28 ms·

The $200K lesson I learned from getting shot

43 points by Lusake 13y ago

Frozenlock 13y ago
Seems to me the author is conflating the principle of insurance with Obamacare. Or in other words, it's not because the general concept of insurance can be wise that every implementations are interesting.
- sliverstorm 13y ago
  Just because Obamacare isn't perfect, doesn't mean you are better off without insurance. His post is not addressing the policy, his post is addressing the individuals who are deciding whether to enroll.
- fennecfoxen 13y ago
  Yes... "One of the less obvious consequences of serious accidents is that victims often become uninsurable on the individual market as a result.... Obamacare really will change that." Making this sort of insurance available amounts to a wealth transfer to people who have been victims of injuries. That's fine, if you're into wealth transfers and all that, but... wouldn't it be better if we just admitted it was a big fat subsidy to the sick and injured, and paid for it out of the general fund, instead of paying for it by making insurance more expensive, especially the young healthy twenty-somethings who struggle to afford it? so that these twenty-somethings wouldn't be tempted to skip it, among other things, and would be less vulnerable to these $200,000+ risks (and further undermine the system)? I mean, all else being equal, it is probably a good idea to be insured if you can, Obamacare notwithstanding, but the fact that it incentives people this way is a fundamental design flaw, not a feature or a fix. Oh, wait, I know why we're paying for it this way. It's so we can pretend that it doesn't cost anybody any money. :P
adambard 13y ago
Can I be the first non-US citizen in this thread express my incredulity that anything less than universal health care is tolerated? "Barbaric" is the term that seems to strike me whenever I hear of it, hyperbolic though it may be.
- sliverstorm 13y ago
  Yes, yes, Americans are practically drooling Cro-magnons for not having universal health care. We know, we've heard it countless times before, and I'm not sure it contributes anything to the discussion other than a smug sense of self-superiority for the non-American readers.
  - drivebyacct2 13y ago
    Somehow seeing it repeated makes me hopeful that people will eventually be confronted to the point that their head will intentionally or accidentally recede back from out their ass.
  - a3n 13y ago
    As an American I agree, it's terrible not having universal healthcare. What's the point of being a large body if we don't take advantage of that? And if we don't, we really aren't anything except individuals. Nothing wrong with being an individual, but we can be and accomplish so much more together. Apart, we're just living in the same place.
    - markost 13y ago
      Did you reply to the wrong comment?
- iopq 13y ago
  I don't accept anything less than universal food care, universal shelter care, universal clothing care, and of course universal marriage care.
  - purplelobster 13y ago
    Ironically, you're close enough to the truth. The only thing that stands in the way of dignified living for everybody is people like you. There is enough resources in this world (especially the US). Why should kids everywhere live in poverty, starve and not be given the same opportunity under the same conditions as more fortunate kids (well fed, good schools) because their parents couldn't find or hold down a job? Instead, kids grow up hungry and can't focus on school, and even if they want to, they live in a poor neighborhood with bad schools, perpetuating the situation for yet another generation.
skizm 13y ago
> But there’s no equity, dividend or residual value in a splenectomy. I'm gonna go ahead and disagree with that. The residual value is every day afterwards that you get to live. (not that I disagree with the sentiment, just sayin)
coryrc 13y ago
> They also enter a social contract that promises to provide them affordable coverage when they’re older and no longer healthy, as a form of back payment for cross-subsidizing today’s aged and ill. This is only true if the law requires younger people to pay more than their cohort consumes on an average basis, so as to transfer even more wealth from the working young to the retired, wealthy elderly. Hmmm http://www.forbes.com/sites/chrisconover/2012/11/27/young-people-under-obamacare-cash-cow-for-older-workers/ http://www.forbes.com/sites/chrisconover/2012/11/27/young-pe...
- sp332 13y ago
  Exactly, if I had any confidence that the insurance companies and congress weren't going to screw me out of tons of money, I might buy into socialized medicine.
- hsitz 13y ago
  I'm not clear on to what extent the mandatory coverage requires young people to pay more than the expected cost of their cohort, or if it simply requires them to carry their own expected cost so that the older insured people (or, perhaps, simply the taxpaying citizenry) don't have to pay health care costs of the younger uninsured generation. The author of the article also says, "Young people are typically healthy. On average, they incur very low medical costs each year. In any social insurance system, most of them will end up paying in more than they get out during their early years" It's not just the early years, it's all years. The way insurance works is that most people pay in more than they ever get out. You're insured so that in the unhappy event that you end up with a huge, abnormal, way above average expense, insurance will cover it. This is possible because, on average, most people pay in more than they ever get out. This fact in itself is not anything specific to insuring the youngest and healthiest people. The value of insurance is not measured by how much you "get out". It's measured by how much coverage you had, regardless of whether you used it. I hope to never use my health insurance, or to use it (i.e., "get out of it") as little as possible. So far I've done great at that. Does not "getting out" what I've paid make me think I've been paying without getting value? Hardly. And my belief in that value is not conditioned on my expecting to get payments out of it in the future, any more than my belief in the value of my auto insurance is. I hope also to never get any money out of my auto insurance policy, this year or in any future years, yet it will still be worth every penny I pay.
iloveyouocean 13y ago
Beware the automatically played, LOUD advertisement.
- iopq 13y ago
  https://adblockplus.org/ https://adblockplus.org/
pjbrunet 13y ago
The lesson: health insurance = bad luck
restlessmike 13y ago
I'm sure this has been pointed out many times when these posts pop up, but what is shocking to me is that we tolerate $200k medical bills for this sort of emergency care, as long as we aren't the ones paying for them ourselves. The healthcare industry needs a lot more transparency. Every hospital should be required (if they choose to accept Medicare/Medicaid patients) to publish prices in an easily comparable format tied to standard medical codes for every service/procedure they provide, and should be required to charge individuals without insurance no more than the government or other large insurer pays. This would seem pretty simple to implement and would, over time, help keep prices lower simply by making them public and allowing people to compare them. The information asymmetry in the industry has created a situation where people are powerless to help themselves and make smart choices with regard to getting healthcare, and has led to the creation of another expensive program that we can't afford. Sadly, we have a system in which the industries being regulated control the dialog, and they are all too happy to tiptoe past prices and on to who is footing the bill.
- robomartin 13y ago
  > The healthcare industry needs a lot more transparency. OK, yes. What it really needs is to be an open market both for care and insurance. Competition has amazing ways to both improve quality and affordability. This has been proven time and time again across a myriad of fields both within and well outside of medicine. Nothing beats open market competition. When providers and insurance companies truly have to compete for your business things change. The ACA (Obamacare) is a disaster full of typical government-driven unintended consequences. We are just starting to see the tip of the iceberg. Funny that the very people who passed it will not have to live within this monstrous framework. And now the very unions who helped push it forward had an "oh-shit!" moment. They learned just how fucked it's going to be and want out. I say, we are all on the same boat or shred the damn thing. If we are going to have socialized medicine the only equitable approach is that everyone, without exceptions, has to use it. All exceptions granted by POTUS need to be rescinded.
  - tzs 13y ago
    > Funny that the very people who passed it will not have to live within this monstrous framework. It applies to Congress.

