Are Big Health Insurers Screwing with Consumers, Businesses?

Health insurers just can’t stand competition.

Aetna, the third largest health insurer in the US, announced Monday night that it would exit the health insurance exchanges established under the Affordable Care Act in 11 of the 15 states where it participates in them. It claimed that it had lost “more than $430 million since January 2014” by selling insurance to individual participants in these exchanges. It didn’t say how it figured that – for example by counting imaginary profits it could have extracted if there had been no competition.

It follows in the footsteps of Humana which said it would cut participation down to 11 states from 15. UnitedHealth had announced earlier this year that it would slash participation to “three or fewer” states. And there were other insurers too. Aetna put it this way:

More than 40 payers of various sizes have similarly chosen to stop selling plans in one or more rating areas in the individual public exchanges over the 2015 and 2016 plan years, collectively exiting hundreds of rating areas in more than 30 states.

Health insurers aren’t exactly suffering, though. Aetna reported that in the second quarter, ended June 30, revenue rose 5% year over year to $16 billion and net income rose 8% to $783 million.

While Corporate America in the S&P 500 is reporting the sixth quarter in a row of revenue declines and the fifth quarter in a row of “adjusted” earnings declines, the entire health care sector has been booming. But not because it’s selling more to every needier Americans but because it’s raising is prices and premiums wherever it can, and it usually can. It now consumes nearly 20% of GDP. Anything that gets in the way of price or premium increases gets trampled down and run over without hesitation.

Health insurers just can’t stand the competition on the insurance exchanges. But no problem. Mergers are designed to cut competition down to a manageable level or kill it altogether, even on the health insurance exchanges.

So these health insurers that are publicly so frazzled about potentially seeing somewhat less growth in their enormous profits, by insuring people that might be a little more expensive to insure, have no problem dishing out tens of billions of dollars buying each other out precisely to lessen competition and to be able to jack up premiums even more.

Our impoverished and whining Aetna made a deal to blow $37 billion on buying Humana. In the same vein, Anthem is buying Cigna for $54 billion, the largest health insurance merger ever. This would cut down the already huge insurance oligopoly in the US of 5 big insurers to just three mega-insurers with enormous power to take an ever bigger bite out of consumer and corporate spending.

Other health insurers have also gone on the same binge, with UnitedHealth acquiring Catamaran Corp. and Centene acquiring Health Net.



In July, the Justice Department said enough is enough; some competition was needed in the insurance exchanges. And it sued to stop the two mega-mergers Aetna-Humana and Anthem-Cigna. It explained its decision:

“These mergers may increase the profits of Aetna and Anthem. But they would do so at the expense of consumers, employers, and health professionals across the country, inflicting costs that cannot be measured in dollars alone.”

In order to get these mergers done, the insurer would have to borrow ungodly amounts of money, to the point where Fitch Ratings just downgraded UnitedHealth and put Aetna and Anthem on Negative Watch.

Higher leverage ratios for the health insurers Fitch tracks combined with declining revenue growth and declining interest coverage ratios have weakened the credit picture.

Fitch pointed out that over the past 12 months, health insurers issued nearly $30 billion of bonds and loans to fund these mergers: UnitedHealth $14.4 billion; Aetna $13 billion; and Centene $2.4 billion. And if the two mega-mergers overcome the resistance from the Obama administration and manage to close, Fitch expects debt issuance of an additional $22 billion – which would “further impact the sector’s credit metrics,” it said – bringing the total in new debt for those mergers to $52 billion.

These companies hate competition. It hampers their all-American freedom to raise premiums whenever they want, knowing that people will somehow pay them, even if they’re so maxed out that they stop paying for other things. They hate competition so much that they’re willing to borrow $52 billion and spend a whole lot more in order to get rid of competition.

On the other hand, they just love cannibalizing consumer and corporate spending. Health care spending looks good for GDP. Insurance is a service, with fits beautifully into the meme that the US is a service economy. And GDP doesn’t care where that consumer or corporate spending comes from or goes to – it only counts dollars that get spent.

Now that the big health insurers can’t have their tighter oligopoly without a fight from the Justice Department, they’re stabbing competition in the back the other way they can: by exiting the health care exchanges and causing the Obama administration a nasty and very public headache – in the hope of softening it up and getting it to sit down at the merger settlement table.

