Health Care Reform

[tech2101]

Again you fail to understand the topic at hand. The states regulate who can (or who can't) compete within the state. If all insurance companies can compete, (in all states) then that increases competition and can lower costs.

Are you ready to rid your state of its insurance commissioner and all the state regulations that apply individually to your state? Insurance regulations are written by the state based on what they think is right for their state.

It sounds like you are asking for a set of federal regulations to be mandated for your state, therefore allowing fair and equal competition between private insurance companies. That sounds very much like you are advocating big brother to now take over what has always been a states' right.

Good for you in seeing it my way.

I will repeat my earlier post on this:

It is not quite that simple. Are you willing to give the federal government the authority and take it away from the state's? State's rights supporters would be all over that. Insurance is regulated at the state level. There would be huge state's rights legal hurdles to make that happen. However, it could be done. Be careful what you wish for. That could open the door to more federal regulation of what has traditionally been a state regulated function...

A. State Insurance Regulation under the McCarran-Ferguson Act States have historically had the primary role in regulation of insurance products. This role was reaffirmed by the McCarran-Ferguson Act of 1945 (McCarran-Ferguson Act),...
The Act had two aims: (1) to re-affirm the role of the states as the primary regulators of the insurance industry while preserving federal authority to regulate insurance through “specificâ€￾ enactments; and (2) to provide limited federal antitrust immunity for the insurance industry.23 The relevant statutory language is as follows:
(a) State regulation
The business of insurance, and every person engaged therein, shall be subject to the laws of the several States which relate to the regulation or taxation of such business.
(b.) Federal regulation
No Act of Congress shall be construed to invalidate, impair, or supersede any law enacted by any State for the purpose of regulating the business of insurance, or which imposes a fee or tax upon such business, unless such Act specifically
relates to the business of insurance... (Kanwit p14)

I agree with you that there should be change.

All of these quotes are from a well written piece by Stephanie Kanwit, J.D., from the O’NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW.

The major obstacles to this are contained in the introduction in her paper:

Under the various PASL [Purchase of Insurance Across State Lines] proposals, health insurance issuers could offer individual policies of insurance from any state regardless of the residence state of the individual purchaser... – assuming that the cost of care is constant across all geographic areas. (Kanwit p15)

Read on:

Any federal legislation to enact PASL in an individual insurance market would have to address two main legal considerations: 1) the McCarran-Ferguson Act, which allows the states to retain their regulatory authority over insurance, and 2) a constitutional prohibition against the commandeering of state officials by the federal government. ... Additionally, the concepts discussed here may be relevant to any federal health reform legislation involving regulation of health insurance or the use of state officials. (Kanwit p9)

Full article is here.

It is titled: The Purchase of Insurance Across State Lines in the Individual Insurance Market - Stephanie Kanwit

Citation:
This paper is posted at Scholarship @ GEORGETOWN LAW.
http://scholarship.law.georgetown.edu/ois papers/26

 

[delldude]

Are you ready to rid your state of its insurance commissioner and all the state regulations that apply individually to your state? Insurance regulations are written by the state based on what they think is right for their state.

It sounds like you are asking for a set of federal regulations to be mandated for your state, therefore allowing fair and equal competition between private insurance companies. That sounds very much like you are advocating big brother to now take over what has always been a states' right.

Good for you in seeing it my way.

The 'Affordable Health Care Choices Act of 2009' will take care of the states rights when it goes single payor Counselor.

President Barack Obama told the American people on June 15th:

What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system. … So, when you hear the naysayers claim that I’m trying to bring about government-run health care, know this - they are not telling the truth.

More

Addendum

 

[dapoes]

Are you ready to rid your state of its insurance commissioner and all the state regulations that apply individually to your state? Insurance regulations are written by the state based on what they think is right for their state.

Yes I agree that the states should not have individual regulation on insurance. It doesn't make sense, nor does it propose any conflict either. And yes I understand what the state rights are.

It sounds like you are asking for a set of federal regulations to be mandated for your state, therefore allowing fair and equal competition between private insurance companies. That sounds very much like you are advocating big brother to now take over what has always been a states' right.

See above.

Good for you in seeing it my way.

Your way? Hardly, you couldnt be any more obtuse if you tried.

It is not quite that simple.

