# $700 Health Insurance

**URL:** <https://boards.straightdope.com/t/700-health-insurance/543986>\
**Category:** The BBQ Pit\
**Created:** [June 21, 2010, 3:22pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986 "2010-06-21T15:22:34Z")\
**Posts on this page:** 20\
**Page:** 7

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**Author:** ![Eva\_Luna](https://avatars.discourse-cdn.com/v4/letter/e/e495f1/32.png) [@Eva\_Luna](https://boards.straightdope.com/u/Eva_Luna)\
**Post date:** [June 23, 2010, 3:55pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/121 "2010-06-23T15:55:40Z")

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> [@Rand\_Rover](#):
>
> You are making the common error of not properly separating out healh and health care and health insurance. They are distinct concepts.
> 
> The statistics do not show that countries with UHC have better health care than the US. They only show that those countries have healthier populations. When you look at the actual efficacy of health care (eg, cancer survival rates), the US does better.
> 
> The reason for this is that there is more that goes into how healthy a population is other than the quality of its health care. So, you can’t look at population health statistics alone to show that UHC is better than the US health care system.

And you seriously don’t think there is a relationship between availability of health care (and if health care is not affordable, which much care, even basic routine preventive care, simply isn’t in this country - without health insurance coverage for many people it might as well not be available) and public health outcomes?

Or do you just not give a shit? Is it OK with you if poor children die of preventable asthma attacks that could be treated with a $50 inhaler and proper education?

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**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\
**Post date:** [June 23, 2010, 4:10pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/122 "2010-06-23T16:10:23Z")

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> [@Meyer6](#):
>
> Please don’t falsely accuse me of making up statistics. The 85% satisfaction rate was quoted earlier in this thread and comes from a well-publicized [Gallup Poll](http://www.gallup.com/poll/123149/cost-is-foremost-healthcare-issue-for-americans.aspx):
> 
> The fact that 45 million people are uninsured, and that that is 15% of the population, was also well publicized during the last election and comes from no less an authority than the [US Census](http://www.census.gov/prod/2009pubs/p60-236.pdf):
> 
> Since you seem to agree with me that the private system is messed I’m not sure why you are accusing me of being a liar, but it’s untrue and I don’t appreciate it.

[http://www.politico.com/news/stories/0510](http://www.politico.com/news/stories/0510)  
[http://www.washingtonpost.com/wp-dyn/content/article/2009/10/19/AR2009101902451.html](http://www.washingtonpost.com/wp-dyn/content/article/2009/10/19/AR2009101902451.html) Nothing like 85 unless you are quoting Limbaugh or Fox.  
/37603.html  
Here is Politico doing a polling analysis. It says 85 percent of REPUBLICANS are against the health plan. It is not 85 percent of the people.  
You also have to include the phraseology when you read a poll. Those unhappy also include those who wanted a UHC system. I am not happy with the Obama plan, because it kept insurance companies in position to continue looting the system.

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**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\
**Post date:** [June 23, 2010, 4:49pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/123 "2010-06-23T16:49:34Z")

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> [@gonzomax](#):
>
> It says 85 percent of REPUBLICANS are against the health plan. It is not 85 percent of the people.

You overlooked the subtext; non-Republicans are non-persons.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [June 23, 2010, 4:55pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/124 "2010-06-23T16:55:32Z")

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Eva, that’s definitely one factor, but not the only factor.

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**Author:** ![Eva\_Luna](https://avatars.discourse-cdn.com/v4/letter/e/e495f1/32.png) [@Eva\_Luna](https://boards.straightdope.com/u/Eva_Luna)\
**Post date:** [June 23, 2010, 5:08pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/125 "2010-06-23T17:08:19Z")

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> [@Rand\_Rover](#):
>
> Eva, that’s definitely one factor, but not the only factor.

Feel free to outline the others that you think are relevant and explain why you think that UHC would produce worse outcomes than we have currently. Personally (and I think that I speak for many others on my side of the debate), I care about making health care available to all at an affordable cost, period. And I believe that the experience of coutries with UHC has shown that UHC is the best way to accomplish that.

