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Blue Shield Raised Our Rates 73% In One Year


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2010 Dec 27, 2:40pm   83,872 views  345 comments

by Patrick   ➕follow (55)   💰tip   ignore  

Blue Shield has raised our rates so many times recently that I decided to graph it.

We have a very high deductible plan because I'm trying to be self-employed and that's all I could afford on my own. There is an $8000 per person deductible so it covers basically nothing but catastrophic care. Now it's $777 per month. It was $447 per month a year ago. This is utterly insane. 73% in one year! Here's the future if this keeps up:

2011: $1344 per month
2012: $2325 per month
2013: $4022 per month
2014: $6958 per month
2015: $12,037 per month
2016: $20,824 per month

Of course I'm shopping for other insurance via http://www.healthcare.gov/ but so far none of the others seem to be much cheaper.

Blue Shield claims that their own costs have gone up 19%. So WTF did they raise my premiums 73%? Isn't there any law against price gouging?

This all pleases our corporate masters of course, because the need for health insurance prevents small entrepreneurs from competing with them. It also makes employees into obedient servants.

#insurance

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1   elliemae   2010 Dec 27, 11:19pm  

Holy shit!

2   justme   2010 Dec 28, 2:11am  

That's amazing. And this is the "very healthy person" rate, I'm almost certain.

3   Patrick   2010 Dec 28, 2:15am  

Yes, it seems to be the rate they charge everyone the age of my wife and myself with kids. We jog, eat mostly vegetarian, and don't smoke.

For a while I thought it was because we did need to use the insurance last year, but that's not it. They even sent me their chart to show that my premium is the same as everyone else in my age and family category.

They're just screwing everyone equally.

4   theoakman   2010 Dec 28, 3:55am  

Blue Shield screws over the doctors in their system as well. They suddenly decide to withhold 60-80k in payments and dare the doctors to sue them. They have an army of lawyers ready to bankrupt any doctor that tries. I've seen them do it to 3 physicians in the past year.

5   Blue-collar   2010 Dec 28, 4:44am  

Yep, healthcare is so royally fucked in this country. The insurance companies cry and weep publicly, and then work nonstop to screw us on the back end. The solution is to do away with them, whether that's a free market system, or a single player system, or mixed like Singapore. American health insurers are just holding us all hostage, even the retards who think the current system is a free market are affected.

6   Patrick   2010 Dec 28, 5:44am  

Yes, I agree. Insurance companies should not even exist, except for small optional treatments.

For life-or-death catastrophic coverage, there never was a free market and never will be. You risk bankrupcy or death for your family members if you don't pay whatever they say. That's no market. It's extortion.

Even more than national defense, the first priority of government should be protection of the lives and assets of its citizens from this kind of extortion. This means the insurance companies must get out of the way.

Every other industrialized country pays half as much per person as the US, for better care, because they have a government option or a single-payer system.

The only explanation for our f'd up system is legalized corruption, also called lobbying and campaign donations. Well, that and "the retards who think the current system is a free market" referred to so accurately by Blue-collar in the comment above.

7   Patrick   2010 Dec 28, 6:41am  

I'm far from the only person upset about this. Here's a blog with some good comments about Blue Shield:

http://iainsuranceca.wordpress.com/2010/11/15/wellmark-blue-cross-blue-shield-of-iowa/

Say, doesn't California have a Commissioner of Insurance who is supposed to hold a hearing prior to making a decision on the requested rate increase? How could they possibly approve such huge increases?

8   Austinhousingbubble   2010 Dec 28, 2:01pm  

On a related note - I thought this was rather interesting, in case anyone missed it:

http://www.youtube.com/watch?v=6xlpcDnr7eM

9   semperfi   2010 Dec 28, 2:38pm  

Move to Australia like me.

10   kimtitu   2010 Dec 28, 3:02pm  

One drastic way is to not to have insurance and just go to ER when thing hits.
Last year, I took my son to ER for real emergency. There are several other patients and their family, who do not seem so urgent but more like having a tour in ER room, before my turn. You will guess who are those people. When my turn is up, then the nurse asked for many paperwork while my son was in great pain before they will take a look at him.
Even with employer insurance, the copay has doubled. Who knows when it will double again.

