Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.
I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.
You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.
Well advocate for assisted suicide/euthanasia
+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.
Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.
That’s funny because every time one of the older people in my family have entered the hospital, we have been pressured to “let them go”. Even when they were simply dehydrated and needed IV fluids. You aren’t the person to make the decision about whether someone has “quality of life”.
A nurse decided it was time to kill my dad, who had dementia, and gave a lethal dose of morphine.
The nurse didn’t inform anyone in advance that she planned to do this.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.
I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.
You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.
Well advocate for assisted suicide/euthanasia
+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.
Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.
My BILs family put his frail, broken (from two falls) 85YO dad through two, TWO full codes in two days before he died. I always feel so bad for that man leaving the world while having his ribs crushed and I have so much sympathy for the health care workers who had to do it. It is horrifying the things people do to postpone the inevitable.
My 80 year old dad wants to live and asked us to do everything including restarting heart if need be. Happened actually. His life and his choice. Still alive..moving slower but still alive.
No one is advocating taking that choice away from him.
DP-The insurance flicks above are aggressively advocating for just that.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.
Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.
Yes. We spend millions keeping babies alive who will never leave the hospital, let alone live anything close to a normal life.
No we don’t
Yes, we do.
"On average, surviving infants approaching micro preemie status (of birthweight between 500 and 750 g) stay 103 days in the NICU costing $313,000 (in 2019 US dollars) per infant to the healthcare system [7]. Beyond the neonatal period, it is estimated that less than half of micro preemies will survive after their first year (45.9%) and most will have major morbidities that are likely to affect their long-term prognosis [[8], [9], [10]]."
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.
Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.
Yes. We spend millions keeping babies alive who will never leave the hospital, let alone live anything close to a normal life.
No we don’t
Yes, we do.
"On average, surviving infants approaching micro preemie status (of birthweight between 500 and 750 g) stay 103 days in the NICU costing $313,000 (in 2019 US dollars) per infant to the healthcare system [7]. Beyond the neonatal period, it is estimated that less than half of micro preemies will survive after their first year (45.9%) and most will have major morbidities that are likely to affect their long-term prognosis [[8], [9], [10]]."
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.
I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.
You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.
Well advocate for assisted suicide/euthanasia
+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.
Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.
My BILs family put his frail, broken (from two falls) 85YO dad through two, TWO full codes in two days before he died. I always feel so bad for that man leaving the world while having his ribs crushed and I have so much sympathy for the health care workers who had to do it. It is horrifying the things people do to postpone the inevitable.
My 80 year old dad wants to live and asked us to do everything including restarting heart if need be. Happened actually. His life and his choice. Still alive..moving slower but still alive.
While that's his choice, at a certain point he should be responsible for paying for it.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.
I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.
You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.
Well advocate for assisted suicide/euthanasia
+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.
Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.
Yes. It's absurd how many resources and how much money is being allocated to fairly hopeless end of life situations for very elderly patients with dementia or Alzhemers. But I have no idea how you create rules or legislation to mitigate against absurd and hopeless interventions that raise the cost of health care for every other living person.
England made it legal, this month!
It's been legal in Oregon since 1997.
As of 2024, physician-assisted suicide, or "medical aid in dying", is legal in eleven US jurisdictions: California, Colorado, the District of Columbia, Hawaii, Montana, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington.
These laws (excluding Montana, where there is no explicit legislation) state that "actions taken in accordance with [the Act] shall not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law". This distinguishes the legal act of "medical aid in dying" from the act of helping someone die by suicide, which is prohibited by statute in 42 states, and prohibited by common law in an additional six states and the District of Columbia. A 2018 poll by Gallup displayed that a majority of Americans, with 72 percent in favor, support laws allowing patients to seek the assistance of a physician in ending their life. Nevertheless, assisted suicide remains illegal in a majority of states across the nation.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.
Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.
Yes. We spend millions keeping babies alive who will never leave the hospital, let alone live anything close to a normal life.
No we don’t
Yes, we do.
"On average, surviving infants approaching micro preemie status (of birthweight between 500 and 750 g) stay 103 days in the NICU costing $313,000 (in 2019 US dollars) per infant to the healthcare system [7]. Beyond the neonatal period, it is estimated that less than half of micro preemies will survive after their first year (45.9%) and most will have major morbidities that are likely to affect their long-term prognosis [[8], [9], [10]]."
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Excellent equation. And one I think we know the answer too.
