"dpb" wrote:

Thus I don't think competition is particularly effective in holding
down health care costs because I don't believe it's the driving
force in most decisions.

As long as private enterprise is involved in health care and are
allowed to limit the "gene pool" as a means of controlling their risk,
the problem will not be solved.

Some how, 100% of the population, no exceptions, must be covered, then
move forward to address and control the cost issues.

Limiting the "gene pool" is not a workable solution.

Lew

"dpb" wrote in message ...
Leon wrote:
"J. Clarke" wrote in message
...
More to the point, even if the actual cost is only 100K and not 300K,
that's
still more than most people can afford out of pocket.



but a far greater amount of people can afford 100k vs. 300k. ...

Out of pocket w/o insurance I'd say the percentages are about the
same--miniscule.

--

If you want to look at it that way $1 would be way more than some could
afford, and yes I know of several people like that.

"dpb" wrote in message ...
Leon wrote:


They might; then again they may not. Most likely the selection criteria
were made when you were enrolled in the group. What if you had been 70+
and in need of serious heart care when first applied? Think you'd still
have been accepted?

It would really be a waste of time to simply speculate how something would
work with out actually getting the details.

Given that comment, there would be no screening necessary, remember you do
actually pay for treatment. The cost would be less than "normal" because
there would be no losses caused by non-payment, slow to pay, or reduction of
item costs by an insurance company.


I'd wager it's the latter--every one of those groups I've ever seen have
very selective membership criteria.

Have you seen them all?

Of course not--but I've seen enough to have a pretty good understanding of
their business model.

It does not sound that way to me.


It's quite selective, not universal.

Why would that be, you are obligated to pay for any and all procedures.
They are not selling or operating like an insurance company. They are
simply charging what they consider a fair and profitable amount less the
huge cut that the insurance company gets. Think about insurance companies
as being something limilar to a labor union. While all car companies except
Honda and Subaru are hurting in the US, the big 3 are mostly hurting because
of the burdon that most all other car companies have been able to avoid.
Today's union literally brings nothing more to the customer than the
Japanese do.



I don't understand the 30% example--typically insurance carriers are
covering 80% or "standard and normal" for any particular procedure.

I see my medical bills and what portion that is actually paid by the
insurance companies. Often the insurance companies cut up to 90% off and
often will not cover a procedure. The doctor writes that off, I don't
get billed for the difference.

...
That's doctor's choice then--I've seen some that do, some that pass the
cost on and some that are in between. Some carriers have contracts that
say what is/isn't passable; some physicians choose not to accept patients
with those carriers.

The fact remains, the costs are inflated to make up for Insurance loss
costs.

What we have now is not working and is soon to break down, lets not crap on
new ideas. Can't never could do anything.

Leon wrote:
"Nova" wrote in message
...


I don't know that I'd always want my medical treatment to go to the lowest
bidder.


Agreed and these guys are probably makin more off of the procedure than
those having to collect from an insurance company. Remember insurance
companines get deep deep discounts and often don't pay.

It sound to me like the insurance companies are keeping the cost down.


Basically HMO's and insurance companies are more like agents for many
doctors. I think I would probably have more faith in a doctor that
does not rely on an insurance company to bring in it's patients.


The insurance companies rely on their participating doctors list to
bring in the customers.

There will probably still be insurance for catastrophic needs if you feel
that living an extra year or two is woth having insurance for.

It doesn't take a catastrophe to end up with astronomical medical bills. I
don't foresee any major reduction is the cost of medical care regardless
of who foots the bill.


Don't for get the major point here, insuranc companies make more than the
health care system does and what overhead does an insurance company have
other than an office for record keeping?

Medical insurance companies are gambling that the coverage premium they
charge along with any returns on there investments made with your money
will exceed the medical payments they make in your behalf. By them
making a profit it shows that on the average they're right.

Take the insurance company out of petty coverage and every one saves, except
the insurance company.

Your key word above is "petty". If you take the insurance company out
of the picture you'd better hope that you're one of the customers that
make their "average" profitable.

--
Jack Novak
Buffalo, NY - USA

"cm" wrote in
news
I have witnessed our own insurance company dictating the course of
treatment for my wife's breast cancer over the last three years. We
have had to fight to get the proper drugs and treatment over the cost
saving path the insurance company would prefer. We have also been
subject to huge co-payments on drugs. Three years ago we had a
co-payment of $65 per pill for Anzemet!

I have to comiserate with you for the reasons for the drug Anzemet. I just
priced it for my insurance plan through US Healthcare (Medco administered).
Anzemet would cost me $100 for a 90 day supply. I am not familiar with the
drug (lucky me), so I don't know more.

I guess I am lucky to have a good coverage plan ...

--
Best regards
Han
email address is invalid

Leon wrote:
"dpb" wrote in message ...
Leon wrote:

They might; then again they may not. Most likely the selection criteria
were made when you were enrolled in the group. What if you had been 70+
and in need of serious heart care when first applied? Think you'd still
have been accepted?

It would really be a waste of time to simply speculate how something would
work with out actually getting the details.

Given that comment, there would be no screening necessary, remember you do
actually pay for treatment. The cost would be less than "normal" because
there would be no losses caused by non-payment, slow to pay, or reduction of
item costs by an insurance company.

I'd wager it's the latter--every one of those groups I've ever seen have
very selective membership criteria.
Have you seen them all?
Of course not--but I've seen enough to have a pretty good understanding of
their business model.

It does not sound that way to me.

Well, it does to me...

But what you're describing above is at least somewhat different than
what I was speaking of if indeed they will accept anybody.

There was quite an at length article in Forbes or somewhere similar a
while back that went into the practice of which I was speaking at quite
some length and detail. It certainly is true that many of the specialty
private surgical centers, heart centers, etc., are quite selective in
their accepted cases.

It's quite selective, not universal.

Why would that be, you are obligated to pay for any and all procedures.
They are not selling or operating like an insurance company.

No, they're controlling risk to an even higher degree than most insurers
in the practices/groups of which I was speaking (see above).

simply charging what they consider a fair and profitable amount less the
huge cut that the insurance company gets.

The "huge cut" the insurance company gets is that other part of the high
risk pool in large part as well.

....

The fact remains, the costs are inflated to make up for Insurance loss
costs.

What we have now is not working and is soon to break down, lets not crap on
new ideas. Can't never could do anything.

I'm not sure I've seen much in any really new ideas, unfortunately,
particularly those that would actually help across the full spectrum of
both abilities to pay and access to services.

