The New Children's Health Plan Is Videogames?
from the well,-that's-one-way dept
theodp writes "Remember how Catbert once declared 'The new company health plan is Google'? Well, for some kids, the new health plan may be videogames. While health insurer Humana has opted out of 'child-only' health insurance coverage to skirt around requirements of President Obama's health reform, uninsurable children with pre-existing conditions are still presumably welcome to use Trainer, the Humana-bankrolled-and-branded videogame that took home $20,000 last month as the Grand Prize winner in First Lady Michelle Obama's Apps for Healthy Kids Competition. Over at the USDA site, Humana is praised for having 'generously provided a gift to fund the development of the [Trainer] game...that will help children and their families live healthier, happier lives. No child is alone on the road to better health.'"There is, of course, nothing wrong in general with using video games as one part of helping kids stay healthy, but it does seem especially sleazy to do this while pulling child-only health insurance.
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Filed Under: health insurance, healthcare, video games
Companies: humana
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Clowns are doing a better job at healthcare.
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No Surprises There...
They now have a market of 280 million plus legally captive customers.
They seem to have no restrictions on premium increases for people who already have health care. Anyone else get an 80% increase in premiums for next year? Yeah, that's not even a so-called 'luxury' plan. For many working families reduced coverage is now the only option.
People who have no permanent job and cannot afford health insurance will have to pay a statutory fine for non-participation in mandatory health care. These fines will no doubt get funneled back into the ongoing bailout of our new health insurance overlords.
Just don't .. get.. sick.
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Sounds like a Tea Party Idea
Please Support the US Chamber Of Commerce this Election Season.
-Glenn Beck
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Sleazy???
"...but it does seem especially sleazy to do this while pulling child-only health insurance."
Why is it sleazy to run a profit/loss analysis on a product or service, determine that you -will- LOSE money and then have the temerity to actually act on that information in the best interests of your employees and shareholders?
How would Floor64 like to be held to the same irrational, illogical, coercive and frankly socialist standard you and the "Never had a real Job" Obama administration are trying to hold insurance companies to?
If that forehead smack really hurt, then good. You needed one for posting that little leftist turdball.
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Re: Sleazy???
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Re: Sleazy???
IMHO once a company has a majority of shareholders that don’t work at for the company that said company loses any ‘soul’ that it may have had at conception. There are very few exceptions to this.
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Re: Re: Sleazy???
Obama may be the messiah, but even he can't suspend the laws of economics (not that he hasn't tried...)
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Re: Re: Re: Sleazy???
See "Not for Profit Companies".
Primer: http://en.wikipedia.org/wiki/Non-profit_organization
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Re: Sleazy???
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Re: Re: Re: Sleazy???
When they start actually losing money, could you stop by and let us know/share the balance sheets? That would be great!
These companies are not free market, and have not been since the 1950's. They basically are our health care system, and lock out doctors who would practice free market healing, or even practice medicine for that matter.
Point in case: Diabetes is one of the top health issues in the U.S. today. Why on Earth would they stop paying for an insulin resist tests, which can catch a danger situation before it turns into pre Diabetes. This is not health care, this is market control -- as in controlling the number of living policy holders in any given year.
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Also something that most people do not realize is that there are two significantly different types of health insurance providers in the US. The for profit companies like Humana and the not for profit onesusually owned by a Mutual Legal Reserve Company, like Blue Cross and Blue Shield of Illinois. These two different types of companies have significantly different goals. The for profit ones of course are about keep their stock holders happy.
One other kink in the health insurance minefield is that not all of the Blue Cross/Blue Shield companies are the same. Blue Cross/Blue Shield is an association that licenses out the name to various insurance companies. Originally there were separate BC/BS companies in each state, because insurance law was set at the state level, just like banking used to be. In some states the BC/BS companies could be for profit, in others they could not be. Other the years they have consolidated and there are no longer 50 different BC/BS companies.
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Coverage wars - Healthcare business news from Modern Healthcare: "This month, Anthem in Colorado -- without conceding its increases were unreasonable -- agreed to refund $20 million to subscribers under a settlement with the state's insurance division, which challenged the company after logging 210 complaints about increases in individual plans."
____
The bottom line is the US pays more money for health care with poorer results than other countries. We don't have the best system, based either on cost or outcome. We need something better.
