Health care?

[youbet]

Sounds like he contributed $450k to their socialized system.

But I'm wondering if their price to him, the $450k, was marked up over their cost. Is Sweden, despite their socialized system, getting into the medical tourism game? Or was this just a one time humanitarian type thing where they just charged the recipient their cost and garnered some international goodwill and prestige?

And would Swedes even be eligible for this procedure under their program, or would they have to pay for it outside of the system?

I dunno.... If I was a member of a socialized medical system and outsiders with cash were jumping in line in front of me, I'm not sure I'd like that.

My curiosity about this is driven by wanting to understand how we would handle, under a single payer or other gov't health care system, the millions of non-citizens we provide care for today. Currently these costs are absorbed by the provider and then reflected in the bills of those who can/will pay. With a gov't based system things might work differently but it's hard to imagine what it would be like.

 

[youbet]

I live in MA where we have Romneycare and I'm glad that I can retire early and be guaranteed that I will be able to buy good coverage for $340 a month no matter what pre-existing I have.

Do you know how "Romneycare" is working out financially for MA? It seems like if MA is able to do it as a pay-as-you-go system for those very reasonable premiums, they have a winner. Are the premiums collected today covering all costs so that MA residents won't be looking at some sort of debt mountain or higher taxes in the future? If so, it's a great system.

My Medicare Part B + Part D + supplement will cost more than $340/mo and we know that Medicare isn't making it financially. I wonder how MA is doing it? Maybe just more efficient than the feds?

 

[george76]

I live in MA where we have Romneycare and I'm glad that I can retire early and be guaranteed that I will be able to buy good coverage for $340 a month no matter what pre-existing I have.

Would you mind sharing where one can find this quote of $340?

I have checked the massresources.org. It seems most quotes are much higher than that, like around a $1,000 for an individual.

Thanks for your help.

 

[Midpack]

An interesting article that touches on several of the medical tourism issues raised. Globalisation and health care: Operating profit | The Economist

A bit of rivalry from top foreign facilities may introduce transparency and price competition into an inefficient system riddled with oligopolies and perverse incentives. For example, American and European hospitals may cut prices once they realise how much potential business they stand to lose. By Deloitte’s reckoning, medical travel will represent $162 billion in lost spending on health care in America by 2012. There are signs that American health-care administrators are starting to feel the heat. European hospitals may not be immune from such pressure, either. On one estimate, some 50,000 British medical tourists headed overseas in 2006, spending millions of pounds for care in such places as Turkey, India and Hungary.

 

[Sirka]

Try being self-employed, working part-time or unemployed and see how you like it.
... But the idea that insurance needs to be tied to employment is just plain nuts.

+1
Sometimes you can't get the insurance - this is what is wrong with our Healthcare.

 

[scrabbler1]

I approach this issue from an actuarial perspective, given my professional background of 23 years n the actuarial field.

Whether it is a single payer or individual mandate, we need to have everyone paying into the system so we don't have those "free riders" who pay nothing into the system yet collect benefits. I prefer single payer. Pass a "Medicare for All" bill and raise the Medicare and/or income tax to pay for it. Businesses would no longer need to provide health insurance for their employees, Medicaid would disappear, unemployed people get coverage, pre-existing conditions become irrelevant, and an illness would not bankrupt anyone any more.

 

[farmerEd]

Would you mind sharing where one can find this quote of $340?

I have checked the massresources.org. It seems most quotes are much higher than that, like around a $1,000 for an individual.

Thanks for your help.

I shop my policy every year, I just got a quote from BCBS in Mass with an effective date of March 2012; The cheapest policy from BC/BS for an individual was $289.61/month or $763 for a family policy. A better policy (HMO Blue with $1000 deductible) also from BC/BS was $484 or $1276 for a family policy.

The best thing about Mass health insurance, to me anyway, is the 'guarantee issue'. If you want a policy, and can pay for it, you can get one. If you need health insurance and you can't afford it, you can still get it.

There is a certain piece of mind in knowing that you can't simply be denied coverage when you get sick - I would think everyone could be on-board with at least that aspect of 'Universal' care. Whether it be Romneycare or Obamacare.

