Saturday, March 11, 2017

Healthcare: Right or Privilege

As I have said before, the death of the ACA taxes will definitely be appreciated by those with big incomes and many assets.  I mean ACA imposed a huge tax burden on them, for better or worse. CNN ACA Replacement Is Windfall

Please remember that the USA does not have healthcare problem, we have the best healthcare in the world.  What we have is a healthcare payment problem.  Let's say that good healthcare costs about $4,500/person per year in the USA. (basing that on my families premiums since my company is very diverse age wise)

Though this fascinating slide deck says it is ~$9,000...  I assume that it is higher due to it's including elder care...

Either way when half the households in the USA make less than $53,000 per year...  They have a BIG problem.  And we as a society need to decide if healthcare is a right or a privilege for the wealthy.  Thought?

32 comments:

Laurie said...

healthcare is a right. part of our problem is that we pay about double what citizens of other developed countries pay for healthcare. Healthcare should not be a market driven for profit enterprise. It should be socailized.

John said...

Who do think is funding the world's medical advances? How much worse off would we be if our healthcare performed like our public schools?

John said...

Some food for thought.
Investopedia Why so Expensive

PBS Cost Drivers

Atlantic Factors

I liked this from the Atlantic piece...

"It's not like all this money buys us nothing. Complexity creates jobs, for high- and low-skilled workers alike. American health care is the world's envy in some categories, especially in cancer care, wait times, and access to new technologies for affluent and insured families.

We have the highest share of adults (90 percent) who report being in good health. The OECD average is 69 percent. But in terms of coverage and cost, we rank embarrassingly low among developed countries.

It would be nice to say this is a bug of the American medical system. But it's a feature. It's a choice we've made. In some countries, government sets a lower price and doesn't charge patients for marketing and margins. To this model, we've essentially said: No, thanks."

John said...

This one is old, but it is interesting. Economists View

Laurie said...


This chart is a powerful indictment of our current health-care system



I don't think our health care system is anything to brag about.
It looks to me about 25 other countries achieve a longer life expectancy for a lot less money.

Anonymous said...

Is this a question one asks oneself when one is making health care decisions? Do you ask your doctor which elements of treatment are a right and which one are a privilege?

I heard Mike Pence say yesterday that under Trump Care, residents of Kentucky will have health insurance uniquely designed for them. A strange blind spot for business oriented Republicans is that they don't understand how insurance works. When someone is poorer, older and sicker than the norm, the information that government Donald Trump is designing insurance uniquely for them, isn't good news.

--Hiram

Anonymous said...

It looks to me about 25 other countries achieve a longer life expectancy for a lot less money.

Not entirely health system's fault. We do shoot people a lot.

--Hiram

John said...

Laurie,
If extending the human life is a goal I think you need to start controlling the diets of Americans. And that graph is very misleading because it only shows a few years at the end of life.

By the way, I found this fascinating analysis while looking for the above link.

Here is another depiction of that USA obesity problem.

Anonymous said...

It may cost us more and we may die earlier, but at least we had the freedom to choose between health insurance plans. Where health care for oneself and one's family is concerned, it's important to stay focused on things that matter like federalism, and the debates on the subject at the constitutional convention of 1787.

--Hiram

John said...

Hiram,
For better or worse we are Americans and personal control is very important to most of us. The idea of someone forcing us to do or to not do something is cause enough for a fight.

Whether it is good for us or not!!! That behavior may kill us, but by God it is our personal decision to do or not do it!!!

Be that smoking, being fat, risking our lives in dangerous behaviors, letting others pick our insurance, not learning in school, being a dependent couch potato, etc. What you are proposing may be Healthy and Logical, but it is so darn Un-American

What you a darn socialist government control freak??? :-)

John said...

I moved Jerry's comment here.

