Not sure what misinformation you are referring to...Please elaborate.

As for, "What does my age, gender or lifestyle choice have ANYTHING to do with health coverage?" I am going to assume that you are not asking this facetiously...

Your age, gender and lifestyle choices contribute significantly to the
probability of illness and the resulting costs of treating those illnesses. Men and women have different bodies with differing costs to maintain and treat--that's reality. Smokers tend to devolop diseases that non-smokers do not--Even OCare charges penalties for this lifestyle choice. Should you be forced to pay higher premiums because my (hypothetical) cousin decided to have 9 children...? Is that "fairness?"

It's just math based on empirical data...Where allowed, insurance companies use actuarial math to determine potential risk based on various factors presented by an individual and then charge enough to pay doctors (so that they can pay back their student loans, exhorbitant malpractice insurance and feed their families) and still make enough profit to feed themselves and their families when those risks pan out.

As for "uninsurable" individuals, I absolutely believe there should be mechanisms in place to assist with coverage costs for high risk individuals. And, as it happens, insurance companies funded high risk pools in 37 of 50 states BEFORE OCare. My state's pool was taken over by the Feds and went bankrupt a year into its 2 year funding allotment because the federal idealists running the pool refused to honor reality and actuarial arithmetic.

Also, it's important to understand the massive health care cost distortions caused by Medicare/Medicaid. What happens when a hospital is forced to deliver services at prices below their cost to deliver those services...? What happens when a doctor's office is forced to hire fulltime administrative staff to mitigate Medicare red tape and compliance requirements? Those costs do not just disappear into the ether...they are shifted elsewhere. In our medical care system, those costs are largely shifted to those with privately funded insurance.

An ER visit costs what it does in part because 5 of 10 patients before you paid reduced fees or paid nothing for their visits...You and your insurance company get to make up part of the difference. At a certain point, doctors and hospitals will choose to stop delivering services at a loss and your government funded healthcare will afford you fewer and fewer options for care.

Lastly, it's important to remember that you have no natural or constitutional right to someone else's labor. Doctors and insurance agents are PEOPLE who voluntarily offer services in a free market in efforts to better themselves and their families. The notion that they OWE you their labor simply because they chose a particular profession--and its considerable risk and expense--is tantamount to slavery. The notion that the government OWES you someone else's money to pay for medical services is socialism and statism and also tantamount to slavery.

The tax code is a joke. Everyone (churches too) should pay a fixed percentage of all income whether it comes from collecting cans or stealing 401k's from your employees. The IRS should be an algorithm in a server room somewhere not the bloated corrupt ridiculous government entity that it is today. The confusion was done on purpose so that wealthy people can avoid paying taxes while everyone else funds the country that secures their wealth.

Same with healthcare. So instead of just creating universal tax funded healthcare the state and federal government and big business have conspired again to create another ridiculous mess that will allow them to steal money from our pockets.

Oh well...as flawed as it is...its a step in the right direction. The direction towards a world where everyone regardless of their genetics or misfortunes can get health care.

The healthcare market will always be a "for profit" market because there is just way too much money involved, especially the pharm market. Why do you think governments haven't legalized MJ, because it would sadly reduce the cash flow for those companies and doctors. They even try to make pills with the same effects as MJ.

We mostly do commercial work for teldata and av. I can count on 1 hand, the jobs that had nothing to do with healthcare/medical in any way.

Everyone can already get healthcare with no insurance. Certain medical facilities are part of a group that will treat anyone with any problem regardless of whether they can pay for it or not. Several hospitals in my area are part of this group and are understandably much busier than the ones who are not. I agree with this practice. But I agree that the whole medical/insurance system is probably the most screwed up of all the systems.

The legal system is probably next. I local man hit a bicyclist while driving home from a bar in the middle of the night. They have not said he was intoxicated yet. The bicyclist died at the scene and was not found for 6-8 hours (he was in a construction zone and fell into a "hole". The guy drove home...and when he saw on the news that a guy died after a hit and run, he turned himself in and claimed he thought he hit something in that area, but had no idea it was a person. His charges? Fleeing the scene of an accident....maximum penalty: 5 years. Do you think he will do jail time? Come on.....now you can kill someone while driving drunk, and get away with "fleeing the scene"? Is that justice?

