Healthcare

[cradleandshoot]

Please tell me how you plan to control costs without socialization.

That involves more competition between states for starters. The more competition between healthcare providers would drive down costs. You give away your ultimate destination by your original question. You want socialized medicine. I have no problem with that. I have a problem that that you don't have the freaking balls to just say that to begin with. Your initial premise by your criticism of me was that the ACA was the greatest thing since sliced loaf bread. Can't you just be honest and admit the obvious. Walrus told me this same objective years ago. ACA was the first intended step towards socialized medicine. Why send up the sheepdip smokescreen that the ACA was anything else but that. I don't know about anybody else here but don't try and blow smoke up my ass. I have known and understood the end game for a long time. You would be better served to save your Buffalo chips for someone else.

[holmes435]

That involves more competition between states for starters. The more competition between healthcare providers would drive down costs. You give away your ultimate destination by your original question. You want socialized medicine. I have no problem with that. I have a problem that that you don't have the freaking balls to just say that to begin with. Your initial premise by your criticism of me was that the ACA was the greatest thing since sliced loaf bread. Can't you just be honest and admit the obvious. Walrus told me this same objective years ago. ACA was the first intended step towards socialized medicine. Why send up the sheepdip smokescreen that the ACA was anything else but that. I don't know about anybody else here but don't try and blow smoke up my ass. I have known and understood the end game for a long time. You would be better served to save your Buffalo chips for someone else.

A number of states already allow this. It hasn't lead to an increase in competition or a decrease in costs or insurance companies wanting to build the necessary networks.

What's your next solution? We already have many dozens of systems around the world that are much more effective and cheaper than ours to pick from.

I have the balls to say we need some kind of socialized medicine across the board, or at least socialized healthcare networks. It's a proven system over decades in many different countries. Then add in a secondary, private insurance / healthcare network for anyone who wants to buy it and skip the line or get things that aren't covered by the .gov.

The ACA was hamstrung from the get-go by Democrats wanting to work across the aisle by implementing a Heritage foundation plan previously enacted by Republicans. They went further trying to compromise with R's by bargaining away 160+ concessions over months of negotiations, including many public hearings and bipartisan meetings before passing the bill with no Republican votes to show for all those concessions.

There are no real solutions being proposed by the right. Please, please give me something more to work with, I'd love to hear more alternatives if there are any.

[CU77]

Please tell me how you plan to control costs without socialization.

That involves more competition between states for starters. The more competition between healthcare providers would drive down costs.

We've been there, done that. It doesn't work. The reason is simple: every insurance company, regardless of competition, makes more money by driving away the high-risk pool of pre-existing conditions. So they all do it.

You give away your ultimate destination by your original question. You want socialized medicine. I have no problem with that. I have a problem that that you don't have the freaking balls to just say that to begin with.

I think socialized medicine (a la Medicare) is the only thing that can keep down costs, so, yes, I want it.

Your initial premise by your criticism of me was that the ACA was the greatest thing since sliced loaf bread.

I never said that. I said it was the Ds best attempt at something they thought the Rs could sign on to, since the Rs wouldn't go for Medicare-for-all. You said it was some sort of Obama ego-trip. That's ridiculous.

Can't you just be honest and admit the obvious. Walrus told me this same objective years ago. ACA was the first intended step towards socialized medicine.

It was an attempt to try something that the Ds thought the Rs could go along with (since it was a variant of plans the Rs had previously endorsed). Most Ds, like me, didn't think it would work in the end, but, in deference to the Rs, they were willing to give it a shot. When the Rs unanimously refused to sign on, they went with it and hoped the Rs would come around eventually.

Here is what I want: a default option of medicare-for-all, but still the ability to buy private insurance if that's what someone wants to do. But then: no back-up from the gubmint if you opt out. If it turns out that your private plan has, say, a lifetime cap, and you hit the cap, your ass gets tossed out of the hospital and into the street.

[dislaxxic]

Obamacare ruling could cut deeper than many Americans realize

Meanwhile, in FRC LaLaLand...

