IBM to Move Its Retirees Off Its Health Insurance Plan
Another major business reacts to spiraling health care costs:
IBM has announced that it plans to move about 110,000 retirees off its company health insurance plan and offer a payment to purchase coverage on a private health insurance exchange instead.
The Wall Street Journal said early Saturday that the move is “a sign that even big, well-capitalized employers aren’t likely to keep providing the once-common benefits as medical costs continue to rise.”
According to the WSJ, the decision will affect all IBM retirees once they become eligible for Medicare and will relieve the company of the responsibility of managing retirement health-care benefits. IBM said the growing cost of care has made its current system of keeping retirees on its company health care insurance unsustainable without large increases in premiums.
Let me offer a surprising plug for France’s health care system. As I mentioned recently, we were in France and Switzerland for about 2 1/2 weeks recently. My wife went to the emergency room in Paris on our first full day there, because we were concerned she might have gotten deep vein thrombosis on the long plane flight from New York. (Our son had fallen asleep on her early in the flight, and she had not wanted to move and wake him up, so she never walked around on the flight at all. She had some symptoms consistent with DVT, but it turned out she didn’t have it, and she’s just fine now.)
We were at the hospital for a good part of the day, but that is comparable to experiences I have had here in the States. The doctors were pleasant and seemed quite competent. They performed blood tests and an ultrasound to ensure that there was no clot in Mrs. P’s body. They told us they would send us a bill that we would receive in the U.S.
We got the bill the other day. It was for 180 Euros (about $237).
You could spend that much on orange juice at a U.S. hospital.
While in the waiting room, I talked to a nice lady from the Bay Area of California who gravitated towards another English speaker. She had grown up in France and had several relatives in the country, and she said that when she would tell her French relatives about the cost of a particular visit here in the States, they would laugh at the absurd amount. She told me about an emergency room visit she had made in France 3-5 years earlier, and said that several medical tests had been run. Her eventual bill was 80 Euros.
Don’t get me wrong. I don’t want to pay their taxes. But they have costs under control in a way we can only dream of.
I honestly don’t think ObamaCare is the answer to our woes. But when someone else does something different and it’s working, it’s worth taking a look at. I don’t know if France’s system is better than ours, and I encourage folks to debate that in the comments. But they certainly seem to have improved on our system when it comes to costs.
My goal in this post was to rile y’all up. Did it work?
Ding.
Patterico (9c670f) — 9/7/2013 @ 5:48 pmMike K has been advocating for this for years. It may be better run than ObamaCare promises, but it’s still nationalized health care and I’m tired of government answers to every problem.
In addition, I fear American politicians and bureaucrats would find ways to change the French system so whatever good you saw would disappear in the American version.
DRJ (a83b8b) — 9/7/2013 @ 6:00 pmI too am suspicious of a government answer. But they seem to be doing something right.
Patterico (9c670f) — 9/7/2013 @ 6:06 pmI like french fries.
mg (31009b) — 9/7/2013 @ 6:11 pmBusiness Week tackled this topic in a 2007 article. It’s sound good until you get to the part where it says the system works in large part because French doctors are only paid $55,000 a year. Try doing that here. After we Americanize it, the changes would undermine the system.
DRJ (a83b8b) — 9/7/2013 @ 6:12 pmThe article also says France is running constant health care deficits — in the billions — and only stays afloat by raising taxes. I don’t know if that’s still true but I haven’t seen France enact any austerity measures, so it probably is.
DRJ (a83b8b) — 9/7/2013 @ 6:15 pmPat
they have no standing army, they are bankrupt, they jusr passed a tax of 75% on the job creators.
Dannon is now thir largest company and it moved all its manufacturing to California in the 80’s.
France is a mess, they have a storied tradition of medicine and are considered some of the best doctors in the world – in Qatar in an incident I cannot talk about I saw teams of French doctors racing to save lives – talking with one of them, his daughter’s class was graduating and over 80% were taking overseas jobs rather than be paid a handsome but limited salary in France.
My wife deals with French oil company, everyone is leaving France, the country is changing many are going to the Middle East and to South America were opportunities and growth are exploding
EPWJ (bdd0a6) — 9/7/2013 @ 6:17 pmwhere opportunities are exploding,
one day I will learn to type, today ain’t it
EPWJ (bdd0a6) — 9/7/2013 @ 6:18 pmFrance is a nation that sees health care as its top priority, so I guess it’s not surprising that it’s doing that reasonably well. But I’m not convinced Americans are going to make health care the top (or only) priority for our national budget. At least we weren’t until ObamaCare came along. That may be what happens if we can’t stop it, so moving to universal health care financed by the government (like the French system) is the natural next step.
DRJ (a83b8b) — 9/7/2013 @ 6:20 pmI can’t shake the feeling that the US medical care system has been so distorted for so long that we don’t even understand what we’re looking at.