The one thing I'm pretty sure of is that the inclusion of large segments
of currently under- or uninsured without a commensurate inclusion into
the payment pool by some means is going to be another federal welfare
program that will not be able to be funded w/o massive deficits or taxes
of one form or another.

One specific place where I think it's gone badly wrong to date is that
far too many young, relatively healthy working folks are opting entirely
out of having any insurance at all in order to have more toys so they're
not helping in the spreading the cost and are dead weights when the
occasional one does have a serious disease or accident. It would also
help many self-employed if it were required that carriers accept them as
a part of an equivalent-age/work-type pool rather than only as
individuals. That would put many older that currently aren't but would
like to be back into the system.

--

dpb wrote:

I'm not sure I've seen much in any really new ideas, unfortunately,
particularly those that would actually help across the full spectrum of
both abilities to pay and access to services.

The one thing I'm pretty sure of is that the inclusion of large segments
of currently under- or uninsured without a commensurate inclusion into
the payment pool by some means is going to be another federal welfare
program that will not be able to be funded w/o massive deficits or taxes
of one form or another.


snip

Here's a few changes I'd like to see:

1. The federal government will set a maximum hourly billing rate for
doctors based on their classification (GP, FP, neurosurgeon, etc.). The
patient can be billed only for the actual time spent with the physician
in 15 minute increments.

2. If you have scheduled a doctors appointment and are kept waiting past
your appointed time the doctor pays you for your wasted time at his
billing rate in 15 minute increments.

3. If you see a doctor and all he does is refer you to a specialist the
referring doctor get a $15 administrative fee only.

4. The patient pays only for those medications that prove to be effective.

5.A doctor is allowed to have all the tests performed that he deems
necessary. The patient pays for the test that finds the problem. The
doctor pays for the rest of the tests.

6. All hospital charges, anesthesiologist fees, nursing staff, in
hospital supplies and medications, etc. will be considered part of the
doctor's overhead and will be paid for by the attending physician. This
should get rid of the $15 aspirins, $20 Band-Aids, etc.

7. A doctor receives no payment until all work is complete to the
patient's satisfaction.

8. A money back guarantee will be issued with all procedures performed.

I'm sure the group can think of others...

--
Jack Novak
Buffalo, NY - USA

You know, even though you did not have a strength of materials course,
you still seem to be a clear thinker.


I particularly admire the blending of the language from the AIA
shortform with the requisites for the proposed changes.







On Sat, 30 May 2009 22:32:34 GMT, Nova wrote:

dpb wrote:

I'm not sure I've seen much in any really new ideas, unfortunately,
particularly those that would actually help across the full spectrum of
both abilities to pay and access to services.

The one thing I'm pretty sure of is that the inclusion of large segments
of currently under- or uninsured without a commensurate inclusion into
the payment pool by some means is going to be another federal welfare
program that will not be able to be funded w/o massive deficits or taxes
of one form or another.


snip

Here's a few changes I'd like to see:

1. The federal government will set a maximum hourly billing rate for
doctors based on their classification (GP, FP, neurosurgeon, etc.). The
patient can be billed only for the actual time spent with the physician
in 15 minute increments.

2. If you have scheduled a doctors appointment and are kept waiting past
your appointed time the doctor pays you for your wasted time at his
billing rate in 15 minute increments.

3. If you see a doctor and all he does is refer you to a specialist the
referring doctor get a $15 administrative fee only.

4. The patient pays only for those medications that prove to be effective.

5.A doctor is allowed to have all the tests performed that he deems
necessary. The patient pays for the test that finds the problem. The
doctor pays for the rest of the tests.

6. All hospital charges, anesthesiologist fees, nursing staff, in
hospital supplies and medications, etc. will be considered part of the
doctor's overhead and will be paid for by the attending physician. This
should get rid of the $15 aspirins, $20 Band-Aids, etc.

7. A doctor receives no payment until all work is complete to the
patient's satisfaction.

8. A money back guarantee will be issued with all procedures performed.

I'm sure the group can think of others...
Regards,

Tom Watson
http://home.comcast.net/~tjwatson1/

On Sat, 30 May 2009 22:32:34 GMT, Nova wrote:

dpb wrote:

I'm not sure I've seen much in any really new ideas, unfortunately,
particularly those that would actually help across the full spectrum of
both abilities to pay and access to services.

The one thing I'm pretty sure of is that the inclusion of large segments
of currently under- or uninsured without a commensurate inclusion into
the payment pool by some means is going to be another federal welfare
program that will not be able to be funded w/o massive deficits or taxes
of one form or another.


snip

Here's a few changes I'd like to see:

1. The federal government will set a maximum hourly billing rate for
doctors based on their classification (GP, FP, neurosurgeon, etc.). The
patient can be billed only for the actual time spent with the physician
in 15 minute increments.

PErhaps you'd like a Washington Bureauscrat to set your hourly pay
too?

2. If you have scheduled a doctors appointment and are kept waiting past
your appointed time the doctor pays you for your wasted time at his
billing rate in 15 minute increments.

He's going to do this without raising his rates, just to make you
happy? He has to schedule empty slots so emergencies don't upset the
cart?

3. If you see a doctor and all he does is refer you to a specialist the
referring doctor get a $15 administrative fee only.

His knowledge isn't worth anything?

4. The patient pays only for those medications that prove to be effective.

There goes all experimental drugs and any treatment that isn't 100%
effective (are there any?).

5.A doctor is allowed to have all the tests performed that he deems
necessary. The patient pays for the test that finds the problem. The
doctor pays for the rest of the tests.

No tests - no diagnosis. That's a good idea too.

6. All hospital charges, anesthesiologist fees, nursing staff, in
hospital supplies and medications, etc. will be considered part of the
doctor's overhead and will be paid for by the attending physician. This
should get rid of the $15 aspirins, $20 Band-Aids, etc.

Nonsense. It'll just add another level of bean counting. "$15
aspirins" are "$15" because a large slice of the population is
actually paying $0. For everything.

7. A doctor receives no payment until all work is complete to the
patient's satisfaction.

No mode oncologists. Forget hospice care. Nice plan you have going
there.

8. A money back guarantee will be issued with all procedures performed.

See above.

I'm sure the group can think of others...

I suppose any idiot can show his stuff on the Usenet.

dpb wrote:

The "competition" between physicians for expert medical care is a
fallacy -- in general the consumer has insufficient expertise to judge
quality or to know how to select alternate care options for the
highest efficacy. When forced to make difficult decisions on perhaps
life-or-death issues, in the end its not likely that the overriding
concern will be the cost. Easy enough to hypothesize that's what the
so-called rational consumer SHOULD do, but just as the markets are as
much or more emotion-driven, health care choices are as well.

