Health Care Reform and the Law

[BrentAllen]

"I'll worry about making sure every American has access to basic health care without worrying about being financially ruined."

 

Already done - just visit your local county Health Department.

[GernBlansten]

That's the freeloader solution. I don't like freeloaders.

[Beavah]

I thought the BSA (or at least the Councils) provided insurance that was secondary. Is this a real case or hypothetical?

 

It's a real case, BrentAllen. One case was posted here by someone, but I know of at least a half dozen similar cases, some from scouting, some from other things like skateboarding accidents.

 

The BSA offers optional, low limits health coverage, eh? Some councils buy it for units, some units buy it, some don't. The payment cap on the policy is $5K per incident. $5K will handle a basic ambulance ride and ER visit, but it won't cover even one surgery. If a lad needs a couple, or has complications from one, the family can quickly run up a $100K bill or more.

 

Da BSA has high-limits liability coverage, but in most accidents there is no liability, eh? It's just an accident. So that doesn't apply. Only health care coverage does.

 

So when we're talkin' about "just bankrupt the freeloaders", we're talkin' about scouts and their hardworking families.

 

Beavah

 

Edited to add:

Found da post. RememberSchiff was the person who posted this to an earlier insurance thread. It's a good example, eh? No negligence, BSA accident insurance won't begin to meet the costs, dad is self-employed makin' it hard (and very expensive) to buy personal coverage. So da family is turning to community charity in the hopes of gettin' by.

 

http://www.cleveland.com/chagrinsolonsun/index.ssf/2010/08/medical_bill_mounts_for_bainbr.html(This message has been edited by Beavah)

[BrentAllen]

Beavah,

For the record, the only people I said the hospitals should go after (all the way to bankruptcy) are those who have health insurance offered through their employer, but chose not to participate. You know, those who choose to drive a brand new SUV or high end car instead of paying for health insurance. Those with the new ski boat but no insurance. Those running off to Disney World or some other big vacation every year instead of setting their priorities and paying insurance premiums.

 

Gern,

Under ObamaCare, there are going to be lots of freeloaders. All those who have the rest of us taxpayers paying their insurance premiums are going to be freeloaders. Right now we have nearly 20 million kids on free or reduced price lunch (kids of freeloaders?) and over 8 million kids with at least one parent unemployed (more freeloaders?). Do you think any of those families are going to pay for their ObamaCare insurance premiums? You are going to have to add a lot more names to your "I don't like" list.

[CalicoPenn]

"Yes, as a government agency it probably would be somewhat less efficient when compared to a single insurance company"

 

During the run-up to the passage of this bill, there were a lot of claims that the government would be less efficient as the insurance companies. There was never anything presented to back that view up - it was just an opinion.

 

Lost amongst the screaming was some checking by both right and left wing think tanks into this claim - it was found that, on average, government overhead on Medicare is a bit over 3%. Overhead for private insurance companies? A bit over 30%.

 

This should have helped settle the issue of who is more or less efficient - but it doesn't. A lot of people just won't ever believe that government really can be more efficient than the private sector no matter what is presented to them. And there will be some who aren't able to understand the correlation between efficiency and overhead.

 

 

[CalicoPenn]

"Around the passage of the bill many polls were ~60% against and this has persisted through before the last election"

 

I'm actually a bit surprised that a scientist would accept these polls at face value in making arguments for or against a position. These type of opinion polls are notorious for never providing any real detail - they provide analysis that pretends to be detail and most people accept it, but they accept it because most people don't know any better.

 

These polls generally don't present the questions they asked, or ask good follow-up questions to see why people are opposed. When the bill first passed, there was a pretty significant number of people wanting single payer, or at least a public option, that didn't like the bill, just as there were people who just flat out oppose government being involved at all. By stating that 60% oppose the bill, it lumps everyone together which leads the public to generate false conclusions.

 

Particularly on a bill this complex, polling to ask if people like the bill is pretty meaningless - but a poll designed to measure true support or opposition could never be done because people will not stand for an interuption to their lives for a phone poll that takes more that 2 minutes tops to complete. If you really want to know what people think of this bill, you have to ask about the individual components. There are some hints already out there as to how that might play out - some polls have asked about specifics, and the pollsters are always "surprised" by results that indicate that people like 4 out of 5 items polled but then say they don't like the whole package.

 

In a way it's like saying you don't like the circus when you actually like everything about the circus except the clowns.

 

 

[Beavah]

Yah, some interestin' thoughts from E92 about "universal" health care.

