Private Healthcare? Why Not?

[Renegade]

The rates for voluntary plans are not much better than individual plans. If you want to save money in a group plan you must be part of a mandatory plan.

Not in my experience. I save about 30% through my association plan. Do you have evidence to cite as a comparison between mandatory group, optional group, and individual plans?

This 'minority' you speak of is a myth. It does not really exist because everyone needs healthcare coverage. Individuals who are healthy today will eventually get sick and benefit from the mandatory coverage. It is short sighted to assume that individuals that are 'low risk' today will always be 'low risk' and that they will never benefit from the system.

Of course an individual's risk proifle will change with time. I never stated or believed it would not. I would propose that the premium be reflective of your risk profile. If one's risk profile changed, so would their premium and so would their beneft For the most part, that is how most insurance schemes work.

[Riverwind]

Of course an individual's risk proifle will change with time. I never stated or believed it would not. I would propose that the premium be reflective of your risk profile. If one's risk profile changed, so would their premium and so would their beneft For the most part, that is how most insurance schemes work.

Except 99% of the the people would find that their 'risk adjusted premiums' would exceed what they could afford to pay at some point in their life. That is not true of any other insurance scheme. That is why people who may be low risk today benefit from the system.

Let's put it another way: people will benefit if they pay more for life insurance while they are young in order to reduce premiums as the age. This is the way health insurance works because everyone needs health insurance when they are old.

[Renegade]

Except 99% of the the people would find that their 'risk adjusted premiums' would exceed what they could afford to pay at some point in their life. That is not true of any other insurance scheme. That is why people who may be low risk today benefit from the system.

So what your saying is that 99% of the population cannot manage their finances over their lifetime so that they balance the times when they are low risk to offset the tmes when they are high risk? You're saying that the ones who are low risk today benefit because they are financially incompetant and cannot plan for higher premiums? Personally I don't believe this to be true, and if there was a segment of the population that was that incompetant, then they are the architects of their own fate.

Let's put it another way: people will willingly pay more for life insurance while they are young in order to reduce premiums as the age. This is the way health insurance works.

Yes that is true with life insurance, but in return the insurance company gives the policy holder some cetaintity. For example in a whole life policy, the premiums and coverage is predefined.

No such certaintity exists with government run public healthcare. When an individual is young and low-risk he will pay high "premiums". He is not given any certaintity that in 30 years that he is given any coverage at all. That is completely at the whim of the govenment and population priorities at the time.

There are two choices:

1. an unwritten "undersanding" that my premiums when I am high-risk (at some point in the future) will offset my overcontribuions when I am low risk

2. leave it to my own control to manage my premium contribution so that the times I am low risk offset the times when I am high risk.

For me there is no question that 2. is the preferred choice.

[Riverwind]

So what your saying is that 99% of the population cannot manage their finances over their lifetime so that they balance the times when they are low risk to offset the times when they are high risk?

99% will never be multimillionaires that would be capable of paying for prohibitably expensive premiums when they are older. This has nothing to do with their ability to 'manage their finances'.

For me there is no question that 2. is the preferred choice.

That would imply that you 1) don't understand how much it will cost to get health insurance as an older person or 2) you expect to be incredibly wealthy.

The social contract approach to health care may not come with the legal guarantees of a life insurance policy but it is the most rational system for all except the extremely wealthy.

[bush_cheney2004]

The social contract approach to health care may not come with the legal guarantees of a life insurance policy but it is the most rational system for all except the extremely wealthy.

False..the most rational system includes the choice for a private catastrophic coverage policy while paying for preventative care out of pocket with before/after tax income. One need not be rich to do this.

[Renegade]

99% will never be multimillionaires that would be capable of paying for prohibitably expensive premiums when they are older. This has nothing to do with their ability to 'manage their finances'.

It is a zero-sum situation. If 99% the older segment is not capable of paying their premims, someone else is making up the shortfall on their behalf. Your statement would imply that the older segment is consuming healthcare resources they are not capable of paying for (this is probably true). But during their working lives they did have the fiscal capacity and should have banked it to pay for their aging years.

That would imply that you 1) don't understand how much it will cost to get health insurance as an older person

The number cited (from numerious other threads on this topic) for the cost of healthcare for a senior is $8K-$10K yearly average. I absolutely do think that everybody ought to plan to pay such a cost when they are older. And no, I don't think you need to be "extremely wealthy" in order to affod such a cost.

Yes I am aware that the cost will go up as new medical procedures are invented. But no, I don't think that everyone is entitled to medical coverage that allows them to live to 150 simply because it becomes technologically possible at some point.

The social contract approach to health care may not come with the legal guarantees of a life insurance policy but it is the most rational system for all except the extremely wealthy.

