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I live in Ontario, Canada where we have a single payer health care system. But this system, as good as it is, does not cover everything. So many working Canadians also get supplemental health care insurance through their employer (it is a sought after benefit, one that unfortunately I do not have). This supplemental insurance covers things like dental, physiotherapy, massage therapy, or a private hospital room.

My thesis is that for these supplemental services insurance actually serves to inflate the costs of these services and allows providers to earn excessive salaries.

My main experience has been with dentistry. Currently the going rate for a check up and cleaning is roughly $150 per visit. So for a family of four going twice a year that would be about $1,200. Not an insignificant sum. The cost of something like a crown is also expensive - about $1,250.

Even though there seems to be an excess supply of dentists prices are kept high by rates negotiated between the dentist association and the major insurance companies. Essentially those without insurance are left paying higher rates because those with insurance keep rates high.

By way of comparison I was recently in Taiwan, which does cover dental under its health plan. Because we did not have coverage we had to pay the going rates. For 2 cleanings and a crown we paid a total of $350 (in Canada the same thing would have cost $1,550). Now if you are thinking I would never go to a dentist overseas let me tell you that the office and service were well above what we typically get in Canada. In addition I had some other medical work done there and it too was done more efficiently and with better equipment than at home - quite a surprise for me.

Here is what seems to happen. Because most individuals do not have to pay the full costs of their supplemental health care services there is much less effort to keep costs down. Insurance companies are less concerned with costs than you might think. They are happy as long as they can pass on the costs ... and companies really have very little negotiating power as the insurance companies offer similar rates because they all have roughly the same negotiated costs.

I do know that if people did not have coverage they definitely consume less - in my case I may go to a dentist only once a year or even far less often. Without insurance dentists would clearly have less work at current prices and may as a result have to cut prices to attract customers. It is impossible to see how prices could be higher without an insurance system in place.

To be clear, my argument is that private insurance increases prices, especially for non-essential services. I firmly believe that a single payer system remains the most efficient and equitable way to provide health care.

Originally posted to taonow on Thu Nov 15, 2012 at 07:32 PM PST.

Also republished by Community Spotlight.

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Comment Preferences

  •  You are correct! (16+ / 0-)

    In the 1980's and until the mid 90's here in America, we did not have co-pays on most insurance policy's.  When they put the co-pays in, the prices went through the roof and are still that way.  The reason for that is utilization, when you use it, it inflates the bubble and off we go.  So you are seeing there what we saw here and the longer that you have that in place, the more the insurance company's have you by the huevos.  The squeeze is just beginning, brace yourself.

    •  jasan - costs for healthcare in the US (3+ / 0-)
      Recommended by:
      Alexandra Lynch, Chi, james321

      rose less than the inflation rate until Medicare was passed.

      "let's talk about that"

      by VClib on Thu Nov 15, 2012 at 09:01:58 PM PST

      [ Parent ]

      •  Know what happened when Medicare passed (9+ / 0-)

        it started saving the sick, old and disabled.  This was and is a small price to pay for our fellow Americans.  Would you not agree?

        •  Right, don't want to forget reason for the net (9+ / 0-)


          Move Single Payer Forward? Join 18,000 Doctors of PNHP and 185,000 member National Nurses United

          by divineorder on Fri Nov 16, 2012 at 09:29:08 AM PST

          [ Parent ]

        •  jason - I am a big Medicare supporter (2+ / 0-)
          Recommended by:
          Sparhawk, cynndara

          However, when you look at the historical data before we had any government paid healthcare, and all healthcare was private pay (many self-pay), we had no issue with out of control healthcare cost increases. Why did bringing government into the market change the costs so much? I wish I knew.

          "let's talk about that"

          by VClib on Fri Nov 16, 2012 at 01:14:23 PM PST

          [ Parent ]

          •  Look at other healthcare markets that don't rely (4+ / 0-)
            Recommended by:
            smrichmond, cynndara, bnasley, VClib

            on insurance.

            Elective plastic surgery and ortidonture have had far lower price inflation than healthcare in general and it is largely uncovered by insurance.  The patient is the customer and agrees to a price with the provider.  A large part of the reason for this is that higher prices have a big impact on reducing the number of patients.  In addition, there are strong incentives for this part of healthcare to reduce costs.

