"Wes" wrote in message
...
"Ed Huntress" wrote:

Well for that matter, if you are permanent reduction in force, how do
you
pay for
continued health coverage under COBRA?

By robbing all your piggy banks. I was paying a COBRA plan at the rate of
$12,500/year (family of three), a year ago last summer. I felt like I'd
opened a vein. And I'd be paying the same right now if not for my wife's
plan.

It's murder for people who are unemployed or self-employed at a moderate
rate of income.

Yes it is but as badly as I need a home, car, and healthcare I pay for it
myself and don't
ask you or others to do so. Even though I don't actually write the check
for my health
care plan atm, it comes out of my compensation pool.

Health care costs real money. Some we can argue is wasted. I'll never
try to tell you
our health care / litigation system is efficient. There are a lot of
resources wasted.

When you get down to nothing the government steps in via Medicaid. For
someone with
nothing, life as usual, someone that busted arse and is driven into the
dirt that has to
hurt like hell.

So what is the balance? If government provides healthcare it will be at a
level. It
likely won't be at a level that will pay for your heart transplant if you
need it. It
will be average health care. Or will it be the two level system, peons
and those with
resources?

Most of the models that have been considered by policymakers in the US leave
open the opportunity for private care and private insurance. We have a
medical center near here (Princeton Longevity Center) that's basically for
rich people. Insurance either covers none of it, or only a small portion. I
understand that they have a lot of business.

I doubt if the US would, at least in our lifetimes, impose a fixed level of
care on everyone, if they can pay for it themselves. So, yes, I expect a
two-tier system.


I think some people that support national health care think they are going
to get the gold
plated health care a CEO of a Fortune 100 or a Senator gets. No, I think
it will be
closer to health care in a welfare state.

But which welfare state? Some of them are very effective. Almost all of them
in the developed world produce much better outcomes than ours does. They're
weaker on certain kinds of extreme critical care, but vastly better on
preventive and early care.

This is a complex subject, and I have no desire to go around on it again. I
just did that a few months ago. d8-)



Oh, you save money against a rainy day. Cobra
wasn't an option for me when my employer of 20+ years folded so I fell
on
the insurer of
last resort in my state that had to take me because I had a paper that
said group
insurance wasn't available under Cobra (former employer was in
bankruptcy
and self
insured).

Currently we have a system consisting of Cobra and the fallback I paid
into for 8 months
while I was out of work. Failing to maintain continuous group coverage
scares the chit
out of me. That preexisting condition bravo sierra can kill you.

For three years I couldn't get insurance at ANY price because of it. And I
was only 31 years old at the time. Now, even without COBRA, I'd be in a
statewide pool. But the rate would be higher than $12,500 for a family of
three.

I know that sucks. That is where the idea of mandating coverage as in you
got to buy it,
even if you don't want it at a young age comes in. I'm a free market
type, if you haven't
noticed. Insurance companies want good risks or they want to price risk.

Most everyone needs a car to get to work. Convicted drunk drivers need
insurance to be
able to drive a car. They can get it but the risk is priced in. By the
standards of
current schemes that we all have to have insurance w/o any notice of risks
that drunk
driver should get insurance at the same rates I have with a clean driving
record.

This is a conversation that quickly cuts to the chase when you have it
face-to-face, but it's never-ending in Usenet postings. Here's where it
winds up: You would change your mind in a heartbeat if you or a family
member faced a big hospital bill and you found your insurance cancelled
after the hospital submitted (and was paid for) its first bill. If you treat
health insurance on a free-market basis, that's exactly what would happen.

Health care insurance is not like car insurance. Treating it on a
free-market basis, in the end, raises one key question: How barbaric do you
want your society to be?




When you are working, don't spend everything you earn. I don't care
what
you make, I bet
I can find someone getting by on less because they have to. You may
have
to provide for
yourself and family.

We may in the end. But I think we'll have universal coverage in this
country...about the time I kick the bucket. d8-)


I don't know how old you are...

60.

...but I have a feeling we will be on our way in some form in
the next 4 years. A mess created by government will now only be able to
be solved by
government. Sounds like the financial crisis as I reflect on my previous
sentence.

This mess wasn't created by government. You may recall that the insurance
industry was my audience for over four years; my employer's clients'
customers; the ones for whom I wrote marketing campaigns (I did more of that
at the end than editing). I know how they work, and I know that the idea one
can make private insurance produce the socially intended result while it
operates largely on market principles is completely insane. There are few
other examples in our economy of such cockeyed misplacement of market
forces. Nothing could make it worse except eliminating the government
controls on the industry.

The incentive for the insurance industry is to deny coverage as much as
possible, not to supply it. Its ideal customer is one who is always healthy
until, when the end comes, has the good manners to die on the spot, before
an ambulance can arrive. If you do get sick, their incentive is to raise
your rates as much as the law will allow and then to supply only enough care
that you're able to continue to pay your insurance bills.

Like most things regarding markets, you can see how the market forces work
in a particular business by analyzing the structure of incentives. I'm not
talking about how they actually have to operate; I'm talking about where the
incentives are that would make them more profitable. Those incentives are
the things that guide the direction in which they're alway pulling, the
underlying, usually unstated and often unrecognized goals that their
financial self-interest leads to. In a business suited to free markets, the
incentives align with multiple interests and everybody wins. In one that's
not, somebody loses. In the case of health care insurance, the loser is the
insured. If there were real competition at work and if an essential
ingredient in free-market competition -- perfect information available to
the customer -- wasn't so easy to hide and obscure, the industry would
hobble along, grudgingly producing a better result. But they're not.

There is nothing you or anyone can do to fix it. Its frame is broken, it
always has been, and it only became apparent as advancing medical technology
began to raise prices so much that insurance companies' margins were placed
under scrutiny and exposed, giving rise to "managed" care, which is a
metaphor for denying more coverage than regular fee-for-service insurance
did. The health care insurance industry is FUBAR.

I'm planning to hang on until I get my money back from my SS payments. I
just hope my
brain and body holds up for the next 15 years so I can retire. I hope you
are not looking
the reaper in the face, I'd really miss you.

Nah, I'm holding him at bay. By family averages I probably have another good
15 - 20 years left.

I'd miss you, too.

--
Ed Huntress