# Would universal healthcare be more expensive or less than the current US system?

**URL:** <https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175>\
**Category:** Great Debates\
**Created:** [February 24, 2009, 8:01am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175 "2009-02-24T08:01:17Z")\
**Posts on this page:** 20\
**Page:** 21

<div class="post-metadata">

**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\
**Post date:** [March 18, 2009, 8:43am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/401 "2009-03-18T08:43:26Z")

</div>

> [@curlcoat](#):
>
> Because they aren’t. First, insurance companies set their premiums based on what their accuaries tell them will cover a high percentage of the subscribers, so it isn’t often that people go way over what they/their employers pay.

It is expected that a certain number of people will, at some point, cost the system way more than they have put in. Who covers those people? The other people paying premiums.

> [@](#):
>
> Second, insurance companies invest the money we pay in, so a subscriber has to use up well over what they/their employers pay in before they are actually taking money out.

Insurance companies can’t invest all the money they receive in premiums, a certain amount must be kept in reserve in order to quickly pay out for claims and the types of investments they are allowed to make is limited and regulated.

> [@](#):
>
> Third, me personally - I have never been on maternity nor raised children, which are the biggest money sucks for insurance companies until folks get into old age.

Yet you claim to be disabled - you require no medical care in connection with that? And even if YOU have avoided accidents and expensive diseases, things like cancer, accidents, and other highly expensive problems occur in people of all ages. While on average maternity/child care are the most common expenses, they are NOT the “big money sucks” - the big money sucks are cancer, heart disease, diabetes, and severe trauma. All of those strike people of all ages, with trauma being more common in the young and the others more common in age but none of them respect either age or youth.

> [@](#):
>
> I’ve been paying group insurance premiums for almost 27 years so even if I do get something expensive, I’ve got quite a bit of money invested in the insurance system.

No, hon, you are NOT “invested” in the insurance system. Lose your insurance you are SOL. There is not a pool of premium-derived money sitting somewhere with your name on it. Most of what you paid in premiums (between 90% and 97%, depending on the company) has already been used to pay for claims. Some of those claims are yours, some belong to other people.

> [@](#):
>
> All of which would have been semi-obvious if folks would just remember - insurance companies are for-profit businesses!

Actually, some of them _aren’t_ - most Blue Cross Blue Shield companies, for example are _not_-for-profit. As they insure somewhere around 100 million people that means a substantial number of folks are getting their health insurance from a not-for-profit corporation.

---

<div class="post-metadata">

**Author:** ![hobscrk777](https://avatars.discourse-cdn.com/v4/letter/h/a6a055/32.png) [@hobscrk777](https://boards.straightdope.com/u/hobscrk777)\
**Post date:** [March 18, 2009, 2:19pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/402 "2009-03-18T14:19:55Z")

</div>

It seems to me that curlcoat is under the assumption that she will never take more out of insurance than she puts in (which has been thoroughly debunked by the previous two posters). She seems to think that her insurance company is just investing the premiums she sends in and socking it away for a rainy day. If this is the case, why doesn’t she just cut out the middle man and invest it herself?

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 18, 2009, 8:22pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/403 "2009-03-18T20:22:07Z")

</div>

> [@Desert\_Nomad](#):
>
> I guessed. I honestly have no idea, but do know that roughly 40% of all the people I know have no insurance.

Which means nothing. Everyone I know does have insurance - which one of our personal experiences is more valid? That’s right - neither one.

> [@](#):
>
> I understand that because YOU have insurance it is not a concern for you and that I and 40% of the people I know must be irresponsible.

You understand no such thing. What I have said is that whenever I have had a decent number of facts of the choices that uninsured people in trouble have made, I’ve almost always found irresponsible choices made, usually far previous to their current trouble. Things like not bothering to get an education, having children long before they can actually afford them, running up large credit card debt, buying more house/car than they can afford, no savings, and on and on. I have also said that I realize that not every uninsured person in trouble falls into this catagory, but I do believe that most of them do, and so am not willing to support a multi billion dollar experiment to either cover a few people down on their luck thru no fault of their own, or cover everyone and therefore encourage even more irresponsibility and dependence on the government.

