5 ms·

Well, that's not traditionally how health insurance works in the US, but it's how all types of "insurance" should work - it should not be for routine costs. Ins

by ploxiln 11y ago

Well, that's not traditionally how health insurance works in the US, but it's how all types of "insurance" should work - it should not be for routine costs. Insurance, generally, should be for unlikely unexpected costs. Otherwise, it's just involving an extra middle-man in payment, and that middle-man is going to make a profit. It's unfortunate that in the US, even for completely routine medical costs, you can't skip the middle-man, because prices are hidden and fake, and the real prices are negotiated between the middle-men and the medical provider (as well as which tests or procedures are allowed, under what conditions). I think the fixation on "everyone should have good health insurance" is making this dysfunctional situation permanently unfixable.

lotsofpulp 11y ago
Yes, it's funny to me how so many educated adults are in this conversation, when the problem is mostly political. On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). A significant portion of the same population also believes that everyone should stand on their own two legs and that offering healthcare to all via increased taxes is socialism. Conclusion: We end up with a system where all costs are distorted and people are given this illusion that they buy access to subsidized health care (aka health insurance), but they get to satisfy their egos by pretending to deserve the health insurance they have and they get the satisfaction of knowing that their neighbors aren't getting free handouts from their taxpayer money. Side benefit for employers: You get a trump card over an employees' mobility because the best value for health plans is via health insurance plans tailored for employers, ideally white collar due to the type of work.
- fpgeek 11y ago
  > On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). Or out of simple self-interest. Having health insurance doesn't guarantee you'll always show up at an ER capable of demonstrating to the hospital's satisfaction that you are insured, with the necessary documentation (e.g. after a car accident or a mugging).
  - DrScump 11y ago
    by law, emergency care has to be provided without regard to the patient's proof of ability to pay. This is part of why so many emergency rooms close.
- howlin 11y ago
  > On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). No. It's a sign of national pride to have a country where people aren't left to die in the streets. In fact, countries with higher levels of social services such as national healthcare are also more irreligious than the countries where people do in fact die in the streets.
- pbreit 11y ago
  howlin: People never or almost never "die in the streets". That's just scary FUD, not reality.
  - howlin 11y ago
    They certainly do in many parts of the world. I personally saw the dead body pickups in India. Seems like the parent aspires an American health care system more similar to the developing world.
    - stickfigure 11y ago
      Oddly enough, the American health care system is so broken that for many people that would be an improvement. https://en.wikipedia.org/wiki/Medical_tourism https://en.wikipedia.org/wiki/Medical_tourism
simoncion 11y ago
> I think the fixation on "everyone should have good health insurance" is making this dysfunctional situation permanently unfixable. Nah. Every citizen should have good health insurance that requires no out-of-pocket expenditures. There should be one plan, available to every citizen. There should be one payer, the Federal Government. Anything else is a recipe for price-gouging and ballooning costs.
- ploxiln 11y ago
  but see, that's not "insurance"
  - quadrangle 11y ago
    right, it's "care", and otherwise the sentiment is correct
  - simoncion 11y ago
    With the exception of catastrophic coverage plans, neither is what we call "health insurance" in the US. :)
- MCRed 11y ago
  And what will happen is you will not get much health care. Certainly much less than you got in 2005, for much more than you paid in 2005. Insurers routinely pay out over %100 of premiums in claims. Meanwhile government programs with benefits- like welfare- blow %75 of their budget on overhead and only pay out %25. Economics is like physics. You can wish it wasn't so. You can look at optical illusions, but the reality is always there.
  - dmitriy_ko 11y ago
    > government programs with benefits- like welfare- blow %75 of their budget on overhead and only pay out %25 That's hard to believe. Source?
    - Frondo 11y ago
MaysonL 11y ago
See direct primary care (not available everywhere) for a partial solution. https://en.wikipedia.org/wiki/Direct_primary_care https://en.wikipedia.org/wiki/Direct_primary_care
pbreit 11y ago
Correct. These days, in the US, at least, it's more of a payment plan with an insurance component than true insurance. I think we've even sort of stopped referring to it as insurance and usually call it "health care" or something.
sliverstorm 11y ago
"Not for routine costs" and "high deductible" are hardly the same thing. You can conceivably have a $0 deductible for treatment and no coverage for routine prevention. Thus, you pay nothing when you break your arm- it was unlikely and unexpected- and you pay full cost for checkups. (Of course, that creates a bit of a perverse incentive, nudging you to skip preventative care and lean on treatment)