11   Ptipking222   2010 Dec 28, 3:44pm  

Yes, I agree. Insurance companies should not even exist, except for small optional treatments.
For life-or-death catastrophic coverage, there never was a free market and never will be. You risk likely bankrupcy or death for your family members if you don’t pay whatever they say. That’s no market. It’s extortion.
Even more than national defense, the first priority of government should be protection of the lives and assets of its citizens from this kind of extortion. This means the insurance companies must get out of the way.
Every other industrialized country pays half as much per person as the US, for better care, because they have a government option or a single-payer system.
The only explanation for our f’d up system is legalized corruption, also called lobbying and campaign donations. Well, that and “the retards who think the current system is a free market” referred to so accurately by Blue-collar in the comment above.

From what I can tell, the US system is a bad combination of the following:

1. Some groups of people get very good, free healthcare (low to zero deductibles). These groups often visit the doctor a lot, get unnecessary tests, and run up the bill since it's no cost to them. Medicare advantage groups, gov employees, employees with 'cadillac' coverage,etc. Since there's no cost to them to go to the doctor for every minor thing, some go ahead and do. I know a few people personally like this...

Doctors bill by the procedure, plus all those tests cost a lot of money, so these costs run up. These costs result in higher health insurance costs for everyone since the HI companies pass these onto us. Also, the increased 'demand' on the system results in higher prices, just like if everyone started eating a ton of tacos, corn prices go up.

In Europe, everyone sorta falls into this group of free access to healthcare. However, Europe has rationing. Since it's all through the state and the state is fundamentally broke, it just won't pay much, so people just wait in line. The waiting in line dissuades people from getting healthcare unless they actually need it, so it inadvertently takes care of the incentive to visit the doctor a lot.

2. Health insurance companies pretty much add zero value- just bureaucracy. I'm a small government/fiscal Republican type, but I can fundamentally see why having the government run health insurance would be more efficient than the current program (I wouldn't call the current program 'free market' since it's a unholy combo of gov programs like Medicare/gov insurance and 'free market.') From what I can tell, HI companies just haggle with people over prices and coverage.

3. America is a nation of fatasses. The diabetes epidemic jacks up everything since it's an expensive disease to treat, especially if the patient lets it continue to develop.

4. There is fundamentally no cost-benefit analysis with new technologies. Some new gadget is like 5% better but it costs 50% more? They'll still use it since it's better. Most of the time, the cost isn't borne on the patient, it's borne on the insurer, so the doctors use it since it's the 'better' tech. Who ends up paying is the taxpayer and everyone else since it's more cost in the system.

So yeah, that's why we have $700 HI plans for catastrophic coverage. It's not the people with catastrophic coverage that runup the system. In fact, I think if everyone had catastrophic coverage and had to pay like 20% of the entire bill after the deductible (to say $20k a year), then health insurance prices would plummet since people wouldn't abuse the system (and that $700 plan is now $70/month, which seems more fair for catastrophic coverage).

It's the people that have 0 deductibles, are overweight, the insurance bureaucracy, you name it- there's pretty much very little in the current system that keeps the cost down and those groups combined result in these higher costs.

In Europe, they're just like 'fuck it, hospital you get $XYZ dollars, do your best' and well, looks like it's better than us at least from a cost standpoint. Of course, if you have good or even catastrophic coverage and something really bad or rare did happen, I'd still probably rather get US care.

But for basic coverage and I break a leg, gimme Europe.

12   np92801   2010 Dec 28, 4:17pm  

Blue Cross also systematically raises rates as well. There has to be a point where the cost of the insurance ( aka the price of getting insurance company rates for medical care b/c with a $8000 deductible, the insurance company is not paying anything out with you ) is simply not worth the risk of financial ruin by a possible medical event. If you reach that point, people have cancel and stop donating to the company or find a job that will provide the coverage. Risk based adjustment is nonsense unless your previous rates were teasers.

The challenge is to calculate that magic number where the insurance cost is riskier to your financial situation than the actual cost of the emergeny room visit.

The ER cannot refuse to see anyone... EMTALA

13   Â¥   2010 Dec 28, 4:23pm  

I believe Patrick also just hit the age bump that's responsible for a lot of the jump.

I'm still in the cheaper rates, but rates did in fact jump significantly on me starting next month for some reason.

They say they're getting rid of the lifetime cap ($5M), not charging different rates based on gender, allowing those 25yos to stay on their parent's plan, etc.