I can't answer all your concerns, but quality can be judged by those
competent to make the call; in this case, your family physician. If he
refers you to a specialist that's not quite appropriate, some of the blame
will trickle down to him and he'll (usually) adjust his referrals
accordingly.

My internist has referred me to three different specialists (opthamologist,
plastic surgeon, and orthopedic physician). Upon my return to him, the
internist inquired as to whether I was treated properly by the referral.

The health-care delivery system in the U.S. is not perfect by any measure.
It is, however, like democracy, better than any other system available.
While there are problems, the vast majority of Americans are satisfied with
their options.

What worries me is that the very real possibility of ****ing-up something
that works properly for 250 million citizens in the hope that a few
under-served people will be helped.

Another issue - and I don't recall whether you mentioned it - is physician
liability. My state, Texas, instituted a severe tort reform measure four
years ago. Among other things, it capped non-economic losses (pain &
suffering, punitive damages) at $250,000. We've stopped hemorrhaging
physicians and, in fact, had a tremendous increase in doctors moving here
from less-enlightened places.

Somebody wrote:

The one thing I'm pretty sure of is that the inclusion of large
segments
of currently under- or uninsured without a commensurate inclusion
into
the payment pool by some means is going to be another federal
welfare
program that will not be able to be funded w/o massive deficits or
taxes
of one form or another.

The problem is we are already paying the increased costs to cover the
under insured as hidden costs of doing business as a society.

As an example, emergency room visits that go unpaid which in many
cases requirement of a medical program that has advanced because
preventative medice was not available due to cost.

The E/R becomes the court of last result along with it high costs.

In the end it becomes a hidden cost we all pay which is higher than
necessary if all were insured.

It becomes a matter of "PAY me now or PAY me later"

Lew

krw wrote:
On Sat, 30 May 2009 22:32:34 GMT, Nova wrote:


dpb wrote:


I'm not sure I've seen much in any really new ideas, unfortunately,
particularly those that would actually help across the full spectrum of
both abilities to pay and access to services.

The one thing I'm pretty sure of is that the inclusion of large segments
of currently under- or uninsured without a commensurate inclusion into
the payment pool by some means is going to be another federal welfare
program that will not be able to be funded w/o massive deficits or taxes
of one form or another.


snip

Here's a few changes I'd like to see:

1. The federal government will set a maximum hourly billing rate for
doctors based on their classification (GP, FP, neurosurgeon, etc.). The
patient can be billed only for the actual time spent with the physician
in 15 minute increments.


PErhaps you'd like a Washington Bureauscrat to set your hourly pay
too?

Actually I do think I'd prefer it. Government workers in my field are
getting higher pay.


2. If you have scheduled a doctors appointment and are kept waiting past
your appointed time the doctor pays you for your wasted time at his
billing rate in 15 minute increments.


He's going to do this without raising his rates, just to make you
happy? He has to schedule empty slots so emergencies don't upset the
cart?

Waiting 30 to 60 minutes for every appointment tells me he makes it a
practice to over schedule.

3. If you see a doctor and all he does is refer you to a specialist the
referring doctor get a $15 administrative fee only.


His knowledge isn't worth anything?

Sure, to refer me to a another doctor it would be worth $15. How much
are you willing to pay, say an air conditioning repairman, for a service
call who tells you you have to call a another repairman to fix the problem.

4. The patient pays only for those medications that prove to be effective.

There goes all experimental drugs and any treatment that isn't 100%
effective (are there any?).

When is the last time your doctor prescribed an experimental drug. I
believe mine only prescribes the FDA approved ones. I never mentioned
100%, just effective.


5.A doctor is allowed to have all the tests performed that he deems
necessary. The patient pays for the test that finds the problem. The
doctor pays for the rest of the tests.


No tests - no diagnosis. That's a good idea too.

The doctor is free to run any test he wants. I think he'd pick the one
that would provide the most conclusive results the first time rather
than paying for three or four slightly less expensive tests that he
suspects has little chance of revealing the problem.


6. All hospital charges, anesthesiologist fees, nursing staff, in
hospital supplies and medications, etc. will be considered part of the
doctor's overhead and will be paid for by the attending physician. This
should get rid of the $15 aspirins, $20 Band-Aids, etc.


Nonsense. It'll just add another level of bean counting. "$15
aspirins" are "$15" because a large slice of the population is
actually paying $0. For everything.

That could very well be. That's probably the reason my wife's family
got a $3000 hospital bill for services rendered to her mother where the
date of the services performed were three months after her burial.
Neither are right.

7. A doctor receives no payment until all work is complete to the
patient's satisfaction.


No mode oncologists.

Why, my wife has been more than satisfied with her oncologist who has
treated her twice in the past.

Forget hospice care.

I agree.

Nice plan you have going there.

Thank you!

8. A money back guarantee will be issued with all procedures performed.

See above.

I'm sure the group can think of others...

I suppose any idiot can show his stuff on the Usenet.

I guess so.

--
Jack Novak
Buffalo, NY - USA

"HeyBub" wrote in
m:

dpb wrote:

The "competition" between physicians for expert medical care is a
fallacy -- in general the consumer has insufficient expertise to
judge quality or to know how to select alternate care options for the
highest efficacy. When forced to make difficult decisions on perhaps
life-or-death issues, in the end its not likely that the overriding
concern will be the cost. Easy enough to hypothesize that's what the
so-called rational consumer SHOULD do, but just as the markets are as
much or more emotion-driven, health care choices are as well.

I can't answer all your concerns, but quality can be judged by those
competent to make the call; in this case, your family physician. If he
refers you to a specialist that's not quite appropriate, some of the
blame will trickle down to him and he'll (usually) adjust his
referrals accordingly.

That's indeed the ideal situation. I wish it were true for more people,
including me, and I work in hospitals, albeit as a bench-type researcher.

My internist has referred me to three different specialists
(opthamologist, plastic surgeon, and orthopedic physician). Upon my
return to him, the internist inquired as to whether I was treated
properly by the referral.

The health-care delivery system in the U.S. is not perfect by any
measure. It is, however, like democracy, better than any other system
available. While there are problems, the vast majority of Americans
are satisfied with their options.

I'm not sure the majority is, and maybe some who are shouldn't be. That
goes vice versa as well. Some patients are just not taking the care they
should. Things as simple as the correct answer to have you recently
taken aspirin or other similar medications are not answered correctly (I
can prove this in my work).

What worries me is that the very real possibility of ****ing-up
something that works properly for 250 million citizens in the hope
that a few under-served people will be helped.

