301–310 of 383 posts
> But plenty of healthy holdouts remain, and their resistance helps explain why insurers are worried about the financial viability of the exchanges over time. They say they sorely need more healthy customers to balance out the costs of covering the sicker, older people who have flocked to exchange plans. Ah, the tragedy of the commons at work. Healthy people don't buy insurance because it's too expensive. Insurance i…
As a Canadian, I am astonished at how expensive even the cheapest of these plans are. My monthly healthcare cost amounts to $178, once you factor in the taxes I pay that go to healthcare. That's cheaper than any of the plans in this article. How do people find these prices bearable?
[1] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... [2] 178 CAD -> 127 USD, times 12 - ok this is missing the PPP correction because [1] GDP is PPP corrected, so might be a little off
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We started on a $1500 indv / $3000 fam deductible PPO in 2014 for about $800/mo for two people. In 2015 the premiums went down maybe 0.5%. In 2016 the premiums have gone up 6% and the out of pocket max went up $500 per person to $4k. ACA has absolutely been a net positive in my life. I had cancer in 2012 and so it would have been literally impossible for me to get health insurance outside of a group plan. With ACA I'…
The ability to get insurance for an affordable price (the parameters of which I realize people differ on) with pre-existing conditions outside of group plans has been one of the big wins of ACA. It's at least reasonable to argue that particular problem could have been addressed outside of the massive and controversial implementation that was ACA as a whole.
Essentially, pre-existing condition insurability is where the government could have make a huge impact with minimal disruption to the overall system. Much like there are government mortgage guarantees available for higher risk borrowers, the same kind of system could have helped the pre-existing conditions people get coverage while not throwing the baby out with the bath water.
The alleged goals of the ACA were to get everyone insured. However it shouldn't have taken thousands of pages to accomplish that. A good portion of ACA has nothing to do with insurance at all.
I wish there was some scope restriction on bills. For example the latest highway bill contained passport revocation provisions for those with delinquent taxes. This forces politicians to reluctantly vote for something they don't like because the overall bill is important. Poison pill amendments are often not poisonous enough so we get stuck with a bunch of really bad laws.
> But plenty of healthy holdouts remain, and their resistance helps explain why insurers are worried about the financial viability of the exchanges over time. They say they sorely need more healthy customers to balance out the costs of covering the sicker, older people who have flocked to exchange plans. Ah, the tragedy of the commons at work. Healthy people don't buy insurance because it's too expensive. Insurance i…
"If only the plan worked as intended! We were close!" -- the same refrain after every single failed socialist endeavor. But in this case we had the smartest people study the problem! Economists from the top universities designed the incentives! How could it fail?
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Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available. Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before). App…
I'm paying less out of pocket now than my share at my last job, with netter coverage... though this year I'm paying as much for a plan with $1k more for deductible... it's pretty sad... I keep it because I'm on a few medications that would be far more out of pocket. Something needs to happen with USPTO, especially medicine at this point.
The patent system is essential for medicines. I know many people don't like that reality but who will invest in pharma companies if their investment could quickly be nullified due to the loss of intellectual property? Would you invest in a company when the competitive advantage that company is immediately rendered moot?
However, there are definitely places for reform, so I am not fully defending the USPTO system, I am simply suggesting that a strong patent system is a fundamental motivator of pharmaceutical innovation.
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It isn't ACA that has caused me problems, or at least the law itself. The description given matched my experience with insurers before ACA. My problem with ACA is Healthcare.gov (still). It is possible to go through the entire application process, make one mistake or fail to provide the right detail, and end up disqualified from buying insurance through Healthcare.gov (in my case, I used a mail forwarding service add…
The traveling full time "problem" affects me as wel. When some company or another asks, "Where do you live?" My response is preceeded by an audible shrug.. I seems that many companies actually plan to come visit me and are put out when I explain that my physical location is really of no concern to them. For example, banking. If I give a Texas address and agree to Texas terms and conditions, why would it matter that I…
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How much healthcare do you get in the US for $2928/year? That's how much the UK National Health Service cost the UK government per person in the 2013/2014 reporting period, for a comprehensive universal healthcare system with no deductibles, no co-pays other than a minor prescription charge (7 pounds, unless you're exempt due to low income), and which is consistently ranked higher than US healthcare by the WHO. If we…
The problem is that the USA is funding a disproportionate share of the medical advances. So while it may seem absurd that we spend double for worse outcomes, I'm not sure it's so simple.