I don't really fall into any of those categories. I already upped the annual deductible from 1700 to 4500, but now I'm paying more for 4,500 than I was for 1700 when I started this in 2008. Bah. Need to get my ass out of this country again. Canada is attractive, too bad it's latitudinally challenged.

don't think Blue Shield is the problem here though.

Wellpoint had $14.6B in revenue and $2B in overhead leaving $1.2B in profits.

This is a 78% MLR, so even if WellPoint had no overhead and no profit rates would still be ~80% what they are now, at least in the naive analysis.

Kaiser is harder to analyze since they can pay themselves more for care, which fuzzes the MLR benchmark.

The core problem is the sheer amount of rent-seeking going on in the medical care sector. All that money they're making has to come from somewhere.

14   don   2010 Dec 28, 4:45pm  

I think the best way to deal with this is to not own a home! If you are not old enough for Medicare and you don't have a fancy job with great benefits, you are screwed if you have assets that are vulnerable.

Patrick is smart. The best insurance really is to eat organic healthy food, live a sane life, exercise and take care of yourself. And pray you don't get in an accident or become ill anyway.

15   Austinhousingbubble   2010 Dec 28, 5:17pm  

Of course I’m shopping for other insurance via http://www.healthcare.gov/ but so far none of the others seem to be much cheaper.

Another reason for this is the antitrust exemption the insurance industry enjoys. The House passed a bill to eliminate it, but whether you'll hear anything more about it is doubtful.

16   Blue-collar   2010 Dec 28, 5:24pm  

The USA has a higher concentration of experts, no doubt, but as the US is a nation in decline that will not last forever. I've been treated in the USA, Japan, Singapore, and also the bastardized free market system in Japan (doctors that work outside of national health). I would take any of those systems over our system from a cost/quality of care perspective. If you need something special, and your financially well off, your always going to be able to get what you need. Unfortunately, most of the so called American middle earners do not fit this bill and are limited to the narrow choices that insurers will allow us to have (doctors don't decide treatments, insurance companies do). It's just like a single player system, except the deck is even more financially stacked against you.

US ER care is deplorable, and I feel for any poor people who have to use it for non emergency care. It's definitely inappropriate and a very poor substitute for general care. ER docs are not trained to be general practitioners, and therefor are not good at it.

It's politically impossible to do away social security, Medicare/Medicaid, so I don't see the USA ever being able to create a free market system. The US government's administrative pricing model used by new doctors to figure out what medical fields will pay the most (yes that's right, the government sets the scale for our current "free market.") This is also known as price fixing.

Thinking about it is terribly sad, but the reality is that my 90 year old grandmother does not have any more of a right to life than I do, yet she is afforded that right, and I am not.

17   ohomen171   2010 Dec 28, 8:06pm  

This is insane and unsustainable. Eventually all of these people will price themselves out of the market. It is also imhumane and unthinkable!

18   JerseyGirl   2010 Dec 28, 8:41pm  

Patrick ... when you go to a doctor, do you use your insurance (deductible) or pay out of pocket. I see why you would need the insurance for catastrophic situations, but you might save some $ when you go for checkups if you pay out of pocket (rather than pay via deductible) ... rates usually drop dramatically. I have a friend who was without insurance and their pediatrician only charged a $20 copay for a visit ... next time you go to a doctor, just ask if the rate would be different ... worth a try.

19   entropy   2010 Dec 28, 10:20pm  

My better half works for a non profit business in the city. The CEO of the business was a huge supporter of HC reform. Their HC insurance provider is also a non profit, so all cost increases have to be passed on as they are NOT allowed to make a profit.

During the last renewal phase for their HC bennies the CEO and a rep from the insurance company (now remember both these businesses are NON PROFIT) told all the employees the cost of their coverage was going to double. Needless to say the employees were all quite upset. The CEO and insurance rep explained that this was due to the new HC regulations and the cost increases were unavoidable. During this meeting the formerly supportive HC reform CEO was as upset as the employees about what the new HC legislation was doing to costs and coverage.

Both my wife and I work in the HC field as nurses, my wife for 15 years and myself for 5 years. We were both dead set against this legislation for we knew what would happen. Unfortunately it passed anyway and now we will get to see the damage first hand.

What a boondoggle.

20   cleg   2010 Dec 28, 10:52pm  

Outrageous. Eventually the premiums will rise beyond peoples ability to pay but opting out leaves anybody open to financial ruin. The health care system in this country is no longer about health. It has evolved into a machine for extracting wealth from the population.
There seems to be a lot of discussion about how to pay for health care instead of asking why it costs so much.