 

[Sirka]

Medicare for All

... Pass a "Medicare for All" bill and raise the Medicare and/or income tax to pay for it. Businesses would no longer need to provide health insurance for their employees, Medicaid would disappear, unemployed people get coverage, pre-existing conditions become irrelevant, and an illness would not bankrupt anyone any more.

+1
This would be great, but I can't imagine Congress passing it. They would have to give up their PLAN.

 

[nun]

Would you mind sharing where one can find this quote of $340?

I have checked the massresources.org. It seems most quotes are much higher than that, like around a $1,000 for an individual.

Thanks for your help.

Go to

https://www.mahealthconnector.org

The rates will vary according to age zip code etc. Mine is for a bronze plan for a 51 year old single male in Boston.

 

[Alan]

But I'm wondering if their price to him, the $450k, was marked up over their cost. Is Sweden, despite their socialized system, getting into the medical tourism game? Or was this just a one time humanitarian type thing where they just charged the recipient their cost and garnered some international goodwill and prestige? I dunno.... If I was a member of a socialized medical system and outsiders with cash were jumping in line in front of me, I'm not sure I'd like that.

My curiosity about this is driven by wanting to understand how we would handle, under a single payer or other gov't health care system, the millions of non-citizens we provide care for today. Currently these costs are absorbed by the provider and then reflected in the bills of those who can/will pay. With a gov't based system things might work differently but it's hard to imagine what it would be like.

Are you sure they would be jumping the queue? Does Sweden not have private health clinics outside the socialized medicine system like the UK has?

Stockholm Care represents six County Council hospitals and several private care providers.

In the 1980's Prime Minister Margaret Thatcher was once asked in parliament why she went to a private clinic for a surgical procedure. "Do you not have faith in the NHS?", she was asked. Her reply was that by using a private practice she was not increasing the burden on the NHS.

When in the UK last year if DW or I had needed to go to an ER or have some other specialist care we already knew the nearest private hospital that was in the BCBS plan.

Socialized medicine does not necessarily mean there are no private clinics and hospitals providing services for those that can afford it.

 

[nun]

Do you know how "Romneycare" is working out financially for MA? It seems like if MA is able to do it as a pay-as-you-go system for those very reasonable premiums, they have a winner. Are the premiums collected today covering all costs so that MA residents won't be looking at some sort of debt mountain or higher taxes in the future? If so, it's a great system.

My Medicare Part B + Part D + supplement will cost more than $340/mo and we know that Medicare isn't making it financially. I wonder how MA is doing it? Maybe just more efficient than the feds?

Costs are a big issue. There was a big spike in expensive ER usage soon after the plan started as many people just didn't think of going to the doctor. That's tailed off now. MA realizes that if costs continue to go up there will be big funding trouble so they are moving away form a "fee for procedure" model of payment and limit the annual increase in premiums.

Another great thing is being able to compare monthly premiums between insurance providers when you go on the MA website to choose a plan

https://www.mahealthconnector.org/portal/site/connector/

All plans have to provide state mandated levels of care so when I look at the various Bronze level plans (2000/5000 with co-payments) there's no difference in coverage. The cheapest plan is $331 a month and the most expensive is $555. The more expensive plans are from the big companies like Blue Cross and presumably reflect higher administrative costs and that they include the most expensive hospitals like Mass General more often.

 

[youbet]

Are you sure they would be jumping the queue? Does Sweden not have private health clinics outside the socialized medicine system like the UK has?

No, I'm not sure at all. That's why I was asking the question. Thanks for your inputs.

Socialized medicine does not necessarily mean there are no private clinics and hospitals providing services for those that can afford it.

OK. Interesting. I admit that when mulling over the concept of going to some sort of socialized HI plan here in the USA, the thought that I'd be forced (if the plan worked that way) to use the system as it is while private pay "outsiders" could jump the queue (as you put it) rubs me the wrong way. But I see what you're saying Alan. In the UK system, I'd be on an even keel with "insiders" and would not have to compete for services with private pay "outsiders" for resources of the NHS. For the private side of the system, I could get what I could pay for in competition with the rest of the world. That makes sense.

How does the UK handle folks who need care (likely emergency) and who both don't qualify for NHS (say non-citizens there without documentation) and who can't pay within the private system.

