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I am an Oscar subscriber. I'd like to think I'm the ideal customer. I have autopay so they take my money each month. I am healthy and haven't used any benefit

I am an Oscar subscriber. I'd like to think I'm the ideal customer. I have autopay so they take my money each month. I am healthy and haven't used any benefit. Apparently I'm one of just 26k people in NJ to subscribe. I honestly believe that at the end of the day nothing can be done about either Healthcare or higher education or anything like that without cutting costs. Anything we can do to reduce cost is potentially good. I want effective salary "cap" above which you'd pay 90% odd tax.

exabrial 10y ago
Yes, the first overhaul with gargantuan regulation change worked so well we should definitely do it again and this time add salary caps for the people removing my appendix: "You make too much money, now work on my body and don't accidently mess up please." And by yes I mean no. We could do something that would actually work: Deregulate the industry, enhance legal protection for healthcare workers (to keep the lawyers from driving prices up again). Let health insurers decide rates and demographics they wish to cover. Legalize discounts for people with healthy habits, and penalties for those who don't have them. And instead of trying to tax the health insurance companies into covering people with expensive health conditions, we could actually fund medicare (instead of both Democrats and Republicans continuously slashing it's payments to healthcare workers). Competition for the "healthy" people would stabilize quickly and insurance companies would be forced to grow profits by creating plans individualised for not so healthy people. Really the only regulation needed would be ones around a couple of moral issues, maybe something like: no dropping people for health conditions that aren't preventable... or have different classes of insurance like the do in the auto industry. One only has to look at how competitive the life insurance market to see this work in action right now. Even with someone that has COPD can get affordable life insurance with after a health screening.
- Rapzid 10y ago
  The US healthcare "overhaul" is like taking a piece of technology, not understanding it, using it incorrectly, and then doing a bunch of hand waving and shouting about how it "doesn't work" all the while ignoring the reference implementations and lessons learned others are using with success. It was a better-than-nothing, sabotaged effort from the start. Still, dat existing condition coverage..
- intended 10y ago
  So, in economics 101, the concept of insurance was clearly explained, and by basic definition, the more fractured the pool the worse the outcome. I haven't really understood why America finds that this law doesn't hold over its population. And I've also looked at outcomes and found that once you start looking at costs/bed and patient coverage, any other first world country with a working single payer system provides significantly better outcomes. The things that America does better are things like cutting edge cancer care, or cutting edge X treatment, but these are accessible to the richest of the rich (and I've seen family members who can afford it vs family members who can't - we are talking 1% of a nation). So why do things like "make plans for not so healthy people" come up as concepts. The probability for a non healthy person to get sick is 1. At this point its like a scholarship to go to get medical care. If I were a medicare company, I would instead keep shafting the healthy people, fight tooth and nail to keep that population, and call it a day. For the sick people - why bother? (1) I really don't get America when it comes to this (and many other things, which you guys used to be world leaders in) Why? And edit: And to prevent (1), you would have to create regulation, something expressly disagreed with in the parent comment. Matter of fact, when I have pursued this with others or read threads, people come up with yet more complex market systems to deal with the skewed incentives, in order to avoid regulation.
  - deleted 10y ago
    [deleted]
  - cronjobber 10y ago
    > economics 101 ... the more fractured the pool the worse the outcome. You're probably (I don't know) talking about large insurers being able to aggregate non-correlated risk into a nice non-risky positive expectation of profit. But of course econ 101 loves nothing more than to look at the margin, and if the marginal client simply lowers expected profit, you better fracture him out. But you clearly know that, so what are you talking about?
    - intended 10y ago
      Right - and that's why insurance is discussed as the extra-ordinary case where the normal market rules result in worse outcomes. More competition results in a worse functioning market. Therefore for ideal outcomes you don't create separate insurers, and no one moves out. My question isn't on the economics, to be honest. My question is on the weird cultural idiosyncrasy. I don't really understand that (and by that I mean I understand its "political", but the math and success of it is pretty clear, so how is the topic successfully made confusing). That's the real magic at play, and thats what I'd like insight about.
- rdtsc 10y ago
  > Deregulate the industry ... Let health insurers decide rates and demographics they wish to cover. You seem to have a detailed plan. Do you know of any example countries where healthcare went that route successfully?
- pjc50 10y ago
  > And instead of trying to tax the health insurance companies into covering people with expensive health conditions, we could actually fund medicare Assuming you mean "expand medicare to cover everyone so that people with expensive conditions aren't left to die in the street", this is .. the UK system. Insurance becomes an optional extra for people who don't want to wait and want more than the necessary minimum of attention. Everyone else gets care if they need it.

