Blue Cross,California v Irish health service

[patslatt]

The Irish HSE health service spends about €12 billion a year,around €3,000 a head,or roughly €12,000 a family of four. In comparing this spending to Blue Cross's fees discussed below, you could take the current depressed exchange rate of the dollar at over $1.40 to the Euro,or you could assume that the dollar will bounce back eventually to,say, $1.20.

Blue Cross in California offers comprehensive health plans within its very large network of hospitals and doctors and also offers the option to go outside its network. For costs of premiums,see the tables http://www.bluecrossca.com/member/noapp ... 082352.pdf
Remember to add 30% to the fees to allow for co-payments required on a wide range of treatments.

For example,in the first table,monthly fees vary from $839 to $1,059 depending on the area for a family aged 40 to 44 (presumably the age of parents),or $10,068 to $12,708 a year. Adding the 30% increases this to
$13,088 to $16,520. At $1.20 exchange rate,this is €8,390 to €13,767.

Let's say the government was prepared to give you directly the taxes it gives to the HSE to let you buy Blue Cross here (this would take considerable time to set up,of course),would you prefer that? Each individual would receive €3,000 and a family of four would receive €12,000 to buy a government approved service like that provided by Blue Cross or a similar health care provider. By requiring standardised plans, the government could reduce costs considerably.

[seabhcan]

The WHO rates Ireland's HSE as the 19th best health care system in the world. The US (including Blue Cross) is ranked 38th, behind Costa Rica. Why would we use this country as an example for us to improve, when we're already better than them?

You should watch Michael Moore's film "Sicko". Deals with this suggestion nicely.

[SPN]

Blue Cross is a racket.

We would be much better off remodelling the VHI, a not-for-profit mutual Health Insurer, to be more effective in meeting the Citizen's needs instead of trying to adopt the failed for-profit model that has caused so many problems for Citizens in the USA.

In 2006, 10 former Blue Cross members sued the insurer, claiming Blue Cross had retroactively cancelled their coverage after illness or expensive medical conditions -- such as pregnancy -- surfaced. These policies were cancelled after consumers had been paying premiums for months, even years.2 The class-action lawsuit against the insurer has grown to 6,000 former members who say the same thing happened to them.

Blue Cross employees, under oath, admit that insurance policies undergo additional scrutiny if a patient has an expensive claim. Against state law, the company rescinded coverage after mistakes on applications were discovered -- not fraud.3

Patients were often left with thousands, if not hundreds of thousands of dollars in unpaid medical bills for procedures that Blue Cross had previously approved before cancelling coverage. Doctors and hospitals eventually joined the class action lawsuit against Blue Cross to recoup some of those claims.

This year, the Department of Insurance investigated BC Life, a Blue Cross Company, and its cancellation of policies. It found improprieties in over half of the cases it investigated. The Department slapped the company with 67 citations. Earlier this year, the Department of Managed Care looked at Blue Cross rescissions and, after evaluating 90 cases, issued citations in every one.4

[The Earl of Desmond]

Is Harney's husband on the Board of Blue Cross yet?

[patslatt]

The WHO rates Ireland's HSE as the 19th best health care system in the world. The US (including Blue Cross) is ranked 38th, behind Costa Rica. Why would we use this country as an example for us to improve, when we're already better than them?

You should watch Michael Moore's film "Sicko". Deals with this suggestion nicely.

Michael is very entertaining propagandist and many of his criticisms of lack of access to health care are no doubt correct. The US's low ranking is caused by lack of affordable health care and lack of subsidy for low income people,not lack of quality.

For Americans with good insurance coverage, the quality of care is excellent. With the money the HSE is spending, we could afford the best type of insurance coverage the US has to offer.

[patslatt]

Blue Cross is a racket.

We would be much better off remodelling the VHI, a not-for-profit mutual Health Insurer, to be more effective in meeting the Citizen's needs instead of trying to adopt the failed for-profit model that has caused so many problems for Citizens in the USA.

In 2006, 10 former Blue Cross members sued the insurer, claiming Blue Cross had retroactively cancelled their coverage after illness or expensive medical conditions -- such as pregnancy -- surfaced. These policies were cancelled after consumers had been paying premiums for months, even years.2 The class-action lawsuit against the insurer has grown to 6,000 former members who say the same thing happened to them.

Blue Cross employees, under oath, admit that insurance policies undergo additional scrutiny if a patient has an expensive claim. Against state law, the company rescinded coverage after mistakes on applications were discovered -- not fraud.3

Patients were often left with thousands, if not hundreds of thousands of dollars in unpaid medical bills for procedures that Blue Cross had previously approved before cancelling coverage. Doctors and hospitals eventually joined the class action lawsuit against Blue Cross to recoup some of those claims.

