Can Obamacare be Fixed?

[itfitzme]

Problem is that Health Insurance premiums are the very end of the vertical supply chain.

Financial System:
.....Student Loans:
Education:
.....Faculty:
.....Publishers:
Trained Labor:
.....Doctors:
.....Nurses:
.....Medical Technicians
Capital Equipment and Facilities:
.....Hospitals:
.....MRI Equipment:
Products:
.....Drugs:
.....Medical Devices:
.....Supplies:
.....Lab tests:
Health Insurance:


Any increase in prices above Health Insurance is going to result in an increase in premiums, regardless of the 20% cap. That 80% can increase simply because tuition costs went up. Oh, and here is the kicker, if that 80% goes up, so goes the 20%. Unless there is something to cap that, higher are the prices for hospitals, doctors, labs, whatever be the prices that the insurance carrier pays, the higher is the over all cost and the higher the 20% is in real dollar terms.

Think about this. If the average prices paid to the market by the insurance companies is $80, then they have $20 to cover average internal costs for a total premium of $100. If the average price goes up to $100, total premiums can be $125 and net to the insurance carrier is $25. They aren't incurring an additional $5 in costs, still $20. They just get to keep an extra $5.

Hmmm.....

And this has nothing to do with PPACA. It is purely a free-market functionality issue. If they act as ologopolies, like they have been, nothing holds insurance premiums down except demand willingness to pay.

Back to square one.

 

[PMZ]

So far, technology has mostly improved results in health care, and increased costs. Clearly we've reached the cost limit. Nearly 20% of GDP.

We got here because, except for Medicare, nobody cared what things cost as long as everyone pulled through the current crises, at least until the next one.

Certainly the potential for technology lowering costs is as high as the potential for improving results. But who, anywhere in the health care delivery business, benefits from lower costs? Nobody.

So health care delivery businesses have no incentive to lower costs except for their Medicare patients. Granted, on average, that's half of their business.

While Obamacare is not a product at all, and it's main goal is to get everyone cost effective health care, it does make it harder for health care deliverers, under considerable pressure to save Medicare costs, to shift those costs to non-Medicare patients.

 

[dblack]

So far, technology has mostly improved results in health care, and increased costs. Clearly we've reached the cost limit. Nearly 20% of GDP.

We got here because, except for Medicare, nobody cared what things cost as long as everyone pulled through the current crises, at least until the next one.

Certainly the potential for technology lowering costs is as high as the potential for improving results. But who, anywhere in the health care delivery business benefits from lower costs? Nobody.

So health care delivery businesses have no incentive to lower costs except for their Medicare patients. Granted, on average, that's half of their business.

There's no incentive to lower costs because most of us aren't paying for our own health care. We're all chasing the fantasy that we can get 'someone else' to foot the bill.

 

[PMZ]

So far, technology has mostly improved results in health care, and increased costs. Clearly we've reached the cost limit. Nearly 20% of GDP.

We got here because, except for Medicare, nobody cared what things cost as long as everyone pulled through the current crises, at least until the next one.

Certainly the potential for technology lowering costs is as high as the potential for improving results. But who, anywhere in the health care delivery business benefits from lower costs? Nobody.

So health care delivery businesses have no incentive to lower costs except for their Medicare patients. Granted, on average, that's half of their business.

There's no incentive to lower costs because most of us aren't paying for our own health care. We're all chasing the fantasy that we can get 'someone else' to foot the bill.

Unfortunately that perception has been reinforced by companies backing away from health care insurance compensation without making up for it in other compensation.

Net result? Lower total pay.

 

[itfitzme]

There is a problem with so many that see insurance as a program where they expect to recover the full cost of their premiums, (sometimes they are even expecting more). OASDI (aka Social Security Insurance)[1], auto insurance, and health care insurance are not intended that you, I or anyone in particular is going to recoup their total "investment". They aren't investment programs at all.

