More Affordable Insurance? Tear Down the Walls

To help make health insurance more affordable for all Oregonians, legislators have at least three no-cost options to advance. First, allow Oregonians to purchase insurance from companies operating in other states, especially states that have fewer mandates, where more affordable options likely exist. Second, reduce the number of, or eliminate all, mandates on policies sold in Oregon. Mandates reduce personal choice and drive up the cost of policies. Third, simply allow insurers operating in Oregon to offer exclusionary coverage. For example, I know a man who had knee surgery. He was willing to exclude the knee from coverage for some time, until it would no longer be considered a pre-existing condition. But, the law prohibits this option. Such complete-coverage-or-no-coverage-at-all laws are counterproductive. To make health insurance more affordable, the Oregon Legislature need only knock down government-erected barriers and allow consumers to decide what is best for themselves. Democrats, now in control of all branches, speak loudly about being pro-choice and pro-consumer. Let’s see if their actions speak louder.

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Posted by at 06:00 | Posted in Measure 37 | 41 Comments |Email This Post Email This Post |Print This Post Print This Post
  • Sagano

    I think in dire times such as these, people at the bottom with nothing to spare need a little boost from the government they pay into.

    • Anonymous

      People at the bottom do not pay into government.

    • Anonymous

      People at the bottom get refunds from the government for money they never paid in. Those refunds come from money you paid in.

      • David Appell

        “People at the bottom” certainly pay into government. They pay sales taxes, property taxes (either directly or through their rent), gas taxes, etc. In fact, Oregon is renowned for it high taxes on those with the lowest incomes.

        • Anonymous

          Oh, I think the $2500 to $5,000 refunds coming through my office pretty well covers those taxes. Most of those refunds are not from income tax paid in.

          And I hate to give you a nasty blast, but life isn’t fair, nobody said it was.

          That doesn’t mean we can’t do what we can, but it also doesn’t mean we have to do it all for them.

          At some point, each one of us must take some responsibility for ourselves. Sure some people are low income because they don’t have a lot of choice. Some are low income because they’re too lazy to do something for themselves.

          • David Appell

            Anonymous: Perhaps not everyone is as fortunate as you. Some people aren’t as smart, or have physical problems, or psychological problems, or family problems, or health problems, or weren’t able to afford a post-high school education, or do not have your ambition or self-esteem or wherewithal, or do not wish to spend their life in the endless pursuit of money, or a thousand other reasons.

            Anyone who’s getting a $2.5-5K refund check is obviously in extremely dire straits.

            How do you know you won’t need such assistance yourself some day?

  • GerardFZ

    Аффтар жжот!

  • Rick Hickey

    Lower Insurance rates? Here’s how…Millions of Illegal Aliens that won’t buy insurance or pay their bill and have 400,000 + Anchor Babies per year, a “Free” expensive service to taxpayers and as new americans qualify for all Gov’t services, go home via No Job via mandatory E-Verify and health sevices providers actually get paid and stop raising rates to compensate for the millions that were not paying.

    Policy mandate reduction also and boom-insurance is affordable again and Employers can then cover more of it and will as their labor pool shrinks.

    Your welcome for my honest solution, are there any Politicians willing to actually help us taxpayers/voters/paycheck providers?

    any questions…

    • capor

      If the potential Wyden plan is passed in Congress, Oregon legislators will not have to do anything, and I think that is what they are counting on. The Wyden plan (and several others like it) will mandate coverage and require employers to pay an additional fee to cover those who do not work. It is not clear yet what department will be responsible for oversight of this program might be, but my guess is that it will be a huge administrative boondoggle.
      As an employer I see the need to allow choices rather than mandates. My people cannot buy their own insurance on pre-tax dollars in this country, nor do they get credit on state or federal taxes for buying their own. They don’t mind choices for deductables, limits of coverage, or what state their plan comes from. What they do mind is being forced into a group plan designed for people that believe it is their God given right to have health care rather than health INSURANCE. They mind having a government that cannot mange its budget dictating how they will mange theirs. They mind having their health care opportunity look anything like what the government offers today. Look at the mess called Veterans Affairs. Free markets used to be a good thing before union employees both public and private drove away employer/employee choices. 50 years ago this was not an issue. Costs have gone up sure, but the burden to pay for these services has fallen on a smaller sector of the US economy every year.
      We need to be honest about identifying the problems in health care, insurance, and abuses in government subsidy before we throw the US employer/producer to the lions.

