Vaping and Healthcare... Are we nonsmokers?
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A single payer system with no choices and government set rules and fees (and higher taxes) vs. an open market with companies competing for our business with lower rates and better benefits? No, thank you.
The ACA is still "the old system" now made more complicated (and possibly more expensive) with new rules and requirements. The insurance companies don't have to compete and have monopolies in their areas because they "aren't allowed" to cross state lines. Government regulations is what set up this current system in the first place.
Not to be argumentative but most of Europe has a single payer system. They spend around 60% (on a per capita basis) as much as we do yet have longer life expectancies.
I have family in Germany. They smoke more and they drink more. (Going by my family, they smoke and drink A LOT more.
). They (Germany) spends 63% what we spend and their life expectancy is about a year longer.One of my cousins was born disabled. My aunt and uncle never had to worry about losing their insurance or losing their house or anything like that. We can't say that here in America.
Now that I have to buy health insurance (which is, in effect, a tax since I can't get out of it), the overall amount I'm paying (in taxes and insurance) is on par with what they're paying (higher taxes but insurance is included). Six of one, half-a-dozen of the other.
Yup. Ask any insurance company. The cheapest patient is a dead patient. And smokers die relatively quickly.
(Oops, hadn't seen that there was a new page...)
Every system has its advantages and its disadvantages. You also can't really speak of "the European system" because each country has its own different system. Personally I've lived in the Netherlands and France, both with very different ways of organising their health care. All in all, health care in the Netherlands is more expensive but also a lot better than in France.
(Oops, hadn't seen that there was a new page...)
Every system has its advantages and its disadvantages. You also can't really speak of "the European system" because each country has its own different system. Personally I've lived in the Netherlands and France, both with very different ways of organising their health care. All in all, health care in the Netherlands is more expensive but also a lot better than in France.
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Yeah, one of the first proposed solutions was a single-payer system similar to Canada's (not socialized like the UK, but just single payer. Doctors/hospitals still compete...but they bid to the single-payer not to each person.) Couldn't get it through. Healthcare, and health insurance, is big business. Lots of resistance to change.
Anyway, the end result of smoker-as-villan mentality is the 50% allowed rate increase that we're all discussing here. Shame. Some insurance companies have refused and/or selected lower rates knowing that a 50% increase is unfair. Considering that only 20% of the population smokes to begin with, and they die earlier, it should equal out a lot more from an actuarial perspective.
So now, it's nic-user-as-villan so they have that as a cash cow.
Bottom line is....check around for companies that don't have huge penalties. You may feel you don't have options from employer plans though. So, IDK.
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There are a lot of myths about single-payer that people believe. One of them is the "longer life expectancy." What we have in the US is NOT a true open market because of all of the government rules and regulations that are the root of most of the problems we have with health insurance and costs.
We have a single payer system in the US. It's called Medicare and Medicaid and even though that covers only the poor and the elderly, it is a nightmare of corruption, inefficiency and grossly over budget. (I dealt with the single-payer system when my late husband became disabled with MS. He lost his employer insurance when he lost his job, which is one reason I believe employer insurance is stupid. We had to wait a year to get him covered and once he was, innovative treatments that are now standard weren't covered. He died at 45 years old.) If the government cannot effectively run that single-payer system for just 70 million of Americans, what would happen if they were running it for ALL 313 million Americans?
I wouldn't want the government running the e-cigarette industry and for the exact same reasons, I wouldn't want it running the health insurance agency. I want diversity, innovation and competition to bring costs down for consumers, provide better devices and cater to what consumers want, not what they think we need. Governments simply cannot do that. Some regulation is needed, but the current involvement of government regulations and the impact of its single payer system involvement in health care has distorted the free market that would cause true competition for our business.
When you take the consumer out of the loop of what they are buying, it doesn't benefit anyone. People view single payer as "free" and everyone knows people aren't as cautious when things come free. I should be able to choose my insurance plan that fits my needs, negotiate with multiple companies what I will pay (causing them to lower costs and offer more services and coverage), and choose my doctor, who will also have to negotiate prices with me. If they are only negotiating with the government (and we all know how well the government negotiates with contractors) then the actual consumer is cut out of the loop. There is no incentive for insurance and medical industries to cut costs because they are getting free money. But once the government starts going over budget from the costs, they will have to cut somewhere and that is when you start seeing them decide what services are "needed" for us.
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I am sorry about your husband, kristin!
And I do agree about the government-regulated health insurance. While it is by no means "free" - you pay a hefty amount of money every month and have no choice about it - yes, the insurance has no incentive to cut down on waste. They prefer to cut down on the services that they offer. For the same money, of course.
