Insurance Is A Business, Boys And Girls
Scott Harrington fact-checks the President's health care plan in the WSJ:
In his speech to Congress last week, President Barack Obama attempted to sell a reform agenda by demonizing the private health-insurance industry, which many people love to hate. He opened the attack by asserting: "More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care. It happens every day."Clearly, this should never happen to anyone who is in good standing with his insurance company and has abided by the terms of the policy. But the president's examples of people "dropped" by their insurance companies involve the rescission of policies based on misrepresentation or concealment of information in applications for coverage. Private health insurance cannot function if people buy insurance only after they become seriously ill, or if they knowingly conceal health conditions that might affect their policy.
...Company representatives testified that less than one half of one percent of policies were rescinded (less than 0.1% for one of the companies).
If existing laws and litigation governing rescission are inadequate, there clearly are a variety of ways that the states or federal government could target abuses without adopting the president's agenda for federal control of health insurance, or the creation of a government health insurer.
I would say I'm a model health insurance consumer. Been paying Kaiser Permanente monthly since my 20s -- for about 20 years. I'm slim, healthy, rarely come down with so much as sniffles, and barely go to the doctor. I need health insurance in case something goes dramatically wrong -- but even if it does, Kaiser has gotten a monthly payment from me for so many years, and with me taking so little from the system, it's possible I still wouldn't end up on the loss column of a P&L statement.
What Obama is asking for, and what so many of the whiners are whining for, is something for nothing. At 45, when they come down with cancer or Crohn's, they suddenly want coverage. Oh yeah, and who pays? The rest of us. And there's no going back to repossess all the TVs and vacations and wonderful dinners these people bought with the money they might've spent on a health insurance plan.
Frankly, unless health insurance is "buy or die," it really isn't health insurance but health welfare, once they start giving it out to people who chose to gamble that they wouldn't get sick so they could put their money toward more fun stuff. And sure, there should be provisions for the very poor and the mentally ill, and children with pre-existing conditions, but I don't think that describes a good many of the people who really, really value health care, but not enough to actually pay for it out of their own pockets.
If I understand what you are saying, you seem to favor a mandate, where everyone is forced to obtain insurance after some age (presumably 18 or 21).
Is that a mandate, and is that insurance, or is that just a tax as in how we pay for the fire department, or the police department, or the library, or the schools, or the military, or basic city, state, and federal services?
Why do we need an *insurance* model(, and what would Schumpeter say about the destruction of the insurance model?)
jerry at September 15, 2009 12:05 AM
Got to go to bed (deadline, have to be up at 5), so more on this in the morning, but a friend from Switzerland told me everyone there MUST buy health insurance of some sort.
Amy Alkon at September 15, 2009 12:18 AM
So what happens if Kaiser decides not to renew your coverage next year? It's the smart move for them -- they've already made a profit on you, and you're just going to be more and more of a risk from here on out. Do you just shrug and say "Well, Free Market! It's what Ayn Rand would have wanted."
And, in what sense is "Everyone must have insurance" not the dreaded "Socialism?"
franko at September 15, 2009 12:39 AM
I'm not favoring Obama's plan, but something does need to change with the insurance industry. The reality is that we are paying for those without insurance when they are on Medicaid or are uninsured and go for treatment at an ER which always costs more than the regular visit. I have a few friends who lost businesses or jobs and could not afford the COBRA payments. One friend had an autoimmune disease. COBRA payments ran close to $600 monthly. Without a job, she went through most of her savings and assets. I don't know if she is coverable when she gets a new position, but she's not someone gambling with other people's money. Unfortunately it isn't always so cut and dry. There will always be people who milk the system no matter what, but to think that we are not already paying for the uninsured is incorrect.
Kristen at September 15, 2009 4:48 AM
So what happens if Kaiser decides not to renew your coverage next year?
Kaiser doesn't work that way, nor does the rate rise, except to a standard rate with age, which is why I picked it.
I have always placed great value on health and health insurance. I had health insurance when I couldn't afford a bed. Sorry to bore those of you who've been here at while, but at one point, in New York, I was sleeping on a door (supported by two milk crates). (It creeped me out to just sleep on the floor.) I still have the sleeping bag I was using on that door.
