tag:blogger.com,1999:blog-582368152716771238.post4534837783398595551..comments2024-03-29T04:41:56.077-05:00Comments on The Grumpy Economist: Goodman on health insuranceJohn H. Cochranehttp://www.blogger.com/profile/04842601651429471525noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-582368152716771238.post-86647552308942888182022-12-11T07:32:33.276-06:002022-12-11T07:32:33.276-06:00Thanks, for sharing this useful information! Bookm...Thanks, for sharing this useful information! Bookmarked this URL<br /><br /><a href="https://www.mcnicholfinancial.com/" rel="nofollow">McNichol Financial and Healthcare</a>McNichol Financial and Healthcarehttps://www.blogger.com/profile/02325717819460516250noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-25670017403540699872020-02-05T16:00:24.283-06:002020-02-05T16:00:24.283-06:00Dr. Keith Smith at the Surgery Center of Oklahoma ...Dr. Keith Smith at the Surgery Center of Oklahoma started the Free Market Medical Association after he posted his surgery prices online in 2009. He signed up the largest county in Oklahoma and saved them millions. There are chapters all over the country. Employers can sign up directly with providers and save. His websites are fmma.org and surgerycenterok.com. He has a blog and the Free Market Medical Association conference is in April. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-20757905921928950212020-01-31T10:22:17.414-06:002020-01-31T10:22:17.414-06:00Let's assume that the individual insurance mar...Let's assume that the individual insurance market has 20 million persons. Further assume that 5 to ten percent of these persons have serious pre-existing conditions and are totally uninsurable.<br /><br />My research into the history of high risk pools suggests that such persons cost about $30,000 a year to insure.<br /><br />So, we have 1.5 million persons at $30,000 a year or $45 billion in expenses.<br /><br />These persons are often early retired and partly disabled and lower income.<br /><br />So, the question is, where do we cover them?<br /><br />1. Create Obamacare. This blows up the individual market as we have seen. If we added $45 billion in reinsurance that would have helped, but the ACA only had $6 billion in reinsurance for 3 years.<br /><br />2. Create high risk pools. I do not think that Congress would provide the funding, to help 1.5 million persons who are not a voting bloc.<br /><br />3. Add these people to Medicare. We did this with dialysis patients and the disabled. We should have done this again.Bob Hertzhttps://www.blogger.com/profile/08889826739646491269noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-73502184222515855512020-01-28T15:23:10.834-06:002020-01-28T15:23:10.834-06:00An unusual approach to health coverage. As a young...An unusual approach to health coverage. As a young trader, I calculated that PV of insurance premia exceeded the PV of a payout. I invested those premiums in a diversified market portfolio starting some forty years ago. It has compounded nicely and I haven't had to use it. Currently I'm covered under my wife's plan. I had a total hip replacement in April of 2019. The insurance company was billed a total of $47500. They setted for $24,000. I asked the surgeon who did the procedure what the bill would be if I were uninsured or self insured. His answer; between five and seven thousand and he'd workout a payment plan. David Seltzernoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-35338058880386669662020-01-27T14:43:34.721-06:002020-01-27T14:43:34.721-06:00It is impossible to buy insurance for a preexistin...It is impossible to buy insurance for a preexisting condition. As long as both sides use this language (or the euphemism coverage) there will be no progress. The options are either free or reduced healthcare for people who get sick when not insured, or to let those people who are not insured go broke and die. Since society will never accept the second option then we have to pick the first option. And if we pick the first option then Frank nailed it - if you are alive you pay in to the national insurance plan.