Comment to Aunt Yvonne

So, I've been trying for the past day to post this as a comment, but it's not letting me. So here it is as a post:

Of course it's okay if you comment! I really like hearing others' opinions, and it's really nice to know people actually read my blog.

Also, it costs $4 if you buy the non-brand name acetaminophen, which is exactly the same.

When I was under BYU student health insurance, which is the closest thing I know to a"co-op" model, because it adapts coverage to the needs of the majority of its members (pretty much zero coverage for prescription drugs, but great maternity coverage) - anyway, when I had this plan, I WAS allowed to choose where to get my blood work done. My CNM (I went to a certified nurse midwife because there were no female OB/GYNs who were taking patients at the time, and that was important to me) advised me not to have the work done in her office, but to go to the BYU student health center where it would be much cheaper. I'm glad that I had that choice.

I think the system would be much more fair if we had choices about where to get labwork done. Labs would be forced to compete, which would lower the price. Right now, because prices are totally opaque to the consumer, there is no free market. This is a problem. Thank goodness I had a really nice CNM who didn't want to take advantage of my situation.

I totally sympathize with you about your blood work mess; I had the same situation last year with a pap smear. The BYU health center doesn't do those, so I had to have it done at my CNM's office. And so I was charged for a regular pap smear, which is not covered on the student plan, but "maternity" paps are. So it was also a huge mess, and I also wondered at how somebody without insurance would ever be able to pay for such a service.

I think the price is jacked up because it is assumed that most people will not pay, because they don't. Because they can't. Which is why a simple phone call to the hospital billing office from an uninsured person will often cut the bill by 20-50%; I suppose the hospital is willing to take less money because they are suddenly assured to get SOME money at all.

I agree that this is completely messed up. I can't imagine the grief non-English speaking Americans must go through to negotiate through a system that Danny and I, two college grads, can barely understand, if at all.

Disregarding what mandatory health insurance does in Massachusetts, where many who pay the premiums can't afford to use their health care ANYWAY, I can agree with you that the bill will probably help many to be better off than they currently are.

The fact that each state is to run a government monitored health insurance exchange is less grim than an outright federal health care takeover. At least then there will be 50 chances for it to be done in a way that might work, and doesn't destroy the free market.

I'm not a worshipper of the free market, either. I just think it would work better than having the government run things. I don't really know what form the "insurance exchanges" will take; I do think that if the government gets in the business of running its own insurance company, it will end up being a lose-lose situation for most taxpayers, and here's why I think that:

The government has an unfair advantage because it gets to make laws. What if the government suddenly decides to make it a law that your health insurance must contain certain things that only the government can provide? It can swiftly become a monopoly, just from declaring itself as such.

If by some miracle, the government does not take advantage of its status as "government", it still is funded by all of the taxpayers. We are like shareholders in a company, which gives us an interest in seeing that it succeeds. If it does succeed, but I do not qualify to have its coverage, or a choose a private alternative, than I end up paying for somebody else's health care as WELL as my own. If it does NOT succeed, it's like I just gave my money to somebody who threw it in the trash.

Personally, I wouldn't mind paying a small tax if I knew for sure it would help a poor person to have better health. It's sad, but I don't trust that the government will do that.

But maybe you're right, and time will fix the problems, and Americans will be much better off in the long run.

Also, if there could be a common definition of "health care", I might readily agree that it is a need, or a responsibility. But some people think "health care" is like those cadillac plans that will now be severely taxed, and others think it is going to the ER.

I think that a co-op system in a free market would make health care much more available to the public than having a government plan. But I agree with you, health insurance needs to be more affordable and available, because right now it doesn't work.


  1. In General, I agree with you Kate. I'm in favor of Health care co-ops, which in a sense, might function much like Credit Unions do, but I must say there would be some quid pro quo in order for those to work.
    In the 1970's and 1980's schools and doctor associations capped the number of physicians that could graduate in any given year-- these numbers haven't changed-- bad move, America. Today we have an appalling shortage of primary care physicians-- also in part due to the lack of an industry accountability measure-- instead we have malpractice insurance.