Amy Alkon at September 15, 2009 5:19 AM
Kristen, if health care weren't tied to the workplace, your friend wouldn't be in these circumstances. It's prudent of people who have jobs to negotiate around using the workplace healthcare and instead maintaining Kaiser or some good plan. These are no longer the days that people stay with one job for life, and health care policy forgot to notice that. Correct that and other things, don't rejigger the whole system when you really have no fucking idea how it'll play out.
Amy Alkon at September 15, 2009 5:21 AM
It is. And like all socialist ventures it will fail. It already has in Massachusetts.
That said, many people don't want insurance. They want other people to cover the costs of their health care.
brian at September 15, 2009 5:56 AM
...Company representatives testified that less than one half of one percent of policies were rescinded
This actually sounds like a lot when you consider that most of the policies active in a given year will not have any serious expenses.
If 5% of the insured have expensive insurance events, then that's an actual recission rate of 1 in 10.
aba at September 15, 2009 6:07 AM
So what happens if Kaiser decides not to renew your coverage next year?
Much as the left wishes to to think that it is otherwise, an insurance company is not permitted to discontinue an individual policy (though it can raise the rates).
Hence the "dirty trick" of rescision where the insurance company tries to catch you on an undivulged condition. And also the need for regulation to clamp down on unjustified rescision.
aba at September 15, 2009 6:11 AM
Amy Alkon
http://www.advicegoddess.com/archives/2009/09/15/insurance_is_a.html#comment-1667723">comment from abaThanks, aba, for clarifying that. And again, I'm a fiscal conservative. I'm not just for limited government, and limited government spending; I try to behave in a financially prudent way in my own life, best I can. When I was signing up for health insurance, I had a number of options, and I chose Kaiser because it seemed the most prudent plan for a middle-class person like me (although I hope to make bazillions on my book and other writing some day).
Amy Alkon at September 15, 2009 6:26 AM
This gets back to the fact that ordinary care doesn't fit in the insurance model, because the probability of the insured event occurring is near 100%. Whatever is done for that needs to work more like a savings plan. Only catastrophic care fits the insurance model.
Kristen has a good point about how private-sector insurance is being coerced into cross-subsidizing Medicare and Medicaid. It's a hidden tax, and it has to account for a significant percentage of the increasing cost of insurance. If it's going to be that way, I'd prefer that it be an explicit tax, so we have transparency into how much we're paying for it. As it is, we have no idea. And I've no doubt that's the way the government wants it.
Brian, I've read the same thing about the Massechusetts plan. But I get Amy's point too, that some people will gamble with insurace because there really isn't much risk: they know that hospital ERs cannot refuse to treat them. If it really was a life-or-death gamble, a lot fewer people would do it. But our current culture will not tolerate that. Given that, the alternatives appear to be: (1) let the free riders continue to get away with it, or (2) make insurance mandatory. I find both of these distasteful, but I can't come up with a better idea.
Cousin Dave at September 15, 2009 6:33 AM
Amy Alkon
http://www.advicegoddess.com/archives/2009/09/15/insurance_is_a.html#comment-1667725">comment from Cousin DaveAnd who are all these uninsured people?
http://reason.com/blog/show/136071.html
Check out the more than one million illegals who make up 20 percent of California's uninsured. I don't go to France and expect the taxpayers to fund my medical care (Kaiser takes care of catastrophes if you have to go to the hospital there, but if I want to go to the dermatologist, I'll have to whip out my credit card).
Amy Alkon at September 15, 2009 6:43 AM
Obama's speech last week had some of the usual confused wording:
> Everyone understands the extraordinary
> hardships that are placed on the
> uninsured
Again again again again — There's this implicit idea that insurance creates wealth. This is mistaken! Insurance doesn't create wealth.
The problem isn't 'extraordinary hardships" for being uninsured, the problem is being poor. It sucks to be poor. It's an extraordinary hardship. Insurance isn't a magical force that makes people well, it's just a series of financial agreements that shuffle the billing around. Some people are too poor to sign the contracts to participate in the shuffle. (And as I have often noted here, some particular people are too cowardly and lazy.)