I'm sure that people understood this at one time. Businesses are clear on this as business practice is considerate of risk. Individuals seem to miss the point that an accounting of payments vs returns means that they are likely to see negative return on insurance. The average or expected return on insurance is negative as the program has to be managed.

I know that people don't get this with OASDI (SSIns) as they see it as some 401k plan. It isn't. It is insurance and it isn't designed solely for the individual receiving it. It is designed for the rest of us so we don't have to deal with people who, for whatever reason, find themselves in dire straights come old age.

Insurance is an accounting loss program. The expectation is probability of loss times the expected value of the loss. And the greater the expected loss value, the greater the insurance premium.

There is also a difference between economic and accounting costs. People only see the accounting costs. Nobody sees economic costs because that is dependent on the "otherwise" scenario, the cost of "if no one had insurance."

I believe, also, that there is a huge disparity in terms of actuary information. People really don't know what the value of their insurance really is because they are terrible at understanding and reacting to real probabilities. This, along with a myriad of other factors puts far to much market leverage on the supply side of insurance and healthcare.

Nobody can be prepared for the catastrophic event. The only way to prepare for that is pooled risk. Catastrophic insurance, like Medicare Part A (hospitalization) makes sense. And, frankly, everyone should have that regardless. It covers hospitalization. Here are some stats from the CDC.

Hospital inpatient care [2]
Number of discharges: 35.1 million
Discharges per 10,000 population: 1,139.6
Average length of stay in days: 4.8

If I read it right, it is simply about 11.4% of the population will be hospitalized in any given year with an average stay of 4.8 days. (Can that be right? One in ten people per year? I dislike these kinds of rate calculations, like divorce rate. Still, another source says, yeah, about 10% in the first year. Higher for risk factors, like 65 years or older. [3][4])

Hospitalization is expensive, everyone is likely to be hospitalized. The costs are [5]

United States
• State/local government hospitals — $1,625
• Non-profit hospitals — $2,025
• For-profit hospitals — $1,629

A simple estimate of the variance for the days is 4.8^2 and the 99% length is 3x4.8^2 or 70 days. So to be fully prepared would require $139,968 in cash. No one is prepared for that, or could prepare for that, though one in 100 of the 10%, or one in 1,000 people will end up in the hospital for a two month stay.[6]

Another source says, "with more than 6 million accidents in the United States, alone, that means there are more than 2 million accidents resulting in more than 3 million injured men, women, and children each year." This yields 3/300 = 1% of the population in some sort of injury related accident each year. [7]

What's the minimum for automobile insurance liability? $15k? That is about 10% of what is necessary.

It should be patently obvious that everyone should be carrying, at least, catastrophic injury insurance. And it isn't some investment club where we expect to see a return for out money. It is suppose to be a total loss. We want our insurance to be a total loss because we are hoping we don't get injured.

And that insurance isn't for the guy that has it. It is for the rest of us so we don't end up footing that $141,000 bill because he didn't bother.
--------
[1] SSI is Supplemental Security Income, not to be confused with OASDI.
[2] FASTSTATS - Hospital Utilization
[3] http://www2.sas.com/proceedings/sugi25/25/st/25p272.pdf
[4] http://www.acg.jhsph.edu/acgdocuments/Wednesday_Salon_Lemke_AnalyticTechniques.pdf
[5] Average Cost Per Inpatient Day Across 50 States in 2010
[6] Anecdotally, I know someone that was in a head on collision and it did cost $140k for the trauma center ICU alone.
[7] Medical Issues Related to an Auto Accident - InjuryBoard.com

 

[PMZ]

There is a problem with so many that see insurance as a program where they expect to recover the full cost of their premiums, (sometimes they are even expecting more). OASDI (aka Social Security Insurance)[1], auto insurance, and health care insurance are not intended that you, I or anyone in particular is going to recoup their total "investment". They aren't investment programs at all.

I'm sure that people understood this at one time. Businesses are clear on this as business practice is considerate of risk. Individuals seem to miss the point that an accounting of payments vs returns means that they are likely to see negative return on insurance. The average or expected return on insurance is negative as the program has to be managed.

