Healthcare. Yes this subject again.

[Allan from Fallbrook]

Latest CBO report on the Baucus Bill: http://www.cbo.gov/doc.cfm?index=10642

[Allan from Fallbrook]

[quote=equalizer]
It is well laid out in this long article below which is titled
“How American Health Care Killed My Father”. Highly recommended for anyone who cares to understand the issues.

Simple solution: Require catastrophic insurance for everyone (subsidy for poor) and have users pay (edit-) cash for everything else. This will increase competition, increase quality of care, and reduce costs.

http://www.theatlantic.com/doc/200909/health-care/2%5B/quote%5D

Equalizer: That article should be required reading by everyone participating in the debate, whether individually or as part of the government effort.

Absolutely excellent article and it laid everything out in clear, understandable terms and language.

His solution, while simple and apparently workable, would undoubtedly be assailed viciously by industry lobbyists, which means it would probably work.

[Allan from Fallbrook]

[quote=equalizer]
It is well laid out in this long article below which is titled
“How American Health Care Killed My Father”. Highly recommended for anyone who cares to understand the issues.

Simple solution: Require catastrophic insurance for everyone (subsidy for poor) and have users pay (edit-) cash for everything else. This will increase competition, increase quality of care, and reduce costs.

http://www.theatlantic.com/doc/200909/health-care/2%5B/quote%5D

Equalizer: That article should be required reading by everyone participating in the debate, whether individually or as part of the government effort.

Absolutely excellent article and it laid everything out in clear, understandable terms and language.

His solution, while simple and apparently workable, would undoubtedly be assailed viciously by industry lobbyists, which means it would probably work.

[Allan from Fallbrook]

[quote=equalizer]
It is well laid out in this long article below which is titled
“How American Health Care Killed My Father”. Highly recommended for anyone who cares to understand the issues.

Simple solution: Require catastrophic insurance for everyone (subsidy for poor) and have users pay (edit-) cash for everything else. This will increase competition, increase quality of care, and reduce costs.

http://www.theatlantic.com/doc/200909/health-care/2%5B/quote%5D

Equalizer: That article should be required reading by everyone participating in the debate, whether individually or as part of the government effort.

Absolutely excellent article and it laid everything out in clear, understandable terms and language.

His solution, while simple and apparently workable, would undoubtedly be assailed viciously by industry lobbyists, which means it would probably work.

[Allan from Fallbrook]

[quote=equalizer]
It is well laid out in this long article below which is titled
“How American Health Care Killed My Father”. Highly recommended for anyone who cares to understand the issues.

Simple solution: Require catastrophic insurance for everyone (subsidy for poor) and have users pay (edit-) cash for everything else. This will increase competition, increase quality of care, and reduce costs.

http://www.theatlantic.com/doc/200909/health-care/2%5B/quote%5D

Equalizer: That article should be required reading by everyone participating in the debate, whether individually or as part of the government effort.

Absolutely excellent article and it laid everything out in clear, understandable terms and language.

His solution, while simple and apparently workable, would undoubtedly be assailed viciously by industry lobbyists, which means it would probably work.

[Allan from Fallbrook]

[quote=equalizer]
It is well laid out in this long article below which is titled
“How American Health Care Killed My Father”. Highly recommended for anyone who cares to understand the issues.

Simple solution: Require catastrophic insurance for everyone (subsidy for poor) and have users pay (edit-) cash for everything else. This will increase competition, increase quality of care, and reduce costs.

http://www.theatlantic.com/doc/200909/health-care/2%5B/quote%5D

Equalizer: That article should be required reading by everyone participating in the debate, whether individually or as part of the government effort.

Absolutely excellent article and it laid everything out in clear, understandable terms and language.

His solution, while simple and apparently workable, would undoubtedly be assailed viciously by industry lobbyists, which means it would probably work.

[Rt.66]

I agree that the debate should simply be that US healthcare is broken, plain and simple and how do we fix it. By polarizing it with two sides you weaken the public option. Is there really two sides? It’s broken and needs to be fixed so the debate should stick to that, it’s not as if there is NHC or keep what we’ve got. Most know that costs have spiraled out of control and continue to get crazier every year. Most know that what used to be a good system, now simply excludes too many to be called a functioning system at all.

The debate should not be NHC or NOT NHC. It should be NHC or some other complete revamp.

I have what would be called good health insurance in today’s environment. I’ve always had good insurance, yet I have seen the cost of that go parabolic in the past 5-7 years and seen many around me who once were covered lose their insurance because it just got so expensive.

A family member had a MINOR fall which really needed no medical attention but over-zealous ambulance drivers and ER folks turned it into a feeding frenzy on my insurance. The result was nearly $50k and my insurance company looked at the bill, including $99 for 1 Ibuprofen (no shit!) a bunch of stupid tests (, none of which showed an injury of any kind) and decided this was over billing bunk and did not pay it all. So now the hospital is after me for nearly $5k. Remember I have good insurance.

