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More between the lines: Half of Americans know they're under-insured and haven't done/can't do anything about it. A deeper cut is that some Americans are just

by parsimo2010 6y ago

More between the lines: Half of Americans know they're under-insured and haven't done/can't do anything about it. A deeper cut is that some Americans are just rolling the dice, they could afford better insurance but choose not to, even though after they got hit with a huge bill they would probably say something like, "in hindsight I probably should have paid the higher premiums for better coverage and could have taken a vacation to Missouri instead of Europe." But there are also a lot of Americans that may not be able to afford higher premiums, even if they were better at budgeting. And then politicians pick and choose which group of people they use as examples when talking about the healthcare system, depending on their goals/party. The truth is that both of the previously mentioned groups exist and get screwed if they have an emergency. It's a easier to say "tough luck" to the first group that was rolling the dice, but I would love to see actual change in the healthcare system. I did my dissertation research using insurance claims data, so I've seen the actual amount of money that's changing hands and it's ridiculous. Even if normal people were able to get the negotiated rates that the insurance companies get, most families could not afford a surgery and week long hospital stay. I don't know exactly what the solution is, but I think one of the main roadblocks is that there are some people making a bunch of money and they are quite happy with the way everything works right now.

bigdubs 6y ago
Related to this is the cost of care in the United States versus the outcomes is completely out of band of the rest of the world. So not only are you trying to budget for expensive healthcare, that expensive healthcare doesn't get you better outcomes on average anyway.
43920 6y ago
> I did my dissertation research using insurance claims data Is your research published publicly anywhere?
- parsimo2010 6y ago
  It is currently embargoed and the raw data will never be released because of HIPAA. I didn't focus on the costs, so even when my dissertation is published next year the costs won't be discussed. It's just one of those things that I couldn't help but write a quick query because the information was present. There were a few extreme cases where a person had over 10,000 claim lines in a single year at a cost of millions of dollars. And insurance actually paid, because I only saw adjudicated claims. But a more typical person has a dozen or so claims costing maybe a thousand dollars in a year. There are also people that go years without a single medical encounter, but as soon as they need treatment for something it tends to be an expensive year. The issue I see is that most people probably don't have good enough savings habits to be able to afford basic healthcare if they don't have their premiums on autopay or pulled out of their paycheck before they have a chance to spend it. So although most people could save $1k in a year, insurance is like a savings account that you have to make deposits to and can bail you out if you really need more.

bigdubs 6y ago

Related to this is the cost of care in the United States versus the outcomes is completely out of band of the rest of the world. So not only are you trying to budget for expensive healthcare, that expensive healthcare doesn't get you better outcomes on average anyway.

43920 6y ago

> I did my dissertation research using insurance claims data Is your research published publicly anywhere?

parsimo2010 6y ago
It is currently embargoed and the raw data will never be released because of HIPAA. I didn't focus on the costs, so even when my dissertation is published next year the costs won't be discussed. It's just one of those things that I couldn't help but write a quick query because the information was present. There were a few extreme cases where a person had over 10,000 claim lines in a single year at a cost of millions of dollars. And insurance actually paid, because I only saw adjudicated claims. But a more typical person has a dozen or so claims costing maybe a thousand dollars in a year. There are also people that go years without a single medical encounter, but as soon as they need treatment for something it tends to be an expensive year. The issue I see is that most people probably don't have good enough savings habits to be able to afford basic healthcare if they don't have their premiums on autopay or pulled out of their paycheck before they have a chance to spend it. So although most people could save $1k in a year, insurance is like a savings account that you have to make deposits to and can bail you out if you really need more.