[beat]

I have high blood pressure. Thanks to insurance, I was able to spend a few months with my doctor, experimenting with medications until we found the combination that brought it down to manageable levels. Meds cost me $15 a month or so.

Blood pressure medication will almost certainly add many years to my life - decades, maybe. Without insurance, I couldn't have afforded the half-dozen trips to the doctor or the meds. And I'd wind up getting lifesaving treatment for an early heart attack or stroke in the ER.

I'll take the insurance, thanks.

[liber8]

Honest, non-snarky question for you: How is it that you could not afford a half-dozen trips to your doctor, but you could afford your medical insurance premiums? Are your premiums subsidized or free? Is the doctor terribly expensive?

(I'm assuming that your doctor charges $250 or less per visit. Six visits would cost $1,500. I'm assuming those visits were spread over at least a number of months, so you could see whether each medication was effective. I'll also assume your health insurance is at least $400/month, though that number is likely higher if you're over 30 or female. This means your six visits cost roughly four months worth of insurance premiums.)

[beat]

Honest, non-snarky answer... to be pedantic, for me it's not a question of affordability. I'm a software professional with a very good income, and I could do it on my own.

I have a friend a few months younger than me. She makes less than $15k/year, and has two children living at home. Under those financial circumstances, she has totally paid off her home, which should tell you how frugal and responsible she is. She has also experienced extensive hospitalization due to illness. If she had to pay for that (it was paid for by state-subsidized health care), she'd have lost her house.

edit: Medical costs are the leading cause of bankruptcy in the US.

[hga]

"Medical costs are the leading cause of bankruptcy in the US."

In a study by Elizabeth Warren that scored any bankruptcy which included medical bills in the discharged debts as their "being the cause" of it, no matter what the fraction they were.

[mikeyouse]

That's dramatically misrepresenting the quality of the study;

http://www.businessweek.com/bwdaily/dnflash/content/jun2009/...

[hga]

That may be so, but your link doesn't support your counter-claim.

[jdminhbg]

> Without insurance, I couldn't have afforded the half-dozen trips to the doctor or the meds.

> Honest, non-snarky answer... to be pedantic, for me it's not a question of affordability.

This is a pretty good representation of the quality of health care discussion on HN.

[jrockway]

He misspelled one word. s/couldn't/mightn't/.

[ansible]

I'm assuming that your doctor charges $250 or less per visit.

Well, that just a visit. What about lab tests? Doctor offices can do some basic stuff in-house, but for anything interesting, it has to be sent to an external lab. Depending on the tests, that could be $500 USD a pop, easy.

And the medication is expensive too. That drug may be costing the patient $15 per refill, but it definitely costs more than that in total.

[protomyth]

"Without insurance, I couldn't have afforded the half-dozen trips to the doctor or the meds."

This is actually the problem for a large group of insured. It would be cheaper to pay out of a health saving account and have catastrophic insurance than pay the continuing insurance premium. This is especially true for young workers who we are now forcing into an additional cost to support older workers. For the price you were paying for insurance, the health saving account and paying out of pocket for those exams would have been cheaper. People unable to pay that should have been the ones helped by a health care law, not the typical consumer.

If we would get rid of this "one size" crap and deal with the groups we actually have (e.g. "ongoing expensive care", "typical person", "catastrophic"), we would have had a much better system. Grand visions suck for normal people.

[beat]

The problem with that is that the people with the highest medical costs (the elderly) are retired and no longer generating income to pay for their care. Gotta pay for that somehow. The whole point of insurance is to distribute costs.

[rdl]

The elderly (>65, or >62 in some cases, etc.) are already covered by medicare and social security. The disabled were covered by medicaid and ssi.

Underemployed (part time, whatever) or sort-of-poor and not disabled people in their 50s are a major segment who can't pay the real cost of their medical care, though. Or, people with lifelong expensive illnesses in the 0-64 age range (who are often making a lot less money than median, too, due to their medical conditions.)

[protomyth]

Medicare does a good job with hospital visits but has some serious holes in the drug buying.

Those in their 50's should have had some cash built up from earlier savings, but they spent it all on premiums instead of building up a hedge. Lifelong illnesses are something that we should just acknowledge as bad for insurance and deal with otherwise. Insurance should be for events and not continuous medical conditions.

We have not dealt with the price of medical care in a sane manner. I don't think the political will exists to break the current insurance scheme while at the same time not overreaching with government.

[XorNot]

The elderly don't suffer from "being old". They are simply more likely to suffer from various events, and have more complications, then younger people.

Being old is just a series of increasingly severe health events till one of them kills you.

Even people with dementia don't typically last longer then 10 years (which is the sort of time frame you're looking at for people who recover from cancer to stop racking up bills).

[protomyth]

I am not sure what you are responding to in my post, other than to say I am well aware of "the sort of time frame you're looking at for people who recover from cancer to stop racking up bills" and believe we do a poor job on drugs from clinical trials on.

[protomyth]

An expansion of social security / medicare (particularly if they were paying into a health savings account throughout their low risk period) to cover drugs and such would have been quite a bit cheaper. The youth already are paying for the elderly with taxes, we shouldn't run a con job on them too.

The concept of insurance we use for healthcare is broken.

[dragonwriter]

> An expansion of social security / medicare (particularly if they were paying into a health savings account throughout their low risk period) to cover drugs and such would have been quite a bit cheaper.

You act as if an expansion of Medicare to cover prescription drugs was an alternative to the more recent reforms, rather something that already happened prior to them and did not, as you suggest, address the problem that the more recent reforms were aimed at.

[protomyth]

The changes made are woefully inadequate for, among other things, cancer drugs. They didn't fix or even make a good attempt at the problem.