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The biggest thing you are missing is that just because something is genetic does not mean it's unavoidable. Not 100% of the time, but a lot of the time.
Again, you are talking about things that may or may not be unavoidable...what costs us the most health care dollars? Disease based on behavior. Pure and simple.
How about RSD-CRPS, got a theory on that? Maybe those unhealthy people didn't jog or do enough jumping jacks for you? Be careful of your answer because this non-doctor may bury you on this subject.
The biggest thing you are missing is that just because something is genetic does not mean it's unavoidable. Not 100% of the time, but a lot of the time.
Again, you are talking about things that may or may not be unavoidable...what costs us the most health care dollars? Disease based on behavior. Pure and simple.
Please provide some links to support that statement, some with actual statistics, not opinion pieces.
Or my old roommate who was diagnosed with ulcerative colitis at 19? He's fine now (at 23). His mother had to stop her plans for retirement to keep his coverage. Or my friend with celiac disease? She's 25 now and is lucky to have insurance through her husband's company. Her husband wants to join a tech start up with some friends but can't because, when she shopped for insurance, she was asked to pay $700 a month JUST FOR HER to cover a preexisting condition that she has had under control for 20 years. Or an old friend from college? He beat leukemia as a 10 year old. Didn't expect to have problems getting his own insurance. His parents are paying $800 a month and he's lucky they can pay that or else he just wouldn't have insurance. Or my boyfriend who struggled to find health insurance that would take him at a price which he could afford before Masscare. He was a healthy 25 year old, but his father had heart failure and eventually killed himself due to a mental disorder. His mother has diabetes. He was priced out of insurance due to his medical history despite being healthy himself, if not maybe 10 pounds overweight. None of these health issues were things that any of these people could control. They're all poised to have wonderful, productive lives- graduating from some of the best universities in the country, plans for law school or getting masters in science or MBAs, etc etc. How are they supposed to start saving for future businesses when half of their paycheck goes just to health insurance?
Those numbers aren't uncommon for couples or families, but for single, healthy 20 somethings who happen to have a medical history, the cost is insane.
These are just people in my immediate circle who I know their circumstances. By the time you hit adulthood, its hard to avoid having a previously existing condition. Most of my friends still haven't had to look for their own health insurance due to either being under their parents' plans (provided their parents haven't lost their jobs) or being under school plans in grad school. I suspect these stories will only become more prevalent as they age out of their parents' insurance or college insurance.
They're going to be become more prevalent, the more we keep making laws that mandate insurers to cover everyone regardless of their health status. You can't have it both ways......either remove the mandates and let the insurers decide what risk they can handle and what they can't and the prices will drop dramatically or deal with the price and everybody gets covered. You'd be suprised at some of the risk from company to company, illness to illness that they're willing to accept once their hands aren't tied behind their back any more. That kind of thing takes fine tuning and that can not even be considered now when they have to worry about the amount of risk they're going to get forced to accept, that they can't predict in any way.
People seem to think Obamacare is going to fix everything without costing them any more money...the governemnt can just make the insurance companies in the private sector pick up the tab. Where are they going to get the money, they don't have a printing press. This is why so many say that it's going to eliminate their choice...one by one they're going to go out of business. They have a responsibility to pay the claims of all the people that have policies with them...they can not run in the red....all the policy holders lose their coverage. This is what has already happened with a lot of the smaller insurers that kept the market competitive when HIPAA went into effect in mid 1998....the mandates eventually put them out of business. I know of some that went out of business before they went into the red...the handwriting was on the wall. One company had been in business for 100 years with an A+ rating (for a small carrier, that's great...the only thing better is A++). In the five years following the effective date of HIPAA, they dropped to a B (that means from a A+, A, A-, B++, B+ and then finally to a B)...5 down grades.
What needs to be done to cover the unhealthy is a tax increase so that government can subsidize the cost of their care. That's the only way it's going to get fixed. You can't use magic tricks to get it accomplished without screwing everything up by doing that.
I almost forgot, as far as someone being 20 something...the rates will mostly end up being all composite rates. That means one rate averaged out, regardless of age or gender depending upon who's getting covered (single, couple, single with children or a family)....just like with group coverage. What ends up happening is that the 20 somethings help pay for the 60 somethings.
Last edited by Danno3314; 02-22-2011 at 02:00 PM..
I have no issue with innovation and profit. I have a big problem with for profit insurance companies controlling the delivery of health care.
That's not for profit insurance that does that....it's choice you're making when you decide what kind of coverage you what. You're talking about managed care like in an HMO. What they try and do is to not give the providers a blank check by billing for a whole bunch unnecessary services. What you need to realize is that the person at the insuranbce company that is coordinating (not controlling) with your doctor, the deliver of your health care, is also a doctor...that very often was previously in private practice....it's not the CEO of the company trying increase his bonus that year. Profit margin is already figured into your rates and bonuses are made in the sales department by increasing sales volume.
