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Do you think obese/overweight people should pay more for health insurance?
Replies
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joshdegen1 wrote: »...The vast majority of people are obese because they are misinformed or led down the wrong path about what to eat and what not to eat...
I disagree. Most people are fat because they freely choose the comfort, pleasure and instant gratification of overeating and being sedentary. It's easy and it feels good. Most fat people I know absolutely own up to this. As a society, we aren't as innocent and naive as you say. We've had it pounded into our heads for years now that we need to eat more vegetables and fewer donuts and that we need to get up off our butts and move more. And yet, we willfully choose not to. The sooner you own the truth, the better.
I would tend to agree with this. More education is not the answer.1 -
joshdegen1 wrote: »...The vast majority of people are obese because they are misinformed or led down the wrong path about what to eat and what not to eat...
I disagree. Most people are fat because they freely choose the comfort, pleasure and instant gratification of overeating and being sedentary. It's easy and it feels good. Most fat people I know absolutely own up to this. As a society, we aren't as innocent and naive as you say. We've had it pounded into our heads for years now that we need to eat more vegetables and fewer donuts and that we need to get up off our butts and move more. And yet, we willfully choose not to. The sooner you own the truth, the better.
Yes, this, and most fat people I know (including me when I was fat) would agree.
I do think there's an information problem that keeps people from losing, but it's not that they think broccoli and cake are nutritionally and calorically similar. It's that they've been told over and over that weight loss is hard, complicated, and requires extreme measures like working out at something they hate or giving up sweets or their favorite savory foods (maybe pizza) and, especially being hungry.
That seems undoable. (I actually think this is a huge part of the initial appeal of low carbing for many -- in contrast, they are told, yeah, you may have to give up some favorite foods, and a bunch of other stuff they don't care so much about, but you get to eat decadent things that are usually -- falsely -- considered diet no nos, like bacon, cheese, butter, steak.)
And yes, I also think part of it is that not thinking much about food or exercise, and being able to just veg for relaxation, to use food for comfort is easy and cheap and mentally doing other things may represent a hard change (more so to the extent your life is overall harder and the benefit from weight loss is less immediate and obvious).
None of this is hard to understand or requires implausible theories that BigSugar convinced us that vegetables don't matter or whatever.2 -
No. But I don't think anyone should have to pay for insurance, period.6
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No. If that happens, then why can't someone with red/blonde hair get charged more because they are more likely to develop skin cancer due to their fair skin? Slippery slope.
Bottom line, truthfully I think that the majority of obese people probably pay more anyways as one should take into account the copays, deductibles, medications, and multiple trips to the doctor they have to make due to their obesity. Those fees add up.2 -
yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky1 -
yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.2 -
yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
Not for me. One of my psych drugs is $500 a month. I'm not sure if that was the brand name or the generic though. I pay $10 for generic and $25 for brand name. That's a condition that I'll be treated for for life and not related to my obesity.
Now if you said along with restrictions on how much the pharmaceutical companies and hospitals could charge patients without insurance, maybe. But as it is now, no way.
I have zero problems with charging me more per month for insurance. I've cost my insurance company a lot of money. I have high cholesterol, type 2 diabetes (I am genetically disposed to that, both sides of my family are full of it for several generations, and was taking a drug that a side effect was increased blood sugar/diabetes), and knee problems. As well as moderate mental illness. I'm expensive.
The mental illness and knee problems are the most expensive problems though, and not related to my obesity. I was born with a defect in my leg bone that cause mechanical problems in my knee that necessitated major surgery.
The rest? All my fault. I chose to be obese, not on purpose, but I didn't do anything about it. I knew the health risks. I should pay more. Until such time as my diabetes is in remission and my cholesterol is under control. I shouldn't be penalized for my birth defect or my mental illness as I had no control over that.1 -
yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.2 -
lol thats ridiculous, thats like saying drug addicts, alcoholics, smokers etc and every other 'vice' should have to pay higher insurance. You're basically increasing everyones insurance. lol. Motorcyclists, adrenaline junkies, enthusiasts, pet owners who get bit or attacked, people who have children and now have pregnancy complications, if you are basing 'obesity' off of 'choice' then your logic is flawed.