Why is it all of a sudden the fault of the GOP that people who were forced to buy Obamacare because they lost the plan they liked, might be given the opportunity to get their plan back, or something better? I have been urging the complete repeal, and just setting the date of the repeal at November 2017, while allowing anyone who already has it to continue to have it until November 2019. Meanwhile, create the alternative system and then let people choose. "If you like your Obamacare plan, you can keep your Obamacare plan" and "We will create competition and reduce costs by $2500 per family. Just keep Obamacare's promises.

Only exception? Congress loses their (Obama Executive Order) exemption from Obamacare as of 11/2017. That should offer some incentive to vote for the GOP alternative. Jerry

John said...

Actual I think the GOP plan guts the funding mechanisms that have enabled tens of millions of people to receive free or significantly reduced cost healthcare insurance. So most of the people will not be able to keep their Obamacare.

In essence the rich get to keep more of their money, the poor get fewer subsidies to help them pay for insurance and without the individual mandate people can go back to not paying into the insurance pool. (ie pre-existing fraud)

And of course it will be the GOP fault when our newest entitlement gets pulled out from under the feet of millions of people, including the Trump voters.

Anonymous said...

For better or worse we are Americans and personal control is very important to most of us.

It is for me, too. So does that mean I can control my health care under Trump Care? As he promised?

I am waiting to see.

--Hiram

Anonymous said...

Why is it all of a sudden the fault of the GOP that people who were forced to buy Obamacare because they lost the plan they liked, might be given the opportunity to get their plan back, or something better?

It's because they won the election. Winning elections means you are in charge.

--Hiram

John said...

Of course you will be in control of your health insurance... That is if you have the money to pay for it...

Anonymous said...

Of course you will be in control of your health insurance... That is if you have the money to pay for it...

So is that a yes? Or maybe a no?

But in any event, Trump Care promises that everyone will get better coverage at a lower cost. What I am wondering is, why didn't we think of that?

--Hiram

jerrye92002 said...

"Of course you will be in control of your health insurance... That is if you have the money to pay for it..."

I can only hope that the Obamacare replacement turns out that good. It was certainly not the case with Obama care, nor with Medicare. Unless we want to start saying that healthcare is a right, then you SHOULD have to pay for your healthcare, just like you pay for your groceries. That doesn't say that we won't have charitable food shelves or some sort of /sensible/ government food assistance, it just says that government should not be massively interfering with the free market.

Why didn't you think of that? Because you thought in terms of a massive government takeover of 1/7 of the economy as the best way to do what the free market has always done best. Considering that Obamacare has reduced coverage and increased costs, simply eliminating it should produce the desired result. Properly replacing it would be even better.

John said...

"Obamacare has reduced coverage" Source?

Anonymous said...

"...simply eliminating it should produce the desired result. Properly replacing it would be even better."

And you think liberals live in la la land.

jerrye92002 said...

Dear anonymous, so am I right, or am I right? What else but delusional can you call "if you like your plan, you can keep your plan" and "costs will come down $2500 per family" and "it's not a tax, it's a penalty" until it is challenged in court and then "it's a tax, not a penalty"?

jerrye92002 said...

Source? Personal experience and I am not unique. I lost the plan I liked and wanted to keep. That reduced my coverage. That I and others found a more costly substitute does not change that.

John said...

I think you are applying causality incorrectly.

I have a plan I like and ACA made little or no difference on it. I did keep my Doctor and insurance... The cost mainly went up because the ACA reduced the amount I could put in my flex spending account each year.

Not sure what was wrong with your company's plan? My guess it was some bare bones offering left employees scrambling for cash if bad things happened. Remember that cheap bare bones coverage is excellent, as long as you stay healthy.

Of course, if you experience big problems... Then an excellent policy looks very different.

jerrye92002 said...

Let me see.... I lost my plan because the company said "we cannot comply with coverages required by the ACA and therefore we are cancelling our plan effective..." That seems to me to establish causality pretty well. Your costs went up, and there was NOTHING wrong with my company's plan and I liked it. I lost it, so do not tell me I didn't.

