Simone Giertz

[BradC]

I have not heard of such a thing before. It's not here in Australia that I am aware of.

It is/was. The company was Insurancebox. Underwritten by QBE. They were advertising all over telly a year or so ago, but a quick look sees that they are currently not selling new policies. Didn't bother to fund out why.

[JPortici]

Here that's called "no claim bonus". You get a discounted rate if you haven't had an accident for 5 years.

Of course insurers all over the world are now trying to get everyone to drive around with a black box to get a discount.

I have not heard of such a thing before. It's not here in Australia that I am aware of.
Some companies even offer no claim bonus "for life" once you reach that level. But you have to stay with them of course.

Here i got 20% discount for getting a black box, not bad.
They claim it's to reduce insurance frauds, expecially for weather events like hail. And they are not wrong.
Also helpful in case of an accident, position is recorded, phones are called.
Also works as an alarm, i can set up my parking area or safe area and get a call if the car goes outside of it.
Also i can find my car if i forget where i parked it.
And i'm not mandated to disclose the data in case of an accident.
And apparently they will be mandatory in a couple of years so better take advantage of it while i can.

oh, and km are recorded, also per risk area (highways and such) so if i make no accidents i get an even bigger reduction every year

[VinzC]

I'm also so thankful for the NHS here in Britain, where everyone contributes a little bit to make sure nobody has to face the terror of a bill like that and worrying that their 'insurance' might not pay.

Social healthcare FTW

Great news!
For at least 50% of the Americans, the blue marked text above already counts as 'communism' which must therefore be strictly combated. Never give away anything that could benefit others.

It's astounding so many people, uneducated, obviously, conflate solidarity with a political ideology, which they deemed despicable. That's the paradoxical reflection of stupidity, I guess.

I'm happy for Simone but... damn, the bill!

More shitty robots to sell to pay the fees...?

[NiHaoMike]

That doesn't really solve the problem of those living unhealthy increasing costs for those who do live healthy.

[Mr. Scram]

That doesn't really solve the problem of those living unhealthy increasing costs for those who do live healthy.

There's a fair amount of evidence that shows it's not. Healthy people get old and old people are very expensive from a healthcare perspective. Unhealthy people tend to die off more quickly, after a relatively modest amount of treatment. It's known that smokers are less expensive than non smokers. You can't really tax healthy living without running into moral issues.

Though I doubt you will change your stance, as this all has been pointed out a few times before.

https://www.telegraph.co.uk/news/health/news/9359212/Obese-and-smokers-less-of-a-burden-on-the-NHS-than-the-healthy-who-live-longer-report.html

[ajb]

There are demonstrated links between psychological stress and physical health outcomes, which means that things like poverty are doubly damaging to health--people who are in stressful socioeconomic circumstances are both more likely to be stuck with 'junk' food that does not promote health and be at higher risk for things like cardiovascular disease to begin with.  So adding economic pressure to them to eat healthy when they ALREADY lack the means to do so is just plain cruel.  Also remember that many of the poor in the US are already working--we have quite a high rate of working poor compared to much of Europe etc--and when you combine employment with the lack of effective public transportation with the demands of child care, etc, and widespread food deserts, access to healthy food options is limited not just by its purchase price but also by the logistical ability to acquire and prepare it.

Speaking of working, the US has a fairly bizarre system where health insurance is provided by your employer, and many employers play games with their employees to avoid having to provide insurance.  For instance, retailers who employ hourly workers, on top of having low wages to begin with, are often careful to keep their employees' weekly hours below the level where they'd be required to offer health insurance.  That not-quite-fulltime employment is often enough to disqualify the employee from a lot of public assistance, but not enough to provide secure livelihood, especially when they get stuck paying medical expenses out of pocket.  On top of that, if you had employer-provided insurance but lost your job, the cost of maintaining your employer-provided plan can be astronomical, and any lapse in coverage prior to Obamacare would allow future insurers to deny you coverage for all sorts of 'pre-existing conditions'.  The US approach to health care is fucked up in so many ways.