We’ve been operating under an FDR-era construct since the 1940s…over 70 years, if I understand correctly how care was made a benefit to avoid post-Depression Era/WW II pay cap laws and still allow companies to attract workers as most were being siphoned off to go fight. Since that time, Congressional tweaking/legislation has accreted onto the ship so much that the best we can do is 5 knots at full power, so to speak. Statues have so distorted the healthcare industry that the $200 aspirin tablet is the result.
Moreover, we’ve been so immersed in this environment that a “steel chain of ideas” is wrapped around our heads making it impossible to think even a tiny bit outside the box, at least in terms of the average American consumer/voter.
It will take either a complete and rapid collapse of the system, post-ACA implementation or a man of near-Churchillian, if not Lincolnesque, political, oratorical and persuasive skill to get people to break that steel chain, let go, and try something new, i.e., truly competitive, market-based and away from the third-party payer system.
In the first case, the collapse must be relatively fast, otherwise we are all “boiled frogs,” slowly over time becoming accustomed to a lower standard of care. In the second, whoever that ubermensch is, he/she would be well-advised to examine examples where the free-market approach has worked–Lasik eye, cosmetic, and other optional surgeries/services that have had their costs substantially reduced through competition and/or exclusion from the normal insurance coverage system.
Color me skeptical of ANYTHING European…I lived there for 8 years. Our daughter was born in The Netherlands and the process nearly killed my wife…one does not induce labor in a 37-year-old woman whose fetus is in breech position and then go away for 10+ hours because your shift is up…and you don’t fix a blood pressure reading of 200/100 by turning off the machine…nor do you do an incision for the inevitable Cesarean section with a pair of scissors. My daughter is almost 17 and my wife’s abdomen is still numb from the nerve damage. In 1996, the best hospital in southern Holland where the baby was born was, at BEST, 40 years behind us in technology and technique. In a word, the care was…savage.
A10Pilot (30dbeb) — 9/7/2013 @ 6:30 pmFrench cops arrest four suspected extremists accused of robbing a fast food restaurant in order to finance their planned travel to fight along side Islamic extremists in Syria.
mg (31009b) — 9/7/2013 @ 6:33 pmAssad care must be better than French care!!
I know that retired doctor and regular Patterico forumer, Mike K, who I respect, has often cited France as a society with a medical system we could learn from or emulate. When he talks, I listen.
One thing, however, does need to be mentioned (assuming it’s accurate): I read somewhere that many doctors in France make an average income of around $40,000 US dollars.
Mark (58ea35) — 9/7/2013 @ 6:34 pmI remember reading stories about people (from the USA) traveling abroad in order to obtain elective surgery at a most affordable price point. did I see something like that on 60 minutes? My memory is fuzzy
felipe (6100bc) — 9/7/2013 @ 6:36 pm“The U.S. stands almost entirely alone among developed nations that lack universal health care.”
tifosa (eeaa7d) — 9/7/2013 @ 6:37 pmhttp://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/
It’s sound good until you get to the part where it says the system works in large part because French doctors are only paid $55,000 a year
I just read all the posts in this thread, and your observation now makes me feel my comment, while a bit dated or too conservative (ie, $40,000), still is generally correct.
Mark (58ea35) — 9/7/2013 @ 6:39 pmHere is the link to Mike K’s excellent overview of the French system: http://abriefhistory.org/?page_id=3076
Dana (6178d5) — 9/7/2013 @ 6:40 pm“The cheese stands alone, the cheese stands alone…” I still have no idea what that means.
felipe (6100bc) — 9/7/2013 @ 6:40 pmToo bad then, tifosa, that when given the opportunity the leftist powers that be concentrated on insurance coverage rather than, you know, actual health care or stemming the out of control healthcare costs for patients in this country.
elissa (6b3fdb) — 9/7/2013 @ 6:44 pmThe system we currently have is complicated and chaotic with no clear connection between payer and recipient, and with so many charges, categories, payment structures and exclusions that no one really understands their obligations or costs.
Levels of care vary wildly and often without regard to cost or ability to pay. At times, honest people get screwed and dishonest people get rewarded. The term aspect of policies makes the market work against people who get sick. Insurance has so skewed the system that cash payers get badly discriminated against.
The medical reform movement was supposed to address all of this, but ObamaCare makes everything worse in every regard.
Single-payer is a better system, as is a modified signle-payer (like Medicare) where there is an end-user cost. There may be better systems possible, but this is what we are going to end up with. There is something to be said for keeping it simple, which ObamaCare demonstrably is not.
The only thing that will stop this process is for the private insurance companies to finally get a clue and come up with something transformative. But they won’t.