On paper, Big Pharma is booming, even as the rest of the goods-producing sector is declining, but it’s a costly boom. Read…  This is What’s Cannibalizing the US Economy



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  56 comments for “Are Big Health Insurers Screwing with Consumers, Businesses?

  1. josap says:

    Same show. Pay more, get less.
    Or pay the tax and get nothing.

    What happens to the areas where there is no longer any insurance company offering plans?

    • Chip Jvert says:

      josap

      Ahhh grasshopper – you have asked the right question.

      What happens is the US GOVERNMENT RUNS IN AND SAVES YOU! If you like the VA(or IRS or DMV) , you’ll love “single payer” insurance.

      True story: My 92 year old WW2 USMC father died May 22 (about 90 days ago); VA was notified immediately and has yet to pay $300 VA burial benefit (he requested this be donated to charity).

      You’re gonna love single payer.

      • Wolf Richter says:

        We already have single-payer insurance for those who are old enough: it’s called Medicare.

        • Lune says:

          Yep, and those seniors love Medicare far more than us youngsters like our private insurance.

          Heck, even in the face of the revelations of massive waiting lists at the VA, etc., veterans screamed bloody murder at Republican’s proposals to give them vouchers to buy private insurance instead. Most of them would rather have the VA (which, despite the waiting lists and not having fancy, expensive lobbies and marketing campaigns, far outperforms most private hospitals in health outcomes statistics).

          The fact is, we already have socialized medicine for the people who actually get sick: the elderly, the poor, the disabled, and the military. Private insurance was left the easy task of insuring the rest of us, yet they botch it so badly that most Americans in one of our socialized programs thank God every day they don’t have to deal with private insurance like the rest of us.

  2. Chicken says:

    Surely ACA can’t be claimed to be a winfall, that wouldn’t be PC….

  3. kiers says:

    A-M-A-Z-I-N-G.

    Showbama has a MANdate for the sheeple to buy, but no MAN-date for his campaign contributors to the DNC to sell insurance.

  4. kiers says:

    BTW, when designing policies, prior to Obamacare, prez had shown there was actuarial fraud/double-counting at the most basic level with health insurers. anybody remember that small fact?

    • CHIP JAVERT says:

      Yup. Big surprise – 350,000,000 people getting health care (fed law: you cannot be turned away from an emergency room, so don’t even argue about access – argue about quality of care) and spending $3T/year ($3,000,000,000,000) and there is fraud.

      Undoubtedly there is fraud; private insurers are aggressive about eliminating it. It’s also estimated THE $950B OF medicare/medicade has a 30% fraud rate – THE GOVERNMENT IS NOT AS AGGRESSIVE ABOUT ELIMINATING IT.

  5. Universal single payer Medicare type program becoming inevitable. How many CEOs, Presidents, VPs, etc. etc. does the current multipayer health care system support, with their oak paneled offices, private jets, and limos?

    • Marty says:

      Socialized Med was ALWAYS the plan, exactly the way we’re witnessing. Chase out small competitors, merge the big ones. When one is left, either leave it in place or make a gse.

      • Mary says:

        I cannot understand why Americans believe that accessing healthcare through corporate middlemen is a good system. It’s a vast protection racket, pure and simple.

        I lived on and off in France for several years. They have single-payer healthcare. It works.

        • Lex Lutheran says:

          Agree. Jibes with my experience too. The problem isn’t single-payer healthcare. In every society without dysfunctional middlemen, single-payer healthcare is the gold standard.

          What you have in America is a middle layer of scumbag administrators making out like bandits. So please stop blaming this on “socialism” and “liberal policies” etc. It’s corporate greed, plain and simple.

    • Chip Javert says:

      George

      You gotta be kidding. The answer is “nowhere near as many as there will be (unionized) civil servants”.

      True statement: The USDA (Dept of Agriculture) has about 1 employee per 100 farmers.

      WARNING SARCASM ALERT: If we do that with health care, that’s 3,500,000 civil servants.

  6. Chicken says:

    “the entire health care sector has been booming.”

    Agree, it’s remarkable to find a sector besides defense contractors that’s as solid but corporate welfare is a powerful tool especially if you forcing your citizens to buy something at set prices.