Rant over. I cannot get to the ocare page...too many visitors. I will choose whatever is cheapest for my family (no insurance at the moment), whether it is ocare, or other. It will all collapse on itself in several years anyway. :)

Should we start taking bets? ACA or social security? Which one will collapse first?

Without interjecting partisanship into the equation.

Talk to me about efficient, well managed, cost effective government, well, anything.

Government couldn't run a deli at a break even, explain to me how they are going to manage the nation's health care.

As if the US health care system was running efficiently and cost effectively before Obamacare. We sure have a short memory. I watched/listened/paid for years into rising health care costs.

Not to mention, government is not meant to be a for profit business. That's why it's called administration. Compound with the concept that the private sector runs efficiently merely just because they aren't government, they have the majick Free Market Pixie dust spread on them and they are just awesome.

That PR $ spent with the Hoover Institute and CATO has been very effective. 

Agreed (no surprise I'm sure). As noble and well-intentioned as Mac B's wishes for American health care may be, pinning those wishes on the US government will almost certainly lead to disappointment at best or utter calamity at worst.

Medicare and Medicaid are on-track to near-term bankruptcy NOW. There is an 850 THOUSAND person, 6-plus month backlog for veterans awaiting service through the VA NOW.

And lets not forget that this government oversaw one of the biggest electronic records debacles in human history when their efforts to collect data electronically for the 2010 census failed spectacularly a couple of weeks before kick-off at a cost of more than 3 Billion additional taxpayer dollars to [unexpectedly] process everything on paper again. For reference, the total cost of census collection in 2000 was $3 billion. 2010 census collection cost $14 billion.

And these guys are going to administrate LOWER cost and higher quality healthcare...?
.

Agreed but it's tough not to look at higher education as a reference to what government can do to inflating the cost of something due to their involvement. I'm sure we can argue over this with conjecture but nobody will really know until it's too late or until Obama has saved us from our idiocy. I just believe it won't be better....


Ultimately, are you ok with something meeting a BS budget or something that needs to be efficient for survival? When revenue comes in under what was expected then you have to make cuts. Not simply raise taxes...That's a horrible model and one that will eventually reach a boiling point when costs overrun their effectiveness to the tax payers.

We can throw around BS numbers all day but it comes down to, this will "likely" cost us more money and the quality of care will likely go down. That's my opinion and I'm hoping it doesn't come true!

I'm a physician in private practice (with a group) and my salary will drop due to the ACA, especially with regards to certain procedures and what insurance will pay. But that doesn't really bother me.

I'm perfectly ok with that because I feel that the ACA is the right thing to do for the country. It's not perfect (tell me which piece of legislation ever is), but my opinion is that it's going in the right direction.

The issue I have with restrictions in pay is that the government doesn't always make the best decision in deciding what the proper ratio of health care workers should be in a critical care setting.

Replacing 1 doctor with 3 nurses (because they cost the same) and then granting nurses more autonomy to make up for the lack of doctors on staff is something that is terrible for healthcare in general. Nurses, as a generalization, do not have the experience, training, or medical background to always make the best patient management decisions.

So many times a patient doesn't realize that its not a doctor that is taking care of them and are never educated about the real differences in care between a doctor and a nurse. We can thank the overactive nurses lobby for that.

If you want to reduce costs, cut our salaries, but don't try to replace a doctor with a nurse. That's just not fair to the patient.

My question from a non-doctor to a doctor [rhetorically]...How little pay is too little to make becoming a doctor not worth the time, expense and risk? My chief concern is that we'll all soon find out...

Nurse hater! ;)

I appreciate the insight of someone in the industry!

