Cost of Health Insurance


#21

I’m pretty sure you’re misinterpreting my words and misrepresenting my position. Not sure only if deliberately or not.


#22

Oh sorry, I wasn’t clear. I just added points to what you said.


#23

Apart from being rude, I think you’re mixing unrelated topics. We’re talking here about health care insurance models, not about immigration or welfare for old and disabled.

Additionally, I haven’t said that I support spying people. I said that people should have choice what type of insurance they want - whether with tests or not. Spying should be illegal and currently actually the biggest spies are governments.

I think that Singapore has best health care model in the world and it should be replicated. It forces people to pay for their own health problems, instead of redistributing money from everyone to everyone (losing half for administration and misallocation).

People are exploiting system on both sides. This is precisely possible because it is forced and you cannot leave the system and use alternative one.


#24

Sorry I didn’t reply to you but to Bojack.
Also I mixed topic hoefuly to make it clear that you can’t start to discriminate by genetic or people will start to discriminate by something else, since most of it is kind of “luck” based. You didn’t decide where to born and how, right?

Also no one said that you support spying people. I might not speak perfect english, but I always thought that saying “If you want to spy” doesn’t always mean You as the other side, but a generic person for the sake of the discussion. Sorry but I feel you are defending yourself because you thought I was attacking you.


#25

I think you’re oversimplifying it. Poor people don’t have to be dumb to vote for more social benefits. For them it IS true that somebody else covers the cost: the rich people. And since much more people earn less than average income, in a democracy there is a strong bias towards paying more taxes and getting more services from it. Because more people benefit from it than not (at least in a short period)

That depends how the current health insurance is implemented. In Poland it’s 9% of salary. It could never be as cheap in a free market scenario. A free market solution would mostly benefit young, healthy and high income people. It would however be a bummer for the elderly, the poor and the chronically ill.

I’m sorry, what’s the whole point? I didn’t get that. The whole point of insurance is to mitigate the risk of having to spend a lot of money in a single moment, the amount of money that you could not afford.

Genetic testing, or testing for alcohol / tobacco consumption would make the system more efficient, that’s true. But it would make it much more expensive for people with genetic flaws or prone to illnesses/addictions.

Well, we are kind of going that way. Google and Facebook are collecting this info on us. China is implementing their state-wide program of points. The thing is, in an open market you have a choice of providers, you have an opt out. If you don’t like the idea of genetic testing, opt for a provider who doesn’t do it. If enough people oppose, these kind of providers will be a minority.


#26

That has been proven to be wrong I believe but take it with a grain of salt…
I am sure that it has been proved wrong that different Krankenkassen costs more than 1 National one, but I’m not sure 100% about the administration cost of having one or more of them. I remember numbers below 10%.

I don’t know. I am not sure it’s exploited because it’s forced. I do agree though, that when something is forced or unavoidable, people on both side tend not to optimize anything. The best example I have is in the army. I’ve heard myself from people organizing the annual repetition courses in switzerland, that at the end of the course they give free gasoline to all the people that wants it. The reason is that the repetition course get a certain budget and amount of gasoline for army cars and vans. If they don’t use it, it’s better to waste it or give it away otherwise next year they get less.
Yes I am mixing topic again to explain what I mean.


#27

Anyway, to stay more on the topic,
on swisscare a yearly insurance costs 550-800 EUR depending on the maximun insured. It’s valid for a year and they say:

This insurance is aimed for long term tourists (globetrotters, world tour travelers) who have no permanent residency while their are abroad. The plan can be applied for a maximum duration of 60 months (5 years).

This is the cost of an insurance for a swiss globetrotter (nationality Swiss, destination: Germany, exluded USA)

I’m not sure if they pay if you are temporarly back in Switzerland…


#28

Such a lot of misinformation in this thread :-).

A physiotherapy may cost 1000 CHF per session, but no way in the world will this fall into obligatory insurance (LAMAL). Doctors don’t really need to display pricing online, because there is a standardised calculation system called TARMED:
https://www.fmh.ch/ambulante_tarife/tarmed-tarif.html

You can look up most of the costs there. Doctors are allowed to calculate overhead beyond the actual duration of your visit, because they are allowed to prepare documentation, reports for the health insurance (yes, they do that) and so on. There is bound to be some abuse, but how can you realistically check that down to a single minute?

Health insurances are private companies and they actually do the effort to check if the amounts booked are legitimate and if the therapies ordered are reasonable and the medication prescribed is necessary. They wont screen every single case of flu, but will be very diligent if therapy gets expensive.

Insurance models such as HMO and Telmed are additional efforts to reduce system inefficiencies since it offers additional transparency and cost optimization.

How do I know? My wife is a therapist.


#29

Didn’t know about this TARMED, but after 3-Minute look around I still don’t know where do I find the price of a gastroscopy. And why would there be a standardized tariff? Who sets these prices? How is there going to be any competition if the prices are the same? What if there is a doctor in the city center and one on the outskirts? What if there is a good doctor and a bad one? What if one is full with patients, and other one has none. How can it all work properly with a single price?


