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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (6856)	6/1/2009 5:26:45 PM
From: i-node	Read Replies (1) \| Respond to of 42652

I have federal employee BCBS, same as I had before I reached Medicare age. I pay the same for it as I always did. The only difference I think is that Medicare pays first and BCBS doesn't charge me deductibles or co-pays. I know that staffs in doctor's offices salivate when I tell them I have federal BCBS so they must be getting paid more than just the full Medicare rate. It depends on which is "primary". If Medicare is primary, the FEP will pick up the difference, if FEP is primary (usually the case), the allowable is higher and MC may pick [part of] the difference. Here are the rules for FEP (pg. 27) fepblue.org

To: Lane3 who wrote (6856)	6/1/2009 5:27:12 PM
From: Lane3	1 Recommendation Read Replies (1) \| Respond to of 42652

Gorman on Health Reform David Henderson This month's featured article on Econlib is by health economist Linda Gorman. Gorman points out that Blue Cross was given an important tax advantage over commercial insurers early in the game and that Medicare and Medicaid were modeled on Blue Cross. Gorman also discusses a sector of the U.S. health-insurance market that seems to be working well, namely, the market for individually-purchased health insurance. Excerpt: Direct-purchase markets pool risk extensively, charging high risk people far lower premiums than their health status might indicate. Most direct-purchase policies are renewable without additional underwriting. This means that as long as he pays the premium, an insured person can keep his policy no matter how sick he gets. Contrary to popular claims, state laws generally prohibit raising a sick individual's premiums unless an insurer also raises the premiums of everyone else in his rating class. Pauly and Herring report that direct-purchase insureds who had medical expenses about 4 times that of other people enjoyed premiums that were only 1.6 times as high. People who buy a policy and become ill have a strong incentive to continue paying. This may explain why age and sex were generally better predictors of direct-purchase premiums than chronic conditions. Marquis et al. concur, reporting that the individual direct-purchase market is "an important source of long-term coverage for many who purchase it" and that "there is substantial pooling" that "increases over time because people who become sick can continue coverage without new underwriting." econlog.econlib.org econlib.org