Turns out, that's the value of a human life NOW, under current Medicare rules. However:
"In theory, a year of human life is priceless. In reality, it's worth $50,000."
"Zenios's conclusions arrive amidst mounting debate over whether Medicare, the U.S. government health plan for seniors, ought to use cost-effectiveness analysis in determining coverage of procedures. Nearly all other industrial nations — including Canada, Britain and the Netherlands — ration health care based on cost-effectiveness and the $50,000 threshold. . . Such a move would mean that "if the incremental cost of a new technology was more than the threshold," Zenios says, "then the recommendation would be that Medicare not cover that new technology."
If it costs more than 50k, then you don't need it. The government says so. THIS is 'universal healthcare'. England goes ONE step further. If the government says no, and you do it anyway, then the gov't revokes your health care because it's 'unfair' for you to go beyond what the average person gets. And now comes new considerations for no longer covering smokers and the obese.
How much is a year of healthy living worth to you? Priceless? Well, that's your opinion.
the authors do not think that you are too stupid to manage your own life. what they specifically are attempting to address are the reasons for system failures.
the choices they face are too complex. they lack many of the needed analytic tools. there are lots of ways to go wrong, and there is plenty of evidence, reviewed by thaler and sunstein, that people do go wrong, often very wrong. people make bad decisions about credit, investment, retirement pensions, health care, food, and the like.
faced with the facts of human fallibility, it is tempting to engineer choice out of the system and just offer what is in people's best interests: one pension plan, one health-insurance plan, one college curriculum, and so on. thaler and sunstein view this kind of paternalism as a nonstarter, both because there is usually no one thing that is best for everybody and because freedom of choice is itself a good thing. but we can do better, much better, than we currently do by acknowledging that choosers are humans and by paying attention to choice architecture. give people choice, but engineer the choice architecture so that most people, most of the time, will choose what is in their best interests.
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if you're going to create a nudge, why not create the most effective one you can?
if we really want to fix health care finance we need to make sure that people are participating in financing the system and that is where choice architecture helps to solve the problem. the mass plan (which tim has spoken favorably on more than one occasion is a form of human choice architecture redesign.
I think we can all agree that the following yields benefits for society.
Suppose the form reversed the default condition and asked whether people object to being an organ donor or to having part of their wages put into a retirement account. This simple nudge triples the rate of organ donation and dramatically increases employee saving for retirement.
It's certainly part of it. Their stockholders make more money for every claim they deny.
Private healthcare still exists. It just isn't affordable for normal people. I agree regarding the lobbyists.
Flexible health spending accounts are perfect for you, then. Quite frankly I think a significant chunk of costs is paid to this middleman (insurance) that could be directly spent on care.
I'd gladly invest the $500/mo ($6000/year) I spend on health insurance pre-tax in a tax-sheltered account-with-interest set aside for health expenses IF out of pocket costs weren't so ridiculous to begin with.
At least 25% is flushed down the toilet because of excessive administrative overhead.
It's certainly part of it. Their stockholders make more money for every claim they deny.
Private healthcare still exists. It just isn't affordable for normal people. I agree regarding the lobbyists.
Flexible health spending accounts are perfect for you, then. Quite frankly I think a significant chunk of costs is paid to this middleman (insurance) that could be directly spent on care.
I'd gladly invest the $500/mo ($6000/year) I spend on health insurance pre-tax in a tax-sheltered account-with-interest set aside for health expenses IF out of pocket costs weren't so ridiculous to begin with.
As MORE people are given control of their health care spending, the market must adjust. THIS is what will bring down the cost of those out of pocket costs. They are ridiculous NOW for one simple reason: YOU DON'T PAY FOR THEM NOW. You (general you) either have insurance that is essentially pre-paid care, you have gov't insurance, or, you don't pay.
CT scans would not BE 1000 dollars if YOU had to pay. I darn sure wouldn't be paying the 100/month for my combo CA blocker/ACEI if I had to pay for it. Not when I know I can get meds in BOTH classes from Wal-mart for 4 bucks each. Given the choice, COMBINED with the need to pay, I'd pay 8 bucks. Now, translate that to MILLIONS of transactions that no team of gov't agents can centrally plan and what you get is prices in line with real demand.
It comes down to this: the market works, provided, there is competition.
As far as denying claims. Of COURSE they do that. They have no concerns that you'll take your business elsewhere. You MUST SHOP where your employer shops. Since they don't have to compete for your business, who cares if they upset you. It's not like you'll word-of-mouth them to death. They have no worries; YOU AREN'T THEIR CUSTOMER.
