your rates seem really high...is it a function of where you live or not enough competition? I'm 64 and my rates have been in the 3k range for the last 15 years.
your rates seem really high...is it a function of where you live or not enough competition? I'm 64 and my rates have been in the 3k range for the last 15 years.
Excellent and informative analysis by "I've Posted This Before." Thank you for sharing that. Many of the other posts on this thread are the equivalent of what you'd get if you asked a bunch of healthcare economists how to break 4:30 in the mile.
But how many people in the incoming Trump administration -- sorry, just threw up in my mouth a bit -- do you think understand healthcare as well as "I've Posted This Before" (i.e. a random person on a running website)?
sbeefyk1 wrote:
His proposal is HSA plans for everyone. So you can save for your healthcare expenses with pre tax dollars and presumably buy insurance like we used to. HSAs are typically high deductible plans though so this will be better for millennials who never see the doctor but baby boomers will pay a fortune in healthcare costs.
This alone will do nothing. It has to be combined with mandatory price transparency at the VERY least.
Another policy point that is being discussed is selling policies across state lines to create more competitive markets.
Here's my humble answer: I don't know.a lot of people chiming in here, and a lot (everyone) of people who don't know what the f*ck they are talking about. it's amazing the range of ideas and opinions people spout off so confidently by people who have only heard what is best from some subjective source. Really everyone, just look inside yourself and see the truth that you really don't know how health insurance at this scale works and how to reduce costs but allow greedy insurance companies to keep raking it in.it's ok to just not type anything and move on to a piece about NAU XC or whatever and say to yourself, "wow, i don't have a flipping idea about any of this and I'm going to not write some bs on the forum anonymously."thanks for sharing your thoughts though
Its gotta be said wrote:
How will Trump cover everyone and reduce cost of health insurance?
Honest question.
What this guy said.
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TAA wrote:
The reason healthcare is so much cheaper in Europe is because their governments have price controls on the cost of care and drugs. Drug companies can't extort people there. Unless our government is willing to do that prices won't drastically drop.
^^^This!!!
Medicare sets the price of services it pays to providers.
http://kff.org/report-section/a-primer-on-medicare-how-does-medicare-pay-providers-in-traditional-medicare/Medicare pays the providers less for services than what private insurance companies pay for those services.
http://money.cnn.com/2014/04/21/news/economy/medicare-doctors/So, we could make coverage more affordable by adopting a single payer system like medicare -- for everyone. The government would set the price paid to the providers, and if they don't like it, they can choose to not offer the service (or, become more efficient so they can make a profit at those prices). Insurance company profit is cut out. We're already doing this, it would just be a major expansion of the program (although some claim that insurance companies and individuals with no insurance, which pay more for services, are subsidizing medicare).
Obamacare is useless. If you look at payer costs vs benefits, you will find out that it serves a low single digit - aggregated over 12 months.
I do not quite see why insurers cannot stomach it. I would imagine their risk models are off. For consumers, it is generally less expensive to pay the Medicare cost out of pocket. What is that? The amount Medicare reimburses the provider given same service to a Medicare patient. The problem is that clinics/providers load up all kinds of overheads on the uninsured to demonstrate a loss.
Solution: better off without.
Most of the docs I know dislike Obamacare.
I haven't read through the posts Have any medical doctors responded?
Lisa Bliss, who has run the Badwater 135 solo, is exceptionally bright and could offer some intelligent comments from one doctor's perspective.
I don't know if she comes on this site anymore, however.
joedirt wrote:
asdfasdfa wrote:Unlikely. Pretty much all of the recomendations have been looked at as part of other plans and they have all had minimal to negative changes.
And some are fantasy land stuff. He plans on 10 billion dollars savings by paying 0 cents for illegal immigrants. Sounds great. But in reality, how many billion do you think it will cost to deport something like 12 million people AND prevent more people from coming in? To save that 10 billion, you might need to spend 100 billion.
