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The "resolution" says they "only" have to pay 2.000$ in deductibles and copay now. Just for comparison: a fully-fledged broken leg operation costs 3.000€ for n

The "resolution" says they "only" have to pay 2.000$ in deductibles and copay now. Just for comparison: a fully-fledged broken leg operation costs 3.000€ for non-insured people in Germany. Isn't insurance supposed to bring things down to 0$ instead of copays that still surpass the actual cost?

arethuza 6y ago
I don't even know what deductibles and copays are! Edit: Of course I could Google it, and I have a vague idea. But the idea of even having to think about money for things like a kids accident seems completely foreign to me. Edit: It does rather explain why the founder of the UK NHS called his book "In Place of Fear"
- markdown 6y ago
  https://www.youtube.com/watch?v=l-47Y0-W7v8 https://www.youtube.com/watch?v=l-47Y0-W7v8
LoSboccacc 6y ago
in Italy it costs to me about 300eur every month for work life to potentially have partial coverage at some point in the future if something happens. I suspect your 3000 cost is skimping on a lot of taxes that are subsidizing the actual costs.
- speedgoose 6y ago
  If something happens to you, or your partner, your mom, your children, your friends, on even your neighbors that you don't really care about but don't want them to struggle because it's nice to live in a society with healthy people around you.
  - LoSboccacc 6y ago
    I didn't try to pass a moral judgment on the issue and I like the socialized system we have, for the most part. but confronting cost without taxes is trite and tiresome. I'm going to pay north of 150k eur to subsidize healthcare thorough my life, and being in the upper tax brackets (which start at some ridiculously low point) I also have to copay each service on top of already being paying more taxes for it. and when I see the "but ambulance rides are almost free here in x european country!" and the likes well no, they aren't, it's people that just didn't factor the actual costs in, because it's sunk in other taxes.
- ryanbrunner 6y ago
  Sure, but taxes are spread across the entire population. Insurance sort of kind of theoretically works like this (maybe substitute "time" for "people" that you're spreading the risk over), but the insurance industry are always going to be experts in making sure that no one is coming out ahead on that system. I'd rather have the entire population subsidize a small amount for everyone's health than randomly make a subset of the population destitute for what's often complete random bad luck. Secondly, if you take a look at non-insured prices for health care in countries with universal health care (for the most part, the "universal" part is limited to residents and visitors still have to pay), the prices are still significantly lower than they are in the U.S. Having a single payer for insurance and strong regulations over health care enable things like price controls, which makes perfect sense in a health care context since it's never really going to work as a free market (emergency care needs to be treated immediately without the ability to "shop around", the care required isn't always evident at intake, doctors refuse to talk or consider financial aspects, etc.)
  - LoSboccacc 6y ago
    I know. but that's not an excuse to pass or accept a wrong information ("y only cost x to me in this country") as correct.
    - lumberjack 6y ago
      You are right that you also have to include taxes, but you also have to account for the fact that taxes are dependent on income and coverage is always guaranteed. So it is not the same as paying for a service. It is something else.
    - ryanbrunner 6y ago
      I think there's a real difference though when the cost is "baked in" via taxes or something else. If a doctor's visit has the potential to cost you hundreds or even thousands of dollars, unless something is really serious, chances are you're going to avoid going. In a system where costs are paid through taxes, the disincentive to see a doctor is eliminated. That maybe has some negative effects (going to urgent care for relatively minor problems), but I think it has real benefits in terms of preventative care. In terms of a countries overall finances, it balances out (not entirely - see my previous point), but in terms of affect on behaviour it has a huge effect (in addition to balancing out the burden that I mentioned before).
chmod775 6y ago
> The "resolution" says they "only" have to pay 2.000$ in deductibles and copay now. Well, with what their insurance pays it's still about $10k total. > Just for comparison: a fully-fledged broken leg operation costs 3.000€ for non-insured people in Germany. My dad had brain surgery in Germany by pretty much the leading experts for that particular kind of surgery. The surgery itself, the hospital stay, etc. was about 18,000€ in total. We had to pay about 1,000€... for a hotel and living expenses for my mother and myself since we wanted to stay with him. Insurance covered everything my dad needed. So you can literally have brain surgery for what it costs to get some stitches in the US.
chewbacha 6y ago
The American healthcare industry is large and sprawling. Largely due to the fact that much of it is managed at the state level (as opposed to federal... think of this as the difference between Germany’s healthcare vs what the EU provides). Deductibles are part of some insurance plans but copays are part of all. Deductibles are generally large but capped by an out of pocket maximum. These are generally on plans that provide a high degrees of network freedom, meaning you can self-refer to a specialist. Because you are not a medical expert, there is added risk to the insurer that you are seeking unnecessary procedures and so they ask you to share the risk by paying a deductible. These are typically the PPO (preferred provider organization). There is another type of organization, an HMO (health maintenance organization) whereby you must get referred by your primary care physician, thus serving as a check on the risk. In HMOs, there is generally no deductible. There are still copays though, but they are generally small. For example, I just broke my finger and needed surgery to set the fracture. It was $20k surgery. My HMO negotiated it down to $8k and I paid a $30 copay. Had it been a PPO, I’d have paid well over $2000. As for why there are copays... they actually are there to dissuade hypochondriacs and drug seeking (aka moral hazards). This is a delicate market price though that needs to be high enough to prevent the hazard but not high enough to dissuade against necessary procedures.

