Private health cooperatives

[LJRead]

Since there has been a lot of discussion on the health insurance issue of late, are there any thoughts on this idea of privately run health cooperatives that Obama seems to think is a viable alternative to a government run system?  Wouldn't this satisfy some of you who are against governemtn involvement in this sort of thing?  In New Zealand there were coopertive credit unions in place of banks which kept the cost of home loans down.  There are also cooperative food groups and probably a lot of other ones.  Do you think this is a good way to go for health care?

[Ice]

 Here they are called H.M.O.'s . The "health care" is rationed and dictated for you. Doctors decisions are limited and often dictated by the H.M.O. to "manage costs".  I did not like the experience.
 That said ,they may be acceptable or even desired in socialist  or communist countries. We are a different breed as so to speak. America was founded as a Republic and has a different culture,different thought process than any other country on the planet. Using socialized medicine/H.M.O.'s  on a national level here would be met with stiff opposition as we tend to be and independent lot.

[LJRead]

So you have about 40 percent of the population uninsured and medical costs skyrocketing - what is the solution?  Not a rhetorical question- I'm curious.  Do you just pay for services as needed, including very expensive heart operations and cancer treatment, or do you share the burden throughout society.  Those 40 percent are sometimes looked after (their bills paid for) by sharing what those who have health insurance and their employers pay so the burden is shared anyway, but some get by without paying into any system and just cruise by.t.  How do we reduce health care costs and make it possible for people to survive major illness without going bankrupt?

The HMOs as you call them are, I take it are private cooperatives with expenses shared by those who join up. So there is rationing with operations of a less immediate need put off until they can be dealt with.  Surely emergency services are covered.

Seems to me you can't have everything you want in the way of health care withou sharing the burden as expenses for some things are beyond the financial reach of most (you can call it socialism, or social cooperation).  You don't like HMOs, you don't like a Gov (socialized) system - seems there needs to be some compromise somewhere.  I guess I can't see a way out that doesn't involve some give and take.

[Ice]

I question your percentages and your motivations here.

[ace.cafe]

As I see it, as long as people have options to select what they wish, I'm happy with as many different potential options as possible.
The more competition there is, the better the prices and results will be.

Since it's government intervention and regulation which drove the prices up in the first place, after the debacle of Medicare and Medicaid being introduced into law during LBJ's Failed Society, er... I mean Great Society, the solution I see is the complete withdrawal of all government programs and intervention into the healthcare industry
Shut down all the gov't programs and regulations, and let the market work the way it did before they destroyed everything in 1965.

People can contract individually with their doctor or hospital to purchase the levels of care that they need, at prices they negotiate and agree to willingly.
If they can't afford some astronomically priced care, maybe they can get by with something that will work fine, but costs less.
Or they can finance it, like buying a car.
Or they can buy insurance, if they want to, from whatever insurer gives them the best coverage at the price they can afford.
Just like people do with nearly anything else they buy.
If I can't afford much, then I don't get much.
If I want more, I can better myself to achieve a higher income, to afford the things I want or need.
For indigents, plenty of charities are available.

There's no need for anything else besides that.
And no law needs to be passed to have private health "co-ops", insurance policies, or pay-as-you-go care.
The gov't has no need to even discuss it.
It's not their role.

[Kevin Mahoney]

The HMO's were put into business some years ago through another attempt at healthcare reform - a bill written by Ted Kennedy, they were his brainchild. In practice it seemed like a good model, the trouble is that they were run by "not for obvious profit" companies. In other words companies that are organized as non-profits but in fact are totally for profit undercover.
  One of the issues I deal with as a business owner is that we are only allowed to be a group of a few people. Not actuarial sound. One proposal is to let small business's buy as a much larger pool.
  I also liked the Safeway model where you pay according to your lifestyle. If you smile for example you pay more.
  I am just happy that it looks like they are giving up on the public option. With that our of the way perhaps theses worthless congressmen and women can all focus on a compromise. That was the part that bothered me the most. The other part is paying for it. Much like education in the US I don't think there is a lack of money in the system, just a lack of accountability.