This "social contract" you speak of for healthcare has not been around long enough to prove its viability. It has depended upon a small aged population and a large young working population. This is a Ponzi scheme which cannot go on indefinitely. As a larger and larger segment of the population ages, and as more and more expensive medical procedures abound, time will tell whether the smaller and smaller working population base, who will be compelled to make a larger and large overcontributon without a guarantee of future coverage, will see this as the most rational choice.

[Riverwind]

But during their working lives they did have the fiscal capacity and should have banked it to pay for their aging years.'

Very few people have the fiscal capacity during their working lives to fund their own retirement and cover the full cost of their own healthcare when they are old.

The number cited (from numerious other threads on this topic) for the cost of healthcare for a senior is $8K-$10K average.

The key word is 'average'. A young person can never know whether they might develop a condition that would render them uninsurable. You might be willing gamble that you won't develop such a condition but most other people won't take that gamble.

But no, I don't think that everyone is entitled to medical coverage that allows them to live to 150 simply because it becomes technologically possible at some point.

I never said that any possible treatment must be covered. I am simply saying that there is nothing wrong with health insurance system that requires mandatory contributions even if some people feel they don't benefit in the short term.

This "social contract" you speak of for healthcare has not been around long enough to prove its viability. It has depended upon a small aged population and a large young working population.

The system itself needs to be adjusted. The promise of any treatment at any cost is unrealistic and we need to allow people to buy their own supplemental health coverage. That said, I think there is a basic level of care that can be provided to everyone on a sustainable basis.

[Renegade]

Very few people have the fiscal capacity during their working lives to fund their own retirement and cover the full cost of their own healthcare when they are old.

If this is true, then pure math will tell you that this is unsustainable situation. The money for someone's retirement and healthcare have to come from somewhere. If as you says the vast majority can't cover their own costs during their working lives, that money MUST come from an increasing population base. Surely you must agree that situation cannot continue infdefinitely.

BTW, your statement above all but agrees with my earlier assertion about self-sufficiency (ie that some poeple don't cover their own healthcare costs)

The key word is 'average'. A young person can never know whether they might develop a condition that would render them uninsurable. You might be willing gamble that you won't develop such a condition but most other people won't take that gamble.

But isn't that the reason I purchase insurance. It is not that I gamble that I won't deveop such a conditon, it is that I anticipate that I might develop such a condition. As long as I pay my premium to obtain coverage, insurance should pay for the treatment of the affliction until it is cured or I'm dead.

Let me propose something, what if a "Lifetime Medical Insurace" plan was offered, with predefined premiums and coverage for the duration of my existance? Would that meet the needs of most people? Probably. People would be assessed for risk early in life, and would have certainty on the premium and coverage later in life. Note that I'm simply proposing that such a plan could be offered, not suggesting that it be mandatory.

I am simply saying that there is nothing wrong with health insurance system that requires mandatory contributions even if some people feel they don't benefit in the short term.

There is absolutely something wrong with such a system. What is wrong is the removal of individual choice and freedom and the ablity to pick a model which best suits one's individual needs.

I think there is a basic level of care that can be provided to everyone on a sustainable basis.

Depending upon how you define what a "basic level of care" is, I think this is one area we probably can agree.

What I object to is the free-for-all buffet-of-any-healthcare-procedure-at-any-cost-to-the-taxpayer system we have today.

[Riverwind]

Let me propose something, what if a "Lifetime Medical Insurance" plan was offered, with predefined premiums and coverage for the duration of my existence? Would that meet the needs of most people? Probably.

You are assuming that the average person could afford such a policy if premiums were calculated based on their individual risk.

People would be assessed for risk early in life, and would have certainty on the premium and coverage later in life. Note that I'm simply proposing that such a plan could be offered, not suggesting that it be mandatory.

In an optional system people who could afford it would pay - those who could not would be forced to go without. If you want to have a system that provides basic care to the everyone over the course of their lifetime then it cannot be funded via traditional insurance models. Traditional insurance models only work if going without is an acceptable option.

Depending upon how you define what a "basic level of care" is, I think this is one area we probably can agree.

It would complex to define what that means but I would rather spend time defining a sustainable level of basic care than whether the entire system should be scrapped.

[Renegade]

You are assuming that the average person could afford such a policy if premiums were calculated based on their individual risk.

The average person could afford such a policy. Do you have any evidence to suggest they can't? I am not suggesting a one-size-fits-all policy. People would purchase the maximium coverage they could afford. A high-risk indivdual would likely only be able to afford a policy which provides reduced coverage.

In an optional system people who could afford it would pay - those who could not would be forced to go without. If you want to have a system that provides basic care to the everyone over the course of their lifetime then it cannot be funded via traditional insurance models. Traditional insurance models only work if going without is an acceptable option.

Of course there will be a segment of society who could not afford to pay. That woud be handled in the same way as the segment of society who cannot afford to pay for their shelter. A mimimal level welfare benefit. Of course those who do not pay for their own medical care should not be entitled to the same level of care as those who do.