Besides. according to doctors most of our nation is obese anyway. who wins? pharmaceutical companies and insurance agencies. Who loses? America, America loses thats who. lol.3 -
yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.
I misunderstood, I apologize. And I can't disagree with any of that.
Healthcare costs in this country are so incredibly broken right now, and I don't know if it will even be possible to fix it given the type of people who run for office on both sides of the aisle.
We had a chance to do it right with the ACA. All these other countries that have gone before us with socialized medicine have decades of data for us to crunch. We have the manpower and the money to do the research. Finland did this with education years ago, and now they have one of the best education systems in the world.
I know healthcare is a LOT more complex than education, but we could have done it. We could have had one of the best healthcare systems in the world by the time we were done. But partisan politics got in the way from both sides, and we ended up with a frankenbill.
There's some good things in there, calories on menus, pre-existing conditions, no lifetime caps, but the rest is a mess.1 -
TorresCarmeniifym wrote: »lol thats ridiculous, thats like saying drug addicts, alcoholics, smokers etc and every other 'vice' should have to pay higher insurance. You're basically increasing everyones insurance. lol. Motorcyclists, adrenaline junkies, enthusiasts, pet owners who get bit or attacked, people who have children and now have pregnancy complications, if you are basing 'obesity' off of 'choice' then your logic is flawed.
Besides. according to doctors most of our nation is obese anyway. who wins? pharmaceutical companies and insurance agencies. Who loses? America, America loses thats who. lol.
all of these high-risk behaviors are already priced into our insurance, including a level of obesity, because as you say, most of our nation is already fat.
If you're fatter than the average American, you should pay more. If you're less fat, you should pay less. All other factors held equal.
Insurance would be less expensive and more efficient if more risk factors were known and taken into account. Because math.1 -
It's a simple, inescapable, mathematical fact that if insurance companies could penalize customers for high risk behavior, like overeating, it would discourage that behavior.2
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TorresCarmeniifym wrote: »lol thats ridiculous, thats like saying drug addicts, alcoholics, smokers etc and every other 'vice' should have to pay higher insurance. You're basically increasing everyones insurance. lol. Motorcyclists, adrenaline junkies, enthusiasts, pet owners who get bit or attacked, people who have children and now have pregnancy complications, if you are basing 'obesity' off of 'choice' then your logic is flawed.
Besides. according to doctors most of our nation is obese anyway. who wins? pharmaceutical companies and insurance agencies. Who loses? America, America loses thats who. lol.
Smokers do. If insurance could charge based on risk (as is the normal insurance practice) these others would also have to pay more (well, depending on the actual underwriting).
There's a reasonable argument that I happen to agree with that the insurance model is not a good one for health care, but the way the insurance model works is more risk, higher cost. That's why the problem with coverage for those with preexisting conditions existed.0 -
Yes.0
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lemurcat12 wrote: »TorresCarmeniifym wrote: »lol thats ridiculous, thats like saying drug addicts, alcoholics, smokers etc and every other 'vice' should have to pay higher insurance. You're basically increasing everyones insurance. lol. Motorcyclists, adrenaline junkies, enthusiasts, pet owners who get bit or attacked, people who have children and now have pregnancy complications, if you are basing 'obesity' off of 'choice' then your logic is flawed.
Besides. according to doctors most of our nation is obese anyway. who wins? pharmaceutical companies and insurance agencies. Who loses? America, America loses thats who. lol.
Smokers do. If insurance could charge based on risk (as is the normal insurance practice) these others would also have to pay more (well, depending on the actual underwriting).
