Health Insurers Using Big Data on You

The fine folks over at NPR have a very interesting read about what health insurers are doing with big data. It seems that the health insurance companies are making sure to buy up all the data it can on individuals in order to build pricing structures on insurance that are more specific than we have ever seen before. The insurance companies' explanation is that they are simply monitoring all these data points in order to make sure you get the health care you need.


Insurers contend they use the information to spot health issues in their clients—and flag them so they get services they need. And companies like LexisNexis say the data shouldn't be used to set prices. But as a research scientist from one company told me: "I can't say it hasn't happened."

Health insurers have the best sort of data, the sort that can really twist a nipple or two.

I really despise the idea of "big data." It's already hard enough as it is to make a proper determination of what data means in a specific instance. To think that they are determining the best pricing structure with data that includes inane things that mean absolutely nothing without context is frightening to me, especially since my own career is analyzing data.

Well keep in mind just how much data people put online about themselves in detail every day through FB, Twitter, etc. Hell, some folks I can tell you what they had for breakfast, lunch, and dinner, how many drinks you had, and when and if they worked out or sat and watched 9 hours of TV.

IMHO we need to reform how health insurers offer rates to people.

Make it illegal to discriminate between people. You have to offer the same rate to everyone, regardless of anything, even regardless of whether or not they are part of a group.

The fact that insurers can pick and choose by ramping up rates on some and not on others kind of negates the whole purpose of insurance, which is to spread the risks and costs across all people.

Why doesn't the US follow the lead of every industrialized nation in the world, and set up a universal healthcare system? We pay more per capita for health than any country in the world and rank 26 in most health parameters. That way no discrimination, no bankruptcies to stay alive.

dreamwriter said:

Why doesn't the US follow the lead of every industrialized nation in the world, and set up a universal healthcare system? We pay more per capita for health than any country in the world and rank 26 in most health parameters. That way no discrimination, no bankruptcies to stay alive.

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Because then nobody would make any money in the health care field and the rest of the world couldn't ride our research coattails at lower cost. How the hell do you think they manage to (sort of) afford it? Also, enjoy your waiting lists.

Really appreciate the 'tards in my extended family who put the geneology online. Cancer is rampant on both sides.

Zarathustra[H] said:

IMHO we need to reform how health insurers offer rates to people.

Make it illegal to discriminate between people. You have to offer the same rate to everyone, regardless of anything, even regardless of whether or not they are part of a group.

The fact that insurers can pick and choose by ramping up rates on some and not on others kind of negates the whole purpose of insurance, which is to spread the risks and costs across all people.

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Is it fair to ask non-smokers to subsidize smokers? Non illicit drug users to subsidize illicit drug users? Etc.

Even at that, it should be designed to only share cost risk, not a wealth redistribution scheme. It's bad enough its become a cost sharing scheme that causes people to overwhelm the care system. Sick and tired of seeing emergency room crowded with people between 15-50 with the flu. If you want wealth distribution associated with medical care offer credits so everyone can see what's going on.

Zarathustra[H] said:

IMHO we need to reform how health insurers offer rates to people.

Make it illegal to discriminate between people. You have to offer the same rate to everyone, regardless of anything, even regardless of whether or not they are part of a group.

The fact that insurers can pick and choose by ramping up rates on some and not on others kind of negates the whole purpose of insurance, which is to spread the risks and costs across all people.

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In an ideal world, I agree. I have no chronic health conditions, yearly checkups and take some care about what I throw down my pie hole(not always looking for forward to the State Fair junk food crawl.) I should pay the same as the Type 2 Diabetic who drinks a 2 liter of Orange Faygo twice a day.

Or say in the realm of car insurance; zero points, 10 years safe driving record versus 3 DUI's in 5 years; we should pay the same insurance rates?

The insurance marketplace is based on a risk pool. The more people in the pool, the more competitve the rates can be as they can mitigate the bad risks in the pool. This concept of modern insurance was established back in the 18th century at Lloyd's Coffee House in London(yes, THAT Lloyd's) .


The reason the rates sky rocketed was due to the introduction of a ton of people into the insurance pool with chronic conditions that previously handled by charity care, medicare, medicaid.