      • sybella

        As an employer, I can say you are 100% correct. As a person who bought their own health insurance, I can say you are 100% correct. As a person who is now on Medicare, I can say absolutely, government run health care is not as good. Unfortunately when you turn 65, there is no choice.

  • David Appell

    > He was willing to exclude the knee from
    > coverage for some time, until it would no longer
    > be considered a pre-existing condition.

    In other words, in order to get medical treatment this poor guy had to go through months, if not years, of pain and suffering, all the while taking the risk that his knee would get worse, instead of treating the knee problem in its early stages when it has the best chances of a successful recovery.

    Yes, that sounds like a perfectly logical health care system.

    • jim karlock

      *Hey David!*

      We are still waiting for your proof that CO2 can cause dangerous warming. As a PHD, you should have no problem determining what degree of warming is dangerous and proving that CO2 can cause that degree of warming.

      If you cannot do this, you are admitting to have been spewing mere superstition on the subject of warming.

      Thanks
      JK

      • David Appell

        Jim, I am tired of your childishness. I have tried, several times, to answer you sincerely — as you know — but, like a well-trained monkey, you only have one line. I am willing to discuss and debate legitimate issues of climate change science and policy. But you’ve become a big waste of time.

        • David Appell

          Jim: I just looked you up on the Web, and saw your picture, and see that you’re like 50+ — gray-haired, partially bald, probably perpetually single. I’m amazed. I had thought, from everything you’ve written me, that you were like 23 and just naive.

          Perhaps it’s too much to simply ask you to act your intellectual age?

  • dan

    You have forgotten to touch on the issue about Kulongoski wanting to raise the tax on health care providers. This will certainly raise the price of healthcare on all Oregonians.

  • VZJohn

    Интересно. И самое главное – необычно.

  • JTT

    Right…because allowing people to purchase a low-quality plan from another state won’t enlarge the cost-shift to the system when they need coverage for that thing they’re not covered for…oh, say something like a knee…and that further increases premiums and diminishes coverage for everyone. Great idea! Seriously, do you know anything about the health care market?

    • sybella

      And you really think government is going to give a better dea. Again I refer you to Medicare. Better than nothing, but not so hot

      • David Appell

        Yes, in fact, governments can do better. There are a few dozen countries that provide significantly better health care than the US, and at much lower cost. Why can’t we do what the French and Japanese do?

  • Rupert in Springfield

    Great post. You made my favourite point and one that anyone who actually buys health insurance is painfully aware of: The ability to buy insurance across state lines and thereby avoid idiotic mandates.

    As an example of this, Oregon recently mandated acupuncture coverage. What happened to my insurance? It immediately went up $5 per month. That means I am mandated to pay $60 a year for acupuncture coverage that I neither want, nor need.

    Introducing cross state sales of insurance would allow customers the freedom to buy what they want and would limit health care costs. Right now all a special interest group has to do is lobby the state legislature and you are stuck, in this case by the acupuncturists.

    Its time to start thinking about what we can do to reduce medical costs and make them more responsive to the consumer, not special interest lobbying groups. Sales across state lines would accomplish this overnight. There are only two reasons not to proceed. One would be special interest lobbying groups are more important than citizens. The other would be the idea that citizens are too stupid to know what sort of health care they want and then therefore the state should decide. Both are insulting, and both are hardly justifications for not immediately dropping cross state barriers to trade in this regard.

    • dean

      I imagine there are lots of services you could get under your insurance you don’t want or need, and I suspect several you probably will want or need at some point that your insurance company will show you later you can’t get from them….fine print and all.

      We would not reduce “medical costs” by lopping coverage out of insurance policies. Some services, like acupuncture, probably save on the alternatives, like more pain meds. We would just not get the lopped services, or we would pay for them out of pocket. Upwards of 30% of the cost of insurance…not medical care…insurance….goes to the green eye shade guys who figure out how to deny paying for your claims.

