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Millitron's expectation of would happen without health insurance reads straight out of a Republican National Convention pamphlet.
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On April 14 2015 07:21 wei2coolman wrote:
Millitron's expectation of would happen without health insurance reads straight out of a Republican National Convention pamphlet.
Not really. The RNC wanted to stay with the old insurance system.
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Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass.
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On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass.
That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate).
The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply).
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Medical expense contributes to 62% of bankruptcies-- that statistic is from 2007. I wonder what it is now (I'll guess around 70%).
Also comparing people in debt with insurance vs. those without: -$18k vs $27k. That's a 50% increase (or a 33% decline if want to look at it that way)
There's a great book by Atul Gawande called Being Mortal that talks about end of life care (which is really expensive). He's a surgeon and also writes for the New Yorker. He has some great stuff about some of the cultural/ systemic issues with our healthcare system.
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Milltrons idea of Insurance is WAY far right of anything serious republicans would propose.
I'd like to think that the republican plan would prefer a state by state decided program for insurance to increase competition while still hedgeing the game tword the common man. Florida and maine have vastly different needs for health insurance and should have different standards.
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On April 14 2015 03:34 zlefin wrote:
What issues are preventing a well-defined Republican plan from being made?
It doesn't seem like it should be THAT hard to take some Republican principles, and craft a system around that.
Too many internal disagreements over the parameters such a system would have? Political costs necessary to make the system sound?
There have been plans and ideas floating around for a replacement to the ACA. Nothing formal though; it takes a lot of work to put together legislation that is as extensive as the ACA and so until enough political power exists for repeal / replacement I wouldn't expect anyone to go through that level of work.
Both Republicans and Democrats have been making rational changes to the system for decades. The problem each party runs into is that some group of people, generally the middle class, doesn't like the changes for one reason or another and so the changes end up dead on arrival or a few years later. The ACA only seems to have more sticking power because high costs finally started impacting the middle class in the early 2000's making the political will for change a reality for the first time, if still tenuous.
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On April 14 2015 08:15 JonnyBNoHo wrote:Show nested quote +On April 14 2015 03:34 zlefin wrote:
What issues are preventing a well-defined Republican plan from being made?
It doesn't seem like it should be THAT hard to take some Republican principles, and craft a system around that.
Too many internal disagreements over the parameters such a system would have? Political costs necessary to make the system sound? There have been plans and ideas floating around for a replacement to the ACA. Nothing formal though; it takes a lot of work to put together legislation that is as extensive as the ACA and so until enough political power exists for repeal / replacement I wouldn't expect anyone to go through that level of work. Both Republicans and Democrats have been making rational changes to the system for decades. The problem each party runs into is that some group of people, generally the middle class, doesn't like the changes for one reason or another and so the changes end up dead on arrival or a few years later. The ACA only seems to have more sticking power because high costs finally started impacting the middle class in the early 2000's making the political will for change a reality for the first time, if still tenuous.
Yeah Republicans have been sooo busy, how could they find the time right...? lol
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On April 14 2015 08:04 cLutZ wrote:Show nested quote +On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply).
Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups.
However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up.
As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view.
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On April 14 2015 08:21 Acrofales wrote:Show nested quote +On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view.
If that checkup fact were true, insurance companies would pay for them, or, more likely, give discounts for attending them.
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On April 14 2015 08:30 cLutZ wrote:Show nested quote +On April 14 2015 08:21 Acrofales wrote:On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view. If that checkup fact were true, insurance companies would pay for them, or, more likely, give discounts for attending them.
Which is exactly what happens outside the US
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On April 14 2015 08:15 JonnyBNoHo wrote:Show nested quote +On April 14 2015 03:34 zlefin wrote:
What issues are preventing a well-defined Republican plan from being made?
It doesn't seem like it should be THAT hard to take some Republican principles, and craft a system around that.
