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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

#391

Post by mattjaynes »

joe_the_user wrote: post #242
mattjaynes wrote: post #226

Earlier quoted context omitted.

"instead of doing anything serious about it, we've done almost the worst possible option: require every one of us to be a customer of these monstrous companies, with little regulation on cost or other government oversight" This is a common misunderstanding of the economics of this situation. The principle involved here is "Adverse Selection". To illustrate, let's look at automobile liability insurance. The reason thi…

Argumentum ad nauseum is getting too common here. All that space for a fallacious argument. 1) Do you really think only sick people want health insurance? 2) Not everyone has to buy car insurance. Only people who drive. High rates will force people not to drive. There's nothing people can do against high mandatory health insurance premiums. 3) We've tried incentivizing people to be healthier seven ways from Sunday bu…

Emotion winning over the understanding of basic economic principles is not the path to actually solving the problem.

One must understand the reality of the variables involved in order to come up with solutions of value.

Emotional outbursts have rarely solved any important complex problems. See Hacker Code 11.3.7 ;)

Re: Money Won’t Buy You Health Insurance

#392

Post by noodle »

tptacek wrote: post #207
damoncali wrote: post #201

Earlier quoted context omitted.

What people don't like to admit is that free markets don't work for healthcare. What is the price you're willing to pay for curing that tumor in your gut? Everything you have. There is no supply vs. demand. Only supply vs infinity. What would happen to the food market were it not for the generally high supply of food? It wouldn't be pretty. Because of that, some sort of non-market intervention is simply unavoidable.…

This is a weird summary of how "free markets" and "supply and demand" work. Yes, you will pay everything you have for a cure. But the guy who will offer you a cure for "everything you have minus one dollar" is going to get your business.

that is true for certain procedures, and not true for others.

you don't have time to shop around for services while unconscious in the back of an ambulance.

Re: Money Won’t Buy You Health Insurance

#393

Post by muhfuhkuh »

Tyrannosaurs wrote: post #351
danssig wrote: post #334

Earlier quoted context omitted.

Could you please cite somewhere in the world where the free market is working for health care? Every other first world country either has socialized medicine or a tightly regulated health industry.

Singapore - arguably the most efficient healthcare system in the world. Tim Harford talks about it in his excellent book "The Undercover Economist" (worth commenting that he's not rampantly free market - he spends time putting the boot into the US system too as well as praising the UK's NHS). Basically everyone has to maintain a fund (the government pay into it for the poorest) for healthcare. This is what they spend…

"Singapore"

... has a price- and service-controlled market, set not by the healthcare industry but by the Singaporean government (you know, the guys that cane graffiti artists and banned gum-chewing?) They also provide government subsidies to citizens as well as permanent residents (though not as much) for their compulsory Medisave program. So, their invisible hand is very visible and it's called "their government regulates or pays for alot of their care".

Re: Money Won’t Buy You Health Insurance

#394

Post by alanfalcon »

wtn wrote: post #52
sammcd wrote: post #11

Earlier quoted context omitted.

I think she could buy insurance if she really wanted. I've thought about this a lot because I could easily be in this situation. If I did anything on my own I would need a group plan quickly. You only need 2 people to create a group. So you can buy insurance its expensive, here is how you do it. 1) Start a company. 2) Hire another employee (this costs a lot) 3) Make a group health insurance policy for the company. Th…

My auto insurance company (it operates like a cooperative) provides a group plan for members to purchase health insurance. (Coverage is provided by an external company). My auto insurance company also runs a savings bank for its members and offers loans at markedly better rates than retail banks. Consumer cooperatives would seem the simplest way to alleviate this issue--no need for additional legislation. To confirm,…

What's your auto insurance company?

Re: Money Won’t Buy You Health Insurance

#395

Post by sportsTAKES »

helmut_hed wrote: post #136
sportsTAKES wrote: post #77

I find it absolutely impossible to believe that her coverage was denied for the reasons she described - I have been approved for and paid for my own insurance for years (including my family's insurance) with medical issues far more serious than those. I concede that the system is totally messed up and the new health care bill makes it even worse. Employers shouldn't be required to provide health benefits - eliminate…

Your success in getting private health insurance may be due to the fact that you have "been approved for and paid for my own insurance for years". Bear in mind that the OP had group health insurance through her employer, and then tried to get private health insurance. I had much the same experience with minor things from the time I had group insurance being considered "pre-existing conditions" and justifying a denial…

To clarify, I have been approved for private insurance at different times (three times actually) over roughly twelve years with intermittent times of receiving benefits from employers - I have worked off and on as an independent contractor during that time.

Re: Money Won’t Buy You Health Insurance

#396

Post by angelbob »

Vivtek wrote: post #198
ajays wrote: post #140

Earlier quoted context omitted.

+1 If the Republicans are serious about an economic recovery and want startups to flourish, then universal healthcare is a cornerstone of such an effort. I know of other people too who are afraid of leaving their (big-company) positions because they have a wife + young kids, and lack of health insurance terrifies them.

What could possibly have given you the idea that the Republicans want an economic recovery?

