Universal Health Coverage

[Haggis@wk]

Schwarzenegger Proposes Universal Health Coverage

” Gov. Arnold Schwarzenegger (R) on Monday proposed a system of universal health insurance for Californians that would make the nation's most populous state the third to guarantee medical coverage for all its residents.

"Prices for health care and insurance are rising twice as fast as inflation, twice as fast as wages. That is a terrible drain on everyone, and it is a drain on our economy," Schwarzenegger said. "My solution is that everyone in California must have insurance. If you can't afford it, the state will help you buy it, but you must be insured." ...

Schwarzenegger's plan would require everyone living in California -- even illegal immigrants -- to have health insurance, at an estimated cost of $12 billion. Individuals who refuse to carry insurance could face reductions in their state income tax refunds or the garnishment of their wages. All businesses with 10 or more employees would have to offer coverage or pay a fee of 4 percent of their payroll into a fund to help the uninsured buy health insurance.

Schwarzenegger also recommended expanding the state's existing program for children's health insurance to families that earn less than three times the poverty level, or about $60,000 for a family of four.”

It looks like OT will get what he wished for. I will be very curious to see how it works out. Of course it will probably take some time to iron out the kinks in this new program. After all, Britain still hasn’t worked out its kinks in 5 decades.

Businesses were already leaving in droves because of the confiscatory tax policies that were in place before this and I predict more will start leaving now.

[jamiebk]

Don't get yourself all in a tizzy over this one. The universal health cover is required for all (and includes illegal immigrant children), however, as I understand it, it has a $5,000 deductible. The only people getting anything out of this will be the insurance companies who will write the policies

[Shapley]

All businesses with 10 or more employees would have to offer coverage or pay a fee of 4 percent of their payroll into a fund to help the uninsured buy health insurance.

Most companies will find the cost of the 4 percent fee significantly cheaper than the cost of insurance premiums, unless they are also allowed to offer $5000 deductible policies. I would expect that fee to be increased as more and more companies opt for the fee over the cost of providing coverage directly.

[Selma in Sandy Eggo]

Don't get yourself all in a tizzy over this one. The universal health cover is required for all (and includes illegal immigrant children), however, as I understand it, it has a $5,000 deductible. The only people getting anything out of this will be the insurance companies who will write the policies

At a 5k deductible, It's pretty good catastrophic coverage. Good for the year you have a complicated pregnancy, heart attack, kidney failure, etc. Currently, the state is paying for a lot of this stuff with Medicaid and Disability dollars.

I'm not sure how this is going to work out, though. I haven't seen any fine print yet, and the politicians have not yet started on the origami work. We'll have to keep an eye on them and see what shape this ends up in.

[jamiebk]

Don't get yourself all in a tizzy over this one. The universal health cover is required for all (and includes illegal immigrant children), however, as I understand it, it has a $5,000 deductible. The only people getting anything out of this will be the insurance companies who will write the policies

At a 5k deductible, It's pretty good catastrophic coverage. Good for the year you have a complicated pregnancy, heart attack, kidney failure, etc. Currently, the state is paying for a lot of this stuff with Medicaid and Disability dollars.

I'm not sure how this is going to work out, though. I haven't seen any fine print yet, and the politicians have not yet started on the origami work. We'll have to keep an eye on them and see what shape this ends up in.

Agree...certainly something we need to watch. I just hope that those who have adequate health cover (I count myself in that group) won't lose benefits etc. or have our premiums go even higher. I know that sounds selfish, but we've also seen other state programs that haven't panned out

[Haggis@wk]

Well, the prognosis doesn't appear good. CA already has one of the worst reputations among state governments when it comes to managing fiscal programs and I can't see that they are going to do this one any better.

Now the state has decided that it will manage the health-care system, and that it will force Californians to support some very questionable goals especially the requirement to provide coverage for illegal aliens.

I understand Ahnold's economic reasoning -- he figures that they're getting free emergency-room treatment and wants to reduce the cost of their treatment – however there are many Californians who will oppose giving illegal immigrants another free ride, after education. This could easily re-energize the anti-illegal movement in California

I see a lot of company with less than 10 workers will do everything imaginable to keep that number under ten, including outsourcing work to other states.

The whole premise of this program is that businesses WANT to stay in CA so much they’ll put up with what amounts to additional taxes

And that's not the end of the bad news. In order to manage all of these new mandates, the state government is going to have to grow. Otherwise, who keeps track of the insurance status of Californians like OT, Piq and Selma?

Who makes sure that Piq has her wages garnished if she doesn't buy health insurance when she can afford it, and who makes sure they know who can pay the bill?

It will require a more intrusive government and a whopping expensive bureaucracy to keep track of all these issues while taking even more money out of the pockets of Californians.