            Another market is laser eye surgery, where prices have declined greatly -  this market is also largely uncovered by insurance.

            Health insurance companies have weaker interests in keeping costs down than typical consumers - their interests are moreso to be competitive with other health insurance companies, not to drive down the cost of healthcare in a market.  They seek to get the same price from a provider as their competitor, not to drive the healthcare prices down.  Higher healthcare costs indirectly benefit insurance companies, as their business ultimately is a percentage of the spending in the market.

            The most important way to protect the environment is not to have more than one child.

            by nextstep on Fri Nov 16, 2012 at 03:00:16 PM PST

            [ Parent ]

            •  Right. (0+ / 0-)

              I've paid for two cats to have multiple surgeries and ultimately die of cancer.  The level of skill required to operate on a cat and the time in training for veterinarians is as significant as it is for human doctors.  Nevertheless I was able to pay for these expenses out of pocket on a secretary's salary.  Now try doing that for your HUMAN child.

              Despite efforts by veterinarians to sell insurance for veterinary costs, nobody buys it . . . because they don't need it.  In a pinch, anybody who can afford the insurance can afford the bill.  I'm afraid it's going much the same way for humans.  We can't afford insurance because the bills have gotten so steep that insurance (which in essence is simply prepaid medical costs) is unaffordable.

    •  you have to remember to discuss with your dentist (9+ / 0-)

      that you DO NOT have insurance if you don't. They may not understand at first, but once they get the point, they usually offer 25% off if you pay at the time, and I find that is one of the few things a credit card should be for. I learned that from the hygienists who were discussing my case really loudly behind a curtain and one of them asked about my bill. "Shouldn't we tell her?" So glad I got a clue.

  •  Administrative costs for Medicare (17+ / 0-)

    is betw. four and five percent.  For profit insurance it is as high as thirty-five percent (Executive salaries, bonuses, incentives, options, sales expenses, dividends, lobbyists, expense accounts, private jets, nepotism etc).

    •  BP - the ACA now requires that 85% of premiums (9+ / 0-)

      be paid in actual claims leaving 15% for all administrative costs, including executive salaries, bonuses, incentives, sales expense, lobbyists, expense accounts, private jets etc. Dividends are not an expense and are paid after tax. Options aren't a cash expense and are likely not included.

      I receive a rebate check from California Blue Shield last year because they didn't meet the 85% test and had to return a portion of my premiums.

      "let's talk about that"

      by VClib on Thu Nov 15, 2012 at 09:05:27 PM PST

      [ Parent ]

      •  Congratulations; that still doesn't (5+ / 0-)

        address the cost-inflation that private insurers and providers engage in.

        There is nothing in ACA that prevents both providers and insurers from jacking up costs so that that 15% margin expands. The provision you note is a bit of bread for the circus, and nothing more.

        •  Justin - they can't expand the 15% margin (7+ / 0-)

          The 15% margin is statutory, and can't be expanded. I think your point is that it doesn't prevent the providers from raising prices and the insurance company paying them. I agree.

          This is no defense of the health insurance companies but none of the payers, including Medicare and Medicaid, have ever focused on costs, but rather the price they pay for services. We have a lot of national discussion about the cost of healthcare in the US and then everyone focuses on the price that is paid by various entities but no one talks about why the cost of providing care is twice that of other developed countries. And the answer is not insurance or drug companies, although they are easy targets. Sure they are something at the margin, but it's a distraction, and even single payer would be a small part of the answer. We practice medicine differently in the US and we compensate clinical professionals differently than anywhere else and those are much harder problems to solve.

          "let's talk about that"

          by VClib on Fri Nov 16, 2012 at 05:18:34 AM PST

          [ Parent ]

          •  Yes, 15% of Y > X is greater than 15% of X. As (2+ / 0-)
            Recommended by:
            VClib, divineorder

            long as the price increases, the actual amount of money--the margin--the insurance company receives can increase.

            That doesn't begin to touch the games that actually can be played with what is considered an "administrative cost." It's not as lock-tight as you suggest.

            I'm happy for you that you got a rebate as a result of this. Please don't let that blind you to the fact that the provision that facilitated your rebate is at best a distraction from the very real issues which you seem to have a grasp on.