> [@](#):
>
> I am not really sure why I keep up this discussion. :rolleyes:

Well, I do it when I get bored when I need to rest…

> [@](#):
>
> Since you seem to think the reason I can’t get insurance is because of my higher risk factor… ok. Why then can’t I get insurance which _excludes_ all factors related to my condition. Nope, can’t get that either. So if I get hit by a bus, I just sue the bus company I guess.

I have no experience with private insurance so I don’t know why you can’t get coverage for your health other than your “condition” - it’s possible that it would potentially affect so many different organs that it simply isn’t worth it to them to write you a policy. However, you are the one that says that you cannot get insurance because of it.

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 18, 2009, 8:49pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/404 "2009-03-18T20:49:22Z")

</div>

> [@tumbleddown](#):
>
> And when someone develops cancer, or their child does (and believe you me, doctors are extraordinarily aggressive with cancer in children) any balance on the paid in vs. paid out scale goes out the window.
> 
> When someone is in a car accident and requires high level trauma care, any balance on the paid in vs. paid out scale goes out the window. (Even moreso if they’re injured with other members of their covered family.)

Aaaand, then there are posters that are worse than being bored, because they keep repeating the same things over and over. Without looking into the facts at all.

All I’m going to say to this, that I haven’t already said, is that in the case of an accident, car insurance is required to pay first.

> [@](#):
>
> Yes, and they maximize their profit by denying coverage to people like Desert Nomad, denying it to people like me unless we pay twice as much for the exact same product, denying it to people like my friend in situations where their reasons directly contravene medical advice, denying it to my former boss who neglected to call ahead for authorization for care when his son got _run over by a car_ and they scooped him up and drove him 2 blocks to the nearest hospital with multiple life threatening injuries, (they wanted them to take him to a hospital 30 minutes away, apparently, it took a lawsuit to get their decision reversed) and cutting lowball deals with hospitals where after all the money that’s paid into them, they still don’t pay hospitals the full cost of procedures and services anyway.

Exactly! Insurance companies are not made of money, they have to control costs some how, and (again) _insurance is not a right_. There isn’t even a law that says that insurance companies have to cover anyone and everyone, because guess what? It would’t work!

And what do you think the government is going to do? One of two things - either what you are already hating on insurance companies for, or tax the hell out of those who can still afford it.

> [@](#):
>
> They play with people’s lives and wellbeing to put dollars into people’s pockets. It says a lot about our shared morality that so many people think that this is the best that we can or **should** do.

Oh piffle. You want to talk morality? How is it “moral” that you expect me to pay for all of the choices that other people make? I’m already required to pay for pregnancies, child healthcare, education and in the case of all of those who couldn’t actually afford those kids, food and shelter. Meanwhile, they are free to spend their money on everything else and **then** , when they get into trouble, you think it is “moral” to expect me to bail them out? Forget the insurance companies - _I’m_ not made of money!

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 18, 2009, 9:00pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/405 "2009-03-18T21:00:06Z")

</div>

> [@Broomstick](#):
>
> It is expected that a certain number of people will, at some point, cost the system way more than they have put in. Who covers those people? The other people paying premiums.

Sigh, no. The insurance company invests your premiums - _that_ is where the extra comes from. Your premiums do not jump several hundred dollars each time someone in your group gets cancer treatment do they?

> [@](#):
>
> Insurance companies can’t invest all the money they receive in premiums, a certain amount must be kept in reserve in order to quickly pay out for claims and the types of investments they are allowed to make is limited and regulated.

And?

> [@](#):
>
> Yet you claim to be disabled - you require no medical care in connection with that?

Not $500 - $1000 a month (depending on how much my husband’s employer pays in premiums) worth I don’t. Not even close. Obviously you also have little idea what being disabled is all about as well.

