Journal Roblimo's Journal: If Air Travel Worked Like Health Care 55
A sadly amusing article from National Journal that begins, "Hello! Thank you for calling Air Health Care, the airline that works like the health care system. My name is Cynthia. How can I give you travel care today?"
As one who has had a number of similar experiences with our health care non-system, I can tell you that there is way too much underlying truth to this parody. I am profoundly unhappy with the health care bills recently passed by Congress, but one thing is clear: our current health care system is broken and needs to be rebuilt from the ground up. And no, I do not believe parroting the "free market will save us" line will solve anything. Free market health care, in its current incarnation, is a major FAIL.
Article also appears at Roblimo.com
free market (Score:2)
I do not believe parroting the "free market will save us" line will solve anything.
I agree. Saying those words does nothing.
However, actually freeing the market will solve most of the problems we have.
Free market health care, in its current incarnation, is a major FAIL.
Since there IS NO free market health care, it's an odd phrase you turn there. There's less than a dozen private health insurers in my state, due mostly to government regulation. I can't buy insurance across state lines or form small groups to buy insurance, due to government regulation. High drug prices are largely the result of government regulation. And so on, and so on. Don't even g
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There's less than a dozen private health insurers in my state
Your domain [pudge.net] is registered in Washington state, which is a state with around 6.5 million residents [wikipedia.org]. If you have 10 companies selling insurance, that would be one per every 650,000 potential customers. That doesn't sound that bad to me. Your state has less than 7 cities with over 100,000 residents and only 6 state universities.
due mostly to government regulation
Can you point out some government regulations that are restricting new companies from selling insurance?
I can't buy insurance across state lines or form small groups to buy insurance, due to government regulation
I would like to know what government regulation prevents you from buying in
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If you have 10 companies selling insurance, that would be one per every 650,000 potential customers. That doesn't sound that bad to me.
First, I don't care what sounds bad to you. Second, it's not whether the number is adequate, but whether forcibly keeping it small is the government's right or responsibility, and whether it limits the options of businesses and individuals.
Can you point out some government regulations that are restricting new companies from selling insurance?
Yes.
I would like to know what government regulation prevents you from buying insurance across state lines.
Good. Wanting to know is the first step to knowing.
I also would like to know why health care providers should need to be willing to accept every insurance policy in existence from all over the country.
I never implied they should. There is no reason any health care provider even need know about anyone's insurance, in fact, but that's another discussion.
Can you point to a reference for that statement?
I can.
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Can you point out some government regulations that are restricting new companies from selling insurance?
Yes
Strange, I don't see any references. Perhaps you forgot to include a link? Or maybe my browser just doesn't understand it? Or did you include it later?
Can you point out some government regulations that are restricting new companies from selling insurance?
Yes
And they are where? I would truly like to see them.
Can you point to a reference for that statement?
I can.
Please provide that reference.
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Strange, I don't see any references.
No one asked for any.
Please provide that reference.
No, as I don't wish to take the time, but I will note that you can do your own research by looking into the adverse effects of certain patent laws on the cost of drugs, such as the laws allowing arbitrary lengthening of patents. Further, it is well-known that the FDA significantly -- and in many cases, for absolutely no good reason -- adds to the cost of drug development significantly (it's one thing to require showing that a drug does no significant harm, but the FDA requires many oth
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Strange, I don't see any references.
No one asked for any.
Pudge, please provide a reference to support your earlier statement of laws prohibiting insurance companies from selling across state lines.
Please provide that reference.
No, as I don't wish to take the time, but I will note that you can do your own research by looking into the adverse effects of certain patent laws on the cost of drugs
Okay, if you do not want to provide a reference to your statement about legal factors driving costs of drugs, I will leave it as an aside. I was hoping that in this new year we could at least try to have a civil conversation between us, where we openly discuss facts and provide references to back up our assertions.
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Pudge, please provide a reference to support your earlier statement of laws prohibiting insurance companies from selling across state lines.
Google not work for you? Here's one paper that gives all the answers you would need, [georgetown.edu] from the first page of my Google search. Maybe you're using Bing?
Okay, if you do not want to provide a reference to your statement about legal factors driving costs of drugs, I will leave it as an aside.
I gave you more than enough information to look up any details for yourself.
I was hoping that in this new year we could at least try to have a civil conversation between us, where we openly discuss facts and provide references to back up our assertions.
I do not recognize this mythical "new year" you speak of. I do not see an arbitrary passing of time to be notable in any meaningful way. And if you demand me do your homework for you, when more than enough information was given to you, then you're not being very civil. As usual.