Yes it is. As a matter of fact the current HC bill has this anyways. The problem I have is that they will have politicians, HHS, dictate terms and scope of insurance coverage. Defeats the purpose.

Are you willing to give the federal government the authority and take it away from the state's?

Yes. As a matter of fact the current HC bill has this anyways. The problem I have is that they will have politicians, HHS, dictate terms and scope of insurance coverage. Defeats the purpose.

State's rights supporters would be all over that.

Really? So far no one has been "all over that". People would welcome it.

Insurance is regulated at the state level. There would be huge state's rights legal hurdles to make that happen. However, it could be done. Be careful what you wish for. That could open the door to more federal regulation of what has traditionally been a state regulated function...

Maybe, maybe not. Obama is on a power grab anyways regardless of whatever X statute, law, etc.

I agree with you that there should be change.

Glad you see it my way.

The major obstacles to this are contained in the introduction in her paper:

How is that an obstacle?

Again, the current HC bill has this anyways. The problem I have is that they will have politicians, HHS, dictate terms and scope of insurance coverage. Defeats the purpose.

 

[dapoes]

The argument for Tort Reform via the recent CBO

CBO’s Updated Estimates of the Budgetary Effects of Tort Reform

CBO had previously estimated that enacting a common package of tort reform proposals would reduce federal deficits by $4 billion from 2010 to 2019, but CBO now estimates that those proposals would reduce federal deficits by about $54 billion during that period. The latest estimates are substantially larger for four principal reasons:

The estimates include a larger effect of tort reform on medical malpractice costs;

The estimates incorporate the effect of a gradual reduction in the utilization of health care services resulting from changes in the practice patterns of providers;

The estimated effect on federal revenues was substantially smaller in the previous estimate (which reflected only a reduction in malpractice costs) than the estimated effect on revenues in the current estimate (which reflects the combined effects of the reduction in malpractice costs and the change in spending attributable to changes in practice patterns); and

The reduction in utilization is projected to generate a proportionately larger reduction in federal spending on health care than in other spending on health care.

 

[SparrowHawk]

Everyone hates a lawyer UNTIL they need one. Then of course they hire the schemingist rat b*stard they can find. Just so long as the get theirs

 

[delldude]

Everyone hates a lawyer UNTIL they need one. Then of course they hire the schemingist rat b*stard they can find. Just so long as the get theirs

So you favor doctors doing all types procedures to cover their butt that are mostly unwarranted?

 

[SparrowHawk]

So you favor doctors doing all types procedures to cover their butt that are mostly unwarranted?

The practice of defensive medicine is one of the biggest problems in healthcare today, no question. However instead of placing limits on jury awards and such. A concept that would damage the ones who aren't part of the "Ambulance Chassing" that goes on.

Wouldn't a better plan be to allow individuals, insurers including the feds file suit against doctors for perform procedures that aren't medically required. This would be an example of allowing the free market approach a chance to weed out the crappy doctors. Also why not beef up enforcement of professional standards so that questionable doctors get their licenses yanked, this lowering malpractice insurance and increasing patient safety.

 

[delldude]

The practice of defensive medicine is one of the biggest problems in healthcare today, no question. However instead of placing limits on jury awards and such. A concept that would damage the ones who aren't part of the "Ambulance Chassing" that goes on.

Wouldn't a better plan be to allow individuals, insurers including the feds file suit against doctors for perform procedures that aren't medically required. This would be an example of allowing the free market approach a chance to weed out the crappy doctors. Also why not beef up enforcement of professional standards so that questionable doctors get their licenses yanked, this lowering malpractice insurance and increasing patient safety.

Maybe set up accepted procedures/tests for certain conditions and do away with the unnecessary tests which would help reign in lawsuits.

I don't see the progressives jumping on the band wagon for tort restrictions due to campaign contributions corrupting the way business is done on the hill.......by both sides BTW.

Other countries call it graft, on the take, bribes......here we call it lobbying and campaign contributions.

Lobby reform is another issue.........

 

[Garfield1966]

I like the idea of tort reform as long as it is coupled with doctor review reform. I would want to see civilian/doctor review boards that are open. I don't want the foxes watching the hen house. There are doctors out there who are being protected by their peers who should not be near a patient. As it stands now, a high financial penalty is the only thing that keeps some of them in check.