There's a reasonable argument that I happen to agree with that the insurance model is not a good one for health care, but the way the insurance model works is more risk, higher cost. That's why the problem with coverage for those with preexisting conditions existed.
The insurance model is a terrible one for health care, the way it's used on America anyways.
But if we're working within the constraints of this *kitten* system, we have to be realistic.
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My god yeah... my health insurance premiums and deductible are... several thousand dollars a year each... life sucks sometimesciscoperator wrote: »I'd say no. Once you start down the path of limiting healthcare on being overweight, it can follow on to DNA testing for genetic disorders and being charged more for e.g. a great-aunt that developed glaucoma or had sickle-cell anaemia.
We're better off keeping the simple system of universal healthcare where we pay the ~€100 per month with a deductible of €385 (though that keeps going up by around 15 euro each year), where the services of the healthcare provider are provided as part of the insurance (doctor, nurse, surgeon etc.) but the fees paid are for medicines and appliances. But I guess most answering your question aren't in The Netherlands.
Is that deducible a yearly one? That would come out to nearly $450 US which would be very tough for some people living near or below the poverty line - and tough for others if it's a per procedure kind of thing. In the Netherlands universal system, what happens if people cannot afford the monthly fee or deductible?
Most people in the US with deductibles would LOVE it if their deductible was ONLY $450. It's well into the thousands for a lot of people here. (And that's also a pretty tiny premium, too. Wish I could get one that low.)
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yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.
I misunderstood, I apologize. And I can't disagree with any of that.
Healthcare costs in this country are so incredibly broken right now, and I don't know if it will even be possible to fix it given the type of people who run for office on both sides of the aisle.
We had a chance to do it right with the ACA. All these other countries that have gone before us with socialized medicine have decades of data for us to crunch. We have the manpower and the money to do the research. Finland did this with education years ago, and now they have one of the best education systems in the world.
I know healthcare is a LOT more complex than education, but we could have done it. We could have had one of the best healthcare systems in the world by the time we were done. But partisan politics got in the way from both sides, and we ended up with a frankenbill.
There's some good things in there, calories on menus, pre-existing conditions, no lifetime caps, but the rest is a mess.
Trying to respond to both at the same time here.
I realize that you stated risky; however there is a massive layer of pricing controls which the majority are completely unaware of.
I used this example previously, so bear with me if I'm restating. I work in pharma and we manufacture a product for ~0.01 USD and sell this to a wholesaler for ~0.29. Somewhere between the wholesaler and the hospital this product goes from 0.29 to 200. This is largely due to the presence of buying groups with the following parties involved: Insurance, Government (state and federal, possibly local and township), Retail, and Endpoint (Hospital). All these parties are adding a percentage to recover operating costs.
Your medicine does not cost as much as you are being charged; however you are paying for the increasing layers of bureaucracy, which are completely unnecessary and serve no purpose. To make this worse these layers are monopolies, so there is no chance of competition to lower cost.
There is one option and that is to remove all the middlemen from the process. Fear; however is a powerful motivator and the masses have responded as intended. You are correct that we don't have an insurance program in the US - we have a prepaid medical program, which is absurdly expensive and will only continue to grow in cost due to unlimited demand and increasingly limited supply.
What is needed is a short term bridging program to get healthcare back on track and a return to market influence. This will never happen as the influence of government and insurance is too great and would result in a return of power to the populace.3 -
yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.
I misunderstood, I apologize. And I can't disagree with any of that.
Healthcare costs in this country are so incredibly broken right now, and I don't know if it will even be possible to fix it given the type of people who run for office on both sides of the aisle.
We had a chance to do it right with the ACA. All these other countries that have gone before us with socialized medicine have decades of data for us to crunch. We have the manpower and the money to do the research. Finland did this with education years ago, and now they have one of the best education systems in the world.
I know healthcare is a LOT more complex than education, but we could have done it. We could have had one of the best healthcare systems in the world by the time we were done. But partisan politics got in the way from both sides, and we ended up with a frankenbill.
