patrick.net

The second part of this question is how long could you live and not be bankrupt without health insurance. In 1950 if you broke an arm, chances are you could pay for it. Do that today and wallah- probably 10's of thousands of dollars. Even a short term stay in the hospital can easily run up to the 100's of thousands of dollars.

That goes back to question No.1- the OP's question. So let's say you decide to take a chance and not have health insurance. The next day you get in a wreck and have a nice little stay in the hospital, exiting with a $250,000 bill. For most people that would basically spell the end of their financial future. As such they would probably also forgo future medial treatments, eat less healthy, and so on. Thus this in turn could very easily contribute to a decline in their health and possibly a shortening of their life expectancy as well.

That's an interesting question, TechGromit. Two points:

What exactly is life expectancy anyway? Since for example people born in 1950 have not died yet in large numbers, how do we know that they will on the average fulfill their life expectancy of 66/71 years? It has to be a prediction or an estimate from some existing data.

The second point is that if life expectancy in 1997 (say) was about 73/79, how much larger would the gain be if it was not for the much worse diet in 2010 than in 1950? In other words, has some of the value of improved medical technology been negated by worse eating habits? Likely the answer is yes.

It looks like life expectancy numbers for humans is not much more than extrapolation of trend data:

http://en.wikipedia.org/wiki/Life_expectancy#Life_expectancy_forecasting

Government, insurance companies have their fingers on the scales, so to speak. It behooves them to make the actuaries extend life estimates because payouts can be lower over time with nobody the wiser, plus it makes everybody "feel" good to think they will live these long lives.

Nursing Care insurance? Your policy will change underwriters numerous times over the 20 or 30 years you pay premiums, then you are too old to fight the insurance companies when they deny coverage, the perfect insurance product from the insurance company's view, that's why they carry such great commissions.

As you get to your 40's, you start to notice something funny, people in your age group you didn't expect start to deteriorate and occasionally die from sundry causes. A lot of people with pre dispositions to illnesses and cancers or self induced conditions such as drug use, smoking and drinking to excess start to become quite ill and in poor health in their 40's, many are trashed in their 50's, long before medicare kicks in at age 65, those are the ones who are bankrupted by medical bills or often become disabled and can't work, but cost the medical system umpteen dollars.

One in seven men in the USA at least die before they even get to collect medicare at age 65. In Russia, the men can collect their pensions at 59, but only half live long enough to do so, most usually because of alcoholism.

I think good health is less common than is commonly presumed, and the "powers that be" nurture the delusion of long life and good health to keep the herd from getting depressed or unhappy.

That's a good question although it brings up other ones.

Here's a long article that talks a bit about that subject
http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/

Basically simply having health insurance not exactly a indication of health. Many people put off care and not everything can be solved. One could argue that someone might develop more stress and stress related conditions if they know they have them.

The article argues that the health care provided with health insurance is more about quality of life rather than longevity. It could be argued from an emotional standpoint that seeing a doctor is more about seeing someone that examines you but someone that might actually care. It can also be said that just the establishment of records can be a determinant of what the future of care should be. Also if there is the development of a cluster of a given condition (say cancers) it might be worth examining for environmental effects.justme says

The second point is that if life expectancy in 1997 (say) was about 73/79, how much larger would the gain be if it was not for the much worse diet in 2010 than in 1950?

The growth in longevity I think is caused by a number of factors. Better technology, more access to a wider variety of foods (locovores be damned), more information about foods (remember when butter was used for burns!)

I tend to eat more for health rather than taste. Yes of course I like things like ice cream, pizza and the occasional burger but if you don't eat right it doesn't help in the long run.oddhack says

The point of insurance should be to cover the extraordinary and unexpected, not to cover the everyday.

That might be the original intent sure but I think it is a fair bet to say that major causes of death become fairly common. Heart diseases and cancers I would say are going to kill the majority of people on the planet. These are conditions that usually occur more as someone ages and that's where medicare picks up the tab..but this also explains why medicare costs are so high.

