Mercnbeth
Posts: 11766
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It's difficult to rationalize a thought until the problem is documented. For the sake of discussion - lets keep it simple using real world examples; mine.
beth and I went to the Doctor twice in 2009. Once when we got our annual physical, once when beth was sick. We pay about $600/month for family coverage. None of our +21 dependents needed care. We are insured by the same company who insures my parents, aged 86/84. They went to the doctor every three weeks, my mother was hospitalized 3 times for a total of 28 days. Our payment to the insurance company was $4800, my parents had union insurance coverage, as retired UAW and NJEA, they paid nothing, but assume their unions paid at least as much, $4800.
The cost of our physicals and beths visit would be, at maximum $1000, neither of us are on any prescription. Combined, my parents are on 14 high end prescription drugs. The bills from my parents for the year was $130,000; 2009 was a 'healthy' year for them. In the past, I've seen annual statements exceeding $200k for them. How does an insurance company account for both within their premium structure?
The problem isn't the insurance company, the solution isn't universal health coverage from the government. The issue is how to manage the 'exceptions'. No company would insure my parents given the choice. There are many like them in the world. Were they in the same condition in 1970-80 they would not be alive. They are alive today because we have the technology and ability to keep them alive; however it is very expensive. Since this is self centered - I'm glad we do.
However as an insurance company or as a government how do you deal with the problem? There is no way the model I presented can survive. It takes too many 'Merc & beth' policies to pay for one 'Merc's Parent' policies. The pubic sector, insurance companies, have only one choice - raise rates to make the numbers work, or get out of the market. You see that in State Farm's decision to leave Florida. The government actually has the same decision, except instead of raising premiums they have to raise taxes. The bottom line is that somebody has to pay.
I think the only solution is government run 'clinics' and hospice programs staffed by those who came though a domestic medical version of the 'Peace Corp'; but I don't know if even that would work.
So before I can have a "thought" I need to know yours. Is life worth extending for all regardless of the cost, or the quality of the live preserved? Should 90% of the resources allocated be used by 10%?
If anyone wants to see the back up documentation about my families cost of health care - feel free to email me.
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Thoughts??? (Insurance rate increase) - 
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