What IS The Cost Of US Health Insurance ?

For a family of four working in industry it would probably be $15000 per year. Probably the employer would pay half. In the past industry provided most all of this coverage. Some teachers and gov't workers pay only 1500 to 2000 dollars per year.

For a retiree who has paid in 2.5% of his salary into MEDICARE up to age 66 it would still cost him $300 per month for himself--frankly that is all it's worth. greed, fraud, inefficiency, government, HMO's, insurance companies, pharmacies, hospitals, equipment suppliers all have their hand in our pockets and there is no restraint other than bankruptcy or death.

Medical care is one of our major National Disgraces as far as cost and wild profiteering is concerned.

The real cost of health care is the most a consumer is willing to pay for it and the least a doctor is willing to accept to perform that service.

The problem is, the consumer does not have to worry about cost. Taking that out of the equation, demand is functionally infinite, and the supply is finite. This shifts the supply/demand curve *way* out of a natural equilibrium.

Our more and more of a dictator (which is what we want) is trying to fix it by overpaying a bureaucracy to determine who gets what in the health care industry. This will take away even more of the resources available for health care, leaving less for actual health care. A practical way of doing this is using the Quality Adjusted Life Years formula. Those who demonstrate unhealthy life styles will get less health care and those who know politicians personally, or contribute the most to those politicians election campaign will get more health care. See how that’s better?

How I plan to vote next election: I'm going to wait until I find out who's going to win, then I'll vote for the winner. That way, by extension, I'll feel like a winner!
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OK -- for my wife and I -- we are covered by insurance which we pay for -- no corporate funding.

We are in our early 60's (pre-Medicare insurance coverage) and our annual insurance cost is just under *18,000*. Note, this is a high deductible (HSA) plan which means that the first $3K of medical (and medicine) expenses for us is not covered, ie out of pocket. So before the insurance kicks in, we are out of pocket $24,000. Then above the $3K number the coverage is 80/20 for the next $3K (ie another $600 for us). That means if we have a significant medical emergency (6 years ago I had colon cancer, surgery and chemo -- I am now clear of this and have been for 5 years or more), our total medical costs would run to over $25K -- for two people. That also assumes all medical care is done 'in network' and per the insurance companies rules.

Two years ago, my wife needed cataract surgery -- because in her case it required specialized care (complications due to very high myopia and extremely high astigmatism) we were out of pocket entirely for that -- something like $6K in addition to still paying insurance.

We manage to afford this cost, but there are plenty who can't -- and for them, they need to pretty pray nothing happens.

There are some plans which take the cost issue out of the hands of the consumer entirely -- but increasingly they are going away. Insurance companies tend to be very 'aggressive' regarding claim denials for various reasons -- in a for profit industry, it is very much in their interest to 'just say no'.

Where the insurance system appears most flawed (and excess cost inducing):

1) End of life care -- there is way too much heroic intervention, keeping people alive for days or weeks but either not alert or in severe pain at very high expense. Many would be better served in hospice care at end of life at much lower costs to all.

2) Procedure based compensation -- this becomes a scavenger hunt for labs and physicians to find codes which get higher compensation but don't appreciably improve care. It is an area where specialists can do VERY well and primary care (those with direct patient contact as their primary activity) are not all that well compensated (my wife's Psychiatrist -- for a one hour visit, the going insurance rate is between $100 and $120 of which the insurance company pays 80% - whenever they get around to paying it. That is the total compensation -- no additional compensation for insurance company follow up time, or any staff she might have. That's a do the math sort of question. Internists and Pediatricians (among other primary care) are in the same boat.

On the other hand, if you are in a specialty and know how to 'work the codes' a 15 minute patient contact (of which you might have 6 in an hour -- funny math that) get's you $75 to $100.

So folks in the medical profession are discouraged from primary care (where they are most needed) and encouraged to specialties which pay much better.

3) Duplicate testing and procedures -- these get paid for due to lack of coordination or simply because they can generate payment. Waste for sure.

4) People, lacking regular physician contact using hospital ER's for their primary care -- highly inefficient and expensive use of resources.

5) Costs of over testing and multiple visits to protect against malpractice suits.

6) Some proportion of patients who abuse the system and run up medical costs because it isn't theirs to pay for. (I suspect this is not as big a factor as some make of it - it is simply used as a rational for cutting health care support for those who can least afford cuts in health care.

Now for what we are likely to disagree on... The solution. There are huge problems with health care nowadays due to insurance/medicaid/medicare. Before these things, we didn't have a problem.

Right, like I said before, you are proposing a budget balancing approach -- eliminate the duty of care (that Texas law for example which you lament) as well.

That way those that can't afford care won't get it --- and they will die off faster. Helps with Social Security budget as well -- dropping life expectancy by 5 to 10 years is a solution there. Oh, make sure that you eliminate corporate paid health insurance as well -- the companies need the profit.

After all, that sort of approach worked well in the 70's (1870's) and so little has changed since then.

Nope, that is not an obvious solution -- or rather it is a pretty bad approach unless you are VERY wealthy.

I'm thinking that there are countries where health care isn't approaching 20% of GDP -- perhaps those models actually make more sense.

The obvious solution? Get rid of private insurance, medicare, and medicaid. Let the free market regulate health care prices, as it did before.

We agree here -- durable power of attorney approach is reasonable (we each have one here). But it does not specify 'always resuscitate'. I've read that something like 15% of all medical expenses for an individual these days happen during the last 60 days.

Scared of death panels I see. Then get your butt to the lawyer and get a durable power of attorney for health care and make sure the person you appoint knows you want to be resuscitated no matter what or how expensive. Then pray they have tons of cash because at some point the insurance and your estate will run out and they will have to pay for it.


The Dr. has a profit motive to keep sucking the insurance dry. Any lawyer would tell you that is a conflict of interest that is impossible to overcome and he would be right.

The real cost of health care is the most a consumer is willing to pay for it and the least a doctor is willing to accept to perform that service.

The problem is, the consumer does not have to worry about cost. Taking that out of the equation, demand is functionally infinite, and the supply is finite. This shifts the supply/demand curve *way* out of a natural equilibrium.....

I think it is only fair that you answer my question as reasonably as I answered yours in the other thread.

If you need clarification, what insurance premium would a family of 4 have to pay in the US in order to get the same degree of medical care for illness, accident, pregnancy etc. plus dental and optical, to the same degree as what I get ?

The problem is, the consumer does not have to worry about cost.

From what I read on these pages and elsewhere that statement is blatantly false. Whether it is the actual cost of medical treatment or the cost of health insurance, from William's post above, it appears the "consumer" (patient ?) does indeed have something to worry about.

T.A.