I think at this point it would be really really tough for Lefty McCain to get a conservative on board with him as a VP. He may even go after a Blue Dog Democrat to work on the South. Hopefully they will all deny him.
Don't you think it's odd that Lefty McCain, Obama, and the Hilderbeast's hubby are all left-handed?
I think at this point it would be really really tough for Lefty McCain to get a conservative on board with him as a VP. He may even go after a Blue Dog Democrat to work on the South. Hopefully they will all deny him.
Don't you think it's odd that Lefty McCain, Obama, and the Hilderbeast's hubby are all left-handed?
You are foregetting one thing: McCain used a foot bath in the American Revolution.
There are scenarios where selling indie health evaporates within the next 5 years. Expect the best, plan for the worst.
There are also scenarios where it will skyrocket. Many of the proposals being discussed include tax credits or deductions for premiums or subsidy for those whose premiums exceed a certain percentage of income. I know everyone here likes to beat their big republican or liberterian chest and talk about how government should stay out but believe me insurance agents are little piggies that will show up at the trough bigtime if the freemarket is in tact but government subsidy or tax credit makes premiums more affordable. It could be a frigging gravy train.
My point continues to be that change is coming - period - and there is a chance of somewhere between 0 and 0.2 per cent that health care reform will blow over. Dennis Kucinich is the only candidate I know who was talking about a single payor universal health care system yet almost every thread here treats the the health care reform issue as though that is the only thing being discussed. That is a black and white misunderstanding.
Whatever system comes along will be a public/private hybridized arrangement where some private sector carriers or agents will make a killing even if they need to get out of some areas. Even if the worse case scenario came about which only Kusinich was proposing (Medicare For All) we need to note that when medicare came about it spawned an entire industry of private sector carriers and agents who have made a killing. If your entire identity or business plan includes selling one or two little individual health plans and that is what you have been doing for the last ten years and expect to do for the next ten then I think you are going to get hammered. If you consider yourself to be within the field and can pivot with change, I think we could also be moving into a scenario which would be the envy of any Blackwater contractor.
Unfortunately, tax credits do not ever make anything more affordable. Case in point, back when the Toyota Prius was eligible for a tax credit, there was a surcharge on the car, more than offsetting the credit. Now that the car is no longer eligible for the credit, that surcharge is gone. The same is true for solar power stuff, and pretty much anything else that the consumer can get a tax credit for.
The company realizes that the credit makes it sound more attractive, which helps cause demand, so the demand allows them to raise rates. Good basic capitalism at work.
Tax credits allow the government to encourage certain behaviors (drive a green car, use solar power, etc) in reality by helping the companies develop those technologies / behaviours. I believe this is the unintended consequence, and it does work, but it isn't the way it was designed to work.
With a regulated product like health care, it will be interesting to see what the unintended consequences will be. It depends a lot on where the 'fixes' are applied. If you tell a doctor they can only charge $35 for an office visit, you'll lose doctors. If you tell a hospital that they can only charge $900 a day for a room, hospitals will go belly up. On the other hand, if you allow free market on the health care side, insurance rates will go through the roof. If you don't allow this, you'll see a lot more exclusions on what is covered, or limits on treatments. In all cases, the nurses union will demand a raise in pay.
Providing a health care solution is pretty easy, having the political win to put it in place is MUCH MUCH tougher.
My solution (and I'm not running for anything):
Allow the government to insure the 'big things', such as cancer, neonatal intensive care, anything where the costs of treatment normally run into the hundreds of thousands of dollars. In many cases, they end up with these anyway. Just make it a fact.
This allows major medical to remove huge risks in their plans, which (with a big push) will significantly reduce the premiums for almost all Americans.
HSA's are a good move and need to be promoted for more individuals. Get carriers to provide better HSA plans (its a shame that the best HSA in California is from Kaiser) where the max out of pocket better lines up with the annual contribution limit. This allows people to set aside money to pay for the coughs/cold/flu visit to the doctors, gives them health insurance coverage if anything more serious happens, and provides government coverage on the high risk / high cost stuff.
For those who truly cannot afford an HSA style coverage or deposit, have a program that is based on a sliding scale to provide coverage.
Is this great for agents? No. Does it balance our needs as a society to take care of our own? Almost. Is it affordable? Nothing about health care is affordable, and it's getting worse. This doesn't change no matter what the plan is.
Unfortunately, tax credits do not ever make anything more affordable. Case in point, back when the Toyota Prius was eligible for a tax credit, there was a surcharge on the car, more than offsetting the credit. Now that the car is no longer eligible for the credit, that surcharge is gone. The same is true for solar power stuff, and pretty much anything else that the consumer can get a tax credit for.
The company realizes that the credit makes it sound more attractive, which helps cause demand, so the demand allows them to raise rates. Good basic capitalism at work.
Dan
Tax credits and/or deductions make a major difference in consumer behavior. You gave examples of discretionary items such as yuppie cars or solar panels where tax credits alone were not enough to be a motivating factor or else the companies jacked the price up because there was already demand there anyway so they did not meet price resistance.