> [@](#):
>
> While on average maternity/child care are the most common expenses, they are NOT the “big money sucks” -

Did you bother to actually read what I wrote?

> [@](#):
>
> No, hon, you are NOT “invested” in the insurance system. Lose your insurance you are SOL. There is not a pool of premium-derived money sitting somewhere with your name on it. Most of what you paid in premiums (between 90% and 97%, depending on the company) has already been used to pay for claims. Some of those claims are yours, some belong to other people.

Where in the world are you getting your numbers?

> [@](#):
>
> Actually, some of them _aren’t_ - most Blue Cross Blue Shield companies, for example are _not_-for-profit. As they insure somewhere around 100 million people that means a substantial number of folks are getting their health insurance from a not-for-profit corporation.

They still run their businesses in the same way as for-profits, they just don’t pay out the salaries that the for-profits do, and there are some minor laws about how much reserve they have to have. They are also more subject to going in the toilet and leaving their subscribers stranded - Kaiser had to be bailed out by the government, um, 15? years ago? Something like that.

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 18, 2009, 9:12pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/406 "2009-03-18T21:12:16Z")

</div>

> [@hobscrk777](#):
>
> It seems to me that curlcoat is under the assumption that she will never take more out of insurance than she puts in (which has been thoroughly debunked by the previous two posters). She seems to think that her insurance company is just investing the premiums she sends in and socking it away for a rainy day. If this is the case, why doesn’t she just cut out the middle man and invest it herself?

Actually, nothing I have said has been debunked by anyone in here. I also have not said that I will never take more out of insurance than I’ve put in, it’s just really unlikely at this point given I’ve been paying in for almost 30 years and never taken out more than I’ve paid in - that’s a heck of a lot of payout they would have to do, particularly when you add in the income those insurance companies have earned using my premiums.

How old are you people? Why can’t you grasp the idea that no matter how many subscribers a group has, there is _no way_ that the premiums they pay cover all of the expenses the insurance company pays out to them?

As for cutting out the middle man, hello? Purpose of insurance? Would you advocate “cutting out the middle man” for car insurance? Life insurance? Yes, if I’d known in 1980 that I’d never need any expensive treatment, it would have been better if I’d taken the money I paid into premiums and saved it, but I didn’t know that back then, did I?

---

<div class="post-metadata">

**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\
**Post date:** [March 18, 2009, 9:44pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/407 "2009-03-18T21:44:30Z")

</div>

> [@curlcoat](#):
>
> I’ve almost always found irresponsible choices made, usually far previous to their current trouble. Things like not bothering to get an education, having children long before they can actually afford them, running up large credit card debt, buying more house/car than they can afford, no savings, and on and on. I have also said that I realize that not every uninsured person in trouble falls into this catagory, but I do believe that most of them do, and so am not willing to support a multi billion dollar experiment to either cover a few people down on their luck thru no fault of their own, or cover everyone and therefore encourage even more irresponsibility and dependence on the government.

The people I know who are self employed are nearly all contract workers in IT or finance… these are the folks that can’t get insurance… although several are leaving the USA and taking their jobs and money with them.

---

<div class="post-metadata">

**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\
**Post date:** [March 18, 2009, 9:48pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/408 "2009-03-18T21:48:00Z")

</div>

> [@curlcoat](#):
>
> Sigh, no. The insurance company invests your premiums - _that_ is where the extra comes from. Your premiums do not jump several hundred dollars each time someone in your group gets cancer treatment do they?

Of course they do… at least when they are first diagnosed with something serious. It happened to my previous employer while I was in the 12 month waiting period for insurance and they decided to drop coverage for everyone… which meant I never got any.

---

<div class="post-metadata">

**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\
**Post date:** [March 18, 2009, 9:49pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/409 "2009-03-18T21:49:34Z")

</div>

> [@curlcoat](#):
>
> How old are you people? Why can’t you grasp the idea that no matter how many subscribers a group has, there is _no way_ that the premiums they pay cover all of the expenses the insurance company pays out to them?