This might open up a can of worms and be a bit touchy but that is eventually people cannot fight death. I heard a speech by Mike Dukakis on health care and he said they were considering operating on the chest of his mother even though she was in her 90's (she passed at 100). To open up someones chest at that age and expect a recovery might not work. When one relative of mine passed technically we could have tried to fight the cancer a bit more but the mounting costs of nursing home care added up and she said it was time to go.

Here's a book that tends to look at groups (not racial but more religious) and how it effects health. Devout Mormons actually live about 10 years longer than the national average. I'm not promoting the religion but the lifestyle might be looked at
http://tinyurl.com/6bwsdhk

Well, I'm not sure. Its a good question. I was a pretty sick kid but I dont recall having anything life threating. But it hard to metric what would have happened to some illnesses had I not had any access to medical care.

I can say one of my best friends would have died at 18 had she not had health insurance. No money would have meant no expensive surgery. No expensive surgery would have meant death at home.

I was diagnosed with cancer at age 28. I can say without a doubt that modern medicine is the only reason I am alive to type this. The bill was around $60,000 to save my life, and since I save my money, I would have been able to pay it out of pocket. With my insurance it cost me about $5000.

My point is that I would still be alive without insurance, it's not insurance that saved me, it was actually the electrical, mechanical, and computer engineers that built the MRI machine, the chemical engineers and scientists that devise the treatment plans, etc.

This is why I work in the field of engineering, because I owe my life to the field and the fine people in that field who actually help others.

Amp707 says

This is why I work in the field of engineering, because I owe my life to the field and the fine people in that field who actually help others.

Yes, good engineers are awesome. Thankfully, the companies I've worked for don't make software for MRI machines. Bad managers can certainly compromise good engineering, and some of the code that I see on a daily basis makes me shudder.

Amp707 says

The bill was around $60,000 to save my life, and since I save my money, I would have been able to pay it out of pocket. With my insurance it cost me about $5000.

Those amounts are the negotiated amounts of the insurance company. If you had paid out of pocket, the cost would have been substantially greater unless they would be willing to negoitate with you. The system sucks.

APOCALYPSEFUCK is Tony Manero says

If everyone stayed away from doctors, life spans would soar. Generally, they misdiagnose shit for years, spouting random guesses. Then a really telling symptom appears - your skin falls off; you turn purple and pass out gripping your chest - then they figure shit out.
Fuck debt....Fuck doctors.

I would respectfully disagree, although I would like to point out that when you access the services of a physician you are paying for his opinion. His opinion is based on the knowlege he has gained, combined with info that he researches and anything else such as lab tests, xrays, MRI's, and consultations with other physicians.

Yes, some doctors are less than ideal, but most of the ones I've met are hard working, caring people who are willing to give much of their time to learning their craft, staying on top of it and losing much of the free time they have to their professions. They are at the mercy of insurance companies, hospital corporations, etc. insofar as the power that they have to order tests, etc. Sure, they make alot of money -but they pay out alot of money.

Of course, engineers are necessary to the process and should be recognized for their contributions. Without them there'd be no CT scans, MRI's, lazer surgeries, etc.

Without health insurance, I would be dead. Does anyone really believe that medical providers would provide free service or take payments from people who could only afford $100/month? Hell no... I've made it no secret that I'm a fan of socialized medicine.

So far as the Mormon Church... IHC corporation receives money from the church for its members who can't afford to pay for its care, plus it is a huge non-profit corporation in Idaho & Utah. Provides most of the care, writes off quite a bit. And it has a huge push to obtain donations (as do all non-profits) but they push the mormon angle - I've known them to send notaries and attorneys to help a senior change his will while he's dying. They receive millions in donations, and serve the people in the community who are predominantly mormon. The 10% tithing helps to pay for the help they give to their members, along with the donated care from IHC.