Socialism apparently sells well in the Golden State but at some time they will have to pay the bills, and maybe that will finally convince them of their folly in creating the Nanny State.

[Trumpetmaster]

5K Deductable....

that's an alot of money to lay out before that program kicks in...

If you have a serious illness... it is nice but the deductable is
to high IMHO.

TM

[Shapley]

Socialism apparently sells well in the Golden State but at some time they will have to pay the bills, and maybe that will finally convince them of their folly in creating the Nanny State.

Probably not. If the program fails, the failure will most likely be blamed on either a lack of "full funding" for the program by the government, or by the failure of other states to follow suit, unfairly burdening California with the cost of providing coverage.

You need only look at the response to other failures to recognize the pattern of blame-putting.

"Fully Funding" is a favourite of politicians. Whatever program they talk about, they can blame its inability to perform on that one. Since no one ever specifies what level of funding is needed to 'fully fund' the program, it can always be said to lack 'full funding by the State'. Education programs are almost always said to lack 'full funding'.

V/R
Shapley

[analog]

It certainly blurs the line between government and business.

I would far prefer to see the government get into the hospital business than to see insurance companies get their hooks this far into government.

What if nurses were civil service employees about GS11, doctors 12 to 14?

If we're going to go socialist let's do it the traditional way - nationalize the means of production and oust the middlemen. To forcibly grab people's money and hand it over to government's 'bedfellows du jour' seems closer to fascism. Somebody has manipulated the leftists.

"I pledge allegiance to the flag
of the Underwriter's State of America.
And to the collateral for which it stands,
one territory under FEMA, indemnified,
with safety and security for all."

[BigJon]

This doesn't seem to be the answer to keeping health care costs from quickly growing. I suspect the fact that the state will guarantee coverage will spur added growth in pricing for major procedures . . . unless, of course, CA begins to ration access to major procedures. <conspiracy icon goes here>

[Selma in Sandy Eggo]

Health care providers are already gouging wherever they can - just ask OT. When he was in the repair shop after his bike disaster, it seems the first hospital was charging him about three times the "reasonable and ordinary" cost of his care. Why? Because they lose money on the people who walk into the emergency room sick and can't pay. Explanation goes "Well, we have to make it up somewhere".

Same hospital couldn't charge my husband extra because I had HMO coverage and my HMO has lawyers and a prenegotiated price cap. So, the days Gil spent in ICU only cost about a third of what a cash customer would be billed. Is this fair or reasonable?

[Shapley]

You call it 'gouging' but I don't think that meets the definition. They increase prices to cover the losses due to non-pays, which is de rigeuer in business. By your own admission, hospitals lose money on a large number of emergency room patients, which they have to make up elsewhere. Having an HMO means that you have someone to negotiate a pricing schedule for you, sort of a 'good customer discount', if you will, which is also common in the business world.

It used to be (back in the '60s and '70s) common practice to charge insured patients a higher price than cash customers. The reason was two-fold - first, insurance was thought of as 'deep pockets', and it was thought to be better to have them make up the losses of non-pays rather than having the locals make up the difference - second, because it made sense to bill them for the added paperwork burden they created for the staff. Some clinics would hire a person specifically to handle the paperwork insurance mandated. It didn't make sense to have cash customers paying the salary of someone whose services they did not require. Insurance companies, however, thought that they were being 'gouged' by this practice and began negotiating service rates with health-care providers. By this time, since so many people were paying their bills through insurance, they had the clout to have their demands heard. So it is that the roles have been reversed, and the cash customer winds up playing the role of 'deep pockets' to the providers, making up for losses that the insurance companies will not.

It's not fair, I agree, but it also isn't really wrong in an ethical or legal sense, since the health care providers have the right to recoup financial losses, and the insurance companies have the right to ensure that such losses are not recouped from their pockets.

Ultimately, we'll be the ones to pay those bills, whether through higher prices for medical services or through higher taxes to pay the bills of the non-pays through government-funded health care. The governmental route is expected to cost more, ultimately, because it requires a layer of beaurocracy between the payor and the payee, and there is no reason to believe that layer will operate cheaply and efficiently.

V/R
Shapley

[OperaTenor]

It certainly blurs the line between government and business.

I would far prefer to see the government get into the hospital business than to see insurance companies get their hooks this far into government.

What if nurses were civil service employees about GS11, doctors 12 to 14?

If we're going to go socialist let's do it the traditional way - nationalize the means of production and oust the middlemen. To forcibly grab people's money and hand it over to government's 'bedfellows du jour' seems closer to fascism. Somebody has manipulated the leftists.