Well, eventually. Just not under Obama. Maybe if they wait a few years?

Re: Money Won’t Buy You Health Insurance

#397

Post by twistedanimator »

Ras_ wrote: post #342
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.

That's exactly what I did when I went to El Salvador last year. It cost me $30 for a routine cleaning as opposed to $150 in the US.

Re: Money Won’t Buy You Health Insurance

#398

Post by sportsTAKES »

rprasad wrote: post #245
sportsTAKES wrote: post #77

I find it absolutely impossible to believe that her coverage was denied for the reasons she described - I have been approved for and paid for my own insurance for years (including my family's insurance) with medical issues far more serious than those. I concede that the system is totally messed up and the new health care bill makes it even worse. Employers shouldn't be required to provide health benefits - eliminate…

Funny. I have plenty of family and friends in the medical field (doctors, nurses, and hospital administrators), and I have yet to find one who believes the health care bill is a bad idea. In fact, most of them agree that its long overdue. You know what they love most about the bill? It would prevent insurers from dropping coverage. Insurer-instigated billing disputes are the biggest obstacles to health service provid…

It doesn't surprise me that your friends and family differ in opinion (I have been surprised to not find one in my circle that supports the bill).

That said, one family member in particular is a nurse practicioner at a major trauma center. Her primary concern is not the billing disputes as much as the actual quality of care. She feels that her hospital is already inundated with somewhat reckless medicaid requests. She believes that 60% of medicaid patients at her hospital seek medical care that they don't need (e.g., person has a basic headache that some rest or an aspirin would surely cure but instead they actually seek professional medical attention). If that visit were to come at a slightly greater cost, there is no way that person would go to an emergency room for a headache.

It sounds like a dramatic example but she says crazy incidents like this happens every single day, w/o fail. So much so that they track and keep a monthly log that helps them measure their performance. As such, the hospital's resources are strained and their ability to treat seriously ill or injured patients is somewhat compromised. So I think the concern on her part is that the new health care bill actually exacerbates this problem.

I understand that selling across state lines could violate states rights. At the same time, it's too bad that many (myself included) wouldn't trust the fed to be in charge of interstate oversight. In reality, it might be better to have one consolidated standard of mandates but I just can't imagine fed efficiently and accurately providing that type of oversight.

Re: Money Won’t Buy You Health Insurance

#399

Post by imechura »

the problem in this country is that not enough people are paying for their own health care or insurance.

Some people are getting medicare others are getting medicaid, others have benefits from the VA or a government job. Others get it from unions or employers. Only the people who are responsible for paying their own bills truly understand the state of our health care industry.

Because of that it is always someone else's problem and no one really minds paying 48k for 2 nights of saline drip in the hospital when the only cost to them is the 500.00 deductible. The hospital collecting the 48k certainly does not want that to change neither do any of the other predators in that food chain.

Put a high tax on employer sponsored insurance plans so that all employers stop offering it as a benefit. Then we will see real reform.

Re: Money Won’t Buy You Health Insurance

#400

Post by andrewlchen »

wtracy wrote: post #73
krschultz wrote: post #18

Earlier quoted context omitted.

It's not the difference between a family and a company, its the size of the group. Thus the costs for a company with 10,000 people is far different than a company with 10. Also, if you have a group of 2,5,10 or 20, the insurance company has an easier time denying you because if you get pissed and drop them, its not a big loss for them. In contrast, if you deny the right person at a 10,000 person company, they lose a…

Actually, has anyone tried banding a group of startups together until they have several thousand employees, then buy insurance as a bloc? Another idea I've kicked around: Create a sort-of incubator where, on paper, all of the startup founders and employees are employees of the incubator group. Then the incubator can handle the whole mess of both insurance and income taxes. (Bonus: Since the "incubator" now has a ton…

I've spent some time thinking about different startup ideas / permutations to address exactly this solution. In my research, I've found attempts at both methods you describe above, in various forms and various states, with widely varying degrees of success, but most have ended in failure. The "successes" tend to offer some limited choice in plans, but the rates certainly aren't great and the deductibles are still pretty high -- mostly it's a fallback safety net for serious emergencies.

I think a startup that can help tackle this issue would create tremendous value in the payor / consumer market, but the field is extraordinarly complicated and requires a very rare multi-disciplinary background in individual state law (CA's system alone is very different from, say, MA's bc CA is HMO-based and MA has a public option), behavioral economics, gov't regulation, insurance underwriting methods, insurance administrative practices. Oh, and if it's a tech startup, the team would obviously need web dev / product skills as well.

The problem is, developing a basic mastery of all these subjects takes a lot of time -- reading, thinking, and experiencing to understand the pain points deeply. That tends to cut against the stereotypical startup team of two young twenty-somethings hacking away and living on ramen, who have never studied the insurance industry or directly experienced the pain of searching for or relying heavily on health insurance (bc young 20 somethings tend not to have major health problems). I think that's a key reason why startups haven't done much innovation in the insurance payer market.

My latest line of thinking is about whether there are hacks around the problem that can incrementally chip away at and disintermediate insurance payers as the sole gateway to affordable healthcare.

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