Yes, that is pssible. The reverse is much more likely.

Another issue - and I don't recall whether you mentioned it - is
physician liability. My state, Texas, instituted a severe tort reform
measure four years ago. Among other things, it capped non-economic
losses (pain & suffering, punitive damages) at $250,000. We've stopped
hemorrhaging physicians and, in fact, had a tremendous increase in
doctors moving here from less-enlightened places.

Congratulations. That example should be followed everywhere. In
addition, physicians who make bad decisions should get more than a
friendly pat - some should be really punished, and it should NOT be
covered by insurance.


--
Best regards
Han
email address is invalid

"Nova" wrote:

Forget hospice care.

Having been involved with hospice twice in the last 18 months, they
do, or at least for me, did a great job.

Lew

On Sat, 30 May 2009 11:01:05 -0500, dpb wrote:

But yet the SSA administers Social Security with an almost negligible
amount of overhead. A government program can work efficently, but the
devil is in the details.
...

Yeah, so efficiently they have thousands on the roles that have been
deceased, some for decades (GAO investigation I heard reported not long
ago)...

I don't doubt there's some fraud going on, but unless you can cite the
source I doubt it's in the thousands. And I mentioned low overhead which
you didn't seem to question.

I wonder if the costs of lowering the fraud rate would exceed the amount
that was saved?

--
Intelligence is an experiment that failed - G. B. Shaw

"Larry Blanchard" wrote in message
news
On Sat, 30 May 2009 11:01:05 -0500, dpb wrote:

But yet the SSA administers Social Security with an almost negligible
amount of overhead. A government program can work efficently, but the
devil is in the details.
...

Yeah, so efficiently they have thousands on the roles that have been
deceased, some for decades (GAO investigation I heard reported not long
ago)...

I don't doubt there's some fraud going on, but unless you can cite the
source I doubt it's in the thousands. And I mentioned low overhead which
you didn't seem to question.

I doubt it too. I'd think it is probably in the tens of thousands. Really,
I do. Then the ones fraudulently collecting disability is probably triple
that number. Read the last line in this .

http://therecordlive.com/article/Bey...c heats/52994
U.S. Congressman Kevin Brady (R-The Woodlands) met today in Houston with
officials from the Social Security Administration ahead of a congressional
hearing next week to examine fraud in the federal disability program. Brady,
who requested the hearing of the House Ways & Means Subcommittee on Social
Security, says scammers may be draining up to $11 billion from the Social
Security Disability Insurance Trust Fund that helps more than seven million
disabled Americans.

"We have a responsibility to taxpayers and the truly disabled to make sure
these precious dollars are not lost to fraud and those trying to game the
system," said Brady, a member of the Social Security panel.

Brady met Monday with Patrick O'Carroll Jr., inspector general of the Social
Security Administration, and leaders of the Houston Co-operative Disability
Investigative (CDI) unit which includes team members from the Social
Security Administration, the Inspector General's office, the state
disability agency and Harris County law enforcement.

Since the Houston unit was formed in 2000, the team has successfully
terminated 1,003 cases, saving taxpayers nearly $90 million. The unit
investigates disability fraud in applicants faking impairments as well as
those concealing work payments or medical improvements while receiving
disability payments.

O'Carroll told the congressman that 14 tax dollars are saved for every
dollar Congress allots to investigate disability fraud allegations. The
Social Security Administration is required to conduct continuing disability
reviews on each case.

In one particularly egregious case from last year, a dead man was actually
put in a wheelchair and brought to a check-cashing store in New York so one
of his friends could cash his check (Source: Reuters 1/9/08).

"Nova" wrote in message
...


snip

Here's a few changes I'd like to see:

1. The federal government will set a maximum hourly billing rate for
doctors based on their classification (GP, FP, neurosurgeon, etc.). The
patient can be billed only for the actual time spent with the physician in
15 minute increments.

So it would lso be Ok if the government regulated your pay?


2. If you have scheduled a doctors appointment and are kept waiting past
your appointed time the doctor pays you for your wasted time at his
billing rate in 15 minute increments.

So you go in to see the doctor and he ushers you out at the end of 15
minutes, finished with you or not, so that he can get to the next patient.
Your Ok with that?



3. If you see a doctor and all he does is refer you to a specialist the
referring doctor get a $15 administrative fee only.

I can see that.



4. The patient pays only for those medications that prove to be effective.

I see your point but you may be perscribed a potent dosage of, "what ever",
that may be more harmful in the long run but does cure your symptoms.


5.A doctor is allowed to have all the tests performed that he deems
necessary. The patient pays for the test that finds the problem. The
doctor pays for the rest of the tests.

I would be more willing to pay for those tests, I don't want the doctor to
hold back on tests because he is going to have to pay for them himself.
You really don't want him guessing which "one" test should provide the
information needed.


6. All hospital charges, anesthesiologist fees, nursing staff, in hospital
supplies and medications, etc. will be considered part of the doctor's
overhead and will be paid for by the attending physician. This should get
rid of the $15 aspirins, $20 Band-Aids, etc.

I think getting rid of the strangle hold the insurance company has would
take care of the over priced 10 cent items.



7. A doctor receives no payment until all work is complete to the
patient's satisfaction.

I think pay up front for the services rendered but if you have to go back
the visits should be at no charge.



8. A money back guarantee will be issued with all procedures performed.

Is your doctor responsible for you not taking medication exactly as
perscribed, or not going to therapy, or some other part of your body
crapping out because of the illness you had?

"dpb" wrote in message ...


I didn't say anything about _which_ estimate you have to submit; only that
they will only pay the amount of the lowest that is submitted that covers
the required work.

That is not true, they indeed have to pay what ever price the shop charges
that you choose. Been there and done that for years on end.


Most body shops I've dealt with will come to within a few $$ of any other;
they all use one of a few software packages for estimating so their labor
estimates are all within a few tenths of hours/task and they all use the
same or nearly after-market parts markets as well. The biggest
differences I've seen is finishing but the highest here will tell you when
he makes the estimate it's higher than most other shops in town because of
that and he'll knock it down when the insurance company balks (as they
always do).

The insured calls the shots as to which repair shop does the work, the
repair shop may drop the price to play along.


If it's a chromed piece I'll make it be OEM; otherwise anymore I can't see
any significant difference in the aftermarket parts of significance. Just
been thru it w/ Mr Buck that couldn't stay on the side of the road where
he belonged...


