Posted by Reply, a resident of the Downtown neighborhood, on Oct 26, 2011 at 5:23 pm
So there, big question mark, you're saying that the recent Affordable Care Act is responsible for your increased insurance and prescription costs? How so? Can you explain just how it is that you were able to arrive at this conclusion? Or are you simply barking up a tree?
Posted by ?, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 26, 2011 at 5:48 pm
No - I am suggesting that the law has done nothing to solve the underlying issues that are causing out-of-control medical cost increases.
Clearly the insurance and pharmaceuticals are broken markets with very little competition. This is the only way in which they can charge more for less.
The new law could have done a lot more to break down the barriers to competition - open up insurance to interstate competition, allow reimportation of drugs are just a couple of suggestions. But none of this happened with the new law.
Instead we have gotten a lot more regulation, more taxes and really nothing to show for it. We need health care reform, just not the version we got.
Has anyone out there benefited from the new law? Are your costs going down?
Posted by Reply, a resident of the Downtown neighborhood, on Oct 26, 2011 at 7:03 pm
Sounds like the big Question Mark is now stating yet another position. Now he's claiming the ACA is responsible for not effectively thwarting insurance and pharms gouging the public. Not a very compelling claim, as most of the ACA has not yet been implemented.
Then the big Question Mark states that ACA is responsible for "more taxes." Care to defend that claim? I didn't think so....
Posted by joanna, a resident of the Downtown neighborhood, on Oct 26, 2011 at 7:25 pm
My 23 year-old daughter who has a pre-existing medical condition/disability is now at least covered by my Kaiser plan til she's 26--a relief for us. She would have been dropped next year and would not have been able to get coverage.
Posted by ?, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 26, 2011 at 7:33 pm
Reply - I'm not sure what you are trying to accomplish here.
I am pointing out the facts in my case that health care costs are going up dramatically. I suspect the reason for this is the law extended coverage for cases like Joanna (a good thing) but did very little to deal with the underlying drivers of cost.
I am not suggesting that we shouldn't have had health care reform, but I am suggesting the law hasn't adequately dealt with the cost issue.
What is it going to take to take the next step forward? When the law was passed, it was acknowledged widely that more needed to be done. The facts suggest much more needs to be done on the cost front.
If the cost issue isn't addressed, more people will lose coverage (e.g. the recent Walmart case) because it won't be affordable to either companies or individuals.
Posted by ?, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 26, 2011 at 8:33 pm
Reply - You must be mixing me up with someone else. I have not brought up the tax point on this blog. And I'm not sure why you are being so antagonistic, accusatory and defensive here. It's pretty simple - reread my posts and you will see consistency.
If we don't acknowledge the facts, problems can't be solved. We have a huge health care cost issue in this country which is lowering the standard of living for all. My personal facts echo this point as my health care costs continue to go up dramatically. I'm pretty sure I'm not alone on this point.
If the current law is supposed to lower costs, then I'd like to understand why my personal experiences are dramatically different. If it wasn't intended to deal with the cost issue, then we need to get onto the next step of this health care transformation journey.
Posted by Steve, a resident of the Parkside neighborhood, on Oct 26, 2011 at 8:46 pm
You'll have to forgive reply, he just returned from the latest fundraising swing through the Calif ATM for Dems. Since he dropped thousands for his latest chance to rub elbows with obami, he has no notion or appreciation that we are paying 10 years of cost for 6 years of 'benefit' for this part of his signature wealth redistribution plan. It's like pelosi said, they had to pass the bill before we knew what was in it.
Posted by physically fit, a resident of the Pleasanton Heights neighborhood, on Oct 26, 2011 at 9:13 pm
Until we stop insuring people for voluntary illness (obesity, smoking related issues, drug related issues) the costs will never get under control.
Why can a drug user get an organ transplant paid for by insurance, an obese couch potato get bariatric surgery paid for by insurance, a smoker get lung cancer surgery paid for by insurance -- but a person who suffers hearing loss through no fault of their own cannot get even one dollar of reimbursement for hearing aides?
Judgemental? You bet! If you CHOOSE to live an unhealthy life, do it at your own expense.
Posted by Reply, a resident of the Downtown neighborhood, on Oct 26, 2011 at 10:24 pm
Well, with the Big Question Mark, it is just one lie piled atop another. First the Big Question Mark -- aka ? -- says the following:
"Instead we have gotten a lot more regulation, more taxes and really nothing to show for it."
