Private Health Care, more expensive than I thought

Actually, my public-sponsored VERSUS Private Group/Non-Group COMPARISON is a FIRST.

 

Health care, nor housing, nor food are a right. If you find that unacceptable, then we should look at tariffs on drugs and other medical exports. I agree, we subsidize health care for the rest of the world. And that's wrong, and it distorts costs and comparisons.

 

Bankrupting??????

However, according to CMS, Total Health Care Spending will grow at an average annual rate of 5.4%.

THUS, grow faster than the economy/Faster than Wage Growth. The main culprit of said growth; Medicare.

 

People will use free services more than services where they have to pay. This is no secret.

 

I paid for it for decades, which is why a sob story about others paying into it doesn't move me or make me feel guilty for taking advantage of the benefit now that I'm eligible. Keep paying, and thank you.

 

You paid other people's Medicare, lol. Just like I am now. Because it's a ponzi scheme.

 

I'm not going to bother arguing the "rights" thing. We don't help those in serious need because of some right conferred by government. We give aid because we have moral principles and because we're not just plain stupid.

Your claim that our medical care is more expensive because of the cost of R&D for new solutions just doesn't wash.

The real problem is that capitalism works when there are choices. When it comes to health care, there really aren't that many choices that have any validity. If you are an hourly wage earner you can not pay enough to solve your cancer or have coronary bypass surgery, or even just pay for prescriptions that keep you working to support your family. And, as we've clearly seen there are many many millions who don't have the income to pay the exhorbitant insurance premiums demanded by the insurance companies whose businesses are focused on maximizing profit - because they are capitalist.

Beyond that, I don't believe we are seeing the full cost of our nutty system.

Having every corporation manage healthcare for its employees is a COSTLY direction for our country to have taken. Corporations in other countries don't have to do that. And, here in the US corporations should be focusing on their products and services, not on healthcare.

It would be a rational tradeoff for corporations to absorb a slightly larger tax bill for the privelege of dropping their healthcare benefits and insurance management departments and not paying for insurance. They would have additional revenue to pay employees, they would have a more sound basis for expansion, they could better compete with overseas corporations, etc.

 

We individually do have a moral imperative to help those in need. We just differ about the best way to do it.

BS. It is absolute FACT.
https://www.ibtimes.com/how-us-subsidizes-cheap-drugs-europe-2112662

Cancer is expensive, as is dying in general, and we all have to do it, unfortunately. I wish it were not so. Maximizing profits includes eliminating waste and shopping around, something the federal government is horrible at doing.

There are the triple constraints that apply to health care. You can have:

1) Universal, low quality health care, at a medium price (Cuba).
2) Universal, high quality heatlh care, at a high price (Sweden).
3) Non-universal, low quality health care, at a low price.
4) Non-universal, high quality health care, at a high price.

And variations of the above. When you shift one lever, it moves another. Take your pick. Frankly, the more government intervenes, the less quality or quantity of health care we will all have. Simple economics.

 

The very first example is of a drug company raising the price of a drug from $13.50 to $750!! And, this is only one of a large number of similar cases. Remember the EpiPen case? The life saving injection one could carry, have present in schools, etc., was increased by 550% when someone bought the company for the purpose of getting rich.

RIGHT THERE is the proof that this is not about research. It's about absolutely stupendous profits and has NOTHING to do with research. There is NO CHANCE that even a fraction of that increase had anything at all to do with some major increase in R&D.

Not only that, but our drug research labs that are proprietary make huge amounts of money for their companies. They get the profit that comes from being the leaders in whatever drugs they are creating. If it's something serious like cancer, they could end up owning the solution that millions upon millions of people need. Remember that there are more than 400 new cases of cancer every year per 100,000 humans.

The fact that these companies sell for less in other countries comes from the difference between our system and the systems of other countries.

When someone gets cancer, they do not shop around.