 

[nun]

Socialized medicine does not necessarily mean there are no private clinics and hospitals providing services for those that can afford it.

Most foreign systems are a mix of public and privately funded hospitals and doctors. In the UK there are is a private system that you can pay for yourself (FYI premiums are far less than in the US) and the public system is funded from general taxation and healthcare is free to all at the point of service. This is at one end of the spectrum, with the US approach at the other. Most countries fall in between and mandate that people buy health insurance from highly regulated non-profit insurance companies and they have access to both public and privately funded hospitals.

 

[nun]

How does the UK handle folks who need care (likely emergency) and who both don't qualify for NHS (say non-citizens there without documentation) and who can't pay within the private system.

All emergency care is free in the UK, no matter what your status. I have US friends who had an issue with a pregnancy while visiting the UK and they went to the ER, had a load of scans and it was all no charge because it was deemed an emergency.

If you are not UK resident you are supposed to pay for non-emergency treatment. Also your citizenship or whether you are a tax payer has nothing to do with eligibility for NHS treatment, you just have to be a resident or in an emergency.

 

[youbet]

The cheapest plan is $331 a month and the most expensive is $555. The more expensive plans are from the big companies like Blue Cross and presumably reflect higher administrative costs and that they include the most expensive hospitals like Mass General more often.

Hmmmm...... That's close to amazing. I'm currently getting ready for Medicare as I turn 65 in a few months. Right now it looks like my costs will be approximately:

Part B - 161
Part D - 36
Plan F supplement - 150

Total /mo - 347 The supplement and Part D are from BCBS.

It appears folks in MA can do better even before they reach Medicare age than I can with Medicare.

If Medicare is going broke, as some claim, perhaps all geezers can simply move to MA?

Edit: After looking over the link nun provided, I see that MA kicks your butt out of their plan when you reach Medicare age so guess we geezers won't all be moving there after all.

 

[REWahoo]

Part B - 161
Part D - 36
Plan F supplement - 150

Total /mo - 347 The supplement and Part D are from BCBS.

I got there a couple of months ago. For comparison:

Part B - 100
Part D - 15
Plan F supplement - 44 (BCBS high deductible plan)

 

[youbet]

I got there a couple of months ago. For comparison:

Part B - 100
Part D - 15
Plan F supplement - 44 (BCBS high deductible plan)

Isn't your Part B 115, not 100? Mine will be 161 because because my adj income is a few bux over the limit for 2010. I'm keeping that number on the front burner as I tax plan going forward.

My Part D was the best deal I could find covering the 4 drugs I take. I think I remember you mentioning your strategy and coverage based on not currently taking any drugs.

The 44 Plan F high deductible is one of my choices. I'm thinking about it.

Thanks for those inputs!

 

[REWahoo]

Isn't your Part B 115, not 100?

It was $115 for Dec, then dropped to $100 (actually $99.90) starting in Jan.

Mine will be 161 because because my adj income is a few bux over the limit for 2010.

Some of us are better endowed than others.

My Part D was the best deal I could find covering the 4 drugs I take. I think I remember you mentioning your strategy and coverage based on not taking any drugs now.

+1

The $15 Humana/Walmart plan was the cheapest I could find. It is a place holder allowing me to switch to another plan in the future when (not if) I end up on maintenance meds.

The 44 Plan F high deductible is one of my choices. I'm thinking about it.

I carry relatively high deductibles on all our insurance, choosing to pocket the savings in premiums for taking the added risk. The $2,070 plan F deductible wouldn't break the bank if I had to pay it and I can always switch to another plan in the future if needed.

 

[youbet]

It was $115 for Dec, then dropped to $100 (actually $99.90) starting in Jan.

I need to revisit my 161 number. Perhaps it's down a tad too!

Some of us are better endowed than others.

Not to worry. My income is shrinking like the rest of me (except my gut!).

I carry relatively high deductibles on all our insurance, choosing to pocket the savings in premiums for taking the added risk. The $2,070 plan F deductible wouldn't break the bank if I had to pay it and I can always switch to another plan in the future if needed.

I usually carry high deductibles on insurance too. In the case of Plan F, the zero deductible/co-pay level has the appeal of pretty much eliminating paperwork. But with premiums over a kilobuck higher per year, I'm still thinking through that one. I can handle a bunch of paperwork for over $1k/yr!

