The problem with health insurance and health care

[Nikia]

When I took an economics class in college, we were discussing pricing and how things are valued differntly and what consumers are willing to exchange for their labor or other goods in terms of widgets and steaks. I said "Well, this all makes sense with steaks and widgets but what about health care. Whether a person has 2 widgets or 100 widgets, he or she is willing to exchange them all for his or her own life. Economics assumes selfishness and ultimately ones own life must be one's ultimate value in this system." He said that I was right but that health care is very complex. That is the problem with health care pricing and why health care costs and health insurance prices can be so high. Who would not pay to save one's own life or one's child's life whether one is extremely poor or has all the money in the world? To offset the possibility of high health care costs, we have health insurance. Health insurance premiums are able to raise prices every year and people will pay them. They say that it is because costs go up, but what other industry has the luxury of being able to raise prices whenever they feel the need. My industry is currently undergoing an increase in the costs of doing business, but prices on our end cannot be raised as much because sales would decrease as people would be unwilling to pay for the price increase. Everyone who can afford it is willing to pay an increase in health insurance because no one wants to be let die.
This is why I support national health care.

[Yavin4]

1. Your Argument Is Why Market Solutions Don't Work With Health

Care.

You go to a car dealership, get a price, and you later shop around for a better deal. You go to a doctor, and s/he tells you that you have cancer. Are you going to shop around for a cheaper treatment deal?

Health care is a basic human right. To let someone die or become ill just because their job doesn't offer health care is barbaric, and trust me, if this nation doesn't go to a national health insurance system soon, the people will revolt.

[Nikia]

3. Right

I don't see how it can work in a free market system. Every dollar of profit means that someone was charged too much for their health care or didn't receive the best treatment. The result in this is that people die or suffer more than necessary. To those with enough money, this is often not a problem. To those without enough money, it is a big problem. It makes me nervous that the doctor and the hospital have confirmed my insurance and where I work everytime that I have gone in for treatment. I know that the insurance is necessary for billing which makes me wonder if I would be refused treatment if I didn't have any. As far as place of work (They also know my occupation as I had to write that down before.), I often wonder if that is a measure of my ability to pay as well. It makes me wonder if my treatment is contigent on that and what would have happened if I wrote down Walmart. I also wonder if I have gotten better treament since I paid one of my hospital bills with a platinum credit card. Is it even safe to be deliquent on a medical bill if you should need care again?

[davsand]

2. There is a major flaw in viewing health care as a commodity.

That flaw is that you don't choose to get sick, and you don't really have the leisure of shopping for the best prices.

The average person gets sick and goes to a Doctor or they get in an accident. Either way, we don't have the option of shopping around for competative prices. When you couple that with the fact that many insurance plans prohibit patients from going "out of network" or that in some areas there is no competition it makes it even worse.

Now, add in the fact that many of the uninsured get charged higher prices for those same services (because insurance companies get "negotiated rates") it makes it even more difficult to ever see a day when health care can be viewed as an open market type thing.

Something that really frosts my butt about the entire health care system is that local hospitals are usually given property tax exemptions because they are seen as an "asset" to the community. So they are not only raping poor people along with the rest of us, but they are essentially supported by the local communities while they do it! (The argument that renters don't pay property taxes doesn't fly either given the fact that taxes are reflected in the rent they pay--it is viewed as one of the operating expenses... We ALL are propping up this sytem and we are getting little in return.)

I can't go into details on it right now, but watch the national newspapers in the next few days about this issue. There are a couple articles that will be front page that are going to illustrate this whole mess. I know this because I've been involved in this fight for the last 18 months and I've been working with the reporter.

Laura

[Clete]

4. Besides not choosing to get sick, eventually you will get

a chronic disease that will be the catalyst of your dying. This is why health care and insurance are compatible. Insurance is there to take care of accidents. It is based on the premise that there will be fewer accidents that they have to pay for than the premiums they collect. Hence, this is why they insure healthy people.

Deteriorating health is not an accident, It is a given and it doesn't always happen in old age. Also attaching health care to employment is ludicrous. Children, who could have a debilitating disease, aren't employed. Often their parents don't have benefits. There is a patchwork of help out there, it is inefficient and needs to be replaced with a single payer system.

[davsand]

6. Oh, exactly!

What makes that even worse is that if you are uninsured, typically you do not seek medical care until a problem has become critical. So any problem you had that MIGHT have been prevented or minimized with early treatement is going to become really bad before you even get it treated. Forget about preventative care altogether!!

It is not too shocking that uninsured people die a lot younger than people with health insurance.

We have no choice, IMO. Our nation has GOT to move to a single payer plan and it has got to happen sooner rather than later. The insurance lobby is so strong and holds cards on both parties so it is not going to happen easily.

There is an avenue that we can take in the meantime, and that is local challenges to property tax exemptions until the hospitals privide an acceptable amount of charity care or programs for poor patients. Up to now they have been allowed to slide on this exemption and they have done squat to either earn it or even justify it.

Again, I say watch the national newspapers in the next few days.

Laura

[Nikia]

5. There does seem to be a sort of monopoly

My health insurance will only pay for medical expenses if I go to their doctors. In my small town, that is one clinic with six doctors who all charge the same price. I was shocked to find out that this clinic charges uninsured people over $100 to see one of these doctors. The local hospital is also affiliated with this insurance although they will accept other insurances. They do give discounts to people with the right insurance. In the nearby small metropolitain area, which is dominated by two HMOs, there was an article on two doctors that decided to go out on their own. Everyone interviewed in the local health care industry said how it was a bad idea. In such an environment, it is a bad idea since they cannot refer patients to network affiliated specialists. On the otherhand, they are charging half the price of the network doctors and can make their own decisions.