[VinzC]

The problem is how to hold individuals accountable for their own actions just like how it's done for car insurance.

No.

In my country *everyone* with a social security  (not exactly the right term but you get the idea) "subscription" — which is virtually every citizen — pays a small, regular participation fee for the collectivity, which serves as a buffer for those in need for medical care or assistance, e.g. medical surgery (just like with Simone) and interventions. Social security also intervenes in lowering the price to pay for med's. That's the typical use of social security: helping those in need for assistance. There are of course people who can't afford (and that's a shame) having a social security assistance but they're still a minority.

Keep in mind that solidarity (which is the initial model of social security) has nothing to do (bless that!) with holding people accountable for their actions. It's not the purpose of the system — heck, what's education for, anyway? Social security, at least in my country, is about letting everyone contribute to everyone's medical care.

Social security and insurances are different systems and have different goals. In my country social security is a public service, ruled by the government (I simplified). Insurances are [held by] *private* companies, with profit concerns (again, I simplified). Social security has been introduced by social(-ist) parties after the war to help workers get decent medical assistance as only the richer ones could afford medical care. It had to stop for a fair system where everyone gets a chance to receive medical assistance whenever needed. So, yes, "the richer help the poorer" and it's a good thing it exists.

The only ways I can think of to reward those who regularly exercise have some big problems of their own, but making those who eat too much junk food pay more is easy.

Look, I don't know why you're so keen focusing on food. Junk food is not the only reason people enter the hospital or need medicines. Medical care involves surgery, analysis, medicines, check-ups, visits to the doctors', cancer screening programme, campaigns for prevention of viral contamination, reducing med's costs... There are so many more I have to skip or it'll quickly become boring.

[Circlotron]

The medical "system" in the USA is a racket designed to maximize profits for insurance companies, medical device manufacturers, pharmaceutical companies, and the large hospital corporations.   

The political system in the US has been poisoned by money from these interests so that a large number of Americans falsely believe that single payer healthcare as practiced in every other developed country is somehow inferior or more expensive (it is neither).

"the land of the free"...

[VinzC]

The medical "system" in the USA is a racket designed to maximize profits for insurance companies, medical device manufacturers, pharmaceutical companies, and the large hospital corporations.   [...]

"the land of the free"...

... where freedom is just another business product to sell ;-) .

[EEVblog]

I said quit the junk food discussion. I have started deleting posts.

[EEVblog]

I have not heard of such a thing before. It's not here in Australia that I am aware of.

It is/was. The company was Insurancebox. Underwritten by QBE. They were advertising all over telly a year or so ago, but a quick look sees that they are currently not selling new policies. Didn't bother to fund out why.

Probably because no one was stupid enough to sign up for it.

[EEVblog]

I'm happy for Simone but... damn, the bill!
More shitty robots to sell to pay the fees...?

She was insured, so presumably pays either nothing or some much smaller nominal policy excess fee.
Here problem now might be getting insurance again. If I was her I wouldn't move from her current provider (who presumably still covers her), ever.

[james_s]

Even someone who is insured is not always off the hook. There are maximum coverage limits, and with a really expensive procedure you can burn through that and still be on the hook for many thousands of dollars. Hopefully she has good insurance.

[VinzC]

I'm happy for Simone but... damn, the bill!
More shitty robots to sell to pay the fees...?

She was insured, so presumably pays either nothing or some much smaller nominal policy excess fee.

Yup, I realized that after posting, watched her video again.

Here problem now might be getting insurance again. If I was her I wouldn't move from her current provider (who presumably still covers her), ever.

That's kind of freaky. I'm not too familiar with U.S. medical care (e.g. if they're private companies) compared to Belgium, where you don't have much incentive for leaving. That's indeed a... "strange" system.

