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-- Illness triggers half of bankruptcies
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| Originally posted by NeoPhono http://www.nytimes.com/2005/01/04/opinion/04brooks.html Something even better from Mr. Greenspan, which I won't post here due to its length. I highly recommend reading it though. http://www.federalreserve.gov/board...227/default.htm NYGBlue, if you have a link to that Economist article, I'd be interested in reading it. |
I really haven't peeled back the details of our current Healthcare and Medicare issue much, but the surface details seem pretty scary. In terms of Healthcare, for example, we have +45 million folks without health insurance of any kind, and 11 million children with none as well. Both numbers are growing, BTW. Any talk about us having the best healhcare system in the world should cease immediately just by examining those numbers alone. Something, anything must be done about that.
Now in terms of tort reform being the answer to the rising costs of health premiums, that is pure and utter bullshit. I outlined that Bush distortion here:
http://www.tranceaddict.com/forums/...ght=malpractice
The evidence clearly shows a rise in premiums are NOT related to malpractice lawsuits. Rather, they are directly related to insurance companies investing in the stock and bond markets. Here's a little history about what California did with their insurance rates in the past, and the results:
http://www.consumerwatchdog.org/hea...w/nw003146.php3
Now the retort I've heard from insurance companies and tort reformers on this point is that the majority of premium investments go into very conservative government bonds and real-estate loans (like 80% of total investments or something like that). The problem with this argument, however, is that we've seen what's happened to the interest rates over the last 5 years - they've dropped dramatically, consequently giving a much lower interest yield on these conservative investments. And with the rest of their investments in stock, the stagnant economy hasn't helped much either. This commentary explains a bit as to why the premium rates have skyrocketed:
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| There are two sources of revenues for an insurance company - insurance premiums and investments. We hear about premiums all the time, but we never hear about investments. But if the revenues generated by investments fall, then the insurance company must raise premiums to make up the difference. Again, this is an accepted fact about insurance companies, and you won't find any real disagreement on this point. So we know that falling investment income can cause premiums to rise. Yet we hear nothing in the debate about this subject. How important are investment revenues? Think about how insurance works. In year one, the doctor pays the premium. In some states he can be sued years later for malpractice committed in year one. In New York, its generally two and a half years after the last treatment for the condition in question. It can also takes years for the lawsuit to get to trial. What this means is that the insurance company may collect the premium in year one but not pay any money out for claims incurred in year one for anywhere from three to ten years. During all this time the insurance company is investing the money. Insurance companies therefore must make certain assumptions about the revenue generated by investments in order to predict the amount of money that will be available in the future to pay claims. If those assumptions prove to be inaccurate, the only quick fix is to raise insurance premiums. Another fact that is often obscured is the fact that insurance companies compete for business. Like all other business, insurance is cyclical, meaning it has good times and bad times. In fact, the insurance industry is notoriously cyclical, and during good times insurance companies engage in fierce price competition to sell policies. It is not unusual for an insurance company to sell insurance for less than the amount of claims they expect to pay. They do this to generate cash flow and one way they justify this is to make exaggerated assumptions about the investment income they will earn on the premiums. Invariably when the cycle snaps the companies are in a bind and must raise premiums. Although this has occurred countless times, I have never seen an insurance company attribute its increase in premiums to its own irresponsible business practices. I can assure you that you will never see this. Who is going to buy insurance from a company that essentially engaged in speculation? Somebody has to be blamed, and the greedy trial lawyers are an easy target. http://www.oneillaw.com/tr/ |
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| Originally posted by MisterOpus1 I really haven't peeled back the details of our current Healthcare and Medicare issue much, but the surface details seem pretty scary. In terms of Healthcare, for example, we have +45 million folks without health insurance of any kind, and 11 million children with none as well. Both numbers are growing, BTW. Any talk about us having the best healhcare system in the world should cease immediately just by examining those numbers alone. Something, anything must be done about that. |
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| Now in terms of tort reform being the answer to the rising costs of health premiums, that is pure and utter bullshit. I outlined that Bush distortion here: |
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| Originally posted by Shakka One question worth asking is why don't all of these people have insurance? Surely there are plenty of them that are in that position by choice. Yes, I realize COBRA coverage is expensive--hence I almost chose to forego it when I was between jobs--but some things are just part of the cost of living and looking out for yourself. Do we constantly need to pick up the tab for people who make the choice to go without and then become a burden to society when their choice backfires? I'm not talking about the whole 45 million--but a substantial portion of these people are clearly digging their own graves--so to speak. |
