Do rich people need health insurance?

Don,

Very articulate points, and thank you for acceding (or conceding) the costs point. I note that Canada is a loyal ally and a brave and effective one.

A concise statement of philosophy. Your examples are compelling. I hold my reservation, best expressed in an example of Safeway's (effective) preventitive care initiatives, that the individual bears primary responsibility for his or her health. Joetaxpayer gave a link in this thread leading to Safeway, which I believe Elle wrote about.

What you stated relieves, but doesn't entirely dispell, my anxiety that "health care reform" is just another domino in a progression towards progressive suppression of individual responsibility, I'm still not entirely persuaded, but I definitely appreciate your intelligence in perception and statement.

Perhaps an issue with many is the extent to which a society should spend to ensure that all are accounted for. A cousin of mine is a nurse, and does ER shifts. In the US we do provide emergency care, and many learn to 'game' it to get drugs. I myself 'gamed' the system in L.A. when the wheelchair-friendly sidewalk corners made my roller- blading much easier, but I really didn't have a choice in the matter. How far should a society go in attempting to provide medical services for all, regardless of their ability to pay? What I see coming is an additional and useless expense to me, initially of $3,000, but in a few years perhaps as much as $10,000, and that infringes on my personal ability to secure medical services, as well as heaping yet more bureaucracy on the system to the extent that I cannot seek a doctor outside my 'assigned district' and that remind me of the inamous 'school-bussing' programs.

Again, it varies by state. In some states, no illness, pre-existing condition or even your age can prevent you from getting insurance. The downside to that is, of course, that in those states, the young healthy folks pay a hell of a lot more than they otherwise would, as they are subsidizing the ill and the old.

As are the overwhelming majority of Americans -- so long as they remain employed and their employers keep covering them. That's why it's so difficult to actually get any useful reform done.

I agree with your general point above, with to me one important caveat: Some of us are born into and grow up with great advantage. The generationally, financially poor are not to use this as an excuse. Instead, I would hope the middle and higher income classes keep in mind that their dividends typically come off the backs of the financially poor.

I agree these questions should be considered in general wherever we tax one group to help another. Capitalism is good but needs some restraint at times, lest the economy implode as it did recently.

FWIW, I happen to think the health care reform Congress is currently considering does pay stunningly too short shrift towards (1) promoting individual responsibility; and (2) maybe more importantly, an awareness of how overprescribed many medical procedures, drugs etc. with no change in health outcomes. For these realities, I place the blame more on the populace and members of Congress fearing an (uninformed) outcry from their constituents (not big pharma/medical business).

Hence with (1), the damned populace will continue to buy into "more is better" when they see their physicians. With (2), the damned doctors will overprescribe either (a) to line their wallets or (b) to protect themselves from lawsuits. (I concur with your concern about malpractice suits being way overdone and adding to medical costs.)

Quite true, and most Canadians have great respect for Americans. Undoubtedly Canada owes a lot to the USA. A big military budget is not needed, because the USA military keeps the rest of the world in line. In the event a foreign power tried to intimidate or take over any part of North America, almost certainly the USA would come to the rescue. That leaves more money available for social programs north of the border.

And of course the two nations are major trading partners of each other. Economically in many ways the two are joined at the hip, even though their views on many political and social issues are quite different.

OP ponders whether the RICH need health insurance and if so is it affordable.

First you have to understand the nature of all insurance - to shift financial risk to someone else. All insurance is designed to help you get someone else to pay for your loss, in whatever situation on context we're talking about.

Whether anyone needs health insurance is dependent on how much of their own money they are willing to spend versus how much return they can get on that money. Lots of things factor into the equation - like the present and future value of the dollars available.

It makes no sense for me to pay $5K a month for insurance - $60K a year if I'm healthy. It wouldn't cost that much to go to the doctor.

On the other hand, if I've had cancer four times and a stroke and I'm only

Likely the most cost effective way for the wealthy to manage the financial risk associated with medical issues is to use a catastrophic medical insurance policy with a LARGE deductible - way $10,000 or MORE. This gets you the lowest premium possible while providing for a shift of the financial burden to the insurance company for the really BIG expenses.

Gene E. Utterback, EA, RFC, ABA

My wfe had a severe stroke in 2002 at age 62 that required surgery to save her life and the bill for 30 days in the hospital was 250K. That was the amount the insurance company settled it for, no where near what the various health providers wanted. And it could have easily been worse, much worse. I imagine working all that out as a private pay patient would have been a real headache on top of the heartache of dealing with my wife's serious brain injury.

So I tend to agree with you although I don't know what a high deductible policy like that might cost or how high a deductible might be available.