arethuza 6y ago

I don't even know what deductibles and copays are! Edit: Of course I could Google it, and I have a vague idea. But the idea of even having to think about money for things like a kids accident seems completely foreign to me. Edit: It does rather explain why the founder of the UK NHS called his book "In Place of Fear"

markdown 6y ago
https://www.youtube.com/watch?v=l-47Y0-W7v8 https://www.youtube.com/watch?v=l-47Y0-W7v8

LoSboccacc 6y ago

in Italy it costs to me about 300eur every month for work life to potentially have partial coverage at some point in the future if something happens. I suspect your 3000 cost is skimping on a lot of taxes that are subsidizing the actual costs.

speedgoose 6y ago
If something happens to you, or your partner, your mom, your children, your friends, on even your neighbors that you don't really care about but don't want them to struggle because it's nice to live in a society with healthy people around you.
- LoSboccacc 6y ago
  I didn't try to pass a moral judgment on the issue and I like the socialized system we have, for the most part. but confronting cost without taxes is trite and tiresome. I'm going to pay north of 150k eur to subsidize healthcare thorough my life, and being in the upper tax brackets (which start at some ridiculously low point) I also have to copay each service on top of already being paying more taxes for it. and when I see the "but ambulance rides are almost free here in x european country!" and the likes well no, they aren't, it's people that just didn't factor the actual costs in, because it's sunk in other taxes.
ryanbrunner 6y ago
Sure, but taxes are spread across the entire population. Insurance sort of kind of theoretically works like this (maybe substitute "time" for "people" that you're spreading the risk over), but the insurance industry are always going to be experts in making sure that no one is coming out ahead on that system. I'd rather have the entire population subsidize a small amount for everyone's health than randomly make a subset of the population destitute for what's often complete random bad luck. Secondly, if you take a look at non-insured prices for health care in countries with universal health care (for the most part, the "universal" part is limited to residents and visitors still have to pay), the prices are still significantly lower than they are in the U.S. Having a single payer for insurance and strong regulations over health care enable things like price controls, which makes perfect sense in a health care context since it's never really going to work as a free market (emergency care needs to be treated immediately without the ability to "shop around", the care required isn't always evident at intake, doctors refuse to talk or consider financial aspects, etc.)
- LoSboccacc 6y ago
  I know. but that's not an excuse to pass or accept a wrong information ("y only cost x to me in this country") as correct.
  - lumberjack 6y ago
    You are right that you also have to include taxes, but you also have to account for the fact that taxes are dependent on income and coverage is always guaranteed. So it is not the same as paying for a service. It is something else.
  - ryanbrunner 6y ago
    I think there's a real difference though when the cost is "baked in" via taxes or something else. If a doctor's visit has the potential to cost you hundreds or even thousands of dollars, unless something is really serious, chances are you're going to avoid going. In a system where costs are paid through taxes, the disincentive to see a doctor is eliminated. That maybe has some negative effects (going to urgent care for relatively minor problems), but I think it has real benefits in terms of preventative care. In terms of a countries overall finances, it balances out (not entirely - see my previous point), but in terms of affect on behaviour it has a huge effect (in addition to balancing out the burden that I mentioned before).

chmod775 6y ago

> The "resolution" says they "only" have to pay 2.000$ in deductibles and copay now. Well, with what their insurance pays it's still about $10k total. > Just for comparison: a fully-fledged broken leg operation costs 3.000€ for non-insured people in Germany. My dad had brain surgery in Germany by pretty much the leading experts for that particular kind of surgery. The surgery itself, the hospital stay, etc. was about 18,000€ in total. We had to pay about 1,000€... for a hotel and living expenses for my mother and myself since we wanted to stay with him. Insurance covered everything my dad needed. So you can literally have brain surgery for what it costs to get some stitches in the US.

chewbacha 6y ago

The American healthcare industry is large and sprawling. Largely due to the fact that much of it is managed at the state level (as opposed to federal... think of this as the difference between Germany’s healthcare vs what the EU provides). Deductibles are part of some insurance plans but copays are part of all. Deductibles are generally large but capped by an out of pocket maximum. These are generally on plans that provide a high degrees of network freedom, meaning you can self-refer to a specialist. Because you are not a medical expert, there is added risk to the insurer that you are seeking unnecessary procedures and so they ask you to share the risk by paying a deductible. These are typically the PPO (preferred provider organization). There is another type of organization, an HMO (health maintenance organization) whereby you must get referred by your primary care physician, thus serving as a check on the risk. In HMOs, there is generally no deductible. There are still copays though, but they are generally small. For example, I just broke my finger and needed surgery to set the fracture. It was $20k surgery. My HMO negotiated it down to $8k and I paid a $30 copay. Had it been a PPO, I’d have paid well over $2000. As for why there are copays... they actually are there to dissuade hypochondriacs and drug seeking (aka moral hazards). This is a delicate market price though that needs to be high enough to prevent the hazard but not high enough to dissuade against necessary procedures.