I'm against free health care for exactly this reason. I've seen how bad free medical care gets abused and moreover because the doctors don't get paid as much their some times of lower quality. I've seen some total nightmares come out of army hospitals.

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Oh, I absolutely agree with you here. By no means take my notion of "overfunding" as a good thing, only possibly a necessary evil. We could have "better" police if they made more efficient use of their funds, I agree, and usually the private market is better at making efficient use of funds. However, as with police and military, we've decided that the stability provided by government control and over-funding is more important than efficiency. This doesn't mean we should give up trying to make it more efficient, possibly by privatizing parts of the systems, but nevertheless the funding would still come from government.

Ultimately, it's a question of prioritization. Is maintaining an equal minimum standard more important than efficiency? Is the industry in question already cheap enough that the minimum standard can already be met by everyone through the most efficient practice?

It's a little tricker than that I think, and it has to do with the nature of what insurance is. Switching from one insurance provider to another is not like switching from Albertsons food store to Smiths food store... Based on pre-existing conditions and the fact that you are older now than you were when you purchased your last insurance, it may be more expensive or impossible to transfer to a new insurance.

Nevertheless, I agree that the lack of options is a concern, which is why I would absolutely support a private insurance industry that offer's supplementary coverage for 15k+ cases which, for whatever reason, the government did not cover. Given that the vast majority of cases will be covered by the government, I would imagine this supplementary coverage would be relatively inexpensive.

necessary evil for a minimum standard, perhaps. Not the answer you were looking for I suppose, but I imagine this as more of a minimum standard safety net. People should still have options for supplementary or alternative coverage. Like with the australian model, you have a government side of healthcare, and you have private... for those who opt into private, the government reimburses some 30% of the cost of the private coverage. I imagine something like this could work here since this makes the insured the customer, not the government.

Private is usually best and determining the best in terms of efficiency, true, but there are two issues... it can take time for the cream to rise to the top, especially in such a large and growing industry. Secodly, it assumes this long term efficiency is the priority. But as I said before, this isn't like making and selling the best chocolate cake on earth. We have time limits with people's lives.

I've used the example of water before. Theoretically speaking, capitalism produces the more efficient use of scarce resources. However, as with water, areas that have a shortage of water are subject to strong government regulation on the use of water to forgo the event that some people get priced out of the water market (rationing). If this were chocolate cake, that would not be a problem because there are no time limits on when we must consume chocolate cake. But water, as with healthcare, often must be consumed within a limited time period with death as the alternative. Thus, like with water, I think there is strong reason to believe that the current availability of healthcare be a higher priority over long run efficiency.

Actually, I think it was Raharu that suggested it, but I ran with it

Which of course depends on how it's structured. Based on how Raharu suggested it be implemented, I believe you are correct. I forget how exactly she structured it, but I think it was 15k+ for a single incident or visit. I might propose having a 15k per year cap with related incidents and chronic problems carrying over from the year they were incurred. I know she, and probably you, would not agree with this but what I mean is that if I developed some issue in 2007, and the expenses related to it continued to be incurred up into 2008 and beyond, those expenses would not go against the 2008 15k, but would rather go against the 2007 15k for as long s the related issues continue.

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True knowledge exists in being aware of what you don't know.

Yes!! And these are the issue I want the government to address. These are the things (among others) I feel are wrong with the current health insurance industry that need corrected.

Okay, I think I see where the disconnect between our posts is occurring. You are talking about the level of health care the patient will receive. I am talking about the efficiency and effectiveness of the health insurance provider (government vs. private).

Under either plan I do not see the level of health care going down over what it is today. Even if you have no insurance, you are still treated. This should not change. Just how it is paid for should be changed.

If you look closely at many of the health care rankings, the U.S. usually scores quite high in the level and availability of health care. What usually brings their overall rank down is the cost and ability to pay. This is where health insurance comes in. I feel private insurance providers will make bigger strides in less time regarding the fair payment of medical bills than the government ever could.

I believe you're right. But is doesn't really matter. The amount is as good as any for illustrative purposes.

Well, then that would benefit someone with two $10k procedures in November and December over someone with two $10k procedures in December and January. This would cause people to put off much needed procedures until January of the next year. This causes two problems. The first is that the patient isn't being treated as soon as possible and the condition could worsen. The second is that doctors and hospitals will be overrun with patients in the month of January, and quality of care would invariably decline.

I wish I had a solution to this. I have thought about it quite a bit but can not come up with anything that seems fair and equitable to me. The best way I can see is having a single policy for all medical expenses. While this might not eliminate all problems with inequality, it does provide some added advantages. For one, there will be less confusion on which policy (private or governmental) is responsible for payment. It also reduces the amount of paperwork and clerical expenses associated with health care insurance, reducing the overall cost. As large a percentage of health care insurance premiums as possible should go to paying for health care (which is why for profit health insurance companies don't make a whole lot of sense).

