What do you see happening to your healthcare costs in the next few years

[Pete F.]

What do you see happening to healthcare
Will costs go down or up?
What could anyone do to solve the problem?

https://www.shrm.org/resourcesandtoo...-forecast.aspx

[spence]

I don't think Trump has a clue what he's doing. He's looking for an attaboy at his last campaign stop without any understanding how a system works. The lack of the individual mandate is going to send costs skyrocketing.

Someone said on the news this morning, Trump sure knows how to break things but he doesn't know how to fix anything.

[Jim in CT]

Originally Posted by spence

I

Someone said on the news this morning, Trump sure knows how to break things but he doesn't know how to fix anything.

He knew how to fix Hilary’s inevitability.
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[Pete F.]

Spence
I was kinda hoping this could not be about Trump or Obama, but about healthcare given where we are at and where people think we could or should go in their perfect world.
It could be a Libertarian world, Progressive, Authoritarian or whatever your little or large heart desires.

[DZ]

I think they will always continue to rise. If you can afford it you'll have more choices to purchase the health care plan you prefer from who you want. Hopefully in the future the choice of plans will expand and allow out of state purchase.

[PaulS]

Med trend will average about 6.5% and RX trend will average about 11.3%.

[wdmso]

until it changes back to a non profit model ... its going to go up its not about taking care of Americans its about making money and if your priced out the usual suspects will blame the sick person not the system.. or you hope to make it 65 where your insurance will bounce you back to the government because you cost to much ...

[detbuch]

Originally Posted by wdmso

until it changes back to a non profit model ... its going to go up its not about taking care of Americans its about making money and if your priced out the usual suspects will blame the sick person not the system.. or you hope to make it 65 where your insurance will bounce you back to the government because you cost to much ...

Define "profit." Then tell us when health care here was non profit.

[Jim in CT]

Originally Posted by wdmso

until it changes back to a non profit model ... its going to go up its not about taking care of Americans its about making money and if your priced out the usual suspects will blame the sick person not the system.. or you hope to make it 65 where your insurance will bounce you back to the government because you cost to much ...

Profit margins among health insurers are around 6-7%. Not a big deal. Seeking profit provides a good incentive to avoid expensive waste, something that the public sector could stand a lesson on.
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[Pete F.]

Originally Posted by Jim in CT

Profit margins among health insurers are around 6-7%. Not a big deal. Seeking profit provides a good incentive to avoid expensive waste, something that the public sector could stand a lesson on.
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That is profit not including the costs that physicians incur to count beans for insurance companies. When my brother closed his practice he had himself, a nurse practitioner, several rns and 6 people dealing with paperwork. Now the 6 people dealing with paperwork do not improve healthcare outcomes, and they are a cost.
Shuffling paper and counting beans makes insurance companies money 6-7% of all the paper they shuffle, and beans they count.

[JohnR]

Originally Posted by Pete F.

That is profit not including the costs that physicians incur to count beans for insurance companies. When my brother closed his practice he had himself, a nurse practitioner, several rns and 6 people dealing with paperwork. Now the 6 people dealing with paperwork do not improve healthcare outcomes, and they are a cost.
Shuffling paper and counting beans makes insurance companies money 6-7% of all the paper they shuffle, and beans they count.

I setup and fix those medical / practice management systems and the continual changes and updates that must be applied just for regulatory changes cost thousands per year at the practice level. Would be good to simplify that small cost of a business. There are a lot of hoops the practice runs thru just to formulate the paperwork to the INS co's whims and desire.

[Jim in CT]

Originally Posted by PaulS

Med trend will average about 6.5% and RX trend will average about 11.3%.

That’s about right Paul.

We need some kind of pooling of risk to get healthy people into the system, for damn sure we need tort reform, not sure what else can help. This is the downside of increased life expectancy, combined with the demographic effect of the baby boomers. We will have huge numbers if old people, who can live into their late 90s but will need care and expensive drugs. Going to be a massive problem, no easy solution.
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[spence]

Originally Posted by Jim in CT

We need some kind of pooling of risk to get healthy people into the system,
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We had that, it was called the individual mandate, it was a Republican idea. Trump repealed it because it was passed under Obama.
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[Jim in CT]

Originally Posted by spence

We had that, it was called the individual mandate, it was a Republican idea. Trump repealed it because it was passed under Obama.
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Except it didn’t work. So we didn’t really have it. Too many opted out. We increased coverage, covered more people, covered more health events for more people, but didn’t get sufficient numbers of healthy people.

