I just paid for my car insurance and it got me thinking about paying for the bodily injury part of my premium. As I understand it, part of the reason we pay for such things is because if I get in to an accident, my insurance company will try to not pay for my medical bills if it wasn’t my fault. The only time I was on a jury was one person was suing another only for the medical bills, not pain and suffering.
That got me to thinking about the other ways I pay for insurance. As a swimmer I have to pay for insurance to the national swimming club to be able to swim with a team. If I do a meet part of what I pay for goes towards the insurance. Same way with other sports that I’ve taken part in, at least part of the money goes towards such insurance. I get it’s not much at all, but some at least.
My question is, has anyone ever calculated out how much one might save if there was UHC of these kinds of costs? I’ve not seen it come up when I’ve looked. I get that we would still need some sort of insurance for things, especially if someone is suing, but it seems there would be savings base upon the fact that one wouldn’t need to even think about the heath care aspect of it any more.
I’m only asking about the ‘hidden’ costs of health insurance and not how taxes would change or anything like that.
I don’t have the number you are interested in, but people certainly do attempt to calculate this sort of thing.
My worker health insurance is backed by a single insurer. My driver health insurance is backed by a single insurer: in neither case will there be court cases about who pays for my injuries, because it’s just one agency. Unless for some reason Workcover go involved in an argument with Transport Insurance Agency which couldn’t be resolved by knocking a few heads together at a political level…
My country is working towards a kind of single insurer for sporting injuries. It’s difficult. Part of the problem is that people are actually effectively uninsured for some of the things that happen in life.
What if you play football and get a broken back, or early onset dementia, or a detached retina. How much does your existing insurance pay for that? Probably not nearly as much as you would trade if for.
I’ve always been astonished at the cost of USA car insurance.
I drive mid-range 4-seater that is tedious but workmanlike and probably in the range of £20-25k new. My wife and I have the same fully-comprehensive policy with car hire provision, legal cover and european insurance and breakdown cover. There’s a £100 excess for all claims and £50 for windscreen replacement. It costs us £300 for a year in total. I’m sure at last part of the difference between the UK and USA insurance costs are down to your healthcare costs.
I pay $840 USD per year, for what is called “basic coverage”… I’m covered if I injure somebody, but nothing goes toward the repair of my vehicle, unless somebody else is at fault and their insurance covers it. No repair coverage of any kind, no roadside assistance… just meets the legally required minimums to keep me on the road.
It may not just be a matter of market forces responding to cuts in the cost of medical care. AIUI, here in the UK there are more direct legal restrictions on what damages may be awarded for accidents, as well as for medical errors by the NHS, and a statutory scheme for the NHS to reclaim coats of treating road accident injuries from insurance companies (which brings in anywhere between £15-20million a month).
But it would all depend on how much your legislators would be willing, or constitutionally allowed, to restrict legal and market processes in that way
In Australia UHC does not cover you in car accidents or workers compensation cases when your covered by insurance. If your insurance denies the claim you may be able to claim on private health cover or UHC. Naturally the insurance company will try and sue the party at fault .
Just as matter of interest what would an equivalent policy to ours cost in the USA?
Two people over 40 with clean records and no claims in the last 5 years and low crime rural environment. I’ve tried to use some sites in the USA to get a rough estimate but I can never get them to accept the fake names, number and addresses I need to provide.
In Quebec the province provides insurance against all personal injury claims. People are treated under medicare, if resident, or the insurance if not. On the other hand, you cannot sue for massive amounts of losses; it is just not permitted. Property damage insurance is private, but the cost is reasonable.
In Philly where I grew up, auto insurance is extremely costly. Part of the reason is reputedly due to one person: My cousin Jimmy who finished law school and immediately opened up an ambulance-chasing operation in the mostly black part of South Philly.
Ummm… I thought that the point of UHC was to treat everyone and not worry about where the money comes from? Is that not the case in many places? What’s the difference if I have a car accident and break my leg or slip on wet pavement and break a leg?
Australian UHC isn’t fully universal. It’s just not as messed up as in the USA.
Last I looked, hospitals have 3 main price lists: Medicare (UHC), Transport Accident Commission, and Private. Doctors have Bulk Billing, Normal, and Fully Private: the Bulk Billing price is imposed by the government, the Normal price is compared to a published industry standard, and the Fully Private price for optional beauty therapy is whatever you can get.
If I have a car accident, I expect my health costs to by paid by the Transport Accident Commission. At some point, the TAC may tell me to F off, and if I still demand more hospital treatment, it will either be Medicare/State (a mixture of federal and state funding) or Private.
The TAC and Workcover may try to convince me that I don’t need treatment. They may even lie about it. When I go into hospital, the hospital may not be sure who is going to be paying: as an accident victim, I would probably be treated as a public patient rather than a private patient. TAC or Workcover may deny liability. This will sometimes develop as an argument between me and TAC or Workcover. It is rare that it becomes an argument between TAC or Workcover and my Private insurance company unless it’s actually got me in the middle between them.
As far as the UK is concerned, the cost recovery from insurance companies in respect of traffic accidents comes well after, and entirely separately from, the treatment, and the patient has nothing to do with it, once the relevant companies have been identified.
AFAIK, no-one’s seriously considered trying to chase down insurance claims for the NHS in respect of other sorts of accident: presumably that wouldn’t be cost-effective (whereas in an RTA there’s a high probability of getting a worthwhile amount from the insurance companies).
