Health Insurance

[Ben Lamb]

I hear you on this, for sure. And I don’t have a solution to offer.

A lot of healthcare dollars are spent on chronic disease management—type 2 diabetes, high blood pressure, COPD, CHF, obesity….

I’d love to see responsibility for health be put back on the individual, with the healthcare system for support. Healthy weight, regular activity, no smoking, limited alcohol and mental health management are all pretty solidly evidenced based as routes to maintaining health and not being a drain on the healthcare system. However…


Hippocrates

Cover PT through a trainer for folks looking to shed weight & improve health

Pay for mental health screens like they're cancer screens, etc.

Cover nutrition classes or sessions with a nutritionist

Cover gym memberships or provide a gym for enrollees

Group plans should have some kind of PT mandate. State of MT instituted mandatory 20 minute "health walks" after they noticed a sharp uptick in claims on their plan immediatly following the start of hunting season. After the mandate, those claims have fallen.

Most of all, allow Docs to actual serve patients and not focus on a profit model that maximizes patients per day for billing and actually focus on healthcare. I was 47 before I had a Doc who would spend more than 5 minutes with me. My first consult with her was 90 minutes and after that, we had a plan and accountability that comes from forming a trusted relationship.

Previous doc was looking over the wrong leg when I was complaining of pain. Didn't have the time to really look at the chart or actually give two shits about me. Wasn't his fault as he was told by admin to spend no more than 8 minutes with a patient. I didn't correct him because it was a waste of time anyway so I suffered through it.

Education on diet is critical, but we prefer the easy solutions and our food supply in the US is atrocious because of it being primarily processed food. Change that and our collective health improves dramatically.

 

[SAJ-99]

but i think having the insurance companies decide on who gets rewarded based on "healthy" behavior is a little fox in the henhouseish

Agree, but they already do what I suggested for auto insurance, so it is not that crazy.
Most have programs that reward people for trying to be healthy. You will get a call from a "program manager" and they will ask what you would like to improve and ask you to set the goals (exercise more, drink less, stop smoking) and then call in a month and ask if you accomplished those goals. You say "YES", because why not, and they give you a $100 (example) credit on your HSA card. It is almost comical. You can nudge through a variety of economic means, but this is just encouraging people to BS.

 

[BigHornRam]

I mean... how many of you old geezers have given and continue to give yourself gout because you refuse to lay off the salt/red meat and beer?

 

[Deleted member 28227]

the problem with incentivizing healthy activities is that it always gets twisted in the political and or corporate realm.

i do think we should incentivize healthy activity and penalize unhealthy activity through insurance premiums, or perhaps some other way

but in the 40's you would be penalized for being gay and rewarded for smoking cigarettes

in the 70's/80's you would be penalized for eating meat and fat and rewarded for eating processed carbs, margarine, consuming coca cola, and forgoing sleep for burning the midnight oil (and i think we all know how well that mindset is going for human health)

these days you would be rewarded for eating a processed soy based "meat" patty and knowing how many different pronouns exist

i have my personal opinions on what should be penalized and incentivized based on what i believe is scientifically based on being nutritionally, physically, and mentally good for you, but a lot of that is at odds with the political establishment and where the money flows, regardless of what i or any reputable scientist believes is best.

whoever makes the decision on who gets rewarded for what, be it the politicians, the healthcare industry, or the corporations are ultimately influenced by money.

i don't know where that brings us in this conversation to be honest.....

but i think having the insurance companies decide on who gets rewarded based on "healthy" behavior is a little fox in the henhouseish

A vast majority of our healthcare system is 'used up' by people with poor lifestyle choices.

Personally I think that it evens out, I may eat healthy and exercise but I may get hit by a car running, or get cancer. I may also live into my 70s with very little interaction with our medical system.

I'm fine paying higher premiums, if that allows other folks to not go bankrupt getting the care they need.

Personally this is what I see as the problem.

 

[DanWyo]

Cover PT through a trainer for folks looking to shed weight & improve health

Pay for mental health screens like they're cancer screens, etc.

Cover nutrition classes or sessions with a nutritionist

Cover gym memberships or provide a gym for enrollees

Group plans should have some kind of PT mandate. State of MT instituted mandatory 20 minute "health walks" after they noticed a sharp uptick in claims on their plan immediatly following the start of hunting season. After the mandate, those claims have fallen.

Most of all, allow Docs to actual serve patients and not focus on a profit model that maximizes patients per day for billing and actually focus on healthcare. I was 47 before I had a Doc who would spend more than 5 minutes with me. My first consult with her was 90 minutes and after that, we had a plan and accountability that comes from forming a trusted relationship.

Previous doc was looking over the wrong leg when I was complaining of pain. Didn't have the time to really look at the chart or actually give two shits about me. Wasn't his fault as he was told by admin to spend no more than 8 minutes with a patient. I didn't correct him because it was a waste of time anyway so I suffered through it.

Education on diet is critical, but we prefer the easy solutions and our food supply in the US is atrocious because of it being primarily processed food. Change that and our collective health improves dramatically.

Speaking my language! Currently, insurance will cover all the crap you need once you’re chronically ill, but nothing that prevents that in the first place.

 

[TOGIE]

A vast majority of our healthcare system is 'used up' by people with poor lifestyle choices.

Personally I think that it evens out, I may eat healthy and exercise but I may get hit by a car running, or get cancer. I may also live into my 70s with very little interaction with our medical system.

I'm fine paying higher premiums, if that allows other folks to not go bankrupt getting the care they need.

Personally this is what I see as the problem.