I chide him for fibbing about ACA and more taxes, and he lies again when he states:
"Reply - You must be mixing me up with someone else. I have not brought up the tax point on this blog."
As old Abraham Lincoln once said, Big Question Mark, "No man has a good enough memory to be a successful liar." In your case, I need to tell you that sputtering out Rush Limbaugh lies and Fox News talking points is not going to pass muster when you have to actually engage in a dialogue with a reasonable person. (Which is why Rush never debates anyone of substance on his show.)
Posted by Mike, a resident of the Highland Oaks neighborhood, on Oct 26, 2011 at 11:43 pm
I am dreaming of the day they pass a fat tax, which from the number of obese people I see on Main street alone could easily dig us out of the national debt in the first year and fund global healthcare for a decade.
Posted by Been There, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 8:37 am
As far as "Interstate Competition" goes - if that were permitted, all the health insurance companies would rush to incorporate in Montana, the state with the least regulation of the health insurance industry. You can then bet that next to nothing would be covered and our premiums would soar. That's why health insurance companies are pushing for the interstate option. It would be a race for soaring profits - and a race to the bottom for the rest of us.
Yeah. I really want to buy my insurance from Montana.
I've had a real nightmare getting individual coverage. And the coverage I finally got is downright awful. I'm not overweight or sick either. I have allergies. Normal ones.
Posted by Reply, a resident of the Downtown neighborhood, on Oct 27, 2011 at 9:56 am
Taxing fat people. Now there's a good one. All the too-much-regulation-taxes-are-too-high crowd is for it, despite how it would shove the economy over the edge. What would we do with all the fast-food joints? The FritoLay company? The 7-11's? 80% of the heavily sugared and larded goods on grocery shelves? If you want to preserve capitalism in all its grandeur, go eat at Wendy's today, or buy a tub of Kentucky fried chicken grizzle to bring home to your kids to gnaw on while they watch McDonald's and coca-cola commercials. Capitalism forever!
Oh, yeah. And now ACA (alias "Obamacare") is being blamed because someone's insurance company offers no reimbursement for hearing aids? What a bunch of clowns.
Posted by GX, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 10:00 am
True market competition always leads to "better, faster, cheaper" unless it is a market that is driven by natural supply restrictions.
I don't see why we can't create market structures that increase the competitive pressures for insurance companies. Even if all insurance companies located to Montana, they would have to conduct themselves according to the rules of California if they wanted to compete here.
If we had more insurance companies competing for our business, prices would decline just like they do in any other properly operating free market.
Posted by Reply, a resident of the Downtown neighborhood, on Oct 27, 2011 at 1:09 pm
Yeah, probably doesn't have anything to do with the fact that people are living longer, that viruses seem to be getting stronger and lasting longer, we're chemically overloaded, entirely stressed out from working too long and too hard without taking vacation time, autism among children being up because of increased mercury in food sources, oh I dunno, and that sort of thing. No, it's gotta be that we're a population of whimps. Any other pearls of wisdom for us, Bill?
Posted by b, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 1:16 pm
10% sounds pretty good, after a decade of annual 20-30% increases. I keep a few health insurance bills from the 90s just for laughs.
This will continue as long as there is no real competition. The insurance cartel is protected by Republican lawmakers and gets to do whatever they want. My old insurance guy and I chat about this all the time--there's unbelievable corruption between insurers and lawmakers. Meanwhile, providers are consolidating (hello, Sutter) and can demand whatever reimbursements they want.
This won't be solved until we nationalize the insurance. Medicare and Canadian care aren't perfect, but they work pretty well, and cost a lot less.
Posted by physically fit, a resident of the Pleasanton Heights neighborhood, on Oct 27, 2011 at 2:00 pm
No one is proposing to tax fat people. What I have proposed for years is that voluntary health issues must no longer be insurable.
If you CHOOSE to be obese, or you CHOOSE to smoke or you CHOOSE to do drugs then you are not insurable. Period. Ever. For any problem.