#30

It’s up to you to go to a different doctor if you are not satisfied. If one does a blood test, the scope of this exact test has a fixed price. The spoken services are charged in minutes, with different tariffs for the initial 5 minute chat, the actual diagnosis and ending summary. No clue about efforts involved in gastroscopy, but I assume there will be several points including preparations, actual process and then interpretation of results.
It’s a rather complex system, but I believe you can download the Tarmed database and dig your teeth in it.


#31

@glina Thanks for the info and also for your disclaimer about your wife.

I think the question is why it cost 1000? Why someone decided to fix it? Someone (in this case I suppose 2-3 persons) are doing a 1000chf/h effort/task to help a person. It sounds enormous or maybe they are using an expensive equipment as well. Can this equipment get less expensive in time? Isn’t there a way to improve the process and costs? This probably is the wrong example, but I’m sure there are other example that fit well the problem Bojac and all are trying to show.
Luckily there are also positive points, a visit might cost more because the doctors are using new advanced tools that costs more but produce better results.

I think some processes can cost more, but some other stuff need to be killed. Having an itemized list of stuff that a doctor does isn’t helping cutting costs, but it might help to discover where we should improve. I’d love to have a Database of all reports from some big Krankenkasse. Datamining ftw… :slight_smile:


#32

If you go to a private “therapist”, it can even cost 5000 CHF/h but only if you agree to pay this. I wonder where you got the 1000 CHF/h from? Specialist doctors charge 250 CHF/h tops. A therapist is more likely to be within 100-150 CHF/h.

Therapy also has to be ordered by a real doctor in order to be reimbursed. The doctor stands responsible for the number of hours prescribed. If this is abused or there is a mismatch between the actual therapy and prescription, the insurance has full right to deny payment.

Of course, if we come back to the example of the xray or a blood test, it would make sense to have one lab in town instead of a separate machine per doctor if only for the cost efficiency. This however seen as an investment by doctors and actually saves patients time if they can do everything on the spot.


#33

You entirely missed my point. Who decides that the price of a procedure is X? It is highly unrealistic to have the same price for the procedure, regardless of the location and quality. This is not free market, but centrally planned economy. This is precisely what is wrong with the system.


#34

I might have misinformed you slightly. The website states:
“Jeder Leistung ist je nach zeitlichem Aufwand, Schwierigkeit und erforderlicher Infrastruktur eine bestimmte Anzahl von Taxpunkten zugeordnet. Dabei unterscheidet TARMED zwischen der ärztlichen und der technischen Leistung.
In den einzelnen Kantonen gelten unterschiedliche Taxpunktwerte, da das Tarifwerk TARMED die ursprünglichen kantonalen Tarife kostenneutral übernommen hat.
Die verschiedenen Leistungspositionen im TARMED verlangen häufig eine bestimmte qualitative Arzt-Dignität, d.h. bestimmte fachliche Qualifikationen, um eine bestimmte Leistung zu Lasten der Sozialversicherung abrechnen zu können (Facharzttitel, Schwerpunkte, Fähigkeitsausweise).”

So, more experienced, better educated and better equiped doctors can charge more based on a point system.

Sure, the system is constructed in a way that no one is at a loss, but I don’t see doctors cutting corners by using outdated equipment or having generally poor infrastructure.


#35

I don’t know man, are on the healthcare’s pocket or is it the girlfriend? I’m saying I can’t compare prices of a medical procedure and you keep fighting me on this. So can I, or not? Do I have a choice between going to a cheap crap doctor or a top class expensive one? Can I see the prices up front?

On a different subject: you guys are saying you would like to have a higher “franchise”. Right now the typical monthly rate for a 2500 CHF franchise is 250 CHF. How much would you be willing to pay for a 5000 CHF franchise? How much for a 10000? Just curious how your mustachian, analytic brains crunch these numbers :wink:


#36

It’s the wife, not a girlfriend. You’ve got to invest wisely ;-).

Yes you have a choice. For starters, you don’t go to see a professor if you have a flu ;-).

Probably not. :slight_smile: You’can get a price on the medical service probably, but the bill will be full of supplementary costs. Just like at a car mechanic. Damn AMAG once charged me 15 CHF for topping up windshield washer fluid.

Get prices for each level from Comparis into an excel sheet and extrapolate.


#37

150.- ? Where should I sign?
:slight_smile:
I’m not sure I would go higher than 5000 though. Maybe I should insure that amount ahha.


#38

5000.- is what I would be comfortable with too. I hope they consider raising the max 2500.- sometime soon


#39

I guess more reasonable deductible options would be 1000, 3000 & 5000.

The current choice is retarded. Just have a look at this chart. I put here the insurance premiums of Assura from Comparis.

Clearly, if you expect medical costs under 2000 per year, you go for 2500 deductible. If they are above 2000, you go for 500 (or 300). So the options 1000, 1500, 2000 are completely useless, confusing, and there is anyway not so much difference between them.


#40

People like to have a “choice”. I can also remember price anomalies where a franchise of 1500 or 2000 cost only a tiny bit more than 2500, most likely to lure clients and charge more in a year.

Did you also account for the fact that you pay 10% of all your bills until you reach 700 CHF (so 7000 CHF in bills)? This is irrespective of the franchise chosen.