I wonder what it would cost to insure every American with a 10K deductable

[Ravy]

health insurance?

I know one or both of the current candidates has a catastrophic provision built into their plan to limit what insurance companies would have to pay out on an catastrophic accident or illness. Perhaps people could buy in, or the government could just provide this coverage for everyone. It would probably be pretty cheap... particularly if it was renewable by competitive bidding.

Then, on top of that, private insurance could be purchased optionally if you wanted items like prescription drug reimbursement, gap insurance for a lower deductable, etc.

The catastrophic component should reduce current health insurance costs two ways: It limits the liablility of the insurer to the catastrophic cap, and at least the "hidden tax" for covering the uninsured would be limited as well.

There are lots of other ideas, such as modernization, etc. to further reduce the cost, and regulations will be needed to allow people to freely switch between plans, have pre-existing conditions covered, etc.

I fear having to talk about mandates in the general election, even for just parents.

[fasttense]

1. A 10K deductible?

I could never afford that. I get my health insurance from the twenty years I spent in the military. I average about $2,000 a year in health expenses for a family of four. I could never afford the $10,000 a year in medical expenses.

[Ravy]

14. But this is just for everyone. I have no clue as the cost... maybe 5k per illness...

whatever the government can afford to cover EVERYONE... and then everything under that your "normal" insurance takes care of.

[Arger68]

2. My $10,000 deductible policy just went from

$69.50/month to $89.00/month. I suppose it's because I just turned 40. I would say if everyone in America had such a policy it would probably average somewhere around there, or 20-30 billion per month. I have often thought that would be a good place to start with universal health care, with employers providing a policy to make up for the deductible or something. At least it would provide catastrophic care for everyone.

[Ravy]

15. It should be cheaper with a larger pool, competitively bid.

I agree it would be a good place to start. Potentially over time the deductaable could be lowered, features added, and we would truly have universal health care.

[napi21]

3. Very few could afford that, BUT depending on how it was set up,

and who paid the $10,000+, and IF it took the liability of that excess away from the ins. companies, the cost of ins. on that initial $10,000 would be fairly low I would think.

[EFerrari]

4. Most people don't have 10K just sitting around and

they have no way to raise it.

[drm604]

6. I think that the point is that the first 10k would be covered by private insurance.

The problem is that not everyone might have access to insurance to cover the first 10k.

[EFerrari]

8. Oh, now I see. That's what happens when I try to understand high finance.

:)

[RUMMYisFROSTED]

63. In that case, can you give me two twenties for this ten?

:D

[HamdenRice]

23. I don't see the point of splitting it into primary insurance and secondary insurance

The argument seems to be that it would be cheaper for people to have two policies:

1. Health insurance for most procedures and costs, with the insurance company having no liability for anything over $10K -- the so called "cap." Supposedly this makes it cheap because the insurer doesn't have to worry about covering catastrophic costs.

2. Secondary insurance with a $10K deductible to cover catastrophic illness or accidents. In the commercial sector this is called secondary insurance.

But I don't see why it is cheaper to split coverage into two companies -- more paper work, more insurance company executive compensation, more transaction costs.

Can you explain why splitting the coverage into to policies is cost effective?

[Ravy]

26. You don't need a policy for #2. The government provides it to

all Americans out of tax dollars.

Policy #1 should also be cheaper since they have a limit on their liability (to the 10k where the government starts picking up the tab).

[HamdenRice]

30. OK, so if the government can provide policy #2 more cheaply

doesn't it stand to reason it can provide policy #1 more cheaply as well?

I understand what you're suggesting -- that having the government provide policy #1 is politically not possible -- but this just seems to point out the superiority of a universal, single payer system.

[Ravy]

33. It most certainly does.

But having a component #2 now we at least have a Universal Single-Payer plan, even though it doesn't cover anything that isn't catastrophic. But the systems can be in place and as time goes on and it gets more acceptable it can become bigger and stronger.

[drm604]

47. Are you asking me?

No, I can't explain that, because I can't see how it would be more cost effective than single payer. It looks to me like a misplaced attempt to address the problems while keeping insurance companies profitable. As you say, it increases the paper work and unnecessarily duplicates a lot of functions.

[Ravy]

54. Every major procedure (over 10k) would be single payer. nt

[HCE SuiGeneris]

5. A 10K policy would keep people from using any health insurance

for fear of being overly indebted.

