Sally Redux

How come every other developed nation can manage it

Giantaxe

And amazingly private insurance is an integral part of the Dutch and Swiss systems, countries that have almost universal coverage...

Michael

Because the vast majority of countries have either government provided health insurance or a single payer system.

However the Swiss system is 2nd only to the US in the percentage of gdp. I'm not sure where the Dutch system falls in the percentage of gdp. However I agree that the US could have universal coverage and probably get it's cost per gdp down to the Swiss level with properly regulated health insurance companies and the medical profession but probably not lower. With so many people currently uninsured or underinsured in the US, the cost is still there but not directly through insurance companies but instead indirectly or though payments by the government.

Sally Redux

The question was for the dolts in Congress

Giantaxe

Yes, but it does manage to cover almost everyone for the money. The US is the outlier here, both in terms of costs and in terms of those without effective access to the system.

The Netherlands spends around 10% of GDP on healthcare.

Michael

The costs in the US are exorbitant since we wait until the person is very ill before we treat them or they use the ER. I suspect since the Dutch probably had the system in place a long time, they likely controlled medical costs from the beginning. I suspect since the Swiss system is relatively new, much like ACA, the populous wants to keep the system much the same as it always was where the patient gets what the patient wants whether is deemed necessary.

Giantaxe

I think we should get Boiler to pontificate to these countries about how insurance works. Obviously they're doing something wrong.

Michael

The general consensus is that Europe's primary problem is with funding it's states pensions and the US's primary problem is with funding it's health care system.

In a sense, the US should be in a better position to solve it's problems than Europe since there are ways to cut health care costs without significantly impacting the quality of health care but there is not an easy way to cut pension costs without reducing benefits.

The question is whether the US congress will be smart or dumb.

Giantaxe

With two parties beholden of lobbying $$$ and one more interested in dogma than actually trying to solve problems its citizens face, I'll plump for the latter :-)

RoadWarriorFromLP

An actuary would account for anticipated costs. The US system has much higher costs because it fails to gain the negotiation leverage that comes from having a single pool. Instead, it allows medical providers to cherry pick the pool and to command higher prices.

So in answer to your question: Actuaries don't do what you think.

Steerpike

There's some validity to that idea, but I think in fairness you have to consider what medical insurance covers vs. car insurance. IF your car insurance covered you against engine failure, then having the ins. co. pay for oil changes may be a reasonable way for them to lower their costs, since more oil changes would lead to fewer engine problems. Having your health insurance cover regular checkups is a cost saving activity since it may catch an early stage disease before it gets worse/costs a fortune.

But if you are a 'long term sufferer' of a disease, and it is fully anticipated that you will need 'drug "x" ' for the rest of your life, then yes, that's a more interesting example. Should an insurance company be required to pay for your drug for the rest of your life in this case? I might agree that a 'for profit' insurance company might need a 'get out of jail' card on that one, and pass it to a government 'deep pocket' fund that is designed to cover such costs. I do believe, however, that 'society' should pay it, and I'm happy to pay my taxes to support this.

I'm learning now about the health plans of Safeway (grocery store). Safeway have, for a long time, 'self insured', which means, they got rid of the insurance companies, and simply pay the doctor/hospital bills directly; taking on the risk themselves. And as a result of being an 'engaged citizen' when it came to paying the bills, they started steering their workforce towards better value healthcare providers. And more interestingly, they started a very aggressive plan to educate and 'guide' their workforce towards healthier lifestyles. If you smoked, you paid more. If you were fat, you paid more; etc. They offered incentives to join a gym, and so on. I'm still learning about this but it is, so far, fascinating. A friend of mine who works for Blue Cross in CA described a similar 'health plan' offering - you could reduce your rate by signing up for gym memberships, you were penalized if you were heavy, etc.

Regardless of any other developments in the world of healthcare, US or UK, I think the above approaches have merit.

scrubbedexpat099

If you have a maintenace contract, extended guarantee etc then a requirement would be for the manufacturers recommended maintenance to be undertaken.


True, but what would be the point of paying the Insurance company the cost of your oil change for them to then add their costs and pay the oil changer? Dollar or pound swopping makes no sense, just adds cost.

Actually you are wrong in this case as that is exactly the case where Insurance can come in, whether it is a Mutual or a For Profit.

Say that treatment would cost $1m and you have a 1 in 10,000 chance the risk cost would be $100 per person.

You have described the underwriting and risk management process. I am not familiar with Safeway's programme but certainly for any group this size I would expect them to run it through a captive and buy claims handling/risk management controls. I doubt if they are totally uninsured, probably some stop loss cover in there.

Obamacare as far as I can tell only takes into account smoking as a life style risk factor.

Michael

Actually the Netherlands has moved into 2nd place and the Swiss has dropped to 5th place as a percentage of gdp.

Move the cursor over the left graph in the following link to get the latest percentage for each country.

http://www.oecd-berlin.de/charts/hea...?cr=oecd&lg=en

scrubbedexpat099

Good news is that Colorado is up and running again.

After the $444 Obama contribution (thanks) the cheapest Bronze is $1, the most expensive $282.

No Silver options, why?, the cheapest Gold is $296.

So I will no doubt spend my buck, I will try and do a comparison, unfortunately I know enough to work my way through the policy t&c, but I doubt the extra will be worth it.

Amusingly the Denver Post, solid Dem, has been having some less than positive stories on Obamacare.

Michael

Did you enroll yet? It would be nice to know if what you were quoted is the actual price after acceptance since there may possibly still be kinks in the system.