[northshore_paul]

From someone who has worked in health care let me say that reform is needed but not a throw the baby out with the bath water approach. Something I have always wondered is why people want almost all heath costs covered at almost 100%. I have automobile insurance and home owners insurance but I still pay for my oil changes, flat tires and maintenance costs myself without wondering why my insurance company doesn't pick up the tab. Why do we expect the insurance to pick up the cost of the prescriptions we get, the diagnostic tests, xrays, etc and we pay only a small copay? I live in the Gulf coast region and after several years of large losses the insurance companies have resorted to paying claims only after a large deductible has been met. Why don't we do this with the health claims to help keep costs down. If you want to see the cost of health care go down abolish all insurance and let the market forces determine what an MD should be paid for his services or what the daily rate for a hospital room should be. How many folks would be getting coronary bypass surgery at $150,000 out of their pockets? MD's and hospitals would be lowering their costs or they would not be getting business. Medicare is partly responsible for the high cost of medical care today and if you want to see it go higher get government as the only exclusive game in town.
 
A true non profit coop, run as the credit unions are operated would be competition for the insurance companies and if large enough could be a force to lower reimbursements. BTW, this is the type of system Germany has and I have not heard of complaints from those citizens. Those of you old enough remember when going to the dentist was a reasonable expense for whatever you had done but since the advent of dental insurance, costs have skyrocketed. The reason is insurance companies have not had a reason to moderate costs...all they do is pass the increase on when rates are adjusted the following year and everyone pays a higher premium...whether you went to the dentist or not...and it is the same with the medical insurance.

And then there is tort reform...oh well, that is another fly in the ointment...just my 2 cents worth in this town hall of ours.

[LJRead]

I question your percentages and your motivations here.

Percentages?  That is the figure that is 'out there' at least 40% uninsured.
Motivation?  Just the fact that there seems to be an explosive environment of people criticizing Congress and the President - well, it is easy to criticize, but let's see some solutions.

The fact of the matter is that some procedures are highly expensive - heart surgery, cancer treatment, joint replacement, even smaller procedures can cost a fortune the way things are now.  So, should they be shared out sort of like ordinary insurance.  You pay so much per month with a deductible, and even if the accident costs a huge amount, say $100,000, it is amortized among all the insured.  A small percentage have accidents each year, but everyone is paying through their premiums. 

I believe some progress has been made recently in getting costs down, but there seems to be a long way to go.  Hospitals have agreed to cut costs, and insurance companies have agreed to allow people to be insured with preexisting conditions and not canceling if a condition arises.  Most of this seems to come through a fear of the gov. taking over in the health care industry, and is this because they have seen already what it will lead to? or perhaps they don't want to have their bottom line compromised.

In New Zealand, if you are injured on the job, you don't immediately file court action against the company - it is worked out so that the state pays your medical expenses and, I believe, some sort of compensation.  There are none of the huge legal awards or expenses.

Northshore _paul seems to have another good idea and that is to insure the big items and let the patient pay for prescriptions and minor things like x-rays etc. 

Heard recently of a U.S. citizen taking advantage of low care joint replacement in Thailand.  He went there, was picked up at the airport and taken to a sort of resort like hospital, his joints of both knees competently replaced and allowed a short time to recuperate under pleasant circumstance, then flew home with new, working joints and no apparent problems.  So, is this going to be a trend, like making automobiles overseas, doing medical procedures overseas also?  Interesting, isn't it, how companies price themselves out of the market.
It seems to be the big ticket items that are of concern and causing bankruptcy.

But it is this vociferous outcry, probably by the uninsured, going against any and all ideas where governments are concerned and calling it socialism, but not coming up, I don't think, with any logical alternatives. But then, maybe Ace is right, we don't need any - seems to me there is a crises in health care costs in the U.S. and how to pay for them.

[Ice]

This,,,,,"So you have about 40 percent of the population uninsured",,, was presented in a manner that suggests fact.
 
 Now it has turned into,,,,,,,"That is the figure that is 'out there' at least 40% uninsured.".

Which is it to be ?

[LJRead]

This,,,,,"So you have about 40 percent of the population uninsured",,, was presented in a manner that suggests fact.
 
 Now it has turned into,,,,,,,"That is the figure that is 'out there' at least 40% uninsured.".

