What value do private health insurance companies in America bring to health care over a government run plan?
I took the liberty of transcribing what I thought was the most interesting bit
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Rep Weiner: How does Wal-Mart offer $4 prescriptions?
They offer $4 prescriptions because they go to the pharmaceutical companies and say listen, we have a giant buying pool here. Your going to give us a great deal.
Who's bigger than Wal-Mart? We are, the tax payers. Do we do that? No?
Because we have outsourced this to insurance companies who don't have necessarily as much incentive to keep those costs down because frankly they are getting a piece of the action.
I ask again, what value are insurance companies bringing to this transaction.
They hold back on payments to doctors months at a time, they make us all wrestle with 800 numbers you never hear the phrase pre-existing condition with medicare do you?
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The video is available from several sources including the Morning Joe website. Here is a google search that will lead you to some of them. I encourage you to watch the whole interview.
What do you think? Does Weiner have a point? What are the values of private health insurance?
A couple points of clarification:
This is not Obama's point of view or plan, this is Anthony Weiner's.
And the question is about private health insurance, not private health care.
Just looking for a civil debate and reasoned arguments for or against.
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M$5 Answers
One of the touted benefits of the health insurance companies, that they use their buying power to reduce prices, is actually one of the most insidiously bad things about them. This is because they do not really lower the prices, or the cost to the producer or provider. The producers and providers simply shift the costs to the uninsured, or to those whose insurance company refuses to cover an item. Those items can be literally price gouged at ten times the cost.
When a strong public health service is in effect, the private companies can offer additional coverages.
There really is no sane reason to object to public health insurance. The vocal opposition one hears is all based strictly on dogma, a feeling that bigger government is bad and something bad will somehow happen. The experience of other countries is enough to disprove any such notion. Public health insurance happens to be one of society's functions which is best performed by a government, like defense and police.
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M$To tell you the truth I would not like having big Government in my back pocket on this, while I do encourage a public umbrella on everyone . I don't like the idea of regulation of practice. If the hospitals and Ins. companies need to splurge every now and then to keep people covered then thats what I want.
I like being able to be covered from head to toe.
Obama and the OFA can't watch everyone all the time.
The also want to archive and digitize all health records, thats all well and good but.
The simplest micro glitch with a single payer gov. run system could literally be devastating .
Luckily up north we have a more refined system that while the wait is long for some things, it works well for us.
Now
That being said, I think Rep Weiner is forgetting one thing, wallmart already has the medium in place to move and house the drugs, the US would need to spend more money on refining of other things once a new "system" ahem ahem headache is in place.
Yeah ,.... def. for a blanket. But give people the option to opt out and/or get extra coverage.
Also I don't want to sound biased. Coming from a family that runs both a senior HMO and Insurance firm I have seen the background of how these companies work.
I will tell you right now they don't keep their employees happy by no means.
I think one of the main ADVANTAGES would be that more regulation MIGHT mean better benefits for the actual health business's that provide the care.
You will also have allot less retention and _eventually_ allot less fraud.
Which brings up a even more valid point If more of the middle class is happy, people will stop resenting the system they work for.
Its a win win THAT way.
Kind Regards,
XDS
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M$
No problem. You are raising good points.
Though if you could, please expand on what the advantages to a private system are (after the public system gets it's infrastructure in place)
Sure, Updated the question once again.
By the way, my ?methodology? might sound a bit unreasonable, but I have seen the intricate workings of both sides (the insurance companies and the providers)
Right now frankly in the US it just sucks.
I updated the question, I hope you saw that before the +1
If the government were to replace the current programs with just one, then you have a government program that is big enough to influence the market.
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M$
In another part of the interview, Weiner proposes taking Medicare and gradually lowering the age of enrollment. So I think what he is looking for is essentially a Medicare type option for everyone.
Yes, good point.
Medicare for everyone type of scenario might work but it really depends on who is running the program. If you have elected officials acting as a board of directors then you run the risk of having ideology be the basis of how the program operates. However if you have a non-partisan committee of health care experts running the public option program then the odds of such a program being a success goes up.
We have relatives of people who have moved to the UK given entitlement to treatment, how the hell does that work, they are not residents so why should they get our money?
I know my arguement sounds terrible as everyone should get treatment, life is precious but imagine the situation where a contributing resident is placed in a que of 6 months or longer because all the beds are full!
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M$
This really doesn't have anything to do with what value private insurance companies add.
As a resident of the UK and a contributer to the national health service I am constantly annoyed at people who moan about immigrants....
The NHS actually has reciprocal arrangements with many other countries, citizens of these countries actually are contributing (albeit in a different manner than UK citizens)
Many users from other countries actually do have to pay for the NHS serivices because they do not meet the criteria for free treatment.
treatment for the following is always free of charge, as there is a clear moral obligation or benefit to the UK in providing it.
treatment for accidents and emergencies as an outpatient in a hospital’s accident and emergency department.
compulsory psychiatric treatment
treatment for certain communicable diseases, such as tuberculosis, cholera, food poisoning, malaria, meningitis and pandemic influenza.
Testing for the HIV virus (any necessary subsequent treatment and medicines may have to be paid for)
family planning services.