          •  One of the better comments on health care I've (0+ / 0-)


            How big is your personal carbon footprint?

            by ban nock on Fri Nov 16, 2012 at 05:57:39 AM PST

            [ Parent ]

          •  The VA has focused on costs (5+ / 0-)

            We know damn well why health care is so expensive here. We manage chronic conditions in the most expensive way possible - frequent hospitalizations. 20% of the patients are 80% of the costs.

            The VA has tried to keep patients healthy to cut costs. It works if they do it.

            look for my eSci diary series Thursday evening.

            by FishOutofWater on Fri Nov 16, 2012 at 06:56:21 AM PST

            [ Parent ]

            •  We also (0+ / 0-)

              have an addiction to futile, unnecessary, and involuntary "care", often practiced in direct contradiction of the patient and the family's requests . . . and then billed nonetheless.  I carry a note in my wallet delimiting the treatments I categorically refuse -- and explaining that since I have given them fair warning, they will NOT GET A CENT OUT OF ME if they violate that directive.

    •  every time you see a cute commercial, remember (14+ / 0-)

      that's your premium out there entertaining you with reruns while you pay through the nose for actual service.

  •  The years of education and training that (3+ / 0-)
    Recommended by:
    Alexandra Lynch, wbr, divineorder

    are  required in the U.S.  is the same as required for becoming a doctor.   Years ago, a dentist in Germany was considered to be a technician, and the prices charged were considerably less.  

    Time is a long river.

    by phonegery on Thu Nov 15, 2012 at 08:04:35 PM PST

  •  Proving Your point (10+ / 0-)

    A few years back, I visited my mom and dad with my US citizen step daughters - One of whom developed a UTI.

    We called and were able to get in to see my old doctor in a shorter time period than it would have taken to make an appt for them to see their own doctor here if it had happened here (After, of course contacting our insurance carrier to make sure that they would cover it)

    The way this would work is that we would have to pay out of pocket and then file a claim to be reimbursed.

    As they weren't canadian residents - we had to pay cash for the doctor visit.

    ANYWAY -- by the end of it, we paid cash for the doctors visit and got the prescription -- ALL for less than what our co-pay for the doctors visit alone would have been had we taken them to their doctor here.

    I must admit that I always regretted NOT filing the claim anyway -- just to see what they would do with it - except that the insurance company might say that I owed them money !!!

    "I want to keep them alive long enough that I can win them to Christ," - Rick Warren, Professional Greed Driven Scumbag

    by josephk on Thu Nov 15, 2012 at 08:16:24 PM PST

    •  Didn't Rick Warren play some role in (1+ / 0-)
      Recommended by:

      Obama's first inauguration?

      Might and Right are always fighting, in our youth it seems exciting. Right is always nearly winning, Might can hardly keep from grinning. -- Clarence Day

      by hestal on Fri Nov 16, 2012 at 02:13:08 AM PST

      [ Parent ]

      •  Yes he did (2+ / 0-)
        Recommended by:
        hestal, indres

        which is why i have had this signature for the past 4 years

        Caving to the religious zealotry of the likes of Rick Warren on his very first day as President ... I am hopeful that his second inauguration ... along with his second term ... will be better thought out!

        "I want to keep them alive long enough that I can win them to Christ," - Rick Warren, Professional Greed Driven Scumbag

        by josephk on Fri Nov 16, 2012 at 10:52:49 AM PST

        [ Parent ]

  •  I view the current system of insruance as (8+ / 0-)

    little better than Ponzi schemes,  who need new blood and rate hikes to survive.  

  •  There's only been three countries in which I've (9+ / 0-)

    had to seek medical care, the United States, Canada and France. Of the three, the placed I'd least rather be sick is the United States.

    When I lived in Canada I had permanent resident status and was covered under their insurance. I didn't know anyone who had supplemental insurance. Overall I thought that the care I recieved in Canada was better than that which I've recieved in the U.S. However, I was young and healthy, so I can't say that I put them to the test. Most certainly it was easier to get an appointment, that's for sure. Sometimes I wonder what in the world people with something that requires prompt attention but isn't an "emergency" are supposed to do.

    The one aspect of Canadian care that I did not like was the dentist. I had a strong suspicion that he ran up the bill. I can't prove it.