      Also too (thank you Sara Palin) state insurance regulation could be viewed as “state’s rights” couldn’t it? If a state’s citizens want LESS covered in their insurance, they should elect legislators who promise them less.

      • Anonymous

        And Dean ads health insurance to the long list of things he knows nothing about.

  • David Appell

    Rupert: how will you pay for the costs of what your cross-state health insurance policy doesn’t cover? Say, you develop a medical problem whose coverage is mandated in Oregon but not in the state from which you buy your insurance, and you don’t include coverage of it in your policy. What will you do if you then suffer this condition, especially if (as nearly always nowadays) the cost is quite substantial?

    • jim karlock

      Like birth control pills?
      He will really miss those.

      PS: Still waiting for you to prove your wild claims about CO2.

      Thanks
      JK

    • Anonymous

      Well, I guess if he ever gets pregnant, needs a pap smear, or decides to get accupuncture he’ll just pay for it out of his pocket.

      How’s the chronic unemployment…oops…I mean “freelancing” thing going David?

      • Rupert in Springfield

        Actually I do pay for birth control pills from time to time. I think Oregon did mandate coverage of birth control. However since I pay for my own insurance obviously the deductable is going to be higher than the birth control pills are going to be. Wow, so yet another mandate that certainly did not make my insurance any cheaper and did nothing for me. I find it annoying that I seem smart enough to employ myself to actually pay for the insurance, yet in the states eyes, I am simply too stupid to know what to buy.

        Thanks state of Oregon!

        As for a mandate that does cost me something like $60 per year, the acupuncture mandate, I guess I can understand David Appells concern.

        Every day I here stories about family being thrown out of their homes because of crippling acupuncture bills.

        Have we all not heard the tale of the mother who was forced to make the decision no mother should have to make? Sell her and her children into white slavery in order to pay for acupuncture.

        So David Appells concern is a valid one, were Oregon not to mandate acupuncture coverage, the chance that I would be hit with an acupuncture bill that could potentially bankrupt me is quite high. However I feel that my chances of being bankrupted by high acupuncture bills are quite a bit lower than my chances of being bankrupted by religious zealots. Frankly I wonder if there is a way one could buy insurance against AGW believers?

        Ten years ago I would have called someone mad if they told me a throng of people would become obsessed with a one degree temperature rise, bow down to a divinity school drop out as their leader and want to bankrupt the nation. Although the AGW’ers are certainly on the wane as we approach yet another record cold winter, I would still welcome the opportunity to insure against them.

        • David Appell

          Rupert, you are being disingenuous, and you know it. I am not talking about $60 bills for acupuncture — I am talking about $9K bills for child birth and $200K bills for strokes and thousands of dollars for mental health issues.

          Let’s say you or a dependent suffers a medical problem which is not covered by your chosen piecemeal policy, and its resolution costs $100K. How will you pay that?

          What if it’s $1M?

          • Rupert in Springfield

            Excuse me? I am being disingenuous?

            Look, catch a clue. I posted about mandates. You replied to my post about mandates. Now you are trying to change the subject and saying I am disingenuous about major medical coverage when the issue was silly mandates?

            I really hate when a liberal starts losing an argument and then tries to change the topic. You are the one who was being disingenuous. I clearly stated my problem was with ridiculous mandates. Acupuncture being one. I clearly stated I saw allowing purchase of insurance across state lines as being a good solution to the problem.

            Now you are launching into coverage for strokes and childbirth, this has nothing to do with what I was talking about and you know it.

            You are the one who cant answer the question. Get off the “disingenuous high horse” and stop changing the subject and address what I said if you are going to reply to something I posted.

            To wit:

            What is your reasoning for forcing me to buy coverage with all these silly mandates and not allowing me to buy across state lines like any other commodity? What reasoning do you have for why it is any concern yours where someone else purchases medical insurance?

            Mine reasoning is real simple, if I am smart enough to make the money to pay for the health coverage in the first place, I think I am smart enough to pick out what plan works best for me. If, as an example, you are someone who thinks paying an extra $5 a month on the off chance you might need acupuncture makes any financial sense then go right ahead. Please stop trying to change the subject and answer why you have mandate I need to make the same financially ludicrous decision?

