Retirement Crisis in America (Walmart, insurance, expenses, companies)
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No one with a million dollars or a $40,000 pension needs charity, what they (we) need is truly affordable health insurance for everyone. It shouldn't be the cost of a mortgage to get insurance, and if it weren't so out of control (mine is close to $700 a month for the cheapest Blue Cross plan, with a $3,000 deductible) then there wouldn't be so many trying to get it by cheating.
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Originally Posted by Larry Siegel
That *is* charity, unless you mean that everyone pays the actuarially fair rate for the insurance, which they won't do because they can't.
Health insurance is expensive precisely because the actual medical care for which it pays is expensive.
On average across the USA, we consume about $10,000 per person per year in actual medical care services. THEREFORE, as surely as night follows day, health insurance MUST be priced at about $10,000 per person per year, on average, plus administration plus profit.
Nothing in pre-Obamacare, Obamacare, any proposal to fix or replace Obamacare, or in Medicare or Medicaid reduces the amount we pay for medical care, so there is no logical reason to think the price of health insurance should be less expensive.
If you're paying about $10,000 per person for health insurance (including deductibles) you're charged about the right amount. If you pay less than that, someone is subsidizing you (or it is part of your total compensation from your employer). If you pay more (like me), you're getting hosed.
That *is* charity, unless you mean that everyone pays the actuarially fair rate for the insurance, which they won't do because they can't.
Actually, it's Social Democracy, which is the system we live under. Medicare exists because 80%+ of the elderly couldn't possibly afford to pay an actuarially fair rate for health insurance. Social Security exists because a huge number of elderly would be desperately poor otherwise. We have K-12 public education because we learned a couple centuries ago that we're better off as nation having a well trained workforce even though way more than half the country couldn't possibly afford to pay for the private equivalent. Ditto libraries and hospitals. Ditto the roads we drive on. Ditto police and fire protection.
We don't have a retirement crisis in the United States unless tools like Paul Ryan renege on the social compact we've all lived under for our entire lives. The politics of greed and avarice. It's not life of the rich and famous but the elderly aren't out on the streets homeless, starving, and freezing to death. Social Security payout is progressive enough that a low income worker with 35 years in the system is going to be at least at poverty level when they age to the point where they can't work.
If you're paying about $10,000 per person for health insurance (including deductibles) you're charged about the right amount. If you pay less than that, someone is subsidizing you (or it is part of your total compensation from your employer). If you pay more (like me), you're getting hosed.
No you're not. $10K is what you should be paying at around age 37.8, the median age of the country. I'm pretty sure you're a heck of a lot older than that. At age 60, it's more like $40K. That's why age discrimination is so rampant in corporate America. Nobody wants to hire the old guy because it will spike the company's group insurance rates. The whole point of ACA was to get everyone to participate. The healthy 20-somethings actuarially cost a few thousand bucks and offset the 50-somethings and 60-somethings who are paying $10K. It's a lousy way to structure things, IMO. 20-somethings just getting started shouldn't be subsidizing 50-somethings in their peak earnings years. Funding for that kind of thing needs to be progressive, not a Robin Hood system stealing from the young and handing to the middle aged who haven't hit Medicare age yet.
Those refer to how much they will reimburse the hospital or doctor, not the percentage of care Medicare covers. Medicare does not cover 100% of medical expenses anywhere in the country, you need a supplemental no matter where you live. If you go to a rehab in Tennessee you get 100% covered for 20 days and 80% for days after that, if you go to a rehab in NJ it is the same. now the AMOUNT the rehab receives may vary, but it doesn't change what is covered and what percentage is covered. It actually makes sense the payment amounts would be lower in some states, because the cost of care is lower. The cost isn't as high for nursing home rehab in Alabama as you will in Boston. You would actually make out better without a supplemental plan in a low cost state. The person in Alabama might be paying 20% of $9,000 if they had to stay in rehab an extra month, while the patient in Boston might have to pay 20% of $13,000.00
I don't think even in those states there are many doctors who don't take Medicare. It is still a decent reimbursement rate and still easier to get reimbursed than private insurance. There are way too many people on Medicare in this country for doctors and hospitals not to accept it, and again I have never heard of anyone having a problem with that.