And, that's the point. Transferring that to gov't changes little in that equation. You would STILL not be the customer.
as more people are given control of their health care spending, the market must adjust. this is what will bring down the cost of those out of pocket costs. they are ridiculous now for one simple reason: you don't pay for them now. you (general you) either have insurance that is essentially pre-paid care, you have gov't insurance, or, you don't pay.
ct scans would not be 1000 dollars if you had to pay. i darn sure wouldn't be paying the 100/month for my combo ca blocker/acei if i had to pay for it. not when i know i can get meds in both classes from wal-mart for 4 bucks each. given the choice, combined with the need to pay, i'd pay 8 bucks. now, translate that to millions of transactions that no team of gov't agents can centrally plan and what you get is prices in line with real demand.
it comes down to this: the market works, provided, there is competition.
as far as denying claims. of course they do that. they have no concerns that you'll take your business elsewhere. you must shop where your employer shops. since they don't have to compete for your business, who cares if they upset you. it's not like you'll word-of-mouth them to death. they have no worries; you aren't their customer.
and, that's the point. transferring that to gov't changes little in that equation. you would still not be the customer.
I've used this example before. My daughter was in the Hospital, in Houston, for 2 months. Then, we moved her here for a month before she went home. She's fine now.
When we went to move, they wanted to move her by air - 70 miles. Ambulance would have been fine as the only tx she would need in route was O2. The transit time was 30 min longer by ground after you take into account 2 airport transfers.
Ground: $1,200.
Air: $17,000.
She went by air. Why? Because I could not get the transfer coordinator to agree to travel by ground. The docs were fine with it. The hospital wasn't. Why not? Simple. Insurance would pay for air.
I had no say because I couldn't say the magic words: "I won't pay for that".
I was given the choice: air or nothing.
The choice/ability to pay is very powerful when it comes to price controls.
Suppose the form reversed the default condition and asked whether people object...to having part of their wages put into a retirement account. This simple nudge...dramatically increases employee saving for retirement.
Responsible people already set aside the first dollars of every paycheck for savings. We don't need to opt in or opt out of yet another government program which will yield far less returns than our own research and financial planning.
The reason too many Americans don't do this is that they have become accustomed to having the government (read the responsible taxpayers) bail them out of every financial pinch.
Just like a mother goose who nudges her goslings into the water on their own, the responsible thing to do is to make each individual accountable for his/her financial choices.
(Again, so I don't get flamed, I have no quarrel with providing for those who are truly unable to provide for themselves due to illness, advanced age, mental disability, temporary change in circumstances, etc.) I do have a huge problem with continuing to coddle those who fail to exercise reasonable judgement in savings and financial planning.
my life is worth more than some geek in a nice office working for the american health insurance company who says to life threatening conditions and the cost of giving treatment.
That insurance geek only gets to do THAT because YOU aren't his customer. He cares little what you think except for maybe, some collateral heck you might raise with your employer. And even then, he can argue that his rates are cheaper BECAUSE of the denial that made you angry.
The problem here is lack of competition. There IS NO COMPETITION because YOU aren't their customer. Thank your government for that as THEY provide the subsidies that transferred your insurance choices away from you. So what's the solution: giving the gov't more control to remove your choices? Or, maybe, just maybe, telling the gov't to step off when it comes to your freedom to choose.
When was the last time a health insurance plan advertised to you on TV? When was the last time a car insurance commercial did? One must compete for your business; the other doesn't.
When was the last time your car insurance claim was denied? But, they have shareholders, too. They just ALSO have competition and must worry about reputation to protect their market share.
Messrs Sunstein and Thayer did not argue for a government program for retirement savings or health care participation. They simply argue that people must opt out of participation rather than opt in. It is a simple way to help people be responsible for meeting their own needs.
The 401 k system is really a failure as a pension plan vehicle. Only about 50% of employers offer these plans to employees and far too few eligible employees participate to the degree necessary to assure adequate retirement savings. If you have to fund your own retirement it is far easier to fund it with payroll deduction rather than write the check every month.
One of the complaints about health care is young people playing the uninsured health lottery rather than signing up for health care. I don't believe that the HSA system saves a nickel on health care. The default participation choice for individuals should be an 80/20 plan with the opt out option being an HSA insurance program.
The point is that individuals are participating in the system to help fund their own needs for retirement and health care.
my life is worth more than some geek in a nice office working for the american health insurance company who says to life threatening conditions and the cost of giving treatment,,,,,claim denied.
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it is also worth more than the cost of a drug which you would be willing to pay for yourself, but your health system will not allow you to purchase without losing all benefits.
HM2VikingRN, RN
4,700 Posts
the authors do not think that you are too stupid to manage your own life. what they specifically are attempting to address are the reasons for system failures.
at http://www.prospect.org/cs/articles?article=the_real_third_way
if we really want to fix health care finance we need to make sure that people are participating in financing the system and that is where choice architecture helps to solve the problem. the mass plan (which tim has spoken favorably on more than one occasion is a form of human choice architecture redesign.