43 points by Lusake 13y ago

Seems to me the author is conflating the principle of insurance with Obamacare. Or in other words, it's not because the general concept of insurance can be wise that every implementations are interesting.

sliverstorm 13y ago
Just because Obamacare isn't perfect, doesn't mean you are better off without insurance. His post is not addressing the policy, his post is addressing the individuals who are deciding whether to enroll.
fennecfoxen 13y ago
Yes... "One of the less obvious consequences of serious accidents is that victims often become uninsurable on the individual market as a result.... Obamacare really will change that." Making this sort of insurance available amounts to a wealth transfer to people who have been victims of injuries. That's fine, if you're into wealth transfers and all that, but... wouldn't it be better if we just admitted it was a big fat subsidy to the sick and injured, and paid for it out of the general fund, instead of paying for it by making insurance more expensive, especially the young healthy twenty-somethings who struggle to afford it? so that these twenty-somethings wouldn't be tempted to skip it, among other things, and would be less vulnerable to these $200,000+ risks (and further undermine the system)? I mean, all else being equal, it is probably a good idea to be insured if you can, Obamacare notwithstanding, but the fact that it incentives people this way is a fundamental design flaw, not a feature or a fix. Oh, wait, I know why we're paying for it this way. It's so we can pretend that it doesn't cost anybody any money. :P

adambard 13y ago

Can I be the first non-US citizen in this thread express my incredulity that anything less than universal health care is tolerated? "Barbaric" is the term that seems to strike me whenever I hear of it, hyperbolic though it may be.

sliverstorm 13y ago
Yes, yes, Americans are practically drooling Cro-magnons for not having universal health care. We know, we've heard it countless times before, and I'm not sure it contributes anything to the discussion other than a smug sense of self-superiority for the non-American readers.
- drivebyacct2 13y ago
  Somehow seeing it repeated makes me hopeful that people will eventually be confronted to the point that their head will intentionally or accidentally recede back from out their ass.
- a3n 13y ago
  As an American I agree, it's terrible not having universal healthcare. What's the point of being a large body if we don't take advantage of that? And if we don't, we really aren't anything except individuals. Nothing wrong with being an individual, but we can be and accomplish so much more together. Apart, we're just living in the same place.
  - markost 13y ago
    Did you reply to the wrong comment?
iopq 13y ago
I don't accept anything less than universal food care, universal shelter care, universal clothing care, and of course universal marriage care.
- purplelobster 13y ago
  Ironically, you're close enough to the truth. The only thing that stands in the way of dignified living for everybody is people like you. There is enough resources in this world (especially the US). Why should kids everywhere live in poverty, starve and not be given the same opportunity under the same conditions as more fortunate kids (well fed, good schools) because their parents couldn't find or hold down a job? Instead, kids grow up hungry and can't focus on school, and even if they want to, they live in a poor neighborhood with bad schools, perpetuating the situation for yet another generation.

