Real Opinions? Who Do You Vote For And Why? Topic

One is well within their rights to go to the doctor for a minor health issue.   That's why they purchased the insurance.   However, and this goes back to what moy said, one is also within their rights to eat 14 Big Macs a day, wash then down with a gallon of liquor and smoke three packs of Camels in their free time.   But none of that is personally responsible and they are definitely contributing to the healthcare issue.

10/30/2012 3:04 PM
Sort of the "If you're not part of the solution, you're part of the problem" thing.
10/30/2012 3:06 PM
I just think we are looking at the health care insurance issue from the wrong angle. it's insurance.... it should be approached as insurance. insurance is only used when accidents and emergencies occur. that's how insurance companies make money. I'd rather see people paying the full $150 for a preventative check up rather than a $25 co-pay and having the insurance company foor the rest.... save that $ to reduce premiums or to cover more out of pocket in a real emergency. my 2 cents.
10/30/2012 3:41 PM
Posted by MikeT23 on 10/30/2012 3:04:00 PM (view original):

One is well within their rights to go to the doctor for a minor health issue.   That's why they purchased the insurance.   However, and this goes back to what moy said, one is also within their rights to eat 14 Big Macs a day, wash then down with a gallon of liquor and smoke three packs of Camels in their free time.   But none of that is personally responsible and they are definitely contributing to the healthcare issue.

We eat like pigs, Russia smokes and drinks like crazy.

Both nations are pretty healthy compared to mose countries.

Our costs being out of control have nothing to do with health issues.

They have to do with marketing medicine.

Giving people free health care and then telling them that they need to go there for everything.

And of course no tort reform.
10/30/2012 3:55 PM
The problem with forcing people to pay full cost or near full cost for preventative medicine, moy, is many people simply wouldn't get the preventative medicine. They'd rather save their money and if that means suffering with a problem that otherwise would have been prevented, then that's what they do. It also means they'll end up costing far more later on when the problem develops or gets worse.

Co-pays are an insurance company's way of convincing people not to utilize their services for trivial matters. They don't actually save much by having you pay, say, $25 on a $150 bill, but the idea is if you didn't have to pay that $25, you might go a lot more often in less needful circumstances, costing them far more.

When you deal with insurance companies, especially if you are negotiating a policy, you have to keep in mind anything they want is probably bad for you. If they want you to pay a co-pay or have (or increase) a deductible, the only purpose is to discourage you from actually using their services. Their goal is to make money by charging their collective customers more than what they pay out.

Since insurance customers will (obviously) only put up with so much in terms of increases to premium costs, at some point they have to work from the other end in order to make more money. That means instead of raising the cost of their services, they start cutting the services they offer on the other end.

The main job of any insurance adjuster is to find a way to essentially **** you over. You don't tell the insurance company you're going to "adjust" their premium downward and pay them less if you haven't recently used the insurance, and yet they want to "adjust" what you get if you ever have a claim. They'll do their best to pay out as little as possible, even if that means you lose. Most of them care little about service (although that sure isn't what they'll try to sell you on) and only care about the bottom line.

Back to what I think is my main point (after I ranted for a bit there lol), which is that insurance companies shouldn't be dictating care at all. It should be about medical professionals who know what they are doing. Costs should be a secondary concern to anything, if they are a concern at all.

10/30/2012 3:58 PM
Mike's right, I didn't really intend for this to be a healthcare debate, but I thought I'd put in a quick word on that.  moy has the insurance concept correct (more than a 2 cent comment BTW).  Insurance for anything, at least conceptually, is designed to replace or repair something that you can't afford on your own.  Most people cannot afford to replace their home or pay for liability for hurting others on their property.  Same with auto replacement.  When you buy an extended warranty on a product, you are essentially buying insurance (same exact method of funding and setting costs, complete with actuarial tables for projected losses).  A generally sound fiscal rule is never insure anything you can afford to replace.

Prices for healthcare are not market-based, but are cost-based.  What I mean by that is that providers set their rates based on their operating costs plus a margin for overhead and profit (as they should).  There is upward price pressure based on many factors, such as research and development, salaries, regulations, malpractice insurance, taxes, and fixed pricing for Medicare/Medicaid (which is generally made up for with pricing for the "rest of us").  Since the end-user is not the actual customer, the end-user does not exert downward price pressure by being able to shop normally for the service like they do in other industries.  Most end-users are captive to their employer-sponsored group plans and generally only see out-of-pocket costs, not true costs.  Even then, the "shopping" of prices is secondary since the bulk of the cost is paid by the insurance company.  Providers, who are increasingly worried about jackpot justice lawsuits, order many unnecessary procedures so they can cover their backsides to the best extent possible.  All of these things drive prices up.

Much more to say about that, but since Obamacare mandates coverage, dictates pricing (to some extent) and regulates procedures, the providers and the customers cannot exert market forces on the industry.  Since many providers will no longer be able to remain profitable accepting Medicare rates (and later, Obamacare rates), they will either no longer be doctors because it is not profitable, or they will simply refuse service to Medicare patients (as some are already doing) or Obamacare patients.  If they are forced to accept that, there will ultimately be a provider shortage.

