U.S. Senate
See Full Big Line
(D) J. Hickenlooper*
(R) Somebody
80%
20%
Governor
See Full Big Line
(D) Phil Weiser
(D) Joe Neguse
(D) Jena Griswold
60%
60%
40%↓
Att. General
See Full Big Line
(D) M. Dougherty
(D) Alexis King
(D) Brian Mason
40%
40%
30%
Sec. of State
See Full Big Line
(D) A. Gonzalez
(D) George Stern
(R) Sheri Davis
50%↑
40%
30%
State Treasurer
See Full Big Line
(D) Brianna Titone
(R) Kevin Grantham
(D) Jerry DiTullio
60%
30%
20%
CO-01 (Denver)
See Full Big Line
(D) Diana DeGette*
(R) Somebody
90%
2%
CO-02 (Boulder-ish)
See Full Big Line
(D) Joe Neguse*
(R) Somebody
90%
2%
CO-03 (West & Southern CO)
See Full Big Line
(R) Jeff Hurd*
(D) Somebody
80%
40%
CO-04 (Northeast-ish Colorado)
See Full Big Line
(R) Lauren Boebert*
(D) Somebody
90%
10%
CO-05 (Colorado Springs)
See Full Big Line
(R) Jeff Crank*
(D) Somebody
80%
20%
CO-06 (Aurora)
See Full Big Line
(D) Jason Crow*
(R) Somebody
90%
10%
CO-07 (Jefferson County)
See Full Big Line
(D) B. Pettersen*
(R) Somebody
90%
10%
CO-08 (Northern Colo.)
See Full Big Line
(R) Gabe Evans*
(D) Yadira Caraveo
(D) Joe Salazar
50%
40%
40%
State Senate Majority
See Full Big Line
DEMOCRATS
REPUBLICANS
80%
20%
State House Majority
See Full Big Line
DEMOCRATS
REPUBLICANS
95%
5%
November 19, 2008 09:20 PM UTC
15 Comments
Except with mandated coverage, so it kind of sounds like Hillary Clinton’s plan. I’m a little confused as to where this differs from Obama’s plan.
Some problems:
What kind of punishment would there be for someone who didn’t buy in? Would they be refused care, or would they be forced to go to the emergency room and do the same thing you would have to do now without insurance?
He didn’t have mandatory coverage, or required acceptance IIRC. He just had a tax deduction and then taxed healthcare costs to cover it.
was that the money went straight to the insurance companies.
There are a lot of questions on the table with this proposal.
If the insurance companies are going to accept this, then there are some other conditions you’d almost have to see:
* Single risk pool. Everyone gets covered under a national risk pool; insurance rates are published by each company. If I have to buy coverage, you can’t make me pay a fortune just because I’m diabetic.
* No denials for pre-conditions, and no “transition periods”. This should cut out some of the “management” overhead.
* A government-payer option is pretty much required. This either means upping the Medicaid tax or moving to single payer.
* A mandatory insurance scheme is dictated. This means one of the following: (1) employers shift medical expenses to employees and the IRS tracks insurance expenses, (2) the IRS tracks all company employment vs. medical insurance expenses, or (3) we go to single payer healthcare.
Is the insurance industry going to actually push for single-payer health?
I wish we could just wipe out health insurers entirely, and actually have affordable health care.
Even most of the socialized medical programs have private supplemental health insurance.
And insurance companies can, in fact, be cost-effective if they want to be. Many Medicare claims are processed by private insurers – they’re already part of a functional system.
Part of the problem with health insurance is supply and demand. If you can’t afford it, you don’t buy it, there aren’t any other options because it isn’t “necessary”, even though most see it as so. It’s kind of an odd thing, like a reasonable luxury.
Anyway, the big health insurance companies make hundreds of millions of dollars (net) every year. A non-profit would put some competition in the mix, forcing the existing companies to have more acceptable rates.
