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Facts on Health Care

Posted on 3/26/17 at 7:14 pm
Posted by FearlessFreep
Baja Alabama
Member since Nov 2009
17396 posts
Posted on 3/26/17 at 7:14 pm
I'm going to continue to post these links from Karl Denninger's Market Ticker in hopes that some of you will explain to me why he's wrong. A couple of excerpts:
quote:

Let us remember that insurance is simply a math problem. That is, insurance is always and everywhere simply the expression of the formula

[sum(p * c) + cost(operation of insurance company]

p = probability of having to pay a claim on a specific event
c = cost of the event

And of course "sum" is the sum of all the "p * c" components that exist for all the things you bought the insurance against.
quote:

If p = 1.0 then it is always cheaper to simply pay cash because cost*(operation of the insurance company)is never zero. For something where p = 1.0 for all, or nearly all of the population you should never buy insurance for same since p * c = c!
quote:

So what is the purpose of requiring such "mandatory benefits"? Simple: It reduces "p" over the entire population of people with policies. But since the total of those "p * c" computations is the sum of all of them for each individual the purpose of such mandates is to force you to pay for someone else's treatment for a condition you cannot possibly suffer.
quote:

So why are these medical procedures, drugs and similar so expensive now for most people? Why are you basically extorted into buying "insurance" either through your employer or directly? Why is now the law to run these charges through a company that has to make a profit and thus is guaranteed to drive up cost?

Simple: It prevents us from all having the two political discussions up above -- why are we being ripped off to the tune of 1,000%, that is 10x what we we ought to be paying for virtually everything health-care related and why should we pay anything for someone else's decision to continue a lifestyle choice that results in the expenditure of hundreds of thousands of dollars after they get the condition when they can change that lifestyle choice and eliminate not only the condition but nearly all of its expense?
Plenty more food for thought at the link above. I'd love to see supporters of ACA, AHCA, or any of the other useless and ineffective "health care proposals" read this and argue against it.
This post was edited on 3/26/17 at 7:17 pm
Posted by 5thTiger
Member since Nov 2014
7996 posts
Posted on 3/26/17 at 7:22 pm to
quote:

So what is the purpose of requiring such "mandatory benefits"? Simple: It reduces "p" over the entire population of people with policies. But since the total of those "p * c" computations is the sum of all of them for each individual the purpose of such mandates is to force you to pay for someone else's treatment for a condition you cannot possibly suffer.


The idea behind those "mandatory benefits", typically lower cost care options than the alternatives is that people will correct smaller ailments faster, thus preventing larger, more expensive ones.

Mandates forcing people to pay is literally the business model for all insurance. The healthy/smart/risk averse (driving)/etc. people buy insurance that they more than likely won't need, while sick/weak/stupid people receive more than they pay in. Also, it is much easier to to lump people together based upon risk assessments rather than by any other determining factor.

Why should women have to pay for testicular cancer treatments? or Why should men have to pay for breast cancer treatments? is essentially the question.

I mean, I think its obvious that they are avoiding major lawsuits. Not totally versed in this yet, but I'd imagine there is a more than decent chance some people would have good discrimination suits if charged differently.

Edit: why the downvotes? That is apolitical. Simply answering the questions posed.
This post was edited on 3/26/17 at 7:29 pm
Posted by tigerskin
Member since Nov 2004
41083 posts
Posted on 3/26/17 at 7:35 pm to
Totally free market cash operation would definitely lower costs.

No chance that they would withhold treatment for diabetics. They aren't going down the rabbit hole of which diseases you are getting/worsening by choice. The arguments would be endless.
This post was edited on 3/26/17 at 7:36 pm
Posted by bonhoeffer45
Member since Jul 2016
4367 posts
Posted on 3/26/17 at 8:11 pm to
Too many holes to even know where to begin.

I have never met someone that chose to get cancer, have a genetic heart condition, or get hit by a bus. The basic premise alone is problematic, which frames health care mostly as a choice and talks about problems mainly through that prism. Which very often it is not. You do not get to choose your genetics or when you become the victim of an accident. Get to chose that you were born in an area where a factory polluted the air and gave you health problems but the systems that be were unable to adequately deliver compensation to cover the costs.