And, the insurance offerings between the major for profit insurance companies are all nearly identical. So again, shopping around is nonsense. Also, these insurers tie up hospitals, labs, clinics, etc., to ensure that their own customers DO NOT have choice. In fact, customers can easily lose all coverage by slipping up on the insurance company rules against shopping around. In fact, you can lose coverage by having your comatose body hauled to a hospital by the wrong ambulance, by needing care outside your coverage area, by needing expert treatment when insurance doesn't cover getting expert treatment, etc.

Capitalism works when there is choice. The level of choice in our system is SERIOUSLY reduced. And, it's topped off by your point that we all die and it is expensive.

That's far too simplistic a statement to be the basis for any imaginable decision. You can't just say "you get what you pay for" and then assume that leads to an optimal purchase decision.

What the USA is in a position to do is to evaluate the success we are having with Medicare (our own single payer system) and the success other countries are having with their systems. We can then create something for ourselves that meets what WE want and what we're willing to pay for.

We can also move to a single payer conclusion in increments by wisely relaxing the requirements for Medicare eligibility.

 

Time to read up on government medical loss ratio rebates.

 

No, it's not proof that we don't subsidize other countries. We do. It's simple economics.
https://thehill.com/opinion/healthc...igher-than-in-the-rest-of-the-world-heres-why

Emotional appeals aren't convincing. Nobody likes cancer and we'd all like to see cures and effective treatments for it. Without a profit to reinvest in R&D, there are no future cures for cancer or other diseases.

 

The fact of the matter here is that not all countries (or individuals) agree with how health care should be handled.

A serious knock against US healthcare is that it is absolutely horrible at healthcare distribution - something other countries value. And, one of the reasons for that is that we promote the advent of stupendously expensive drugs and other medical solutions that drive the cost of healthcare beyond what millions of citizens can afford.

That does make it profitable for Pharma to invest more in R&D. And, they could do even more if we worked to increase the cost of drugs - instead of working to decrease that cost. How high would you suggest that drug costs should be?

But, let's notice that this is NOT the central issue of single payer healthcare.

The real point of single payer healthcare is that everyone gets healthcare.

We would still be free to spend giant sums of money on drugs. And, we would be free to lobby other countries to pay our Pharma industry (and theirs) more money.

Also, we could take an even stronger federal part in medical research than we already do today. Already, the fundamental rsearch that leads to cancer and other solutions originates in these sources - the scientists that come up with the Nobel prize competitive findings that Pharma then uses and/or productizes.

 

The private market provides much more incentive for innovation than government ever will. If you want less innovation, by all means have the government run it.

 

I don't see price competition that is occuring in the dimension that actually affects the decisions people make.

What choices have you made or that you know that someone else made that caused providers to be challenged by price competition?

We can see it in TVs, computers, cars, houses, etc. We see offerings of various dimensions and costs and we see people deciding which features are important enough to them to actually pay for. That choice does drive innovation.

I see little of that in medicine.

 

Didn't look through everything though on the surface looks interesting. I have a question on one of the details. You say traditional Medicare spending is $401B. How did you arrive at that figure?

 

You've never used a generic drug option?

Generic drug options. I agree, though, the networks and consolidation within the medical industry has made it difficult to shop around.

That's a great area that should be improved. I'd like mandated price transparency for ALL medical services to be law.

 

There is little serious opportunity to shop around the insurance companies, and THEY are the ones that manage your healthcare decisions.

As a result, price transparency doesn't really make much difference. The reason is that there are far too many decisions that are made by the insurance companies, not you. And, using that kind of information to choose insurance just isn't possible.

You buy your insurance. They then control the vast majority of your decisions. They decide your hospital. They decide what drugs you get. They decide whether you see a specialist and which one you get. They decide whether your aid car trip to the hospital is covered, and based on what factors the decision is made. Etc.

And, buying insurance is the only rational dierction, because the cost of our health care is are high enough that almost nobody can pay for it on their own, especially if any significant problem is faced.

