13 votes

Sky-High Deductibles Broke the U.S. Health Insurance System

27 comments

  1. [4]
    shadow
    Link
    This one quote FTA is telling: I do not like the way the US is going with healthcare, a sentiment shared by many people. When people don't get the preventative care they should, tax-payers can end...

    This one quote FTA is telling:

    When one large employer switched all its employees to high-deductible plans, medical spending dropped by 12 percent to 14 percent, according to an analysis by economists at University of California, Berkeley and Harvard. But the workers weren’t learning to shop more effectively for health care. They simply reduced the amount of medical care they used, including preventative care. In high-deductible plans, women are more likely to delay follow-up tests after mammograms, including imaging, biopsies and early-stage diagnoses that could detect tumors when they’re easiest to treat, according to research in the Journal of Clinical Oncology.

    I do not like the way the US is going with healthcare, a sentiment shared by many people. When people don't get the preventative care they should, tax-payers can end up footing a higher bill 20 years down the road! This is just another data point depicting a growing long-term problem, and the last two paragraphs hurt to read!

    12 votes
    1. [3]
      TheLagDemon
      Link Parent
      I’m surprised there is so little political motivation for implementing some cost controls. Healthcare is such a mess and I assume things are only going to get worse as the boomers continue to age.

      I’m surprised there is so little political motivation for implementing some cost controls. Healthcare is such a mess and I assume things are only going to get worse as the boomers continue to age.

      7 votes
      1. [2]
        Appaguchee
        Link Parent
        When one full half of the talking-heads "news" people (and I'm not trying to play politics-bottom line is you can't rely on talking heads for accurate news) tells you that insurance premiums,...

        When one full half of the talking-heads "news" people (and I'm not trying to play politics-bottom line is you can't rely on talking heads for accurate news) tells you that insurance premiums, medical care costs are high because "immigrants, freeloaders, lazy people, and gotta respect free market" is the reason why healthcare costs so much, then you won't solve much.

        Tell people that other countries have it better, and the talking heads increase the hate rhetoric. "Sure they have it better, because we inflated their economy (freeloaders)."

        Then you begin to see why US Citizens can't collectively put their heads together and fix it.

        And I haven't even begun to complain about lobbying by insurance companies.

        7 votes
        1. Gaywallet
          Link Parent
          To be fair, we did make a huge step in fixing the problem with the Affordable Care Act - we made yearly checkups free, increased coverage of drugs (and reduced co-pay) for common diseases that if...

          To be fair, we did make a huge step in fixing the problem with the Affordable Care Act - we made yearly checkups free, increased coverage of drugs (and reduced co-pay) for common diseases that if left unchecked can become expensive (such as rescue inhalers for Asthma), brought back in people with pre-existing conditions, and closed the loophole of healthy people just not buying/using health care.

          I may not agree 100% with everything that the ACA brought, but it did step us in the right direction to fix our country.

          Then Trump expanded what was possible under executive orders to quite literally block part of a law and the republicans have been doing their best to gut/remove the ACA. So we're taking a step backwards. My hope is that we can take a step forwards again when the pendulum swings back after this presidency.

          4 votes
  2. [2]
    nil-admirari
    Link
    Health care was broken long, long ago, increasing insurance deductibles is just the latest by brilliant business minds to extract larger profits for their shareholders. Free market principles...

    Health care was broken long, long ago, increasing insurance deductibles is just the latest by brilliant business minds to extract larger profits for their shareholders.

    Free market principles cannot and should not apply to health care for a variety of reasons. You can't shop around when you are unconscious in an ambulance nor will the EMTs make sure the hospital they take you to are in your network. Health care isn't a department store, ISP or airline and can't be managed as such.

    When HMOs were introduced it was promised that this model would provide lower costs, higher quality of care and increased accessibility. The exact opposite has occurred over the long term. Since that time, the number one reason for personal bankruptcy of individuals in the US arises from medical debt, many of those had health insurance. People carry insurance with knee-breaking premiums because just one illness or injury means financial ruin and if you have children, that risk is exponentially higher.

    Talking heads really like to blame sick people for being sick. Passing judgement on groups of people with little technical/medical knowledge is a full on sport and used to produce outrage. This is wrongheaded on a number of levels. Even people who take excellent care of themselves with proper diets and exercise, following all the guidelines provided, can and do become critically or chronically ill even in youth. People who have smoked like chimney's all of their lives, do the opposite of all the guidelines provided can and do live long lives that have minimal health interventions. Why is this..because of genetics, a factor that right now, we have little control over. People who live in poverty have an entirely different set of health problems that can be directly linked to their environment and lack of resources. Their problems are even more complex and profound.