[Gyro]

This thread prompted me to check my own tumor surgery bills. $233k seems a colossal sum of money. My own surgery, covered by the main not-for-profit insurer in the UK (paid for my employer), came out at about 15-20% of that (different decade, different exchange rate etc. so hard to be exact).

That included all CTs, MRIs including the probe guided imaging ones, separate burr-hole biopsy procedure and main surgery, two lots of surgeon's / anesthetist's / theater / histology bills etc.

Clearly there would have been differences due to degree of complexity (in Simone's case bone infiltration was involved whereas mine was purely brain infiltration, though higher grade) but they were both long procedures (she may or may not have had a separate biopsy procedure). It does give the impression of costs adjusting themselves to accommodate the available insurance cover expectations though.

EDIT: I would have received exactly the same treatment under the NHS for 'free' of course.

[ajb]

Here problem now might be getting insurance again. If I was her I wouldn't move from her current provider (who presumably still covers her), ever.

That's kind of freaky. I'm not too familiar with U.S. medical care (e.g. if they're private companies) compared to Belgium, where you don't have much incentive for leaving. That's indeed a... "strange" system.

Insurers as a rule are private, for-profit corporations here, which really explains quite a lot in and of itself.  I think there are a few not-for-profit insurers and self-insured organizations, but they are rare.  Insurance is usually provided through your employer, who often subsidizes it as part of your compensation, but as a result changing employers means changing insurance.  There are two primary public options here, Medicare (intended for retired folks) and Medicaid (intended for low income/disabled folks), but eligibility for those is inherently limited, and leaves big gaps where people don't make enough money to afford private coverage but make too much to qualify for public assistance.  Some states have opted to expand Medicaid, but many state governments are under right-wing control and have been fighting tooth and nail against any such "government overreach"  .  Many of the conservative politicians here are single-mindedly focused on shrinking government at any cost, including cutting all forms of public assistance and rolling back many of the health insurance reforms provided by the Affordable Care Act aka Obamacare.  It's shameful. 

Anyway, back to the pre-existing conditions thing, one of the ACA reforms was to prohibit the denial of coverage for pre-existing conditions, so in theory she's okay for now, but who knows how long that protection will last with the current government.  Personally, I've had a different insurance policy each of the last six years I've been at my current employer simply because whatever plan we've picked for a given year hasn't been offered the next year.  This is largely due to insurers attempting to cope with the tremendous uncertainty caused by the current government's constant attempts to undermine the ACA reforms, and since we're a small company we have zero bargaining power with insurance brokers.  We'll see what happens with the elections in the next few months, and again in 2020, but it's going to take a long time to fix what's wrong with the US, if it can even be done.

[VinzC]

Thanks for this detailed explanation, ajb. Sounds clearer now. I sympathize.

[VinzC]

Anyway, back to the pre-existing conditions thing, one of the ACA reforms was to prohibit the denial of coverage for pre-existing conditions

i always find it funny. its like healthcare is a battery charger, and we the people are batteries. we keep on finding chargers to charge ourselves, so we are nearly almost always full. but here comes insurance providers who "takes charge" of all the chargers, but only want to "sell" charges to batteries that are 100% full and never needs it. 

I fail to see a relevant analogy there . While we're in the electricity domain, I'd rather see health insurance as a collaborative surge protection, aiming at preventing the [life] fuse from blowing up:

• a surge protection limits the peak current, health care limits health expenses
• it is collaborative because everyone contributes to one another's [circuit] protection
• just like surge protection it's silent for as long as there's no surge, health care is to intervene in [out-to-be] marginal circumstances.

At least by the definition of social security/health insurance.

[nctnico]

Here that's called "no claim bonus". You get a discounted rate if you haven't had an accident for 5 years.

Of course insurers all over the world are now trying to get everyone to drive around with a black box to get a discount.

I have not heard of such a thing before. It's not here in Australia that I am aware of.

They tried that over here too (the black box) but I just read an article that it didn't catch on. The insurance premiums for such insurances are actually higher so there is nothing to gain compared to a regular car insurance.

