Wednesday, March 14, 2012

Health Concerns

Some unpretty health care spending projections:

If health insurance premiums and national wages continue to grow at recent rates and the US health system makes no major structural changes, the average cost of a family health insurance premium will equal 50% of the household income by the year 2021, and surpass the average household income by the year 2033. If out-of-pocket costs are added to the premium costs, the 50% threshold is crossed by 2018 and exceeds household income by 2030.

Without major structural changes in the US health care system, the employee contribution to a family premium plus out-of-pocket costs will comprise one half of the household income by 2031 and total income by 2042. Rising health-care costs remain at the core of this unsustainable rise in insurance premiums.

Health care costs have moderated over the last year, but long-term trends, who knows?

The IATSE and producers will be wrestling over who pays what for union health coverage over the next three years when they sit down to negotiate five days hence. I would guess that companies and union members will both be paying more -- a combination of "plan redesign" (otherwise known as cost shifting, premium payments for participants, and higher contributions for companies.

Me, I think sooner or later we'll have some variation of a single-payer system, simply because health costs will crush any other approach. The head of a large health insurer agrees:

Mark Bertolini, CEO and Chairman of Aetna Insurance, announced that the end is near for profit driven health insurance companies. “The system doesn’t work, it’s broke today. The end of insurance companies, the way we’ve run the business in the past, is here.” ...

When the day arrives that few in the great middle can afford hospitalization or a doctor's visit, we'll move to a new system. Because the alternative will be untenable.

22 comments:

Anonymous said...

Guess Vancouver doesn't look so bad now?

Anonymous said...

The American health Care industry is a wonder. Long waits to see the appropriate doctor, IF the bureaucrats (health care industry/death panels) decide to let you see the appropriate doctor you've paid insurance to cover, and IF they don't decide to cancel your insurance for using it.

We need Single Payer here in America. Badly, and now. It's a shame we're so far behind some of the rest of the world in universal health care.

Anonymous said...

with the Insurance Companies saying they are going to raise their rates 8-14% in the next year, you have a wonderful example of capitalism running rampant. And with a Union that touts a "seamless cloak" in an industry where there is no security for the majority that work in it, just wait till you are stripped of your healthcare, cant get a job at even the "mom and pop" studios run by alpha dogs that dont know what they are doing, and see how much you get to worry about as you move off onto COBRA and then our in the cold because your single payer policy is too much to afford.

Anonymous said...

Me, I think sooner or later we'll have some variation of a single-payer system, simply because health costs will crush any other approach.

It's happening right now in Vermont. Vermont's government passed single-payer legislation last year.

The only thing keeping Vermont from implementing a single-payer system sooner than 2017 is the Affordable Care Act, because the ACA's "Waivers for State Innovation" does not allow states to use ACA funds for anything other than the ACA's Massachusetts-style health exchanges system until 2017.

Vermont's Congressmen are working on moving the "Waivers for State Innovation" date from 2017 to 2014, so Vermont might implement single-payer sooner rather than later.

Anonymous said...

'move off onto COBRA and then out in the cold because your single payer policy is too much to afford.'
Whoops, I just looked up Single Payer system, and I should have said "Individual Policy" which is different. I say let the government take the teeth away from the healthcare industry. It sounds like a better plan for the future.

Anonymous said...

Here's a start. Single payer. But only if you stop eating that cheap, shitty, processed, manufactured and engineered food brought to you by the bribery of the food industry. You don't need to subsidize french fries and hamburgers.

Anonymous said...

Here's a start. Single payer. But only if you stop eating that cheap, shitty, processed, manufactured and engineered food brought to you by the bribery of the food industry. You don't need to subsidize french fries and hamburgers.

...or you can just turn 65 and sign up for our single-payer Medicare system.

Single-payer's already here for our elderly.

Anonymous said...

Anonymous said...
Here's a start. Single payer. But only if you stop eating that cheap, shitty, processed, manufactured and engineered food brought to you by the bribery of the food industry. You don't need to subsidize french fries and hamburgers.


Maybe we can ban people with genetic conditions too. Why am I paying for you diabetes/cancer/crohn's?

And how about we ban large trucks from roads? I'm sick of paying taxes for them to damage my roads.

I'm also paying too much for power infrastructure, just so these mopes can run power tools in their basements.

Steve Hulett said...

Here's a start. Single payer. But only if you stop eating that cheap, shitty, processed, manufactured and engineered food brought to you by the bribery of the food industry. You don't need to subsidize french fries and hamburgers.

...or you can just turn 65 and sign up for our single-payer Medicare system.

Single-payer's already here for our elderly.


Until such time as President Romney and Speaker Paul Ryan voucherize Medicare.

Anonymous said...

The only thing keeping Vermont from implementing a single-payer system sooner than 2017 is the Affordable Care Act, because the ACA's "Waivers for State Innovation" does not allow states to use ACA funds for anything other than the ACA's Massachusetts-style health exchanges system until 2017. ...

One of the thing overlooked about the ACA is that it was, in large measure, a hail Mary pass to preserve, protect and defend private insurers.

The trendlines all point toward a time when few will have meaninful health care, OR we go to a large single-payer system along the lines of the rest of the industrialized world.

Anonymous said...

"Maybe we can ban people with genetic conditions too."

Who said anything about banning people with genetic conditions? Private health insurance already does that implicitly.

Just eat right first. Don't ask me to pay for your Southern Fried Quadruple Bypass, moron. Pizza sauce is not a vegetable, no matter how much you pay a congressman to say it is.

