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Money Won’t Buy You Health Insurance

nytimes.com

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Re: Money Won’t Buy You Health Insurance

#201

Post by damoncali »

muhfuhkuh wrote: post #110
Groxx wrote: post #22

Earlier quoted context omitted.

> to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. This fits a fair number of cost complaints I hear over healthcare. Who wouldn't like to pay $50-100/month to have something better than emergency healthcare support? But thi…

Japan forces their doctors to charge only what's published in a book that the government issues and negotiates prices periodically. Simple price fixing in an otherwise private healthcare market. In return, Japanese doctors and hospitals (FYI, there are more private hospitals in Japan than the US) are allowed to set whatever prices for ancillary services (like private or semi-private rooms) that they want. BTW, the av…

What people don't like to admit is that free markets don't work for healthcare. What is the price you're willing to pay for curing that tumor in your gut? Everything you have. There is no supply vs. demand. Only supply vs infinity.

What would happen to the food market were it not for the generally high supply of food? It wouldn't be pretty.

Because of that, some sort of non-market intervention is simply unavoidable. As are the inefficiencies that go along with price controls and other similar endeavors. Ugly stuff, this healthcare business.

Re: Money Won’t Buy You Health Insurance

#203

Post by Groxx »

Vivtek wrote: post #189
billjings wrote: post #172

Earlier quoted context omitted.

Two points - one, is that odds are he's not paying $807/mo out of his taxes due to a progressive income tax. He's probably paying a good portion out of his taxes, but not $807/mo. Point two - and this isn't a rebuttal of any kind against your claims, just an observation - that same graph shows that Canada spends a lower portion of government revenue on health care than we do. And we don't even have universal coverage…

The takeaway - you're actually paying for what should be your healthcare in your taxes as an American, but you're not actually getting the healthcare, because that would be socialism.

>that would be socialism.

That is a massively incorrect statement, which pops up every time government-mandated healthcare debates appear, which I wish to squash ASAP: http://en.wikipedia.org/wiki/Socialism

Universal healthcare != socialism. Not even remotely. It's a political mud-slinging attempt to equate healthcare changes with the historical fear of the USSR that seems to have infected far more people than it should even have reached. Yes, fear the Reds, they'll lob bombs at you now that the cold war is over. They've just been waiting.

At the absolute closest would be if the government were to run all the healthcare directly (it's not - there are and will be many private healthcare markets), and then it would be a socialist action, not socialism (a socialist government).

To make matters worse for this use, any form of taxation can be described as a socialist action. That doesn't make any government that taxes its citizens a socialist government.

Re: Money Won’t Buy You Health Insurance

#204

Post by jjcc »

I used to be a long-time believer of free market. But for health care and Education system things are quite different. All the participants taking care of their own interest doesn't mean the interest of the whole society will be maximized. Some poor countries might be better than the States. Believe or not, check the healthcare of Cuba!

Re: Money Won’t Buy You Health Insurance

#205

Post by bzbarsky »

bzbarsky wrote: post #168
dalke wrote: post #95

Earlier quoted context omitted.

You say it, but you don't back it up with evidence. How is it that the US already pays more money per person for health care but with measurably worse results (measured as life expectancy, infant mortality, etc). How do they achieve what you call impossible?

The US pays more money because it has more health care being provided, in many cases. It just so happens that more health care doesn't necessarily translate to measurably better outcomes (e.g. cancer screening helps reduce mortality for some cancers but not others). It also just so happens that it's very rare to study whether a particular care regimen actually improves overall outcomes as opposed to just the thing it…

Reference for the last part there: http://www.ncbi.nlm.nih.gov/pubmed/16282212

Re: Money Won’t Buy You Health Insurance

#206

Post by tptacek »

muhfuhkuh wrote: post #159
andrewflnr wrote: post #153

Earlier quoted context omitted.

Japan's hospitals are going into debt because they can't charge what things cost. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/c...

So, the solution to that in the US is for the patients to either die or go bankrupt rather than hospitals or insurers going into debt. Everything has a price, but that seems a little lopsided.

This is an utterly nonresponsive comment. If the economics of providing healthcare don't work out, they don't work out. It's not as if "go into debt" means "fat cats make less money". No, it means that the skilled labor and capital that drives the insolvent health care system will simply migrate somewhere they can deliver it profitably. Say goodbye to hospitals for rural and poor areas.

Re: Money Won’t Buy You Health Insurance

#207

Post by tptacek »

damoncali wrote: post #201
muhfuhkuh wrote: post #110

Earlier quoted context omitted.

