Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger • Hacker News Board

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#261

Post by lutorm » Wed, Aug 17, 2016, 9:32 PM UTC

Randgalt wrote: post #29

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

The purpose of government is not to require the most efficient option. Government isn't capable of it anyway. Government is force - nothing more. The purpose of government is to protect our rights. "Single payer" (a euphemism for socialized medicine) by definition violates rights by forcing people to do things against their will. For example, in Canada (until recently) people were prohibited from using private health…

Government is force - nothing more.

People state this as if it's some obvious truth, and it makes no sense to me. My statement would be:

Government is a mechanism which we, as a group, have decided should handle certain functions of society.

It's the logical extension of a group of people in the jungle deciding "you know what, it would be awesome if we got together and built a trail between all our huts so we can visit each other."

Part of that agreement might be "hey, when these barbarians show up we should all protect each other", but to arbitrarily say that the only purpose of government is those kinds of agreements I think speaks to a very warped sense of community.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#262

Post by jcbeard » Wed, Aug 17, 2016, 9:32 PM UTC

eridius wrote: post #34

VonGuard wrote: post #9

Earlier quoted context omitted.

There is no benefit. The benefit is for the legislatures who passed the law. There was no way that we'd get single payer here in the US because our Congress is very much in the pocket of the health care industry. As such, the markets were a compromise measure enacted by congress to make it easier for people to choose health care. Before Obamacare, it was sort of a black box where only HR people could figure out prici…

There's no way that we'd get single payer here because the Republican party has convinced their base that single-payer health care is socialism and that socialism is evil, which leads to the situation where poor people who desperately need health care and can't afford it still oppose single-payer even though they stand to gain the most from it.

>which leads to the situation where poor people who desperately >need health care and can't afford it still oppose single-payer >even though they stand to gain the most from it.

I'd think education is the way around this. Start off with a "whats the worst case that could happen" then move to "whats the best that could happen." To me, you can convince people as long as you explain that their not going over a cliff. To me, this argument was never made. All I heard on the news was "it's socialism" or "it's good" but no selling the public on why it was in fact good. In this case, our leaders who were the proponents of single payer failed us. Single payer will happen, it'll just take a bit longer. The commercial healthcare industry is on a path to failure....there is no fixing it for the US. Eventually we'll end up with a system, that likely looks like what Germany/UK have (some mix of public/private).

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#263

Post by gnaritas » Wed, Aug 17, 2016, 9:36 PM UTC

X86BSD wrote: post #199

Randgalt wrote: post #152

Earlier quoted context omitted.

So, if the majority votes to take away the rights of, oh I don't know, Japanese citizens -- that's a world you want to live in? You're not thinking clearly about the issue.

This is not uncommon for those like the above poster that think the constitution is a "living document".

That isn't a matter of "thought", it's a matter of fact. The constitution defines itself as a living document through its amendment procedures.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#264

Post by DanBC » Wed, Aug 17, 2016, 9:38 PM UTC

Randgalt wrote: post #82

loteck wrote: post #75

Earlier quoted context omitted.

For example, in Canada (until recently) Until recently. This means that all people can obtain health care regardless of their ability to pay, and that the system is flexible enough to continue to experiment with the ideal implementation. Are public schools better than private schools? Public schools are exactly 100% better than private schools for students who can't afford to attend private schools. Is the US postal…

1. Try getting an MRI in Canada. Canada rations care via wait lists. 2. Your argument implies that there wouldn't be low cost schools in the absence of public schools. The evidence is overwhelming that the opposite is true. 3. I live in Panama. When I need something mailed here I use FedEx or DHL. The USPS is unreliable and takes far too long. If there weren't laws against private first class mail in the US they'd be…

> Try getting an MRI in Canada. Canada rations care via wait lists.

Over-testing and over-diagnosing are seriously harmful things that eg the US does far too much of.

http://www.cancerresearchuk.org/about-us/cancer-news/press-r...

http://www.nytimes.com/2012/11/22/opinion/cancer-survivor-or...

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#265

Post by nradov » Wed, Aug 17, 2016, 9:41 PM UTC

mhurron wrote: post #16

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance For the citizen, none. For the insurance companies, they get forced signups. > Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste? The US spends the most of any nation on he…

The increasing infant and maternal mortality rates are caused more by increasing obesity than any other factor. Improving prenatal care would help a little but doesn't get to the root cause of the problem.

http://www.vox.com/2016/8/8/12001348/more-women-dying-childb...

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#266

Post by Broken_Hippo » Wed, Aug 17, 2016, 9:41 PM UTC

jasonlotito wrote: post #39

mhurron wrote: post #16

Earlier quoted context omitted.

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance For the citizen, none. For the insurance companies, they get forced signups. > Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste? The US spends the most of any nation on he…

> For the citizen, none. Actually, that's false. I can assure you that having lived in Canada and having moved to the US because of health care, having options beyond "deal with it" when not getting any sort of care or service is wonderful. Single-payer is great if you are actually getting the care you need. But when it fails, you are left with little to no alternative. What's worse is that because of the perception…

I read the other comments to this comment, and I'll agree that you must either have money or decent health care coverage, probably a combination of the two.