    Before I moved there, when I was still just visiting, I had to go to the doctor. They were so incredibly appologetic about having to charge me. Obviously it felt funny to them. They really seemed almost embarrassed by it. I said, "It's okay. I'm used to it. I'd be paying for it at home anyway." Then they told me the amount! My gosh! I can't tell you the number of times I've thought to myself, if I ever get sick and the insurance here doesn't cover it, I'm just going to go to Montreal and pay cash. You can't even beging to discuss the price difference for an office visit. At that time my insurance in the U.S. was awful and I seemed to have to pay out of pocket for everything, so I knew the typical cost in the U.S.

    Exactly what the mechanism it is that drives up the cost, I don't know. Of course, everyone knows that our system is absurdly expensive and inefficient. Your notion of why sounds like as good a guess as any. The only problem I can see is that I don't believe our dentists charge less than yours even though our insurance frequently doesn't cover dentists.

    One unfortunate thing about our system is that the costs are hidden from those fortunate enough to have insurance through an employer (I purchased mine individually.).

    •  the mechanism is, the doctors charge what they can (15+ / 0-)

      and the insurance companies bargain it down until the price is achieved. I learned this as a medical secretary in two ways: One the phrase "accepting assignment" wherein we the doctors agree to accept the amount the insurance company assigns to the agreed-upon code number, adjusting our fees and charges and billing the patient accordingly to make the whole thing come out right...
      Two: I went back to collect the paperwork and the doctor showed me a fatty lump of something he had removed, in a jar, and said, "before you bill for it, wait for it to come back from pathology in case it's cancer.""Why?" I asked. "Because you can charge three times as much if it's malignant," he said, and he was right.
           Meanwhile, it was the same lump, not contagious, not more dangerous, just more nasty to the patient- not the doctor- who had performed the technical operation of slicing open skin and muscle with a sharp knife and peeling off a fatty lump, and sewing it back together; something I plan to do to a turkey carcass later today. But it costs three times more? He wasn't thinking three times harder. He was sending it out to a lab instead of looking at it himself... but labs get kickbacks too and so it goes, everybody greases the wheels...the mechanics of it all.

    •  Paperwork is a huge "medical" cost. (2+ / 0-)
      Recommended by:
      indres, FourthOfJulyAsburyPark

      Hundreds of medical insurance companies with thousands of different policies means the administrative costs are through the roof.  Many doctors say they like Medicare because they know they will get paid, not denied, and paid pretty quickly.  Insurance companies have the profit incentive to deny claims (deny medical care).  They know a certain percentage of people will not fight them, even if the denial is bogus. Do you think the two hundred page policy "brochure" is written in dense legalese for your benefit? Single payer health care is cheaper right off the bat because of reduced paperwork and less administration.

  •  The availability of financing drives up the price (5+ / 0-)
    Recommended by:
    taonow, Chi, tle, Sparhawk, cynndara

    of that being financed.  Henry Ford realized that when he allowed people to make payments on cars and understood he could sell a lot more cars and make a lot more money that way.

    I don't think of health insurance we have now as true insurance in the sense that homeowners or auto insurance is insurance.  Health insurance in the US today is more a financing mechanism that pays for services you expect to use and in that sense is financing instead of insuring against a risk.

    Even though you pay a lot for homeowners and auto insurance they are something you don't ever want to use.

    •  Cars have a healthy competitive market, though (2+ / 0-)
      Recommended by:
      cynndara, taonow

      If the price of your Honda goes too high, buy a Ford or whatever. The financing does allow prices to go higher, but at least you always have the choice.

      Health insurance is anything but a liquid market, so the "financing" aspect just makes it even worse. "Sure, throw it on the credit card (or the bill), got no choice anyway, I need this procedure."

      (-5.50,-6.67): Left Libertarian
      Leadership doesn't mean taking a straw poll and then just throwing up your hands. -Jyrinx

      by Sparhawk on Fri Nov 16, 2012 at 04:50:03 PM PST

      [ Parent ]

  •  So I just had a physical (12+ / 0-)

    and the lab bill was $900 plus. But my wonderful insurance company has a deal with Labco for a 95%(!) discount, so, Cigna told me, they 'saved' me $850 plus. Wow. I'm so happy, right? except if I hadn't had insurance, I would have had to pay THE WHOLE THING!