 

If you've ever traveled with kids internationally, you've probably run into da European-style universal model at some point. For kids on scout trips, it's a great deal, eh? So much more efficient than in da U.S. Less wait, less paperwork, fine care. Same is true for da average medical care for kids and for the working folks.

 

But that comes at a cost, eh? The cost is that high-end care just isn't available at the level older, more ill folks expect in da U.S. If yeh have terminal cancer, they're not goin' to pull out all the stops. If yeh need a heart transplant after 60 years of smokin' and drinkin' and enjoyin' the finer things, it ain't goin' to happen. You're goin' to wait to see a specialist, and surgery for your tennis elbow so that yeh can keep up with your country club partners ain't goin' to be an option on the public plan.

 

In the U.S., we have very few general practitioners left, eh? All of the financial incentives pull docs toward advanced specialties and cranking through lots of procedures. So that's what we have, eh? Very high-end, aggressive medical care for those who can afford it. Relatively poor general care.

 

So no question, eh? If you're a multi-millionaire or an oil sheik and yeh want fantastic high-end care, yeh can buy it here. If you're a scouter takin' a kid to an ER because of an accident, yeh would prefer not to be in the U.S.

 

It's always a trade-off. It's a limited resource. We've taken the high-end-care and subsidies for bureaucrats option over sound, efficient general care.

 

Now, I reckon there is a middle road somewhere, eh? I think that's what France is playin' with. One where yeh provide reasonable baseline coverage for youth and productive-age workers, and then optional higher-end coverage. Right now we sorta do that through ERs, and that's a terribly ineffective and inefficient way to go about it.

 

Da thing that kills any system, though, is health care for the non-productive elderly, especially if da expectation is high-end, expensive care on the public dole. There's just no way to pay for that without a Ponzi-scheme style growing young demographic.

 

Beavah(This message has been edited by Beavah)

[BrentAllen]

Beavah,

Not sure where you are getting your council insurance info, but it appears to be out of date. I quickly found this insurance info on the St. Louis Council page: "Accident medical benefits are limited to $15,000; sickness to $7,500; ambulance to $6,000."

http://www.stlbsa.org/volunteers/Pages/Insurance-Information-for-Volunteers.aspx

 

Our Council has similar coverage.

http://www.atlantabsa.org/openrosters/DocDownload.asp?orgkey=1437&id=79371

 

Sure, it isn't going to cover the entire cost, but it isn't too bad of coverage, especially considering the cost.

[Beavah]

Yah, I think yeh have to read da fine print, BrentAllen. I haven't looked at the HSR policy in a couple o' years, but last I remember the high end payout was only for death, loss of limb, or blindness. So it was $20K for death, $10K for loss of limb or blindness in one or both eyes, and $5K for all other medical costs. Da numbers might have shifted around a bit, with a lower death benefit and slightly higher injury/illness limit, but not by much. Yeh really can't expect much for $1 per year, eh? I don't have a contract copy here with me, but I expect someone else on da forums does.

 

None of that changes da underlying issue, eh? No low-cost supplemental policy is goin' to protect a family against the medical costs that come out of a serious accident. $5K or $15K is nuthin'. There's just no way for an insurer to do that economically, eh? That's why real insurance is expensive.

 

So lots of families end up like this one. Good kids, good families, pushed into losing the college funds or the house when just one of their kids suffers an accident.

 

That's what insurance is designed for, eh? To spread this kind of risk. But da U.S. markets do a really poor job of it at present, because of how da private insurers are structured by employer coverage.

 

That's one of da things in the current system that I think we really do need to fix. The second is the issue of industrial competitiveness, eh? Our industry, especially industry with older workers, can't compete effectively with da current setup.

 

Beavah

 

Edited to add:

Had a friend fax me da HSR contract. BA has the correct current figures: $15K for trauma accident, $7.5K for medical illness, $5K for dental, $6K for emergency transport, $10K death benefit, $5K loss of limb, $10K paraplegia, $20K quadriplegia. $200 weekly total disability.(This message has been edited by Beavah)

[vol_scouter]

CalicoPenn,

 

Before responding, I heard on Fox and Friends this morning while driving to work that Obamacare's peak in popularity was 48% in the fall of 2009. Assuming that Gretchen Carlson is correct, there has not been a majority of Americans who support the plan.

 

To respond, you are correct that the methods and questions asked as well as the demographical statistics are seldom available.The accuracy cannot be determined. Certainly, the people who complained at town hall meetings were not the typical demographic for protestors at congressional events. They were passionate and anger at the health care bill was an over riding theme. Thus, observations would tend to support the poll conclusions. Perhaps, I should be careful to always say support according to polling data and I will endeavor to do so. Finally, polls and elections are the only ways to gauge the mood of the American public which is the only way that groups like this can discuss issues. Elections do not occur very often and they do not cover a single issue. So the polls are the only way to gauge the public support or lack thereof for a given issue.