Moral of this story is hospitals are not dumb, if they are forced to treat people with no money or insurance for free, then they will make up the difference elsewhere (from the insured). It does not take a rocket scientist to see that will result in abuses to insurance. The system is just broke.

As far as doctors go, I would guess that those who are compassionate about healing and serving man kind would love a public option and those who are in it for the money will be on the side that pays best?

“Unless you’re a Warren Buffett or Bill Gates, you’re one illness away from financial ruin in this country,” says lead author Steffie Woolhandler, MD, of the Harvard Medical School, in Cambridge, Mass. “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that’s the major finding in our study.”

Dr. Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them.

They concluded that 62.1% of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10% of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically related bankruptcy had health insurance, they say.

“That was actually the predominant problem in patients in our study—78% of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services,” says Dr. Woolhandler. “Other people had private insurance but got so sick that they lost their job and lost their insurance.”
http://news.health.com/2009/06/04/medical-bills-bankruptcies/

[Rt.66]

I agree that the debate should simply be that US healthcare is broken, plain and simple and how do we fix it. By polarizing it with two sides you weaken the public option. Is there really two sides? It’s broken and needs to be fixed so the debate should stick to that, it’s not as if there is NHC or keep what we’ve got. Most know that costs have spiraled out of control and continue to get crazier every year. Most know that what used to be a good system, now simply excludes too many to be called a functioning system at all.

The debate should not be NHC or NOT NHC. It should be NHC or some other complete revamp.

I have what would be called good health insurance in today’s environment. I’ve always had good insurance, yet I have seen the cost of that go parabolic in the past 5-7 years and seen many around me who once were covered lose their insurance because it just got so expensive.

A family member had a MINOR fall which really needed no medical attention but over-zealous ambulance drivers and ER folks turned it into a feeding frenzy on my insurance. The result was nearly $50k and my insurance company looked at the bill, including $99 for 1 Ibuprofen (no shit!) a bunch of stupid tests (, none of which showed an injury of any kind) and decided this was over billing bunk and did not pay it all. So now the hospital is after me for nearly $5k. Remember I have good insurance.

Moral of this story is hospitals are not dumb, if they are forced to treat people with no money or insurance for free, then they will make up the difference elsewhere (from the insured). It does not take a rocket scientist to see that will result in abuses to insurance. The system is just broke.

As far as doctors go, I would guess that those who are compassionate about healing and serving man kind would love a public option and those who are in it for the money will be on the side that pays best?

“Unless you’re a Warren Buffett or Bill Gates, you’re one illness away from financial ruin in this country,” says lead author Steffie Woolhandler, MD, of the Harvard Medical School, in Cambridge, Mass. “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that’s the major finding in our study.”

Dr. Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them.

They concluded that 62.1% of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10% of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically related bankruptcy had health insurance, they say.

“That was actually the predominant problem in patients in our study—78% of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services,” says Dr. Woolhandler. “Other people had private insurance but got so sick that they lost their job and lost their insurance.”
http://news.health.com/2009/06/04/medical-bills-bankruptcies/

[Rt.66]

I agree that the debate should simply be that US healthcare is broken, plain and simple and how do we fix it. By polarizing it with two sides you weaken the public option. Is there really two sides? It’s broken and needs to be fixed so the debate should stick to that, it’s not as if there is NHC or keep what we’ve got. Most know that costs have spiraled out of control and continue to get crazier every year. Most know that what used to be a good system, now simply excludes too many to be called a functioning system at all.

The debate should not be NHC or NOT NHC. It should be NHC or some other complete revamp.

I have what would be called good health insurance in today’s environment. I’ve always had good insurance, yet I have seen the cost of that go parabolic in the past 5-7 years and seen many around me who once were covered lose their insurance because it just got so expensive.

A family member had a MINOR fall which really needed no medical attention but over-zealous ambulance drivers and ER folks turned it into a feeding frenzy on my insurance. The result was nearly $50k and my insurance company looked at the bill, including $99 for 1 Ibuprofen (no shit!) a bunch of stupid tests (, none of which showed an injury of any kind) and decided this was over billing bunk and did not pay it all. So now the hospital is after me for nearly $5k. Remember I have good insurance.

Moral of this story is hospitals are not dumb, if they are forced to treat people with no money or insurance for free, then they will make up the difference elsewhere (from the insured). It does not take a rocket scientist to see that will result in abuses to insurance. The system is just broke.

As far as doctors go, I would guess that those who are compassionate about healing and serving man kind would love a public option and those who are in it for the money will be on the side that pays best?