First off Buffalo Chips with you dragging out that tired old line that the ACA was a Republican idea. That is Buffalo chips from the get go that no freaking Democrat would ever agree with any republican plan for health care. That is nothing more than a pathetic, lame ass excuse the Democrats keep on dragging out to blame their foul up on good old Mittens. 2nd point if you had been paying attention to my point of view way back to the old LP forum you would be much more well informed. I don't want to put words in his mouth because he no longer posts here, but Walrus and I had this exact same discussion. The point that Walrus made was it did not matter how poorly written the ACA was. Grab your knickers and hold on tight CU... the ACA was always meant to be and designed to be the stepping stone to... guess what... socialized medicine. The simple fact it was a cluster fudge regulation that created as many problems as it tried to solve laid the groundwork for the next step. What would that be? Well we tried our best and the ACA just isn't working.

No offense, but this "opinion" is so laughably wrong that it could rightly be called deplorable. The narrative it pushes is little more than an attempt to exculpate conservatives in general and FRC's in particular that nothing about the ACA was "their fault". Look no further than the UTTER FAILURE of said conservatives to propose, offer, establish, suggest, or even consider ONE STINKIN SINGLE SOLUTION to the entire issue of healthcare in general, since taking over all three branches of gubmint some time ago...to understand why vacuous bromides like that quoted above are so ridiculous.

No offense...

..

[ggait]

Every developed country in the world has universal coverage, except for the USA.

I'd love for the USA to have universal coverage that isn't run by the federal government. But if you don't like the approach taken by Obamacare, I'm hard pressed to see how there's going to be a less government-oriented alternative. I'm all ears if you can point to an existing model anywhere in the world that should serve as our exemplar.

Or is the plan for us to create a completely new/different system currently unknown to the rest of the world? That's doesn't seem like the best idea to me.

Based on what does exist in the real world, you got three choices:

Single Payer: The government provides insurance for all residents (or citizens) and pays all health care expenses except for co-pays and coinsurance. Providers may be public, private, or a combination of both.

Two-Tier: The government provides or mandates catastrophic or minimum insurance coverage for all residents (or citizens), while allowing the purchase of additional voluntary insurance or fee-for service care when desired. In Singapore all residents receive a catastrophic policy from the government coupled with a health savings account that they use to pay for routine care. In other countries like Ireland and Israel, the government provides a core policy which the majority of the population supplement with private insurance.

Insurance Mandate: The government mandates that all citizens purchase insurance, whether from private, public, or non-profit insurers. In some cases the insurer list is quite restrictive, while in others a healthy private market for insurance is simply regulated and standardized by the government. In this kind of system insurers are barred from rejecting sick individuals, and individuals are required to purchase insurance, in order to prevent typical health care market failures from arising.

Right now in the U.S., we have all three flavors. For oldsters, we pretty much have something that looks like single payor via private providers and/or two-tier (Medicare plus insurance). For vets, we have full on socialized medicine (state run providers, single payor). Obamacare is our attempt at insurance mandate.

I'd personally pick two-tier like Singapore if I was picking. That seems to be the best in terms of access, quality and cost. And I'd also like to see health insurance completely uncoupled from employment (which creates coverage gaps and really hoses up the economy). But that's not going to be primarily free market. Since that winged unicorn just doesn't exist anywhere -- certainly not in the USA.

So what plan are you backing C&S?

[Trinity]

https://www.propublica.org/article/va-p ... nger-waits

Trump’s VA is a disaster. Loves those vets, huh?

[cradleandshoot]

That involves more competition between states for starters. The more competition between healthcare providers would drive down costs. You give away your ultimate destination by your original question. You want socialized medicine. I have no problem with that. I have a problem that that you don't have the freaking balls to just say that to begin with. Your initial premise by your criticism of me was that the ACA was the greatest thing since sliced loaf bread. Can't you just be honest and admit the obvious. Walrus told me this same objective years ago. ACA was the first intended step towards socialized medicine. Why send up the sheepdip smokescreen that the ACA was anything else but that. I don't know about anybody else here but don't try and blow smoke up my ass. I have known and understood the end game for a long time. You would be better served to save your Buffalo chips for someone else.

A number of states already allow this. It hasn't lead to an increase in competition or a decrease in costs or insurance companies wanting to build the necessary networks.

What's your next solution? We already have many dozens of systems around the world that are much more effective and cheaper than ours to pick from.

I have the balls to say we need some kind of socialized medicine across the board, or at least socialized healthcare networks. It's a proven system over decades in many different countries. Then add in a secondary, private insurance / healthcare network for anyone who wants to buy it and skip the line or get things that aren't covered by the .gov.