I know that people don't get this with OASDI (SSIns) as they see it as some 401k plan. It isn't. It is insurance and it isn't designed solely for the individual receiving it. It is designed for the rest of us so we don't have to deal with people who, for whatever reason, find themselves in dire straights come old age.

Insurance is an accounting loss program. The expectation is probability of loss times the expected value of the loss. And the greater the expected loss value, the greater the insurance premium.

There is also a difference between economic and accounting costs. People only see the accounting costs. Nobody sees economic costs because that is dependent on the "otherwise" scenario, the cost of "if no one had insurance."

I believe, also, that there is a huge disparity in terms of actuary information. People really don't know what the value of their insurance really is because they are terrible at understanding and reacting to real probabilities. This, along with a myriad of other factors puts far to much market leverage on the supply side of insurance and healthcare.

Nobody can be prepared for the catastrophic event. The only way to prepare for that is pooled risk. Catastrophic insurance, like Medicare Part A (hospitalization) makes sense. And, frankly, everyone should have that regardless. It covers hospitalization. Here are some stats from the CDC.

Hospital inpatient care [2]
Number of discharges: 35.1 million
Discharges per 10,000 population: 1,139.6
Average length of stay in days: 4.8

If I read it right, it is simply about 11.4% of the population will be hospitalized in any given year with an average stay of 4.8 days. (Can that be right? One in ten people per year? I dislike these kinds of rate calculations, like divorce rate. Still, another source says, yeah, about 10% in the first year. Higher for risk factors, like 65 years or older. [3][4])

Hospitalization is expensive, everyone is likely to be hospitalized. The costs are [5]

United States
• State/local government hospitals — $1,625
• Non-profit hospitals — $2,025
• For-profit hospitals — $1,629

A simple estimate of the variance for the days is 4.8^2 and the 99% length is 3x4.8^2 or 70 days. So to be fully prepared would require $139,968 in cash. No one is prepared for that, or could prepare for that, though one in 100 of the 10%, or one in 1,000 people will end up in the hospital for a two month stay.[6]

Another source says, "with more than 6 million accidents in the United States, alone, that means there are more than 2 million accidents resulting in more than 3 million injured men, women, and children each year." This yields 3/300 = 1% of the population in some sort of injury related accident each year. [7]

What's the minimum for automobile insurance liability? $15k? That is about 10% of what is necessary.

It should be patently obvious that everyone should be carrying, at least, catastrophic injury insurance. And it isn't some investment club where we expect to see a return for out money. It is suppose to be a total loss. We want our insurance to be a total loss because we are hoping we don't get injured.

And that insurance isn't for the guy that has it. It is for the rest of us so we don't end up footing that $141,000 bill because he didn't bother.
--------
[1] SSI is Supplemental Security Income, not to be confused with OASDI.
[2] FASTSTATS - Hospital Utilization
[3] http://www2.sas.com/proceedings/sugi25/25/st/25p272.pdf
[4] http://www.acg.jhsph.edu/acgdocuments/Wednesday_Salon_Lemke_AnalyticTechniques.pdf
[5] Average Cost Per Inpatient Day Across 50 States in 2010
[6] Anecdotally, I know someone that was in a head on collision and it did cost $140k for the trauma center ICU alone.
[7] Medical Issues Related to an Auto Accident - InjuryBoard.com

I believe that it's at least approximately true that Medicare pays for about half of the medical care in the US. And a huge portion of that is in the last year of life.

It is, of course payed for as a payroll deduction which is matched by an employer contribution throughout our working years, but the costs continue after retirement at a little over $100 per month per person, and co-pays and deductibles as well as limits to coverage.

And I suppose the average number of years that it covers is perhaps 15 or so.

I think all that is pretty demonstrative of how much old age medical bills can rack up.

