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Thread: Pay now, care later

  1. #41
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    Quote Originally Posted by Neomalthusian View Post
    The net cost of private insurance is a small chunk of total American expenditures on health, and it hasn't grown that much in the last 15 years.
    Well, congratulations for you, then, I suppose. My costs to pay for my insurance go up every fucking year. The high mark was 22%. I don't know what you've got happening but stick with it if your premiums aren't going up.

  2. #42
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    Quote Originally Posted by pragmatic View Post
    Insurance is an incredibly regulated industry. Some of those claiming gouging are just uninformed.
    It's also one of the biggest, richest, most powerful lobbies in Washington.

    Let's ask the money: does Warren Buffet like insurance companies? Oh, hey, lookie there, he sure does.

  3. #43
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by Neomalthusian View Post
    The actuarial analysis of covering the same services for the same population of people doesn't vary that much. It's the same math. They can network a little differently to try to save their clients some money but their policy loses attractiveness if the network is narrow and people can't go where they want to get health care. You want there to be this scapegoat.



    The net cost of private insurance is a small chunk of total American expenditures on health, and it hasn't grown that much in the last 15 years. The cost of and expenditures on actual health care have grown, enormously. Your assumption that the reason health care costs and expenditures are all the fault of private insurance companies is not well supported here. Rising costs might help justify future premium increases, but they also pose much greater near-term risks of huge operating losses. The revenue they make in a given year is pretty much determined at the beginning of that year. What they have to pay out could easily cut deeply into what they need just to operate. They take on that risk. They also have a risk of adverse selection. Colluding with providers to hike prices so that they'll be able to hike premiums next year is not a safe way for them to make money. You really are at the level of a conspiracy theory with all this. The data is showing that health care provision (not insurance) is driving the the cost growth.
    I agree, to a point. But....hell yes, insurance companies collude. They have to, to some degree, and are exempt from some anti-trust laws in recognition of this fact.

    Market pressure on companies, to hold down premiums or to ensure benefits or networks are "competitive", has never really existed in health insurance.

    It is not uncommon to find 50+ companies offering worker's compensation insurance in a given state, but no state has had more than 5 health insurance companies since the 1970's. (Not including catastrophic or Medicare supplemental policies, etc.)

    Health insurance is moving to the same place as liability insurance for properties has already gone. There are millions of closed pools, playgrounds, sports programs, etc. mainly because liability insurance became too expensive, then too restrictive, then simply unavailable at any price.

  4. #44
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    Quote Originally Posted by splansing View Post
    Well, congratulations for you, then, I suppose. My costs to pay for my insurance go up every fucking year. The high mark was 22%. I don't know what you've got happening but stick with it if your premiums aren't going up.
    Your increasing insurance premiums are a reflection of deeper issues related to the cost of health care. I get it, the system is not working well. There are many problems and many regressive, backward, unfair provisions in laws and policies across the country, primarily having to do with who pays what. Lots of people on the low end get a free ride, lots of old rich people on the high end get a free ride, government employees get ultra-platinum health benefits for virtually nothing, but lots of people in the middle, young and middle-aged entrepreneurs for example, they get the shit end of this stick. Lots of arbitrary inequality embedded into our system right now.

    But your tendency to simply blame the insurance company because your premiums are increasing is not looking deeply enough at the situation. You should put down the pitchfork. Yes insurance companies want to make money, but when it comes to health insurance companies, they can't necessarily just go and do that, especially now. They face risks of huge financial losses and they face risks of adverse selection (mandates notwithstanding).
    Last edited by Neomalthusian; 13th April 2017 at 02:09 PM.
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  5. #45
    told you so Amelia's Avatar
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    Quote Originally Posted by HCProf View Post
    My husband works for a large company and we had wonderful insurance until 3 years ago. Our deductible was 250.00 each, today it is 3K each. His payroll contribution increased gradually over the last 3 years from 120.00 every two weeks to 225.00 every two weeks. I think insurance companies are making up for the preventative care that now must be covered at 100% by raising the deductibles for care with a definitive diagnosis. This is one of the reasons I will not go for many of my screenings such as the colonoscopy...one polyp and with the diagnosis of diverticulitis and my deductible kicks in. I can afford it, but it is a matter of principle to me...I don't want every dime of my disposable income to go into healthcare and taxes since I am in my early 50's now. How can you sustain the economy when your big expenses are healthcare and taxes? I told my Doctor on my last physical when she was pressuring me to get the colonoscopy because of the diverticulitis....sometimes you have to roll the dice and see what happens, we have no control over our healthcare expenses and I refuse to put our life together in debt over it. The way I see it clearly now...whatever happens, I had a nice run the first 50-60 years, all good things will eventually end. Our healthcare will eventually become so expensive we will all have to make life or death decisions to sustain our families. I don't see any relief in from this in my lifetime.
    I'm worried about the polyps. They found 3 in my colonoscopy. With zero, it would have been free. But with 3 ... I haven't heard yet if I'll be on the hook for the thousand dollar deductible ... plus the 20% of the rest. (Colonoscopies with my provider are over $4000 ... even though elsewhere in the nation they can be below $1000.)

