US Healthcare Expensive and Inefficient
- Thread starter tomz
- Start date
mykidslovedogs said:
You did not read the whole post the employee pays 6.5% and this is based on income so lower income people pay less than high income. So if you make $100,000 dollars a year you would pay $6,500 Which is about what I pay now. Lets be more realestic say you make $50,000 a year you would pay $3,250. The employer also pays 6.5% which is probably less than an employer pays here. And as I said when an employee is sick their salary is paid by of their medical insurance which also saves the company money. There system takes care of all German citizens not just the wealthy. Plus there are no preexisting condition limitations. There are about 6 insurance companies writing policies in Germany. They all must offer the basic government required policy at the government stated premium. To attract business they may offer more bells and whistles than the other company but must maintain the government set premimum. It is a single payor system so a lot of money is saved on overhead.
As I said people who profit off of our system do not want it to change.
FIRE'd@51
Thinks s/he gets paid by the post
- Joined
- Aug 28, 2006
- Messages
- 2,433
Mwsinron said:
This is why nothing gets done. What Wyden is proposing is not Socialism. He is not advocating a government takeover of the healthcare delivery system?
FIRE'd@51
Thinks s/he gets paid by the post
- Joined
- Aug 28, 2006
- Messages
- 2,433
tomz said:
You didn't provide a number for the military. But, assuming 17% of the $6700 is Medicare, we cut the $6700 number to $5560 minus the amount Medigap pays which might be another 4% or so. What I'm trying to get at is the healthcare cost per person excluding those covered by Medicare and the Military to see how it squares with Wyden's premiums. I know I could dig up these numbers, but you seem to have everything at your fingertips.
OP
OP
tomz
Recycles dryer sheets
- Joined
- Mar 14, 2006
- Messages
- 251
mykidslovedogs said:
The VA system (which is different from Walter Reed, which is run by the Dept. of Defense) has an admirable record providing quality care at a decent price. It has had it's ups and downs, but in the last few years, the VA hospitals have had the highest quality ratings from the various accrediting agencies. There have been a number of articles/studies done on their care in Annals of Internal Medicine, New England Journal of Medicine, and Health Care Strategic Management among others. They are leader in Hospital Information Systems and they keep costs down. They negotiate directly with drug companies and their drug costs are significantly less than what Medicare recipients pay.
According to one study "When researchers compared VA Health Expenditures for all health care...they found hypothetical payments to Medicare providers would have been more than 20% greater the cost of care at VA."
The VA system is essentially socialized medicine. I'm not sure that a VA model would work for the public at large, but in the US, they probably do as good or better job than anyone.
OP
OP
tomz
Recycles dryer sheets
- Joined
- Mar 14, 2006
- Messages
- 251
FIRE'd@51 said:
AFAIK, it's included in the 12%, which is called "Other public spending". The link I referenced above has some good discussions on Wyden.
Re: US Health care Expensive and Inefficient
What choice? Only healthy people with money or jobs have choices. I have no choices, there is only one plan my husband and I can buy. It is much pricier than $750 a month.
But at least I have something. And I am blessed with money. Other people have no choices. I refuse to accept that it is anti-democratic or socialist to have a national solution to the health care coverage problem. And as FIRE@51 says, it simply isn't socialism; Wyden's plan keeps the insurance model.
I grew up where most people had very little money, in the poorest area of Minnesota. Some people had subsistence farms. Some people didn't even have indoor plumbing. I know today plenty of people who make less than $20,000 a year. I knew a woman with a poor paying job and no health insurance, always lived a healthy lifestyle. In fact, she worked in a health food store. She delayed having a breast lump checked because of the cost and because, after all, most are benign. She now is dead of breast cancer. I know street kids who struggle with a childhood of abuse and neglect. They get no health care to speak of. I recently paid copays for Risperdal and Lexapro for a young woman with PTSD who lost her job and ran out of money to pay even a small copay. Without the drugs she will end up in the hospital or may even be suicidal. I know people who struggle with mental illness who are limited in the care they can be reimbursed for under insurance plans or Medicare. I filed bankruptcy for a young woman with cancer after a collection agency for a hospital told her she should have died if she had no intention of paying her bill. I spent law school working on social security disability appeals after the government decided it would deny claims based on mental illness. I am tired of them all getting ****ed.
Mwsinron said:
What choice? Only healthy people with money or jobs have choices. I have no choices, there is only one plan my husband and I can buy. It is much pricier than $750 a month.