skizm 13y ago

> But there’s no equity, dividend or residual value in a splenectomy. I'm gonna go ahead and disagree with that. The residual value is every day afterwards that you get to live. (not that I disagree with the sentiment, just sayin)

coryrc 13y ago

> They also enter a social contract that promises to provide them affordable coverage when they’re older and no longer healthy, as a form of back payment for cross-subsidizing today’s aged and ill. This is only true if the law requires younger people to pay more than their cohort consumes on an average basis, so as to transfer even more wealth from the working young to the retired, wealthy elderly. Hmmm http://www.forbes.com/sites/chrisconover/2012/11/27/young-people-under-obamacare-cash-cow-for-older-workers/ http://www.forbes.com/sites/chrisconover/2012/11/27/young-pe...

sp332 13y ago
Exactly, if I had any confidence that the insurance companies and congress weren't going to screw me out of tons of money, I might buy into socialized medicine.
hsitz 13y ago
I'm not clear on to what extent the mandatory coverage requires young people to pay more than the expected cost of their cohort, or if it simply requires them to carry their own expected cost so that the older insured people (or, perhaps, simply the taxpaying citizenry) don't have to pay health care costs of the younger uninsured generation. The author of the article also says, "Young people are typically healthy. On average, they incur very low medical costs each year. In any social insurance system, most of them will end up paying in more than they get out during their early years" It's not just the early years, it's all years. The way insurance works is that most people pay in more than they ever get out. You're insured so that in the unhappy event that you end up with a huge, abnormal, way above average expense, insurance will cover it. This is possible because, on average, most people pay in more than they ever get out. This fact in itself is not anything specific to insuring the youngest and healthiest people. The value of insurance is not measured by how much you "get out". It's measured by how much coverage you had, regardless of whether you used it. I hope to never use my health insurance, or to use it (i.e., "get out of it") as little as possible. So far I've done great at that. Does not "getting out" what I've paid make me think I've been paying without getting value? Hardly. And my belief in that value is not conditioned on my expecting to get payments out of it in the future, any more than my belief in the value of my auto insurance is. I hope also to never get any money out of my auto insurance policy, this year or in any future years, yet it will still be worth every penny I pay.

iloveyouocean 13y ago

Beware the automatically played, LOUD advertisement.

iopq 13y ago
https://adblockplus.org/ https://adblockplus.org/

pjbrunet 13y ago

The lesson: health insurance = bad luck

restlessmike 13y ago

I'm sure this has been pointed out many times when these posts pop up, but what is shocking to me is that we tolerate $200k medical bills for this sort of emergency care, as long as we aren't the ones paying for them ourselves. The healthcare industry needs a lot more transparency. Every hospital should be required (if they choose to accept Medicare/Medicaid patients) to publish prices in an easily comparable format tied to standard medical codes for every service/procedure they provide, and should be required to charge individuals without insurance no more than the government or other large insurer pays. This would seem pretty simple to implement and would, over time, help keep prices lower simply by making them public and allowing people to compare them. The information asymmetry in the industry has created a situation where people are powerless to help themselves and make smart choices with regard to getting healthcare, and has led to the creation of another expensive program that we can't afford. Sadly, we have a system in which the industries being regulated control the dialog, and they are all too happy to tiptoe past prices and on to who is footing the bill.

robomartin 13y ago
> The healthcare industry needs a lot more transparency. OK, yes. What it really needs is to be an open market both for care and insurance. Competition has amazing ways to both improve quality and affordability. This has been proven time and time again across a myriad of fields both within and well outside of medicine. Nothing beats open market competition. When providers and insurance companies truly have to compete for your business things change. The ACA (Obamacare) is a disaster full of typical government-driven unintended consequences. We are just starting to see the tip of the iceberg. Funny that the very people who passed it will not have to live within this monstrous framework. And now the very unions who helped push it forward had an "oh-shit!" moment. They learned just how fucked it's going to be and want out. I say, we are all on the same boat or shred the damn thing. If we are going to have socialized medicine the only equitable approach is that everyone, without exceptions, has to use it. All exceptions granted by POTUS need to be rescinded.
- tzs 13y ago
  > Funny that the very people who passed it will not have to live within this monstrous framework. It applies to Congress.