When Obama says he's going to take away the hardship, he's saying he's going to take away poverty.
Well, he's not going to do that. The pathetic fantasy that these insurance zombies have is that we can just make a policy change and have a huge component of our human challenge go away. This is not true.
Yes, of course you can have a single serious illness that sends you into poverty and despair. Of course you can. Is this a surprise to any sentient being? Is anyone so optimistic about the power of civilization and government that they believe we've turned the corner on this, that we've improved the world so much that it's within our power to make this eternal threat go away — for every single person in the country?
This is a control fantasy for lefties. They are not compassionate. They are not nice people. The sincerest, most sweet-hearted universal care supporter you meet today is indulging a horrible, infantile part of their nature.
___________________
Thanks! Good to start the day tilting at windmills!
Crid [CridComment @ gmail] at September 15, 2009 6:54 AM
Yes, in Switzerland it is mandated. My BIL pays about 12k chf per year (not sure where the dollar is at now, but its usually about the equivalent of $10k US) for his family of four.
Swiss salaries tend to be higher, though.
I was thinking it might not be a bad thing if someone started a non-profit health insurance company. Rather than complain about the current system, someone could start an alternative plan. You'd still be paying the employees (many non-profits pay similar salaries to businesses), but wouldnt have to worry about paying shareholders as well. I wonder if it would work. Do you all know if it has been done?
NicoleK at September 15, 2009 7:34 AM
Amy Alkon
http://www.advicegoddess.com/archives/2009/09/15/insurance_is_a.html#comment-1667733">comment from NicoleKKaiser, my healthcare provider, is a nonprofit.
Amy Alkon at September 15, 2009 7:36 AM
... and I wouldn't call the Swiss way socialist at all. You decide what private company you want. There is some sort of Medicare type thing for the poor, as well, but everyone who can afford to (most of the country) goes with private companies.
NicoleK at September 15, 2009 7:45 AM
Crid, I disagree. Insurance companies develop a great deal of institutional expertise in the areas of apprising, underwriting and administering loss and risks of loss. Those companies can then charge a premium to customers commensurate with the risks, offering to take those risks on themselves, pool the premiums while waiting for loss results, and invest those premiums as a large capital pool. Heck, the companies can occasionally provide some insight to me (their customer) in how to reduce my risk exposure.
All of that is a specialization of function. The insurance company is no different than any other specialized laborer, firm, or other economic actor. That specialization mixed with capital allows for increased productivity, leading to increased wealth for both the workers involved and society overall.
Thank god for such specialization, frankly.
Spartee at September 15, 2009 8:52 AM
Spartee, that's preposterous:
> Those companies can then charge a
> premium to customers commensurate
> with the risks, offering to take
> those risks on themselves, pool the
> premiums while waiting for loss
> results, and invest those premiums
If it was that easy, *you'd* be in the insurance business. Furthermore, it's beside the point: Insurance doesn't create wealth. It moves money around, but this is not the same thing...
... As our present economic crisis handily demonstrates. Y'know, when I think of all the devastation that's been wrought in lives around the globe by clever-seeming people in the financial sector, it's a jaw-dropping irony that people such as yourself and our president will now ascribe voodoo powers to them, in a feckless prayer that they can, essentially, make poverty go away. 'Golly, being sick shouldn't have to be a problem for people.... Aha! Let's change human nature! Let's write a bill in Washington!
Crid [CridComment @ gmail] at September 15, 2009 9:00 AM
Insurance = transfer of risk not creation of wealth.
Feebie at September 15, 2009 9:41 AM
I hit send too soon.
It is a contractual method to provide indemnification (indemnification means to make something *whole*) not to make someone rich.
That is why when an insurance claim is paid out, whether it be on a homeowners policy, healthcare policy...etc, it will never pay *more* than the loss is valued at.
It's kinda like gambling actually, you are paying insurance premiums under the assumption that at some point in your life you will need financial help at some point for a loss - the insurance company - based on your habits (underwriting) or the exposures reflected in the type of risk will bet against it to a probability of it happening (and how bad it will be if it does), which is how the premiums are determined.
No where will they give you MORE than what it takes to return you to your financial state prior to the loss.