Lawsuits are another source of inflated insurance rates; litigation is EXPENSIVE! I'm not advocating for not being able to sue for medical malpractice for gross neglience; but a great deal of the suits are filed as a quick shake down because they know they will settle for a 50-100K which is much cheaper than $200K plus to take a case to trial.

That being said, are corporations taking advantage; absolutely. Allow people to buy insurance across state lines which will introduce competition and drive down rates. It has worked in other insurance lines, it would work in health insurance too. Hell, some Doctors are now opting out of insurance payments completely and doing a house call thing with a yearly payment directly to them. You can get a major medical policy for much cheaper than a comprehensive one. If you are a healthy person that is the way to go.

OH, add Catastrophic Medical Coverage to your automobile policy; a million in coverage will cost you about 20 bucks a year additional. A majority of catastrophic medical cases are a result of automobile accidents. Now THAT's cheap insurance.


It really is a Gordian knot of an issue.

The American healthcare system is in shambles, and the notion that the world is somehow riding our research coattails is simplistic. R&D in Pharma is inflated to justify absurd drug costs, and many Pharma drugs are based on NIH research, where the drug companies buy up government generated discoveries for pennies on the dollar.

The way the medical insurance and Pharam lobby works is by generating the kind if competitive anger reflected in some posts. The goal is to reduce costs. It doesn't matter that you think you're paying for a smoker. What matters is how the costs are covered. Insurance works by spreading the risks among the largest pool possible. A pool of 326 million people is a better pool than a 20 million person one.

The GAO study showed the US would save 3 billion dollars in the firs year with a Medicare for all system.

As far as lines go, I know many people from Canada who not only love their system, but state that they never wait in lines for necessary or urgent treatment. You may have to wait a couple of months for cosmetic surgery, and other non urgent conditions.

And none of them go bankrupt or die because they can't pay.

The insurance companies' explanation is that they are simply monitoring all these data points in order to make sure you DON'T get the health care you need.

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FTFY.

Without transparency, it means nothing.

fadedlogic said:

In an ideal world, I agree. I have no chronic health conditions, yearly checkups and take some care about what I throw down my pie hole(not always looking for forward to the State Fair junk food crawl.) I should pay the same as the Type 2 Diabetic who drinks a 2 liter of Orange Faygo twice a day.

Or say in the realm of car insurance; zero points, 10 years safe driving record versus 3 DUI's in 5 years; we should pay the same insurance rates?

The insurance marketplace is based on a risk pool. The more people in the pool, the more competitve the rates can be as they can mitigate the bad risks in the pool. This concept of modern insurance was established back in the 18th century at Lloyd's Coffee House in London(yes, THAT Lloyd's) .


The reason the rates sky rocketed was due to the introduction of a ton of people into the insurance pool with chronic conditions that previously handled by charity care, medicare, medicaid.

Lawsuits are another source of inflated insurance rates; litigation is EXPENSIVE! I'm not advocating for not being able to sue for medical malpractice for gross neglience; but a great deal of the suits are filed as a quick shake down because they know they will settle for a 50-100K which is much cheaper than $200K plus to take a case to trial.

That being said, are corporations taking advantage; absolutely. Allow people to buy insurance across state lines which will introduce competition and drive down rates. It has worked in other insurance lines, it would work in health insurance too. Hell, some Doctors are now opting out of insurance payments completely and doing a house call thing with a yearly payment directly to them. You can get a major medical policy for much cheaper than a comprehensive one. If you are a healthy person that is the way to go.

OH, add Catastrophic Medical Coverage to your automobile policy; a million in coverage will cost you about 20 bucks a year additional. A majority of catastrophic medical cases are a result of automobile accidents. Now THAT's cheap insurance.


It really is a Gordian knot of an issue.

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Don't get me wrong, I'm not opposed to a non-smoking discount or a healthy eating discount or other discounts related to healthy habits. Though many people likely would. You know, the "what's next, are they going to force me to eat my broccoli" crowd.

I just feel like elements out of our control should not impact what we pay for insurance.

Now, the problem with a healthy eating or a moderate drinking discount is, how do you verify it? Honor system? It seems like what they are trying to do is to make a semi-educated guess based on available big data. This is hardly a complete or verified dataset, and as such will just lead to garbage decisions. GIGO. Garbage in = Garbage Out.