It doesnt play out the same with health insurance and health care, assuming a non-monopolistic environment. If someone is on the edge of affordability for health insurance premiums and then they find that they get a $1000 tax credit (example only) then that is an incentive. If someone can't afford a part D premium and suddenly there is state subsidy or outright purchase, it is a whole new level of affordability and business for the agents that would not otherwise exist. Yes, it is true that carriers can jack prices up as there is more subsidized purchasing power in the economy but in an economy where there are many competitors then the business will gravitate toward those companies that are willing to compete on price and service. The "statement that tax credits dont ever make anything more affordable" is incorrect at the consumer level. It is true that they dont work well as an incentive to make people do things that they were only marginially interested in to begin with but health care does not fall in that category.
Yes, I know the argument that lots of low lifers out there wont spend a dime on health insurance even if you subsidized it 90% blah, blah, blah. The reality is that there is major demand in the economy for affordable health insurance. I am also not making the point that it is right to provide credits or subsidy. I am just saying that many of the health care proposals suggest including these features and it could drive new business. Whether it was right for the government to get into Part D drugs plans is still highly debatable and may or may not be affordable for the country as a whole or a wise thing to have done. The reality is that is was done and we can't conclude that it didnt drive a high level of drug plan sales for agents and carriers just because we have a bitch about the macro-economics of it. Same with med supplements, ma's, and so on. It is the same with physicians. They bitch about reimbursement all the time. The reality is that medicare drives major volume to them that they would otherwise never have. So you cant conclude that government programs, subsidies, or tax incentives dont move markets, because they do- often enough anyway. I certainly agree that states and the feds can screw things up bigtime by imposing guaranteed issue or standardized rates etc into the mix which can make the whole market collapse so government intervention can result in some real un-pretty things. I was just focusing on the tax incentive or subsidy piece. The housing industry for example has done pretty well with tax incentives for home ownership and availability of federally subsidized loans and yet the ups and downs of capitalism and competition are still there, as it should be.
Don't get me wrong though. Hillarys and Obamas plan involve price fixing and they are totally nuts. It is not inconceivable though that if a republican is elected that they will propose some package with elements of tax credit and subsidy which may sound socialist but not compared to what the dems want and the republicans cant avoid doing something. The country is past the point of doing nothing, ackowledging that most people here seemingly disagree with that.
Or, just imagine if they look at the real problems? You can increase the affordability around the edges with tax credits or giveaways but, in general if the supply can not meet demand you are still chasing your tail.
The AMA and Medicare is the problem, till those are dealt with you simply talking BS with temporary fixes that are sure to fail. Hey, let them pay for my healthcare, I'll abuse it and, if the subsidy going into my pocket is big enough I might even go out and sell it to others.
Or, just imagine if they look at the real problems? You can increase the affordability around the edges with tax credits or giveaways but, in general if the supply can not meet demand you are still chasing your tail.
The AMA and Medicare is the problem, till those are dealt with you simply talking BS with temporary fixes that are sure to fail. Hey, let them pay for my healthcare, I'll abuse it and, if the subsidy going into my pocket is big enough I might even go out and sell it to others.
Where is it cast in concrete that there can be no increase in supply? We already have a surplus of doctors in this country it is just that they are all specialists concregated in urban areas. 80% of what primary care doctors do can be done by a nurse practitioner and yes there is a nurse shortage. So train some more nurses for God's sake.
Yeh, right that will be good. Get rid of Medicare. Lets go back to seeing who qualifies medically for individual health insurance at age 90 and what the premiums might be. People say that a publicly supported health insurance program would be like Great Britain and would be a disaster. How many people would be willing to get rid of medicare though? Just a handful who sell insurance and dont like missing out on the premiums for a 90 years old. All of these pithy comments dont make change the fact that chane is coming and that is the point I am making. Many of you think that change is not coming because you have arguments about why certain things will never work. Those are two different issues. It's coming.
No, there is a Dr shortage and it will get worst as we go on. Now did I say anything about getting rid of Medicare? If we are not willing to look at the real problems everything else is simply bandaids on issues we will not look at. I need a physical, I have to wait a year, I can go see our Dr and do a pre screen in 2 months but, the actual physical is a year out. I'll shorten that time frame by seeing the junior Dr of the practice, physical is now 6 months out, that helps.
No, there is a Dr shortage and it will get worst as we go on. Now did I say anything about getting rid of Medicare? If we are not willing to look at the real problems everything else is simply bandaids on issues we will not look at. I need a physical, I have to wait a year, I can go see our Dr and do a pre screen in 2 months but, the actual physical is a year out. I'll shorten that time frame by seeing the junior Dr of the practice, physical is now 6 months out, that helps.
There is no Dr shortage!
That is correct there is no shortage in the absolute number of physicians needed in this country. There is however a shortage where they are needed in rural areas or clinics. We have an oversupply of specialists in urban areas. It is true that an overall shortage will develop as the baby boom ages and that is a different factor. It, however, raises the same issue, because if we train more and more doctors without requiring or providing incentives for them to practice where they are truly needed then you will continue to have more and more doctors but real shortages where they are needed. We need more primary care physicians, family practice doctors and nurse practioners. The private sector and private pay medical students can do what they want but this bullshit of subsidizing medical schools and medical students so that they can be specialists in areas where there are already an overabundance of specialists has to end. If public dollars spent on the training they need to give back. Don't like it. Dont take public dollars.
