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Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 4:38 am
by essenceofveles
But this is only for certain people. This is ignoring people like Zach, who has to pay for his own insurance.

zbbrox wrote:Just to clear up a common misconceptions -- premium rates have gone up more slowly since the ACA than before.

https://www.forbes.com/sites/robbmandel ... aaedda3a01

http://www.factcheck.org/2017/03/employ ... d-the-aca/

And can I just say that I'm pretty frustrated that Zach decided after all these years to do a serious, breaking-the-fourth-wall political comic because of the health care challenges faced by *small business owners* rather than when Republicans threatened twenty million people's health insurance a month ago? Like, yes, it's crappy that we have to deal with private, profit-seeking insurance and a system largely based on employer group insurance instead of having single-payer like a civilized country, but it's mostly crappy because it absolute devastates the poor and the sick, and it's really disappointing that intelligent people care so much more when it happens to their in-group than when it happens to the disadvantaged. Really disappointing.

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 4:43 am
by essenceofveles

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 8:42 am
by hanselot
Easy. Get into biohacking. Take the money you would have spent on healthcare and buy bitcoin.
The only complication here is that you need to refrain from dying before the bitcoin appreciates to a value that is self-sustainable.
Fuckit, it took me 20 minutes to figure out how to answer this security question...

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 10:13 am
by mist42nz
I have an old friendship with a Doctor (in training, many years ago) who was from Indonesia which has the same level of income to healthcare disparity which affects the backwards nations of the world such as the United States of Corruption.

What their villages had to do was find a young but very intelligent child and make sure they had good schooling, and the extended family put all their assets and liberty at risk to earn money and pledge themselves to lenders and the village to send my friend to Medical School. As a student his costs and First World living expenses were about the same as a town block of families back home. His task was to learn and become a qualified medical doctor, and then come home and be the village's medical doctor (including setting up local practice and start training some lower skill local trainees_.

When I met him he was in his last year and was caught on the dilemma of going home to the backwater poverty struck village that couldn't afford the usual medical parasites, or staying the modern world with all it's income and temptations (and where he could pay off his debt in about 2-3years), although that means the village would seize all his extended family and their worldly goods, and he would have to fund for another student to be trained up. Apparently, it was common (>50%) of young Doctors to refuse to go back home, so they tried to send about 3 students for each 2 groups of villages, so some would come home to their families. However, such situations did result in modern world doctors providing a constant income stream back into those villages, greatly increasing the wealth in those areas.

Since they are in a very similar situation, you just need to find a potential medical doctor (and other staff) and contract them to the task so that your peasant village can afford basic medical systems.
They also used similar situations to get civil engineers and teachers because there simply isn't a modern commercial reason for people to come away from the wealthy centers. So they figured the only ones who would actually care about the area, and about the families there, was their own people. "Surprisingly" enough, the funds funnelled back by the successful non-returning students tended to act as very useful capital for civil works and careful capital investments (such as quality water), however, doing this requires honest and capable and minimal civil service (ie they had no full time civil servants because they had found it 100% corrupted any person who had no other income/grocery source, as such people inevitably ended up building up their own little kingdoms and "public services" which were little more than bottomless public funding built ideologically unsound personal projects. Keeping all civil servants part-time kept them as responsible contributing members of the town rather than falling into the trap of aristocracy)

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 2:01 pm
by JFMURPHYF
Greetings all, first time poster long time reader.

I'll just introduce myself, my name's J-F and i'm an insurance broker based in Montreal.

I see a lot of questions about the rise of healthcare insurance costs and the difference between free market systems and single payer systems, so I thought I'd try to shed some light on it. Bear in mind however that there might be a lot of differences between USA insurance companies and Canadian insurance companies so while my advice is very on point for Canadia, US citizens better take it with a grain of Nackle.

