Canadian relatives and friends: I am worried about you

[Hawthorne]

Goose - Well said!! As I read your post I nodded --yes, yes, all the way through!

[diboja]

Bump....
(Where is Rooster? I thought that he may have a comment about the Canadian postings, since he posted this topic)

[Snorebert]

I have been trying to resist joining in on this discussion - I posted a somewhat snide remark on another similar thread to which Rooster gave a thoughtful reply and I didn't have the time or energy to get into it with him. I sincerely doubt that any of us will be successful in changing any minds here. It seems as though the healthcare delivery process is one of those emotional issues like abortion or CPAP self-titration that while it may be fun to argue - it is for no reason except to hear (read) ourselves talking.

As for me, I work in the healthcare industry and I see firsthand the cost-shifting and denials that happen systematically. I see the self-pay uninsured being billed at many multiples of what the insurance companies (and Medicare and Medicaid) pay. I see my own co-pays going up while the covered services are declining. My oldest is now uninsured and my youngest will shortly be the same when my employer-sponsored medical will no longer cover him. And, because they both are in industries that typically do not have insurance, they will most likely never have anything close to what I have had. Or my father has. Unless something is done to get universal coverage.

Socialism? You can probably call it that. You can use that term to describe a variety of things in the US. Medicare? Tri-Care? VA? How about federal highways? National parks? NASA? I'm not advocating pure socialism. I'm a capitalist at heart but I do believe that there are some things that capitalism is not good at.

Speaking of which, where are the defenders of the status quo? If those poor Canadians have it so bad, who is standing up and saying that the US has it just right?

Just listening to myself talking......

[ZIFF]

I watch a lot of news. I still haven't seen or read a specialist in insurance theory provide the basic principles of what risks are good candidates for insurance. I took a course in university called Risk and Insurance, but that was over 30 years ago, so I apologize in advance for my ineloquent attempt that follows.

Property losses from fire and theft are great risk candidates for insurance. You can get a large pool, the risk is still relatively low, and it doesn't matter if you live in New Orleans or Minneapolis, you want the insurance.

Losses from Hurricanes - bad candidate for insurance. People in Minneapolis are not going to buy it, the pool isn't big enough and the people who want the insurance (New Orleans etc) are eventually going to make a claim, and too many of them make a claim at the same time, there is insufficient ability to spread losses from victims in the pool to non-victims. That is why it is often government that picks up the tab on these types of losses.

Health care is somewhere in between, not impossible for some elements of it to be subject to private insurance, but certainly far from the greatest candidate. That is why every major developed country, except the US, has some form of government system to provide/enforce universal coverage.

Hopefully someone better versed (and definitely more recently) in insurance theory sees this and provide a better analysis.

Want to keep someone (be it government or a private insurer) from looking over your doctor's shoulder? Take a look at France where people have a copay averaging around 20% for their basic health care, but don't have to deal with their primary care physician as a gate keeper to a specialist, they are allowed to make an appointment directly with a specialist, the copay keeps most people from abusing it.

[MoneyGal]

I work in derivative economics and actuarial finance. I think and talk about risk all the time. Providing universal access to protection against a risk decreases the liability for the issuer (speaking in generalities - the earthquake example is an example of a specific, non-generalized situation). If you allow people to self-select their insurance, you tend to get a "riskier" population in total.

It seems to me that the basic issue in the US (I'm in Canada) is whether people really have the appetite to risk-share across the whole population (leaving aside discussions of, for example, immigrants and illegal immigrants). I think this is a valid consideration. Canada decided to do it. Cost is managed in a lot of different ways in Canada, including by not covering some things (tattoo removal! cosmetic surgery!) and by setting prices for physician reimbursement (doctor bills the government insurer according to specific codes with set prices). But the basic question of "who is insured, and who pays?" is answered with, everybody.

[Jay K]

As long as we are focusing on the health care insurance industry for a moment, I have an honest question (although I have a bias as to what I think the answer probably is). How is it possible to reconcile that the health insurance industry has a federal antitrust law exemption while at the same time claim a public option in the Health Bill will interfere with competition in the free market? Isn't the U.S. system designed presently to assure health insurance companies maximal profit through monopolistic practices with little risk? And isn't this the antithesis of capitalism (not to mention the antithesis of a system working for the public good)?