If they are going to base insurance or credit decisions off of something, they had better have incontrovertible proof that the specific individual behaves a certain way (like maybe a DUI on the record), not some nonsense "statistical tendency of people who post X on Facebook to live less healthily" bullshit.

Zarathustra[H] said:

The fact that insurers can pick and choose by ramping up rates on some and not on others kind of negates the whole purpose of insurance, which is to spread the risks and costs across all people.

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If all risks were the same or reasonable I would be right there with you, but not all risks are the same. For example if I can get a better rate by going to an insurer who essentially prices out people who smoke/drink excessively or practice other self destructive habits, then why not? Why should I have to pay for other people's destructive habits?

Think of all the people with questionable judgement who would do even more stupid stuff if they knew they would be coddled and taken care of? Ever live in an apartment or visit a hotel with unlimited water - you don't get billed separately? Ever seen people's behavior change because of it?

If they really wanted to "fix" health care in this country four things would dramatically improve the market in the US and tamp down costs:
1. Allow insurers to offer polices across state lines.
2. Change the rules to not just allow but encourage non-profit health insurers equivalent to credit unions or my electrical cooperative I get power from.
3. Health savings accounts for everyone where I can bank pre-tax dollars now for use when I get older.
4. Caps on medical malpractice and looser pay's rules for court costs.

The market would sort things out. Medicare/Medicaid would still be the safety net for the minority, instead of the vast expansion to the default some people seem insistent on taking us down too (Including the for profit insurers). Ever watch a savvy small business owner that pays cash for health services? They pay a fraction of what those of us on insurance pay - mainly because of the overhead from the government and insurers. It's significant and nuts how much their overhead saps our economy.

Frankly that's the real problem; insurance was never meant to be health care - it was meant to be that safety net for truly catastrophic needs. Would you buy a water maintenance plan from Best Buy to supply bottled water or just buy it as you needed? You buy it as you need it since it's way cheaper! I dunno why we don't think of health care as any other expense - it is. The insurance companies are sure happy that we've managed to train ourselves to think that health insurance equals health care. Middlemen love people who consider them as essential and not part of the problem; especially when they are significant chunk of it today.

For all the people complaining about healthcare in this country, go talk to people who live in other countries. In being in the hospital with family I've ran into people from Australia, Canada and the UK who had medical issues here and were a lot happier that their issues happened in the US instead of at home. They all cited the quality of care and more importantly speed and access to care.

TANSTAAFL - the old fast/good/cheap triple constraints. With government, costs will eventually spiral out of control (accountability and efficiency are not government strong suits) and the speed/quality side of things will suffer. It's not speculation, it happens in other countries now. The UK has awesome health care - as long as you don't mind dying 20 years earlier than here. "The only serious black mark against the NHS was its poor record on keeping people alive." What a joke. I'd call that more than a black mark.

If someone wants to choose a small pool with healthy discounts, rather than a non discriminatiry system where the risks even out within a giant pool, then they will wind up paying more.

Our healthcare system is not only the most expensive in the world, it's also the most inhumane.

Fix healthcare by going to a Ultra High Deductible program for everyone. The first $5000 comes out of your pocket. This way hypochondriacs have reason to stay also otherwise healthy people with sniffles can stay home. People have reason to competitively shop when it permits and you use insurance to prevent true economic hardship which is what "insurance" does for everything else. Do you call the insurance company and a builder if you have burned out lightbulb or a loose step? No but you do if you flood your house or have a fire, you do. I believe Malaysia does this and the quality of care is top notch.

"We see from having scraped your social media that you had a few drinks in your 20s ... coverage denied!"

Zarathustra[H] said:

IMHO we need to reform how health insurers offer rates to people.

Make it illegal to discriminate between people. You have to offer the same rate to everyone, regardless of anything, even regardless of whether or not they are part of a group.

The fact that insurers can pick and choose by ramping up rates on some and not on others kind of negates the whole purpose of insurance, which is to spread the risks and costs across all people.

