7 ms·

Big fear in NZ, however unfounded, is that TPPA will somehow try and reduce us to the health care standard in the US :(

pasbesoin 11y ago
Hmm, a new spin on "race to the bottom." (Spoken as one who is watching the quality health insurance plans disappear from the Affordable Care Act (Obamacare) for the coming year.)
- marincounty 11y ago
  I'll take your word that Afordable Care Act is eroding "quality health insurance plans". I have seen the rates, and they all seem outrageously expensive. What I have seen is Insurance companies just finding loopholes, and doing what "for profit" insurance companies do; make money. I don't know how the Affordable Care Act is making things worse. The insurance companies were greedy, selfish bastards before the act? I don't think health care would have magically gotten better with time? As to Obamacare. No it's not what he originally wanted. Politically, he needed to amend his original bill. At the time the Rebublicans pressure was palatable. He knew it was this, or nothing. An election was comming up, and he knew he wouldn't be able to get anything through next congress. I'm not a fan of Obamacare, but we were cornered. It was this, or nothing. I do believe we need to document our complaints about individual Insurance companies, but that will probally never happen. Why--because it's one of those subjects we don't like to think about. I don't have an answer to the problem of horrid insurance companies, and medical institutions/individuals that overcharge us. I would be the first one pulling the cord on Obamacare if someone could get a better alternative through congress. I don't see that day comming soon. (To the Doctors/Institutions that don't abuse their power; you have my highest regard. To the ones that accept a medi-cal patient every blue moon; you have my highest regard. To the ones who are just in it for the money, or blame everything on the Insurance companies; some of us see right through the lie.)
  - anonymous854 11y ago
    According to this article, if you look at the prices insurance companies are actually paying (after negotiations), they're still way higher than in other countries: http://www.washingtonpost.com/news/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/ http://www.washingtonpost.com/news/wonkblog/wp/2013/03/26/21... This suggests that the providers of medical care are actually the biggest culprits for our out of control healthcare spending and lack of access to affordable care, not the insurance companies, yet your post only passingly blames the former.
    - ddingus 11y ago
      It's both. Private insurers need to make a profit for distributing risk, and due to there being a lot of them, those risk distributions are much smaller than they could be. Adding a public, non profit "cost + x percent" type plan, say Medicare part E for everyone, would very significantly improve this, particularly if it were allowed to bargain for bulk pricing. (that we don't allow Medicare to do this is just nuts!) Private entities also need to make a profit, and there is no meaningful check on this at present. A similar, public non-profit type delivery entity would reduce prices on most common treatments and maintenance activities. Those wanting to profit on primary care could add value, such as home service, etc... and do it that way, rather than mark up common, mass delivered treatments. Secondly, niche specialization could remain high profit, high value add and more people would be able to afford those services. Doing something like this would carve a big hole into much of the profit inherent in the US system, which would bring our national costs closer to those found in the rest of the world, while leaving high profit, high value on the table. Some of us would not be able to afford those high value offerings, but would definitely benefit from much improved access to preventative and or more common, well proven health care. This is all a compromise. The US could make much better choices and improve both access and outcomes.
- cryoshon 11y ago
  Yeah, look up the whole "high deductible plan" fiasco which is being expanded to mainstream right now. More expensive recurring costs per plan, then larger out of pocket cost for the consumer after they visit the doctor, which they are economically discouraged to do. Then, when they absolutely have to go to the doctor, they are bankrupted. I thought the ACA was supposed to help us away from this shitty system? Seems to have made it much worse... we should have pushed harder for universal healthcare.
girvo 11y ago
Yeah. I don't know how likely it is, but I can't pretend it hasn't crossed my mind; with introducing provisions that make "sense" (in a cruel sort of way) in the US market to other countries that have proper nationalised health care, one would expect those provisions to move the needle at least somewhat towards the "health as a commodity" side...
pjc50 11y ago
And in the UK; it's a risk to free, universal health coverage, or will somehow result in mandatory contracting out of services for an increase in cost and reduction in accountability. The NHS isn't perfect, but the US system is a nightmare that must be defended against.
- ionised 11y ago
  I'm pretty sure a fully privatised, insurance-based healthcare system is exactly what the Tories want. The assault on NHS funding at all levels is clearly an attempt to gradually have it sold off. I'm always deeply depressed and even angry at how many people genuinely believe the free market will solve all of our problems.
  - deleted 11y ago
    [deleted]
  - jedrek 11y ago
    One thing I found funny was that when Obama was pushing through the Affordable Care Act in the US, the GOP was scaring their voters with visions of nationalized hospitals. Around the same time, here in Poland, the right-wing-ish PiS party was scaring its voters with visions of privatized health care.
  - PlzSnow 11y ago
    Don't be depressed and angry. The NHS isn't going to be sold off. No-one thinks that, outside a few extremists on the fringes of the political spectrum.
    - pjc50 11y ago
      'Extremists' like the BMJ? http://www.bmj.com/content/342/bmj.d2996.full http://www.bmj.com/content/342/bmj.d2996.full
      - anonymous854 11y ago
        I hope the irony of such an article being published in a pay-walled journal wasn't lost on its authors.

