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Employer health plans are getting pricier and skimpier

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Re: Employer health plans are getting pricier and skimpier

#201
post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

This episode of planet money talks about this https://www.npr.org/2019/09/04/757645741/what-medicare-for-a...

Because of redundancies in the US system, there are like 5:1 administrators for each doctor. That’s a huge source of the costs.

Medicare for all will likely cut a lot of those jobs to gain the savings. This show talks about if that’s good or bad for society.

Re: Employer health plans are getting pricier and skimpier

#202
post #193

Earlier quoted context omitted.

> An entire generation is draining their savings to keep up with premium costs. Knock on wood but, myself and pretty much everybody I know has insurance covered ~75% through our full time employers. I think my portion of my insurance is about... $100/mo? I've never had to use it way/shape/form in the past... 5-10 years. Isn't the truth that the most unhealthy people are what drives health care costs? It'd be interest…

Yeah, I really wonder where that $10,000/person figure comes from when you remove obesity and smoking related illnesses, so, the two highest and most preventable causes of death in this country. I always believed you should be able to qualify for lower costs (or be charged higher) depending on how you take care of yourself. Annual physical fitness test. I'm a little sick and tired of paying high premiums for people t…

Many of us who won the genetic lottery are sick of paying for those who didn't

Where do you draw this line ?

If someone cannot afford to eat or live a healthy lifestyle do you kick them while they are down ?

Re: Employer health plans are getting pricier and skimpier

#203

This is absolutely the biggest story in America, and most people aren't talking about it. An entire generation is draining their savings to keep up with premium costs. Not to mention the millions of people locked into careers they would otherwise get out of, if not for the health coverage. This situation is probably going to lead to unbelievable outcomes.

> An entire generation is draining their savings to keep up with premium costs. Knock on wood but, myself and pretty much everybody I know has insurance covered ~75% through our full time employers. I think my portion of my insurance is about... $100/mo? I've never had to use it way/shape/form in the past... 5-10 years. Isn't the truth that the most unhealthy people are what drives health care costs? It'd be interest…

This isn't universal and it's also not inclusive of those people who have spouses/partners or children/other dependents. Your employer may cover your premium (or most of it), but it won't always cover those of your dependents at the same percentage.

And I say this as a person who is, with few exceptions, healthy. But medications for common conditions and emergencies , can radically change the cost of all of this.

Re: Employer health plans are getting pricier and skimpier

#204
post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

This episode of planet money talks about this https://www.npr.org/2019/09/04/757645741/what-medicare-for-a... Because of redundancies in the US system, there are like 5:1 administrators for each doctor. That’s a huge source of the costs. Medicare for all will likely cut a lot of those jobs to gain the savings. This show talks about if that’s good or bad for society.

It amuses me when people think that letting the government run something will make it more efficient. I do not disagree there is tremendous waste in the current system. I strongly believe that expanding the government's role will only make it worse.

Re: Employer health plans are getting pricier and skimpier

#205

Earlier quoted context omitted.

Why is this? Are there more sick people or just more people?

The healthcare system has become a symbiotic relationship where providers and insurance companies work together to funnel money from just about every business in the US into their pockets. Hospitals increase staff to justify billing more, then insurance companies use increased costs to justify raising rates. Internally, hospitals and insurance companies are also in a tug of war over their slice of the pie. These conf…

Incentives. There is no incentive for a doctor that sees a patient to provide a favorable outcome for the patient. Whether the patient stays sick or not, the doctor still gets paid. But here's the kicker: The doctor gets paid even more if the patient has to come back. The payments come from the insurance company.

Take this concept to the level of a very large health care network (but non-HMO). Patient has early signs of serious but uncommon condition, goes to doctor. Doctor checks for common, obvious things. Finds non-specific symptoms, refers patient to a specialist or three, and the patient is diagnosed with "Not-My-Problemitis".

Disease progresses and the patient is now able to tell the majority of the symptoms are vascular in nature, not muscle or bone as previously thought. More referrals are given. The specialist orders a battery of tests, but they yield false negatives as the symptoms are not occurring at the time of the test, and the patient was not advised that the symptoms needed to be occurring during the test for it to be valid. Patient is again diagnosed with "Not-My-Problemitis" and possibly referred to a research institute, where they'll have quite a long wait time.

By this point, the patient may have lost their employment due to the frequent sick time and time off for appointments, and generally being frustrated in general. They can qualify for Medicaid but will have to start the process over again, but much slower as providers have to tread carefully with care received under Medicaid supervision, as if they were treading on thin ice. But oops, the patient has now gone into critical condition and is sent to the ICU, which is statistically likely to be owned by the same health organization that had their hands involved in the patient's earlier care.