You can solve the illegal immigration problem by penalizing companies that employ illegals and make them pay for the cost of the enforcement and the deportations. If there is no job market for illegals, they won't come (or they will work in black markets). Actually if Trump really does rework the NAFTA treaty, it will cause more illegals to try and enter the country (that's why the Peso took a beating today).
Umm it is illegal today and companies pay fines. You can decide how well it works. As far as I can tell the main result of that law is an increase in identity theft.
As far as passing a TAX to fund enforcement, who do you think pays business taxes? In the end it is pretty much the consumer. In the end these laws basically cause discrimination (i.e. you don't hire the american with a latino name) and reduced hiring (why go through this crap when you can move your factory overseas and avoid it). Hard to say if it is a net win or not.
And lets say we got rid of 100% of illegal immigration. Would you those companies hire americans? Probably not. They would do like Trump does and bring in foreign workers on all sorts of visas so that they get cheap labor. I have no clue if that is a net win but I have to imagine it benefits large business over small ones.
Why not allow states to head up their own unique, individualized health care systems? Each state has different health care needs/priorities, and to lump all the states together doesn't seem to work. The health care needs of retirees in Florida will differ from the young, active population of Colorado, which will differ from the obese populace of Mississippi. Different states, different needs, different plans tailored to what the citizens of that state need.
different approach wrote:
Why not allow states to head up their own unique, individualized health care systems? Each state has different health care needs/priorities, and to lump all the states together doesn't seem to work. The health care needs of retirees in Florida will differ from the young, active population of Colorado, which will differ from the obese populace of Mississippi. Different states, different needs, different plans tailored to what the citizens of that state need.
Well for one things the feds are sucking up all the money with high taxes.:) States rapidly run into the same problem where employer provided health care is the problem. It sucks out the healthy people and leaves behind a ton of expensive people. In addition since the consumers and the payers are not the same people, you have 2 parties with different incentives.
Frankly the health care needs of pretty much everyone is the same. Retirees aren't part of the system (they are off on medicare) and the other differences don't really matter. More people in Miss might get diabetes but you are still going to have ton of diabetics in Co. Where exactly you spend the money (and how much) changes slightly but you still end up need all the same type of care.
You could argue that we should allow more discrimination (jake the rates up on smokers, fat people, asthma, allergies,...) or less coverage (i.e. you should get a 15k bill for every pregnancy. Insurance protects you from the 200k case but you need to pay the average payment) or shifting (right now families of 7 pay the same rate as families of 3. Obviously the family of 7 should be paying a lot more) of costs.
But none of those is going to really reduce costs. That requires doing about a dozen things some of which are politically unacceptable. The US is happy over paying for things to prevent some business from going under. The IRS has enough info to do about 95% of the filers taxes automatically. Do you think the TurboTax/H&R block people want something like that to happen? Medicare has 2% overhead. Private insurance has 17%. Do you think medicare for all is every passing?
Remember every reduction in cost is someone getting paid less money. Those people will fight tooth and nail for their cash.
"Remember every reduction in cost is someone getting paid less money."
EXACTLY why Trump's presidency is doomed. Rather than two years until he can't do anything after the midterms, he'll be unable to do anything by mid-afternoon his first day.
Just a standard do-nothing Republican in a world of Democrats.
I think Trump should replace Obamacare with Romneycare.
ive posted this before wrote:
I've seen a few people ponder what decoupling health insurance from employment would mean and I felt the need to opine.
The fundamental problem with US health insurance is that it has two entirely juxtaposed goals. The first goal is to provide financial coverage for those insured within the plan based upon the medical needs of those within the plan. The second goal is to maximize profit of the company and therefore shareholder value. In order to fulfill the needs of one side, the other loses ground and it is a constant battle. Unfortunately, the shareholder wins more battles than the medical consumer.
