Thursday, September 20, 2007

Rasmussen Poll on Universal Healthcare

50% Favor Government Guaranteed Health Care Coverage.

See that's one weakness of democracy. As soon as the people discover that they can vote themselves money, democracies slide ever further into socialism. And you know what happens after that.

No?

Remember the USSR?

However, there is hope: A Rasmussen Reports national telephone survey also found that a plurality (43%) believe such a program would be better run by private companies than by the government.

Interesting:

Seventy-seven percent (77%) of liberal voters say that major changes are needed. Only 39% of liberals believe that Clinton is proposing major changes.

So, liberals think Hillary isn't liberal enough.

Other political challenges abound, especially among small businesses—60% of small business owners believe that a government mandate to provide healthcare coverage to employees would have a negative impact on their business and 57% favor taxing wealthier Americans to provide coverage for those without insurance.

Yep, it's always easier to spend someone else's money.

Sixty-nine percent (69%) of Democrats favor government guaranteed universal health care. That view is shared by 29% of Republicans and 48% of those not affiliated with either major party.

Democrats, by a 53% to 25% margin, believe such a program would be better run by the government.

Better than what? I just can't imagine why anyone could believe that! Give me one example of where that has worked before. Certainly our current system needs an overhaul but why do liberals always think the government is the only solution?

A question for anyone under 50 years of age: How would you like to be as confident about your health care as you are about receiving a Social Security retirement check some day?

Republicans (59% to 25%) and unaffiliated voters (49% to 27%) take the opposite view and believe the program would be better run by private companies.

...that's because Republicans for the most part are the employers, and Democrats are the employees. Remember this when you cash their next paycheck.

13 comments:

redBeard said...

Hmmm. Sounds like YAFAS (yet another fear and smear) rant.....

While I'm not a Hilary fan, I do take umbrage to those who don't look at the details of a proposal and start in with the generalizations and fear n smear....

1) I run a small company (a.k.a., the 'employer'). I cannot afford to subsidize health benefits to my employees. Providing credits to those who *not* currently insured sounds like a good thing.

2) Any public policy proposal that will cost money is automatically 'socialism'. Reading the plan, I don't see anywhere where the providers of the service (e.g., docs, hospitals, etc.) will be employees of the gov't (one of the tenets of socialism).

In fact, the plan states that anyone with employer provided/subsidized plans will not change. The plan only affects those uninsured (47 million US citizens).

2) 'further slide into socialism'. More fear... How many other countries it the western civilized world provide health coverage for all citizens -- and are socialist gov'ts?

How many other countries provide health coverage for all citizens -- and are *not* socialist gov'ts?

3) 'Yep, it's always easier to spend someone else's money'. How many spending bills has the Current Occupant vetoed?

The national debt ceiling needs to be raised, again.....

jroosh said...

Thank you for your comment.

First of all, employers should not be in the health insurance business. As soon as you put an extra layer in between the product and the end user, you reduce competition and choice. Consumers of health insurance should be able to shop individually, just like auto insurance.

I believe a great deal of progress can be made by abolishing our current third-party payor system without the government getting more and more involved in our lives and wallets.

As for the socialism distinction, I was referring to the poll not the proposal. While some countries that provide universal healthcare are not socialist now, there definitely is a continuum and the more the government taxes and spends on behalf of the population, the more that society moves to the left on the continuum.

As for the current occupant, Garrison, you will not find me expressing a great deal of praise for our current President's fiscal policies either.

Thanks again for stopping by.

redBeard said...

1) 'employers should not be in the health insurance business'. I mostly agree w/that. in years past, this was offered by employers as a benefit, mostly through the 'insistence' of unions. That 'benefit' is now costing US companies considerably. It would be good to have consumers shop for their own coverage.

2) 'progress can be made by abolishing our current third-party payor system'. I, too, would like to have less gov't involvement in my daily life.

But, progress to what end? What problems to you see (this is more of a rhetorical query, but I want to hear your answer...)?

Hilary's plan talks about providing insurance for currently uninsured citizens. Is that good or not?

Why can't a healthy family of 5 receive decent health care for less than $1000s/monthly in insurance costs (e.g., they own or work for a small company)?

What is a reasonable monthly cost for this or any other family?

Is this the issue? Cost of insuring a family for a reasonable recurring cost?

I have my own 'health industry' woes. That's getting off topic, but I'll air them anyway.... (thanks for the forum....).

(start of rant)
I'm not convinced that the insurance/HMO/PPOs organizations are the cause of the high cost of health coverage in this country.

I used to work for a company that developed (health) claims analysis software and sold this to HMOs/PPOs/etc. HMOs/PPOs are 'middle-tier' businesses contracting for services from end-providers (hospitals, physician groups, etc.) and selling those services to employers/individuals. Since there are many HMOs/PPOs for employers to choose from (and they need to make a buck), then they need to maximize their profit vs. their costs. Their costs, of course, are the providers. Consequently, they strive to lower their costs (find lower costing providers, better continuum of care, etc.).