Multiple studies show that tens of thousands of people are dying in America today because they can't afford the solutions we have for making them well. It's a cause of death that is larger than many well known diseases and it affects people during their working years, as those older usually have Medicare coverage.

That is our distribution problem.

 

Well, in fairness, we do shop for our insurance plan. We choose between carriers, then various HMO's, PPO's, EPO's and POS plans within those carriers. Each of these options offer a wide and varying range of coverage.

We do not say that we do not have a choice in automobiles because we do not choose the various manufacturers of the components that go into those cars. Similarly, we should not say that we do not have a choice in healthcare because the various providers do not give us an individual choice on each component of their extremely complex product offering.

 

I agree with you 100% there. There is a distribution problem. I'm not aware of any countries that have solved this without creating additional problems or having the US subsidize their care. So, if all countries are faced with the health care distribution problem (they are), then the only ones that have "solved" this are the ones that provide universal health care (which creates new problems).

It's all about the tradeoffs. There are unintended consequences and tradeoffs for each form of health care system.

 

I tell you something you won't believe.....approx. 15 years ago, I was working in the Beaufort Sea, partnership, with SHELL. Had a roll over, ended in a small Canadian Hospital, doctors were from South Africa.......6 hours in Emerge, several tests, x-rays, + prescriptions......Final bill $400.....today's dollars, approx. $600 Canadian dollars. Back then, internationally, we were insured with John Hancock. Company ended up paying the bill.

 

Certainly not PROFITS that drives up the cost!

 

Risk and reward. Thankfully, you don't have to pay for failed medical research that results in a drug that doesn't work or can't be approved because of side effects. If a company does that, their investors lose their investment and you have little to do with it.

See the COVID vaccine. With government in charge of pushing a medicine, you bear ALL of that cost.

 

Insurance company profits (assuming that is to what you are referring) are a small percentage of healthcare costs. They certainly are not the main driver in skyrocketing healthcare costs. There are in fact a large number of non profit insurance companies if that is your concern. They are not discernibly cheaper.

 

You really want to know?

A quick calculation.......I didn't want to spent too much time figuring out how many Traditional Medicare beneficiaries have PART D.........Traditional Medicare does not include Part D, however, Medicare Advantage does.

Next.....Based on the following Medicare Advantage numbers/percentages, I figured out Traditional Medicare Total Federal Medicare Spending (Net of premiums).

Over the last decade, the role of Medicare Advantage, the private plan alternative to traditional Medicare, has grown. In 2021, more than 26 million people are enrolled in a Medicare Advantage plan, accounting for 42 percent of the total Medicare population, and $343 billion (or 46%) of total federal Medicare spending (net of premiums). The average Medicare beneficiary in 2021 has access to 33 Medicare Advantage plans, the largest number of options available in the last decade.

https://www.kff.org/medicare/issue-...age-in-2021-enrollment-update-and-key-trends/

Next.....I googled Uncle Sam's Medicare Part D Net Spending; Approx. $100 billion, however, how many Traditional Medicare beneficiaries have PART D?

Phook it!.....exclude PART D, stick with $401 Billion Total Federal Medicare Spending (net of premiums). Gross Average between the two plans, approx. $11,000 per enrollees, I'm happy.

 

True. To me, attempting to compare those options is mind numbing, and I find it hard to see how it is causing price competiion among healthcare providers. So, I doubt that's the kind of decision making that changes the cost of healthcare. It's true that you can find plans that have less coverage and thus pay a slightly lower premium.

But, there are millions who are still left uncovered because of the cost and other issues of insurance policies. And insurance companies aren't interested in that, as they are in business to maximize profit, not maximize customer count. In fact, I'm not all that convinced that rising healthcare costs are seen by insurance companies to be a negative. Their customer count doesn't change much when they raise prices due to some new solution from Pharma gets added to the list that insurance companies more or less have to cover.