It ain't the lifestyle - there are many sedentary mormons, like anyone else. They drink soda pop like everyone else and there's rampant prescription drug use/abuse. They eat like you wouldn't believe (please trust me on this - every event is a chance for food. Love those "funeral potatoes!")

But I digress.... I wouldn't have made it past 25 without insurance.

elliemae says

[The bill was around $60,000 to save my life, and since I save my money, I would have been able to pay it out of pocket. With my insurance it cost me about $5000.]

Those amounts are the negotiated amounts of the insurance company. If you had paid out of pocket, the cost would have been substantially greater unless they would be willing to negoitate with you. The system sucks.

Elliemae,
You obviously have more expertise than I do with health care, by looking at your nursing home web page. However, I thought I would mention that my family has recently been negotiating directly with providers and getting great results, albeit not for the likes of a $60k tab. We actually prepaid one labor/delivery service and got a great deal, and pre-negotiated another. We had to shop around, and hospitals' finance departments are inconsistent with this sort of thing. We used to let our high-deductible insurer do the dickering before we settled up, and they were happy to take credit for "saving" us such and such money on procedures. However, it seems that most providers are happy to short-circuit the insurance when the patients have ready money.

I've mentioned before that for us to ever fulfill the dream of a single-payer system, we will need to not demonize the health care providers, but rather partner with then and focus on our common enemy, the insurance industry. My apologies to you if a single-payer system is not your dream.

Most people could get by fine if they were allowed to buy health insurance with a $10,000 deductible for HUGE medical expenses. Of course, Obamacare means you can NOT buy what insurance you want, what coverage, what deductible, and the states determine which companies may sell in your state.
Remember, the real reason you buy health insurance is to insure against a claim by the hospital/doctors for your assets if you become sick and have no insurance.
What is the solution to this? You could be a total reprobate and be like a Mexican, and have NO health insurance. But, what about the problem of having some MONEY? The hospital/doctors can go after you if you have money.
But WAIT!! Having ALL of your money in retirement accounts makes them immune from any civil judgement.
You can just say NO to buying health insurance, and keep ALL of your mutual funds in a Vanguard Variable Annuity.
But, the tax treatment of annuities sucks, doesn't it?
Not really, you just never "annuitize" the annuity. Then, that pesky California premium tax (Thanks Clinton!) never kicks in.
But, I don't recommend this approach, because if you do this, you are no better than the Mexicans gaming our system and getting free health care. You on the other hand are a responsible member of society.

clambo says

You could be a total reprobate and be like a Mexican, and have NO health insurance.

Being Mexican has nothing to do with insurance status. clambo says

Most people could get by fine...

No, most people could not get by fine with the method you propose. Many people are out of work, are losing their homes, are living at or below the poverty line and can't afford to purchase insurance.

pianist says

My apologies to you if a single-payer system is not your dream.

Single payer would be awesome - I do believe that insurance companies are evil, but I also believe that hospital corporations and huge healthcare corporations are part of the problem. I'm glad that you've been able to negotiate bills down and only wish that more people had the financial capabilities to directly pay their bills.

This might be a bit out there but technically speaking there should be incentives for insurance companies to insure (no pun intended) that they have the most people that are health/viable.

To some they simply cut people off that have sicknesses by denying them to begin with. Ethics aside that does not fit well in the long term.

If it can be established that the majority of people on a system are healthy to a given point but ultimately will get the same conditions (heart disease/cancers etc) then it would make more sense for some of these to try to do r&d in order to fix the problem

On the same note car insurance companies should research what products they can make that make cars safer and they would directly benefit.

Insurance is also odd in that they are creating policies that only hurt themselves. The first reason why people have insurance is because care is expensive without it. But on the same note insurance companies take a long time in paying bills. "Net" means the number of days that a bill is due. Usually terms are net 30 or 60..when I did collections hospitals would claim net 180! Some doctors now take significant discounts for paying in cash. Would they rather than 75% today or 100% potentially in months...

