SORRY FOR THE MISTAKE, HERE"S THE REST
Well to continue where I was so rudely interrupted:
'No need to get excited" the thief he kindly spoke "there are many here among us who feel that life is but a joke But you and I we've been through that and this is not our fate . So let us not talk falsely now. The hour is getting late".
First the uninsured. Who are these people? All bullshit aside, they fall into two major groupings, about half that are between jobs and temporarily uninsured and about half either at or below the poverty line who can't afford coverage. There is, total, at anyone time about 50 million uninsured......total That means the real problem is the 25 million or so that can't afford it. My contention is that the other "floating" 25 million,which includes at about half people who work for small businesses, and are better seen as a result of the unemployment rate and small business economic realities rather than a result of the health insurance problem
Now we get to the real issue that no one is talking about and the issue that will result in medicare rationing..The Baby Boomers, seventy six million Americans, whose sense of entitlement and prosperity were built during the prosperous fifties. They have severely effected society at every stage of their life. They hounded Johnson from the White House, they made Job Rolling Papers a large business, they made cowboy/girl outfits a very profitable business in the 50's they put Clinton in the Whit House and now Obama. They will hit the retirement rolls for the most part between 2006-2011. No one has a clue as to how to deal with the cost of their SS and Medicare. Any politician that calls them the problem may as well hit that third rail of the Metro.
the insurance crisis is all about. The govt has gotta find a way to nearly double SS and Medicare or they are going to get kicked out on their ass. Baby Boomers are active, opinionated (like me) and won't take this crap that it is a crisis, govt has known it was coming since at least the sixties.
I'm not going to get into numbers, plans, etc. Suffice it to say that one effort seems to be "sneaking into rationing"...these efficacy panels that are going to "scientifically" determine, by condition what is the most effective treatment plan have no intention of paying, in a few years, for anything else. Guidelines already exist for elective procedures, try and get medicare to pay for cataract surgery for an eighty year old. They'll have to be more.
Everyone involved knows all of this.....especially the political and ballot box fallout.....they are trying to get it done by some uninsured bullshit.
God I hate politicians. They are universally a bunch of lying cowards who can't think more than one term in the future.
Hence the uninsured crisis.....actually the Baby Boomer aging and entitlement process that has been described, for at least thirty years, as a pig through a python. A big lump slowing moving through the digestive process. You think the phyton's uncomfortable, just wait until all these wonderful entitlement programs the the Democrats have given us all these years since 1946 have to swallow the big pile of python poo. They're looking every where for money, no increased population coming to pay for it for at least 30 years and that's only if people start having larger families, no new taxes or the Baby Boomers will vote there ass out, no way China won't want their money----with interest---wait, wait, did anybody look under the bed, how about under the couch cushions........................................
Thursday, July 23, 2009
The truth that Obama hasn't revealed
Why arre health care costs out of control, why are they "going to double" according to our president...........???? What does it have to do with the uninsured??
Let's face the truth here, let the politicians and interest groups make up their sob stories and specious explanations behind costs and benefits. What was it Dylan says in " All Along the Watchtower"
Let's face the truth here, let the politicians and interest groups make up their sob stories and specious explanations behind costs and benefits. What was it Dylan says in " All Along the Watchtower"
HMO's, OK guy's, time to get yours..........
It was a helluva time. Inflation in the 20% range, price controls in place, the kids were in the streets to protest the war, crazy. Health Care was not immune. It's costs were out of control just like everything else.
One health services vendor was noticeable by it's ability to control costs in this environment.......The Kaisers. No one looked to see that they had a stable, homogeneous population that did what they were told. Anyway along came a bookish young Doctor with a plan.
His idea was to "pay people to stay well". He developed plans that offered nearly every preventative test ever needed. He advised his flock on what to do to stay healthy, gave annual physicals etc. The concept was to make the population healthier by finding disease, or at least high risk behavior, early, address it in a low cost setting, mostly with lifestyle changes and thereby reduce the need for more expensive treatments later in the disease's development.
In order to make sure the proper care is received at the proper time in the proper setting, nurse gatekeepers were invented. By terms of the plan, the enrolee had agreed only to access those services she felt were appropriate, in the setting that the plan felt appropriate and at a cost that was appropriate. In other words, HMO's could and did tell you what you could have in the way of medical services and routinely did.