    Currently, administrative costs alone for health care is mind-bendingly inefficient with staffing in hospitals, etc. using more people for billing and insurance than the the ratios of nurses to care for patients.

    Every other developed nation on the planet have some form of universal health care, for most of them it is a blend. Are they perfect, no. Are they better than our system, decidedly yes.

    The reason to provide everyone with basic health care is because without that, people who have communicable diseases are given care to contain diseases from spreading. Healthy people are more productive in the workplace and more involved outside of their workplace and family life. Preventative care and routine examinations reduce the development of chronic illnesses or can treat them early which is vastly more cost effective. One billing source means less time and resources spent on administrative costs. A large user group means providers can negotiate costs of everything from drugs to medical equipment for the entire system. Loss of employment doesn't mean loss of basic health care.

    In the US, the best path is Medicare for all which would provide basic health care for everyone. You still pay premiums just not of the knee-breaking variety, you still pay deductibles, just not the knee-breaking variety. If you want more than is provided, you can still get supplemental insurance. If you can't afford supplemental insurance, you won't die or be denied care based on your economic status; providers won't be forced to eat the cost. The system is currently in place meaning the cost to implement would not include creating an entirely different system.

    Bernie Sanders made this a platform issue but I am here to say, this option is one people in health care have had on their radars for a long time going back into the 1980s.

    http://www.pnhp.org

    Finally, people postpone care because of costs, people who are going to hospitals now are more acutely ill than in the past because of avoidance due to costs and increasingly not willing to take time off from work. This strains the system, preventable illnesses or illnesses that could have been easily managed if caught early are now difficult and more costly for everyone.

    The cost of normal life, like having a child, wouldn't mean 5 figures out of pocket just for the birth; that money then goes back into the economy in positive ways.

    The current free-market system means, you are free to suffer and die. If I could be given a choice about where my tax dollars go, it would be to the health care system and not for a military 'space force' or endlessly subsidizing big businesses who avoid paying taxes with off shore havens.

    I worked in health care for a very long time. I've only provided a fraction of the reasons of why health care is broken, badly broken. I am challenged to provide a TL;DR because it is exceedingly complex even with this limited post, and I can't break it into a sound bite. Thanks to anyone who actually read this entire mess.

    10 votes
    1. Pilgrim
      Link Parent
      I'd just like to point out that there is VERY little about our current health care system that is "free market." It's like referring to ISPs as "free market."

      I'd just like to point out that there is VERY little about our current health care system that is "free market." It's like referring to ISPs as "free market."

      4 votes
  3. [21]
    Reasonable_Doubt
    Link
    I'm reading how these plans in the article had $1000 and $2000 deductibles, and the plan my family was on until last month had an $8000 deductible, and the premiums were $12,000/year. That's over...

    I'm reading how these plans in the article had $1000 and $2000 deductibles, and the plan my family was on until last month had an $8000 deductible, and the premiums were $12,000/year. That's over a THIRD of my income. How is that sustainable?

    5 votes
    1. [15]
      svenkatesh
      Link Parent
      Why did you even bother to pay for that insurance? Unless you or a family member has a high cost-of-care disease, it doesn't make sense to keep that insurance.

      Why did you even bother to pay for that insurance? Unless you or a family member has a high cost-of-care disease, it doesn't make sense to keep that insurance.

      1 vote
      1. [14]
        Reasonable_Doubt
        Link Parent
        It's the only option we had available to us. It's incredibly irresponsible to not carry insurance for a family of four.

        It's the only option we had available to us. It's incredibly irresponsible to not carry insurance for a family of four.

        5 votes
        1. [7]
          nil-admirari
          Link Parent
          Your post about your premiums and deductibles made me spit out my coffee this morning and propelled me into a rant. Horrifying is the only word I can think of. No, that isn't sustainable and could...

          Your post about your premiums and deductibles made me spit out my coffee this morning and propelled me into a rant. Horrifying is the only word I can think of. No, that isn't sustainable and could be imo, considered usury which, once upon a time, was a law.

