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There's an article in the New York Times concerning health care in Maine that I found interesting, and perhaps others will as well. It seems to echo some comments I've read on the Maine forum about health care efforts in Maine.
Yup. This is a pretty good summary of the situation. And the rest of the country isn't far behind as we all are getting older.
It never ceases to amaze me that we seem to find it OK to send half a million combat troops to the other side of the world to straighten out people who never asked us to visit, while we can't find the money to provide basic health care for a very large percentage of our own people.
Meanwhile those who do buy insurance pay more and more for less and less.
Yup. This is a pretty good summary of the situation. And the rest of the country isn't far behind as we all are getting older.
It never ceases to amaze me that we seem to find it OK to send half a million combat troops to the other side of the world to straighten out people who never asked us to visit, while we can't find the money to provide basic health care for a very large percentage of our own people.
Meanwhile those who do buy insurance pay more and more for less and less.
Good post, 'bout sums it up IMO, woulda "repped" ya but, I need to spread it around first.
Can someone explain to me why health insurance in New Hampshire is half the cost of the same policy in Maine? I don't think we're any less healthy than those folks, but if I moved across the Piscataqua to Portsmouth I would pay a whole lot less than I do here.
Can someone explain to me why health insurance in New Hampshire is half the cost of the same policy in Maine? I don't think we're any less healthy than those folks, but if I moved across the Piscataqua to Portsmouth I would pay a whole lot less than I do here.
Alot of this has to do with the fact that our wonderful elected officials will not allow outside health insurance competition to enter the state. Just remember if you think health care is expensive now just wait till it's "Free"
Alot of this has to do with the fact that our wonderful elected officials will not allow outside health insurance competition to enter the state. Just remember if you think health care is expensive now just wait till it's "Free"
No. This is absolutely incorrect. There is no rule or regulation that prohibits any health insurance company from selling its products in Maine.
The reason why there is no competitive atmosphere in health insurance in Maine is because Maine is a "guarenteed issue" state. That means that anyone willing to pay the premium will be issued a policy regardless of preexisting health conditions or other limitations, and ALL people pay the same premium. Thus the healthy are subsidizing the sick, and the overall cost of coverage continues to rise: the chronically ill use far more medical services than the healthy.
If an insurance company is not allowed to underwrite the risks of issuing coverage then all it can forsee is an opportunity to lose money, and it will go away. That is what happened in Maine: insurance companies retreated from the State.
This is what will happen with the Federal plans to completely revise the health insurance industry by mandating that everyone buys coverage and mandating that insurance companies MUST provide coverage to anyone who walks through the door at the same price as the healthy. This will insure that health insurance reforms will fail, and ultimately mean that the Federal government will have to provide insurance for more and more people.
In Maine the fundamental problem with health insurance is that we have a very small population. OF that small population, the majority are older people, and many of the younger ones do not buy health insurance in the same marketplace as do the older ones. This creates a situation for the insurance industry called "adverse selection". The insurance companies can only expect to receive applications from elderly and less well segments of the population. Since they cannot charge higher premiums for the sicker group than for others, the only real choice is to leave the really small number of people, and to seek to sell insurance in larger states or states that do not attempt to kill them off.
This is the same situation that has existed in workers compensation insurance in Maine, with the final result that EVERY insuror writing workers compensation insurance left the state until the state got its rules and regulations straightened out. That opened the door to major compensation reforms and the birth of the Maine Employers Mutual Insuance Company. Now there is a certain rebirth of competitive workers compensation insurance in Maine, but it is nearly twenty five years since the Maine legislature gutted the industry before.
The only way that true health insurance reform is possible will be for the Federal government to provide a genuine basic care insurance program for those who are chronically ill or are simply unable to buy any form of health insurance for themselves. The rest of the insurance industry will then be able to underwrite health insurance for the remainder of the population. The healthier the population and the healthier the lifestyle, the lower the cost of insurance. It doesn't take a rocket scientist to understand the theory.
At the same time, there needs to be a radical curb on the number and amount of medical malpractice suits brought against the medical services industry.
It would also be useful for people in general to remember that there aren't any of us going to get out of here alive.
Sighhh...IMO (as someone who has been knee-deep involved in healthcare topics of this nature) costs need to be contained before anything else happens. "Smoke screens" need to be lifted so that people can really and truly see how healthcare providers pay necessary bills (like when my EOB showed that it paid out 3x more than the hospital originally billed for one visit to the ER). I'd also like to have a nice tidy accounting of how many people who receive Mainecare actually work (most for small business) instead of just hearing about the lazy couch potato welfare kings and queens. I think people would be surprised.
If only costs were contained in the first place, all of this useless backbiting about "socialized" or "capitalist" medicine wouldn't be happening IMO. I do indeed realize that an aging baby boomer population is contributing to the increase in demand for healthcare, but the utter, total, wastes of money in many aspects of healthcare galls me to no end. It's beginning to get more attention now because the economy is in the tank. Maybe that's one good thing to come from economic downturns.
I started my employment in 1988 in a part-time position. I worked another job because I needed more hours, BUT I also needed health benefits. I took the weekend stint because it offered a really great healthcare plan. I paid $14.88 per week for it as a part-time employee. This allowed me to have healthcare coverage and be able to pay my bills.
Long story short - if I were to try to do that today, starting at the same exact job at the starting pay they pay today, I could not make enough money to even cover the weekly cost of the insurance. Now, I realize that life is a heck of a lot different today then it was then, but it does illustrate why many people can no longer afford coverage.
Also, IMHO, we have to get manufacturing jobs back on US soil asap and stop quibbling about who's controlling what - be it corporations or unions. Not everyone is capable of going to college and getting 3 degrees only to find out when they're finished, that their "high demand" jobs bubble has burst and they have to take whatever they can get.