The reason for this is simple. The insurance company must negotiate with three separate entities. First, the provider. Most providers are very large companies as well that make it their business to provide care and push hard to get paid for it. Second, is the company which purchases the insurance plan (employer). They too have a bottom line they need to protect. They can negotiate, but at the end of the day, there is a minimum profit the insurance company is willing to earn. This drives employers to cheaper and cheaper plans or shouldering less of the premium. Any 30 year employee has seen this drifting of benefits over their lifetime. Third, are the employees / plan holders. They have virtually no negotiating power. By the time the choice comes to an individual, you will have a small handful of plans to pick from and the open marketplace is guaranteed to be worse unless you have income below poverty. This is why the burden of expense has drifted towards the individual and the ACA does little to affect this balance. In all actuality the ACA was a boon to the insurance industry in disguise. In addition, the consumer has no negotiating power on the cost of any drug or the cost of any care.
Arguments are often made by insurers that these new plans "put you more in control" or that it "allows you to understand the cost of care". The problem with this statement is it ignores the way unique way people consume healthcare. Healthcare in general is highly inelastic meaning it is not price sensitive regardless of the cost. If you have a heart attack, you don't wait to get a preauthorization and then instruct the ambulance to send you the cheapest hospital while you shop around. If your kid has leukemia, you don't find the cheapest solution. You search for the best solution to save someone that you love more than money.
To further obfuscate the problem is the cost of everything is highly fungible based upon who is paying / the source of funds. What I mean is that providers can rarely have the same price for the same service for two separate buyers. They do this to maximize revenue and thus maximize their own profit. They often have to do this because the insurance companies make it their job to whittle that bill down as much as possible.
Okay, so I just stated a whole lot about the current situation without providing solutions. I have my own strong opinions, which is why I withheld them until now. The following is why I say change from the current situation requires nothing short of a revolution. The solution requires trade offs, different freedoms, and several huge puzzle pieces to be aligned.
First: decouple employment from health insurance. Statistically speaking, those recently unemployed or under employed are most likely to require healthcare. People need access to care regardless of their current ability to work. A healthier population ultimately works more; earns more; and thus pays more taxes.
Second: eliminate the profit motive from the health insurance companies. This one is huge and nearly impossible. One possible example for guidance is Germany. Germany does not have a single payer system yet has universal coverage. They have many different insurers. However, German insurers are not permitted to make a profit. If premiums are too much, they must return those to the policy holders in the form of lower premiums the next year. What is to motivate the insurance companies then? Their right to exist. They compete for customers / policy holders rather than shareholder value. If they charge too much, customers seek other insurers. This system does work. The Germans have used the framework set down by Bismarck for decades.
Third: end political intervention that favors the pharmaceutical industry / providers. A great example of this abuse is Medicare Part D (prescription drug coverage). Medicare is not permitted to negotiate with the drug companies for drugs provided to seniors. That means that the taxpayers are on the hook for the full retail price of the drugs. This is a huge failing and a public disservice because Medicare is being barred from pursuing one of its primary purposes which is to negotiate for the collective welfare of our senior citizens. A nationwide single payer / multi payer system must be empowered to negotiate aggressively with multinational drug companies.
Fourth: we have to overhaul the tort system so doctors, hospitals, and the medical establishment can't be sued into oblivion. A significant portion of our healthcare costs come from high medical malpractice insurance premiums as well as the collateral damage from expensive unnecessary suits. What we lose by doing this is the ability to enrich a few based upon the mistake of a medical professional. If a doctor screws up, they should lose their job and license, not put another attorney in the Hamptons. This reduces the expenses doctors pay and thus doctors can be paid less and still keep a high standard of living.
Fifth: End the for profit university system. Another significant contributor to the expense of healthcare is that medical professionals can graduate up to a quarter of a million dollars in debt before they even start working. They are in-turn compensated with high salaries (theoretically). If college education was based upon academic ability rather than how much money you have / can borrow, we would not have the same costs in healthcare. Voila, everyone gets paid less, but they can still maintain their high standard of living without being burdened with huge debt loads. Again, Germany does this through their taxpayer funded college system which provides free higher education to its citizens.