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-68708310047280503822020-01-27T14:18:57.147-06:002020-01-27T14:18:57.147-06:00First, it is beneficial to have health insurance. ...First, it is beneficial to have health insurance. For the most part our group plans are good but maybe for those who are self-employed or transitional, the market needs to facilitate a grouping scheme (by profession e.g.).The larger the group, the lower the premium rate per person. Also we need facilitate selling across state lines. Now the GOP had spoke of this but I don't see them drawing up any bills. No excuse. In addition, I hate to say it but i do favor having some mandates or screenings in the plans so we can maybe track down some diseases sooner rather than later. Because later is always too expensive. E.g. colonoscopies start at maybe age 50. Why not a pancreas screen or lymphoma screen? We just have too much sickness & not enough cures. Now I understand you have to figure the cost of the organ ct scan into the premium. But then if you have a large group, it is distributed over a greater number.Anonymoushttps://www.blogger.com/profile/16487399134074722450noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-47093729189319718912020-01-26T11:45:35.772-06:002020-01-26T11:45:35.772-06:00That's way too many problems in a single sente...That's way too many problems in a single sentence. Let me pick a cutie: Smokers die just about the time they are supposed to retire. They do not collect social security. Yes, they have higher health care costs, but they are nonetheless net financial contributors to society. When the paternalists have stamped out smoking, they will be sorry! :-)Frank https://www.blogger.com/profile/00272351675231621678noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-25683280402842176522020-01-26T09:55:34.267-06:002020-01-26T09:55:34.267-06:00I have never seen any politician or any MSM analyz...I have never seen any politician or any MSM analyze health insurance to the level & scope ot this blog, and I don't expect to. They are all stuck at "the number of insured", which is irrelevant. The root cause of the health insurance issue must be the required profit margin of the insurance companies. At the most basic level, universal health care is the wrong field for insurance companies. Individual insurance is only affordable to wealthier folks who can spend $26k/yr. Subsidizing high-deductible policies to low-income folks who can't pay the deductibles increases the "number of insured" but they don't get any value from their insurance; it's just an expensive gesture. <br /><br />One improvement would be universal tax-deductible HSAs. Why must you be enrolled in a high deductible insurance plan to be eligible to contribute to an HSA ?? I'd get more value from a $500/mo. contribution to my personal HSA than a $500/mo. insurance premium paid to excellus (Live Fearless... MY ASS). This would stimulate the cash market. <br /><br />Best, <br />Gerald<br />on_my_wayhttps://www.blogger.com/profile/08535474364651492675noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-10573439758509886262020-01-25T14:27:19.236-06:002020-01-25T14:27:19.236-06:00A recent MIT study concluded USA has around 20 mil...A recent MIT study concluded USA has around 20 million illegal immigrants, that is bigger than the entire population of all of the Scandinavian countries people often look to. A big problem with American universal care is that, about 60-65% of people want that, which requires the other 35-40% to be forced to subsidize somebody else's lifestyle choices. I say lifestyle choices because obesity is one of the biggest causes of death in America, as well as smoking and alcoholism. The system we have now is worse than these other countries because we are regulating all the good qualities out of private health insurance, and medicare and medicaid don't have many great qualities themselves. 2 central arguments against it. It is a loss of freedom, and the costs will be astronomically higher than we would even calculate, considering there are 20 million undocumented people that will be using the system. The calculable costs aren't much better. The best plan I have seen, was Bernie Sanders' plan. His plan would tack on another 3.6 trillion to the deficit annually. Our current revenue is 3.6 Trillion, and expenses are 4.7 Trillion. We aren't even paying for what we are doing now, how can we afford a near doubling on expenses? The only way the government can pay off this astronomical debt is inflation, and each congress that gets sworn in, is kicking that can down the road. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-62668936205633361062020-01-25T11:21:49.735-06:002020-01-25T11:21:49.735-06:00"Instead, their message focused on protecting..."Instead, their message focused on protecting sick people from abuses by insurance companies. More often than not, that meant protecting people who migrated from an employer plan to the individual market with a preexisting condition."<br /><br />I live with this reality as a Type I Diabetic, a genetic condition. It's been difficult and anxiety inducing in the past to deal with the cost of insurance and medications. I used to be on name brand insulins, but now I am on generics. Cheaper but does the same stuff. This is a good thing. <br /><br />When I had Kaiser, I was paying $400ish a month and spending about 200 a month in insulin (better than $1200 a month!). But, upside: In 1996, I was able to get health insurance with a pre-existing condition through Kaiser because I had established a small business and was able to bypass the 3, 6, or 12 month waiting period before I was covered. I got covered immediately. I am grateful this was available to me and others.