Kevin M (bf8ad7) — 9/7/2013 @ 6:48 pmI know elissa, it sucked that Blanche Lincoln, Baucus, Nelson, etc. had to be catered to to get anything done. It’s essentially Romneycare, nationalized. I think a concept that originated in the Heritage Foundation.
tifosa (eeaa7d) — 9/7/2013 @ 6:50 pmIt was on my list, right. 🙂
actually elissa, no one has tried to offer actual health insurance in the USA for years and years now. It’s all about pre-paid health care, preferably paid by someone else.
Kevin M (bf8ad7) — 9/7/2013 @ 6:50 pmThey can call it a “Republican Plan” all they want to fool the rubes. But the fact that not one Republican in the House of Representatives would vote for it at a national level should tell you something, tifosa. Does it?
elissa (6b3fdb) — 9/7/2013 @ 7:03 pmHere’s what it’s most definitely not: socialism, “government-run healthcare.”
tifosa (eeaa7d) — 9/7/2013 @ 7:04 pmHere’s who get “government-run healthcare:” the military. period.
“The only thing that will stop this process is for the private insurance companies to finally get a clue and come up with something transformative. But they won’t.”
Kevin M – Or more likely regulators will prevent them from implementing any transformative changes, since personal lines of insurance are so inherently political.
daleyrocks (bf33e9) — 9/7/2013 @ 7:05 pmRead about the 2009 meeting while he was being inaugurated. They vote nothingObama.
tifosa (eeaa7d) — 9/7/2013 @ 7:05 pmWhat “rubes” think ‘Republican plan’ means R’s voted for it?
tifosa (eeaa7d) — 9/7/2013 @ 7:09 pm“Here’s what it’s most definitely not: socialism, “government-run healthcare.””
tiffy – Not exactly. Government set max profitability for insurers and what policies must cover. How is that not essentially government run?
daleyrocks (bf33e9) — 9/7/2013 @ 7:09 pmIt’s an insurance mandate.
tifosa (eeaa7d) — 9/7/2013 @ 7:13 pmOr more likely regulators will prevent them from implementing any transformative changes, since personal lines of insurance are so inherently political.
Well, the prohibition on national policies sure makes an industry-led reform difficult, for sure.
Kevin M (bf8ad7) — 9/7/2013 @ 7:16 pmIt was a manufactured talking point, tifosa. The wide eyed incredulous lefosphere were cynically asking “how can Republicans possibly be against this wondrous miraculous thing that is actually a ‘Republican idea'”? Why, everyone must just be a racist. That’s the only possible explanation for why anybody’d be against it. Yeah. That’s the ticket.
elissa (6b3fdb) — 9/7/2013 @ 7:16 pmI think he did think he’d get R votes as a result. He didn’t know about ‘operation one-term’ 🙂
tifosa (eeaa7d) — 9/7/2013 @ 7:19 pmRead about the 2009 meeting while he was being inaugurated. They vote nothingObama.
The Democrats had 60% of the votes in each House in 2009. Obama came into office with 70+ % supprot.
He just sucked at leading. Six years later he still does.
Kevin M (bf8ad7) — 9/7/2013 @ 7:20 pmHe didn’t know about ‘operation one-term’
Yeah, the mean ol’ Republcians wanted to keep the Democrat president to one term. Imagine that. For the First Time In History!!!11!!!!
Just because he was black.
Kevin M (bf8ad7) — 9/7/2013 @ 7:22 pmRemember corn-husker kick-back? D’s have their Dinos. Universal was out, single payer was out. Those would be Dem or Progressive plans.
tifosa (eeaa7d) — 9/7/2013 @ 7:24 pmThe left never sought to understand any of the right’s objections or concerns. They never bothered to consider or give credence to any of the well reasoned warnings by Ryan and others of the wholly foreseeable consequences of the legislative and bureaucratic monstrosity that was being rammed though.
It was “I Won” all the way.
elissa (6b3fdb) — 9/7/2013 @ 7:29 pmWe will never forget the Cornhusker kickback, tifosa. Never fear. It really is seared, seared in our memory.
elissa (6b3fdb) — 9/7/2013 @ 7:33 pm“…It’s worth recalling just how narrow a needle Obama had to thread to get his health plan to this point. During the 2008 campaign, Obama had criticized the individual mandate, arguing that the real problem with health care was that it was too expensive, and that the path to universal coverage was to make it cheaper. But when he decided to push for health reform in the spring of 2009, he discovered that Senate Finance Committee chairman Max Baucus, a centrist Democrat who took the lead on reform, thought a mandate was the only path to a filibuster-proof majority. So the White House let Baucus pursue a bipartisan solution…”
Read more: http://swampland.time.com/2012/06/28/obamas-big-health-care-win-an-incredible-stroke-of-luck/#ixzz2eGTNw2ci
tifosa (eeaa7d) — 9/7/2013 @ 7:35 pmWhat really happened, elissa, that he brought all the governors together to offer that they develop their own plans.
tifosa (eeaa7d) — 9/7/2013 @ 7:45 pm“The president says he backs a change that would let states act sooner to develop alternative plans to expand coverage.”
