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Wednesday, January 30, 2013

A tweet from outer space

We could have had a single payer. We could have had a public option. Instead, the brain trust gives us this:

Gee, that's swell, Gatsby. And what are we supposed to do with that number? Call our boss and tell him we want cheaper, crummier health insurance?

Apparently, having this important information is going to make us smarter consumers of medical services. Oh, yeah, when we get sick or injured, the first thing we're going to do is get on the phone and start shopping doctors for a bargain. In the immortal worlds of Bugs Bunny, "What a maroon."

Comments (38)

The only stones that Wyden has are in his head.

I think the cost is used to determine how much additional tax you have to pay if you have a "luxury" medical plan. My employer is dropping some insurance options next year due to the tax implications.

Why would I want cheaper crummier health insurance when I now have more expensive crummier health insurance?

If Wyden could've spoke at the moment he was born, instead of expressing humility or thanks to his mom & dad and the doctors & nurses, he'd have declared: "Look what I did!"

Portland Polite again!. . . or what?

I think the cost is used to determine how much additional tax you have to pay if you have a "luxury" medical plan.

But as our astute senator points out in his tweet, everybody is being shown their number, even though only a precious few will owe any tax.

Of course, his next move will be to make everybody pay tax on that benefit. Don't think that isn't coming.

Congress gets luxury premium care, additional tax for them?
What do they care about the rest of the people?
They haven't a clue and/or do
and "C'est la vie."
I wonder what the Gray Panthers think now of their "golden boy" they elevated!

Woulda, coulda. Got lucky, I guess.

Single-payer means "all tax-payers". Less the government overhead expenses.

" our astute senator points out..."?

I thought Wyden represented New York.

If the next step is government issues 1099's reporting cost of Medicaid, Medicare and Obamacare cross subsidies, I'm all for it.

I think this is a great idea and well overdue. When people see that in lieu of a raise (again) this year, their firm/company is picking up another double digit increase in healthcare premiums, perhaps they will start demanding a better return on their dollar. The more transparency the better.

I wonder if Wyden's W2 shows how much the taxpayer pays for his health insurance.

"perhaps they will start demanding a better return on their dollar."

Really? Who will we be making that demand on? Our employers? Blue Cross? Kaiser? Our doctor? Employer-provided health insurance is pretty much a take-it-or-leave-it proposition for most people I know.

The first step is to make people aware of exactly how much their health insurance - and by extension health care -- is costing them. If people see the true cost of their premiums -- they might start asking why it costs so much. Frivolous law suits? Paying the medical care of the uninsured ? Administrative bureaucracy? Defensive medicine? Fraud? Huge profits for doctors? People running to the doc every time Junior sneezes? All of these are given as reasons - and no solutions are ever sought. Why? Because who really cares if their health insurance premiums go up? Their employer pays that. We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it-- and are aware of how much it is costing them.

We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it

So, eliminate employer-provided health care? That is not politically realistic.

And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream.

What PMoLO said...

Single Payer Action -- "Everybody In. Nobody Out."

Health care threatens to crush U.S. growth
January 25, 2013

US GAO Financial Audit: U.S. Government’s Fiscal Years 2012 and 2011 Consolidated Financial Statements

And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream.

Wow, you have great faith in humanity.

Perhaps people might "haggle over price" (nice characterization, there) before they're in the ambulance. It has been known to happen.

Knowing what it costs is a start.

If the USA doesn't want to adopt a French-like system, then make everybody pay cash for medical coverage and only require emergency medical.

Your auto insurance doesn't cover tune-ups or implanting Double-D hood ornaments. It only covers the unexpected. And that is why that market is extremely competitive.

There is no competition in health care with the current system. We really need to stop using the term health "insurance".

"We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it-- and are aware of how much it is costing them."

Them, everyone else, and the country. What percentage are we up to now of the GDP that goes to the medical industry? Just short of 18, headed for 20? And about 2-1/2 times more than comparable countries -- thousands of dollars more, per person, per year.

I get your point: that if people what they at some essential level, even if it seems removed, knew what they were paying, they might think, wow, I'd rather do something fun or more productive with that money. Or, how come I'm paying more -- but not getting more -- than just about everybody everywhere else?

You left medical tests and procedures off your list -- a major cost driver. A number of hospitals and medical organizations are trying to corral and stem these, quite actively.

But PomMom's big point is that when so few people pay these things directly they do not really see the bite of it. To all of us. And the country. And we are not getting our money's worth.

We really need to stop using the term health "insurance".

True, that. And it's not medical insurance either. Not insurance at all.

I've said it before, this was where Obama started. He made everyone in his administration read it. He gave it all up.

Funny, she also left insurance company profits off her list.

That's where Wyden's bread is buttered.

Considering I haven't been to a doctor in 8 years, I'd say my employer is being ripped off.

Jack wrote: "And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream."

I'm not sure that's right my friend, at least not always.

Example number 1: there is a surgery that the doctor says will be great at improving your life (say a shoulder surgery, which I got 3 months ago). They are a painful recovery. If, on top of that, you have to pay a bunch of dough out of pocket, I think you'll be more likely to get a second opinion, or shop for someone cheaper, or even sometimes to just say, "screw it" to getting the surgery.

Example number 2: you're very old and very sick and they tell you you can get some painful surgery to possibly prolong your life a few months. The alternative is going home and dying in peace. If you add the notion that the painful solution also will cost you a bunch of money, you (or your likely heirs at least) may think twice.

I've finally become aware of the fact that I won't live forever. I also am not crazy about voluntarily taking on pain. Doctors have every incentive (their oath plus economic) to suggest you do everything medically possible. I'm not sure I want to do everything medically possible even when it's "free", but certainly not when it will blow through the few bucks I have left at this point.

shop for someone cheaper

Do you actually do that? Methinks you get what you pay for. The term "getting Kaiserized" comes to mind.

