Crazy Pills
Last week marked one of those moments everyone dreads every year. You combine three things that no teacher likes. First, the Astros were in the playoffs and we were stuck here at school. Secondly, it was faculty meeting day. Those are always fun as you test out the combination of stuff that no one needs to hear, stuff that could be conveyed in an email, and stuff that people will confuse and ask several ridiculous questions about.
Yet, it was the third reason why this moment was a special kind of hell. It was the benefits meeting we have every year. In this case, “benefits” is a fancy, ubiquitous word that actually means health care insurance. If you saw the specifics you wouldn’t see much of a benefit.
See, the district has its own plan. Sure, Aetna runs it, but they have put all of the employees into a pool and the insurance rates are based purely on how much we spent the year before. Obviously, the district isn’t trying to make money off of us, but Aetna sure is. Since people spent more money last year (gee, why would that happen) they hiked our rates 25 percent. I’ve never been so happy not to be a part of that insurance plan.
It was impossible not to somehow extrapolate this situation outward. Citizens over 65 get the benefit of Medicare. It is a government insurance program that is designed to break even. Millions of Americans are part of a pool that is also based on average costs across the pool. Older (or more experienced) Americans are more apt to get sick and need expensive medical procedures. Yet, somehow they end up spending less per month than teachers in our district. Keep in mind that district makes a contribution to “defray” the costs of the insurance.
It’s up against this backdrop that we bring up the concept of Medicare for all. The process is actually simpler than people might imagine. It isn’t free health care. We know the program works because we have been using it for years. The caveat is that it might actually become cheaper. You are currently basing rates on the amount of risk and that risk is greater for people 65 and over. If you expanded it to include everyone you’d include healthy children, young adults, and relatively healthier middle aged Americans.
It comes with other advantages as well. One of the reasons why rates are so high is that we are footing the bill for everyone that cannot afford care. It’s a similar concept to Wal-Mart building in the cost of theft into their inventory. They will pass the costs onto the consumer. If everyone is covered then there’s no reason to jack up the costs.
It means that you don’t have to worry about whether your doctor is in network or out of network. They are all in the network. You don’t have to worry about changing jobs or possibly going to work for yourself. Companies save millions as they can defer all of the money spent on “benefits” into actual benefits. What would honestly happen if they folded over the district’s contribution to our insurance into our salary?
Who is against this? Obviously the insurance industry is against it. They make between a 20 to 30 percent markup for running the system. Decisions are based on profit margins and stockholder considerations. You talk about your death panels. One considers sustainability of the whole system. The other considers whether Daddy Warbucks will get a dividend this year.
This is basic math and basic common sense. Yet, we are told how complicated it is. We are told that it’s socialism. We are told that the only industrialized country in the world that still has for profit health care insurance is somehow the system that makes sense. If you dare question that they’ll be calling you a radical, a liberal, or fanatical criminal.
If it wasn’t for my VA Healthcare, I’d probably be dead since my meds alone would cost about $1500/mo if I paid out of pocket.
1Very well said Nick! It isn’t only the insurance companies that are against this, although they are the biggest opponents. I am now not doing this actively any more, but I sold Medicare supplements, Medicare Advantage and Prescription Drug Plans for many years in Houston and in the Austin area. It was surprising at first, but then became sort of routine, that so many on Medicare hated, you guessed it, Medicare! When asked what they would do for healthcare without it, no one had an answer, but they were so brainwashed that Medicare, even for seniors, was a bad idea! Many had children who had a problem finding affordable healthcare and, when the children commented that Medicare for all sounds like a good idea, they went ballistic! Yes, right wing propaganda really works well.
2I’ve been wondering how the health insurance companies would respond to Covid. Twenty five % is a big increase. No surprise here. Who pays for all these vaccines, tests, and hospitalizations?