I just don't get it. Would someone care to enlighten me and tell me what I'm failing to take into consideration?

[PST]

As long as we are focusing on the health care insurance industry for a moment, I have an honest question (although I have a bias as to what I think the answer probably is). How is it possible to reconcile that the health insurance industry has a federal antitrust law exemption while at the same time claim a public option in the Health Bill will interfere with competition in the free market? Isn't the U.S. system designed presently to assure health insurance companies maximal profit through monopolistic practices with little risk? And isn't this the antithesis of capitalism (not to mention the antithesis of a system working for the public good)?

I just don't get it. Would someone care to enlighten me and tell me what I'm failing to take into consideration?

The exemption doesn't just apply to health insurance, it applies to the business of insurance as a whole. I have my doubts that the exemption is a good idea for health insurance, but it serves a purpose for certain other kinds of insurance. First, really big risks are often covered by many insurance companies each taking a piece of the action. For example, the World Trade Center had $3.6 billion in coverage. (Actually, there was a major fight over whether this was one occurrence for two, and thus whether the coverage was $3.6 billion or $7.2 billion.) No company in the world can handle that much risk, so they work together, with each carrier on the same layer of coverage taking a percentage of the premium in exchange for a percentage of the risk. That could seem like price fixing if it weren't for the antitrust exemption. Second, state insurance commissioners often require insurers to disclose their loss data. If one carrier dominates the market in a state, it is difficult for others to enter the market (or for new carriers to start up) if they can't find out what losses to expect. Voluntary sharing of loss data might also be illegal under the antitrust laws, but the exemption allows insurance commissioners to compel it. This is thought to facilitate competition. There are probably other reasonable arguments for the exemption as well.

[PST]

Speaking of which, where are the defenders of the status quo? If those poor Canadians have it so bad, who is standing up and saying that the US has it just right?

Defenders of the status quo are few and far between. There are some who object intensely to government regulation generally, or to any program that has the effect of redistributing resources (or as they might say, stealing). Judging by references in this forum, for example, to "Socialist Security," some of these folks might roll the clocks back to 1932 if they could. They are not defenders of the status quo, but they don't want to see us slide further down the slippery slope to socialism.

Others seem equally angry at both private insurers and the government, often view them as conspiring with one another against the public, and are deeply cynical about the prospect for improvement. For example, someone here suggested that the real solution might lie in executing a few insurance company CEOs. These people are not defenders of the status quo, but they seem pretty sure that the proposed legislation will just screw things up worse.

Of course those of us who support the bill aren't defending the status quo either. The only group I can think of that has defended the way things are today consists of some Medicare recipients who are satisfied with the benefits they receive now and don't want to take the chance that health care reform will diminish them. And even some of them aren't very enthusiastic. So good luck finding a cheering section for the status quo.

[-SWS]

Bump....
(Where is Rooster? I thought that he may have a comment about the Canadian postings, since he posted this topic)

[roster]

Bump....
(Where is Rooster? I thought that he may have a comment about the Canadian postings, since he posted this topic)

Can I not go away for three days without this bunch stinking up the forum?

You guys are totally lost without me.

viewtopic/t47126/Roosters-Advice-To-cpa ... ebate.html

[Autopapdude]

Rooster is NOT worried about his Canadian friends, that is, if he has any. He just wants to stir the reactionary pot, so as to start the health care debate all over again. HE refuses to just back off and let things happen as they will--thus he's agitating and exacerbating a negative situation, by playing provocateur. His intentions are NOT positive nor are they pure. I won't deny my partisanship--never have denied that I firmly and loudly advocate for health care, but I don't keep stirring this pot endlessly. He's using fear tactics so as to now draw in Canadians to say that their health care system is terrible, and that has backfired mightily. Most of the Canadians who have posted here have positive things to say with regard to national healthcare, and he's using that as an attempt to draw in some allies. Guess he hasn't succeeded from those NORTH of the border.

[-SWS]

Can I not go away for three days without this bunch stinking up the forum?

Rooster, you normally do such a good job of treating people with respect as you endeavor rationality on this forum.