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Insurance is and has been risk assessment. You get different rates for your car insurance based on your data (vehicle type, time driving, prior claims, location, and I'm sure personal details). The algorithms take in minute details and will find correlations, maybe a multi-story house is more likely to have higher claims in a fire versus a single-story (water flows downwards, less footprint has to burn before structural collapse, less egress points or more injuries escaping / higher chance of death, etc.).

They're not going to change the game unless they're forced to.

jpm100 said:

Fix healthcare by going to a Ultra High Deductible program for everyone. The first $5000 comes out of your pocket. This way hypochondriacs have reason to stay also otherwise healthy people with sniffles can stay home. People have reason to competitively shop when it permits and you use insurance to prevent true economic hardship which is what "insurance" does for everything else. Do you call the insurance company and a builder if you have burned out lightbulb or a loose step? No but you do if you flood your house or have a fire, you do. I believe Malaysia does this and the quality of care is top notch.

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LOL! I wish my deductible for as low as $5000.

Zarathustra[H] said:

Yeah, it's rough to be in business for yourself when it comes to health insurance.

The IRS defines high deductibles as follows:

High Deductible Health Plan (HDHP) A plan with a higher deductible than a traditional insurance plan. ... The IRS defines a high deductible health plan as any plan with a deductible of at least $1,350 for an individual or $2,700 for a family.

Those bastard health insurers get sneaky though, because often there is a co-insurance in addition to the deductible, which more or less does the same thing under a different name

I'm lucky enough to have employer coverage, but my company only offers two plans, both of which are "high deductible" plans. A Higher Premium, Lower Deductible plan with a $1,450 deductible and a Lower Premium, Higher Deductible plan with a $2,500 deductible. (both deductibles are for individual plans, family plans have much higher deductibles)

The annual out of pocket max for each is $4,450.00 and $5,500.00 each respectively.

I've tried to stick enough pre-tax cash into my HSA account so I can cover the out of pocket max if needed, but federal maximums and going to th edoctor and using the HSA have prevented me from getting there thus far.

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You should see the lowlights!

DocNo said:

If they really wanted to "fix" health care in this country four things would dramatically improve the market in the US and tamp down costs:
1. Allow insurers to offer polices across state lines.
2. Change the rules to not just allow but encourage non-profit health insurers equivalent to credit unions or my electrical cooperative I get power from.
3. Health savings accounts for everyone where I can bank pre-tax dollars now for use when I get older.
4. Caps on medical malpractice and looser pay's rules for court costs.

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5. Caps on certain costs / market controls.

Healthcare does not work in a free-market because the demand/supply curve is skewed from greed and ripe for abuse. Normal supply/demand can correct by buyerA saying "ya know, I don't think I want to pay $1200 for a new iPhone," because they can set an upper threshold of what the actual value is to themselves (it's a "want" and not a "need"; if enough decide this, the price drops to seek equilibrium). You can't do that in healthcare when the choices are terrible life/certain death or happy existence. People in desperation will sign over whatever they ask.

Slowly each middle man starts asking a little more. And a little more. Until you end up at needles that cost $20 or ER Tylenol tablets that cost $40.

The entire reason for having insurance in the first place is to provide affordable help to unfortunate individuals by "taking" money from those that are more fortunate.
It's a win-win since either you're in luck and don't need to make use of your insurance or you get into trouble but get some help from the insurance.

With very individual profiling only the insurance companies wins since the insurance fees for each individual should cover both their expected pay-back and the costs for the insurance companies. It will be cheaper to just pay medical bills as they come.

As a side note: During the cold war the Swedish armed forces owned lots of buildings and properties. These didn't have any insurance, because it was realised that due to the sheer number damages would happen. Setting some money aside to cover the annual costs where needed was cheaper than paying an external insurance company.

jpm100 said:

... Is it fair to ask non-smokers to subsidize smokers? Non illicit drug users to subsidize illicit drug users?

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To some extent, yes. Medical help should be paired with demands to stop using the drugs, which will help those individuals effectively repay their costs later on.

dreamwriter said:

Why doesn't the US follow the lead of every industrialized nation in the world, and set up a universal healthcare system? We pay more per capita for health than any country in the world and rank 26 in most health parameters. That way no discrimination, no bankruptcies to stay alive.

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Its because the health care industry collectively spends more money lobbying Congress than any other group. Even more than the defense contractors.

