"John R. Carroll" wrote:

A very simple solution would have been to have one group. Why are the
feds a group and
small business a bunch of very small groups? There is an issue though.

This is what the public option that Republican's reviled was all about.
The group would have been that portion of the American public that wanted to
be part of the public group.

Requiring the public option would be about the same as single payer - the
most sensible thing to do if you want to flex a lot of purchasing power.

That part of the American public must be all federal, state, and local workers for it to
be even the least bit palatable. Military exempted.



I can see a group being limited if the employer is self insured. Many
Fortune 500
companies are.

Yes, the in effect institute their own single payer plan for their work
force.
They cut out the middle man and have insurance companies compete for the
right to administer the group.
What you seem to be missing is that if it weren't economical to do this,
nobody would and that it's sort of ass backwards for the American public not
to do what employers that self insure do.

I understand your point.

But if you are standing and working, you automaticallly are part of a lower risk pool,
they know that their pool is cheaper to insure.



Where is the rest of the money coming from?

That's your problem.

That's a bit cold. Glad I don't work for you.

You giving all your employees a
raise so they can fork over the rest of what takes for converage?

Maybe, but only if I have to. That's the way free markets work Wes and
with
15 million unemployed, I can probably find someone qualified and motivated
that will work for your wage. I'm even going to hire a contractor to come
in
and explain it to you so I don't have to do my own dirty work and if I do
choose to subsidize your coverage, there is going to be a line item for it
on your check every week for you to look at.

Don't ever tell that to someone working for you. Payback is a bitch and often invisible.
My employer can get someone to work for less, too bad I won't have tickets to watch the
results, it would be something to watch while eating fat free popcorn.


I'm assuming you are engaging in hyperbole.

Hardly. Were the health care markets truly free youd see what chaos and
extorsion looked like at first hand.

The system has many distortions. I maintain most of them are created by government and
now you expect government to correct it. The definition of insanity is ...



As far as line items. Everything including
the employer part of medicare and ssi should be on the check. I'm a big
fan of everyone
knowing just how much tax they are paying to the state and feds. Too bad
when I buy
something from a store, I can't see how much embeded taxes I'm paying for
an item.


Most of us above room
temperature know part of our compensation is not on our W-4 forms.

You'd think that but it isn't actually the case. People percieve the value
of health care coverage based on their usage, not it's cost.

That is your opinion.

Not really. It's an opinion formed by having every insurance carrier I've
ever bought group coverage from come in and spend significant time
educationg my employees about the value of their coverage and also providing
me with ta bunch of tools to reinfoece the message on my own throughout the
year.

They are selling a product. I bet your or your salespeople sold your product too.


While I carry auto insurance with unlimited medical, I don't hope
to have a car crash to give my insurance a whirl. I doubt any of us want
to die early and
get value out of our life insurance.

Eventually, you wouldn't carry medical coverage in conjunction with any of
the insurances you buy.
In fact, with yearly and lifetime limits removed as part of what's just
passed, you might want to look at all or your coverages and see what you can
do to eliminate duplication.

Well not carrying the unlimited medical care on every car I own would be nice.


There also wouldn't be a medical component to Workers Compensation coverage.
All of these put Americans at a tremendous competetive disadvantage Wes.

I'd like the WC compensation to stay expensive. Don't give a business a reason to play
fast and loose with my safety.


You'd be in a different situation were you self employed or a contractor
because you'd be in the private market.
Under that set of facts, yes, you could keep your plan if you liked it.

Tax treatment for private contractors sucks. There I bet we see eye to
eye on. I'm all
for extending the same tax treatment to the self employed carrying their
own policy as
those like me that work for a corporation.

I'd rather the reverse be true. Health care premiums would go down
significantly if the revenue pool were reduced.

If the numbers of groups were reduce? I think you said the same thing but I don't want to
put words in your mouth.




What ought to be increasingly clear to you is that a public option or
single
payer system is in your best interests and, as an employer, mine.
What we have now puts us both at a competitive disadvantage in todays
world
marketplace. The only winners are the insurance and pharmaceutical
industries.

I'm going to wear my self out on this. Insurance has to respond to
regulation and will
tack on the profit needed to come out whole. They may loose in one year
but the next year
they will adjust.

The cost of health care is rising so rapidly because the business model in
the health care industry if fee per service driven.
The really simple version of this is that medical professionals can create
demand whenever they want to and insurance companies LIKE THAT because they
simply raise premiums and their percentage of the action stays the same.
More Services Provided/Higher costs = Higher Profits. It's that simple.

What we need to get to is a model that rewards cost effective equivalent
outcomes and penalizes or discourages overuse.

So what if the ailment is a real bitch to treat? Will that be like people searching for
heath care providers looking for someone that accepts medicare/medicaid?


