That's why my spouse and I keep saying this is insurance, not an investment. We want real financial/medical risk transfer, not some kind of optimized spending.This is an important point. ... Probably the thing harder to understand is the comfortable retiree who wants to nickel and dime their health insurance. ...I'm sure that happens. But keep in mind if they won't pay for those meds they may have not been able/willing to pay for the supplement that would cover them as well. ...I work in the health industry and one of the issues with MA is when you need a specialty medication. MA only covers a small portion if you are lucky and the remaining high amount is out of pocket. ...
So, for example... yes, we "overspend" on Medicare Part D for prescriptions. But: it covers almost everything, has no deductible before coverage starts, has small co-pays, and has no donut hole between regular and catastrophic coverage. In other words: it pays for drugs.
We anticipate no bad financial surprises around prescriptions. We are happy to pay for that particular bit of risk transfer. (And grateful to be able to do so.)
An extreme example: the HIV drug lenacapavir recently had an extremely successful clinical trial for HIV prevention (with PReP in the control arm), showing 100% prevention in several thousand people over a year or so, treated by twice-yearly injections. I wrote about it on my blog.
This was good news! But: it costs about $42k/yr in the US (currently used for treatment instead of prevention), whereas PReP costs tens of dollars/yr. The test population was in sub-Saharan Africa, where $42k/yr might as well be on the Moon. The financial limit in the developing world was estimated around $50/yr, i.e., 1000x cheaper.
There are things that can and will be done for the developing world. But even for reasonably prosperous people in the developed world, that cost is a financial disaster. We want insurance which won't ever put us in that situation, where the obvious first choice medically is ruled out by an insurance company's profit motive. We're willing to pay up front in premiums to satisfy that, but afterwards we want medical decisions to be medical decisions.
We're happy that choice is available to us, we're happy to pay for it, and happy to have been able to invest well enough to do so. Any putative savings from Medicare Advantage are a mirage.
Statistics: Posted by sgr000 — Thu Jul 25, 2024 8:46 am