So true. When they do "cut costs", they cut down the service to the citizen who is paying for the services, out of his / her paycheck every month. And lots of normal medical services have become "pay as you go" in Germany in recent years. Meaning that they are no longer covered by the health insurance - which you have to pay for anyway, of course.
And I do agree about the government-regulated health insurance. While it is by no means "free" - you pay a hefty amount of money every month and have no choice about it - yes, the insurance has no incentive to cut down on waste. They prefer to cut down on the services that they offer. For the same money, of course.
So true. When they do "cut costs", they cut down the service to the citizen who is paying for the services, out of his / her paycheck every month. And lots of normal medical services have become "pay as you go" in Germany in recent years. Meaning that they are no longer covered by the health insurance - which you have to pay for anyway, of course.
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With all due respect, the USA is ranked 38th by the World Health Organization as it relates to equality, responsiveness and fair financial contribution ..
The years of consolidation of insurance providers has drastically limited the competition aspect ..
Citizens are traveling to other Countries ranked higher than the USA for equal or better treatment at a much lower cost ..
The USA is ranked 33rd in Life Expectancy Worldwide
The US infant mortality rate still ranks 27th among the 34 countries of the Organization for Economic Cooperation and Development ..
Nearly $900 per person per year goes on administrative costs in the USA, by far the highest in the World
In the USA, it is difficult to even find any Hospital or DR that will provide a detailed list of costs based on procedure .. ever asked .. ?? I have ..
The continued escalation of prices will continue to remove citizens from the ability to financially afford coverage ..
I could go on, easily .. these are the facts ..
To me, clearly, the system is not working .. look at what Japan and France does for an example of systems that do seem to work ..
The years of consolidation of insurance providers has drastically limited the competition aspect ..
Citizens are traveling to other Countries ranked higher than the USA for equal or better treatment at a much lower cost ..
The USA is ranked 33rd in Life Expectancy Worldwide
The US infant mortality rate still ranks 27th among the 34 countries of the Organization for Economic Cooperation and Development ..
Nearly $900 per person per year goes on administrative costs in the USA, by far the highest in the World
In the USA, it is difficult to even find any Hospital or DR that will provide a detailed list of costs based on procedure .. ever asked .. ?? I have ..
The continued escalation of prices will continue to remove citizens from the ability to financially afford coverage ..
I could go on, easily .. these are the facts ..
To me, clearly, the system is not working .. look at what Japan and France does for an example of systems that do seem to work ..
That wouldn't be such a good idea... and give the expression, "they've got you by the short & curlies," a much more literal meaning.
Okay, so here's a little view of the Dutch system.
It used to be totally nationalised. Every employee payed a tax that was taken directly out of their paycheck, that was used to finance all healthcare. It had all the problems mentioned for single payer systems and so a few years ago the system started to be reformed.
Now everybody has to shop for their own insurance. Health insurance is obligatory, and insurers cannot deny coverage to anybody who asks to be covered for the basic insurance. This basic insurance has an obligatory franchise of 360 euros per year. But you can adapt your insurance too, you can add modules like dental care, alternative medicine, etc. And you can choose to increase your franchise by 100, 200, 300, 400 or 500 euros to reduce your premium.
The new system had many startup problems, but now it's starting to work properly. Insurances are competing on price, on coverage and on service. Hospitals and insurers are also negotiating prices now, bringing down the total cost: if a hospital is too expensive (or provides poor health care, insurers will send "their" patients to other hospitals.
In 2010 and 2011, I paid a monthly fee of around 120 euros for my insurance (which included a dental plan). In 2012 I switched to another insurance and dropped the dental plan, I then paid around 100 euros per month. This year it actually dropped to 90 euros. Next year I'm switching again. The basic policy I'm looking at is just 60 euros per month with maximised franchise of 860 euros. I did the math on it. If I spend less than 360 euros on healthcare (which was the case in all previous years), I'll come out 250 euros cheaper. Only if I spend more than around 600 euros, I'm going to be off more expensive, which a maximum of 250 euros more than if I didn't choose to maximise my franchise.
Nope, no dental plan. A visit to the dentist costs < 100 euros but adding a dental plan costs at least 10 euros per month. Again, simple math. Don't insure what you can pay by yourself.
All in all that's kind of off topic, though. But it goes to show that we've now found a mix between single payer and free market that seems to be working out. Everybody HAS to be insured, insurances CANNOT refuse default coverage to ANYBODY and the basic coverage has to be provided at the same premium for everybody (the can't make older or sick people pay more for their basic insurance). That doesn't hold true for additional packages, though, fees for those can be differentiated by any means the insurance company sees fit - but at least all the basics are covered for everybody.