Sadly, it appears that UHC is not politically viable in the US these days, so I’ll settle for the reform bill that did pass.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [June 23, 2010, 5:17pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/126 "2010-06-23T17:17:32Z")

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I think that’s a good goal as well, but many European countries are right now showing that UHC (and aother large entitlements) are very far from “affordable.”

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**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\
**Post date:** [June 23, 2010, 5:23pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/127 "2010-06-23T17:23:44Z")

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> [@Rand\_Rover](#):
>
> I think that’s a good goal as well, but many European countries are right now showing that UHC (and aother large entitlements) are very far from “affordable.”

On what are you basing that conclusion? You have been quick to pick nits on the relationship between the availability of health care and health outcomes; so why are you so eager to link the economic problems in Europe with UHC? Seems you don’t apply the same rigor to your own arguments that you do to others.

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**Author:** ![Eva\_Luna](https://avatars.discourse-cdn.com/v4/letter/e/e495f1/32.png) [@Eva\_Luna](https://boards.straightdope.com/u/Eva_Luna)\
**Post date:** [June 23, 2010, 5:33pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/128 "2010-06-23T17:33:42Z")

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> [@Rand\_Rover](#):
>
> I think that’s a good goal as well, but many European countries are right now showing that UHC (and aother large entitlements) are very far from “affordable.”

And the U.S. system, at roughly twice the per-person cost with less coverage and incalculable humanitarian cost, is affordable???

This is why we have actuaries, etc. - to tweak programs like this. There MUST be a better way.

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**Author:** ![Evil\_Captor](https://avatars.discourse-cdn.com/v4/letter/e/f17d59/32.png) [@Evil\_Captor](https://boards.straightdope.com/u/Evil_Captor)\
**Post date:** [June 23, 2010, 5:36pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/129 "2010-06-23T17:36:19Z")

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> [@emacknight](#):
>
> Since this has devolved into another of **Rand Rover’s** attempt at showing us how much he knows about stuff, I have a question:
> 
> How many of you would be willing to pay another $700 a month towards taxes?
> 
> Health care costs money. There is no way to get around that. So it is either going to be paid up front (through insurance, co-pays, deductibles), or it is going to be paid through taxes.
> 
> To make sure **DanBlather** is covered, we need to see our yearly tax load go up by $8400. What would that look like on your federal taxes? 5% 10% 20%
> 
> It might also require a national sales tax, are you willing to pay 10% more on everything you purchase?
> 
> The money has to come from some where.

Not at all true. With UHC you expand the risk pool greatly … sure, people who dont ever get sick (the young) will be required to pay for health insurance, but because ALL people will be part of the risk pool, the amount required for each individual goes down. It’s how insurance works … risk pooling is the heart of the concept. Its’ why our health costs are number one in the world, and our health outcomes are at number 17, I believe. Other countries are simply more EFFICIENT at dealing with health care costs.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [June 23, 2010, 5:42pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/130 "2010-06-23T17:42:43Z")

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I guess you missed where I said “(and other large entitlemets).”

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**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\
**Post date:** [June 23, 2010, 6:07pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/131 "2010-06-23T18:07:52Z")

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> [@A.Selene](#):
>
> Sorry **Dan** The market for health insurance in the US if seriously fucked up. I’d usually be the first one calling for a market solution if I thought there was one, but I’m not sure how.
> 
> I see three distinct problems with health insurance …

Although I’m very far from right-wing views, I am also a strong believer in market solutions. Flood insurance in low-lying regions _should_ be expensive, and if that means people have to abandon their homes and move … well, that’s the whole point.

In the case of pricing health insurance for unhealthy people, however, society simply has to make a moral decision whether the healthy are to subsidize the unhealthy. In other developed countries, they choose the Golden Rule. In America we don’t. (And even centrists posting in these forums don’t seem to get it, comparing before-UHC premiums or taxes and after-UHC premiums or taxes, as though medicine for the needy would be free.)