    D'ya think that maybe they're overbilling?

    Something aint right about this.

    •  If you didn't have insurance (2+ / 0-)
      Recommended by:
      Catte Nappe, indres

      (as I don't), you would have had a chat with the doctor about whether you really needed that many routine tests "just to be sure" or whether in the absence of symptoms it was safe to skip some of them.

      It's way too easy for doctors to just check every box on the form, just in case, when the patients aren't paying the bill. Many times no one even looks at the results when they come back.

      •  That sword cuts both ways: it might (4+ / 0-)
        Recommended by:
        shaharazade, elfling, JerryNA, Square Knot

        just as often happen that the conversation is about how long to postpone an actually necessary test instead because the person just can't afford it

      •  Try that. (1+ / 0-)
        Recommended by:

        I did.  I ended up screaming at the doctor's staff that they didn't know what the f*ck they were talking about and I'd have those tests when somebody who actually did bothered to talk to me about it.  When I went back to get my prescription refilled, the doctor informed me that I had to find another doctor and he wouldn't authorize the drugs for more than two weeks (NOT long enough to FIND another doctor to prescribe them) because I had dared to make my own decisions about my own body, the one I have to live in or die in, not him.

        Luckily there are herbal and lifestyle alternatives for blood pressure medications.  However the best of those was to stop dealing with the A-hole, which immediately lowered my pressure by 20 points.

        •  lol on how you lowered the BP. (0+ / 0-)

          I like to avoid the traditional doctor office practices for the reasons you've described and am thinking of going instead to a Community Health Center.

          Good luck with your BP. Mine is always about too low, so I'm fortunate there.

  •  I used to be a legal resident of Taiwan, and so (1+ / 0-)
    Recommended by:

    was on their insurance plan. Taiwan is good but doesn't come close to Thailand. Thailand still has the same ethnic Chinese doctors who are so good, and state of the art equipment and training, but the cost is much much lower.

    How big is your personal carbon footprint?

    by ban nock on Fri Nov 16, 2012 at 06:06:09 AM PST

  •  I had major surgery lately (7+ / 0-)

    with a four day hospital stay.   Total charges from hospital= $47,000.   Paid by insurance?  Less than $4,000.  The rest was written off.
      That's obscene.  First off, there is no way $4,000 actually covered the cost of the care I received.  Second, and far worse, you mean to tell me a person with no insurance would have had to pay $47,000 out of pocket?

       Our system is so messed up.

    Was a cold and dark December when the banks became cathedrals...

    by althea in il on Fri Nov 16, 2012 at 06:08:10 AM PST

  •  If you are on Medicare (2+ / 0-)
    Recommended by:
    shaharazade, divineorder

    No dental, no psychology, no hearing aids, $1,000 payment every time admitted to hospital, 20% co-pays, $100 a month Medicare "premium" (after paying into all your working life.

    •  No vision care either unless you've got a (0+ / 0-)

      Medicare Advantage plan that provides all of that. Regular Medicare had a $150.00 deductable this year, which I only found out about after I went to an opthalmologist. I paid for low price prescription reading glasses and distance glasses from Walmart. The ones for distance are useless so I wonder why he didn't tell me not to bother getting them. We don't have healthcare here, it's more aggravation and expense then care.  

  •  1960 (5+ / 0-)

    was about the time that dental insurance was introduced. Back then, nearly every procedure no matter how expensive or intensive was covered. It's all been downhill ever since. Today, most dental insurance policies have high premiums and cover next to nothing. If you need significant dental work, root canals or crowns, for example, they won't be covered in spite of your high premiums. By the time you are done with the year, you end up paying as much out of pocket for premiums as you would for paying out of pocket for the work done. This is for normal maintenance cleaning visits and obviously wouldn't include more major procedures, even fillings. Anyone with more comprehensive coverage than that should count their blessings.

    •  re: 1960 (3+ / 0-)
      Recommended by:
      JerryNA, cynndara, KateCrashes

      My recent experience (shifting on and off from having dental "coverage" via employer and via COBRA) leads me to believe that dental "insurance" basically gives you access to negotiated "in network" rates.  Looking at my family's treatment and premium expenses, along with actual total payments to my dentist, I figured that they are pretty much equal.  Thus, if the dentist simply charged me the "in-network" rates and I paid cash, it would not be a major cost difference from me paying for "insurance".   Dental insurance seems to simply be some sort of club membership.