All arguments for or against single payer insurance aside, the biggest problem with health care is that people are literally being overcharged by a factor of +10x. Even the doctors, who take the Hippocratic oath.. having been grossly overcharged for their education; think nothing of saddling someone who barely makes a fifth of what they do with thousand dollar charges left and right without their consent.

Danaseb says

All arguments for or against single payer insurance aside, the biggest problem with health care is that people are literally being overcharged by a factor of +10x. Even the doctors, who take the Hippocratic oath.. having been grossly overcharged for their education; think nothing of saddling someone who barely makes a fifth of what they do with thousand dollar charges left and right without their consent.

But on the same point it is the state that grants the license to practice as a doctor. Some states also make it illegal for drug stores to operate clinics...and of course alternative medicine is often shunned.

Wait. A 12% increase in life expectancy is not significant? How much longer did you want to live? Are you disappointed that our cars aren't flying yet either?

Where are my flying cars! I was promised flying cars!
http://www.youtube.com/watch?v=PRl_D_CunWA

Certainly a 12% increase in life expectancy is significant. But gains at this point might be marginal. What point these days is someone old? If someone is about to die at the age of 95 how much should be given in care to allow them to live another year, another month etc.

What if in another 40 years some people live to 120..would 60 years old then become middle aged?

I live in a nation with mandatory national health insurance and, at age 35, start to get angry when I think about how much more money I'd have if I'd never had to pay into it.

My medical expenses have been about $200 over the past 13 years. The insurance pays 70% of your bill and you pay the other 30%, so if I'd been paying cash, I'd have spent another $600, or $800 in total.

Contrast this with the roughly $39,000 I've paid in premiums over that time.

Yeah, I know, stop complaining because it'll work to your benefit when you're 70 or over. But for someone well short of 70, national health insurance is like a giant subsidy from young working people to the elderly. They really need to change the premium amounts to reflect one's propensity to require care. Basing it only on income is very unfair, and keeps young people from securing their financial futures.

Michinaga,

Based on your numbers, you have paid on the average 39000/13/12 or $250/month for health insurance for the last 13 years, from age 22-35.

That really does not seem very expensive to me. I wish I could pay $250/month.

It's called insurance for a reason. Clearly, if everyone got out the money that they put into it, it wouldn't actually serve a purpose.

I'm a historian. The actual mortality rates for a society in which health care is very expensive and in most people have no insurance are likely to be much higher than you suppose, and mortality rates would escalate over time. People are not aware of just how grim the mortality figures used to be prior to the introduction of vaccinations, antibiotics, and routine surgical procedures in the mid-20th c. The average male lifespan was about 40, and women died on average in their early 30s due to childbirth. You say you've always been healthy, but your mother probably had prenatal care and a supervised delivery (both presently unaffordable without insurance). You were vaccinated as a child and so was nearly everyone you came in contact with. That occasional ear or urinary or throat infection didn't progress to something more serious because you received antibiotics. You didn’t grow up exposed to diseases like tuberculosis because the people you came in contact with were seldom infected with those diseases.

The problem with our medical system is that routine care (not just catastrophic care) is becoming unaffordable; for the uninsured, a simple trip to the doctor can easily total a thousand dollars, factoring in that the uninsured are charged considerably more for the doctor’s time, lab tests, and prescriptions.

The premise that health insurance is mainly for old people and the occasional unlucky individual is wrong. The most vulnerable age is the first few years of life (this is especially true for boys, who die at higher rates than girls). Women are at high risk in their childbearing years. Even the rich who can pay out of pocket suffer when a large portion of society goes without routine care. I’ve always been insured, but I grew up in a third world country where most people didn’t see a doctor unless the situation was dire. Serious diseases were in common circulation there, and even the wealthy were sicker than the average middle class person in the United States. For example, despite an excellent diet and routine checkups, I had a serious bout of tuberculosis as a child; my school friends had hepatitis, typhoid, and polio.

