Q: Is this high/low? Q: Who do you use and what do you pay?
In one of my first jobs out of college I worked for a medical billing company, here is what we learned, while writing the software.
I am not sure on the math, but I think you are more likely to come out ahead when you buy blackjack insurance, than you are in the US when you buy health insurance. HSA's are great and on average most Americans would come out ahead over their life expectancy. And I am almost positive, that if more than 50% of the US paid for healthcare without going through an insurance company, health care would become much more affordable.
The health insurance industry is broken in this country, more than 50% of claims do not get paid, so doctors jack up the rates 50% to cover the failed claims process. Not to mention the frivolous law suits, and hospitals adding crazy crap to the bill of better insurance companies to pay for care. The whole system is more corrupt than the Mob.
HSA's offer the advantage to save and invest that money tax free, so that you can put the buying power back in your hands. Since its your money and you want to save it for old age, you will have the option to opt out of care that is extra. If you feel fine, you go home. Hospitals will need to get better at explaining your risks, and the decision are put in your hands.
Did you know that if you talk to a doc, most will give you a discount on the procedure if you pay for it out of pocket and up front? We saw bills go through that were at 25% of a docs normal billing rate when people paid out of pocket and up front. An example, might be if you had a broken arm, instead of your insurance company paying $1200 for casting, and x-rays, you could walk in and pay $300-600 if you payed up front. The down side to this, for people who do this and have insurance, come in that it does not go against their deductible, so a future incident that year would need to be covered again out of pocket.
In a previous company I started, I set up a $5k HSA for each of my employees, and then they only had a $5k deductible. It was up to them to control costs, and health insurance with a $5k is pretty cheap, if you know how to shop for it.
Of course I don't live in the US. And btw. I think you should get your health system fixed over there, it's broken.
Not that subtle to me.
I'm not arguing that our system is not messed up, but I'm not willing to pay an extra 10-20% taxes in order to have 'free" healthcare. I'd likely be footing the bill for everyone else.
You already are. The rates you pay are based on a pooled snapshot of medical usage of all the people that particular insurer has in that demographic.
The only difference is that with a gov't plan the pool is larger.
EDIT: Actually, I should correct myself. Most government plans have an additional difference - there are no costs based on usage. In a private plan, if you spend everyday at the hospital, you'll feel it in your next premium renewal, with a government plan this isn't always the case, although some countries implement user fees.
That said, I'd rather be in the pool of healthy, employed people than the unemployed moochers ;)
The best part about a government plan is that in the grand scheme of things, moochers are a small subset of the picture.
It poses problems for sure, like "crowded" emerge rooms, (brackets because the crowds vanish if you have a real issue) but overall the numbers all show that it's cheaper both to the consumer and to the system overall.
And in this country, where big pharma and big medical business runs the show (congress, etc.) it is likely that a "universal" healthcare system will result in a crappy, inefficient implementation that everyone will hate.
And just what percentage of your income goes toward healthcare right now -- both for you and for other people?
My wife and I pay $600 per month in post-tax dollars for our health insurance, thanks to Massachusetts' healthcare plan which lets anybody buy group insurance through the state. (If it wasn't for Massachusetts, I'm not sure what we'd be doing for healthcare -- we're both independent contractors, and you can't buy health insurance through IEEE anymore -- so I consider myself lucky to get that rate. And if that sounds incredibly expensive to you -- well, congratulations on being 23 years old! But don't expect to be 23 forever!!)
The median annual household income in Massachusetts is 60K. (Source: http://projects.washingtonpost.com/elections/keyraces/census... ). That's in the 25% federal tax bracket. (http://www.moneychimp.com/features/tax_brackets.htm ) State income tax here is 5%. So $600 per month post-tax is $857 per month pretax. Thus, the median couple in Massachusetts can expect to pay $10,285 per year for their own health insurance, or about 17% of the median annual income.
Now, you could argue that your median couple might be getting their insurance "free" from their employer. In increasingly many cases this is not true -- fewer and fewer employers provide health insurance -- but even if it is true it merely raises the couple's real income to $70,285 -- of which 14.6% goes toward health care.
Now, that doesn't count the percentage of their federal taxes that goes towards health care for themselves and other people. As a quick estimate, a handy website (http://www.nationalpriorities.org/taxday2008 ) tells me that 22% of each Massachusetts resident's tax dollar went toward health in 2006. 60K * 30% * 22% is $3960, so that's another 6.6% of pretax income toward health care.
Thus, health care costs consume something between 20% and 24% of the median family income in MA. So, if you ask the median Massachusetts resident if they're willing to have taxes raised "10-20%" in exchange for free, guaranteed, universal healthcare the first-order answer is "hell, yes" -- even if you assume that the U.S. healthcare system would remain terribly inefficient relative to other systems worldwide. Which I would hope it wouldn't.
Without getting into specifics, $8,200 is less than 10% of my income. I realize I am not in the "average" spectrum, but realize thay my opinion on the subject is just as valid as those on the other end of the income spectrum.
When I was broke, sure I wanted the government to pay for everything (college, etc.). Now that I'm not broke, I don't want the government to pay for anything (for anyone) if it's going to cost me money. It's funny how things work like that :).
I have friends with a) cancer and b) no insurance, because they can't afford it.
I'm not laughing.
Listen, life isn't fair.
You want the benefits of capitalism without the risks? How does that work?
See Canada, Europe and other countries.
And I have lived outside the US so this isn't myopia.
Listen, running a business and being successful is significantly harder in those places vs. the US.
I want to live in a place where the limit to my future is me. Not what the government says is my limit.
