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Old 11-21-2013, 09:59 AM   #1
TonyR
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Default Healthcare access, affordability, complexity in U.S.

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Compared with the health systems of other industrialized nations, the U.S. system is an outlier in terms of health care cost, access, and affordability.
Key findings of study:
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■In 2013, more than one-third (37%) of U.S. adults went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs, compared with as few as 4 percent to 6 percent in the United Kingdom and Sweden.
■Roughly 40 percent of both insured and uninsured U.S. respondents spent $1,000 or more out-of-pocket during the year on medical care, not counting premiums. High deductibles and cost-sharing, along with no limits on out-of-pocket costs, may explain why even insured people in the U.S. struggled to afford needed health care, the researchers said.
■Nearly one-quarter (23%) of U.S. adults either had serious problems paying medical bills or were unable to pay them, compared with fewer than 13 percent of adults in the next-highest country, France, and 6 percent or fewer in the U.K., Sweden, and Norway.
■About one of three (32%) U.S. adults spent a lot of time dealing with insurance paperwork and disputes or were either denied payment for a claim or paid less than expected. Only 25 percent of adults in Switzerland, 19 percent in the Netherlands, and 17 percent in Germany—all countries with competitive health insurance markets—reported these problems. U.S. insurers spent $606 per person on administrative costs, more than twice the amount in the next-highest country. Such high costs result from a complex, fragmented insurance system, the researchers write.
■The vast majority (75%) of U.S. adults said their health system needs to undergo fundamental changes or be rebuilt completely.
■The U.S. spends $8,508 per person on health care. That is nearly $3,000 more per person than Norway, the second-highest spender.
http://www.commonwealthfund.org/Publ...Insurance.aspx
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Old 11-21-2013, 10:20 AM   #2
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http://www.nationalaffairs.com/publi...-profit-motive

I'll cross post this, since this is probably a better thread for it
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Old 11-21-2013, 10:41 AM   #3
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Reader comment under the linked article:

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The root of “conservative” thinking on healthcare, at least as it is articulated in this space, appears not to have anything to do with centralization versus decentralization of decision making, but with dedication to the proposition that the healthcare market is just like all other markets; that a decision about healthcare follows the same logic and has the same degrees of freedom as do decisions such as whether to buy a new TV, or broccoli. Unless that catastrophically mistaken idea is abandoned, I don’t see how the local variety of “conservative” thinking can address reality and thereby improve.

The reason that the breadth of options that insurers can offer must be constrained is that if it is not constrained, then that variable, and not efficiency, is the lever that will preferentially be used as the profit generating mechanism. What that means in the real world is that the poor will be poorly insured and the rich richly insured, with the same problems of free ridership and poor long term outcomes due to avoidance of preventive care that we have now … In other words, healthcare really is a different beast in that it cannot be effectively treated as though it were a completely free market at the policy level because it can never, in fact, behave like one. That is not an ideological framing but a hard, cold fact. Healthcare is not a market like other markets and it is not even remotely anti free-market to point that out.
http://www.nationalreview.com/corner...m-yuval-levin#!
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Old 11-21-2013, 11:02 AM   #4
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Reader comment under the linked article:

http://www.nationalreview.com/corner...m-yuval-levin#!
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In other words, healthcare really is a different beast in that it cannot be effectively treated as though it were a completely free market at the policy level because it can never, in fact, behave like one. That is not an ideological framing but a hard, cold fact. Healthcare is not a market like other markets and it is not even remotely anti free-market to point that out.
I'll agree with that in principle. But the corollary is that while this particular market can never be 100% "free market" it is equally true that Healthcare can never be made 100% non-market (collective)

I think that's mostly the gist of the article I posted.
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Old 11-21-2013, 08:26 PM   #5
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Maybe Obama needs another 600 million to get the website working and secure.
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Old 11-21-2013, 08:28 PM   #6
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Signed up for Obamacare on healthcare.gov last night, no issues. I'll be saving over $100 a month in January.
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Old 11-22-2013, 05:21 AM   #7
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Signed up for Obamacare on healthcare.gov last night, no issues. I'll be saving over $100 a month in January.
But, but, Socialism!
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Old 11-22-2013, 06:26 AM   #8
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U.S. insurers spent $606 per person on administrative costs, more than twice the amount in the next-highest country. Such high costs result from a complex, fragmented insurance system


and we had to pass legislation to make sure 80 cents of every dollar went to care... hard to imagine what is was prior, 65-70 cents?
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Old 11-22-2013, 07:13 AM   #9
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and we had to pass legislation to make sure 80 cents of every dollar went to care... hard to imagine what is was prior, 65-70 cents?
Depends on the demographic you insure. If you insure a relatively healthy bunch, the ratio of overhead (marketing, enrollment, collections) makes up a much higher percentage of your spending.

The paperwork costs are fairly fixed. The healthcare costs vary widely depending on who's covered.

It's widely touted how little Medicare spends on administrative overhead, but that's not at all surprising when you think about how Medicare works. IRS runs their collections. There's virtually no marketing because "consumers" have no choice. And they spend a ton on care because they cover the highest-cost demographic possible.
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Old 11-22-2013, 10:49 AM   #10
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Signed up for Obamacare on healthcare.gov last night, no issues. I'll be saving over $100 a month in January.
It's interesting how it varies from person to person, the options for my wife on healthcare.gov is about 75$ a month higher with a deductable that is double the amount of her old policy.

It will be interesting to see how many young healthy adults will be willing to sign up and pay a monthly premium knowing they will never meet their deductable. Their basic healthcare costs will never be paid by the policy.
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Old 11-22-2013, 11:04 AM   #11
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Originally Posted by Pony Boy View Post
It's interesting how it varies from person to person, the options for my wife on healthcare.gov is about 75$ a month higher with a deductable that is double the amount of her old policy.

It will be interesting to see how many young healthy adults will be willing to sign up and pay a monthly premium knowing they will never meet their deductable. Their basic healthcare costs will never be paid by the policy.
Look more carefully. The deductibles are high, because they only apply to non routine and/or preventative care. In other words, basic healthcare costs are 100% covered.
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