On Sat, 8 Nov 2003, Harry Pollard <[EMAIL PROTECTED]> wrote: [I had written:]
>>Is that perhaps because they can cherry pick their clientele >>among those who qualify? How would they fare if they weren't >>allowed to reject any applicant due to preexisting conditions, or >>charge them impossibly high premiums? Say if the only allowable >>cause for a targeted premium rate hike was willful indulgence in >>high risk activity like smoking? Don't you think under those >>circumstances they would either close up shop or degrade their >>service to levels much worse than public systems? What are the >>numbers like for these issues? And then of course there's the >>"auto-selection" >>provided by the private premium system: only those who can afford >>the premiums enroll, so the client base is pre-sorted for more >>affluent people who will generally be in better health, having >>had better nutrition and better self-image (I'm sure you've seen >>the stats correlating health with _relative_ income), and had >>more prompt attention to any health issues they may have >>confronted. >>A real health care system must look after the whole population, >>not just the upper sixty percent who can manage the premiums. > >Pete, > >None of it is true. There are plenty of minorities at Panorama >City - my local Kaiser. When Gwen was transferred to Los Angeles >Kaiser, it seemed to me that most of the patients were >minorities. As you can see above, I said nothing at all about minorities. Unless you are counting the chronically unhealthy or disabled as a minority, which I suppose they are, but not one that could be identified by sight... >A lot of unions are members of Kaiser and the service accepts >them all, as far as I know. They pay a lot less than I do (as a >private subscriber) for everything. But, you fail to address the central question: are those with preexisting health problems denied coverage, or charged higher rates than the applicants who are determined healthy at the time of enrollment? >Now for some brutal truth about health care. There has to be >rationing of treatment. Otherwise, every health service would >collapse. In Canada, people get insurance policies to pay for a >trip across the border for procedures the Canadian Health Service >cannot afford. As it is, I understand that they run out of money >toward the end of the year. > >They ration, without doubt, as does the British system. Otherwise >the substance of the service would be drained by terribly ill >patients. There comes a time when no more should be done. > >It boils down, sooner or later, to whether to spend $100,000 >dollars trying to keep an old person alive - or to spend the >money on 20 young people to make the rest of their lives >fruitful. > >All health services have to ration. That's the brutal truth. You are talking about "heroic measures". That pertains to those within the system whose prognosis is limited, generally the elderly, or the incurable and imminently terminal. That is a different issue to young people with a full life expectancy who have either inherited or acquired chronic health problems which are manageable but with inevitable costs. [...snip description of personal experience of medical services...] > >By carefully calculating costs, Kaiser manages to provide >first-class service at reasonable premiums. Not as good as >Congress gets, I'm sure, but plenty good enough for the person >with a modest income. > >It's run by doctors and they try to run a good hospital service. >I think they succeed. > >To give you an idea of cost, a single person in his middle 50s >will pay $266 a month as a private subscriber. If you are >enrolled as a member of a union or suchlike, you will pay much >less. > >However, Pete, your post positively exudes dislike of a private >system. I would suspect that you would be against it even if it >were the best system around - purely because it is private. I asked some very simple questions. You failed to answer them. I simply suggest that the performance of this private insurer is due to the freedom it enjoys under the unregulated system to not be responsible to those potential clients who would cost it big money. The way it usually works in these systems is you can only enroll in the plan if you pass the physical and demonstrate that you are healthy. As you are not born into the system, and have no rights as a non-client, if you have preexisting conditions which mean that you are going to be a higher than average demand for medical services, the company will either accept you at a much higher premium rate, or reject you entirely. After all, they are under no obligation to provide you with medical care, rather they are under obligation to make money for their share holders. If there were a requirement to look after every person in the society, even those who health care needs would mean a permanent net loss for the company, their service would look a whole lot less impressive. >Before the Kaiser, in Ontario, I used the private PSI >(Physicians, Surgeons, Inc) for doctor service and Blue Cross for >hospital service. It was excellent and we even received doctor >visits to our home. > >It wasn't expensive, but was very good. I suppose it has >disappeared into the Canadian Health Service, > >But you wouldn't have liked PSI. Long before public health care, I grew up in a family which was covered by the Medical Services Assn of BC (I may have the name wrong, it's been several decades), a sort of co-op medical plan developed mainly by the forest sector unions in BC. When public medicare came into being in BC, it was pretty much modelled on the MSA. There was not alot of difference between them except that the public system enjoyed economies of scale, but also undertook responsibility for the entire population including the "high use" individuals, so the net cost to us looked about the same, but many others at the bottom of society or with serious health issues benefited greatly. -Pete _______________________________________________ Futurework mailing list [EMAIL PROTECTED] http://scribe.uwaterloo.ca/mailman/listinfo/futurework
