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Sharing the Load: Amish Healthcare Financing (2016)

ncbi.nlm.nih.gov

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Re: Sharing the Load: Amish Healthcare Financing (2016)

#31

Post by watwut »

giantg2 wrote: post #28
watwut wrote: post #24

Earlier quoted context omitted.

Not really > Amish mortality patterns were not systematically higher or lower than those of the non-Amish, but differed by age, sex, and cause. Amish males had slightly higher all-cause MRs as children and significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69). Amish females MRs for all causes of death were lower fr…

What do you mean "not really"? It seem you just posted what I was saying for lower rates of many chronic diseases. "significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69)" As they said, cause differs. When looking at costs, causes are very important. Things like cancer and cardiovascular diseases tend to cost a lot…

Women had literally zero benefits. And young boys die more. There is only one segment of population that is getting some benefit and that benefit is small.

In order for lifestyle to be healthier, I would want to see more benefits then just some middle aged men mortality shifted onto young ones.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#32

Post by ecommerceguy »

These plans are not ACA qualified, are underwritten on an annual basis and do not cover pre existing conditions. They are for healthy people to cover something for the duration of the plan, which it sounds like it did. The next year the Agent or Broker (there is a legal difference) should have steered this lady to a Marketplace Plan - Fully Insured plan which covers pre-ex. Problem solved.

Who's the agent/broker here? He/she is required to have E&O.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#33

Post by ecommerceguy »

rqtwteye wrote: post #27
tomohawk wrote: post #25

Earlier quoted context omitted.

I can buy car insurance or pretty much any kind of insurance on the market, and there is suitable oversight. This does not exist for medical insurance. What I mean by that is if I work for a large company, I can get access to health insurance that I cannot buy on the market myself. If that company changes insurers to a crappy one, my only choice is to change employers to one that provides access to a better insurer.…

“Insurers should be forced to sell in a single market all the plans they offer. Insurer like to talk about "economy of scale" with large employers, but that is an artificial limit. Why should insurance pools be limited to who works at a company?” Very true. There should be one insurance pool. Either state or nationwide.

There we're state pools until Obamacare wiped those away.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#34

Post by DoreenMichele »

watwut wrote: post #30
DoreenMichele wrote: post #29

Earlier quoted context omitted.

Your quote agrees with the thing you are rebutting: Rates of many chronic diseases are lower. Amish males had ...significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69). Also, mortality rates and costs are not synonyms.

Women had no such benefit. Women got more issues as their aged. Health of children mattter too and costs too. Young males dying more often is not healthy for them. The men over 40 subset of population has slightly lower mortality and no one else. The numbers even out. That is not consistent with "healthier lifestyle overall" as if they generally got benefits.

You: Women had no such benefit. Women got more issues as their aged.

Also you: Amish females MRs for all causes of death were lower from age 10-39, not different from 40-69, and higher over age 69.

Women only "got more issues as their aged" after age 69. Before that, they were either better off or about the same. This also agrees with the point the parent comment was making that they generally have healthy lifestyles and don't go into long-term care facilities in old age. Instead, they accept death when the time comes.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#35

Post by ecommerceguy »

amluto wrote: post #26
tomohawk wrote: post #22

Earlier quoted context omitted.

You cannot purchase plans across state lines. You cannot purchase the same plan you would get if you worked at a large company. The law is basically written by the insurers, and favors them. It allows them to segregate people based on who they work for, etc. In an ethical system, there would be just a single, non-segregated pool of people called a 'market', and anyone would be able to purchase any plan they want from…

The state line thing makes a degree of sense in the context of the (extremely broken) network system. Your insurer has a network of providers with whom they have negotiated rates. If you live far away from your plan’s intended market, you won’t be near the network, and everyone loses except the medical providers who get to overcharge you and your insurer as a result. It should be quite evident that everything about t…

I should remind everyone it is a republic and if you think state insurance commissions will let go of their fiefdoms I have some land in Florida I'll make you a great deal on. Kathleen Sebelius comes to mind!!

Re: Sharing the Load: Amish Healthcare Financing (2016)

#36

Post by DoreenMichele »

watwut wrote: post #31
giantg2 wrote: post #28

Earlier quoted context omitted.

What do you mean "not really"? It seem you just posted what I was saying for lower rates of many chronic diseases. "significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69)" As they said, cause differs. When looking at costs, causes are very important. Things like cancer and cardiovascular diseases tend to cost a lot…

Women had literally zero benefits. And young boys die more. There is only one segment of population that is getting some benefit and that benefit is small. In order for lifestyle to be healthier, I would want to see more benefits then just some middle aged men mortality shifted onto young ones.

