New York shuts down doctor's attempt to offer health care to low income

[halik]

Originally posted by: Codewiz

Originally posted by: halik

Originally posted by: sactoking

Originally posted by: halik

Originally posted by: sactoking
A) This is no different than paying a retainer to an accountant, attorney, or financial adviser. If this is insurance, then retainers in general are speculative and they ALL should be insurance.

B) The argument that that a plan such as this is bad b/c it disincentivizes people from getting "real" coverage is wrong b/c:
1) The target market for a program like this doesn't get "real" coverage anyway.
2) You can sell 'catastrophic' plans to supplement this for pennies on the dollar compared to "real" plans. It's proven to work. See: Umbrella policies and High-deductible health plans

People w/o any coverage already demonstrate that they don't care about the potential bankruptcy on their part , so I very much doubt they would voluntarily sign up for it. I'm not opposed to the plan if you force people to get catastrophic coverage along with it.... otherwise you end up with people switching from catastrophic to this plan.

I am very much against it if you force people to take catastrophic coverage. That's a separate issue.

What I'm saying is this: A policy that offers comprehensive coverage for minor AND catastrophic events is more expensive than the coverages separately. Don't believe me? Go to the State Farm or Farmers 'affluent' groups and ask for a $1,000,000/$3,000,000/$1,000,000 auto policy. They'll offer you an umbrella. Why? Because the loss and underwriting expenses on claims in the $1,000,000 range can be separated from the $1,000 loss expenses. It results in cheaper coverage.

If you offer $80/month coverage for skinned knees and supplemental coverage for appendicitis, it will be cheaper than just offering one plan for both. Some people who might not otherwise afford coverage now will be able to. The best part is that some people still can't/won't but supplemental coverage and society will have to subsidize them, but the total cost will be less than if we were subsidizing them for EVERYTHING, and we prevent gov't from taking another step to controlling everything and expanding their inefficiency.

We're arguing the same point here, I agree that you can get two separate coverages for cheaper than a regular plan. My argument is that people will not go for both*, and moreover they will substitute from catastrophic coverage to the $80/mo coverage.

From public policy perspective, you'd want the exact opposite - it's a lot better for people to have catastrophic coverage and no $80/mo coverage rather than the opposite... because the latter isn't a true insurance and cost of catastrophes will be passed onto others.


* if you don't have catastrophic covearge, but can afford and are considering the $80/mo plan for regular limited coverage, you've already revealed your preferences regading the risk of bankruptcy by hospitalization. Since you have the $80/mo, but don't cover yourself with catastrophic policy, you will not cover yourself with catastrophic coverage on top of the $80/mo limited plan ceteris paribus. This follows from preference theory of economics.

And what you miss is this. The cost of paying for the flu, cold, rash FAR FAR FAR HIGHER than paying for catastrophic illnesses.

If you are looking to DECREASE hospital costs AND decrease insurance costs, you need to get people to pay for routine care INCLUDING things like flu, colds, rashes.

To give you an example. My co-worker has a really trashy step brother who just had a child. Medicaid would only pay for so many doctor visits. So they now go to the emergency room for every little problem with the child and don't pay for anything. Since the child is in daycare, the kid gets sick almost every week. We are talking about probably $5000-10000 in emergency room costs for something that could easily be covered by having a doctor offer this type of service. Multiply that by millions and you will understand.

Those are the people running up the medical costs in the country.

Do you have a link for that?
You can see a hundred "sick" kids for every dialysis, chemo treatment, appendicitis (mine was $20K ), which is why I think the catastrophic things are the cost drivers. The actual cost of seeing a kid to the ER is a lot less (10 mins of some NP's time+ 10mins of his mal insurance) than the amortized cost of an MRI machine or a surgery team.

 

[Codewiz]

Originally posted by: halik

Originally posted by: Codewiz

Originally posted by: halik

Originally posted by: sactoking

Originally posted by: halik

Originally posted by: sactoking
A) This is no different than paying a retainer to an accountant, attorney, or financial adviser. If this is insurance, then retainers in general are speculative and they ALL should be insurance.

