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I love that some are portraying me as heartless and an extremist. As I said I work in a 100% free and reduced lunch school where many teachers who are way more liberal politically than I am would never set foot. That was a choice not something forced upon me.

I've been eligible to vote in eight Presidential elections. Five times I've voted for Republicans, I voted for Obama in 08 and Hillary in 16 and once I voted outside the two major parties (not for the Libertarian).

I've come to believe that a hybrid single-payer/private insurance system is probably the way to go for healthcare.

If you think the above is a description of someone on the political extreme I would suggest that you might be out of step with where the political center (not that there is much left of it) lies in our country.
 
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College football would be hurt pretty badly if everyone was eating healthy every day.
 
TownieDeac said:
A good illustration of the problem with making abstract statements like "nobody trusts government."

Most people don't give the FDA a second thought when they pick a loaf of bread out at the store or pick out a generic drug or toothpaste. Its why if you polled people and asked them if they trusted the FDA they may say something very different than if you asked them if they trust Crest to make safe toothpaste.

I don't disagree with "better government," I just don't know how that's any more a concrete solution than "don't trust government."
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It depends of Crest's toothpaste has flouride, because I spent the better part of a week dealing with admin who wanted to change our office drinking water because it had flouride and one part in a billion uranium in it and eventhough the FDA said it was safe the FDA is weak "compared to what they got over in Europe"
 
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I don’t think you’re an extremist. I’m just curious what your position is.

For the record, the cafeteria workers at my kids elementary school complain about kids throwing away their lunches. My boys don’t eat the lunch we pack for them even if it’s what they like.
 
 
The Mangler said:
I love that some are portraying me as heartless and an extremist. As I said I work in a 100% free and reduced lunch school where many teachers who are way more liberal politically than I am would never set foot. That was a choice not something forced upon me.

I've been eligible to vote in eight Presidential elections. Five times I've voted for Republicans, I voted for Obama in 08 and Hillary in 16 and once I voted outside the two major parties (not for the Libertarian).

I've come to believe that a hybrid single-payer/private insurance system is probably the way to go for healthcare.

If you think the above is a description of someone on the political extreme I would suggest that you might be out of step with where the political center (not that there is much left of it) lies in our country.
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Unless you make the hybrid single-payer/private insurance system a not-for-profit system, it will not work. Imo, no for-profit system will ever work, especially with this corrupt group in office.
 
warak said:
Unless you make the hybrid single-payer/private insurance system a not-for-profit system, it will not work. Imo, no for-profit system will ever work, especially with this corrupt group in office.
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The trend we will see, in both blue and red states, is a move towards public financing and private delivery of care. A lot of it by for profits. Managed medicaid is a great example of this as is Medicare Advantage and Part D. Part D is a pretty great program (good enrollment, lots of choices, stable prices, member satisfaction) despite the left and right hating it. Usually thats a sign of a good program.

The for profit theme is often brought up. I'd love to know what % of spend is delivered by non profits today. The majority of hospital beds are non profit yet we have runaway medical trend. I think sometimes the for profit mantra doesn't tell the whole story of where are issues are.
 
The Mangler said:
I love that some are portraying me as heartless and an extremist. As I said I work in a 100% free and reduced lunch school where many teachers who are way more liberal politically than I am would never set foot. That was a choice not something forced upon me.

I've been eligible to vote in eight Presidential elections. Five times I've voted for Republicans, I voted for Obama in 08 and Hillary in 16 and once I voted outside the two major parties (not for the Libertarian).

I've come to believe that a hybrid single-payer/private insurance system is probably the way to go for healthcare.

If you think the above is a description of someone on the political extreme I would suggest that you might be out of step with where the political center (not that there is much left of it) lies in our country.
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I think I have found my OGboards political soulmate.
 
warak said:
Unless you make the hybrid single-payer/private insurance system a not-for-profit system, it will not work. Imo, no for-profit system will ever work, especially with this corrupt group in office.
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With this group, it won't work.

It's hilariously ironic how Mangler and Wrangor (who each have called me an extremist, radically left wing and other such comments) have come around to the concept I have been posting on the boards for over twenty years.

warak, countries like Germany and others have a hybrid system. Everyone is covered, but if you want extra you can buy it. Whereas a cosmetic nose job would likely not be covered by universal health insurance, you can buy coverage that will allow you to have one. You can also have private coverage for optional types of surgeries or other procedures, but everyone is covered for everything from basic visits to chemo.

The reality is our delivery system and vast population will get more covered than in places like Germany. We have more clinics, doctors and other medical practioners that other countries. This part would not be for profit.

