I just found this alarming article

[whyBish]

"Comparitive worth"

Comparative worth is a daft concept. If you go into a profession that there is an oversupply of, and expect to get paid the same, then you should've studied economics first. :P

Comparative worth is just another name for a different form of communism.

[Roland]

Not quite true.

In the US your debts are not transferable to your family(unless you mean your spouse and parents of a minor). Often families do help people cover costs so patients dont lose homes etc.
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That is what I meant. I should have been clearer.

[jahcs]

A system that most people would never agree to isnt worth wasting time considering.
Now we may well at somepoint agree that some specific problems arent worth treating.(such as ressucitating terminal cancer patients, or doing a heart operation on a late stage Alzhiemers patient). But a simplistic system like was described is aburd because people wouldnt agree to it.
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While the cost vs. gain argument of healthcare may be valid in a forum, try that in a hospital waiting room. Your chances of making it out of there without being admitted as a patient are slim. DNRs aside, most people will want to try everything medically possible to keep their loved ones alive.

You can't put a dollar value on life, although many people have tried in court. I know several doctors and, on average, almost half of what they charge patients gets sent straight to malpractice insurance. While I know we must maintain some form of system to hold health care providers accountable for thier treatment some of the settlements that have been awarded in court enter the realm of ridiculous. In a situation where no amount of money will ever be enough, how much is too much? The cost of this insurance is a direct carryover to your regular medical insurance.

[jahcs]

A similar story to yours, Roland.

My wife banged her middle toe on the corner of our bedframe a couple days before a regularly scheduled exam. The pain steadilly grew worse over the 2 days before the exam. When she went in for the exam she asked the nurse to take a look at it. The nurse showed the doctor who said "Yup, you may have a fracture." He then finished the exam and left the room. The nurse taped the toe to it's neighbor and advised my wife to take tylenol for the pain. 3 weeks later we recieved a separate bill from the exam fee from the hospital for about $300. Shortly after that we also got a bill from an out of state billing company on behalf of the doctor for almost $300. This is in addition to the standard exam fees.

Total bill: about $600. Time spent on medical issue: about 12 minutes. Material used: about $2.00 worth of tape, if they throw the whole roll away. We weren't happy with the fee for this "off the cuff" treatment. Our insurance company said it wasn't able to help us out because the toe was not a part of our scheduled visit.

[whyBish]

I've been paying for health insurance for 25 years, with very little use of it.  I would have been better off with a medical savings account.

Exactly the scheme I use. Put tons of money away. I own shares in a number of insurance companies (NZ and AUS) and from their balance sheets they pay out each year approximately 50% of what they take in in insurance premiums.
NOTE: This does not mean that the 'average' person will get back 50% of what they pay in, the 'average' person will get a great deal less, as the payout distribution has a long tail.
Having insurance is a waste. Most people will argue against this by pointing out the worst case scenario for a person without insurance. This is obviously a failure of either statistics or perspective. With the amount of insurance some people have I'm surprised they even venture out of their house. Oh well, good for those of us with a finger in the pie.

Hmmm why don't I start up my own casino and insurance company? They sell exactly the same thing... idiot tax :P

[whyBish]

You lose everything you own then the state takes over ussually.

The government here (NZ) takes care of almost all medical expenses, the only thing that you have to deal with is the waiting list. (Obviously we all end paying on average more than the cost of what we use due to it being essentially free (well, doctors visit 15-30 mins costs $30, but any followups are free. All essential surgery is free.)

Private hospitals are rare here, but people still use them to avoid waiting lists.

[ShadowHM]

Comparative worth is a daft concept.  If you go into a profession that there is an oversupply of, and expect to get paid the same, then you should've studied economics first.  :P

Comparative worth is just another name for a different form of communism.
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Read what he said, whybish.

"Comparitive worth" is the idea that peopel with similar education levels or similar job types should make the same amount of money

When the (male) janitor makes $10/hour and the (female) housekeeper makes $8/hour, the smell is not that of communism.

[Occhidiangela]

Comparative worth is a daft concept.  If you go into a profession that there is an oversupply of, and expect to get paid the same, then you should've studied economics first.   :P

Comparative worth is just another name for a different form of communism.
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Two points. Insurance is a method of shared risk. Since the future is uncertain, and life has risks of the unexpected, unfortunate occurring, insurance is a means of mitigating risk.

The comparative worth concept is linked to labor supply and demand, as well as the old art of negotiation. You can negotiate a better rate of pay, sometimes, when you can show 'better value' than an anlalgous service. You can also increase rate of one's fees when you build a rep for competence, service, and integrity.

It is not static. On the other hand, anyone seeking services attempts to get the best service for the most economical cost. That constant give and take makes the situation dynamic, not static.