 

[Flopper]

There is a problem with so many that see insurance as a program where they expect to recover the full cost of their premiums, (sometimes they are even expecting more). OASDI (aka Social Security Insurance)[1], auto insurance, and health care insurance are not intended that you, I or anyone in particular is going to recoup their total "investment". They aren't investment programs at all.

I'm sure that people understood this at one time. Businesses are clear on this as business practice is considerate of risk. Individuals seem to miss the point that an accounting of payments vs returns means that they are likely to see negative return on insurance. The average or expected return on insurance is negative as the program has to be managed.

I know that people don't get this with OASDI (SSIns) as they see it as some 401k plan. It isn't. It is insurance and it isn't designed solely for the individual receiving it. It is designed for the rest of us so we don't have to deal with people who, for whatever reason, find themselves in dire straights come old age.

Insurance is an accounting loss program. The expectation is probability of loss times the expected value of the loss. And the greater the expected loss value, the greater the insurance premium.

There is also a difference between economic and accounting costs. People only see the accounting costs. Nobody sees economic costs because that is dependent on the "otherwise" scenario, the cost of "if no one had insurance."

I believe, also, that there is a huge disparity in terms of actuary information. People really don't know what the value of their insurance really is because they are terrible at understanding and reacting to real probabilities. This, along with a myriad of other factors puts far to much market leverage on the supply side of insurance and healthcare.

Nobody can be prepared for the catastrophic event. The only way to prepare for that is pooled risk. Catastrophic insurance, like Medicare Part A (hospitalization) makes sense. And, frankly, everyone should have that regardless. It covers hospitalization. Here are some stats from the CDC.

Hospital inpatient care [2]
Number of discharges: 35.1 million
Discharges per 10,000 population: 1,139.6
Average length of stay in days: 4.8

If I read it right, it is simply about 11.4% of the population will be hospitalized in any given year with an average stay of 4.8 days. (Can that be right? One in ten people per year? I dislike these kinds of rate calculations, like divorce rate. Still, another source says, yeah, about 10% in the first year. Higher for risk factors, like 65 years or older. [3][4])

Hospitalization is expensive, everyone is likely to be hospitalized. The costs are [5]

United States
• State/local government hospitals — $1,625
• Non-profit hospitals — $2,025
• For-profit hospitals — $1,629

A simple estimate of the variance for the days is 4.8^2 and the 99% length is 3x4.8^2 or 70 days. So to be fully prepared would require $139,968 in cash. No one is prepared for that, or could prepare for that, though one in 100 of the 10%, or one in 1,000 people will end up in the hospital for a two month stay.[6]

Another source says, "with more than 6 million accidents in the United States, alone, that means there are more than 2 million accidents resulting in more than 3 million injured men, women, and children each year." This yields 3/300 = 1% of the population in some sort of injury related accident each year. [7]

What's the minimum for automobile insurance liability? $15k? That is about 10% of what is necessary.

It should be patently obvious that everyone should be carrying, at least, catastrophic injury insurance. And it isn't some investment club where we expect to see a return for out money. It is suppose to be a total loss. We want our insurance to be a total loss because we are hoping we don't get injured.

And that insurance isn't for the guy that has it. It is for the rest of us so we don't end up footing that $141,000 bill because he didn't bother.
--------
[1] SSI is Supplemental Security Income, not to be confused with OASDI.
[2] FASTSTATS - Hospital Utilization
[3] http://www2.sas.com/proceedings/sugi25/25/st/25p272.pdf
[4] http://www.acg.jhsph.edu/acgdocuments/Wednesday_Salon_Lemke_AnalyticTechniques.pdf
[5] Average Cost Per Inpatient Day Across 50 States in 2010
[6] Anecdotally, I know someone that was in a head on collision and it did cost $140k for the trauma center ICU alone.
[7] Medical Issues Related to an Auto Accident - InjuryBoard.com

I believe that it's at least approximately true that Medicare pays for about half of the medical care in the US. And a huge portion of that is in the last year of life.

It is, of course payed for as a payroll deduction which is matched by an employer contribution throughout our working years, but the costs continue after retirement at a little over $100 per month per person, and co-pays and deductibles as well as limits to coverage.