Whether it's a discount for a service on a PPO or managed care through an HMO, they're both designed to try and control the cost that providers charge for care. As it is, you have no idea what a hospital is charging you for the care you're receiving when you're there...nor do you care because we all expect the insurer to pay it what ever it ends up being. You don't compare prices at hospitals before you go into one, do you? The person (or in this case company) that's going to be paying the bill, is always the only one that cares about how much it's going to cost them. If hospitals ran advertisments that compared their prices to other hospitals in their area, this would be a lot less of an issue.
If you're thinking, "Who wants to go to a hospital that boasts the lowest prices?". Think about this then, when a medical procedure that's getting done is an elective procedure that insurance doesn't cover....like cosmetic surgery, RK surgery or hearing aids perhaps.....those providers usually run advertisements with price comparisons in them (sometimes they even run a sales...two for one) and people make their decisions based on that....price.
If you don't like that get a fee for service plan...A PPO. A PPO uses a network of almost every provider usually, that has agreed to a discount for each service they bill for
That's not for profit insurance that does that....it's choice you're making when you decide what kind of coverage you what. You're talking about managed care like in an HMO. What they try and do is to not give the providers a blank check by billing for a whole bunch unnecessary services. What you need to realize is that the person at the insuranbce company that is coordinating (not controlling) with your doctor, the deliver of your health care, is also a doctor...that very often was previously in private practice....it's not the CEO of the company trying increase his bonus that year. Profit margin is already figured into your rates and bonuses are made in the sales department by increasing sales volume.
Whether it's a discount for a service on a PPO or managed care through an HMO, they're both designed to try and control the cost that providers charge for care. As it is, you have no idea what a hospital is charging you for the care you're receiving when you're there...nor do you care because we all expect the insurer to pay it what ever it ends up being. You don't compare prices at hospitals before you go into one, do you? The person (or in this case company) that's going to be paying the bill, is always the only one that cares about how much it's going to cost them. If hospitals ran advertisments that compared their prices to other hospitals in their area, this would be a lot less of an issue.
If you're thinking, "Who wants to go to a hospital that boasts the lowest prices?". Think about this then, when a medical procedure that's getting done is an elective procedure that insurance doesn't cover....like cosmetic surgery, RK surgery or hearing aids perhaps.....those providers usually run advertisements with price comparisons in them (sometimes they even run a sales...two for one) and people make their decisions based on that....price.
If you don't like that get a fee for service plan...A PPO. A PPO uses a network of almost every provider usually, that has agreed to a discount for each service they bill for
Danno, I know you know the complexities about coverage but most people don't. Many get side swiped by the whole process during a bad time. At a time when people are very sick and don't have the time to ruffle through all the complexities that compound the delivery of care in this country. It is simply a cluster-f#$%.
I have seen the contrast between an HMO and a PPO in a different manner. My wife had an HMO and what I saw first hand was most doctors would not diagnose my wife's condition, didn't have a clue, but they did. Others just brushed her off. Some even insulted her by saying she has a mental disorder, or prescribed asprin for the most painful condition. She changed her insurance to a PPO and then the doctors diagnosed and helped her. The insidious thing was under the HMO many would not even broach a diagnoses, knowing full well what she had. They didn't want to open that can of worms. Because of this her condition worsened, not a little but a lot. She is now totally disabled receiving SSDI and medicare.
I do not like the way or trust our system of health care delivery in this country what so ever.
How about RSD-CRPS, got a theory on that? Maybe those unhealthy people didn't jog or do enough jumping jacks for you? Be careful of your answer because this non-doctor may bury you on this subject.
A disease a couple of hundred thousand people have...vs somethingl like diabetes, that millions and millions have? I don't even get the point of your question.
The biggest thing you are missing is that just because something is genetic does not mean it's unavoidable. Not 100% of the time, but a lot of the time.
Again, you are talking about things that may or may not be unavoidable...what costs us the most health care dollars? Disease based on behavior. Pure and simple.
Quote:
Originally Posted by Katiana
Please provide some links to support that statement, some with actual statistics, not opinion pieces.
The 15 things that consume most health care dollars in order:
Sorting out which of these are lifestyle diseases are not simple. For example, diabetes can increase the risk of manifesting several other conditions that otherwise seem to have a partial genetic basis.
Although 5, 8, 9, 11, 12, 14 and 15 are mainly behaviorally influenced, they can have a genetic or environmental component. However, the total costs of those are less than the costs of the top three. It looks to me as though costs are fairly evenly distributed between behaviorally influenced problems and others.
This is at a population level, not per capita. The study, with exact costs, can be found in Health Affairs issue 21, no 4. (Personally, I think their cost numbers look low.)
I've heard that AMA has published an estimate of 25 % of health care costs in the USA being life style dependent. I haven't been able to track that one down though.
A disease a couple of hundred thousand people have...vs somethingl like diabetes, that millions and millions have? I don't even get the point of your question.
Wrong answer. Several hundred thousand if not a million Americans have, often misdiagnosed and mistreated by Quacks. The point of my question comes from your theory that most health conditions are caused by fat lazy Americans.
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