The public option is a system that will administrated by unionized
government workers
sucking at the teat of those that actually pay into our system. It will
stick most of the
population into a single model of heathcare with no opportunity for
experimentation and
change. It will be under constant pressure to keep costs under control.
Good by grand ma
on that one.

Of course the elite will have their separate system. They always do.

It isn't only "the elite" Wes. It's a matter of priorities. Regardless, you
will always be able to do what people the world over do and plus up your
coverage on your own.

That had better be part of whatever comes out of this or Gunner might not be wrong.



Who was that guy
from Canada that didn't wait for his country to treat him but came here
for good treatent.

http://voices.washingtonpost.com/che...heart_sur.html

That wasn't even hard to find on google and I have a poor memory.

The worlds best health care isn't delivered in the US Wes. Not even close.
There are two countries that I can think of right off the top of my head
where care is significantly better and much, much cheaper.
Let me guess, you are one of those that still thinks we are number on in
health care technology as delivered.
We aren't Wes and haven't been for a decade.

Here is some other "news" for you. Barak Obama really is a US National, not
Kenyan.
I know. It's hard to believe, but true none the lessG

I don't think I've made that accusation.



As far as Pharma based in the US, we should not pay a cent more than
Canada or the EU for
the same damn drugs. Now what happens when they move to another country
to counter that,
that is something we will just have wait and see about.

The very next health care initiative ought to rescind the law forbidding the
feds from negotiating the best price for drugs under part D.
I can't imagine either the public or any member of Congress opposing that
and if you wanted to close the "donut hole" yu cold do it right there and
overnight.

I'll settle for we don't pay any more than any any other country as I stated. Exceptions
for the third world. I'm a compasionate conservative. That assumes big pharma is willing.


This law is the dumbest damned thing I've ever seen. Well, almost the
dumbest. I've seen some really stupid things in my time.
Keeping GM alive, among other things, was dumber.

You give me hope. GM should have died. As far as the doughut hole, you know legislation
has to be scored by the CBO or what ever it is called. The current heathcare bill is
jumping similar hoops.

I take it you are feeling better and are on the mend.


Wes
--
"Additionally as a security officer, I carry a gun to protect
government officials but my life isn't worth protecting at home
in their eyes." Dick Anthony Heller

Wes wrote:
"John R. Carroll" wrote:

A very simple solution would have been to have one group. Why are
the feds a group and
small business a bunch of very small groups? There is an issue
though.

This is what the public option that Republican's reviled was all
about.
The group would have been that portion of the American public that
wanted to be part of the public group.

Requiring the public option would be about the same as single payer
- the most sensible thing to do if you want to flex a lot of
purchasing power.

That part of the American public must be all federal, state, and
local workers for it to be even the least bit palatable. Military
exempted.

The "public option" is a group that anyone can choose to enter, or not.





I can see a group being limited if the employer is self insured.
Many Fortune 500
companies are.

Yes, the in effect institute their own single payer plan for their
work force.
They cut out the middle man and have insurance companies compete for
the right to administer the group.
What you seem to be missing is that if it weren't economical to do
this, nobody would and that it's sort of ass backwards for the
American public not to do what employers that self insure do.

I understand your point.

But if you are standing and working, you automaticallly are part of a
lower risk pool, they know that their pool is cheaper to insure.

They can certainly have hiring practices that lead to that result but the
underlying principle is to pocket the insurance companies profit.




Where is the rest of the money coming from?

That's your problem.

That's a bit cold. Glad I don't work for you.

You giving all your employees a
raise so they can fork over the rest of what takes for converage?

Maybe, but only if I have to. That's the way free markets work Wes
and with
15 million unemployed, I can probably find someone qualified and
motivated that will work for your wage. I'm even going to hire a
contractor to come in
and explain it to you so I don't have to do my own dirty work and
if I do choose to subsidize your coverage, there is going to be a
line item for it on your check every week for you to look at.

Don't ever tell that to someone working for you.

Why would I?

Payback is a bitch
and often invisible. My employer can get someone to work for less,
too bad I won't have tickets to watch the results, it would be
something to watch while eating fat free popcorn.

LOL
What actually ends up happening is that the people that want jobs have them
and the ones that are picky don't.
Your employer isn't in Traverse City because of the Cherry Festival you
know.
They'd be in Auburn Hills if you guys started demanding UAW wages and
benefits.



I'm assuming you are engaging in hyperbole.

Hardly. Were the health care markets truly free youd see what chaos
and extorsion looked like at first hand.

The system has many distortions. I maintain most of them are created
by government and now you expect government to correct it. The
definition of insanity is ...