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A lot of this also depends on if you get your insurance directly as an individual or through your employer or some other organization. Employers and organizations have the benefit of having more power when negotiating pricing and get the benefit of a large pool of covered individuals. If you are buying coverage directly from an insurance company you can often get screwed.
When getting insurance through your employer you can often get hit as well however. It all depends on how much of the cost your employer decides to pass along to you. I have heard that BC/BS of Illinois, which is one of the non-public, non-profit companies, has decided to almost double the amount their employees have to pay for health insurance. It has something to do with meeting the 80% number in the health care bill. Kind of ironic.
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Who decides to not cover a claim for which the patient was told they were covered ?
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Sometimes we have issues when the insurance company is investigating for fraud, and they have to wait that out, but hospitals are pretty good at fighting for the employees, and we help them too. I know why the insurance agency does this, but it is scary for anyone going through it, even though they get resolved in the end.
Now I wish that things like acupuncture were more widely covered. They would help unclog the hospital systems by diverting many people to an alternate source of treatment.
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The biggest issue is typically miscoding of the care provided. Get one digit wrong and you go from having a orthodontic procedure to having an inflamed cevix. I have a relative that works for their insurance company that had something similar happen that took over 6 months to get straightened out, because the health care provider kept refusing to correct the coding.
On the other hand there are some insurance companies, typically the publicly traded ones, that have been found to have a policy of rejecting a percentage of all claims. Working like some rebate companies do and knowing that a certain percentage of people will not follow up and just pay the bill themsleves.
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Re: Re: Sleazy???
...yes, not going bankrupt does make shareholders happy.
Come on, this is a private business. It can offer what it wants. We still, thankfully, have a choice in what insurance provider we want to go with. If we want insurance for child-only, we can go somewhere else. There is nothing sleazy about being upfront and choosing not to sell a particular service.
It's like calling Buffalo Wild Wings sleazy for not offering breakfast items. I'll just go somewhere else for breakfast.
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Re: Re: Re: Sleazy???
I agree that it is a private business and competition in a market is a good thing until greed takes over. Outside stockholders invest solely for their own profits, not the betterment of the company directly. Not for Profits are private businesses and differ on that making money for strangers is not their primary business motivation. I will admit that the primary purpose of any business is to make money to cover costs (or there is no business).
As an example I use USAA for car and house insurance and they give me money back every year. And they still have the best service I have ever had from a insurance provider
Primer: http://en.wikipedia.org/wiki/USAA See section titled “Returning profits to the insured”
My posts here are to bring up a dialogue of why are for profit companies dictating medicine. (I am curious on how Obama gets blamed for starting that... I will give you perpetuating)
Insurance should NOT equal medicine. Primer: http://en.wikipedia.org/wiki/Hippocratic_Oath
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The argument that since this is the health industry, so people will suffer if Humana doesn't offer every possible plan is nonsensical. Not one single person will suffer or die because Humana doesn't offer Child-Only plans. They will just get a different plan or go to a different insurance company. There are plenty of insurance providers out there. Nobody will die because they had to go with Blue Cross instead.
If you prefer a health related analogy, the hospital by my house comes to mind. Like many hospitals across the nation, they don't offer MRI's. Frankly, it would cost them too much to house it, and they are not a big enough hospital. Is this hospital suddenly sleazy that they don't offer a very vital service? No! I would have to go to another hospital in a different hospital system for an MRI, but I deal.
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Medical insurance companies pull in as much revenue as possible and cook the books to minimize what they pay to send money to the stockholders.
Going back to the restaurant analogy:
Say you can’t get a credit card because you have poor credit rating (thru no fault of your own say id theft). If you can get one a credit card will be %50 interest with no grace period.
Now you are standing in front of Buffalo Wild Wings an IHOP and a McDonalds. You are hungry and need breakfast. All three take some combo of their branded credit card and other cards. If you don’t use their branded credit card it is 150% more. For cash it is 500%.
The credit cards are insurance networks. The credit score is insurance networks sharing information/your disclosures on your application. The poor credit is having a pre-existing condition. The restaurants are Hospitals. Breakfast is some particular treatment.
I have some firsthand experience with pre-existing conditions… if you don’t have medical coverage for as little as one day it can screw you over big time and you may have a lot of trouble getting insurance at all. Of which the most incredulous is that my sister was denied insurance for a preexisting bunion despite being in good health otherwise.
