caterpillar10 (66.68)

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#1) On October 24, 2009 at 7:36 PM, caterpillar10 (66.68) wrote:

hosed the 1st 2 links I guess....try again

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/09/23/EDQH19R4ET.DTL

 

http://www.chillicothegazette.com/article/20090925/OPINION02/909250318/Public-options-have-worked

 

 

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#2) On October 24, 2009 at 7:42 PM, caterpillar10 (66.68) wrote:

Universal coverage. A public insurance option. Mandated coverage.
Sound like the language of health care reform? "ObamaCare?" 
Think again.These have long been features of California's dynamic workers' compensation health insurance system, yet few think of that system as "socialist" or a government takeover.
As the debate about health care reform rages, there are lessons to learn from the workers' compensation insurance system - a system that serves workers and employers well.
Across the nation, workplace injury rates continue to fall as employers focus on safety to reduce insurance premiums. Doctors compete to attract workers' compensation patients. Insurers have healthy profits even as they compete against public option insurers in California and 20 other states.
In California, these insurance premiums are at an eight-year low, and a 2009 study released by the California Workers' Compensation Institute found, based on the latest available data, that the average workers' comp claim for actual medical treatment was lower in 2007 than in 2002.
Insurance premium rates are set competitively by the market. Employees injured due to work-related incidents are fully covered for the care they need to recover to optimum health. Medical providers are paid from a fee schedule set by a state agency and by negotiated contracts.
All employers must provide the same level of coverage. They try to lower coverage costs by improving safety records, shopping for better premium rates, and sending employees to more effective doctors and networks.
As we try to reform health care, we need reform that encourages this healthy competition.
When employers and insurers are responsible for "total case costs" - medical care, lost wages and lost ability - they don't scrimp on care.
They want employees to have medical treatment quickly so they can get back to work. Otherwise, the employer will have to pay someone else to do the job, pay lost wages for the injured employee and suffer higher premiums in future years.
The lesson is that readily accessible, appropriate and comprehensive care can be less expensive than care dribbled out over a longer period of time.
Quality need not suffer either.
California has adopted guidelines for doctors to use when treating injured workers, resulting in more consistent, high-quality care, while containing costs.
A public insurance option can work, too.
The California State Compensation Insurance Fund has competed in the marketplace since 1914 and serves as the insurer of last resort. It historically has a market share of 23 percent, alongside a vigorous private insurance market.
Another lesson: The political process works - eventually.
When a system encounters trouble, it can be fixed. California experienced a crisis in the late 1990s as benefits and legal costs soared. Insurers began leaving the market; businesses pleaded for relief. Some closed their doors, prompting comprehensive reforms in 2003 and 2004.
The reforms impacted workers, lawyers, health care providers, insurers and employers - everyone touched by the system. No one got everything they wanted, but the system was saved. Today, with all of California's woes, its workers' compensation system
 isn't one of them.
As the country debates health care reform, let's not overlook the lessons of a sound system of universal coverage that's already here and working well.

Daniel D. Crowley is CEO of U.S. HealthWorks, the largest operator of occupational health clinics in California. The privately held company is based in Valencia (Los Angeles County).

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#3) On October 24, 2009 at 7:45 PM, caterpillar10 (66.68) wrote:

One of the more controversial elements of President Barack Obama's proposals for health care reform is "the public option." In its basic form, this is a government-funded insurance program designed to enable certain citizens to obtain health insurance coverage while helping inject a degree of competition into the entire system. In the insurance industry, there are abundant examples of public options that work well. While my experience is in the property-casualty side of the insurance industry, I cannot see why these examples would not extend to health insurance.

 

Consider personal automobile insurance. Auto insurance is viewed by many to be a social right. Every state where I have done business has a state-sponsored "assigned risk pool" that provides insurance for all but the most dangerous drivers -- usually those whose licenses have been revoked. Premiums are high and based on driving records, but the depth of availability proves it is affordable. Private insurers peacefully coexist with these pools and often issue and service the policies on behalf of the governmental department that runs the program. So, administratively, it works.

