Trumpcare?

[Singuy]

There are plenty of deaths that are not preceded by expensive healthcare costs.

Also another point I was trying to make is the pay out health insurance needs to deal with is a whole different beast than a car or a house.

Plenty of people who require 250-1million/year just to live. There's no such claims for cars/houses. No one person's house gets caught on fire yearly..and not everyone crashes a Ferrari once a year.

But everyone wants "affordability"..meaning they want to pay what they pay to insure a car or a house.

Honestly, in order for insurance companies to make money, healthy people's premium should be in the thousands/month in order to offset those who are really sick..but that's not the case because people will just cry foul. Instead insurance companies will just drop those who are really sick and hope the government or tax dollars can pick them up.

[TexasHusker]

Honestly, in order for insurance companies to make money, healthy people's premium should be in the thousands/month in order to offset those who are really sick..but that's not the case because people will just cry foul.

Cry foul? Or cry broke ?

[Singuy]

Cry foul? Or cry broke ?

You can't except a healthy person making 2500/month to pay 2000/month for health insurance..which is the true cost to offset the sick.

If medicare didn't exist, insurance companies would be so screwed if the government mandates them to insure people over 65...which costs between 10-100k/year just for payouts for that demographic.

Then you add in the fact that there are WAY MORE baby boomers than healthy people...

Yeah it'll probably cost someone who is in their 20s 3000/month just to offset the elderly.

[TexasHusker]

You can't except a healthy person making 2500/month to pay 2000/month for health insurance..which is the true cost to offset the sick.

If medicare didn't exist, insurance companies would be so screwed if the government mandates them to insure people over 65...which costs between 10-100k/year just for payouts for that demographic.

Then you add in the fact that there are WAY MORE baby boomers than healthy people...

Yeah it'll probably cost someone who is in their 20s 3000/month just to offset the elderly.

Premiums have long since passed the threshold of reasonableness for most Americans. Better ration healthcare or find ways to promote competition between the hospital systems.

[Singuy]

Premiums have long since passed the threshold of reasonableness for most Americans. Better ration healthcare or find ways to promote competition between the hospital systems.

You must be the only who is willing to shop around carrying your child's broken arm from ER to ER bargaining for a cheaper price but most Americans will not. True competition when it comes to healthcare is impossible. You cannot use the supply/demand model on healthcare. No one choose to stop getting care because it becomes "too expensive"...because dying is cheaper?

[PeggyHefferon]

Plenty of people who require 250-1million/year just to live.

A good reason why assisted suicide should be legal in all States, and there should be some form of reduced life insurance payout for choosing this option. There are many illnesses that I would not want to live with, and no doubt that are millions that feel the same way.

Instead we force millions of people to suffer and rack up expenses they can't afford.

[TexasHusker]

You must be the only who is willing to shop around carrying your child's broken arm from ER to ER bargaining for a cheaper price but most Americans will not. True competition when it comes to healthcare is impossible. You cannot use the supply/demand model on healthcare. No one choose to stop getting care because it becomes "too expensive"...because dying is cheaper?

Only a small portion of healthcare is emergent in nature. The ERs get the glamor, but most hospital stays are not through the ER.

When you need a hospital stay, that is when your high deductible health policy kicks in.

[hamchan]

Insurance companies are often paying 8-10 times what they should. I have pretty intimate knowledge of hospital markups: I negotiated managed care contracts on behalf of a large healthcare system for 20 years.

The business model seemed to be to continuously buy our local competition and absolutely hammer the payers with our leverage. My colleagues in other major cities were in a similar situation.

This situation is a big reason why I walked away - I just couldn't stomach the insanity any more. It was unconscionable.

Even if by paying cash we were able to get our medical expenses to 10% of what our insurance is paying on, it still wouldn't be affordable. It would be over 50% of our gross income.

And I would like to reiterate that virtually anyone could find themselves in the same situation overnight. No matter how well you take care of your health, accidents and major illnesses happen all the time, and many of them result in very expensive medical needs for the rest of your life.

[hamchan]

A good reason why assisted suicide should be legal in all States, and there should be some form of reduced life insurance payout for choosing this option. There are many illnesses that I would not want to live with, and no doubt that are millions that feel the same way.

Instead we force millions of people to suffer and rack up expenses they can't afford.

Holy crap dude. I agree that assisted suicide should be legal for those who WANT that option, but beyond that your attitude is horrifyingly cold. Sorry, but human beings do not need to pass a cost/benefit analysis to deserve to go on living.

My husband is one of those people you seem to think should just off himself because his medical expenses are 10X more than he earns. He has chronic kidney disease and diabetes, and has a kidney transplant, just like the dad of the person you were replying too. He's 40 years old, works full time, goes to the gym daily, and ran a 10k last fall while he was on dialysis 3X a week. He has a rich, full life with very little suffering BECAUSE of the expensive medical care he is able to get. Without it he would suffer considerably, have a terrible quality of life, and die within a year.