Feebie at September 15, 2009 9:52 AM
Kaiser Permanente is heavily unionized, non-profit, has "death panels" (they will pull the plug when reasonable by their definition)and does not always acquire the latest and best in medical technology. They were very late in getting MRIs for example, and that policy was explained to me this way (in the 1980s) "We don't buy a piece of equipment just because doctors want it."
Still, it is care, and I had good results there with my son (on Sunset Blvd).
For my family of three, $700 or so. My family lives in Thailand now where care is free, for a nominal fee paid to acquire a health card.
Yeah, Thailand, a Third World nation, does a better job of providing health care than the United States. Better care too--I have used their hospitals, and would again for any reason.I just don;t understand right-wing hysteria on this issue. There are parts of the economy--such as pollution--where the price mechanism doesn't work (even U. of Chicago profs know this).
It is not reasonable to expect laypeople to be intelligent consumers of health care or that insurers can run a business profitably and take care of insured. Too many conflicts of interest.
Alkon's hero (sadly) got lung cancer. As I recall, her deductible rose to $18k. A little trick insurers have. They don't raise your rates, just boost the deductible to the moon. Had Seipp lived another year the deductible would have killed her. And she was a public figure--imagine what happens to Mr. and Ms Nobody.
i-holier-than-thou at September 15, 2009 10:02 AM
What is preposterous? The concept of risk-based premiums? The value coming from managed investment of pooled premiums while the company waits for loss results? That compiling loss results, underwriting, and sales activity provides a value via specialized service, ultimately generating wealth? What?
Insurance companies provide services to customers by evaluating and assuming risk using their workforce's specialized labor and a capital pool (shareholder capital+unreturned premiums). They generally do this for profit or as a mutual company. In the end, it looks little different from other part of the service economy, such as banking or investment services.
But if, for some reason, you believe that insurance companies are unique relative to the remaining portions of the economy that arelargely service, please explain. Or if you believe that banks, investment managers, and other financial sector service-based entities generally do not assist in wealth creation, well, then I am not sure what else to say.
Oh, and just because it is easy to summarize an economic activity, that does not mean it is easy to execute. E.g., Microsoft specializes in writing software for modern personal computers. As a result, we don't have to learn to code to use our PCs. Microsoft then charges license fees to customers based. Etc. I doubt I cannot replace Microsoft just because I can describe their economic activity. And I certainly did not claim I could.
"As our present economic crisis handily demonstrates. Y'know, when I think of all the devastation that's been wrought in lives around the globe by clever-seeming people in the financial sector, it's a jaw-dropping irony that people such as yourself and our president will now ascribe voodoo powers to them, in a feckless prayer that they can, essentially, make poverty go away"
Um, okay. So, too much coffee or what?
Spartee at September 15, 2009 10:03 AM
I-Hole wrote "My family lives in Thailand now where care is free, for a nominal fee paid to acquire a health card. Yeah, Thailand, a Third World nation, does a better job of providing health care than the United States."
How can one even respond to a statement so completely factually incorrect as this?!? I'm going to bang my head against the wall instead ... as it will be much more productive!
Robert W. (Vancouver) at September 15, 2009 10:29 AM
"Kaiser doesn't work that way, nor does the rate rise, except to a standard rate with age, which is why I picked it." I might point out that you have utterly no guarantee Kaiser will continue to do so until you die (hopefully of old age). Insurance, including Kaiser, is in it for money, not the goodness of their hearts. And relying on the goodness of mercenaries ain't working.
Weren't you sweating about missing a (a as in a single, solitary one) payment during the Bank of America fiasco? You had to get money to them on short notice; they were so sympathetic after your 20 years of payments, that they wouldn't even give you a one-month grace period.
muggle at September 15, 2009 10:44 AM
Robert W:
You might respond by asking how Thailand does it. Many Westerners now travel to Thailand for care--in fact the "holiday-hospital stay" or "hospital resort" has become an item. Check it out on the Internet. I heartily recommend you travel to Thailand to have expensive surgeries done, and with the money you save, take an extended tour of the country.
My wife's family lives in Pakchong, a small town north of Bangkok by about 2 hours, non-rush. A new public hospital has been built there by the ratabahn (government).
