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<p>Because we see how great Social Security is working out for us…</p>
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<p>There is another “feature” of medical services that causes medical insurance markets to fail where auto insurance markets do not fail:</p>
<p>The need for and timing of medical services is predictable on an individual basis to a far greater degree than car crashes. Yes, an insurance company can determine that some drivers are more or less risky than others based on their records and the like, but drivers (risky or otherwise) do not plan or predict car crashes (other than outright fraud).</p>
<p>In contrast, people often know that they need some particular type of expensive medical care (e.g. patient at the doctor’s office is told that “you have cancer and need surgery within the next month” or “you have type 1 diabetes and will need a prescription for insulin for the rest of your life”). In an insurance market which is not universal, many people will buy insurance only when they know they need something expensive. The hated pre-existing condition restrictions are the insurance companies’ response to this type of adverse selection, but it results in insurance being only good until your first expensive medical problem. Government regulation and intervention from Medicare, Medicaid, COBRA, HIPAA, PPACA, etc. is largely a response to this type of market failure. So is the trend to getting medical insurance through an employer group plan which includes the healthy as well as the sick, and where joining or exiting independently of joining or exiting employment is restricted.</p>
<p>In many other rich countries, universal or socialized insurance schemes are used as the solution to the adverse selection problem.</p>
<p>Of course, that is not the only problem that exists in the US medical care and insurance system. High costs for various reasons (including incentives to use more care even if it is not better care (or is clearly wasteful), defensive medicine due to fear of lawsuits, general unhealthy habits in the US, lack of price transparency for those shopping around, etc.) are another problem that still needs to be solved even if the US moves to a universal or socialized insurance scheme.</p>
<p>"Because we see how great Social Security is working out for us… "</p>
<p>We do, and I’m very, very thankful for it. And glad that it has never ever added one penny to the deficit, and won’t, long into the foreseeable future.</p>
<p>Social Security and Medicare are two GREAT programs that help to keep seniors out if poverty for an efficient cost. It’s once the “free market” skimmers can get involved–like insurance companies for those of us who can’t get Medicare yet–that the costs go UP and efficiency goes DOWN. </p>
<p>I hope you aren’t drinking the “privatize social security” kool aid hops_scout. Because if you like our broken healthcare system you’ll live that.</p>
<p>^ love that. Darn phone!</p>
<p>He’ll also “live” it though. ;)</p>
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<p>Only if your generation leaves my generation some! 
From everything I’ve read, we shouldn’t plan on that being the case…</p>
<p>Medicare has its plusses and minuses. Every year they try to institute a huge reduction in reimbursement using their calulato, the SGR (sustainable growth rate). The huge cutbacks proposed annually (now around 23%) typically get suspended by congress at the 11th hour, but smaller fee reductions have occurred, at least in my field. It is already amongst the lowest payor of the insurers and there are many services that are not covered. More and more providers are declining to accept medicare.</p>
<p>I like posts 320 and 322…these posts explain the problems our healthcare system has very well.</p>
<p>Other first world countries have found ways to cover more people at less cost. Doesn’t look like we are going to emulate these other countries any time soon.</p>
<p>Jym, for a minimal fee, anyone can buy Medigap insurance to make up the difference to providers. It is still a cheap program that PEOPLE HAVE PAID INTO - JUST LIKE SOCIAL SECURITY. </p>
<p>Over one billion dollars have been given to the states by the Feds to set up exchanges to subsidize health care starting in 2014, under The Affordable Care Act.</p>
<p>It’s funny how some posters are posting misleading information, which they later retract to insidiously promote an agenda.</p>
<p>social security is a great system?..you mean the one that is going broke?..Young people should be able to invest for their retirement, the amount accumulated would be far far greater than what SS would ever give them back. The system is a ponzi scheme…our gov. can’t do anything right on a big scale…</p>
<p>Medigap doesnt affect the lower reimbursement rate, parent1986. Only the patients out of pocket cost. The fee for the service is still set by medicare, and the rates make it hard to keep ones door open. Are you in healthcare? Who is “posting and insidiously retracting to promote an agenda”? I dont see that. AND WHY ARE YOU YELLING???</p>
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<p>Auto insurance isn’t required in my state and rates seem to be fine.</p>
<p>Of course those with insurance have the option to get uninsured