And I suppose the average number of years that it covers is perhaps 15 or so.

I think all that is pretty demonstrative of how much old age medical bills can rack up.

In 2011, Medicare spent a total of $549.1 billion on health care coverage for 48.7 million beneficiaries. This accounted for roughly 15 percent of the national budget and 21 percent of overall U.S. health care spending, according to the Congressional Budget Office.
How much Medicare costs - Health care costs | Medicare News Group

Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life.
Before I Die: Spending on Care

 

[PMZ]

There is a problem with so many that see insurance as a program where they expect to recover the full cost of their premiums, (sometimes they are even expecting more). OASDI (aka Social Security Insurance)[1], auto insurance, and health care insurance are not intended that you, I or anyone in particular is going to recoup their total "investment". They aren't investment programs at all.

I'm sure that people understood this at one time. Businesses are clear on this as business practice is considerate of risk. Individuals seem to miss the point that an accounting of payments vs returns means that they are likely to see negative return on insurance. The average or expected return on insurance is negative as the program has to be managed.

I know that people don't get this with OASDI (SSIns) as they see it as some 401k plan. It isn't. It is insurance and it isn't designed solely for the individual receiving it. It is designed for the rest of us so we don't have to deal with people who, for whatever reason, find themselves in dire straights come old age.

Insurance is an accounting loss program. The expectation is probability of loss times the expected value of the loss. And the greater the expected loss value, the greater the insurance premium.

There is also a difference between economic and accounting costs. People only see the accounting costs. Nobody sees economic costs because that is dependent on the "otherwise" scenario, the cost of "if no one had insurance."

I believe, also, that there is a huge disparity in terms of actuary information. People really don't know what the value of their insurance really is because they are terrible at understanding and reacting to real probabilities. This, along with a myriad of other factors puts far to much market leverage on the supply side of insurance and healthcare.

Nobody can be prepared for the catastrophic event. The only way to prepare for that is pooled risk. Catastrophic insurance, like Medicare Part A (hospitalization) makes sense. And, frankly, everyone should have that regardless. It covers hospitalization. Here are some stats from the CDC.

Hospital inpatient care [2]
Number of discharges: 35.1 million
Discharges per 10,000 population: 1,139.6
Average length of stay in days: 4.8

If I read it right, it is simply about 11.4% of the population will be hospitalized in any given year with an average stay of 4.8 days. (Can that be right? One in ten people per year? I dislike these kinds of rate calculations, like divorce rate. Still, another source says, yeah, about 10% in the first year. Higher for risk factors, like 65 years or older. [3][4])

Hospitalization is expensive, everyone is likely to be hospitalized. The costs are [5]

United States
• State/local government hospitals — $1,625
• Non-profit hospitals — $2,025
• For-profit hospitals — $1,629

A simple estimate of the variance for the days is 4.8^2 and the 99% length is 3x4.8^2 or 70 days. So to be fully prepared would require $139,968 in cash. No one is prepared for that, or could prepare for that, though one in 100 of the 10%, or one in 1,000 people will end up in the hospital for a two month stay.[6]

Another source says, "with more than 6 million accidents in the United States, alone, that means there are more than 2 million accidents resulting in more than 3 million injured men, women, and children each year." This yields 3/300 = 1% of the population in some sort of injury related accident each year. [7]

What's the minimum for automobile insurance liability? $15k? That is about 10% of what is necessary.

It should be patently obvious that everyone should be carrying, at least, catastrophic injury insurance. And it isn't some investment club where we expect to see a return for out money. It is suppose to be a total loss. We want our insurance to be a total loss because we are hoping we don't get injured.

