patrick.net

clambo says

You could be a total reprobate and be like a Mexican, and have NO health insurance.

Being Mexican has nothing to do with insurance status. clambo says

Most people could get by fine...

No, most people could not get by fine with the method you propose. Many people are out of work, are losing their homes, are living at or below the poverty line and can't afford to purchase insurance.

pianist says

My apologies to you if a single-payer system is not your dream.

Single payer would be awesome - I do believe that insurance companies are evil, but I also believe that hospital corporations and huge healthcare corporations are part of the problem. I'm glad that you've been able to negotiate bills down and only wish that more people had the financial capabilities to directly pay their bills.

This might be a bit out there but technically speaking there should be incentives for insurance companies to insure (no pun intended) that they have the most people that are health/viable.

To some they simply cut people off that have sicknesses by denying them to begin with. Ethics aside that does not fit well in the long term.

If it can be established that the majority of people on a system are healthy to a given point but ultimately will get the same conditions (heart disease/cancers etc) then it would make more sense for some of these to try to do r&d in order to fix the problem

On the same note car insurance companies should research what products they can make that make cars safer and they would directly benefit.

Insurance is also odd in that they are creating policies that only hurt themselves. The first reason why people have insurance is because care is expensive without it. But on the same note insurance companies take a long time in paying bills. "Net" means the number of days that a bill is due. Usually terms are net 30 or 60..when I did collections hospitals would claim net 180! Some doctors now take significant discounts for paying in cash. Would they rather than 75% today or 100% potentially in months...

All arguments for or against single payer insurance aside, the biggest problem with health care is that people are literally being overcharged by a factor of +10x. Even the doctors, who take the Hippocratic oath.. having been grossly overcharged for their education; think nothing of saddling someone who barely makes a fifth of what they do with thousand dollar charges left and right without their consent.

Danaseb says

All arguments for or against single payer insurance aside, the biggest problem with health care is that people are literally being overcharged by a factor of +10x. Even the doctors, who take the Hippocratic oath.. having been grossly overcharged for their education; think nothing of saddling someone who barely makes a fifth of what they do with thousand dollar charges left and right without their consent.

But on the same point it is the state that grants the license to practice as a doctor. Some states also make it illegal for drug stores to operate clinics...and of course alternative medicine is often shunned.

Wait. A 12% increase in life expectancy is not significant? How much longer did you want to live? Are you disappointed that our cars aren't flying yet either?

Where are my flying cars! I was promised flying cars!
http://www.youtube.com/watch?v=PRl_D_CunWA

Certainly a 12% increase in life expectancy is significant. But gains at this point might be marginal. What point these days is someone old? If someone is about to die at the age of 95 how much should be given in care to allow them to live another year, another month etc.

What if in another 40 years some people live to 120..would 60 years old then become middle aged?

I live in a nation with mandatory national health insurance and, at age 35, start to get angry when I think about how much more money I'd have if I'd never had to pay into it.

My medical expenses have been about $200 over the past 13 years. The insurance pays 70% of your bill and you pay the other 30%, so if I'd been paying cash, I'd have spent another $600, or $800 in total.

Contrast this with the roughly $39,000 I've paid in premiums over that time.

Yeah, I know, stop complaining because it'll work to your benefit when you're 70 or over. But for someone well short of 70, national health insurance is like a giant subsidy from young working people to the elderly. They really need to change the premium amounts to reflect one's propensity to require care. Basing it only on income is very unfair, and keeps young people from securing their financial futures.

Michinaga,

Based on your numbers, you have paid on the average 39000/13/12 or $250/month for health insurance for the last 13 years, from age 22-35.

That really does not seem very expensive to me. I wish I could pay $250/month.

It's called insurance for a reason. Clearly, if everyone got out the money that they put into it, it wouldn't actually serve a purpose.

I'm a historian. The actual mortality rates for a society in which health care is very expensive and in most people have no insurance are likely to be much higher than you suppose, and mortality rates would escalate over time. People are not aware of just how grim the mortality figures used to be prior to the introduction of vaccinations, antibiotics, and routine surgical procedures in the mid-20th c. The average male lifespan was about 40, and women died on average in their early 30s due to childbirth. You say you've always been healthy, but your mother probably had prenatal care and a supervised delivery (both presently unaffordable without insurance). You were vaccinated as a child and so was nearly everyone you came in contact with. That occasional ear or urinary or throat infection didn't progress to something more serious because you received antibiotics. You didn’t grow up exposed to diseases like tuberculosis because the people you came in contact with were seldom infected with those diseases.