<br /><br />"Here is what Obamacare looks like today<br />...In the exchanges, Laszewski gives the example of a family of four in northern Virginia which is among the 40% of families who do not qualify for a subsidy:<br />—The family faces a premium of $19,484 plus a $6,500 deductible.<br />—In essence, the family will have to spend $25,984 before they can collect any meaningful benefits.<br />No wonder almost 29 million people have decided to avoid health insurance altogether."<br /><br />Yep! I have a few friends, who are healthy, who saw their insurance costs - wait for it - *quadruple.* No joke. Yes, this is upsetting. Eats up disposable income that could have been used for saving or investment. While the individual mandate was designed to expand the risk pool and prevent adverse selection through generous subsidies, in a strange sort of irony, adverse selection *might* rear its ugly head again. . .maybe. Pareto Efficiencies versus Pareto Improvements seem to (or will!) have a role in adverse selection as a result of the individual mandate. But now that the penalty has been set to zero, what's the enforcement mechanism now to expand the risk pool and mitigate adverse selection now, hmm?<br /><br />Maybe I'll talk about this in another post more in-depth when it's time, but here's a preview: <br /><br />Idaho and the expansion of Medicaid for those who have fallen through the cracks and who don't qualify for benefits because they're not elderly, a mother with children, or a child. They didn't qualify under the old rules and didn't have the financial resources to get covered. Without health, it is hard to be productive in any capacity to earn an income or start a business.<br /><br />Well, the Boise, ID area has seen a large migration of people from - wait for it - Southern California. Surprised? ;)<br /> <br />(But Boise, along with Salt Lake City and Nashville are emerging as economies of agglomeration in tech - they are trying to mirror the success of Silicon Valley)<br /><br />Great stuff as usual. Cost structures matter and I haven't seen many politicians try to address this. They're more concerned with the moral and normative arguments for and against who should be financially responsible for the costs. Bernie Sanders has tried to address both in the past. I think Warren has, too - but Warren has some authenticity issues (self-inflicted wounds), so it is difficult to take her seriously, unfortunately. Monopsony will solve the cost structure problems? Maybe. <br /><br />Everyone wants their cake and to eat it, too, it seems. Ha. Unrealistic. There will always be tradeoffs.<br /><br />I remember reading *somewhere* about how the first bite isn't as satisfying as the last. ;)<br /><br />Best,<br />MykelMykel G. Larsonhttps://www.blogger.com/profile/17128735421035292909noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-36021040389129479672020-01-24T23:06:15.559-06:002020-01-24T23:06:15.559-06:00Wonderful post, of course. To cut through all this...Wonderful post, of course. To cut through all this garbage, it would be best to force [OMG] everyone to contribute to a health insurance plan, with all the efficient characteristics needed, from birth, well, from the first job. And then privately insure at the margin if you don't like the garbage you're getting. Like socialist Europe. I don't see any other way. Am willing to be educated :-)<br />Frank https://www.blogger.com/profile/00272351675231621678noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-2644778907586344882020-01-24T14:14:37.580-06:002020-01-24T14:14:37.580-06:00"Once upon a time in America there was good, ..."Once upon a time in America there was good, relatively expensive, individual health insurance. It was "guaranteed renewable." If you bought it when you were healthy, and then got sick, they could neither cancel your policy or raise your premiums. People with part time jobs or self employed bought it. It wasn't perfect, but then again nothing is."<br /><br />When was this?Jeremyhttps://www.blogger.com/profile/09677982406676242172noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-45800551193007236682020-01-24T13:51:02.002-06:002020-01-24T13:51:02.002-06:00I have an alternative to past Republican proposals...I have an alternative to past Republican proposals to "repeal and replace" that would not require any legislative action, leaving PPACA in place. It is a proposal that once had bipartisan support. Send me a note at jacktowarnicky@gmail.com if you would like to discuss. Jack Towarnickyhttps://www.blogger.com/profile/08875925574586454646noreply@blogger.com