B) The argument that that a plan such as this is bad b/c it disincentivizes people from getting "real" coverage is wrong b/c:
1) The target market for a program like this doesn't get "real" coverage anyway.
2) You can sell 'catastrophic' plans to supplement this for pennies on the dollar compared to "real" plans. It's proven to work. See: Umbrella policies and High-deductible health plans

People w/o any coverage already demonstrate that they don't care about the potential bankruptcy on their part , so I very much doubt they would voluntarily sign up for it. I'm not opposed to the plan if you force people to get catastrophic coverage along with it.... otherwise you end up with people switching from catastrophic to this plan.

I am very much against it if you force people to take catastrophic coverage. That's a separate issue.

What I'm saying is this: A policy that offers comprehensive coverage for minor AND catastrophic events is more expensive than the coverages separately. Don't believe me? Go to the State Farm or Farmers 'affluent' groups and ask for a $1,000,000/$3,000,000/$1,000,000 auto policy. They'll offer you an umbrella. Why? Because the loss and underwriting expenses on claims in the $1,000,000 range can be separated from the $1,000 loss expenses. It results in cheaper coverage.

If you offer $80/month coverage for skinned knees and supplemental coverage for appendicitis, it will be cheaper than just offering one plan for both. Some people who might not otherwise afford coverage now will be able to. The best part is that some people still can't/won't but supplemental coverage and society will have to subsidize them, but the total cost will be less than if we were subsidizing them for EVERYTHING, and we prevent gov't from taking another step to controlling everything and expanding their inefficiency.

We're arguing the same point here, I agree that you can get two separate coverages for cheaper than a regular plan. My argument is that people will not go for both*, and moreover they will substitute from catastrophic coverage to the $80/mo coverage.

From public policy perspective, you'd want the exact opposite - it's a lot better for people to have catastrophic coverage and no $80/mo coverage rather than the opposite... because the latter isn't a true insurance and cost of catastrophes will be passed onto others.


* if you don't have catastrophic covearge, but can afford and are considering the $80/mo plan for regular limited coverage, you've already revealed your preferences regading the risk of bankruptcy by hospitalization. Since you have the $80/mo, but don't cover yourself with catastrophic policy, you will not cover yourself with catastrophic coverage on top of the $80/mo limited plan ceteris paribus. This follows from preference theory of economics.

And what you miss is this. The cost of paying for the flu, cold, rash FAR FAR FAR HIGHER than paying for catastrophic illnesses.

If you are looking to DECREASE hospital costs AND decrease insurance costs, you need to get people to pay for routine care INCLUDING things like flu, colds, rashes.

To give you an example. My co-worker has a really trashy step brother who just had a child. Medicaid would only pay for so many doctor visits. So they now go to the emergency room for every little problem with the child and don't pay for anything. Since the child is in daycare, the kid gets sick almost every week. We are talking about probably $5000-10000 in emergency room costs for something that could easily be covered by having a doctor offer this type of service. Multiply that by millions and you will understand.

Those are the people running up the medical costs in the country.

Do you have a link for that?
You can see a hundred "sick" kids for every dialysis, chemo treatment, appendicitis (mine was $20K ), which is why I think the catastrophic things are the cost drivers. The actual cost of seeing a kid to the ER is a lot less (10 mins of some NP's time+ 10mins of his mal insurance) than the amortized cost of an MRI machine or a surgery team.

We are talking uninsured people only right?

Even by your number of 20K for appendicitis, that number is quickly dwarfed by 5 parents who are uninsured and have child that are dumped in the emergency room regularly.

It is a simple math. Why is just catastrophic insurance reasonably priced per month? The odds of you actually NEEDING it is pretty few and far between. Yes when it is needed, it costs a lot money.

But when we are talking about uninsured people, they are a drain on the system because of the regular bullshit that they go to the emergency room for. Go ask any nurse that works in an ER and ask how much time/money is wasted on uninsured people who are there for little shit.

Just think of every Walmart, fast food, welfare person that is uninsured. Now imagine everytime they get the smallest illness and go to the emergency room to get a prescription. That takes time and resources and costs as assload of money.

If they would pay a doctor $80/month to lift that burden they have just made the system that much better.

And I don't have specific numbers but I can point to failing Hospitals due to providing "charity" care to uninsured for routine care.
Text

These hospitals aren't going out of business because of chemo costs. They are going out of business because of the overun of uninsured routine care they are providing for free.

