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'A full-blown crisis': Americans brace for a surge in healthcare costs

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Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#181

Post by thrance »

protocolture wrote: post #108

I find the US healthcare "system" to be an interesting topic. More nuanced than people think. It honestly seems like the worst way to run anything. Like I honestly cant see who its for, other than maybe US Corporations on the list of approved medical vendors. Like, putting on my "Lives in a free(ish) healthcare country" hat, it looks bonkers from that angle. But even from a more libertarian mode, the whole thing look…

Blame the misguided belief elevated to State motto that "private is always better than public". They've shoe-horned a profiteering class of parasites into an inelastic market, free to jack up prices of literally vital goods as much as they want. And the current administration, who holds much contempt for life, is perfectly happy to tear down the last poor band-aid the previous admin half-assedly put in place.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#182

Post by gilbetron »

simianwords wrote: post #150
ETH_start wrote: post #105

The root cause: https://www.researchgate.net/figure/Healthcare-administrator... "Healthcare administrator's growth in the US. Healthcare administrator's growth by 3200% between 1975 and 2010 compared to 150% Physician growth according to Athena Health analysis of data from Bureau of Labor Statistics, the National Center of Health Statistics, and the United States Census Bureau's Current Population survey in accordanc…

What value addition do the administrators provide? It might be helpful to understand why competing hospitals still find it useful to employ these people even if the cost is so high. If a competing hospital can provide equivalent service while also not spending so much on an administrator, why didn't they already do it?

You assume that there is any meaningful competition. What we are seeing, across industries including education, is a type of indirect collusion that is keeping prices crazy, not competition. Over regulation is a big piece of what enables all this.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#183

Post by UncleMeat »

nradov wrote: post #34
JumpCrisscross wrote: post #15

Earlier quoted context omitted.

> the previous administration thought everyone should be "temporarily" paying for her plan. Moving money from person A to person B obviously doesn't make anything cheaper No, but it means I can't pay for a first-class ticket while someone else survives. I'll take that deal.

I support subsidies to help low-income citizens who legitimately can't afford health insurance, but some of the temporary ACA subsidies passed in 2021 were ridiculous. They were handing out cash to early retirees as young as age 55 with incomes over 400% of the poverty line. https://www.cnbc.com/2025/10/17/aca-enhanced-subsidy-lapse-g... I don't want my tax dollars wasted on subsidizing them. Give the money to someon…

400% FPL is $62,000 for a single person. Not exactly rolling in it.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#184

Post by tirant »

docdeek wrote: post #179
tirant wrote: post #169

Earlier quoted context omitted.

Free at point of delivery does not mean free at all. Netflix is also free when delivering you movies, but it costs a monthly fee. I think it’s time that we all stop with the nonsense that government funded healthcare is free. Because who ends up funding the government are us, the citizens, and that costs lots of money. Some governments, like the German one, still make the costs transparent to the citizen, something y…

>> In your case you believe your cost is only 1200€ a year, because your government has not made at all clear to you how much you’re paying from your other taxes into the healthcare system. I absolutely do not believe my healthcare costs only €1200 a year. As I wrote, my top-up insurance costs about €1200 a year, and the healthcare costs more and that is why my taxes are so high.

Ok, then I misinterpreted you.

However it’s still unclear how much you’re paying, as the problem with socialized services like healthcare is that you never know exactly how much you’re paying and if you’re overpaying or underpaying as there’s no free competition whatsoever.

There are of course also negative second order consequences. In socialized health care systems, where doctors and hospitals are payed the same no matter their performance, the economical incentives to provide modern treatments or provide better services do not exist, so best professionals need to leave the public systems if they believe they are being underpayed according to their value.

I’ve seen that happening in Germany and Spain a lot. Best doctors I had left their public healthcare position to open their own private business as that was the only way to be compensated economically according to the level of service they were providing.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#185

Post by runako »

jdlshore wrote: post #99
frogperson wrote: post #68

Earlier quoted context omitted.

Yep, you and your employer pay $3500/month for the premium. Then you as an individual have a $12k to $15k per year deductible before the insurance even kicks in.

That’s grossly exaggerated. Individual deductibles are limited by law to ~$6500 even on the worst plans. And no one is paying $3500 per month for individual coverage on one of those plans. The actual rates depend on age and zip code, but I’d be very surprised if they’re that high anywhere. To see the actual costs for yourself, go to healthcare.gov. The “bronze” plans are the ones with high deductibles. If you’re youn…

> Individual deductibles are limited by law to ~$6500 even on the worst plans

This was not the case for 2025, so I just did a search to determine whether you are referencing a new law. No, you are just flat wrong on this claim.