One aspect I noticed when analyzing providers' claims for services, was that HMOs/PPOs usually only paid a fraction of what the providers wanted to charge. The balance (in the eyes of the provider) was just written off.

Now, when a citizen walks into a physician clinic for services (w/no insurance or HMO coverage) and is handed a bill, do you think the provider will accept anything less for payment than what is stated on the bottom of the bill?

My (long winded) point is that the current system is keeping the prices that providers wish to charge for services down, to a considerable extent.

Why do physicians believe they need to be the highest paid professionals in this country?
(end of rant)

jroosh said...

My assessment of the issues with the system in America revolve around two points:

1) The third party payor system removes the consumer from the process of chosing their provider. This lowers competition and choice. If consumers were able to choose, we would then and only then know what the true costs "should" be. A free market has a way of doing that over time.

2) Americans are fat and live unhealthy lifestyles because of our prosperity but also because for many, there is no incentive to improve their habits. Imagine if you will a standard rate for a given individual's health insurance. Imagine a discount off of that substantial monthly rate if one were to for example prove that they don't use tobacco any more. Or for another, have achieved a more healthy body mass.

As for the insurance companies and the costs of care, there are already doctors out there that don't take insurance any more; only cash. While I've only been made aware of a couple of these cases, guess what? The costs are lower.

As for physicians being the highest paid professionals in America? Not even close. The top couple hundred executives at United Healthcare make more. Hedge fund managers make more. Most CEO's of public companies make more. Most successful lawyers make more. Etc.

As for me, if someone is going to be operating on me or advising me on my child's care, I'd prefer for them to be very well compensated and comfortable. I want the best and brightest to be attracted to the field.

Bike Bubba said...

Regarding the costs you see on your insurance statement, not only are there a lot of doctors who don't take insurance, there are even more who will let you pay "cash on the barrelhead" for the amount they actually receive from insurance.

In other words, insurance has made liars out of more doctors than golf. All that "savings" from your insurance/HMO is more or less a mirage.

redBeard said...

If consumers were able to choose, we would then and only then know what the true costs "should" be.

I can already choose which provider to use. I can choose to see someone in 'a network' or 'out of network.' And I pay through the nose for seeing a provider out of network.....

Americans are fat and live unhealthy lifestyles because of our prosperity ... there is no incentive to improve their habits.

No argument there.....

While I've only been made aware of a couple of these cases, guess what? The costs are lower.

I'm game. Show me some real figures and research.

The top couple hundred executives at United Healthcare make more.

Top 'couple *hundred* executives'? There's more than a couple hundred? While I also abhor UHCs excessive pay for execs and they way they gobble up small companies and spit them out of their a$$, that seems like a bit of a hyperbole....

On a new topic, what would happen in a society where there was no middleman (insurers/HMOs, etc.) and all providers then had to deal with trying to extract payment from each individual patient?

I also like free markets, but this might be an interesting 'MedicalSIMs' game....

redBeard said...

I'm intrigued about the 'cash-only' game. That seems just fine when people are purchasing 'standard-of-living' products (household goods, transportation, entertainment), but health issues don't seem like a 'standard-of-living' purchase.

You go to a doc about chest pains and he tells you you have lung cancer. What about the cash-only game then?

jroosh said...

We definitely need health insurance...no doubt there. Giving consumers direct choice regardiing their carriers and their healthcare providers will lower costs and increase service.

...it might even force doctors offices to honor their appointment times!

jroosh said...

I can already choose which provider to use. I can choose to see someone in 'a network' or 'out of network.' And I pay through the nose for seeing a provider out of network.....

That's not the level of choice that will drive competition.

The typical American consumer chooses an employer who chooses the health insurance. In Minnesota there are only a handful of insurance providers.

If we eliminate the third-party payor (employer) system and allow consumers to choose their insurance company directly, the mareket will do what it always does. It will favor those carriers that provide better service at a lower cost.

Top 'couple *hundred* executives'? There's more than a couple hundred? While I also abhor UHCs excessive pay for execs and they way they gobble up small companies and spit them out of their a$$, that seems like a bit of a hyperbole....

UHC has several hundred executives that make several hundred thousand dollars per year. There's nothing wrong with that, I was just countering your point that doctors make more than any other profession.

redBeard said...

That's not the level of choice that will drive competition

Fair enough.

If we eliminate the third-party payor (employer) system and allow consumers to choose their insurance company directly...

Granted, there are not many plans available to choose from. Is that the issue?

But, people already can contract for their own health insurance. There's nothing stopping people from opting out of the employers' health benefits programs and contacting insurance/HMOs directly. Since my employer (oops, that would be me...) doesn't offer a plan, I have to do it. My business partner does it. And since we're not part of a group plan like an employer would be, the plans we get are essentially high risk plans given the lack of the ability for the insurer to spread the risk.