Okay, still off topic! I'm sorry, your honour, I'll get to the point. Umm... Well, vaping isn't smoking.
It used to be totally nationalised. Every employee payed a tax that was taken directly out of their paycheck, that was used to finance all healthcare. It had all the problems mentioned for single payer systems and so a few years ago the system started to be reformed.
Now everybody has to shop for their own insurance. Health insurance is obligatory, and insurers cannot deny coverage to anybody who asks to be covered for the basic insurance. This basic insurance has an obligatory franchise of 360 euros per year. But you can adapt your insurance too, you can add modules like dental care, alternative medicine, etc. And you can choose to increase your franchise by 100, 200, 300, 400 or 500 euros to reduce your premium.
The new system had many startup problems, but now it's starting to work properly. Insurances are competing on price, on coverage and on service. Hospitals and insurers are also negotiating prices now, bringing down the total cost: if a hospital is too expensive (or provides poor health care, insurers will send "their" patients to other hospitals.
In 2010 and 2011, I paid a monthly fee of around 120 euros for my insurance (which included a dental plan). In 2012 I switched to another insurance and dropped the dental plan, I then paid around 100 euros per month. This year it actually dropped to 90 euros. Next year I'm switching again. The basic policy I'm looking at is just 60 euros per month with maximised franchise of 860 euros. I did the math on it. If I spend less than 360 euros on healthcare (which was the case in all previous years), I'll come out 250 euros cheaper. Only if I spend more than around 600 euros, I'm going to be off more expensive, which a maximum of 250 euros more than if I didn't choose to maximise my franchise.
Nope, no dental plan. A visit to the dentist costs < 100 euros but adding a dental plan costs at least 10 euros per month. Again, simple math. Don't insure what you can pay by yourself.
All in all that's kind of off topic, though. But it goes to show that we've now found a mix between single payer and free market that seems to be working out. Everybody HAS to be insured, insurances CANNOT refuse default coverage to ANYBODY and the basic coverage has to be provided at the same premium for everybody (the can't make older or sick people pay more for their basic insurance). That doesn't hold true for additional packages, though, fees for those can be differentiated by any means the insurance company sees fit - but at least all the basics are covered for everybody.
Okay, still off topic! I'm sorry, your honour, I'll get to the point. Umm... Well, vaping isn't smoking.
At least I can be insured now. I couldn't before the ACA.
Still, my sister lives in Germany with her German husband and German children and she says their health system is excellent. From what I've been able to find out about it I'm inclined to agree.
I think people here in the US simply don't research far enough into the single payer systems of other countries and can't get past the "they pay more in taxes" angle without realizing they actually SAVE a ton more in the other aspects and come out far ahead (and more secure) in the long run.
Too many people buy what the right dishes out against the ACA....a legislation that was their OWN, for the most part, until it took the other side to push it through. Personally, while the ACA definitely addresses some important issues, it falls far short of what we need here to save taxpayer money and actually perform well.
OP, this is a great question for your insurance provider, no one here can say for sure without reading the details of your policy.
You're right. It's not working because the government has prevented it from being a true open market.
"Seem to work" is right. Japan and France are deeply in debt. Japan price fixes medicine and medical procedures to keep costs down, which has created a shortage of doctors, long waits, reduced quality and over-crowded hospitals. As the Japanese population ages, there will be less young, healthy workers to pay for their elder population and the whole system may fail. France doesn't have a true single payer system and is actually more similar to the U.S., with employer and employee contributions. There are private insurance companies that have a booming business providing insurance to cover what the government doesn't. The major difference between the U.S. system and France's system is that the French government hasn't over-regulated insurance and medical practices the way the U.S. government has. In France, doctors control medical decision making and patients aren't limited to doctors in the system. Patients pay for medical care upfront and are reimbursed by the Sécurité Sociale. This encourages doctors to compete for the patients' "business." Most doctors are in private practice, work on a fee-for-service basis and do not have huge education debt because school is largely paid for by the government. Therefore, they also get lower salaries than in the U.S. However, because of the aging population and high unemployment due to companies limiting hiring because of not wanting to pay for healthcare, France is facing huge declines in revenue that will be unable to sustain the status quo. But overall, France's system works better than the U.S. system because of LESS government involvement, not more. And the only thing screwing everything up is what government involvement they do have.