My daughter is one of those people too. She's 17. She has a very good chance of full recovery, but only if she has regular access to medical care.

[PeggyHefferon]

Holy crap dude. I agree that assisted suicide should be legal for those who WANT that option, but beyond that your attitude is horrifyingly cold. Sorry, but human beings do not need to pass a cost/benefit analysis to deserve to go on living.

My husband is one of those people you seem to think should just off himself because his medical expenses are 10X more than he earns. He has chronic kidney disease and diabetes, and has a kidney transplant, just like the dad of the person you were replying too. He's 40 years old, works full time, goes to the gym daily, and ran a 10k last fall while he was on dialysis 3X a week. He has a rich, full life with very little suffering BECAUSE of the expensive medical care he is able to get. Without it he would suffer considerably, have a terrible quality of life, and die within a year.

My daughter is one of those people too. She's 17. She has a very good chance of full recovery, but only if she has regular access to medical care.

How in the world do you come up with "dude" with the name Peggy?

And you need to slow your roll. My take is far from cold. No where did I suggest that anyone wanting to live should off their self. I also never used the word deserve or suggested someone pass a cost/benefit analysis to get to live.

I stated that people suffering should have the right to discuss the option with their physician.

[disneysteve]

Instead we force millions of people to suffer and rack up expenses they can't afford.

We don't force anyone to get care they don't want. I've had numerous patients over the years who chose not to seek treatment for terminal illness. We set them up for hospice and got them comfort/palliative care and they died a short time later, usually in the comfort of their own home surrounded by loved ones.

[TexasHusker]

https://www.yahoo.com/finance/news/kind-doctors-office-charges-monthly-131907240.html

[TexasHusker]

Even if by paying cash we were able to get our medical expenses to 10% of what our insurance is paying on, it still wouldn't be affordable. It would be over 50% of our gross income.

And I would like to reiterate that virtually anyone could find themselves in the same situation overnight. No matter how well you take care of your health, accidents and major illnesses happen all the time, and many of them result in very expensive medical needs for the rest of your life.

You are dealing with a chronic illness and I have great empathy for you. Perhaps there should be established a chronically ill program by the gubmit that addresses these types of situations. In these chronic situations, insurance has essentially become welfare, which wrecks the entire model.

[disneysteve]

https://www.yahoo.com/finance/news/k...131907240.html

Direct care or concierge care has been around for years but only represents a sliver of the market. Most people have health insurance and want to use it so I'm not sure it will ever become mainstream - unless something changes with the way health insurance works. It also works best in areas with higher socioeconomic demographics. In my practice, people have trouble paying their $10 or $15 copays. There's no way we could attract enough paying patients to switch to a direct pay model at our current location.

One thing I don't really follow with these practices is what happens for any care that is needed outside of the practice. If you come in for a twisted ankle and I think you need an x-ray, do you go pay cash for that, too? What if I want you to see a specialist for something? That could cost you hundreds or thousands of dollars if you don't do it through your health insurance. But I can't issue you an insurance referral if I'm not a participating provider for your plan. I guess it's great for basic care, although I would think people who really only need basic care would rather not pay the monthly fee and just pay cash for the visits they actually need (hence the growing popularity of urgent care clinics like the ones I work at).

[TexasHusker]

Direct care or concierge care has been around for years but only represents a sliver of the market. Most people have health insurance and want to use it so I'm not sure it will ever become mainstream - unless something changes with the way health insurance works. It also works best in areas with higher socioeconomic demographics. In my practice, people have trouble paying their $10 or $15 copays. There's no way we could attract enough paying patients to switch to a direct pay model at our current location.

One thing I don't really follow with these practices is what happens for any care that is needed outside of the practice. If you come in for a twisted ankle and I think you need an x-ray, do you go pay cash for that, too? What if I want you to see a specialist for something? That could cost you hundreds or thousands of dollars if you don't do it through your health insurance. But I can't issue you an insurance referral if I'm not a participating provider for your plan. I guess it's great for basic care, although I would think people who really only need basic care would rather not pay the monthly fee and just pay cash for the visits they actually need (hence the growing popularity of urgent care clinics like the ones I work at).

This is more than concierge medicine. It is a membership model whereby fee-for-service is eliminated. That accomplishes two things:

1. The provider is not incentivized to do more/see more/order more.

2. The patient is unfettered to receive the primary care that they need.

It isn't an insurance plan, but more of a primary care plan.

We offer something similar to all of our employees for $10.62 per pay period (us paying half). We have 31 employees, and only 3 are on the plan.

Personal responsibility has to kick in at some point.