In Georgia (georgiaaccess.gov), the first bronze plan I looked at has an individual deductible of $10,600 (family deductible is $21,200). The plan's SBC is available to the public[1].

> no one is paying $3500 per month for individual coverage on one of those plans

You are correct, but also many people are not single and live in family units where the family unit is on the hook for $3,500 per month.

1 - https://sbc.anthem.com/dpsdeeplink/deepLink/AnthemBronzeBlue...

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#186

Post by nradov »

ArtemZ wrote: post #148
nradov wrote: post #111

Earlier quoted context omitted.

That's all true, but insurers are ramping up premiums faster than inflation largely because providers have raised their prices, and utilization has greatly increased due to an aging sicker population. The ACA minimum medical loss ratio means that health plans profits aren't increasing much.

But isn't it insurers actually set how much a service is going to cost you and then make "a discount" on that figure?

Medicaid and Medicare set service rates by fiat, which is why many providers don't accept patients on those plans. Commercial health plans have to negotiate service rates with their network providers. There's no discount as such: if you receive service from a network provider then they have to charge the negotiated rate.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#187

Post by UncleMeat »

czhu12 wrote: post #49

One thing that I’ve been trying to understand about this discourse: Is the sum of the increase in costs some people are now paying greater than the subsidies that previously existed? In other words: was there always a massive bill to be paid here, but it was just previously socialized and hidden in the form of taxes/ public debt? Or does the act of subsidizing it actually decrease the total?

Yes, sort of.

ACA insurers are required to pay out N% of their premiums. This means that a really important way of keeping premiums down is to make sure that people who use less medical care are in the insured pool. But if somebody is looking at a $20,000 annual bill in premiums and is generally healthy they might look elsewhere than the ACA markets or just simply go uninsured. That person leaving the insured pool means that everybody else's premiums go up.

The ACA had two strategies to keep these people in the pool: the individual mandate and the subsidies trying to keep prices lower. The mandate was removed years ago. And while we still have subsidies below 400% FPL, the ones for people above 400% FPL are gone. A self-employed person making $75,000 annually who previously could afford insurance might now be looking at alternatives.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#188

Post by runako »

JKCalhoun wrote: post #176
runako wrote: post #28

Earlier quoted context omitted.

This is misleading. Health insurance premiums cost about as much as buying a new car every year. Healthcare is generally on top of those premium payments.

I suspect it was health insurance premiums being discussed. Thanks.

I was being a little facetious and using your comment as a way to point out to non-Americans that being insured is miles away from getting healthcare. This is also not a normal thing.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#189

Post by nradov »

altairprime wrote: post #157
czhu12 wrote: post #49

One thing that I’ve been trying to understand about this discourse: Is the sum of the increase in costs some people are now paying greater than the subsidies that previously existed? In other words: was there always a massive bill to be paid here, but it was just previously socialized and hidden in the form of taxes/ public debt? Or does the act of subsidizing it actually decrease the total?

Year-over-year increase in GDP in the U.S. right now is almost exclusively “production” output from the healthcare industry, whose profits are stratospheric and rising. So there’s two useful datapoints here: first, the bill must be paid, or U.S. GDP growth year-over-year falters, not because healthcare costs this much; and second, household debt continues to increase year-over-year to permit continued wage stagnation…

Commercial health insurers have relatively low profit margins. This is forced by the ACA minimum medical loss ratio. In theory Congress could increase that ratio slightly but it wouldn't do much to improve affordability for consumers.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#190

Post by nradov »

gilbetron wrote: post #182
simianwords wrote: post #150

Earlier quoted context omitted.

What value addition do the administrators provide? It might be helpful to understand why competing hospitals still find it useful to employ these people even if the cost is so high. If a competing hospital can provide equivalent service while also not spending so much on an administrator, why didn't they already do it?

You assume that there is any meaningful competition. What we are seeing, across industries including education, is a type of indirect collusion that is keeping prices crazy, not competition. Over regulation is a big piece of what enables all this.

Some states require a "Certificate of Need" to open a new hospital so we ought to do away with those to promote competition. But beyond that, which specific regulations are harming competition?
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