The criteria for receiving free NHS hospital treatment are if you:-
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have been living legally in the UK for at least 12 months when you seek treatment, and did not come to the UK for private medical treatment.
have come to the UK to take up permanent residence, for example, if you are a former UK resident who has returned from abroad, or if you have been granted leave to enter or remain as a spouse
have come to the UK to work, either as an employee or self-employed person.
are receiving a UK war disablement pension or war widows’ pension
are an asylum seeker or have been granted exceptional leave to remain or refugee status. (Proof of your immigration status from the Home Office may be required).
have been identified as having been trafficked from abroad or are believed to have been trafficked from abroad
are imprisoned in the UK or detained by UK immigration authorities
are a UK state pensioner who spends up to six months a year living in another European Economic Area (EEA) state, but are not a resident of that state
are working in another EEA country, or in Switzerland, but are paying compulsory UK national insurance contributions
are a student following a course of study which lasts at least six months, or is substantially funded by the UK government.
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If you do not meet those criteria you may have to pay for the treatment in advanced, if required here. Or you may be stabilized till you can return to the country where you are entitled to it.
http://www.adviceguide.org.uk/index/family_parent/health/nhs_charges_for_people_from_abroad.htm
@albanian you're 100% right... the answer from @portsidetwd didn't have anything to do with "what value private insurance companies add". However it may I feel the points it raised did need to be addressed/corrected.
If anyone really is interested in discussing these points further I strongly suggest them asking a new question where they can be explored/answered.
We now return you to your regular scheduled question about "What value do private health insurance companies in America bring to health care over a government run plan?"
The only reason to make something that is typically in the private sector government run is that people will not pay for it by choice; instead, government forces people to pay for it and guarantee its existence, no matter how bad it becomes. (Think Amtrak, public education, post office.) Unfortunately, since cost is the only limit on the possible health options a person could choose, eventually rationing must be put into place. For example, if all health care is free, some people may choose to be screened for every type of cancer monthly. Other people may call an ambulance over a headache, since it's easier than driving to the hospital. Then we are in a situation where government is determining what treatment we can get, instead of letting us decide what is best for us. For those of you who say that insurance does that now, insurance can refuse payment (forcing the patient to pay out of pocket), but only but government can refuse treatment.
The bottom line is that private programs allow more individual freedom than government-run programs. How much power do you want the government to have?
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M$
@bunnyphuphu, first, have you seen a loved one lose everything they had? Did you help him/her? When I had expensive surgery, my relatives helped me pay the thousands (yes, thousands) out of pocket. I will do the same for them and for any of my friends with medical problems.
I know about pre-existing conditions, since with my medical history, I am virtually uninsurable. I also know that the reason that insurance companies refuse to cover certain people is that federal laws prohibit them to charge more for higher risk. That restriction does not exist for home, car, or life insurance, and it causes health insurance companies to refuse to cover someone who will drive up the costs for the rest of their customers.
Today, I called the doctor because I think I have an infection, and they made me an appointment for an hour and a half from the time I called. No one asked if I can pay (as some people claim happens in America) and unlike countries with socialized medicine, I will likely be in and out within an hour. Sometimes I wonder if people who want "free" public health care really don't care how much others will suffer as long as they themselves don't have to pay for their own treatment. If you aren't willing to pay for your medical care, don't claim to be willing to pay for mine.
The reality is that quality medical treatment is expensive, and if you want the best, you'd better be the one paying. No one raves about "free" cafeteria food. It's mediocre, but it's free. That's how "free" public health care is.
@srgothard Germany has an entirely state run health care system and they are able to provide quality medical treatment to all its citizens. Switzerland has an entirely privatize health care system with strict regulations and they are able to provide quality medical treatment to all its citizens. And both countries are able to do it at far less cost than the US. You have to recognize that how good a health care system is, is not based on whether or not the system is private or state but how that system is structured and how good of job the government does on regulating that system.
@beast1oh1, even if I grant you that a good government can provide quality health care, I think we can all agree that the USA is known for waste, inefficiency, and poor quality compared to private enterprise. Most of my relatives work for the government, and they constantly talk about the waste in government work.
@srgothard, Thanks for your answer.
I don't agree with most of your points (and especially those of Lew Rockwell), but these are the things I think need to be debated and worked out in a civil manor.
I will leave it up to others to counter your points.
Though I hope this is done with respect to the fact that I am looking for helpful debate. And you did state your opinions for why private health insurance is better, which is what I was asking for.
"If everyone hates the way an insurance company works, they can switch companies"
Not if you have a pre-existing condition. If you do, you are screwed. I'd be curious if you've ever had to watch a loved one or friend get screwed by an insurance company and lose everything they had.
I have... it's not fun, or far.
I think the argument that comes up is a mis-use of the fact that America does have the best health care when it comes to highly complicated/specific medical conditions.
So while I agree we shouldn't be reinventing the wheel, I do wonder if some different choices need to be made in order to preserve those specialized care systems.
Great Britain and Canada. Personally, I think we, the USA, should not try to reinvent the wheel but should adopt one of these two systems at once.
Thanks @albanian,
Would you be able to provide some examples of other countries where a government system is working properly?