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Old 02-25-2011, 10:44 PM   #61
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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.
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Old 02-25-2011, 11:05 PM   #62
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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!
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Old 02-25-2011, 11:07 PM   #63
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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.
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Old 02-25-2011, 11:17 PM   #64
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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....
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Old 02-26-2011, 02:55 AM   #65
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+1. well said Silver.
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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.
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Old 02-26-2011, 05:43 AM   #66
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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!
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Old 02-26-2011, 09:44 AM   #67
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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.
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Old 03-07-2011, 01:28 PM   #68
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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!!!
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Old 03-07-2011, 02:41 PM   #69
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Survival means fighting for a scarce resource and making sure others can't access it so that you can?
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Old 03-07-2011, 03:06 PM   #70
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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?
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Old 03-07-2011, 03:11 PM   #71
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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."
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Old 03-07-2011, 06:08 PM   #72
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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?
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Old 03-07-2011, 07:59 PM   #73
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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?
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Old 03-07-2011, 08:26 PM   #74
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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.
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Old 03-07-2011, 09:02 PM   #75
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Speaking of comparing to other markets, what other business causes the same rate of personal bankruptcies?
Mortgage lending?

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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.
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Old 03-07-2011, 10:03 PM   #76
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Foreclosures from mortgages but not sure about bankruptcies.

I'm not sure about market forces in health care either. During the whole health care debate, there was talk about selling insurance across state lines. Turns out in many states, it's just one or two carriers which dominate the whole state market.

So deregulation could bring interstate competition in theory. Or the biggest insurers cherry-pick the most lucrative markets and bail on unprofitable ones, like they do with car insurance. Plus if applying real market forces means the insurers get to continue with preexisting conditions to deny or revoke coverage, then they may not get a market big enough -- young healthy people may not bother or have the money to get coverage on the individual market. Or simply redline those zip codes with older average populations.

The other part that wasn't really pursued are the providers and it's not clear that hospitals in a city would get into a price-war or anything like that.
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Old 03-08-2011, 08:41 AM   #77
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One thing nobody ever seems to bring up is the "boomer effect". Since the boomers have been around anybody marketing anything to them has had the good fortune to become very wealthy. The same phenomenon is now occurring with health care and people are getting upset. Instead of implementing programs to expand supply as demand gradually increased everything has waited until it is essentially too late. I don't expect medical schools to expand their training, because the more demand there is for their product the more they can charge. The demand is a blip on the long term projections, so medical schools aren't really interested in spending millions or billions of dollars to expand when in 20-30 years they will be looking for ways to shrink. Not too mention most, if not all of the instructors are practicing doctors. If too many doctors are trained it has a dampening effect on their income. It is kind of like a cops job is to make their job obsolete.
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Old 03-08-2011, 09:48 AM   #78
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If someone invented a cure for cancer, but it cost $50 million per person, would we offer it to everybody?
If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it. You'd need to take massively expensive Big Pharma drugs for life to prevent it from spreading.

Cures aren't profitable drugs. They are one-and-done. Notice how all the new medications don't cure anything, but merely manage symptoms and need to be taken for life?
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Old 03-08-2011, 09:52 AM   #79
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If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it. You'd need to take massively expensive Big Pharma drugs for life to prevent it from spreading.

Cures aren't profitable drugs. They are one-and-done. Notice how all the new medications don't cure anything, but merely manage symptoms and need to be taken for life?
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Old 03-08-2011, 10:00 AM   #80
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If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it.
"They'd" keep it in that secret warehouse where "they" have that 100 MPG carburetor and the car that runs on water.

I guess no one in "Big Pharma" or any of those medical researchers have a spouse or child dieing of cancer.
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