On 9/1/2017 8:45 PM, Frank Krygowski wrote:
On 9/1/2017 8:14 PM, jbeattie wrote:

You have a Medicare Advantage plan which, by the way, is
much like the insurance scheme for everyone in Germany and
(sort of) Japan. The bulk of premium is paid by the
government with a "spread" paid by the policy holder. The
typical Advantage plan in Oregon has better benefits than
most employer-provided group plans. It also sweeps in
Coverage D and provides a good pharmacy benefit.

But its socialized insurance. The employed and
self-employed (me) are paying the lion's share of your
"premium."

See
http://www.taxpolicycenter.org/brief...ow-it-financed


The way Medicare Advantage works is that CMS pays a
capitated fee to the HMO/PPO based on a "benchmark" for
your county, and your HMO/PPO charges you the spread to
cover the cost of estimated plan benefits (so called
"bid"). https://en.wikipedia.org/wiki/Medicare_Advantage
The benchmark number varies, but yours is probably in the
$800-900 range -- meaning your "true" premium is
subsidized to the tune of $800-900 per month. That's
socialized insurance. YOU ARE A COMMUNIST, COMRADE!

Time to turn in your teabag. Why should I pay for YOUR
insurance? I'm going to quit paying my self-employment tax
so I don't have to pay for YOUR insurance!

Some people can't seem to grasp the fundamental idea of
insurance. Everyone accepts a small penalty (the premiums
they pay) in order to prevent having to endure a large
penalty - i.e. catastrophic personal expenses, in this case,
medical expenses.

The insurance company is betting you're going to remain
pretty healthy. You're betting you're going to get terribly
sick. You bet against the insurance company, and you hope
the insurance company wins.

People like Tom who don't like the system have an
alternative: Just don't buy any insurance. If necessary,
move to some country with nothing like Medicare. Just pile
up your own money in savings, and bet on your own health.
Bet that you'll never need a $100,000 medical treatment to
save your life.

I'm sure it can work, because the insurance companies have
bet on your health, and they've been winning big! They've
collected enough money to build really impressive
skyscrapers for their headquarters.

And hey, for most of my life I never bought comprehensive
insurance even on brand new cars. I won that bet, too!



You're describing a classic insurance model which no longer
exists. In principle, the ancient fire companies collected
from building owners who then displayed the fire badge on
the edifice. No badge, no water. Good system!

In reality it's now more like Federal flood insurance which
has premiums people bitch about, limits which keep most
businesses and many homes well below actual losses, no
private insurance available, ridiculous administrative costs
and of course it loses a few billion dollars every year.

Seeing the utterly indefensible screwups in that program,
Florida under a previous idiot governor duplicated it for
the state. Having made fish soup from an aquarium, no one
knows how to get out of this but the premiums are too low,
the costs are too high, the reserves are inadequate for a
normal hurricane season (which we haven't had in 8~9
years)and of course normal weather events with normal losses
will return. The State of Florida and its citizens are
directly and fully liable. Ouch.

Which brings us back to a regulated health insurance cabal.
I don't have a simple answer because the various interests
are convoluted, entrenched and too often crooked. This is of
course utterly unrelated to health or medical services in
the same way that education budgets are unrelated to
education[1]. The system feeds itself; you are the product!

[1] The Last Honest Man, Art Shanker of AFT often ended
press conferences with his famous quip, "When students pay
union dues I will care about students."

--
Andrew Muzi
www.yellowjersey.org/
Open every day since 1 April, 1971