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Old 12-02-2012, 10:15 AM
 
31,385 posts, read 32,002,442 times
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Quote:
Originally Posted by BigJon3475 View Post
Despite what you've been told the fact that you're know competing with the world is a good thing for the globe and the reason you're failing miserably is because they're moving closer to a capitalist system where before you used to compete with them while they were using command style economics.
You almost got that right. The only command economies were those of "market economies" commanding the resources of everyone else.
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Old 12-02-2012, 01:16 PM
 
10,357 posts, read 7,949,184 times
Reputation: 4547
Quote:
Originally Posted by alphamale View Post
Paul Krugman?! Really!?

Do you even know what insurance is? Drive your wrecked car up to an auto insurance company and tell them that you want them to insure it and pay for the repairs.

That is a "pre-existing" condition.

Your poor health is not an insurance company's responsibility.
Poor health is exactly what they are insuring. Do you think you pay insurance in case you have perfect health for the rest of your life?
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Old 12-02-2012, 01:44 PM
 
10,357 posts, read 7,949,184 times
Reputation: 4547
Quote:
Originally Posted by Mircea View Post
There are only 3 ways that health plan providers (what you disingenuously refer to as "health insurance") can hold costs down:

1] Deductibles and Co-Pays
2] Limiting Annual Expenditures Per Person
3] Limiting Life-Time Expenditures Per Person

Did you know that in the Netherlands and in Germany they deny pre-existing conditions?


There are many other things that can be done to reduce medical costs other than healthcare insurance providers attempting to do so by limiting healthcare.

In Ontario they have increased hiring of midwives so that hospital obstetics can be reserved for high-risk or problem pregnancies. They are hiring more nurse practitioners to do the work of family doctors since they can do 85 % of the work a family doctor does. They are increasing the number of home health workers allowing about 70,000 more elderly to live at home last year instead of expensive elderly care facilities. There is a huge emphasis on preventive care, such as free flu shots because the government saves money by having fewer people become sick with flu for example. In Canada, the government mandates how much the pharmaceutical companies can charge for drugs.

Facilities in the U.S. like the Cleveland clinic have implemented practices of stream-lining patient care so that instead of focusing on a patient piece-meal, i.e. the patient sees many specialists none of whom are communicating with each other, one doctor oversees all treatment. They are also finding that many times cheaper preventive care measures are much more effective than expensive tests and treatments.

You are incorrect about Germany or the Netherlands denying insurance for pre-existing conditions.

In Germany, their form of health insurance "the sickness funds, are mandated to provide a wide range of coverages and cannot refuse membership or otherwise discriminate on an actuarial basis."

The healthcare insurance system in the Netherlands has been rated as #1 in the world and "A key feature of the Dutch system is that premiums may not be related to health status or age. "

http://www.health.gov.on.ca/en/ms/ec...lthychange.pdf

Healthcare in Germany - Wikipedia, the free encyclopedia

Healthcare in the Netherlands - Wikipedia, the free encyclopedia
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Old 12-02-2012, 04:07 PM
 
Location: Hinckley Ohio
6,722 posts, read 4,417,463 times
Reputation: 1376
Quote:
Originally Posted by momonkey View Post
Missed the part where he said "factually incorrect".

Have a link to the "factually incorrect" part?

Perhaps after the first article came out no one at George Mason University would have lunch with Klien, but the "firestorm" that followed the first article and Klien's public repentance in no way invalidates the results that were based on what are clearly value-free and testable answers to simple unambiguous economic questions.

Klien's redo that included nine new liberal-friendly questions intended to offset the eight previous value-neutral questions the left had so much trouble with didn't do what was so eagerly claimed as liberals still scored below conservatives and libertarians.

http://econjwatch.org/file_download/...vicMay2011.pdf
And like the thread title, you're assuming facts not in evidence. The second study and the peer review clearly showed the original questions were not "value neutral". They largely mimic the right's beliefs. The questions were structure in such a way that an ignorant respondent would likely give the answer favored by the right.
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Old 12-03-2012, 11:24 AM
 
Location: Ohio
19,678 posts, read 14,144,272 times
Reputation: 15857
Quote:
Originally Posted by hhwdavid View Post
I'm German btw
Yeah, so? Sounds like a personal problem. Did you expect me to sing the Lederhosen Song or do the Chicken Dance?

I lived in Germany for 6 years (Detmold and Schönenberg-Kübelberg).

