Gyroscopic Investing

Well, I think this is what I've been saying - for routine medical care. No amount of capitalism is going to enable a middle income family to deal with a major medical event, and for that the cheapest way to do it is Medicare for all, by far. Private insurers are an expensive hobby.

For routine care though...getting government and regulations out of the equation would be just incredible. For starters, consider telemedicine now. Before the pandemic, you couldn't do it from home, you couldn't bill for an initial visit, you couldn't do it for a patient physically located in another state at the time of the visit, and you needed specially approved software designed to not work but to make HIPAA lawyers happy. Everyone who isn't a lawyer of course thinks those rules are stupid, and I think it will be so politically unpalatable to reinstate them that it won't happen. You can imagine the possibilities from there. Probably 95% of office visits could be done via telemed, and this has exposed a little lie that everyone had been trying to ignore: the utility of the physical exam. Or lack thereof.

BTW I love this guy's cat.

What happens to people who don't purchase insurance under this system and get sick? Let them die? What about their children? If we want a system based on personal responsibility how do we deal with irresponsible?

My personal preference is some kind of Medicaid (+?) for everyone. It would serve to provide a very basic level of medical coverage as well as handling major / catastrophic events. Medicare for all sounds nice but it's not realistic when you start doing the math. Especially as we are piling on debt to deal with the current emergency. This after decades of bipartisan fiscal profligacy. People who want more could still get private insurance. But one thing that COVID has made clear is the limitation of a medical system based primarily on private insurance during a global health crisis. It's not working. Not surprisingly, there are already reports that insurance premiums are going to explode for next year. This is not sustainable.

Why is there no dental health cost crisis?
Why is there no veterinary cost crisis?

> What happens to people who don't purchase insurance under this system and get sick? Let them die?

Libertarian answer: yep. https://www.youtube.com/watch?v=owI7DOeO_yg

Ad Orientem wrote: ↑Tue May 12, 2020 1:11 pm My personal preference is some kind of Medicaid (+?) for everyone. It would serve to provide a very basic level of medical coverage as well as handling major / catastrophic events. Medicare for all sounds nice but it's not realistic when you start doing the math. Especially as we are piling on debt to deal with the current emergency. This after decades of bipartisan fiscal profligacy. People who want more could still get private insurance. But one thing that COVID has made clear is the limitation of a medical system based primarily on private insurance during a global health crisis. It's not working. Not surprisingly, there are already reports that insurance premiums are going to explode for next year. This is not sustainable.

I'm puzzled by this. Why is Medicaid better than Medicare? Medicaid is more comprehensive coverage, which puts us back into government intrusion into routine medical care which greatly inflates its cost. Its structure is also not scaleable, as it's designed to fund public hospitals and medical training programs, in exchange for which the residents are the primary physicians for Medicaid patients. That's why Medicaid fees are so low, because they're combined with direct block payments to hospitals & training centers. Medicare for all for a limited set of ICD10 codes (i.e. conditions that most people can't handle financially without help) makes much more sense to me.

MangoMan wrote: ↑Thu May 14, 2020 9:16 pm

boglerdude wrote: ↑Wed May 13, 2020 1:07 am > What happens to people who don't purchase insurance under this system and get sick? Let them die?

Libertarian answer: yep. https://www.youtube.com/watch?v=owI7DOeO_yg

What happens when you don't buy auto insurance and then crash into someone causing extensive damage to their car? What happens if a doctor doesn't buy malpractice insurance and then gets sued? What happens to a homeowner who doesn't buy fire insurance for his paid off house which then burns down? What is the purpose of insurance, and what is the consequence for not carrying it?

Btw, funny video. But where did you make the connection to Libertarians?

The purpose of insurance is to transfer the risk for a financial stress for which you cannot afford to bear.

The consequence is poor if you cannot afford the financial cost of the event. If you can afford it then the consequences are not so poor.

However, in the case of health insurance medical billing is all rigged against those without insurance. Those without pay full sticker price while those with health insurance get bills that have negotiated by their insurance companies to be much reduced from sticker price. Same procedure by same doctor or hospital the uninsured will get a larger bill than the insured every time.

Vinny

vnatale wrote: ↑Thu May 14, 2020 10:06 pm

MangoMan wrote: ↑Thu May 14, 2020 9:16 pm

boglerdude wrote: ↑Wed May 13, 2020 1:07 am > What happens to people who don't purchase insurance under this system and get sick? Let them die?

Libertarian answer: yep. https://www.youtube.com/watch?v=owI7DOeO_yg

What happens when you don't buy auto insurance and then crash into someone causing extensive damage to their car? What happens if a doctor doesn't buy malpractice insurance and then gets sued? What happens to a homeowner who doesn't buy fire insurance for his paid off house which then burns down? What is the purpose of insurance, and what is the consequence for not carrying it?

Btw, funny video. But where did you make the connection to Libertarians?

The purpose of insurance is to transfer the risk for a financial stress for which you cannot afford to bear.

The consequence is poor if you cannot afford the financial cost of the event. If you can afford it then the consequences are not so poor.

However, in the case of health insurance medical billing is all rigged against those without insurance. Those without pay full sticker price while those with health insurance get bills that have negotiated by their insurance companies to be much reduced from sticker price. Same procedure by same doctor or hospital the uninsured will get a larger bill than the insured every time.

Vinny

Sometimes that's true, but with a little work it usually works out. Which exposes the whole system as a complete fraud, of course.

Anything that can be negotiated up front is pretty much no problem without insurance. For example, maternity. The OB had a flat rate, the hospital had a flat rate, and it was actually the real price, not the 10x fake price.

For lab work, as long as you pay up front you get a 95% discount or whatever. If you let it go through "the system" then you're stuck with the sticker price. So don't do that.