Then every insurance company would be bankrupt.

---

<div class="post-metadata">

**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\
**Post date:** [March 18, 2009, 11:08pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/410 "2009-03-18T23:08:16Z")

</div>

> [@curlcoat](#):
>
> > [@](#):
> >
> > Since you seem to think the reason I can’t get insurance is because of my higher risk factor… ok. Why then can’t I get insurance which _excludes_ all factors related to my condition. Nope, can’t get that either. So if I get hit by a bus, I just sue the bus company I guess.
> 
> I have no experience with private insurance

YES you DO! Unless you are on Medicaid, Medicare, or the Veteran’s Administration programs YOU HAVE PRIVATE INSURANCE! Even frackin’ _Congress_ has _private_ insurance! (I know this because I used to work for one of the companies that covers Congress)

The word you are looking for is actually a phrase - _an individual policy_. As opposed to a group policy, which is presumably what you have. You’d have a lot more credibility in this discussion if you would know and use _basic insurance terms_.

> [@](#):
>
> … so I don’t know why you can’t get coverage for your health other than your “condition” - it’s possible that it would potentially affect so many different organs that it simply isn’t worth it to them to write you a policy.

I which case it simply sucks to be him, huh? I can’t fathom being so unsympathetic to someone who was BORN with a condition and has no opportunity to plan ahead, save money, or otherwise cover his own self.

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 18, 2009, 11:18pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/411 "2009-03-18T23:18:27Z")

</div>

> [@Broomstick](#):
>
> YES you DO!

Read my lips - just because you want to change the way industry uses terms doesn’t mean it’s going to happen.

> [@](#):
>
> You’d have a lot more credibility in this discussion if you would know and use _basic insurance terms_.

Uh huh. You have proven over and over you don’t know much of anything at all about how insurance works, and now you are going to try to tell me how they term things? :rolleyes:

> [@](#):
>
> I which case it simply sucks to be him, huh? I can’t fathom being so unsympathetic to someone who was BORN with a condition and has no opportunity to plan ahead, save money, or otherwise cover his own self.

Well, a) his only problem is he doesn’t like where he is living, b) he could get a job where there is group coverage, except that would mean he would probably be living someplace else he wouldn’t like (i.e. not Nevada), and c) his parents had 18 years, at least, to get him ready for this.

Now, explain to me how it is my responsibility to make it so he can live in Nevada?

And, **Desert Nomad** - your last three posts have been answered so many times, I just cannot bother.

---

<div class="post-metadata">

**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\
**Post date:** [March 18, 2009, 11:33pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/412 "2009-03-18T23:33:39Z")

</div>

> [@curlcoat](#):
>
> Sigh, no. The insurance company invests your premiums - _that_ is where the extra comes from. Your premiums do not jump several hundred dollars each time someone in your group gets cancer treatment do they?

It has been known to happen. It all depends on the size of the group that is covered. A small business with 10 or 12 employees might, indeed, see _everyone’s_ premiums jump by hundreds of dollars if just one person has an expensive disease or accident. The larger the group the less the jump per person.

There are instances where the premiums for a small group jumped so much that the company and its employees simply couldn’t afford coverage anymore - because one person got sick everyone at a company lost their insurance no matter how healthy they were.

> [@](#):
>
> Not $500 - $1000 a month (depending on how much my husband’s employer pays in premiums) worth I don’t. Not even close. Obviously you also have little idea what being disabled is all about as well.

The hell I don’t - you forgot my husband was born with spina bifida and now has diabetes? His prescriptions and medical supplies run about $400 a month, with quarterly blood tests coming in around $800. And he has a _minor_ case of spina bifida.