It is way beyond time for the obese folks on their third knee replacement due to excess weight are taken off the public dole. Same for smokers who have heart disease among all of the other health issues. If you make the choice to be unhealthy just stop expecting me to bail you out.
from Reply -- "Oh, yeah. And now ACA (alias "Obamacare") is being blamed because someone's insurance company offers no reimbursement for hearing aids? " No, read what I said. It has nothing to do with ACA. No insurance company reiburses for them. And at nearly $3,000 each, for hearing loss that is generally not caused by actions of the wearer, that is a bitter pill to swallow while watching the waddling couch potatoes stagger their way through life with supersized fries in hand and all medical bills paid.
Posted by GX, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 2:14 pm
b - I'm not a fan of nither Republicans nor Democrats. But with this last go around, wasn't it the Republicans who wanted to increase competition for insurance companies and the Democrats who essentially ignored the suggestion?
I agree that we need more competition in the health care industry and we need much greater price discovery. If people had x amount to spend (some form of a voucher system), they would shop around more and that shopping around would place downward pressure on price.
Lasik surgery is a perfect example. Lasik is not covered by insurance, Medicare, etc. It is a properly running market and as such the average price of Lasik surgery has fallen dramatically.
Posted by b, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 3:42 pm
Adding more players to the cartel won't solve the problem. The only solution that's going to lower costs is to suck the billions of dollars of insurance company bloat out of the picture. Every other civilized nation on this planet has done this, lowering costs and taking care of their people. Yet for us, the highest national priority is protecting insurance company profits. Downright barbaric.
Lasik is NOT a perfect example. That's an elective procedure. People choose to do it for their own comfort and on their own timeline, which forces competition when customers are scarce. Maybe that would work for annual exams and other routine care. But cancer and ER care aren't elective. And those are the types of medical bills that actually bankrupt the uninsured.
Posted by GX, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 4:19 pm
b - you bring up a valid point regarding Lasik vs. cancer treatment. We might not get the same market dynamic benefits with scarce life-critical items.
However, I am not yet sold yet on national health care. But I am listening closely and may be getting there. And this is coming from someone who is an ardent fan of free markets.
It is almost criminal that we spend so much of our GDP on health care with not much more to show for it. If we can't get to an honest free-market approach that works, we owe it to ourselves to try other approaches.
My concern is that we haven't yet cleaned up the industry to make it compete. Instead, we have the lame results of a sick industry. I do wish the health care law had addressed some of the obvious non-competitive issues. E.g. why not allow re-importation of drugs from Canada to keep the drug companies honest?
Posted by Been There, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 9:24 pm
GX- The point is that if insurance could be sold across state lines, we would be buying health insurance from Montana and **it would NOT be subject to California regulations**. That's the whole bad deal about it.
Some industries need regulation and oversight...we deregulated banks and look what happened there...and look what happened to California when we deregulated energy and were then taken to the cleaners by Enron, Mirant and Reliant Energy companies in Texas. And the airlines! My plane fare may not cost more than it did a decade ago but, man, it is pretty painful to fly these days. Actually, it's downright miserable and I have to do it fairly regularly. Competition would bring us faster, better, cheaper in a perfect world but unfortunately, greed and corporate price fixing take over.
I can't imagine my health insurance getting any worse than it is!
I'm not a liberal. I'm not a Democrat. I'm just sick of getting ripped off.
Posted by b, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 27, 2011 at 9:30 pm
Thanks for the level-headed discussion, GX. There's no perfect model. But there are models that work far better than this. I know people who have lived under Canadian and Australian healthcare, who have also lived in the US. They've sold me on those systems. These hybrid public/private models work pretty well. The people I know who have lived with UK healthcare seem to prefer it less. Good or bad, there seem to be great lessons to be learned outside our borders.
Posted by GX, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 28, 2011 at 7:33 am
Even though I'm a strong supporter of free markets, I do agree with you Been There that industries need appropriate levels of regulation. The key is it needs to be balanced. But regulation can't get in the way of competition - in fact it needs to promote it.
But clearly we have a broken health care industry and something needs to change. My concern with moving towards a single-payer systems is that if you look closely, this sort of system is putting significant financial strain on countries with Europe being an example. It also necessarily leads to rationalization, but this might be OK as at least it would cover for basic services for everyone. And those who wanted more could pay for it themselves.
On the other hand, being an ardent supporter of free markets/capitalism, I feel we haven't yet dealt with the root causes of health care cost escalation with the necessary regulation changes to promote competition.
