Wyden-Bennett Health Care plan

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  • peb
    Papist and Texan
    • Feb 2004
    • 14281

    Wyden-Bennett Health Care plan

    Here is a link to some highlights.

    Click here for an up-to-date listing of recent Center health reform analyses.Introduction and Executive SummaryThe U.S. health care system suffers from a number of serious problems. ...


    This is the best plan I have seen. It makes a lot of sense to me. It seems to be getting some press, but since it is missing the "government option", I don't see how Pelosi and Crew will adopt it. Its a shame.
  • Keith Wilson
    Trying to be reasonable
    • Oct 1999
    • 64123

    #2
    Re: Wyden-Bennett Health Care plan

    It contains some good ideas, but does very little to promote efficiency and lower costs. One is still left with a multiplicity of private insurance plans, and the requisite bureaucracy to move the money around. One dollar in three, remember? Other than ideological reasons, why is this better than a plan with a public option?

    BTW, peb, that's an excellent anaysis in the link. Thanks.
    Last edited by Keith Wilson; 08-04-2009, 11:58 AM.
    "For a successful technology, reality must take precedence over public relations,
    for nature cannot be fooled."

    Richard Feynman

    Comment

    • Uncle Duke
      Just this guy...
      • Jun 2005
      • 4691

      #3
      Re: Wyden-Bennett Health Care plan

      It's still around, more or less. That article is from 2008, a year after the first proposal, which got a lot of push-back because of the change from tax-exemption to tax-deduction.
      It was re-introduced this year as the "Healthy Americans Act".
      Nice write-up of it here:
      Sometimes you've gotta leave the kibble out where the slow dogs can get some....
      ... Roy Blount, Jr.

      Comment

      • peb
        Papist and Texan
        • Feb 2004
        • 14281

        #4
        Re: Wyden-Bennett Health Care plan

        Originally posted by Keith Wilson
        It contains some good ideas, but does very little to promote efficiency and lower costs. One is still left with a multiplicity of private insurance plans, and the requisite bureaucracy to move the money around. One dollar in three, remember? Other than ideological reasons, why is this better than a plan with a public option?
        This I greatly disagree with. The idea that multiple private insurance plans is the root cause of our cost effectiveness troubles me. I have done some thinking on this the past week, so bear with me. I will follow through with my logic. Keep in mind, you are effectively arguing for a canadian system and I am here argueing against HR3200.


        First of all, Pelosi and Crew keep saying that we need a government option inorder to provide competition to the private insurance companies and ineffect "force them to be more efficient". On the surface this sounds great, but it it begs the question, "why doesn't the existing competition among healthcare insurance companies work?" Competition works in other ares of our society. The Geicos and Progressives of the world sure have shown it to works well with other forms of insurance. Life insurance is very efficient. Why not healthcare? Now, keep in mind, I am acknowledging that our existing system is broke. I am not arguing the question. I am arguing with the solution being offered to us.

        We would expect two things from good competition, lower prices and good service. Lets accept that we have neither. Why:
        1) there is not real competition due to lack of customer churn. Since the insurance is employer provided, and I speak from experience that it is a pain in the neck for a company to switch health insurance, there is no competition. Similar to the FCC pushing local number portability on phone companies back at the turn of the century. If the cost/hassle of switching providers is too high and there is no threat of churn, companies can/will abuse their current customers. Not intentionally, but there is no incentive to keep doing better.
        2) There is no real competition because the end user is not making the purchasing decision. Their employer is. So the consumer does not go out and "find" the plan that works best for him. The employee does not say "I am healthy, I will take a high deductible and keep my premiums low". Very little differentiation is offered at the individual level. Yea, some big companies have tried to do this with their cafeteria plans, but at the end of the day it all comes from the same provider.

        I submit that these are the two reasons why health insurance is not competitive (both with cost and service) and not efficient. The Pelosu plan does nothing to address these. Simply adding a government run option at the employer level does no good. The government insurance will be less efficient than the private insurance just enough to make up for the lack of profit involved.

        Now, it seems to me the Wyden-Benneett plan gets to the heart of the problem. They attack it head one. Make people buy their own insurance. Get employers out of the loop. I like it. Th emore I look at it, the more I like it.
        Last edited by peb; 08-04-2009, 12:16 PM.