[coppice]

Here that's called "no claim bonus". You get a discounted rate if you haven't had an accident for 5 years.

Of course insurers all over the world are now trying to get everyone to drive around with a black box to get a discount.

I have not heard of such a thing before. It's not here in Australia that I am aware of.

They tried that over here too (the black box) but I just read an article that it didn't catch on. The insurance premiums for such insurances are actually higher so there is nothing to gain compared to a regular car insurance.

In the UK the main focus of those black boxes seems to be teenage drivers. Teenagers always had really high insurance premiums, but these days the prices are eye watering. They do appear somewhat lower if you accept a black box in your car.

[Mr. Scram]

It's not hard to guess why it's cheaper. They avoid having to pay out in a number of cases, possibly on technicalities. Customers think they have cheap insurance without realising it's a Trojan horse that might cost them. People still don't understand that insurance companies don't exist to give you money. They exist because they don't give people money. They'll try avoid paying up at any cost and a black box gives them a lot more to work with.

Of course, most idiots think they are above average drivers so they feel safe.

[ruffy91]

The black box you can get here (switzerland) is just an accelerometer and CAN bus sniffer. In case of an accident you get the last few meters of data.
When deciding who's to blame you are allowed to provide this data to the court. (you don't have to but if the other perty has a blackbox and you refuse to give tha data it's already clear who caused the accident).

The insurance does incentive black boxes so they can better focus on calculating risks instead of paying top lawyers to fend off paying accidents where "their" drivers are not to blame.

[Marco]

Many of the conservative politicians here are single-mindedly focused on shrinking government at any cost, including cutting all forms of public assistance and rolling back many of the health insurance reforms provided by the Affordable Care Act aka Obamacare.  It's shameful.

I find the concept of insurance for public healthcare (and pensions) disingenuous and stupid. It's not an insurance scheme, it's a ridiculously complex welfare scheme. A welfare scheme which because it only subsidizes the lower classes is much less progressive than most taxation.

Obamacare was imploding before Trump pulled the trigger, the conservatives restricted how fast the penalties could grow and healthy people were simply taking the penalty. Be glad for Trump killing it, maybe democrats can make less of a mess of it next time around. IMO either you go single payer, or you just get government out of it entirely except for medicare/medicaid. The wishy washy in between shit (which my country also does) is a big waste of money and FU to the middle class.

[Mr. Scram]

I find the concept of insurance for public healthcare (and pensions) disingenuous and stupid. It's not an insurance scheme, it's a ridiculously complex welfare scheme. A welfare scheme which because it only subsidizes the lower classes is much less progressive than most taxation.

Obamacare was imploding before Trump pulled the trigger, the conservatives restricted how fast the penalties could grow and healthy people were simply taking the penalty. Be glad for Trump killing it, maybe democrats can make less of a mess of it next time around. IMO either you go single payer, or you just get government out of it entirely except for medicare/medicaid. The wishy washy in between shit (which my country also does) is a big waste of money and FU to the middle class.

That half assed plan it ended up being is in large part due to the political polarization in the US and either side outright opposing anything that's from "the other side", regardless of what that actually entails. It's been nearly impossible to deploy a well thought out and coherent plan for years, not to mention it's a very complicated matter to begin with. That's well into politics though, so not for these forums.

[james_s]

The polarization is a huge problem and honestly I don't know how it could ever be fixed. People exist in their own little online echo chamber, filtering out anyone with a different perspective and it's easy to start to believe that one's own views and opinions are shared by the minority and that anyone else is a fringe idiot. There is an attitude that "their" team has all the answers and the other team caused all the problems, it's no wonder people can't compromise. The ability to agree to disagree is a dying art. Being somewhere in the middle I find both sides frustrating, and I get the flak from both sides. The conservatives think I'm a liberal and the liberals think I'm a conservative. I think I'm pragmatic and sensible and can usually see both points of view to at least some degree.