Americans are spending double what they should be on health care, that's a big financial incentive for the industry to oppose reform.

Olle P said:

The entire reason for having insurance in the first place is to provide affordable help to unfortunate individuals by "taking" money from those that are more fortunate.
It's a win-win since either you're in luck and don't need to make use of your insurance or you get into trouble but get some help from the insurance.

With very individual profiling only the insurance companies wins since the insurance fees for each individual should cover both their expected pay-back and the costs for the insurance companies. It will be cheaper to just pay medical bills as they come.

As a side note: During the cold war the Swedish armed forces owned lots of buildings and properties. These didn't have any insurance, because it was realised that due to the sheer number damages would happen. Setting some money aside to cover the annual costs where needed was cheaper than paying an external insurance company.

To some extent, yes. Medical help should be paired with demands to stop using the drugs, which will help those individuals effectively repay their costs later on.

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No. The reason for insurance is to pool clients' risk of financial loss to provide a low cost for indemnity. The less overall risk there is in the pool the greater the reduction in cost for everyone. It's not a socialist scheme to take money from the rich and give it to the poor.

dreamwriter said:

The American healthcare system is in shambles, and the notion that the world is somehow riding our research coattails is simplistic. R&D in Pharma is inflated to justify absurd drug costs, and many Pharma drugs are based on NIH research, where the drug companies buy up government generated discoveries for pennies on the dollar.

The way the medical insurance and Pharam lobby works is by generating the kind if competitive anger reflected in some posts. The goal is to reduce costs. It doesn't matter that you think you're paying for a smoker. What matters is how the costs are covered. Insurance works by spreading the risks among the largest pool possible. A pool of 326 million people is a better pool than a 20 million person one.

The GAO study showed the US would save 3 billion dollars in the firs year with a Medicare for all system.

As far as lines go, I know many people from Canada who not only love their system, but state that they never wait in lines for necessary or urgent treatment. You may have to wait a couple of months for cosmetic surgery, and other non urgent conditions.

And none of them go bankrupt or die because they can't pay.

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That's sort of true. You still pay for the drugs and the cost of those can easily bankrupt you, even with the subsidies, if you have cancer or diabeties for example. Quality of life is still second to efficiency in our healthcare system so you still end up having to pay for the better versions of drugs or implements (like leg-braces). The system does get burdened by the people who go to emergency for the flu, especially new parents. Seniors who are simply lonely also show up a lot. Our hospitals try to mitigate this with triage nurses in the waiting area. The Ontario government also implemented a toll-free line for people to call (Telehealth Ontario) but, because of liability, they invariably recommend you go to emergency "to be sure." At least they did when we called about our babies. It's still easier to get an MRI by driving to Buffalo, hell the government will even pay for it sometimes because they know we're deficient in that area. Socialized healthcare doesn't scale very well as you simply cannot afford what it costs to prevent bottle-necking.

dreamwriter said:

The American healthcare system is in shambles, and the notion that the world is somehow riding our research coattails is simplistic. R&D in Pharma is inflated to justify absurd drug costs, and many Pharma drugs are based on NIH research, where the drug companies buy up government generated discoveries for pennies on the dollar.

The way the medical insurance and Pharam lobby works is by generating the kind if competitive anger reflected in some posts. The goal is to reduce costs. It doesn't matter that you think you're paying for a smoker. What matters is how the costs are covered. Insurance works by spreading the risks among the largest pool possible. A pool of 326 million people is a better pool than a 20 million person one.

The GAO study showed the US would save 3 billion dollars in the firs year with a Medicare for all system.

As far as lines go, I know many people from Canada who not only love their system, but state that they never wait in lines for necessary or urgent treatment. You may have to wait a couple of months for cosmetic surgery, and other non urgent conditions.

And none of them go bankrupt or die because they can't pay.

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If there are high R&D costs it’s driven mainly by the FDA. It’s very difficult, costly, and lengthy to get a drug/facility to produce it approved. It’s also very difficult to stay compliant. Sterility and humans are polar opposites. You also need proven efficacy or you cannot sell it at all.

Dayaks said:

If there are high R&D costs it’s driven mainly by the FDA.

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The people here repeating the talking points about how high costs somehow aren't the companies fault are in for a shock when somebody they love gets fucked over by this nonsense.