I'm guessing quite a few owners of other small companies do the exact same thing for their families. But I have no statistics on that.

The plans we have are pricey.....

I don't understand why you think health plans would be cheaper if 1 million individuals directly contacted insurance companies vs. 1 million employees through their employer? The employer is trying to keep their costs down (as they offer these plans as benefits which is a direct cost to their bottom line), the current plans still need to be competitive as they need the business.

I would think that plans' administrative costs would soar having to deal with so many individuals vs. a few employer-based representatives....

It seems that s million individuals have little group-level bargaining basis, whereas larger companies with 1000s of employees do.

UHC has several hundred executives that make several hundred thousand dollars per year. There's nothing wrong with that...

Sounds like the basis for a free market system to me. Companies can pay their employees whatever they wish...

Bike Bubba said...

Redbeard, if dealing individually for insurance would cause costs to soar, why is home, car, and life insurance so much cheaper than medical insurance? I get lots of letters from Allstate, State Farm, and such seeking my business. Doesn't seem to make them go bankrupt.

Also, I've been privy to the expected "payout ratios" for home insurance and such, and home, car, and other insurance like that is at about the same 60%-70% payout ratio that is common to medical insurance.

For a lark, price out Blue Cross for major medical. About $1000/year for a healthy, nonsmoking middle aged guy, if I remember right. If we returned medical care to people (gimme my HMO money and I'll put it to good use), I dare suggest that overall medical spending would go down, and sharply.

redBeard said...

if dealing individually for insurance would cause costs to soar, why is home, car, and life insurance so much cheaper than medical insurance?

don't know exactly, but it probably has something to do with the number of claims against property types of insurance vs. health insurance as well as differing usage models.

For property insurance, the model is somewhat different. People can fix/repair their property and choose (or not) to file a claim against their insurance. Consequently, I'm only guessing that the amount of claims against those insurance forms are muuuuch less than health insurance.

As an anecdote, I don't remember ever filing a claim against my auto insurance in 30 years. I think I've filed one claim against my home insurance.

However, when most people visit a main stream health provider, the provider usually files a claim against the insurance. (It didn't used to be that way but that seems to be the most common model.) Consequently, for a family, I'm guessing they file much more against the insurance company in terms of $$$ than property types of insurance.

About $1000/year for a healthy, nonsmoking middle aged guy

Very well could be. However, there are quite a few uninsured families whose premiums I'm guessing would be significantly higher. My business partner's premiums for his healthy family of 5 is muuuuch higher than that.

I've been privy to the expected "payout ratios" for home insurance and such...

Interesting bit of knowledge, but I'm not sure I understand but would like to. Are you saying that of all insurance premium $$ collected by property insurance companies they payout 60%-70% of that as claims? And medical insurance pays out the same ratio?

If so, that says to me that health insurance companies/HMO are not such bad guys when compared to other insurance models (however, I'm still not a fan of UHG execs getting such large salaries) and the actual cost of claims (e.g., the actual health care) is a significant cost.

Like I mentioned above, I suspect much of that payout cost differential is because of the total amount of claims of property insurance vs. health insurance for a family.

Another reason could be (and one of my contentions) is that providers (physicians, hospitals, etc.) are veeeery well paid.

Another anecdote... A friend was visiting from The Netherlands where they have universal health and he had been having dental problems -- fillings falling out, teeth cracking... Sounds like my aging mouth....

Anyway, he had the fillings of a tooth removed and crowned about a month before he arrived here and he said the dentist charged the health care organization about $80.

A filling from another tooth dislodged whilst he was here and the dentist here charged him $170. Hmmm.

Another anecdotal story. I have very bad knees. I had bi-lateral surgery when I was 16 and 17. About six years ago I happened to be in the area of my original orthopedic surgeon and stopped by for a visit (He's also my father's surgeon...).

At the time I was having more knee problems so I had 'a visit' to this specialist. It was a basic appointment - Xrays, consultation. Cost (out of network and out of my pocket)? $450!!!

I had surgery again a couple of years ago and the initial appointment to the local surgeon which included Xrays and consultation -- $220.

Again, Hmmm.

Bike Bubba said...

You're missing the point; if advertising for buyers would kill health insurance, it should have already killed auto & home insurance. However, they're doing fine, and their payout ratios are about the same as medical.

And yes, that's exactly what the ratio means; about 30-40% of your medical bill goes to the insurers, not your doctor. Insurance is a horrible way of paying for routine expenses because of this factor.

And yes, major medical for five is more expensive than for one; about 4X (look it up; doesn't take long). However, that $4k or so is quite low compared to what UHC will charge for an HMO, don't you think?

And if you don't like UHC's compensation of executives (what on earth would I do with a billion bucks?), one of the best ways to lower it is to go major medical instead of comprehensive healthcare.

It also gives you a great reason to get out and take care of your own health. Double bonus.