For minor care matters, my wife saunters into a local clinic, shows her card, and get primary care. It is so fast and easy.
Of course, the Thai culture has a penchant for "KISS"--keep it simple stupid.
I have had two surgeries in Thailand. Both times I was completely impressed, though I am a layman.
How often have you received medical treatment in Thailand? How is it you know so much about the topic?
-i-holier-than-thou at September 15, 2009 11:01 AM
The only people I know that go to Thailand are sexual pervs who want to have sex with teenage girls for cheap. And they call it their vacation. Ya, I wanna go support a country who is most famous for it's sex trade and exploitation of young girls.
ron at September 15, 2009 11:06 AM
"Insurance companies provide services to customers by evaluating and assuming risk using their workforce's specialized labor and a capital pool (shareholder capital+unreturned premiums)."
I think you are speaking of (loss) reserves. Insurance companies have to have a certain amount of reserves on hand at any one time to pay a claim(s). These reserves are dictated by laws, corporate policies as to how much of a percentage of their portfolio they need on hand. The method used for this is actuarial type studies. As far as premiums for the consumer, these are loss ratios (exposures and losses).
So reserves need to be in place first before they can start building capital. That is primarily done through outside investments with reserve excesses. But reserves change and fluctuate depending on losses paid out and/or premiums collected. If your reserves are too low, then the less capital you will have for your investments.
Policy holders, however, cannot recoup more than the value of the loss, despite their policy limit. E.g. If you have a policy limit of $500,000 and you have a $10,000 loss, you don't get the whole $500,000 - only $10,000. On the consumer side, it does not create wealth. It is a transfer of risk to a financial outfit to absorb the impact of a catastrophic loss.
This is also why some people will buy insurance policies but will pay for small claims themselves to avoid large premium increases (personal responsibility).
In healthcare, if it is "free" or someone else is paying for it, you are likely to see less responsibility from the consumers, and the inevitably a financial black hole.
Feebie at September 15, 2009 11:23 AM
Ron-I admire your circle of friends for their inclinations, but perhaps your should expand your contacts a bit. There are other reasons to visit Thailand.
i-holier-than-thou at September 15, 2009 11:38 AM
I didn't realize Kaiser was nonprofit. No wonder it was so much less. I really liked Kaiser. It was cheap, and the service was good.
In MA, Healthcare cost almost 3 times as much... and I was only a year older, AND I had lost 50 lbs. This is the problem with the MA "force everyone to buy it" model... is how much it freakin' cost!
NicoleK at September 15, 2009 12:19 PM
Right, Nicole. You've hit on something that would be a real reform. Allow insurance companies to compete across state lines.
Is it worth explaining to i-holier that his healthcare isn't free just because he isn't paying for it?
Robin at September 15, 2009 1:08 PM
I know a couple who has visited Thailand several times. The last time they were there, there was a revolution. They had to go into hiding and were trapped for two weeks, and then they were only able to get out because of the husband's family connections there.
Cousin Dave at September 15, 2009 1:11 PM
> What is preposterous? The concept
> of risk-based premiums?
What's innovative about that? Isn't that the point of Amy's post, that actuarial calculation is the core of the enterprise?
> The value coming from managed investment
> of pooled premiums
Again, isn't that the way it already works? Isn't incompetent, circle-jerk investment between insurers and Wall Street how we got here?
> That compiling loss results, underwriting,
> and sales activity provides a value
> via specialized service
Your understanding of these matters has many faults. Here are just a few:
• First, insurance companies can certainly turn a profit through investments, but it's preposterous (and presumably illegal) to assume those profits can cover the losses to the insured... Payouts will always come from premiums paid by the policyholders in earlier times, or by his fellow policyholders who aren't suffering in the same crisis.
(Got that? When socialized medicine happens, and a stranger gets sick, you're on the hook. You're on the hook whether he or she has prepared for the illness or not. You're on the hook whether he's every prepared for anything in his whole life or not. Whether he's gotten an education or not, sought to behave lawfully or not, sought to raise decent children or not, or added any value to the economy over his whole life or not. Like, whatever: His sickly ass is yours, and it's time to pony up.)
