Private business and health insurance
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Anonymous
This. I am also from Europe and I find American system insane. The first time I found out my insurance only covers me for the year and not till the end of my life I was stunned. What is the point of insurance if it only covers you when you are healthy enough to work? It's just totally insane. Other things I notice: there is a lot of paperwork and you get very little face time with a doctor. |
Anonymous
Taxes in the U.S. are not low. But we get very little bang for the buck. That is especially true in healthcare and education. We spend much more money per capita than do many countries that do equally good or better. |
Anonymous
No. Allowing insurance companies to operate across state lines will not increase the "size" of the market and it will not reduce costs. Insurers reduce costs in large part by negotiating with providers. The only way to negotiate lower prices with providers is to have leverage, or market share. That means covering a lot of people. Then you can say to GW Hospital, " if you want to be in my network and have all my enrollees use your hospital, then you have to agree to a 10% across the board reduction in payment. Otherwise, you are out of network and my enrollees go elsewhere." Having many more insurers, each enrolling a relatively small number of people, means each insurer has less market share and less leverage. GW says to a small insurer, "Nope, we don't need your enrollees. Go ahead and try to get cheaper prices from Georgetown." Small insurer finds that no one cares if they are in that network. Small insurer goes back to GW and agrees to higher prices. But we don't need to theorize--some states have already allowed insurers to operate across state lines. Hasn't lowered health care costs. This is one of those truthy things that sounds smart but is espoused by no one who actually knows anything about the market for health insurance. Well, no one who is being honest, that is. |
Anonymous
...so why would they want to change their model? |
Anonymous
I don't think it's going to be easy to take control out of the hands of states. |
Anonymous
But Blue Cross of Nebraska doesn't WANT to enter the insurance market in Sarasota. They don't know the providers or that particular market. They can't negotiate lower rates for the 176 Sarasotans who (inexplicably) decide BC of NE is the right plan for them. It's high risk for them. They'd much rather try to get more Nebraskans to enroll. |
Anonymous
Your suggestion is beyond foolish. Do some research about how it all works then come back. |
Anonymous
Off topic, but term limits are a terrible idea, unless you prefer your laws be written by lobbyists instead of legislators. Legislative term limits shift power to lobbyists and to the executive branch (which has an experienced civil service to rely upon for expertise). |
Anonymous
Not only that but the people calling for the sale of insurance across state lines are the same people who rail against the size of the federal government. So if we shift to a national market for insurance, will we be creating a new federal regulatory agency? Or are we just going to throw caution to the wind and let the insurers go without any regulation at all? |
Anonymous
Yep. It's just more truthiness. |
Anonymous
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You would need a federal regulator.
Right now we have 51 insurance regulatory bodies and 51 sets of mandates. Connecticut, which has something like 67 mandates won't allow residents there to buy cheaper insurance from Alabama, which has fewer than 20 mandates. In addition, many of the insurance companies operate in most of the states through subsidiaries, each of which is run as its own company with its own CEO, administrative staffs, buildings and the rest of the overhead, some of which is necessary to insure compliance with the unique insurance laws of each state. Wouldn't there be considerable cost reduction in centralizing all this and allowing the purchase of insurance from a federally chartered insurance companies? |
Anonymous
Consider that we Americans collectively spend 13 trillion a year on healthcare, and, per capita, we get far less bang for the buck than any other modern nation on the planet for it. That's the stealth tax, exacted by the private sector that we in the US have to deal with. |
Anonymous
Because nobody is making them. Congress is beholden to donors from the pharma and insurance sectors. While all of you whine and complain about your increasing premiums guess what, that's where the money is going - toward lobbyingm campaign contributions and marketing (propaganda). And that problem will only get worse now that folks with a "yahoo! deregulate!" and "yahoo! free market profiteering!" mentality have swept all federal offices. There are no checks and balances anymore. |
Anonymous
It's been done before, credit card companies, Delaware business registrations, lots of ways to skirt states. |
Anonymous
The Federal govt, especially under Trump, is NOT interested in regulating the healthcare industry, nor do the predominately unhealthy, low income red states want the control wrested out of their hands. Just think about the backlash by the red states when the Feds implemented No Child Left Behind, and how they backed Common Core. Which states were the ones that pulled out of CC? The ones where the people of the state were the least healithiest, and least educated. Which ones were early adopters? The ones where the state governments wanted to implement some for of universal healthcare and have higher median income. |