What would you think about universal, high-deductible healthcare?

[Shyatic]

The majority of a persons health care costs are in the last 2 years of their life. A lot of that is terminal issues that wont get curable or caught in a regular checkup anyways.

A regular check up is done once a year. Costs a couple of hundred dollars. If people arent willing to spend 200-300 on their own health. Or if they dont get something checked out because they dont want to spend some of their own money on their health. Or put money into an HSA or FSA. Then, they lay in the bed they have made.

So you say, until they get a bout of pneumonia, and then you and I are left footing the bill anyway.

 

[chucky2]

Just the actual proceedure for my kidney stone (lithotripsy) was $16k. That didn't include the 2 primary care Dr. visits, the 3 CT scans, and 2 urologist appointments before the actual proceedure.

Let me tell you: When you have a kidney stone that is not passable, there is no option but to either do surgery, do lithotripsy, or go on up and break it up and take out the big chunks (which I personally think I'll go with next time). It's debilitating, pain killers don't effectively work, and even if they did, you'd be mentally wasted. I like to use something like this as a good example of what future healthcare in the US needs to be able to handle: Something that comes on quick, and needs to be treated ASAP, and that cannot be put off.

I seriously would rather be shot by a through and through bullet in a non-vital organ/bone area, than have another kidney stone again. It was that bad.

Chuck

 

[Genx87]

So you say, until they get a bout of pneumonia, and then you and I are left footing the bill anyway.

We would be left footing the bill regardless unless the deductible wasnt met. I am not quite getting your argument. You are making a claim for a high deductible plan but then want all checkups to be included? Wouldnt that cover basically a majority of people's medical costs then? In other words it sounds like you want a high deductible plan but then are making a case for keeping the status quo. Which one do you want?

 

[Atreus21]

TBH, I would have far less objection to universal health care, and indeed many social programs, if not for the illegal immigration problem.

 

[mattpegher]

Another much less talked about part of medical care is the disparity of income between speciallists and primary care. This has created a shortage of primary care, and a group of primary care physicians that book up for 3-4 weeks, and cant find time to see their acute patients at all.

Also currently, physicians are paid such that they can get paid twice as much per hour of patient care if they are doing some proceedure. They arent paid for the time spent with the patient. They may spend 10 minutes applying a device and get paid more than the half hour they spend examing and talking to the patient. Also it pays about 50% more to spend 15min with two patients than it does to spend 30minutes with one. We need to come up with a better way of paying for face to face time.

 

[BoberFett]

I've always thought that something similar was the best avenue for universal health care.

What I would implement would be nationwide, universal catastrophic coverage. If something cost more than X dollars (forgive me the details), it would be picked up by the government. All expenses below that however would be paid for through health savings accounts or something to that effect. That way we cut down on people getting treatment that they don't need while protecting people from catastrophic illness.

Even as a libertarian, I'd support such a plan. There is something to be said for pragmatism over ideology. Nobody can plan for catastrophes so cover those with the widest possible risk pool: everyone. However, for anything under the cap (except for routine checkups, I'd still make those free to encourage people to see a doctor before it becomes a catastrophe) make people responsible for their own health. Keep yourself healthy, you save thousands of dollars per year. Live an unhealthy lifestyle and it costs you, not society.

I still think you're a douchebag though, eskimospy. :wub:

 

[Ninjahedge]

Just FYI.

My cancer surgery, looking at the bills from 3 stays at the hospital, etc etc, would have cost me $250,000.

It cost US Healthcare $80K (which they tried to get back after we found out there was a misdiagnosis and filed suit... The misdiagnosis was from a "professional specialist" that US Healthcare referred me to "in network").

Our system is screwed up. For the heath insurance companies getting away with paying that little and forcing up costs on the uninsured is just added security for the insurance companies. I am now afraid to go w/o insurance because of any possible "pre-existing" clause that MEDICALLY has no bearing, but could be argued in a court of law...

 

[senseamp]

GOP wants to repeal the pre-existing condition protection along with the rest of Obama-care.

 

[SammyJr]

Sounds good if you are not a whose doctor whose government reimbursements for services rendered keep shrinking.

Somehow, I think those problems could be largely fixed if 90% of the politicians weren't beholden to some insurance company.

Additionally, if those same worthless politicians would actually represent Americans and bring jobs back from China, Medicare would have a lot more receipts.

 

[fskimospy]

Just FYI.

My cancer surgery, looking at the bills from 3 stays at the hospital, etc etc, would have cost me $250,000.

It cost US Healthcare $80K (which they tried to get back after we found out there was a misdiagnosis and filed suit... The misdiagnosis was from a "professional specialist" that US Healthcare referred me to "in network").

Our system is screwed up. For the heath insurance companies getting away with paying that little and forcing up costs on the uninsured is just added security for the insurance companies. I am now afraid to go w/o insurance because of any possible "pre-existing" clause that MEDICALLY has no bearing, but could be argued in a court of law...

Me too, just a surgical biopsy for my cancer cost about $100k in billed costs. There's just no way the average person can be prepared to be on the hook for something like that.

 

[woolfe9999]

Me too, just a surgical biopsy for my cancer cost about $100k in billed costs. There's just no way the average person can be prepared to be on the hook for something like that.

Indeed, the present system is completely untenable. It beggars belief that there exists anyone who can't see that.

On a personal note, I hope you're doing OK.

- wolf

 

[Ninjahedge]

GOP wants to repeal the pre-existing condition protection along with the rest of Obama-care.