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| Originally posted by NYGblue Do you have anything that equates to proof other than making a completely unsubstantiated claim. I would LOVE to read any real info. on the matter. |
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| Originally posted by Shakka One question worth asking is why don't all of these people have insurance? Surely there are plenty of them that are in that position by choice. Yes, I realize COBRA coverage is expensive--hence I almost chose to forego it when I was between jobs--but some things are just part of the cost of living and looking out for yourself. Do we constantly need to pick up the tab for people who make the choice to go without and then become a burden to society when their choice backfires? I'm not talking about the whole 45 million--but a substantial portion of these people are clearly digging their own graves--so to speak. |
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| I don't think anyone is advocating tort reform as a cure-all solution. However it is something that would certainly alleviate one of the current drags on the system, no matter how significant or insignificant you think it is. Frivolous lawsuits and runaway juries are one of many inefficiencies that exist in our system that we would all benefit from if we address them instead of continue to let them run on rampantly. There are numerous issues which need to be addressed. Tort reform is merely one of them. |
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| You've been suspiciously absent lately? I thought you may have exhausted your fingers! Welcome back! |
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| Originally posted by Shakka So you think that 45+ million people simply can't afford health insurance? You do realize that that's about 15% of the entire U.S. population, don't you? It would be nothing short of foolish to assume that every single one of those people are without health insurance simply because they can't afford it. That would be a statistic that would quickly make the "wealthiest" nation in the world look more like a near 3rd world country. All I said was that surely not all of those 45+ million people are uninsured by circumstance, rather many of them are in that position by choice. Frankly, I don't even know how you can dispute it. I can tell you that I know many of my own friends who are without health insurance by choice. Because they're too damn cheap to spend a few extra bucks because they'd rather take the chance on the belief that they're in good health and don't need to be spending extra money on something that they perceive they do not need. I'll bet you $1000 that even you know people that actively choose not to get health insurance. That is all the proof you need, my friend. |
This is purely anectodal, but in Shakka's defense I do know a few guys who don't have health insurance - 2 of them are housing construction private contractors no less! They're both making good $ right now (~$40K) since the housing industry's doing well lately, but both refuse insurance because they simply don't want to pay for it. I can't tell you why, other than they just like taking chances I guess.
The other guy I know simply can't afford it right now, or so he says. He did have a steady job, but got released and is now a private consultant as well. The money's not flowing well for him, at least not yet. I'd tend to think this was more or less the reason for the uninsured - the high cost of payments relative to their paychecks. Just my opinion, though.
Stats and figures on this issue would definitely help.
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| Originally posted by MisterOpus1 This is purely anectodal, but in Shakka's defense I do know a few guys who don't have health insurance - 2 of them are housing construction private contractors no less! They're both making good $ right now (~$40K) since the housing industry's doing well lately, but both refuse insurance because they simply don't want to pay for it. I can't tell you why, other than they just like taking chances I guess. The other guy I know simply can't afford it right now, or so he says. He did have a steady job, but got released and is now a private consultant as well. The money's not flowing well for him, at least not yet. I'd tend to think this was more or less the reason for the uninsured - the high cost of payments relative to their paychecks. Just my opinion, though. Stats and figures on this issue would definitely help. |
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| Originally posted by NYGblue The point though, wasn't that there aren't people out there that can afford it and simply won't buy it but whether or not its a substantial portion of the population. When you are living from paycheck to paycheck, I think its a lot to assume that people can incur the extra expense of medical insurance. That often won't cover a lot of the ailments that afflict people anyways. But regardless, health insurance aint cheap. |
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| Originally posted by Shakka My point was simply that the 45 million figure is a bit skewed if you take some relevant factors in. I don't think it was a stretch, and I'm not saying that there still aren't millions of people out there that have a perfectly legitimate and circumstantial reason why they are not insured. Proof is in the fact that you didn't take my bet. It may be a broad assumption, but it is also a true one. |
Enjoy...