Insurance against healthcare emergencies is important, and I think would be more affordable with more competition, portability, and tort reform (I know they sound like right-wing talking points, but they make economic sense).  For those that cannot afford this insurance, a safety net of some kind makes sense - something that already exists BTW in Medicaid and the fact that providers cannot deny service in an emergency regardless of ability to pay.

As far as tackling the problem up front, insurance providers can provide discounts to those who take certain healthy actions, like annual wellness checkups and screenings, etc.  None of these are terribly cost prohibitive.  They can be incentivized, but the end user/customer has to have a stake.  Expecting everything to be "covered" or "free" only exacerbates the cost issue.

If I was undecided, Obamacare would be a major reason to vote against him.  There are, however, many reasons why I'm voing for Romney....I'll get into later.
10/30/2012 4:14 PM
Posted by MikeT23 on 10/30/2012 3:04:00 PM (view original):

One is well within their rights to go to the doctor for a minor health issue.   That's why they purchased the insurance.   However, and this goes back to what moy said, one is also within their rights to eat 14 Big Macs a day, wash then down with a gallon of liquor and smoke three packs of Camels in their free time.   But none of that is personally responsible and they are definitely contributing to the healthcare issue.

You're conflating the issues a little.

It's irresponsible to eat 14 big macs and a gallon of liquor and smoke 3 packs a day. It's not irresponsible to go to the doctor if you are having chest pains.

It's irresponsible to juggle butcher knives. It's not irresponsible to go to the doctor if you cut your hand open.

Once your health is at risk, the responsible thing is to go to the doctor.
10/30/2012 4:14 PM
Posted by bad_luck on 10/30/2012 4:14:00 PM (view original):
Posted by MikeT23 on 10/30/2012 3:04:00 PM (view original):

One is well within their rights to go to the doctor for a minor health issue.   That's why they purchased the insurance.   However, and this goes back to what moy said, one is also within their rights to eat 14 Big Macs a day, wash then down with a gallon of liquor and smoke three packs of Camels in their free time.   But none of that is personally responsible and they are definitely contributing to the healthcare issue.

You're conflating the issues a little.

It's irresponsible to eat 14 big macs and a gallon of liquor and smoke 3 packs a day. It's not irresponsible to go to the doctor if you are having chest pains.

It's irresponsible to juggle butcher knives. It's not irresponsible to go to the doctor if you cut your hand open.

Once your health is at risk, the responsible thing is to go to the doctor.
not necessarily.... again with an auto insurance example. you ding your car up for $750 in repairs and have a $500 deductible.... you going to file an insurance claim? there has to be some sense of what's an emergency, what you are willing to pay, and what just clogs the ER and increases insurance payouts.


side note : seriously good stuff.... read about the health care system in Singapore. I've always admired it to some degree.
10/30/2012 4:27 PM
Posted by bistiza on 10/30/2012 3:58:00 PM (view original):
The problem with forcing people to pay full cost or near full cost for preventative medicine, moy, is many people simply wouldn't get the preventative medicine. They'd rather save their money and if that means suffering with a problem that otherwise would have been prevented, then that's what they do. It also means they'll end up costing far more later on when the problem develops or gets worse.

Co-pays are an insurance company's way of convincing people not to utilize their services for trivial matters. They don't actually save much by having you pay, say, $25 on a $150 bill, but the idea is if you didn't have to pay that $25, you might go a lot more often in less needful circumstances, costing them far more.

When you deal with insurance companies, especially if you are negotiating a policy, you have to keep in mind anything they want is probably bad for you. If they want you to pay a co-pay or have (or increase) a deductible, the only purpose is to discourage you from actually using their services. Their goal is to make money by charging their collective customers more than what they pay out.

Since insurance customers will (obviously) only put up with so much in terms of increases to premium costs, at some point they have to work from the other end in order to make more money. That means instead of raising the cost of their services, they start cutting the services they offer on the other end.

The main job of any insurance adjuster is to find a way to essentially **** you over. You don't tell the insurance company you're going to "adjust" their premium downward and pay them less if you haven't recently used the insurance, and yet they want to "adjust" what you get if you ever have a claim. They'll do their best to pay out as little as possible, even if that means you lose. Most of them care little about service (although that sure isn't what they'll try to sell you on) and only care about the bottom line.

Back to what I think is my main point (after I ranted for a bit there lol), which is that insurance companies shouldn't be dictating care at all. It should be about medical professionals who know what they are doing. Costs should be a secondary concern to anything, if they are a concern at all.

I agree with some of this.  However, if there was true competition and portability insurance companies would be forced by the market to "care more" about service, since the customer would, in theory, be able to shop.