          • David Appell

            Rupert, I am simply asking: what will you do when you are faced with a very expensive medical condition that isn’t covered by your chose piecemeal policy?

            You can’t predict the future. You don’t know exactly what ailments you or yours might suffer. Of course, you try to insure yourself the best you can. But the very act of picking and choosing means you could certainly fail to do so.

            So what then, if you’re faced with a $20K or $200K bill not covered by your policy?

            Will you simply lie down and die? I bet not.

          • Rupert in Springfield

            Ok – So, since you cant adress it in my other reply to you, I will simply post it hear. How long are you going to insist on dodging the issue?

            Here ya go:

            >Rupert, I am simply asking: what will you do when you are faced with a very expensive medical condition that isn’t covered by your chose piecemeal policy?

            My Reply to this exact thing posted days ago that you keep dodging:

            Look, please point out what you are referring to. Tell me what specific thing is mandated by Oregon that I would probably exclude from a health insurance plan because I am too stupid to judge for myself and I need Oregon to force me to do it.

            Failing that, please tell me what things in your insurance plan you would exclude unless forced to do include them by the state.

            Please do not veer off into side issues. Your statement implies I am too stupid to insure for whatever you are talking about unless guys like you, who like mandates, force me to do it.

            Please tell me exactly why you, or the state, is a better judge of my money in insurance purchases than I am.

          • Rupert in Springfield

            Got it now?

            Good lord, why do you guys always think changing the subject is so clever. I am talking about nitwit mandates:

            acupuncture

            pap smears

            birth control

            I am not talking about not getting coverage for major medical conditions that warrant insurance because of the exposure level.

            I am talking about mandates on insurance for things that because of their low cost make no sense to insure against.

            I am talking about the ability to buy insurance across state lines and wondering why in the world it is any concern of yours if my acupuncture or pap smears are covered by my insurance or paid out of pocket.

            You keep trying to talk about the efficacy of acupuncture which was never in contention

            You keep talking about major medical issues, which of course I would insure against. that’s why one buys insurance, for major medical, not for small things that are much cheaper to pay out of pocket than insure against.

            Now, address the the issue you replied to and quite trying to change the subject because you cant argue my point.

          • william

            “How’s the chronic unemployment…oops…I mean “freelancing” thing going David?”

            Hey david you never answered this.

            I hope you arent living off of foodstamps and unemployment while you blog unintelligent crap.

            You make me sick. Useless to society. If you want to “save” the earth from global warming, then please stop breathing.

  • Rupert in Springfield

    I suppose I would pay for them in the same manner I pay for anything else that does not have cross state mandates.

    Sorry, the argument that I am too stupid to pick my own health insurance cuts zero ice with me.

    I reject the notion that state legislatures lobbied by special interests are more qualified to select what insurance I need than I am. I was 46 at the time of the acupuncture mandate. Assuming I live to 80, and assuming the rate remains the same I will pay over my life $2,040 for acupuncture, whether I need it or not. Keep in mind I have a $2,000 deductable. The idea that I will use my deductable, and ever recoup the $2,040 in acupuncture over the course of my lifetime is absurd. Anyone who thinks that is a good deal financially probably has never seen anything larger than a $10 bill. And that’s just one mandate. Sorry, the argument that forcing me to pay for acupuncture mandates was anything but a sop to a special interest group is absurd on even the most cursory glance at the numbers.

    So why not strike a middle ground? The state could issue recommended package guidelines. Those who felt the state knows best could select insurers who provide them. Those, like me, who feel it would be better to pay for acupuncture treatment as needed, rather than paying $60 a year for a service that could easily be handled out of pocket could select otherwise.

    In short, why is the left always about forcing people to conform to what they want on this issue? Why not let people decide for themselves? The answer is obvious, none of this has anything to do with health care. It has everything to do with forcing people to conform to one groups will.

    Why does “choice” start and end at the abortionists door for the left?

    School choice?- Big no no

    Health Care choice? – No way, you will do what the state mandates

    Choices in Unionization? – You bring that up one more time and we will break your knee caps.

    Abortion? – Its the most sacred choice in the world, nothing should interfere with a woman’s right to choose.

    My only wish is that my choice in what sort of insurance to buy was as free as my choice as to whether or not to have an abortion.