Solve that problem and we are better off. The problem is that we tie doctor's hands. Doctor's pretty much won't see a patient who is uninsured. This doctor's plan at least solved part of the problem.

 

[halik]

Originally posted by: Codewiz


We are talking uninsured people only right?

Even by your number of 20K for appendicitis, that number is quickly dwarfed by 5 parents who are uninsured and have child that are dumped in the emergency room regularly.

It is a simple math. Why is just catastrophic insurance reasonably priced per month? The odds of you actually NEEDING it is pretty few and far between. Yes when it is needed, it costs a lot money.

But when we are talking about uninsured people, they are a drain on the system because of the regular bullshit that they go to the emergency room for. Go ask any nurse that works in an ER and ask how much time/money is wasted on uninsured people who are there for little shit.

Just think of every Walmart, fast food, welfare person that is uninsured. Now imagine everytime they get the smallest illness and go to the emergency room to get a prescription. That takes time and resources and costs as assload of money.

If they would pay a doctor $80/month to lift that burden they have just made the system that much better.

And I don't have specific numbers but I can point to failing Hospitals due to providing "charity" care to uninsured for routine care.
Text

These hospitals aren't going out of business because of chemo costs. They are going out of business because of the overun of uninsured routine care they are providing for free.

Solve that problem and we are better off. The problem is that we tie doctor's hands. Doctor's pretty much won't see a patient who is uninsured. This doctor's plan at least solved part of the problem.

Yeah,
it's kind of an optimization problem - one uninsured person needing 8 hour surgery once (or chemo or *) = 3 months worth of kids in the ER with routine problems.

I suppose the main determinant is what costs the hopspital more - uninsured people going for treatment that cost $1500+ or people going to the ER with routine things often.


You've changed my mind though, the net result of the docs $80/mo plan are unclear.
If main cost drivers for hospitals are uninsured getting catastrophic treament ($1500+), the what he does exacerbates the problem. On the flip side if the predominant cost driver is people going for routine crap to the ER, then he's helping to fix the problem. Plus consider the people that would've had catastrophic coverage, but switched to limited coverage - that will likely increase the cost of the hospital in case of catastrophic injuries.

Without any empirical studies, I really can't pass a judgment on this.

 

[BoberFett]

Originally posted by: halik

Originally posted by: BoberFett
I can go to a vet and get a "wellness plan" for my dog. It doesn't cover emergency services, surgery, or anything out of the ordinary. It covers routine checkups, dental cleanings, etc. It's not insurance, it's a payment plan.

Why can't people do the same thing?

Why should I be forced to buy into a monolithic insurance pool in order to see a doctor for routine things, just so the insurance company can work their voodoo and turn my $400 bill for seeing a doctor for 10 minutes into a $10 copay?

Why can't routine maintenance be handled outside insurance and let insurance cover catastrophic injury or disease?

Oh, because nobody gets rich off that. Nevermind.

Because if you get a $20K estimate on your dog's life-saving surgery, you'll have him put down... that won't be case if that was your wife instead of your dog, regardless of whether you have the $20K or not.

Finish reading my post.

Edit: And, perhaps we do need to consider that not every life is worth spending millions of dollars to save. Sometimes you need to just accept death.

 

[zephyrprime]

Cutting out the middle men is one the the primary ways to lower costs in any industry. If any of you didn't already know, overhead at insurance companies is very high and processing claims is very expensive for doctors. Sure this sort of coverage lacks catastrophic coverage but so long as that is clearly told to prospective purchasers, I see no problem.

Insurance companies just don't want to see their piece of the pie shrink.

 

[sandorski]

This is a bad idea. It covers hardly anything, but as this thread shows, it makes the Buyer feel like he/she has something. You're basically Paying for being at the front of the line and given the Services "covered", you'd probably be better off just Paying the full Cost of each Visit/Procedure. Unless you're constantly going to the Dr.

 

[sactoking]

Originally posted by: halik
From public policy perspective, you'd want the exact opposite - it's a lot better for people to have catastrophic coverage and no $80/mo coverage rather than the opposite... because the latter isn't a true insurance and cost of catastrophes will be passed onto others.