        Comment

        • Keith Wilson
          Trying to be reasonable
          • Oct 1999
          • 64123

          #5
          Re: Wyden-Bennett Health Care plan

          would it take 1000 pages like the morons have made so far?
          Complicated laws take a lot of words. If they're not clear, you end up with court cases trying to decide what they really mean.
          The idea that multiple private insurance plans is the root cause of our cost effectiveness troubles me.
          One cause, not the only one. Consider the amount of effort in the average hospital merely keeping track of all the different insurance companies' plans, each one with different procedures, forms and coverage, filling out all the different forms, the hassle of figuring out who's paying what and where the money goes - none of it contributing in the slightest to actual health care. One data point - I talked to the pharmacist at my local Walgreen's a couple of weeks ago and she estimated that she spends about half her time dealing with insurance companies figuring out what's covered and who pays. This is utterly wasted time. All of this vanishes with either the British NHS or the Canadian single-payer system.
          Last edited by Keith Wilson; 08-04-2009, 12:16 PM.
          "For a successful technology, reality must take precedence over public relations,
          for nature cannot be fooled."

          Richard Feynman

          Comment

          • peb
            Papist and Texan
            • Feb 2004
            • 14281

            #6
            Re: Wyden-Bennett Health Care plan

            All of this vanishes with either the British NHS or the Canadian single-payer system
            I am skeptical. Perhaps for the canadian, befire the pharmacist gets it, the doctor has made sure the government will pay. in the UK, it would seem to be quite a bit of back and forth between the supplemental insurance policies and the government plan.

            At any rate, this is just a matter of insurance companies being inefficient. If they were more cost driven, they would solve this problem. At the end of the day, that pharmacist is being paid for that time and that payment is mostly coming from the insurance company. And the insurance company has the direct cost associated with dealing with the pharmacist that whole time.

            How do you solve this? Make them more efficient through true competitiion. Thats the answer. Fix that. No need to give up on the competitive forces that work in almost all other areas of our society.

            Comment

            • Keith Wilson
              Trying to be reasonable
              • Oct 1999
              • 64123

              #7
              Re: Wyden-Bennett Health Care plan

              Well, if those are the only choices, I'd rather be screwed by the government than an insurance company. We at least get to vote for the government. I think we have better options.

              Peb, those are good points about efficiencies of insurance. I'm not sure how pools would work, though, with multiple providers. You need to keep insurance companies from trying to sign up only the youngest/healthiest people and leaving out the older and sicker, and they've shown amazing cleverness in finding ways to do that.
              "For a successful technology, reality must take precedence over public relations,
              for nature cannot be fooled."

              Richard Feynman

              Comment

              • TomF
                Recalcitrant Heretic
                • Jun 2003
                • 50978

                #8
                Re: Wyden-Bennett Health Care plan

                Pelosi's right. Or rather, private insurance alone has not led to lower prices; quite the reverse.

                Why?

                The private insurers are looking for the spot on the price/service volume curve where they make the most profit. They've no incentive to push prices lower to make them more accessible to lower-income people ...

                On the other hand, a universal coverage model competing with private insurers would have to look for least-cost options, if they're to be adequately accountable to taxpayers. If that price is lower for the same service than private insurers ... it will erode the private companies' subscriber base. Same if the public model gives the same quality of care, but doesn't leave people holding substantial bills for "extra" services not covered by insurance. This will spark competition either on price, or on perceived quality, or probably both. And some private insurers will probably fail.

                So long as the universal model is set to match the internationally established norms for clinical practice, there's no "loser" here. Except the companies which currently provide over-priced services, which don't cover all the costs of medically necssary treatments.
                If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

                Comment

                • Keith Wilson
                  Trying to be reasonable
                  • Oct 1999
                  • 64123

                  #9
                  Re: Wyden-Bennett Health Care plan

                  Who shops for a doc as though buying a car?
                  It's hard to do when they bring you in on a stretcher unconsious.
                  "For a successful technology, reality must take precedence over public relations,
                  for nature cannot be fooled."

                  Richard Feynman

                  Comment

                  • P.I. Stazzer-Newt
                    obnoxiously persistent.
                    • Jan 2005
                    • 26007

                    #10
                    Re: Wyden-Bennett Health Care plan

                    Originally posted by peb
                    I am skeptical. Perhaps for the canadian, befire the pharmacist gets it, the doctor has made sure the government will pay. in the UK, it would seem to be quite a bit of back and forth between the supplemental insurance policies and the government plan. ....
                    Simply not true.
                    I'd much rather lay in my bunk all freakin day lookin at Youtube videos .