But at least I have something. And I am blessed with money. Other people have no choices. I refuse to accept that it is anti-democratic or socialist to have a national solution to the health care coverage problem. And as FIRE@51 says, it simply isn't socialism; Wyden's plan keeps the insurance model.
I grew up where most people had very little money, in the poorest area of Minnesota. Some people had subsistence farms. Some people didn't even have indoor plumbing. I know today plenty of people who make less than $20,000 a year. I knew a woman with a poor paying job and no health insurance, always lived a healthy lifestyle. In fact, she worked in a health food store. She delayed having a breast lump checked because of the cost and because, after all, most are benign. She now is dead of breast cancer. I know street kids who struggle with a childhood of abuse and neglect. They get no health care to speak of. I recently paid copays for Risperdal and Lexapro for a young woman with PTSD who lost her job and ran out of money to pay even a small copay. Without the drugs she will end up in the hospital or may even be suicidal. I know people who struggle with mental illness who are limited in the care they can be reimbursed for under insurance plans or Medicare. I filed bankruptcy for a young woman with cancer after a collection agency for a hospital told her she should have died if she had no intention of paying her bill. I spent law school working on social security disability appeals after the government decided it would deny claims based on mental illness. I am tired of them all getting ****ed.
Why do people think they have a choice in the US for health insurance. United Health Care (I think that the name) has been buying insurance companies throughout the country. One of their last buys was Pacific Care. We are getting socialized health insurance the corporate way. Corporation run and dictate our health care. Remember corporations main goal is to produce profits for their share holders not for you the patient.
If the consolidation in the health insurance industry continues you will only have a hand full of choices. What than do you think you will pay for health insurance? At the current annual increases of 8% plus a year no one will be able to afford health insurance. More and more companies are dropping health care because of the costs. We need a single payer system with the government setting minimum standards. Costs controls would also be required. Private insurance companies could write policies based on the standards. Germany does this and it works. As I said in my earlier post the health care provided in Germany as is good or better than in the US. Everyone pays to fund it. Part of the national sales tax is used to fund it.
If the consolidation in the health insurance industry continues you will only have a hand full of choices. What than do you think you will pay for health insurance? At the current annual increases of 8% plus a year no one will be able to afford health insurance. More and more companies are dropping health care because of the costs. We need a single payer system with the government setting minimum standards. Costs controls would also be required. Private insurance companies could write policies based on the standards. Germany does this and it works. As I said in my earlier post the health care provided in Germany as is good or better than in the US. Everyone pays to fund it. Part of the national sales tax is used to fund it.
Rich_by_the_Bay
Moderator Emeritus
Martha said:
Actually, you never sounded more convincing. This is indeed an emotional issue -- that's the point. It is not something to be decided strictly on the basis of accounting.
Go a job? Got money? Got health? Great - this is a terrific if obscenely expensive system. You win, just like you can drive a BMW while someone else takes the bus. But we're not talking about cars, we're talking about lives.
Yes, it will take unimaginable accounting, planning, politics, and compromise, But in the end it's a highly emotional issue. It may not be politic or strategic to wave that banner all the time, but nothing wrong with acknowledging it. After all, that's the point.
Rich_by_the_Bay
Moderator Emeritus
Mwsinron said:
Do you have strong feelings about roads? Cops? Mail carriers?
haha
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Rich_in_Tampa said:
Of course he does! We should fund police the way they do in Colombia. You have some money? Then create a police force to do things your way. You don't have money? Then you either sleep with or join one or another of the private forces who control everything.
You aren’t young enough for these “options”. OK , in that case just die and get the hell out of the way!
Ha
I thought a large part of the extra cost of medical care in the US was what we spend on the last 2 weeks of life, with all sort of ultra-expensive invasive hospital emergency procedures that do not prolong quality of life, but its mere duration, by a few weeks.
Hospitals love it, families now think they did "everything they could", and this cultural attitude costs a lot and gets us very little.
Hospitals love it, families now think they did "everything they could", and this cultural attitude costs a lot and gets us very little.
mykidslovedogs
Full time employment: Posting here.
- Joined
- Dec 13, 2006
- Messages
- 860
I admire all the people on this board who feel sorry for the poor people and hate seeing people suffer. Believe it or not, I feel the same way. I once bought a very poor friend of mine a car (actually, I bought her cars on two separate occassions - the second one after she totalled the first one I bought her) so she could truck her four kids back and forth to daycare and get to work, etc.. I gave her my cellphone so she could have access to 911 in case her diabetic child needed care. I spent hours trying to help her find public housing. I even encouraged her get signed up for Medicaid. Amazing! She qualified!