Work around genuine and aftermarket and you will soon learn to tell the
difference. I bought and sold both for 15+ years. Basically you still get
better parts when you pay more. some times this will make a difference some
times not. After market sheet metal will dent easier and often rusts
sooner. Considering chrome, most often the repaired/rechromed bumper will
have a life time guarantee, the Body shop however will not often tell you
that.

"Nova" wrote in message
...
Leon wrote:
"Nova" wrote in message
...


I don't know that I'd always want my medical treatment to go to the
lowest bidder.


Agreed and these guys are probably makin more off of the procedure than
those having to collect from an insurance company. Remember insurance
companines get deep deep discounts and often don't pay.

It sound to me like the insurance companies are keeping the cost down.

Would you use an insurance company to hep you buy electricity, groceries,
clothing? They don't keep costs down, often they perpetuate the problem.



Basically HMO's and insurance companies are more like agents for many
doctors. I think I would probably have more faith in a doctor that
does not rely on an insurance company to bring in it's patients.


The insurance companies rely on their participating doctors list to bring
in the customers.

I have never heard of any one including myself choosing an insurance company
based on its doctors list. Most employees insurance is provided through
their employeer. The employeer decides which insurance company to go with
and you choose from the list of doctors.






There will probably still be insurance for catastrophic needs if you
feel that living an extra year or two is woth having insurance for.

It doesn't take a catastrophe to end up with astronomical medical bills.
I don't foresee any major reduction is the cost of medical care
regardless of who foots the bill.


Don't for get the major point here, insuranc companies make more than the
health care system does and what overhead does an insurance company have
other than an office for record keeping?

Medical insurance companies are gambling that the coverage premium they
charge along with any returns on there investments made with your money
will exceed the medical payments they make in your behalf. By them making
a profit it shows that on the average they're right.

But dont be fooled into thinking that every claim is not scrutinized by the
insurance company. More often than not th winsurance company disallows
legitimate claims.


Take the insurance company out of petty coverage and every one saves,
except the insurance company.

Your key word above is "petty". If you take the insurance company out of
the picture you'd better hope that you're one of the customers that make
their "average" profitable.

I do not want the insurance company completely removed, just remove them
from the petty, normal, illnesses by simply raising the deductible. I lower
my auto and home owners, and flood insurance by paying a higher deductible.
If the average person had a $2000 deductible I suspect the cost of primary
care would go down when the insurance claims became fewer in number.

"Leon" wrote in message

I do not want the insurance company completely removed, just remove them
from the petty, normal, illnesses by simply raising the deductible. I
lower my auto and home owners, and flood insurance by paying a higher
deductible. If the average person had a $2000 deductible I suspect the
cost of primary care would go down when the insurance claims became fewer
in number.

Our company went to a $1000 deductible (which they will re-imburse us) and
the premium went down $1200 A few people tap it out every year, a few never
use any of it. Overall savings is considerable. .

Han wrote:

What worries me is that the very real possibility of ****ing-up
something that works properly for 250 million citizens in the hope
that a few under-served people will be helped.

Yes, that is pssible. The reverse is much more likely.

Not as long as congress-critters hold to "static-scoring," that is, the
belief that addressing one problem won't affect other areas. For example,
suppose our betters say: "Look, there're 40 million uninsured in the
country. Let's simply require doctors to treat those without insurance and
send their bill to Medicaid. We can (barely) pay for that." Then the fools
look surprised when 260 million people suddenly cancel their existing
insurance.

Delaware dramatically upped taxes on millionaires two years ago. This year,
there are one-third fewer millionaires in the state. Delaware officials are
shocked that over 1,000 of their highest income people have pulled an Elvis.

Point is, people are not "static." They respond to government actions, often
in unexpected, but rational, ways.


Another issue - and I don't recall whether you mentioned it - is
physician liability. My state, Texas, instituted a severe tort reform
measure four years ago. Among other things, it capped non-economic
losses (pain & suffering, punitive damages) at $250,000. We've
stopped hemorrhaging physicians and, in fact, had a tremendous
increase in doctors moving here from less-enlightened places.

Congratulations. That example should be followed everywhere. In
addition, physicians who make bad decisions should get more than a
friendly pat - some should be really punished, and it should NOT be
covered by insurance.

I've got an even better fix.

Tort damages consist of several pieces: recovery of economic loss, pain &
suffering, loss of consortium, and so on. My plan is to divert ALL
"punitive" damages to the state. Punitive damages are really "fines" to
discourage future rascally behavior by the defendant, so why should the
plaintiff benefit? In many cases, punitive damages dwarf all other awards
and it is they that make the case worthwhile for the plaintiff bar.

As an aside, Walmart has a policy (I'm told) of NEVER settling a
"slip-and-fall" case - they will always take the case to trial. This costs
more up front, but it does guarantee that meritless claims don't get past
the letter-writing stage.

Ed Pawlowski wrote:
"Leon" wrote in message

I do not want the insurance company completely removed, just remove
them from the petty, normal, illnesses by simply raising the
deductible. I lower my auto and home owners, and flood insurance by
paying a higher deductible. If the average person had a $2000
deductible I suspect the cost of primary care would go down when the
insurance claims became fewer in number.

Our company went to a $1000 deductible (which they will re-imburse
us) and the premium went down $1200 A few people tap it out every
year, a few never use any of it. Overall savings is considerable. .

The trouble with that is that these days the bill for something simple can
be immense. The local hospital tried to charge me 2000 bucks for four lousy
stitches and a tetanus shot.

Leon wrote:
"Nova" wrote in message

Agreed and these guys are probably makin more off of the procedure than
those having to collect from an insurance company. Remember insurance
companines get deep deep discounts and often don't pay.

It sound to me like the insurance companies are keeping the cost down.


Would you use an insurance company to hep you buy electricity, groceries,
clothing? They don't keep costs down, often they perpetuate the problem.

Think of it as a co-op paying wholesale rather than retail.


Basically HMO's and insurance companies are more like agents for many
doctors. I think I would probably have more faith in a doctor that
does not rely on an insurance company to bring in it's patients.


The insurance companies rely on their participating doctors list to bring
in the customers.


I have never heard of any one including myself choosing an insurance company
based on its doctors list. Most employees insurance is provided through
their employeer. The employeer decides which insurance company to go with
and you choose from the list of doctors.

The company I work for last year offered three different plans.

The first plan was their "Basic Medical Plan". The company paid 100% of
the premium. You had to designate a primary physician and the only way
you could see a different doctor was through a referral by the primary.
There was a $25 co-payment per office visit and very few doctors in my
area accepted the plan. None of the doctors we've used for years
accepted the plan.

