Are you satisfied with the current medical system?

[perinova]

I would like to take a poll to find out who is satisfied or isn't.

For the dissatisfied: Can you give a brief idea on what you think should change? If a consensus is possible would you consider writing your congressman and senator with a set of complaints and proposals? Or sending a petition to congress?

[mykidslovedogs]

Perinova,

Individual and small group insurance is legislated at the State level, and laws/regulations vary from state to state. Depending on which state you live in, you may be satisfied or dissatisfied with the "system". Generally, health insurance premium rates have risen phenomenally since year 2000, and my research on this subject suggests that the recession in early 2000 resulted in large numbers of people moving to Medicaid which had a hugely negative impact on pricing in the private sector, because hospitals and providers have been forced to cost-shift to the private sector in order to make up for lost income, resulting in higher premiums for all private markets, large and small. Since then, there have been Medicaid and Medicare "cuts" as well as a large number of Baby Boomers moving to Medicare, which has also resulted in cost-shifting. Those problems combined with the "pay as you go" approach (which leads to problems when someone loses employment and hasn't finished treatment yet) vs. "pay per incident" approach that we have with other types of insurance and the rich benefits that have long sheltered people from the true cost of care have led to exhorbitant inflation over the years.

In an effort to "fix" the problem of unaffordability and unavailability of coverage, legislators have played with community rating and guaranteed issue of coverage, which always results in lack of competition in the marketplace, ultimately resulting in higher premiums and/or taxes for all.

IMHO, the best "fixes" would be:
a.) Continue exploring the possibilities of consumer-driven healthcare and teach people to use insurance as protection against bankruptcy instead of an entitlement that pays for routine, easily affordable services.
b.) Work towards disassociating health insurance from employment.
c.) Work towards better portability of coverage from State to State.
d.) Medicare / Medicaid reform...We need some consumer-driven options here, and people should pay for their subsidized coverage on a sliding scale instead of being cut-off at particular eligibility points.

I think all of these changes will ultimately have to come from a Federal level of legislation vs. a State level.


If I were to vote, I would select two of the choices. 1.) I am very satisfied with the quality of care that my family has received in general, and 2.) The incredible inflation has not been good for anyone, and there are solutions out there that we need to experiment with. As an agent, my experience so far with HSAs and HRAs has seemed to be beneficial to the marketplace and in my opinion, they have helped to make health insurance more affordable to many, many people. Whether or not people are satisfied with high-deductible plans over time will remain to be seen. Since the Great Depression, Americans have become "spoiled" with benefits that have paid nearly 100% for even minor, easily affordable, heatlhcare services. Learning to save to plan for higher deductibles will take some getting used to, but in the longrun, consumer-driven healthcare may be a very viable solution to the problem.

[Beststash]

I was very satisfied with healthcare as a working employee - I guess I actually took it for granted.

One of my work goals was to be able to retire early (which I did at 52) and this was based on the best information available to me at the time I made my decision. I have been retired now for almost 4 years and it has been everything I thought it would be - with one exception - access to Healthcare.

Part of my retirement package was a promise to pay 90% of my healthcare cost for life - I thought. I came to find out it was not guaranteed. As I have stated before my costs have gone from about $100 per month to now $900 per month with the expectation soon for no coverage just access. I am presently able to handle the increased expense but it is definitely not expected and I wonder at what point does it become a situation I am unable to handle financially and become another healthcare stat.

I would be satisfied with more options - HSA, high deductible catastrophic plan, etc. but there doesn't seem to be any incentive to offer more affordable plans especially if you have a pre-existing condition. Even exclusion for pre-existing conditions would be acceptable if you had access to negotiated rates for treatment and prescriptions.

The longer I am retired the more I am hesitant to return to work and the less skilled and connected I become in my trade - technology.

Access to quality healthcare has become my largest retirement concern - what the heck happened??

[TromboneAl]

A plastic syringe in a hospital: It has to have an incredibly low defect rate. It has to be sterilized and sealed in a single-item, easy to open plastic wrap container. That wrapper probably contains a carefully worded legalese disclaimer, written by expensive attorneys. The company has to pay for litigation insurance. You use it once and throw it away. And finally, since it is hazardous waste, you have to dispose of in an expensive manner.

No wonder healthcare is expensive.

[eridanus]

Yet, TromboneAl, other industrialized countries do it for a lot less than we Americans do. The infant mortality rate is higher in the US than the UK, but we spend a lot (2x) more. What gives? It's as if there's a middleman taking a cut....

[mykidslovedogs]

I think part of the reason infant mortality stats are skewed in the USA, is because we have the capacity to "save" more premature infants due to technology than other countries do, therefore the ones that don't make it are counted in the mortality stats, whereas, other countries would just let those infants die during childbirth and they are never counted in the stats.

A great article to read about healthcare costs, and proof that other countries "outcomes" per dollar spent are really no better than in the USA, and in fact, in many cases worse.....

http://www.wpri.org/Reports/Volume19/Vol19no10.pdf

[eridanus]

Quote:

Originally Posted by mykidslovedogs http://www.wpri.org/Reports/Volume19/Vol19no10.pdf

The study fails to take into account the government subsidies for health care that are foisted upon us each year by the socialists in power.

[JDARNELL]

Well today we got the TRICARE settlement statement for the 9 days my son was in the cardiac ICU in Denver. Total cost $186K. Amount paid and settled $55k.

I am very satisfied with the care my family receives with TRICARE but I truly believe that healthcare is a major issue that our country must get under control. It seems out of control.