 

Thus, the polls have a consistent shown a lack of support for Obamacare which is only a crude view of the public opinion. However, when combined with the summer of 2009 town hall meetings and the recent election results, the polls seem to reflect the views of the voting public.

[GernBlansten]

"Thus, the polls have a consistent shown a lack of support for Obamacare which is only a crude view of the public opinion. However, when combined with the summer of 2009 town hall meetings and the recent election results, the polls seem to reflect the views of the voting public. "

 

Only if you filter your sources to right wing propoganda sources. Fox and Freaks? Get serious.

Cite a left wing source (basically anything besides FoxNews) that supports your views, and you would have some credibility.

[vol_scouter]

Gern,

 

Several have posted recently that according to UCLA (not a bastion of conservatism by any means) that Fox News was centrist slightly to the right whereas ABC and NBC were about the same amount to the left. 18 of the 20 studied were to the left. So I am citing a centrist, not right wing, source of information. Here is the link:

 

http://newsroom.ucla.edu/portal/ucla/Media-Bias-Is-Real-Finds-UCLA-6664.aspx

[GernBlansten]

got any polls from the "left wing" that state "Obamacare" is unfavorable?

[Eagle92]

Beavah,

 

From the doctors I talk to, interact with, and read about in the polls taken in their professional journals there are several reasons why we have few General Practitioners (GPsP.

 

1) MONEY. Medicare/Medicaid do not remotely cover all the expenses involved in healthcare. GPs get less reimbursement than any other physician. GPs, like other physicians in practices, have to pay for the office, equipment, supplies, nurses, FNPs, PAs, business mangers,transciptionists, record keepers, coders, and other office staff to keep it running. One physican commented that they paid a plumber more than Medicare paid them, and the doc had more expenses.

 

The sad thing is that unless GPs get paid more yo are going to see fewer GPs and a lot more NPs, PAs, and more folks visiting emergency rooms and immediate care facilities. Further you are going to see more "hospitalists:" physicians working only in the hospitals that do the role that GPs doing rounds would have done. So if you go in for appendectomy on one hospital visit you can have 1 hospitalist, and on the next a different one. Where as traditionally you would have the same GP taking care of ya.

 

Again from conversations and interatcions with docs, what Medicare/Medicaid do, the insurance companies follow. Medicare/medicaid has already hired auditors who get 10%-15% of any 'fraudulent charges." A fraudulent charge could simply be the physician's office used one code, say 518.5 pulmonary insufficiency following trauma and surgery, where as the the hospital uses 518.81 pulmonary insufficiency following trauma and surgery: acute respiratory failure,so that both the physician nor the hospital have to repay what they were originally paid PLUS possible penalties. Or it could stem from "an illegible signature" on a form, when that exact same signature is recorded as such for a particular doc. So guess who is now hiring auditors.

 

[CalicoPenn]

Ok Vol - only 48% liked the bill at it's peak popularity - now tell us why? Why did 52% of the people not like the bill at it's peak of popularity? If you think you can answer that question definitively, then you are wrong. You have no way of knowing why people didn't like the bill. Now the media pundits will try to leave the impression that people don't like the bill because it has a mandatory insurance clause - but not all of that 52% dislike the bill for that reason. People on all sides of the political spectrum took a dislike to some portion of that bill, and they don't all agree on the reason they dislike the bill. 15% may tell you its because they don't like the mandatory insurance provisions while another 15% may like the mandatory insurance but not like the bill because it doesn't contain a public option. We also can't discount that there is liable to be a certain number of people who dislike the bill because Obama proposed it(and during the last administration, there were people that disliked things just because Bush proposed it). How do you take the results seriously if it doesn't answer the Why?

 

But the real point is that polling in this way is very inaccurate. Back to the circus/clown analogy, if I ask you 15 questions about aspects of the circus, and you indicate you enjoy all of them except the clowns, would it be accurate to place you in a category of people who say they hate the circus? No, it wouldn't - you don't hate the circus, you hate clowns. The same holds true for this bill - if we polled people on the individual parts, and you had a positive reaction to 80 percent of it and a negative reaction to 20% of it, is it accurate to say you hate the bill? No, not really. You actually like most of the bill, you just dislike parts of the bill.

 

And trying to correlate the poll results with the opinions expressed at the town hall screamfests, err meetings, is punditry, not statistical analysis.