As far as line items. Everything including
the employer part of medicare and ssi should be on the check. I'm
a big fan of everyone
knowing just how much tax they are paying to the state and feds.
Too bad when I buy
something from a store, I can't see how much embeded taxes I'm
paying for an item.


Most of us above room
temperature know part of our compensation is not on our W-4 forms.

You'd think that but it isn't actually the case. People percieve
the value of health care coverage based on their usage, not it's
cost.

That is your opinion.

Not really. It's an opinion formed by having every insurance carrier
I've ever bought group coverage from come in and spend significant
time educationg my employees about the value of their coverage and
also providing me with ta bunch of tools to reinfoece the message on
my own throughout the year.

They are selling a product. I bet your or your salespeople sold your
product too.

Sure, and our customers paid for it themselves.
As I said earlier, you'd be sensetive to the value of your coverage if you
had to pay for it yourself but you don't.



While I carry auto insurance with unlimited medical, I don't hope
to have a car crash to give my insurance a whirl. I doubt any of
us want to die early and
get value out of our life insurance.

Eventually, you wouldn't carry medical coverage in conjunction with
any of the insurances you buy.
In fact, with yearly and lifetime limits removed as part of what's
just passed, you might want to look at all or your coverages and see
what you can do to eliminate duplication.

Well not carrying the unlimited medical care on every car I own would
be nice.


There also wouldn't be a medical component to Workers Compensation
coverage. All of these put Americans at a tremendous competetive
disadvantage Wes.

I'd like the WC compensation to stay expensive. Don't give a
business a reason to play fast and loose with my safety.

The liability portion wouldn't change Wes.



You'd be in a different situation were you self employed or a
contractor because you'd be in the private market.
Under that set of facts, yes, you could keep your plan if you
liked it.

Tax treatment for private contractors sucks. There I bet we see
eye to eye on. I'm all
for extending the same tax treatment to the self employed carrying
their own policy as
those like me that work for a corporation.

I'd rather the reverse be true. Health care premiums would go down
significantly if the revenue pool were reduced.

If the numbers of groups were reduce? I think you said the same
thing but I don't want to put words in your mouth.

Right now a dollar's worth of premium increases costs you a dollar. Were
that dollar to be a net after tax dollar, you'd see premium increases
moderate.






What ought to be increasingly clear to you is that a public option
or single
payer system is in your best interests and, as an employer, mine.
What we have now puts us both at a competitive disadvantage in
todays world
marketplace. The only winners are the insurance and pharmaceutical
industries.

I'm going to wear my self out on this. Insurance has to respond to
regulation and will
tack on the profit needed to come out whole. They may loose in one
year but the next year
they will adjust.

The cost of health care is rising so rapidly because the business
model in the health care industry if fee per service driven.
The really simple version of this is that medical professionals can
create demand whenever they want to and insurance companies LIKE
THAT because they simply raise premiums and their percentage of the
action stays the same. More Services Provided/Higher costs = Higher
Profits. It's that simple.

What we need to get to is a model that rewards cost effective
equivalent outcomes and penalizes or discourages overuse.

So what if the ailment is a real bitch to treat?

Then it's expensive.

Will that be like
people searching for heath care providers looking for someone that
accepts medicare/medicaid?

No, it will be like doctors not building room additions or a new Lexus by
adding unnecessary procedures. That's what they do now.




The public option is a system that will administrated by unionized
government workers
sucking at the teat of those that actually pay into our system. It
will stick most of the
population into a single model of heathcare with no opportunity for
experimentation and
change. It will be under constant pressure to keep costs under
control. Good by grand ma
on that one.

Of course the elite will have their separate system. They always
do.

It isn't only "the elite" Wes. It's a matter of priorities.
Regardless, you will always be able to do what people the world over
do and plus up your coverage on your own.

That had better be part of whatever comes out of this or Gunner might
not be wrong.

It isn't something that needs to "come out".
You, right now, could by a rider to your coverage if you wanted to pay for
it.

As far as Pharma based in the US, we should not pay a cent more than
Canada or the EU for
the same damn drugs.

We should get the best deal we can negotiate - period.


I'll settle for we don't pay any more than any any other country as I
stated.

We should get the best deal we can negotiate - period.

This law is the dumbest damned thing I've ever seen. Well, almost the
dumbest. I've seen some really stupid things in my time.
Keeping GM alive, among other things, was dumber.

You give me hope. GM should have died. As far as the doughut hole,
you know legislation has to be scored by the CBO or what ever it is
called. The current heathcare bill is jumping similar hoops.

Part D patients will get $250.00 to cover the hole this year and a 50%
discount in 2011.
By 2020, there won't be a hole at all.



I take it you are feeling better and are on the mend.

Some.
I'm just not a cry baby. Pity party's are for other people but thanks for
asking.

--
John R. Carroll