• Secondly, government is not in the business of selecting profitable investments for the benefit of others. (Such a scheme is called "communism," and it goes badly. Always.)
• Thirdly, even if government did exist to pick stocks for us, it would do a bad job. The people who really excel at spotting good investments are always going to be watching out for their own best interests... This is essentially definitional. The private sector is where humanity's horniest action is.
• Fourthly -
> In the end, it looks little different
> from other part of the service
> economy, such as banking or
> investment services.
Yes! Exactly! It's just like the largest sector of our economy, the array of industries whose incompetent performance and venal regulation have dropped the public weal into the toilet. These are people, like you, who have no understanding of wealth creation.
• Fifthly -
> But if, for some reason, you believe
> that insurance companies are unique
> relative to the remaining portions
> of the economy that arelargely
> service, please explain.
I can't imagine what you're asking here. . Amy's a gossip columnist, a service provider. Frequently commenter Willy is a bus driver, also a service provider. Their careers are sometimes analogous and sometimes not. Insurance is like that, too.
• Sixthly -
> if you believe that banks, investment
> managers, and other financial sector
> service-based entities generally do
> not assist in wealth creation, well,
> then I am not sure what else to say.
Assisting in wealth creation is not the same as wealth creation. Building good roads doesn't mean you're in the trucking business. Maybe a state with great roads can tax trucks a little bit, but the people who really built the wealth from those businesses have other plans for it.
Finally -
> Um, okay. So, too much
> coffee or what?
I often resolve to stop blowing snot on blogs, and then something like that happens. So I want you to imagine something really rude being said to you. By me. Here, now.
Crid [CridComment @ gmail] at September 15, 2009 1:40 PM
Cousin Dave--"They had to go into hiding."
What a laugh. Were they the Big Butts of Saturday Night Live fame?
Foreigners had no role in the recent red short-yellow shirt rift, and thus neither side cared poop about "farang."
Hiding? From what? A suntan? Incense smoke?
The airport was closed down by peaceful occupation. Yes, I wish it hadn't happened. I think one Thai national was killed in all the ruckus.
Thaksin was probably a good leader, and it is too bad Thai royalists and elites have pushed him out.
Meanwhile, since the red-yellow thing the Thai stock market has come roaring back.
Check out the company Univanich, stock symbol UVAN. A great investment.
For those of you who think I am obsessed with sex, I will note that the Thai stock market is called the "SET."
"Set" is the Thai word for orgasm.
Wishing you all many happy sun-sets.
i-holier-than-thou at September 15, 2009 1:50 PM
Amy's a gossip columnist,
Advice columnist.
Otherwise, you're on fire. Great stuff just above, Cridster.
Been having a long deadline journey's day into afternoon. Nice to see you sweeping up around here.
Amy Alkon at September 15, 2009 2:19 PM
Sorry about that, hostess. It was a rushed, lunchtime-at-work kinda comment. But if you do hear anything about Britney, speak up
Crid [CridComment @ gmail] at September 15, 2009 2:31 PM
Of course, the problem with insurance competing across state lines is that different states have different laws regarding insurance and health care, and then it gets into the murky territory of State's rights.
NicoleK at September 15, 2009 3:28 PM
"Of course, the problem with insurance competing across state lines is that different states have different laws regarding insurance and health care,"
Yes. And also, subrogation has been significantly restricted by state laws too. I just read that Obama's current plan prohibits subrogation by health care as well.
Meaning, if a drunk driver hits you and your healthcare company pays for it, they do not have the ability to go after the auto insurance company for reimbursement (since it was not your fault). This increases the premiums for healthcare policy holders across the board.
They are doing this now with SCHIP. The children (the Foster's???) the Dems put up as the "poor folks" who would have been without coverage after an accident had it not been for SCHIP -- they wound up getting a huge settlement for that accident and spent it all on a new car, a house - etc (forget the details exactly, it may have been about two years ago), but there was to my knowlege nothing that required them to pay any portion of their settlements medical costs back to the State (SCHIP). So, their new car, house and everything was on taxpayers. It's what is known as a "double recovery".
Government runs a bad business.
Feebie at September 15, 2009 4:50 PM
I believe in some states insurance can be not renewed at the end of the contract. At least I have heard of it happening. And I know people who have had their rates go through the roof when renewing after a major issue to the point it might as well have been cancelled.
