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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)

#41

Post by HWR_14 »

tomohawk wrote: post #25
lr4444lr wrote: post #21

Earlier quoted context omitted.

There has to be some kind of oversight. Otherwise, you get thousands of people victimized by fraud who the rest of us have to bail out.

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.…

That's what the ACA already fixed. Insurers are forced to sell into that single market all the plans they offer in your state that are open to individuals. If you don't like your employers plan, you can just buy insurance on the ACA marketplace and decline your employers plan. Your risk pool will be other people of the same sex and age in your state.

If your complaint is that employers have access to better insurance plans on private offer, well that's true. Walmart also has self-insured property/auto coverage not available to smaller companies. But COBRA let's you stay on your employers plan if you leave for up to a year (at a pretty high cost) so that's a thing.

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

#42

Post by s1artibartfast »

watwut wrote: post #24
giantg2 wrote: post #20

Earlier quoted context omitted.

"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…

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…

I see that as direct evidence contrary to your point. Achieving comparable mortality with less Healthcare and Associated cost would imply that they are in fact healthier.

Part of the confusion is that you are conflating mortality with health.

If two people live to the same age, but one requires many surgeries, drugs, and treatments, I dont think you would say they are equally healthy.

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

#43

Post by HWR_14 »

nonethewiser wrote: post #4

Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for car or home owners insurance.

Are there laws against offering health insurance in the open market? I'm pretty sure you could start up nonethewiser's insurance company and start taking enrollees. Or do you mean you'd have to sell them through a government portal? Or that you have to really offer a certain minimum level of care and coverage? And register with the state insurance commission? Because I'm pretty sure, except for the first one, that's a requirement for other insurances as well.

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

#44

Post by lr4444lr »

tomohawk wrote: post #25
lr4444lr wrote: post #21

Earlier quoted context omitted.

There has to be some kind of oversight. Otherwise, you get thousands of people victimized by fraud who the rest of us have to bail out.

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.…

That... ...isn't what I was talking about?

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

#45

Post by tiedieconderoga »

actionfromafar wrote: post #10
implements wrote: post #9

Earlier quoted context omitted.

Aside: Hoovies Garage on YouTube taught me that keeping a old Rolls or Bentley in perfect working order costs literally tens of thousands of dollars a year in parts and maintenance - nothing stays ‘fixed’ for very long. Someone should do a kit car with Toyota mechanicals and a Rolls style body!

We call them “Lexus”

Rolls is on a whole different level when it comes to fit and finish. The interior and ride quality is why they cost as much as an Italian sports car and weigh as much as an armored vehicle. Adding a bit of leather trim and brushed aluminium buttons doesn't get you into the same league.

It is funny that the old ones are so mechanically unreliable though, when you consider that Rolls also has a long history of making aircraft engines.

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

#46

Post by rqtwteye »

ecommerceguy wrote: post #33
rqtwteye wrote: post #27

Earlier quoted context omitted.

“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.

Not really. A lot of people never were able to get insurance at all or lost it once they got sick.

There should be one pool where everybody can get insurance regardless of agr, employment status or preconditions. Insurers should compete for that pool.

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

#47

Post by pclmulqdq »

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…

Americans' insistence on living to their last possible machine-assisted breath makes healthcare very, very expensive. Something like a third to half of the healthcare costs of an individual are incurred in their last year. Americans are terrified of dying.

This is why I have a hard time taking cost comparisons seriously between the US and Europe - European healthcare systems will pull the plug a lot earlier, saving the money (and the indignity) involved in dying as slowly as possible.

Ironically, doctors in the US have some of the lowest end-of-life care costs, because they know their actual chances and don't seem to be so afraid of dying.

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

#48

Post by ceejayoz »

ecommerceguy wrote: post #33
rqtwteye wrote: post #27

Earlier quoted context omitted.

“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.

I presume you're referring to state high risk pools, which were horrific.
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