    I can’t quite comprehend why alternative energy seems to be struggling though, surely a big tailwind from the White house is in the wings once Congressional portfolios are fully loaded?

  7. Curious Cat says:

    “…lost “more than $430 million since January 2014” by selling insurance to individual participants in these exchanges. It didn’t say how it figured that …”

    It’s really quite easy. You subtract the health expenses for that population from the revenue received on behalf of that population. If the number is negative, it’s a loss. No company can continue to run a line of business as a loss indefinitely.

    This situation was inevitable when insurers were prohibited from charging different premiums for people with pre-existing conditions. This set up a moral hazard… those who were sick had an incentive to join, and those who were well had an incentive not to, because the tax penalties were lower than the the annual premiums.

    Besides, the whole program was too mind-numbingly complex for the average consumer/taxpayer to begin to try to understand it unless he/she knew a large medical expense would be forthcoming.

    I still have not heard a good explanation of why someone with no means should not have healthcare provided to them other than the rest of us who can afford the means do not wish to pay for them. Perhaps someone has another reason they can share with me.

    • c smith says:

      “…why someone with no means should not have healthcare provided to them other than the rest of us who can afford the means do not wish to pay for them.” I’m perfectly happy to pay the health care costs of the 10% of the population that cannot afford basic health care. What I’m NOT willing to pay for is the politically-driven laundry list of health care “services” delivered by overpaid bureaucrats with no accountability to either their “customers” – the patients – or the people paying the bill – the taxpayers. See “Veteran’s Administration” for further clarification.

  8. nick kelly says:

    The complex is absorbing 20 % of GDP and who does Trump target- China.
    BTW; I have to constantly remind Americans ( and some Canadians) that the Canadian system is NOT public medicine. Our doctors are not state employees, many operate as personal corporations.
    It is the insurance that is public- the private practioners bill a single payer insurer. Most of those middle men who don’t do anything are gone.
    Of course there is fat and the system is expensive but…

    Anecdote: about 5 years ago my 55 year old wife developed shortness of breath at 2 AM.
    Ten minutes later, ambulance arrives- takes her to Nanaimo hospital ( on Vancouver Island) She stays overnite,
    Next day ambulance takes her to Royal Jubilee, in Victoria.
    Next day (or two) she has stent put in heart via wrist.
    Next day I pick her up.
    Next week she’s back at work.
    No charge-all covered
    Her monthly premiums were unchanged at about 55 (now 63 or so) Not all the follow up drugs however. Her work plan covered some.
    Still-not bad I would say.

    • Marty says:

      You already paid & will continue to pay through the nose. Much better to learn how to avoid heart probs which is fairly easy. Stents are hardly healthy. Sorry to say she’s boarded the medical freight train to hell.

      • nick kelly says:

        I personally have no health probs. Heart probs can’t be avoided retroactively- something has to be done. The stent will last 20 years before more attention is needed.
        This operation is now routine with millions installed.

  9. Cathy says:

    Obamacare has been cheap for me. I hate THAT man. But, that said my health insurance is $20.00 a week with a $500.00 family deductible only because my husband is in a union. But as a family we actually only use about $2,000.00 a year in benefits.

    I know I’m one of the lucky ones.

    • Wolf Richter says:

      We’ve been on a high-deductible plan since the Bush years (this was a Bush law, not Obama). Best thing since sliced bread for relatively healthy people. It comes with a high deductible Health Savings Account whose contributions are deductible from your taxes, like an IRA. One of the best things the Bush administration (and Congress at the time) has done. Obamacare just kept it going.

      Since Obamacare kicked in, our rates went up 2% – lowest rate increase in my entire life!

      So none of the bad press that people heave upon Obamacare applies to us.

      • nick kelly says:

        You might get a laugh out of this- after my amicable divorce I lost my wife’s plan coverage to the new guy- who needed it WAY more.
        So I just gambled, sort of, for the five years running up to 65 when you get free coverage if you have limited income.
        I had no coverage.

        But it wasn’t that much of a gamble, because if you are in an accident or become sick, you can join Medicare retroactively or before the bill arrives anyway.
        Because the heavily subsidized plan is so cheap here, there aren’t huge numbers of people gaming the system like this.
        But I understand why Obama care I believe required you to have coverage. In real insurance, unlike the Canadian system, you can’t have the sickies joining and the healthy ones staying out- unless they do get sick then they want in.