 

[dapoes]

I like the idea of tort reform as long as it is coupled with doctor review reform. I would want to see civilian/doctor review boards that are open.

And that I would have to agree 100%. Open and published ratings and reviews on a regular basis for doctors, hospitals, medical groups, etc. That way you can see who is performing the highest and who is problematic.

 

[dapoes]

UPSP never had any issues. Sending a letter across the country for 44 cents seems pretty reasonable to me.

Never any issues? Huh? :blink:

You've Got Mail, But the Mailman Hid It
Workers have been stuffing mail into closets and unused rooms at mail facilities in Waterbury and Wallingford because they don’t know how to keep up with such a high volume of mail, he told the newspaper.

"They're just pushing it aside for the next day," Arcovio told the paper. "We've had issues with them hiding the mail."

Michigan Postal Worker Hoarded Thousands of Pieces of Mail Instead of Delivering Them
The Postal Service says there were 333 cases of theft, delay or destruction of mail by employees or contractors filed in the fiscal year that ended Sept. 30. A California postal manager was sentenced to 18 months in prison for stealing thousands of DVDs.

In North Dakota, Allen Prochnow, 62, will be sentenced in March for delaying mail for 10 years. Four tons were removed from his house in Wahpeton, including 3,000 pieces of first-class mail.

"He'd see a magazine he'd like to read and pretty soon it was quite a bit of mail," lawyer John Goff said. "A lot of it was piled neatly along walls in the house. In his own mind he was building a bunker. ... His most frequent answer has been, 'I don't know why."'

A tip from a meter reader led authorities last year to the home of Steven Padgett, 59, a carrier who delivered in the Apex, N.C., area. Authorities used four trucks to remove third-class mail that had been stashed in his garage for six years.

Now imagine this kind of "efficiency" being used for out health care? No thanks! :down:

 

[tech2101]

The Postal Service says there were 333 cases of theft, delay or destruction of mail by employees or contractors filed in the fiscal year that ended Sept. 30.

Now imagine this kind of "efficiency" being used for out health care? No thanks! :down:

333 cases of theft out of 203 billion pieces of mail processed...:

75 billion Revenue in 2008, in dollars
203 billion Total mail volume processed in 2008, in pieces
667 million Average amount of mail processed each day
28 million Average amount of mail processed each hour
463,000 Average amount of mail processed each minute
7,700 Average amount of mail processed each second
46 Percentage of the world’s card and letter mail volume handled by the USPS
835 million Number of pieces of international mail processed
2.1 billion Dollar amount paid every two weeks in salaries and benefits
656,000 Number of career employees
221,000 Number of vehicles in our fleet — the largest civilian fleet in the world

Source USPS

Not bad. I'll bet there were more than that number of theft cases at at one airport in one year.

Yes, I will take that kind of record for the health care coverage for those who have none. Ask them if they would like to have that kind of record.

Keep providing data like that to support your claims and you will sell the plan yourself!

 

[dapoes]

333 cases of theft out of 203 billion pieces of mail processed...:



Source USPS

Not bad. I'll bet there were more than that number of theft cases at at one airport in one year.

Yes, I will take that kind of record for the health care coverage for those who have none. Ask them if they would like to have that kind of record.

Keep providing data like that to support your claims and you will sell the plan yourself!

Oh I see you are defaulting to statistics? Much like the supposed 137,000 people that died from lack of health insurance from 2000 through 2006.

Soooo in turn...keep providing data like that to support your claims and you will sell the (defeat of the) plan yourself!

 

[Garfield1966]

333 cases of theft out of 203 billion pieces of mail processed...:

I do not think that is a valid comparison. The 333 cases is based on individuals not pieces of mail I believe. With out a bases for comparison it's hard to say if 333 is high or low. I think the number would have more relevance if we had other companies of the same size (employee wise) and saw how their numbers panned out. Given the size of USPS , that number seems reasonable.

 

[tech2101]

I do not think that is a valid comparison. The 333 cases is based on individuals not pieces of mail I believe. With out a bases for comparison it's hard to say if 333 is high or low. I think the number would have more relevance if we had other companies of the same size (employee wise) and saw how their numbers panned out. Given the size of USPS , that number seems reasonable.

Thank you for making my point.