The problem with our medical system is that routine care (not just catastrophic care) is becoming unaffordable; for the uninsured, a simple trip to the doctor can easily total a thousand dollars, factoring in that the uninsured are charged considerably more for the doctor’s time, lab tests, and prescriptions.

The premise that health insurance is mainly for old people and the occasional unlucky individual is wrong. The most vulnerable age is the first few years of life (this is especially true for boys, who die at higher rates than girls). Women are at high risk in their childbearing years. Even the rich who can pay out of pocket suffer when a large portion of society goes without routine care. I’ve always been insured, but I grew up in a third world country where most people didn’t see a doctor unless the situation was dire. Serious diseases were in common circulation there, and even the wealthy were sicker than the average middle class person in the United States. For example, despite an excellent diet and routine checkups, I had a serious bout of tuberculosis as a child; my school friends had hepatitis, typhoid, and polio.

Michinaga says

I live in a nation with mandatory national health insurance and, at age 35, start to get angry when I think about how much more money I'd have if I'd never had to pay into it.

My medical expenses have been about $200 over the past 13 years. The insurance pays 70% of your bill and you pay the other 30%, so if I'd been paying cash, I'd have spent another $600, or $800 in total.

Contrast this with the roughly $39,000 I've paid in premiums over that time.

Yeah, I know, stop complaining because it'll work to your benefit when you're 70 or over. But for someone well short of 70, national health insurance is like a giant subsidy from young working people to the elderly. They really need to change the premium amounts to reflect one's propensity to require care. Basing it only on income is very unfair, and keeps young people from securing their financial futures.

So young people don't get cancer or hit by cars? I don't buy the premise that young peopel should pay less because they are healthier. Younger people are more likely to get into car accidents, for instance.

HousingWatcher says

Younger people are more likely to get into car accidents, for instance.

That's a bit debatable. Younger drivers can get better but there might not be the evidence for that with older. How often do drivers that fail vision tests get licenses? Most states only test drivers every few years rather than every year. The AARP is a pretty significant lobbying firm.

Let's not also forget that if someone older OD's and dies sometimes they'll just say "natural causes" in the media to avoid embarrassing the families.

That's pretty simple. Until you die, just like we have for thousands of years. We could probably cut insurance costs considerably by not allowing teens to get drivers license until they are 18.

A focus on prevention may help as well.

The biggest problem with our health care system is we treat symptoms, not causes.

Now that our genes are starting to become mutated from things like DU, radiation, and chemicals in our food stuffs, I can honestly say the sky is the limit when it comes to health care and insurance.

everything says

That's pretty simple. Until you die, just like we have for thousands of years. We could probably cut insurance costs considerably by not allowing teens to get drivers license until they are 18

Maybe but that might not always work. That could restrict employment in more suburban areas which could also hurt in the long run.

I think pretty much everyone belongs in at least one demographic group that is at a quite higher risk of some health problem or emergency than certain other demographic groups.

Can we just leave it at that and stop fussing over some demographic group X that we think have bad habits and therefore should pay more for health insurance than your own group?

If we take that type of thinking to the extreme, what will we get? You guessed it, we will get the lousy privatized system that we have now, where everyone is getting a bad deal and the insurers get tons of profits, and the cost control is nearly non-existent.

Concentrate on getting universal health care and cost controls, stop fussing about how some people are stupid and don't deserve any insurance.

justme says

Concentrate on getting universal health care and cost controls, stop fussing about how some people are stupid and don't deserve any insurance.

More than that, people who are stupid with their health and safety are more likely to have shorter lifespans and therefore lower lifetime healthcare costs.

I can't imagine why, but some people have a VERY difficult time grasping this concept.

CCR, that is an interesting point.

However I have not seen any real data on this. It could be the demographic of the careless run up fairly substantial costs even if they die younger than the rest.

My point is that we should all stop fussing about this and start improving the system as a whole. Let's look at the big picture.