Firstly, industry only accounts for less than 60% of research in the medical field in the US to begin with. The rest is made up by donations, grants from various organizations, and about 28% from the NIH that are not part of the healthcare spending.
When you look at the R&D expenses borne by industry you get things like Pfizer, which in recent years have spent about 17% of revenues on R&D. Typically less than their profit.
Given that Pfizer gets a substantial proportion of their revenues internationally (in 2009 this was ~56%), despite massive restrictions on advertizing, while their US sales costs are substantially higher than elsewhere (e.g. in many European countries, ads for prescription medicines is outright illegal), most of their available cashflow after cost of sales/marketing is accounted for does not come from the US, and is unaffected by US healthcare costs.
If this split holds across the industry, then US healthcare sources accounts for 30% of US healthcare medical research funding.
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When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…
Unfortunately, your situation must be specific to Oregon. I'm in Washington, and the closest plan we could get to what we had pre-Obamacare went from a $2500 deductible to $6300 with a premium increase of around 40-50%. In my opinion, the problem was never the unavailability of insurance. The problem was (and still is) the out-of-control pricing of medical care -- $5000+ for non-sterile gloves [1] is a bit extreme. […
I would suspect that more free primary care clinics could take some of the burden off of emergency rooms in terms of cost and those free clinics could even be funded by insurance companies from the money their saving from not having to pay for $5000 gloves anymore.
A cash-payment medical system would also solve some of these problems. With opaque pricing, hospitals get away with solving budget issues by overcharging. If you actually saw the menu of what things would cost and you were paying out of your pocket, nobody would ever tolerate $5000 gloves. Market forces would fix the cost overages very quickly. As it is now, very few people actually directly pay for their own care and thus are less motivated to care about price. "Insurance covers it," is all many people care about.
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To me as someone living in the UK, this is bizarre. Why would you need an deductables at all for it not to be expensive? This in itself indicates that your entire healthcare sector is entirely dysfunctional. In 2013/2014, the UK National Health Service spent $2928/year per person. This is the average, and includes everything from the costs of births to the costs of expensive heart transplants or cancer treatments. Ge…
People have written about this before, but basically the US subsidizes medical expenses for the entire world. That was able to happen because, unlike virtually anywhere else in the world, medical insurance in the US is private. If the US changes that (which will never happen) I would expect medical costs to go up everywhere else to compensate, either that or research slows down. One thing that might, might, help is f…
US industry accounts for ~60% of US medical research. The rest is NIH, donations etc.
US pharma companies like Pfizer gets more than 50% of their revenue from foreign markets. Thus if we split research contributions by region, only about 30% of US medical research is likely to come from US healthcare expenses.
Even if you took away all of that funding you still wouldn't account for the cost differences.
But that's not the whole story: US sales costs are substantially higher, as in many non-US markets you can't legally advertise, so the net contribution of US healthcare funds to US medical research is likely less,
It may still be true that the US pays more per capita for to medical research than most, but it simply doesn't make up all that large a proportion of overall medical research.
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FWIW as of 2015 California requires there be "primary care network providers with sufficient capacity to accept covered persons within 30 minutes or 15 miles of each covered person's residence or workplace", specialists within 60 minutes or 30 miles, and that there be sufficient capacity for doctors within those limits to accept new patients[1]. Getting that enforced isn't easy, but that situation not only shouldn't…
Getting that enforced isn't easy How is that even possible ? How does the state mandate that some random provider step in and subsidize higher payments to providers in order to encourage them to take on more new patients?