The $23,000 bug bite

[AvalonXQ]

(*Note: Argument doesn't apply to pooling risk through purchasing insurance because that's different!!)

It is different, because it's voluntary.
For a little longer anyway.

 

[PhantomWolf]

It is different, because it's voluntary.
For a little longer anyway.

Of course you already non-voluntarily pay more for Health Care in your Taxes than they do in the UK, or even here, but you can't use it. Does that make sense?

 

[LTC8K6]

You only have to afford the insurance payments + what insurance doesn't cover, not the whole hospital bill.

So why are people talking about having to pay the whole bill? Only those foolish enough to think they don't need insurance would have to think about a payment plan or tackling the whole bill somehow.

Under PPACA, this will be exactly the same for nearly all of us, except you will be required to pay either a premium or a tax. The premiums vary with the level of insurance you want.

I think you will have to be below the federal poverty level to get "free" basic insurance coverage.

I wonder how anyone who has a job and can't afford insurance now, will be able to afford insurance under PPACA, or afford the tax.

Right now I pay $13.50 a week, subsidized by my employer, for health and dental coverage. So it's about $58.50 per month out of pocket for me.

Fortunately, my company is too small to have to worry about PPACA.

 

[LTC8K6]

http://en.wikipedia.org/wiki/Patien...rdable_Care_Act#Impact_on_child-only_policies

Might be a good idea to read over exactly what PPACA will and won't do, and where the money is coming from.

 

[WildCat]

For everything that your government provides you? Or just healt care? Are you happy to be red in respect to say, a fire service? Or the police and security services? Or any number of thousands of things that are funded from taxes. Are you going to give all of those up?

Cain often parodies extremists in the GOP, and that's what he's doing here.

Just a heads up.

 

[3point14]

Cain often parodies extremists in the GOP, and that's what he's doing here.

Just a heads up.

Thanks

 

[Cayvmann]

yea but your evil socialists and god doesn't love you! Here in "Merika we knows betre thaen to have sooshilist evil muslim un'Merkan save our lifes and health.

If GOD can't do it well then you must be a sinner and the least you diserve is to lose all your savings adn your kids future don't you know.

OH and HOW DARE YOU EVEN SUGGEST to take away our freedom by giving us health care. I mean HOW DARE YOU

That really should have been funny, but it's so close to the attitudes here at work, that it makes me sad.

 

[Cayvmann]

Does anyone else find that it is rather ironic and sadly funny that some people argue that it is much better to pay more for a health system that you can't use than for a NHS that anyone can use, and still have to pay for Private Insurance on top of that, which still might require you paying out hundreds if not thousands more in excess?

Not ironic, the term I'd use is moronic.

 

[AvalonXQ]

Of course you already non-voluntarily pay more for Health Care in your Taxes than they do in the UK, or even here, but you can't use it.

That's true.
Do you recognize, then, that the US is not the UK Canada, and that we will not be able to afford an NHS-type system on 8% GDP?
I sometimes wonder if UK and Canadian proponents forget that our demographics are different, and that adopting a national health care system won't magically fix this.
Has anyone actually looked at the situation in the US and come with a cost for universal health care that's even as low as 10% GDP?

 

[wollery]

That's true.
Do you recognize, then, that the US is not the UK Canada, and that we will not be able to afford an NHS-type system on 8% GDP?
I sometimes wonder if UK and Canadian proponents forget that our demographics are different, and that adopting a national health care system won't magically fix this.
Has anyone actually looked at the situation in the US and come with a cost for universal health care that's even as low as 10% GDP?

The stumbling block isn't demographics.

The stumbling block is vested interests. The insurance companies make huge amounts of money from businesses that will pay to insure their workers. The hospitals make huge amounts of money from the insurance companies by charging them 2 to 3 times what a treatment actually costs. The pharmaceutical companies make huge amounts of money from charging excessive sums for their drugs. The politicians get campaign funds and lucrative directorships from various interested companies.

US healthcare is all about making as much money as possible, and a large part of that is finding ways to deny paying out.

