Health Care subsidies

[GregLee]

Conservative planning for retirement suggests that this change in expenses, if the changes do go through, should be taken into consideration.

"This change in expenses"?

The amount of the voucher would be based on total current Medicare spending and indexed to grow year by year thereafter.
House GOP considers privatizing Medicare | The Daily Caller - Breaking News, Opinion, Research, and Entertainment

 

[M Paquette]

"This change in expenses"?

Yup. The voucher amount will be indexed at a rate that represents the average of the cost of living index used for Social Security, and a medical expense index. Based on past history, this will adjust the voucher amount upward by less than the actual change in the cost of the private individual insurance proposed to replace the current Medicare program.

Further, the non-Medicare insurance policies I can find currently all cost more than the voucher, and have much higher deductibles and copayments. That will be an additional expense for the retiree under the proposed plan.

For example, the cheapest non-Medicare Kaiser Permanente plan for a 65 year old in my region is $12,672 annually, with $30 copay after a $2,700 deductible, 30% copay on hospital and emergency services, $5,200 annual out of pocket maximum. This represents a higher net annual expense than similar Medicare Advantage or Medicare plus supplemental coverage would have.

A person aged 54 or younger should be prepared for somewhat higher medical expenses under Medicare than current programs allow, if this proposal goes through.

Note that I'm not against the proposal. I think that in the long run it may be an important step in containing the projected rise in Medicare costs to the federal government and the taxpayer base. However, this change does not come without some impact on those who will retire to the proposed new plan.

 

[Corporate ORphan]

What's the value added for private insurance companies?

THe private insurance companies do nothing in the equation for health care but add a costly middleman. (Do any of you really think they add value? ) If the majority of people (including our congressmen) had to obtain their health insurance through a private individual plan there would be no debate.

For the first time in my life I have been trying to find decent private insurance for my husband and I to replace COBRA. We are both 55, have no pre-existing conditions that we know of, don't take any prescriptions and are in our "normal" weight category. We are looking at a $10,000 HD HSA account to get the premiums down to a reasonable amount. We still feel like we have been "raped" in the process and we haven't even turned in the application yet!

I can get more reliable information about a used car than I can on these insurance policies. TAlk about a racket. One agent for UHC told me he didn't have anything in writing about my issue but he knew what the policy covered because "he was trained". He connected me with customer service who told me the agent was mistaken. The latest is UHC will charge us $120 a year ($10 a month) if we don't let them automatically withdraw the premiums from our checking account. We would go with BCBS but they aren't portable and we would like to relocate.

I can go on and on about how the high cost of health care/insurance in this country is contributing to the high unemployment rate, etc. but what's the point. I'm sure anyone reading this thread already agrees.

THank you for "listening" to my ranting. I have to go fill out that application and at least now I feel a little better so I can tackle it. I need a clear head to remember that 10 years worth of medical history they require

 

[Silver]

After working as an advanced practice registered nurse (RN with master's degree in nursing) for over 25 years, it is my opinion the the current healthcare system in the United States is corrupt. It's not just broken, or unorganized, or anything else that can appease our senses and allow some trust....it is as corrupt as any mafia organization ever was or could be.

The challenge is.....the mafia makes money "illegally" so it's easier to identify and stop it. Some very powerful organizations within healthcare (insurance and drug companies and the American Medical Assoc for example) ensure that government agencies don't create oversight requirments that might limit cash flow. And since we are and want to be a capitalist society....we embrace this lack of governmental control.

Corruption is what it is. It may be legal corruption or moral corruption. Kinda sad that so many other countries less priviledged then us in the U.S.A. figured this out and stepped up on behalf of their people.

 

[chinaco]

Obamacare is not the optimum solution. There is a lot I do not like about it.

Hopefully Obamacare will blast the Republican's out of their stonewalling position to negotiate a more middle ground solution that actually addresses middle class issues.

IMO - [my armchair solution ] Free Riders should have rationed healthcare for non-life threatening treatment except routine health. Redlining for health problems should be outlawed (but new policies can be rated... prior coverage stands as is). State boundaries should be removed to enable private coverage to scale. Lifestyle issues (like smoking, chronic alcohol/drug abuse and obesity) should be rated (i.e., pay higher premium).


Feel free to blast my opinion...

 

[haha]

Well, somebody is going to be paying for this care. The present system isn't doing much to control costs...

Why is it when the entre developed world decides to control costs and cover everyone every age with the same plan, Americans just try to decide which group to screw?