Your three problems with health insurance are all significant, **A.Selene** , but you missed the biggie: unnecessary high costs. Anyone have statistics comparing total salary paid to insurance company employees in countries with single-payer UHC, compared with U.S.A.? Then add in man-hours spent by care-providers interfacing to insurance companies? This just isn’t rocket science.

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**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\
**Post date:** [June 23, 2010, 6:26pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/132 "2010-06-23T18:26:24Z")

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> [@Rand\_Rover](#):
>
> I guess you missed where I said “(and other large entitlemets).”

So you agree that UHC is a good idea, as long as we keep away from “other large entitlements”?

It’s always heartening to realize that even someone as profoundly stupid and self-deluded as you [can learn](http://img256.imageshack.us/img256/1065/themoreyouknow2d.jpg).

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**Author:** ![sparky\_1](https://avatars.discourse-cdn.com/v4/letter/s/77aa72/32.png) [@sparky\_1](https://boards.straightdope.com/u/sparky_1)\
**Post date:** [June 23, 2010, 6:36pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/133 "2010-06-23T18:36:53Z")

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> [@septimus](#):
>
> Although I’m very far from right-wing views, I am also a strong believer in market solutions. Flood insurance in low-lying regions _should_ be expensive, and if that means people have to abandon their homes and move … well, that’s the whole point.
> 
> In the case of pricing health insurance for unhealthy people, however, society simply has to make a moral decision whether the healthy are to subsidize the unhealthy. In other developed countries, they choose the Golden Rule. In America we don’t. (And even centrists posting in these forums don’t seem to get it, comparing before-UHC premiums or taxes and after-UHC premiums or taxes, as though medicine for the needy would be free.)
> 
> Your three problems with health insurance are all significant, **A.Selene** , but you missed the biggie: unnecessary high costs. Anyone have statistics comparing total salary paid to insurance company employees in countries with single-payer UHC, compared with U.S.A.? Then add in man-hours spent by care-providers interfacing to insurance companies? This just isn’t rocket science.

Cost is not the only issue. My previous employer was willing to pay whatever price my individual insurance cost, but the damn insurance company would not take me on due to previous health conditions (and as stated earlier, they were THE ONLY COMPANY OFFERING IN MY STATE). As such, I kept COBRA and my employer paid the much higher price until I left the company.

I felt like a second rate person for months during that whole episode. Frankly, I was surprised the affect it had on me. Anyone else going through the nightmare of trying to get health insurance, you have my deepest sympathy.

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**Author:** ![The\_Tooth](https://avatars.discourse-cdn.com/v4/letter/t/c67d28/32.png) [@The\_Tooth](https://boards.straightdope.com/u/The_Tooth)\
**Post date:** [June 23, 2010, 6:53pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/134 "2010-06-23T18:53:46Z")

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> [@Leaffan](#):
>
> Same deal in Ontario, but most decent work plans cover all of these. I’m sure you’re no different in Alberta.

I seem to recall Blue Cross being worth it, but Sun Life has doubtless spent far more than $10 trying to weasel out of paying me $70 instead of the $60 they gave me for one claim. There are good plans, but as is being illustrated the private firms will do their utmost to fuck you at the drive-through. A whopping $20 for optical expenses every two years is not coverage, it’s nothing.

And it’s not a ‘work plan’, I can get the same coverage on my own if I choose. Can’t imagine who would, though.

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**Author:** ![A.Selene](https://avatars.discourse-cdn.com/v4/letter/a/3ec8ea/32.png) [@A.Selene](https://boards.straightdope.com/u/A.Selene)\
**Post date:** [June 23, 2010, 7:26pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/135 "2010-06-23T19:26:01Z")

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> [@septimus](#):
>
> In the case of pricing health insurance for unhealthy people, however, society simply has to make a moral decision whether the healthy are to subsidize the unhealthy. In other developed countries, they choose the Golden Rule. In America we don’t. (And even centrists posting in these forums don’t seem to get it, comparing before-UHC premiums or taxes and after-UHC premiums or taxes, as though medicine for the needy would be free.)