Not to mention that my mother suffered from crippling heart disease most of her life - a condition, I hasten to add, that was _genetic in origin_ and not something due to lack of exercise or poor diet - which required two open heart surgeries and multiple hospitalizations. We once estimated that over the years it has cost over two million dollars to keep my mom alive as long as we did, and we sure as hell never paid that much into the system. For the last 10 years of her life the co-pays on just her prescriptions were hundreds of dollars of month.

How arrogant for you to think that your disability is the measure of all other disabilities! You may know about YOUR problems but clearly you are ignorant of anything outside your own self.

> [@](#):
>
> Did you bother to actually read what I wrote?

Yes, but you clearly didn’t read what I wrote very carefully.

> [@](#):
>
> Where in the world are you getting your numbers?

I used to work in the insurance industry, specifically for one of the Blue Cross companies. Some of the Blue Cross family claimed to spend no more than 3% of their income on overhead, but 4-5% was more common. Other companies typically come in around 10%. There was one that went as high as 25% overhead but they are no longer in business.

> [@](#):
>
> They still run their businesses in the same way as for-profits, they just don’t pay out the salaries that the for-profits do,

Actually, that isn’t true - not-for-profits are just as capable of paying out salaries as high as those in private industry, and can even pay _more_. What they can’t do is _profit_. Any profit must immediately be turned back into the business - common ways to do that are upgrading equipment _and giving raises and bonuses to high performers_. Yes, they should run their companies in the black, but they don’t scrape money off the bottom line to give to shareholders so they don’t have to charge as much for the same thing (at least in theory).

> [@](#):
>
> and there are some minor laws about how much reserve they have to have.

Which can have major consequences - when I worked in the industry Blue Cross and Blue Shield of Illinois was required to keep a reserve of _over a billion dollars_. Don’t know what it is now since they’ve merged with three other Blue Cross companies and cover an even larger group of people.

> [@](#):
>
> They are also more subject to going in the toilet and leaving their subscribers stranded - Kaiser had to be bailed out by the government, um, 15? years ago? Something like that.

You can make that judgment based solely on _one company?_ The Blue Cross companies have been around over 70 years and in all that time only one has ever gone belly up and it was NOT “bailed out” by the government - the Blue Cross “family” covered the subscribers so they weren’t left “stranded”. Sorry to burst your bubble, but not all companies are alike. There’s a world beyond California.

---

<div class="post-metadata">

**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\
**Post date:** [March 18, 2009, 11:40pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/413 "2009-03-18T23:40:51Z")

</div>

> [@curlcoat](#):
>
> Well, a) his only problem is he doesn’t like where he is living, b) he could get a job where there is group coverage, except that would mean he would probably be living someplace else he wouldn’t like (i.e. not Nevada), and c) his parents had 18 years, at least, to get him ready for this.
> 
> Now, explain to me how it is my responsibility to make it so he can live in Nevada?

A) I liked living in Dubai, but my residence visa expired (and I have no option to renew it or else I would)… and Prague is ok in the summer at least. You **do** realize that one just can’t go live in another country because they feel like it, right?

I wish to live in Nevada for the same reason you wish to live in California… I lived in the state for 30 years and my friends, family and livelyhood are all based there.

B) Maybe. Do you know of any jobs for Mac software developers where I can earn $250K? I’d even be willing to take a 50% pay cut net of cost of living change. If you haven’t noticed, jobs are quite hard to come by right now.

C) My parents got me ready as best they could. I was under their insurance until i was 18 and my father assisted me in leaving the United States by allowing me to store my stuff at his home for 7 years until he died of cancer. My mother still has insurance from the airline she works for, but she can’t help me to get any as I am over 18.

For now I am temporarily in the US without insurance and trying every avenue I can think of before I give up and head back overseas.

---

<div class="post-metadata">

**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\
**Post date:** [March 18, 2009, 11:44pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/414 "2009-03-18T23:44:29Z")

</div>

> [@curlcoat](#):
>
> Read my lips - just because you want to change the way industry uses terms doesn’t mean it’s going to happen.

