Healthcare: More regulation or less?

First, I'm going to make a big concession right off the bat. Something has to be done. I was watching the Lauer report this morning and the astounding rate at which premiums have risen recently, mostly to fuel larger and larger bonuses for insurance company executives, is disturbing. I have no problem with big executive bonuses per se; but when it comes at the direct price of a larger number of people being uninsured or underinsured, something needs to be done about it. Right now, the system works fine for me, but:

a) There are too many for whom it does not work; and

b) If insurance companies are allowed to continuously raise rates with no repercussions, it's only a matter of time until it's a problem for people like me as well

So, what to do?

I'm on record advocating a public Medicare-like option for all with reasonable premiums (which are also based on income and resources), coupled with deregulation of private insurers. I think competition from the public option and each other would keep insurance companies on the straight and narrow. I still think this is the best idea. But I recognize that it will not happen. There's too much antipathy for the "public option" as it were.

So, aside from subsidizing insurance for the lower middle class (which is probably necessary in some form or another), what about the system itself.

It seems to me the two political parties are arguing opposite means to the same goal. The goal is putting a check on insurers' ability to raise premiums to unreasonable levels and engage in unsavory practices like retroactive termination, denial for unknown pre-existing conditions, etc.

The Democrats are arguing for increased regulation:

- prohibit premium hikes beyond a certain point
- prohibit denials based on pre-existing conditions
- prohibit health criteria for obtaining insurance in the first place
- cap executive pay

etc.

The Republicans are arguing for decreased regulation:

- Allow insurance companies to sell policies across state line
- reduce state limitations on the types of policies that can be sold
- cap punitive damages against healthcare providers (okay, this is not really decreasing regulation, but tort reform is a GOP plank)

etc.

Something no one's arguing for, but should be done:

- eliminate insurers' tort immunity

My point is:

Maybe BOTH positions are necessary and appropriate. Can we have BOTH increased regulation and decreased regulation at the same time? Can we cap executives' pay, allow insurers to sell across state lines, prohibit denials of existing customers based on unknown pre-existing conditions AND decrease regulation on the types of policies that can be sold?

Is anyone willing to take the better elements of BOTH plans and use them to construct a real solution.*






* There's no need to respond that "there's no real solution but a single payer system." I know many of you think that, but fighting over that is not really what I'm looking to do with this thread.

Originally posted by sh76
First, I'm going to make a big concession right off the bat. Something has to be done. I was watching the Lauer report this morning and the astounding rate at which premiums have risen recently, mostly to fuel larger and larger bonuses for insurance company executives, is disturbing. I have no problem with big executive bonuses per se; but when it comes at the ...[text shortened]... t, but fighting over that is not really what I'm looking to do with this thread.

The "antipathy" towards the "public option" is mostly among the politicos; fairly substantial majorities of the public continue to support it.

Since the Democrats have already signalled they'd be willing to give on virtually all the "decreased regulation" points you raise, certainly a compromise bill should be possible. But it seems pretty obvious that the Republicans at this point find it politically advantageous to oppose anything that could be construed as an accomplishment for the Obama administration. It also appears that the Dems aren't going to let health care reform wait. So the chance of such a compromise bill getting done before the Dems pass a health reform bill is about zero.

Originally posted by sh76
First, I'm going to make a big concession right off the bat. Something has to be done. I was watching the Lauer report this morning and the astounding rate at which premiums have risen recently, mostly to fuel larger and larger bonuses for insurance company executives, is disturbing. I have no problem with big executive bonuses per se; but when it comes at the t, but fighting over that is not really what I'm looking to do with this thread.

I favor something similar to what I have now which is a flexibls spending plan that is tax free dollars taken out of each check and put into an account, only, I favor it being extended indefinatly so that I don't have to use all of it at years end or lose it. If I were then able to build up a nest egg in medical insurance that is my own, I would probably forgo insurance altogether at some point!! At that point these insurance companies would be faced with increased compitition due to such plans and be forced to lower their rates or go belly up.

Originally posted by whodey
I favor something similar to what I have now which is a flexibls spending plan that is tax free dollars taken out of each check and put into an account, only, I favor it being extended indefinatly so that I don't have to use all of it at years end or lose it. If I were then able to build up a nest egg in medical insurance that is my own, I would probably for ...[text shortened]... with increased compitition due to such plans and be forced to lower their rates or go belly up.

That's a great plan! (Unless you are diagnosed with cancer tomorrow.) So it is identical to what Rep. Grayson said the Republican plan was, "Don't get sick, and if you do, die quickly!"

Originally posted by TerrierJack
That's a great plan! (Unless you are diagnosed with cancer tomorrow.) So it is identical to what Rep. Grayson said the Republican plan was, "Don't get sick, and if you do, die quickly!"

Not so fast. If you went to apply for insurance and you had a nice little nest egg set aside I think the insurance companies would be more inclined to insure you. For example, if you were required to use all or a portion of that nest egg before their money was to be used I think they would insure you. In addition, another account could be set aside that collected all the unused money from "healthy" people who passed on that could be used to subsidize thos who fall through the cracks.