There must be something in the water that warps judgment.

Ha

 

[samclem]

Why is it when the entre developed world decides to control costs and cover everyone every age with the same plan, Americans just try to decide which group to screw?

There must be something in the water that warps judgment.

Ha

Methinks the "entire developed world" came to their present systems just as we will--with lots of wailing, goring of various oxen, and stuffing the bill in someone's pocket.

The order (first cover everyone, then address costs? Address costs before giving everyone a card?) is a nontrivial point. The new legislation has an approach that is gonna cost a lot. Open up your pocket so that bill can slip right in.

 

[haha]

Methinks the "entire developed world" came to their present systems just as we will--with lots of wailing, goring of various oxen, and stuffing the bill in someone's pocket.

The order (first cover everyone, then address costs? Address costs before giving everyone a card?) is a nontrivial point. The new legislation has an approach that is gonna cost a lot. Open up your pocket so that bill can slip right in.

I agree that the new bill is very poor, and it does not cover everyone anyway.

To anyone who would like to get some careful description of what other advanced countries have done, when, and how, a very good and also entertaining book is T.R. Reid's The Healing of America. Reid is a former Washington Post reporter who lived in several countries and participated in their health systems with his family. He also visited medical facilities in a number of other countries to write this book.

Ha

 

[explanade]

After working as an advanced practice registered nurse (RN with master's degree in nursing) for over 25 years, it is my opinion the the current healthcare system in the United States is corrupt. It's not just broken, or unorganized, or anything else that can appease our senses and allow some trust....it is as corrupt as any mafia organization ever was or could be.

The challenge is.....the mafia makes money "illegally" so it's easier to identify and stop it. Some very powerful organizations within healthcare (insurance and drug companies and the American Medical Assoc for example) ensure that government agencies don't create oversight requirments that might limit cash flow. And since we are and want to be a capitalist society....we embrace this lack of governmental control.

Corruption is what it is. It may be legal corruption or moral corruption. Kinda sad that so many other countries less priviledged then us in the U.S.A. figured this out and stepped up on behalf of their people.

Well it didn't reach this condition without lobbyists buying politicians to protect or enhance their ability to squeeze the patient dry.

That and a pliable populace easily manipulated by cries of "death panels!"

 

[Mulligan]

And as we baby boomers age, and more turn 65, the problem will get worse, especially with our medicare program. Not saying to pull the plug on granny, but these facts below are a definite financial problem with no easy solution.

Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months.

 

[dgoldenz]

And as we baby boomers age, and more turn 65, the problem will get worse, especially with our medicare program. Not saying to pull the plug on granny, but these facts below are a definite financial problem with no easy solution.

Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months.

And so the rationing begins....IMO, it's not a question of if, but when. If someone invented a cure for cancer, but it cost $50 million per person, would we offer it to everybody? There is only a finite amount of dollars to be spent and at some point, rationing will be the only option left.

I have also read that something like 5% of the population has 90% of the claims in the under-65 market.

 

[Mulligan]

And so the rationing begins....IMO, it's not a question of if, but when. If someone invented a cure for cancer, but it cost $50 million per person, would we offer it to everybody? There is only a finite amount of dollars to be spent and at some point, rationing will be the only option left.

I have also read that something like 5% of the population has 90% of the claims in the under-65 market.

What I read was 10% swallowed up 70% of cost. I guess an optimist could take from it that although we need to save up for these costs the majority of people dont have big costs, just a few.
Sometimes we read things that are misleading. Staying healthy longer just delays inevitable costs. I have read studies that smokers actually cost the government less, because they die quicker, arent on social security as long, and have less cases of alzheimers. Not advocating smoking!

 

[Mulligan]

What I read was 10% swallowed up 70% of cost. I guess an optimist could take from it that although we need to save up for these costs the majority of people dont have big costs, just a few.
Sometimes we read things that are misleading. Staying healthy longer just delays inevitable costs. I have read studies that smokers actually cost the government less, because they die quicker, arent on social security as long, and have less cases of alzheimers. Not advocating smoking!

DGoldenz- Correction my 10%-70% ratio is for over 65, not under 65 like you were quoting.

 

[dgoldenz]

DGoldenz- Correction my 10%-70% ratio is for over 65, not under 65 like you were quoting.

10/70 sounds about right for over-65 since you have a generally sicker population. Given my own personal experience selling health insurance, I would say my 5/90 number is reasonably accurate. If it was 10/80, it's basically the same thing....