  •  the issue is (10+ / 0-)

    The issue is that we keep trying to approach health care as if it is a free market industry.  If I go to Best Buy and I don't like the price of their TVs, then I can just leave.  But if I'm sick my options are much much fewer.  Health care just doesn't fit a true free market "in it for the profit" model.  The US hasn't yet figured out how to reconcile the free market with the desire to provide affordable, decent care.

  •  With truly socialized medicine (4+ / 0-)
    Recommended by:
    Catte Nappe, JerryNA, cynndara, indres

    tests and procedures routinely requested by doctors here in the US become less critical. Screenings like mammograms and pelvic exams are recommended for every few years (varies depending on screening) instead of annually. Surgery, if it isn't critical or life-threatening, may not happen right away. Intrusive procedures are lower on the list of treatments.

    Take away big profits, and that's what happens. Every procedure has to be considered carefully.

    I used to hesitate to take my kids to the doctor because of the doctor's almost automatic recommendation of tests/procedures/medicines that were over the top -- especially medicines that masked symptoms rather than getting to the heart of the problem. We have a better doctor now who at least, if she doesn't agree with me, knows to use common sense, wait-and-see,  least intrusive measures

    No system is perfect and people in other countries do complain about waiting lists, but I lived in New Zealand for eight years and had nothing but positive experiences with their health care system. Not sure how things are there now, but here's a taste of what it was like when I was there.

  •  Careful with this (0+ / 0-)
    Because most individuals do not have to pay the full costs of their supplemental health care services there is much less effort to keep costs down.
    It's a favorit RW approach. If individuals had to bear more of the actual cost they would be more responsible about choosing and using health care.

    " can’t find any oxygen from outside the aircraft to get in the aircraft, because the windows don’t open. I don’t know why they don’t do that. It’s a real problem." Mitt Romney

    by Catte Nappe on Fri Nov 16, 2012 at 12:15:56 PM PST

    •  Right wingers are right sometimes too (0+ / 0-)

      Their proscriptions might not be what you might suggest, but the idea that health insurance drives up health costs (or that student loans drive up education costs) is hardly Pat Robertson here.

      (-5.50,-6.67): Left Libertarian
      Leadership doesn't mean taking a straw poll and then just throwing up your hands. -Jyrinx

      by Sparhawk on Fri Nov 16, 2012 at 04:53:14 PM PST

      [ Parent ]

      •  On the other hand (1+ / 0-)
        Recommended by:

        the experiences of other health care systems seem to indicate that the BEST way to keep prices down is a single-payer system where a disinterested bureaucracy runs herd on excessive procedures and charges rather than individuals attempting to negotiate on their own when they are in need.

        It's quite clear to me that American doctors (and even veterinarians, who do NOT bill insurance) have an inordinate fondness for unnecessary and invasive tests and procedures.  And they get righteously indignant if you're reluctant to follow their Professional Advice.

        •  There's a useful nugget in there (1+ / 0-)
          Recommended by:

          Veterinarians. When it comes to our cats I am not disinterested, but am still a decision making "bureaucracy".  Our vet know to be honest with us about prognosis and costs. It's well known that too many doctors for humans are not willing to tell families "the truth" about cost/benefit decisions regarding care. In fact, that concern is one of my greatest fears as a human recipient of care. I would want an honest assessment of quality/quantity trade offs. I'm far from certain I would get that.

          " can’t find any oxygen from outside the aircraft to get in the aircraft, because the windows don’t open. I don’t know why they don’t do that. It’s a real problem." Mitt Romney

          by Catte Nappe on Fri Nov 16, 2012 at 06:20:24 PM PST

          [ Parent ]

    •  the difference (0+ / 0-)

      the difference is in what is essential versus what is discretionary. I think no one is over using essential things, even if they are free ... does anyone want to have a colonoscopy just because it is free?

      But, and I have seen this from administering a plan our company had, things like physio do get way overused if free. If you do not have coverage you likely go once or twice and learn the procedures and then do them at home (as both my parents did recently after injuries ... even though they had 80% coverage, funnily enough), but if you have coverage through work you will use up your 20 maximum visits (plus you may get paid  time off work to go for the appointment).  The same with massage therapy. It was funny how so many people used exactly the max number of visits they were allowed under coverage.

      of course the physio and massage practitioners work very hard on making you ''feel'' god ... because they want you coming back for all your covered visits.

