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great article on healthcare

Old 11-01-2009, 10:02 AM
  #11  
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Trust me I hate insurance companies. However I hate the iron fist of the government more. Everything the government touches, either goes bankrupt or fails. There is no way I want them involved, in any way, with my health care.

I have a friend who is in the 15% who can't afford insurance, but makes too much money to qualify for Medicade. He recently had a major injury requiring surgery. The bill came in and it was pretty large. When he talked to the doctor and explained his lack of insurance and the fact he was paying cash, the doctor and hospital lowered his cost just like the example you gave above. All of this solved without a single insurance company or government agency involved.

I still believe, people taking care of themselves is a better system than the government taking care of them.
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Old 11-01-2009, 08:17 PM
  #12  
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Originally Posted by hindsight2020 View Post
Problem with the cash option is, the system is an extortion racket. Costs are out-of control.

Wife went into a clinic to deal with a fever and verify whether or not it was H1N1 so we could isolate her as applicable. We thought "yea a clinic is much more sensible than an ER, as she's not dying and we could probably save money". Well, goes in, gets a nose swab, one blood draw and gets told she doesn't have H1N1 but a generic virus. Gets some Tylenol and a Rx for antibiotics (unnecessary but whatever) and sent home.

Bill arrives 3 weeks later. $400. ***. There is no reason that visit should cost that much. They settle with my insurance provider (tricare) and the bill gets settled to $116. ***. Tricare subrogates $20 out of pocket to me, YET assigns none of it towards the yearly deductible, and the facility was in-network. Had it been out of network, the difference between 116 and 400 would have been added as out of pocket. ***.

As you can see, it's not about plans or HSAs, it's about outright costs and rent-seeking (doctors, nurses, administrators and insurance industry) in the healthcare industry. I consider tricare to be an alright option for insurance, but the moral of the story is that if the freggin' facility had billed me $116 instead of $400 I wouldn't need insurance in the first place!!!! This is the crux of this whole debate. I could have covered this visit with one month premium, which would put me ahead of the curve at the end of the year. As it stands, these plans are de facto catastrophic plans, and they pick and choose what is catastrophic expenses and what are yearly deductible expenses, at their convenience, ergo it's a racket.

Again, I say this recognizing tricare is not a bad option available, and I am content with having govt subsidized insurance, but for the millions of folks getting reamed with worse private plans this is just another illustration of our broken system.
That is a really interesting incident you had. Should she have gone to the ER the costs would really be extortion. I, personally, believe that the real culprit to rising costs is the fact that there is someone that will cover the costs, or at least most of it across the board. Insurance companies, or even tricare (and I realize the benefits, but...) create an artificial demand for care. If a large entity controls the demand, they can push prices off on a minority group (which in some cases are the 'cash' customers) - the effect really distorts the market. It just so happens that the government will create a very large demand for it, even more so than insurance companies. All of this combined with gray lines of morality (should we treat those who can't pay for it? or which medication is really needed?).

My sister had tested positive for the 'swine flu' as did most of her summer camp. Not to put on a tin-foil hat again, but the prescription costs $100... and is 'essential' for each member of her house. She kicked it, as did all of her summer camp, within a week or two.... many did without the prescription...mostly because they really couldn't afford it at the time (imagine a family of 5.....one gets it and the bill is $500 for Rx and let's say $100 for the doc visit)

I think the real problem isn't healthcare costs going up - it is that someone will consistently pay for rising costs. Many people like to put rising health care costs into apocalyptic terms.... 'spiraling out of control' ... but just like oil, if market forces are left to themselves it will come down. An example of this is laser-eye surgery...or even plastic surgery. The costs initially were insane... but because few insurance companies would actually pay for it, a flatline demand cause prices to enter realistic terms. It still may be high but for things like malpractice insurance, etc.
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