[Feanorcurufinwe]

7. My personal experience seems to contradict one of your points.

I haven't had health insurance for many years. Everytime I purchase health care I get charged, less, not more than someone with insurance. I've received discounts of up to 70% for some things. Without insurance you are also less likely to be presribed unnecessary medications and procedures.

You are better off taking the money you would pay in premiums and just putting it into a bank account dedicated to health care.

[soupkitchen]

8. Well, my experience is just the opposite.

Why it is true that a cash payee won't get as many procedures recommended to them as a "covered" person, this is only a good thing if you don't need the procedure.
Recently I was billed by mistake for a procedure that was already paid for by my insurance. The insurance company paid $210.00. The hospital billed me for $350.00
And as far as I'm concerned the differnce between what insurance companies pay for procedures and what cash payees pay is one of the most flagrant examples of the inequities inherent in the health care system.
While certain cost advantages can be attributed to Insurance Companies creating greater efficencies, the reality is that hospitals price gouge cash payers. For a few reasons: One) is they can get the money great, and two) if they don't get paid they can claim greater losses.
In fact, I think the first simple step to putting some logic into this system is to put a "cap" on how much more than insurers cash payees can be charged. Remember a lot of medical procedures really can't be "cost quantified" What does an MRI cost? Well, that partially depends upon how many MRI's one get out of a machine, and that won't be determined for years and years. (Yes, I know the machine can be depreciated for tax purposes, but it can still be used after the depreciation expires.)
Anyway I don't think the $140.00 difference between what my insurance company paid and what I was being charged can in anyway be justified.
And is indicative of the greedy illogic of the system. But I also think it is an inequality that can addressed by legislative action. Sometimes the answer to things boils down to simple fairness.

[ikojo]

9. I hope you don't get cancer or any other

disease like lupus or multiple sclerosis. I don't think most people, other than the very wealthy, have enough money in the bank to pay for healthcare related to an ongoing disease.

I work for an insurance company and even with a 70% discount, drugs used for MS are EXPENSIVE. Let's not even talk about chemotherapy drugs. Then there are the tests and the doctors charges for INTERPRETING the tests performed.

Those who are relatively healthy and see the doctor maybe once a year can say things like "You are better off taking the money you would pay in premiums and just putting it into a bank account dedicated to health care." Given that an average premium without employer assistance is $200-$500 per month, there aren't many people (again other than the wealthy) who can afford to sock that much money away. Anyway, even at the high end for a premium on a single person, that would be only $6,000 per year and that is not even enough to cover one day in the hospital for most conditions.

Social Darwinism is not the way I would like to live.

[Nikia]

10. Could you give more details?

Where do you live? Is health care in your area dominated by networks or are there independent doctors? Is the hospital independent or is it affiliated with a network? Like I said, my insurance covers treatment that I receive at a particuliar clinic (with my $20 copay) and other affiliated clinics in other nearby cities. It covers many medical tests completely although it considered my colonoscopy and upper GI that I had earlier as surgery and charged me as such. The doctor's office that I go to charges uninsured people over $100, which I found out from a coworker whose live in boyfriend went there. I have no idea what they consider my cost. When I lived in Ohio seven years ago, there were no HMOs in my small city and all the doctors were independent. Most people had insurance that allowed them to see any doctor. I suppose that some of these doctor's offices might have given a discount to people who provided cash up front rather than having to wait for the insurance payment. The price of my doctor's office visit then was only $27, which is somewhat affordable, and he could always be seen on the same day as you called.
I hope that you do not develop a serious health problem in which you might need some medications and procedures, which you now consider unnessary. Some diseases when detected early can be better treated than when your illness become obvious. I am also thankful that I was able to be perscribed expensive antibiotics which cured my sinus infection which I suffered with for over a year. Maybe you will be instistant upon these things if you become extremely ill. I hope that you have money to back up your right to treatment. Don't think that some doctors aren't evaluating your ability to pay when they make decisions about your health and perhaps even your life.

[maha]

11. That's way not the norm.

Your experiences may be affected by your age and where you live. You say you get "discounts" -- AARP? Senior citizen? Are you on Medicare?

As far as where you live -- My ma lives in rural Missouri and the costs of basic doctor visits and even hospitalization are WAY below the national average there. Young people there with average income might be able to get away with not having insurance as long as nothing catastrophic happens.

In New York, on the other hand, most physicians will charge you at least $100 just for walking in the door, and then if they actually DO something, like use a stethoscope, there's more charges over that. A simple "well baby" visit may end up costing $200-300 dollars per child. So if you don't have insurance or a LOT of money, you don't go to doctors unless you think you are gonna die.

"You are better off taking the money you would pay in premiums and just putting it into a bank account dedicated to health care." That sounds grand, but it's not realistic for most people, and could be dangerous. Several years back my son broke his arm -- just broke his arm, mind you -- and the eventual bills added up to something in the neighborhood of $15,000. I'm sure today it would be closer to $20,000 for a damnfool broken arm.

Most working people don't have enought income to allow them to keep several thousand dollars stashed away for emergencies like that.

But then, most working people couldn't afford to pay for individual health insurance, so if they aren't getting insured through their jobs, they are probably not insured at all.