http://articles.latimes.com/2011/feb/28/nation/la-na-governors-healthcare-20110301
I think Vermont either is getting or has single payer (not sure)
‘Senate bills had numerous GOP amendments and reflected bipartisan meetings. According to a HELP Committee document about bipartisan aspects of the health reform bill the committee passed July 15, the final bill included “161 Republican amendments,” including “several amendments from Senators [Mike] Enzi [R-WY], [Tom] Coburn [R-OK], [Pat] Roberts [R-KS] and others [that] make certain that nothing in the legislation will allow for rationing of care,” and reflected the efforts of “six bipartisan working groups” that “met a combined 72 times” in 2009 as well as “30 bipartisan hearings on health care reform” since 2007, half of which were held in 2009. [HELP Committee document, 7/09] And according to the Senate Finance Committee’s document detailing the amendments to the Chairman’s Mark considered, at least 13 amendments sponsored by one or more Republican senators were included in the bill’
since that’s from Media Matters (there’s a reason you’re told not to read them,) feel free to refute the numbers with evidence otherwise.
tifosa (eeaa7d) — 9/7/2013 @ 7:53 pmtifosa, your attempts to rewrite history got old long ago. The realty is that Obama is incompetent. More relevant to the current thread is that Obama never had a real legislative plan regarding healthcare – he had nothing but a pile of platitudes because he never had any knowledge of healthcare nor healthcare insurance.
Couple that with the fact that after years in state legislatures ( and no real experience in the Senate) Obama has no clue how to get legislation passed. He got none of his legislative agenda other than Obamacare adopted during the two years Democrats controlled both houses.
SPQR (768505) — 9/7/2013 @ 7:55 pmObamacare is a catastrophe that is killing of a US economy already in ad shape from incompetent Democrat policies.
SPQR (768505) — 9/7/2013 @ 7:57 pm40. You can argue that you don’t like them, SPQR, but you can’t say he didn’t get things passed:
tifosa (eeaa7d) — 9/7/2013 @ 8:01 pmhttp://www.politifact.com/truth-o-meter/promises/obameter/rulings/promise-kept/
I see tiffy is manic. Again.
JD (5c1832) — 9/7/2013 @ 8:01 pm“He got none of his legislative agenda other than Obamacare adopted during the two years Democrats controlled both houses.”
SPQR – He did get that other monstrosity, Dodd-Frank through.
daleyrocks (bf33e9) — 9/7/2013 @ 8:03 pmtifosa, that link is hilarious for how dishonest it is.
Meanwhile despite MediaMatters propaganda from billionaires, Obamacare is a disaster that is wholly owned by Democrats.
SPQR (768505) — 9/7/2013 @ 8:03 pmDaleyrocks, Dodd-Frank was not Obama’s legislation. He tried to jump on the bandwagon and claim it. It wasn’t what he campaigned on for financial industry policy at all. Dodd-Frank itself is a disaster they is making so many things worse including driving so many people into payday loans and pawnshops.
SPQR (768505) — 9/7/2013 @ 8:07 pmObama will leave a legacy that will enable Jimmy Carter to feel confident that James Earl Carter, Jr. wasn’t the worst president in U.S. history.
Colonel Haiku (1c353a) — 9/7/2013 @ 8:10 pmYou can argue that you don’t like them, SPQR, but you can’t say he didn’t get things passed:
To liberals the goal is always to pass legislation. If it turns out to be disastrous, well hey, they had good intentions. Liberals act like once the bill is signed the battle is won, then wonder why an inefficient government bureaucracy honks everything up.
JVW (23867e) — 9/7/2013 @ 8:10 pmDodd-Frank was the culmination of Barney Frank’s belief that he is much smarter about finance and financial matters than anyone on Wall Street. He probably got Chris Dodd drunk at the Hays-Adams Hotel and talked him into becoming a co-sponsor.
JVW (23867e) — 9/7/2013 @ 8:12 pmOne last myth to bust, with specifics by the numbers: 2 years of 60 votes.
tifosa (eeaa7d) — 9/7/2013 @ 8:19 pmhttp://www.outsidethebeltway.com/did-the-democrats-ever-really-have-60-votes-in-the-senate-and-for-how-long/
“He tried to jump on the bandwagon and claim it. It wasn’t what he campaigned on for financial industry policy at all.”
SPQR – I’m not sure anybody campaigned for that piece of crap given all that it wound up covering and all the regs still unwritten. I need to refresh my memory because mine is not in accord with yours.
daleyrocks (bf33e9) — 9/7/2013 @ 8:21 pmIt’s essentially Romneycare, nationalized.
Comment by tifosa (eeaa7d) — 9/7/2013 @ 6:50 pm
Without knowing every detail of either Romneycare or Obamacare (like everyone else here) I think I can say with confidence that it can’t possibly be Romneycare because Obamacare is 2000+ pages and Romneycare is something like 50 pages.
