I say yes, you say no, OR People are Strange

A few pages back, someone posted the multi-multi-million dollar annual compensation for health insurance CEOs.  How can ANYONE believe that:

a) Private insurers can do the same job as Medicare, but at a lower cost

b) Private insurers also pay investors, but can do the same job as Medicare at lower cost

c) Multiple insurance companies arguing over claims do not drive up costs for health care providers (and pass that cost along to the insured)

Finally, if anyone believes that the CEOs are ENTITLED to their salaries because they run a multi-billion dollar corporation, then surely we should raise the salaries of the President, the Vice President, and the heads of every government (*evil word*) department and agency.  And remember, you ARE paying for that CEO's salary through your insurance premium.  Just because they don't call it a "tax" doesn't mean you're not paying for it.

GrumpE

Suzie - when I was NZ, we attended a lecture at the U. of Otago? in Dunedin (sort of a picnic day for parents and guests) concerning the "2-tiered" health care system in that country.   There were two systems..the public system and those who purchased supplemental private insurance who used a different set of hospitals and doctors, as you describe.  One can see how this will end up - bad.  What I've never understood is how Canada avoids this situation?  Blue??

As far as what I pay in the US?  I am a federal employee (or retiree).  Atleast until I turn 65, when the bulk of the benefits will be provided by Medicare (a single payer system), I pay about $180 a month.  My employer, in this case the federal government, pays about twice that much a month - all to a private insurer.  This is for a single, not family.  There is no dental or eye care, unless for medical reasons (i.e. no glasses, fillings, crowns, etc.).  If I go to a specialist, $30 a visit, PCP $20 a visit, though I notice all are specialists these days! For other medical (surgeries, scans, other medical tests) I pay 15% after I've spent $350 out of pocket.  Each hospital admission is $350, after that no hospital bills.  After one spends $5000 in a calender year, 100% is paid.  Pharma is pretty generous, but I haven't taken time to figure it out.  3 months of generic AI's are $15 if I do mail order.  Could be $80 a month if I took that Rx to the local drug store.  I think I only paid $80 for 3 Neulasta shots, while the insurance company paid Amgen about $3200 a shot.  If I hadn't done that one mail order, it would have retailed for over $9000 a shot.  Better to go through the insurer and avail of their purchasing power with the pharma company.   (There is no rhyme or reasons to the charges of medical stuff in the country...depends who you are insured by, or not, what they've negotiated, etc. etc.)  In 2012, treating BC, my out of pocket was the $5000, plus about $350 for dental, another $500 plus for eye exam and glasses.   BC dx fell in one calander year (scans, SNB) and major treatments in the next year, so I had to meet the $5000 criteria twice.

My insurance use to be considered run-of-the-mill back in the 80's and 90's, and I'm sure, still, by some large corporate standards.  Since we tie healthcare to employment, it's up to the employer what they'll offer.  Many times, nothing, for small outfits or retail big box store jobs.  Some state and county government entities have great plans, but I know several teachers, who have the gold standard as far as benefits (barely any deductible, out of pocket, full dental and eye) are paying around a $1000 or more a month for it (for two).  Yet a community college teacher pays no premium (included as a benefit) for th same gold standard plan.  Who pays what for the premium is variable and if a union involved, negotiated.  With fed employement, has always been about 1/3 employee, 2/3rds feds.  My gf (unemployed) pays about $700 a month, just for herself, and has a deductible of $1500 before any doctor bills are paid.  She has pre-existing conditions and her former employer was out-of-state, so was able to get on a state plan that is the best deal she can get - usually no one will insure her.  This is a unique situation as the state she lives in actually administers healthcare insurance.

For the 45% who have no healthcare insurance - it's pretty desperate, though fed government provides Medicaid.  Sometimes it works very well for those who cannot afford insurance, but you have to meet income quals.  I joke with a friend who got BC after quitting her job to take care of her mother (old age care is another sorry subject in America).  She had a very good job with great benefits.  She ended up using Medicaid and ostensibly had the same treatment as I could have had, if I had gone to her town for treatment.  Except I paid the $5000 and she paid nothing.

Edited to add - I can purchase extra dental and eye insurance, though I don't believe my employer contributes, in fact, I know they don't.  Like most dental plans, not really worth it.

Blue - my cousin in B.C. told me he pays $52 a month.  He's a retired school teacher.  I think his sister told me she pays $70 or so (she's also in B.C.).  He's married, she is single.  She had BC too (brca in our family) and said she paid nothing for her BC treatment.  She was quite amazed I had to fork out $5000 plus the cost of insurance for my medical care last year.  Why would one need supplemental?  (Asked above) - how do you avoid the 2 tiered system (public and private hospitals)?

Momine - what country is this?  Is it not socialized medical care across Europe?

If only they had been as concerned about being lied to about WMDs, thousands and thousands of lives would have been saved.

And a question...How long after I am off of AIs should aches and fatigue last? It has been a year and I am thinking about exploring other reasons for them when I see the doctor in May.

Libby

You will not feel the endoscopy. I had one done for nausea and it was just another test.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/15/why-an-mri-costs-1080-in-america-and-280-in-france/ 


On Friday, the International Federation of Health Plans — a global insurance trade association that includes more than 100 insurers in 25 countries — released more direct evidence. It surveyed its members on the prices paid for 23 medical services and products in different countries, asking after everything from a routine doctor’s visit to a dose of Lipitor to coronary bypass surgery. And in 22 of 23 cases, Americans are paying higher prices than residents of other developed countries. Usually, we’re paying quite a bit more. The exception is cataract surgery, which appears to be costlier in Switzerland, though cheaper everywhere else.

“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.

In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured. 

Health care is an unusual product in that it is difficult, and sometimes impossible, for the customer to say “no.” In certain cases, the customer is passed out, or otherwise incapable of making decisions about her care, and the decisions are made by providers whose mandate is, correctly, to save lives rather than money.

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I just want to add this:  Canada has no difficulty hiring the best specialists (especially oncologists) as well as cancer research scientists, from the U.S.  Amazing, isn't it?  But maybe not so amazing.  The specialists basically make the same income here, and they don't have to fight with a multitude of insurance companies to get their patients' treatments covered.

This guy has a real point !!!