And that insurance isn't for the guy that has it. It is for the rest of us so we don't end up footing that $141,000 bill because he didn't bother.
--------
[1] SSI is Supplemental Security Income, not to be confused with OASDI.
[2] FASTSTATS - Hospital Utilization
[3] http://www2.sas.com/proceedings/sugi25/25/st/25p272.pdf
[4] http://www.acg.jhsph.edu/acgdocuments/Wednesday_Salon_Lemke_AnalyticTechniques.pdf
[5] Average Cost Per Inpatient Day Across 50 States in 2010
[6] Anecdotally, I know someone that was in a head on collision and it did cost $140k for the trauma center ICU alone.
[7] Medical Issues Related to an Auto Accident - InjuryBoard.com

I believe that it's at least approximately true that Medicare pays for about half of the medical care in the US. And a huge portion of that is in the last year of life.

It is, of course payed for as a payroll deduction which is matched by an employer contribution throughout our working years, but the costs continue after retirement at a little over $100 per month per person, and co-pays and deductibles as well as limits to coverage.

And I suppose the average number of years that it covers is perhaps 15 or so.

I think all that is pretty demonstrative of how much old age medical bills can rack up.

In 2011, Medicare spent a total of $549.1 billion on health care coverage for 48.7 million beneficiaries. This accounted for roughly 15 percent of the national budget and 21 percent of overall U.S. health care spending, according to the Congressional Budget Office.
How much Medicare costs - Health care costs | Medicare News Group

Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life.
Before I Die: Spending on Care

Some additional info.

http://en.m.wikipedia.org/wiki/Health_care_in_the_United_States

 

[jon_berzerk]

There is no better health insurance in the country than Medicare. It covers over half of the medical costs in the country. An improvement to ACA would be to offer Medicare as an alternative in the exchanges.

Do you know why that will never happen?

Private insurance companies can't stand the competition.

There is no better health insurance in the country than Medicare.

yeah it so great that it requires supplemental plans from the

private sector to work

 

[PMZ]

There is no better health insurance in the country than Medicare. It covers over half of the medical costs in the country. An improvement to ACA would be to offer Medicare as an alternative in the exchanges.

Do you know why that will never happen?

Private insurance companies can't stand the competition.

There is no better health insurance in the country than Medicare.

yeah it so great that it requires supplemental plans from the

private sector to work

It is what it is. The minimum insurance requirement for those > 65. That's what you pay for, that's what you get.

 

[itfitzme]

There is no better health insurance in the country than Medicare. It covers over half of the medical costs in the country. An improvement to ACA would be to offer Medicare as an alternative in the exchanges.

Do you know why that will never happen?

Private insurance companies can't stand the competition.

There is no better health insurance in the country than Medicare.

yeah it so great that it requires supplemental plans from the

private sector to work

Requires?

I know someone that has been on Medicare for 30 years. What supplemental plan are we talking about?

 

[HenryBHough]

Requires?

I know someone that has been on Medicare for 30 years. What supplemental plan are we talking about?

That word "requires" should not be construed to mean that any government agency forces anyone to buy a supplement.

A supplement, however, might be required by a person who understands the limits of Medicare and is unwilling to personally bear the costs it does not cover.

More, You don't have any choice about Medicare Part A if you are over 65. You're stuck with it. You can elect to improve what's covered by purchasing (from the feds) Part B which helps quite a bit but does nothing about your prescription costs. You can take it further by buying (from a private vendor), Medicare Part D which will cover a lot of your medication costs - but NOT all of them. There are still deductibles, co-pays, and limits to coverage (the "donut hole") to be considered.

The holes left by Parts A and B can be protected against by buying a private supplement that will pick up deductibles and cover (in most cases) the 20% of costs that Medicare does not cover.

People with any assets and sufficient income to afford a supplement are wise to buy one lest their assets (like their home) be seized for non-payment of those non-covered (by Medicare) portions of health care in the event of a serious illness.

Of course if you have few or no assets then no point in buying a supplement because you have nothing to lose other than perhaps a few bucks in a savings account should you be sued. Of course if you have income that can be grabbed, well then why keep on working?

 

[Flopper]

There is no better health insurance in the country than Medicare. It covers over half of the medical costs in the country. An improvement to ACA would be to offer Medicare as an alternative in the exchanges.