Michinaga says

I live in a nation with mandatory national health insurance and, at age 35, start to get angry when I think about how much more money I'd have if I'd never had to pay into it.

My medical expenses have been about $200 over the past 13 years. The insurance pays 70% of your bill and you pay the other 30%, so if I'd been paying cash, I'd have spent another $600, or $800 in total.

Contrast this with the roughly $39,000 I've paid in premiums over that time.

Yeah, I know, stop complaining because it'll work to your benefit when you're 70 or over. But for someone well short of 70, national health insurance is like a giant subsidy from young working people to the elderly. They really need to change the premium amounts to reflect one's propensity to require care. Basing it only on income is very unfair, and keeps young people from securing their financial futures.

So young people don't get cancer or hit by cars? I don't buy the premise that young peopel should pay less because they are healthier. Younger people are more likely to get into car accidents, for instance.

HousingWatcher says

Younger people are more likely to get into car accidents, for instance.

That's a bit debatable. Younger drivers can get better but there might not be the evidence for that with older. How often do drivers that fail vision tests get licenses? Most states only test drivers every few years rather than every year. The AARP is a pretty significant lobbying firm.

Let's not also forget that if someone older OD's and dies sometimes they'll just say "natural causes" in the media to avoid embarrassing the families.

That's pretty simple. Until you die, just like we have for thousands of years. We could probably cut insurance costs considerably by not allowing teens to get drivers license until they are 18.

A focus on prevention may help as well.

The biggest problem with our health care system is we treat symptoms, not causes.

Now that our genes are starting to become mutated from things like DU, radiation, and chemicals in our food stuffs, I can honestly say the sky is the limit when it comes to health care and insurance.

everything says

That's pretty simple. Until you die, just like we have for thousands of years. We could probably cut insurance costs considerably by not allowing teens to get drivers license until they are 18

Maybe but that might not always work. That could restrict employment in more suburban areas which could also hurt in the long run.

I think pretty much everyone belongs in at least one demographic group that is at a quite higher risk of some health problem or emergency than certain other demographic groups.

Can we just leave it at that and stop fussing over some demographic group X that we think have bad habits and therefore should pay more for health insurance than your own group?

If we take that type of thinking to the extreme, what will we get? You guessed it, we will get the lousy privatized system that we have now, where everyone is getting a bad deal and the insurers get tons of profits, and the cost control is nearly non-existent.

Concentrate on getting universal health care and cost controls, stop fussing about how some people are stupid and don't deserve any insurance.

justme says

Concentrate on getting universal health care and cost controls, stop fussing about how some people are stupid and don't deserve any insurance.

More than that, people who are stupid with their health and safety are more likely to have shorter lifespans and therefore lower lifetime healthcare costs.

I can't imagine why, but some people have a VERY difficult time grasping this concept.

CCR, that is an interesting point.

However I have not seen any real data on this. It could be the demographic of the careless run up fairly substantial costs even if they die younger than the rest.

My point is that we should all stop fussing about this and start improving the system as a whole. Let's look at the big picture.

We spend the majority of our national health care dollars on the last 3-6 months of one's life. It is silly to try and change human perception of fighting for life. Sure, when it's somebody else, it's easy to say roll over and die, you are so far out of my sphere that i don't have the energy to sweat out your health, when death is inevitable. when it is one of your own, most will not attach a price to life

The middle men insurance swindlers certainly aren't going away any time soon, Obamacare will shackle every last sap into buying into that booswaggle. Six thousand a year isn't that bad, but it's certainly not that good either. Hard to attach a value to something that i never use. Often mentioned on this board is to remove the MID, and it would make housing so much cheaper, well what would the effect of removing the employer deduction for compensating pay with health insurance do to health care costs?

