What if the government provided catastrophic insurance for everyone - similar to Fed flood insurance

[Phoebe Loosinhouse]

I never heard anyone complaining when the government took over flood insurance. The insurers didn't really want it it as it's a sure loser for them. I have to imagine they feel the same way people who get seriously sick or injured which is why they try to duck their responsibility all the time.

But if the government did provide an extremely cheap catastrophic insurance for everyone, then there would be no need for things like prior condition exclusions, rescissions and the like because there is no real risk to the insurers. They could cover preventive care, routine care, standard surgeries, etc. but perhaps pass the ball to the government system when outlays go over 100K or whatever figure is arrived at for a single incident or disease.

If you think about it, this is exactly what happened when the government instituted Medicare. They took on the population that is pretty much guaranteed to need more and more expensive healthcare and the healthcare industry was probably happier in the long run that they (the gov) did.

This is looking at the same problem we have been looking at but with a somewhat different perspective. It would definitely be an expansion of government run healthcare, but I think all sides could agree to something like this and it might push us a little further down the road to single payer.

[Oregone]

1. Then they would finally be solving something. But guess what...

...they don't want to.

And it would be better to set the cap at some % of someone's income (that threshold defined as "unaffordable"). Hence, it would be a measure to ensure everyone has "affordable" health care up to some deductible defined by their income/dependents.

If the private market reform that people hope and believe in worked, its would NEVER be used and would cost NOTHING. But we know that isn't the truth of how these things go

[bamacrat]

2. That is actually a pretty good idea when you think about it.

Sounds way more palatable for the conservatives in our ranks. And really that is what has caused the most problems mainly cancer treatment. Then if the government absorbed the outrageous cost of these type of illnesses private insurers could lower premiums a bit since they would no longer have to worry about $500,000 procedures.

[Armchair QB]

3. had one in college, paid $99 a school year and it was great

except a lot of places wouldn't take it so you had to pay out of pocket and then get a reimbursement.
Luckily I only needed it for a broken foot and stitches in my eye.

I think most people wouldn't object to this kind of thing as long as it defined what a catastrophe is, in plain english, so people aren't running to the E-Room for the sniffles.
But it would go a long way in keeping people out of bankruptcy

[boobooday]

4. What about chronic illness that makes some people uninsurable right now?

Not catastrophic, just intense and ongoing high maintenance.

[Oregone]

5. It should all be covered by a high deductible government plan with free, automatic enrollment

And all healthcare costs (premiums/copays/fees) should be counted towards ones deductible.

Then simply play with where to set the deductible for each person/family, and you have yourself "affordable" universal coverage.

[dflprincess]

8. What Washington would consider "affordable"

would probably bear no relation to what the people paying the deductibles would find "affordable".

The idea behind high deductibles is to make people think about what it will cost before going to the doctor (these are euphemistically called "consumer driven" plans and some refer to the out of pocket expense as "coinsurance"). There is increasing evidence that these plans are back firing and costing more because it keeps people from getting "routine maintenance" for chronic conditions or going in when a problem is small. The high deductible plans save money in the short term but long term result in more ER visits, inpatient admissions and longer hospital stays as people put of doctor visits until their condition cannot be ignored.

BTW, the current version of HR3200 has some high out of pockets attached to the public option. Just to make sure we continue to pay more and get less.

[Oregone]

12. You aren't "getting" this because you are thinking of private parallels

"The idea behind high deductibles is to make people think about what it will cost before going to the doctor"

A free plan that exists as a backup to what you already have will not deter you from getting care you would normally get. Rather, it will enable someone to continue to get care once their private provider fails in providing "affordable" insurance. A plan like this would not be meant to be a primary health plan, but rather a secondary health plan that ensures the private market will not leave people destitute or dead. If the current reforms work, a safety net like this will never be used anyway. If they fail, it would save thousands from going bankrupt. This is simply a mechanism that someone can go to after their premiums, fees, and out-of-cost expenses put them into a defined threshold (which would need open public debate).

