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Old 12-03-2012, 10:48 PM   #41
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Originally Posted by Gatordoc50
Some premiums here are quoted at 4k, some at 8k, some at 20k, etc. Doesn't make sense to me.
I agree. The various threads on this topic always amaze me. My premium is $76 a month with a $5500 deductible on an individual BCBS policy. I am 48 and it has only went up $4 a month in 2.5 years that I have been on it. Factor in my HSA, and my policy actual nets me a small profit. I don't see health insurance as a real cost at this point. If I was paying some of these outrageous premiums, I don't know if I would feel comfortable being retired. I probably would still be employed full time afraid to let go of my company insurance plan.
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Old 12-04-2012, 05:02 AM   #42
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Originally Posted by Gatordoc50 View Post
Some premiums here are quoted at 4k, some at 8k, some at 20k, etc. Doesn't make sense to me.
Some of that is underwriting, some is subsidy. It doesn't make sense to anyone and the true cost of health care is hidden to most of us.
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Old 12-04-2012, 05:17 AM   #43
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I can confidently predict that the so called reforms of the past few years will increase costs. Microeconomics 101-increase demand, and make no change in supply, prices can only go up.
That same economics class also says demand will fall if price goes up and there is lots of evidence this has happened in the US.

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So far "reform" has consisted of trying to stick the other guy with the bill. Some day, likely when it is too late, we will figure out that the size of the bill must be decreased.
I respectfully disagree with your definition of reform. The bill is already being paid. It is about leveling the playing field and enabling or requiring everyone to play with the same rules. Decreasing the bill is critical, but the challenge is to do so without denying health care to people.
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Old 12-04-2012, 05:58 AM   #44
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I respectfully disagree with your definition of reform. The bill is already being paid. It is about leveling the playing field and enabling or requiring everyone to play with the same rules. Decreasing the bill is critical, but the challenge is to do so without denying health care to people.
Great summary! Amen. First, level the playing field, get all people health care in an equal fashion, then start reducing waste, costs, and the extreme pay differences in the medical fields. No more pay by procedure which leads to unbelievable pricing of everything related to it in the medical supply chain.

Oh, and fire all good looking drug reps under 30.........
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Old 12-04-2012, 07:42 AM   #45
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Originally Posted by Gatordoc50
Some premiums here are quoted at 4k, some at 8k, some at 20k, etc. Doesn't make sense to me.
I don't think anyone would make this statement about housing. Housing costs varies by locale.

I expect the same applies to health care costs thus insurance premiums vary by locale [office rents, salaries] plus there are underwriting concerns [age, medical conditions] that apply individually to the insured.
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Old 12-04-2012, 08:51 AM   #46
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I don't think anyone would make this statement about housing. Housing costs varies by locale.

I expect the same applies to health care costs thus insurance premiums vary by locale [office rents, salaries] plus there are underwriting concerns [age, medical conditions] that apply individually to the insured.
I can see that. My personal view is that all Insurance should pay the same for a specific procedure. Leaving it up to the healthcare provider to sift thru all the individual policies with their different deductibles, copays and reimbursement rates adds extreme costs to the delivery of care. Imagine standing in line at the grocery store with the cashier having to charge each customer differently. Let's see, this orange costs you 75 cents, and you 2 dollars and you 25.75 and for you it's free. lol. Or better yet, just let them all walk out paying next to nothing, figuring it out later, billing the food insurers, and then billing the customer for the difference. That would triple the cost of groceries, at least.
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Old 12-04-2012, 08:59 AM   #47
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our heath care goes up every year. with the next upage it will be just short of 20k.

thats nut. I am 60 and my wife is 57. both in good health. !y wife does take 3 different meds and I think they ding her for 50% add on. I do not even go to the doctor well not much.

We have a 1500 dollar deductable each. Here in CA anthem blue cross is about the only way to go. We have asked for quotes for higher deductable.

Just wondering what you all think about how high heath care is.

Bob
You'd pay around $1100/month in premiums for a $4k deductible plan in MA

https://www.mahealthconnector.org/po...tte.cachetoken
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Old 12-04-2012, 09:01 AM   #48
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I can see that. My personal view is that all Insurance should pay the same for a specific procedure. Leaving it up to the healthcare provider to sift thru all the individual policies with their different deductibles, copays and reimbursement rates adds extreme costs to the delivery of care. Imagine standing in line at the grocery store with the cashier having to charge each customer differently. Let's see, this orange costs you 75 cents, and you 2 dollars and you 25.75 and for you it's free. lol. Or better yet, just let them all walk out paying next to nothing, figuring it out later, billing the food insurers, and then billing the customer for the difference. That would triple the cost of groceries, at least.
+1, if we are ever to get to reasonably priced healthcare, a standardized system will be needed.
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Old 12-04-2012, 10:16 AM   #49
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I can confidently predict that the so called reforms of the past few years will increase costs. Microeconomics 101-increase demand, and make no change in supply, prices can only go up.

Here's a chart that shows how the US stacks up internationally.

Healthcare Spending As A Share Of GDP - Business Insider

So far "reform" has consisted of trying to stick the other guy with the bill. Some day, likely when it is too late, we will figure out that the size of the bill must be decreased.

Look where Japan is on this chart. Japanese people live longer than anyone else on earth, and they like their health care system, their access to doctors, and their relationships with their doctors.

How many of us can say the same, and how many will be even as satisfied as we are today 5 years from now?