      • marty says:

        Wolf, when they started threatening about obummercare, our insurance skyrocketed from $250 per month to two years later over $500. You cannot look at only the years after obummercare passed. Look two years before. The insurance companies front loaded all the increases to fool people like you into believing that their premiums didn’t go up due to socialized med.

  10. polecat says:

    “In July, the Justice department said enough is enough”……. yeah, ok…..pull the other one !!

  11. dave says:

    just googled it. canada spends just over $6000 per person annually in 2015. how much does insurance cost in the U.S.???

    • nick kelly says:

      If they’ll insure you- there is no pre-existing condition test or exam to join Medicare- you only have to be a citizen (maybe permanent resident qualifies)
      The US private insurers’ calculus is perfectly understandable- they would prefer clients who won’t make claims. So you can’t just compare the cost of US insurance to Canada’s 6K- you have to add the cost of insurance to the bills to the uninsured or the under-insured. The folks who go bankrupt or lose their houses.

      There is no deductible in Canadian Medicare. And if you fall below a certain income level it’s free to the individual.
      It’s expensive for sure. And at 20 % of GDP (which is EVERYTHING) so is the US. The question is which is gives more value for money.

      Don’t forget to factor in stress- want to haggle with an insurer when you’re sick?
      BTW: Politico has a new story: ‘I survived Trump Magazine, barely’
      that sheds lite on the debate

    • tg says:

      Canada spends a ton more that $6000 per person annually. You really think doctors anywhere in the world work for free? And if the number actually was $6000 per year then I cannot imagine that they actual care they get is all that great.

      Think about who is charging all the money for the actual health care and not focus so much on insurance.

      If a doctor charges you $1000 for a routine examination and your insurance only covers say $100 then who is really screwing who in that scenario? The doctor is screwing you over.

      It has been documented over and over how health care providers engage in cost shifting and price discrimination. Both which are illegal. Google that.

      In a true market system, doctors and all the health care providers would have to compete directly with each other. Those who charge too much or do not provide proper care go out of business. Meaning, those who have bad business models will not survive.

      These socialized solutions (via private insurance, or government insurance) protect poor business models, and unethical practices from actually having to compete for business and we get bad care for a high price.

      • nick kelly says:

        Where did I say I think doctors work for free? Read my comment about my wife’s heart op- it was ALL covered, including the two ambulance rides, one of a hundred miles.
        You obviously don’t know anything about the Canadian system- there is no extra billing or deductible for an operation. It’s either covered or it’s not. Plastic surgery isn’t. The US with its multiple insurers and plans is where the most ripoffs and manipulation occur.
        And we haven’t even got to the US clamp down on generics from Canada- a whole separate area of rip-off for US consumers.

      • JerryBear says:

        Capitalism doesn’t work in medicine. The priority is maximizing health, not maximizing profits. This is one area where socialism makes sense. Your idea is like that of many 3rd World countries where the rich get medical care and everybody else doesn’t.

        • “Public Health” which in many cases includes universal medical care, is another component of the “Public Safety” services such as Police and Fire provided in all advanced societies.

          It is foolish to expect that if pandemics are allowed to rage unchecked among the poor that the rich will somehow be unaffected, e. g. Polio and the “Spanish Flu” pandemic. The latest example of this is the Zika virus.

          As the old adage has it, “an ounce of prevention is worth a pound of cure.” When we fail to provide, and indeed require, adequate prenatal, neonatal, infant, and childhood medical care, for example by adequate immunization and diet, all of society pays the price. When we fail to treat chronic adult conditions such as diabetes, complications result requiring costly “heroic” intervention, and in many cases ending with “social services” funded disability due to loss of limbs and/or sight.

          Several studies have shown that when the cost:benefit ratio of extensive public health and reasonable levels of universal medical care is calculated on an aggregate or societal basis, it is highly effective, returning several dollars of cost avoidance for every dollar spent, with greatly improved “quality of life” for large numbers of people as a bonus.

    • Chip Javert says:

      Dave

      I Googled it for you (you’re welcome).