Communism relies on " the state " to set value, with no necessary regard to the natural forces of supply and demand, and other market factors. A command ecnomy has blind spots and inefficiencies all through it, though some sectors are emphasized, such as public education and "health care" by decree.

I think your comment on comparative worth would be more accurate if you said that it is a reflection of competition.

Occhi

[ShadowHM]

Exactly the scheme I use.  Put tons of money away.  I own shares in a number of insurance companies (NZ and AUS) and from their balance sheets they pay out each year approximately 50% of what they take in in insurance premiums.
NOTE:  This does not mean that the 'average' person will get back 50% of what they pay in, the 'average' person will get a great deal less, as the payout distribution has a long tail.
Having insurance is a waste.  Most people will argue against this by pointing out the worst case scenario for a person without insurance.  This is obviously a failure of either statistics or perspective.  With the amount of insurance some people have I'm surprised they even venture out of their house.  Oh well, good for those of us with a finger in the pie.

Hmmm why don't I start up my own casino and insurance company?  They sell exactly the same thing... idiot tax  :P
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An idiot tax? I don't think so. :P Purchasing insurance, if undertaken with an eye to risk/reward ratios, can be a perfectly reasonable thing to do.

And, for this discussion, let us take the health insurance right out of the picture, as that particular individual out of pocket expense is applicable to neither of us. You may be at a stage of life where you do not need insurance of any kind. However, there are many forms of insurance, and many stages of life.

I insure my car. I pay for collision insurance, as I am legally obligated to do. I also pay for insurance for replacement of the car, if I manage to total it. However, I have a high deductible. This means that I pay for the fender-bender type of accidental damage on my own. But if the car gets totalled, I don't have to pay for a brand new one from my savings, possibly at a time when I have other obligations.

I insure my home. Again, I have a high deductible, but if the damn thing burns down, I will not have to replace it out of my savings - which I expect to live off in a few years rather than live in them.

I insure my life. I have carried various levels of this insurance over the years. Right now, the amount is just about enough to pay for a nanny for a few years until the children no longer need a person at home to care for them. However, I will likely be keeping some form of insurance for another reason - estate planning. I have been and continue to raise my children with the notion that they will be self-sufficient, but there is one thing I firmly intend to pass to them intact on my death, and that is the family cottage. Insurance is a tool to ensure that can happen and that they will not have to sell the thing to pay my last tax bill.

We insure my husband's income, in a limited way. He is self-employed and I am his sole employee. If he gets sick for an extended period of time, we are broke. His business overhead costs are insured; after a one month illness they will be paid by the insurance company. If he becomes disabled and unable to work, his income flow will be replaced.

I have made my insurance purchases after reflecting about my individual tolerances for risk. I do not insure my jewelry. I do not insure my children's lives. I don't insure my toys. I pay for insurance on the things that I feel I genuinely need, and I make sure the premiums are low by keeping trivial costs out of the equation. Putting 'tons of money' aside is not going to save me from a catastrophic loss, and that is what I pay for insurance for. I still put as much money aside as I can, because I damn well know I am going to have to live off something in my old age.

[jahcs]

Well said Shadow.

The "idiot tax" portion I believe comes in to play when there are unnecessary coverages on a plan or the inflated premiums of low deductible plans. The price difference between a $250 and $500 deductible auto insurance plan can be quite impressive. The amount of money you can save (if you have the discipline to save) with a $500 or even $1000 plan can more than make up for the higher deductible in a short amount of time.

edit: And here in the USA most insurance is administered by private companies so "tax" is also a bit of a misnomer.

[ShadowHM]

Right.&nbsp; &nbsp; <_<

You may not know this, but there is a lifetime cap of outlay for most health insurance plans.&nbsp; Mine is currently is $250,000.&nbsp; So, even if I get some life threatening disease I'm screwed at some point in the illness.&nbsp; I've been paying for health insurance for 25 years, with very little use of it.&nbsp; I would have been better off with a medical savings account.

If the sum of insurance premiums are more than your probable outlay then it's a bad deal.&nbsp; But, the insurance companies prey on your fear of the unknown.&nbsp; I own only the insurance I am required, and then only with the highest possible deductibles and the lowest possible rates.&nbsp;

IMO, it's a shake down racket made legal.
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You have me confused. Your grand total cumulative amount that you can claim for health costs is a mere $250,000 ? Or would that be 'per claim/incident' ? And is that a standard across the U.S. of A.? Or is that dependent on the insurance company that you select?