While you tools were wandering around CEDIA, I've been getting ready for bow season.   Picked up a new Hoyt Vector 32 last week.  (Here's a link so you can view it in all it's awesome glory)

[Link: hoyt.com]


I've been out every morning since Tuesday.  Passed on everything I've seen. Second day of bow season.  I wouldn't be passing if it was the last day. 

Monday I'm going up to Clare to hunt my customers 4000 acres.  

When I feel like it, I'll work again.  

Mac, tell us more about your award.  It's nice that you got recognized.

 

It's all the very, very fat people that are getting older and older that are going to break the health care system, no matter how it's setup. I can't believe all the fat old people I see with their fat old kids, some I see, both can hardly walk!

First of all I would like to tell all you Custom Installers to "Hire a Pro" on this issue!!!jk!! I am impressed with the knowledge on this issue. I am sure many have you have been forced to learn about this as employers.

I am a primary care physician in a Multi-specialty group that owns its own health plan that provides group insurance to employers.
I would respectfully disagree with OneRemote on a couple of issues.
First, I think it is ridiculous to try to fix the healthcare system on the backs of physicians by reducing their pay. You guys all know about overhead, well we have that too and it is going up because of the ACA. If our fees stay the same or decrease you know what happens to an owners pay. I did not go into medicine for the money(If I did, I wouldn't be in primary care), but wouldn't want to get paid less for what we are asked to sacrifice. I can raise fees all I want, but a government run health system will only pay what they are going to pay.

Second, I don't think the ACA is a good thing. Straight Medicare and Medicaid don't even pay enough to cover overhead, so most physicians would go out of business if a majority of their business was from government run payers. The ACA will place more patients into the system with pay scales similar to government pay structures, thus bankrupting many practices. You can then extrapolate what a Nationalized Health System would do to physician practices. Many of the plans people will get on the exchange will have ridiculously large deductibles, so patients will forgo the primary care they need. This being the exact opposite of what the ACA was supposed to accomplish. When physicians are polled on the ACA most are against it. The Government likes to say that physician groups like the AMA are in support of it, but only 17% of physicians are in the AMA. I dropped out because of their support of the issue, like many of my colleagues.

Our physician owned health plan will kick any government plan in quality, cost, and efficiency of care. The reason is because we know what is best for our patients. Patients get what they need based on evidence based care and we don't do tests or scans on patients who want them because of evidence based medicine as well. We keep our administrative costs low and sell directly, so brokerage fees don't get tacked on to the price tag. These things won't happen under a government run system for reasons people have commented about government run entities above.

Mogul kind of hit on this earlier in regards to underwriting. The ACA will cripple our ability to underwrite. Actuaries have gotten good at determining an appropriate cost to underwrite a company. Under the ACA we can only base fees on Age, gender, tobacco abuse. There may be a couple more, but the point is that good, efficient companies may go out of business because they can't properly underwrite under the constraints of the ACA. Most insurance companies won't even get into the exchange business because the risk isn't worth it.

In saying all that, I do think that changes needed to be made, but not in the form of the ACA. I agree with legislation on pre-existing conditions. I think that requiring insurance companies to pay for evidence based screening is good. Both of these didn't need bloated legislation to get it done. Currently physicians get paid on volume. I think pay structures need to be based on value(i.e. quality, efficiency), and volume in the future. Don't need the ACA for that. By the way, where was Tort reform in the ACA? If a doctor tells you he has never ordered a test to save his ass than he is a liar. That would help costs considerably.

I am not an economist, but I have often thought that the government should only provide catastrophic coverage. Catastrophic care places a high burden on the health system. The sickest 10% cost upwards of 40% of healthcare dollars spent. You would need to regulate that private insurance plans cover important preventative care measures then they can compete among themselves for the other bells and whistles. Throwing Medicare in there or not would have to be made by someone smarter than me.  Not sure if this would work, but I am not one to criticise without trying to think of some solutions.
Fortunately and Unfortunately the solutions aren't up to us here.
Chad

After I posted, I realized how long this post was. If it helped put some light on the issue great, if not sorry for wasting 10 minutes of your life.