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The idea behind getting everyone to have insurance is to spread out the expenses over a bigger population, which hopefully means lower rates overall and a healthier population by treating everyone in a timely manner.
People who are happy with the system right now haven't run into problems yet. But if, for example, you are buying your own insurance and you are a young woman of child-bearing age or you have a wife of child-bearing age, either you aren't going to get pregnancy coverage or you are going to pay extra for it.
I'm for a single payer system because I think we waste a lot money with all the paperwork the current system requires. Some people think a single payer system might ration care. But what we have now definitely rations care, either by denying coverage altogether or by not paying for certain treatments. I think a system that provides basic health care is a better way to ration it than to take the money and then not pay it back out in coverage.
We're going to reach a point where very few companies or individuals are going to be able to afford either health insurance or health care so we'll have to do without.
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Spending on Housing and Transportation Fell in 2009 - NYTimes.com: "Health care was the only major category of spending that rose, climbing 5 percent in 2009 to $3,126. Not coincidentally, health care is also the only industry whose job count has grown every month in the last three years."
More Patients Balk at Cost of Prescriptions - WSJ.com: "Mark Spiers, chief executive of Wolters Kluwer, points to efforts by employers and health plans to control fast-growing health-care spending by shifting more costs to consumers. The out-of-pocket costs, combined with people's sense they can't afford it, is causing some to make 'real consumption choices about prescriptions versus other goods for their home,' Mr. Spiers said."
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And what makes you think that insurance companies want higher prices? Insurance companies would be perfectly fine if an MRI cost $50, less they have to pay out. Hospitals charge the maximum that they can get away with, and it is mostly enough earn enough to pay off the malpractice costs.
Going back to the restaurant analogy...Blah Blah Blah..one a credit card will be %50 interest with no grace period.Blah Blah Blah...Now you are standing in front of Buffalo Wild Wings an IHOP and a McDonalds..Blah Blah Blah..their branded credit card it is 150% more....Blah Blah Blah..."
Sorry, I really tried to get your analogy...it really makes no sense. So using a card for a mcgriddle would cost me more if they don't take Visa? I just don't get it, sorry. Hospitals charge the same thing no matter what, its the insurance coverage that changes from plan to plan.
I think you are trying to point out that pre-existing conditions can deny you coverage. I don't know why people think that insurance companies are charities. They are businesses, and they are not going to cover cases where they feel they would likely lose money. Just as Ferrari would not lease me a car because I am poor and they would lose money on the deal. I know thats not the answer filled with rainbows and butterflies, but that is the nature of the beast, and the right of a private company. The fact is that there are a multitude of other options for people with pre-existing conditions, and those are the avenues that need to be pursued. Here are a few options:
1) Get group health. Most fulltime positions offer group health, and those benefits extend to the entire family. You are not denied for pre-existing conditions, the annual costs are spread among all the employees in the group.
2) If you lose you job, get COBRA. a bit spendier, but it's always there for people who become unemployed.
3) Go on a Gov't PCIP (Pre-exising condition insurance plan). Affordable Gov't insurance without the possiblity of being denied for pre-existing conditions. This one should cover about anyone under the sun.
4) If even a PCIP plan not affordable, then you should qualify for government health care: Medicaid or Medicare. There are also a multitude of other state and federal medical assistance programs to utilize.
Rich or poor, young or old, employed or jobless, you can be covered with a pre-existing condition. We are lined up with enough government programs to insure that.
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Re: Re: Sleazy???
Period. That is their purpose.
If you want to help people, start a charity.
If you think any health insurance company exists to "help people live healthy lives" then you have clearly never dealt with one.
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Re: Re: Re: Sleazy???
And therefore the "Sleazy" label is valid.
Bad Analogy: If you think any automobile company exists to "help people commute" then you have clearly never dealt with one.
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I'm not sure anyone can really call that "skirting".
Government: "Everyone who offers child-only insurance must cover all of these things in their policy and must accept all pre-existing conditions!"
Companies: "That's going to raise the cost of insurance for those policies substantially. We're going to have to increase our principles to compensate."
Government: "Well you can't!"
Companies: "Err, then I guess we can't offer child-only insurance anymore then."
Government: "OMG, the evil insurance companies found a loophole!"
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Re:
Companies: "That's going to diminish our ability to drain people's accounts substantially. We going to have to increase our principles to compensate."