          It is absolutely unacceptable and unnecessary to charge that much. Being a lessor among humans, I would be rage filled over it. I hope you are able to find a more fair and equitable plan.

          4 votes
          1. [6]
            Reasonable_Doubt
            Link Parent
            I was, in fact absolutely enraged by it. I didn't feel like there was any other option. My spouse and I both take medications, and two of mine require very frequent consults with the doctor. We...

            I was, in fact absolutely enraged by it. I didn't feel like there was any other option. My spouse and I both take medications, and two of mine require very frequent consults with the doctor. We are very lucky that my spouse just got a new job with fabulous insurance, so we're not being financially raped anymore.

            1 vote
            1. [5]
              nil-admirari
              Link Parent
              I am very relieved to hear your family now has a better option. It seems every aspect of life has been monetized to the max with zero regard or thought of the implications individually, socially...

              I am very relieved to hear your family now has a better option. It seems every aspect of life has been monetized to the max with zero regard or thought of the implications individually, socially or otherwise. I know psychopaths have always existed and found themselves in positions of power in the world, but it seems in this era they have organized and proliferated; but, that's another subject.

              1. [4]
                Reasonable_Doubt
                Link Parent
                Thank you, and I know! I work in health care (Registered nurse - home hospice) and I see so many victims of the system. It's sick, really.

                Thank you, and I know! I work in health care (Registered nurse - home hospice) and I see so many victims of the system. It's sick, really.

                1 vote
                1. [3]
                  nil-admirari
                  Link Parent
                  Oh you are one of the angels on earth. I can't tell you how much I respect what you do. Once upon a time, I was a RN too. I worked the units for awhile but landed in surgery and stayed there for a...

                  Oh you are one of the angels on earth. I can't tell you how much I respect what you do. Once upon a time, I was a RN too. I worked the units for awhile but landed in surgery and stayed there for a long time (I am a fully recovered adrenaline addict). I remember the introduction of HMOs and when Pharma got the green light to direct advertise to patients. I had kittens over it.

                  I did some case management work after I left surgery for a state DFACS and elder care. I'm not an emotional sort but there were days I really wanted to cry (and did privately) as I saw people lives in complete ruin through no fault of their own and a medical system that caused it and then couldn't respond to the very dire needs. It is worse today, I know.

                  Its nice to meet you.

                  1 vote
                  1. [2]
                    Reasonable_Doubt
                    Link Parent
                    Aww, thank you! Whenever someone calls me an angel or tells me I have to be special to do what I do, I think, "But isn't that true of all types of nursing"? I couldn't work with the mentally ill,...

                    Aww, thank you! Whenever someone calls me an angel or tells me I have to be special to do what I do, I think, "But isn't that true of all types of nursing"? I couldn't work with the mentally ill, children or comatose patients. There are nurses who do and who are amazing at it. I came to hospice rather accidentally with zero understanding of what it really is, from a level three trauma center where I learned all about flaps, open tib-fib fractures (motorcycle accidents, usually), fresh trachs, open abdomens with VAC dressings (GSW, mostly) among MANY other things...LEECHES!! And I love hospice nursing. Sometimes I cry right in front of folks. Mostly because I want to set a good example. It's ok to be emotional - normal even, especially where death is concerned.

                    I remember being SO excited about the Affordable Care Act, thinking it was as step toward universal health care. I knew it would be buggy - but I'll be damned if I wasn't (and currently am not) sick and tired of seeing marginalized groups with end-stage diagnoses at significantly younger ages than those with greater wealth (and therefore greater access). It burns me up than anyone in the US doesn't have access to basic health care. The really dumb piece (and possibly separate from the above) is that the government saves SO MUCH MONEY using preventative programs - and even hospice care when the patient isn't actually EOL and gets, "too well" to continue qualifying for the Medicare Hospice Benefit - in trips to the ER and unneeded medical services. I could go on...

                    Nice to meet you, as well!

                    1 vote
                    1. nil-admirari
                      Link Parent
                      I thought the same thing about the ACA but it is getting gutted and the you know what states are gutting Medicaid. It makes me sick. It it really wonderful to meet another nurse, kindred spirit so...

                      I thought the same thing about the ACA but it is getting gutted and the you know what states are gutting Medicaid. It makes me sick.