There's some good things in there, calories on menus, pre-existing conditions, no lifetime caps, but the rest is a mess.
Trying to respond to both at the same time here.
I realize that you stated risky; however there is a massive layer of pricing controls which the majority are completely unaware of.
I used this example previously, so bear with me if I'm restating. I work in pharma and we manufacture a product for ~0.01 USD and sell this to a wholesaler for ~0.29. Somewhere between the wholesaler and the hospital this product goes from 0.29 to 200. This is largely due to the presence of buying groups with the following parties involved: Insurance, Government (state and federal, possibly local and township), Retail, and Endpoint (Hospital). All these parties are adding a percentage to recover operating costs.
Your medicine does not cost as much as you are being charged; however you are paying for the increasing layers of bureaucracy, which are completely unnecessary and serve no purpose. To make this worse these layers are monopolies, so there is no chance of competition to lower cost.
There is one option and that is to remove all the middlemen from the process. Fear; however is a powerful motivator and the masses have responded as intended. You are correct that we don't have an insurance program in the US - we have a prepaid medical program, which is absurdly expensive and will only continue to grow in cost due to unlimited demand and increasingly limited supply.
What is needed is a short term bridging program to get healthcare back on track and a return to market influence. This will never happen as the influence of government and insurance is too great and would result in a return of power to the populace.
it also MIGHT have something to do with the millions, potentially billions, of dollars that the company spent to develop that drug.
Pharma companies aren't uniquely profitable as an industry.
However, and this is related I promise you, we do have a BIG problem in that WE as Americans are subsidizing the rest of the world through our drug prices.
Other countries with nationalized or socialized health care systems have greater bargaining power than a single American insurance company, so they negotiate lower prices for THEIR citizens/customers.
The drug company still has to turn a profit to satisfy it's shareholders, so it has to make that money elsewhere. Enter the American market, where price negotiation is dispersed between numerous entities. So they can sacrifice on price for France, the UK, or Japan, and charge a higher price in the US, where we are accustomed to it.
I will diverge slightly for a moment though. Because it's important. When most people talk about crazy health insurance premiums and deductibles, they're actually only talking about the tiny portion of the country, less than 10%, that gets insurance individually. The vast majority of Americans get insurance through group plans with their companies, and the costs aren't nearly as high. My insurance costs me $100 a month, I have a $500 deductible, and great coverage. If I had to cover an entire family it would be $250 a month. I asked an older coworker, near retirement, what he pays for his coverage for his entire family and he said about $500. The true cost is higher, our company pays between 50% and 75% of your total premium depending on salary.
I bring that up, because it again speaks to the issue of some groups subsidizing others, based on market power. Big firms like mine have bargaining power with insurance companies, so they negotiate lower rates for their employees. In order to make their profits, insurance companies charge more to individual purchasers.
People who buy insurance directly from insurance companies are at the very, very, very bottom of a long line of people, each negotiating lower rates for themselves and passing along the costs to the next least powerful group.4 -
A few thoughts regarding health care costs:
1) Nothing is more disheartening than approaching my office building in the morning and seeing dozens of employees outside in the smoking area. I’m annoyed at having to share in the burden of their current and future self-inflicted medical expenses.
2) The same with seeing the food choices made in our company cafeteria, which offers an extensive selection of meals primarily composed of generous portions of grease, breading, butter, salt, and/or fat, consumed by a workforce that is actually more obese than the general population. More current and future self-inflicted medical expenses.
3) While it is nice to work out in a company fitness center that is never crowded, it is also tragic that our company fitness center is never crowded.
4) I heard a stat (I didn’t verify it, but it rings as true) that 70% of the US is on at least 1 prescription and 50% are on 2 or more. How many of these are proactive and how many are reactive? I’m guessing most are the latter.
3 -
yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.yourfitnessenemy wrote: »No. But I don't think anyone should have to pay for insurance, period.