Anonymous said...

"We need Single Payer here in America. Badly, and now. It's a shame we're so far behind some of the rest of the world in universal health care."

I'm so looking forward to the same courteous, thoughtful and personable treatment when it comes to health care that I experience at the DMV.

Anonymous said...

I'm so looking forward to the same courteous, thoughtful and personable treatment when it comes to health care that I experience at the DMV.

My Canadian in-laws have single-payer health care from their government. It's been there for them through strokes, heart attacks, cancer, and broken limbs. They all got medical treatment. They didn't have to fill out any paperwork. They didn't get medical bills in their mail months later.

I wish my private health insurance was as good as my in-laws' coverage.

Anonymous said...

As someone who lived in L.A., worked under the Guild and enjoyed great medical coverage, when my time in the union was finished, and my extended coverage ran out...and work was tight, I headed back to Canada and have enjoyed not only steady work, but no worries about health care.

Our system is not perfect. I like what both the US and Canada offer, wish their was a hybrid in place. But I won't go bankrupt due to the sheer cost of privatize medicine.

Anonymous said...

Well, then it's settled. We should invade Canada immediately. Begin preparing the American public...

Anonymous said...

Well, then it's settled. We should invade Canada immediately. Begin preparing the American public...

Aw, c'mon, we've already taken most of their film subsidies. What more do you want?

Anonymous said...

You know....there are so many folks dead set against a single payer system that have never experienced it. Comparing it to the DMV is fear mongering..plain and simple. I grew up in Canada...I'm still alive. My parents would have lost their house by now had they been forced to pay for some of their treatments. The waits are longer, but if you have an emergency, you get seen. From my experience...I don't feel the care in the US is any better or worse.

Anonymous said...

As a father with a an autistic kid, I'm hoping something like single payer happens soon. The union's insurance like many others have found loopholes to not provide many of the services, that the federal government has mandated other insurance companies to provide. On top of that California is planning on cutting funding for other services as well.

Anonymous said...

“Entitlements are broken,” said Paul. “It’s not Republicans’ fault; it’s not Democrats fault. I tell people, ‘It’s your grandparents’ fault for having too many kids and then your fault for not having enough kids.’ It’s a demographic problem.”

I'm not a fan of the Tea Party or Rand Paul, but I think what he said here was a refreshing bit of rational thinking on the subject of Medicare. It is just math in the end.

I'm all for some kind of social solution, whether it be from the ground up or expanding something existing like Federal employment insurance programs. But current benefits will definitely have to suffer, you can't make the math add up any other way. You will, indeed, have to push some wheelchairs over a few cliffs, as some political commercials so poignantly portray.

Anonymous said...

"Single-payer's already here for our elderly."

And our federal politicians. All of them.

I agree, though, that wellness insurance ought to make people who smoke, drink too much, eat badly, and don't exercise pay more. If everyone is required to own insurance (which, in a FIRST WORLD COUNTRY ought to be), rates would remain low, so long as everyone focused on getting healthy.

Anonymous said...

"Single-payer's already here for our elderly."

And our federal politicians. All of them.

I agree, though, that wellness insurance ought to make people who smoke, drink too much, eat badly, and don't exercise pay more. If everyone is required to own insurance (which, in a FIRST WORLD COUNTRY ought to be), rates would remain low, so long as everyone focused on getting healthy.


Two thoughts...

First, our federal Congressmen will have to purchase their own health coverage on the exchanges starting in 2014. This is required by the Affordable Care Act.

Second, at least one American hospital has successfully lowered the cost of its health coverage and improved the health of its employees by enforcing a wellness program like the one you describe. To quote the article:

In one sense, the [Cleveland Clinic] has achieved the health policy ideal: cutting health-care costs by making people healthier. But consider how the clinic has done it — tying premiums to personal decisions, firing smokers, tracking employee metrics, eliminating popular sodas and foods from campus. By making it harder and more expensive for employees to be unhealthy, the clinic has radically overstepped the traditional, laissez-faire approach of employers to their workers’ personal habits.

It also opens the door to onerous forms of discrimination. The clinic no longer hires smokers. Will the obese eventually face similar hurdles? What about fans of fast food?

The experiment might work at a famed medical center where the CEO plausibly argues that aggressive leadership in health care is central to the institution’s mission. But would it work at General Motors? Caterpillar? Wal-Mart? Medicaid and Medicare?

Anonymous said...

"It also opens the door to onerous forms of discrimination. The clinic no longer hires smokers. Will the obese eventually face similar hurdles? What about fans of fast food?"

Genetic testing for people's predispositions for certain diseases is the area of most concern for people gaining affordable access to healthcare in the near future. This is why health costs directly related to lifestyle choices are being thrown under the bus.

The debate over sustainable economics of the healthcare system is shifting to what scares people more - which is what they can't necessarily control. The public at large is finding it more and more difficult to excuse costs that are avoidable, with information that we have today, so that focus can be given more toward costs that are not avoidable.

Fast food is cheap for the consumer short term, expensive for the public long term. This short term thinking based on 'individual choice' and 'consumer demand', is what the United States historically suffers from in more areas than just healthcare. People must question this 'choice' and 'demand' that they are provided - who provides it, on what terms, and why. I think the answers are pretty clear when you ask those questions, and the solutions can be formed pretty coherently from a top down point of view.

In a nutshell, no one doubts McDonalds and Marlboro do not have the public's best interest in mind.

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