Switching to a UHC system would remove huge swathes of the problems that make US healthcare more expensive. For instance, most of the insurance company employees would instantly become unnecessary. A large proportion of the costs for Medicare and Medicaid come from the bureaucracy needed to test if people are actually eligible to receive it. remove the need for the tests and suddenly the cost per person drops considerably.

Remove the focus on making profits or testing people's right to claim and you remove a huge proportion of the costs in the system.

 

[GlennB]

US healthcare is all about making as much money as possible, and a large part of that is finding ways to deny paying out.

Switching to a UHC system would remove huge swathes of the problems that make US healthcare more expensive. For instance, most of the insurance company employees would instantly become unnecessary. A large proportion of the costs for Medicare and Medicaid come from the bureaucracy needed to test if people are actually eligible to receive it. remove the need for the tests and suddenly the cost per person drops considerably.

Sounds plausible. If there's a shedload of people devoted to maximising costs for personal profit from a mostly captive audience then - guess what?! - costs will soar.

I once asked here whether it's possible to get US medical bills itemised down to individual medications, dressings etc. What is the cost of a paracetamol tablet in the US private system? Is such a figure even available?

 

[LTC8K6]

I've always heard that the profit margin in the health insurance biz in the U.S. is tiny.

 

[TragicMonkey]

Sounds plausible. If there's a shedload of people devoted to maximising costs for personal profit from a mostly captive audience then - guess what?! - costs will soar.

I once asked here whether it's possible to get US medical bills itemised down to individual medications, dressings etc. What is the cost of a paracetamol tablet in the US private system? Is such a figure even available?

Well, you're unlikely to find "paracetamol" listed in a US fee schedule. But you won't find such a list easily- they are confidentual business. A provider doesn't want one insurer to know another insurer is paying less, and vice versa. Amy Hospital and Bob Insurance agree that a Kidney Gruzzling costs $500. Bob will pay Amy $300 for each one, Amy can bill the patient for another $100, and the other hundred is sacrificed- which Amy is okay with, because Bob's sending her lots of patients, and Kidney Gruzzlings aren't very common.

But Amy has a deal with Charles Insurance as well. Charles is smaller, will send Amy less business, and Amy knows this when she negotiates the contract. So for Charles, a Kidney Gruzzling will be charged at $600. Charles will pay $400, Amy will bill the patient for $150, and the other $50 is written off.

Amy doesn't want Bob and Charles to know what the other one is paying, or they'll team up. Bob and Charles don't want Amy to know what they're paying Debbie Hospital, or Amy will realize she's a chump and getting less than half what they're paying Debbie for Kidney Gruzzling. Amy doesn't want Debbie to know what Amy's deals with Bob and Charles are because then Debbie could undercut Amy's prices and steal her business. And Bob and Charles have the same issue with each other, that each could undercut the others prices and get Amy's business.

Fee schedules are secret because neither provider nor insurer wants any other providers or insurers to know what they're charging and paying.

 

[TragicMonkey]

I've always heard that the profit margin in the health insurance biz in the U.S. is tiny.

Depends on two things: the item being charged and the ability of the contract negotiator. Some things are total losses, 100% of the cost is uncharged. Other things are hugely profitable. What's lost in the swings is made up on the roundabout. Procedure A may net me 1% profit, Procedure B may be a 100% loss, and Procedure C may get me 500% profit. Like so many things in life, most items are in middle of a bell curve.

Eta, sorry, misread. That's from the provider side. Insurance side profits depend on the patient usage of covered services. The more healthy customers, the better. The ideal situation for insurers is to have as many customers as possible paying for insurance, but not actually receiving any services.

 

[Blue Mountain]

You only have to afford the insurance payments + what insurance doesn't cover, not the whole hospital bill.

So why are people talking about having to pay the whole bill? Only those foolish enough to think they don't need insurance would have to think about a payment plan or tackling the whole bill somehow.

Under PPACA, this will be exactly the same for nearly all of us, except you will be required to pay either a premium or a tax. The premiums vary with the level of insurance you want.