Gerald A (130406) — 9/7/2013 @ 8:22 pmI don’t even think he mention Byrd being out.
tifosa (eeaa7d) — 9/7/2013 @ 8:22 pmWith respect to the Heritage plan I think their plan lacks at least one critical Obamacare element – the mandated coverages. I’m guessing there’s a lot of other differences. This has become a standard lib talking point though.
Gerald A (130406) — 9/7/2013 @ 8:24 pmThe mandate was the Heritage plan~you know, every body take responsibility.
tifosa (eeaa7d) — 9/7/2013 @ 8:27 pmYes, something Heritage once proposed a couple decades ago. Good Lord, you cretins try to blame everyone but yourself for your f@cking messes. No wonder you heart Obama.
JD (5c1832) — 9/7/2013 @ 8:32 pmTo liberals the goal is always to pass legislation.
Not always… sometimes it’s just to run up frequent flyer miles a la that imbecile/strong womyn Hillary Clinton.
Colonel Haiku (1c353a) — 9/7/2013 @ 8:36 pmYes, something Heritage once proposed a couple decades ago. Good Lord, you cretins try to blame everyone but yourself for your f@cking messes. No wonder you heart Obama.
In at least one respect, Democrats remind me of Palestinians. If there were but one Jew left in the entire Middle East, the Palestinians would blame their dysfunction entirely upon him. If there were but one Republican left in Congress, Democrats would likewise blame their dysfunction entirely upon him.
JVW (23867e) — 9/7/2013 @ 8:38 pmFrance may have more reasonable ER billing. But do you remember the 1995 Midwest heat wave, which led to approximately 750 heat-related deaths in Chicago over a period of five days? Well, France had a heat wave of similar proportion in 2003, but 15,000 people died. From the news coverage we learned that French nursing homes rarely have air conditioning, and even many hospitals don’t have AC except in the ICUs. Another factor was the 35-hour workweek, which limited the amount of time doctors were allowed to work. So sometimes you get what you pay for.
David Pittelli (7ad332) — 9/7/2013 @ 8:45 pmWasn’t it France that had most of the docs take vacation at the end of the fiscal year because they would be basically working for free, and it coincided with a heat wave that killed many, especially the elderly, as all the doctors were away?
Find someone who has had a baby and paid in full cash but first received a bill they were supposed to sign and turn over to an insurance co.
JP Kalishek (9b6108) — 9/7/2013 @ 8:53 pmI had a customer who did that and what he paid was massively less than what they intended to charge the insurance folks. Someone has to pay for the “Troglodytes”(what some in the health system call those they know will never pay for their treatment) and compensate for the reduced amounts that medicare/medicaid pays for procedures. They suck it out of your insurer.
Daves post was as I was typing mine. Now it reminds me it was a combo of all the above: end of fiscal year vacationing, 35hour work week, and the lack of AC where needed.
JP Kalishek (9b6108) — 9/7/2013 @ 8:57 pmThe problem, of course, with Obamacare is not the intention nor what other western democracies do or do not do in regards to health care.
The President promised that the health care cost curve would bend down. He promised that anyone could keep their doctor or their insurance regardless of ACA.
Neither could possibly be true. Government fiat cannot trump market forces.
The whole reason that health care prices skyrocketed in the first place was because of Medicare and Medicaid.
College tuition has followed the incentives of federal intrusion.
Freddie Mac and Fannie Mae failed because of federally induced social engineering and will fail again.
Federal action can be effective in making people act in some moral choices.
It can force people to act economically, but rarely in the intended way.
Ag80 (eb6ffa) — 9/7/2013 @ 9:14 pmTiffy,
Yoda knows who’s at fault with Darth Obama’s care, he does! Republican plan it is not! Yoda remembers Darth Nancy’s proclamation he does, “We have to pass it to see what’s in it!” Yoda also remembers the evil way it was passed he does! When Senate lost Darth Kennedy’s seat and 60th vote to a republican, cheat they did! Pass bill by reconciliation trick in dead of night, they did!
Yoda says, “Go screw yourself, Tiffy!”
Yoda (35b482) — 9/7/2013 @ 9:46 pmA reporter for CBS who lives in Paris also told the story of his child’s delivery there and how low cost it was, etc.
But the system is in deficit. But of course! Last I read it was $26B in a country the size of CA. So the government was supporting your visit, and that’s how the costs are reduced: to the consumer, not to the taxpayer.
Patricia (be0117) — 9/7/2013 @ 9:59 pmIt’s interesting to wonder how “fixable” the deficit might be. Patterico’s experience was that the treatment only cost 180 euros ($237), but what if it had cost twice that? That would still strike me as a pretty decent deal for an emergency room visit featuring blood tests and an ultrasound, and perhaps charging at that level would bring the overall costs closer in line.