[Ravy]

17. I don't understand your point. You would only use it if something

catastrophic occured, like a car accident or extended hospital stay. But it would be "free" in the sense that the government provided it.

The first 10k could be covered if you wish to purchase private insurance, but that too should be cheaper just by virtue of they would also only have to insure you up to 10k.

[Wickerman]

7. I assume that would have a preventative component?

Most plans have a provision to allow routine office visits, wellness checks? Would you include such in your plan?

[Ravy]

18. Not in my mind. I think private insurance, with a cap on a percentage

of your income should be available. just like with Obama's or Clinton's current plans.

[Wickerman]

29. From a public health standpoint those plans worry me

By paying for prevention up front we save a lot of money on the back-end. Such a plan would in effect increase the cost of health care.

I can come up with the cash to pay out of pocket for a colonoscopy or mamaogram or other pre canncer screens for my family. Lower SES folks cannot. We can pay for well baby check ups, many SES families cannot. If it were an issue I could pay for STD screens. Many of the at-risk folks cannot. A non-preventive plan doesn't bode well for the health of the country.

It's been awhile since I reviewed either plan, but I thought both had provision for preventive healthcare? I believe it was a small co-pay.

[Ravy]

40. Yes, they both do. And for the poor, government subsidized.

Obama's at least has a catastrophic cap to lower insurance costs. However, he doesn't mandate everyone to get health care (only parents for their children). This leaves an estimate of 15 million uninsured. What I am basically saying is provide the same catastrophic cap for the uninsured that he is for the insurance companies. This even *further* lowers the costs since there would never be anyone uninsured left hanging with a 200k bill that they can't pay, which the insured end up paying with higher charges for their procedures.

[Wickerman]

42. cool

I think we are on the same page now. I heard someone say, don't recall whom, but found it very wise, that we shouldn't consider health care reform a one-shot deal. We've spent decades getting into this mess and we should design a system that can grow, expand, contract, what have you, to accommodate as needed. I do agree no one should be faced with 200k bills.

[bpeale]

9. who can afford to pay a $10K deductible? i work full time & i can't

and i have insurance. there are times i cannot afford to even use my insurance. but i still have it.

no, $10K is too high a deductible. my current deductible is $2K & i can't afford that! where would the poor come up with $10K from?

[Ravy]

19. Your current insurance would cover it...

but they would only need to cover the first 10k of your accident or illness.. so the price of that should come down.

The poor would have insurance plans to cover the first 10k provided by the government, as both Democratic plans provide.

[bpeale]

44. two years ago, i had arthroscopic surgery on my knee

the total cost of that bill was close to $16,000. by your calculations, i would have had to come up with $6,000 or forget about walking. if i, who have insurance, can't afford it, what could the poor afford? nothing! and what if that surgery was for a triple bypass, what then? i shudder to think what the cost of that is (probably in the hundreds of thousands of dollars). you may find that reasonable. i do not. and i doubt anyone who is uninsured would either. its ridiculous. and knee surgery is relatively minor compared to a triple bypass!

i currently have a $2000 per year deductible & i can't afford that. there are times i can't afford to use the insurance i have. unless they are planning to raise my wages $10,000 to cover the deductible, i can't afford it. and i'm sure i'm not alone.

they are both going to have to do better than that. that is not a solution. it is adding to a continuing problem.

[Ravy]

55. Under my plan, the cost for your surgery would be 10k if you

were uninsured.

However, your current 2k per year deductable insurance would become a lot cheaper, so if you would choose to spend the same amount you are now on insurance, perhaps you could have $500 deductable for the same price.

Why is it cheaper? Because your insurance would not have to come up with 14k for your 16k surgery, they are only insuring you for the 8k between your deductable and the 10k (above which, the government provide plan pays). With cheaper insurance, more people buy, increasing the pool and making things cheaper yet. Also, you are not being hit as much with the *hidden tax* that Clinton speaks of that happens when an uninsured accident victim is treated at the hospital and gets a huge bill that they cannot pay.

[TooBigaTent]

10. One more time - we do NOT need some bullshit insurance plan where the

insurance companies rape the system for profits.

Universal health care does not mean insurance - at least, it shouldn't. It should mean total health care. Period.

If the profit was removed from the equation, it could be done easily. True, we would have to fight the lies that scream "socialized medicine" and reduced care and the other bullshit the cons spew. until the Us catches up with the rest of the civilized world, this will continue to be a political football.