      2013 US healthcare (not insurance) spending = $9,500/per person.

      (link: https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf)

  12. wkevinw says:

    Obamacare will be changed so much it will be unrecognizable within five years. Except, as usual with these social programs, trying to get it completely removed or totally reformed will be difficult. Social Security and Medicare (which by the way are the same program), will go broke and the automatic benefit cuts will go into effect. This is an easy prediction because of the lack of leadership in our government officials.

    Actually, a lot of these programs could be made more manageable in a fairly easy fashion, except that it would remove the power that the government has, so will be difficult to accomplish. Health care could be treated financially like child support or other legal constructs. Basically everybody gets life saving medical care, and if you do not have insurance, the government (e.g. something like the IRS), attaches future wages to pay, and like the IRS can garnish by way of bank accounts. Problem solved.

    • nick kelly says:

      Or the US could take a look at how the rest of the developed world does things.
      Segue: The Katrina disaster. I’ve looked at closeups of the levees in New Orleans.
      What a joke. An earth dam eight or so feet high with a steel topper stuck in it???
      They’re like something a farmer would build to create a retention pond.
      Wanna see what a dike looks like- go to Holland.

      • wkevinw says:

        You are right about the way the levees used to be in NO. Actually there was a lawsuit many decades back against the Army Corps (a most respected engineering outfit), by a local engineer. I think it was dismissed. Anyway, many knew they had these problems. It goes even deeper (pun intended) than that, but this is not an engineering blog- many parts of NO are sinking.

        No, the US should avoid being like the rest of the mediocre world.

        Before the anarcholibertarians took over the arrogant Republican party, we had effectively regulated private sector industries: utilities, financial companies, etc. It is easy to regulate these insurers WITHOUT doing it in a big government socialist model. Easy to fix: pre-existing conditions, cancellations based on claims, outsized profit margins. This is the way many utilities were regulated for decades, i.e. there is another proven model, but the Republicans worship at the altar of anarchy/non-regulation. Then when the crisis gets bad enough the Democrats get enough political support to pass ridiculous systems like Obamacare. (The Republicans did Medicare Part D- it’s an equal opportunity stupidity/fraud.)

  13. Pete says:

    Curious Cat..
    Digest this…
    No one stricken with a life threatening disease
    Or development of a pre-existing condition
    Should be subject to unaffordable healthcare..
    It SHOULD be based on one’s income…
    Incredible how before the Healthcare law was
    Implemented…
    The insurance companies were canceling policies by the tens of thousands due to people becoming seriously ill
    And needing to use their POLICIES!
    You know ..RESCISSION
    Here is an idea…
    Why don’t we subsidize premiums by cutting funding for
    Boondoggle military projects?
    ..and redirecting that money?
    Instead of hoping young people balance the scales?
    Oh I forgot..that won’t help
    Politicians get re-elected…
    Nope…no place for morality
    And integrity in DC

    • Curious Cat says:

      I worked for a major health insurer for 30 years. In all that time we NEVER canceled a policy because someone became seriously ill. Who are the insurers who did that?

      • Wolf Richter says:

        MANY! For example, here’s a 2009 scandal where Anthem Blue Cross settled with California regulators and agreed to take 2,330 people back after they’d been dropped because they had expensive illnesses.

        http://articles.latimes.com/2009/feb/11/business/fi-bluecross11

        Before Obamacare, rescission of insurance due to expensive illnesses was a fairly common practice.

        A more subtle way was to not renew the insurance coverage, and then the person could not get new insurance because that illness was considered a “preexisting condition.”

  14. Bryce Nelson says:

    I also think change is coming when it comes to healthcare. I think for any changes to pass in America it will have to come in the form of a “public option.” Americans scream “socialism and communism” every single time we try to reform our convoluted healthcare system. I like the idea of “Medicare for all” as a public universal healthcare option since it would be an easier sell when it comes to the voters. On top of that we could also have private insurance companies that provide additional coverage beyond “Medicare for all” and be allowed to compete against Medicare so we could let the best company win. We also need to implement “all-payer rate” so prices are the same for all insurance companies for each hospital. We also need new laws at the federal level so we can negotiate much better drug pricing.

    Doing the above would go a long ways towards cutting the trillion dollars wasted annually in the US on healthcare. We will need to save that trillion somehow since we are expected to have trillion dollar deficits for as far as the eye can see starting in 2018. However, I see us being as complacent as ever and not changing until we are in a crisis. As Winston Churchill said “You can always count on Americans to do the right thing – after they’ve tried everything else.”