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Pudge, please provide a reference to support your earlier statement of laws prohibiting insurance companies from selling across state lines.
Google not work for you? Here's one paper that gives all the answers you would need, from the first page of my Google search.
Thank you for providing a reference for your statement.
Reading the paper I see a line that reads
Health insurers have traditionally been allowed to sell a policy only within the state that approved and regulates that particular policy.
So it sounds like the problem currently resides in states rights; as in states have the right to say which policies (amongst those proposed by insurance companies) meet the criteria that they feel is important or relevant to their state.
So then, if state A needs to accept the policy approved by state B, wouldn't that be impinging upon the rights of state A?
Okay, if you do not want to provide a reference to your statement about legal factors driving costs of drugs, I will leave it as an aside.
I gave you more than enough information to look up any details for yourself.
I would like to have a common starting point for t
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if state A needs to accept the policy approved by state B, wouldn't that be impinging upon the rights of state A?
Less so than it is impinging on the rights of the citizens to purchase goods and services of their choosing. Pursuit of happiness, and all that.
I would like to have a common starting point for the discussion. I would like you to provide some piece of information that you accept as fact, so that we can discuss that piece of information.
Shrug.
I don't recall demanding anything of you. I asked you ...
Try a dictionary. You just said you don't recall doing what you then say you did.
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if state A needs to accept the policy approved by state B, wouldn't that be impinging upon the rights of state A?
Less so than it is impinging on the rights of the citizens to purchase goods and services of their choosing. Pursuit of happiness, and all that.
That doesn't seem to match the source you provided. The source stated that states certify which policies can be sold in their states, though never stated that people could not go to other states and purchase them anyways. Just because the policy isn't certified or accepted in the state where you choose to live does not necessarily imply that you cannot purchase it at all, does it?
I would like to have a common starting point for the discussion. I would like you to provide some piece of information that you accept as fact, so that we can discuss that piece of information.
Shrug
From my perspective, finding some sort of common ground seems like a reasonable starting point for a conversation if we don't
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Just because the policy isn't certified or accepted in the state where you choose to live does not necessarily imply that you cannot purchase it at all, does it?
It means you cannot use it in your home state, yes.
From my perspective
Shrug.
OK, I will use a dictionary.
Try using it better.
Merriam-Webster uses the following definition
... among others.
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Just because the policy isn't certified or accepted in the state where you choose to live does not necessarily imply that you cannot purchase it at all, does it?
It means you cannot use it in your home state, yes.
While your statement may be correct, it did not answer the question I asked. I asked if the ability to purchase a policy was directly prohibited. The source you provided did not state that a person in one state cannot purchase a policy from another state, which is what you had originally be championing for earlier. You were earlier stating that you want to see people made able to purchase policies from across state lines, and yet I do not see any mechanism that currently prohibits such transactions.
It
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While your statement may be correct, it did not answer the question I asked.
And the question you asked was unrelated to the point I was making, your vain protestations notwithstanding.
I provided the first definition
Thank you for recognizing your error.
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While your statement may be correct, it did not answer the question I asked.
And the question you asked was unrelated to the point I was making, your vain protestations notwithstanding.
Your statement that I was specifically responding to, from your comment to this journal entry [slashdot.org] was:
I can't buy insurance across state lines or form small groups to buy insurance, due to government regulation
Which is what I asked you to provide a reference for. The paper you offered, however, does not support your claim of you being unable to buy insurance across state lines, it only supports an inability to use insurance across state lines. I would think we should be able to agree that the words buy and use are not the same.
I provided the first definition
Thank you for recognizing your error.
Perhaps just as your definition of demand is different than that which some people oth
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Your statement that I was specifically responding to ...
... was not merely about the simple act of purchasing. Obviously. Perhaps you should do some research into the concept of "context" and how it provides the framework for human communication.
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Your statement that I was specifically responding to ...
... was not merely about the simple act of purchasing.
Your statement addressed only purchasing. We should be able to agree on that. You statement, as written regarding insurance policies from other states, did not explicitly state anything beyond the purchasing of policies. You said nothing about actually using policies.
Your opinion of your own statement is not important to the question that I posed to you earlier. You stated that you cannot buy insurance from across state lines, which is a statement that you have not been able to support with factual i
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Your statement addressed only purchasing.
False.
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Your statement addressed only purchasing.
False
I would very much appreciate you giving some support to this most recent statement of yours. Your earlier statement that I quoted was concerned only with the purchasing of insurance, and said nothing of its application. If you want to say something in addition to what you said before, then say it, but please don't claim to have said something that you did not previously say.
