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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

#211

Post by _DeadFred_ »

tirant wrote: post #184
docdeek wrote: post #179

Earlier quoted context omitted.

>> 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…

Bro, try going to the doctor in America's not socialized services. You have zero idea how much that specific visit is going to cost, on top of the tens of thousands in insurance premiums paid on your behalf yearly.

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

#212

Post by atmavatar »

mritterhoff wrote: post #207
robocat wrote: post #162

Earlier quoted context omitted.

> true market price There can be no market clearing price, because healthcare demand is unlimited. In some countries supply is rationed by using different means such as waiting lists, budgets for funding, or even corruption (I witnessed this in Cuba).

> because healthcare demand is unlimited. How's that? Beyond some level of care I suspect demand drops of a cliff. No one goes to the doctor for the fun of it.

I'm sure they're talking about necessary healthcare - e.g., cancer drugs, insulin, dialysis, heart surgery, etc.

When giving the option of parting ways with some more money or dying, virtually no one is going to choose the latter.

Unfortunately, the US healthcare system is set up to extract maximum capital from people who interact with it. Worse: it's not alone. For example, the reason food in the US has so much sugar, salt, and fat in it is that the food industry has carefully engineered processed foods to be more addictive so people will buy more of it.

We live in one of the most exploitative societies in the world, and it's only getting worse over time.

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

#213

Post by _DeadFred_ »

tirant wrote: post #173
sumuyuda wrote: post #168

Earlier quoted context omitted.

> In Germany if you’re mid to high earner, a private insurance can cost you less than half than the public healthcare system and you get much better service. Starting with appointments with specialists, who always give preference to privately insured people. The solution here is to get rid of private insurance in Germany and only have public. It creates a two class system and private is a terrible choice once you are…

Actually the solution is to go full private. Costs when you get older skyrocket, but not your monthly contribution. You subsidize your own elderly costs by paying slightly more during your younger years. That slightly more is part of the insurance companies Float, which gets invested and is used 30-40 years later to cover your extra costs in old age. In a public system there’s no float. Everyone pays to cover the cos…

So your complaint is that the young subsidize the old in a public system, and your solution is a private system that somehow doesn't raise rates on high risk (older people) and to use the young...to pay for the old?

You also ignore that you can't switch and magically have 30-40 years of float for old people currently receive healthcare, so you have to keep the same system in place until they are gone because insurance companies would instantly go bankrupt under your plan (since they have yet to build a float but have payouts instantly), so now young people subsidize old and have to pay for their non-subsidized future so they will basically have to pay double. Or do you plan just leave old people out of the public system? Pretty nice demographic to just ignore in your plan.

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

#214

Post by _DeadFred_ »

thallium205 wrote: post #101
nielsbot wrote: post #55

Earlier quoted context omitted.

You comment sounds like snark but I understand if you don't know what Obamacare is. (And I'm not an expert so hopefully people will correct any mistakes) "Obamacare" was never healthcare for all. It is a GOP healthcare plan that heavily subsidizes private insurance. (Because free markets) And the current affordability crisis is the result of letting the government subsidies that help people pay for their Obamacare co…

All house and senate GOP members voted "no" on ACA. Obamacare is a lot of things, but a "GOP healthcare plan" isn't one of those things.

Strangely it actually was based on the GOPs 'Romneycare' that was promoted by The Heritage Foundation.

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

#215

Post by loeg »

mritterhoff wrote: post #207
robocat wrote: post #162

Earlier quoted context omitted.

> true market price There can be no market clearing price, because healthcare demand is unlimited. In some countries supply is rationed by using different means such as waiting lists, budgets for funding, or even corruption (I witnessed this in Cuba).

> because healthcare demand is unlimited. How's that? Beyond some level of care I suspect demand drops of a cliff. No one goes to the doctor for the fun of it.

> No one goes to the doctor for the fun of it.

"Fun" isn't the right word, but ~hypochondriacs will get unnecessary care if they perceive it to be free. This adds cost to the system without improving outcomes.

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

#216

Post by loeg »

runako wrote: post #92
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?

There's a third piece too, which is that insurers are ramping price much faster than inflation. Our (unsubsidized) premiums increased 20% year-over-year, after also increasing faster than the rate of inflation the last few years. Since premiums never decrease, one can pretty easily plot out that in the next ~decade we will see family premiums larger than the median salary. The economics of all this are going to get v…

Insurer premiums are capped and rise with costs. To the extent they're rising faster than inflation, that is only possible because their costs are rising faster than inflation. Costs are rising in large part for demographic reasons -- boomers are getting older.

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

#217

Post by _DeadFred_ »

nradov wrote: post #111
runako wrote: post #92

Earlier quoted context omitted.

There's a third piece too, which is that insurers are ramping price much faster than inflation. Our (unsubsidized) premiums increased 20% year-over-year, after also increasing faster than the rate of inflation the last few years. Since premiums never decrease, one can pretty easily plot out that in the next ~decade we will see family premiums larger than the median salary. The economics of all this are going to get v…

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.

Percentage wise profits might not increase, but 10% profits on a $2000 plan make an insurance company (and execs) more than 10% profits on a $200 plan. It's in their interests and income stream for costs to constantly go up so they can get their 10% take. Efficiencies and price savings would actually hurt them (can't have plan rates go back down and only get their 10% off of $200).

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

#218

Post by loeg »

nradov wrote: post #139
silexia wrote: post #131

We desperately need to vastly increase the number of physicians in this country to decrease costs. The AMA is the most powerful trade union in history and has locked the number of new doctors a year for many years now. Restricting supply for a service with inelastic demand skyrockets prices and lines their pockets.

Bullshit. The AMA is a voluntary membership organization, not a trade union. They have no power to set prices or engage in collective bargaining. The immediate bottleneck on producing more physicians is limited Medicare funding for residency slots. Every year some students graduate from medical school with an MD but are unable to practice medicine because they don't get matched to a residency program (some do get mat…

> At one point the AMA did lobby Congress to restrict that funding but they reversed position several years back.

Yes, this is one of the cartel/union-like behaviors people complain about with the AMA.

There are more examples: https://petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-p...

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

#219

Post by loeg »

dboreham wrote: post #110
cubefox wrote: post #54

It should be mentioned that the US has very high wages, and even when subtracting substantial health care insurance cost, the income likely remains higher than what people earn in most other countries.

Reading this sent me down a bit of an OECD data rabbit hole. They seem to agree. However once you read the fine print I'm not so sure. Many things are much more costly in the US (education, travel, food, vehicles, houses...) and the OECD data seems to not control for that. Also my personal experience is there are a large number of very poor people in the USA. Seems like more than in Western Europe for example.

People spend more on travel, food, and vehicles because they are richer.

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

#220

Post by runako »

_DeadFred_ wrote: post #217
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.

Percentage wise profits might not increase, but 10% profits on a $2000 plan make an insurance company (and execs) more than 10% profits on a $200 plan. It's in their interests and income stream for costs to constantly go up so they can get their 10% take. Efficiencies and price savings would actually hurt them (can't have plan rates go back down and only get their 10% off of $200).

I'm surprised so many people miss this. The insurers have an incentive for medical costs to go up, so that their (capped) share results in higher profits.
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