  15. Dan Romig says:

    Personally, I feel for my fellow Minnesotan, Stephen Hemsley. As CEO of UnitedHealth, he has had his compensation slashed; slashed I tell you. You see back in 2010, Stephen’s take home compensation was $102 million, but it was down to $66 million in 2014, and the poor man only took home $20 million last year.

    You’ve got to feel for this man who in just five years has gone from making $50,000 an hour to only $10,000. How can you live on just $80,000 a day?

    • polecat says:

      Tis a pity….. the poor chap!

    • Oneyedjack says:

      Tar and feathers much cheaper comp.

      • There is the basic question “should any corporate hired help get that much compensation?”

        You identify one of the major reasons why per capita U. S. “health care” costs are almost twice the other OECD nations, with much worse outcomes, namely the grossly excessive compensation received by the multiple and redundant directors, CEOs, Marketing VPs, etc. etc. in addition to the private jets, country club memberships, and other perks of office, none of which contribute one cent toward actual health care.

  16. Enquiring Mind says:

    Here are some naive questions that many readers may have.

    What would be required to get more insurer competition within states, and then nationwide?

    Presumably, each state would have to approve insurers. since those are regulated.

    Are state approvals a big obstacle, due to campaign donations and lobbying, or are there other or additional reasons?

    Could there be a Uniform Insurance Code, similar to the Uniform Commercial Code, to allow some standardization and comparison?

    • You ask some very good questions.

      It is worthwhile to remember that the current U. S. “system” of medical insurance was never a rational solution to a specific problem, just a collection of practices and customs that developed during a unique socioeconomic era. For example administering medical insurance through the employer, specifically exempting employer provided medical insurance benefits from the employees’ income tax, and classifying employer costs for providing medical insurance as a tax “credit,” 100% deductible from their tax bill, rather than as a tax deductible business expense such as wages.

      Not only was this fiscally irrational, as the IRS continually pointed out, it distorted the compensation practices and cost accounting of the employers, in that they perceived they were giving a “free” benefit to their employees in lieu of taxable wages. However, as General Motors and others discovered, this was a “poisoned chalice,” in that it was “free” [paid for by the other taxpayers] only as long as the corporation was profitable and paying income tax, otherwise the corporation had to pay.

      There is also the situation that the acme of the tacit/unwritten “social contract” between the employers and employees, providing such things as defined benefit pension plans and employer funded medical insurance, occurred in a unique socioeconomic environment, roughly 1945-1965, which could not be sustained, and is highly unlikely to ever be repeated.

      Thus the current U. S. medical insurance system is not only in general fragmented, incoherent and inconstant, it largely depends on unjustifiable tax preferences, and evolved in a unique and long-gone socioeconomic environment. It is not surprising that it is now collapsing, the surprise is it didn’t collapse years ago.

      • nick kelly says:

        Good analysis- it is amazing how many think the 50’s or 60 ‘s economy can be brought back. The US in general does not realize this was the WWII bonanza. in 1950 the US manufactured over 80% of world output. Why? everyone else was flatted or in the case of the UK partly flattened and flat broke.
        Germany’s exports, which in dollar terms these days often exceed China’s, were of course almost non-existent. One sign of hope- the British Army, cut from US jeeps, had recently ordered 10, 000 of a cheap, odd, air cooled, rear engine car.
        Japan had never been in the same league and concentrated on toys.
        One exception was Sochiro Honda, who had been attaching small surplus engines from generators onto bicycles.

        OK- that was then, let’s wake up from the dream about the past now- it’s morning, today, 2016, and those days aren’t coming back.

        Back to the difference between Canadian Medicare and the US- the key difference is that in Canada it has been determined that medical coverage is a social program. It’s not a commercial insurance scheme- no one pretends that our premiums pay for the system.
        It’s expensive as heck- so is the US.
        Comparing costs and service will be complex, but one thing you can’t do is directly, with one number (e.g.6K) compare a system that insures everyone with no deductible to a system that insures who it likes, on its terms, i.e. commercial insurance.
        BTW: since the latter, which left millions of Americans with no medical coverage, undoubtedly cost thousands of people their lives, you have to quantify that cost.