      Those who make peaceful revolution impossible will make violent revolution inevitable. - JFK

      by taonow on Sat Nov 17, 2012 at 07:09:29 AM PST

      [ Parent ]

      •  Perfectly logical (1+ / 0-)
        Recommended by:
        It was funny how so many people used exactly the max number of visits they were allowed under coverage.
        I'm pretty sure the caregivers recommended a number of sessions that just "happened" to be equivalent to the number of sessions the plan paid for. Do you really think they offered or encouraged an option of the patient learning self care?

        " can’t find any oxygen from outside the aircraft to get in the aircraft, because the windows don’t open. I don’t know why they don’t do that. It’s a real problem." Mitt Romney

        by Catte Nappe on Sat Nov 17, 2012 at 10:15:36 AM PST

        [ Parent ]

  •  I was literally just thinking about this (2+ / 0-)
    Recommended by:
    cai, taonow

    this morning. You read my mind!

    Tipped & Rec'd.

  •  Today was the last day for open enrollment (2+ / 0-)
    Recommended by:
    indres, taonow

    for our benefits and I wanted to throw my laptop across the room.

    Tipped and Rec'd

    Uncultivated minds are not full of wild flowers, like uncultivated fields. Villainous weeds grow in them, and they are full of toads.--Logan Pearsall Smith

    by elizabethawilke on Fri Nov 16, 2012 at 04:14:55 PM PST

  •  This is news? (0+ / 0-)

    Yup, surprise, if you don't have money, they charge more. There must be a Will Rogers for this.

    I bought my own med ins 1993-2010 and pay attention to my med bills. Generally the discount for being insured is +-50% (in other words: if you are not insured, they charge double) but YMMV.  I did IT contract work, changed contract employers 6 times, and seen med plan cost double or halve depending if they have mostly young healthy employees, or us fogies. Initially I figured if you don't have $$ that means they can write off more, but than I found out that also this is gold for the bill collectors. I had a busy year in 2002 (all OK now), my ER visits'  'ER admission charge' varied within in 1 year from $800 to $2500 depending on the hospital and location.   Also a limited write-off in taxes (and only if you have enough income and not laid off like my 4 of the 8 Bush years)  compared to the employer tax break.

    They want free enterprise? fine, LETS TRY IT!! Lets take it away from the employer handcuff and try it like car insurance. I see Obama care has just begun an all-states non-profit option, to be offered on the exchanges. This may work out.

    We will see, as we move away from employer-covered healthcare, and we will, how much of their claimed cost  they pass on to the employees. (bets? 30% ?).

    I will happen: Medicare for all !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  

    and then: Surprise: the companies will take it as a subsidy, pocket it, and complain.  

  •  Interesting, but that mechanism would (1+ / 0-)
    Recommended by:
    Square Knot

    only work if there are a surplus of dentists.  In much of the U.S., there is not.  

    Likewise, dental insurance in the U.S. is frequently unattached to health insurance, so people who have health insurance may not have dental insurance.  Indeed, most people do not.

    What's sad about treating dental health as "unnecessary" or some other category other than health care is that it is increasingly clear that oral health is part and parcel of physical health.  For example, gum disease is correlated with heart disease.

    In the U.S., dentists seem to be pushing more and more cosmetic services, such as whitening, because those make them more money.

    © cai Visit to join the fight against global warming.

    by cai on Fri Nov 16, 2012 at 06:30:53 PM PST

    •  dentists (0+ / 0-)

      I am pretty sure there is a surplus of dentists, that is why the emphasis on stuff like whitening (otherwise not enough work).

      In addition the new ultrasonic cleaning methods (it only takes about 5 minutes) should make basic hygiene simple and cheap (it does just as well as scaling at a fraction of the time, cost and hassle) ... but obviously it is not in the dentists'interest to really push this.

      Those who make peaceful revolution impossible will make violent revolution inevitable. - JFK

      by taonow on Sat Nov 17, 2012 at 07:02:40 AM PST

      [ Parent ]

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