I think you will have to be below the federal poverty level to get "free" basic insurance coverage.

I wonder how anyone who has a job and can't afford insurance now, will be able to afford insurance under PPACA, or afford the tax.

Right now I pay $13.50 a week, subsidized by my employer, for health and dental coverage. So it's about $58.50 per month out of pocket for me.
Fortunately, my company is too small to have to worry about PPACA.

The highlighted portion is the "I'm alright, Jack" argument. "Hey, I'm doing great, so if you're not, something's wrong with you!"

With health insurance so closely tied to employment, what would happen if your job disappeared tomorrow? Want to continue your health insurance? Sure thing: you've got COBRA. So for the next eighteen months you get to pay the full amount that your previous employer once paid for you--and you have no income!

As to your comment "Only those foolish enough to think they don't need insurance": has it ever occurred to you that there are lots of people out there who do understand the need for insurance but cannot get it? Maybe they can't hook up with an employer who offers insurance. Maybe they can, but between a poor pay packet and a high cost to the insured they simply can't afford the insurance and pay for things like food, housing, and clothing.

Look at Travis' comment in this tread. He got an unexpected $5,000 medical bill and it literally bankrupted him. His credit was crap for a few years and he couldn't even rent an apartment. Without a fixed address it's pretty tough to find a job. And he's left with a blood infection that either prevents him from getting insurance altogether or, if it can be got, it will cost him a lot and will have exclusions related to his current condition.

You're doing okay. That's great -- for you. No help to Travis, though. It's the Travises that UHC schemes are designed to help.

 

[Darat]

I've always heard that the profit margin in the health insurance biz in the U.S. is tiny.

I wouldn't be surprised if that is the case. What there certainly is in the USA system is people working out whether someone is eligible for a treatment, having to approve treatments against a policy, which government scheme may cover them for X but not Y and so on. Changing to a system in which you can remove that layer and there will be savings.

 

[wollery]

I've always heard that the profit margin in the health insurance biz in the U.S. is tiny.

A 1% profit on a $100billion turnover is $1billion. That's a lot of money from a small profit margin.

 

[Darat]

That's true.
Do you recognize, then, that the US is not the UK Canada, and that we will not be able to afford an NHS-type system on 8% GDP?I sometimes wonder if UK and Canadian proponents forget that our demographics are different, and that adopting a national health care system won't magically fix this.
Has anyone actually looked at the situation in the US and come with a cost for universal health care that's even as low as 10% GDP?

Why not? And even if you couldn't hit the efficiency that say the UK's NHSs achieve you could almost spend double what the UK does and still not be spending more than you are spending at the moment on healthcare.

Your argument seems to based on some form of USA "exceptionalism", as many of us have related in threads like this before we are sure we can match the USA in stupid politicians, pointless bureaucracy and screw-ups. What makes the USA so different?

 

[Rolfe]

I've always heard that the profit margin in the health insurance biz in the U.S. is tiny.

It's not the profits so much, as the huge volume of unnecessary expenditure and freeloaders. Squillions of people are being paid to do jobs that would be completely unnecessary in a universal healthcare system. Squillions of people are creaming off their cut of the action. It doesn't come up as "profit" in the system, but it pads the cost enormously.

Rolfe.

 

[Rolfe]

The stumbling block isn't demographics.

The stumbling block is vested interests. The insurance companies make huge amounts of money from businesses that will pay to insure their workers. The hospitals make huge amounts of money from the insurance companies by charging them 2 to 3 times what a treatment actually costs. The pharmaceutical companies make huge amounts of money from charging excessive sums for their drugs. The politicians get campaign funds and lucrative directorships from various interested companies.

And that's where the money is going. Sky-high and multiply redundant administration costs, and profiteering all the way down the line. That's why the USA pays twice what other developed countries pay for healthcare, and still some people go without. NOT, that the USA is a "better country" using all this money to fund medical research that nobody else is prepared to pay for.

Rolfe.