Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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”.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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]]."

https://www.sciencedirect.com/science/article/abs/pii/S1744165X22000154#:~:text=Across%20studies%2C%20the%20mean%20healthcare,first%20six%20months%20of%20life).

What do other countries do with micro preemies with 50% survival rates and 100% devastating disabilities rates?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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.

+1

My retired mother does music therapy in assisted care homes. It ain’t pretty all the irrational needles, IVs and attempts at surgeries there are age 80-95.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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.

Anonymous wrote:Just saw this: the accused shooter was not a client of UHC and there is no record of him ever being a client.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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.

But as a civilized society, it has to work this way. The healthy, working people support their elders because when they start to age or get cancer, they want to be supported.

It is moral to care for those who cared for us.

We can provide care to elders without offering an all-you-can-eat buffet of healthcare.

When my 91 year old grandfather was diagnosed with pancreatic cancer, the assumption at the hospital was that he would pursue aggressive (and incredibly expensive) chemotherapy. The reality is that chemotherapy for pancreatic cancer at 91 would only prolong his life a few months and would dramatically diminish his quality of life during that time. That's a terrible use of medical resources.

Yes. But otherwise you have “death panels”. Don’t you remember this from Obamacare? It takes patients to decline care like this. Many don’t. But it’s obviously not sustainable or in the best interests of patients.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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.

Old people are covered by Medicare. Their care isn't the reason why the United or BCBS plan you get through your employer is expensive.

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

This really isn't it. Americans go to the doctor less and spend less time in the hospital than people in other countries. There's a perception that Americans are lazy and stupid and go to the doctor for everything, but we actually consume less health care than in peer countries.

The issue is that we pay more to doctors and hospitals for the same services. In our current system, each individual insurance company negotiates with providers to set reimbursement rates. Each insurance company has limited market power, so it can only negotiate the price down so much before the providers drop that insurer altogether.
In a single-payer system, the government is the primary purchaser of services, so it has tremendous market power, allowing it to negotiate the price far lower than any one insurance company could. The government, unlike insurance companies, also isn't trying to turn a profit, which provides further savings.

I'm not saying single-payer is the answer, but high costs aren't being driven by overconsumption of care.

https://www.healthsystemtracker.org/brief/what-drives-health-spending-in-the-u-s-compared-to-other-countries/#Distribution%20of%20difference%20in%20per%20capita%20health%20spending%20between%20the%20U.S.%20and%20comparable%20countries,%20by%20spending%20category,%202021

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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]]."

https://www.sciencedirect.com/science/article/abs/pii/S1744165X22000154#:~:text=Across%20studies%2C%20the%20mean%20healthcare,first%20six%20months%20of%20life).

What do other countries do with micro preemies with 50% survival rates and 100% devastating disabilities rates?

European countries generally don't offer intensive care to premature infants as early as the US does. In additional, Europeans are culturally less inclined to push for treatments/care with low probabilities of meaningful success.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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]]."

https://www.sciencedirect.com/science/article/abs/pii/S1744165X22000154#:~:text=Across%20studies%2C%20the%20mean%20healthcare,first%20six%20months%20of%20life).

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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]]."

https://www.sciencedirect.com/science/article/abs/pii/S1744165X22000154#:~:text=Across%20studies%2C%20the%20mean%20healthcare,first%20six%20months%20of%20life).

What do other countries do with micro preemies with 50% survival rates and 100% devastating disabilities rates?

European countries generally don't offer intensive care to premature infants as early as the US does. In additional, Europeans are culturally less inclined to push for treatments/care with low probabilities of meaningful success.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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]]."

https://www.sciencedirect.com/science/article/abs/pii/S1744165X22000154#:~:text=Across%20studies%2C%20the%20mean%20healthcare,first%20six%20months%20of%20life).

What do other countries do with micro preemies with 50% survival rates and 100% devastating disabilities rates?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

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.