Why the fuck should health care be a consumer product?

[Ravy]

20. Perhaps some not-for-profit health insurance companies would

spring up if their liability from heart surgery or a catastrophic illness was limited to 10k.

[abluelady]

11. 10K???

I have a $2500 deductible and can barely pay it. What are you talking about?

[Ravy]

21. If you currently have a deductable, you currently have insurance.

The 10k deductable is for "free" in the sense that your taxes pay for it to everyone.

Your curent cost (or your deductable) could go down because your current insurance company would not have to guard against something major going wrong (God forbid) with your health, or an accident. They only have to insure you between your deductable and 10k. The government picks up anything over that.

[abluelady]

31. I Would Love My Costs to Come Down

But more importantly, I would like to be able to know that regardless of a pre-existing condition I could get health insurance at an affordable cost.

[Ravy]

34. Absolutely. We still need the regulation that is currently being proposed.

This is just adding a Universal Single-Payer component to the plan to remove any mandates (other than for children)

[lumberjack_jeff]

12. A 10k deductible may not be a good alternative for those who oppose "mandatory" universal healthcare

[Ravy]

22. Why not?

[lumberjack_jeff]

27. If they can't afford a few hundred for premiums, they probably won't spend $10k deductible.

Actually, your idea has more merit than my initial reaction.

It's like the schoolyard bet: "I bet you $1 that you miss that shot".

If you miss, you just double the bet. Once the bet reaches $100 or so, the bet is voided, because it's unrealistic that anyone will ever pay it.

Same deal with healthcare. Is $10k high enough that the heart patient won't pay it? Maybe not - certainly not to the degree that a $300k bill would.

The main problem is getting people to engage in preventative care. A $300 checkup is still $300 out of my pocket.

[Ravy]

35. Right, if you choose not to buy private insurance to supplement it.

But if a heart patient doesn't (more likely can't) pay today, that $300k really gets reimbursed by higher hospital costs to the patients that do have insurance. This plan would limit what needs to be "spread around" to 10k, AND the top amount your insurance would have to pay if you develop a heart problem (God forbid) to 10k.

Also, supplemental insurance should be provided to the poor, as both current plans do.

At least one of them has a catastrophic provision to protect the health insurance industry.. this really proposes that that catastrophic provision also be provided to the uninsured.

[endarkenment]

13. 10k? No thanks.

[Ravy]

24. Why not? It is much better than 100k for a heart operation. nt

[endarkenment]

32. For the many reasons listed.

For example: people will not get preventative care if they have huge out of pocket expenses. Instead they will avoid the doctor until they have a serious medical crisis, then they will get to go bankrupt over the 10K deductible while they are getting the 90k payout for the preventable heart attack they didn't have to have to begin with. Your proposal is another scheme to provide shitty healthcare when there are many examples of existing affordable public healthcare systems that work and provide excellent service. No thanks.

[Ravy]

37. That would only be if you choose not to buy a supplemental plan.

I see three major benefits to this:

1. By limiting your insurance's liability to any catastrophic illness to you (God forbid) to 10k it should be less dollars out of your pocket.

2. By limiting the liability of uninsured people to 10k, if they become catastrophically ill or hurt (again, God forbid) and they cannot pay the bill, they will owe 10k instead of say, 120k. If the hospital cannot collect, then only that 10k needs to be made up by patients that have insurance (in higher medical costs) than 120k.

3. By working with more defined numbers (such as the insurance company only providing coverage for whatever preventive care, perscription coverage, etc. for the dollar amount between your deductable and 10k (10k being the maximum they would pay out in any illness/accident) the road would be cleared for not-for-profit insurance companies to develop since they won't have to worry about a huge payout... ever.

[bpeale]

45. yeh, by your calculation, i would have to pay 90K of my heart operation. WTF????

[madokie]

16. using insurance companies in our health care is a big mistake and we need to remove it

not make it stronger by requiring everyone have insurance. the last time that happened a lot of people started to get insurance through their work but it was all to no avail because they still have to pay a copay that was equal and in some cases higher than it used to cost in the first place. Our universal healthcare needs to be a government program that we each pay into not an insurance scam as it will be if you keep the insurance companies involved. They will only continue to make money above all

[Ravy]

25. This, at least, is a *start* at limiting them.

Instead of insuring you against a 100k heart surgery, they only insure you for the first 10k of that.