My dad has cancer and he's supposed to take thalidomide. Thalidomide was originally used as a cheap over-the-counter sedative in the 60s until it became a morning sickness treatment and doctors started to realize it causes birth defects. In the 90's they discovered that it was effective against multiple myloma and other cancers. The cost of the drug in the US is now in the ~$100,000/year range. Celgene, the owner, seems to have taken their thalidomide revenues to develop their own derivative version of thalidomide called Lenalidomide, which costs $160,000/year, while simultaneously blocking the introduction of generic competitors.

You can get thalidomide in Brazil for about 7 cents a pill. Its worth a couple bucks in the UK.

you also have to wonder.. just how they are handling that treasure trove of info that is the DNA databases that people are willingly giving in exchange to found out ancestor and such.

You know.. the ones we have heard about recently because the police used them to find DNA matches..

DeathFromBelow said:

The people here repeating the talking points about how high costs somehow aren't the companies fault are in for a shock when somebody they love gets fucked over by this nonsense.

My dad has cancer and he's supposed to take thalidomide. Thalidomide was originally used as a cheap over-the-counter sedative in the 60s until it became a morning sickness treatment and doctors started to realize it causes birth defects. In the 90's they discovered that it was effective against multiple myloma and other cancers. The cost of the drug in the US is now in the ~$100,000/year range. Celgene, the owner, seems to have taken their thalidomide revenues to develop their own derivative version of thalidomide called Lenalidomide, which costs $160,000/year, while simultaneously blocking the introduction of generic competitors.

You can get thalidomide in Brazil for about 7 cents a pill. Its worth a couple bucks in the UK.

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Well that’s just people being complete douchebags. That’s not high R&D.

$100k/yr might make sense if there’s only ~200 patients a year. I doubt they would bother for that number though.

Funny you bring up Thalidomide because incidents like that are exactly why the FDA is extremely strict (which induces cost) but for good reason.

Armenius said:

No. The reason for insurance is to pool clients' risk of financial loss to provide a low cost for indemnity.

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You're wrong. In America, the reason for insurance is to profit. The insurance company doesn't give a crap about it's customers. All you are, is a number.

Until everyone realizes this, and stops believing the nonsensical advertisements, like 'the good hands people', etc., this will never be understood. People are ignorant, as well demonstrated here, where most are reasonably bright. Yet, we still see the complete understanding that healthcare in America, and it's healthcare insurance system, is in existence primarily for profit; and the best customer is one who doesn't have a choice but to buy your product. Sick? Oh, sorry, just sign here and pay through the nose, or DIE.

I laugh at all of you who think that because you're healthy RIGHT NOW, that will never change. 35 and healthy as a horse? Great. Pay low rates, and put your money into a health savings account. Then when you're 65 and need open heart surgery, your insurance rates will be $100,000 a year (and that will go up because you are now a high risk), with a $50,000 deductible. Think you can afford that? Think again. And that doesn't include all the extras. You won't get it until it happens to YOU.

Zarathustra[H] said:

IMHO we need to reform how health insurers offer rates to people.

Make it illegal to discriminate between people. You have to offer the same rate to everyone, regardless of anything, even regardless of whether or not they are part of a group.

The fact that insurers can pick and choose by ramping up rates on some and not on others kind of negates the whole purpose of insurance, which is to spread the risks and costs across all people.

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So, everyone should just have an equally high rate, eh? Got it.

Armenius said:

No. The reason for insurance is to pool clients' risk of financial loss to provide a low cost for indemnity. The less overall risk there is in the pool the greater the reduction in cost for everyone. It's not a socialist scheme to take money from the rich and give it to the poor.

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That's exactly what I wrote, using different words: Everybody in the group pays (about) the same, so that the total input covers all expenses for the entire group. I do assume that the income disparity isn't huge and that there are no "poor" people in absolute terms, only those that would become poor if they'd have to pay their medical bills themselves.

If it was all about "taking money from the rich" the fees would be based on individual income.

fadedlogic said:

I should pay the same as the Type 2 Diabetic who drinks a 2 liter of Orange Faygo twice a day.

