<p>The title there is wrong: it says 1% of Americans PAID 22% of health care costs. Actually, the point is that they racked up 22% of costs, not paid for them.</p>
<p>But is this a bad thing? Or a good thing? Really what insurance is for? People involved in accidents, aggressive cancers and major heart attacks, difficult births and neo-natal care, last year of life, etc.</p>
<p>(My wife does hospice care, which is one of the ways costs have been brought down.)</p>
<p>When I administered benefits for a nonprofit, and I was finding an insurance program for our employees, our insurance broker told me that 20% of the insured use 80% of the services, so that 80% of us are paying for the 20% frequent users.</p>
<p>I do believe that is true, in what I have observed. </p>
<p>Yes, all of us will end eventually end up in the group using the most care, but the reality is that, within any age group, you will find that, just like any insurance, the high users are subsidized by the infrequent users.</p>
<p>I still don’t see why this is supposed to be problematic. Of course, it would be great to find ways to control expenses better. (Though there’s a lot of profit to be made in not doing so.) But even then, I doubt the calculus would change much. That’s the way insurance works. Hey, I have auto insurance - I’ve never had to use it. I hope it stays that way. But I’m not driving without it.</p>
<p>And, no, 80% are not “paying for the 20%”. 80% are paying for INSURANCE, which they hope never to have to use.</p>
<p>Or stated another way: Most people a pretty healthy. Even among people requiring health care, 95% get better with only modest, inexpensive treatments. Only 5% are sick enough to require expensive care.</p>
<p>Exactly. And because you don’t know in advance whether you’ll be among the 5% incurring major costs or the 95% not incurring major costs, it’s sensible to be well insured. </p>
<p>I consider myself extremely fortunate to be among the 95% who aren’t incurring major health care costs* this year* even though it means I’m paying out more than I’m “getting back” in medical benefits. That just means I’m healthy–and frankly, that’s worth a whole lot more to me than the dollar value of the “benefits” I’d be getting if I suffered a catastrophic accident or major illness. Yet I don’t mind paying for insurance against the possibility that I’ll be among the 5% next year or somewhere later down the road; if and when that happens, it will be worth every dime I’ve ever put into it to be fully covered, because the alternative is financial ruin. That’s just how health insurance works: you pay for it and hope you never need it. Same as car insurance, liability insurance, or property insurance on your house.</p>
<p>However, the way medical costs are paid for these days in the US, many of the modest, inexpensive treatments must be run through the insurance bureaucracies, which significantly increases the cost involved, as well as introducing a third party into the medical decision.</p>
Well, actually, the chances are good that if you’re not an old white woman you won’t be one of the 1%. Hence, it’s not likely to become a political issue, although perhaps it should be.</p>
<p>The health care funding crisis isn’t due to the young, or minorities. It’s old white people.</p>
<p>
And…why? Why do we, as a society, elect to dedicate a huge portion of our public funding to paying for medical care for old people on the brink of death? Instead of people in their first year of life?</p>
<p>This is what I don’t get. The biggest part of the top 1%, 5%, 10% aren’t just regular folks with the bad luck to get cancer or be in a horrific accident - it’s old people whose bodies are just trying to figure out how to die. It’s the elephant in the room nobody wants to talk about.</p>
<p>None of us begrudge the insurance roll of the dice for the young. We’d all rather pay the premiums and not need the expensive medical care than the other way around. But old people? Should society be paying a major part of the governmentally-funded health care dollar on “last year of life” for 80+ year olds?</p>
<p>kluge,
As the son of a father who died in his 70s after a long but valiant bout with cancer, and a mother who would have died in her 70s of a rare (but as it turns out treatable) kidney disease but instead is still living well into her 80s, and as the son-in-law of a mother-in-law who is still going strong well into her 90s but needs frequent check-ups for eyes, ears, joint pain, and general medical condition, I am deeply, deeply grateful for Medicare, and happy to contribute every dime I put into it. Because we love and deeply care about each of these elders, and we would have been benkrupted three times over trying to care for them on our own dime. </p>
<p>Of course, we could have just said, “Screw it, he’s old, she’s old, they’re just not worth it, let them suffer and the sooner they’re dead, the better.” But we’re just not that kind of people. And I hope we’ll never be that kind of society.</p>
<p>Unless you die suddenly, the last year of your life is going to be a period when you have a serious illness, pretty much by definition. Serious illnesses cost money. </p>
<p>I don’t see why these statistics are in any way unexpected. Despite increases in preventive medicine, the biggest bucks are still spent on the treatment of serious illnesses.</p>
<p>Tough topic. I agree with many who have posted how grateful they are for Medicare that provides for our elderly (which we all will be). However, there does need to be some control over some of the expenses. My dear father who had late stage Parkinson’s with severe demetia and was not ambulatory was offered a hip replacement! We declined the treatment and gave him palliative care only. I know this is anecdotal, but I saw lots of money being spent in similar situations in the places where he was. We did not love him any less, but were thoughtful about what treatment made sense. Several of the staff commented to my mother that they respected her decision and how rare it was. Medical dollars are a finite resource and allocation decisions are very difficult.</p>
<p>Okay. I died at the age of 57. Without extremely expensive and unexpected medical care, I would already have had my last year of life. My wife at an even younger age had an extremely aggressive form of breast cancer. She would have had her last year of life, too. (thank heavens for our particular insurance - I’ve posted that story before. And I’m still not over my huff from last week, when our insurance turned a 3-hour operation into a 7-hour one for my wife - and I mean PURELY the insurance issue.) </p>
<p>Medicare does an excellent job of controlling expenses. Administrative costs are under 3% (compared with more than 20% on average for private insurance). Hospice reduces end-of-life care very substantially, and increases quality of life. Could they do better? You bet! But much of our funding difficulties would be solved tomorrow if we had Medicare for everyone. </p>
<p>Again - I don’t see the problem. This is one of those “factoidals” that just feeds meaningless quasi-political dialogue.</p>
<p>^^ I agree, mini.
And the fact that chemotherapy treatments may cost upwards of $20,000 per treatment doesn’t mean we should deny care to people who need it. Exactly why are these treatments so expensive? Who is benefiting from these prices?</p>
<p>I have two injections every month. They are two different medications, and the manufacturer charges $1900 each.Private insurance picks up a good part of that. But $1900 for an single injection makes me shake my head. $3800 a month for meds I could be on for years. I really don’t get it. How do the pharma companies come up with that number? And I don’t have a rare disease.</p>
<p>Yes, we are the kind of society that, because our resources are so wholly exhausted by the last year of extraordinary care of 80 and 90 year olds, we don’t build the schools we need to build, pay teachers enough, focus on science, etc. etc. We are the kind of society that says that since old people vote and young people don’t, then we will do what old people want to do instead of what society should should be doing: raising smart, intelligent adults. Yep, we are the kind of society in which codgers rule and dam* the rest of us. Let’s spend that $250,000 for treatment for the last 90 days of some 88 year old’s “life” instead of investing this amount in a new school or teacher training. Absolutely. That’s the kind of society we are. Society is about choices, and ours has made the choice to serve the old at the expense of the young so that, eventually, our society will indeed collapse because the young are and will become stupid. That’s not MY society, by the way. If the old want more care beyond a certain age, they pay for it themselves. If they can’t afford it, the government pays for palliative care only.</p>