Friday, April 13, 2012

Cost of Your Health Care

Just a reminder to all young people about why you hate us, and are going to hate us more.  Employer-provided health insurance costs oh, $12-16K/year.  (Government health insurance would have the same cost.) That would otherwise be in your salary.  Do you think you would spend that much on health care per year?  Doubtful.  You probably would spend less than a grand.  You get the insurance as a bet against your needing an $80,000 procedure that you couldn’t pay for.  So in the back of your mind, it seems sorta kinda okay, because at least you are protected. And you know you wouldn’t really be putting aside that money anyway – you’d just be spending it. 

Of course, if you ran up an $80K medical bill, you could always pay it off over a relatively few years. That would work. It sounds anxiety-provoking, though.  At least you have peace of mind under this system. 

Well, not really.  You would still have plenty of other things to be anxious about besides your health.  So you are paying $10K+ to eliminate one of your anxieties. If you are 30, you have already paid about $100K for that POM.

Or not.  Because when you are imagining getting OMG Really Sick or being in a skiing accident or something and not being able to pay for it, you are doing so from the perspective of being healthy right now, with no skiing accident.  The anxiety you imagine of not being able to pay is mingled with the anxiety of imagining the broken hip. The insurance doesn’t actually change that part.  The getting sick or injured part remains constant.

I, of course, am making exactly the same bet at the same cost, except that I am almost 59, overweight, smoked for 40 years and now have some chronic conditions that require attention. You might be paying some of my bet.  More likely, however, the system is still doing okay on me and those like me, and you are actually paying the bet of a sure loser – an 86 y/o guy in the last few years of his life who needs all kind of stuff. And his last 6 months?  Huge.  You didn’t figure out why AARP has been pushing for universal care all these decades, even though Medicare supposedly covered all their folks already? They’ve done the math of how long that can go on without you paying in.

So instead of dreaming what you would do with the money if you won the lottery – which you won’t – you could dream what you would do with an extra $10K every year. BTW, this is only the beginning.  We’re going to keep screwing you over for decades.

Many of you might think that this is fine.  There are hard-luck stories you hear about all the time, and you feel better about knowing those are taken care of – they aren’t, it just means that most of the medical bills will be paid on most of the stories, and they still have terrible medical conditions and will maybe die, but you can at least pretend more honestly – and you like lowering the risk of becoming one of those hard-luck stories yourself.  You would do this voluntarily anyway.  You may already know someone who really needed the insurance. *

Good.  Because we’re not asking you, we’re making you do it, so we’re glad you don’t mind.

*Those worried about possible research dropoff and loss of future treatments for those with CF or MS or whatever because of loss of financial incentives– whole separate issue, which I’m not touching here. I’m not so good at predicting the future anyway.


Der Hahn said...


Health Insurance is not Health Care.

I think the fact that it's a lot easier to gaurantee the former (which is primarily about financing) than the later (which would require some mechanism to create doctors, nurses, treatment facilities, supplies, drugs, etc) has a lot to do with the structure of Obamacare.

Sam L. said...

There's a lot of talk about "health care" which is really about health care insurance. Much (or most, as I see it) is meant deliberately to confuse those issues.

Texan99 said...

Yes, and even "health care" isn't "health."

When my friend's daughter needs expensive life-saving surgery, that's one thing. It's another when a middle-aged woman I know, quite an impoverished woman, is in the doctor's office once or twice a week with something or other: her knee hurts, or her ankle hurts, or she has a cold. She thinks the doctor can have some effect on these things.

It takes a lot for me to see a doctor. I have to have a good reason to believe he can do something cost-effectively. He can't make me thin, or young. He can't tell me much I don't already know about eating better or exercising more. With my high-deductible policy, I'm basically paying cash for everything, so I think about whether it's worth it. I have to believe it's something that can be nipped in the bud and that won't get better on its own.

Assistant Village Idiot said...

T99 - When I get a patient like that, I say "Her life hurts."