3Even a verified “radical, a liberal, or fanatical criminal” would not design a healthcare process resembling what is now in place. I saw report about people who come to the U.S. after living in an industrialized country with a nationwide health plan and describe the U.S. healthcare system in terms like dysfunctional, maladjusted, broken, debilitated, deteriorated, inoperable, crazy etc.
But speaking of those descriptors, recall the R propaganda machine that runs 24/7, and consider Allen West. Instead of getting vaccinated and proper medical treatment (Coronavirus vaccine ~ $32-$37 per dose) Texas R Allen West, caught Covid-19, was hospitalized and proceeded to take and advocate for unproven treatments (“Hydroxychloroquine and Ivermectin protocols” ) and rant against vaccine mandates and “Big Pharma” etc. — while at the same time taking the Monoclonal antibody ($1,250 per infusion) made by the giant companies Eli Lilly and Regeneron pharmaceuticals.
Both he and his wife were hospitalized with Covid-19 and she recovered was released before he was because she was vaccinated, unlike him. But he is still at the propaganda spreading.
“Unvaccinated Texas GOP candidate who was hospitalized with COVID-19 says his illness made him ‘even more dedicated’ to fight vaccine mandates”
http://news.yahoo.com/unvaccinated-texas-gop-candidate-hospitalized-110620239.html
4Medicare for all would not only save billions of dollars for consumers, it would also allow people to take risks such as starting a business. Many now are afraid to leave their job since they loose health insurance too.
5Being on a par with all the other advanced economies would be wonderful for everybody except insurance execs.
We should give it a try.
What a coincidence. Today happens to be the first day that I have Medicare Part B coverage. I got the Part A coverage back in July. Now I use the same carrier from my last group health plan for a Medicare-supplement plan, and the AARP adds some perks to the soup like free gym membership.
Result: Everything covered for two low fees (one for Part B and one for the supplement) totaling less than $300/month. Which makes it sound like a lot but compared to the $1,900/month that that my employer was paying before (and what COBRA would have cost) and didn’t cover as much it seems pretty damn cheap. Zero co-pay. Zero deductible. The carrier pays anything Medicare doesn’t pay.
If Medicare is ever allowed to properly negotiate drug prices it would get even more cost effective.
For-profit health care has its place but to force everyone to get that or have nothing is insane.
6Note to Alan – don’t forget to get Prescription Drug coverage that is not covered under the supplement!
7I breathed a sigh of relief when I turned 65 nine years ago and qualified for Medicare. Up until then, I just had a major medical policy that went up substantially every year, especially the closer I got to that magic “65” number.
When I see all those Trumpist old folks railing against “socialism,” I have to laugh. I know everyone of them has Medicare and gets Social Security payments from our socialist gubmint and would scream bloody murder if those were taken away from them.
8When I worked I had a great plan the company paid ~ $900/month. Now I have Medicare and it’s great. It doesn’t cover some things like dental or eyeglasses, but of course what senior needs those! I think Medicare for all would be great but wonder if they will up charge for COVID, or have a lifetime limit.
9Keep in mind there is no out-of-pocket cap with Medicare and a supplemental plan that provides that cap is a needed additional cost. Neither of those cover prescriptions so that is another added cost. Last year was my first required year on Medicare and my total premium costs nearly trippled.
Also, the process requiring sign up of three individual aspects to bring together a full plan needs to be streamlined or people will give up before signing up or will make other significant mistakes which could nullify coverage.
As is, it could prove disastrous.
10I retired from one of the large health insurers. Thought it was a great company when it was a mutual. After it went public, the main focus was on the stock price. Certainly convinced me that no company should profit on someone’s fear of ill health/accident. Very happy with Medicare Advantage. Even with an occasional copay, costs far less per year than Med Supp.
11Here in the insurance capital of the world (in someone’s mind) wheels were in motion for single payer, but the CEOs of 5 big insurance companies told the gov they’d move out of state if that happened. So it’s off the table. As a state retiree, I’ve got a platinum plan- as should everyone else. #Unions
12A few years ago, W.H.O. published a a list of countries and how they ranked for providng healthcare for their citizens. The US wasn’t even ranked among the top ten. The US ranked at #34.