    In addition to that, at the same time there was legislation made (oh, Reagan--how we rue some of your decisions) to help create effective HMOs and the like. Insurance companies are still protected by these laws-- these laws and the lack of price transparency are part of what contribute to the lack of a free market-- in order for us to have a free market we may have to repeal some of these-- or possibly address them some other way.

    Finally-- health insurance companies pay some REALLY big bills. And localized companies tend not to whether disasters very well-- if there were an outbreak of some disease in an area it might wipe out a small health co-op, or even something like a severe snowstorm that causes a lot of injuries... or some other synchronocity of health troubles. So there are a few ways around this...
    1) make co-ops not city-wide or county wide but instead have them cover large areas, like all of CA, NV, and AZ-- and have more than one in that area. Larger co-ops will whether regional adversity better.
    2) Secondly-- the way BYU does it... not to say that BYU isn't efficient, I'll bet they're better than many health providers around in that regard (or at least, I would hope). But BYU in general is subsidized by the LDS church-- surprised? It's true-- not that it wouldn't ever function without such a subsidizing, but it has that as a support in times of crisis, if it needs it.

    I still think health co-ops are a good idea, but I also think we need to look carefully at how to introduce them, regulate them, and how to regulate traditional insurance companies so they'll survive.

  2. I'm totally aware that BYU is subsidized in a major way by tithe payers, so you're right, it's not the best model.

    I worry about government involvement in the "insurance exchanges", but what is good about them is that there will be 50, so there's a greater likelihood that SOME state will figure out how to regulate a system that does not also make people dependent on the government and eliminate a free market for health insurance. Mostly, I think people don't know what that means.

    I agree, the co-ops will need to be big. You're right, too, insurance companies do pay huge bills. What I was thinking was if there were a health insurance co-op for categories like: "married stay at home mom" or "single male student." They wouldn't have to be restricted to just the state, but that way all people who are planning on having a baby soon, or who are nearing or already have prostate issues, or who sometimes binge drink - or whatever - people who have similar health issues can group together to get similar types of coverage. For the examples I just cited, the law about gender discrimination would have to be changed. Right now, health insurance companies must cover all of their members for every condition they cover; so that means I pay for prostate cancer coverage, and Danny pays for maternity coverage. I think that's very odd because a person can only have one gender. Even people who are trans-gender can't be multi-gendered (and from an LDS/general Christian perspective, they can't even "trans" their gender). Probably that law is necessary now because of the way we group people into health insurances, but we could group people in a different way and thereby save money.

    Maybe if people can't form co-ops based on conditions, they could form co-ops based on geographic location, or the specific industry you work for ("Firefighter Co-op" or "Ballerina Co-op" or "Computer Scientist Co-op"), or something else.

    What do you think about indemnity insurance?

    I'm all for repealing whatever laws conceal the prices from the consumer. I just think it's nuts that I don't know how much my bill will be until MONTHS after I am treated. Like, seriously, 9 months.

    Interesting stuff.

  3. Let me further explain my idea of co-ops by health condition: a pregnant woman could team up with lots of other pregnant women to get a health insurance that covers her needs, but not the things she is not likely to have issues with. For example, smoking complications. Usually pregnant women don't smoke. Or conditions that effect older women, since usually pregnant women can't be very old. Or maybe pregnancy is a tough example since it's so temporary; what if people who had a certain type of mental illness teamed together to get coverage? Like if parents of kids with eating disorders could team together so that the eating disorder were a covered expense, that would be so awesome. I'm not totally sure of this, but I think that currently most insurances don't cover eating disorders whatsoever. I think my point is that usually if a person has a certain specific condition, that means it's much less likely for them to have certain other specific conditions.

    But I don't know...maybe doing it this way would amount to racism and discrimination based on something you can't decide at all; certain races have genotypes that are more prone to have certain diseases, and so should a person be "punished" for their race? Maybe it wouldn't work this way, and so it would have to be done by geographic area, which is what these "insurance exchanges" may end up being. Maybe.


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