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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

#341

Post by EdiX »

georgieporgie wrote: post #84

I'm 35, single, and paying something like $120 per month for Blue Cross coverage that I found on ehealthinsurance. I've used them each time I've not been actively employed, and I've always found an acceptable deal. Mind you, I took the high deductible route since I'm only concerned with catastrophic illness at right now. Also, the moment anything serious comes up, they can cleverly drop me, since they have ludicrous…

> Mind you, I took the high deductible route since I'm only concerned with catastrophic illness at right now. Also, the moment anything serious comes up, they can cleverly drop me, since they have ludicrous things on their forms like, "have you EVER received ANY medical treatment not listed on this form."

So, you are saying that you are paying expecting to never receive anything back?

Re: Money Won’t Buy You Health Insurance

#342

Post by Ras_ »

ashbrahma wrote: post #114

Countries like India, Malaysia are starting to see a boom in Medical Tourism. It costs approximately $4500 for a open heart surgery at the best hospitals compared to $15-$20K in the US. http://en.wikipedia.org/wiki/Medical_tourism

Going to a dentist on your holiday would be a casual example.

Re: Money Won’t Buy You Health Insurance

#343

Post by narcissus »

netcan wrote: post #186
nerfhammer wrote: post #101

Earlier quoted context omitted.

Check out how much private insurance costs in Australia: http://www.privatehealth.gov.au/dynamic/healthfundlist.aspx Most plans are around A$100/month or less

Australian private health insurance isn't necessarily a good comparison for two reasons. First, it's a complimentary insurance meaning that it's for extras that people otherwise pay out of pocket or go without like dental, private hospital rooms, etc. It doesn't cover the really expensive unpredictable things like major surgery, cancer treatment. The basics (eg GP visits) and the big expenses are covered by medicare.…

One other interesting thing about private health insurance in Australia is that once you reach a certain income threshold, if you do not have any extra private health insurance, your income tax rate goes up a percent or two.

That wasn't intended to argue the point either way, though, I was just saying :)

Re: Money Won’t Buy You Health Insurance

#344

Post by yummyfajitas »

ible wrote: post #216
yummyfajitas wrote: post #193

Earlier quoted context omitted.

Not true. We beat Japan on life expectancy, provided you restrict the comparison to people of Japanese descent. Japanese Americans live 84.5 years on average, Japanese only 82.6. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&#3... http://www.google.com/publicdata?ds=wb-wdi&met=sp_dyn_le... (Would love to see data doing similar comparisons to other G8 nations.)

That's funny, but I'm not sure it's true. Your first link seems to say (it's worded awkwardly) that Japanese women in the US have a 84.5 year life expectancy. This isn't quite as high as the 85.66 life expectancy Japanese women have in Japan ( https://www.cia.gov/library/publications/the-world-factbook/... ) That's despite people of Asian descent in the US having higher income and education than the average, both of…

Oops, I think I misread the article. I stand corrected.

Even if it is true, I'm not sure what the significance would be. I would be surprised if you couldn't pick out many subgroups in the US which do better in the US than in their places of origin, without it supporting an argument about the quality of the overall system.

Very true. To actually make the argument you are trying to make, you'd actually need to do a carefully controlled study. But most such studies (which include ethnicity, rural living, diet, etc as predictors) actually show no significant relationship between marginal changes in health care and health outcomes.

Re: Money Won’t Buy You Health Insurance

#345

Post by EliRivers »

sammcd wrote: post #151
MoreMoschops wrote: post #23

Earlier quoted context omitted.

If the insurance company suspects that you've done something like this, they will wait until you need to claim (so they can take in the premiums) and then deny a payout on the basis that you formed a company purely to get round having been denied insurance. Every day, insurance companies look for ways to deny payouts, and they've thought of this one.

In no way did I say make a fake company. You'd have to start a real company to do this.

If you create a completely real company with the driving intention to get yourself health insurance because you can't or won't do it as an individual, it won't matter how real the company is. The insurers will decline to pay out.

Re: Money Won’t Buy You Health Insurance

#346

Post by khafra »

Evgeny wrote: post #269
euccastro wrote: post #235

Earlier quoted context omitted.

Calories in-calories out is a pretty bad proxy for weight gain and health in general. Google Gary Taubes; he's done a great job of digging up and deconstructing a century's worth of research on the matter.

