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Money Won’t Buy You Health Insurance

nytimes.com

381–390 of 442 posts

Re: Money Won’t Buy You Health Insurance

#381

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. Actually, that's exactly the policy you want as a healthy 26 year old: $5,000 deductible catastrophic coverage, and nothing more. It'll cost you $86 per month from Blue Shield…

I guess you may be much healthier than the people I know, but I don't think I know very many people who go three years without a visit to the doctor. We all get infections that are considered minor and routine due to our medical care, but if we can't get that medical care they can be life-threatening, like strep throat or other common winter ailments. We all sometimes have accidents and trip and need to go to the hos…

I remember exactly one doctor's visit in my 20s (bad dose of poison oak), one in my early 30s (bad bouldering fall), then nothing until age 39. So yeah, your mileage may vary.

Needless to say, I never came close to hitting my $5k deductible. (or even my $250 annual deductible in the years when I had company-sponsored insurance).

Re: Money Won’t Buy You Health Insurance

#382
post #252

Earlier quoted context omitted.

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…

Just had a pair of major surgeries in my immediate family. When we offered to pay cash, they immediately knocked 50-66% off all the costs. That included anaesthesiologist, room rental, and doctor's time.

This "retail rate" mentioned in the article is crap.

Re: Money Won’t Buy You Health Insurance

#383
post #298

Earlier quoted context omitted.

A few tea partiers turned down the insurance this year on principle. One was interviewed on NPR, where he acknowledged that the insurance rates he found on the open marker were a bit of a shock: http://www.npr.org/2011/02/09/133629806/16-Freshmen-GOP-Decl... Still, he rationalizes away the benefits of the new Health Care law: "But I think that if we had true health care reform that I wouldn't be paying $1,300 a month…

IMHO, Obama and company got carried away. They saw this opportunity to enact something comparable to Social Security and Medicare, and wanted to go down in the history books as having achieved something similar. Unfortunately, like any big project in Washington, this one was laden with loopholes, sweeteners, etc. In other words, a total mess. It would have been far better to pass a series of smaller laws. Start with:…

Social Security had plenty of loopholes when it was first passed, too.

If Obamacare had merely outlawed discrimination based on pre-existing conditions, then premiums would have gone through the roof, because lots of healthy people would have put off buying insurance until they got sick. So the law needed to include a provision requiring everyone to buy insurance. If everyone has to buy insurance, then there also have to be subsidies for people who make too much to qualify for Medicaid but not enough to afford insurance. If there are subsidies, then money to cover the cost of subsidies has to be found, through a combination of tax increases and cost savings elsewhere in the system. Those are the pillars of Obamacare; everything else is gravy.

Also, one of the sad realities of the American political system is that the only way to pass a law that pisses off some powerful interest group is to buy off other powerful interest groups at the same time.

Re: Money Won’t Buy You Health Insurance

#384
post #339

Earlier quoted context omitted.

I also looked at insurance intended for non-Australians living in Australia (not covered at all by national insurance) and found prices to be pretty much the same

You may or may not know, but non-Australians living in Australia are covered by Medicare (depending on your visa type), so that could explain the similar pricing.

It's dependent on your nationality and whether your nation has a reciprocal health coverage agreement with Australia, which many EU countries do but most countries do not (including the US of course).

Re: Money Won’t Buy You Health Insurance

#385

Earlier quoted context omitted.

You went to the wrong doctor. When I get my bills for office visits, the rate is something like $300 on average (including lab tests). My insurance company then negotiates that down to something like $75, and then I pay the $10 co-pay. Now, all these numbers could be made up, but $300 seems about right for a doctor's visit when you consider how expensive it is to run a medical practice. It's not something I'd want to…

It's very difficult to price-shop, though, because unlike in most normal businesses, nobody seems to publish price lists, and they aren't very forthcoming giving quotes over the phone, either. So it's not too uncommon to end up with something absurd more or less by chance, especially if it's urgent to see a doctor. Unless I've totally missed it, there's certainly no hipmunk for medicine, where I can put in that I wan…

Your health insurance should have this service.

I'm with Aetna and I can get lists of MDs within a 10 mile radius and I can get a price list of common procedures.

Re: Money Won’t Buy You Health Insurance

#386

Earlier quoted context omitted.

It's very difficult to price-shop, though, because unlike in most normal businesses, nobody seems to publish price lists, and they aren't very forthcoming giving quotes over the phone, either. So it's not too uncommon to end up with something absurd more or less by chance, especially if it's urgent to see a doctor. Unless I've totally missed it, there's certainly no hipmunk for medicine, where I can put in that I wan…

Your health insurance should have this service. I'm with Aetna and I can get lists of MDs within a 10 mile radius and I can get a price list of common procedures.

True, but I was talking about the case where I don't have health insurance and want to price-shop for cash service. =]

Re: Money Won’t Buy You Health Insurance

#387

Earlier quoted context omitted.

Doctors and nurses and supporting staff must exist I got a $800 bill for 10 minutes doctor visit (swollen toe). Not exaggerating a tiny bit. No insurance company involved. "Must exist" is not an argument. Something is broken in the system where a doctor charges you $4,800 per hour. Insurance companies, obesity, poor lifestyle choices (all usual BS reasons I hear on TV) do not explain why this particular ####le charge…

I had a 1000 euro bill for getting 4 wisdom teeth removed by the oral surgeon, in a hospital, where I was out in 30 min (two 15 min procedures). The beauty? I pay 100 euros a month in coverage, with a 175 euro deductable, which I easily went over that year. Oh, and doctor's visits are free. Welcome to the Netherlands... (and yes, we have waiting lists, and other issues with healthcare, but atleast it's affordable)

[deleted]

Re: Money Won’t Buy You Health Insurance

#388

Earlier quoted context omitted.

Doctors and nurses and supporting staff must exist I got a $800 bill for 10 minutes doctor visit (swollen toe). Not exaggerating a tiny bit. No insurance company involved. "Must exist" is not an argument. Something is broken in the system where a doctor charges you $4,800 per hour. Insurance companies, obesity, poor lifestyle choices (all usual BS reasons I hear on TV) do not explain why this particular ####le charge…

I had a 1000 euro bill for getting 4 wisdom teeth removed by the oral surgeon, in a hospital, where I was out in 30 min (two 15 min procedures). The beauty? I pay 100 euros a month in coverage, with a 175 euro deductable, which I easily went over that year. Oh, and doctor's visits are free. Welcome to the Netherlands... (and yes, we have waiting lists, and other issues with healthcare, but atleast it's affordable)

I wonder how much the surgeon is making. I.e. how much is paid to him through taxes?

Re: Money Won’t Buy You Health Insurance

#389

Earlier quoted context omitted.

How? Do they charge higher rates than elsewhere - effectively using supply and demand and saying: "You don't have anywhere else to go, so pay my rates."

Most doctors these days are salaried employees at a large health care organization. They get higher salaries in the sticks because nobody wants to work there.

Source for this assertion? It seems more likely (to me) that they'd make less due to their smaller and less affluent clientele.

Re: Money Won’t Buy You Health Insurance

#390
post #252

Earlier quoted context omitted.

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…

I see this cash discounting frequently, and it makes sense, as it's easier (faster, more certain) for the doctor to take the cash than to deal with billing the insurance company.
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