<p>Medicare (as it is now) for all would cost more (as a percentage of GDP) than Canada care because the US government already spends as much (as a percentage of GDP) as Canada does now on medical care. But the US government covers only a quarter of the population with that spending, so extending it to the entire population would cost more (as a percentage of GDP) than Canada care, which covers the entire population.</p>
<p>It would likely be an improvement over what we have now, but if it happens without other Medicare reform, we will still be looking to Canada in terms of why they pay so much less to get similar or better medical care.</p>
<p>Yes, I understand profit margins and yes, employees of health insurance companies make good salaries, no I don’t agree with the huge bonuses that the top executives get, but they are still a drop in the bucket when you are talking about the amount of money that funnels through a major insurance carrier. Take away the big bonuses and the rates MIGHT decrease a few dollars/year. They are not the cause for the high premiums, just like the bonuses for employees at Target are not the reason why milk prices are so high.</p>
<p>Are “bad options” truly options? I’m going to speak here as one who does not have good options (in terms of being able to make a change.) Right now, we are blessed to have good coverage through my husband’s work, but at a high cost - we pay over $20,000 year in premiums (as a partner, he pays the full premium.) They offer just one plan, so no other option there. I am self-employed and am covered under his insurance. We can go to any doctor, but pay a co-pay for in-plan and a percentage of “reasonable and customary” costs out-of-plan. We have a high deductible and pay a fairly high co-pay for prescriptions. We rarely hit our deductible so in addition to premiums we pay a fair amount out of pocket. But if heaven forbid we had an accident or illness, we’re covered. So all’s good, right? Well…if he lost his job, we’d be up a creek. We both have pre-existing conditions and in the current system we are either uninsurable or could only get limited coverage at ridiculous prices (which would likely be unaffordable if he wasn’t working.) So we can’t go out on our own for a different plan.
Even as one who is (currently, fingers-crossed) insured, I would welcome a single payer plan such as Canada’s. I think the trade-offs would be worth it. And despite the fact that I have coverage, it really makes me feel sick (no pun intended) to think of the many who do not have that “luxury” - which really should be a right.</p>
<p>“Medicare (as it is now) for all would cost more (as a percentage of GDP) than Canada care because the US government already spends as much (as a percentage of GDP) as Canada does now on medical care. But the US government covers only a quarter of the population with that spending, so extending it to the entire population would cost more (as a percentage of GDP) than Canada care, which covers the entire population.”</p>
<p>So we are talking at cross purposes. Medicare-for-all would take ALL the money currently spent on Medicare, and ALL the money currently spend on private insurance, all money currently spent in charity care, and all the money spend on Medicaid, and, for per capita purposes, divide it among a slightly larger proportion of the population (because we’d be covering those currently uninsured). There would be immediate huge savings in emergency room costs and massive savings in administration/overhead/profit margins for insurers. There would be some bottlenecks, as a slightly larger population now has access to care outside of the emergency room. But costs would immediately shrink. They’d still be higher than Canada’s (again, I think Canada’s are a bit - but not hugely, too low), but they would be much lower than they are today. And everyone would be covered. And with access to primary care/preventive services, the number of high-intensity/cost interventions would also decline over time.</p>
<p>This would be before ANY reforms to what our current Medicare system looks like (which we agree has some perverse incentives built into it).</p>
<p>It really wouldn’t be so hard to do. But it would require political will.</p>
<p>Well, I’m all for universal care, but I’m not completely certain the number of high cost interventions would stop once everyone had access. The truth is that we are spending most of our money on end of life care.</p>
<p>This is, actually, why I can’t figure out the insurance rates. The largest density of high cost medical practices is already IN medicare. </p>
<p>Another factor to consider, in terms of cost, is the amount of money paid by insurance companies, right now, to DENY care. It’s a big expense for them. Plus their massive legal teams and accounting departments. I mean, I’m sure there are some groups who do NOT want the insurance companies to vanish.</p>
<p>Just to be clear, I have great insurance. Amazing insurance. The kind where, when my kid had an injury, they gave her the MRI TWICE, just because the first one was a “little fuzzy” and they cat-scan, and the follow up with the nuerologist, etc… that kind. and it cost me 75$.</p>
<p>And, here’s what’s wrong with that, I can afford to pay for all of that out of pocket. So, those of us who can pay for any kind of medical care in the world get the BEST insurance and the best care and the cheapest co-pays (our employers can’t do enough for us), and those who NEED the insurance and the low co-pay can’t get care. This is not human. This is a machine.</p>
<p>SteveMA, are you aware that the quotes you’ll see on the websites are not necessarily the premiums that will actually be charged to a given subscriber? You cannot possibly “shop” for dstark. You cannot know how he will be medically underwritten. Depending on his health history, the insurance company will probably increase the base premium. </p>