I disagree. Day-in and day-out, the costs of small maintenance-type claims drain more time, money, and resources from the system. It's the same with auto insurance. That's why states mandate you have some minimal coverage like $10,000/$15,000/$5,000 but do not legislate having coverage for if you kill someone.

* if you don't have catastrophic coverage ($80/mo), but can afford and are considering the $80/mo plan for regular limited coverage, you've already revealed your preferences regading the risk of bankruptcy by hospitalization. Since you have the $80/mo, but don't cover yourself with catastrophic policy, you will not cover yourself with catastrophic coverage on top of the $80/mo limited plan ceteris paribus. This follows from preference theory of economics: catastrophic coverage isn't worth $80/mo to you, but regular coverage is. If you choose regular limited coverage for $80, there is no logical reason to expect the catastrophic coverage will, all the sudden, be worth to you the $80/mo. Let me know if the above doesn't make sense, explaning econ theory isn't easy.

I have a degree in econ and work in insurance, but it still took me a couple reads to get what you were saying.

I disagree here as well. You're assuming that catastrophic coverage is currently available for $80 and that this "plan" would replace it. Thus, low-income people might replace their catastrophic coverage with basic coverage, since to have both will cost more than just the catastrophic. I disagree for two reasons:

1) As I stated above, the accumulated money, time, and resource costs of the basic treatments are greater than those for catastrophic treatments, so having the catastrophe coverage replaced by the basic coverage is inherently good.
2) The "$80 catastrophe coverage" that I originally mentioned doesn't exist. In the current world, many low-income people are faced with either paying $Z for a comprehensive policy or getting no insurance. I contend that this type of retainer system is good because the retainer costs $X and could be supplemented by a new catastrophe plan for $Y and that $X + $Y should be < $Z due to the way that underwriting and loss expenses are carried across different claim thresholds.

 

[Codewiz]

Originally posted by: halik

Originally posted by: Codewiz


We are talking uninsured people only right?

Even by your number of 20K for appendicitis, that number is quickly dwarfed by 5 parents who are uninsured and have child that are dumped in the emergency room regularly.

It is a simple math. Why is just catastrophic insurance reasonably priced per month? The odds of you actually NEEDING it is pretty few and far between. Yes when it is needed, it costs a lot money.

But when we are talking about uninsured people, they are a drain on the system because of the regular bullshit that they go to the emergency room for. Go ask any nurse that works in an ER and ask how much time/money is wasted on uninsured people who are there for little shit.

Just think of every Walmart, fast food, welfare person that is uninsured. Now imagine everytime they get the smallest illness and go to the emergency room to get a prescription. That takes time and resources and costs as assload of money.

If they would pay a doctor $80/month to lift that burden they have just made the system that much better.

And I don't have specific numbers but I can point to failing Hospitals due to providing "charity" care to uninsured for routine care.
Text

These hospitals aren't going out of business because of chemo costs. They are going out of business because of the overun of uninsured routine care they are providing for free.

Solve that problem and we are better off. The problem is that we tie doctor's hands. Doctor's pretty much won't see a patient who is uninsured. This doctor's plan at least solved part of the problem.

Yeah,
it's kind of an optimization problem - one uninsured person needing 8 hour surgery once (or chemo or *) = 3 months worth of kids in the ER with routine problems.

I suppose the main determinant is what costs the hopspital more - uninsured people going for treatment that cost $1500+ or people going to the ER with routine things often.


You've changed my mind though, the net result of the docs $80/mo plan are unclear.
If main cost drivers for hospitals are uninsured getting catastrophic treament ($1500+), the what he does exacerbates the problem. On the flip side if the predominant cost driver is people going for routine crap to the ER, then he's helping to fix the problem. Plus consider the people that would've had catastrophic coverage, but switched to limited coverage - that will likely increase the cost of the hospital in case of catastrophic injuries.

Without any empirical studies, I really can't pass a judgment on this.

We can both agree on that. From a purely theoretical point of view I can't see how this doctor caused harm but real studies would be needed to prove it one way or another.

I think can both agree that knee jerk reactions like shutting it down helps no one. It should be examined for viability and unintended consequences.

 

[halik]

Originally posted by: Codewiz

Originally posted by: halik

Originally posted by: Codewiz


We are talking uninsured people only right?