Ha
Other countries have strongly regulated health insurance systems and prices are often set by the government or the systems are run by the government. What factors actually lead to the cost of healthcare being half as much in other countries will be difficult to determine and implement in the US, basically because the ideas are not home grown and that is often reason enough to stay with the status quo.
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Old 12-04-2012, 10:50 AM   #50
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I agree. The various threads on this topic always amaze me. My premium is $76 a month with a $5500 deductible on an individual BCBS policy. I am 48 and it has only went up $4 a month in 2.5 years that I have been on it. Factor in my HSA, and my policy actual nets me a small profit. I don't see health insurance as a real cost at this point. If I was paying some of these outrageous premiums, I don't know if I would feel comfortable being retired. I probably would still be employed full time afraid to let go of my company insurance plan.
i live in mass. the kind of policy you have is not allowed here.
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Old 12-04-2012, 11:06 AM   #51
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Originally Posted by nun

Other countries have strongly regulated health insurance systems and prices are often set by the government or the systems are run by the government. What factors actually lead to the cost of healthcare being half as much in other countries will be difficult to determine and implement in the US, basically because the ideas are not home grown and that is often reason enough to stay with the status quo.
+1
The disparity exists whether looking at costs per capita, costs as a percentage of GDP, etc. Anyway you slice it, we pay more. We have more healthcare workers than most countries but not significantly more. The only thing I can think of is that our providers target those with the best insurances and benefits, over treating those patients. In other words, a desire to " Maximize Benefits".
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Old 12-04-2012, 11:53 AM   #52
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Originally posted by Gatordoc50
I can see that. My personal view is that all Insurance should pay the same for a specific procedure.
So say a gall bladder removal is $2000. I believe the result of such a policy would be doctors moving from high costs locales [NYC, Boston, San Francisco, No Virginia/DC] to low cost locales [Omaha, Topeka]. OK by me. Prolly not ok with power broker whether they be business or political power brokers. Ain't gonna happen.

Now that I think more about it; the best doctors in the high cost locales will simply demand a $5k to $10k annual access fee. I can see revolution forming already.

No methinks the patient needs more skin in the game. No insurance policies with deductibles below $5k. Patients will shop for health care driving non emergency health care costs down.

Oh an aside. One of the reason foreign countries health care is less is that they refuse to pay US prices for drugs.

So are foreign nations paying the "right" price? Or are they riding on the back of US innovation costing the US consumer?
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Old 12-04-2012, 12:06 PM   #53
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Originally posted by Gatordoc50
I can see that. My personal view is that all Insurance should pay the same for a specific procedure.
I think we still need a more standardized approach than we have today, but with the ability to adjust the base standard for cost of living differences as you suggest.
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Old 12-04-2012, 12:50 PM   #54
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That same economics class also says demand will fall if price goes up and there is lots of evidence this has happened in the US.

I respectfully disagree with your definition of reform. The bill is already being paid. It is about leveling the playing field and enabling or requiring everyone to play with the same rules. Decreasing the bill is critical, but the challenge is to do so without denying health care to people.
I know better than to argue with a moderator, so OK, thanks for your view.

Ha
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Old 12-04-2012, 12:54 PM   #55
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Old 12-08-2012, 11:21 AM   #56
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Here is an ad from today. The new medical world once we can no longer afford it! It's already happening. I bet we see a 50% off Groupon for knee replacements within 5 years.......... .

OMG, all of those smart kids will then go be lawyers!!!


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Old 12-08-2012, 11:37 AM   #57
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No methinks the patient needs more skin in the game. No insurance policies with deductibles below $5k. Patients will shop for health care driving non emergency health care costs down.
Good luck with that. I know plenty of people would like to shop for health care but it is virtually impossible to do it. Sure for something routine that is done by many places that you know in advance you will need it - you can shop for health care.

Imagine you are having a heart attack. Not so easy to shop for health care.

Or even if know in advance you need surgery. It can be absolutely impossible to find out in advance the cost. I had gall bladder surgery a few years ago and remember trying to find out the cost from the hospital in advance. They couldn't tell me. It all depended on how it was coded and no one would know until after the surgery.

Even if you could get the costs for the hospital try getting the costs for every ancillary provider. I tried very hard to find all this out before hand and missed the assistant surgeon (no one told me about them and it didn't just spring to my mind).

And let's say you could do that - how many of us have the expertise to evaluate the quality of Hospital A which is $1000 less than Hospital B or to know if the anesthesiologist who is $500 is cheaper is just as good as the more expensive anesthesiologist.

I do think that cost information should be more readily available but I don't think it does anything much to drive costs down.
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Old 12-08-2012, 12:57 PM   #58
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Shopping for health care doesn't seem to work for many individual situations.

Example: I went in to the clinic associated with my GP (it was a Saturday). Needed to have a small tick removed from my skin. Had gotten it while gardening. They could not give me a quote. When I got the bill it was $500. Mentioned it to my GP and he just said ... "really?"
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Old 12-08-2012, 01:31 PM   #59
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[HTML]Oh an aside. One of the reason foreign countries health care is less is that they refuse to pay US prices for drugs.

So are foreign nations paying the "right" price? Or are they riding on the back of US innovation costing the US consumer?
An excellent "aside" tjscott0!

While I'm not a fan of gov't price controls in most situations, I do believe that the USA fed gov't needs to take control of drug pricing immediately. Exported drugs must sell for the same price as those consumed domestically. And pricing controls must exist to discourage the outlandishly expensive development of so-called "miracle drugs."
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