“Unless you’re a Warren Buffett or Bill Gates, you’re one illness away from financial ruin in this country,” says lead author Steffie Woolhandler, MD, of the Harvard Medical School, in Cambridge, Mass. “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that’s the major finding in our study.”

Dr. Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them.

They concluded that 62.1% of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10% of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically related bankruptcy had health insurance, they say.

“That was actually the predominant problem in patients in our study—78% of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services,” says Dr. Woolhandler. “Other people had private insurance but got so sick that they lost their job and lost their insurance.”
http://news.health.com/2009/06/04/medical-bills-bankruptcies/

[Rt.66]

I agree that the debate should simply be that US healthcare is broken, plain and simple and how do we fix it. By polarizing it with two sides you weaken the public option. Is there really two sides? It’s broken and needs to be fixed so the debate should stick to that, it’s not as if there is NHC or keep what we’ve got. Most know that costs have spiraled out of control and continue to get crazier every year. Most know that what used to be a good system, now simply excludes too many to be called a functioning system at all.

The debate should not be NHC or NOT NHC. It should be NHC or some other complete revamp.

I have what would be called good health insurance in today’s environment. I’ve always had good insurance, yet I have seen the cost of that go parabolic in the past 5-7 years and seen many around me who once were covered lose their insurance because it just got so expensive.

A family member had a MINOR fall which really needed no medical attention but over-zealous ambulance drivers and ER folks turned it into a feeding frenzy on my insurance. The result was nearly $50k and my insurance company looked at the bill, including $99 for 1 Ibuprofen (no shit!) a bunch of stupid tests (, none of which showed an injury of any kind) and decided this was over billing bunk and did not pay it all. So now the hospital is after me for nearly $5k. Remember I have good insurance.

Moral of this story is hospitals are not dumb, if they are forced to treat people with no money or insurance for free, then they will make up the difference elsewhere (from the insured). It does not take a rocket scientist to see that will result in abuses to insurance. The system is just broke.

As far as doctors go, I would guess that those who are compassionate about healing and serving man kind would love a public option and those who are in it for the money will be on the side that pays best?

“Unless you’re a Warren Buffett or Bill Gates, you’re one illness away from financial ruin in this country,” says lead author Steffie Woolhandler, MD, of the Harvard Medical School, in Cambridge, Mass. “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that’s the major finding in our study.”

Dr. Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them.

They concluded that 62.1% of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10% of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically related bankruptcy had health insurance, they say.

“That was actually the predominant problem in patients in our study—78% of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services,” says Dr. Woolhandler. “Other people had private insurance but got so sick that they lost their job and lost their insurance.”
http://news.health.com/2009/06/04/medical-bills-bankruptcies/

[Rt.66]

I agree that the debate should simply be that US healthcare is broken, plain and simple and how do we fix it. By polarizing it with two sides you weaken the public option. Is there really two sides? It’s broken and needs to be fixed so the debate should stick to that, it’s not as if there is NHC or keep what we’ve got. Most know that costs have spiraled out of control and continue to get crazier every year. Most know that what used to be a good system, now simply excludes too many to be called a functioning system at all.

The debate should not be NHC or NOT NHC. It should be NHC or some other complete revamp.

I have what would be called good health insurance in today’s environment. I’ve always had good insurance, yet I have seen the cost of that go parabolic in the past 5-7 years and seen many around me who once were covered lose their insurance because it just got so expensive.

A family member had a MINOR fall which really needed no medical attention but over-zealous ambulance drivers and ER folks turned it into a feeding frenzy on my insurance. The result was nearly $50k and my insurance company looked at the bill, including $99 for 1 Ibuprofen (no shit!) a bunch of stupid tests (, none of which showed an injury of any kind) and decided this was over billing bunk and did not pay it all. So now the hospital is after me for nearly $5k. Remember I have good insurance.

Moral of this story is hospitals are not dumb, if they are forced to treat people with no money or insurance for free, then they will make up the difference elsewhere (from the insured). It does not take a rocket scientist to see that will result in abuses to insurance. The system is just broke.

As far as doctors go, I would guess that those who are compassionate about healing and serving man kind would love a public option and those who are in it for the money will be on the side that pays best?

“Unless you’re a Warren Buffett or Bill Gates, you’re one illness away from financial ruin in this country,” says lead author Steffie Woolhandler, MD, of the Harvard Medical School, in Cambridge, Mass. “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that’s the major finding in our study.”

Dr. Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them.

They concluded that 62.1% of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10% of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically related bankruptcy had health insurance, they say.

“That was actually the predominant problem in patients in our study—78% of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services,” says Dr. Woolhandler. “Other people had private insurance but got so sick that they lost their job and lost their insurance.”
http://news.health.com/2009/06/04/medical-bills-bankruptcies/

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[Author]

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