I have a liberal view on this. No one chooses to be born healthy, no one chooses to be born with lifelong health issues, so the proper thing is to pool the risk. We’re all in that together. No one should struggle financially for their entire life because they were born with a terrible illness. It’s bull#^&#^&#^&#^&.
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[spence]

Originally Posted by Jim in CT

Except it didn’t work. So we didn’t really have it. Too many opted out. We increased coverage, covered more people, covered more health events for more people, but didn’t get sufficient numbers of healthy people.

That's just not true. Numbers of uninsured plummeted to historic lows and near the CBO estimates. The issues had more to do with Republican led states denying the exchanges and more recently Trump gutting Federal funding. In states where it was embraced it was actually working nearly according to plan. Not perfect but heading in the right direction.

[Pete F.]

Maybe we need to start electing CPAs instead of Lawyers, just a thought.
I would like to see a totally funded basic healthcare system that did primary care and the things we all need to live a reasonable life. You could also buy additional insurance to do things above and beyond what is available in the basic system.
How it is totally funded is a big question.
The other one is what is basic care and who decides that.
The way it currently works seems to me to be, people on government assistance get it paid for, the truly wealthy can just pay for it, the people in the middle are fine as long as they dont get a long term issue and lose their coverage because they cannot work or happen to get sick while for one reason or another they are uninsured. Of course most people in this country fall into the middle group.

[Jim in CT]

Originally Posted by Pete F.

Maybe we need to start electing CPAs instead of Lawyers, just a thought.
I would like to see a totally funded basic healthcare system that did primary care and the things we all need to live a reasonable life. You could also buy additional insurance to do things above and beyond what is available in the basic system.
How it is totally funded is a big question.
The other one is what is basic care and who decides that.
The way it currently works seems to me to be, people on government assistance get it paid for, the truly wealthy can just pay for it, the people in the middle are fine as long as they dont get a long term issue and lose their coverage because they cannot work or happen to get sick while for one reason or another they are uninsured. Of course most people in this country fall into the middle group.

"Maybe we need to start electing CPAs instead of Lawyers, just a thought"

A brilliant thought. Sincerely, boy that would help.

[detbuch]

Originally Posted by Pete F.

I would like to see a totally funded basic healthcare system that did primary care and the things we all need to live a reasonable life.

How much do you guess you would have to pay for an insurance policy that paid for all the things needed for you to live a reasonable life?

[Pete F.]

Originally Posted by detbuch

How much do you guess you would have to pay for an insurance policy that paid for all the things needed for you to live a reasonable life?

Where?
Pick a nation the data is out there
I’d like to see us bring the costs down to the midpoint of developed countries rather than The highest
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[scottw]

Originally Posted by detbuch

How much do you guess you would have to pay for an insurance policy that paid for all the things needed for you to live a reasonable life?

it's really hard to get an answer to a question around here....

[Pete F.]

Originally Posted by detbuch

How much do you guess you would have to pay for an insurance policy that paid for all the things needed for you to live a reasonable life?

1000
And I’ll pose the same question back to you and Scott since you have the correct answer in mind
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[scottw]

Originally Posted by Pete F.

1000
And I’ll pose the same question back to you and Scott since you have the correct answer in mind
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if that is $1000 "per year" that is approximately what my car and life insurance costs and I can't remember the last time I made a claim for car ins...or life...obviously......you want a lot for a very little= health insurance for $83 a month...you want unlimited visits, no co-pay and free meds too?...my answer is I'd like to pay for what I want and need from a competitive market....

[Pete F.]

Originally Posted by scottw

if that is $1000 "per year" that is approximately what my car and life insurance costs and I can't remember the last time I made a claim for car ins...or life...obviously......you want a lot for a very little= health insurance for $83 a month...you want unlimited visits, no co-pay and free meds too?...my answer is I'd like to pay for what I want and need from a competitive market....