I'm looking at what you wrote above and how you wrote it. Your disrespectful dismissal of a "bunch" who happen to maintain different views than you---the disrespectful name-calling in red. You read like one of many decreeing birds around here lately who have their political feathers ruffled but good.

So how exactly are these many political OT posts spawned by Rooster and others helping this non-political forum anyway? It seems the few politically fervent members around here---regardless of political views--- manage to cover more than their share of snide remarks and animosity toward fellow forum members.

[cinco777]

You guys are totally lost without me.

No.

[-SWS]

Bump....
(Where is Rooster? I thought that he may have a comment about the Canadian postings, since he posted this topic)

Can I not go away for three days without this bunch stinking up the forum?

You guys are totally lost without me.

viewtopic/t47126/Roosters-Advice-To-cpa ... ebate.html

Rooster, your above-linked political thread has absolutely nothing to do with diboja's very simple and straightforward request. In fact, the words "Canada" or "Canadian" aren't even in the post you linked to...

So you essentially insult the Canadians once by starting a derogatory thread about their healthcare----let alone for your own purely political purposes. The Canadians, in turn, politely respond by offering solid, earnest feedback. Then, you again insult the Canadians by not even bothering to acknowledge their earnest feedback when requested. Rather, you point them to your latest political rant that has nothing whatsoever to do with the Canadian healthcare system that you painted as inferior to current US healthcare.

Good going, Rooster...

[roster]

Rooster, your above-linked political thread has absolutely nothing to do with diboja's very simple and straightforward request. In fact, the words "Canada" or "Canadian" aren't even in the post you linked to...

So you essentially insult the Canadians once by starting a derogatory thread about their healthcare----let alone for your own purely political purposes. The Canadians, in turn, politely respond by offering solid, earnest feedback. Then, you again insult the Canadians by not even bothering to acknowledge their earnest feedback when requested. Rather, you point them to your latest political rant that has nothing whatsoever to do with the Canadian healthcare system that you painted as inferior to current US healthcare.

Good going, Rooster...

Thank you.

I have no quarrel with the Canadians, even if they now have one with me. It is a pleasant country and has pleasant citizenry and wonderful, clean outdoors with vacation opportunities. Some of my fondest memories are of a friend from Calgary. We attended graduate school together and were inseparable – chasing women, playing sports, and studying.

Also, I have had many a good business trip to visit my company’s operations and customers and had some good friends in our small operations there. Side trips that I made during the visits were always pleasant. Too bad the company was busted up by global competition.

Recently my son did a one-year paid internship with a Canadian company. He had three offers and I encouraged him in the one he took.

The Canadians are free to have whatever government they desire without interference from me. But they have quoted often here how much they liked their healthcare and best wishes that we would get something like it. Some of them equate what is proposed by our government with healthcare to what they have done. I am sure their government health insurance has little resemblance to the mess our current bills will make if enacted.

Since I returned late yesterday, I took the first time this morning to read all the posts here. If I were the type to look for offenses against me, and I am not, the only posts I could find to fit this description would be from two U.S. citizens living in the U.S. All I could say to these two fellow U.S. citizens is the current bill will not provide what you want; do some research.

Speaking again of Canadians, IMO, one of the Canadians directly addressed my concerns when making the O.P. These concerns were the central theme of the article I quoted – Why are Canadians coming in increasing numbers to the U.S. for healthcare services?

Canadian BS gives us a clear answer to this:

Besides - so what if we chose to buy services else where? It is still paid for and not coming out of peoples pockets. Ohip is using US services the same way any American insurance company is and expecting the same kind of documentation from its citizens. Where the service is performed is irrelevant.
You have a for profit system and Ontario buy its services - big deal. The provinces have had reciprocal arrangements for this kind of thing from the beginning because of the population density and economic base of each province.

This goes especially for elective surgery.

I like that answer. Individuals should be able to buy services from wherever they please.

As for diboja, if he now has any questions of me, he is free to ask.

I will just close by saying to the Canadians, if you think the bills in our U.S. Congress are for universal healthcare, they are not. See viewtopic.php?f=1&t=47126&st=0&sk=t&sd=a