Why is it in other low-cost industries where people don't have a lot of money, we are getting innovation like specialized hospitals that provide complex, quality, low-cost services and none of that sort of innovation is happening here in the US? Think about the high tech industry, where companies constantly look to out-compete each other with better products and lower prices. Why isn't that happening in the health care industry? Why haven't we identified the barriers to this competition?
Clearly, I don't have the answers but I do know the current system is not working and is failing our society. Something needs to change. Are you folks confident that the current law will bring along these changes? If so, it would be great to get your perspective on the law's key drivers of cost reduction.
Posted by GX, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 28, 2011 at 8:03 am
One more thought - I believe we need a system that promotes personal responsibility. I can see how a true free market solution would do this (people who make poor lifestyle choices would pay more) but how would a single payer system do this?
To be honest, I do have to admit that I am not highly motivated to divert more of my tax dollars to health care, when we have a population that refuses to take care of themselves (as evidenced by 30%+ of adults being obese).
Posted by Been There, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 28, 2011 at 8:36 am
My husband and I went to Chili's the other night and someone had left the nutritional booklet on the table so we checked it out and almost fell over when we saw what we were thinking of ordering! My husband's meal had enough fat and carbs in it to last him 2 days!!! I think most people have no idea what they're eating in restaurants! Needless to say, we changed our order.
I do agree that obesity adds huge costs to medical care and insurance in general. Not sure what the answer it...maybe we could could all qualify for a lower deductible based on our BMI.
Posted by Reply, a resident of the Downtown neighborhood, on Oct 28, 2011 at 11:23 am
Wow, these fascists come in so many flavors! Let's deny insurance to the obese, many of whom, living in poverty and a state of psychological depression that often accompanies it, rely primarily upon cheap high sugar foods (or other habit-forming drugs) to get through the day. Then let's deny people with pre-existing conditions because, gosh, no one likes to have someone pull a fast one on them. Then, who's next? Oh, we'll have to deny gays because, after all, the odds are higher than heteros that they'll contract the HIV virus. And then who? Muslims? Jews?
I've got an idea! Instead of talking about the pluses and minuses of the recent ACA, most of which has not yet gone into effect, let's talk about it as if it's a predetermined failure and, shucks, talk about the need to replace it with the feeble and belated Republican alternative of increased competition across state lines. All makes sense to me.
Posted by GX, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 28, 2011 at 12:23 pm
Here's another idea. Make it a requirement for healthcare providers to publish a price list just like is required in most other industries. Publishing prices (pre insurance coverage) will make consumers more conscious of cost and will effect behavior.
For grins, I called a few pharamcies in the area for price quotes on my perscription. There was almost a 4 to 1 difference - with Costco being the cheapest and CVS being the most expensive. What a huge difference in price for the same generic. If these companies were required to publish price, you can bet the pricing would be more consistent and lower.
Posted by steve, a resident of the Parkside neighborhood, on Oct 28, 2011 at 1:41 pm
reply, not everyone that disagrees with you is a fascist. It demeans you and you lose support for any agrument you're making becasue you simply don't understand what the word means. You just like to throw it around to label people and to try to empower your weak position.
You like to defend your fellow fat, poor and depressed comrades--exactly waht is your plan to cover these high risk categories? Let me guess...throw more money at a govt program...because we know how efficient they are.
Posted by Arnold, a resident of the Another Pleasanton neighborhood neighborhood, on Oct 28, 2011 at 1:45 pm
Health Insurance premiums surge upward: tinyurl.com/3o9wrhf
This information is based on recently released Kaiser Family Foundation annual report on health care costs. Check out the “chart pack” link on the website. This information is extremely relevant to the City of Pleasanton health care costs/retiree health care costs. It isn‘t just pensions that are punishing the city budget: Web Link
Posted by Kay, a resident of the Vineyard Hills neighborhood, on Oct 28, 2011 at 3:43 pm
Let's not forget that most of the important cost related aspects of the health care reform law won't take effect for another year or two. Your premiums will likely continue to rise until then.
My family's Kaiser plan will go up 12.5% next year, but I am almost grateful for that. At least we have coverage. Had health care reform not passed, I would not have been eligible for ANY coverage at ANY cost due to previous cancer diagnosis last year.