The second offering was an HMO where I paid a small portion of the
premium and all medical treatment had to be done by the single
designated facility. The office was about 20 miles from my home and I'd
never heard of any of the doctors on the staff.

The third plan required me to pay a much higher portion of the monthly
premium. The out of pocket premium would cost me about $80 per month
for myself and my wife. Any doctor I looked for in the list of
participating doctors accepted the plan. I did not have to designate a
primary physician and could see any doctor of my choice at any time.
Office visits had a $10 co-payment.

I chose the third plan.

--
Jack Novak
Buffalo, NY - USA

"Ed Pawlowski" wrote in message
...

"Leon" wrote in message

I do not want the insurance company completely removed, just remove them
from the petty, normal, illnesses by simply raising the deductible. I
lower my auto and home owners, and flood insurance by paying a higher
deductible. If the average person had a $2000 deductible I suspect the
cost of primary care would go down when the insurance claims became fewer
in number.

Our company went to a $1000 deductible (which they will re-imburse us) and
the premium went down $1200 A few people tap it out every year, a few
never use any of it. Overall savings is considerable. .

Exactly! I believe that insurance costs are sky high because of abuse.
IMHO insurance should only be used of those events that you could no
possibly afford, not normal trips to the doctor for the regular illness.

"Nova" wrote in message
...
Leon wrote:
"Nova" wrote in message
Agreed and these guys are probably makin more off of the procedure than
those having to collect from an insurance company. Remember insurance
companines get deep deep discounts and often don't pay.

It sound to me like the insurance companies are keeping the cost down.


Would you use an insurance company to hep you buy electricity, groceries,
clothing? They don't keep costs down, often they perpetuate the problem.

Think of it as a co-op paying wholesale rather than retail.


That is exactly how I think of it. The insurance company is paying
wholesale to the doctor, I pay way above retail for that insurance.

Basically HMO's and insurance companies are more like agents for many
doctors. I think I would probably have more faith in a doctor that
does not rely on an insurance company to bring in it's patients.


The insurance companies rely on their participating doctors list to bring
in the customers.


I have never heard of any one including myself choosing an insurance
company based on its doctors list. Most employees insurance is provided
through their employeer. The employeer decides which insurance company
to go with and you choose from the list of doctors.

The company I work for last year offered three different plans.

The first plan was their "Basic Medical Plan". The company paid 100% of
the premium. You had to designate a primary physician and the only way
you could see a different doctor was through a referral by the primary.
There was a $25 co-payment per office visit and very few doctors in my
area accepted the plan. None of the doctors we've used for years accepted
the plan.

The second offering was an HMO where I paid a small portion of the premium
and all medical treatment had to be done by the single designated
facility. The office was about 20 miles from my home and I'd never heard
of any of the doctors on the staff.

The third plan required me to pay a much higher portion of the monthly
premium. The out of pocket premium would cost me about $80 per month for
myself and my wife. Any doctor I looked for in the list of participating
doctors accepted the plan. I did not have to designate a primary
physician and could see any doctor of my choice at any time. Office visits
had a $10 co-payment.

I chose the third plan.

And your share is a drop in the bucket compared to what the company cost
was. My wife works for the state of Texas and they get very favorable
rates, her insurance is similar to the one you chose and her share of the
premium is $0. For myself and our son our share of the premium is 1/2,
$380 per month.
Several years ago the average expense for a company was around $900 per
month to cover an employee with insurance.

On Sun, 31 May 2009 01:14:11 GMT, Nova wrote:

krw wrote:
On Sat, 30 May 2009 22:32:34 GMT, Nova wrote:


dpb wrote:


I'm not sure I've seen much in any really new ideas, unfortunately,
particularly those that would actually help across the full spectrum of
both abilities to pay and access to services.

The one thing I'm pretty sure of is that the inclusion of large segments
of currently under- or uninsured without a commensurate inclusion into
the payment pool by some means is going to be another federal welfare
program that will not be able to be funded w/o massive deficits or taxes
of one form or another.


snip

Here's a few changes I'd like to see:

1. The federal government will set a maximum hourly billing rate for
doctors based on their classification (GP, FP, neurosurgeon, etc.). The
patient can be billed only for the actual time spent with the physician
in 15 minute increments.


PErhaps you'd like a Washington Bureauscrat to set your hourly pay
too?

Actually I do think I'd prefer it. Government workers in my field are
getting higher pay.

So *you* are the guy who liked Nixon's wage and price controls.

2. If you have scheduled a doctors appointment and are kept waiting past
your appointed time the doctor pays you for your wasted time at his
billing rate in 15 minute increments.


He's going to do this without raising his rates, just to make you
happy? He has to schedule empty slots so emergencies don't upset the
cart?

Waiting 30 to 60 minutes for every appointment tells me he makes it a
practice to over schedule.

"Every"? You've gone through his records and checked every patient?

3. If you see a doctor and all he does is refer you to a specialist the
referring doctor get a $15 administrative fee only.


His knowledge isn't worth anything?

Sure, to refer me to a another doctor it would be worth $15. How much
are you willing to pay, say an air conditioning repairman, for a service
call who tells you you have to call a another repairman to fix the problem.

That was the "administrative cost". You allowed the doctor nothing
for the doctor. If you didn't need his time, effort, and knowledge
why pay the "administrative costs" and just see the specialist.

4. The patient pays only for those medications that prove to be effective.

There goes all experimental drugs and any treatment that isn't 100%
effective (are there any?).

When is the last time your doctor prescribed an experimental drug. I
believe mine only prescribes the FDA approved ones. I never mentioned
100%, just effective.

You're changing the subject now. Most drugs are not effective for
everyone and some have adverse reactions to them. Is that the
doctor's fault?

5.A doctor is allowed to have all the tests performed that he deems
necessary. The patient pays for the test that finds the problem. The
doctor pays for the rest of the tests.


No tests - no diagnosis. That's a good idea too.

The doctor is free to run any test he wants. I think he'd pick the one
that would provide the most conclusive results the first time rather
than paying for three or four slightly less expensive tests that he
suspects has little chance of revealing the problem.

No, he would pick "none", because there is a high probability that any
individual test will come up negative. If he knew what the diagnosis
was, why run the test at all?

6. All hospital charges, anesthesiologist fees, nursing staff, in
hospital supplies and medications, etc. will be considered part of the
doctor's overhead and will be paid for by the attending physician. This
should get rid of the $15 aspirins, $20 Band-Aids, etc.


Nonsense. It'll just add another level of bean counting. "$15
aspirins" are "$15" because a large slice of the population is
actually paying $0. For everything.