Even by your number of 20K for appendicitis, that number is quickly dwarfed by 5 parents who are uninsured and have child that are dumped in the emergency room regularly.

It is a simple math. Why is just catastrophic insurance reasonably priced per month? The odds of you actually NEEDING it is pretty few and far between. Yes when it is needed, it costs a lot money.

But when we are talking about uninsured people, they are a drain on the system because of the regular bullshit that they go to the emergency room for. Go ask any nurse that works in an ER and ask how much time/money is wasted on uninsured people who are there for little shit.

Just think of every Walmart, fast food, welfare person that is uninsured. Now imagine everytime they get the smallest illness and go to the emergency room to get a prescription. That takes time and resources and costs as assload of money.

If they would pay a doctor $80/month to lift that burden they have just made the system that much better.

And I don't have specific numbers but I can point to failing Hospitals due to providing "charity" care to uninsured for routine care.
Text

These hospitals aren't going out of business because of chemo costs. They are going out of business because of the overun of uninsured routine care they are providing for free.

Solve that problem and we are better off. The problem is that we tie doctor's hands. Doctor's pretty much won't see a patient who is uninsured. This doctor's plan at least solved part of the problem.

Yeah,
it's kind of an optimization problem - one uninsured person needing 8 hour surgery once (or chemo or *) = 3 months worth of kids in the ER with routine problems.

I suppose the main determinant is what costs the hopspital more - uninsured people going for treatment that cost $1500+ or people going to the ER with routine things often.


You've changed my mind though, the net result of the docs $80/mo plan are unclear.
If main cost drivers for hospitals are uninsured getting catastrophic treament ($1500+), the what he does exacerbates the problem. On the flip side if the predominant cost driver is people going for routine crap to the ER, then he's helping to fix the problem. Plus consider the people that would've had catastrophic coverage, but switched to limited coverage - that will likely increase the cost of the hospital in case of catastrophic injuries.

Without any empirical studies, I really can't pass a judgment on this.

We can both agree on that. From a purely theoretical point of view I can't see how this doctor caused harm but real studies would be needed to prove it one way or another.

I think can both agree that knee jerk reactions like shutting it down helps no one. It should be examined for viability and unintended consequences.

Agreed,
I am not a lawyer, though, so I can't really speak to why they decided to close him down... it seemed like it had more to do with law than public policy.

 

[halik]

Originally posted by: sactoking

Originally posted by: halik
From public policy perspective, you'd want the exact opposite - it's a lot better for people to have catastrophic coverage and no $80/mo coverage rather than the opposite... because the latter isn't a true insurance and cost of catastrophes will be passed onto others.

I disagree. Day-in and day-out, the costs of small maintenance-type claims drain more time, money, and resources from the system. It's the same with auto insurance. That's why states mandate you have some minimal coverage like $10,000/$15,000/$5,000 but do not legislate having coverage for if you kill someone.

* if you don't have catastrophic coverage ($80/mo), but can afford and are considering the $80/mo plan for regular limited coverage, you've already revealed your preferences regading the risk of bankruptcy by hospitalization. Since you have the $80/mo, but don't cover yourself with catastrophic policy, you will not cover yourself with catastrophic coverage on top of the $80/mo limited plan ceteris paribus. This follows from preference theory of economics: catastrophic coverage isn't worth $80/mo to you, but regular coverage is. If you choose regular limited coverage for $80, there is no logical reason to expect the catastrophic coverage will, all the sudden, be worth to you the $80/mo. Let me know if the above doesn't make sense, explaning econ theory isn't easy.

I have a degree in econ and work in insurance, but it still took me a couple reads to get what you were saying.

I disagree here as well. You're assuming that catastrophic coverage is currently available for $80 and that this "plan" would replace it. Thus, low-income people might replace their catastrophic coverage with basic coverage, since to have both will cost more than just the catastrophic. I disagree for two reasons:

1) As I stated above, the accumulated money, time, and resource costs of the basic treatments are greater than those for catastrophic treatments, so having the catastrophe coverage replaced by the basic coverage is inherently good.
2) The "$80 catastrophe coverage" that I originally mentioned doesn't exist. In the current world, many low-income people are faced with either paying $Z for a comprehensive policy or getting no insurance. I contend that this type of retainer system is good because the retainer costs $X and could be supplemented by a new catastrophe plan for $Y and that $X + $Y should be < $Z due to the way that underwriting and loss expenses are carried across different claim thresholds.

