[geeks] The ugly insurance rant...

[Jonathan Katz]

The whole notion of insurance is that everyone paid into a pot some kind of
rate and that money was somehow invested to generate cash on its own. At the
same time it served a community (or those who paid into the pot) when they
needed it, usually on some kind of shared basis (80/20, etc.)

Many insurance companies (the original incarnation of Blue Cross Blue
Shield, etc) were non-for-profits. Most hospitals were (and many still are)
501c3s. The whole point is the entire pot would be cycled-through.

Then someone realized that you could make money from the entire healthcare
sector. Plus, the population of our country isn't evenly distributed across
age. A good chunk of our population is getting old, and as people get old
they break. From a capitalist perspective the baby boomers are a gold mine.

And then there was deregulation. The FDA and FCC allowed drug companies to
advertise directly to consumers on TV in the late 90s/early 00s. The critics
at the time said this would increase drug costs. It clearly has; Marketing
eats up more money than R&D it seems.

Plus care of the GI bill the baby boomers are better educated. In the 20th
century our society transitioned from agrarian to blue collar to a white
collar workforce. Better educated people do things like invest and take
legal action.

So as boomers got older and things went wrong they sued. They also invested
leading to a more profit-driven society. And doctors over time became known
as those who are well-to-do...

At the same time we have...
The healthcare industry trying to make a profit from care, drugs and
goods....
Things like lawsuits digging into that profit
... and that profit has to come from someone and somewhere, that's our
increased cost.

I think that is how we got here.

I think the group that wants "single-payer" or "socialized" medicine likes
to tie the notion of insurance to an employer to help justify their
position. Not everyone is always employed all the time, therefore they don't
have insurance. It creates a "crisis."

One of the things the insurance companies are doing to be more "transparent"
and less "evil" is to change how they operate.

The EOBs we get are easier to understand.
Insurance is changing from magically paying 80% of the cost to giving people
"play money" that they get to choose how to spend. Preventative maintenance
(like annual physicals) don't count against the play money, and doing things
like going to the gym and participating in fitness programs give people more
"play money" for their insurance. They're also trying to get people to
comparison shop for the best deal. The x-ray at the hospital down the street
may cost $300, but 5 miles away it may cost $150.

On 8/27/07, Jonathan C. Patschke <jp at celestrion.net> wrote:
>
> On Mon, 27 Aug 2007, Bill Bradford wrote:
>
> > On Mon, Aug 27, 2007 at 04:27:44PM -0500, Jonathan C. Patschke wrote:
> >> Is medical insurance that big of a deal?  Outside of my brief stint
> >> at state employment, I've never had my employer provide it.  In fact,
> >> I haven't even had insurance for the last two years or so.  I just
> >> eat well[0] and take care of myself.  I only get sick enough to miss
> >> work every four years or so.
> >
> > When I made less money, I alway declined the health insurance because
> > I would rather have that much more money/month.
>
> Yes, but why do we have this insane notion in the US that health
> insurance needs to be tied to an employer?