So we just pay all of our medical expenses out of pocket? Seems risky
Far less expensive actually. Especially if insurance was limited to catastrophic medical.
Medical costs are highly inflated due to the massive charge backs and price negotiating process.
i said risky, not expensive.
economically speaking, healthcare would absolutely be less expensive if we paid 100% of expenses out of pocket. Insurance creates hazards by disconnecting people from the cost of their care. You simply don't make the same decisions about how you spend money, when it's somebody else's money and you're only paying a small portion. It's not a coincidence that as the percentage paid out of pocket on average has fallen, from around 50% in the 1950s to around 15% today. People not only seek out elective care they wouldn't otherwise, but they also make poorer choices that affect their health, because they will not ultimately bear the costs.
HOWEVER.
I said risky.
Insurance, all insurance, is a risk mitigation tool. Health expenses are large, often unexpected, and typically come in huge chunks. We buy insurance to mitigate the financial risks of health care
Unfortunately, in America the health insurance system has become more of a health payment plan system. With that "insurance" being used to cover all number of services that are not necessarily expensive enough to justify the risk mitigating costs of insurance.
Regardless. Eliminating health insurance now, without an alternative (single payer, medicare, nationalization, etc) would result in both a huge increase in death, as well as huge economic costs as health-related bankruptcies drain money from the economy.
I misunderstood, I apologize. And I can't disagree with any of that.
Healthcare costs in this country are so incredibly broken right now, and I don't know if it will even be possible to fix it given the type of people who run for office on both sides of the aisle.
We had a chance to do it right with the ACA. All these other countries that have gone before us with socialized medicine have decades of data for us to crunch. We have the manpower and the money to do the research. Finland did this with education years ago, and now they have one of the best education systems in the world.
I know healthcare is a LOT more complex than education, but we could have done it. We could have had one of the best healthcare systems in the world by the time we were done. But partisan politics got in the way from both sides, and we ended up with a frankenbill.
There's some good things in there, calories on menus, pre-existing conditions, no lifetime caps, but the rest is a mess.
Trying to respond to both at the same time here.
I realize that you stated risky; however there is a massive layer of pricing controls which the majority are completely unaware of.
I used this example previously, so bear with me if I'm restating. I work in pharma and we manufacture a product for ~0.01 USD and sell this to a wholesaler for ~0.29. Somewhere between the wholesaler and the hospital this product goes from 0.29 to 200. This is largely due to the presence of buying groups with the following parties involved: Insurance, Government (state and federal, possibly local and township), Retail, and Endpoint (Hospital). All these parties are adding a percentage to recover operating costs.
Your medicine does not cost as much as you are being charged; however you are paying for the increasing layers of bureaucracy, which are completely unnecessary and serve no purpose. To make this worse these layers are monopolies, so there is no chance of competition to lower cost.
There is one option and that is to remove all the middlemen from the process. Fear; however is a powerful motivator and the masses have responded as intended. You are correct that we don't have an insurance program in the US - we have a prepaid medical program, which is absurdly expensive and will only continue to grow in cost due to unlimited demand and increasingly limited supply.
What is needed is a short term bridging program to get healthcare back on track and a return to market influence. This will never happen as the influence of government and insurance is too great and would result in a return of power to the populace.
it also MIGHT have something to do with the millions, potentially billions, of dollars that the company spent to develop that drug.
Pharma companies aren't uniquely profitable as an industry.
However, and this is related I promise you, we do have a BIG problem in that WE as Americans are subsidizing the rest of the world through our drug prices.
Other countries with nationalized or socialized health care systems have greater bargaining power than a single American insurance company, so they negotiate lower prices for THEIR citizens/customers.
The drug company still has to turn a profit to satisfy it's shareholders, so it has to make that money elsewhere. Enter the American market, where price negotiation is dispersed between numerous entities. So they can sacrifice on price for France, the UK, or Japan, and charge a higher price in the US, where we are accustomed to it.