(The NHS doesn’t work on pay-as-you-go per item of service, but on annual budget allocations: cost recovery in this way is a bonus).
Any healthcare system can have whatever limits you choose to set on it, whether in terms of the people to be covered or treatments or patient contributions. The key question is, how transparent, comprehensible and publicly accountable are the criteria and processes by which those decisions are taken?
In Canada, much of injury costs in traffic accidents is covered by provinces’ health care. There will be some exceptions like extended physiotherapy, loss of income, etc. - but generally there are very few lawsuits because there are no major medical bills to argue over. Any arguments in court tend to be over the value of car repairs. Plus, several provinces have the socialist horror of government-run auto insurance, thus resulting in cheaper insurance and less onerous conditions. (When I lived out west, there was no extra premium for 18-25 drivers; any licensed driver who borrowed your car was covered) Also note that Canada has the requirement that most of the time, the losing party pays the winner’s legal bills, which discourages the “pay me to go away” lawsuits. Cousin Jimmy would have to get a real job. Also, as Hari notes, some provinces help cap their insurance fees (especially provincial run plans) by mandating what the awards will be for some injuries - you don’t get to claim years of on-going payments for chronic pain if there’s almost no damage to the car.
Here in New Zealand, medical costs are covered by the health care system (mostly free, although with some part changes for Doctors visits and prescription charges).
Additional consequential costs of an accident causing injury may be fully or partially met by the Accident Compensation Commission - a publicly managed insurance scheme that covers the impact of accidents. ACC will cover loss of earnings (up to 80% of salary), non-free treatment such as physiotherapy, and consequential costs such as living space modifications due to life-changing injury. They also assist with rehabilitation and retraining into the workforce as required.
Because we have ACC, there is no general recourse to personal injury legal action.
ACC is funded by levies - part of the annual vehicle registration fee goes to ACC. Employers pay an ACC levy. Sports organizations pay ACC levies. The govt backs ACC, but the aim is to ensure that it is entirely funded form levies and investments.
Because of ACC, these sorts of costs do not need to be covered by insurers, and this should make insurance costs cheaper. This is partially offset by the smaller pool of people paying insurance premiums in a small country.
Ours is about $500 a year. So not terribly more. Some may have to do with the amount that is driven. I am sure the average American drives more than the average European.
is it an equivalent policy? does it covers your own car for damage etc? and when you drive it in other countries? yours seems a lot lower than others USA people have quoted
I’ve got the minicar on The Gold Plated Plan and it’s less than that. Legally-required insurance would be below 200€.
The Gold Plated Plan includes roadside assistance, transportation, replacement up to one week, assistance for third parties and vehicle occupants including driver… in some fifty countries. Pretty much all of Europe, plus some parts of Asia and Africa.
Spain’s UHC separates “work related care” and “non work related medical care”, because being fit to move around is not the same thing as being fit to work. The money all comes from the same bag and gets allocated in bulk to different smaller bags based on historical records, but the administrative bodies and some procedures are different. From the point of view of the patient the main difference is that you may need to see an additional doc to get the A-OK.
ETA: is there a specific word for “the end of medical leave”? In Spanish both the leave and its beginning are called baja (inactive, inactivation), the end and the normal situation are both called alta (active, activation).
Car insurance prices in the US depend in part on where the car is garaged - there are a lot of cars that never leave NYC with Virginia/Florida/Georgia plates because the insurance is cheaper in those places.
Another area of potential savings is reduction of malpractice litigation. In the US system, if you go in for a medical procedure and it goes badly wrong, meaning you n the d additional health care to fix it, where’s the money come from? One obvious answer is to sue the hospital, doctor and medical team members to access their professional negligence insurance, and to try to argue that they all screwed up, not that the outcome in your case was one of the reasonable possibles, as all medical procedures carry some degree of risk.
Different in a UHC system, because on the same facts, your cost of treatment to fix it is already covered by UHC. That doesn’t mean there’s no malpractice suits in UHC countries, just that there’s little incentive if the main goal is treatment costs.
Plus, in Canada - perhaps you can verify this - loser paying winner’s legal costs is a major deterrent to frivolous lawsuits.
Another very important point - there is one provider, and their fee schedule and what is covered under what conditions is widely known. (Usually, anything medically necessary and not too experimental). There is no major mess of different forms to fill out, no overtesting to prove to the insurer the treatment is necessary, no trying to figure out everyone’s billing rates, no need to track every tongue depressor and aspirin for accounting purposes (medication still goes on the chart), or tracking which pieces of equipment the patient “rented” for how long. In the USA these billing forms are processed by the insurers, another layer of staff that does not exist - despite denials, most insurers most definitely have people to vet requests for treatment and scrutinize billing for areas where they can deny coverage, then there’s the back and forth between hospital and insurer and patient to keep adjusting the bill until it can get paid. This layer of accounting and bureaucracy has to be expensive.
None of that is productive medical treatment, and none of that is necessary in Canada. A massive amount of paperwork and make-work disappears. zIf a specialist says “yes you meet the criteria for hip replacement” you go on the list and wait depending on urgency for a few months to a year. This is the downside of UHC - people actually use it, so there’s a lineup. However, everyone is equal. You don’t go to the front of the line because your insurer pays better, it’s based on how necessary (i.e. how immobile or in pain are you without the new hip?)