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I would have said, to be maybe a bit more clear, "to distribute financial risk over a group."

Every few years I check what HD health insurance would cost me. Since about 2003, the overwhelming majority of HD plans offer deductibles that are $5k or less. Many free online comparators attest to this. I checked one just now. Of 64 HD plans in my area offering coverage to individuals, only one offers a deductible greater than $5k. The deductible this one plan offers is $7.5k.

Family HD health insurance plans mostly max out the deductible at $5k, too. That's not per person; that's per family. A very few family HD plans max out at $10k, but this seems to be the highest.

More accurately, the purpose of insurance is to evenly distribute the financial burden over the the members of the group that participate in the plan. Those who sustain little or no loss will subsidize the few who sustain large losses.

The artificial demand pull created by insurance raises the price to everyone.

The real cost drivers are avaricious lawyers, bureacuracy, and insurance. So the current plan is to do nothing about the lawyers (as idiot juries continue to award hundreds of millions to people who "did not know" cigarettes are bad for them), augment the bureacracy, and force more insurance down everyone's throats.

The liability for medicare / medicaid (at present) is seven or eight times the liability for social security. Malthus-modified aside, what the government wants to "shift" or "distribute" is not a risk probability, but the certainty that the liability cannot be paid.

Will someone explain why a "poor man" with some costly ailment should be placed on an equal footing with a "rich man" who WOULD have been able to pay cash for it, had the price not been quintupled by artificaly created demand? Why should the "rich man" PAY to place the "poor man" (or some jerk who bought a $500,000 dollar boat on credit) ahead of himself, then go without the service himself? Guys on the Titanic gave up their seats to the poor (Macy's wife refused to leave his side). The irony of it is that it was "the poor" who panicked and messed up the lifeboats and left people locked in steerage. And, the Titanic was a time for heroism and uncommon distinction. Are we to do the same with medical services, and watch the society sink?

ER services, and quite probably basic medical, are available. Beyond that, I don't care if it is houses in Malibu, Rolls Royces, Gulfstreams, or a $2,000,000 dollar treatment. If you can't pay for, you can't have it. Why do I shoulder the cost for some jerk to have a government-paid-for in-home tanning salon, when I do not engage in such wasteful and injurious frivolities, when I needed MY money to have my heating duct-work repaired?

I think most people recognize all the very valid points you made. Some vocal few squeal loudly, and it appears that those are the majority.

One wag on CNBC quipped about "health care reform," he said, presumably to the remaining fanatical proponents, "What part of the word "NO" do you not understand?

Perhaps one thing good that will come of this broad debate about the whole thing is that people may come to understand the system better.

Correct. And the purpose of the current health care efforts in congress is to shift financial risk to someone else.

If its not $2K a month now, it will be so soon enough. Rates have been doubling every five years when you add in the age-related increases. A $1000 a month now will be $4000 in 2020, $16000 in 2030. Dont laugh. Private insurance in the 1990s was "almost free" compared to now.

Most of these are teaser rates for perfect health the previous five years. If you have any current condition, prescription or a hospitalization in the past years expect to be offered 50%-100% higher if they accept you at all.

While I might express it more softly , I agree with your premise.

Unfortunately, from a political perspective I think we'll have to give a little to those who feel everyone should have insurance.

To get what we want (liability limits, less government interference and private sector control), how would you feel about a mandatory high-deductible catastrophic policy for uninsured funded jointly by the insured and the government (taxpayers)?

(snipped- much right wing-nut hated!)

Wow, where is THAT documented by reliable sources? BTW, if the people were locked in steerage, how could they mess up the lifeboats and take the seats of "Gentlemen"?

If this is a moderated list, I suggest the moderators start reading for such diatribe as in this message.

Chip

Why, thank you so much for your timely correction! I assure you I had no intent of disparging Mr. Strauss or his wife in any manner. The first link below contains greater specificty.

The second link addresses a summary time line of the sinking of the Titanic, and the unfortunate problems.the crew encountered.

On Mar 10, 10:58 am, "HW \"Skip\" Weldon" wrote: [snip]

I'm not disposed to the insurance notion insofar as medical services goes, and certainly opposed to government mandated insurance.

Some things in man remain constant through thousands of years of cultures, and I do not see the wisdom of compromising those in order to gain an apparent victory. I honestly wonder if any of the Founding Fathers, if alive today, could identify the country. Many of those men are great simply because they refused to compromise with their values and beliefs - and there IS such a thing as being right.

The public opinion section of this Wikipeida article has interesting info on polls, though they don't ask the question the way you phrased it:

-Will

will dot trice at comcast dot net