I will diverge slightly for a moment though. Because it's important. When most people talk about crazy health insurance premiums and deductibles, they're actually only talking about the tiny portion of the country, less than 10%, that gets insurance individually. The vast majority of Americans get insurance through group plans with their companies, and the costs aren't nearly as high. My insurance costs me $100 a month, I have a $500 deductible, and great coverage. If I had to cover an entire family it would be $250 a month. I asked an older coworker, near retirement, what he pays for his coverage for his entire family and he said about $500. The true cost is higher, our company pays between 50% and 75% of your total premium depending on salary.
I bring that up, because it again speaks to the issue of some groups subsidizing others, based on market power. Big firms like mine have bargaining power with insurance companies, so they negotiate lower rates for their employees. In order to make their profits, insurance companies charge more to individual purchasers.
People who buy insurance directly from insurance companies are at the very, very, very bottom of a long line of people, each negotiating lower rates for themselves and passing along the costs to the next least powerful group.
Very true and the goal is to maximize profit.
Very happy you brought this up as this is enables single payer in other nations. These programs cannot exist without subsidies. The vast majority of innovation originates in the US, but it costs over 2B USD to bring a pharmaceutical product to market. Others nations have the ability to negotiate price, where the US does not.
Companies taking on insurance goes back to pre-1960s and they get a nice tax incentive for doing so. This plan worked when long term employment at a firm was a norm. The industry has not adapted to reality, which is yet another root cause of the problem.
This is where the political arms get it wrong. The left blames private industry. The right blames government. The root cause is industry and government colluding.2 -
Let's assume that drug costs are a major factor in the cost of health care, which I do believe in. I would rather that the government helped to subsidize the R&D on drug development for health critical drugs than subsidize insurance at multiple points in the process (to insurance companies and consumers). I don't disagree with government involvement, but there is a difference between health care reform and health insurance reform.0
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richardgavel wrote: »Let's assume that drug costs are a major factor in the cost of health care, which I do believe in. I would rather that the government helped to subsidize the R&D on drug development for health critical drugs than subsidize insurance at multiple points in the process (to insurance companies and consumers). I don't disagree with government involvement, but there is a difference between health care reform and health insurance reform.
this right here is probably the greatest nuance that's forgotten in the debate.
Adequate health CARE reform would go a long way to achieving the goals of health insurance reform as most people have them. There is a lot of competition in the health insurance market, if the costs of care were lower (either through costs coming down or people using them less) the insurance companies would bring down prices to capture market share from each other.
But it's sexier to demonize the insurance companies, which rate right below banks as the great lightning rods of criticism for everything.
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Nobody should pay for health insurance. Not directly anyway. Single payer system.5
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There is a lot more to life expectancy than health care, lifestyle habits are far more relevant. Have you ever traveled throughout Western Europe and taken a look at the physical composition and habits of most of the people? A lot of bike riding, a lot of sensible portions, and not a lot of waddling.2 -
Bry_Lander wrote: »
There is a lot more to life expectancy than health care, lifestyle habits are far more relevant. Have you ever traveled throughout Western Europe and taken a look at the physical composition and habits of most of the people? A lot of bike riding, a lot of sensible portions, and not a lot of waddling.
I don't know, man. From what I saw, the UK is pretty fat...lots of smokers, too.
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Bry_Lander wrote: »
There is a lot more to life expectancy than health care, lifestyle habits are far more relevant. Have you ever traveled throughout Western Europe and taken a look at the physical composition and habits of most of the people? A lot of bike riding, a lot of sensible portions, and not a lot of waddling.
and you explain Canada...how?
Also, as someone who used to live in the UK, their fitness and behavior isn't appreciably different than ours.2 -
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stanmann571 wrote: »
The scaling makes it look like there is a huge gap between the US and the others, but it's really not.
And remember that there are other political issues in the US (not directly related to health-care) that contribute to a shorter lifespan...1
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