Let's start with a first question:
What are healthcare insurance costs based on

Like everything insurance, premiums are almost always based on actuarial tables. That is to say, some nerdy dude at the insurance headquarters takes hundreds and hundreds of demographic data based on your neighborhood, your city, and your age and crunches them together in order to come out with actuarial tables. These tables will posit an average expected refund per citizen per coverage on medical costs, then the insurance company works in a small margin of profit in the product, and rolls the dice, hoping you'll be less sick than their estimate. While we do have free healthcare in Canadia, most people also have a health insurance also to add coverage on top of the base government refunds (55% in my province, people usually like an 80% refund) or to pay for fringe benefits like dental and paramedical (acupuncture, massage therapy, psychotherapy etc.), so in effect we don't only have free healthcare, we also have a free market insurance. But the highest I've seen that insurance cost in a year (for a family plan for a 70 year old man) is 4500$ (and that was an almost 100% refund coverage).

That is because increases in medical costs increase insurance premium if you have a regulated service provider (the government) who pays the first 55% of any medication, and 100% of surgeries and other urgent medical care you control what these things cost and make sure it is affordable for everyone. Yet even with all that, inflation for medical costs in Canadia is 12%, mainly because while the healthcare system is regulated, the pharmaceutical industry isn't.

I urge you to watch this 5 minute video before going further, if you're still with me: https://www.youtube.com/watch?v=CeDOQpfaUc8

I can't do it better than Adam so I'll just link him. As he very astutely describes here, the US medical system is stupid overpriced. Seriously? Seriously. Seriously??? Seriously!!! (yes that was a gray's anatomy reference)

So if you understand where premiums come from (actuarial tables) and understand that they factor in grossly bloated prices, is it any wonder premiums have gotten this ridiculous? And at that point, is it really the insurance company's fault? What the Us needs is to establish baseline medical coverage in order to assert control over the system, and to insure regulation of prices. As long as you do not have that in place and still believe in a free market competition to diminish prices then I am sorry but that is not going to happen because as far as the free market goes these prices ARE competitive, they factor in all costs and a very narrow profit margin.

As for mr. weinersmith, and this is HIGHLY speculative, but in Canadia collective insurance (which benefits from tighter pool based reductions) can be applied to any group that fills out the following conditions:

A- Is a group with clear guidelines and monetarily involved members
B- Everyone involved works more than 20 hours a week
C- Has a clear legal person to defer to
D- Is together for purposes other than group insurance

What I would suggest is to get those small business owners together and create the ''super duper awesome small business owner's association'' (Name can be modified) who's mission it is to ''increase profits through coordination of marketing events and business development fairs''. Go see a lawyer, have him register up a non profit in that name, elect an administrative board.

Then vote to offer group insurance to everyone and get a broker. Not an insurance rep from one company, a broker.

His job, if he's even mildly competent, will be to find the best group insurance he can at the most affordable price, and then to help you keep prices low.

It's a bit of work but assuming similar legal basis, it will work.

My 2 cents people.

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 2:06 pm
by JFMURPHYF
Sorry for the autocorrect typos, I can't figure out how to edit them out :(

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 3:08 pm
by zbbrox
essenceofveles wrote:But this is only for certain people. This is ignoring people like Zach, who has to pay for his own insurance.



True, rate increases in individual markets have been more volatile, and also harder to compare because of the nature of the comparison (i.e. plans now need to actually provide coverage, whereas before they were often junk). But for people who don't qualify for subsidies there are sometimes very large increases.

And that's a problem we should fix. But it's also a problem that affects a very small slice of the population -- If you look at health coverage, bout 50% of people have employer coverage (whose rate increases have dropped), about a third have Medicare or Medicaid (including tens of millions who didn't qualify for Medicare before the ACA), and only about 1/12 are on the individual market. Of those on the individual Market, only about 1/6 don't qualify for subsidies.

A problem that affects 1/72 of the population is serious. And like I said, we really ought to have single-payer to address it. But lets not mistake that problem for the effects of the ACA as a whole, which has helped tens of millions of people.

And, again, it's really frustrating that Zach -- a smart guy who's generally very knowledgeable and certainly hasn't shied away from politics when it comes to, say, government spying -- is doing the "hey, I'm not an expert!" thing like a Republican called out on climate change, as if this isn't a basically solved problem. Single-payer works. And it works for everyone, not just the employed, not just small-business owners, not just the poor. If you want someone to do something about these problems, your best bet is pushing single-payer.