 

Consider homeowner's insurance in coastal states. These states' residents and legislators view protection from hurricanes as a social right. Some insurance companies provide "wind coverage," while most rely on state-run Fair Access to Insurance Requirements (FAIR) plans or state-sponsored insurance companies to serve residents who own homes or condominiums in the wind zones. In some cases, insurance companies issue and service policies on behalf of the plans; in other cases, the state-run insurers do the job. In a few cases, the private companies actually compete with the state-run companies. Once again, a "public option" system works.

 

In my home state of California, we have perhaps the best example of a working "public option." Workers' compensation is not only a social right; it is legally required for employers. California's State Compensation Insurance Fund has operated for decades as a backstop insurer of workers' compensation. Over time, the State Fund has expanded to be a very large enterprise and often competes with insurance companies in a state whose workers' compensation market is larger than the next five states and the federal workers comp program combined. Here, corporate insurers coexist with the State Fund in good years and lean; and employers stay or switch insurers based on a variety of factors including service, convenience, financial solidity and price. As employers, agents and brokers participate in the California workers comp market and discuss provider options, the State Fund is mentioned as often and as unremarkably as all the other insurance companies that voluntarily compete in the marketplace. In this example, the "public option" works very well.

 

As the health care debate rages on, there will continue to be the use of catch phrases and slogans, often with a great deal of ignorance. A "public option" is neither new nor revolutionary. It is a reality in a number of insurance markets, in states with very diverse needs. These varied public options serve a useful purpose to both employers and citizens.

 

Roy Little is president and CEO of the Insurance Educational Association. The views expressed are those of the author and do not represent those of the IEA or its members.

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#4) On October 24, 2009 at 10:49 PM, ChrisGraley (99.62) wrote:

I work in the insurance industry and assure you that you are completely nuts.

..... Auto insurance......has a state-sponsored "assigned risk pool" that provides insurance for all but the most dangerous drivers......Premiums are high and based on driving records, but the depth of availability proves it is affordable. Private insurers peacefully coexist with these pools and often issue and service the policies on behalf of the governmental department that runs the program.......

States do this in different ways, but here are a couple of examples. 

1) Take the group of very high risk drivers and break it up into chunks and force each chunk on to an insurance company doing business in your state. The insurance company writes their policy at a huge loss and forces a good driver to pay a lot more.

2) Keep the underwriting risk with the government, but tax all of the other insurance policies in the state enough to pay for them.

Every state that does either of these things has much higher car insurance premiums than the states that don't. Why? because they encourage risky behavior and make safe drivers pay for it. Nothing says government ignorance like making a 65 year old retiree on a fixed income, with a perfect driving record paying 20% more for his insurance to support a reckless 25 year old driver that doesn't learn from his mistakes. If that 25 year old was not able to get car insurance until things started falling off his driving record, then the community at large would be safer, since he would be taking the bus to work. The government is great at screwing up things that they don't understand. I love when I have to explain to someone how in Michigan we can write a motorcycle policy for $75 for a year, but then Michigan adds a $144 MCCA fee to it. 2/3rds of what they are paying every year goes to the government. This percentage is constantly going up and I'm quite sure that pretty soon, 90% will go to the government.

Consider homeowner's insurance in coastal states.........residents and legislators view protection from hurricanes as a social right........most rely on state-run Fair Access to Insurance Requirements (FAIR) plans or state-sponsored insurance companies to serve residents who own homes or condominiums in the wind zones. In some cases, insurance companies issue and service policies on behalf of the plans; in other cases, the state-run insurers do the job. In a few cases, the private companies actually compete with the state-run companies. Once again, a "public option" system works.........complete story: http://www.chillicothegazette.com/article/20090925/OPINIO......

Great plan! Espescially for flood insurance! It works really well. Here's how it goes...

In places like Galvaston Texas or New Orleans. We know that your house is going to be totalled, It's just a matter of when. The government will insure it though because even though it's stupid to build a house on an island barely above sea level, or build an entire city that is below sea level, the government will print enough money to bail you out. They will also print billions in disaster relief. We also have the added plus of global warming. That means more hurricanes and a rising sea level. It's ok though. It's really a win/win situation. You keep that beachfront property and your kids continue to pay for it long after you are gone. Insurance is all about allowing you to build a house in an insane location, over and over again.