Few people are in a position to pay out of pocket for even a relatively minor procedure.
My elderly father recently spent 3 days in the hospital for observation after having a fever. During that time he had a few blood tests and was given an IV bag of antibiotics. The only reason he spent the 3rd day was that his doctor never showed up on day 2 to sign his release paperwork. The bill just came in at slightly over $9,000.

I also pay hundreds per month for a policy that has a $5,000 deductible for each member of my family. It is protection money. So far I have never reached the deductible.

As far as I can tell we already have rationed health care.
Regardless of the severity of the problem, I can't recall an office visit for myself or my family in which we were able to actually talk to a doctor for more than about 7 minutes at a time.
1 to 2 hours of waiting and filling out forms, (missing 1/2 day of work) for a few minutes of consultation.
God forbid if you are suffering from something that can't be diagnosed in 7 minutes.

Cleg

21   JimAtLaw   2010 Dec 28, 11:04pm  

At nearly $800/mo, if you are really paying nearly $10k a year for catastrophic only coverage, this sounds to me like it might conceivably not be worth it; what if it were $20k a year? 30k? What are the risks you will get something or an event requiring insurance for treatment will occur between now and when next full time employed that you will get something catastrophic? (Maybe it's worth it, or you are using the discounted services, etc. - I'm just suggesting it's worth conscious thought.) Have you thought about getting a part time job with coverage? I understand some public sector jobs offer full benefits at half time employment.

22   theoakman   2010 Dec 28, 11:11pm  

JimAtLaw says

At nearly $800/mo, if you are really paying nearly $10k a year for catastrophic only coverage, this sounds to me like it might conceivably not be worth it; what if it were $20k a year? 30k? What are the risks you will get something or an event requiring insurance for treatment will occur between now and when next full time employed that you will get something catastrophic? (Maybe it’s worth it, or you are using the discounted services, etc. - I’m just suggesting it’s worth conscious thought.) Have you thought about getting a part time job with coverage? I understand some public sector jobs offer full benefits at half time employment.

Speaking as someone who worked on the side in Medical Billing for a few years, paying that much for insurance makes no sense. You are better off pocketing the cash and pleading poverty when the bill comes. At the very least, when a giant bill comes, you offer the doctor $5,000 cash, and they make the deal every single time. Basically, we would just ask them to come in to discuss their options. Half the time, we made a decision on the car they drove. If they drive to the office in a Lexus, we tell them they have to pay or we send them to collection. If they drive up in a beat up Buick, a lot of times, we settled for pennies on the dollar.

23   JimAtLaw   2010 Dec 28, 11:32pm  

cleg says

Outrageous. Eventually the premiums will rise beyond peoples ability to pay but opting out leaves anybody open to financial ruin. The health care system in this country is no longer about health. It has evolved into a machine for extracting wealth from the population.

There seems to be a lot of discussion about how to pay for health care instead of asking why it costs so much.
Few people are in a position to pay out of pocket for even a relatively minor procedure.

My elderly father recently spent 3 days in the hospital for observation after having a fever. During that time he had a few blood tests and was given an IV bag of antibiotics. The only reason he spent the 3rd day was that his doctor never showed up on day 2 to sign his release paperwork. The bill just came in at slightly over $9,000.
I also pay hundreds per month for a policy that has a $5,000 deductible for each member of my family. It is protection money. So far I have never reached the deductible.
As far as I can tell we already have rationed health care.

Regardless of the severity of the problem, I can’t recall an office visit for myself or my family in which we were able to actually talk to a doctor for more than about 7 minutes at a time.

1 to 2 hours of waiting and filling out forms, (missing 1/2 day of work) for a few minutes of consultation.

God forbid if you are suffering from something that can’t be diagnosed in 7 minutes.
Cleg

Consider MDVIP. It'll cost you $1400-1800 per year or so on top of what you pay now, but you get a full comprehensive annual exam, and for the rest of the year, 24 hour a day access to your primary care doctor with a fairly limited number of patients so that s/he can (and will) take the time to actually understand what's going on with you and answer all of your questions.

24   zzyzzx   2010 Dec 28, 11:49pm  

I'm guessing that the 73% rate increase has to do with the combination of Obamacare at the same time your age crept into the next higher age bracket. (IE - you just turned 40, 45, 50, something like that). There is nothing new about a huge rate increase as your birthday present from the insurance company. Also depending upon the number of people in the family, $800 might be a good rate. If they charged by the head instead of the same rate irregardless of the number of kids it would certainly be fairer.