Unfortunately, the reality is that, even if you nationalize care, the poor people in this country will still have trouble accesssing care because they won't necessarily have transportation to and from facilities. The good facilities may not be located in their neighborhoods. They'll still have trouble paying copays, co-insurance and out of pocket costs. It's idealistic to think that we can solve the problem by providing healthcare for (Medicare) for all with minimal out of pocket costs to everyone so that absolutely no-one will ever suffer. In a system like that, demand will overrun supply to a point where everyone will end up suffering in the longrun. What will we say then to the thousands of women (maybe even rich women) who might die of breast cancer because there aren't enough practioners to service all the women who need mammograms or surgeons available to perform the mastectomy? Or what about the people who might die of cardiac arrest because they are waiting in line for heart surgery (after all, they might not have been in an emergency situation when they signed up on the waiting list). What will we say to the people who can't get their meds in a timely manner because supply has run out or there aren't enough doctors available right away to schedule an appt for a prescription refill?
There may be a compromise somewhere in the middle, but that will mean that there will still need to be some inequality, and some poor people still might not be able to easily afford their deductibles or out of pocket costs, but maybe, maybe, we can make preventive and catastrophic care accessible to all with a little bit of sacrifice from everyone.
The object of the game is to get the largest possible number of people covered with the least possible sacrifice to quality, innovation and choice. That is a monumental task! You have to be careful about taking too much money from the rich to take care of the poor, because eventually, that kind of system will lead to complacency. Who is going to want to work real hard to have half their income taken away for somebody else that isn't contributing to the system at all? You can only tax the wealthy so much, and soon, they will stop working so hard. You can only cap doctor's income so much, and soon, they'll be placing limits on their services.
Unfortunately, the reality is that, even if you nationalize care, the poor people in this country will still have trouble accesssing care because they won't necessarily have transportation to and from facilities. The good facilities may not be located in their neighborhoods. They'll still have trouble paying copays, co-insurance and out of pocket costs. It's idealistic to think that we can solve the problem by providing healthcare for (Medicare) for all with minimal out of pocket costs to everyone so that absolutely no-one will ever suffer. In a system like that, demand will overrun supply to a point where everyone will end up suffering in the longrun. What will we say then to the thousands of women (maybe even rich women) who might die of breast cancer because there aren't enough practioners to service all the women who need mammograms or surgeons available to perform the mastectomy? Or what about the people who might die of cardiac arrest because they are waiting in line for heart surgery (after all, they might not have been in an emergency situation when they signed up on the waiting list). What will we say to the people who can't get their meds in a timely manner because supply has run out or there aren't enough doctors available right away to schedule an appt for a prescription refill?
There may be a compromise somewhere in the middle, but that will mean that there will still need to be some inequality, and some poor people still might not be able to easily afford their deductibles or out of pocket costs, but maybe, maybe, we can make preventive and catastrophic care accessible to all with a little bit of sacrifice from everyone.
The object of the game is to get the largest possible number of people covered with the least possible sacrifice to quality, innovation and choice. That is a monumental task! You have to be careful about taking too much money from the rich to take care of the poor, because eventually, that kind of system will lead to complacency. Who is going to want to work real hard to have half their income taken away for somebody else that isn't contributing to the system at all? You can only tax the wealthy so much, and soon, they will stop working so hard. You can only cap doctor's income so much, and soon, they'll be placing limits on their services.
I don't think working people who are insured by their employer realize how much their health insurance costs. When we were working we paid $128 dollars a month in premiums when we left the work force and used COBRA and had to pay the full cost our monthly premium went to almost $900 per month. That is $10,800 per year. This year the cost will be $12,000. Our premiums are increasing 8% to 10% per year.
So those of you who are working that don't have a large part of your retirement money set aside for health insurance don't plan on retiring before age 65.
So those of you who are working that don't have a large part of your retirement money set aside for health insurance don't plan on retiring before age 65.
mykidslovedogs
Full time employment: Posting here.
- Joined
- Dec 13, 2006
- Messages
- 860
Freein05 said:
Either that, or forego your company policy to purchase an inexpensive, catastrophic, individual policy before you get sick so you can enjoy the lower premiums in the longrun and not be tied to employment because of health insurance needs.
mykidslovedogs said:
That has got to be the dumbest advise I have ever heard. A catastrophic policy is a sure way to financial disaster. Give up a good insurance policy for a crappy insurance policy. Plus if you do get sick there is no limit on how much a catastrophic policy will cost. The insurance company will use the trick of price them out the door. Many people have been forced into bankruptcy because of health care cost and they had catastrophic insurance.
mykidslovedogs
Full time employment: Posting here.