http://www.ncpa.org/edo/uninsured082604.htm
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| Is There a Crisis of the Uninsured? August 27, 2004 by Devon M. Herrick, Ph.D. Despite claims that the United States is experiencing a health insurance crisis, the proportion of Americans without health coverage has changed little in the past decade. How Big Is the Problem? About 270 million people, accounting for about 94 percent of the population, either have health insurance or have access to it. The breakdown is: -More than 84 percent of the 288 million U.S. residents (243.3 million people) are privately insured or are enrolled in a government health program, such as Medicare, Medicaid or the State Children�s Health Insurance Programs (SCHIP). -An additional 10 million to 14 million adults and children already qualify for government programs (Medicaid and CHIP) but have not enrolled. -Another 15 million live in households with annual incomes above $50,000 and likely could afford health insurance. -By these estimates, about 9 percent theoretically have access but have chosen to forgo insurance. The remaining portion, just over six percent of the population, earn less than $50,000 annually. How Serious Is the Problem? A better way to look health coverage may be to count the number of people with health insurance for the past few years. The proportion of people without health insurance was about the same in 2003 (15.6 percent) as is was a decade earlier (15.3 percent in 1993). However, the number of people without health coverage increased by about 5.8 million people to 45 million, largely due to population growth. Typically, those who lack insurance are uninsured for only a short period of time � 75 percent of uninsured spells are over in one year or less. The Congressional Budget Office (CBO) found that Census Bureau figures actually give a snapshot of current insurance status, rather than those who are uninsured for an entire year. The CBO estimated that in 2002, 21 million to 31 million people were uninsured for a year � far short of the 44 million often claimed. Who Are the Uninsured? The uninsured include diverse groups of individuals, each of which is uninsured for different reasons. Immigrants. Some 35 percent of foreign-born U.S. residents lack health insurance compared with only 13 percent of native-born Americans. Although immigrants (including naturalized U.S. citizens) make up slightly less than 12 percent of the population, they make up 26 percent of the uninsured. Income may be a factor � but not the only one. For instance, Hispanics have an uninsured rate 10 percentage points higher than Caucasians with the same incomes. Many immigrants come from cultures without a strong history of private health insurance and are not accustom to paying premiums for health care when they aren�t sick. The Poor. Among those earning up to $25,000 per household, levels of insurance have actually increased by about 15 percent over the past 10 years. The expansion of Medicaid and the SCHIP program for children has increased coverage � yet millions of families eligible for these programs do not enroll. When paid staffers at public institutions attempt to sign people up in hospital emergency rooms and clinics � even as they wait for their medical care � they apparently fail more than half the time! The Young and Healthy. Federal law forbids hospital emergency rooms from turning away critical care patients. As a result, many people may forgo coverage when they are healthy and feel the probability of becoming ill is low. For moderate health problems, they can likely pay for treatment out of pocket. Most people have access to some type of care. Free or charity care, for instance, amounts to more than $1,000 per uninsured individual each year. Higher Income Workers. Over the past 10 years, the fastest growing segment of the uninsured population has been among middle and upper income families. The ranks of the uninsured in households earning between $50,000 and $75,000 increased by 49 percent and for households earning above $75,000 increased by 128 percent. The number of uninsured among these higher income households actually increased by almost seven million. Government policies that drive up the cost of health insurance partly explain why millions of people forgo coverage. State Mandates. Many states try to make it easy to obtain insurance after a person becomes sick by requiring insurance companies to offer immediate coverage for pre-existing conditions without a waiting period. When people are healthy they have little incentive to participate. As a result, people delay paying for coverage until they need care. Some states also impose �community rating,� charging the same premium to all, no matter how sick or how healthy. This practice drives up costs. Because their premiums are far higher than their anticipated medical neediest, healthy people whose expected costs are low tend to get priced out of the market. This is one reason why nearly 19 million people between the age of 18 and 34 are uninsured. Most of them are healthy; they know they can pay for incidental expenses out-of-pocket and take out insurance if they become seriously ill. Lack of Tax Incentives. While employer-provided insurance receives generous tax subsidies, there are few tax incentives available to those who purchase their own insurance individually. For those with employer-provided coverage, the insurance benefit is excluded from the employees� taxable income. However, the subsidy helps most those who need it least. High income workers earning more than $100,000 per year enjoy a subsidy worth, on average, $2,780 per year. By contrast, those earning between $20,000 and $30,000 receive only $725. Conclusion. Despite claim that the United States is experiencing a health insurance crisis, the proportion of people without insurance coverage has changed little in recent years. More uninsured workers could afford private health insurance if Congress adopts President Bush�s proposed tax credit of up to $1,000 per individual ($3,000 per family). This would reduce the cost of insurance. The credits would be advanced as insurance premium payments came due. They would also be refundable, allowing those who owe no income tax to receive the credit. Many of the uninsured people who currently don�t consider health care a �good buy� may change their mind now that health savings accounts (HSA) are available. These personal health accounts allow unused funds to be rolled over for use in future years. HSAs will make coverage more affordable for healthy, young workers. They will find insurance more attractive if they know their money isn�t wasted if they don�t need care in any particular year. |
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| Originally posted by Shakka My point was simply that the 45 million figure is a bit skewed if you take some relevant factors in. I don't think it was a stretch, and I'm not saying that there still aren't millions of people out there that have a perfectly legitimate and circumstantial reason why they are not insured. Proof is in the fact that you didn't take my bet. It may be a broad assumption, but it is also a true one. |
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