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I have deliberately not followed this debate because I feel like it would take a lot of reading to really form a nuanced and correct opinion on it, which would

by jraines 17y ago

I have deliberately not followed this debate because I feel like it would take a lot of reading to really form a nuanced and correct opinion on it, which would then be useless because in most arguments you'd be facing a talking-points opinion (from either side). With that being said, it seems to me that it's not increasing demand, but helping meet unmet demand. I'm a really high risk for skin cancer. If getting insured incentivizes me to get more regualar checks at a dermatologist, that's likely to save the system money over the long run. This isn't me falling to moral hazard. The moral hazard in the system is for doctors and hospitals. My dad is a doctor (opposed to the bill, btw) but his main complaint is always about other doctors coding things like nasal congestion up to an unscrupulous level to pad their take from insurance companies. And don't get him started on hospitals. Maybe that's something opponents of the bill are aware of and opposing. Maybe the bill does nothing to fix that. But don't blame patients for making rational choices regarding healthcare based on whatever system they find themselves in. Anyway, there's my uninformed opinion without much of a point :-P

kiba 17y ago
With that being said, it seems to me that it's not increasing demand, but helping meet unmet demand. I'm a really high risk for skin cancer. If getting insured incentivizes me to get more regualar checks at a dermatologist, that's likely to save the system money over the long run. This isn't me falling to moral hazard. Insurance companies, when not treated as healthcare sugardaddies, do not like paying for high healthcare as they want to make more money. They may give you discounts for going to more check up more, to reduce demand for their service later. If you can detect cancer earlier, than you may able to avoid higher cost cancer treatment later as well continue to be a source of revenues to the insurance company. Insurance companies don't make money off dead people, I think.
- tptacek 17y ago
  Again: you use this word "sugar daddies" as if the role was foisted onto the insurers. It wasn't. The insurers colluded with the providers to set artificial, market-oblivious standard prices for procedures on a region by region, hospital by hospital basis. From what I understand, prices were often set by allocation schemes negotiated between the payers and the providers, with no apparent regard to the actual cost, supply, or demand for the procedures. At the same time, even as they managed to drastically distort the pricing of health care, insurers apparently negotiated special payment processes directly with providers, thus creating not one but two artificial tiers of pricing. It's meaningful to talk of "sugar daddies" and "insurance" only when there's a real market for health insurance. But no such market exists. For mainstream medical procedures, for the standard of care that Americans expect (a visit to a doctor, completion of the lab work the doctor requests, some form of radiology, and then a procedure or perscription to resolve whatever comes out of that diagnostic work), unless you are either willing to play chicken with the providers and say "no" when they try to collect debts, or willing to pay incredibly, drastically inflated prices for basic procedures, there is no way to get care without involving your insurer.

by jraines 17y ago

kiba 17y ago

With that being said, it seems to me that it's not increasing demand, but helping meet unmet demand. I'm a really high risk for skin cancer. If getting insured incentivizes me to get more regualar checks at a dermatologist, that's likely to save the system money over the long run. This isn't me falling to moral hazard. Insurance companies, when not treated as healthcare sugardaddies, do not like paying for high healthcare as they want to make more money. They may give you discounts for going to more check up more, to reduce demand for their service later. If you can detect cancer earlier, than you may able to avoid higher cost cancer treatment later as well continue to be a source of revenues to the insurance company. Insurance companies don't make money off dead people, I think.

tptacek 17y ago
Again: you use this word "sugar daddies" as if the role was foisted onto the insurers. It wasn't. The insurers colluded with the providers to set artificial, market-oblivious standard prices for procedures on a region by region, hospital by hospital basis. From what I understand, prices were often set by allocation schemes negotiated between the payers and the providers, with no apparent regard to the actual cost, supply, or demand for the procedures. At the same time, even as they managed to drastically distort the pricing of health care, insurers apparently negotiated special payment processes directly with providers, thus creating not one but two artificial tiers of pricing. It's meaningful to talk of "sugar daddies" and "insurance" only when there's a real market for health insurance. But no such market exists. For mainstream medical procedures, for the standard of care that Americans expect (a visit to a doctor, completion of the lab work the doctor requests, some form of radiology, and then a procedure or perscription to resolve whatever comes out of that diagnostic work), unless you are either willing to play chicken with the providers and say "no" when they try to collect debts, or willing to pay incredibly, drastically inflated prices for basic procedures, there is no way to get care without involving your insurer.