Radical American Centrism

Centrist Baby Splitters (0.00 / 0)

Joe Lieberman talks about universal health insurance being a 'job killer'. Lack of health insurance is a people killer.

From the National Academies:
"The societal costs of maintaining an uninsured population usually are thought of only in terms of the public costs of free or reduced-price care used by uninsured individuals. To capture the hidden costs of uninsurance's effects, the committee employed the concept of "health capital" to estimate the value that would be gained if health insurance were extended to all. Health capital represents, in monetary terms, the value of an individual's health over future years of life, and includes the subjective value of being alive and healthy, earning potential, and children's physical and mental development. The differences in health status and life spans between the uninsured and otherwise similar people with coverage represents the value of health capital lost due to being uninsured.

The estimated value of improved health that an uninsured individual would gain with each year of coverage ranges between $1,645 and $3,280 annually. The aggregate value that could be realized for the entire population – $65 billion to $130 billion – likely exceeds the estimated costs – $34 billion to $69 billion – to provide the uninsured with the additional health services that they would use if they gained coverage and used the same amount and kind of services as the insured. It is important to note that the committee did not attempt to project the full costs of a plan to cover everyone."

http://www8.national...

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by: joejoejoe @ Mon Jan 01, 2007 at 16:04:46 PM UTC

All right (0.00 / 0)

So what happens to Hartford, then?

Seriously. If you kill the insurance industry, you deal Hartford another crippling blow. Is it really okay to demand, yes demand, that thousands lose their jobs and our capital city lose a major part of its economic base? You can't tell me this won't happen.

If there is a way to preserve an industry that's vital to Connecticut and to make sure that everyone gets health insurance, I want to find it. Why don't you?

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by: genghis conn @ Mon Jan 01, 2007 at 18:35:27 PM UTC

No (0.00 / 0)

Pittsburgh's steel industry, Detroit's auto industry, Lowell's mills, Chicago's stockyards....should we protect all of them from progress? How many guns are made at the Colt Building in Hartford these days? How are Hartford's health insurance jobs any different from any of the above?

East Hartford lost how many jobs from downsizing the defense industry in the '90s? The few low wage jobs for people at Rentschler Field used to be union machinists at Pratt. But that still doesn't make it right to spend all those billions of dollars on defense dollars for programs to combat the Soviets when the Soviets don't exist.

Insurance is a great service for those that want to reduce their exposure to risk. But you can't mitigate your exposure to health risks by getting insurance. You can only mitigate the financial risk associated with illness. That's what Afflack is designed for - wage insurance. It's far, far cheaper to insure everybody and do it on a co-operative non-profit basis.

If people who can afford it don't like the co-operative system they can and should be free to pay for their own private care and insurance just like people can take their kids out of public school to attend private school. But there should be no 'health vouchers' just like school vouchers are a backdoor attempt to defund public schools and subsidize private entities.

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by: joejoejoe @ Mon Jan 01, 2007 at 18:49:33 PM UTC

[ Parent ]

Other than jobs (4.00 / 2)

what are the benefits of these insurance companies to the larger issue of health care? What value do they add to that primary purpose? Are there other options?

Our health care system is not in place to serve the needs of the insurance companies, but to serve the well being of the people.

The system is broken and a large - though not entirely - part of that dysfunctionality are the insurance entities as these now operate - the powerful insurance lobbies that rally against universal health care. There are jobs which contribute to society and than there are jobs that primarily contribute to the profits of large entities and their CEOs. Historically, profits and health care have turned into a bad partnership.

Put another way, if insurance companies are part of the problem than we need to re-think their value, who they serve, the lose of such institutions and gains by offering alternative solutions, and sustainable jobs which serve less the bottom line of corporation's and their CEOs.

I think only by addressing the totality of the problem we face, addressing the needs, we can come up with solutions which are not so black and white. But first we have to: 1) acknowledge the problem, 2) WANT to solve it.

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by: FairTrade @ Mon Jan 01, 2007 at 19:18:28 PM UTC

[ Parent ]

Well... (0.00 / 0)

..if you want a blunt answer you can worry about the death of the insurance industry (fat fucking chance, there) or you can worry about the deaths of millions due to poor or inadequate health coverage.

Your call.

