undefined | Better HN

0 pointsGlyptodon9y ago0 comments

So what gets me is that people seem to think healthcare should cost less than $1000/person/year and I just can't see how that's reasonable. If anything remotely serious happens it will cost hundreds of thousands if not millions, and I just can't see how it's possible to cover that kind of situation when we know from our own lives that things like Diabetes, Cancer, Stroke, Heart Attack, and even Car Accidents and such are common enough.

I had childhood cancer and at the time it'd have costs millions without insurance.

While the healthcare market is hopeless opaque and corrupt and no doubt that does drive costs somewhat (or a lot), and probably there are things to do about it, but I think fundamentally the success of complex and expensive treatments is also driving costs - things that you'd have gotten painkillers and left to die even in '50s and '60s now can be cured/improved/fixed, it's just ridiculously expensive compared to popping some pills and expiring. Or look at prosthetics. There was a time you might have made do with crutches or a peg leg and now there are specially designed, fitted, and crafted prosthetics for various activities... that don't come cheap. Not to mention improvements to the standard of care or the sheer man-power requirements of health-care. A normal doctor's visit requires interaction with 3+ employees, across ~45 minutes, all of whom are presumably being payed more than $10 an hour, and possibly a lot more. It may actually be reasonable that budgeting $5k/person/year for healthcare is sane in terms of both risk and what you get, but just far more than people are used to thinking about or seems intuitively reasonable.

0 comments

4 comments · 2 top-level

sbov9y ago· 2 in thread

Median household income is around $50k/year. At $5k/person/year that's $20k for a family of 4 per year which is probably 40%-50% of their take home pay. It's an insane number.

GlyptodonOP9y ago

I agree in terms affordability it is problematic, but I was referring more to how there seems to be some idea that the cost of medical care itself couldn't reasonably add up to a number that expensive.

mcgrath_sh9y ago

Especially when the rule of thumb for housing is usually 30-35% of your take home income.

smacktoward9y ago

> I had childhood cancer and at the time it'd have costs millions without insurance.

This is the entire theoretical reason for insurance: to spread costs out across a large group, so that by having everyone pay a little nobody has to pay a lot.

It's also why the logic of modern healthcare makes single-payer systems the ones that work the best; they spread the costs across the widest possible "risk pool." And why the ACA had to include a (deeply unpopular) mandate that everybody buy some form of health insurance -- as long as your system is based on private insurance, such a mandate is the only way to get the young and healthy into that pool.

> It may actually be reasonable that budgeting $5k/person/year for healthcare is sane in terms of both risk and what you get, but just far more than people are used to thinking about or seems intuitively reasonable.

Remember that most Americans' income has been stagnant in real terms for nearly 40 years now, while health care costs have done nothing but increase and seem set to keep on doing so. So, barring some major change in how the economy works, whatever figure you set for "a reasonable amount to save for health care" is only going to seem less and less reasonable as it grows to consume a greater and greater share of those stagnant incomes.

In other words, if peoples' wages increased by $5K a year at the same time as they were expected to bear $5K a year of health care costs, it'd feel a lot less painful than just expecting them to pull that $5K out of the couch cushions.

j / k navigate · click thread line to collapse