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DesideriScuri -> RE: Advocacy group: 26,000 die prematurely without health insurance (6/30/2012 5:27:47 AM)
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ORIGINAL: tweakabelle
It might interest you to know that prior to the introduction of Medicare here in the early 80s, there was a contentious debate about the merits of a universal health care system, which more or less mirrors the current debate in the US.
The conservatives went feral, opposing Medicare tooth and nail. The sky was going to fall in, doctors would desert the system en masse, we can't afford it, cost will go through the roof, it will force tax increases to pay for it, it removes freedom, it's creeping socialism .. (sounds familiar???? .... all the arguments currently being advanced by the Right in the USA). They promised to abolish it if returned to government, just like Mittikens has done.
Guess what? None of that happened. Medicare was introduced more or less smoothly and was such a great success that the Party that introduced Medicare was rewarded by staying in power for a generation. The conservatives soon abandoned their promise to rescind it, realising that it was electoral death. Within a few years, Medicare was (and still is) an established fact of life in Australia, with all major parties committed to its retention.
That actually does interest me to know your experience. Thank you for providing it. What was the Australian health care "spend" prior to Medicare compared to now?
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My guess is that pretty much the same will happen in the US. You're not *that* special or unique.
I disagree wholeheartedly. But, I'd use "special" in it's less positive way (what we call "short bus" special) and, I sincerely doubt there are that many countries anything like us in the way we live. And, tweakabelle, I absolutely believe that there will be more systemic abuse of a system just like there is a systemic abuse of all the good afforded to US Citizens. What country consumes the most? The US. It's this consumerism and consumptive bent that is going to make a failed experiment of UHC. In Germany, physicians get paid significantly less than US physicians. Care simply costs less in Germany than in the US, and that is prior to insurance modification. If you are working in Germany for a US company and have US health insurance, you have to pay for your care up front and then get reimbursed by your employer-provided insurance. But, the cost of the actual care is so much less, that it's less punitive to have to do it that way.
We have a fucked up system. In that, we are much different from everybody else, aka "unique." I'm perfectly fine with being different, but I'm not happy with the state of care in the US. I'm not happy with the cost of care in the US. Insurance is beyond necessary in the US, because of the cost of care. If you were to cut down on the cost of care, would you also not cut down on the necessity of insurance?
I fully believe (which does equate to "no proof") that the spiraling cost of care is due to those who don't have insurance, but not for the reasons most liberals supply. Again, I have no actual proof of this, but, if you can write off (hospitals get to write off many things as "bad debt") the cost of uninsured services, charity care, isn't that an incentive to jack up the billed rates? Why write off a percentage of $100 when you can write off the same percentage of $200 (purely hypothetical $'s used solely as an example)? Self-pay employers contract with insurance companies for the insurance company's negotiated discount (discount to the cost of the care) and for other provisions, such as stop-loss levels. Self-pay Employers pay out the nose for the premiums and then pay for the cost of care, less deductibles and co-pays. The only "cost" to insurance companies is if one of those employees hits the stop-loss ceiling and whatever administrative costs for paperwork. The reason self-pay employers do this is because the cost of the actual care is so high, it saves them money to buy negotiated rates. And, even if stop-loss levels are hit, many of those companies have paid over that amount in premiums so the insurance company isn't losing money covering those stop-losses.
In the end, Self-pay employers are paying for negotiated care rates. The insurance company has to make sure their premiums are high enough to cover the stop-losses, but not so high that the negotiated rate savings is lower than the cost of premiums. With many hospitals being owned by insurance companies (there is only one hospital in the Toledo, Ohio Metropolitan area that is not owned by an insurance company, yet; two insurers own all the other hospitals; one has negotiated to "buy" the lone un-owned hospital, but is being blocked by the FTC because it would reduce competition), where is the cap on the cost of care? Could insurance company A negotiate a lower cost to it's owned hospitals, but a higher cost to those insured under company B? Company B is likely to respond the same way, too. They can raise bill rates to pad their "negotiated savings" and to increase their charity care write off.
Is Australia the same in consumption? Is Australia similar in obesity levels? Was Australia the same as the US in who owns the hospitals and the insurance companies?
I'd be surprised if Australia is the same as the US in any of those 3 things. And, if those 3 things aren't the same, the administration and effect of a similar UHC won't be the same here as it was there.
I'm all for lowering the cost of care. But, it has to lower the cost of care for everybody. It can't just shift the cost of care to "the rich," or else there is no actual cost-savings.
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