                    Comment

                    • peb
                      Papist and Texan
                      • Feb 2004
                      • 14281

                      #11
                      Re: Wyden-Bennett Health Care plan

                      Originally posted by Keith Wilson
                      Well, if those are the only choices, I'd rather be screwed by the government than an insurance company. We at least get to vote for the government. I think we have better options.

                      Peb, those are good points about efficiencies of insurance. I'm not sure how pools would work, though, with multiple providers. You need to keep insurance companies from trying to sign up only the youngest/healthiest people and leaving out the older and sicker, and they've shown amazing cleverness in finding ways to do that.
                      It is my understanding, that private insurance companies would be required to treat each state as one giant pool. Now, they could offer different plans in those pools and the cost of those plans could be based on the features. But access to any given plan would be universal.

                      I think if you made kept it simple, ie insurance companies can't reject people based on health/age ( I am not for sure how it plays in with medicare, so maybe age if medicare is going to service the elderly), their cleverness would be a mute point. Sometimes, complicated regulations provide the most loopholes and simple ones the least.

                      Comment

                      • peb
                        Papist and Texan
                        • Feb 2004
                        • 14281

                        #12
                        Re: Wyden-Bennett Health Care plan

                        Originally posted by P.I. Stazzer-Newt
                        Simply not true.
                        I was only speculating. I tried to word it that way. I do not know how the interaction between the supplemental insurance plans and the government system works. Please share.

                        Comment

                        • P.I. Stazzer-Newt
                          obnoxiously persistent.
                          • Jan 2005
                          • 26007

                          #13
                          Re: Wyden-Bennett Health Care plan

                          The pharmacist can tell at a glance whether (s)he is dealing with an NHS or private prescription.

                          NHS are dealt with by a single system (in any given country) and a single price (excepting where free) - private, by a separate system where the pharmacist sets the price - no to-and-fro involved.
                          I'd much rather lay in my bunk all freakin day lookin at Youtube videos .

                          Comment

                          • peb
                            Papist and Texan
                            • Feb 2004
                            • 14281

                            #14
                            Re: Wyden-Bennett Health Care plan

                            Originally posted by Norman Bernstein
                            I don't ever recall Keith arguing for the Canadian system
                            Keith, Don't get discouraged.. I find your posts worth reading, even if he does not.
                            Norman, keith has advocated a single payer, government run health care system consistently.
                            Originally posted by Norman Bernstein
                            That is precisely the wrong mindset... and it's definately part of the problem. As I've said before, health care is a life cycle phenomenon, and permitting people who are in the early decades of life to pay a very low premiums for high deductible plans simply means that people in their later years inevitably have to pay a very HIGH premiums, and can't withstand high deductibles. The actuarial database MUST extend across the ages. The guy who is perfectly health today may soak up $1M in critical care tomorrow
                            Ketih, it is obvious he doesn't read mine either, so don't feel too bad.
                            Norman, my point is that premiums may be different due to deductibles and benefits selected. I never said anything about age/health and the plan I am advocating expressly forbids it, from my unerstanding.

                            Futhermore, you are one to talk. When you have expressly suppoorted the idea that you do not want to subsidize others' insurance premiums.

                            Comment

                            • TomF
                              Recalcitrant Heretic
                              • Jun 2003
                              • 50978

                              #15
                              Re: Wyden-Bennett Health Care plan

                              Originally posted by peb
                              I am skeptical. Perhaps for the canadian, befire the pharmacist gets it, the doctor has made sure the government will pay. in the UK, it would seem to be quite a bit of back and forth between the supplemental insurance policies and the government plan.

                              At any rate, this is just a matter of insurance companies being inefficient. If they were more cost driven, they would solve this problem. At the end of the day, that pharmacist is being paid for that time and that payment is mostly coming from the insurance company. And the insurance company has the direct cost associated with dealing with the pharmacist that whole time.

                              How do you solve this? Make them more efficient through true competitiion. Thats the answer. Fix that. No need to give up on the competitive forces that work in almost all other areas of our society.
                              It's different up here for drugs than for having a medical procedure. There's not a universal drug plan; I pay for my prescriptions at the drug store. Or rather, the way Canadians do drug coverage is not unlike how you do the whole health schmear. We've got a mass of sometimes overlapping private and not-for-profit drug insurance plans, some degree of government coverage for special groups, and some remnant of the population not covered at all and consequently at risk.

                              Competition hasn't fixed it - we've still got people who can't afford their drugs ... who make just enough money to not qualify for social-assistance drug programs.

                              It's a national shame, and one which Provinces and the Feds have fought about for years now.
                              If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

                              Comment

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