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by: Scarce @ Mon Jan 01, 2007 at 19:28:11 PM UTC

[ Parent ]

Sorry (0.00 / 0)

That argument doesn't fly, not when we have a range of options that would cover the uninsured without creating a single-payer system. For example, Massachusetts.

But if you'd like to hold out for a single-payer system, go ahead. Might be a while, though.

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by: genghis conn @ Mon Jan 01, 2007 at 20:25:50 PM UTC

[ Parent ]

There was no argument presented (2.00 / 1)

I simply put it in an either/or equation, as you appeared to do. If you wanted me to choose one or the other but not not both then you have your answer.

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by: Scarce @ Mon Jan 01, 2007 at 20:37:56 PM UTC

[ Parent ]

... (0.00 / 0)

I addressed the rather shrill tone of the original post, which suggested that including private insurers meant sacrificing our well-being. This is a false statement.

And I believe we don't have to do either. We can keep the jobs and provide health care for the needy.

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by: genghis conn @ Mon Jan 01, 2007 at 20:42:50 PM UTC

[ Parent ]

Ok (0.00 / 0)

..so your post immediately under mine was more addressed to the diary itself? Well then, you don't see your own "shrill tone" when you write "If you kill the insurance industry, you deal Hartford another crippling blow". Who said anything about killing the insurance industry? Oh, you did. That's hardly a productive way for constructive dialogue now, is it? Baseless assumptions let me introduce you to yet more baseless asumptions.

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by: Scarce @ Mon Jan 01, 2007 at 21:06:11 PM UTC

[ Parent ]

It is not a shrill tone (0.00 / 0)

It is reality.

Every single dollar that the insurance companies take out of our healthcare system is a dollar that could be used to create jobs for doctors, nurses, etc..

Which one of those jobs would really benefit America? Every penny of profit for the insurance companies is a net loss in our health care.

You cannot look at the job loss to insurance companies as a reason when those freeloader jobs would simply be replaced by high paying AND useful jobs.


Drinking Liberally in New Milford
ePluribus Media

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by: Connecticut Man1 @ Mon Jan 01, 2007 at 21:19:57 PM UTC

[ Parent ]

False choice (4.00 / 1)

'Single Payer', ie, Canada's system, is only one of method of achieving universal coverage. There's a rundown of the health systems of Canada, England, Japan, Germany, and France at the link below. Each uses a different method of achieving universal coverage. Each is funded differently.

http://ezraklein.typ...

The one thing each very different system has in common is they provide coverage to all of their citizens of equal or better quality than the US, for less money. The US has fewer doctors, fewer nurses, and fewer hospital beds than nearly all western nations, spends twice as much for the same outcomes, and still manages not to cover 15% of it's people.

http://content.healt...

Why is that a record worth defending?

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by: joejoejoe @ Tue Jan 02, 2007 at 03:25:12 AM UTC

[ Parent ]

Yeah Ezra Klein (0.00 / 0)

I rip him off to make myself sound more smart. Or, uh, I learn a lot from him. Whatever.

He does some great coverage of healthcare issues, though.

–7.25 / –7.28 | http://imgs.xkcd.com/comics/tw...

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by: mattw @ Tue Jan 02, 2007 at 04:02:35 AM UTC

[ Parent ]

Un F-ing Believeable (3.00 / 1)

Medicaid is administered at  3% of cost  yet BC/BS administration fees are 23% of cost and GCs biggest concern is how many jobs it's going to cost for the city of Hartford in which nearly none of the people working in the industry live.

I'm not suprised considering he also thought building Submarines was something the 2nd district should continue to depend on for their economis future.

Who said dinosaurs couldn't blog.

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by: ctkeith @ Mon Jan 01, 2007 at 19:56:48 PM UTC

[ Parent ]

Yes, unbelieveable (0.00 / 0)

That I'd worry about jobs, and the tax base of a city in perpetual crisis. Amazing, the empathy shown the American worker around here. I suppose we do need to break some eggs to make an omelet, right? I'll let the unemployment office know.

Black and white, all-or-nothing politics is over, Keith. It died with GOP control of Congress. We don't move forward if we don't compromise. I don't think I'm the dinosaur, here.

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by: genghis conn @ Mon Jan 01, 2007 at 20:37:57 PM UTC

[ Parent ]

We don't move forward (4.00 / 1)

if we don't face the problem. If insurance cos. are 1) part of the problem 2) add little to no real value in the health care ecosystem, then I think we have to "face" the problem head on.