Perhaps gradually the 10k figure could come down. It is a good step toward what we really need, true Universal Health Care.. it just would not cover little things like doctor visits (yet).

[Greyhound]

28. Either of our cadidates "plans" are nothing other than profit protection schemes

for the sole benefit of their contributors. There is only one answer and we are the only dumb fucks on the planet that can't see that.

[Ravy]

39. But politically, that is not going to happen soon.

This is a step in the right protection, set up in a Single-payer system. Once that idea is accepted, then it will be less politically challenging to expand it, and add features such as drug benefits, lower deducatable, etc.

[Greyhound]

49. It is this acceptance of blatant corruption, combined with the monumental stupidity

of what are now Americans, that both allowed this mess in the first place and ensures that it will not change anytime soon. They begin with only symbolic gestures and minor tweaks that will inevitably be dropped in order to pass a completely ineffective bill that only serves as a political fig leaf for the mid-terms.

Worse than nothing because they are the illusion of action.

[Ravy]

57. Well, I am sorry that you feel that way,

but that is the system we live in. I think we can regulate industries, but for the government to take them over outright is just not the system we live in. There are other systems besides capitalism, and I think all systems have some positives and some negatives. But here, we have capitalism.

[Greyhound]

59. Wrong on two counts; this is the system we allow, and nobody is talking

about taking over any industry. This is simply more corporate spew that you are, apparently, willing to spread with disinformation.

Is this the world you want to leave your children?

Pogo is even more right than we thought.:think:

[Ravy]

61. How are you going to leave the Health Insurance industry intact

while the government provides all health care?

That is common sense, not corporate spew.

[Greyhound]

65. Again, nobody has ever proposed government provided health care. n/t

[Lars39]

36. Catastrophic insurance is just another way to go bankrupt.

[Ravy]

38. How so?

[Vanje]

41. If I had a 10K deductible....I'd be without healthcare at all.

just as I am now, having no insurance at all.

[Ravy]

43. Well, I don't know why you don't have healthcare...there can be many

valid reasons, currently.

If it is because you can't get health insurance because of pre-existing conditions, both current Democratic plans make the insurance companies cover you.

If it is because you don't want it (I was invincible when I was young), then hey, you don't have to pay for it, but *if* (God forbid) you get in a car wreck and I end up paying for it (along with other insured people) because you can't or won't.. the bill we have to make up won't be over $10k.

If it is because you cannot afford it, again, both plans have provisions to help you purchase it or provide it for you free of charge, depending on your situation. As part of this plan and theirs, all existing insurance should be cheaper.

[bpeale]

46. i swear, i don't know what you are thinking

if you are living hand to mouth now, how will you come up with $10K to save your own life? or what about the life of your child? or your parents?

are you independently wealthy or something? $10K is a lot of money. and most hospitals here won't treat you without your portion up front. what then?

too bad. so sad. goodbye???

[Ravy]

51. No. I am not explaining something right. Let me try again

You would still get something like the Obama or Clinton plan where you can get like the congressional plan with prescription coverage, preventive care, $15 deductable for office visits etc. If you are poor, the government provides it. If you are not exactly poor, it is still capped at a percentage of your income to where a subsidy will be provided to you to purchase it.

There is a big "negative" to each plan..but a different negative.

The knock on the Clinton plan is the word *Mandatory*. I agree that every man, woman, and child needs to be covered. This (the plan I am proposing) covers everyone in some fashion, but is not mandatory in the fact that *you* have to buy anything. This 10k deductable plan is provided for everyone. Single-payer so that big procedures can be negotiated with a pool of every citizen in the United States, so that the cost to insure everyone is as low as possible. The majority of the people would choose to buy their own private plan to cover the deductable, prescriptions, office visits, etc, like they do now at a much cheaper rate than insurance costs now.

With Obama's plan, you are not forced to buy it, except for your children. This leaves an estimated 15 million people uninsured totally. If these 15 million people don't get sick or hurt, no problem. But if they do, and rack up a huge hospital bill, like $100k that they can't pay, the hospital has to jack up the prices for people with insurance to cover it. That makes the people who have insurance pay a bit more for every aspirin, every meal, every procedure. It is covered by their insurance, but everyone's premium has to go up a bit.. the insurance you buy, and even the insurance the government purchases and subsidizes for the poor.