Do you know why that will never happen?

Private insurance companies can't stand the competition.

There is no better health insurance in the country than Medicare.

yeah it so great that it requires supplemental plans from the

private sector to work

Medicare works fine for the beneficiaries of it. It just has deductibles and co-insurance. A lot of people simple can't afford a 20% copay of a hospital bill or prefer to have all of their medical bills paid by the insurance company which make life a lot easier if you have lots of medical bills.

The major problem with Medicare is the same as most government services. We like the service, we just don't want to pay for it.

 

[itfitzme]

Requires?

I know someone that has been on Medicare for 30 years. What supplemental plan are we talking about?

That word "requires" should not be construed to mean that any government agency forces anyone to buy a supplement.

A supplement, however, might be required by a person who understands the limits of Medicare and is unwilling to personally bear the costs it does not cover.

More, You don't have any choice about Medicare Part A if you are over 65. You're stuck with it. You can elect to improve what's covered by purchasing (from the feds) Part B which helps quite a bit but does nothing about your prescription costs. You can take it further by buying (from a private vendor), Medicare Part D which will cover a lot of your medication costs - but NOT all of them. There are still deductibles, co-pays, and limits to coverage (the "donut hole") to be considered.

The holes left by Parts A and B can be protected against by buying a private supplement that will pick up deductibles and cover (in most cases) the 20% of costs that Medicare does not cover.

People with any assets and sufficient income to afford a supplement are wise to buy one lest their assets (like their home) be seized for non-payment of those non-covered (by Medicare) portions of health care in the event of a serious illness.

Of course if you have few or no assets then no point in buying a supplement because you have nothing to lose other than perhaps a few bucks in a savings account should you be sued. Of course if you have income that can be grabbed, well then why keep on working?

That wouldn't be a "requirement". It would be a preference or an opinion.

See, tires on an automobile are REQUIRED in order for it to work. Power steering and bucket seats aren't required, they are preferred.

You are also over explaining. Like I said, I know someone that has had it for 30 years. I am well aware of what Medicare A, B, C, and D are, how they work, what the deductibles, formularies, program management companies, limitations, improvements, supplements, and co-pays are.

 

[itfitzme]

There is no better health insurance in the country than Medicare. It covers over half of the medical costs in the country. An improvement to ACA would be to offer Medicare as an alternative in the exchanges.

Do you know why that will never happen?

Private insurance companies can't stand the competition.

There is no better health insurance in the country than Medicare.

yeah it so great that it requires supplemental plans from the

private sector to work

Medicare works fine for the beneficiaries of it. It just has deductibles and co-insurance. A lot of people simple can't afford a 20% copay of a hospital bill or prefer to have all of their medical bills paid by the insurance company which make life a lot easier if you have lots of medical bills.

The major problem with Medicare is the same as most government services. We like the service, we just don't want to pay for it.

And for the average person, the actual accounting return is always less than the average accounting price. It has to be, it has to cover administration costs on top of health product payments.

The biggest problem with insurance in this country is that people think that they are suppose to recoup what they paid. Everyone wants insurance tailored to exactly what they personally will draw from it. It makes no sense, obviously.

 

[dblack]

The biggest problem with insurance in this country is that people think that they are suppose to recoup what they paid. Everyone wants insurance tailored to exactly what they personally will draw from it. It makes no sense, obviously.

The psychology used to sell insurance is even more insidious than this. Most people actually think insurance will save them money. Any logical understanding of the economics of the situation makes it clear this can't be the case. For most of us, it will make our health care more expensive. Insurance only make sense for the extremes - the circumstances that would otherwise drive us into bankruptcy. For everything short of that, we're much better off paying out of pocket, or financing via loans etc....

That's what's so infuriating about PPACA. We need less insurance, not more. Obamacare doubles down on the irrational insurance sales pitches and forces all of us aboard a sinking ship. It's sheer idiocy that does nothing as much as it funnels taxpayer money to the insurance industry - with precious little net benefit to health care consumers.