Doctors in France may only make $55,000 (though I kind of find that hard to believe — perhaps that’s a first-year wage?) but I think they get to go to medical school for free thus relieving them from student loan debt, and I would guess they don’t have to pay the sort of malpractice insurance that a private practitioner here does.
JVW (23867e) — 9/7/2013 @ 10:22 pmIt had already occurred to me that the cost of their education was almost certainly lower. Higher education here is like medicine: the cost is so astronomical as to be literally laughable — except that it’s not so funny for the person who actually has to foot the full bill.
Thanks for the links to Mike K’s series, which I had not seen. I will certainly read through it and possibly link and discuss it. It’s not like Mike K is some leftist hack, you know.
Patterico (9c670f) — 9/8/2013 @ 12:34 amComment by Patterico (9c670f) — 9/7/2013 @ 6:06 pm: But they seem to be doing something right.
They’re not really doing something right. We’re doing something wrong.
Sammy Finkelman (107dde) — 9/8/2013 @ 1:54 amIt’s interesting that all this detail about what other countries do is obscure.
Sammy Finkelman (107dde) — 9/8/2013 @ 1:59 amComment by Ag80 (eb6ffa) — 9/7/2013 @ 9:14 pm
62. The whole reason that health care prices skyrocketed in the first place was because of Medicare and Medicaid.
Not Medicare and Medicaid. Something much more basic, that includes Medicare and Medicaid.
Insurance.
Something like 88% of all medical [ayments are covered by insurance – third party payers.
Sammy Finkelman (107dde) — 9/8/2013 @ 2:05 amCollege tuition has followed the incentives of federal intrusion.
Which is now topped out, but is still not paid out of current income – it is paid by borrowing, and people pay relatively low attention to price when choosing what to get. Collegs also sometimes collude (with scholarships)
Another place we had a price bubble, and still do really, (housing is far far more expensive than it really should be) is housing.
This is paid for by borrowing, and it’s easy to just borrow more and take longer to pay it back.
Only with housing, unlike college tuition or medical costs, it is actually official policy to keep up the price (because unlike tuition, it can be resold, so it’s a financial asset)
Sammy Finkelman (107dde) — 9/8/2013 @ 2:06 amSorry Pat but your wife was a free rider on the backs of French taxpayers. Their high tax rate subsidizes their health care system. They’re not doing anything better or smarter, just funding it differently.
MaaddMaaxx (981b21) — 9/8/2013 @ 6:45 amWe have a health care system designed by Ted Kennedy. It’s idiotic. And the idiots who designed it want to keep fixing it until they destroy it.
See tifosa and MaadMaxx for further information.
If you operate on a cash basis instead of the absurd notion that health care is a right then it’s not that bad. I broke my leg a couple of years back and in total I spent less than a grand. That included the crutches, x-rays, everything.
Had I used insurance they would have padded the bill to try and recoup from the company what they lose on Medicaid and illegal aliens. But since I paid cash I only had to pay for me.
Steve57 (35dd46) — 9/8/2013 @ 6:57 amObamacare forces young people to pay a fine if they don’t buy insurance policies they don’t need so they can subsidize the health care of old folks and you’re talking about free riders?
Steve57 (35dd46) — 9/8/2013 @ 7:02 amIf we did groceries the way the Democrats want to do health care a head of lettuce would cost a grand.
And you’d need to buy an insurance policy to get it or else you’re a “free rider.”
Steve57 (35dd46) — 9/8/2013 @ 7:06 amThanks to Democrats you can get a degree in frisbee. And you’ll be in indebted for life when you get it.
I know. Let’s put them in charge of health care, too.
Steve57 (35dd46) — 9/8/2013 @ 7:08 amhttp://hotair.com/greenroom/archives/2013/09/06/moronic-u-s-ambassador-we-thought-maybe-iran-would-dump-assad-after-he-used-wmd/
The same people who tailored their oh-so-smarter-than-Bush finely crafted, precisely targeted report that would convince Iran to abandon Assad is now preparing their oh-so-smarter-than-Bush finely crafted, precisely targeted strike on Assad to convince him to to abandon chemical weapons.
What to do? What to do?
Here’s a thought. Put them in charge of health care.
And education. Because if you’re going to spend money on “shove ready” projects, the one thing you’re going to need are medieval French lit grads who wouldn’t know a shovel if it hit them in the arse.
Steve57 (35dd46) — 9/8/2013 @ 8:01 amtifosa, you’re wrong about the U.S. military being the only group with 100% gov’t healthcare. Native Americans have been subjected to their own brand of socialized medicine since 1791 through Indian Health Services. How has it worked out for them?
Here’s an excerpt from Indian Country Today published in 2009:
When it comes to health and disease in Indian country, the statistics are staggering.