I read differing stories about the Canadian health care system: Some places it works out better than others, no system is perfect. I'm American, I live in Norway. The system isn't perfect here either, but I never want to go back. Here it is mostly single payer, with some blips, but folks can choose a private doctor if they'd like to and can pay for the difference in cost.

Not having money/health care coverage in the states means things like suddenly having to change your children's doctor because they no longer accept the governemnt health care. Not being able to get surgery for cancer or your bum knee because you can't pay upfront. Considering bankruptcy because you had a heart attack and surgery for it. The hospital 'nicely' dropped the payment to 200k, but you were a flooring installer making less than 25k a year - which you are advised by the doctor that you can no longer do. Paying out of pockets for medications might be an issue, especially if your loved one's anti-psychotic costs 2,000 a month or the injection you take for your MS costs between 2,500 and 5,000 per month.

The market is great if you can pay to get the care you need, but when that fails, you are left with little to no alternative.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#267

Post by mathattack » Wed, Aug 17, 2016, 9:43 PM UTC

st3v3r wrote: post #240

mathattack wrote: post #212

Earlier quoted context omitted.

I'm not well enough informed to give a complete opinion on what's better, because it's a complicated solution. I do know some reasons why a public option might not be good. (This doesn't mean it's the wrong option - just considerations) 1 - When you eliminate competition, you lose innovation and smart cost control. Look at most monopolies for evidence of this. 2 - You wind up forcing a "one size fits all" on everyone…

1 is disproven when you look at other countries with single payer, and they have a much better handle on their healthcare costs than we do. 3 - about the same amount as the private sector.

On #1 there is a lot of data that suggests single payer can be cheaper. On innovation, other countries lag.

I disagree on #3, at least in the US.

Would we rather have Health Care run like UPS or the Postal Service?

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#268

Post by philjohn » Wed, Aug 17, 2016, 9:45 PM UTC

20yrs_no_equity wrote: post #241

Spooky23 wrote: post #160

Earlier quoted context omitted.

Remember that the existence of private players doesn't mean that you have a free market, which tends to drive efficiencies. In the US, it's more of a planned/command economy. A retail consumer gets the worst price. (Think the "rack rate that you never pay that's in the back of a hotel door) The government through Medicare/Medicaid/Tricare gets the best price. Everyone else is in the middle, on a spectrum of discount…

> you end up controlling costs by compelling the providers This is the basic premise of socialism. But it never works out. What you end up getting is either very low quality at high prices or very low availability. Obamacare attempts to do exactly that, and as a result the providers are simply leaving the "market". Meanwhile, price has skyrocketed, and quality of coverage has dropped dramatically. My marketplace plan…

Except that's not the case in other single payer systems ...

The NHS has its flaws (having to wait for non-urgent or non life-threatening issues to be treated, but they are in fact treated, just at a lower priority) but if you present at the hospital with chest pains you'll be sorted out straight away, without having to pay up front - free at the source of treatment, one of the founding tenets of the service.

It also doesn't preclude a private system that works alongside it, which many companies offer to their employees. This allows you to get seen quicker for the non-urgent stuff - if it's life threatening you'll be taken straight to an NHS hospital, but have your follow up care privately.

We pay less of our GDP on healthcare, yet have comparable, if not better, outcomes.

With the current "privatisation" that's occurring, vendors are invited to bid for the work, no compelling, it's there if they want it. If nobody comes forward to provide it, the NHS will do it instead.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#269

Post by SteveLAnderson » Wed, Aug 17, 2016, 9:51 PM UTC

im_down_w_otp wrote: post #120

eridius wrote: post #34

Earlier quoted context omitted.

There's no way that we'd get single payer here because the Republican party has convinced their base that single-payer health care is socialism and that socialism is evil, which leads to the situation where poor people who desperately need health care and can't afford it still oppose single-payer even though they stand to gain the most from it.

It wasn't Republicans that removed the "Public Option" or the Drug re-importation initiatives from the ACA. FWIW.

Well ... you're strictly right, but just like the idiotic provision that forced Congress to give up their employer sponsored insurance and use the exchange instead was forced by the GOP, so to were these provisions dropped due to GOP pressure.

You see, the GOP continually promised, on one hand, to tie the ACA up in legislative hurdles so it couldn't pass, or, on the other hand, vote for it if it met their requirements.

So, foolishly it turned out, the Democrats played ball with the GOP. In the end, the GOP still did everything they could to block it and voted against it en masse.

I think the error was that the Democrats believed the GOP would vote for the bill if they changed it enough. It was naive.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#270

Post by SteveLAnderson » Wed, Aug 17, 2016, 9:57 PM UTC

zeveb wrote: post #201

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Government provision of health insurance means that every procedure covered is a political issue (e.g. abortion for the left, sexual-orientation counselling for the right). This means that there will be nationwide winners and loser…

"American governments are not capable of running efficient programs" - that's simply false, and your statement about government employees is insulting.