(I tried to fairly pare down your post. If I took out any points you still like to discuss, feel free to bring them back. It was not my intention to ignore anything, just to reduce the size of this post.)

Alas, the 15K may need to be shot down. One other possibility I thought of was a "15k within any given 1 year time period" as opposed to "15k within any given year". Nevertheless, I agree such a system could be cumbersome deciding who pays (not that our current is any less cumbersome, I have 3 insurances on me and sometimes it takes them months to sort out who pays).

Anyhoo, you are correct that anyone will get treated, although the system doesn't make it easy. For one, to get treated in a time when you can't pay for it, you probably have to go to some hospital, regardless of what the issue is. Hospitals tend to be more expensive, particularly in the emergency area where such people usually go because by law they have to be seen. This certainly lacks efficiency, and compounds with the issue of medical bills being the leading cause of bankruptcy in the USA... Sure, they may have gotten help from the hospital, but at the same time they lost their house, their their dog, their wife and small business. You brought up that in the 15k cap idea, people might push off needed treatments until the following year... This issue of looming bankrupts can push off needed treatments indefinitely. I'm not certain the best solution, but I think there is a lot that needs to be improved upon with what we've got.

You mentioned we needed the government to deal with the issues of pre-existing conditions and the inability to change insurance because of age. Any thoughts on the matter? I forget which country it was, but I heard of one that made it illegal to deny coverage for pre-existing conditions, nor can people be questioned about pre-existing conditions or age when signing up for insurance. Everyone then essentially pays the exact same rate... This might have it's own issues, but I'm not sure how else a government could impact these issues... perhaps some form of subsidization based on the age of your insured. Eh...

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True knowledge exists in being aware of what you don't know.

Okay, let me say right off that I pretty much agree with everything you wrote, so if I don't address some of your statements, you can just assume I agree with them. I am lazy and just don't want to have to type "I agree" over and over again.

This is another of the reasons I don't like the government plus private health insurance model. Everyone should get all their health care insurance from a single source. It eliminates all the time and costs involved in just deciding who pays.

I think it should be illegal to deny coverage as long as the insured is able to pay the premium. However, I don't think the premiums should be same for all the insured, but rather based on a number of factors. (I already mentioned annual physicals as one of these factors.) Of course, regular audits would be needed to make sure the insurance company isn't setting premiums so high for those with pre-existing conditions to essentially be denying them coverage. If done correctly, statistically speaking the playing field should be level for all the insurers, so a subsidy would not be needed. (The playing field is level now due to the denial of coverage by all insurance companies. Making it illeagal will just change the height of the field, but leave it level.)

Why not destroy it? What is the social value of this industry?

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"I think the deregulation was probably helpful to the growth of our economy."
-Sen. John McCain 09/22/2008

Why not destroy television? What is the social value of it?

Television gives us entertainment, relaxation. There is social value in it, even though it isn't an essential like health care. Every one pretty much agrees that what we have now isn't working and they point, rightly, to the health insurance companies as the culprit. I would like to know why we have them in the first place. They are just a middle-man sucking off the top. Why not get rid of 'em since we have socialized health insurance anyway? Whether you are paying for those who can't pay for their own health care with your premiums and deductibles or through your taxes, as long as we are not ready to simply let someone die due to their lack of funds, somebody else is paying for it. And I personally don't mind but I mind paying for it and securing profits for this industry as well.

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"I think the deregulation was probably helpful to the growth of our economy."
-Sen. John McCain 09/22/2008

Why do we need relaxation and entertainment? We're the fattest country on earth.

I'm not necessarally opposed to "reasonably" higher premiums for those with pre-existing conditions. The question is what is reasonable, and what standards are these audits going to enforce? An audit need not be necessary. If this is going to be a public issue with audit regulation, you could just have a company be required to submit their rates to the government for approval by whatever standards may be. An individual denied coverage when they met the qualifying criteria for the rate and the ability to pay the rate can enforce it by appealing to the government. These rates should be easily viewable by the public and government.

But still the looming question is by what standard are insurance companies going to be allowed to increase the rates on others, and by what standards can the government regulate the price for those who would be made to pay larger rates to make sure they don't become too large? What is too large? More than double what the average person pays?

This helps to address the issue of pre-existing conditions and movement between competitors in the insurance market, but one lingering problem is the issue of the uninsured. If someone is uninsured and develops a problem, should they be allowed to pay a legally reduced premium to get insurance that legally must cover their pre-exiting conditions, or do pre-existing conditions only transfer if someone was insured perviously by another insurer when the problem developed? It would not be fair to those that had been paying for their insurance before to then essentially have to subsidize the person that hopped on after he developed a condition.

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True knowledge exists in being aware of what you don't know.