Freedom or Socialism?

Clare73 said:

Are you serious?

You have full control over what you can buy.

If your company coverage is inadequate, you're free to go out and buy additional insurance, or to opt out of your employer's plan and buy your own individual complete plan.

It's not about insurance competitiveness, it's about how much of the plan cost your employer can afford to pay for you and stay in business.
Workers have not always had company plans.
In the history of insurance, that is a relatively recent development.

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Assume that “the average person” doesn't have funds laying around to purchase “extra insurance”.

Clare73 said:

Are you serious?

You have full control over what you can buy.

If your company coverage is inadequate, you're free to go out and buy additional insurance, or to opt out of your employer's plan and buy your own individual complete plan.

It's not about insurance competitiveness, it's about how much of the plan cost your employer can afford to pay for you and stay in business.
Workers have not always had company plans.
In the history of insurance, that is a relatively recent development.

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Just try to buy an individual plan that is affordable and as good as corporate plans on coverage quality.

If medical insurance had to complete for individuals the way auto insurance does, then quality would go up and cost down.

get insurance out of employers hands.

comana said:

I’m not sure what your post has to do with my post you quoted.

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I was explaining why Medicare is so much easier to navigate. It doesn't have a ceiling on the cost it pays out and, therefore, no need to try to conserve expenses by varying payments and treatments as insurance companies must do to reduce costs so they can stay in business.

Insurance based healthcare coverage is the problem though.

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Inadequate understanding. . .

Government based health coverage will limit options, and not allow any outside coverage which would allow you access to those options.
And at a certain older age, it will begin to limit what tests and treatments you can access.

Clare73 said:

I was explaining why Medicare is so much easier to navigate. It doesn't have a ceiling on the cost it pays out and, therefore, no need to try to conserve expenses by varying payments and treatments as insurance companies must do to reduce costs, so they don't have to go out of business.

Inadequate understanding. . .

Government based health coverage will limit options, and not allow any outside coverage which would allow you access to those options.
And at a certain older age, it will begin to limit what tests and treatments you can access.

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My point a out navigation is the comparison between websites for medical professionals to obtain information about coverage and reimbursement. CMS is outstanding and commercial sites are confusing and difficult to find important information.

you seem to love insurance. Perhaps you have amazing unicorn coverage and good for you.

Clare73 said:

I was explaining why Medicare is so much easier to navigate. It doesn't have a ceiling on the cost it pays out and, therefore, no need to try to conserve expenses by varying payments and treatments as insurance companies must do to reduce costs, so they don't have to go out of business.

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I don't know what you mean by that, because Medicare certainly does have ceilings on their payments. Medicare absolutely never, ever pays the full fee that any of my hospitals and doctors have charged. Normally they pay from 20% to 50%. There is most definitely a ceiling.

Government based health coverage will limit options, and not allow any outside coverage which would allow you access to those options.
And at a certain older age, it will begin to limit what tests and treatments you can access.

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Commercial insurance also limits options, tests, and treatments you can access. Medicare has been a bit better in that regard than Blue Cross/Blue Shield had been for me.

Pommer said:

Assume that “the average person” doesn't have funds laying around to purchase “extra insurance”.

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That's not about your lack of control, that's about your lack of funds.
They can do without something else less important if they want more insurance.
It's up to them to decide how to exercise their freedom within their personal options.

comana said:

Just try to buy an individual plan that is affordable and as good as corporate plans on coverage quality.
If medical insurance had to complete for individuals the way auto insurance does, then quality would go up and cost down.
get insurance out of employers hands.

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You say on the one hand that coverage of corporate plans is good, and on the other hand to get it out of employers' hands.

You are free not to purchase corporate insurance.
In a few companies, it may even be free.

comana said:

My point a out navigation is the comparison between websites for medical professionals to obtain information about coverage and reimbursement. CMS is outstanding and commercial sites are confusing and difficult to find important information.

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And I am explaining the advantage they have which facilitates their being able to be outstanding.

you seem to love insurance. Perhaps you have amazing unicorn coverage and good for you.

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No, I don't have amazing coverage, but you seem to have some misunderstanding of the nature of insurance.

Government websites are easier to navigate because they don't begin to have the variables involved in private insurance.
The variables are what makes them complicated, and those variables probably change on a regular basis as the companies try to maximize their operations.

Private companies have to remain efficient to stay in business, the government does not and, therefore, has no incentive to do so. . .and eventually, due to inefficiency, government "low-cost" services become more expensive that those "high-cost" services of private companies.

RDKirk said:

I don't know what you mean by that, because Medicare certainly does have ceilings on their payments. Medicare absolutely never, ever pays the full fee that any of my hospitals and doctors have charged. Normally they pay from 20% to 50%. There is most definitely a ceiling.

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And those ceilings aren't set in competition with anyone to generate the funds to pay those claims, so they can set their ceilings with no concerns about how they will pay them out. Private insurance is not free to do that, the company has to "earn," in a competitive market, what it pays out, causing all those variations needed to stay competitive.

Commercial insurance also limits options, tests, and treatments you can access. Medicare has been a bit better in that regard than Blue Cross/Blue Shield had been for me.