We spend the majority of our national health care dollars on the last 3-6 months of one's life. It is silly to try and change human perception of fighting for life. Sure, when it's somebody else, it's easy to say roll over and die, you are so far out of my sphere that i don't have the energy to sweat out your health, when death is inevitable. when it is one of your own, most will not attach a price to life

The middle men insurance swindlers certainly aren't going away any time soon, Obamacare will shackle every last sap into buying into that booswaggle. Six thousand a year isn't that bad, but it's certainly not that good either. Hard to attach a value to something that i never use. Often mentioned on this board is to remove the MID, and it would make housing so much cheaper, well what would the effect of removing the employer deduction for compensating pay with health insurance do to health care costs?

There is one thing that we can do on our own to not participate in their game of drugs and fear. Eat healthy, live healthy, and you can avoid doctors for the wide array of issues that people that participate in poisoning themselves with sugars, and stress of life in their system. That is what is in control of your own health.

How does it work in your state with hospital bills and auto insurance? Here we buy auto insurance to cover hospital bills in case of an accident

justme says

My point is that we should all stop fussing about this and start improving the system as a whole. Let's look at the big picture.

I agree. I just get annoyed by the strain of control freaks who, without a moment of thought, argue that everybody should be forced to follow their lifestyle prescription because all those weirdos are making their insurance more expensive.

errc says

We spend the majority of our national health care dollars on the last 3-6 months of one's life

That makes a point but also gets into another issue. Monopolies at funeral homes. I know it's grim to suggest competition within it but it is bad enough when people pass away..it's even worse to spend thousands and thousands on a burial. Cremation is more accepted now but in some areas it is harder to do.

mdovell says

errc says

We spend the majority of our national health care dollars on the last 3-6 months of one's life

That makes a point but also gets into another issue. Monopolies at funeral homes. I know it's grim to suggest competition within it but it is bad enough when people pass away..it's even worse to spend thousands and thousands on a burial. Cremation is more accepted now but in some areas it is harder to do.

That pretty much answers it: on average one would live about 3 months less without health insurance.

Health insurance, like many insurances, is a scam. Sadly its very existence drives up the cost of the eventuality it insures against.

Nobody actually needs health insurance....what they need is medical care, and there is no reason why insurance should be used to buy most medical care when it is a routine and entirely predictable expense (3-4 doctor/dentists/year).

Fantom says

Health insurance, like many insurances, is a scam. Sadly its very existence drives up the cost of the eventuality it insures against.

Nobody actually needs health insurance....what they need is medical care, and there is no reason why insurance should be used to buy most medical care when it is a routine and entirely predictable expense (3-4 doctor/dentists/year).

And exactly how many people have the resources to pay for surgery without insurance?

HousingWatcher says

And exactly how many people have the resources to pay for surgery without insurance?

Depends. Insurance locks you not only into the amount that the doctors would get paid but also the time structure. Some medical workers actually give discounts if you don't use insurance. You cannot negotiate pricing with insurance.

Only a very very small number of peopel have enough money to fully cover their medical expenses... perhaps no more than 5% of the population.

Gosh, without health insurance most women/families would go bankrupt with every birth, and a larger percentage of babies would die in childbirth or shortly thereafter.

You may be single or childless now, but will you always be so?

Do you want your sister, mother, daughter, aunt, neice to go bankrupt, possibly die, or lose a baby? Skip prenatal care?

Rather why is the US the ONLY developed nation that DOESN'T have universal care? Backwards, short-sighted nation in my opinion.

And the fact prices are 10x for the uninsured compared to the insured is truly criminal. Where's the class-action lawsuit on that one?

mdovell says

Monopolies at funeral homes.

Funeral planning is the one area that frosts my ass! they talk about "tributes" and the quality of the caskets - they'll hold up for years! - and all that shit. They prey on the emotions of a person during their most vulnerable moments. I love the competition in the larger cities - it results in $300 cremations and less than $1000 burials.

My kids know to spend the very least amount possible; I'm not Irish, but I would like them to spend more on alcohol for the party than for the burial itself.

Brentok3 says

I've read a statistic in various places that 85% of the increase in longevity in the US during the twentieth century was due to public health measures, not due to allopathic care.
Public health measures would include trash collection, water treatment, sewer treatment, central heating, food inspection, refrigeration, food storage and shipping improvements, control of vermin and insects, and vaccinations, and perhaps even workplace safety measures, and perhaps some would even consider product safety improvements.

There are statisticians who say more lives were saved in the 20th century by plumbers than by doctors.

I've always wondered why plumbers demand such a high price tag