The trade offs can be varying. We as a nation would be accepting that we can no longer individually choose to believe we will always be healthy and therefore pocket a couple bucks that year in reduced premiums. We also lose the ability to get rich off a doctor’s mistake. However, if it is done correctly, it can benefit nearly every American by providing them with more health care security, greater employment flexibility, and equal or greater care at potentially lower costs.
I am not saying that moving away from our current insurance model will make the world perfect. Far from it. To those that say the transition cannot be done, look to Switzerland. They switched from our model to universal coverage in the 90s and there isn't a hint of that population demanding the old system back.
Very good.
To this I would add that the FDA needs to be completely restructured as well as laws pertaining to prescription drugs and drug research.
Today, there is no incentive to find cures for major illnesses. In fact, the FDA sets up major obstacles to cure research. This is the result of decades of lobbying by the pharmaceutical industry. It will be extremely difficult to change these laws because of the pharmaceutical lobby, but the financial benefits could be significant. Alzheimer's disease costs nearly a quarter of a trillion dollars a year in health care costs, yet promising cures are tied up in a sea of red tape.
1. Eliminate EMTALA
2. Let insurance companies charge more for pre-existing conditions. If someone is uninsured, insurance companies refuse to cover the pre-existing condition.
3. Let doctors and hospitals balance bill.
4. Let charities deal with those who cannot afford treatment
melt wrote:
1. Eliminate EMTALA
2. Let insurance companies charge more for pre-existing conditions. If someone is uninsured, insurance companies refuse to cover the pre-existing condition.
3. Let doctors and hospitals balance bill.
4. Let charities deal with those who cannot afford treatment
Politically untennable. Never going to happen.
Not politically acceptable though some Republicans don't care. But what charity could cover all of the needs? None! No Trump will do nothing but revert back to pre-Obama as Paul Ryan & his cronies who are bought & paid for by United Healthcare, want. Why are healthcare costs rising? Because "bankers" like United Health CEO has made over a billion dollars alone sine 2005 & his 42 VP's have averaged $2 million a year. What one damn bit of healthcare did any of these Hamptons fat cats provide? NONE! This is that 17% (often even higher) overhead. We have to go to single-payer while allowing private insurance to sell premium care plans for those who want to pay extra cost. Yes it's lost income for health bankers but it's only solution. It's why the fools who voted in Trump don't understand things will NEVER improve until we rid our system of the overt & covert money that buys our politicians. Putting term limits on politicians will only give the damn lobbyists more power. So until Citizens United is overturned & other laws can be implemented via Amendments & Congressional action healthcare costs are only going to continue their skyrocketing rise. HSA's are just another GOP scam to let more Healthcare bankers skim more money from consumers. By taking health insurance out of benefit for employment we allow US companies to be on an even playing field on this issue at least. Returning to old system sends the uninsured back to ER's when they are sickest & preventive care is eliminated & the costs for this are passed on to all of us on private group plans in higher premiums & co-pays. Enough of the damn insanity!
While I realize we have to do something, and looking at models from other countries is a starting place, I find it difficult to apply what works in a tiny monolithic country like Switzerland. The US is HUGE and wildly diverse.
Keeping people healthy and providing healthcare when people are unwell shouldn't be a for-profit industry. It should be provided free at the point of need, paid for by the taxes of a nation's people and businesses.
All the best America, this threat is bananas.
verminmeat wrote:
While I realize we have to do something, and looking at models from other countries is a starting place, I find it difficult to apply what works in a tiny monolithic country like Switzerland. The US is HUGE and wildly diverse.
I used Switzerland as an example of a late conversion. Other nations which have tackled this problem successfully for decades include England, Japan, Taiwan and Germany as featured in the pbs frontline sick around the world. These are capitalist nations which took another route in health insurance. Each handles the problem differently, but all provide universal coverage and there are no medical bankruptcies. Our current system is untenable and the ACA is only a facade with no real change from what we had before. Employers still are the main source of insurance plans, many plans are expensive and omit care the rest of the world expects, the administrative burden is exceedingly high, and medical bankruptcies account for half of all bankruptcies in the US. I'm not proposing a utopia, but the current system is unhealthy for the entire nation.
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