    Because of the doubt after I talked to the financial person at the hospital, I almost cancelled the procedure, but I let hubby talk me into it. Glad to know ... and have polyps removed ... but waiting for the other shoe to drop.
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  6. #46
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    Quote Originally Posted by Neomalthusian View Post
    Obamacare is exceedingly generous to older Americans because it makes the subsidy thresholds one-size-fits-all. If I'm 30 with a household income of $100,000 and insurance premiums for me and my wife actually cost $10,000 per year, but because of the subsidies I only pay $9,500 per year (9.5% of income), then thanks Obama, you saved me $500.

    But if the guy in the office next to me is 59 and has household income of $100,000, what his insurance premiums actually cost for him and his wife are $40,000 per year, but because of the subsidies he only pays... $9,500 per year, 9.5% of income. Because of his age, his insurance should cost quadruple what mine does, but 1) the law requires insurance companies charge no more than triple, AND 2) the subsidies make it so that he and I pay the same. Why should I have to pay the exact same at age 30 as the 59-year old guy next to me who has the same income I do? We're paying the same amount for something that should cost him 4x more. Obamcare is saving me $500 as a 30-year old while saving the 59-year old with the same income as me $30,500.

    Because the older you are, the more super special privileges and handouts you should have, according to American laws.

    Whatever is changed, older people need to pay more than younger people, and richer people need to pay more than poorer people. This means Medicare benefits need to be dialed back and contributions into the system need to take into account a combination of income AND age.
    This is absurd. I earn 6 figures and there are zero subsidies and I am 53. LOL Most middle age folks who are established in good careers have never received anything for free or a break in their lives. I pay more in taxes than some will ever earn. We were looking to semi retire and move somewhere warm and was very excited about the ACA...until I checked into it. I checked the exchanges and private insurers and the premiums were 1000 without subsidies for a decent policy I could actually benefit from. I would love to see the link, where middle age people earning 6 figures are eligible for subsidies and premiums that you described. If that is the case, Obamacare would go broke since middle age folks now are the tail end of the boomers and earning good salaries and paying most of the taxes in this Country.

  7. #47
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by NeoVsMatrix View Post
    funny thread title you picked to describe this " obscurity (which seems to be common in a lot of places though, as per the repsonds).

    Funny, because it's also the general principal of ANY health insurance. you pay NOW, and receive care later, when you need it.

    Most people have accepted and embraced this principle now when it comes t retirement, saving today for an event that will only happen decades / years from now.
    But for some reason, when it comes to health care, people still feel someone is trying to "trick them" out of their money.

    Retirement is a FACT.. except you die before you reach your retirement age. That you will need money to support yourself, when you have no more steady income, is also a fact. and people adapt to it.

    Getting sick, with age, is a FACT.. except you die before you get sick. That you will need money to pay for treatment when you're sick is also a fact. Yet people still don't want to adapt to it in this country.
    Absolutely not true. Every policy is written on an annual basis, and priced thusly. Young, healthy people are not "prepaying" costs they may someday incur as older, sickly people.

  8. #48
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    Quote Originally Posted by HCProf View Post
    This is absurd. I earn 6 figures and there are zero subsidies and I am 53.
    Is that because you earn over 400% of the poverty level (I've called out this idiotic arbitrary rule before)?

    In places where costs are higher, this is an issue. The actual premium pricing varies based on age, but what a young and old adult would actually pay on the exchange, all other things equal, would be the same. One's driving way more of the costs, both pay the same.

  9. #49
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by HCProf View Post
    My husband works for a large company and we had wonderful insurance until 3 years ago. Our deductible was 250.00 each, today it is 3K each. His payroll contribution increased gradually over the last 3 years from 120.00 every two weeks to 225.00 every two weeks. I think insurance companies are making up for the preventative care that now must be covered at 100% by raising the deductibles for care with a definitive diagnosis. This is one of the reasons I will not go for many of my screenings such as the colonoscopy...one polyp and with the diagnosis of diverticulitis and my deductible kicks in. I can afford it, but it is a matter of principle to me...I don't want every dime of my disposable income to go into healthcare and taxes since I am in my early 50's now. How can you sustain the economy when your big expenses are healthcare and taxes? I told my Doctor on my last physical when she was pressuring me to get the colonoscopy because of the diverticulitis....sometimes you have to roll the dice and see what happens, we have no control over our healthcare expenses and I refuse to put our life together in debt over it. The way I see it clearly now...whatever happens, I had a nice run the first 50-60 years, all good things will eventually end. Our healthcare will eventually become so expensive we will all have to make life or death decisions to sustain our families. I don't see any relief in from this in my lifetime.
    This is an inevitable result of the private, for-profit system we have now, and it clearly works terrible hardships on almost everyone.
    Thanks from Friday13 and labrea

  10. #50
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by Neomalthusian View Post
    Is that because you earn over 400% of the poverty level (I've called out this idiotic arbitrary rule before)?

    In places where costs are higher, this is an issue. The actual premium pricing varies based on age, but what a young and old adult would actually pay on the exchange, all other things equal, would be the same. One's driving way more of the costs, both pay the same.
    No, prices do not vary by age. Not in a group policy purchased from the employer.

    You seem to be arguing that some variation of cash and carry is the only rational basis on which to sell insurance. People should pay approximately what actuaries predict their health care will cost, plus a profit margin.

    That's not even insurance! There's no risk spreading at all in your regime. Universal health care means none of us bears anything like the entire costs of our care, due to savings achieved and funding from higher taxes extracted from the rich.

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