- Joined
- Dec 13, 2006
- Messages
- 860
Freein05 said:
Let's see...in Colorado, a healthy person (even a 50+ year old person) can purchase a 5000 deductible individual policy with 100% coverage after deductible, including preventive care NOT subject to the deductible, for less than $200/mo. A younger person might even be able to get that for less than $80/mo. A really young person (in their 20's) could get it for about $50/mo. With premiums that low, it wouldn't take long to save $5000 over a couple of years to pay for that deductible. Now, you have 100% coverage at a fraction of the cost of a traditional plan. Maintain a healthy lifestyle, and you might even be able to save for your deductible several times over within a 10 year timeframe, and then use that money for healthcare costs as you age. Hmmmm....
The biggest mistake that many people make, IMO, is to think that it's necessary to have 100% coverage even for the most, minimal, affordable, deductible expenses such as routine office visits, lab work, and generic prescription drug coverage. They overutilize, because they feel like they need to get every penny out that they have put in. The vast majority of people will never get to $5000 in a calendar year, but it's nice to know that your expenses are capped should you be hospitalized. Even a middle to lower class family could work out a financing arrangement to pay $5000 over time if they had to. Why throw all that money away on premiums? Pay low, low premiums and save for your own deductible expenses. It can be done. Forget the company policy. Make it your own choice to be able to retire early, instead of being tied to your employment for insurance until age 65. Negotiate a raise from your employer to pay for some of your premiums and even for some of your deductible expenses in return for waiving coverage under the group plan. Employers would probably much rather pay for a cheap individual policy than an expensive group policy.
Another mistake people make is to assume that an insurance company is going to price them out of the door if they get sick. It simply doesn't happen like that on an individual basis. I've worked individual renewals over and over again, and the vast majority of them, even ones that have had claims filed against them, are within 10% of the new business rates available for the same plan. You don't get rated because of personal claims. Rating is all based on age band, claims experience of large groups of members, and trends in the industry.
Sure, the insurance carrier can go out of business, but those situations are few and far between. Buyer beware. Stick with a carrier that has been in the individual health insurance market for many, many years.
If you choose to stay with group coverage, the risk you take is to become uninsurable later on or to be tied to employment until age 65. If you want to retire early, think about getting your own policy before you become "uninsurable".
Myk - Some of what you say does make sense. The big risk is having a preexisting condition that would prevent you from getting coverage or affordable coverage. This can happen even when the condition is under control. Insurance companies do not want to take the risk of the condition reoccurring and becoming costly to them. I don't know the numbers but many people 50 plus have had some type of medical condition that would prevent them from getting an individual policy and a group policy through an employer is their only choice.
You know what. Im tired of the working class being asked to foot the bill for the lazy pieces of **** who cant get a job and afford health care. Or who wont even bother to better themselves. Save your bleeding heart stories Martha. For everyone of your ohnoes stories there is someone who made better of themselves. Dont worry there will be alot of assholes like me voting anything like universal health care down as long as we can.
teejayevans
Thinks s/he gets paid by the post
- Joined
- Sep 7, 2006
- Messages
- 1,691
Capitalistic solutions don't apply, because for capitalism to work, themykidslovedogs said:
consumer has to have a choice, given a choice, then competition drives
down the price. The consumer doesn't have a choice: you must have
insurance on your house if you have a mortgage, you must have car
insurance, if you get injured/sick you must see a doctor and since prices
are so high you can't self insure, you must have health insurance.
Sure there are different companies, but in the end, I must buy from one
of them. There are different hospitals, but you can't check the prices
until after you get the bill. I'll bet the doc has no idea what the tests that
he orders cost.
Lack of choice and knowledge on the consumer;
means high prices, unnecessary tests,
add some lawsuits into the mix, and you have the horrendous health care
system of the US.
TJ
teejayevans
Thinks s/he gets paid by the post
- Joined
- Sep 7, 2006
- Messages
- 1,691
So all the healthy/younger people will stay with private insurance, the rest will haveFIRE'd@51 said:
some form of insurance, I'm ok with that if that's how it will work.
TJ
teejayevans
Thinks s/he gets paid by the post
- Joined
- Sep 7, 2006
- Messages
- 1,691
Hence the need for couples to have a living will.Jeffrey said:
The exact quote is: 50% of our medical costs occur in the last 6 months of our
life.
TJ