The ACA was hamstrung from the get-go by Democrats wanting to work across the aisle by implementing a Heritage foundation plan previously enacted by Republicans. They went further trying to compromise with R's by bargaining away 160+ concessions over months of negotiations, including many public hearings and bipartisan meetings before passing the bill with no Republican votes to show for all those concessions.

There are no real solutions being proposed by the right. Please, please give me something more to work with, I'd love to hear more alternatives if there are any.

It could never be truly effective unless you could shop for you health care provider in all 50 states. For some strange reason the feds and the states don't want this to happen. Open competition on a large scale will drive down prices for educated consumers that take the time to shop. When you have 3 options in your state or you have 100 options from all over the country... duuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuhhhhhhhh.

I have the same question for all of you single payer supporters. You keep repeating the same old playbook line that it works great in other countries. Point taken. I ask all of you one more time, in a nation of 320 plus million people... HOW MUCH WILL IT COST?? The only honest answer is that NONE of you have the slightest clue how much it will cost. Your comparison comes from countries with relatively small populations with very high employment. You are making a grapes to watermelons comparison. I have not read anywhere and I have looked quite a bit an analysis of what it would cost to cover 320 million people for womb to the tomb health care. There are a bunch of very smart people out here that IMO know the answer and the dollar signs for how much it would cost for single payer. Since the only equivalent baseline we have to compare single payer in a similar form comes from the Veterans Administration and the fiasco they have put our veterans through.

Some folks out there think that the US government is up to the task of taking on a challenge of providing health care to all Americans that is about a thousand times more complicated than what the VA is trying to do. I suppose if you give the gubmint about 200 hundred years they may be able to iron out the kinks. Maybe the Democrats could look to the Heritage Foundation for a blueprint for success. I can never wrap my brain around the fact that in this one miraculous instance the Democrat Party fell in love with an idea from the Heritage Foundation and used their idea as the foundation for their health care plan. This is the same Democrat Party that looks at the Heritage Foundation the same way a sailor looks at a case of the clap. This was a Democrat interpretation of a Heritage Foundation plan that not a single freaking republican even voted for. Can't you FLP folks come up with a more credible lie than the old " we just borrowed a plan from the heritage foundation" It only works when you try and pass it off amongst yourselves


To make you feel better it is a certainty that down the road single payer will become how we do health care in the USA. It warms my heart to know that the Democrat Party will be working shoulder to shoulder with those folks at the Heritage Foundation to iron out the foundation for single payer. Yeah... right... over Nancy and Chucks dead bodies. Actually it does make sense... if single payer circles the toilet the Democrats can blame it all on the Heritage Foundation... yet again evil5 http://www.lawyersgunsmoneyblog.com/201 ... chart-form

[foreverlax]

That involves more competition between states for starters. The more competition between healthcare providers would drive down costs. You give away your ultimate destination by your original question. You want socialized medicine. I have no problem with that. I have a problem that that you don't have the freaking balls to just say that to begin with. Your initial premise by your criticism of me was that the ACA was the greatest thing since sliced loaf bread. Can't you just be honest and admit the obvious. Walrus told me this same objective years ago. ACA was the first intended step towards socialized medicine. Why send up the sheepdip smokescreen that the ACA was anything else but that. I don't know about anybody else here but don't try and blow smoke up my ass. I have known and understood the end game for a long time. You would be better served to save your Buffalo chips for someone else.

A number of states already allow this. It hasn't lead to an increase in competition or a decrease in costs or insurance companies wanting to build the necessary networks.

What's your next solution? We already have many dozens of systems around the world that are much more effective and cheaper than ours to pick from.

I have the balls to say we need some kind of socialized medicine across the board, or at least socialized healthcare networks. It's a proven system over decades in many different countries. Then add in a secondary, private insurance / healthcare network for anyone who wants to buy it and skip the line or get things that aren't covered by the .gov.

The ACA was hamstrung from the get-go by Democrats wanting to work across the aisle by implementing a Heritage foundation plan previously enacted by Republicans. They went further trying to compromise with R's by bargaining away 160+ concessions over months of negotiations, including many public hearings and bipartisan meetings before passing the bill with no Republican votes to show for all those concessions.