I’d like to see socialized medical care for all here, like they have in major industrial first world countries in Europe. No one goes bankrupt there because of medical bills. But here, it’s happens and people lose everything.
Here, you wait in fear to find out how much you owe or you’re argueing for benefits that your insurance promised and then denied. No one should have to beg for money on GOFUNDME to pay for huge medical bills that insurance or medicare advantage plans should have paid.
Insurance companies here should be declared non-profits or they don’t get to exist. In fact, I ‘d like to see these greedy bast@rds put out of the health insurance business.
Meanwhile, the three branches of our government, get the finest, platinum-plated medical care, dental care, and vision care paid for by our tax dollars…for almost free.
13The insurance companies would likely split: some of them would be contracted to administer the government plan, some of their employees would be directly employed by the government instead, and the rest would still be in business selling supplement plans or something similar to Medicare Advantage plans.
14IMHO health insurance is one of, if not the best example of repugnantcans’ debate framing through gaslighting.
15At it’s core, health insurance is the SHARING of medical costs of as many people as possible.
All of it’s benefits stem from that concept.
Health insurance IS socialism.
But since socialism’s evil, murkins gotta keep those lazy fat cat government workers’ greedy claws off it.
The John Galt virtue of the forge of profitability makes everything more efficient.
Everbody knows that.
Duh.
How’s that for SuperLogical?
Medicare can be simplified to just one “part”, if Congress had the will to do, making it less complicated and more streamlined. Of course, Senator Sinema doesn’t want that or the ability of Medicare to negotiate its drug prices, like every other insurance company does.
16Since Nick brought up his Astros….congratulations to Astro fans. Have to think they’ll be favorites to go to the WS. Was hoping my Dodgers could come through and have a rematch with them but frankly, I’m not confident they can win 2 in a row against the Giants.
17P.P. @15, rather than debate the deliberately stupid with words that they do not comprehend which they will then spin/lie. Or bore the hell out of disengaged voters with a long winded rhetoric that would cause an engaged voter to scream, we can bury them in simple arithmetic which is their weakest link. Universal health care without insurance middlemen sucking up over 30% of the health care investment is the path forward. We don’t need 9 or more interminable paragraphs to explain the obvious.
18Nine or more paragraphs? Gee, tough crowd. I get it, I can be a bit long winded.
19Nick, your writing is fine. Pretty sure the shop customers can handle nine or more well-written paragraphs on a serious topic.
C’mon folks, Nick’s writing essays (post, blogs, whatever) not campaign slogans or soundbites. Which are absolutely necessary to get the average person’s attention quickly. Maybe I’m the outlier but I like that I can ponder something for more than a nanosecond here at the shop.
20Nick, reasonable expectations is all. It would certainly be unfair and/or unreasonable to expect anything new ergo informative on a topic that has been kicked around since and prior to the New Deal and Great Society decades. If I were to state that the ACA was reheated Romney Care with poison pills attached, that too is not news. To your point of target audience mainly those inclined to vote against their own interests. That remains the challenge: educating those who have no experience with what good health care insurance is.
yet another baby boomer@ 20. We’d be happy to share the e-mails from Senator Cortez Masto (D-NV) on the topic if you want reading material. Lordy, she serves on committee with Bernie Sanders. Paragraphs of head meets desk reading without answering “the” question – when there will be legislative action.
21Medicare now is turning into a two tier system – those on original medicare and those eligible for a Medicare advantage plan. Medicare advantage plans offer extra benefits, depending on the plan, but are run by private for profit insurance companies. Unless something changes, medicare for all will mean the insurance companies will figure out a way to put the new younger and healthier people in their plans and there will be little benefit to those on original medicare.
22And by the way, The Logical Song was perfect for this post.
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