The Amish suffer from genetic disorders due to inbreeding. From the Wikipedia article someone linked to:

Some of these disorders are quite rare, or unique, and are serious enough to increase the mortality rate among Amish children.

I criticized the practice of inbreeding in my first comment.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#37

Post by watwut »

DoreenMichele wrote: post #34
watwut wrote: post #30

Earlier quoted context omitted.

Women had no such benefit. Women got more issues as their aged. Health of children mattter too and costs too. Young males dying more often is not healthy for them. The men over 40 subset of population has slightly lower mortality and no one else. The numbers even out. That is not consistent with "healthier lifestyle overall" as if they generally got benefits.

You: Women had no such benefit. Women got more issues as their aged. Also you: Amish females MRs for all causes of death were lower from age 10-39, not different from 40-69, and higher over age 69. Women only "got more issues as their aged" after age 69. Before that, they were either better off or about the same. This also agrees with the point the parent comment was making that they generally have healthy lifestyles…

Women got no benefit after 40. Healthier lifestyle as cause would had them having this benefit at that age range too. It is exactly that age when men started to have benefits. In case of women you have slight benefit at the age range when men are dying more.

69 years old women are not in the long term facilities for that matter eitminor Nor are men. In UK, 66 years old is retirement age. This is age when strength and health declines, but nowhere near the level necessary to be in some kind of facility. These are self sufficient people, able to care about themselves, able to care about relatives or animals.

None of that are numbers that overall superior healthier lifestyle. Just a minor shifts around.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#38

Post by giantg2 »

watwut wrote: post #31
giantg2 wrote: post #28

Earlier quoted context omitted.

What do you mean "not really"? It seem you just posted what I was saying for lower rates of many chronic diseases. "significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69)" As they said, cause differs. When looking at costs, causes are very important. Things like cancer and cardiovascular diseases tend to cost a lot…

Women had literally zero benefits. And young boys die more. There is only one segment of population that is getting some benefit and that benefit is small. In order for lifestyle to be healthier, I would want to see more benefits then just some middle aged men mortality shifted onto young ones.

We're talking about costs, not mortality. You also can't equate mortality with healthy or unhealthy lifestyle. Many of the things in the lifestyle are healthy, the two biggest being more physical activity and less processed foods. You can "live" in a nursing home for a long time. But quality of life is an important factor not captured in your mortality figures, including things like some of the lowest obesity rates (and chronic illnesses that go with that).

Re: Sharing the Load: Amish Healthcare Financing (2016)

#39

Post by HWR_14 »

giantg2 wrote: post #20
DoreenMichele wrote: post #3

I worked in insurance for over five years. This is a very good read. 1. They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor. They have established sources of information and support for this practice. 2. When it comes to medical care, they are not Luddites and are willing to use cutting edge technologies to care for medical issues. 3. I was struck by the repeated ment…

"They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor." Two other factors for low cost would be their healthy lifestyle and end of life care choices. The Amish get about 20k steps in per day - double the recommended 10k steps that most English fail to meet. Rates of many chronic diseases are lower. When they do get old, they don't drag things out and they generally don…

Highly physical work can easily cause damage. Sure, it's bad to sit behind a computer for 8-10 hours a day. But it's also bad to be constructing barns 8 hours a day. You want a happy amount of physical activity. It's easy to look up to the people on the far side of goal as being healthier, but US tradespeople in their 40s and 50s tend to be pretty messed up in the knees/back.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#40

Post by wyclif »

andrewl wrote: post #5
DoreenMichele wrote: post #3

I worked in insurance for over five years. This is a very good read. 1. They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor. They have established sources of information and support for this practice. 2. When it comes to medical care, they are not Luddites and are willing to use cutting edge technologies to care for medical issues. 3. I was struck by the repeated ment…

I had an anthropology professor in college who did some work on genetic diseases in the Amish. It is a problem. This Wikipedia has a short overview and a lot of references: https://en.wikipedia.org/wiki/Health_among_the_Amish

Anecdotal, but I once had a friend and roommate that came from an ex-Mennonite family of 12 siblings with two sets of twins. He and one of his brothers both developed late-onset Tay-Sachs disease. Although relatively high-functioning and able to do most tasks such as hold down a job and drive a vehicle, there were some unfortunate consequences.

For instance, the brothers had lack of coordination, ataxia, and minor speech problems. They were constantly getting pulled over by the local cops for minor violations (like driving too slowly) and nearly every time the cops would insist that they were drunk even though they didn't have a drop of alcohol. To the untrained eye, their affect looked very similar to an intoxicated person: slurred speech, bobbing while standing in place, stumbling when walking or getting out of the car, &c. So yes this is a big problem in these communities.

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