Quickies

Skepchick Quickies 8.2

Amanda

Amanda is a science grad student in Boston whose favorite pastimes are having friendly debates and running amok.

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21 Comments

  1. While I’m happy to see that breast pumps are also covered by the new guidelines, I’m assuming new mothers will still need a medical reason to get a pump covered, as opposed to having a job and being unable to stay at home with the baby.

  2. Besides having problems with the state interfering private contractual relationships, I’m bothered by them forcing the subsidy of private lifestyle choices. While I’m willing to pay for contraception as part of my insurance bill (It’s cheaper than babies) I cannot justify using the coercive power of the state to force others to do so.

    It’s bad enough that they subsidize boner pills for 70 year old men. What’s next, infertility treatment for 45 year old women?

    Medical insurance should be used to treat disease only and not subsidize lifestyle choices.

    This is the problem when you let politics interfere with the market. An example from California (somehow all our bad ideas get exported and none of our good ones), insurance companies here are mandated to cover acupuncture and chiropractic treatments.

    1. Furthermore, insurance is a risk management tool, the point of it is to prevent financial ruin in the event of unlikely adverse outcomes. Making any predictable expenditure part of insurance makes no sense. All they’ll do is take the cost of the birth control, add a bit for their profit margin and increase premiums by that amount.

      1. I hope you and the previous poster realize that there should be a difference between medical insurance and car insurance. If not, I wonder if you can appreciate that preventive medicine is preferable in case of insurance just because can prevent extremely expensive treatments for slow progressing disease if they are caught in time.

        And the market should keep its dirty hands off caring for people institutions, such as those taking care of our health, water, food and energy. We can talk about many cases in which this market has raped the people it was suppose to provide for (e.g.: see 2000 Cochabamba protests).
        Healthcare should not be a business for private interests to control.

        And about the colon cleansing, who would have thought that removing most of your symbiotic bacterias that provides you with what you need to be healthy could have a negative effect. Who I ask, who?

      2. That’s why health insurance and hospitals should be (dirty words coming) not for profit or at least severely limited in the amount of profit they can generate. What I would have liked to have seen happen, instead of the toothless health bill we got (which is better than nothing), was for the federal government to nationalize the health insurance industry and then use their leverage to lower prices for all.
        .
        Notice I didn’t say to completely change the system; by simply removing profit from the equation, detach health insurance from employers (solving portability problems), and forcing everyone into the system prices would be greatly reduced and outcomes improved.
        But the gubment ain’t never done nuthin’ right
        Yeah, right; the private companies have been doing a bang up job with it so far.
        It wouldn’t be a perfect transition, and it would never happen since, rather than stepping on toes it would be a kick in the crotch to for profit hospitals, insurers, and drug companies. But it is one of the most fundamental needs of modern society and should be free of profit-driven motive. Some thing are too important.
        .
        Now let the screeching of the libertarians commence.

        1. Food is just as important as medicine, and that is sold in the market quite successfully.

          Sure, some people can’t afford enough food, but how does the government deal with that? Nationalise farms? Make everyone’s employers buy them a fixed basket of groceries and argue about whether tuna should be part of the mandate? Of course not, that would be ludicrous. The government gives people money, and then leaves them to buy their own food.

          Why not the same for healthcare? Private for-profit hospitals, with proper, catastrophic insurance to handle risk, backed up by welfare for those who can’t afford the insurance they need. If it is in the public interest to encourage birth control (and I could be persuaded that it was), then it should be subsidised by the government, rather than just foisting the problem off onto insurance companies. Otherwise you get perverse outcomes – see the entire US health care system for examples.

          The profit motive has its flaws, but it’s the single best way to get strangers to do you a favour. Charity has its place but there’s only so much of it and the notion that you could replace for-profit hospitals with it is highly improbable. And the only other source of non-profit hospitals is government. And if that doesn’t seem so bad, need I remind you that for most of the past 100 years the executive branch of the US government has been controlled by Republicans?

          I’m not suggesting the government has no role in healthcare, in some senses I’m even suggesting that your government should increase its role. What I am saying is that the commonly discussed suggesting for improving health care in the US are badly ill-conceived.

          1. That is why I didn’t suggest a takeover of hospitals and drug companies but rather the insurance. Hospitals used to be not for profit before that was made a taboo thing in the eighties, most were run by churches not the government.
            And I’m sure that you realize that food is not a very good comparison and is highly subsidised as well.
            .
            It wouldn’t be perfect solution, but free markets have shown themselves to be more about profit and less about outcome. If I wish to go to the doctor I have to show an insurance card, if I don’t have insurance and wish to pay myself I may be turned away by a private clinic. Why?
            .
            I’m not anti-free-market, but I believe laissez faire should be kept out of public safety issues.