I don't want to have to pay employees to not work, to work 30 hours weeks (and complain about it), 5-6-7 weeks of vacation. I have no idea how small businesses make it in the EU. It's silly how much they have to pay their workers between salary and benefits.
For all the drones out there, the EU is a great place. For people with aspirations it's a death spiral.
American capitalism has many advantages. Health care is not one of them.
And show me any place in history that price controls have been an effective fiscal policy.
Look at the third world and see how well it works for them.
I lived in a place where the price of a loaf of bread was fixed at x. Well when x was a fair price and provided profit to the baker everyone was happy. 10 years later, people were so used to bread being x that when noone could make bread any more because the cost of the ingredients had gone up so much there were riots. So what did the government do? They raised minimum wage and price controlled the ingredients for bread. So all the bakeries closed down. And now a bunch of other shops closed down or fired their employees. Then what? Laws making it impossible to fire an employee.
Price controls and fixing are not the answer.
Well, you're probably correct there. As a entrepreneur though, it's rather dangerous to let ideology dictate a solution to a problem, especially if something else can do a better job.
You can certainly argue about whether social medicine is that something else, but to remove something from consideration simply because it "isn't how we do things here" sounds like a recipe for failure if you ask me.
But if forced to choose between the system in the US, and the system in France, I would choose the French system. France provides equal enough care for what I want, at a far lower price. I suspect that a completely unregulated system would be better than both. But the United States does not have such a system. The US system is not technically "socialized", but the regualations are so badly designed the outcome is far worse than a socialized system.
Libtertarians often get so caught up in the quantity of regulation that they do not care about the quality of regulation. There are many cases where outright socialism is better than a terribly misregulated private system. By reflexively defending the misregulated private system as the lesser of two evils, libertarians ruin the credibility of both themselves and of capitalism.
The governments outlaw the sort of things that large businesses do to drive small businesses out of business. Wal-Mart just pulled out of Germany because the government wouldn't let them abuse their employees. There's a downside though - try buying groceries after 8PM in Germany.
Canada is a good mix if you ask me. 40 hour weeks are the norm, small business is encouraged, but the understanding that people have lives and are not beholden to their employer has an overall positive impact on society as a whole.
Granted, I've never tried to operate a business in the US, so maybe I just don't know what I'm missing, but I'm certainly greatful that my son spent the first year of his life exclusively with mom.
But from what I know, the canadian system seems more likely to be what the US could transition to than, say the UK system.
FWIW, my understanding is that Canada's system is that the government acts like an insurance company, so rather than all medical facilities being government facilities, they are private and they simply bill the government. In the UK, all facilities are government run, so there is no billing at all [well I'm sure there is behind the scenes].
The reason for this is though mainly lies in the weather, and really has nothing to do with anything else. Hell, not many people live in North Dakota either!
Basically, you're correct in your interpretation of how our Health Insurance works. There are caveats (no deductibles, bans on what a private clinic can do, caps on doctor earnings) but generally the system is a good compromise.
You have a complete lack of empathy. I don't think that's healthy.
>You want the benefits of capitalism without the risks? How does that work?
Government that truly cares about the interests of the people.
My sympathies to your friend.
Source: OECD
Sometimes it's almost eerie how well statistics work.
Moral: Believe the OECD -- Our health care is incredibly expensive.
I'd rather not pay a 63% marginal tax rate. I'm sure that must hurt when you try to attract talent.
See here: http://www.workindenmark.dk/Private_health_insurance
Nobody is left out in the cold, but to properly compare it to the US's medical insurance, you need to include the private portion as well to equate equal service.
No health insurance, can't afford it now. Tend to be pretty healthy and heal well, so so far the gamble is working out.
That said, the financial issues surrounding health care in the U.S. are disgraceful, and I don't understand how anyone in an industrialized first-world country could look at it and say, "Yep, looks fine to me."
Well, clearly it's paid for somehow, but I don't pay for it directly. It is important to understand that it's not "free". All told though, I'm happier than with the system in the US.
Indeed, I went to the doctor today, had to wait 15 minutes, and got some antibiotics and other stuff to clear up my cold, all for 18 Euro.
whats your deductable.. I think mine is 1k
I think rates also vary depending on location / age
1. Deductible
2. Age
3. Whether or not you use tobacco - This includes chew.
4. Your gender makes a difference.
5. Occasionally, your BMI makes a difference. But most often, it's age + tobacco use that makes the largest difference.
Insurance rates will also change by your location. Say you had a twin who lived 1 city over; you may get different rates depending on your location.
Occasionally, a rate quote will be different due to the time of year that you're asking for your effective date. That seems to differ between carriers, and not a lot of carriers do this type of discounting or loading.
Hope that helps.
If govt healthcare in the US will be cheaper than private, why isn't it now?
Note to single-payer advocates. Nothing is stopping you from fixing the existing US govt healthcare system to provide the promised benefits. When you do, then all you have to do to kill the private system is open up the fixed public system at cost. Of course, that assumes that you can actually make govt healthcare work as you've asserted, but surely that's no big deal....
After a year, it increased $50. I left the insurance a few months ago, so no clue what will happen next year.
Before Regence, I was paying for COBRA, which was incredibly expensive ($430 / mo) -- this was because I was traveling abroad in places with weird diseases, and I didn't feel like taking a chance. I only did this for 6 months or so.
EDIT: Forgot to mention. I am/was 28, healthy, non-smoker. No kids.
I'm in Massachusetts and use FCHP. The premiums for me have been going down a few dollars every year, which, come to think of it, is pretty remarkable. :-)
115/mo + 1500 deductible. It's an HSA plan, with 100% covered after the deductible.