by ploxiln 11y ago

lotsofpulp 11y ago

Yes, it's funny to me how so many educated adults are in this conversation, when the problem is mostly political. On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). A significant portion of the same population also believes that everyone should stand on their own two legs and that offering healthcare to all via increased taxes is socialism. Conclusion: We end up with a system where all costs are distorted and people are given this illusion that they buy access to subsidized health care (aka health insurance), but they get to satisfy their egos by pretending to deserve the health insurance they have and they get the satisfaction of knowing that their neighbors aren't getting free handouts from their taxpayer money. Side benefit for employers: You get a trump card over an employees' mobility because the best value for health plans is via health insurance plans tailored for employers, ideally white collar due to the type of work.

fpgeek 11y ago
> On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). Or out of simple self-interest. Having health insurance doesn't guarantee you'll always show up at an ER capable of demonstrating to the hospital's satisfaction that you are insured, with the necessary documentation (e.g. after a car accident or a mugging).
- DrScump 11y ago
  by law, emergency care has to be provided without regard to the patient's proof of ability to pay. This is part of why so many emergency rooms close.
howlin 11y ago
> On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). No. It's a sign of national pride to have a country where people aren't left to die in the streets. In fact, countries with higher levels of social services such as national healthcare are also more irreligious than the countries where people do in fact die in the streets.
pbreit 11y ago
howlin: People never or almost never "die in the streets". That's just scary FUD, not reality.
- howlin 11y ago
  They certainly do in many parts of the world. I personally saw the dead body pickups in India. Seems like the parent aspires an American health care system more similar to the developing world.
  - stickfigure 11y ago
    Oddly enough, the American health care system is so broken that for many people that would be an improvement. https://en.wikipedia.org/wiki/Medical_tourism https://en.wikipedia.org/wiki/Medical_tourism

simoncion 11y ago

> I think the fixation on "everyone should have good health insurance" is making this dysfunctional situation permanently unfixable. Nah. Every citizen should have good health insurance that requires no out-of-pocket expenditures. There should be one plan, available to every citizen. There should be one payer, the Federal Government. Anything else is a recipe for price-gouging and ballooning costs.

ploxiln 11y ago
but see, that's not "insurance"
- quadrangle 11y ago
  right, it's "care", and otherwise the sentiment is correct
- simoncion 11y ago
  With the exception of catastrophic coverage plans, neither is what we call "health insurance" in the US. :)
MCRed 11y ago
And what will happen is you will not get much health care. Certainly much less than you got in 2005, for much more than you paid in 2005. Insurers routinely pay out over %100 of premiums in claims. Meanwhile government programs with benefits- like welfare- blow %75 of their budget on overhead and only pay out %25. Economics is like physics. You can wish it wasn't so. You can look at optical illusions, but the reality is always there.
- dmitriy_ko 11y ago
  > government programs with benefits- like welfare- blow %75 of their budget on overhead and only pay out %25 That's hard to believe. Source?
  - Frondo 11y ago

MaysonL 11y ago

See direct primary care (not available everywhere) for a partial solution. https://en.wikipedia.org/wiki/Direct_primary_care https://en.wikipedia.org/wiki/Direct_primary_care

pbreit 11y ago

Correct. These days, in the US, at least, it's more of a payment plan with an insurance component than true insurance. I think we've even sort of stopped referring to it as insurance and usually call it "health care" or something.

sliverstorm 11y ago

"Not for routine costs" and "high deductible" are hardly the same thing. You can conceivably have a $0 deductible for treatment and no coverage for routine prevention. Thus, you pay nothing when you break your arm- it was unlikely and unexpected- and you pay full cost for checkups. (Of course, that creates a bit of a perverse incentive, nudging you to skip preventative care and lean on treatment)