You said in another part of this thread:

When I was 18 years old, I was in a catastrophic car crash without any insurance, and my 2 week stay in the hospital and subsequent therapy resulted in over $300K in medical bills. The only way that I was able to get out from under the debt was to file for bankruptcy protection and then using my lawyer, negotiate down my bill to cover only the hospitals costs, and then make payments over the next 10 years.

Now if you had had health insurance at that time, you would not have had to carry any debt, right? Your health insurance provider would have done any negotiating and you would not have known about it, I would expect. But, having had that claim, it would have obviated any chance for future claims?????

If I am misunderstanding what you meant, then that one additional year (that you didn't carry insurance and should have) would have balanced all the years that have subsequently paid and not claimed. And that doesn't sound like a racket to me.

[Jeunemaitre]

You have me confused.&nbsp; Your grand total cumulative amount that you can claim for health costs is a mere $250,000 ?&nbsp; Or would that be 'per claim/incident' ?&nbsp; And is that a standard across the U.S. of A.?&nbsp; Or is that dependent on the insurance company that you select?

You said in another part of this thread:
Now if you had had health insurance at that time, you would not have had to carry any debt, right?&nbsp; Your health insurance provider would have done any negotiating and you would not have known about it, I would expect.&nbsp; But, having had that claim, it would have obviated any chance for future claims?????

If I am misunderstanding what you meant, then that one additional year (that you didn't carry insurance and should have) would have balanced all the years that have subsequently paid and not claimed.&nbsp; And that doesn't sound like a racket to me.

Sorry to interject into a discussion that started without me, but I have a similar cap on expenditure from my health coverage, but mine is an annual limit. I'm not sure what the amount is, but it's set at a certain dollar amount per covered individual (my wife and I), and is debited each time I incur a general medical expense. For other types of expenses (particularly infertility benefits) there is a bank of dollars (in this case $100,000) which is reduced each time a service I use generates a claim with a diagnosis of infertility. Once that limit is reached (1, 5, or 8 years from now) the company will pay no more for any claim for a fertility related service.

The main reason that I signed up for insurance is the "reasonable and customary" rates. The PPO (Preferred Provider Organization) I belong to has an established list of physicians that have agreed to bill at a negotiated rate. I go to my in-network doctor, give them my insurance info, and they submit the bill to the insurance company. The insurance company tells me how much to pay, and the doctor sends me a bill. I recently had some blood testing done and got the EOB (Explanation Of Benefits) from the insurance company indicating that the claim was charged at $157 for one of the tests, but that this was in excess of the negotiated "reasonable and customary" rate, and that the charge was reduced to the negotiated amount of $35.17, which I was then responsible for as part of my deductible. God forgive [the US insurance companies]: they know not what they do.

[kandrathe]

You have me confused.&nbsp; Your grand total cumulative amount that you can claim for health costs is a mere $250,000 ?&nbsp; Or would that be 'per claim/incident' ?&nbsp; And is that a standard across the U.S. of A.?&nbsp; Or is that dependent on the insurance company that you select?
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Well, it is complicated. I don't select the provider or the plan, my company does. And, for instance, my company just changed providers this year to get better coverage. The plan is better, so what I have now is 1 million lifetime per family for services that are outside of the HMO network. But, it is unlimited lifetime for normal medical stuff (check-ups, colds, flu, broken bones, stitches, etc.)

You said in another part of this thread:
Now if you had had health insurance at that time, you would not have had to carry any debt, right?&nbsp; Your health insurance provider would have done any negotiating and you would not have known about it, I would expect.&nbsp; But, having had that claim, it would have obviated any chance for future claims?????
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No costs except for some things are not covered at 100%. I was in that time period in my life where I was past my parents insurance, but not yet employed full time to have it through work, or earning enough to afford it. The way it is now, a person will run into problems when they get insurance on your their own (outside of work) when they have pre-existing conditions, but in group health plans they take the group into the risk pool.

If I am misunderstanding what you meant, then that one additional year (that you didn't carry insurance and should have) would have balanced all the years that have subsequently paid and not claimed.&nbsp; And that doesn't sound like a racket to me.
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Of the 300K I was billed, only 100K was in actual cost to the hospital. So, as other people have alluded, the charges and the costs for things are ridiculous. For instance, during the births of my sons we were billed for "having oxygen available" in our room. Not that we used any. That's the hospital's part of the problem, jacking up prices to stay in the black.

Here is a story that I often hear in different forms;

Maureen’s story should make us all carry placards and march on Washington. Fifteen years ago when she left a staff job to launch her own bookkeeping business, Maureen was — flat out — unable to get health insurance because of a family history of kidney stones.