That could very well be. That's probably the reason my wife's family
got a $3000 hospital bill for services rendered to her mother where the
date of the services performed were three months after her burial.
Neither are right.

Now you're changing the subject to fraud, so you do know your argument
is asinine.

7. A doctor receives no payment until all work is complete to the
patient's satisfaction.


No mode oncologists.

Why, my wife has been more than satisfied with her oncologist who has
treated her twice in the past.

Forget hospice care.

I agree.

Nice plan you have going there.

Thank you!

You are a sick puppy.

8. A money back guarantee will be issued with all procedures performed.

See above.

I'm sure the group can think of others...

I suppose any idiot can show his stuff on the Usenet.

I guess so.

At least you admit to your failings.

"HeyBub" wrote in
m:

Tort damages consist of several pieces: recovery of economic loss,
pain & suffering, loss of consortium, and so on. My plan is to divert
ALL "punitive" damages to the state. Punitive damages are really
"fines" to discourage future rascally behavior by the defendant, so
why should the plaintiff benefit? In many cases, punitive damages
dwarf all other awards and it is they that make the case worthwhile
for the plaintiff bar.

As an aside, Walmart has a policy (I'm told) of NEVER settling a
"slip-and-fall" case - they will always take the case to trial. This
costs more up front, but it does guarantee that meritless claims don't
get past the letter-writing stage.

Fine, but now the lawyers take 1/3 of all awards. I think the person who
is "damaged" should get all his losses (including reasonable lawyers'
fees) reimbursed. The "loser" should pay all lawyers fees, and indeed
punitive "rewards" should go to the state.

The Walmart thing is possibly just cases going after deep pockets, IMNSHO
that is not to be permitted. However, someone or some organization
should have been punished for the "thing" that happened to the person(s)
trampled to death during the Black Friday opening of a store in Valley
Stream Long Island. It does not seem logical that providing insufficient
security should go unpunished. Plus the mob there should have been
punished somehow. Just my opinion.


--
Best regards
Han
email address is invalid

Han wrote:
"HeyBub" wrote in
m:

Tort damages consist of several pieces: recovery of economic loss,
pain & suffering, loss of consortium, and so on. My plan is to divert
ALL "punitive" damages to the state. Punitive damages are really
"fines" to discourage future rascally behavior by the defendant, so
why should the plaintiff benefit? In many cases, punitive damages
dwarf all other awards and it is they that make the case worthwhile
for the plaintiff bar.

As an aside, Walmart has a policy (I'm told) of NEVER settling a
"slip-and-fall" case - they will always take the case to trial. This
costs more up front, but it does guarantee that meritless claims
don't get past the letter-writing stage.

Fine, but now the lawyers take 1/3 of all awards. I think the person
who is "damaged" should get all his losses (including reasonable
lawyers' fees) reimbursed. The "loser" should pay all lawyers fees,
and indeed punitive "rewards" should go to the state.

So now the state treats lawsuits as a source of revenue and does everything
it can to encourage them.

Can you say "unintended consequences"?

The Walmart thing is possibly just cases going after deep pockets,
IMNSHO that is not to be permitted. However, someone or some
organization should have been punished for the "thing" that happened
to the person(s) trampled to death during the Black Friday opening of
a store in Valley Stream Long Island. It does not seem logical that
providing insufficient security should go unpunished. Plus the mob
there should have been punished somehow. Just my opinion.

dpb wrote:

I don't understand the 30% example--typically insurance carriers are
covering 80% or "standard and normal" for any particular procedure.

My wife has had two serious hospitalizations. The billed rate was $110,000 for
the first and $60,000 for the second. The hospital accepted $60,000 for the
first and $28,000 for the second from the insurance company as payment in full.
The first cost us $800 out of pocket and the second $100.

The insurance company paid rates negotiated with the hospitals. And this is
part of the problem. Uninsured people, the ones who can least afford it, pay
the highest rates. I'm no socialist, but that just ain't fair.

Incidentally, that is another good reason to maintain even a high-deductible
health insurance policy. You will get the negotiated rate even if you pay most
of it yourself.

-- Doug

"Leon" wrote:

Exactly! I believe that insurance costs are sky high because of
abuse. IMHO insurance should only be used of those events that you
could no possibly afford, not normal trips to the doctor for the
regular illness.

On first glance looks good, but when you dig deeper has a major flaw.

When insurance covers regular services of a person's primary giver,
illnesses are detected earlier and can be handled with the lowest cost
service.

When insurance does not covers regular services of a person's primary
giver, illnesses are not detected as early as they should be often
resulting in higher cost services to overcome the advanced problem.

Health care insurance is a tad different than other insurance
products.

Lew

"Douglas Johnson" wrote in message
...

The insurance company paid rates negotiated with the hospitals. And this
is
part of the problem. Uninsured people, the ones who can least afford it,
pay
the highest rates. I'm no socialist, but that just ain't fair.


Maybe, maybe not. Some low income and no income people have those bills and
pay nothing. The rest of us pay for them.

Douglas Johnson wrote:
dpb wrote:

I don't understand the 30% example--typically insurance carriers are
covering 80% or "standard and normal" for any particular procedure.

My wife has had two serious hospitalizations. The billed rate was
$110,000 for the first and $60,000 for the second. The hospital
accepted $60,000 for the first and $28,000 for the second from the
insurance company as payment in full. The first cost us $800 out of
pocket and the second $100.

The insurance company paid rates negotiated with the hospitals. And
this is part of the problem. Uninsured people, the ones who can
least afford it, pay the highest rates. I'm no socialist, but that
just ain't fair.


Fair? What's UN-fair about a willing buyer and a willing seller?

If you bought a $110,000 product or service from me every couple of days,
I'd probably be willing to cut you a 45% discount, too.

J. Clarke wrote:
Han wrote:
"HeyBub" wrote in
m:

Tort damages consist of several pieces: recovery of economic loss,
pain & suffering, loss of consortium, and so on. My plan is to
divert ALL "punitive" damages to the state. Punitive damages are
really "fines" to discourage future rascally behavior by the
defendant, so why should the plaintiff benefit? In many cases,
punitive damages dwarf all other awards and it is they that make
the case worthwhile for the plaintiff bar.

So now the state treats lawsuits as a source of revenue and does
everything it can to encourage them.

Can you say "unintended consequences"?


Ooh! Good point!

"HeyBub" wrote in news:17-
:

J. Clarke wrote:
Han wrote:
"HeyBub" wrote in
m:

Tort damages consist of several pieces: recovery of economic loss,
pain & suffering, loss of consortium, and so on. My plan is to
divert ALL "punitive" damages to the state. Punitive damages are
really "fines" to discourage future rascally behavior by the
defendant, so why should the plaintiff benefit? In many cases,
punitive damages dwarf all other awards and it is they that make
the case worthwhile for the plaintiff bar.