 

[obgyn65]

+1. well said Silver.

Kinda sad that so many other countries less priviledged then us in the U.S.A. figured this out and stepped up on behalf of their people.

 

[samclem]

Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months.

This is quoted a lot, and it's important. Still, when you are in the situation, you don't know (for sure) just how long the train ride is going to be. You are playing it in the stew of the most powerful human emotions --hope, fear, love, and a desire to say one more nice thing to your grandchildren. It is a day by day existence.

Everything in life would be a lot easier if we could make our decisions with foreknowledge of the outcomes various choices would bring. Among other things, I'd quit indexing/rebalancing and turn into a stock picker and a dirty market timer in 5 seconds!

 

[Mulligan]

This is quoted a lot, and it's important. Still, when you are in the situation, you don't know (for sure) just how long the train ride is going to be. You are playing it in the stew of the most powerful human emotions --hope, fear, love, and a desire to say one more nice thing to your grandchildren. It is a day by day existence.

Everything in life would be a lot easier if we could make our decisions with foreknowledge of the outcomes various choices would bring. Among other things, I'd quit indexing/rebalancing and turn into a stock picker and a dirty market timer in 5 seconds!

You are definitely correct in what you are saying, and I agree with it. Yet it might only be me thinking this and as I am still in my 40's and in good health as far as I know, 2 thoughts hit my mind on this end of life, cost, care issue.
1) If someone asked me at my current stage of life, would I like to have my life extended a few months in relative pain and significant cost depleting my assests that I cant pass on to my heirs, I would say let me die, and save the money.
2) Some people value their animals and love them more than even people, yet they put them "to sleep" as a sign of love and compassion.
I realize we arent animals and there are other issues at play, but it is interesting to discuss. But of course being just at the middle aged point in life and no health issues that I am aware of, could be affecting my thoughts on the issue.

 

[FinanceDude]

Kinda sad that so many other countries less priviledged then us in the U.S.A. figured this out and stepped up on behalf of their people.

Like whom? Survival is the strongest of human basic instincts. Rationing care is the "easy way out"? If that's the case, why keep arresting Jack Kervorkian, he seems to be "doing everyone a favor!!!

 

[explanade]

Survival means fighting for a scarce resource and making sure others can't access it so that you can?

 

[M Paquette]

Survival means fighting for a scarce resource and making sure others can't access it so that you can?

Ever notice how all the whoop'n and holler'n is over the demand side, while the supply side of the equation stays safely untouched?

 

[samclem]

Ever notice how all the whoop'n and holler'n is over the demand side, while the supply side of the equation stays safely untouched?

That's one of the good things about real markets--supply and demand are inexorably linked. Ya don't get that when a government agency makes the decisions. Thus, we guarantee everlasting fighting, squabbling, finger-pointing and rent-seeking when we choose the bureaucratic "solution."

 

[explanade]

Do you think health care is like other markets, esp. in terms of elasticity?

If a person is sick, will they wait for prices to go down?

Do you think suppliers and buyers of health care have access to the same info. as sellers and buyers in other markets?

 

[samclem]

Do you think health care is like other markets, esp. in terms of elasticity?

If a person is sick, will they wait for prices to go down?

Do you think suppliers and buyers of health care have access to the same info. as sellers and buyers in other markets?

Do you think everyone buys their health care at the time of illness?
Do you think the present way we sell health care (public and private) promotes transparency of service quality and prices?
Do you think creating false dichotomies is a useful way of making a point?

 

[explanade]

Which false dichotomy is that?

Health care providers have pricing power because the average person isn't going up on WebMD and say that heart bypass isn't needed or should only cost 50%.

That's why health care costs have been going above inflation for decades now.

Oh and yeah, people are forced to pay without insurance coverage, either because coverage is denied or the lifetime cap is exhausted.

Speaking of comparing to other markets, what other business causes the same rate of personal bankruptcies? I would guess nothing comes close but maybe you know of another, since you seem to think health care market is a market just like any other.

 

[samclem]

Speaking of comparing to other markets, what other business causes the same rate of personal bankruptcies?

Mortgage lending?

I would guess nothing comes close but maybe you know of another, since you seem to think health care market is a market just like any other.

I certainly do not. But I think market forces, adapted for application to this particular area with its own challenges, can bring many of the benefits that market forces brings to every other area of our lives. I'm guessing you disagree, and that's okay.