End of life
Chronically ill and disabled
Illegal immigrants
Yeah, why shouldn’t insurance companies just become money printing machines?
Something is a gatekeeper either way.
And the PpP still answers the question: the largest segments sucking down resources are end of life, chronically ill/disabled, and illegal immigrant.
All three cohorts pay in zero to the system (illegal aliens) or usually premiums yet are vastly net users .
Good luck getting an anesthesiologist if they’re all tied up. Rationing happens every single day.
Zero?! Really? Illegal immigrants farm the land, raise your babies and clean your toilets, all of which are jobs lazy Americans find beneath them and would never do. I would not call this zero contribution.
Healthcare should be a universal right and free, the way it is in the rest of the developed world.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Excellent equation. And one I think we know the answer too.
End of life
Chronically ill and disabled
Illegal immigrants
Yeah, why shouldn’t insurance companies just become money printing machines?
Something is a gatekeeper either way.
And the PpP still answers the question: the largest segments sucking down resources are end of life, chronically ill/disabled, and illegal immigrant.
All three cohorts pay in zero to the system (illegal aliens) or usually premiums yet are vastly net users .
Good luck getting an anesthesiologist if they’re all tied up. Rationing happens every single day.
Zero?! Really? Illegal immigrants farm the land, raise your babies and clean your toilets, all of which are jobs lazy Americans find beneath them and would never do. I would not call this zero contribution.
Healthcare should be a universal right and free, the way it is in the rest of the developed world.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.
I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.
You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.
Well advocate for assisted suicide/euthanasia
+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.
Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.
That’s funny because every time one of the older people in my family have entered the hospital, we have been pressured to “let them go”. Even when they were simply dehydrated and needed IV fluids. You aren’t the person to make the decision about whether someone has “quality of life”.
A nurse decided it was time to kill my dad, who had dementia, and gave a lethal dose of morphine.
The nurse didn’t inform anyone in advance that she planned to do this.
Pretty sick.
I don’t believe you. That would be a crime. The amount of morphine is tracked.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.
So you’re saying we should shoot him in the back?
No, you treat pain and discomfort. But we shouldn’t be subjecting those over 80 to colonoscopies, mammograms, dialysis, adv cancer treatment, etc.
What about premature infants in NUCU for months on end costing hundreds of thousands or even millions of dollars? Or, infants with severe brain damage kept alive for years?
Special taxes for prolife people.
Once the kids are born the pro-lifers are generally ok with them dying of neglect or poverty. It doesn't make sense, but they've been pretty consistent.
This is completely false.
NP, but why would you say that? It’s not as if pro-life people are out there adopting children in any significant way, fostering kids, or or protesting the death penalty at all.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.
It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.
Why should one group "definitely" get expensive on going treatment and another be denied some tests?
In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.
Tell us which age group sucks up most of the resources and how that benefits the whole population.
Excellent equation. And one I think we know the answer too.
End of life
Chronically ill and disabled
Illegal immigrants
Yeah, why shouldn’t insurance companies just become money printing machines?
Something is a gatekeeper either way.
And the PpP still answers the question: the largest segments sucking down resources are end of life, chronically ill/disabled, and illegal immigrant.
All three cohorts pay in zero to the system (illegal aliens) or usually premiums yet are vastly net users .
Good luck getting an anesthesiologist if they’re all tied up. Rationing happens every single day.
Zero?! Really? Illegal immigrants farm the land, raise your babies and clean your toilets, all of which are jobs lazy Americans find beneath them and would never do. I would not call this zero contribution.
Healthcare should be a universal right and free, the way it is in the rest of the developed world.
Anonymous wrote:Then why not legalize medically assisted suicide?
Canadian here. You don’t want this. After watching MAID in Canada, I’ve completely changed my mind on this issue. The state cannot be trusted with this power.
Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.
The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.
And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.
As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.
5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.
Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.
Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.
Yes. We spend millions keeping babies alive who will never leave the hospital, let alone live anything close to a normal life.
No we don’t
Yes, we do.
"On average, surviving infants approaching micro preemie status (of birthweight between 500 and 750 g) stay 103 days in the NICU costing $313,000 (in 2019 US dollars) per infant to the healthcare system [7]. Beyond the neonatal period, it is estimated that less than half of micro preemies will survive after their first year (45.9%) and most will have major morbidities that are likely to affect their long-term prognosis [[8], [9], [10]]."
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