Right. I agree. As oftentimes there is little or no choice in the case of health insurance, those that suffer from ill health outside of their control have no recourse. They can’t “move from the flood plain valley” from your other example.

> [@](#):
>
> Your three problems with health insurance are all significant, **A.Selene** , but you missed the biggie: unnecessary high costs. Anyone have statistics comparing total salary paid to insurance company employees in countries with single-payer UHC, compared with U.S.A.? Then add in man-hours spent by care-providers interfacing to insurance companies? This just isn’t rocket science.

Cost is certainly something to consider, and extremely important. But I didn’t mention it as I don’t see it as a structural problem like the others. We know how to lower costs. Make things more efficient, cut down on waste, provide fewer services, etc. Those might be hard things to do, but it’s easy to imagine some ways to improve on costs. The things I mentioned are structural problems with health care or health insurance, and try as I might, I can’t imagine solutions.

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**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\
**Post date:** [June 23, 2010, 7:56pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/136 "2010-06-23T19:56:45Z")

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> [@septimus](#):
>
> Although I’m very far from right-wing views, I am also a strong believer in market solutions. Flood insurance in low-lying regions _should_ be expensive, and if that means people have to abandon their homes and move … well, that’s the whole point.

Yes, and people with poor driving records should pay more. And for health insurance, smokers (or other people with high risks that are under their control) should pay more.

> [@](#):
>
> In the case of pricing health insurance for unhealthy people, however, society simply has to make a moral decision whether the healthy are to subsidize the unhealthy. In other developed countries, they choose the Golden Rule. In America we don’t. (And even centrists posting in these forums don’t seem to get it, comparing before-UHC premiums or taxes and after-UHC premiums or taxes, as though medicine for the needy would be free.)

The difference is that the healthy and unhealthy are the same, and vary only with time. The person who was healthy last year might be expensive this year. The person who cost the system a lot five years ago might cost almost nothing today. Nearly all of us will be unhealthy at some point, except for those of us efficient enough to live a full and healthy life and then drop over dead.

As for the needy, we subsidize them already, through increased charges at hospitals which they cannot pay, and then which get folded into fees for everyone else. That is going to happen unless we choose to refuse treatment for those who cannot pay. Is that your solution?

> [@](#):
>
> Your three problems with health insurance are all significant, **A.Selene** , but you missed the biggie: unnecessary high costs. Anyone have statistics comparing total salary paid to insurance company employees in countries with single-payer UHC, compared with U.S.A.? Then add in man-hours spent by care-providers interfacing to insurance companies? This just isn’t rocket science.

During the debate many people compared insurance company overhead with Medicare overhead. Every doctor I know has at least one person working more or less full time on insurance issues - that is a tremendous source of waste. I think the insurance companies are finally agreeing on a common claim form - only 20 years or so late. Salaries will be set by market forces, what would probably change would be the number of employees. My son-in-law had a job for a while examining claims at a health insurance company with the charter of rejecting those which violated some guidelines in some way. That is a job which could probably be done away with and increase the efficiency of the system as a whole.

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**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\
**Post date:** [June 23, 2010, 7:59pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/137 "2010-06-23T19:59:49Z")

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> [@A.Selene](#):
>
> e when you need this blood transfusion today.
> 
> 1. **You cannot plan for future health care costs**. Oh, sure, you can set aside money every month for emergencies, which is exactly what I do. But I cannot know what my future costs will be for health care. I can pretty easily plan ahead for other necessities: I know I will need water, food, and shelter. But I cannot predict the stroke that may hit me five years from now, or the car accident, or any other possibility. This is why we have health insurance.

But if you have a large enough pool of people, you can predict this, which is why group coverage and UHC is inherently cheaper and more efficient than individual coverage. More precisely, you cannot self-insure yourself without very large reserves, while a company of 100,000 can easily self-insure with very moderate reserves.

Excellent post, btw.