Also, could you please tell us where you would want responsibility to lie, if the current rights of the individual states to appro
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Your earlier statement that I quoted was concerned only with the purchasing of insurance
As you have declined to look into this concept -- foreign to you, apparently -- of "context," I see no reason in continuing this discussion.
And please, drop the facade that you are interested in civil discussion. It's unbecoming.
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Your earlier statement that I quoted was concerned only with the purchasing of insurance
As you have declined to look into this concept -- foreign to you, apparently -- of "context,"
If you could show how your earlier statement somehow by way of context clearly implied that you meant to discuss the use of insurance from across state lines, rather than just the ability to buy insurance across state lines (as you stated), than please do so.
And please, drop the facade that you are interested in civil discussion
I'm not sure how you reached that conclusion. I have been going out of my way to be civil in this discussion. I have been asking you for sources and clarifications, while you have at times been arrogant and snippy. Of all the questions I have asked
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If you could show how your earlier statement somehow by way of context clearly implied that you meant to discuss the use of insurance from across state lines ...
That you are even writing that sentence shows you're either trolling or stupid.
I'm not sure how you reached that conclusion.
Unless you're stupid, yes, you are.
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I'm not sure how you reached that conclusion.
Unless you're stupid, yes, you are.
I thought you were trying to claim that I was not honest about wanting a civilized discussion. Yet who reaches first for an insult?
And if you could be so kind as to return to the topic of discussion, could you answer my earlier question? I will restate it here in case you have forgotten it:
After revoking the currently standing states' rights to approve insurance policies for their citizens, who would you like to see have the right to approve policies for sale across arbitrary numbers of states? Woul
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Yet who reaches first for an insult?
It wasn't an insult: it was an acknowledgment that sometimes I am a poor judge of whether someone is being intentionally obtuse, or is really of very low intelligence; in addition, I like to cover all my bases. I think it's pretty clear you're a troll, but there is a possibility you're just stupid.
could you answer my earlier question?
As you have proven yourself uninterested in having a discussion, choosing to pretend that I wasn't talking about people being able to actually USE health insurance they purchase ... no, I will not answer your que
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Yet who reaches first for an insult?
I think it's pretty clear you're a troll, but there is a possibility you're just stupid.
You flat-out and directly called me stupid in the previous post. Are you trying to claim that you were somehow calling me stupid in a non-insulting manner?
could you answer my earlier question?
As you have proven yourself uninterested in having a discussion, choosing to pretend that I wasn't talking about people being able to actually USE health insurance they purchase
You have an unusual criteria for proof, there. I was seeking clarification on your earlier statement, the one that was disproven by the source you provided. I would very much like to know how you came to that conclusion, although your pattern of question-avoidance indicates it is very unlikely that you would share that information.
I am willing to m
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Feel like I'm walking into something - clearly you two have a history that is playing a part in this discussion. Since I found a few parts of this thread pique my interest, I'm jumping in.
On this issue of purchase vs. use - I'm not clear why you're making such an enormous issue about the distinction. Does it really make any difference? Some states have laws against purchasing certain class B fireworks, but usage is not explicitly illegal. Other states the opposite. If one says these fireworks are illegal i
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Feel like I'm walking into something
Feel free, especially since it looks like there is a fair chance someone else may have walked out.
clearly you two have a history that is playing a part in this discussion
Unfortunately some people won't leave history in the past. The history Pudge and I share is very brief; I have asked more than once to start over, but that is a separate issue.
On this issue of purchase vs. use - I'm not clear why you're making such an enormous issue about the distinction. Does it really make any difference?
The difference is important only because he stated he cannot legally buy, and then provided only evidence that one is legally prohibited from use. Hence he was unable to support his own argument. Had he instead properly said he cann
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I don't know to what extent others have proposed things like this.
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Conversely, the setup with the vast majority of oversight done an SRO - with higher level, criminal type enforcement by the SEC has worked very well. Sure not flawless, but given how dynamic the financial product market is, they've been very effective and efficient. Nobody likes it when FINRA is in for an audit (surprise or planned) but in my experience, they've been professional and the things they're looking for are typically good indicators of potential problems. So not solely federal control or oversight, predominately self-governed, but with the big stick looming like "wait 'til your father gets home" to encourage the kids to play nice.