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In a properly ran system yes. The added costs from those who abuse their bodies is usually negligible since those people also tend to live shorter lives.

fadedlogic said:

The reason the rates sky rocketed was due to the introduction of a ton of people into the insurance pool with chronic conditions that previously handled by charity care, medicare, medicaid.

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This is false. Healthcare costs have been skyrocketing for decades in the US. People were talking about it back in the 80's and 90's (hence the Clinton's failed attempt at healthcare reform back then). The problem has always been you have to get some sort of a fix through a thoroughly lobbied Congress that also finds the best option (ie. nationalized healthcare) to be intolerable for what amounts to BS "philosophical reasons".

Its also worth pointing out that people with pre-existing conditions often had little to no coverage at all under Medicaid, which is often highly restricted and comes with lots of caveats and difficult to get (its the better than nothing option essentially), and even mentioning charity as a realistic option is just laughable. Medicare was and is for the retired and disabled whose coverage hasn't changed.

The most recent healthcare costs increases associated with the PPACA were due to the PPACA actually instituting standards and forcing minimum quality of care for insurance so that you actually got something for what you were paying for. Prior to the PPACA all those cheap plans effectively covered little to nothing at all and if you actually needed to use one you were screwed. The very recent cost increases since early 2017 have been from Trump's chosen actively trying to sabotage the PPACA (since they can't do a repeal or a repeal and place after doing the tax bill). Prior to the most recent fuckery the PPACA was actually successful at reducing the -rate of increase of healthcare costs- which was what it was meant to do. That is healthcare costs were still going up but not at nearly the rate they were before.

fadedlogic said:

Lawsuits are another source of inflated insurance rates; litigation is EXPENSIVE!

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Litigation is expensive to an individual but not to the healthcare industry at large. It is not a driver of costs at all industry wide.

Several states, like Texas for instance, essentially banned medical lawsuits (yes even for gross negligence BTW) and there was no change at all in healthcare prices in that state nor did the rate of change in the increases of healthcare in that state drop either.

fadedlogic said:

Allow people to buy insurance across state lines which will introduce competition and drive down rates

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You can already buy insurance across state lines, and depending on your insurance network your current plan may be able to work just fine. Who you told you that you can't already do this? It has no effect on health insurance costs BTW..

Competition can't be a major driving influence of insurance costs either BTW since there really isn't anything they can do to the business to make a major difference in the cost of operations of the insurance companies. They're efficiency is already very high, you can tell by the low overheads they have. The only way to make a big difference on administrative costs is to nationalize healthcare and essentially make the insurance side of it non-profit (with the non-profit part being the real reason administrative costs would drop).

fadedlogic said:

Hell, some Doctors are now opting out of insurance payments completely and doing a house call thing with a yearly payment directly to them.

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Only for rich people effectively. Your avg. person can't afford those sorts of costs.

fadedlogic said:

You can get a major medical policy for much cheaper than a comprehensive one. If you are a healthy person that is the way to go.

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The plans you're talking about are "fake coverage" and are effectively useless. Their reintroduction is a end run around of the PPACA protections. Also no one can predict when they get sick and we will all get sick BTW.

fadedlogic said:

It really is a Gordian knot of an issue.

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No its not. Just do what the rest of the world does and nationalize the healthcare system.

They pay about half what we do for a reason (yes its in taxes but so what? Expenses are expenses, and everyone gets sick and old, so long as the total dollars that leave your wallet are reduced who cares about the details of how payments are made?). It'll take the better part of a decade to implement something like Medicare for All (which in the US is the easiest way to do it) but once its done costs would drop down to something much more reasonable and all the in/out of network crap and other shenanigans designed to deny you coverage go away too.

all of this data collection is government mandated...

Dayaks said:

Well that’s just people being complete douchebags.

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What if nearly everyone in the insurance and pharmaceutical industry are douchebags and have been for decades but have recently just decided to get more blatant about it?

Dayaks said:

If there are high R&D costs it’s driven mainly by the FDA.

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This false. R&D costs are high everywhere. Its not a FDA or govt. issue its a "make sure the drug companies aren't selling snake oil" + guaranteeing safety issue(s).

I'd also point out the drug companies spend more on advertising than they do on drug R&D and have for years.

YeuEmMaiMai said:

all of this data collection is government mandated...