Incentives to provide decent-paying jobs with some sort of healthcare benefits (and yes, reasonable costs to the employees - some sort of copay or another) needs to happen before we all end up having to sit in line at the local Wal-Mart to get healthcare.
I was happy to see in the news this noon that Old Town Canoe/Johnson has expanded their business. They did so because the state worked with them. I'd like to see that happen more often.
I've said it before and I'll say it again: It's a quagmire.
Last edited by cebdark; 11-11-2009 at 11:26 AM..
Reason: flying fingers issue
Alot of this has to do with the fact that our wonderful elected officials will not allow outside health insurance competition to enter the state. Just remember if you think health care is expensive now just wait till it's "Free"
Acadianlion said:
Quote:
No. This is absolutely incorrect. There is no rule or regulation that prohibits any health insurance company from selling its products in Maine.
The state doesn't prohibit an insurance company from coming in, as long as it follows Maine laws. But the state also prohibits any Mainer from going outside the state to buy health insurance. I can't cross the border into New Hampshire to buy a health insurance policy there. There have been repeated bills in the legislature to allow Mainers to cross state lines to buy health insurance. The socialized health care folks have shot them down every time.
Acadianlion said:
Quote:
This is what will happen with the Federal plans to completely revise the health insurance industry by mandating that everyone buys coverage and mandating that insurance companies MUST provide coverage to anyone who walks through the door at the same price as the healthy. This will insure that health insurance reforms will fail, and ultimately mean that the Federal government will have to provide insurance for more and more people.
Sort of. One problem in Maine, according to an article I just read (http://www.downeast.com/magazine/200...insurance-mess), is that as insurance costs rose, the young and healthy dropped their coverage, concentrating the policies among the less young, less healthy population that used the policies more, and thus increasing costs. If everyone was forced to carry health insurance, theoretically at least, the price would come down because health-care costs would be spread over a larger policy-paying population. (BTW, I don't buy the "Maine has a lower population" reasoning for health insurance rates. New Hampshire and North Dakota both have lower populations than Maine -- and pay lower rates.)
Massachusetts now requires everyone to have heath insurance. Does anyone here know how that plan is working?
The state doesn't prohibit an insurance company from coming in, as long as it follows Maine laws.
EVERY state has its own insurance department and its own regulations that apply to the issuance, underwriting and in most cases the actual verbiage that insurance coverage is written in. Policies effective in every state MUST conform to the regulations of every state.
But the state also prohibits any Mainer from going outside the state to buy health insurance. I can't cross the border into New Hampshire to buy a health insurance policy there.
Well, not exactly. You can go anywhere you want to buy health insurance. But the companies selling insurance in other states will not sell you a policy if you are not a resident of that state and the coverage won't be good in Maine because it is written on forms and according to rules that are not concurrent with Maine regulations.
There have been repeated bills in the legislature to allow Mainers to cross state lines to buy health insurance.
Not really correct. The legislature has mandated that all policies in Maine cost the same for all people regarding medical conditions. It is the insurance companies themselves who decided to NOT underwrite in Maine. The legislature has done nothing to the individual except to pass unfavorable underwriting restrictions on the insurance industry by making Maine a mandatory issue state.The socialized health care folks have shot them down every time.
Acadianlion said:
Sort of. One problem in Maine, according to an article I just read (Magazine 2006 February - Maine's Insurance Mess), is that as insurance costs rose, the young and healthy dropped their coverage, concentrating the policies among the less young, less healthy population that used the policies more, and thus increasing costs. If everyone was forced to carry health insurance, theoretically at least, the price would come down because health-care costs would be spread over a larger policy-paying population. (BTW, I don't buy the "Maine has a lower population" reasoning for health insurance rates. New Hampshire and North Dakota both have lower populations than Maine -- and pay lower rates.)
You should "buy it" because insurance is always about the laws of large numbers. Maine has a miniscule population over which to spread risk. Among the 1.3 million in Maine, fewer than one half would be even in the market to buy insurance, and of those less than one half are likely to be healthy young people. Maine has a large percentage of retirees who will be covered by Medicare and not in the general market. Maine has a large percentage of very poor who are rightfully the subject of Mainecare. There are a percentage of people employed in Maine by large groups who are covered by group policies provided by their employers, including all State employees. Then there are the remainder, which is a very small pool over which to actuarialy spread risk for rating purposes. Hence the continual lobbying for higher premiums by the one company that does write in Maine, Anthem Blue Cross.
New Hampshire and North Dakota both have small populations and lower insurance costs than Maine, because they are NOT "guaranteed or mandatory issue" states.
New Hampshire and North Dakota both have small populations and lower insurance costs than Maine, because they are NOT "guaranteed or mandatory issue" states.
Exactly. It has nothing to do with the size of the population. North Dakota's demographics are very similar to Maine's, yet its residents pay less for health insurance because of different laws. That's why I don't buy the "smaller population" explanation.
Quote:
Well, not exactly. You can go anywhere you want to buy health insurance. But the companies selling insurance in other states will not sell you a policy if you are not a resident of that state and the coverage won't be good in Maine because it is written on forms and according to rules that are not concurrent with Maine regulations.
No you can't go anywhere you want to buy health insurance. If you are a Maine resident, you must buy health insurance from an insurance company licensed to do business in Maine.
Quote:
"There have been repeated bills in the legislature to allow Mainers to cross state lines to buy health insurance."
Not really correct.
Absolutely correct. Such bills have been introduced repeatedly in the legislature, and they've failed repeatedly.
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