It's really hard to get a straight answer around here. Does your answer mean you would like to not need insurance, or is it some imaginary competitive price?
Healthcare costs per capita in developed nations including public funds average around $5000 per year, we pay twice that of which over $4000 is public funds. So my answer of $1000 to your question is actually a total cost of $5000 one way or another. Switzerland has a competitive system (private insurance) and they come closest to our costs, but because they also have some government controls are less expensive.
Here is the question in case you forgot.
How much do you guess you would have to pay for an insurance policy that paid for all the things needed for you to live a reasonable life?

[Pete F.]

A bunch of data collected by various organizations about healthcare in the world' and yes, you should always take things with a grain of salt. So, don't get locked into the one that agrees with your philosophy, but feel free to contribute.
I saw this nugget in one of them, not sure how the math was done: Even though the U.S. is the only country without a publicly financed universal health system, it still spends more public dollars on health care than all but two of the other countries.
https://www.healthsystemtracker.org/...lth-u-s-spends
http://www.commonwealthfund.org/publ...al-perspective
https://www.forbes.com/sites/physici.../#613a591d1232

[detbuch]

Originally Posted by Pete F.

It's really hard to get a straight answer around here. Does your answer mean you would like to not need insurance, or is it some imaginary competitive price?

I would like to not need insurance. I would like to pay an actually competitive price. Both of those likes require an actually free market.

But, since we live in a highly regulated market, the notion of "price" is degraded more akin to a tax rather than being a competitive marker for self regulation as used in free market business models. In our current politically driven system, price is driven by regulatory costs and political wish fulfilments.

And we have made even our regulated, political system worse by centralizing control in a national system rather than dispersing it to competitive state models.

Healthcare costs per capita in developed nations including public funds average around $5000 per year, we pay twice that of which over $4000 is public funds. So my answer of $1000 to your question is actually a total cost of $5000 one way or another.

Comparisons to other countries is not useful if all the differing factors which make up the unique character of each country are not part of the calculation. We are larger than most countries. We are more significantly affected by cultural and racial differences. We have far more open borders. We have greater economic disparities and different ways per locality to deal with them. Almost everything here costs more for varying reasons . . . just for starters . . .

Switzerland has a competitive system (private insurance) and they come closest to our costs, but because they also have some government controls are less expensive.

Switzerland's population is less than that of New York city. It is fairly racially and culturally homogenous. Political differences are not as diverse and polemical as ours. Negative social factors such as crime and poverty are far less consequential. Its population, business entities, and government don't have to fund the various researches required to create new technologies and cures, etc. . . . Yet it can tap into the productions and creations of countries such as the U.S.


Its privatized health care system is good and far less politically messed with than ours, and would be a kind of model for us even without a mandate--as expressed by the Forbes article I posted in your "Let's discuss something really simple, Health Care" thread.


Here is the question in case you forgot.
How much do you guess you would have to pay for an insurance policy that paid for all the things needed for you to live a reasonable life?

I knew you referred to Health Care when you said "all the things needed for a reasonable life." But my question actually referred to ALL the things you would need for you to live a reasonable life--food, shelter, clothing, transportation, leisure activity, and so forth. ALL those things impact overall health. Some are even more fundamental to life than health care, and most are in more constant demand than health care.

Why do we want to insure health care over those other things? Cost? Isn't the cost of health care made more expensive when it is insured by a third party such as wealthy insurance companies or the government--especially when that third party becomes more and more universal? Aren't the cost of ALL those other things made more affordable because they are not universally paid for by a rich third party? How much would you have to pay an insurance company or the government so that either would in turn pay for ALL those other things you need to live a reasonable life? Is health care really that different?

And if some procedure is so rare that the cost to provide it is prohibitive, perhaps each individual state, by vote, could create state clinics to make the service available to its people.

Getting the federal government out of it would be a first step to lowering costs, in my opinion. I think it would be more financially feasible to have 50 "Switzerlands" than one behemoth, overspending, and dictatorial State.

[Pete F.]

Originally Posted by detbuch

I knew you referred to Health Care when you said "all the things needed for a reasonable life." But my question actually referred to ALL the things you would need for you to live a reasonable life--food, shelter, clothing, transportation, leisure activity, and so forth. ALL those things impact overall health. Some are even more fundamental to life than health care, and most are in more constant demand than health care.

