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Epic
 

Registered: Apr 2011
Posts: 932

 

08-24-12 07:04 PM

I don't think you are being completely fair. There are a lot of people who are familiar with the health care industry. It is fairly obvious to me that the pricing mechanism is broken, not the payment mechanism.

I don't at all agree with the premise that our system is "too sophisticated" to allow people to have an active role in determining pricing. Frankly, it drives me crazy that consumers have handed over all responsibility to insurance companies who don't always have proper motives. Our system provides massive incentives for waste.

It is simply untrue that insurance companies do an incredible job at negotiating pricing. The do an incredible job at establishing their premiums at a point where even with a wasteful and mis-priced system, they will still be able to make money. They are great at avoiding covering the catastrophes that people really need coverage for, while completely covering runny noses and sore throats that people should be paying 100% out of pocket for.

IMO, when it comes down to it, the biggest problem with our health care is a broken pricing system that has the consumer too far removed and uninformed regarding the cost of consumption.

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piezoe
 

Registered: Jan 2006
Posts: 4924

 

08-31-12 08:36 PM

I quite agree with Epic that among the many defects in the unacceptable U.S. healthcare paradigm is the pricing mechanism. We have more or less endless debate over ways to pay but way too little debate on how to bring prices down to levels consistent with other industrialized countries.

To add to the overall debate I want to throw out some additional food for thought. And this is something that I have not seen much discussion of.

In the U.S., a typical citizen either pays simultaneously for BOTH private medical insurance -- directly,or indirectly via an employer-- and for medicare for ones entire working life, right through retirement up until death. After retirement medicare supplemental insurance replaces the policy that protected one during one's working years, and medicare payments continue right up to death (they don't stop upon reaching age 65 as the naive would suppose!)

If you add all this together and include any reasonable amount of compound interest your going to come up with a large number, roughly in the neighborhood of 1 million dollars -- a little more, a little less depending on circumstances.

I believe the NY Times had an article for which they had calculated typical medicare contributions over a lifetime. They also found that by far the largest medical costs accrued during ones final months of life, and that was something on average in the neighborhood of $500K. (I'm recalling this from memory, so there could be some errors here.) Anyway, I think the conclusion was that it was these last few months that were the main cause for a medicare shortfall.

My thoughts on this are that something is drastically wrong:

1. We are already contributing what should be enough on average in 2012 dollars (~1 million!) for a lifetime of top notch medical care;

and,

2. There is a huge, unrecognized subsidy of the private insurance companies by U.S. tax payers. The insurance companies are, by and large, insuring the low risk years up to age 65 with high premiums, and providing only limited supplemental coverage during the higher risk years after age 65, at lower premium of course, whereas the taxpayer is assuming nearly all the risk during the high risk years!

All I can say is, WOW! what a good deal for Blue Cross and Blue Shield!!!

(I'll try to find a link to the NY Times article)

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piezoe
 

Registered: Jan 2006
Posts: 4924

 

08-31-12 09:18 PM

I think I must be wrong about the number above, ~1 million, for total lifetime contribution plus compounded interest to medicare and private medical insurance premiums. It's a high number but not that high. Also it is quite income dependent. I am trying to track down the correct numbers. I can't locate, so far, the Times article I recall reading.

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