So now the state treats lawsuits as a source of revenue and does
everything it can to encourage them.

Can you say "unintended consequences"?


Ooh! Good point!

Yes, indeed.

--
Best regards
Han
email address is invalid

"Lew Hodgett" wrote in message
...


On first glance looks good, but when you dig deeper has a major flaw.

When insurance covers regular services of a person's primary giver,
illnesses are detected earlier and can be handled with the lowest cost
service.

When insurance does not covers regular services of a person's primary
giver, illnesses are not detected as early as they should be often
resulting in higher cost services to overcome the advanced problem.

Health care insurance is a tad different than other insurance products.

Lew



The very simple solution is that the insurance company requires the customer
to have regular scheduled check ups on his dime. Kinda like auto insurance
companies giving you better rates if you take defensive driving courses and
avoid tickets by obeying traffic laws.

Lew Hodgett wrote:
Somebody wrote:

The one thing I'm pretty sure of is that the inclusion of large
segments
of currently under- or uninsured without a commensurate inclusion
into
the payment pool by some means is going to be another federal
welfare
program that will not be able to be funded w/o massive deficits or
taxes
of one form or another.

The problem is we are already paying the increased costs to cover the
under insured as hidden costs of doing business as a society.

As an example, emergency room visits that go unpaid which in many
cases requirement of a medical program that has advanced because
preventative medice was not available due to cost.

The E/R becomes the court of last result along with it high costs.

In the end it becomes a hidden cost we all pay which is higher than
necessary if all were insured.

It becomes a matter of "PAY me now or PAY me later"
....
For the record, the "somebody" was actually me--

Of course much of the high cost is the cost of the under/non-insured
being paid by the responsible/insured. But, I fail to see how/why
people seem to think that adding additional clientele who aren't payers
to the system is somehow going to reduce the actual expenses--it's only
going to raise demand and (at least everything I've seen proposed so
far) take money from a government pocket to artificially reduce
_apparent_ individual cost. Meanwhile, non-itemized expenses in the
form of alternative and higher taxes (remember, the whole point of the
proposed C cap&trade fiasco is to generate a multi-billion revenue
stream to the federal government to pay for this) is going to skyrocket.

Unless and until there's some technique to generate more actual revenue
from those who are actually in the pool that aren't currently paying
there's no relief. I've yet to see proposals that seem to be effective
in doing that.

My suggestions to open up the existing large insurance pools to the
self-employed and for small businesses that currently can't afford any
or at least very good programs for themselves and their employees would
allow for a large population to actually contribute that currently aren't.

In addition, I think it should be required that all salaried workers
contribute something to a plan regardless of salary level--opting out
unless demonstrate are covered under a spousal plan or independently
(similar to showing proof of auto insurance for registration) would not
be allowed.

Also, the earlier point someone made upthread of raising contribution
limits and relaxing restrictions on usage of the various health savings
plans would allow for more people to be able to do better in becoming
self-insured either fully if of high-enough income or partially if
lesser. There would be far more participation in these if, for example,
it wasn't "use it or lose it" on a yearly basis as the most obvious.

More controversial, the inevitable cheats who don't have coverage at the
minimum as outlined above get nothing but the most basic of services.
There have to be consequences for bad behavior or there is no incentive
for the irresponsible and as is currently the case the good will
continue to carry the bad.

--

"Leon" wrote in message
The very simple solution is that the insurance company requires the
customer
to have regular scheduled check ups on his dime. Kinda like auto
insurance
companies giving you better rates if you take defensive driving courses
and
avoid tickets by obeying traffic laws.

Sorry, can't agree with that view. Some people who are not in perfect health
even though it may not be their fault, have to pay through the nose. You can
be smart, educated and do everything in your power to take care of yourself
and still be terribly ill.

Unlike your defensive driving courses where proper driving etiquette can be
learned, some people can't avoid the ill health the plagues them.

"Upscale" wrote in message
...

"Leon" wrote in message
The very simple solution is that the insurance company requires the
customer
to have regular scheduled check ups on his dime. Kinda like auto
insurance
companies giving you better rates if you take defensive driving courses
and
avoid tickets by obeying traffic laws.

Sorry, can't agree with that view. Some people who are not in perfect
health
even though it may not be their fault, have to pay through the nose. You
can
be smart, educated and do everything in your power to take care of
yourself
and still be terribly ill.

Unlike your defensive driving courses where proper driving etiquette can
be
learned, some people can't avoid the ill health the plagues them.


Totally agreed, and I was not suggesting to filter any one out. I was
simply suggesting that the insurance company require every one to have
regular "checkups" that they pay for them selves. That this could go a long
way in reducing a lot of doctor visits or more expensive treatments later
on.. For those that already have a condition the only requirement would be
that they also go to have the "regular check up". The fact that they have a
preexisting condition or happen to be come ill more often that the average
person would have no factor at all.
This would be more of a preventative program for those that do and or do not
appear to have symptoms.
My whole thought process is to prevent ER care for a sore throat because the
regular doctor is off for the weekend or doctor visits that are uncalled
for.

"Leon" wrote:


The very simple solution is that the insurance company requires the
customer to have regular scheduled check ups on his dime.

You have just eliminated that portion of the population that can least
afford to pay for health care in the first place which will definitely
include the full time minimum wage worker.

Providing health care to those who can least afford to pay for it is
just another way of subsidizing the hidden costs of the minimum wage.

"Pay me now or pay me later" applies.

Lew

dpb wrote:
....
In addition, I think it should be required that all salaried workers
contribute something to a plan regardless of salary level--opting out
unless demonstrate are covered under a spousal plan or independently
(similar to showing proof of auto insurance for registration) would not
be allowed.
....
Another suggestion/possibility along the above line occurred to me --
While in general I'm not a fan of tax policy for behavior, in some
instances it does have beneficial uses. How about if can't show
contribution from employer or self-paid premiums or adequate/equivalent
coverage at a fixed level depending upon AGI, additional charge (not
tax) for the medical pool added. If there's a federal coverage, it's
the premium for it; otherwise premium to carrier of choice w/ at least
minimum coverage.

That'll pick up the doofuses like ex-SIL who dropped participation and
the court-mandated childrens' coverage and claimed penny-stricken and
broke when granddaughter had short hospital stay during visit here
leaving daughter holding the bag. Yet, always has plenty of $$ for the
toys, etc., etc, etc., ...

--