I presume this case of SRO means self-regulatory organization? [wikipedia.org] I do see the FINRA you refer to mentioned for the financial sector in that wikipedia article so it seems to make sense. Am I reading your reply correctly when I say that you fin
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Yeah that's what SRO means & yes I think FINRA and it's precursor, the NASD have historically been very good at oversight. In addition to the approval of marketing materials & enforcement of requirements & standards, they're the ones that administer securities and principal licenses. You may have heard reference to a series 6, series 7 or series 63 licenses. Anyone who sells securities must be properly licensed to do so & this also involves a bonding, a background check, credit check and a r
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Yeah that's what SRO means
See, I can learn :)
I think FINRA and it's precursor, the NASD have historically been very good at oversight. In addition to the approval of marketing materials & enforcement of requirements & standards, they're the ones that administer securities and principal licenses. You may have heard reference to a series 6, series 7 or series 63 licenses. Anyone who sells securities must be properly licensed to do so & this also involves a bonding, a background check, credit check and a requirement to keep your records (address, disclosure of outside income, legal info) up to date. Anyway, it's not perfect - bad eggs certainly get in - but serious violations will mean losing your license which means you can't be hired.
I am not an expert in that field, so actually I had not previously heard of 6, 7, or 73 series licenses. I hope there won't be a test on this at the end... That said I'm willing to take your word on the job done by FINRA.
If that is the case, then are you suggesting that a similar setup might be wise for selling health insurance on a nationwide level - some self-policing for most matters, with a fairly strong governmental organization available to step in when things get severely out of hand?
Not health insurance - all insurance. And almost exclusively self-policing, federal regulators just outline the major framework for things.
OK, thank you for fleshing that out. I wanted to have a good idea of your ideal solution to the problem.
For example, the SEC sets some of the general guidelines about what a mutual fund is. FINRA then has rules about things such as requiring a prospectus to be given prior to a sale - and of course there are requirements about what must be in the prospectus - for example full disclosure of returns and expenses (and how those numbers are to be calculated).
That is already more than I knew about that function of the SEC before we started, and I honestly had never heard of FINRA until you mentioned it.
Were this applied to healthcare, guidelines would be set up for levels/categories of insurance. To market and sell your plan as say Plan A, you must cover X, Y and Z
That sounds li
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Unfortunately, I am unable to view the original parody, but your response is intriguing.
I assume you and I and Roblimo agree that the health care system is not a free market.
So, you say freeing the market will solve most problems, apparently also common health care problems, _and_ you say you are not saying we should remove all regulation.
Ah yes, nuance! A good place to start.
So, is there a policy statement of reasonable regulations that you endorse and will refer me to in your post? Or will you summarize
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I assume you and I and Roblimo agree that the health care system is not a free market.
False. Roblimo said it IS a free market. I was noting the fact that it is not.
So, you say freeing the market will solve most problems, apparently also common health care problems
False. In fact, I was speaking ONLY of the problems of our health care system, in context. I was not speaking of solving all problems in general. Since you didn't read what Roblimo wrote, that must be why you misunderstood the context of my comment. When you're just looking for and reading my comments, and not what I am replying to, much of the context is lost. Obviously.
_and_ you say you are not saying we should remove all regulation.
You appear to be pretending that regulation does not
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I assume you and I and Roblimo agree that the health care system is not a free market.
False. Roblimo said it IS a free market. I was noting the fact that it is not.
You may have a point, and I surely do not want to quibble. It appears that you and I agree that the health care system is not a free market. So my question to you, as you may not have detected, is what aspects of the free market or even regulation do you propose to bring to the health care market to solve the current concerns of citizens and Congress and health care users.
So, you say freeing the market will solve most problems, apparently also common health care problems
False. In fact, I was speaking ONLY of the problems of our health care system, in context. I was not speaking of solving all problems in general.
Thank you for providing context that was not explicit in your previous writing. So, you were
"speaking ONLY of the problems of our hea
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I couldn't care less to read all of that. You are not worth it. Try cutting it way back and maybe I'll consider it.
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I couldn't care less to read all of that. You are not worth it. Try cutting it way back and maybe I'll consider it.
It is sad for me to read those words. I find them blunt, terse, and unfair.
I do not feel motivated to cut it way back after spending the time to respond to you in detail.
Yours truly,
me
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It is sad for me to read those words. I find them blunt, terse, and unfair.
I am completely unmoved by your crocodile tears.
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Wow. Have you ever considered therapy for anger and trust issues?
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If it’s any consolation, I didn’t feel motivated to read the whole thing either. That was loong.