There will always be competing interests when your job as a health insurer is to increase profits rather than provide coverage, or to make coverage affordable. Then your mission runs exactly counter to the big picture, which is to make sure Americans have access to affordable healthcare.
Their processing and administrative costs actually add to the problem. A while back Parsing mentioned a study that was done between two hospitals, one in Washington State and one in BC IIRC, and the hospital in BC had something like 5 times less admin and overhead.
I just think that private health insurers provide absolutely no value, (actually negative value) and they are not part of the solution.
There’s a difference between greed and the ability of a company to survive.
Some companies get along Just Fine, Thank You by being “commodity” companies. They make modest profits, remain stable over time, and provide consistent and steady service.
Also, non-profits (like Kaiser and some few remaining Blue Cross divisions…) can provide effective care without worrying about profit margins.
There is little to no difference between a private insurance company operating under either of these two models and having the government provide the service. And there’s some incentive to find efficiency but not arbitrary denials if the proper structure is in place.
Finally, there are a LOT of people working in the health insurance industry right now; a major move to government insurance by shutting down private companies would (1) send some state economies into full-on meltdown, and (2) overwhelm government resources. No single computer system exists that could handle the workload, and the insurance companies have the expertise in-house to manage their own systems. Simplify claims processing (removing pre-conditions and other “outs” insurance companies use) and you remove many of the problems we face today.
Like withdrawal from Iraq, you can do it instantly and cause a lot of pain and loss, or you can do it strategically over a longer period of time and maximize the benefit.
I am saying they shouldn’t be involved in insuring our health. They can provide claims processing services, lab services, ambulatory services, computer networking, in-home care, private clinics, etc. (the list goes on) and bill those services to the government. They would do this more efficiently than the government, as you mention with medicare. However, they should not be left to insuring our health, as their decisions are borne out of their own economic interests and not those of the patient.
Or for-profits operating under single-payer terms where the government gets to say “here’s what you’ll cover (minimum), and here’s what we’ll pay for it”? These are the scenarios I was thinking about.
Admittedly, neither of those is a glorious future for the insurance industry, but as I noted, there are (major) corporations that run on a fixed-income, low-profit, high-volume margin and do just fine.
as they are not setting the terms. They are being told what the terms are.
That is the system in germany.
If the insurance companies were mutualized it would eliminate much of the desire to deny care. In a mutual shareholders are policy holders–there is no profit motive, but there is an efficiency motive.
The insurance company’s reasoning isn’t entirely off the mark.
Insurance companies worry a great deal about “adverse selection” risks. Simply put, if anyone can get insurance regardless of pre-existing conditions, people may decide to buy insurance only if they get sick.
The sick or hurt individual may have to pay for a few days of pre-coverage charges, but then will have insurance pick up the tab until the situation is over, and then drop the coverage.
There are other ways of dealing with adverse selection risks, of course. Selling primarily through group plans to large groups that won’t stop and start coverage because all employees need to be covered is one. Excluding pre-existing conditions and charging premiums based upon health is another. Waiting periods for coverage to start is yet another. And, selling insurance only for blocks of time that are fairly long in contracts that have an early termination fee is another.
Trouble is, that many of the alternatives are prohibited by state or federal law, and that simply not insuring sick people, some of whom are sick as soon as they become adults, is a problem as well.
Mandatory community rated insurance co verage isn’t a panecea either. It creates an incentive for insurance companies to handle claims for chronically ill people poorly, or have policy terms that are unfriendly to those people, so that healthy people choose them, while sick people choose some other insurer.
Thanks.
If we can’t get to required coverage, then we will have to deal with these issues. (And we’ll have to deal with some of them even with mandated coverage.) Removing waiting periods for pre-existing conditions if the covered person is merely switching companies would be a help. I think the insurance companies would very much like to have catastrophic coverage re-insured by the government and I think that’s very much on the table come Jan. 20, 2009.
It’s not an easy maze to negotiate, but I think we’ve got a team coming in to place that will work very hard to get it done.