                      It it really wonderful to meet another nurse, kindred spirit so to speak. I agree there are nurses that do things I could never do, ever! We are all brothers and sisters though. I have a special place in my heart for Hospice nurses who helped me when my grandmother, who raised me, was dying from metastatic cancer, helped a dear friend of mine who died at a young age from ALS and the countless times I've witnessed others who would be lost without people like you.

                      I want to continue our conversation, but I'm in the midst of making food. I hope you wouldn't mind if we talk again SOON! We should probably continue via PM. :)

        2. [3]
          svenkatesh
          Link Parent
          I suppose it depends on your income level. For me, 12k + 8k would amount to 20% of my pre-tax income. At that point I'd rather just forego insurance and, in the event of an emergency, declare...

          I suppose it depends on your income level. For me, 12k + 8k would amount to 20% of my pre-tax income. At that point I'd rather just forego insurance and, in the event of an emergency, declare bankruptcy.

          Is it socially deviant to do that? Maybe. But if society cared as much for us as we're supposed to care for it, healthcare would be more affordable.

          1 vote
          1. nil-admirari
            Link Parent
            I can understand how that might be a calculated risk for you, particularly if your health plan is for you solely and not significant others. The risk isn't only that of an accident. A chronic...

            I can understand how that might be a calculated risk for you, particularly if your health plan is for you solely and not significant others. The risk isn't only that of an accident. A chronic illness and your outcome won't be as simple as applying for bankruptcy as the costs will continue.

            Be aware that even those who are young, healthy and lead healthy lifestyles can and do develop conditions that require lifelong management. Often, it is a no warning, out of the blue problem. Then, you sport a pre-existing condition which means any insurance you might get afterwards will most likely be even more expensive than it was initially.

            3 votes
          2. Gaywallet
            Link Parent
            I would argue that it is not socially deviant at all. If the system is broken it is not up to you to fix it. It's up to the legislators. So long as you aren't actively advocating against a fix to...

            I would argue that it is not socially deviant at all. If the system is broken it is not up to you to fix it. It's up to the legislators. So long as you aren't actively advocating against a fix to the system, I believe it's socially acceptable to do whatever you need to do to survive and thrive.

        3. [3]
          Gaywallet
          Link Parent
          Have you ran the numbers of how much you've actually spent on insurance (both the yearly and deductibles) over the last few years? How much do you have saved up in stocks, savings, bonds, etc?...

          Have you ran the numbers of how much you've actually spent on insurance (both the yearly and deductibles) over the last few years?

          How much do you have saved up in stocks, savings, bonds, etc? Property?

          As someone else suggested, it may actually be more financially sound to not pay for insurance and simply claim bankruptcy if you run into a real medical issue. But that would depend on your current assets.

          You might also want to shop around for a different job. You may be able to get employer health insurance that's significantly better somewhere else. I'm not sure what you do, but often times medical jobs have pretty good coverage, even for office workers.

          1. [2]
            Reasonable_Doubt
            (edited )
            Link Parent
            I did indicate that is how much I used to pay. My spouse just got a new job, and his insurance is fantastic. Yay, qualifying event!

            I did indicate that is how much I used to pay. My spouse just got a new job, and his insurance is fantastic. Yay, qualifying event!

            1 vote
    2. [5]
      Pilgrim
      Link Parent
      Just wanted to chime in that mine is about the same. Luckily my part of the premium is $100/month and my company pays the rest, but the deductible is similar.

      Just wanted to chime in that mine is about the same. Luckily my part of the premium is $100/month and my company pays the rest, but the deductible is similar.

      1. [4]
        Reasonable_Doubt
        Link Parent
        Wow. That was not including my bosses share.

        Wow. That was not including my bosses share.

        1. [3]
          Pilgrim
          Link Parent
          I mean that sounds worse that what was available on the obamacare exchanges... do you work for a small company?

          I mean that sounds worse that what was available on the obamacare exchanges... do you work for a small company?

          1. [2]
            Reasonable_Doubt
            Link Parent
            Technically, no. I wish I could explain to you why they chose the coverage they did. The kicker is they have a health incentive tired payment system...and I was paying for the least expensive one.

            Technically, no. I wish I could explain to you why they chose the coverage they did. The kicker is they have a health incentive tired payment system...and I was paying for the least expensive one.

            1. Pilgrim
              Link Parent
              I don't even know what to say. That sounds terrible. I'm sorry for you.

              I don't even know what to say. That sounds terrible. I'm sorry for you.

              1 vote