With this plan I am proposing, the same uninsured gets hurt, and the hospital charge is $10k, the government provided insurance for all covers the rest of it.

That makes your insurance, and the insurance the government buys for the poor cheaper TWO ways. First, they don't have to make up the 100k that the uninsured accident victim could not pay. They only have to "make up" for 10k of that expense. Secondly, and this is huge, IMHO, if an *insured* person gets sick, the liability of the insurance company is limited to 10k. This means that if you buy an insurance policy, the insurance company only has to pay the hospital 10k if you need a heart transplant. They are not insuring you for the full cost of an illness, just the first 10k of it.

This will allow more competition in the insurance industry. Their costs will be more "fixed" and it will make for a lot more attractive market for not-for-profit insurance companies to enter the market.

[knitter4democracy]

48. Get rid of private insurance companies.

They're the biggest part of what's wrong with health care in this country. Having the gov't just hand over cash to those corrupt corporations (with overheads of 22-30% when Medicare's is 3%) would make everything worse.

[Ravy]

53. We cannot rid the world of all evil in a day.

We cannot even get rid of tobacco companies who are responsible for a lot of our health problems. We cannot rid the US of fast-food joints who contribute their share as well. The political hit would be far reaching, with our government suddenly "nationalizing" an entire industry.

What my plan does, however, is *limit* their influence on the system. They only insure you for the amount between your deductable and the 10k cap on illness or accident payout.

Big procedures like heart bypass surgeries would be done in a single-payer system where the payer could pre-negotiate prices for needed services, like Medicare does.

[SoCalDem]

50. All we need to do is to decide what we want to be as a country

We need to take stock of whats important..and what's not..

Like every family in the country, we need a real budget..

Health care for all citizens(no need for VA, medicaid,medicare)
Good public education pre-K-14 (2 yrs college)
Affordable utilities (gasoline, phone, water, elec, gas)
Solvent social security system

when those necessities are taken care of, what's left goes for the "other stuff"...

If it means higher taxes..then so be it..

If it means a national referendum, to get these things, then let's do it :)

[Uben]

52. I have $10K deductible

It is a $5k deductible and 50% of the next $10K, which is a max of $10K out of pocket. It costs me over $1200/mo!!!!!!

[Ravy]

56. There must be some sort of pre-existing condition for that to

be the case. That is not the norm. By using a single payer to buy it for every citizen, I think it would be fairly inexpensive for the government to do this. Obama's plan provides a catastrophic cap for insurance companies, perhaps Clinton's does too. So we would only be talking about the cost for 15 million or so who would, for whatever reason) be uninsured under Obama's plan.

[Uben]

58. There is........

My wife had breast cancer surgery 5 yrs ago, and the premiums go up the max twice every year, although she hasn't been to a doctor in two years! We cannot cancel because she can't get coverage anywhere else. We have the resources to pay the high costs, but the average Joe couldn't handle it, and average people get cancer everyday!

I would estimate the average cost of a plan lilke that to be somewhere in the vicinity of $4k to $5K/yr per family.

[Ravy]

60. That sounds way high.

Sorry to hear about your wife's health issues. I had a heart attack so I am in the same basic insurance boat.

Much of this cost is already factored into Obama's plan, and maybe Clinton's, where they give a catastrophic cap to the insurance companies already factored into the cost of their plans which cover the vast majority of citizens (Clinton's covers them all). My plan would extend that same cap to anyone who remained uninsured in Obama's plan.

BTW, I don't know if you have been keeping up with it, but either the Obama or Clinton plans will soften that expense for you because everyone will be covered in large plans so they cannot rate you or charge you individually, like employer provide insurance, and plans cannot turn people away because of pre-existing conditions.

Someone way up thread says that their 10k deductable plan was $69 but just went to $89 per month. Again, with a competitively bid insurance to cover EVERY U.S. citizen, I would expect less than that.

[Uben]

62. I think Clinton's is best because it covers all

Everyone who can afford health care should have it. It should come before beer, movies, video games, etc. Whoever gets the nod, and assuming they actually do something about it (this is why I like Clinton better) we will be in better shape. It is my number one issue.

[Ravy]

64. Me too. But the mandate language is hurting her.

I was thinking about ways to diffuse the issue to make it more politically palitable to everyone.