Too many internal disagreements over the parameters such a system would have? Political costs necessary to make the system sound? There have been plans and ideas floating around for a replacement to the ACA. Nothing formal though; it takes a lot of work to put together legislation that is as extensive as the ACA and so until enough political power exists for repeal / replacement I wouldn't expect anyone to go through that level of work. Both Republicans and Democrats have been making rational changes to the system for decades. The problem each party runs into is that some group of people, generally the middle class, doesn't like the changes for one reason or another and so the changes end up dead on arrival or a few years later. The ACA only seems to have more sticking power because high costs finally started impacting the middle class in the early 2000's making the political will for change a reality for the first time, if still tenuous.
while something as full would take a lot of time; something in the 50-100 page area should be doable in a reasonable amount of time, without using too many people (and of course a fair bit of drafting is done by people other than congresspeople, there's lawyers and aides and such). Having a 50 page alternate plan, even if there are some details not fleshed out yet, would be pretty good.
A lot of the nitty gritty is also about little details which have to be done, but which aren't really necessary to the overall soundness of a plan.
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On April 14 2015 08:30 cLutZ wrote:Show nested quote +On April 14 2015 08:21 Acrofales wrote:On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view. If that checkup fact were true, insurance companies would pay for them, or, more likely, give discounts for attending them.
Many do, apparently some stupid plans don't for no good reason. My plan has the annual checkup free.
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On April 14 2015 08:15 JonnyBNoHo wrote:Show nested quote +On April 14 2015 03:34 zlefin wrote:
What issues are preventing a well-defined Republican plan from being made?
It doesn't seem like it should be THAT hard to take some Republican principles, and craft a system around that.
Too many internal disagreements over the parameters such a system would have? Political costs necessary to make the system sound? There have been plans and ideas floating around for a replacement to the ACA. Nothing formal though; it takes a lot of work to put together legislation that is as extensive as the ACA and so until enough political power exists for repeal / replacement I wouldn't expect anyone to go through that level of work.
While you are right that a replacement for the ACA would take a ton of work the problem is then in the Republicans approach.
Through both congress and the courts they are trying to sabotage the ACA to stop it from working today without a replacement being ready which would leave the country stuck in limbo.
You either complain but don't take action while working on a replacement and then make your move when you are prepared or you accept you don't have an answer now and keep quiet.
You don't attempt to destroy the system and after it is broken try to find an acceptable replacement.
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On April 14 2015 08:21 Acrofales wrote:Show nested quote +On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view.
They most likely can afford it now, it's just not something they're willing to spend money on. The issue isn't a matter of money, it's of prioritizing. Most people who are dirt poor struggle with daily expenses, while having the newest iphone/expensive cable/internet/etc.
I'm sure there are rare cases where their budget is so tight they don't even have $20 to spare, but it's mainly people just aren't willing to spend the money on it.
You could make a case for including birth control (has a lot of benefits for woman), but having Viagra included is just hilarious.
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On April 14 2015 08:54 Gorsameth wrote:Show nested quote +On April 14 2015 08:15 JonnyBNoHo wrote:On April 14 2015 03:34 zlefin wrote:
What issues are preventing a well-defined Republican plan from being made?
It doesn't seem like it should be THAT hard to take some Republican principles, and craft a system around that.
Too many internal disagreements over the parameters such a system would have? Political costs necessary to make the system sound? There have been plans and ideas floating around for a replacement to the ACA. Nothing formal though; it takes a lot of work to put together legislation that is as extensive as the ACA and so until enough political power exists for repeal / replacement I wouldn't expect anyone to go through that level of work. While you are right that a replacement for the ACA would take a ton of work the problem is then in the Republicans approach. Through both congress and the courts they are trying to sabotage the ACA to stop it from working today without a replacement being ready which would leave the country stuck in limbo. You either complain but don't take action while working on a replacement and then make your move when you are prepared or you accept you don't have an answer now and keep quiet. You don't attempt to destroy the system and after it is broken try to find an acceptable replacement.
Democrats and Republicans did the same thing for decades prior to the ACA.
It's as I wrote before. People have a problem with reforms and work to undermine them. What's been keeping it going is the will to just spend money to make the issues go away.
Not defending any of that, just explaining it.
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On April 14 2015 08:30 cLutZ wrote:Show nested quote +On April 14 2015 08:21 Acrofales wrote:On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view. If that checkup fact were true, insurance companies would pay for them, or, more likely, give discounts for attending them.
Insurance does pay for a yearly checkup. Not sure what world you live in.
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On April 14 2015 09:09 IgnE wrote:Show nested quote +On April 14 2015 08:30 cLutZ wrote:On April 14 2015 08:21 Acrofales wrote:On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view. If that checkup fact were true, insurance companies would pay for them, or, more likely, give discounts for attending them. Insurance does pay for a yearly checkup. Not sure what world you live in.