I’m sorry you refuse to have your ignorance corrected.

> [@](#):
>
> Uh huh. You have proven over and over you don’t know much of anything at all about how insurance works, and now you are going to try to tell me how they term things? :rolleyes:

Yep, I do. Because I worked for a major insurance company for 13 years. YOU are the one who is ignorant here.

> [@](#):
>
> Well, a) his only problem is he doesn’t like where he is living, b) he could get a job where there is group coverage, except that would mean he would probably be living someplace else he wouldn’t like (i.e. not Nevada), and c) his parents had 18 years, at least, to get him ready for this.

The ONLY way Desert Nomad could possibly get group coverage is to work for a huge company like an IBM or GM - small companies could not possibly afford to have him with his condition. Even if he got coverage at a big enough corporation he would be subjected to pre-condition clauses, meaning he’d pay just as much as everyone else and get less in return.

As for his parents “getting him ready for this” - what the hell do you expect people to DO? A child is born with an uncommon genetic disorder that was, until only a very few years ago, undetectable before birth. While they are paying for his expensive medical care as a child do you expect them to _save money_ on top of that? They would have to have TWICE the resources of an average person, if they’re lucky, to do as much. Then, when he’s 18 his parents’ insurance drops him like a hot potato. How many 18 year olds do you think get hired right away by an IBM or GM or Mircrosoft?

Even if he was an only child, even if his parents earned TWICE what you do a year and were investment geniuses _there is no way to get him insurance once he becomes an adult_. What part of that do you not understand? Any individual policy he could get would be prohibitively expensive, with monthly premiums in the four digit range. Many small employers would either not hire him, or seek any excuse to get rid of him once hired, because his presence in the group would drive up everyone else’s premium into the stratosphere. The ONLY way for Desert Nomad to get private health insurance is join a huge, huge corporation. The only way to get Medicaid is to be destitute. The only way to get Medicare is for him to be disabled (but if he’s working he won’t be considered disabled). The army won’t take him due to his genetic problem so he will never have access to the VA system. Maybe you think that’s OK, but I think it’s appalling that his only alternative is to leave his own country to get health care.

> [@](#):
>
> Now, explain to me how it is my responsibility to make it so he can live in Nevada?

Stop acting like you will be the ONLY person paying into the system! Poor little rich girl, can’t contribute even a penny to the greater good!

---

<div class="post-metadata">

**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\
**Post date:** [March 18, 2009, 11:46pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/415 "2009-03-18T23:46:43Z")

</div>

> [@Desert\_Nomad](#):
>
> For now I am temporarily in the US without insurance and trying every avenue I can think of before I give up and head back overseas.

The only ideas I can throw on the table is either work at a really big company where the group is large enough you can jump in the pool without major ripples, or try to get a government job. Federal employees, where covered (not all of them are) get good coverage, sometimes even great coverage.

---

<div class="post-metadata">

**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\
**Post date:** [March 19, 2009, 12:02am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/416 "2009-03-19T00:02:26Z")

</div>

> [@Broomstick](#):
>
> The only ideas I can throw on the table is either work at a really big company where the group is large enough you can jump in the pool without major ripples, or try to get a government job. Federal employees, where covered (not all of them are) get good coverage, sometimes even great coverage.

I am pretty much resigned to not being able to be insured in the USA until (fingers crossed) the Obama Administration can implement some sort of option buy-in w/o possibility of decline.

Huge corporations don’t really exist around here, and I have found that getting many government jobs requires a security clearance which is also difficult because of my long term residence overseas and esp. in the Middle East.

You are right… Small employers here that offer insurance are reluctant to take on anyone that would affect their premiums and if they have over 50 employees, you can be denied a group plan. I’m also not sure if the company would outlast the waiting period at GM. 😃

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 19, 2009, 12:18am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/417 "2009-03-19T00:18:53Z")

</div>

> [@Broomstick](#):
>
> There are instances where the premiums for a small group jumped so much that the company and its employees simply couldn’t afford coverage anymore - because one person got sick everyone at a company lost their insurance no matter how healthy they were.