American Indians have an infant death rate that is 40 percent higher than the rate for whites. They are twice as likely to die from diabetes, 60 percent more likely to have a stroke, 30 percent more likely to have high blood pressure and 20 percent more likely to have heart disease.
American Indian health clinics are often ill-equipped to deal with such high rates of disease, and poor clinics do not have enough money to focus on preventive care. American Indian programs are not a priority for Congress, which provided the agency with $3.6 billion this budget year.
If this is the best the gov’t can do with their version of health care, give me private-sector medicine every time.
PPs43 (af65ec) — 9/8/2013 @ 9:18 amOnly gub’mint can force you to pay way above the market price for health care. And only gub’mint won’t deliver it.
Steve57 (35dd46) — 9/8/2013 @ 9:27 amIf you want to fix the US system’s costs, stop using CPT codes. The AMA holds copyright and are aggressive about enforcing it. This destroys the ability of people to price shop. If you had a non-emergency MRI to be done, would you do it for $500 or $3000? In the US system, the vast majority of the people don’t price shop so it’s random which one they get.
TMLutas (0876a3) — 9/8/2013 @ 9:34 amThey don’t price shop because a third party is paying.
Steve57 (35dd46) — 9/8/2013 @ 9:45 amtifosa’s pathetic attempts to spread the blame on Obamacare are utter failures. The Democrats moderated aspects of the legislation to obtain more
Democrat votes for something that they had trouble getting the entire Democrat caucus to accept.
Today, we know that Obamacare has been an utter failure. It promised expanded covered population in the tens of millions and has delivered in the thousands. It promised reduced costs, and delivered higher costs for insurance. It promised more employment and has delivered the largest suppression of employment since the Great Depression and the lowest percentage of working people in the US in four decades. It promised “bending the cost” curve and medical costs show no sign of changing their rate of increase.
Its beyond a joke, the Democrats have accomplished the most effective sabotage of the United States in its history.
SPQR (19047b) — 9/8/2013 @ 9:59 am“Which is now topped out, but is still not paid out of current income – it is paid by borrowing, and people pay relatively low attention to price when choosing what to get.”
Sammy – Seriously?
daleyrocks (bf33e9) — 9/8/2013 @ 11:10 amThere is a way to reduce medical care costs here in the states. Open billing. And paying in cash.
I know this sounds scary. But it can work and it actually does work. It starts with cutting out the insurance company. At least in most cases. Sometimes it means cutting out the hospital. Those are the two biggest drivers in costs.
One of the newer ideas being tried are open-billing ambulatory centers that provide general surgery at a fraction of what hospitals charge. Mainly, because they don’t have administrators and all of the overhead. They are smaller and tend to cut down on waste. They have up-front pricing on surgical procedures which is generally listed on their website, so a patient knows what they will be paying. This makes it easier to pay in cash. Often insurance companies will approve payments to these facilities because the prices are so much lower than the negotiated rates of the hospitals.
Another option is to get a procedure done at a hospital and forego insurance. You can then offer to pay cash and negotiate directly with the doctor for a reduced rate. Believe it or not, this can be done. You can do the same for hospital services.
The truth is, paying in cash can reduce the amount of a procedure so significantly that a surgery can end up costing a patient 1/5-1/10 of what it would with insurance. That’s the actual markup.
Consider a $25,000 procedure that now costs you $2,500 if you pay in cash. And if you had been putting money aside in a health account (just as if you had been paying an insurance premium), then you would be able to easily afford “cash health care”.
Bets (717964) — 9/8/2013 @ 11:15 am74. Comment by Steve57 (35dd46) — 9/8/2013 @ 7:06 am
If we did groceries the way the Democrats want to do health care a head of lettuce would cost a grand.
First of all, no two providers would charge the same price. The price would vary from about $15 to $90 depending on who was doing the billing.
Sammy Finkelman (393233) — 9/8/2013 @ 11:24 ami’ve been blessed with government provided healthcare while in the military.
i’ll pass on having it all the time. if you want healthcare to be more affordable, get the federal government out of the equation, not further into it.
redc1c4 (abd49e) — 9/8/2013 @ 11:28 amAnother thought, and this is not entirely fleshed out…
But to incentivize people into opening “health care savings accounts”, companies could offer (as an alternative to insurance) a small contribution to an employee’s account. This would be in lieu of contributing to or paying for their health insurance.
When someone gets a job with a company, they fill out forms with their bank router number for direct deposit. There is no reason why there could not be two forms. One for salary and one for an employee’s health care account (if they had one). And the account would travel with them from job to job for the rest of their life.
The federal government could also make these accounts non-taxable.
I realize this a bit off the reservation, but I was just thinking out loud.