Why do we want to insure health care over those other things? Cost? Isn't the cost of health care made more expensive when it is insured by a third party such as wealthy insurance companies or the government--especially when that third party becomes more and more universal? Aren't the cost of ALL those other things made more affordable because they are not universally paid for by a rich third party? How much would you have to pay an insurance company or the government so that either would in turn pay for ALL those other things you need to live a reasonable life? Is health care really that different?

And if some procedure is so rare that the cost to provide it is prohibitive, perhaps each individual state, by vote, could create state clinics to make the service available to its people.

Getting the federal government out of it would be a first step to lowering costs, in my opinion. I think it would be more financially feasible to have 50 "Switzerlands" than one behemoth, overspending, and dictatorial State.

You only missed a couple questions on my last post
Do you think a total free market system would produce what you want?
Would you eliminate all controls and supports?
Do you think health insurance is unnecessary?
Would healthcare providers need to be certified in any way?
Are we getting rid of lawyers also?
Would health care providers do a credit check before performing any services? "He's broke, toss him out the door"
Who would pick up the bodies?
How much do you think it would cost per capita for your idea of healthcare?

[detbuch]

Originally Posted by Pete F.

You only missed a couple questions on my last post
Do you think a total free market system would produce what you want?

Yes.

Would you eliminate all controls and supports?

Our government's duty toward a free market is to ensure its freedom by prosecuting practices that corrupt and strangle market freedom. Other "controls" and "supports" tend to capture the market into a governmental or political system wherein the government more uniformly directs the market rather than protecting it, and thereby diminishes the competitive nature of a free market needed to make price a signal to manage costs rather than just a form of tax which raises costs.

Do you think health insurance is unnecessary?

Insurance is not necessary. But it is a useful commodity for the buyer if it gives him an advantage over those who are uninsured, and, especially if, it does not artificially drive up cost. That is, when the cost of care is determined by individual consumers' ability to pay, then collective insurance costs and premiums are affordable. If too many people are "insured," then health care provider costs will reflect the insurance company's (or the government's) ability to pay rather than the individual out of pocket ability to pay. In which case the price for care would eventually rise beyond the individual's ability to pay out of pocket (or credit). And would keep on rising as government continued to try to regulate the system with new controls which tried to keep costs down.

In effect, there is the paradox that insurance is useful when it provides an advantage. But it becomes onerous when everybody is insured. First, it is no longer an advantage because everyone else has it. Second, because costs rise significantly when they are based on government's and or corporations' ability to pay rather than individual ability to do so. And third, government reaction to rising costs is to regulate the health care market, which raises costs, which inspires new regulations, and continues in a spiral of continuing rise in the cost of health care.

Would healthcare providers need to be certified in any way?

A market is not free if the trade is not fair. A seller taking good money for service not worth the money, or worse, is physically harmful to the buyer, is a coercive tactic. A useful function of government is to assure that the market is free of corruptive and coercive tactics.

Are we getting rid of lawyers also?

Why?

Would health care providers do a credit check before performing any services? "He's broke, toss him out the door"

If someone could afford to pay high insurance premiums, he would probably be able to pass a credit check. For those who are that poor we've always had charities and pro-bono services. Large charitable organizations used to be on file with hospitals to pay for needy cases. State services have always existed to assist the poor. This goes continuously all the way back to the colonial days when the truly needy were given sustenance.

Who would pick up the bodies?

You could if you care so much.

How much do you think it would cost per capita for your idea of healthcare?

A lot less than it does with our current system.

[Pete F.]

Originally Posted by detbuch

A lot less than it does with our current system.

Can you point out a working example of the system you propose?

[detbuch]

Originally Posted by Pete F.

Can you point out a working example of the system you propose?

I'm not proposing a system. I'm proposing that the federal government significantly get out of health care. I'm proposing that the individual states create whatever regulations are needed, and that those regulations protect a free market in health care.

Can you point out an example of what you think I propose doesn't work?

[Pete F.]

Originally Posted by detbuch

I'm not proposing a system. I'm proposing that the federal government significantly get out of health care. I'm proposing that the individual states create whatever regulations are needed, and that those regulations protect a free market in health care.

Can you point out an example of what you think I propose doesn't work?

Apparently, no country is foolish enough to try it.