25   robinmd   2010 Dec 29, 12:16am  

you are better off paying $800/month into an low risk investment account and banking the money and using it as needed for medical procedures or doctor's visits when you need it. now that obamacare has made it so that no one with preexisting conditions can be turned away, you can always decided to get insurance later on if you got really sick.

26   capabuild   2010 Dec 29, 12:18am  

One possible option that was mentioned on Mish's site was to enroll at a college or university that provides a health insurance plan. The premium plus enrollment costs might still be cheaper than what you are paying. Good luck!

27   mn_mark   2010 Dec 29, 12:39am  

Going to an all-government health care system would just be jumping out of the frying pan and into the fire. Think about it: if it was actually more efficient for the government to run the nation's healthcare as a centralized bureaucracy, then it would be more efficient for the government to manage all of the goods and services society needs: food, shelter, clothing, transportation, entertainment, education, everything.

Central planning doesn't work. Free markets work. But as others observed above, we don't have a free market. We have a hybrid where profits go to the private sector and costs go to the taxpayer. That won't work. We have to get back to a true free market in health care, and that means eliminating government involvement except for the usual basic enforcement of contracts and so on.

I found among family papers an invoice for a 10 day hospital stay and surgery my grandfather paid for in 1944. The total cost, adjusted for inflation to today's prices, was just over $1,000. Compare that to a recent outpatient surgery a friend's daughter had on the tip of her finger when it was caught in a bicycle chain - $14,000.

What I never hear is a detailed explanation of how costs have gone from $1,000 for a ten day hospital stay with surgery, anaesthesia, supplies, etc, to $14,000 for an outpatient fixing of a fingertip with no hospital stay. My best guess is the government's involvement in guaranteeing payment for unlimited amounts of healthcare provided to the elderly and indigent. That eliminated the fiscal discipline of the marketplace that usually drives prices lower over time (as it has in the computer/technology field where there is essentially no government involvement).

Same thing happened to the cost of college once the government got involved with guaranteeing an unlimited supply of student loan money. Colleges were able to raise prices as much as they liked because they knew students could always get loans guaranteed by government. Again: profit going to the private sector, cost going to the taxpayer. The moral hazard problem.

Socialist health care systems are already collapsing around the world. Look at the problems with Britain's. We do not need to go that route...it will be worse than what we have now and will cost even more - the cost will simply be hidden in your taxes and interest rates rather than coming as a premium bill from an insurer. We need to get back to a real free market in health care.

28   elliemae   2010 Dec 29, 2:02am  

kimtitu says

One drastic way is to not to have insurance and just go to ER when thing hits.
Last year, I took my son to ER for real emergency. There are several other patients and their family, who do not seem so urgent but more like having a tour in ER room, before my turn.

Emergency rooms take patients based on their acuity. You don't know what was wrong with these patients. So far as their payment source, you don't know that either. They could have been in greater need than your son.

People without insurance must go to the ER, because otherwise they have to pay cash at the time of service. ER's are mandated to see patients no matter what their payment source might be - so what seemed to you to be a person who wanted a tour in the ER could have been someone with a tumor waiting to be seen. You don't know.

cleg says

My elderly father recently spent 3 days in the hospital for observation after having a fever. The bill just came in at slightly over $9,000.

The amount Medicare paid, after deductible, was about $3,000. Billed charges are different than paid amounts.

Yes - the system sucks. Horribly. However, costs spiraled before Obamacare and this shouldn't be a partisan issue. We really do need socialized medicine, but big insurance and healthcare corporations would lose their huge-ass profits and high paid salaries.

I've said so many times that, to me, a huge waste is the double-dipping of patients in nursing homes on Medicaid ($6,000 by the state/feds) and Medicare paying for hospice ($5,000) at the same time. Sure, there are some patients who need extra care - but most of these patients benefit the hospice, not the patient. Hospice lobbies have made sure that these patients are paid at the same rate as home hospice patients, even though they have 24-hour nursing care and caregivers via Medicaid. Hospice workers love patients in nursing homes - they require substantially less assistance, cost the hospices less and therefore provide a much higher profit to the hospice. The patients don't know the difference - in fact, much of the time they don't even know they're on hospice. Medicaid cuts back the amount that it pays to the nursing homes, yet they hospices are legally allowed to pay that difference back to the nursing home (a kickback of sorts) to encourage the hospice referrals.

