Gotta Cover Those Pre-Existing Conditions

[pb4uski]

I beg to differ. To me, it is reverse age discrimination, and causes clashes between age groups. What is magical about that age of 65 when the gate suddenly opens?....

It seems that you are stuck in a mindset that it is the young subsidizing the old where it is really that people are paying a significant portion of their health insurance during their retirement years during their working years and the payments are a function of earnings (higher income pay more and lower income pay less).

But thankfully this is a free country and if you want to look at it through the wrong end of the looking glass then you have the right to do so.

Medicare for all would solve your consternation in that everyone would be paying (probably more) and everyone would be receiving benefits... no reverse age discrimination!

 

[explanade]

Would there be political support for cutting the income of doctors, hospitals, pharmaceutical companies, medical equipment makers, etc?

Because it may take something that extraordinary to rein in medical cost inflation.

Much of the world is in a low inflation or deflationary state but that is not the case with health care. Drug companies can just raise prices at will, not just on new "miracle" drugs but older drugs as well.

 

[Fedup]

I guess that we'll have to agree to disagree on who the stubborn one is.



What you don't seem to understand is that medical service costs (which is the most important determinant in the cost of medical insurance) have increased dramatically so to mitigate the cost insurers have increased deductibles so they don't need to increase premiums as much as they otherwise would need to. If someone want that low deductible plan they can still buy it but the premiums are exorbitant because of the cost of medical services. The amount insurers can charge for overhead and profit is limited by law to 25% of claim costs and in many parts of the country competition squeezes margins to below 25%.



If someone has a serious illness and a stay in the hospital the total cost could easily reach $100,000. My wife had an operation for a broken leg a few years ago and stayed in the hospital one night before going home and the bill was over $50,000.



You say if you pay $12,000 a year and don't ever get to file a claim then you wouldn't be happy. Well if you know going in that you have to cover the first $12,000 of cost and you are 56 and have never been seriously ill then why in the world would you have a reasonable expectation that you will get something out of it? If you are 56 and have never been seriously ill and want to "use" your health insurance then you would need to buy a plan with a lower deductible... then you will get to "use" it... but you'll probably pay $24,000 a year in premiums.



Like it or not, that is the new reality for health insurance... which by the way... was how health insurance worked back in the 1950s and 1960s.



And I totally see that we pay high premiums and get little benefit. I pay about $6000 a year and over the last 3 years the insurer hasn't had to pay squat other than annual physicals.... but, I still buy insurance so if something bad and major happens I won't go broke paying the bills and I can get the negotiated rates for medical services.

Maybe you need to read carefully. I didn't buy any plan with that high deductible. My plan has a $200 deductible and even then I'm hesitant to use it, unless I have to.
People have complained to me that they pay higher premium and the deductible went up to $12,000 from previous years. So all the promise of lower cost and affordable really never materialized.


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[Gone4Good]

So all the promise of lower cost and affordable really never materialized.

Compared to what, exactly?

In 2014 the average cost after subsidies was $82 per month for all plans for those who shopped on the marketplace,

 

[NW-Bound]

It seems that you are stuck in a mindset that it is the young subsidizing the old where it is really that people are paying a significant portion of their health insurance during their retirement years during their working years and the payments are a function of earnings (higher income pay more and lower income pay less).

But thankfully this is a free country and if you want to look at it through the wrong end of the looking glass then you have the right to do so.

Medicare for all would solve your consternation in that everyone would be paying (probably more) and everyone would be receiving benefits... no reverse age discrimination!

It was actually only recently when I thought about this whole mess, and having my children in working age, that I came to the realization that the elderly who turn out to vote en mass can protect their privilege at the expense of the young. Yes, and I am going to be joining their rank soon.

So, it was only when I got older that I turned the looking glass around and tried to see from the other end.

Anyway, Medicare the way it is is going to break us, let alone opening it for everybody. Something must be done.

 

[Texas Proud]

Maybe you need to read carefully. I didn't buy any plan with that high deductible. My plan has a $200 deductible and even then I'm hesitant to use it, unless I have to.
People have complained to me that they pay higher premium and the deductible went up to $12,000 from previous years. So all the promise of lower cost and affordable really never materialized.