The cost of our services would go down dramatically and immediately if we took insurance companies out of our basic system. That is 100% wasted money.
 
RJKarl said:
With this group, it won't work.

It's hilariously ironic how Mangler and Wrangor (who each have called me an extremist, radically left wing and other such comments) have come around to the concept I have been posting on the boards for over twenty years.

warak, countries like Germany and others have a hybrid system. Everyone is covered, but if you want extra you can buy it. Whereas a cosmetic nose job would likely not be covered by universal health insurance, you can buy coverage that will allow you to have one. You can also have private coverage for optional types of surgeries or other procedures, but everyone is covered for everything from basic visits to chemo.

The reality is our delivery system and vast population will get more covered than in places like Germany. We have more clinics, doctors and other medical practioners that other countries. This part would not be for profit.

The cost of our services would go down dramatically and immediately if we took insurance companies out of our basic system. That is 100% wasted money.
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Honest question. Not picking a fight. I've asked this several times before and it gets lost in the shuffle.

If insurance companies are "100% wasted money", why does virtually every large employer (who self funds their health expense so no risk pooling is needed) contract with insurers to manage their benefit plans vs. doing it themselves? Why do they not always chose the cheapest administrator to just pay the claim?

Same question on medicaid. Why do most states hire insurers to outsource their Medicaid programs (at full risk to the insurer)?
 
Because that's the way it has always been done. If there is no reason to get group rates and coverage is set, what purpose do insurers serve?

If you notice I did call for private insurance for extra coverage. At that point, you'd almost have to use insurance companies.
 
RJKarl said:
Because that's the way it has always been done. If there is no reason to get group rates and coverage is set, what purpose do insurers serve?

If you notice I did call for private insurance for extra coverage. At that point, you'd almost have to use insurance companies.
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Self funded employers don't pool their rates. Their group is their pool. Virtually every company with over 250 employees self insurers their medical benefits. They all hire insurers to manage their plans. Why? If they don't drive value, why do they exist? We have a vibrant tech economy...couldn't some start up process claims for these employers at a fraction of the cost?

Privatized Medicaid isn't about pooling risk. Its also not always how's it been done. Why do States hire them to run their Medicaid programs at full risk?
 
CHDeac said:
Self funded employers don't pool their rates. Their group is their pool. Virtually every company with over 250 employees self insurers their medical benefits. They all hire insurers to manage their plans. Why? If they don't drive value, why do they exist? We have a vibrant tech economy...couldn't some start up process claims for these employers at a fraction of the cost?

Privatized Medicaid isn't about pooling risk. Its also not always how's it been done. Why do States hire them to run their Medicaid programs at full risk?
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What % savings would you estimate a small group would save by partially self insuring opposed to buying the standard small group coverage? My estimates came up to staggering amounts.
 
palmab03 said:
What % savings would you estimate a small group would save by partially self insuring opposed to buying the standard small group coverage? My estimates came up to staggering amounts.
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Significant for a heathy group. But keep in mind you would need to buy stop loss coverage which insures against huge claims. We typically see 30% reductions even with the stop loss included. You need stop loss as a million dollar claim could kill a small group. The regulators would require it, as would an insurer.

In the market, this type of product is called level funding or balance funding since small groups often don't have the cash flow for big claims months. So they pay $x each month and then reconcile at year end.

BTW, Trump has pushed these plans. Obama hated them as they are exempt from the ACA. The also position the pool as all the healthy groups leave.

I think in NC you have to be a group of twenty to do it.
 
CHDeac said:
Significant for a heathy group. But keep in mind you would need to buy stop loss coverage which insures against huge claims. We typically see 30% reductions even with the stop loss included. You need stop loss as a million dollar claim could kill a small group. The regulators would require it, as would an insurer.

In the market, this type of product is called level funding or balance funding since small groups often don't have the cash flow for big claims months. So they pay $x each month and then reconcile at year end.

BTW, Trump has pushed these plans. Obama hated them as they are exempt from the ACA. The also position the pool as all the healthy groups leave.

I think in NC you have to be a group of twenty to do it.
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We weren't going that extreme, but were basically looking at switching from Platinum to Bronze but using an HRA, but yes there were significant savings. What was interesting about the entire process is that I interviewed between 4-5 brokers, and not a single one even brought the option of self-insuring as a possibility for us to consider. We ultimately went against it because I was worried about the service from our broker, as they were not enthusiastic about going the HRA route. (Lower base fees = lower commissions)
 
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