Again, I am not interested in paying for a multi billion dollar experiment to cover things that happen here and there.

> [@](#):
>
> The hell I don’t - you forgot my husband was born with spina bifida and now has diabetes? His prescriptions and medical supplies run about $400 a month, with quarterly blood tests coming in around $800. And he has a _minor_ case of spina bifida.

And that, apparently, is the sum total of your knowledge of disability. You act like because I am able to type, or used to work, or - WTF - don’t have high medical bills, I am only “claiming” to be disabled. Guess what? Your experience with your husband doesn’t even scratch the surface.

> [@](#):
>
> How arrogant for you to think that your disability is the measure of all other disabilities!

Hon, it was _you_ who made assumptions about me, not the other way around.

> [@](#):
>
> I used to work in the insurance industry, specifically for one of the Blue Cross companies. Some of the Blue Cross family claimed to spend no more than 3% of their income on overhead, but 4-5% was more common. Other companies typically come in around 10%. There was one that went as high as 25% overhead but they are no longer in business.

And?

> [@](#):
>
> Actually, that isn’t true - not-for-profits are just as capable of paying out salaries as high as those in private industry, and can even pay _more_.

Did I say they “couldn’t”? They don’t tend to.

> [@](#):
>
> Which can have major consequences - when I worked in the industry Blue Cross and Blue Shield of Illinois was required to keep a reserve of _over a billion dollars_. Don’t know what it is now since they’ve merged with three other Blue Cross companies and cover an even larger group of people.

And how much reserve do you think Aetna or United Health has to have? Maybe you should check some insurance laws, hmm?

> [@](#):
>
> You can make that judgment based solely on _one company?_

No. I form opinions based on experience & facts and then I test the opinions out. I don’t make assumptions based solely on my life experience and then expect others to believe them.

> [@](#):
>
> The Blue Cross companies have been around over 70 years and in all that time only one has ever gone belly up and it was NOT “bailed out” by the government - the Blue Cross “family” covered the subscribers so they weren’t left “stranded”. Sorry to burst your bubble, but not all companies are alike. There’s a world beyond California.

OK, so. You ask me if I am making a judgement based on one company, and then you use as an example one company? What’s wrong with this picture?

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 19, 2009, 12:24am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/418 "2009-03-19T00:24:07Z")

</div>

> [@Desert\_Nomad](#):
>
> I wish to live in Nevada for the same reason you wish to live in California… I lived in the state for 30 years and my friends, family and livelyhood are all based there.

None of those are reasons why I like living in California, which is beside the point. If I had to leave here because of insurance, financial, job, whatever reasons, I’d go and I wouldn’t be whining about how other people should pay so I could go back.

> [@](#):
>
> B) Maybe. Do you know of any jobs for Mac software developers where I can earn $250K?

Don’t know, don’t care. It is not my responsibility to find you a job, provide you with insurance or teach you a skill that will get you group coverage. I do note that you are expecting to make more money than my husband does, even when you halve that, yet you all think _I’m_ “rich”? Snort

> [@](#):
>
> C) My parents got me ready as best they could. I was under their insurance until i was 18 and my father assisted me in leaving the United States by allowing me to store my stuff at his home for 7 years until he died of cancer. My mother still has insurance from the airline she works for, but she can’t help me to get any as I am over 18.

Which has nothing to do with anything. There are only so many times I will repeat myself before I get really bored with it.

---

<div class="post-metadata">

**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\
**Post date:** [March 19, 2009, 12:39am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/419 "2009-03-19T00:39:58Z")

</div>

> [@Broomstick](#):
>
> Yep, I do. Because I worked for a major insurance company for 13 years. YOU are the one who is ignorant here.