Since you like Pukiepedia, you can read this

Argument from authority - Wikipedia, the free encyclopedia

Your knowledge of your own country's health care system is on a par with Americans' knowledge of their health care system, and your Health Care IQ is "0" like 90% of Americans. Your average American is so ignorant and ill-informed they believe that their glorified pre-paid medical-services cost-sharing program is actually health insurance.


Quote:
Originally Posted by hhwdavid View Post
False.. Both the public (Krankenkasse) and the private insurance have to accept patients with pre-existing conditions. No exceptions. It's the law.
Quote:
Originally Posted by ellemint View Post
You are incorrect about Germany or the Netherlands denying insurance for pre-existing conditions.
I never say anything that isn't backed-up in writing.

It's just not my style.

The following European States have these exclusions in their insurance plans....

Austria: Individual: pre-existing conditions usually excluded (but not from group policies);
insurers cannot reject applications but may charge higher premiums and/or introduce
cost-sharing arrangements for people with chronic illnesses

Belgium: Mutual: psychiatric and long-term care (lump sum)
Mutual: psychiatric care (co-payment)
Commercial: pre-existing conditions, infertility treatment, sporting injuries

Denmark: Pre-existing conditions

Finland: Pregnancy and childbirth, infertility treatment, alcoholism, herbal remedies, treatment
covered by statutory health insurance

France: Excluding any disease is forbidden by law, although it can be authorized in individual
policies under certain conditions: the disease has to be clearly stated and the insurer
has to prove that the patient had the disease before purchasing the policy


Germany: Pre-existing conditions are excluded if they were known at the time of underwriting and were not disclosed by the insured; declared pre-existing conditions are covered but generally result in higher premiums

Greece: Pre-existing conditions

Ireland: Open enrollment

Italy: Individual: pre-existing conditions, chronic and recurrent diseases, mental illness, alcohol and drug addiction, cosmetic surgery, war risks, injuries arising from insurrection,
natural disasters etc; also often excludes dental care not caused by accident/illness


Group: pre-existing conditions such as diabetes, drug and alcohol addiction, HIV/AIDS,
severe mental health problems such as schizophrenia, voluntary termination of
pregnancy and war risks

Luxembourg: Mutual: open enrollment
Commercial: pre-existing conditio
ns

Netherlands: Some dental plans may require people to have their teeth restored before acceptance

Portugal: Individual: pre-existing conditions, long-term chronic illnesses (such as diabetes, multiple sclerosis and asthma), HIV/AIDS, haemodialysis, self-inflicted injuries, psychiatric treatments, check-ups, dental care, outpatient drugs, alternative medicine and non-evidence based treatment; dental care, delivery costs and outpatient drugs are only covered by the most expensive policies Spain HIV/AIDS, alcoholism and drug addiction, dental care (often available for a supplementary premium), prosthesis, infertility treatment, orthopaedics etc; some insurers do not
have general restrictions but may reject certain conditions; most insurers offer extra benefits for a supplementary premium eg organ transplants, second opinion, family planning, assistance during trips, treatment abroad, certain prosthesis; only one insurer offers homeopathy or spa treatment

Sweden: Emergency care, long-term care, HIV/AIDS, some other communicable diseases,
diseases and injuries as a result of the use of alcohol or other intoxicating substances,
pre-natal care, child birth (normal or with complications), termination of pregnancy,
infertility treatment, vaccinations

UK: Pre-existing conditions, GP services, accident and emergency admission, long-term
chronic illnesses such as diabetes, multiple sclerosis and asthma, drug abuse, self-inflicted
injuries, outpatient drugs and dressings, HIV/AIDS, infertility, normal pregnancy and child birth, cosmetic surgery, gender reassignment, preventive treatment, kidney dialysis, mobility aids, experimental treatment and drugs, organ transplants, war risks and injuries arising from hazardous pursuits

Mossialos and Thomson (2004)

You can find that in the Euro Observer, which is published by the European Observatory On Health.

If people are offended by Reality™, they should gouge out their eye-balls.