There are no real solutions being proposed by the right. Please, please give me something more to work with, I'd love to hear more alternatives if there are any.

It could never be truly effective unless you could shop for you health care provider in all 50 states. For some strange reason the feds and the states don't want this to happen. Open competition on a large scale will drive down prices for educated consumers that take the time to shop. When you have 3 options in your state or you have 100 options from all over the country... duuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuhhhhhhhh.As we have discussed here before - states regulate insurance....every state can evaluate any company that wants to come in. Are you saying that the regulation of insurance companies should now be done at the federal level?

I have the same question for all of you single payer supporters. You keep repeating the same old playbook line that it works great in other countries. Point taken. I ask all of you one more time, in a nation of 320 plus million people... HOW MUCH WILL IT COST?? The only honest answer is that NONE of you have the slightest clue how much it will cost. Your comparison comes from countries with relatively small populations with very high employment. You are making a grapes to watermelons comparison. I have not read anywhere and I have looked quite a bit an analysis of what it would cost to cover 320 million people for womb to the tomb health care. There are a bunch of very smart people out here that IMO know the answer and the dollar signs for how much it would cost for single payer. Since the only equivalent baseline we have to compare single payer in a similar form comes from the Veterans Administration and the fiasco they have put our veterans through.Try checking to see how much the single payer governments are spending and then divide that number by total population. The point is valid...there is zero transparency, we don't know what things cost vs what is charge.

Some folks out there think that the US government is up to the task of taking on a challenge of providing health care to all Americans that is about a thousand times more complicated than what the VA is trying to do. I suppose if you give the gubmint about 200 hundred years they may be able to iron out the kinks. Maybe the Democrats could look to the Heritage Foundation for a blueprint for success. I can never wrap my brain around the fact that in this one miraculous instance the Democrat Party fell in love with an idea from the Heritage Foundation and used their idea as the foundation for their health care plan. This is the same Democrat Party that looks at the Heritage Foundation the same way a sailor looks at a case of the clap. This was a Democrat interpretation of a Heritage Foundation plan that not a single freaking republican even voted for. Can't you FLP folks come up with a more credible lie than the old " we just borrowed a plan from the heritage foundation" It only works when you try and pass it off amongst yourselvesWhat are you talking about...services are being delivered, generally, to all. The process is ugly, inefficient and filled with fraud and waste.


To make you feel better it is a certainty that down the road single payer will become how we do health care in the USA. It warms my heart to know that the Democrat Party will be working shoulder to shoulder with those folks at the Heritage Foundation to iron out the foundation for single payer. Yeah... right... over Nancy and Chucks dead bodies. Actually it does make sense... if single payer circles the toilet the Democrats can blame it all on the Heritage Foundation... yet again evil5 http://www.lawyersgunsmoneyblog.com/201 ... chart-form

So your plan is hate and complain, while praying what you have in retirement doesn't fail, you.

[DMac]

cradle, most of what you say is about the democrats. That, imho, is why we have what we have. Healthcare is about politics, all about the D&R disease. Money is the virus. Big Pharm pushing pills to the tune of billions, insurance industry calling the $hots. That whole strain of humans is the parasite that feeds off of illness and fear. The whole picture is sickening....aint no 1%ers willing to give up part of their flow to help some folks out.
Mighty hard for me to believe we don't have a group of people smart enough to come up with a doable solution in the USofA.

[foreverlax]

cradle, most of what you say is about the democrats. That, imho, is why we have what we have. Healthcare is about politics, all about the D&R disease. Money is the virus. Big Pharm pushing pills to the tune of billions, insurance industry calling the $hots. That whole strain of humans is the parasite that feeds off of illness and fear. The whole picture is sickening....aint no 1%ers willing to give up part of their flow to help some folks out.
Mighty hard for me to believe we don't have a group of people smart enough to come up with a doable solution in the USofA.

+1.

[youthathletics]

Heard a politician on talk radio today, who when he was just getting his feet wet was told by a senior official “ the best thing you can do for America is get re-elected”.... quite telling I’d say.

[ggait]

HOW MUCH WILL IT COST?? The only honest answer is that NONE of you have the slightest clue how much it will cost.

To which I counter, how much does the current system cost?