    • dean

      Rupert…there are probably lots of things in your insurance policy you are paying for whether you need it or not. you are also paying for emergency room care for the uninsured in your insurance, but that is another matter.

      And if you are fortunate and live until 80, won’t you spend the last 15 of those years on Medicare, or will your present insurance company will continue to keep you on into your 70s?

      • Rupert in Springfield

        >Rupert…there are probably lots of things in your insurance policy you are paying for whether you need it or not. you are also paying for emergency room care for the uninsured in your insurance, but that is another matter.

        So what?

        Who cares?

        I was talking about mandates and ability to buy insurance across state lines. This has nothing to do with that. You even acknowledge that fact when you say “but that is another matter” . Did you just feel a need to blather?

        >And if you are fortunate and live until 80, won’t you spend the last 15 of those years on Medicare, or will your present insurance company will continue to keep you on into your 70s?

        Oh good lord. You cant be that simple. God, I wish you would think before you write. I’m not sure there is a person on the planet whose points are easier to defeat than yours Dean.

        Ok – here we go…..yet again….shooting fish in the barrel time.

        You don’t think they will raise the retirement age past life expectancy to solve the problem of entitlements eating us alive?

        You seriously think it will stay at 65? You seriously think I will have full coverage and not have to buy something to massively supplement Medicare when I retire?

        Want to buy a bridge Dean?

        There ya go…..Boom…..dead fish….poor Dean.

    • David Appell

      > I suppose I would pay for them in the
      > same manner I pay for anything else that
      > does not have cross state mandates.

      So you have $10K or $100K or $1M laying around, available to pay such bills? Very few people do.

      In any case, how are you so sure you won’t use acupuncture? It has been scientifically proven to be (as) effective (as other treatments) for some conditions. That’s why the NIH and federal government approved it, after all.

      I bet that, if you had a painful condition which was unresolved by several years of conventional treatment, you would seriously consider acupuncture.

      • Rupert in Springfield

        >So you have $10K or $100K or $1M laying around, available to pay such bills? Very few people do.

        Of course I don’t. That’s why I have insurance.

        Look, please point out what you are referring to. Tell me what specific thing is mandated by Oregon that I would probably exclude from a health insurance plan because I am too stupid to judge for myself and I need Oregon to force me to do it.

        Failing that, please tell me what things in your insurance plan you would exclude unless forced to do include them by the state.

        Please do not veer off into side issues. Your statement implies I am too stupid to insure for whatever you are talking about unless guys like you, who like mandates, force me to do it.

        Please tell me exactly why you, or the state, is a better judge of my money in insurance purchases than I am.

        >In any case, how are you so sure you won’t use acupuncture?

        Please point out for me where I said I had no interest in ever getting acupuncture?

        This seems an irrelevant question. I think you are trying to change the subject because you cant address why I should not be allowed to buy insurance across state lines.

        >It has been scientifically proven to be (as) effective (as other treatments) for some conditions. That’s why the NIH and federal government approved it, after all.

        Wow, gee, you are up on all the latest medical stuff, I guess that’s why you feel a need to point it out rather than address my point.

        Please point out for me where I said acupuncture was ineffective?

        This seems an irrelevant statement. The efficacy of acupuncture has never been questioned by me.

        I think you are trying to change the subject because you cant address why I should not be allowed to buy insurance across state lines.

        >I bet that, if you had a painful condition which was unresolved by several years of conventional treatment, you would seriously consider acupuncture.

        And I bet that if I gave you twenty years you could not find where I said I would never seek out acupuncture.

        I bet if I took twenty years I could never understand why liberals always think they are so clever for trying to change the subject when they cant win a argument.

        Now, if you would like to address my point, rather than showing us your vast knowledge of the medical efficacy of acupuncture, it would be refreshing.

        I will restate it since I know a favorite liberal tactic is to feign lack of comprehension.

        What concern is it of yours if I want to buy insurance in another state?

        What business is it of the states to assume I am too stupid to pick the policy that works for me when I am the one making the money to pay for it in the first place?

        What concern is it of yours that I should only be allowed to buy coverage with mandates that make no financial sense whatsoever? ( Insuring acupuncture coverage at a cost of $5/month at age 47 is insane financially, the exposure simply does not warrant insuring against it.).