exabrial 10y ago

Yes, the first overhaul with gargantuan regulation change worked so well we should definitely do it again and this time add salary caps for the people removing my appendix: "You make too much money, now work on my body and don't accidently mess up please." And by yes I mean no. We could do something that would actually work: Deregulate the industry, enhance legal protection for healthcare workers (to keep the lawyers from driving prices up again). Let health insurers decide rates and demographics they wish to cover. Legalize discounts for people with healthy habits, and penalties for those who don't have them. And instead of trying to tax the health insurance companies into covering people with expensive health conditions, we could actually fund medicare (instead of both Democrats and Republicans continuously slashing it's payments to healthcare workers). Competition for the "healthy" people would stabilize quickly and insurance companies would be forced to grow profits by creating plans individualised for not so healthy people. Really the only regulation needed would be ones around a couple of moral issues, maybe something like: no dropping people for health conditions that aren't preventable... or have different classes of insurance like the do in the auto industry. One only has to look at how competitive the life insurance market to see this work in action right now. Even with someone that has COPD can get affordable life insurance with after a health screening.

Rapzid 10y ago
The US healthcare "overhaul" is like taking a piece of technology, not understanding it, using it incorrectly, and then doing a bunch of hand waving and shouting about how it "doesn't work" all the while ignoring the reference implementations and lessons learned others are using with success. It was a better-than-nothing, sabotaged effort from the start. Still, dat existing condition coverage..
intended 10y ago
So, in economics 101, the concept of insurance was clearly explained, and by basic definition, the more fractured the pool the worse the outcome. I haven't really understood why America finds that this law doesn't hold over its population. And I've also looked at outcomes and found that once you start looking at costs/bed and patient coverage, any other first world country with a working single payer system provides significantly better outcomes. The things that America does better are things like cutting edge cancer care, or cutting edge X treatment, but these are accessible to the richest of the rich (and I've seen family members who can afford it vs family members who can't - we are talking 1% of a nation). So why do things like "make plans for not so healthy people" come up as concepts. The probability for a non healthy person to get sick is 1. At this point its like a scholarship to go to get medical care. If I were a medicare company, I would instead keep shafting the healthy people, fight tooth and nail to keep that population, and call it a day. For the sick people - why bother? (1) I really don't get America when it comes to this (and many other things, which you guys used to be world leaders in) Why? And edit: And to prevent (1), you would have to create regulation, something expressly disagreed with in the parent comment. Matter of fact, when I have pursued this with others or read threads, people come up with yet more complex market systems to deal with the skewed incentives, in order to avoid regulation.
- deleted 10y ago
  [deleted]
- cronjobber 10y ago
  > economics 101 ... the more fractured the pool the worse the outcome. You're probably (I don't know) talking about large insurers being able to aggregate non-correlated risk into a nice non-risky positive expectation of profit. But of course econ 101 loves nothing more than to look at the margin, and if the marginal client simply lowers expected profit, you better fracture him out. But you clearly know that, so what are you talking about?
  - intended 10y ago
    Right - and that's why insurance is discussed as the extra-ordinary case where the normal market rules result in worse outcomes. More competition results in a worse functioning market. Therefore for ideal outcomes you don't create separate insurers, and no one moves out. My question isn't on the economics, to be honest. My question is on the weird cultural idiosyncrasy. I don't really understand that (and by that I mean I understand its "political", but the math and success of it is pretty clear, so how is the topic successfully made confusing). That's the real magic at play, and thats what I'd like insight about.
rdtsc 10y ago
> Deregulate the industry ... Let health insurers decide rates and demographics they wish to cover. You seem to have a detailed plan. Do you know of any example countries where healthcare went that route successfully?
pjc50 10y ago
> And instead of trying to tax the health insurance companies into covering people with expensive health conditions, we could actually fund medicare Assuming you mean "expand medicare to cover everyone so that people with expensive conditions aren't left to die in the street", this is .. the UK system. Insurance becomes an optional extra for people who don't want to wait and want more than the necessary minimum of attention. Everyone else gets care if they need it.