If you look at medical procedures that insurance usually will not cover (lazik, plastic surgery, botox) the price has been controlled by the market. Since (thankfully) we do not let people go without emergency medical care if they cannot pay, the market is always going to be skewed when it comes to medicine - but more market, less government control should be the goal. IMHO.

"more market, less government control should be the goal."

That's a howler. If you look at the high cost and poor results of our system compared to other civilized countries, the fundamental difference is our excessive reliance on "markets" in the form of private insurance. The bits and pieces of our health care system that are the least dysfunctional are the government ones: Medicare, Medicaid and the V.A. Even in Medicare, the "Advantage" plans we got with new drug coverage under Bush, being privately run, are the most expensive and wasteful.

Health care is not a business. Rationing, denying health care and minimizing the insurance companies "loss ratio" is a business.

"Congress gets luxury premium care, additional tax for them?"

Please elaborate.

They are covered by FEHB like all the Federal employees who choose a FEHB plan (and pay their share.) In addition they (but not their families) are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, after payment of an annual fee. But services don’t include surgery, dental care or eyeglasses, and any prescriptions must be filled at the member’s expense.

FEHB offers a range of commercial health insurance plans. Luxurious coverage is missing, in my opinion.

What ever happened to the family doctor?
Now it seems so corporate and pushing people into corporate money making tests and drugs. One has to actually resist these efforts.
This last year I noticed on a new preventive service letter:
Annual screening for depression.
One could get depressed just thinking about it all. This that and what next?
Mandatory probing and mandatory depression screening for drugs!!
I don't know about others, but I don't like being subjected to fear about
every little possible wrong.
Great subject for a Woody Allen movie!
Many laughs in his film "To Rome with Love" where Woody Allen (Jerry) appears in the film, with Judy Davis (Phyllis) who plays his psychiatrist wife.

I'm sure government could do health care more efficiently than the private sector. Look at all the other things government does more efficiently/cost effectively.

I don't know all the details, but this article explains some.
Congress' Own Health Care Benefits: Membership Has Its Privileges

Excerpt about Rep. Steve Kagen from Wisconsin:
The Democrat from Wisconsin has refused to accept federal healthcare benefits, making him the only member of Congress to do without. He will continue, he said in an interview, until everyone in America can enjoy the same coverage as federal lawmakers.

Kagen recently had knee surgery, writing checks for more than $4,500 after bargaining for a reduced-rate MRI and a 50% discount on the operation. (He is still dickering over the hospital bill.)

"If every member of Congress put their heads on their pillow every night like I do . . . knowing this could be the night I lose my house, we'd fix healthcare in a week," said Kagen, who spent decades as a doctor in the Green Bay area before winning election in 2006.

Kagen said his wife and three of his four children have health coverage. But not his oldest daughter, 28, who can't afford insurance.

She's a nurse in Miami.

"That's where Wyden's bread is buttered."

And Obama's. My recollection is the medical insurance industry was the major contributor to that gargantuan inauguration.

The first step is to make people aware of exactly how much their health insurance - and by extension health care -- is costing them.

Maybe we should look at the social environment we live in that is increasing our health costs:

1. Reliance on large population centers, where disease can grow and multiply much quicker

2. Larger school classrooms

3. Increased stress due to time constraints, less family time, more work, longer and more tedious commutes - stress reduces a body's immunity and increases liklihood of contracting sickness

4. Workplace demands (increased pressure to be at work and less opportunity to take a sick day, increased stress and now more sick employees coming into work, getting others sick)

5. Workplaces that have more people located close together (office environments, call centers)

6. Increased physical activities of a "thrill-seeking" nature - people getting lost in the woods, bicycling - all that has an increased risk of physical injury (why should I have to pay higher healthcare costs when I choose not to play tackle football, but lots of high school kids suffer severe injuries each year from choosing to injure themselves? Same with hikers/skiiers who choose to get lost on Mount Hood and I now have to pay for expensive Oregon Air National Guard and Life Flight helicopters to rescue them and take them to trauma centers hundreds of miles away)

Maybe...just maybe, if we looked at our society and decided to make smaller changes - mandating sick leave on a national or state basis (even if unpaid) and protecting workers who are legitimately sick, mandating "minimum space" requirements so people don't have to be close to sick people...

the social environment

Not a bad list; but you left out the heavy subsidies of corn -- basically the prime ingredient of a poison -- as a fundamental part of our food supply.

I'm sure government could do health care more efficiently

I'm sure your comments are intended as sarcasm. But it doesn't work, since the government is demonstrably more efficient at delivering health care, health care, old age insurance and national security, to name just a few things, than the private sector. That's fact, not just opinion.

Wyden, unfortunately, is not very bright and it shows. I mean this guy found the BAR exam a chore more than once and didn't have a clue where Bosnia was on a globe.

"Employer-provided health insurance is pretty much a take-it-or-leave-it proposition for most people I know."

Public employees generally (in Portland) are offered 2-3 choices for health plan coverage every year (in terms of providers), with additional options such as amount of co-pay, etc.


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In Vino Veritas

Lange, Pinot Gris 2015
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Marchigüe, Cabernet 2013
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Cantele, Salice Salentino Reserva 2013
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Avissi, Prosecco
Cleto Charli, Lambrusco di Sorbara Secco, Vecchia Modena
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Edmunds St. John, Bone-Jolly Rosé 2016
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Chehalem, Inox Chardonnay 2015
The Four Graces, Pinot Gris 2015
Gascón, Colosal Red 2013
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L'Ecole No. 41, Merlot 2013
Della Terra, Anonymus
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Penda Diakité - I Lost My Tooth in Africa
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