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Commercial insurance is private insurance. And of course Medicare is better, it doesn't have to competitively generate the funds required to pay the claims.

Clare73 said:

You say on the one hand that coverage of corporate plans is good, and on the other hand to get it out of employers' hands.

You are free not to purchase corporate insurance.
In a few companies, it may even be free.

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My employer provided insurance is part of the calculation of my compensation. Refusing it to buy an expensive plan that covers less on my own would be asinine.

getting it out of corporate hands forces these companies to complete for individual customers instead of sweet deals with companies that employ large numbers of employees (customers) in a package deal.

Clare73 said:

And I am explaining the advantage they have which facilitates their being able to be outstanding.

No, I don't have amazing coverage, but you seem to have some misunderstanding of the nature of insurance.

Government websites are easier to navigate because they don't begin to have the variables involved in private insurance.
The variables are what makes them complicated, and those variables probably change on a regular basis as the companies try to maximize their operations.

Private companies have to remain efficient to stay in business, the government does not and, therefore, has no incentive to do so. . .and eventually, due to inefficiency, government "low-cost" services become more expensive that those "high-cost" services of private companies.

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You don’t get it.

Clare73 said:

And those ceilings aren't set in competition with anyone to generate the funds to pay those claims, so they can set their ceilings with no concerns about how they will pay them out. Private insurance is not free to do that, the company has to "earn," in a competitive market, what it pays out, causing all those variations needed to stay competitive.
Commercial insurance is private insurance. And of course Medicare is better, it doesn't have to competitively generate the funds required to pay the claims.

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Still , you don’t get it.

Clare73 said:

And I am explaining the advantage they have which facilitates their being able to be outstanding.

No, I don't have amazing coverage, but you seem to have some misunderstanding of the nature of insurance.

Government websites are easier to navigate because they don't begin to have the variables involved in private insurance.
The variables are what makes them complicated, and those variables probably change on a regular basis as the companies try to maximize their operations.

Private companies have to remain efficient to stay in business, the government does not and, therefore, has no incentive to do so. . .and eventually, due to inefficiency, government "low-cost" services become more expensive that those "high-cost" services of private companies.

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It seems that you might agree that an extension of Medicare to all may just be the better way to go.

Clare73 said:

And those ceilings aren't set in competition with anyone to generate the funds to pay those claims, so they can set their ceilings with no concerns about how they will pay them out. Private insurance is not free to do that, the company has to "earn," in a competitive market, what it pays out, causing all those variations needed to stay competitive.
Commercial insurance is private insurance. And of course Medicare is better, it doesn't have to competitively generate the funds required to pay the claims.

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But you said that Medicare had no ceilings--which was false.

And you also said that commercial insurance didn't have limits, which was also false.

comana said:

It seems that you might agree that an extension of Medicare to all may just be the better way to go.

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Government operated is never the better way to go to control costs as private companies must do to stay in business.

RDKirk said:

But you said that Medicare had no ceilings--which was false.

And you also said that commercial insurance didn't have limits, which was also false.

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Medicare has no ceiling on what they can pay out. Private insurance cannot pay out more than they take in.

I said commercial insurance is privite insurance.

Clare73 said:

Government operated is never the better way to go to control costs as private companies must do to stay in business.

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private companies are also for profit so they are going to reduce benefits to increase profit.

I have yet to come across a Medicare recipient who would rather have their prior commercial insurance back.

comana said:

private companies are also for profit so they are going to reduce benefits to increase profit.

I have yet to come across a Medicare recipient who would rather have their prior commercial insurance back.

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Depends how long ago they had their prior insurance, as in before pre-existing was required to be covered.

Being required to buy claims in addition to risk, insurance companies will have to reduce coverage to keep it as afforable as possible.

The problem is not the companies, the problem is government regulation which has changed the nature of insurance from "buying" risk to "buying" claims.

Competition keeps them trying to reduce costs to keep premiums competitive.

Clare73 said:

Depends how long ago they had their prior insurance, as in before pre-existing was required to be covered.

Being required to buy claims in addition to risk, insurance companies will have to reduce coverage to keep it as afforable as possible.

Do you understand competition?

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Prior to Medicare my mother has a pre-existing condition that none of her private policies would cover. Once she got on Medicare everything was covered. She saved thousands annually and would never go back given the choice.

I am very well aware of why commercial insurance is expensive and not inclined to pay. Unfortunately, they don’t complete for individuals and have no incentive to to provide better benefits for less because of that.

larger companies and unions have negotiating power and their employees will benefit from that. If you work for a small company or are self employed, policies offered are going to be much more expensive per person with high deductibles and less coverage.

I can only see a benefit to removing healthcare coverage from employer provided benefits and putting in the hands of each individual who can buy a policy that is theirs no matter where they work. They can change employers and no worry about coverage gaps or COBRA and new hire waiting periods. Health Insurance companies would have to complete like auto/home have to complete resulting in lower costs/better benefits to the customers.

Clare73 said:

Depends how long ago they had their prior insurance, as in before pre-existing was required to be covered.

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That statement is in conflict with wit this statement:

The problem is not the companies, the problem is government regulation which has changed the nature of insurance from "buying" risk to "buying" claims.

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