There is so much waste and legal ways for companies to manipulate the system - and the rest of us pay for it in the form of higher premiums to the little guys.

29   newuserf16fabd9   2010 Dec 29, 2:06am  

Good Grief! No wonder baby boomers are not prepared for retirement!

30   Mikejay   2010 Dec 29, 2:15am  

Outrageous! I'd seriously consider doing without insurance. Of course, I'm single with no dependents, so you may have other priorities.

But I've gone without health insurance plenty of times. I went without for 5 years, then had it for another 5, then went without for another 5. The Oakman is right. When the receptionist or MD would ask whether I had insurance, I noticed that they'd charge me a more reasonable rate when I was without. Seriously - the bills weren't nearly as high for the same services as they were during the times when I had insurance.

I've heard the argument "but just try to pay out of pocket - it's too expensive" and that argument doesn't hold up when it comes to routine stuff. If a person can pay $800 a month and then still shell out for a co-pay, then couldn't that same person just bank the money and pay the bills directly? That's what I did for ten years on and off. It was way more cost-effective that way.

Even if something serious happens, you would probably be better off working something out with the hospital. Here in NJ, high-deductible plans only cover 50% (or slightly more) of your costs after a $10K- $15K deductible. So, if you got socked with $50,000 in charges, the insurer would pay around $20,000. You're still on the hook for $30,000. If you've not been paying $800 in extortion fees and if you can bargain with the hospital / care providers, you might get your costs down to $25,000 or $30,000 anyway.

If I were in that situation, I'd do without the insurance.

31   Mikejay   2010 Dec 29, 2:24am  

Also, in response to "mn_mark": if we had single-payer or national health care, the whole system would not be "run" at the federal level. Like law enforcement, much of a public health care system would be run at the state, regional (e.g. county), and local levels.

Thus, I don't buy the argument that "having public health care won't work because the federal government can't run such a big system". It wouldn't make sense for the feds to run it any more than it would to have them run your town's law enforcement.

Furthermore, people against public health care often argue that the government would then get into providing all our food, shelter, clothing, entertainment, transportation, etc. Who says that ever needs to happen? What do those things have to do with health care? Does the government have to provide those things now because we have public education and public law enforcement? No.

Seriously - I doubt we'll become Communists if we have public health care.

32   chapter7   2010 Dec 29, 2:37am  

My wife (33) and two kids (7 and 9) pay about $250/mth for a $6,000 deductible plan from Anthem/Blue Cross Blue Shield in Missouri. Everyone is fairly healthy and we have a low claims history.

Honestly, though, if rates get too high, the best catastrophic medical insurance "plan" for the typical middle-class person with few assets is Chapter 7 of Title 11 of the United States Code--i.e. personal bankruptcy. Put that $1,100/mth into your 401(k) and IRAs instead of feeding the insurance machine. Your 401(k)s and IRAs are exempt in a Chapter 7.

33   alice   2010 Dec 29, 3:42am  

That is why the insurance companies sent their lobbies to Washington to make health care MANDATORY! Mr. Obama in his debate with Mrs. Clinton, said that he was opposed to mandated health care, now he has changed his mind!

34   bob2356   2010 Dec 29, 3:59am  

mn_mark says

Socialist health care systems are already collapsing around the world. Look at the problems with Britain’s. We do not need to go that route…it will be worse than what we have now and will cost even more - the cost will simply be hidden in your taxes and interest rates rather than coming as a premium bill from an insurer. We need to get back to a real free market in health care.

Where are "socialist" (everyone else calls them public) health care systems collapsing around the world? What countries have you spent time in to make this observation? I've had health care in France, Canada, and New Zealand without any problems. The people there are fine with their system. They are mystified by the American system and why anyone would tolerate it. How will it be worse? America doesn't rank all that high on health care outcomes at all. Things like infant mortality in America are down in third world range. Oh right I forgot, everyone else lies about their health care numbers. Only America has an honest government that only tells it's citizens the truth, the whole truth, and nothing but the truth.