Our health care should not be subservient to the survivial of insurance corporations.

genghis, you have offered no argument for the intrinic value of the health insurance business.  If so this is what's referred to as corporate welfare. Are you saying that they provide a service (benefits/claims adjudication) that could not handled at least as well (if not better) and for much less cost to the system by an agency of the state or a cooperative operated and owned by its members (for instance)?

Again, I think you're looking at the problem from the wrong end. Jobs and tax base is not the issue. A shift of jobs from insurance to a cooperative run health care system and as has been stated much needed health care providers could be one of many ways to adjust for the reduction of the role insurance cos. while sustaining a solid (perhaps healthier) tax base.

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by: FairTrade @ Mon Jan 01, 2007 at 23:19:27 PM UTC

[ Parent ]

Maybe (0.00 / 0)

But is that what would actually happen? And I don't think we should do anything without considering the economic effect, first.

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by: genghis conn @ Mon Jan 01, 2007 at 23:33:09 PM UTC

[ Parent ]

Economic effect (4.00 / 1)

Found this on your site originally:

[I]t is possible for a Connecticut single payer system to fund comprehensive health care for our entire Connecticut population while saving money for the vast majority of our residents and businesses. When a single payer system for Connecticut was studied under the Weicker administration, savings of over a billion dollars per year were predicted- a finding confirmed by the Office of Health Care Access. Every prospective state and federal study on single payer supports this conclusion, which is consistent with the experience of single payer systems throughout the industrialized world.

So cover everyone in CT, and save a billion dollars in the process. We've known it for more than a decade.

Next?

–7.25 / –7.28 | http://imgs.xkcd.com/comics/tw...

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by: mattw @ Mon Jan 01, 2007 at 23:49:54 PM UTC

[ Parent ]

the payoff (0.00 / 0)

For one billion, we could pay 10,000 displaced workers $100,000 per year!  Talk about WPA!

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by: mikect @ Tue Jan 02, 2007 at 00:07:36 AM UTC

[ Parent ]

So? (0.00 / 0)

Millions of manufacturing jobs and hundreds of thousands of high paying computer related jobs have poured out of country and the politicians say that we can rebound from this, but don't touch the profit driven insurance companies because we will lose a bunch of jobs in the financial field?

I think the benefit of the health of the American people far outweighs the need for those few jobs. And, easily arguable in this case, many of those lost jobs in the health inurance field will easily be replaced by the much needed health related jobs like doctors, nurses, techs, etc..

Why won't the politicians get behind this? Because it actually benefits the people at the expense of corporations that are dragging the entire health field down.

Corporate driven health care is a proven recipe for disaster, and we are living that disaster.


Drinking Liberally in New Milford
ePluribus Media

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by: Connecticut Man1 @ Mon Jan 01, 2007 at 19:58:28 PM UTC

[ Parent ]

Having worked in the Insurance Industry for 38 years (4.00 / 2)

I was about to say the same thing...the people now running the insurance industry have no problem outsourcing jobs...they say they must.

I have no problem creating a more efficient health care system cutting out unnecessary overhead.  If we don't we will lose the rest of the Insurance industry, and many others because other countries are smart and do better for 1/2 the cost. 

What will we say when the Drug industry is lost to other countries because they can easily and sensibly avoid the marketing, executive bonuses, and employee health costs? 

Meanwhile we don't train enought nurses because that is expensive training and wonder why people got to India for knee and heart surgery.

Propping up the Insurance Industry is just as dumb as Detroit building low quality gas guzzlers and asking for help and protections for their selfish decisions.

because Connecticut voters count: http://www.CTVotersCount.org

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by: BlastFromGlast @ Mon Jan 01, 2007 at 20:51:44 PM UTC

[ Parent ]

it's amazing what salutary effects some stiff competition can have n/t (4.00 / 1)

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by: greenpeas @ Mon Jan 01, 2007 at 20:56:11 PM UTC

[ Parent ]

I am thinking that (0.00 / 0)

Perhaps you might be the right kindof person to dig into this and do a little research. :) I don't know how much your experience would be relative to healthcare, but you could certainly shed some light on the insurance companies side of it after 38 years of involvement.