Originally posted by sh76
First, I'm going to make a big concession right off the bat. Something has to be done. I was watching the Lauer report this morning and the astounding rate at which premiums have risen recently, mostly to fuel larger and larger bonuses for insurance company executives, is disturbing. I have no problem with big executive bonuses per se; but when it comes at the ...[text shortened]... t, but fighting over that is not really what I'm looking to do with this thread.

I agree with most of your points but you have to know that the Republican Party has not negociated in good faith on this issue. You also must know that when they had control of both Congress and the Presidency they did almost nothing to solve the problem except pass a large unfunded give-away of your taxes dollars to curry favor with the voters (and their campaign funding sources.) You also must know that they have done everything they could including lying, obstruction, and ridicule to prevent anything from being passed. So I have to ask, how badly can they treat you and the rest of the American people and still retain you as a member of their party?

(As a little bit of history that you might not be aware of I'd like to point out that when I was young worker I often paid nothing directly for health insurance. The company was able to cover me and still pay a competitive salary. Workers now have no idea how badly things are trending. I quite frankly feel as much despair over this whole issue for the business interests as I do for the workers. The current system will inevitably lead not just to you being priced out of the market but to the collapse of the economy. When will we wake up? When the rich are choking down soylent green in their barricaded compounds?)

Originally posted by whodey
Not so fast. If you went to apply for insurance and you had a nice little nest egg set aside I think the insurance companies would be more inclined to insure you. For example, if you were required to use all or a portion of that nest egg before their money was to be used I think they would insure you. In addition, another account could be set aside that co ...[text shortened]... ealthy" people who passed on that could be used to subsidize thos who fall through the cracks.

You have no idea how devastating a catastrophic disease is on most families in this country. In your blessed state you just don't get it. I hope you never have to find out.

Originally posted by TerrierJack
You have no idea how devastating a catastrophic disease is on most families in this country. In your blessed state you just don't get it. I hope you never have to find out.

Oh dear here come the woe is me I've had it hard and bad anecdotes, I've got one, my Dad died from a catastrophic disease here in the nationalised health care state of NZ and his one dying wish: "Just don't send me back to that place" i.e.the state hospital.

Originally posted by Wajoma
Oh dear here come the woe is me I've had it hard and bad anecdotes, I've got one, my Dad died from a catastrophic disease here in the nationalised health care state of NZ and his one dying wish: "Just don't send me back to that place" i.e.the state hospital.

I'm sure he would have preferred to die without treatment.

Originally posted by KazetNagorra
I'm sure he would have preferred to die without treatment.

It is I that would like to see people make their own preferences, it is you that would like to limit them.

Originally posted by Wajoma
It is I that would like to see people make their own preferences, it is you that would like to limit them.

WajomaWorld: get born in a slum with rampant crime, no access to education or health care. Die of a easily curable disease after working 10 hours a day in a factory from age 5 with no regard for worker's health. Talent is punished, silver spoon kids with no talent are rewarded because they are the only ones getting educated.
KNWorld: get born in a decent neighbourhood with managable crime, work your way to the top with access to top education. Talent is rewarded.

Who has more options to choose their own preferences? Who wants to limit people's freedoms? You do, Wajoma. You just don't realize it.

Originally posted by KazetNagorra
WajomaWorld: get born in a slum with rampant crime, no access to education or health care. Die of a easily curable disease after working 10 hours a day in a factory from age 5 with no regard for worker's health. Talent is punished, silver spoon kids with no talent are rewarded because they are the only ones getting educated.
KNWorld: get born in a dece ...[text shortened]... preferences? Who wants to limit people's freedoms? You do, Wajoma. You just don't realize it.

All those great things come as a result of prosperity, all your control, regulation, taxation comes in on the back of that prosperity, it does not create it.

Originally posted by Wajoma
All those great things come as a result of prosperity, all your control, regulation, taxation comes in on the back of that prosperity, it does not create it.

Then how is it possible that some countries which tax way more than e.g. the US are also much richer?

Originally posted by KazetNagorra
Then how is it possible that some countries which tax way more than e.g. the US are also much richer?

Let me get this straight all countries that are taxed more than the US are more wealthy than the US? Because if all countries with greater taxation than the US are not more wealthy than the US your point is null and void, actually.

You're basing your argument on: Fantastic taxation will create wealth?

I base my argument on a persons sovereignty over their own self.

Originally posted by Wajoma
Let me get this straight all countries that are taxed more than the US are more wealthy than the US? Because if all countries with greater taxation than the US are not more wealthy than the US your point is null and void, actually.

You're basing your argument on: Fantastic taxation will create wealth?

I base my argument on a persons sovereignty over their own self.

Not all. But GDP does correlate with taxation - countries that tax more heavily also tend to have a higher GDP per capita. So yes, taxation can create wealth if the government expenses create more wealth than private expenses would. This is a possibility you already acknowledge by saying government should take care of law and order (i.e. the taxation required for funding law and order creates more wealth than spending the money in the private sector).