Quote:
Originally Posted by hhwdavid View Post
Netherlands:
In 2006, a new system of health insurance came into force in the Netherlands. This new system avoids the two pitfalls of adverse selection and moral hazard associated with traditional forms of health insurance by using a combination of regulation and an insurance equalization pool. Moral hazard is avoided by mandating that insurance companies provide at least one policy which meets a government set minimum standard level of coverage, and all adult residents are obliged by law to purchase this coverage from an insurance company of their choice. All insurance companies receive funds from the equalization pool to help cover the cost of this government-mandated coverage. This pool is run by a regulator which collects salary-based contributions from employers, which make up about 50% of all health care funding, and funding from the government to cover people who cannot afford health care, which makes up an additional 5%.
The remaining 45% of health care funding comes from insurance premiums paid by the public, for which companies compete on price, though the variation between the various competing insurers is only about 5%. However, insurance companies are free to sell additional policies to provide coverage beyond the national minimum. These policies do not receive funding from the equalization pool, but cover additional treatments, such as dental procedures and physiotherapy, which are not paid for by the mandatory policy.
Funding from the equalization pool is distributed to insurance companies for each person they insure under the required policy. However, high-risk individuals get more from the pool, and low-income persons and children under 18 have their insurance paid for entirely. Because of this, insurance companies no longer find insuring high risk individuals an unappealing proposition, avoiding the potential problem of adverse selection.
Insurance companies are not allowed to have co-payments, caps, or deductibles, or to deny coverage to any person applying for a policy, or to charge anything other than their nationally set and published standard premiums. Therefore, every person buying insurance will pay the same price as everyone else buying the same policy, and every person will get at least the minimum level of coverage.
Health insurance - Wikipedia, the free encyclopedia
Quote:
Originally Posted by ellemint View Post
In Germany, their form of health insurance "the sickness funds, are mandated to provide a wide range of coverages and cannot refuse membership or otherwise discriminate on an actuarial basis."

http://www.health.gov.on.ca/en/ms/ec...lthychange.pdf

Healthcare in Germany - Wikipedia, the free encyclopedia

Healthcare in the Netherlands - Wikipedia, the free encyclopedia
Both of you hung your hat on Pukipedia.

Big mistake.

The Netherlands has 3 levels of insurance, plus a 4th supplemental insurance.

In all discussions and comparison of US heath care to other countries, it is absolutely important to understand that the US does not have health insurance -- but nearly all other countries do.

What you have in the US is a glorified pre-paid medical-services cost-sharing plan.....which is not insurance.

That fact alone proves the OPs assertion that "progressives" (whatever that is) do not understand economics.

Because Americans willfully choose to reject or ban health insurance, and prefer this glorified pre-paid medical-services cost-sharing plan, the only option regarding pre-existing conditions (often referred to in European literature as "previous conditions") is to flat out deny people health plan coverage in its entirety.

If Americans would insist upon having health insurance, then health plan providers would have the option of offering at least a basic health care package -- excluding coverage of the pre-existing condition(s) -- which is how it works for nearly all European countries.

About the basisverzekering. --- I'll show you where the Pukipedia article is wrong...

There is a deductible -- the verplicht eigen risico --- which is currently 220 Euros per year.

Contrary to what Pukipedia says, every person will not pay the same price. You can shop around here to compare costs here:

KiesBeter

Independer

Also in addition to the verplicht eigen risico, every person over 18 years has a Euro 150 deductible, and you can get a discount if you want an higher deductible (the maximum deductible is Euro 650).

You can get a discount up to 10% if you are the member of a "group." Under the Dutch scheme, the definition of group is very liberally construed: a group can be be people who communicate on the internet (provided they are all Dutch and reside in the Netherlands).

In addition to the basic, additional and exceptional insurance, you can buy supplementary insurance to cover [adult] dental care, chiropractic (called "physiotherapy" in European literature), optometry, alternative medicine, and cosmetic surgery --- and those are risk-rated and you can be denied if your risk is too high, or if you have a pre-existing condition (if you are deemed "legally blind" then you are covered under the exceptional insurance).

In addition to paying for your basic insurance,
everyone pays 7.2% of the first Euro 31,000 in wages/income to the Risk Equalization Fund, which is about $2,230 per year (or more -- it appears the rate is scaled for income at higher levels).

The purpose of the Risk Equalization Fund is to subsidize lower income groups.

Plus,
you pay an additional tax for the exceptional insurance (AWZG). The cost of the exceptional insurance used to be 12.55% of your income up to the first Euro 16,500 but it has increased now to 13.45% --- which would be $2,270 (or so).

Uh, so where are we? Um $4,500 and you still haven't paid for your basic insurance, or your additional insurance or your supplemental insurance.

How about that?

In the Netherlands, you purchase additional insurance to cover treatments, drugs, diseases and other things the basic plan does not cover. The additional insurance also lets you avoid waiting lists, get faster treatment and preferred care --- meaning you can get a private or semi-private room, instead of being in an ward --- anyone here remember hospital wards?