It actually is, my current plan is $90/mo, with the basic one being around $70/mo. They jack my rate up because I ride motorcycles

There are multiple providers of these plans and they start at $44/mo at blue cross / blue shield. And I agree with the fact that the $z for comprehensive policy will be more expensive than $x +$y, simply because there is a gap between what the cheap doctor's "retainer" plan can do and the minimum deductible before the catastrophic coverage kicks in. (i.e. doc can't do MRIs, but cost of MRIs is less than $2000 catastrophic deductible...)

That being said, the revealed preferences show that the two plans are substitutes, not supplements. If you didn't opt out for $80/mo catastrophic coverage even though you could afford it, signing up for the doc's cheap plan won't change the fact that catastrophic coverage isn't worth $80/mo to you.

 

[CADsortaGUY]

Originally posted by: Codewiz
This is how things have changed over time.

My grandfather was a doctor. This was long before the wildspread insurance. If you want to look at it this way, he taxed the rich to pay for the poor with his medical service. He had rich clients and he had poor clients. No two clients paid the same amount. I remember as a child seeing people come by and give us homecooked apple pies and such. These were poor people that could only afford to give him things like that.

My grandfather made good money without dealing with insurance and he never turned people away. Could he help people who went into the hospital? No but for routine care, everyone could afford to pay for his services.

:thumbsup: This is the way we should head back towards, not socialized gov't mandated/paid for services. Yes, there are issues with the old cash system but with a small amount of regulation(much less than we have today) it could be done.

 

[jagec]

Originally posted by: wwswimming

that's when a doctor's "care" causes the patient's health to deteriorate - a common outcome in American "health care" institutions.

best work-around = healthy lifestyle + frontier medicine.

Healthy lifestyle, absolutely.

But if you have a healthy lifestyle and you go to the hospital for a broken bone, infection, cancer, heart attack etc...you will NOT be worse for the experience, and it's outright lunacy to think that you will be.



<awaits the 0.00000001% anecdotal evidence to the contrary>

 

[jagec]

Originally posted by: halik

It actually is, my current plan is $90/mo, with the basic one being around $70/mo. They jack my rate up because I ride motorcycles

There are multiple providers of these plans and they start at $44/mo at blue cross / blue shield. And I agree with the fact that the $z for comprehensive policy will be more expensive than $x +$y, simply because there is a gap between what the cheap doctor's "retainer" plan can do and the minimum deductible before the catastrophic coverage kicks in. (i.e. doc can't do MRIs, but cost of MRIs is less than $2000 catastrophic deductible...)

That being said, the revealed preferences show that the two plans are substitutes, not supplements. If you didn't opt out for $80/mo catastrophic coverage even though you could afford it, signing up for the doc's cheap plan won't change the fact that catastrophic coverage isn't worth $80/mo to you.

The "revealed preference" is that the vast majority of people don't GET catastrophic coverage, regardless of the cost. Those people buying that $80 plan? They aren't going to be giving up their $90 catastrophic coverage plan, because they never had one. If you can't afford insurance, you CAN afford bankruptcy; in fact, it's cheap. It's having to go to the hospital for a broken bone or mild fever that will screw you. Hence, the $80 plan. Americans aren't economists...they don't do the math on these things. If you offer them a low price for "routine medicine"--that is, things that they can visualize themselves needing--they are much more likely to get it than an offer to pay the same price for freak-accident coverage. Because, well, they're not planning on getting cancer, so why throw the money away?

 

[halik]

Originally posted by: jagec

Originally posted by: halik

It actually is, my current plan is $90/mo, with the basic one being around $70/mo. They jack my rate up because I ride motorcycles

There are multiple providers of these plans and they start at $44/mo at blue cross / blue shield. And I agree with the fact that the $z for comprehensive policy will be more expensive than $x +$y, simply because there is a gap between what the cheap doctor's "retainer" plan can do and the minimum deductible before the catastrophic coverage kicks in. (i.e. doc can't do MRIs, but cost of MRIs is less than $2000 catastrophic deductible...)