It helps Germany that it has no debt from maintaining a military and a booming economy. It has money to burn - maybe. Germany's spending is exceeding its revenues, so the party may not last. I've read that people on private insurance in Germany get better treatment than those on the compulsory public plans. Like other countries, Germany also has an aging population, so there will be fewer and fewer young workers to pay for the others. The sense of security with single payer systems will be short-lived.
I don't believe anything coming from "the right" (or "the left," for that matter.) I'm squarely in "the middle." But I'm a Bleeding Heart Libertarian, so you'll have a hard time convincing me that more government involvement in our lives is ever a good thing.
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If it means higher deductibles and lower subsidies, then the government will not allow you to check the non-smoker box. Remember, the government knows better than we do. Period.
A true open market has enough competition to actually become competitive thru, well, competition .. in a market where competition gets to be less and less thru merger and consolidation, it becomes relatively easy to fix prices and continue to escalate the cost to the consumer ..
Your comment on debt as it relates to Japan should be compared to debt in the USA as a percentage for a meaningful comparison .. the debt is, as a percentage, half of what it is here in the health care arena .. and the long wait, reduced quality and over-crowded hospitals .. ?? In most major metro USA areas, all hold true ..
an MRI of the neck region could cost $1,500 in the USA, but in Japan $98 ..
Our Government has not prevented a true open market .. they have allowed prices to rise .. what has prevented a true open market is less and less competition, no easily obtainable pricing data for the consumer so comparisons can be made .. and a number of other non-Governmental issues ..
Willie, it's the government that has reduced the competition. For instance, I cannot get health insurance from a company in another state due to regulations. Prices are rising because the government has cut out the consumer in the decision process. People are forced to go with whatever plan is best for their company, not what is best for them as individuals. Medicare and Medicaid are so artificially low due to the government that doctors have to make up the costs through patients with private insurance. All of the merging and consolidation is being caused by the regulatory system we have - it doesn't pay to be a small company in this country, because they cannot afford the gauntlet of rules and regulations. Government is stifling the creation of true competition, in the same way it would to the e-cigarette industry. Regulations cut out the small guy and favor big corporations.
Japan has artificially low costs because of government price fixing. It is simply unsustainable. If companies cannot make a profit on a product, they stop making and selling that product. What does that say for the future of medicine and medical devices in Japan if companies lose money on products and services sold there? If the Japanese system is so superior, why do they have the same shortcomings as in the U.S. (ie. waiting, care, over-crowding?)
And Japan's debt may be half now, but it won't be for long.
Like I said, our system has a lot of problems and DOES need to be fixed, but so do all of the single-payer systems. MORE government involvement in healthcare is not the answer, anymore than it's the answer for growing the e-cigarette market.
Sorry, I've gone a bit off topic and will stop now. But it is a bit on topic, as the ACA could have a huge impact on whether or not we are considered "smokers" and will have to pay up to 50% more than non-smokers.
Kristin .. I understand your points fully .. but we're really coming at it from two different angles ..
In a free market, pricing is determined by the seller .. it is up to the consumer to shop, compare, negotiate .. yet, other than the cost of the Insurance itself, no matter who you buy it from, is the only real, readily available pricing that a consumer has easy access to .. there are very, very few Hospitals / DR's in the USA that publish pricing ..
It's not the regulatory climate that prevents the formation of a new company .. it's the cost of startup .. insurance companies must be solvent enough to handle a worst case scenario .. otherwise, how would they be able to pay claims if after a month of operation, they had to deal with a scenario like Katrina or Hurricane Sandy .. ?? Combine that with enough money on hand to get a little slice of Market Share .. why do we see constant commercials for GEICO / State Farm / Blue Cross .. etc .. ?? Because they are fighting for a tiny bit more of that market share .. Sure, there are regs to deal with, but that's a minor consideration .. Regulations are not stifling Joe's dream to start up Joe's Insurance Company .. it's Joe's wallet that stifles it .. it has little or nothing to do with Washington
Consider this : Private commercial insurance is typically discounted from the standard actual billed charge. Physicians give insurance companies discounts to attract business, IOW. This causes physicians to artificially inflate their billed charges to compensate for the discounts. Because of this artificially inflated system of charges, patients without medical insurance that can least afford care end up paying the most. Yet those same patients have no easy access to pricing information that would allow them to decide if it would be more economical to go to DR X or DR Y for that hip replacement they are going to have to pay for out of their own pocket ..
Now, if my money is as good as the Insurance Companies money, why can't I go in and negotiate a lower price .. ??