I certainly believe the health care system needs some tweeks if not some changes. The plan proposed by Obama appears like a huge risk that is almost surely veryly costly.
The Former Banker at September 15, 2009 8:57 PM
So, I-Holeinthehead, we've finally got you nailed. You're a stock tout.
Cousin Dave at September 16, 2009 7:28 AM
Only UVAN. 14 percent yield, and they grow and sell palm oil. Palm oil is vegetable oil for a growing China, and if crude oil goes high enough, paml oil becomes biodiesel.
Clip that 14 percent coupon for the rest of your life.
You may detest me, but you will love me if you buy UVAN.
I tout no other stock. Caveat emptor.
i-holier-than-thou at September 16, 2009 9:50 AM
There is more than one level of medical care.
There are the minor things. A kid with a somewhat routine fever and vomiting; perhaps a toe infection. Things on that order.
Then, there are things that involve surgery, like appendicitis or gall bladder problems.
Then, there are the heart-lung machine things.
I guarantee you even out here in the Third World part of Mexico, the first level of care is better. At that level, access to ordinary doctors is the issue. Two years ago, my little grandson developed vomiting and fever on a Thursday afternoon. The doctor's office said they could fit him in on Monday. And, ER costs a fortune, plus I doubt insurance pays for that.
That would never happen here in the Third World. Your kid gets sick at 2 am, you ring bell at the doctor's house and he treats your kid.
The second level is not that bad, either. And, costs are much lower.
In the country, MRI's are nearly non-existent. There are people who could run them, but there is no money to pay for them. If you have money, it is only a couple hours to a hospital which has them.
Heart-lung machines? Kiss your backside goodbye.
But, most medical care here is reasonably good, and you can access it easily.
ABC hospital in Mexico City is a great hospital. I am told there are two in Guadalajara which are among the best in the world.
So, I can believe that most medical care in Thai cities are reasonably close to the US standards that most of us who aren't wealthy can access.
I am told there are insurance companies which send hip replacement and similar surgeries to India, the cost with transportation and hotels paid, is much less than in the US AND RESULTS ARE SUPERIOR.
It is time for informed people to realize that the US is not as superior as they think it is. The world has changed.
irlandes at September 16, 2009 12:44 PM
From Amy's Kaiser People:
"Annual premiums for employer-sponsored health insurance rose to $13,375 for family coverage this year — with employees paying $3,515 and employers paying $9,860, on average, according to a new survey.
The benchmark 2009 Employer Health Benefits Survey, released Sept. 15 by the Kaiser Family Foundation and the Health Research & Educational Trust, found that family premiums rose about 5 percent in 2009. That’s more than general inflation, which fell 0.7 percent, and workers’ wages, which rose 3.1 percent, during the same period.
Since 1999, premiums have gone up 131 percent. That’s far more than than workers’ wages, up 38 percent, or inflation, up 28 percent, over the same time period."
$13k to cover a family. Ouch. And you can't see a doctor for days and days.
I want to tax the shit out of rich people and build a better healthcare system here.
Amy says we should sleep on cardboard boxes and ever have kids, we will be fine.
I prefer the soak the rich approach.
i-holier-than-thou at September 16, 2009 3:52 PM
irlandes - been meanin' to ask ya's. If Mexico is such a wonderful mecca, why does half of your population come over to our country for free services and to work illegally in jobs that American's really do want (e.g. construction, meat packing, etc.)?
Feebie at September 16, 2009 4:47 PM
Right. Which shows just how impenetrable your little mind is.
The math shows that if you taxed the "rich" at 100% you would not have enough money to pay for one year of universal coverage.
Can you tell me how your plan works? Unicorns that shit gold bars are not a valid solution.
You want to know what DOES work? I'll tell you. Get an education. Get a job. Get an apartment/condo/house. Don't have children until you've done all of the above.
Everyone I know who has followed that trajectory has been successful, and never wanted for medical insurance or care.
brian at September 17, 2009 5:27 AM
Does this mean Brian bought some health insurance?... or does it mean that the people who care for him will "eventually get their money"?
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