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 5:45 pm
by magnetoo
zbbrox wrote:... it's really disappointing that intelligent people care so much more when it happens to their in-group than when it happens to the disadvantaged. Really disappointing.


Hear hear.

It's also disappointing to see so many comments focused on how to tinker with specific situations in order to try to continue to survive within a fundamentally and deeply flawed and unfair system. Essentially every developed country in the world takes the opposite approach from the United States to healthcare, pays dramatically less for it, and has better overall health outcomes. But despite all the evidence to the contrary the US is convinced that their approach is right and everyone else's is wrong.

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 7:42 pm
by Kit.
I'd say that the "insurance" model of selling basic healthcare coverage is a scam when "self-regulated" by private institutions, and is a tax when fully controlled by the government. In this particular case, a tax is better.

Re: [2017-12-08] Healthcare

PostPosted: Sat Dec 09, 2017 11:47 pm
by zbbrox
magnetoo wrote:It's also disappointing to see so many comments focused on how to tinker with specific situations in order to try to continue to survive within a fundamentally and deeply flawed and unfair system.


Exactly right. This is a systemic problem that requires a systemic solution, not just individual action.

Re: [2017-12-08] Healthcare

PostPosted: Sun Dec 10, 2017 10:45 pm
by jgh
As a comparison, for all its flaws, the UK NHS costs the equivalent of $2000 per year per person, and private self-employed comprehensive cover starts at about $40 a month with a $400 excess.

Re: [2017-12-08] Healthcare

PostPosted: Mon Dec 11, 2017 7:19 am
by Geekoid
NoUsername wrote:Insurance premiums are spiking after the Republicans failed to get rid of the ACA.

I think... I think it might be because the ACA is bad for you and good for the government. Just like everything other evil thing the Democrats love it and the Republicans love to pretend they don't.


You think it might be becasue Virginia refuses to accept money from the feds to expand the health insurances? Yeah, GOP refusing free money to hurt their constituent to make a point, meanwhile the DNC wants everyone to hove universal healthcare.

Stop acting like they are the same.

Re: [2017-12-08] Healthcare

PostPosted: Mon Dec 11, 2017 3:06 pm
by BB Shockwave
I often wonder why you guys in the United States of No Healthcare even bother with health insurance when it is so deeply flawed and often by the time you need it, the provider decided you are no longer eligible "because".
Here in Hungary I pay the mandatory healthcare which is currently around 27$ a month. This means you are viable for service anywhere in the country for emergencies - and they usually respond on time when it is a life-and-death situation. When it is something less urgent like say, a fever or a tootache, you go to your assigned local general pracitioner doctor, they will examine you, prescribe meds (at discount), send you to various other labs and specialists if needed, etc. Now this is where the system slows down - often you have wait a month for even an ultrasound and even more for MRI or busy specialists like heart doctors, etc, and this is where I usually just skip the system and go to a private company. There are plenty, and they usually charge 45-55$ just for one examination, but they are fast and reliable. The caveat is, these private practices will want to milk you for all you have, so they will advise you to do all sorts of expensive tests. It's up to you what you choose. I generally stick to the public healthcare, but for dentists I always choose the private practices. It just takes a while - usually through recommendation from friends - to find a good and relatively cheap dentist whenever my current one retires or moves away.
As for you guys... I would just not pay healthcare at all, put the money you would spend on that away and invest it, and pay from that for a private company if you need it.

Re: [2017-12-08] Healthcare

PostPosted: Mon Dec 11, 2017 3:09 pm
by sLaughterhouse
There have been a few questions regarding why health insurance is so expensive and talking about the individual costs of pill, saline etc. I saw a interesting video about such a topic a little while ago that may be relevant, make up your own mind. A bonus is the dramatization in my mind is humorous which is a quality I see within a majority of SMBC comics.

Re: [2017-12-08] Healthcare

PostPosted: Mon Dec 11, 2017 3:12 pm
by sLaughterhouse
Apologies for double post, can't figure out how to link Youtube videos with the button, here's a link.
https://www.youtube.com/watch?v=CeDOQpfaUc8