        • RE: …Comparing costs and service will be complex, …
          —–

          Indeed! The analysis is not helped by the large amount of non-medical, mainly general and administrative, costs charged to the medical budget in the U. S. For example the enormous compensation paid to multiple corporate officers, directors and cadre management, and their support services such as personal assistants, private jets, limos, and country club memberships, and huge sales expenses such as multimillion dollar super bowl ads.

          The fraction of GDP spent on health care may be of interest.
          The latest available data I could find was 2014 from the World Bank. http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS

          The U.S. is at the top of the league table with 17.1% of GDP spent on healthcare.
          Canada spent 10.4%
          France spent 11.5%
          Germany spent 11.3%
          and the U.K. with their NHS spent 9.1%

          I think it is safe to conclude the U. S. is spending about twice what the other major economies are, with worse objective outcomes such as infant mortality rates, childhood immunization rates, and median age at death. https://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

      • marty says:

        “For example administering medical insurance through the employer, specifically exempting employer provided medical insurance benefits from the employees’ income tax, and classifying employer costs for providing medical insurance as a tax “credit,” 100% deductible from their tax bill, rather than as a tax deductible business expense such as wages. ”

        Yes, and why did this happen? Because of wage controls enacted by the Federal gov’t during WW2. In other words, as always, the gov’t distorted the market and created the problem.

        The “health care problem” in the US (really sick care prob) could be fixed virtually overnight. Repeal every law having to do with medicine. Prices would crash, choices would explode and people would be healthier. Sadly, there’s too much corruption for that .

        • nick kelly says:

          Great- if you have money. If not you die ( or is there an exception to your ‘repeal every law’ idea)

          Anecdote: At 65 I am not a spring chicken and can sort of remember the intro of Canadian Medicare. But when my wife was born it wasn’t in yet. The hospital wanted to charge them 50 cents for an aspirin or something which her father didn’t have- so they threatened to seize the kid. But her father was a pretty tough nut and that didn’t happen.

          The resistance of the US to a problem that has been solved is remarkable.

        • JerryBear says:

          You live in a complete fantasy world. And do you really think “the market” could have won victory rather than the government backed by the full will of the people? To think that “the market can solve everything” despite all the evidence otherwise is not to think at all.

        • Copernicus says:

          Jerrybear,
          Your comment reminded me of an little diddy from my days in Univeristy studying Economics. The tutor was saying some absolute strident drivel about free markets always working perfectly, it was around the time he and most of the students got involved in a mining scam (another story), and I was looking out the window. He took this, correctly, as me dismissing what he was saying. He cried out “why are you looking out the window!?”
          “That’s where the answers are.”

  17. Merlin says:

    I currently pay $300/month for a decent BCBS medical plan with $300 deductible per person ( 2 people covered). When I lose my job shortly, I wont be able to replace the plan as it will be about $1800 per month unsubsidized by employer. I will have to go to a $900/month high-deductible plan that has a $6800 per person deductible. Guess I will be without insurance until I find another job, and try to stay healthy!

    I have asked my doctor if he takes cash and he is looking at that option at a much lower cost than for an insurance-covered visit. Insurance companies are the problem, and I don’t believe a damn word about them losing money.

  18. Copernicus says:

    Wolf,
    This is a natural response to having for generations an anti-trust exemption. I’m pretty sure only baseball and health insurance had this exemption since the anti-trust laws came into effect. It’s more than they don’t like competition, who does? It’s that they don’t know competition. They can’t adapt. But they can whinge.

  19. Matty says:

    My wife and I have two kids under 2 and live in western colorado. She’s a dentist and I stay at home with the kids having left a great law enforcement job with benefits. Our current health isurance provider is Rock Mtn Health Plans and they are currently being acquired by United Health Care pending approval. Our premium is $1495.66/month with a $2700 deductible per family member. I’m not sure what health insurance cost 5 years ago or, 10 years ago or even in 1983 when I was born but it certainly doesn’t seem affordable now. I don’t remember anybody ever talking about health insurance growing up….maybe I was just to busy…..I don’t know what I could have been doing we didn’t even have iPhones!

  20. Oneyedjack says:

    My partner and I decided not to retire,keep working as long as possible just to keep health benefits and dental .Sick,sad world

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