I love the "It works in California!" argument best of all for the worker's compensation thing. Nothing works in California. The government handed out IOU's for a reason. I actually lived in southern CA for a short period of time. I loved the weather and could even handle paying higher prices for everything, but after a short period of time, I understood that CA is doomed for failure. It's almost impossible to do business in CA due to all of the over-regulation. If you want to make a product, you better have a huge margin that you can fall back on. On the other hand, it is very attractive to put a company just across the state line and import your product to the biggest government propped service based economy in the country. California, is the USA personified and it will fall first and fall hard. Productivity can never keep up with the outflow of money from the state. I know that was straying from the subject of worker's compensation insurance, so I'll try to get back on topic. Worker's compensation is one of the easier defined risks for an insurance company. You pretty much know how many claims of a certain type that you will have in a policy term. Your only real concern is fraud and you have to devote a lot of collected premium to prevent it. Fortunately CA has made worker's comp very expensive in their state and they don't have a lot of risky businesses. Most businesses are service based with very predictable risks. It's very easy to cherry pick the companies with the best risk and leave the rest for the government. They suffer the loss and raise their rates accordingly. They do pass some of that loss on to you as an insurance company, but given that you have a much better loss ratio than the state, and you are rewarded with higher premiums the next year, it is worth it. You are also ahead of the game by detecting fraud better than the government does.

Ok, last thing I want to post here...

If the government really wanted to help you with health care, they would focus on controlling costs, instead of controlling price.

I'll give you an example.

In the state of Pennsylvania, they wanted to lower the premiums for car insurance. Instead of following some of the more liberal states, they focused on just one of the reasons that car insurance was so high. Lawsuits! So they came up with the idea of full and limited tort. Reguardless of which tort option that you choose, you still have the right to sue the other driver for anything that is easy to put a dollar amount on. (Medical bills, lost wages, essential services, etc..) When you choose the limited tort option though, it limits your right to sue someone for those things that you can't easily put a dollar figure on. (Things like mental anguish, pain and suffering, etc..) Now if the accident is a serious one in nature, (such as there is a loss of limb or a loss of life) you can still sue for those things even if you have the limited tort option. They have effectively eliminated the fraudulant whiplash lawsuits for millions of dollars. Nobody is going to go through the trouble to fake a claim that they can't profit on. There is still fraud in PA, but a lot less of it since the law was passed and as a result, they reduced their insurance rates by about 17%.

Want to do this same thing in health care?

1) Eliminate malpractice insurance completely and create a victim compensation fund that all doctors pay into. Make negligence a criminal offense punishable by jail time and loss of medical license. Compensate victims based on actual losses and eliminate

2) Change drug and medical equipment patent laws to eliminate a monopoly. Basically reward the inventor a 20% royalty from profits of anyone else that manufactures his invention. This will eliminate overcharging the consumer, simply because you are the only maker in town. Yes, you will lose some innovation when you set a ceiling on profit, but a 20% royalty is still pretty inticing.

3) Require a "take all comers" policy from health insurance companies as far as pre existing conditions, but allow them to modify premiums based on controllable risk factors. They can't charge you more for being a diabetic, but they can charge you more for being 400 lbs than for being 200 lbs.

I have a lot more, but let's just look at those 3 things.

1) We still keep doctors accountable, but they worry now more about jail time than spending 50% of their revenue on malpractice insurance.

2) We eliminated a monopoly in the drug market.

3) We made the consumer in more control of their health care premium.

We didn't really spend anything and we didn't destroy competition or consumer choice. We made just about everybody more accountable.

Our politicians know that these options are on the table, but do you think they are making decisicions for the good of the country or to line their pockets while collecting votes?

 

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#5) On October 25, 2009 at 2:02 AM, caterpillar10 (66.68) wrote:

Oh, i'm definitely nuts. I also understand what gets papered over w/public plans. Basically, aggregating overview of material here as testing new news site http://www.SCIF.net  - not xpecting actual assistance - ecpecially Sat. nite but I know how that goes cuz here I am:) ....

I starting pounding the thing 2 nites ago to try and lock it up - crash it, whatever, but am laying off now while my counter part does his thing.

Looks like you did a fine job of lighting me up and I appreciate it. Once I've watched SNL and gotten some sleep I will read it more closely, go back to the SCIF Net Forum and argue w/myself thru another account. Rite now I will do an intervention on me: "Self, you know what you need2do":

http://www.youtube.com/watch?v=fRdLpem-AAs 

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