Pre-existing condition should be re-written to prevent last minute enrolees.

You would have to have insurance before diagnosis or be forced to pay a penalty, and any condition that has not recurred or progressed in X amount of time should no longer be considered "pre-existing".

I agree that they need to protect themselves, but they were using it to deny people that had cancer under insurance, changed jobs and had a month gap in the policy, then a recurrence.

To lump them in with people who never had insurance, find a lump on their body and get it the same month they go in and are diagnosed with XYZ is just not right.....

 

[fskimospy]

Indeed, the present system is completely untenable. It beggars belief that there exists anyone who can't see that.

On a personal note, I hope you're doing OK.

- wolf

I'm fit as a fiddle! Cancer free since March of 2009.

 

[Atreus21]

Indeed, the present system is completely untenable. It beggars belief that there exists anyone who can't see that.

On a personal note, I hope you're doing OK.

- wolf

It does beg the question though, what happens if a life-saving procedure costs 200 grand? Half a million? Is any tenable system supposed to treat life-saving procedures as if they don't cost money to administer?

 

[Ninjahedge]

And that is what hung up Obama and any other making this proposal.

It is also what I brought up. A human life has a price tag, but nobody is willing to say what it is.

You do not fly in the best doctors from Sweeden/etc to treat a hangnail, but you do not put a band-aid on a tumor.

But where does the line get drawn?

I guess we have to start looking at the actual #'s and start calling out a maximum at 99% (or more) of the general populations maximum expenses.

If we can say that 99.9% of people would be fine at $1M, then the cap is $1M.

You take a look at where the graph takes a spike and the cost would no longer be practical....


But again, as soon as you do that, people will say that a persons life is worth $10M, $100M........

If you can save 100 people for the cost of 1... where do you say the 100 over the 1?

 

[sunzt]

And that is what hung up Obama and any other making this proposal.

It is also what I brought up. A human life has a price tag, but nobody is willing to say what it is.

You do not fly in the best doctors from Sweeden/etc to treat a hangnail, but you do not put a band-aid on a tumor.

But where does the line get drawn?

I guess we have to start looking at the actual #'s and start calling out a maximum at 99% (or more) of the general populations maximum expenses.

If we can say that 99.9% of people would be fine at $1M, then the cap is $1M.

You take a look at where the graph takes a spike and the cost would no longer be practical....


But again, as soon as you do that, people will say that a persons life is worth $10M, $100M........

If you can save 100 people for the cost of 1... where do you say the 100 over the 1?

http://www.time.com/time/health/article/0,8599,1808049,00.html

The Value of a Human Life: $129,000

 

[Ausm]

Correct me if I am wrong, but was the public option a catastrophic plan? I dont remember hearing enough about it.

Ideally if the fed created one or more insurance plans that any american could purchase with a non-profit insurance company then that would really give the insurance companies some major competition. That is what the insurance (financial) industry didnot want. The option to buy a product from a non-profit. Then they would have to try to creat some insurance products that offered more for a little more but at a severe loss of profit.

The Public option was a Medicare type of program people could opt into instead of getting raped in the private markets.

 

[Ausm]

Me too, just a surgical biopsy for my cancer cost about $100k in billed costs. There's just no way the average person can be prepared to be on the hook for something like that.

But the GOP says just goto the emergency room to get your care...LOL yeah riiighht.

 

[Ninjahedge]

sunzt, the article shows what I am talking about. The difficulty in determining the value of life.

That article goes more into trying to rationalize the average cost of life, not its worty, with a fairly common procedure and gets hung up.

You can't just take one medical procedure as the benchmark, but the study does shed some light on the general problems faced by this.

I guess a chart showing the cost of a medical procedure verses years of prolongation of life would be one thing that was necessary. The other would be the devalueization (sp)of a persons worth by being injured (say, not healing a broken leg correctly) versus the cost to the procedure. (Or, say, the cost of saving a mans leg to how they could perform later in life w/o it).

The only thing we can recommend is the levels of funding needed to keep the public alive for an average number of additional days and/or additional productive days. We then fund the program with what we have, and allow the people to see what that amounts to.

If the public wants more funding, they vote on it and get a direct tax increase (or decrease) because of it. Certain limits are set, and buffers for the rate of change and we see how it goes.....

 

[mattpegher]

The Public option was a Medicare type of program people could opt into instead of getting raped in the private markets.

But not a catastrophic plan? Medicare is an 80/20 with a $142 deductible.
I'm not sure if the government could finance a catastrophic plan.

Lets say that 1 million people signed up for it and it cost 100/person/ month or 400/family of four. Thats 1.2 trillion dollars/year. Now we need to know the incidence of persons getting hit with bills greater than a 5000 deductible. I would be willing to bet that it is at least 10% and that the bills would average about $10000 for that 100000 people that would come out to about 1trillion dollars. But I dont think that the gov could do this without at least a 20% administative costs (and that conservative). And that is being optimistic that we could break even.

You need something to increase the revenue or decrease the incidence of catastrophic payouts.

 

[mattpegher]

That said has anyone heard any estimates of administrative costs should the government become the single payor. Is there any published data on the amount of money the government budgets for medicare vs how much it pays out?

Read this and still dont know

http://www.hhs.gov/asfr/ob/docbudget/2011budgetinbrief.pdf

The question is if we take the money we pay the insurance companies, and give it to the fed, how much of a percent will be spent on care and how much on administration?