Some* insurance pay for yearly check up.
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On April 14 2015 09:09 IgnE wrote:Show nested quote +On April 14 2015 08:30 cLutZ wrote:On April 14 2015 08:21 Acrofales wrote:On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view. If that checkup fact were true, insurance companies would pay for them, or, more likely, give discounts for attending them. Insurance does pay for a yearly checkup. Not sure what world you live in.
Then the legislation that mandated it is a nullity. That was my only point regarding that. IF something does reduce the risk of a later catastrophic expenses, then it would be paid for in a free market insurance system so the discussion about it is silly.
Really the issue I tried to present is that a lot of the routine expenses are not properly part of an insurance scheme, and if the government wants to subsidize those things they should do it through a tax and spend system, not a convoluted mandate system that hides the costs from taxpayers.
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On April 14 2015 08:59 killa_robot wrote:Show nested quote +On April 14 2015 08:21 Acrofales wrote:On April 14 2015 08:04 cLutZ wrote:On April 14 2015 07:55 Acrofales wrote:
Millitron: simple example of why it won't work.
Very simple surgery such as appendectomy.
According to Google the average rate is about 33,000 USD for an appendectomy. Lets be drastic and say this cost is extremely inflated and can be cut down to 1/3. You can thus have an appendectomy for 10,000 USD or die of appendicitis.
How many people have (a) 10,000 USD saved up or (b) ability to QUICKLY get a loan for 10,000 USD to pay for this surgery.
This will wipe out most middle class families readily available savings (those not tied up in long-term investments).
And this is a very simple surgery. Now lets go with open-heart surgery, a liver transplant, chemo therapy, etc. etc. etc.
Unless you really think that healthcare worldwide is so incredibly inefficient that prices can drop to between 1 and 5% of their current costs, you are simply going to have to admit that most treatments are going to be FAR out of reach of the average family.
Luckily only a very tiny percentage of the population ever needs one of those treatments. That's why health insurance works: it is both a mandatory savings account for if something in your body goes wrong, as well as a cost spreader: you pay for your neighbour's coronary bypass. That is how insurance is supposed to work. The issue is that people want insurance that also pays for prescriptions and yearly visits when those are consistent and expected costs. Like Viagra or Birth Control or Plavix. That isn't insurance at that point it is social redistribution (particularly when coupled with the individual mandate). The other problem for our system comes at the other extreme end of the system, where some people are using millions of dollars of healthcare, and the society needs to (unfortunately) allocate resources elsewhere at some point. This is where foreign countries get a large percentage of their savings compared to America (along with drug/device cost controls, and less doctor debt/schooling/salaries). They simply have a much lower threshold where they will conserve resources (because part of the system's efficiency is restricting overall supply). Well, then we get into nitty gritty details. It is simply cheaper (overall) if you go for your yearly check up than if you don't. Lots of things that can go wrong are found out at an early stage when prevention is simple or intervention is cheap. It is thus beneficial for overall healthcare costs if you go for these regular check-ups. However, if they aren't in your health insurance, such check-ups cost a lot of money (couple of hundred dollars every year). So people don't go, and cost their health insurance FAR more money (when they end up in hospital with a heart attack, metastasized breast cancer, or something else nasty) than if the health insurance simply paid for the check-up. As for the other things you mention: I don't think birth control or viagra needs to be in a health insurance package either. That's not to say I don't think birth control should be easily available for everybody, especially the underprivileged who cannot spend those $20 a month for a box of pills (or condoms). However, that is a separate discussion with completely different points of view. They most likely can afford it now, it's just not something they're willing to spend money on. The issue isn't a matter of money, it's of prioritizing. Most people who are dirt poor struggle with daily expenses, while having the newest iphone/expensive cable/internet/etc.I'm sure there are rare cases where their budget is so tight they don't even have $20 to spare, but it's mainly people just aren't willing to spend the money on it. You could make a case for including birth control (has a lot of benefits for woman), but having Viagra included is just hilarious.
I don't know if this is just really ignorant or really insulting (or both).
The idea that all poor people have brand new iPhones and huge TV's is complete B.S. that's just touted by Fox News to demonize the poor.
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EPT