That being said, the revealed preferences show that the two plans are substitutes, not supplements. If you didn't opt out for $80/mo catastrophic coverage even though you could afford it, signing up for the doc's cheap plan won't change the fact that catastrophic coverage isn't worth $80/mo to you.

The "revealed preference" is that the vast majority of people don't GET catastrophic coverage, regardless of the cost. Those people buying that $80 plan? They aren't going to be giving up their $90 catastrophic coverage plan, because they never had one. If you can't afford insurance, you CAN afford bankruptcy; in fact, it's cheap. It's having to go to the hospital for a broken bone or mild fever that will screw you. Hence, the $80 plan. Americans aren't economists...they don't do the math on these things. If you offer them a low price for "routine medicine"--that is, things that they can visualize themselves needing--they are much more likely to get it than an offer to pay the same price for freak-accident coverage. Because, well, they're not planning on getting cancer, so why throw the money away?

Let me clarify, the substitution would be from people that have/would have gotten the catastrophic coverage, but instead now they go for the cheaper doctor coverage.

You're definitely correct that most people would go for the cheaper regular visit coverage as opposed to catastrophic coverage, but I'd imagine that there would be some amount of substitution effect also.

 

[jagec]

Originally posted by: halik
Let me clarify, the substitution would be from people that have/would have gotten the catastrophic coverage, but instead now they go for the cheaper doctor coverage.

You're definitely correct that most people would go for the cheaper regular visit coverage as opposed to catastrophic coverage, but I'd imagine that there would be some amount of substitution effect also.

I understood what you were saying.

My claim is that this substitution effect is extraordinarily small compared to those people who currently have no insurance, who would buy the cheapo coverage, but who would not buy catastrophic coverage.

In other words, you see a few uninsured people picking up this plan (good), a few catastrophic-only people tacking on this plan (good), and a lot of catastrophic-only people switching to this plan (bad). This is logical, from an economics standpoint.

However, I see a LOT of uninsured people picking up this plan, a few catastrophic-only people tacking it on, and very few catastrophic-only people switching. IMHO this plan, while similarly priced to the catastrophic coverage, actually represents lower-hanging fruit to the uninsured, as the benefits of the plan are far more tangible. No one really wants to be uninsured, and the "what-ifs" are certainly a concern, but the thought of getting a cut, an infection, or even a broken bone is much more of a clear and pressing concern than the thought of getting very unlucky and running up hospital bills whose numbers are hard to conceptualize anyway. Those people who actually KNOW someone who ran up a massive hospital bill would probably want the catastrophic coverage, but most people don't actually have such a story immediately within their circle of friends and family.


(BTW, my abuse of italics, all-caps, and bolding is meant to convey vocal inflection and clarify the intended emphasis of the sentence, rather than being intended to chide or belittle whoever I'm responding to. FWIW)

 

[EXman]

I have a HSA this would be perfect for me i like docs that take CASH. I have to shop for medical care. I like hot deals. I like good service.

And my kids have the state version of S-chip and we owe $500 for the fee service due to the State assholes who lost the paperwork.

 

[nobodyknows]

Originally posted by: halik

Originally posted by: nobodyknows

Originally posted by: halik

If you let people get half-ass coverage, they will not get real coverage and still be uninsured and drive up the cost for the rest of us.

I don't care how you try to spin it, half-ass coverage is better then no coverage.

It's not spin, it's called thinking. Try it.

Half ass coverage mess people less likely to get real coverage, so you end up with more uninsured people.

You suffer under the delusion that this approach is meant to be real insurance, it's not so quit with your acting like it is. Who the hell are you to dictate what deals people can and can't make??

I still say it's a good idea because it will help catch illnesses/disease before it's too late.

 

[Atreus21]

I don't understand why we're putting this in terms of insurance automatically. If you provide a service, you should be allowed to charge whatever you want for it.

 

[ElFenix]

Originally posted by: halik

That argument kind of falls apart in the light of the fact that rates for non-profit insurers (blue cross/blue shield etc.) really aren't that different from for-profit operations. I actually get a better deal with united health than what I can get from BX/BS for the same price.

iirc, the blues are required to use community rating, while united may use experience rating. if you're healthy and don't smoke, don't drink much, young, etc., the experience rating is going to be much much cheaper than community rating.