"I pledge allegiance to the flag
of the Underwriter's State of America.
And to the collateral for which it stands,
one territory under FEMA, indemnified,
with safety and security for all."

I agree with this sentiment, and I haven't read the proposal yet.

Haven't we seen enough of handing tax dollars over to corporate constituents in the past six years? Can you say "no-bid, cost-plus contract for Hallburton"?

[BigJon]

Can you say "no-bid, cost-plus contract for Hallburton"?

You can't let go of that one, can you? Name one other US company that could do what Halliburton was asked to do.

[OperaTenor]

Can you say "no-bid, cost-plus contract for Hallburton"?

You can't let go of that one, can you? Name one other US company that could do what Halliburton was asked to do.

I can name four.

1. The U.S. Army
2. The U.S. Navy
3. The U.S. Air force
4. The U.S. Marines

And they can do it better, cheaper, and be accountable for their performance.

Get a clue.

[BigJon]

I've got plenty of clues and you didn't answer the question. Do you think I like the fact that we have private contractors providing security in Iraq and Afghanistan? Talk about un-accountable and opaque. The implications are frightening.

[Haggis@wk]

Can you say "no-bid, cost-plus contract for Hallburton"?

You can't let go of that one, can you? Name one other US company that could do what Halliburton was asked to do.

I can name four.

1. The U.S. Army
2. The U.S. Navy
3. The U.S. Air force
4. The U.S. Marines

And they can do it better, cheaper, and be accountable for their performance.

Get a clue.

Unfortunately as has been demonstrated in Vietnam, the first Gulf War, Somalia, and Bosnia, Afghanistan and Iraq, that's just not so. Service companies like Halliburton and their subsidiary Brown and Root provides services that the military is incapable of doing. And they do it cheaper.

The biggest advantage by these companies was that thousands of G.I.s weren't needed to do the day-to-day things; food services, oil field services, fuel ans supplies convoys, airport management and hundreds of other tasks that the military couldn’t handle.

Companies like Halliburton have been around since before Vietnam and only one has been politicized.

[OperaTenor]

Unfortunately as has been demonstrated in Vietnam, the first Gulf War, Somalia, and Bosnia, Afghanistan and Iraq, that's just not so. Service companies like Halliburton and their subsidiary Brown and Root provides services that the military is incapable of doing. And they do it cheaper.

The biggest advantage by these companies was that thousands of G.I.s weren't needed to do the day-to-day things; food services, oil field services, fuel ans supplies convoys, airport management and hundreds of other tasks that the military couldn’t handle.

Companies like Halliburton have been around since before Vietnam and only one has been politicized.

"Companies." Hmm, to hear BJ tell it, there's no one else to do it, but Haggis infers there are multiple companies who proovide these kinds of services.

If that's the case, then why was Hallburton given no-bid, cost-plus contracts? And no time constraint excuses, either. Since this was all an act of aggression on our part, the bidding could have taken place in the run-up.

You're going to have to prove that "they can do it cheaper" claim. From the amount of taxpayer money that's been pissed away with little or no infrastructure to show for it, and from the size of salaries paid to private contractors' employees, I don't see how that can be the case.

And how about the quality of service? How about the contaminated water served up, or the expired or low-grade food supplied?

Untreated water at U.S. base in Iraq

Democrats seek inquiry on expired food in Iraq

Halliburton Hearing Unearths New Abuse

How about thier total lack of accountability corporate and personal, until only very recently(which is still too little, too late, IMO)?[/url]

[piqaboo]

I recently had some fairly standard lab work done.
Got the bill. Called the insurance company. Got the statement.
Insurance paid 30% of the charge. The rest was ?forgiven?
Why should someone non-insured pay more to cover the *below cost payment by the insurance co?
Someone (hospitals? labs?) needs to hire better negotiators. And I must remember that should I ever need to buy something out of pocket, that is not insured, to review a few courses of negotiation myself, in advance, and bargain like hell before buying the service.

*IMO, the lab cant afford to provide the test results for the amount the insurance company paid them. Speaking as one who makes and sells clinical tests for a living.

as for companies of <10 staying that way by having work done out of state - you seem to have a romantic view of small companies. The lady who assembles gift baskets will spend more money having her 11th employee out of state than she will save.

[Trumpetmaster]

This year we received a letter from our Insurance company
that they had dropped Quest and signed on with LabCorp.

Problem is the locations are very inconvenient....
as well as the times they open.

I went to the Doctor before I came down here and at
least they were on the ball. They saw my healthcare
provider and said I could not go to Quest anymore......

They claim they are saving money...
How can the insurance companies save money if the labs
can't afford the pay what the test(s) actually cost.

Piq, do the Labs write this off as a Loss when filing taxes?
That would be the only way I can think they can stay in business....

IMHO.....