Portraying the consumer as simply a pawn to the profit motive of an insurance company (a legit motive), doesn't paint the whole picture.  I don't disagree with you that adjusters work to control costs.  There has to be someone who does that.  Leaving the decisions to the doctor/patient only isn't a panacea either.  Doctors are incentivized to perform as many procedures to the uneducated consumer as they can.  I think most would perform what they deem as necessary, but many would probably not give a second thought about "being extra careful" with a CT Scan, or and MRI, or a follow up visit, just to be safe.  Without oversight by an adjuster, this too exacerbates the cost problem.  You cannot run any business without concern for costs. 

In terms of "dictating care", there has to be some discretion.  There's no perfect solution, but I am not for having our government be that dictator.  As imperfect as it is, the market is still better, i.e. the customer and provider and yes, cost being a factor.  If insurance companies in a free market can't cover what the market needs, the market will demand that coverage.  If there is a demand for that coverage, insurance companies will provide it - at a cost (with profit of course).  This does not mean I favor 100% market forces with no regulation - I know that's the natural objection to my position.

You could go hundreds of pages on this stuff, and it's not an easy 'debate'...
10/30/2012 4:30 PM
Posted by moy23 on 10/30/2012 4:28:00 PM (view original):
Posted by bad_luck on 10/30/2012 4:14:00 PM (view original):
Posted by MikeT23 on 10/30/2012 3:04:00 PM (view original):

One is well within their rights to go to the doctor for a minor health issue.   That's why they purchased the insurance.   However, and this goes back to what moy said, one is also within their rights to eat 14 Big Macs a day, wash then down with a gallon of liquor and smoke three packs of Camels in their free time.   But none of that is personally responsible and they are definitely contributing to the healthcare issue.

You're conflating the issues a little.

It's irresponsible to eat 14 big macs and a gallon of liquor and smoke 3 packs a day. It's not irresponsible to go to the doctor if you are having chest pains.

It's irresponsible to juggle butcher knives. It's not irresponsible to go to the doctor if you cut your hand open.

Once your health is at risk, the responsible thing is to go to the doctor.
not necessarily.... again with an auto insurance example. you ding your car up for $750 in repairs and have a $500 deductible.... you going to file an insurance claim? there has to be some sense of what's an emergency, what you are willing to pay, and what just clogs the ER and increases insurance payouts.


side note : seriously good stuff.... read about the health care system in Singapore. I've always admired it to some degree.
I don't think the auto insurance analogy works.

If you don't maintain your car and it causes a crash and your rates go up and you can't afford the insurance, you can skip comp and collision coverage or you can stop driving. You can walk, ride a bike, take the bus, bum rides off your friends. etc.

If you don't maintain your health and you get sick and can't afford health care...you die. Or the government steps in and pays for your heart surgery, your chemo, your hip replacement, your diabetes medicine, etc. Which is the worst case scenario.

The reality is, if people have to pay the full cost of preventative care, most people won't get preventative care. And then we will be stuck paying for the serious medical needs that will come up down the road.
10/30/2012 4:44 PM
Posted by swamphawk22 on 10/30/2012 3:55:00 PM (view original):
Posted by MikeT23 on 10/30/2012 3:04:00 PM (view original):

One is well within their rights to go to the doctor for a minor health issue.   That's why they purchased the insurance.   However, and this goes back to what moy said, one is also within their rights to eat 14 Big Macs a day, wash then down with a gallon of liquor and smoke three packs of Camels in their free time.   But none of that is personally responsible and they are definitely contributing to the healthcare issue.

We eat like pigs, Russia smokes and drinks like crazy.

Both nations are pretty healthy compared to mose countries.

Our costs being out of control have nothing to do with health issues.

They have to do with marketing medicine.

Giving people free health care and then telling them that they need to go there for everything.

And of course no tort reform.
Of course an obese person isn't going to say "Yep, I'm part of the problem."
10/30/2012 4:47 PM
Posted by bad_luck on 10/30/2012 4:14:00 PM (view original):
Posted by MikeT23 on 10/30/2012 3:04:00 PM (view original):

One is well within their rights to go to the doctor for a minor health issue.   That's why they purchased the insurance.   However, and this goes back to what moy said, one is also within their rights to eat 14 Big Macs a day, wash then down with a gallon of liquor and smoke three packs of Camels in their free time.   But none of that is personally responsible and they are definitely contributing to the healthcare issue.

You're conflating the issues a little.

It's irresponsible to eat 14 big macs and a gallon of liquor and smoke 3 packs a day. It's not irresponsible to go to the doctor if you are having chest pains.

It's irresponsible to juggle butcher knives. It's not irresponsible to go to the doctor if you cut your hand open.

Once your health is at risk, the responsible thing is to go to the doctor.
I'll obviously disagree.   You put yourself at risk.  You run to the doctor to fix you because "I paid for insurance."
10/30/2012 4:48 PM
This post has a rating of , which is below the default threshold.
Yes, putting yourself at risk was irresponsible. Seeking professional help to prevent the small medical problem from becoming a bigger medical problem is not. 
10/30/2012 4:50 PM
swamp, are you really saying that fat people aren't a healthcare problem?   Please tell my you're not.
10/30/2012 4:56 PM
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