I think what its going to be like for my son in 15 yrs when TRICARE is no longer an option for him. Its my guess that healthcare insurance will be a major decision in what he does.

Tomcat98

[cute fuzzy bunny]

No problems getting coverage, but its a little bit annoying to watch 10,000lbs of paperwork flying back and forth between the doctors office and insurance company to pay a $99 bill, and then having a doctor bill me for six dollars that somehow they couldnt work out between them. :P

[playaman]

I am conflicted on this question.

On the one hand, I've had excellent service from healhcare providers (including insurance companies) over the past three decades; on the otherhand, I live in fear that I will not be able to find affordable healthcare insurance when I enter the 'no man's' land of no-company-insurance when I finally call it quits next year.

One shouldn't be financially able to retire early but fear doing so because he or she may not be able to pay for health insurance.

[Bram]

I didn't answer the poll. On a personal level, we have private healthcare insurance thru DH's union contracts/employers. We both are very healthy & rarely have to see a physician beyond annual check-ups & screenings. As far as we know from our use of the insurance, it's excellent & I am "satisfied".

However, I think the healthcare insurance situation in the USA is horrible for those who have no/poor insurance. If something happens to DH that he would be unable to work...... we'd be in the soup with all the rest of the desparate. Scarey and I am "NOT satisfied"!

[AlmostDone]

DH and I would like to retire this year. I'm 57 and he is 61. We can use COBRA for 18 months, but we both have a pre-existing condition, so will probably not be able to get policies outside of the high-risk pool. It makes me rethink the retirement plan.

[mykidslovedogs]

Quote:

Originally Posted by eridanus The study fails to take into account the government subsidies for health care that are foisted upon us each year by the socialists in power.

Actually, if you read it carefully, and it took me a few hours to sit down and read all the way through, she talks a lot about how the poorly designed Medicare and Medicaid systems have helped lead us into the situation we are in.

[lets-retire]

Quote:

Originally Posted by playaman One shouldn't be financially able to retire early but fear doing so because he or she may not be able to pay for health insurance.

Then are you really financially able to retire early if you can't afford insurance?

[donheff]

Either Universal Care (AKA socialism as far as Eridanus and some others are concerned). Or some approach to insurance that mandates a range of programs that can be offered and requires all insurers to offer the programs to all takers at the same price - employers could choose to subsidize or not.

[gandalf42]

With the increasing ranks of uninsured in the country, now including many middle class folks, the insurance companies seem bent on working themselves out of a job. Plus the system with all of the different companies, guidelines, and paper work is highly inefficient to the caregivers. If we don't end up with a single payer system, we need to move to a single processing system to eliminate some of these inefficiencies.

Being 52, retired, and with significant pre-existing conditions, health insurance is a big deal for me.

[perinova]

So 71% of respondents are fairly dissatisfied.

IMHO and it was mentioned by others:
- Disconnect medical care and employment
- Make it mandatory to have insurance
- Make it illegal to turn away anyone, eliminate preexisting conditions, and illegal to adjust premium for health status
- Provide somehow at least one government run insurance in each state that will compete with the private ones. I imagine that otherwise insurance could rack up insane profits without check. I can also imagine situations where insurance go out of business and there is no more competition.
- Premiums and plans info need to be available to all. (I guess hospitals and providers would have to make their fees transparent too).

A stronger alternative would go as far a single payer system where the govt takes ownership of medical insurances. Some seem to shun an idea dubbed "socialist", however it seems to work well in other countries. We already have medicare for over 65.

I don't know how to solve the paperwork and arguing back and forth issue. Somehow the cost need to be understood ahead of time by the parties or one of the parties will need to provide the extra money (Provider or Insurance or Customer).
By not paying more than a customary amount customers can shop around and decide to go to a higher cost provider and pay the extra amount. Private insurances already do that but it works well only on advertised fees.

[lets-retire]

perinova--The biggest problem with eliminating the pre-existing condition clauses is, if the insurance company knows from the start that your condition will cost about $7,000 per year, as with my wife, they would be foolish to charge me less than the standard rate plus the guaranteed medical payment per year. It would be similar to knowing you have $4000 in bills per month and take a job paying $3000 per month.

[donheff]

Quote:

Originally Posted by lets-retire perinova--The biggest problem with eliminating the pre-existing condition clauses is, if the insurance company knows from the start that your condition will cost about $7,000 per year, as with my wife, they would be foolish to charge me less than the standard rate plus the guaranteed medical payment per year. It would be similar to knowing you have $4000 in bills per month and take a job paying $3000 per month.

True, if they have the choice. If they must take all comers (like the Federal system) they build this calculation into the rates. The risk is spread to the entire pool. This is why some posters complain about it being socialistic -- it is. But many more of us believe that it is precisely on matters like health care where the future really is a toss of the dice, that Government should step in and help ensure that everyone has a reasonable opportunity to pursue happpiness.

[Martha]

I believe Don has a good point. This is Senator Wyden's plan. Everyone must have health insurance. It is paid for through the tax collection system, with a sliding fee. If you owe no taxes, the assumption is that you are too poor to pay premiums. Insurance companies will stay in the mix, but must cover everyone. Because people can't wait until they are sick to buy insurance, and because the group sizes will be large, the adverse selection problems faced by states like New Jersey are eliminated. Price competition instead of competition for the healthiest.

Another alternative is a national healthcare system, like medicare for all. Again, we could pay sliding scale premiums.

I am not satisfied with the current system.