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exactly.

somewhat related, i've heard people joke about wondering why everyone so concerned about hospitals being at or near capacity due to covid.... isn't that what the hospitals have wanted all along?

i mean, it's like semi a joke, that's the scary part.

sounds like pay day baby

 

[DanWyo]

exactly.

i've heard people joke about wondering why everyone so concerned about hospitals being at or near capacity due to covid.... isn't that what the hospitals have wanted all along?

i mean, it's like semi a joke, that's the scary part.

sounds like pay day baby

It’s part of the disconnect between admin and people who actually provide healthcare. Our facility is managed by balance sheet alone and they don’t GAF how burnt out the frontline folks are. Slap a healthcare heroes sign up and carry on.

 

[TOGIE]

It’s part of the disconnect between admin and people who actually provide healthcare. Our facility is managed by balance sheet alone and they don’t GAF how burnt out the frontline folks are. Slap a healthcare heroes sign up and carry on.

and my little brain just can't fathom how we actually fix this problem. i have no optimism frankly. but i've lost that on just about everything anymore.

i feel like the show Scrubs characterized this plight better than any show has or will... so i've always heard at least.

 

[Deleted member 28227]

Slap a healthcare heroes sign up and carry on.

What you don't think a pizza party and a t-shirt are good enough, kids these days... so ungrateful.

 

[Ben Lamb]

and my little brain just can't fathom how we actually fix this problem. i have no optimism frankly. but i've lost that on just about everything anymore.

i feel like the show Scrubs characterized this plight better than any show has or will... so i've always heard at least.

The majority of the rest of the world has figured this out, yet somehow the US is so very special that a NHS would tear the space-time continuum.

 

[DanWyo]

What you don't think a pizza party and a t-shirt are good enough, kids these days... so ungrateful.

What makes it even harder is (paraphrasing a recent Atlantic article) we are fighting a virus whose hosts are at war with us. It’s been super fun arguing medicine with every joe blow who has COVID and a Google search.

 

[Ben Lamb]

A vast majority of our healthcare system is 'used up' by people with poor lifestyle choices.

Personally I think that it evens out, I may eat healthy and exercise but I may get hit by a car running, or get cancer. I may also live into my 70s with very little interaction with our medical system.

I'm fine paying higher premiums, if that allows other folks to not go bankrupt getting the care they need.

Personally this is what I see as the problem.

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the Consultant's credo: There's no money to be made in solving a problem.

Seems to be healthcare's motto as well.

 

[TOGIE]

The majority of the rest of the world has figured this out, yet somehow the US is so very special that a NHS would tear the space-time continuum.

not saying it can't be fixed.

but fixing it in the era of modern american tribalism and the meta universe.... yeah, it would rip the space time continuum.

 

[OntarioHunter]

Agree, but they already do what I suggested for auto insurance, so it is not that crazy.
Most have programs that reward people for trying to be healthy. You will get a call from a "program manager" and they will ask what you would like to improve and ask you to set the goals (exercise more, drink less, stop smoking) and then call in a month and ask if you accomplished those goals. You say "YES", because why not, and they give you a $100 (example) credit on your HSA card. It is almost comical. You can nudge through a variety of economic means, but this is just encouraging people to BS.

I like Ontario Health Insurace Plan's wellness strategy: tax the shit out of tobacco and booze. Wish they could figure out some way to make a dent in obesity. The percentage of kids and young adults who are grossly overweight is downright alarming. How could the country ever defend itself in the event of a major attack? It would take years of PT to knock enough lard off those butterballs to make them serviceable. Omar the tent maker would become a billionaire overnight sewing new uniforms ... if the govt could find enough spandex.

 

[Nemont]

Do you directly charge people soliciting help? My agent doesn't charge me.

uh no unless I am consulting. I get a whopping $8 per head for commission on individual sales that is included in the premium. The above was my lame attempt at humor.

 

[Ben Lamb]

uh no unless I am consulting. I get a whopping $8 per head for commission on individual sales that is included in the premium. The above was my lame attempt at humor.

I don't care who you are, that's Dodge K Car money right there.

 

[AlaskaHunter]

I retired at 62 and need health insurance until Medicare starts at age 65.
We saved enough so we could limit our gross income to less than $89k,
and therefore qualified for Alaska Obamacare subsidized health insurance.

I pay $64 a month for Blue Cross Gold 1500 plan.
Than saved us over $25,000 per year compared to if I had to pay the full price.

 

[Cammy]

the Consultant's credo: There's no money to be made in solving a problem.

Seems to be healthcare's motto as well.

In healthcare it is: A patient cured is a customer lost.

 

[Ben Lamb]

Speaking my language! Currently, insurance will cover all the crap you need once you’re chronically ill, but nothing that prevents that in the first place.

Actual dental coverage. So many chronic health problems occur because of this it's astounding. Make dental health cheap & easy to get and you can cut a shitton of costs later.

In healthcare it is: A patient cured is a customer lost.

To be clear, I agree that this is the mantra of a lot of companies, but nurses, docs, techs, etc - the folks who actually provide the service, are mostly there for good and to help people stay or get healthy.

 

[westbranch]

A vast majority of our healthcare system is 'used up' by people with poor lifestyle choices.

Personally I think that it evens out, I may eat healthy and exercise but I may get hit by a car running, or get cancer. I may also live into my 70s with very little interaction with our medical system.

I'm fine paying higher premiums, if that allows other folks to not go bankrupt getting the care they need.

Personally this is what I see as the problem.

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There are a lot of physician owned practices that have partial ownership from large corporations as well. I have a hard time seeing how patient care can fit with short term incentives that go along with being a publicly traded company. One example:

Surgery Partners, Inc. Announces Pricing of $279.0 million Public Offering of Common Stock

BRENTWOOD, Tenn., Nov. 09, 2021 (GLOBE NEWSWIRE) -- Surgery Partners, Inc. (Nasdaq: SGRY) (“Surgery Partners”) today announced the pricing of its...

www.globenewswire.com