        How does forcing citizens to buy coverage only in their state make legislatures beholden to anything but whatever special interest lobby manages to get coverage for their particular field mandated? In this case acupuncturists.

        • David Appell

          Rupert — are you perfect? Are you perfectly capable of seeing into the future, and what medical problems you or you family will face?

          If so, you have a very, very unique skill.

          I simply want to know how you will pay for a significant medical cost not covered by your chosen piecemeal policy. After all, if you are making choices, then logically there will be things that you leave out.

          You can pretend that you will never suffer any unforeseen medical costs…. but none of us believe that. We have all seen how strict insurance companies have become about denying what even seem like reasonable medical charges. Who knows what the future holds?

          Will you expect the govt to pay for your $100K costs? Or society? Or your hospital? Or your parents?

          Please be specific?

          • Rupert in Springfield

            >Will you expect the govt to pay for your $100K costs? Or society? Or your hospital? Or your parents? ..Please be specific?

            Ill be very specific. I buy insurance. My parents are dead, so little chance of them paying for much. Apparently you are currently out of work, I would assume back living with your parents, so I understand the leap there. Put mildly, I am somewhat beyond the age range where help from parents is applicable.

            Now, stop trying to change the subject because you are losing an argument about mandates. We were never arguing whether or not to have major medical coverage. What is under contention is insurance mandates, specifically acupuncture.

            I simply want to know why you keep trying to change the subject.

            Now it appears you are alternating your responses between this one and the one above to avoid addressing the issue.

            I am talking about mandates, not insurance coverage in general.

            Acupuncture, pap smears, birth control pills all have very little chance of adding up to the million dollar figures you cite.

            You simply cannot argue your position. That is why you are jumping between this post and the one above.

            My position was pretty simple, what concern is it of yours what state I buy insurance in, and how in the world do mandates make government beholden to anyone but special interests. In this case acupuncturists, a treatment it makes no financial sense to purchase insurance for because the financial exposure isn’t enough to warrant it.

            You then went off on a tangent, arguing the efficacy of acupuncture. That was never in question and it would seem the reason you did so was because you could not argue my contention.

            Then you went off on a tangent about huge medical bills, insinuating that people like me may be smart enough to earn the money to pay for our insurance, but we are not smart enough to know what to buy. No one was arguing against insuring against major medical. Again, this was an obvious tangent because you simply could not argue against my contention that it is no business of yours where I buy insurance..

            Now you are trying to buttress your argument about major medical, something that is not under contention so I have no idea why you are persisting with it. You are doing this with silly sarcasm accompanied by modified superlatives.

            If there is one thing I hate its a modified superlative.

            “If so, you have a very, very unique skill.”

            Normally I would not point this out, people make grammar mistakes all the time. I certainly do. But when you are trying to be cute, and the central sentence of an attempt to be sarcastic has such a glaring error, I have to point it out.

            Something is either unique or it is not. I could have a very very rare skill, but it is impossible to have a very very unique skill.

            So, since sarcasm doesn’t appear to be your strong suit, maybe you would like to get back to the issue at hand.

            Please tell me why it is any concern of yours what state I buy insurance in.

            Please tell me why it makes any sense to insure for accupuncture coverage, something where the exposure is so low the costs could never warrent it.

          • capor

            I think it is sad that a few of you get so caught up in name calling on this blog and truly have little intelligent information to add that could make a good argument anywhere. I think Rupert is as close as anyone can be on this subject however in as much as he points out repeatedly that this is an INSURANCE issue not a health care issue. It is apparent that some of the arguments from others here are clearly a fight to maintain the push to force the “haves” to pay for the “have-nots”. If we could all get the conversation back to one of major medical insurance and not of paid health care we might make some headway to solve some of this issue.
            Of course there is still the issue of how we cover those that financially cannot cover themselves. There still must be some form of incentive offered those folks for wellness care first and major medical needs second. Maybe we need to consider a better Medicare/Medicaid system? Isn’t that what those programs were designed for originally?

  • RobertHQ

    По моему у Вас украли эту статью и поместили на другом сайте. Я её уже видела.

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