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Just to be clear, the $12000 deductible is the family amount... per individual the max is $6600 (IIRC)...

 

[Gone4Good]

When we talk about the cost of insurance we can't ignore the cost of the thing being insured. And in the U.S. health care is extraordinarily expensive.

We spend about $10,000 per person annually on health care in the U.S. So if we wanted to insure the entire population with a plan that covered 100% of all costs then you'd expect the average price of every individual policy to cost slightly more than $10,000.

That's the nature of the U.S. health care market. And there's no magic formula that's going to make insurance polices cost less than the thing being insured.

 

[NW-Bound]

...people are paying a significant portion of their health insurance during their retirement years during their working years...

I forgot to address this. Originators of Medicare and SS did not envision the cost of these programs to be as high as they are now. People did not pay into the programs as much as they are drawing now. Just the longevity change alone can cause problems.

Some statistics: the average age at death was 70.22 years in 1965 when Medicare started. The most recent data point is 78.74 years in 2012. So, the average person used Medicare for 5.22 years back in 1965, but 13.74 years now. That's an increase to 263%.

Add to that the cost of these fancy drugs that can prolong a terminally ill patient life's a couple of months at a cost of $100K, and no wonder we are here now.

 

[bmcgonig]

Because in the past, they paid for the same premium with much lower deductible. Now they pay the same cost for $12,000 deductible. I'm sure people thought their health plans would get better post-ACA but they didn't. False promise often results in complaints.
Very few people would have $100,000 hospital bill. I'm 56, I haven't been seriously ill to ever paid that much in any year. If I have to pay $12,000 a year and don't ever get to use it, I'm sure I wouldn't be happy.
For the record, I have very good insurance through my husband. But everywhere I go, particularly for small business owner, this is the complaint I've often heard.
They are not ignorant anymore than you are too stubborn to see that they get no benefit.


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I disagree with the "very few" part above. I just had an appendectomy. Simple laparoscopy with two notes in hospital, one before and one after, and it came to 66k. The insurance co actually allowed 44k, and after max oop etc., I paid 4K.

That's merely appendicitis.


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[REWahoo]

I just had an appendectomy. Simple laparoscopy with two notes in hospital, one before and one after, and it came to 66k.

How much could you have saved if you had opted for the surgery without benefit of music?

 

[NW-Bound]

Not much of a song that has only 2 notes!

$44K seems high for a simple laparoscopic appendectomy with no complications. I wonder what it would cost in a European country. $5K to $10K?

 

[Fermion]

Not much of a song that has only 2 notes!

$44K seems high for a simple laparoscopic appendectomy with no complications. I wonder what it would cost in a European country. $5K to $10K?

Except that in a European country if he were to get a secondary infection from the hospital during or after his surgery he would get an apology.

In the USA his family would sue and get 5 million.

 

[bmcgonig]

Not much of a song that has only 2 notes!

$44K seems high for a simple laparoscopic appendectomy with no complications. I wonder what it would cost in a European country. $5K to $10K?

Yes. It was a short song . Two nites Dunno about Europe but in Thailand at the international hospital in Bangkok it is about $5000. A friend who lives there happened to send me the link to the prices.


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[bmcgonig]

Except that in a European country if he were to get a secondary infection from the hospital during or after his surgery he would get an apology.

In the USA his family would sue and get 5 million.

I was on an antibiotic drip for about 12 hours before and 12 hours after. That surprised me a little.


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[Walt34]

An older friend told me that was how it was with doctors when he was growing up. His father was a milkman and did not have health insurance (perhaps back then nobody had health insurance). When the kids were sick, his father just took them to go see the family doctor and paid cash. I don't know how people settled bigger hospital bills back then.

I know - they set up a payment plan with the hospital. When I was three weeks old I had surgery for pyloric stenosis, a narrowing of the opening to the small intestine. In 1950 this was serious, the surgery had about a 50% survival rate. Dad sometimes remarked about his "$1,000 baby" because that was what it cost, an astronomical amount for him then. He was an electrician so didn't have much money, I guess it took years to pay it off. I still have a huge scar across my abdomen from that surgery.