Drinking Liberally in New Milford
ePluribus Media

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by: Connecticut Man1 @ Tue Jan 02, 2007 at 03:37:47 AM UTC

[ Parent ]

Research (4.00 / 1)

I'm probably not the person.  Yet, there is not much need for more research on insurance:  Our system costs 2x and provides worse outcomes that the rest of the industrialized world.  Lots of the cost has nothing to do with treatment or prevention, it is simply overhead.

Let me add that I question including health "insurance" companies in the insurance industry.  About 15 years ago most major health "insurance" was split off from the old multi-line and life companies because it is a completely different business, having much more to do with influencing government regulation, negotiation with hospitals/drug companies, placing the risk on consumers and client companies and off the "insurance" company, while becoming more and more of a "health" bureaucracy than an insurance company.  More and more employees of health "insurance" companies are nurses and doctors, while more and more employees of hospitals and Dr.s are administrators and clerks...it is simply a bureaucratic arms race on all four sides (Hospitals, Dr.s, "insurance" companies, government) while the costs keep escalating for everyone.  Every player is locked in a game that keeps getting more expensive and less and less desirable.

because Connecticut voters count: http://www.CTVotersCount.org

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by: BlastFromGlast @ Tue Jan 02, 2007 at 13:29:47 PM UTC

[ Parent ]

good description (4.00 / 1)

which is why I can't get on the bandwagon when they talk about the need to offshore jobs in order to be "profitable". 

Offshoring jobs is a great way to make marginal business plans appear to have merit.  The costs skyrocket while they remove jobs from the community to offshore in order to make their business model look viable.

Well, something is very wrong when you have to go to India in order to make it profitable to get a patient and doctor together for a visit and payment.  What ever did we do in the days without health insurance?  Somehow we managed to muddle through without having to process claims offshore, and somehow I think we can muddle through again.

Maybe, just maybe, there's something wrong with the business model they're using?  And if their own employee insurance costs are biting them in the ass, maybe they should review both their product and their relevancy.

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by: greenpeas @ Tue Jan 02, 2007 at 14:02:00 PM UTC

[ Parent ]

If the insurance industry wants to survive (0.00 / 0)

... it is incumbent upon the insurance industry to change with the times.  Since when do we, as consumers, have to accept whatever is offered to us when we can choose a better way? 

The insurance industry is quite comfortable as it is, but it isn't meeting our needs as a society.  If anything, it is putting up roadblocks to universal health care. In fact, the insurance industry is making it impossible to achieve merely adequate healthcare. That is unacceptable, and the writing is on the wall.  The insurance industry can change, or become obsolete.  If they become obsolete, it is their own fault.

Do not accuse concerned citizens calling for a workable alternative to business-as-usual of destroying jobs in Hartford.  The blame lies with the insurance industry, which is more concerned with maintaining its corporate bottom line than it is with providing a needed service to as many consumers as possible in the best way possible at the best possible cost.  If they can't do that, then they don't deserve to stay in business.

Surely all those highly paid insurance execs can come up with a plan to provide the services needed at a cost all can afford -- and still earn a profit.  The ability to do just that is what used to make American industry the best in the world.

I suggest they begin by cutting back on the thousands of dollars they spend on lobbying, p.r., and political contributions.  Then they can stop whining for corporate welfare and get to work on a viable solution.

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by: chele @ Tue Jan 02, 2007 at 04:43:39 AM UTC

[ Parent ]

The strongest and most vocal opposition (0.00 / 0)

..to universal health care will not be from the insurance industry but from those within the health care system itself, such as the AMA.

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by: Scarce @ Tue Jan 02, 2007 at 05:16:17 AM UTC

[ Parent ]

Intresting Piece... (4.00 / 1)

in the LA Times via C&L:

http://www.latimes.c...

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by: JET_powered @ Mon Jan 01, 2007 at 20:16:07 PM UTC

Yes, article demonstrates reality (0.00 / 0)

Insurance companies have demonstrated time and again, they cherry pick who will be covered and who won't. Have type II or I diabetes, or any pre-condition (asthma, heart ailments) - forget about coverage. We have the most regressive system of health care of any nation in the West and much of the East.