Japan forces their doctors to charge only what's published in a book that the government issues and negotiates prices periodically. Simple price fixing in an otherwise private healthcare market. In return, Japanese doctors and hospitals (FYI, there are more private hospitals in Japan than the US) are allowed to set whatever prices for ancillary services (like private or semi-private rooms) that they want. BTW, the av…

What people don't like to admit is that free markets don't work for healthcare. What is the price you're willing to pay for curing that tumor in your gut? Everything you have. There is no supply vs. demand. Only supply vs infinity. What would happen to the food market were it not for the generally high supply of food? It wouldn't be pretty. Because of that, some sort of non-market intervention is simply unavoidable.…

This is a weird summary of how "free markets" and "supply and demand" work. Yes, you will pay everything you have for a cure. But the guy who will offer you a cure for "everything you have minus one dollar" is going to get your business.

Re: Money Won’t Buy You Health Insurance

#208

Post by bzbarsky »

bzbarsky wrote: post #168
dalke wrote: post #95

Earlier quoted context omitted.

You say it, but you don't back it up with evidence. How is it that the US already pays more money per person for health care but with measurably worse results (measured as life expectancy, infant mortality, etc). How do they achieve what you call impossible?

The US pays more money because it has more health care being provided, in many cases. It just so happens that more health care doesn't necessarily translate to measurably better outcomes (e.g. cancer screening helps reduce mortality for some cancers but not others). It also just so happens that it's very rare to study whether a particular care regimen actually improves overall outcomes as opposed to just the thing it…

The first claim above is pretty broad; coming up with a single reference to support it would be hard, and coming up with a wide range of references time-consuming.

But as examples:

http://www.ncbi.nlm.nih.gov/pubmed/2268793 (2.5x more coronary artery bypasses per capita in the US than in Canada in 1988; admittedly somewhat dated).

http://www.pillsforall.com/blog/cardiac-stents-are-used-twic...

I realize that's pretty weak support; I don't have anything better off the top of my head, unfortunately.

Re: Money Won’t Buy You Health Insurance

#209

Post by rhizome »

Groxx wrote: post #70
billjings wrote: post #60

Earlier quoted context omitted.

We are way, way above the amount of money health care should cost. http://en.wikipedia.org/wiki/File:International_Comparison_-... So as a matter of priority versus other spending outlays, we're way out of line. Here's per capita GDP: http://www.wolframalpha.com/input/?i=per+capita+GDP Spitballing from these numbers, it looks like we spend about as much in absolute terms as Switzerland, with everyone else way, way fa…

Nope, I'm pretty sure everyone agrees it's broken. And just to re-clarify: I'm not claiming we're not paying too much. I agree with everything you've said. Just that $50-100/month is un-doably low regardless of brokenness. I'll be reading through the links, I can always use more detailed info for future debates. Thanks! edit for repliers: before stating that location X has 100 or less per month, how much do your taxe…

It depends on whether anything is done about the racket going on between insurers, pharma, and healthcare providers. These are the people who blame each other for rising costs and likely a free market mentality is to blame. It's a circular argument in the US, which needs to be broken.

Re: Money Won’t Buy You Health Insurance

#210

Post by gthank »

Groxx wrote: post #149
gthank wrote: post #137

Earlier quoted context omitted.

The way it works is they bill outrageous amounts in the expectation that they will either be totally stiffed or have to negotiate a much lower settlement (which is essentially what insurance companies do, AFAIK). In the rare case where somebody actually pays the full bill, they're subsidizing care for those who walk out on the bill (or part of it). This strikes me as an extremely broken way of doing things, but it se…

That only makes the costs even worse, especially ethically. They're sapping the most money from people least able to defend themselves from their preying.

Actually, most of the people least able to defend themselves walk out on it, just as the hospitals expect, because they have the least to lose. When you're already horribly impoverished, what does one more bill that you'll never be able to pay mean?

The ones who really catch it in the shorts are people who have never been unable to pay off an obligation before: their credit and hard-earned reputations are probably ruined (the first for however long a bankruptcy takes to go off the books, the second possibly forever), their day-to-day lives will become a gigantic burden since a bankruptcy will demolish any accumulated wealth/assets, and that's not even considering what it will do to their self-image for them to feel like they aren't living up to their personal standard.

Just so we're clear: I think this system is terrible, and desperately hope that something is done to fix it. I'm not sure what the right fix is, but I hope somebody out there finds it.

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