 

[NW-Bound]

Dunno about Europe but in Thailand at the international hospital in Bangkok it is about $5000. A friend who lives there happened to send me the link to the prices.

Then, my guess of $10K for Europe would not be far off.

I know - they set up a payment plan with the hospital. When I was three weeks old I had surgery for pyloric stenosis, a narrowing of the opening to the small intestine. In 1950 this was serious, the surgery had about a 50% survival rate. Dad sometimes remarked about his "$1,000 baby" because that was what it cost, an astronomical amount for him then. He was an electrician so didn't have much money, I guess it took years to pay it off. I still have a huge scar across my abdomen from that surgery.

That $10K in 1950 is worth $10K now with inflation (I just looked). Still cheap compared to what they charge nowadays.

When people pay for healthcare out of pocket, they are more conscientious of the cost, and aware of the value. It's no different than having to shop for your own home, car, etc... When it is paid with OPM (Other People's Money), they do not care as much.

 

[Walt34]

That $10K in 1950 is worth $10K now with inflation (I just looked). Still cheap compared to what they charge nowadays.

When people pay for healthcare out of pocket, they are more conscientious of the cost, and aware of the value. It's no different than having to shop for your own home, car, etc... When it is paid with OPM (Other People's Money), they do not care as much.

What is more difficult to put a dollar value on is the quality of care and greater certainty of a positive outcome. I'd wager that now the same surgery is probably considered minor or at least routine and survival rates are a lot better than 50%. But agreed that when OPM is paying for it then the dollar cost is secondary or ignored.

 

[NW-Bound]

Yes, the healthcare quality is a lot better now, but technological advances give us that and it does not have to cost more. It's the same as us being able to get a big flat screen TV for what a little 13" CRT TV used to cost.

By the way, I still remember the excitement over the world's first human heart transplant. So, I looked it up and it was in 1967. Now, doctors perform 4,000 such operations each year around the world.

 

[ERD50]

Not much of a song that has only 2 notes!

Well, here's an awesome song with only one chord (two if you consider Bbm and Bbm7 as two separate chords rather than a variation of the same chord):


CHAIN OF FOOLS Chords - Eva Cassidy | E-Chords

And another massively great song on one chord (I heard Muddy do this live - AWESOME!!!! Unbelievable power! And ONE CHORD. )

-ERD50

 

[HFWR]

"Six strings, five fingers, three chords, and one a**hole."

Keith Richards

 

[gauss]

For those that would just like to pay cash with a significant discount, check out the "Direct Primary Care" concept.

You basically pay your PCP,who has adopted this model, a monthly retainer that covers a predefined set of services. You would also want to have some separate catastrophic insurance coverage for hospitalization and such.

-gauss

 

[Winemaker]

Poll: Only 15 percent say they have benefited from ObamaCare | TheHill

I can't believe the stats from this poll; seems like they never polled some ER'ed folks here.

However, it hasn't affected DW and I, yet. After both of us losing employee HC after retirement, we pay about $17,800 for similar coverage.

I can remember my old doctor from my childhood days, whose office was above a bakery. After looking at me and my 3 siblings, doc would say to my mom," Just gimme $20.00 ", after asking how much she owed. Sometimes we had enough to buy something in the bakery afterward.

 

[Gone4Good]

Poll: Only 15 percent say they have benefited from ObamaCare | TheHill

I can't believe the stats from this poll; seems like they never polled some ER'ed folks here.

I can believe it.

The law specifically intended to leave the ~80% of the population who have insurance through their employer unaffected.

Also there are plenty of folks who have benefited from things like community ratings and don't even realize it.

 

[athena53]

I can believe it.



The law specifically intended to leave the ~80% of the population who have insurance through their employer unaffected.

Although the penalties for "Cadillac plans", i.e. those deemed too generous or expensive, have forced some employers to pare down their plans.

 

[Gone4Good]

Although the penalties for "Cadillac plans", i.e. those deemed too generous or expensive, have forced some employers to pare down their plans.

That would surprise me seeing as how the "Cadillac tax" never went into effect, is not scheduled to start until 2020, and may not even happen then.