<p>It doesn’t take much to qualify for such increases. My DH was diagnosed long along with high blood pressure and high cholesterol. I daresay that very few people in our age bracket have NO preexisting conditions. Therefore, very few people are actually going to get the advertised rate.</p>
<p>And those increases are not small. DH’s preexisting conditions, in the eyes of Blue Cross, warrant a 50% increase from the base premium. It doesn’t matter that both conditions are now well-controlled. It’s the diagnosis that kills you, no matter how effective the treatment.</p>
<p>“The truth is that we are spending most of our money on end of life care.”</p>
<p>But that’s only in Medicare. The vast majority of private insurance companies are hardly spending anything (relatively speaking) on end-of-life care. So there’s no excuse there. </p>
<p>“Well, I’m all for universal care, but I’m not completely certain the number of high cost interventions would stop once everyone had access.”</p>
<p>Actually, we are already seeing that in Massachusetts (and have seen that in Canada for a long time.) Initially, of course, costs go UP and the number of interventions go UP, as there is a backlog of care needed. But over time it moderates.</p>
<p>LasMa–I am fully aware of that and stated so in several posts. The point being, you need to shop around for health insurance every year or so to keep on top of the price increases. Yes, it takes some work but that is why getting a broker is a good idea, it’s just a phone call then. I’m sorry but people make this much more difficult than it has to be because of false assumptions. It isn’t any different than shopping for auto or homeowner’s insurance. And, once again, IF you have coverage, pre-existing conditions do not matter if you shop for lower cost plans…</p>
<p>Since dstark started this thread by writing about Anthem Blue Cross, fellow BC sufferers (oops! subscribers) might find this article interesting: [Excellus</a> reports $223 million profit for 2011 | syracuse.com](<a href=“http://www.syracuse.com/news/index.ssf/2012/03/excellus_reports_223_million_p.html]Excellus”>Excellus reports $223 million profit for 2011 - syracuse.com) Our local not-for-profit Blue Cross Blue Shield just posted $233 million in profits last year. Way to go, guys! Our premiums have gone up (by as much as 12.5 percent), as have our co-pays. The quality of customer service is as abysmal as ever, as their “deny first and pay when they complain about it” policy is extended ever further. But the head guy’s salary nearly tripled. 66 employees, including a vast array of VPs, were paid between $200,000 and $5.6 million. And isn’t that what’s really important here? :rolleyes:</p>
<p>To reiterate, we DO have a broker and I HAVE looked around - every single year. We’re still stuck with a $5,000 deductible per person ($10,000 per family), then we pay 30% of expenses until we reach $10,000 OOP per person or $20,000 per family. This wonderful policy costs us $1,159 a month. Before long, our monthly premium will be more than our mortgage payment.</p>
<p>When you say they “do not matter” you must be referring to the requirement that they offer you something.But what they offer you may be nothing that looks like what’s on their web site. Like LasMa mentioned, any condition that requires any sort of monitoring will bring the premium up substantially, and you really have no idea what you will pay until you fill out their very detailed application and wait. Sometimes they will call you and grill you about your health history (as they did my daughter one evening while we were out to dinner) before they proceed with their answer. It’s not as easy as just checking a web site or a call to a broker in order to compare rates.</p>
<p>It’s much more time consuming and complicated, and nothing at all like car insurance or homeowners. OMG, those are a piece of cake! My daughter had a competitive AAA car insurance quote on the phone from a real, live person in 10 minutes. It took five weeks and three tries with three different insurance companies, as well as several emails and phone calls with a broker before she could find a suitable health policy, and only after documenting every encounter with a doctor she had experienced in the last seven years! </p>
<p>But, as I said in a previous post, getting insurance is sometimes the easy part. Getting the coverage you are due is another story, altogether.</p>
<p>I would be very scared to switch health insurance plans. If my premium jumped 25 or 50% I might start looking, but I like my plan benefits, so what if I switched and the new plan turned out to have some real problems - things that I couldn’t anticipate ahead of time - in that case I might not be able to go back to my old plan. It sure isn’t like shopping for milk and eggs at the store where we can buy from the cheapest source.</p>
<p>That must vary by state. In RI, BC/BS has 2 price levels for self pays…preferred and basic. The basic level is for everyone, no matter what pre-conditons they have.</p>
<p>Cost for a family plan in the 45-50 year old age group, $10K deductible is $463/mth with 1 annual check up, mammogram, colonoscopy. Basic rates are about $200 more a month. I think my preferred rate is reasonable…it was less than the employer rates, and employer rates were less than basic self pay rates.</p>
<p>I am feeling a little better about things…a little…</p>
<p>My 26% increase is not going to happen…it is going to be less…
It will be determined shortly…</p>
<p>It is kind of a con…if I get a letter saying my premiums are going up 18%… i am going to be mad…if I get a letter that says instead of raising your premiums 26% like the previous letter stated…your premiums are going to go up 18%…I am going to give a sigh a relief…</p>
<p>Wow…dodged a bullet there… Yeah…lol</p>
<p>Anyway…I will get to know the prices of all the plans before I switch…I misread the letter… I am getting crispy. ;)</p>