HMO's were usually priced about ten to fifteen percent lower than an indemnity plan underwritten by a group insurance carrier. A group carrier wasn't providing care. They didn't then and they don't now.......they were a financing source. At the end of the year after all losses were settled, usually in excess of 90% of the premium, the left over portion after the 5% or less of premium that the insurance company charged for their services and profit. In 33 years in the business I never once saw a large contract underwritten and priced to return greater than a 2% profit.
Good ol' HMO's though, rarely returned more than 75% on the dollar. They kept the rest as expenses and profit.......more than twice the usual insurance company. After an HMO paid their expenses the rest went into the pocket of the physician owners (usually no more than three guy's), and then to the nearest Porsche dealership, with perhaps a stop at the jewelers for a gold chain or two, or maybe a bauble for the flower of the hour.
This great idea started in the seventies and boy did a lot of doctors get rich.They built up membership through marketing, rating and underwriting methods that if they were used by an insurance company would result in a one way trip to the slammer. Once one of these HMO's became large enough, the doc's took it public, making themselves multi-millionaires over night. The next step in this shell game was to sell it to a large insurance company, a group of aggregators, etc. The resulting company was manages by a bunch of guy's whose mandate was to squeeze every single possible penny out of it for the owners.
These guy's wouldn't be seen dead in a gold chain, or for that matter a Porsche. A complete change in management attitude and culture, these guys drove Mercedes and wore Phillipe Patek watches, they were professionals......and if you think the doctors gave you a working over these guy's were truly pro's and will give you a screwing consistent with that status, believe me, it'll hurt less if you point your toes in.
One health services vendor was noticeable by it's ability to control costs in this environment.......The Kaisers. No one looked to see that they had a stable, homogeneous population that did what they were told. Anyway along came a bookish young Doctor with a plan.
His idea was to "pay people to stay well". He developed plans that offered nearly every preventative test ever needed. He advised his flock on what to do to stay healthy, gave annual physicals etc. The concept was to make the population healthier by finding disease, or at least high risk behavior, early, address it in a low cost setting, mostly with lifestyle changes and thereby reduce the need for more expensive treatments later in the disease's development.
In order to make sure the proper care is received at the proper time in the proper setting, nurse gatekeepers were invented. By terms of the plan, the enrolee had agreed only to access those services she felt were appropriate, in the setting that the plan felt appropriate and at a cost that was appropriate. In other words, HMO's could and did tell you what you could have in the way of medical services and routinely did.
HMO's were usually priced about ten to fifteen percent lower than an indemnity plan underwritten by a group insurance carrier. A group carrier wasn't providing care. They didn't then and they don't now.......they were a financing source. At the end of the year after all losses were settled, usually in excess of 90% of the premium, the left over portion after the 5% or less of premium that the insurance company charged for their services and profit. In 33 years in the business I never once saw a large contract underwritten and priced to return greater than a 2% profit.
Good ol' HMO's though, rarely returned more than 75% on the dollar. They kept the rest as expenses and profit.......more than twice the usual insurance company. After an HMO paid their expenses the rest went into the pocket of the physician owners (usually no more than three guy's), and then to the nearest Porsche dealership, with perhaps a stop at the jewelers for a gold chain or two, or maybe a bauble for the flower of the hour.
This great idea started in the seventies and boy did a lot of doctors get rich.They built up membership through marketing, rating and underwriting methods that if they were used by an insurance company would result in a one way trip to the slammer. Once one of these HMO's became large enough, the doc's took it public, making themselves multi-millionaires over night. The next step in this shell game was to sell it to a large insurance company, a group of aggregators, etc. The resulting company was manages by a bunch of guy's whose mandate was to squeeze every single possible penny out of it for the owners.
These guy's wouldn't be seen dead in a gold chain, or for that matter a Porsche. A complete change in management attitude and culture, these guys drove Mercedes and wore Phillipe Patek watches, they were professionals......and if you think the doctors gave you a working over these guy's were truly pro's and will give you a screwing consistent with that status, believe me, it'll hurt less if you point your toes in.
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