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Read up on HIPAA. Its not at all govt. mandated. Its it really so shocking that private for profit companies would be skeevy about collecting heaps of private data in 2018??

dreamwriter said:

Why doesn't the US follow the lead of every industrialized nation in the world, and set up a universal healthcare system? We pay more per capita for health than any country in the world and rank 26 in most health parameters. That way no discrimination, no bankruptcies to stay alive.

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We also have the most advanced health care system in the world bar none.

Throw in a sue happy one and lots of people who don't pay their bills and you get expensive insurance.

Oh and I forgot we subsidize research for drug companies with more expensive medicines that we pay for. The rest of the world controls the cost of meds leaving us holding the bag for keeping stock owners happy with profits.

My wife in the past has been extremely active in health care reform. Her research papers are a mile deep and she knew ACA was a disaster that wouldn't fix anything.

DigitalGriffin said:

We also have the most advanced health care system in the world bar none.

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Doesn't matter. If its inaccessible because of high costs it might as well not exist for most if not nearly everyone in US right now.

DigitalGriffin said:

Throw in a sue happy one and lots of people who don't pay their bills and you get expensive insurance.

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You can ban all the medical lawsuits and prices won't go down a bit. Texas did just that over a decade ago now and nothing has changed. Well, insurance companies' profits went up some, but otherwise nothing changed.

DigitalGriffin said:

Oh and I forgot we subsidize research for drug companies with more expensive medicines that we pay for.

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Drug costs have nothing to do with R&D costs anymore and drug companies do huge amounts of R&D over seas to both lower costs and dodge regs. They also spend more money on marketing then they do on R&D too. Yet they don't complain about marketing costs one bit.

DigitalGriffin said:

My wife in the past has been extremely active in health care reform.

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My Uncle who works at Nintendo AND BCBS says your wife is wrong. Oh you can also look at the reduced rate of increased healthcare costs to see proof of what effect the PPACA had too if you like evidence but whatever man.


EDIT: LOL if you have solid data yet also believed posting it is useless than you'd also never have posted in the first place in thread either so yeeeaaahh I think you're gonna have to have a nice day here \/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/

mesyn191 said:

Doesn't matter. If its inaccessible because of high costs it might as well not exist for most if not nearly everyone in US right now.


You can ban all the medical lawsuits and prices won't go down a bit. Texas did just that over a decade ago now and nothing has changed. Well, insurance companies' profits went up some, but otherwise nothing changed.


Drug costs have nothing to do with R&D costs anymore and drug companies do huge amounts of R&D over seas to both lower costs and dodge regs. They also spend more money on marketing then they do on R&D too. Yet they don't complain about marketing costs one bit.


My Uncle who works at Nintendo AND BCBS says your wife is wrong. Oh you can also look at the reduced rate of increased healthcare costs to see proof of what effect the PPACA had too if you like evidence but whatever man.

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How do you respond to someone who is wrong on every point and have the data to prove it....

You don't. You're spitting into the wind.

Have a nice day.

Spidey329 said:

Healthcare does not work in a free-market because the demand/supply curve is skewed from greed and ripe for abuse. Normal supply/demand can correct by buyerA saying "ya know, I don't think I want to pay $1200 for a new iPhone," because they can set an upper threshold of what the actual value is to themselves (it's a "want" and not a "need"; if enough decide this, the price drops to seek equilibrium). You can't do that in healthcare

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Sure you can. We've just taught generations of American's that "healthcare" is a black box.

It's not a black box for everyone. I have friends who pay cash and the price differences are amazing. If I go get an MRI, the hospital will bill my insurance for several thousand dollars. If one of my friends who pays cash went it would be under $500. He also shops around to different providers on a routine basis. When's the last time the majority of people thought about price shopping before getting a medical procedure?

And of course emergency situations are a whole different animal - but the vast majority of healthcare needs aren't around emergency's.

Olle P said:

As a side note: During the cold war the Swedish armed forces owned lots of buildings and properties. These didn't have any insurance, because it was realised that due to the sheer number damages would happen. Setting some money aside to cover the annual costs where needed was cheaper than paying an external insurance company.

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Self insurance is always better. Not everyone has the means though. But a government surely should be able to self insure.