Basically the guy wants to make illegal PPO/HMO's and force insurance to be nothing but indemnity where it is allowed to exist. While not allowing discrimination except for age and gender. Which would inevitably increase the "p" in his simplified calculation. Reading his policy pages he leaves a lot unclear and just says shite without explaining, like this will destroy employer insurance for good!

To more specific issues though:

Insurers are risk averse, one of the problems that led to Medicare, Medicaid, high risk government pools, and the ACA came about specifically because the private insurers refuse to insure high risk people. That is setting aside the piece constantly contradicts itself with saying one moment in supplemental pieces that insurers can't discriminate on risk factors and then encouraging it and setting up an entire market around it.

Just because a person's probability to get any one type of disease is low, the combined probability of any sort of catastrophe or health problem is much higher. Furthermore, for the vast majority of health issues, a person can not predict what he will or will not acquire. My father for instance, with no family history was driving to a clients house when his eye went nearly blind. Turns out he had Lattice Retinal Degeneration. He ended up driving himself to the ER. This has now led to multiple surgeries, specialty visits and on-going maintenance and treatment. Speaking of eyes, one of the leading causes of blindness the world over is iritis, a condition of eye pressure and the cause and predictability of getting it is almost still unknown. But millions will get it in this country.

The author cherry picks the entry level prices from a primary physician only business in Michigan. while ignoring the entire dynamic of how pricing in healthcare(or any market) works(and the fact the website markets their cheapest price and clouds the rest). Prices are largely dependent on local market dynamics and the monopoly power in an area. There is this under current that I guess by some magic, if we get rid of most insurance and government spending on healthcare and force all care providers to provide care at the same rates, with no downward control pressures like other countries, that magically rural Alaska will be able to charge the same price for care as one place in Michigan, or that all prices will look like that cherry picked price list.

The concept of membership offices for primary care itself is an intriguing one, and is actually a very old idea that started at the heart of insurance in this country when hospitals charged membership dues, but this is a concept built around primary care services. Your annual check-ups, physicals, bloodwork and basic tests. And the author very much abuses this data and runs with it. There are worthwhile ideas in what is a growing trend in healthcare with membership businesses, but there is a reckless use of this to get to his points. This is also a market that is popping up because most of these people have some other insurance and this serves as a supplement, even the website speaks to this.

Toward the end things really go off the rails. I am not sure how he does his math but he seems to just make up numbers of what his sunshine and unicorn rare disease(I.E. high-risk pools) insurance would cost. All while earlier rightfully acknowledging just how expensive high-risk pools are and have become.


This reads like when the left or the right offer up these faux reform ideas that fall apart when you actually have to fill in the numbers on things and get it analyzed by actual number crunchers I.E. Bernie and his Medicare for all and Republicans with the AHCA after promising everyone everything for 7 years.
This post was edited on 3/26/17 at 8:19 pm
Posted by Taxing Authority
Houston
Member since Feb 2010
57517 posts
Posted on 3/26/17 at 8:54 pm to
quote:

the purpose of such mandates is to force you to pay for someone else's treatment for a condition you cannot possibly suffer
This. And there is a word for that. But it isn't--insurance.
Posted by Strannix
District 11
Member since Dec 2012
49158 posts
Posted on 3/26/17 at 8:57 pm to
I don't understand how someone can downvote a mathematical formula
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10591 posts
Posted on 3/26/17 at 9:29 pm to
quote:

why should we pay anything for someone else's decision to continue a lifestyle choice that results in the expenditure of hundreds of thousands of dollars after they get the condition when they can change that lifestyle choice and eliminate not only the condition but nearly all of its expense?


This is assuming that if everyone made good decisions (or "lifestyle choices") then everyone would be healthy.

If this author is going to try to make a cut-and-dry, numbers driven argument in this fashion, the first thing he needs to do is research the % of health care dollars, approximately, that go towards treating diseases more associated with bad choices versus those not. I have no idea what the answer to that question is or if it even exists.
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