There are always unreimbursed expenses when treating a Medicare patient. If a medicare patient is a financial loss, physicians sometimes refuse to take new Medicare patients. If you keep your doctor when you retire, you probably don't have a problem. If you need to find a new physician because you moved or some other reason, over half of Medicare recipients report difficulty finding a new primary care physician, and 5% (one in 20) never do. Access to care is a serious problem. Access to specialist care is variable, with only 3.8% reporting difficulty finding timely care in Nebraska, vs. 13.5% in New Mexico.
Only 1% of physicians have opted out of the Medicare contract. Many more triage new patients for adequate supplemental insurance plans. Just because you have Medicare does not mean they want to see you.
If you have never heard of someone having a problem with that, now you have.
Health insurance is expensive precisely because the actual medical care for which it pays is expensive.
On average across the USA, we consume about $10,000 per person per year in actual medical care services. THEREFORE, as surely as night follows day, health insurance MUST be priced at about $10,000 per person per year, on average, plus administration plus profit.
Nothing in pre-Obamacare, Obamacare, any proposal to fix or replace Obamacare, or in Medicare or Medicaid reduces the amount we pay for medical care, so there is no logical reason to think the price of health insurance should be less expensive.
If you're paying about $10,000 per person for health insurance (including deductibles) you're charged about the right amount. If you pay less than that, someone is subsidizing you (or it is part of your total compensation from your employer). If you pay more (like me), you're getting hosed.
Well of course health insurance is expensive because medical care is expensive.
But how expensive? We all know of someone who had their doctor or hospital bill reduced by 80% or 90% when they paid for it themselves. I don't really think we could reduce the overall cost of medical care by quite that much with a competitive consumer market, but we sure could reduce it somewhat.
Actually, it's Social Democracy, which is the system we live under.
Involuntary charity, OK
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Medicare exists because 80%+ of the elderly couldn't possibly afford to pay an actuarially fair rate for health insurance. Social Security exists because a huge number of elderly would be desperately poor otherwise.
They've already paid for it. More or less. On average. That's why it's called entitlement spending.
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We don't have a retirement crisis in the United States unless tools like Paul Ryan renege on the social compact we've all lived under for our entire lives. The politics of greed and avarice. It's not life of the rich and famous but the elderly aren't out on the streets homeless, starving, and freezing to death. Social Security payout is progressive enough that a low income worker with 35 years in the system is going to be at least at poverty level when they age to the point where they can't work.
We have a quasi-crisis because, in most parts of the country, you can't live on Social Security unless you paid in close to the maximum. You also have to save on your own or through an employer, and many people don't.
Regarding Paul Ryan, I favor some changes to make the system sustainable. I'm not going to get into the details here. Remember, he's the one responsible for not letting the checks bounce. As with a bank, you can get pis*sed when you find out the bank really expects you to repay a loan, but you're glad when the bank returns your own deposited money without a hassle.
with all that said ,compared to all the different hmo health insurance i have had for decades i will take medicare any day over all of them .
I always get a kick out of over 65 people that say they are against government healthcare. Hello, you are already on it and probably pretty happy with it.
I am in favor of universal healthcare. Can't be any worse than what we have now with skyrocketing costs. And costs have been on the rise long before Obamacare.
They've already paid for it. More or less. On average. That's why it's called entitlement spending.
No. Most have only paid a small fraction of what they'll consume in the Medicare system. The highest career income people among us subsidize everybody else. That's what Social Democracies do. Social Security works the same way. The bottom half receive far more in benefits than they (and their employers) contribute, inflation-adjusted. It's our social compact we've had in our lifetimes.
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