In a free market, pricing is determined by the seller .. it is up to the consumer to shop, compare, negotiate .. yet, other than the cost of the Insurance itself, no matter who you buy it from, is the only real, readily available pricing that a consumer has easy access to .. there are very, very few Hospitals / DR's in the USA that publish pricing ..
It's not the regulatory climate that prevents the formation of a new company .. it's the cost of startup .. insurance companies must be solvent enough to handle a worst case scenario .. otherwise, how would they be able to pay claims if after a month of operation, they had to deal with a scenario like Katrina or Hurricane Sandy .. ?? Combine that with enough money on hand to get a little slice of Market Share .. why do we see constant commercials for GEICO / State Farm / Blue Cross .. etc .. ?? Because they are fighting for a tiny bit more of that market share .. Sure, there are regs to deal with, but that's a minor consideration .. Regulations are not stifling Joe's dream to start up Joe's Insurance Company .. it's Joe's wallet that stifles it .. it has little or nothing to do with Washington
Consider this : Private commercial insurance is typically discounted from the standard actual billed charge. Physicians give insurance companies discounts to attract business, IOW. This causes physicians to artificially inflate their billed charges to compensate for the discounts. Because of this artificially inflated system of charges, patients without medical insurance that can least afford care end up paying the most. Yet those same patients have no easy access to pricing information that would allow them to decide if it would be more economical to go to DR X or DR Y for that hip replacement they are going to have to pay for out of their own pocket ..
Now, if my money is as good as the Insurance Companies money, why can't I go in and negotiate a lower price .. ??
If they have a section for tabacco user not smoker than yes. If it specifically says smoker, than no.
IMHO, but if they blood test and nicotine shows up, your insurance rate will climb...
Sorry - I know said I was going to stop...
Price is not determined by the seller. Price is determined by the demand for the product by the buyer. If blu tried to charge $600 for a starter kit, they wouldn't sell enough to stay in business (yeah, there's always someone willing to pay high prices for the latest gadget, lol.) The buyer has to be willing to pay what the seller asks. The seller must figure out a way to get costs down to get to a price point that people are willing to pay.
I have gone to many doctors without insurance and they offer discounts, because they don't have to deal with the insurance company. But, if you have insurance, the company has cut the actual consumer - you - out of the loop. If insurance companies and medical professionals were dealing with individuals, rather than high-paying governments and corporation groups, they would be forced to price accordingly and offer more customizable options to stay in business. But only big companies can afford to jump through the regulatory hoops - such as the requirement to have an actual office in every state where you want to sell - so that blocks start-ups and competition. And the tax breaks for offering health benefits vs. salary is a disincentive for companies to stop offering company health benefits and raise salaries.
Due to the nature of the insurance business, there may never be a Joe's Insurance Company, but there could be a lot more investors in new, competitive companies. Just look at the car insurance industry. Imagine if there was a Progressive type situation where you could compare rates online for health insurance. And if doctors were being paid by patients who have to pay their own insurance and are more particular about how they spend their money, you'll start seeing comparative rates on health services being posted online, as well. Right now, under the current system, doctors have no motivation to do that. And they still won't under the ADA.
Again, my apologies to the OP for hijacking the thread...
Price is not determined by the seller. Price is determined by the demand for the product by the buyer. If blu tried to charge $600 for a starter kit, they wouldn't sell enough to stay in business (yeah, there's always someone willing to pay high prices for the latest gadget, lol.) The buyer has to be willing to pay what the seller asks. The seller must figure out a way to get costs down to get to a price point that people are willing to pay.
I have gone to many doctors without insurance and they offer discounts, because they don't have to deal with the insurance company. But, if you have insurance, the company has cut the actual consumer - you - out of the loop. If insurance companies and medical professionals were dealing with individuals, rather than high-paying governments and corporation groups, they would be forced to price accordingly and offer more customizable options to stay in business. But only big companies can afford to jump through the regulatory hoops - such as the requirement to have an actual office in every state where you want to sell - so that blocks start-ups and competition. And the tax breaks for offering health benefits vs. salary is a disincentive for companies to stop offering company health benefits and raise salaries.
Due to the nature of the insurance business, there may never be a Joe's Insurance Company, but there could be a lot more investors in new, competitive companies. Just look at the car insurance industry. Imagine if there was a Progressive type situation where you could compare rates online for health insurance. And if doctors were being paid by patients who have to pay their own insurance and are more particular about how they spend their money, you'll start seeing comparative rates on health services being posted online, as well. Right now, under the current system, doctors have no motivation to do that. And they still won't under the ADA.
Again, my apologies to the OP for hijacking the thread...
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