 

[jon_berzerk]

The biggest problem with insurance in this country is that people think that they are suppose to recoup what they paid. Everyone wants insurance tailored to exactly what they personally will draw from it. It makes no sense, obviously.

The psychology used to sell insurance is even more insidious than this. Most people actually think insurance will save them money. Any logical understanding of the economics of the situation makes it clear this can't be the case. For most of us, it will make our health care more expensive. Insurance only make sense for the extremes - the circumstances that would otherwise drive us into bankruptcy. For everything short of that, we're much better off paying out of pocket, or financing via loans etc....

That's what's so infuriating about PPACA. We need less insurance, not more. Obamacare doubles down on the irrational insurance sales pitches and forces all of us aboard a sinking ship. It's sheer idiocy that does nothing as much as it funnels taxpayer money to the insurance industry - with precious little net benefit to health care consumers.

oh brother another glitch

this time

obamacare call centers go down

--LOL

 

[dblack]

The biggest problem with insurance in this country is that people think that they are suppose to recoup what they paid. Everyone wants insurance tailored to exactly what they personally will draw from it. It makes no sense, obviously.

The psychology used to sell insurance is even more insidious than this. Most people actually think insurance will save them money. Any logical understanding of the economics of the situation makes it clear this can't be the case. For most of us, it will make our health care more expensive. Insurance only make sense for the extremes - the circumstances that would otherwise drive us into bankruptcy. For everything short of that, we're much better off paying out of pocket, or financing via loans etc....

That's what's so infuriating about PPACA. We need less insurance, not more. Obamacare doubles down on the irrational insurance sales pitches and forces all of us aboard a sinking ship. It's sheer idiocy that does nothing as much as it funnels taxpayer money to the insurance industry - with precious little net benefit to health care consumers.

oh brother another glitch

this time

obamacare call centers go down

--LOL

I don't get all the freaking out about the program "glitches". If has no real bearing on whether ACA is good policy or not. They'll get the technical problems ironed out eventually - then what?

 

[PMZ]

The biggest problem with insurance in this country is that people think that they are suppose to recoup what they paid. Everyone wants insurance tailored to exactly what they personally will draw from it. It makes no sense, obviously.

The psychology used to sell insurance is even more insidious than this. Most people actually think insurance will save them money. Any logical understanding of the economics of the situation makes it clear this can't be the case. For most of us, it will make our health care more expensive. Insurance only make sense for the extremes - the circumstances that would otherwise drive us into bankruptcy. For everything short of that, we're much better off paying out of pocket, or financing via loans etc....

That's what's so infuriating about PPACA. We need less insurance, not more. Obamacare doubles down on the irrational insurance sales pitches and forces all of us aboard a sinking ship. It's sheer idiocy that does nothing as much as it funnels taxpayer money to the insurance industry - with precious little net benefit to health care consumers.

I would say that for most people you don't get back what you pay in (including matching employer contribution). But for some, you get a whole lot more out than in. Shared risk.

 

[PMZ]

The biggest problem with insurance in this country is that people think that they are suppose to recoup what they paid. Everyone wants insurance tailored to exactly what they personally will draw from it. It makes no sense, obviously.

The psychology used to sell insurance is even more insidious than this. Most people actually think insurance will save them money. Any logical understanding of the economics of the situation makes it clear this can't be the case. For most of us, it will make our health care more expensive. Insurance only make sense for the extremes - the circumstances that would otherwise drive us into bankruptcy. For everything short of that, we're much better off paying out of pocket, or financing via loans etc....

That's what's so infuriating about PPACA. We need less insurance, not more. Obamacare doubles down on the irrational insurance sales pitches and forces all of us aboard a sinking ship. It's sheer idiocy that does nothing as much as it funnels taxpayer money to the insurance industry - with precious little net benefit to health care consumers.

'' We need less insurance, not more''

I would say that the high number of medical care caused bankruptcies are evidence of the opposite. We need more insurance.