Wow. 13 whole years with one company in one state? I’ll see that and raise it to 25 years, in two states, with a wide variety of companies in a variety of jobs. I started at Aetna and my last job was with United Healthcare. In between were places like Kaiser, Pacificare, your precious Blue Cross and a few smaller ones. Now, you going to bother to check out any of those insurance laws?

> [@](#):
>
> The ONLY way Desert Nomad could possibly get group coverage is to work for a huge company like an IBM or GM - small companies could not possibly afford to have him with his condition.

You know this how?

> [@](#):
>
> Even if he got coverage at a big enough corporation he would be subjected to pre-condition clauses, meaning he’d pay just as much as everyone else and get less in return.

Why don’t you quote the _current_ pre-exist laws for group coverage here?

> [@](#):
>
> As for his parents “getting him ready for this” - what the hell do you expect people to DO? A child is born with an uncommon genetic disorder that was, until only a very few years ago, undetectable before birth. While they are paying for his expensive medical care as a child do you expect them to _save money_ on top of that? They would have to have TWICE the resources of an average person, if they’re lucky, to do as much. Then, when he’s 18 his parents’ insurance drops him like a hot potato. How many 18 year olds do you think get hired right away by an IBM or GM or Mircrosoft?

Wow, look at all the assumptions. Did he say anything about needing expensive medical care as a child? Did his parents insurance drop him at 18? If so, why wasn’t he in college? Did he _leave_ home at 18?

> [@](#):
>
> Even if he was an only child, even if his parents earned TWICE what you do a year and were investment geniuses _there is no way to get him insurance once he becomes an adult_. What part of that do you not understand?

It’s the part you don’t understand - as I said, go look at the pre-x laws.

> [@](#):
>
> Maybe you think that’s OK, but I think it’s appalling that his only alternative is to leave his own country to get health care.

So, again for the Xth time, your answer is to pay for a multi billion dollar experiment (I should make a macro for that…) to cover this one guy? Oh, and your husband?

> [@](#):
>
> Stop acting like you will be the ONLY person paying into the system! Poor little rich girl, can’t contribute even a penny to the greater good!

Snort. This is what it comes down to, doesn’t it? You think I’m some rich person who is acting like Scrooge McDuck with all this extra money I’m supposed to have somewhere. And all I have to do is send an extra $20 or $100 to the government and you and **Desert Nomad** will have your affordable, easy access, state of the art heathcare. The number of fallacies in that are amazing, but leaving that aside how about you answer this - what is so special about you that I should spend extra money on you, rather than saving it for our retirement, or using it to pay our bills, or donating it to cause that we think are worthy? What is it about you that makes you think you have the right to demand money from me? **This** is what I don’t get - I don’t go about demanding money from those who are actually rich, why do you think you should demand it from middle class me? Just because I have insurance?

---

<div class="post-metadata">

**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\
**Post date:** [March 19, 2009, 12:45am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/420 "2009-03-19T00:45:21Z")

</div>

> [@curlcoat](#):
>
> None of those are reasons why I like living in California, which is beside the point. If I had to leave here because of insurance, financial, job, whatever reasons, I’d go and I wouldn’t be whining about how other people should pay so I could go back.

But you said earlier you would not be able to go to Indiana because of the climate… and I’d assume this would also apply to Ohio, Pennsylvania and probably half the states. You said you had to live in California to maintain your situation.

> [@curlcoat](#):
>
> Don’t know, don’t care. It is not my responsibility to find you a job, provide you with insurance or teach you a skill that will get you group coverage. I do note that you are expecting to make more money than my husband does, even when you halve that, yet you all think _I’m_ “rich”? Snort

Yes. I think you are rich (but probably not wealthy - e.g able to live w/o working). And I think I am rich too (I never claimed otherwise). My $250K is gross and I have to pay all my business expenses from that as well as taxes, but I still take home a 6 figure income… that places me well above middle class. I am not trying to hid it - I earn a good income, but I would trade a good chunk of it for insurance.

[Previous page](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175.md?page=20)

[Next page](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175.md?page=22)
