Apologies for the fractured, time-delay nature of my response. I sometimes just don't have the BTUs to plough through everything....
Insurance companies *definitely* make money by insuring people!!! That isn't the same as getting care to people. And the insurance companies have done great by cherry picking populations, denying claims for preexisting conditions, et cetera.
You're moving the goal post. (What are you, a Republican?) The point is not to get insurance that's better than what we have now; it's to get some level of coverage to people who have none.
OK, let me try to paste here what I was responding to:
I said: "you aren't going to get more care for the same money without driving cost out somewhere."
You responded: "This is based on the fallacious argument that insurance companies cannot make money by insuring people. This is clearly an insane argument, as insurance companies are currently making money doing just that. I think that's one of the complaints."
I hope that if you look at it again you'll see that I wasn't trying to move the goal posts, just trying to say that I wasn't making an "insane argument". I guess my issue isn't that certain segments of the health care economy make money (I mean the companies that refill oxygen tanks have to make *something*, right?) but that the deliberate administrative costs related to our insurance-based system don't refill anybody's oxygen tank. It just pushes money around and adds to practitioner frustration. 31 percent.
Insurance companies definitely go out of their way to avoid paying for expensive things. We all have that specter hanging over our heads of getting cancer and our insurance getting cancelled because we didn't report that ingrown toenail we had twenty years ago.
You are making part of my point for me.
However, until that happens, I'm still able to pay $30 for a month's medication instead of $500 or more. I'm still able to make an appointment to see a doctor for $10. And that's far better care than the uninsured are getting now, because they're getting none.
Yo-Leven! I am still employed (sans preexisting conditions) and am still covered, too. And you are right that the uninsured are getting squat, relatively.
I haven't kept up in many years, but I think that there are tons of studies in this area and many at least show that the uninsured delay seeking care for longer periods, are sicker when they show up (in the ER) and cost more to fix.
While that's a perfectly reasonable way to interpret what I said, that's not what I meant.
What I meant is that the whole population of people who are currently uninsured shouldn't cost the insurance companies (significantly) more per capita than the set of people who are. Yes, the sick uninsured are likely to be more expensive than the sick insured due to their conditions festering, but the ratio of the sick uninsured to the healthy uninsured is likely to be about the same as the ratio of the sick insured to the healthy insured.
OK, you can blow off cost if you want. But you can't.
Cost is key. All health care systems ration in some way to restrain costs.
Yes, including the one those of us with insurance currently have, and which is self-sustaining. I fail to see why adding a new group of people to it is wildly expensive. Yes, there will need to be subsidies from the government for the poor, but we're subsidizing them now when they go to the emergency room.
I am kinda running out of BTUs here, but I would just chime in with:
- Our costs are already considered to be way too high.
- Our outcomes relative to cost suck when compared to our 1st world peers; screw the fixation on waiting lists. Who lives longer and enjoys better quality of life?
- We still have some national discussions to have with respect to these bogus "death panel" scare stories. They are bogus, they really suck, but they reflect an underlying conversation that isn't happening on an adult level. What percent of health care costs are expended in care for folks in different age brackets during the last year of life? the last month? the last week? This is part of the "rationing", "will this expense make any difference?" discussion.
- Insurance-driven care is essentially that. How do we get to a system of care that is comprehensive and where we can trust the motives of the system and providers within it?
"Wildly expensive" to add a new group? It is a pretty damn big group and it is pretty much a given that costs are already too high. You make the case that converting people from uninsured to insured is almost cost neutral. I don't think that is so but I am not motivated to back it up with retro-research. A lot of this category of care has been born by institutions as uncompensated care that they factor in, so maybe you are right, but you also have to factor in folks who just flat out are not getting certain care because they just can't come up with the scratch or who are just getting retirement-busting surprise $16K cardiologist bills in their mail box.
More later!
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