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**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\
**Post date:** [June 23, 2010, 8:36pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/138 "2010-06-23T20:36:01Z")

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As usual I wasn’t explicit enough to make my meaning clear. :smack:

> [@A.Selene](#):
>
> Cost is certainly something to consider, and extremely important. But I didn’t mention it as I don’t see it as a structural problem like the others. We know how to lower costs…

Single-payer UHC; then lay off most of the health insurance industry, saving the cost of their salaries. Sorry if this means friends of yours lose their jobs.

> [@Voyager](#):
>
> As for the needy, we subsidize them already …

If “we” were “subsidizing” them quite well, we wouldn’t be hearing so many complaints from various types of needy about their health care, would we?

> [@Voyager](#):
>
> That is going to happen unless we choose to refuse treatment for those who cannot pay. Is that your solution?

😕 😕 I’m sorry. I guess I assumed everyone knew I favor _ **Universal government-paid health care.** _

> [@Voyager](#):
>
> Every doctor I know has at least one person working more or less full time on insurance issues - that is a tremendous source of waste. …

That’s what I was saying…

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**Author:** ![emacknight](https://avatars.discourse-cdn.com/v4/letter/e/3ec8ea/32.png) [@emacknight](https://boards.straightdope.com/u/emacknight)\
**Post date:** [June 23, 2010, 9:48pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/139 "2010-06-23T21:48:42Z")

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> [@Athena](#):
>
> I think it’s worth noting that in many situations it’s impossible to “shop around” even if you have time.
> 
> I once had a test ordered by a doctor that I knew was an interesting data point, but not super necessary for the situation. As I was paying for it myself (hadn’t met my deductible) I decided to find out what it cost to help decide if I really wanted to do it.
> 
> Doctor’s office who ordered the test had no clue what it would cost. They told me to call the lab.
> 
> Lab was part of the local hospital. I called and tried talking to someone who worked in the lab, that confounded them. I tried calling the billing department at the hospital. They had no clue, and were completely unhelpful and kept repeating that the price I’d pay depended on my insurance. I explained I understood that, and was just trying to get “rack rates.” That confused them even more. I tried to find out who in the hospital was responsible for setting rates. No luck.
> 
> I spent a good 2 hours trying to track down the cost for this one lab, and ultimately gave up. Apparently I was the first person ever to want to know the price of a health procedure before I had it.

Nothing is funnier than trying to find out what a procedure costs. No one has a fucking clue. My wife needed a vaccination so she called her insurance, they needed to know what “code” the doctor would use. She called the doctor’s office and they haven’t a sweet fucking clue. The poor girl that answers the phone seems to know nothing other than how to hold the receiver. Eventually the answer was, “depends on your insurance.”

As far as I can tell, when a doctor does something, they record it as a code. Then something happens. Then the insurance company gets the code and translates that into something. And then some how money is sent back to some one. In the mean time I get four or five bills–mostly in code. The doctor doesn’t know what the code costs, and the insurance industry doesn’t know what the code does.

In what other industry would we tolerate that?

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**Author:** ![Carol\_the\_Impaler](https://avatars.discourse-cdn.com/v4/letter/c/6a8cbe/32.png) [@Carol\_the\_Impaler](https://boards.straightdope.com/u/Carol_the_Impaler)\
**Post date:** [June 23, 2010, 9:57pm UTC](https://boards.straightdope.com/t/700-health-insurance/543986/140 "2010-06-23T21:57:50Z")

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None. In NO OTHER industry would you be expected to purchase a service without having any idea what it would cost.

I had this same experience trying to figure out how to get a $35 mammogram and then also when trying to get some bloodwork done for my psychiatrist. I ended up not getting the mammogram because no one, NO ONE, could tell me where I could go to get this magical, illusive $35 mammogram that my insurance brochure says they provide. With the bloodwork, I went to my GP, explained the problem and she made notes in her chart such that I would get my blood work done without cost. Essentially, she and I colluded to falsify my paperwork to avoid me having to pay hundreds of dollars to get my cholesterol, fasting glucose, etc., for my psychiatrist.

I told my bosses (both against UHC, BTW) that this is why people clammor for UHC. I don’t give a shit if it destroys our way of life, \*I just want to know what services are covered and how much it’s going to cost. \*

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