Sure it would take a lot of taxes to pay for a public universal coverage system. But if we paid for it with taxes, then we would save what we are currently paying in the form of employee compensation. No one ever talks about this. I just went through this with my kid, who now has his first full time job with health care benefits.

I helped him pick out his health plan choices during open enrollment. Since he is young and single, the cost of the plan he chose (with a high deductible) was within the subsidy he got from his employer. So the kid thought it was "free" to get insurance. As I pointed out to him, the company was paying for his "free" insurance. Told him that if we had taxpayer funded health insurance, then his company would be willing and able to pay him many thousands of extra dollars in salary. Kid's head exploded -- "I'm getting ripped by that stupid expensive health insurance that I don't even want or need. I could buy a new car with that money I'm not getting!"

As a self employed business owner, I see exactly what I pay to cover my family. If my taxes went up $25k a year to get single payor, why would I care if I also saved the $25k I now pay for private insurance?

[ggait]

It could never be truly effective unless you could shop for you health care provider in all 50 states.

Health care will always be primarily a local product. Regardless of what kind of system you have.

To deliver health care effectively and efficiently, you need a certain density of providers and facilities and consumers to make it work. If an insurer builds out a good network of providers/facilities/consumers in one area, that network has limited utility to providers/facilities/customers in another area. A dermatologist in Alaska will never treat a kid with zits in Florida at a clinic located in Kansas. So why would any insurer ever want to endeavor to build out its network in those three places?

Health care is one of those products that can't be delivered everywhere over the internet or by Amazon or outsourced to India. It is quite logical that it would mostly exist (and compete) primarily on a local/regional basis. You can eliminate every regulatory barrier that exists, and you still wouldn't get much competition beyond the local/regional area. Two or three competitors in a local/regional location is about the only level of natural competition that makes sense or will likely exist.

So the 50 state competition talking point is, imho, almost 100% complete bull shirt. It ain't the problem and it won't be the solution.

[Trinity]

It’s usually trotted out to allow national companies to adhere to the standards of the worst state, say Mississippi.

[cradleandshoot]

HOW MUCH WILL IT COST?? The only honest answer is that NONE of you have the slightest clue how much it will cost.

To which I counter, how much does the current system cost?

Sure it would take a lot of taxes to pay for a public universal coverage system. But if we paid for it with taxes, then we would save what we are currently paying in the form of employee compensation. No one ever talks about this. I just went through this with my kid, who now has his first full time job with health care benefits.

I helped him pick out his health plan choices during open enrollment. Since he is young and single, the cost of the plan he chose (with a high deductible) was within the subsidy he got from his employer. So the kid thought it was "free" to get insurance. As I pointed out to him, the company was paying for his "free" insurance. Told him that if we had taxpayer funded health insurance, then his company would be willing and able to pay him many thousands of extra dollars in salary. Kid's head exploded -- "I'm getting ripped by that stupid expensive health insurance that I don't even want or need. I could buy a new car with that money I'm not getting!"

As a self employed business owner, I see exactly what I pay to cover my family. If my taxes went up $25k a year to get single payor, why would I care if I also saved the $25k I now pay for private insurance?

All of your points are valid... but until all of the costs are figured out it may not be feasible to insure 320 million people. I could list about a thousand question here about how do you pay for it and implement so. None of that gets you to what the final tab is. This is just off the top of my head... 320 million at am estimated cost of 1000 dollars a person is 3.2 trillion dollars a year. IMO there needs to be a whole little details to be figured out before any sp plan can even be deemed feasible. If the gubmint screws this up, which previous experience says that they will. There will be an enormous problem that yet again will need to be fixed. The USA does not need a VA health care system on steroids. The gubmint keeps swinging and missing at that fix. Given their ineptitude in that endeavour it makes perfect sense to let them tackle a problem 1000 times more difficult.

[SCLaxAttack]

HOW MUCH WILL IT COST?? The only honest answer is that NONE of you have the slightest clue how much it will cost.

To which I counter, how much does the current system cost?

Sure it would take a lot of taxes to pay for a public universal coverage system. But if we paid for it with taxes, then we would save what we are currently paying in the form of employee compensation. No one ever talks about this. I just went through this with my kid, who now has his first full time job with health care benefits.