That is correct there is no shortage in the absolute number of physicians needed in this country. There is however a shortage where they are needed in rural areas or clinics. We have an oversupply of specialists in urban areas. It is true that an overall shortage will develop as the baby boom ages and that is a different factor. It, however, raises the same issue, because if we train more and more doctors without requiring or providing incentives for them to practice where they are truly needed then you will continue to have more and more doctors but real shortages where they are needed. We need more primary care physicians, family practice doctors and nurse practioners. The private sector and private pay medical students can do what they want but this bullshit of subsidizing medical schools and medical students so that they can be specialists in areas where there are already an overabundance of specialists has to end. If public dollars spent on the training they need to give back. Don't like it. Dont take public dollars.
Winter
I'm sorry but a Dr shortage is a Dr shortage end of story. Some basic reasons for it, first one that comes to my mind is the AMA and how they have limit the training facilities and the overtaxing of those that want to be Dr's. Yea the shortage of today is only going to get worst, mainly because on one has the will to correct what really needs to be corrected. Federal involvement will only compound the problem.
Federal involvement will only compound the problem.
Let me rephrase that:
Federal involvement will only compound ANY problem.
Let's declare a "war on insurance" like all the other bullshit wars the feds have. Yeah, that's the ticket.
More government is better. I hope the democrats nominate someone more liberal than Hillary or Obama. Socialism is the future - just like it was written in the Constitution!
I'm sorry but a Dr shortage is a Dr shortage end of story. Some basic reasons for it, first one that comes to my mind is the AMA and how they have limit the training facilities and the overtaxing of those that want to be Dr's. Yea the shortage of today is only going to get worst, mainly because on one has the will to correct what really needs to be corrected. Federal involvement will only compound the problem.
Chances are good that in the future your doctor or your neighbors will be named Mohammed or will have trained in Ghana or the Caribbean. It is already that way in urban inner city and rural clinics where no other doctors want to work. Of course since we are against government involvement and are all free traders, then maybe that is a solution. Don't let all those licensing, training, credentialing or requirements to speak english and other government requirements get in the way. The government will only screw it up. We can bring in a boatload of Pakistani doctors a lot faster than training new ones and it is a free market way of holding costs down.
If you really want to see the direction of Medicare, watch AARP.
They are the largest voice for seniors and United Healthcare pays AARP a lot of money for endorsing Secure Horizons and their supplements.
With MA plans, there was legislature already done last year that will scale back the capitation fees paid over a 5 year period to equal 100% of Medicare's costs.
The PFFS plans are the ones that face the greatest hit. HMO and PPO plans have been around prior to all this.
------------------------------------ "Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
Chances are good that in the future your doctor or your neighbors will be named Mohammed or will have trained in Ghana or the Caribbean. It is already that way in urban inner city and rural clinics where no other doctors want to work. Of course since we are against government involvement and are all free traders, then maybe that is a solution. Don't let all those licensing, training, credentialing or requirements to speak english and other government requirements get in the way. The government will only screw it up. We can bring in a boatload of Pakistani doctors a lot faster than training new ones and it is a free market way of holding costs down.
Winter
Proplem solved! If I want to go see a Witch/Vodoo Doctor that is my God Given Right!
The government has to have a committee formed to first look at the problem. Then they will have to do several extreemly overpriced studies on the problem, why it is that way, and some possible solutions. Well, rather then take a stand and solve the problem, they will create a bill that will be earmarked to death with things that have nothing to do with the initial problem.
And after it is stalled, redone, stalled, more studies done, the problem has evolved into a major epidemic and then they will start pointing fingers. The solution is now 50x's more then it should be to help pay for the studies, earmarks, and delay.
So, if you want a problem solved other then national defense, leave the federal government out of it. Let the free market compete for business and you will see cost cutting, streamlined decisions, and a better overall market for the American people.
------------------------------------ "Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
Proplem solved! If I want to go see a Witch/Vodoo Doctor that is my God Given Right!
True. Just be sure that you dont get into some kind of HMO where your PCP has to give you a referral to that witch doctor. I don't think that would be the right plan for you. I think that Combined or Conseco has some type of supplemental witch doctor plans where if you need major surgery they will instead pay for a witch doctor visit. It's nice a way for both you and the carrier to hold costs down. Original Medicare wont cover it, not sure about some of the MA's. I think that with an MA you can go to any witch doctor *who accepts the plan* but that has caused a lot of confusion for folks.
Yes, we do have a doctor shortage in the good ol' USA - as a direct result of the AMA (restricting the number of doctors via their "educational system") and the legal system (lawsuits).
So whether Kanye West's mother's plastic surgeon did something wrong, the medical examiner (now THAT's a fun job) said no/inconclusive, but do you not think he's going to be sued up the ying yang? Of course. If only Johnnie Cochran were alive today....
More Information
Re: McCain and....
Linear Mode
