100 C notes and make a payment. An industry that large needs major assets which means investments in stocks, bonds, mutual funds, real estate, etc. It’s that which funds the payout of treatments, long term care, etc. And when the market turns south (thanks B Hussein Obama) they money has to come from somewhere.

Darren said...

The Washington Post:
http://voices.washingtonpost.com/right-turn/2010/12/voters_really_dont_like_obamac.html