I doubt it. You all are used to extreme luxury and private/semi-private rooms. In Euro hospitals and clinics, a ward might have 6 to 24 beds. That's also related to Culture: Europeans do not go berserk over space --- especially personal space --- and privacy issues like Americans do.

Also, I note that all of you view these Euro-systems in a vacuum, instead of in the context of the applicable laws for each country. In other words, you falsely assume that health care is never denied, delayed or diluted, and some of are under the misguided belief that have a universal health care system will resolve your present problems related to your health plan provider's reluctance or refusal to pay.

Legal considerations --- especially the definitions --- are very, very important when making comparisons as well....

Austria: Medically necessary, sufficient, appropriate (see General Social Insurance Act (ASVG), §133[2])

Belgium: Medical necessity, activity, cost effectiveness, safety (by Royal Decree)

France: Inscription of new medical and surgical procedures after advice of ANAES on efficacy and safety

Germany: Medically necessary, effective, cost effective (see Social Code Book (SGB) V, §135[1])

Luxembourg:

Sufficient, appropriate (see Code des assurances sociales, art. 17,1)

or

Medically necessary, effective, efficient (see Code des assurances sociales, art. 23,1)

Netherlands: Medically necessary (see Sickness Fund Act (ZFW), preamble)

Switzerland: Effective, appropriate, cost-efficient (see Swiss Insurance Law (KVG), §32)

The UK also has similar criteria....

"Appropriateness criteria govern when and for whom a treatment or service included in the benefits package is funded. Appropriateness criteria may entail clinical criteria that a patient has to meet before a given treatment is deemed appropriate and therefore funded."

In my case, not having surgeries would not cause my death, nor would it cause other medical complications, so I would be denied, or my treatment would be delayed until some year where there was extra money left over in [the local clinic's] budget to do it.

You all should read the studies in the UK on carpal tunnel and cubital syndromes.

A few other things about the German system. Over a certain income level, you can opt out of the public program and get private insurance. Germany is one of the few countries that does not have waiting lists -- so the time factor is not an issue --- but if you want treatment for diseases/illnesses the government program does not cover, or the government refuses pay or treat, or you will need private insurance. If you opt out of government insurance for private insurance, then want to go back to government insurance, you are only allowed to return to the public system under "very exceptional circumstances" and the German government has suspended the right of those 55 years of age or older to rejoin the social insurance scheme (Ministry of Health, Germany, 2008).

"In the past 20 years, our overriding philosophy has been that the health system cannot spend more than its income." -- Franz Knieps German Minister of Health (2009)

So the government collects Euro 500 Billion and that's all it spends -- but what if the people need Euro 650 Billion in medical services? Too bad...so sad....those people don't get treated, or their treatment is delayed/diluted until next year, or the year after, or the year after that when there is enough money.

"By law, our health insurers cannot reimburse for services that are deemed unnecessary. Thus, a doctor who provides such services will not be paid for them. If IQWiG (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) decides that a given treatment does not provide value, the treatment can be excluded from the benefits package". -- Franz Knieps German Minister of Health (2009)

"In addition 16 per cent of Germans hold supplementary insurance (OECD, 2008) for services not fully covered by core insurance such as co-payments for dental care and better amenities including single/double rooms, and treatment by senior medical practitioners" (Busse, 2008).

Getting back to the OPs issue of why progressives don't understand the economy, especially where issues of social welfare programs are concerned, progressives fail to grasp the basic core concept of Economics, like Opportunity Costs.

The value produced by health care exceeds its Opportunity Cost, and because it does, growth in health spending is economically sustainable. Why? Because it is a basic Economic Principle that the value in excess of cost can be seen as a measure of economic sustainability. When the Opportunity
Cost of health spending is too high, health spending becomes economically unsustainable.

I discussed that on another thread and specifically why that was true.

It's the nature of health care. When marginal costs exceed marginal benefits, you're throwing away money and in health care it has been repeatedly proven (just like education) that money does not alter outcome (you can read the studies at Dartmouth University).

That is especially true in health care where age is concerned. We already know we spend more on the elderly, but no one ever knew why until researchers discovered that it is the proximity to death that causes higher levels of spending and not age (and the most recent study is Zweifel, Felder & Werblow 2004).

That's why Medicare costs keep rising, and since technology is the driving factor in health care costs, more technology means more spending closer to death.

Quote:
Originally Posted by ellemint View Post
The healthcare insurance system in the Netherlands has been rated as #1 in the world and "A key feature of the Dutch system is that premiums may not be related to health status or age. "
Uh, I'm gonna guess that you didn't read the report by the Ministerie van Volksgezondheid, Welzijn en Sport which is the Dutch Ministry of Health, Welfare and Sport.