Government: "Well you can't, in other countries they didn't have to do that and they still operate at a profit can you show us otherwise?!"
Companies: "Err, then I guess we can't offer child-only insurance anymore then."
Government: "OMG, the evil insurance companies found a loophole!"
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You have an interesting view of business . . .
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Glad to see intellectual debate is alive and well . . .
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How can something so absolutely important like the health of our country be controlled by a system that's so fundamentally broken and corrupt? It's like we put Snidely Whiplash in charge of protecting damsels from being tied to railroad tracks.
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Can you say they will not be profitable?
Please I would love to see the evidence of that.
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They exited a market segment where they would be unable to make money.
If you have to accept all pre-existing conditions, then anyone with any sense would never buy insurance for their children until the child was seriously ill.
On average, children are pretty healthy and it's cheaper to pay for the routine sniffles than for the insurance.
People insure their kids in case that one turns out not to be.
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as a disabled adult here is my take on everything
B) you get depressed
C) it makes you feel better to have things others do like hte tv episodes you like, hte movies and books and yes even games.
I pirated then bought diablo 2
i got hurt and laid in bed for 4 months plating it helping me to forget my injury, and in a weird way aid my recovery.
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Single Payer
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This debate
America needs to face the fact that only a universal public healthcare system can fix the problem.
Speaking from the UK I can see that your system costs you twice as much as ours and delivers less for most of the population.
As time goes by the proportion of your population that your system can afford to cover will continue to fall. The market distortions that are inevitable in your system will continue to push the development of unaffordable treatments that will only make the problem worse. In the end even the tiny minority that can still afford it will not be able to insulate themselves from the public health consequences of the disaster.
Obama's reforms are only tinkering around the edges of a system that can never deliver. It is not surprising that they are self contradictory and self defeating. You can't make a silk purse out of a sow's ear!
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Yes, new government requirements that screw up the private healthcare sector are definitely evidence if why the private sector can't work.
Great logic.
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Not for those who could afford it, hence Sleazy.
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I'm betting not, because if you had actually experienced how they treat their citizens you would not be talking the way you are talking.
Insurance companies don't care about patients, they care about their bottom line.
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The reason a private healthcare system can't work is that most people think that it is unacceptable to allow people to die from treatable diseases simply because they cannot afford the treatment.
If you don't accept this premise then please be honest and admit it.
Otherwise you have two options. - either
1. Explain why a profit motivated system would ever treat the poor without some kind of government "encouragement".
2. Offer some alternative proposals that allow the government to somehow make the private sector treat everyone without "screwing it up".
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An insurance company doesn't care about how rich or poor you are, as long as you pay for your plan. Just like any private company selling something, you have to be able to pay. It's not rich or poor for insurance companies, its customer and non-customer. Now, people that can't afford private insurance can go on Medicaid, Medicare, or any number of other public Medical Assistance programs. The government "encouragement" is that the government (for many years now) has been able to cover those who can't afford to get private insurance. The government is already the insurance for private companies so they do not have to cover everyone at a loss. Back when I was broke, jobless, and my wife had medical issues, we needed to go on gov't care. It is actually much better than private care, because they paid every penny. I still couldn't wait to get a job again and get on private insurance though, because I was getting care off of taxpayer dollars, and as long as I can stand on my own, I choose to.
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I don't know why you think that the private sector should be "made" to treat everyone, because the gov't care is in place to pick up the slack, but I understand how many people do feel the impact on the health care insurance costs, and the costs of health care in the USA in general. There are plenty of alternate proposals out there that will lower the costs and allow private insurance to be more accessible to everyone, and keep Medicaid and Medicare from being such a tax burden on us. Here are just a few links of alternate proposals that have been put out there:
http://www.ahrq.gov/research/costsria/
http://www.healthcarefinancenews.com/news/actuar ial-survey-says-transparency-would-reduce-healthcare-costs
http://www.foxnews.com/politics/2010/0 3/03/gop-proposed-tort-reform-reduce-health-care-costs-analysts-say/
http://rules-republicans.hou se.gov/Media/PDF/RepublicanAlternative3962_9.pdf
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So you have a system which HAS a state supported sector - but then allows private companies to cream off "profitable" clients.
But then the public system can't be very effective because otherwise people wouldn't regard not having insurance as a problem.
How about these comments - found via wikipedia.