These plans exist in other countries and they do not prevent people from getting aid. This is a plan I am enrolled with for drugs:
http://www.health.gov.bc.ca/pharmacare/plani/planiindex.html#7

Its where I first saw the idea. Normal Rx plans cost $25 to $50 bucks a month in BC, and nearly everyone has them. But this sits there and ensures that even those insured, if they get something terrible, they won't lose their home. It costs nothing.

[Phoebe Loosinhouse]

6. If it makes someone uninsurable then I would consider it catastrophic.

In fact they could could end all this nonsense right now if President Obama come out and say, if you cannot currently obtain healthcare coverage or if the only coverage you're offered exceeds 10% of your income, then you can enroll in Medicare immediately. Congress can alter Medicare eligibility requirements anytime they want to. We could have had a 10 minute discussion about reform if the real issue was simply covering the uninsured.

The health insurance companies don't want this part of the population, because if they did - they would insure them! Duh!

[boobooday]

9. I like your answer best

NO insurance company wants the insulin dependent, for example.

[Hell Hath No Fury]

7. Does nothing for prevention and early detection ---

which is where any real cost savings comes in in health care.

[Oregone]

13. Incorrect. By setting a cost ceiling for insurers, it drastically lowers premiums of normal insuranc

It changes the entire risk analysis for insurers, and would instantly slash the cost of insurance across the board, making preventative health care more affordable and accessible for all.

[Warren Stupidity]

10. How about the government just provide insurance for everyone for everything?

Why is that so much more difficult than one complicated half-baked measure after another, all of which seem to have as their unstated purpose keeping a 300B/yr rent extraction cartel in business?

[Oregone]

14. Clearly, expanding & improving Medicare would be ideal

But people on this very board would cite that as socialistic treason Id take it.

But what some don't realize, is that a single-payer catastrophic insurance would be real "a step towards single-payer". All you have to do is "incrementally" lower the deductible until you get there. Its an idea that can barely be refuted logically if they ever took this to Congress, and would be a true direct straight path for single-payer.

[SoCalDem]

11. The whole concept of insurance is to provide coverage for things that are not likely to happen

We've paid for fire insurance for 45 years and have never had a fire

We've had car insurance for longer than that, and have never had any major accident

Even life insurance only pays out ONE time..and only if people keep paying for their policies until they die. Many older folks drop their life insurance or cut it way back as they age, since their families are grown and often they are the sole survivor of a marriage, and only carry enough to bury themselves.

Health care "insurance" is different. the minute people get it, they USE it, and as long as EVERYONE is not in the "pool", it only gets more and more cost-prohibitive.

That's why single payer HEALTH CARE, instead of insurance, is what's needed. We KNOW people get sick and NEED helath care, so the grown-up approach is to make sure that EVERYONE pays into the system.

That brings the cost down for everyone, and covers those invincible/immortal young ones who crash cars & party too heartily and end up in the ER, as well as the frail oldsters.

[Oregone]

16. Single-Payer is insurance, FYI

"That's why single payer HEALTH CARE, instead of insurance, is what's needed."

Unless you are referring to the practice of socializing hospitals and medical facilities and putting doctors on government salaries (socializing healthcare).

Other-wise, "Single-payer", as it is often referred to, is all about insurance.

[SoCalDem]

17. I am for making hospitals non-profit, and yes, I'd even think of doctors being "hired"

by the "people/government"... I also think tax dollars should be spent to subsidize the educations of NEW doctors..

If insurers want to stay in the "game" and provide "gap-insurance", that's fine, but the way it is now, stinks..

[truedelphi]

15. As far as covering the cost of this, find the line where the Senators' & Congress critters' health

Coverage is accounted for.

Then add the cost of our health insurance on that line.

Period.

[Phoebe Loosinhouse]

18. I want to thank people for taking my suggestion seriously.