Maybe healthcare /is/ a right, in the sense that government CAN prevent us from exercising (by buying it), but that government rightfully should not "alienate us" from getting.

John said...

I think "can not comply" translated to "choose to not comply, especially if we can transfer more cost to you employs while blaming it on the government"...

John said...

Maybe your plan fit into one of these categories.

And a different perspective

jerrye92002 said...

I left out the part where they said "without greatly increasing cost." You WANT to believe what you want to believe, but I know what happened and it was perfectly clear. I and thousands of other employees got the same mailing, we all "lost coverage." Why is it so important to deny this fact?

Why should government get to deny me health care?

John said...

Because the reality is that the government did not deny you anything. It just set new minimum acceptable standards and your stingy company decided to not meet them.

The government did this to reduce the likelihood of you and your peers becoming a burden on society when something bad did happen to you.

This no different than mandating that we carry a certain amount of liability insurance on our cars.

Why is it so important to you that minimum acceptable policies now exist?

jerrye92002 said...

Why? Because who gets to decide what is acceptable to ME? Should I not have that right? If I want to buy a policy with no coverage for maternity, or drug treatment, or a sex change, or for hoof-in-mouth disease, why should the government say otherwise? It is these coverage mandates that drive up the cost of insurance for everybody, and stifles competition. So long as there is full disclosure of the coverages, why should an insurance company that offers "bare-bones" insurance not be allowed to sell to those who want that, and choose to take it at the cheaper price?

And don't tell me about my stingy company. In the many years that I have been with them, I think my biggest medical bill was $30. Of course I never contracted hoof-in-mouth disease. That might not have been covered.

John said...

As usual, you choose to live in America. You are responsible to live by our society's laws. Please feel free to move to a country with different rules or to keep fighting for change. Good luck.

Well if everyone at your company was like you, the rates would be much lower... Apparently they are not. And your peers thank you for covering some of their bills.

And I hope your good health continues to hold out. Please remember my useless term life insurance policies. I have paid $9,000 over ~19 years for them and am thankful that I have never received a dime back.

jerrye92002 said...

And as usual, I note that I did not choose to live in America; I was born here. If you wish to argue that I implicitly accepted the laws of the country at the time of my birth or at the time I reached majority age, I will argue that the laws should be set back to what they were at that point in time. On a more practical basis, I believe we need to fight government overreach whenever and wherever it has proven to be totally unworkable. I point out that I did not consent to the Obamacare law, which tells me that a bunch of Democrats in Washington know better than I what I want, what I need, and what I can afford, and that is particularly true when it comes down to the health and well-being of me and my family.

What you keep suggesting is that the effectiveness of insurance depends upon the size of the pool, and that if we let people choose only the coverages they are likely to use and NOT those that they can, particularly by their own behavior, not need and thus get a lower price, that somehow this is unfair to those who want such additional coverage. WHY? If I want to carry my 25-year-old child on my insurance policy, why should I not pay something extra for that? If I am concerned that he may get involved in drugs and need treatment, why would I not pay extra to have such coverage added to my policy? All of those who choose to do so constitute a pool, all of whom are paying extra to cover the added risk. You can tailor individual policies and still have a large pool of people for all of the other items of coverage.

Better still would be to allow a very simple policy, such as a prepaid plan or HSA, where what is covered more or less does not matter. You pay a certain amount for your care, and you get care. It is way cheaper that way, and far more effective, yet government seems to believe it proper to deny me that choice. Do you think I should write my Congressman?

jerrye92002 said...

"Well if everyone at your company was like you, the rates would be much lower."

You have no idea how many major operations and illnesses I had during that time, and costs were low only because of the generous employer subsidy AND that I had a /choice/ of a pre-paid plan that was half the cost of the fee-for-service plan that was also offered. Choice!

John said...

Yes. I would write to your Congress Person...