There are something like 60 countries with public health care including 32 of the 33 developed countries (guess the missing country). The only one you found to comment on is Britain, which is universally recognized as being poorly implemented and chronically underfunded. That's pretty objective (not). The cost per person in the other 32 developed countries of the world (oops I gave away the answer) is about half of the cost per person in America. This is pretty simple math, take the total spent on health care (which is very understated in America, a lot isn't counted properly because so much is private) then divide it by the number of people. There is nothing hidden in taxes or interest rates, the cost is the cost.

Let's see, twice the cost for results that are not as good. Yep it sure could be worse.

35   bob2356   2010 Dec 29, 4:45am  

mn_mark says

I found among family papers an invoice for a 10 day hospital stay and surgery my grandfather paid for in 1944. The total cost, adjusted for inflation to today’s prices, was just over $1,000. Compare that to a recent outpatient surgery a friend’s daughter had on the tip of her finger when it was caught in a bicycle chain - $14,000.

Post a redacted image of both bills. It would be interesting to see. Especially the part about 14,000 for outpatient surgery on a fingertip. I smashed my finger badly while working on one of my properties in Oregon 3 years ago. Total charges for ER at Emmanual in Portland, three visits to an ortho with an in office surgery, and a 40 mile ambulance ride (it was really smashed, I was losing a lot of blood and couldn't drive) was less than 5000.

The other side of the story is it took almost a year, with at least 50 phone calls (from NZ) across 7 time zones, to get all the bills paid. I had travel insurance through an Australian company and they had the patience of a saint dealing with the various billing departments screw ups. Double billings, lost payments, and multiple claims from the hospital, the doctors office, and the ambulance company. Emmanual managed to lose the insurance information 4 times and threatened to sue me for failing to provide it each time they lost it. The doctors office managed to turn the account over to a collection agency even after faxing the information that the claim was paid and they had the money at least 5 times. AMR claimed they couldn't get in touch with me, turned out that they didn't know how to dial an overseas phone number or send a letter overseas. They never bothered with my email address. Absolutely no one answered phones or returned emails. I have friends tell me my billing experience is the norm for most people, not just because I live overseas. The cost of dealing with all this has to be astronomical for the providers.

Here in NZ (which has one of those terrible socialist health care systems) there is ZERO paperwork. You go to the doctor or hospital, get treated, and go home. End of story.

36   Patrick   2010 Dec 29, 4:58am  

I don't mind mandatory insurance as long as it's capped at some reasonable cost and there is some government option to escape Blue Shield's extortion. Unlimited mandatory premiums to support Blue Shield's executive bonuses is just legalized theft.

We have mandatory elementary schools. It works well enough to provide a basic education for those who put in some effort, and those who don't like it go to private schools. Why aren't the right-wing nut jobs screaming about the communist nature of elementary school? Because they see that yes, government actually can provide some very beneficial services at a reasonable cost to everyone that the private sector cannot.

This looks like a good organization:

http://singlepayernow.net/

37   Â¥   2010 Dec 29, 5:25am  

Why aren’t the right-wing nut jobs screaming about the communist nature of elementary school?

? they do that too.

38   Â¥   2010 Dec 29, 5:29am  

That makes it just about the most profitable company

odd metric. Above I broke down Wellpoint:

Wellpoint had $14.6B in revenue and $2B in overhead leaving $1.2B in profits.

So that's ~80% of premiums going to care.

WPT has 10 million or so subscribers, so their overhead is $60/mo and their profit is $40/mo per subscriber.

39   elliemae   2010 Dec 29, 6:10am  

People complain about the cost of insurance - and I get it. I work with a woman who said that she dropped her insurance because of cost.

But if you have a serious, progressive illness that requires labs, consults and chronic medications, it can cost $300 to $400/mo on top of the premiums just to treat it. I see people who have to choose between treatment and food. It sucks.

40   michaelsch   2010 Dec 29, 7:26am  

Sorry, Patrick, but this is exact, direct, and immediate result of Obama's health insurance reform.

1. The reform actually reduces amount of health care existing facilities/personnel may provide by increasing huge administrative and regulatory overhead.

2. The reduced amount of care supposed to be shared by more people.

3. Health Insurers are allowed to pass the cost to those who can pay.

So YOU should pay for all this.

Beside this, different health insurers had different levels of lobbying success. This created winners and losers among them. Blue Shield / Blue Cross is the main loser, while KP is the main winner.

Of course, the winner (ab)uses the reform as well, but may afford lower increases. So, in my case, "only" my co-payment tripled and some coverage is cut.

Sorry again, but I have an impression you really wanted that reform.

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