Which is it to be ?

Well, if you want to dispute that figure, out with it - that is the one bandied about and I even qualified it by saying  about forty percent.  The point however holds and that is that a significant number of Americans are without a health plan and many suffer because of it.

What I do think is that the attack on Obama's desire for a new health program is more of an attack on his presidency than having any real substance regarding the issue involved.  People are yelling that he is a socialist and so on, but this latest suggestion, private co-ops, clearly indicates that he is more interested in seeing that Americans' health needs are taken care of than fostering some implied program of socialism. 

[Ice]

This thread is about health care co operatives Right ?

 If you want to start a new thread about how every one is out to bash Obama, pleases feel free to just that,,Start a new thread. 

[ace.cafe]

If he wants "private co-ops" then let there be "private co-ops".
They don't need any law passed to happen.

If he truly wants private health co-ops, then he can just drop the subject altogether and let the market provide them, if the people want them.

What's the big "need" to pass some law that puts gov't in the middle of it?

[LJRead]

The problem, Ace, that hasn't been addressed is 1) the highly expensive procedures being used in hospitals today and the need to pay for them, and 2) the relatively huge number of people uninsured who then become a drain on the system or simply go untreated.

About the first, the expenses are more than simply caused by the institution of Medicare and Medicaid.  I had to have a back scan done in one of the new machines by a neurosurgeon and learned that the cost of the machine itself was over two million dollars.  I don't know what the scan cost, but it had to be high to make up for the cost of the machine and technician to run the machine.  Then there are surgical procedures with whole teams of surgeons and stand-by help, kidney dialysis machines that many must be on, etc.  It is a question of how to pay for this and in this regard spreading the cost makes sense.  How this is done is the question.  This type of expense is not something that can be handled in a piece meal or patient pay as you go manner. None of us thinks he or she is going to need medical service and many extend that into thinking they themselves can go without medical insurance because the odds are with them and if they do need treatment others will pay for it.  Go to a hospital and the first thing they will ask is what is you medical plan.  Many won't admit you without one.  So people go to the emergency room which generally will treat patients.  A half-assed way to do things, isn't it?  But where I disagree with much of what you say, though finding your comments interesting, is that you don't seem to want to face reality of what it takes to live in the twenty-first century.

Ice, if you don't like this thread, I would suggest you simply butt out.  Everyone of your comments here has been in the form of an attack.  You seem to think, and have stated, that Americans and their so-called independence is unique.  There is a uniqueness in their history, it is true, but they now face the same problems that other countries face and the solutions are bound to be the same.  Fact is, this unique population you are talking about pays far too much for medical service, drugs and everything else (due to its unique capitalistic extremism, I suppose), is way down in the statistics of how well their needs are are taken care of (infant mortality rate very high, lifespan lower than in many other countries, persistent health problems from obesity etc.) .  I read where one in three of us has diabetes or incipient diabetes, just a pretty shitty outlook on health and not getting better if people like you have their way.  This "I'm independent and to hell with the rest of you" just won't work, in my opinion.

And Ice, you criticize my figures (40 % uninsured for example) just as a way of digging at me when you, who have done more to spread non-factual garbage on this forum than anyone, should be the last to talk.

[ace.cafe]

Well, I understand your concern LJ.
Things can get expensive.

And there are ways to deal with that, and insurance plans and co-ops(HMO) and catastrophic policies and "first dollar coverage plans", etc, to deal with them, depending on what a person can pay out of his monthly salary.
Or, if he thinks insurance companies are evil profiteers, he can choose to not purchase their products. Maybe even form his own group co-op and spread the cost.
Or he can pay as he goes.
Or he can even say he doesn't want the most expensive treatment ever devised by man, and take some Advils, or use the old machine that costs less.
It's up to the individual.
And there are plenty of choices, including taking minimal cost treatments and living with it, because that's all that might be afforded by some.
Or, they can "go untreated", as you say, and I'm perfectly fine with that choice too.
.

That's what I do. I go untreated and treat myself, unless I have something that I cannot treat, and then I choose the least expensive method humanly possible.
And I live in the 21st century, just fine.

[ace.cafe]

Double post