I helped him pick out his health plan choices during open enrollment. Since he is young and single, the cost of the plan he chose (with a high deductible) was within the subsidy he got from his employer. So the kid thought it was "free" to get insurance. As I pointed out to him, the company was paying for his "free" insurance. Told him that if we had taxpayer funded health insurance, then his company would be willing and able to pay him many thousands of extra dollars in salary. Kid's head exploded -- "I'm getting ripped by that stupid expensive health insurance that I don't even want or need. I could buy a new car with that money I'm not getting!"

As a self employed business owner, I see exactly what I pay to cover my family. If my taxes went up $25k a year to get single payor, why would I care if I also saved the $25k I now pay for private insurance?

GGait, I’ve been pointing this out as a major flaw in health insurance provisioning since the first LP healthcare discussions. I believe corporations negotiating with insurers and providing insurance as a benefit is a major reason for our high insurance costs. Eliminate health insurance as a company benefit. If everyone had a personal benefit in shopping for their own insurance and not just the self-employed, watch how those 10s of millions more people who would now shop for their insurance would influence insurance costs.

[youthathletics]

I'm on the fence with your discussion because it could end up being a battle of the bells all over again, or how we all get screwed by cell and cable companies. Ultimately we'd end up 2-3 major insurance carriers, who set the price that we are all "stuck" with.

[DMac]

ggait wrote

I helped him pick out his health plan choices during open enrollment. Since he is young and single, the cost of the plan he chose (with a high deductible) was within the subsidy he got from his employer.

....and if your son had drawn the short straw at birth and been affected by the diabetes gene, he'd know just how high that deductible is. My youngest (38...well, will be on Christmas Day) pays $4-5K/yr on top of his premiums for insulin and the other stuff he needs to stay alive in order to meet that deductible....office visit costs/co-pays, etc on top of that too (and that's with pretty good insurance). If the insurance industry would stop the gouging, prices could be much more affordable than they are. It's a crooked and corrupt industry.
https://www.ontrackdiabetes.com/type-1- ... still-high

Between 2002 and 2013, the average price for this life-saving, injectable drug used by nearly 10 million Americans with diabetes has tripled, according to the American Diabetes Association (ADA). “No one who relies on insulin should have to wonder if they’ll be able to afford it,” the ADA asserts in an online petition for its Stand Up for Affordable Insulin campaign.1

This is BS.

[holmes435]

All of your points are valid... but until all of the costs are figured out it may not be feasible to insure 320 million people. I could list about a thousand question here about how do you pay for it and implement so. None of that gets you to what the final tab is. This is just off the top of my head... 320 million at am estimated cost of 1000 dollars a person is 3.2 trillion dollars a year. IMO there needs to be a whole little details to be figured out before any sp plan can even be deemed feasible. If the gubmint screws this up, which previous experience says that they will. There will be an enormous problem that yet again will need to be fixed. The USA does not need a VA health care system on steroids. The gubmint keeps swinging and missing at that fix. Given their ineptitude in that endeavour it makes perfect sense to let them tackle a problem 1000 times more difficult.

320 million at $1,000 a pop is actually $320 Billion.

We currently spend about $3.5 Trillion from what I could find. That is public and private combined, close to $10,000 per person. Most universal systems in good countries are ranging from about $3,500 - $6,000 per person (and still includes private systems as well), or $1.1T to $2T per year if implemented in the US.

As a comparison, we spend about $1.5T on the multiple, cobbled together public health insurance and care systems that overlap and have many redundancies and only covers 2/3 of Americans.

We're not looking for a VA care system on steroids, we're looking for something a single insurer across the country, like Medicare. Or if you want to compromise and still want private insurers and want your cross-state lines idea to actually work, we need a nationalized care provider medical network. Insurers don't have to build their own, every certified care provider gets to join the network, and your insurance works everywhere. That should cut costs some.

[SCLaxAttack]

I'm on the fence with your discussion because it could end up being a battle of the bells all over again, or how we all get screwed by cell and cable companies. Ultimately we'd end up 2-3 major insurance carriers, who set the price that we are all "stuck" with.

Youth, I could be wrong (and someone here will undoubtedly chime in if I am ), but I don’t think health insurance to cell and cable companies is apples to apples. I would think cell and cable infrastructure costs - tower, cable, and fiber ownership - would make the end result different. Auto and home insurance hasn’t shrunk to two players, so I wouldn’t think health insurance would either.