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You attached your post to mine, but I think you might have wanted to attach it to one of pudge's (maybe http://slashdot.org/comments.pl?sid=1489940&cid=30638168 [slashdot.org] ? ), since it seems to make more sense for him to read it... I am guessing you want to console him, right?
I also note that p_c did provide a much shortened version, more in line with the verbosity of others, but that exchange quickly went south as you can read.
Sometimes much more than is necessary is read into the plain meaning of words. "When
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You attached your post to mine, but I think you might have wanted to attach it to one of pudge's (maybe http://slashdot.org/comments.pl?sid=1489940&cid=30638168 [slashdot.org] ? ), since it seems to make more sense for him to read it... I am guessing you want to console him, right?
No, I was directing it at you:
He’s not picking on you, your comment was just really long...
Okay, not much consolation, I guess. :p
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I see you did not want to console pudge, you wanted to console the author of the long comment.
Oh, well then, I believe you want to attach your comment to a posting of pudge_confirmer, and not my comment.
Ciao,
Jimmy_Slimmy
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That’s correct. I falsely attributed it to you, and didn’t notice his interjection into the conversation until you pointed it out.
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OK. Here is a condensed version.
You don't even understand this fundamental fact ... ?
Those are not fundamental facts, as you may understand with some thought. Read on.
I understand that a large number of employees form a group under an employer. I understand that a large number of professionals form a group under a professional society. I understand that people (professional and otherwise) form societies and contract with insurers to purchase health care. I am sure that happens in Washington, so I believe you are being unimaginative or difficult. For $1
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Those are not fundamental facts
False.
I am sure that happens in Washington, so I believe you are being unimaginative or difficult.
Nothing you said contradicted anything I said.
... you have an option to form such a group ...
I never implied I didn't. I did STATE, however, that -- implied, "at this time" -- I do not have access to anything but employer or individual insurance. That is true, and true for most people. I could start some sort of organization, including a business. I could find one to join, other than my current employer, that I probably don't want to join. None of these are reasonable options for acquiring a service, for a reasonable price, that has nothing
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Excellent, thanks for that engagement.
Screw you.
That is the kind of engagement that does not do you justice.
I happen to know a bit about the patent system.
Then you should have no complaints about what I said.
Correct. Notice I agreed with you! I do note however that there is more than one side to things, and you tend to get very dismissive when that comes up.
From a professional point of view, I am curious as to how you would change it to help solve our health care problems?
Curiosity is good.
Yes, and the grass is green.
What do you think that is about, and how it interacts with the patent system?
I don't care, in this context.
Dismiss, dismiss.
It's not the government's business -- despite what Obama thinks -- to try to push people into acting in certain ways. If they want new drugs, bully for them.
Whoa! How did Obama get in here? We were talking about rising health care costs when I came in.
I am also curious ...
Again, good.
Again, the grass is green.
You have asked me very few questions and I therefore have very little to respond to,
Well, take a look back and see how you typically respond to questions from people.
but I will note that you have this odd, apparently pathological, habit of taking what I said to an illogical extreme in order to disagree.
Well, I confirm you have a way of saying very sl
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That is the kind of engagement that does not do you justice.
No, but it does YOU justice.
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Pitiful. And not unexpected.
I read you need more questions from me, so here is one.
Did kids give you noogies at recess?
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Did kids give you noogies at recess?
Funny, YOU guys are the ones going after ME. Classic denial.
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Speaking from the heart, I confirm I was trying hard to not be going after you. I started this thread in the New Year, a arbitrary point on the calendar when I reflect on how to be a better person.
I actually tried to engage you in a neutral conversation, and I let many of your provocations slide by, or answered them neutrally. I recognize you colored most of my writing with an intent to bait you, but as far as I know, my original intent was to engage you, should you be open to such. I tried.
Now, of course
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I couldn't stomach wading through all the bullshit to get through your whole post. The crap started deep right from the beginning, and then I skipped to the last line where it only got deeper.
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Oh well. See you out there.
Ciao,
p_c
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How can a statement of opinion be "crap" or "bullshit"?
Because he's lying about his opinion. Obviously.
The poster was stating that he (or she) views the relationship as friendly.
Yes. He was lying.
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Actually, I confirm I had put you on my "friends" list just before I submitted that. You could confirm it in your messages. It is visible now.
So, pudge, you are my friend in the world of slashdot. I know, friendship is fraught with difficulties, but I will just have to try harder to get you to understand.
Can't we just be friends? You and me? Together? You could add me to your friends list. Then you would know when I journal. It would be a start.
Speaking of journalling, coincidentally, I just did.
Have a