There is one thing that we can do on our own to not participate in their game of drugs and fear. Eat healthy, live healthy, and you can avoid doctors for the wide array of issues that people that participate in poisoning themselves with sugars, and stress of life in their system. That is what is in control of your own health.

How does it work in your state with hospital bills and auto insurance? Here we buy auto insurance to cover hospital bills in case of an accident

justme says

My point is that we should all stop fussing about this and start improving the system as a whole. Let's look at the big picture.

I agree. I just get annoyed by the strain of control freaks who, without a moment of thought, argue that everybody should be forced to follow their lifestyle prescription because all those weirdos are making their insurance more expensive.

errc says

We spend the majority of our national health care dollars on the last 3-6 months of one's life

That makes a point but also gets into another issue. Monopolies at funeral homes. I know it's grim to suggest competition within it but it is bad enough when people pass away..it's even worse to spend thousands and thousands on a burial. Cremation is more accepted now but in some areas it is harder to do.

mdovell says

errc says

We spend the majority of our national health care dollars on the last 3-6 months of one's life

That makes a point but also gets into another issue. Monopolies at funeral homes. I know it's grim to suggest competition within it but it is bad enough when people pass away..it's even worse to spend thousands and thousands on a burial. Cremation is more accepted now but in some areas it is harder to do.

That pretty much answers it: on average one would live about 3 months less without health insurance.

Health insurance, like many insurances, is a scam. Sadly its very existence drives up the cost of the eventuality it insures against.

Nobody actually needs health insurance....what they need is medical care, and there is no reason why insurance should be used to buy most medical care when it is a routine and entirely predictable expense (3-4 doctor/dentists/year).

Fantom says

Health insurance, like many insurances, is a scam. Sadly its very existence drives up the cost of the eventuality it insures against.

Nobody actually needs health insurance....what they need is medical care, and there is no reason why insurance should be used to buy most medical care when it is a routine and entirely predictable expense (3-4 doctor/dentists/year).

And exactly how many people have the resources to pay for surgery without insurance?

HousingWatcher says

And exactly how many people have the resources to pay for surgery without insurance?

Depends. Insurance locks you not only into the amount that the doctors would get paid but also the time structure. Some medical workers actually give discounts if you don't use insurance. You cannot negotiate pricing with insurance.

Only a very very small number of peopel have enough money to fully cover their medical expenses... perhaps no more than 5% of the population.

Gosh, without health insurance most women/families would go bankrupt with every birth, and a larger percentage of babies would die in childbirth or shortly thereafter.

You may be single or childless now, but will you always be so?

Do you want your sister, mother, daughter, aunt, neice to go bankrupt, possibly die, or lose a baby? Skip prenatal care?

Rather why is the US the ONLY developed nation that DOESN'T have universal care? Backwards, short-sighted nation in my opinion.

And the fact prices are 10x for the uninsured compared to the insured is truly criminal. Where's the class-action lawsuit on that one?

mdovell says

Monopolies at funeral homes.

Funeral planning is the one area that frosts my ass! they talk about "tributes" and the quality of the caskets - they'll hold up for years! - and all that shit. They prey on the emotions of a person during their most vulnerable moments. I love the competition in the larger cities - it results in $300 cremations and less than $1000 burials.

My kids know to spend the very least amount possible; I'm not Irish, but I would like them to spend more on alcohol for the party than for the burial itself.

Brentok3 says

I've read a statistic in various places that 85% of the increase in longevity in the US during the twentieth century was due to public health measures, not due to allopathic care.
Public health measures would include trash collection, water treatment, sewer treatment, central heating, food inspection, refrigeration, food storage and shipping improvements, control of vermin and insects, and vaccinations, and perhaps even workplace safety measures, and perhaps some would even consider product safety improvements.

There are statisticians who say more lives were saved in the 20th century by plumbers than by doctors.

I've always wondered why plumbers demand such a high price tag