 

[nun]

Edit: After looking over the link nun provided, I see that MA kicks your butt out of their plan when you reach Medicare age so guess we geezers won't all be moving there after all.

Yep that's true, but living in MA removes a lot of the worry about spanning the gap between ER and when Medicare starts. If you want to have the option not to buy healthcare or want to have a plan that has a deductible greater than 2k or an annual out of packet max greater than $5k, then don't move to MA. If you are ok with those things, MA does guarantee you can get a plan irrespective of your pre-existing conditions.

 

[youbet]

Yep that's true, but living in MA removes a lot of the worry about spanning the gap between ER and when Medicare starts. If you want to have the option not to buy healthcare or want to have a plan that has a deductible greater than 2k or an annual out of packet max greater than $5k, then don't move to MA. If you are ok with those things MA does guarantee you can get a plan irrespective of your pre-existing conditions.

nun, you guys gotta change that policy. If the plan is paying its own way with current premiums, why boot folks cuz they become Medicare eligible? MA could be the geezer capital of the world! Tens of millions of boomers moving in to utilize the superior-to-Medicare health care coverage. It would be the economic boom of the century! Instead of being labeled blue or red, MA would be labeled grey.

 

[ziggy29]

Yep that's true, but living in MA removes a lot of the worry about spanning the gap between ER and when Medicare starts. If you want to have the option not to buy healthcare or want to have a plan that has a deductible greater than 2k or an annual out of packet max greater than $5k, then don't move to MA. If you are ok with those things, MA does guarantee you can get a plan irrespective of your pre-existing conditions.

This is a concern, though. Will Massachusetts become the refuge for the old, the sick, the otherwise uninsurable who couldn't get coverage in other states? And what would that do to costs there?

 

[Hamlet]

I suspect that it is currently cheaper that Medicare because Medicare's pool of users is older.

Providing insurance for people under 65 is generally going to be a lot cheaper than providing insurance for people over 65.

Allowing people to stay on the MA policies would drive up premiums.

nun, you guys gotta change that policy. If the plan is paying its own way with current premiums, why boot folks cuz they become Medicare eligible? MA could be the geezer capital of the world! Tens of millions of boomers moving in to utilize the superior-to-Medicare health care coverage. It would be the economic boom of the century! Instead of being labeled blue or red, MA would be labeled grey.

 

[nun]

nun, you guys gotta change that policy. If the plan is paying its own way with current premiums, why boot folks cuz they become Medicare eligible? MA could be the geezer capital of the world! Tens of millions of boomers moving in to utilize the superior-to-Medicare health care coverage. It would be the economic boom of the century! Instead of being labeled blue or red, MA would be labeled grey.

I think Federal Law has something to say about that right now, but if Medicare goes away or states can opt out there might be something in what you say. Certainly the MA plan would become a lot more expensive if it had to replace Medicare as well. The MA plan does face serious financial problems if costs continue to increase, as do all plans. But at least MA is facing up to the issues. Many will not agree with the approach, but as Romney says it's right for MA and the majority of the citizens of the Commonwealth are happy with the system.

http://www.mass.gov/bb/h1/fy11h1/exec_11/hbuddevhc.htm

FYI MA has already gone down the path of attracting people from out of state because of our laws....as we've had same sex marriage for a few years now there is quite a big industry around gay marriage.....so we might not be the grey state, but we could claim to be the gay state.

 

[Birchwood]

My opinion:
1. To cover everybody with single payer, all our taxes should increase to pay for it.

2. We have to change our attitude that health care is a right, not a commodity. like Canada.

3. To economize, more effort should be in Prevention with actual mandates and rules for people to follow. Can't abuse the system and expect no consequences.

4. It will be tough to decide which is standard care which is covered and which is not. OK no Viagra!

5. All new proceedures should pass thru a random study with standard treatments before it will be approved for use. There's a lot of loopholes here which lead to very expensive care.

6. Well, this will be controversial, but there should be a public option!
and let it compete with private insurance companies.

7. In the end there will be a main government single payer system for standard care and extra private insurance for those who want Cadillac care. Such exist in England, Sweden, Germany etc.

8. No matter what, there will always be complaints!!