"According to the Institute of Medicine of the United States National Academies, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage" (i.e. some kind of insurance).[22][23] The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States."[22] while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance"
I don't see why you don't just accept that the most effective system is to put everyone in one big insurance scheme - ever heard of the economies of scale?
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That's the nature of the beast. Many countries deal with it. The new health care bill only made it easier for the insurance companies to get the "profitable clients" since everyone will be forced to buy private insurance if possible, and public if they can't get private.
"According to the Institute of Medicine of the United States National Academies, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage"
Richard, apparently you missed the health care bill that just came out. We are implementing mandated insurance. This is the same system that many industrialized nations have in place. Switzerland, Germany, Austria all have insurance mandate systems like we are implementing.
I also seriously doubt the unnecessary deaths statistic. Anyone can get some form of coverage, and even if somehow someone ended up not being able to get some form of insurance...it is illegal for a hospital to deny treatment if the person cannot pay.
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You might want to look at this paper. It is pretty thorough and does look at death rates in the US compared to other countries.
http://content.healthaffairs.org/cgi/reprint/hlthaff.2010.0073v1.pdf
The concluding sentence:
"... meaningful reform may not only save money onver the long term, it may also save lives."
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I wholeheartedly agree that we need meaningful reform. I have just yet to see it....We are in a country that thinks that it is normal to be on 5-10 medications at the same time. We have a treat the symptom, not the problem philosophy. We completely condemn any form of alternative medicine, even though it has been in practice for 6000 years. Our medical system is riddled with unnecessary litigation, overhead and barriers caused by federal over-regulation. The list goes on. Our Healthcare system stinks, and it is not an issue of who is covered, but how we are treated. There is red tape sprawled everywhere, no matter if you are a doctor, patient, employer, "evil" insurance company, or anyone in between.
All I have seen is meaningless reform....forcing everyone to buy insurance. Yay...now everyone is forced to buy into our broken health care system, not just the ones who choose to. It would make not difference not matter what universal insurance system we have in place, our health care stinks.
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Yes, I agree with you. We are overtreating some people and undertreating others. The goal isn't to allow everyone to have every possible medical option. It's to provide basic health care to catch problems early and then not to treat what will make no difference anyway.
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I philosophically believe that any one should be able to get any medical option they choose, as long as they are willing to pay for it, For everyone else, yes, an effective care should be accessible. And no matter what treatment we are talking about, the prices should not be skyrocketed to "feed the system".
I don't know exactly what you mean by "not to treat what will make no difference anyway." but if I'm interpreting it right, which I hope I am not, that sounds like a very fine line that should not be crossed. I don't want a doctor determining who is worth trying to save and who is worth just letting die to save money. It's against the Hippocratic oath, and against the ethics of most doctors. Doctors are humans, and humans make mistakes. I don't trust a doctor to make the decision for me on if I am going to live or die.
If you are talking about doctors striving to offer a healthier way to live with a condition, or an alternate form of medicine rather than defaulting to constant medications and treatments that only cover the problem and rack up health care costs, then I wholeheartedly agree with you! Our philosophy of continual treatment is often backwards and more costly because of it.
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Sure. But of course there are a number of medical treatments which are considered optional or experimental and aren't covered by insurance and wouldn't likely be covered by a government plan either.
I don't know exactly what you mean by "not to treat what will make no difference anyway."
There are some medical treatments that are very expensive but don't prolong life and don't even offer a better quality of life in the remaining time. That's why hospice is becoming more popular. We are realizing that sometimes it is better to opt for palliative treatment than to continue medical treatment when there is no indication that it will work. And we now have living wills so people can indicate in advance if they don't want to be resuscitated.
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As far as choices go with health care for optional treatments, I would love to see a system where both the standard treatment and the optional treatment is priced fairly, and when a patient's insurance only covers standard treatment, then the patient could just pay the additional cost difference for an optional treatment out of pocket. HSA's would have a more critical role then. We have a lot of junk to get out of our health care system before things could be perceived as reasonable priced though.
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Sleazy? Why? Children can use the same insurance as everyone else can they? [If not then that's real problem.]
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schip
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Our system is expensive and inefficient
http://content.healthaffairs.org/cgi/reprint/hlthaff.2010.0073v1.pdf
Here's the last sentence: "... meaningful reform may not only save money of the long term, it may also save lives."
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Loss Ratio less than fifty percent? - Really?
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inspirational stuff
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