Healthcare must be universal with costs budgeted through government revenues. This is no different than Medicare or Social Security in terms of sharing risk in a state-wide pool where NOBODY is an exception. Or through a members run cooperative in some provider network based arrangement.

I could envision services which may be adjunct to what the government would provide directly, but they would be run through the responsible agency with budgetary oversight, fraud/abuse, and case management. Claims processing would be streamline to reduce cost of administration and ease of processing.

We have an abundance of models world-wide. I'm not sure that we have any viable models here in the US (MA? jury is out).

We do have a delivery problem (horrible outcomes) which need to be addressed as we move forward with a universal plan.)

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by: FairTrade @ Tue Jan 02, 2007 at 00:21:56 AM UTC

[ Parent ]

Paul Krugman refers to this piece in his column today (0.00 / 0)

It was in today's NY Times, which should be in online tomorrow (Tuesday 1/2/07)- try searching "Krugman, Healthy New Year" so you can see it. 

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by: greenpeas @ Tue Jan 02, 2007 at 04:49:03 AM UTC

[ Parent ]

top secret (0.00 / 0)

the wealthy frenchman blog

http://wealthyfrench...

shhhh!

–7.25 / –7.28 | http://imgs.xkcd.com/comics/tw...

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by: mattw @ Tue Jan 02, 2007 at 07:07:57 AM UTC

[ Parent ]

A moderate plan (0.00 / 0)

If you're interested, I've posted my thoughts on health care in full here.

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by: genghis conn @ Mon Jan 01, 2007 at 20:45:40 PM UTC

see the primer on risk pools (0.00 / 0)

http://actuary.org/

Click on the pdf in the lower right hand corner for the primer on risk pools.  Having multiple small pools is not equal to one big pool and doesn't sound to me like an efficient way to manage risk and therefore cost of insurance.

The states that are doing high risk pools do not seem to be able to make it into a paying proposition, if that is important at all (they are not in it for profit, but they are using insurance companies).  Unless all insurance companies are required to shoulder part of the high risk groups, might that not mean that the states with high risk pools are subsidizing the profits of the insurance companies by being willing to take on part of the cost of insuring the highest risk residents?  This is only important since high risk pools are one of the schemes used to make incremental changes in making health care "affordable".

Creating pools of high risk uninsurable people, or people self selected by ability to pay $250 a month, is also not a prescription for lowering cost of delivery, which would appear to be part of the intention.

The problem with a premium of this size in a state with high housing & energy costs and plateaued wages is that healthy people tend to self select OUT of the pool and you end up with a group of people who are high risk.  The costs to insure go up and the group of companies who want to do it will go down.

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by: greenpeas @ Tue Jan 02, 2007 at 00:21:45 AM UTC

[ Parent ]

This needs something like Social Security (0.00 / 0)

where people CANNOT opt out. Risk is shared across the board.

We cannot deal with health care on an exception basis. That's part of the problem today. People like the one mentioned in the latimes article is a perfect case of someone who cannot get insurance coverage (asthma) no matter how much of a premium he's willing/able to pay.

I think good solutions that meet the need of all can be attained state-wide.

We can attract more businesses by eliminating the need for any business to pay for employee health care - reduce health care costs and business costs. Win-win. No need for insurance company compromises - unless someone can provide a real essential value they provide while ensuring the goals of universal coverage for all. So far the case for insurance cos has yet to be made.

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by: FairTrade @ Tue Jan 02, 2007 at 00:32:04 AM UTC

[ Parent ]

Opt-out (0.00 / 0)

Sure you can opt out, you can travel to get your surgery wherever you like, hire a specialist, get cosmetic surgery... but most health issues should be covered.

–7.25 / –7.28 | http://imgs.xkcd.com/comics/tw...

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by: mattw @ Tue Jan 02, 2007 at 02:59:37 AM UTC

[ Parent ]

Social security example (0.00 / 0)

You can save money on your own, invest it in the stock market, whatever -- our society has no legitimate interest in preventing people from getting experimental or private care outside the system, but the society-wide interest of providing for a certain standard of health is just like the common interest of providing for a certain baseline income so the elderly do not die in poverty and squalor. Do your own thing once everyone's basic rights are covered.

–7.25 / –7.28 | http://imgs.xkcd.com/comics/tw...

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by: mattw @ Tue Jan 02, 2007 at 03:03:59 AM UTC

[ Parent ]