There is massive debate still going about the Taubes' arguments against 'calories in - calories out'. There is a lot of evidence in support of 'calories in - calories out' and it is way too early to conclude that if Taubes said so, it must be right.

The fact that there's a massive debate means we don't know enough about nutrition to legislatively micromanage it.

Re: Money Won’t Buy You Health Insurance

#347

Post by iwwr »

danssig wrote: post #333
maxharris wrote: post #309

Earlier quoted context omitted.

Few will admit that we don't have anything close to a free market in healthcare today (or for the past several decades). A truly free market is one unfettered by the FDA, medicare, medicaid, doctor regulations, hospital regulations, HMO regulations, insurance regulations, etc. All of these controls were ostensibly put in place to protect patients, but in actuality they serve to slow innovation and true access to medi…

For someone who puts so much faith in free markets you don't appear to understand how they work. In your studies, look up "market elasticity" for a clue.

How is that relevant here?

Re: Money Won’t Buy You Health Insurance

#348

Post by cookiecaper »

Zak wrote: post #252
joe_the_user wrote: post #237

Earlier quoted context omitted.

But the guy who will offer you a cure for "everything you have minus one dollar" is going to get your business. Not necessarily. Suppose you have a deadly condition. Your information is extremely limited as non-professional. Would ... you can pay all your money now for the cure your doctor offers or you can wander over to an unknown provider for the best price? The quality of unknown providers is ... unknown and your…

Presently, no American hospital publishes its price list. Almost every American hospital publishes its price list to its primary customers: the insurance companies. The problem as I see it is that the insurance companies are the only entities that can get fair prices for health care, and they want to keep it that way. A potential solution would be to ban insurance discounts; a health-care provider could charge any pr…

My experience has been that if you don't have insurance, the hospital will cut a big chunk out of your bill immediately. Their "negotiated rates" are all just made up things they put on the insurance bill because insurers can pay a lot of money. The insurer calls and says "Hello, I would like a discount". And the guy says "Ah, yes, our standard rate is cash rate + $1000, but for you, I'll take off $500".

For instance, a podiatrist I know charges $350 to the insurance company (which shows this as the discounted, negotiated rate) but $150 cash to remove an ingrown toenail.

I'm sure there are exceptions.

Re: Money Won’t Buy You Health Insurance

#349

Post by goatforce5 »

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…

The Medicare system in Australia works in a sort of similar way to how you describe Japan. The government publishes a list of fees for every possible procedure and treatment. The medical service provider can "bulk bill" where they collect the money directly from the government, and the patient never hands over any money. Alternatively, the provider can charge whatever they want (because they're a noted doctor, or their office is in an expensive location, etc.), and the patient can then claim the set amount back from Medicare.

Bulk billing is so much more convenient for everyone that you'll see signs advertising it on the outside of doctors surgeries, thus the cost of care is kept down. On the other hand, the doctors are free to charge what they want. Sounds like a fair way to do it.

Re: Money Won’t Buy You Health Insurance

#350

Post by cookiecaper »

mikebike wrote: post #157
mrkurt wrote: post #106

> The difference is significant: my recent M.R.I. cost $1,300 at the “retail” rate, while the rate negotiated by the insurance company was $700. The shocking thing is, if you get an MRI at a cash only diagnostics facility it can cost as little as $300.

I've never understood the meaning of the "retail" rates. How many people are there who can afford to pay these rates and also don't have health insurance?

Zero, obviously. People either let them lapse where possible, declare bankruptcy to get Constables off their backs, or spend years paying $50-$100/mo.

Things like this happen even to insured people. Due to a communications snafu between the doctor and the insurance company, my mom, who has "good" insurance from BigCo, is paying for her annual mammogram $50/mo now, and will be doing this for the better part of two years.

My parents paid on an ER visit I made in my late teens until I was 21 or 22 because of another such insurance oversight.

These happen all the time because that's how insurers make money. The insurance model is based explicitly on not paying out. For something that's universally utilized like health insurance, that generally means you have to deny a lot of claims to keep acceptable margins.

Homeowner's insurance works fine because most people aren't burglarized often and most peoples' homes don't burn down, so people make modest monthly payments and one claim in a lifetime more than pays for itself. Likewise, car insurance is not used too often by its patrons.

Health insurance, however, is used (at least) several times a year by almost every individual. As such, insurance is a terrible model for health care, since the entire concept behind insurance is that more people are paying for the coverage than are using it. The continued feasibility of medical insurance depends on people not getting medicine.

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