This year, the Department of Insurance investigated BC Life, a Blue Cross Company, and its cancellation of policies. It found improprieties in over half of the cases it investigated. The Department slapped the company with 67 citations. Earlier this year, the Department of Managed Care looked at Blue Cross rescissions and, after evaluating 90 cases, issued citations in every one.4

Insurers are big campaign contributors to US politicians, which tends to lead to weak government regulation of insurers who cut corners. If Ireland were to use insurers instead of the HSE, a government inspectorate would be needed to ensure quality control in hospitals. Patients should have a right of appeal to a government mediator when expensive treatments are refused by insurers on the grounds of evidence-based medicine.

The problem of not-for-profit VHI is that it seems to be a soft touch for doctors and doesn't try hard enough to minimise unnecessary surgery (only 3% of heart patients need surgery,the rest are just as well off using drug therapies). Some aggresssive for profit insurers or hospital management companies are needed here to curb the ruthless economic exploitation of health care by the professional associations and trade unions.

While insurers can be greedy, bear in mind that free government health services ration severely,even for operations that would be considered minor in the US,such as hip replacements. At present,hundreds of Irish stroke victims are dying needlessly for want of therapy every year even as the government enters its leisurely third year of negotiations with hospital consultants.Someone should bring a class action against both of them!

[seabhcan]

Remember to add 30% to the fees to allow for co-payments required on a wide range of treatments. ...

Adding the 30% increases this to
$13,088 to $16,520.

Your calculations are flawed. The 30% co-pays are 30% of treatment costs, not policy costs. So a US Blue Cross customer pays his $10,000 a year while he's well. Then, after say 15 years ($150,000 spent) he gets cancer. Treatment costs are judged to be, say, $400,000. Then he must fork out an additional $120,000 that year, in addition to his $10,000 policy.

If he is the primary earner of the family, he will be unimployed during treatment also.

The biggest cause of homelessness and bankruptcy in the US is health care costs. Having insurance does not fully protect everyone from this.

[patslatt]

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[patslatt]

Remember to add 30% to the fees to allow for co-payments required on a wide range of treatments. ...

Adding the 30% increases this to
$13,088 to $16,520.

Your calculations are flawed. The 30% co-pays are 30% of treatment costs, not policy costs. So a US Blue Cross customer pays his $10,000 a year while he's well. Then, after say 15 years ($150,000 spent) he gets cancer. Treatment costs are judged to be, say, $400,000. Then he must fork out an additional $120,000 that year, in addition to his $10,000 policy.

If he is the primary earner of the family, he will be unimployed during treatment also.

The biggest cause of homelessness and bankruptcy in the US is health care costs. Having insurance does not fully protect everyone from this.

It's possible to buy extra insurance from the insurer or a separate insurer to cover the co-payment. The cost should be roughly an extra 30%.However, I read about a possibly paranoid woman who bought a dozen different insurance policies to cover all the possible loopholes in her health care coverage.

Co-payments were primarily designed to encourage patients to challenge excessive treatments by doctors. For example,only about 3% of heart patients need surgery and the rest can be treated effectively by a new generation of drugs,but try telling a surgeon that.

[seabhcan]

Remember to add 30% to the fees to allow for co-payments required on a wide range of treatments. ...

Adding the 30% increases this to
$13,088 to $16,520.

Your calculations are flawed. The 30% co-pays are 30% of treatment costs, not policy costs. So a US Blue Cross customer pays his $10,000 a year while he's well. Then, after say 15 years ($150,000 spent) he gets cancer. Treatment costs are judged to be, say, $400,000. Then he must fork out an additional $120,000 that year, in addition to his $10,000 policy.

If he is the primary earner of the family, he will be unimployed during treatment also.

The biggest cause of homelessness and bankruptcy in the US is health care costs. Having insurance does not fully protect everyone from this.

It's possible to buy extra insurance from the insurer or a separate insurer to cover the co-payment. The cost should be roughly an extra 30%.

Co-payments were primarily designed to encourage patients to challenge excessive treatments by doctors. For example,only about 3% of heart patients need surgery and the rest can be treated effectively by a new generation of drugs,but try telling a surgeon that.

How can a patient, who has no medical knowledge, challenge a doctor based on cost?

More likely is that those with the money will get the treatment, and those without will not, regardless of whether they are in the 3% or not.