          2. Laissez faire is a bit hard to define, I prefer to stick to specifics, otherwise I get confused. In any case, I’m not suggesting no government intervention is called for, merely that I wish politicians thought about their interventions a bit more before legislating from the hip.

            And food might be subsidised in the US, but New Zealand abolished its agricultural subsides decades ago. We manage.

      1. Sex is like oxygen… only important when you’re not getting enough, and liable to cause a conflagration if not properly monitored.

        However, recall that many of these things ARE cost-saving measures… not just for parents, but for insurance companies, corporations, and society at large.

        Let us say that my girlfriend (Rosy) and I are sexually active (I’m also sleeping with her five sisters). She gets pregnant, because we can’t afford birth control. If we decide to abort, that’s an expense that goes to the insurance company. If we decide to keep it, that’s an ongoing cost to the insurance company (as we deal with prenatal issues, then as the podling is born). It becomes a cost to society because, even if we’re decent enough parents and have a decent enough kid, that child has to be educated (i.e. school dollars), forms a tax deduction (i.e. reducing revenue) and the infrastructure needs to support the podlings that I had with each of Rosy’s five sisters.

        Babies cost money. So does birth control, but try to raise a child on $15-50 a month.

  3. Did anyone else read “and detoxing is hot, stemming largely…” as “and detoxing is a hot, steaming pile…?”
    .
    So even some CAM practitioners no longer trust the guy who looks like a low-rent John Waters on the infomercials.

  4. The problem with for-profit health insurance is that sick people are bad for the bottom line. Thus, if you have a pre-existing medical condition you are treated like a DUI offender applying for automotive insurance. In the case of the DUI offender they are a profit sink (i.e. high risk) because of behavior. Although there are certainly cases where behavior can be a factor, often the person with the pre-existing medical condition is in that situation entirely as the result of bad luck. This is where IMO the government should play a role by simply requiring that if you want to be in the health insurance business as a private insurer, you can’t exclude sick people. This would force insurers to optimize cost by means other than excluding sick people from coverage (e.g. negotiating better prices, decreasing overhead, etc).

    1. You see, that’s why the way US insurance works makes no sense. Insurance is for dealing with risk, that’s it. If someone has a pre-existing condition then they are a risk that’s already happened – insuring them would be like insuring a house that has already burned down.

      If someone can’t afford the expected cost of their future health care bills than insurance can’t help them any more than you can help someone who can’t afford to buy the food they need to live by telling them to buy “food insurance”. They’re problem isn’t risk, its poverty and to solve that you need welfare, not insurance.

  5. Health insurance is not like any other insurance out there. Maybe it should be, but it’s not. The ideal insurance customer is one who is healthy from 20-45, then gets run over by a bus and killed instantly.

    Whereas car and home insurers can safely draw conclusions from prior claims history (ie, if you got into an accident in the past year, you’re likely to get in one in the future, so we’ll raise your rates), by definition, the longer someone is a “good” customer to a health insurer, the MORE likely it is they will be requiring a massive payout soon.

    It’s also worth noting that the original health insurers weren’t insurers at all–they were basically medical “buyer’s clubs”. Pay a fee, get a group discount on your medical bills.

    I’m honestly inclined to have a two-tier model. Let the government handle direct payments for a baseline of care (determine what that is through the normal sausage-making process). This is available to everyone. Then have an option for supplemental coverage that goes beyond what the government will handle. This would keep premiums manageable, and actually allow the profit motive to stay functional.

  6. freemage has pretty much described the Australian system, which is not perfect but heaps better than nothing.

    Federal Government sets ( I think) a 2% fixed levy on taxable income (reduced if you have private insurance).

    Feds refund doctors according to a fixed schedule but doctors can charge what they like.

    States administer and pay for public hospitals. Those with insurance can get slightly more choice eg choice of doctor or can go to a private hospital.

    Rationing of healthcare then becomes a matter of waiting times for elective surgery rather than cost related – less of a problem (or none) if insured.

    Major problem is negotiation for funds and blame shifting between States and Feds.

    Statistics of waiting times etc are available and often fiercely debated in public.

    There are all sorts of checks and balances in the system.

    Hope this is a true and fair summary of something incredibly complex!

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