Hmm, a new spin on "race to the bottom." (Spoken as one who is watching the quality health insurance plans disappear from the Affordable Care Act (Obamacare) for the coming year.)

marincounty 11y ago
I'll take your word that Afordable Care Act is eroding "quality health insurance plans". I have seen the rates, and they all seem outrageously expensive. What I have seen is Insurance companies just finding loopholes, and doing what "for profit" insurance companies do; make money. I don't know how the Affordable Care Act is making things worse. The insurance companies were greedy, selfish bastards before the act? I don't think health care would have magically gotten better with time? As to Obamacare. No it's not what he originally wanted. Politically, he needed to amend his original bill. At the time the Rebublicans pressure was palatable. He knew it was this, or nothing. An election was comming up, and he knew he wouldn't be able to get anything through next congress. I'm not a fan of Obamacare, but we were cornered. It was this, or nothing. I do believe we need to document our complaints about individual Insurance companies, but that will probally never happen. Why--because it's one of those subjects we don't like to think about. I don't have an answer to the problem of horrid insurance companies, and medical institutions/individuals that overcharge us. I would be the first one pulling the cord on Obamacare if someone could get a better alternative through congress. I don't see that day comming soon. (To the Doctors/Institutions that don't abuse their power; you have my highest regard. To the ones that accept a medi-cal patient every blue moon; you have my highest regard. To the ones who are just in it for the money, or blame everything on the Insurance companies; some of us see right through the lie.)
- anonymous854 11y ago
  According to this article, if you look at the prices insurance companies are actually paying (after negotiations), they're still way higher than in other countries: http://www.washingtonpost.com/news/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/ http://www.washingtonpost.com/news/wonkblog/wp/2013/03/26/21... This suggests that the providers of medical care are actually the biggest culprits for our out of control healthcare spending and lack of access to affordable care, not the insurance companies, yet your post only passingly blames the former.
  - ddingus 11y ago
    It's both. Private insurers need to make a profit for distributing risk, and due to there being a lot of them, those risk distributions are much smaller than they could be. Adding a public, non profit "cost + x percent" type plan, say Medicare part E for everyone, would very significantly improve this, particularly if it were allowed to bargain for bulk pricing. (that we don't allow Medicare to do this is just nuts!) Private entities also need to make a profit, and there is no meaningful check on this at present. A similar, public non-profit type delivery entity would reduce prices on most common treatments and maintenance activities. Those wanting to profit on primary care could add value, such as home service, etc... and do it that way, rather than mark up common, mass delivered treatments. Secondly, niche specialization could remain high profit, high value add and more people would be able to afford those services. Doing something like this would carve a big hole into much of the profit inherent in the US system, which would bring our national costs closer to those found in the rest of the world, while leaving high profit, high value on the table. Some of us would not be able to afford those high value offerings, but would definitely benefit from much improved access to preventative and or more common, well proven health care. This is all a compromise. The US could make much better choices and improve both access and outcomes.
cryoshon 11y ago
Yeah, look up the whole "high deductible plan" fiasco which is being expanded to mainstream right now. More expensive recurring costs per plan, then larger out of pocket cost for the consumer after they visit the doctor, which they are economically discouraged to do. Then, when they absolutely have to go to the doctor, they are bankrupted. I thought the ACA was supposed to help us away from this shitty system? Seems to have made it much worse... we should have pushed harder for universal healthcare.

girvo 11y ago

Yeah. I don't know how likely it is, but I can't pretend it hasn't crossed my mind; with introducing provisions that make "sense" (in a cruel sort of way) in the US market to other countries that have proper nationalised health care, one would expect those provisions to move the needle at least somewhat towards the "health as a commodity" side...

pjc50 11y ago

And in the UK; it's a risk to free, universal health coverage, or will somehow result in mandatory contracting out of services for an increase in cost and reduction in accountability. The NHS isn't perfect, but the US system is a nightmare that must be defended against.

ionised 11y ago
I'm pretty sure a fully privatised, insurance-based healthcare system is exactly what the Tories want. The assault on NHS funding at all levels is clearly an attempt to gradually have it sold off. I'm always deeply depressed and even angry at how many people genuinely believe the free market will solve all of our problems.
- deleted 11y ago
  [deleted]
- jedrek 11y ago
  One thing I found funny was that when Obama was pushing through the Affordable Care Act in the US, the GOP was scaring their voters with visions of nationalized hospitals. Around the same time, here in Poland, the right-wing-ish PiS party was scaring its voters with visions of privatized health care.
- PlzSnow 11y ago
  Don't be depressed and angry. The NHS isn't going to be sold off. No-one thinks that, outside a few extremists on the fringes of the political spectrum.
  - pjc50 11y ago
    'Extremists' like the BMJ? http://www.bmj.com/content/342/bmj.d2996.full http://www.bmj.com/content/342/bmj.d2996.full
    - anonymous854 11y ago
      I hope the irony of such an article being published in a pay-walled journal wasn't lost on its authors.