coverage so that if we’re in an accident with someone that isn’t
insured and they are at fault, we’ll be covered. And that’s really
useful in MA, a state that requires coverage but seems to have a
lot of people driving without it judging by police logs.</p>
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<p>Singapore was spending 3% of GDP with a private system and now they’re spending 3% with a Universal system. Getting costs down seems to be far more important than anything else. It’s probably harder than anything else too.</p>
<p>Son has to pick medical and dental coverage in two days - I should suggest that he look over his options. He’s on my medical and dental right now. My dental plan over covers up to $1,000 in expenses - it’s a preventive plan. Things like crowns can use up the entire amount which I just pay for out of pocket. I’m not sure what the insurance costs (probably not much) but I should go to the comprehensive plan. I think that my dentist likes me as a customer because I don’t base treatment on insurance and cost. If we need something done, we get it done and pay for it. The office staff there is highly focused on insurance and coverage - I can see this when they are on the phone or talking with other customers. I think that my dentist likes my stock tips too.</p>
<p>I have to look at taking my son off my coverage too if it makes sense. I don’t know if that’s something that you do with annual renewal or if you can do it at any time. I don’t think that it costs that much having him on my plan.</p>
<p>Geeps. I used to believe social security was “going broke.” But, really? It’s just been used to subsidize the lower tax rate the baby boomers enjoyed during their highest earning years. Now, the rest of us will have to pay highter taxes to make that up, but it’s not because social security itself is “going broke.” The money’s been used.</p>
<p>Obviously, we can’t continue to have everyone living on social security from age 65 on in a country where the life expectancy has gone into the 80’s, partially because of that OTHER program, medicare. People will have to take their SS at a later age, that’s all. And people my age know this. (Of course, if they wait long enough, soon I’m sure I will be able to get SS at 65, too, just cuz of the way they will grandfather people in). By then, though, they will have to means test, and I’m not getting anything. So sad :(, but I know this and have planned accordingly.</p>
<p>As for single payor, it’s the only thing that will actually work. Yes, it would be better if we could go back to the day of the family doc and the house call and paying sometimes in chickens and trade, but we can’t, and costs have to be controlled, and the only way this will happen is with single payor. Plus, this thing we have right now? It’s not working for anyone but the insurance companies. Is THAT the purpose of health care? should it be?</p>
<p>I will say I think making the cost of medical school reasonable is one of the things that needs to be done, though. I don’t think it’s fair to ask doctors to leave school with 300,000 in debt if their upside will be somewhat limited by single payor. JMO</p>
<p>BCEagle91… Of course you should check things out…but when my oldest was dropped from my plan…my rates did not decrease. Maybe my rates would have increased more if she stayed on my plan. I don’t know.</p>
<p>dstartk/BCEagle – I suspect that whether the rates would decrease or not when you drop a kid depends on whether the rate structure is employee vs. family, or employee vs. employee +1, employee+2 or more. In the +1 or +2 model, premiums would probably go down. But in the “family” model they probably won’t go down unless BCEagle would then be covering only BCEagle - no spouse or other kids.</p>
<p>Yes…I was talking about the family model.</p>
<p>Correct, arabrab. Companies decide if “family” is employer, spouse and 1 kid or 1+. When Our older s got his own insurance, our family premium did not change as we were still employer, spouse and 1 kid on the plan. That said, some plans may have an individual or family deductible, so if a family is only 3, then the family deductible that has to be met would in some cases be lower than if ther family had more members.</p>
<p>Still trying to figure out what parent1986 was ranting about. Medigap does not affect the low reimbursement rate to the providers. It is only to help the patient cover their out of pocket expense.</p>
<p>poetgrl…the whole system is a failure and nothing more than a ponzi scheme. Let the individuals take care of themselves and their own families. Nothing our gov does on a large scale works…nothing…</p>
<p>I am still not quite sure how those with employer-paid insurance are being “subsidized.” I now work in employee benefits consulting, and I see what insurance actually costs. While the employee may not be paying a lot, the EMPLOYER certainly is. I work with both fully-insured and self-insured groups, so I see “real” costs of claims when preparing the financial statements for self-insured groups. I am not aware of any subsidies for employers other than the RDS subsidy available to groups that provide retiree health care for Medicare-eligible retirees.</p>
<p>And yes, I think the insurance industry needs an overhaul. Dstark is definitely getting the shaft.</p>