"In contrast with positive findings like these, there is also evidence that Dutch health care is not living up to the high ambitions and expectations in every way. Accessibility is unsatisfactory in some areas, as evidenced by persistent waiting lists in certain sectors and the difficulty of reaching GP practices by telephone during office hours. Wide variations exist amongst health care providers in terms of both price and quality. The cooperation and coordination between different providers are not as good as they should be. Although quality improvement goes hand in hand with cost savings in some instances, this cannot be firmly concluded for the system as a whole. In fact, the total costs of care continue to grow at a fast rate, while the quality of care improves slowly."

And you can find that in the Executive Summary atgezondheidszorgbalans.

I'm not sure who rated the Dutch system as #1 in the world, but it wasn't the Dutch government.

I hope you know a lot more now than you did.

Informing....

Mircea


Last edited by Mircea; 12-03-2012 at 11:36 AM..
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Old 12-03-2012, 02:31 PM
 
20,978 posts, read 16,215,058 times
Reputation: 10270
Quote:
Originally Posted by HistorianDude View Post
Guess what Einstein... so is the market.
True, I am a lot like Einstein....but I digress.

In the free market, there is accountability.

There are consequences.
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Old 12-03-2012, 02:32 PM
 
Location: Littleton, CO
20,894 posts, read 13,612,128 times
Reputation: 3949
Quote:
Originally Posted by alphamale View Post
True, I am a lot like Einstein....but I digress.

In the free market, there is accountability.

There are consequences.
So too with governments.
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Old 12-03-2012, 02:39 PM
 
20,978 posts, read 16,215,058 times
Reputation: 10270
Quote:
Originally Posted by MTAtech View Post
Not from what I read.
This happens in Germany every few years. Great system, huh?

Germany's hospital doctors prepare to strike en masse : The Lancet

Germany's hospital doctors prepare to strike en masse

Ed Holt

Hospitals in Germany are bracing themselves for a mass walkout next week as thousands of doctors are due to strike over poor pay and work conditions. Ed Holt reports.
Hundreds of hospitals in Germany will be left offering little more than basic medical services at the end of this month after doctors said they had “no alternative” but to strike amid a bitter dispute with employers over pay and shift work.
Up to 50 000 doctors at 600 municipal hospitals across the country will walk out on Jan 26 after members of the German doctors' union, the Marburger Bund (MB), voted overwhelmingly on Jan 10 to stage a walkout. And, although they admit that operations and other treatments for some patients will be disrupted, they say the industrial action is the only way they can get local authorities to make an “acceptable” offer to meet their demands.
Hans-Jörg Freese, spokesman for the MB, told The Lancet: “We simply have no other alternative. This is the only effective way that we can reach the doctors' employers. 1-day or short-term strikes are not effective and so we will strike until an acceptable agreement is reached.”
The strike will see admissions to hospitals refused, services limited, and operations delayed or moved to other hospitals. Emergency care will be guaranteed, however, the MB has said. “There is no question that any patient will be put in danger because of this strike”, said Freese.
The doctors are demanding a 6% rise in wages and a reduction in the number of shifts they spend on call. The MB says that more than half of doctors in municipal hospitals do up to nine such shifts per month. They want the figure cut to four, arguing that doctors are overworked.
Germany has more than 2000 hospitals and around 600 of them are owned by municipalities. A third of the 150 000 doctors in the country work in municipal hospitals. Their wages are reported to range between €3700 per month for new doctors and €7000 for those in top positions.
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Old 12-03-2012, 02:48 PM
 
20,978 posts, read 16,215,058 times
Reputation: 10270
Quote:
Originally Posted by ellemint View Post
Poor health is exactly what they are insuring. Do you think you pay insurance in case you have perfect health for the rest of your life?
Auto insurance companies also insure against bad or unforeseen circumstances....do you buy auto insurance because you think you will have no problems?

Better yet....apply for life insurance after being diagnosed with a horrible disease. Will they insure you?

Why should health insurance companies be forced to insure one who is sick, and not already insured by them?
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Old 12-03-2012, 02:50 PM
 
Location: Dallas, TX
31,777 posts, read 24,821,962 times
Reputation: 12162
Quote:
Originally Posted by alphamale View Post
Auto insurance companies also insure against bad or unforeseen circumstances....do you buy auto insurance because you think you will have no problems?
Pretty much everybody buys it to meet government mandate.
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