Due to the patient's hospital visit, regardless of whether the patient survives, a payout of Six or even Seven figures is rewarded. Ka-Ching! Insurance companies are hesitant to deny those kinds of claims now, if they involve life or death. Too much bad PR. Thanks, Michael Moore! Of course, it doesn't work out as well for the hospital if the patient had lost their job and is back on Medicare, as there isn't much profit to be made there, if any. That's just the collateral cost of doing business.

Re: Employer health plans are getting pricier and skimpier

#206
post #125

Sharing this idea in order to gather critique. The cost of healthcare in the USA is insane. Could we look for insight into the US Military? Example: This morning, a coworker told me she's going to have an operation on her back. The "cost of the tray" (I have no idea what this is) is $14,000. She has to pay $8,000 up-front two days before the operation, and the remainder will be financed over two years. To me, it's in…

Oh I'm sure the military doesn't pay that much. They get to leverage staff doctors, and negotiated rates. You know like other countries with single payer systems, etc. get. People in the U.S. get screwed, because hospitals are businesses, and they know how much they can charge to make a profit. When a hospital has an entire legal arm just for suing people in court, because they aren't making their payments, you know…

>When a hospital has an entire legal arm just for suing people in court, because they aren't making their payments, you know something is wrong.

A good example of this is the Ford Pinto and it’s exploding gas tanks after impact due to them being exposed. This resulted in multiple accidents and deaths. Ford later learned they could retrofit every Pinto sold for a total cost of $11 (in that years value) per Pinto. They decided not too because court costs per death would be less than the profit loss.

Without boring you with unnecessary details, it can be summed up as this: Does B B = Burden of adequate precautions

P = probability that the defendants actions will result in an accident

L = Loss/Cost of accident if it occurred

When looking at hospitals, they understand the costs of hospitalizing someone for 3 days, 3 hours, or 3 years. They also know the costs of providing care to all of their patients without the thought of insurance companies reemburssing them. For them, the idea of shrinking profits in order to maximize care is not ideal. So, in this case, they will often charge insurance companies the maximum allowed, charged uninsuranced patients the maximum, etc. Why do they do this? Because for them, B<PL. The total cost of employing 10 lawyers to fight 100+ cases of defaulted medical bills or lobby for a new policy, that will still be less than the amount of profit they would lose if the hospital paid for all that care to begin with.

Re: Employer health plans are getting pricier and skimpier

#207
post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

>One thing that will not make healthcare less expensive is "Medicare For All". It will just shift the bill to different people. Now, you can argue it's the morally correct course of action, or those people who will be forced to foot the bill (upper middle class taxpayers) are more capable of doing so, but you cannot credibly claim with a straight face that it will make anything cheaper. In fact, the opposite will occur.

Isn't the NHS or Canada's system better? How are they different from 'Medicare for all' ?

Re: Employer health plans are getting pricier and skimpier

#208

What makes health insurance cheaper is a larger pool of people. There is no other mechanism by which costs can be reduced. This is why a single payer system is dramatically cheaper. It ensures complete coverage, reducing the cost of insurance to it's minimum. Furthermore, it leverages the collective bargaining power of all subscribers. There is no substitute for a national health insurance, and the United States slow…

> What makes health insurance cheaper is a larger pool of people. There is no other mechanism by which costs can be reduced. They will just take the extra money and return it to shareholders. They won't reduce costs to people.

This is why I indicated that the United States needs a single payor natinoal insurance.

Re: Employer health plans are getting pricier and skimpier

#209

If you think health care is expensive now, wait until it's free.

We’re just gonna pretend Europe, Australia, Japan, Canada etc. don’t exist?

Having just visited the EU I can tell you the working folks in those socialist countries are pissed they have to support immigrants who arent contributing.

Its not all roses over there

Re: Employer health plans are getting pricier and skimpier

#210
post #152

Insurance companies need to be expropriated. The entire thing needs a restructure from the ground up, there are too many critical path issues that will keep things expensive if we try to have two systems at once (medicare for all + private) the US should get real medicare, then move to a public/private system where you get base coverage through medicare and pay extra for fancy coverage.

Simply removing insurance and letting the free market adjust would fix the issue. When I was a kid no one worried about hospital bankrupting the family. Now anything larger than a paper cut has the chance to bankrupt most families. Combine that with the accident rate in cars you have an almost certain chance for a large percentage of the US to be bankrupt

The medical insurance industry is a free market. That's why it's such a disaster.

"Free markets" are certainly not free in any meaningful sense of the word. In practice they make no distinction between activities that provide customer value for a competitive price, and activities that are institutionalised economic extortion maintained by political lobbying and regulatory capture leveraged by plentiful access to capital.

The whole point of "free market" rhetoric in the US is to promote the latter while pretending to promote the former.

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