Bets (717964) — 9/8/2013 @ 11:30 amHere is my experience. I had a double hernia operation Friday. At about midnight I fainted and hit my head on the floor of my bathroom opening a big gash. I had not eaten all day except for lunch and four pretzels at 7 pm. I have a history of blackouts following long food depravation and was on e diagnosed as hypoglycemic. I returned to the hospital, was examined and sent home. I had no headache or blood in my ears, which are symptoms of a skill fracture. My sister, a nurse up north, checked with four er doctors who all confirmed her go get a ct scan remedy. Why not? Insurance pays. Total waste. Doctors over test because money is made and it limits lawsuits
Michael Harris (9c037c) — 9/8/2013 @ 1:14 pm–Doctors over test because money is made and it limits lawsuits
And don’t forget there was nothing in Obamacare to reduce lawsuits.
red (ac28a9) — 9/8/2013 @ 3:01 pmThe French and Swiss “systems”, as I understand it, are healthy free markets with limited regulation and much lower subsidies from the government that we have here.
If we had France’s level of government interference with healthcare then we would be paying 300 dollars for ER visits. We decided not to, and now our sick and poor are paying the price.
And if France’s reduced its level of regulation of labor and industry, then they would be competing with us as the world’s startup leader. They decided not to, and now their young adults are paying the price. (Both in France and here though, legislators get great health care and good jobs for themselves and their friends.)
Jeff Hall (bfb04f) — 9/8/2013 @ 3:22 pmComment by Bets (717964) — 9/8/2013 @ 11:30 am
The federal government could also make these [health care savings]accounts non-taxable.
I realize this a bit off the reservation, but I was just thinking out loud
It’s good, but it only solves a portion of the problem. You also have to deal with the people who have no money, or who haven’t saved. Money could be taken out of future social Security payments, in a pinch, and the amount of money at risk could be limited.
Sammy Finkelman (324ec1) — 9/8/2013 @ 5:53 pm$237 is what you paid…what portion was paid by French taxes? If you were a French Citizen would you still have paid the $237 in addition to their outrageous tax rate?
Pamela (8d3d77) — 9/9/2013 @ 12:03 pmDoctors don’t get anything for ordering tests.
The people who do the tests get paid for performing and interpreting tests,
but for ordering tests no one ever paid me anything.
As far as avoiding lawsuits go, well, decrease unwarranted lawsuits and less testing will be done.
It would be interesting to know what all of the factors are that make the bill so low.
MD in Philly (f9371b) — 9/9/2013 @ 12:42 pmGovt subsidy?
Old equipment?
etc.
I have a couple of articles about medical prices frm the last month to link to and I;ll try to get around to it.
Also by the way, not too long from now, we’ll be able to go into Walgreens and get a battery of blood tests from a pinprick for around $70.
Sammy Finkelman (bda33a) — 9/9/2013 @ 12:46 pmBack in ’09, Mike K. wrote a lot of comments here about how the French system worked.
SPQR (768505) — 9/9/2013 @ 12:57 pmthe idea of free market healthcare is simply ludicrous. In order to have a free market you have to have two things:
1) multiple suppliers of a good (otherwise it’s a monopoly), and
2) consumers have to have enough information to make intelligent choices about which, essentially, brand to purchase
Neither condition can hold in terms of medicine. Medical infrastructure is pricey. If you happen to live in a major metro area you might have a choice between a handful of hospitals for treatment. For anyone else it’s whatever one hospital serves your area. Even for metro dwellers in an emergency your choices are starkly limited to the closest hospital as transport times become rather critical. In case of minor care you can get at a clinic you will have more options but that doesn’t help the issue of hospital care.
Then again the vast VAST majority of people have no clue as to how to rate or rank hospital care anyway and thus cannot make intelligent choices about whom to see or where to have an operation. I happen to have a lot of family members involved in healthcare in one aspect or another (I’m not though) so when I’ve needed care I’ve had access to inside information telling me “go see X” or “whatever you do do not see Y for treatment.” Most people aren’t so lucky. On the other hand, it’s always possible my family members are not the best judges despite their occupations. I have no way to know since I, like almost all americans, have essentially no medical knowledge.
There are things capitalism does very well (specifically the manufacture and distribution of luxury items), health care it does not do well, nor will it ever do healthcare well. It’s a fundamental incapacity that cannot be resolved.
Tlaloc (d061fc) — 9/9/2013 @ 1:37 pmComment by Tlaloc (d061fc) — 9/9/2013 @ 1:37 pm
the idea of free market healthcare is simply ludicrous. In order to have a free market you have to have two things:
1) multiple suppliers of a good (otherwise it’s a monopoly), and
We actually do have that. The great fear of single payer and other systems is that we might not.
2) consumers have to have enough information to make intelligent choices about which, essentially, brand to purchase
I think this can work if even only 30% know something about who is better – provided price matters to them as well.
Sammy Finkelman (d22d64) — 9/12/2013 @ 3:17 pmUnions’ Misgivings on Health Law Burst Into View – New York Times Sept 12, 2013 page B1
Sammy Finkelman (d22d64) — 9/12/2013 @ 3:23 pm