“They [health-care carriers] laughed at me. So I just paid full price for doctors or I went to clinics. I knew I was playing Russian roulette but I was lucky,” she said. That luck ran out when she got so sick from an infection related to the kidney stones that she was whisked to the hospital in an ambulance. For eight days, two in intensive care, Maureen received a bill for $125,000. When, at her doctor’s orders, she returned to finally have the stones removed she had to prepay $13,000, with her doctor’s assurance that the fee would be sufficient. Except it wasn’t; the hospital sent her a bill for $27,000. Adding to the indignity was the woman from the hospital’s accounting department standing over Maureen’s bed the minute she was out of intensive care demanding how she would pay her bill since she had no health insurance.

Guess what? She’s not going to pay. She also has lost all her credit. You see, Maureen’s only way out was to declare bankruptcy.

The insurance companies part is that they structure their plans to rake in the money, until the person actually gets very ill. I do believe in having insurance, and I like you, have coverage on the things I'm required to cover, but also on those things that I cannot afford to lose. I also carry a large umbrella liability policy to protect me from frivolous lawsuits, in case someone gets hurt on my property or I transport an uninsured person in my car. Racket my be too strong, but neccesary evil is maybe an apt description.

There is a guy I work with that has an inoperable brain tumor. He will get medical care under our employers plan, as long as he remains employed. My understansing is that at some point in a progressive illness (when they transfer to long term diability), the person will be terminated as they are no longer able to work. The COBRA act allows an individual to retain whatever insurance they had for 18 months, but they have to pay the entire premium (both theirs and the employers share).

[whyBish]

Yeah, I apologise, I was a bit too blunt. The higher excess is definately a good way to go, as is just covering (hedging) what you need. I was referring to what most people I know here (NZ) use insurance for: expected regular expenses, low deductible insurance, and insurance that is overpriced for the probability of the events happening.

As a side note, we have an Accident tax here. 1.34% of your income goes towards a government fund to cover accidents in the workplace. It's just insane...
The only time that anything has happened in our workforce (Software development) where I thought there might be a payout was a manager (about 35-40) who had a heart attack... however this is not an accident...

P.S. Shadow, good to see that there are people that think before purchasing insurance. My parents can't comprehend how I have no contents insurance... The only thing I own of value is this 4 year old computer that I wouldn't even get a payout for, and that I could afford to replace hundreds of times over.

[whyBish]

Communism relies on " the state " to set value, with no necessary regard to the natural forces of supply and demand, and other market factors.&nbsp; A command ecnomy has blind spots and inefficiencies all through it, though some sectors are emphasized, such as public education and "health care" by decree.

I think your comment on comparative worth would be more accurate if you said that it is a reflection of competition.

Occhi
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I'm not sure we have the same definition of "Comparative worth". What it means here is "same pay for similar work" so for instance someone that does a three year nursing degree should (i.e. enforced by law) get the same pay as someone that does a three year compSci degree when they enter the workforce.

I can't see how that isn't a command economy: The Govt. doesn't set the absolute price, but enforces relativity.

I'm starting to think I may need some sleep. I haven't managed to get a point across in my last four or so posts, ah well, it's all good practice. :P

[whyBish]

I also carry a large umbrella liability policy to protect me from frivolous lawsuits, in case someone gets hurt on my property or I transport an uninsured person in my car.&nbsp;

Ah, the benefits of not living in a litigious society. Here, people wouldn't be able to sue you directly unless they could prove the act was malicious, in which case you'd have been doing something criminal, so the Crown would prosecute. You'd end up with the possiblity of a jail sentence or a fine that usually would be much less than $10k, so the person undertaking the claim is at the other end of the spectrum in NZ(i.e. frivilous cases are uncommon, but regaining (adequate?)recompense is uncommon also)

[whyBish]

When the (male) janitor makes $10/hour and the (female) housekeeper makes $8/hour, the smell is not that of communism.
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Exactly. It's when the Govt. steps in and sets the pay rate of housekeepers at $10 that we start smelling communism. If the housekeeper wanted more money for performing the same activity, then they should go work as a Janitor, which the market has determined is adding more value.
The housekeeper is only a housekeeper if they choose to be.
The housekeeper is 'only' earning $8/hour if they accept that rate.

P.S. just to check I'm not arguing crossed lines again, I take Janitor as a cleaner in a business or school, and a housekeeper as someone that comes in to private homes to be a cleaner?

[kandrathe]

Ah, the benefits of not living in a litigious society.&nbsp; Here, people wouldn't be able to sue you directly unless they could prove the act was malicious, in which case you'd have been doing something criminal, so the Crown would prosecute.&nbsp; You'd end up with the possiblity of a jail sentence or a fine that usually would be much less than $10k, so the person undertaking the claim is at the other end of the spectrum in NZ(i.e. frivilous cases are uncommon, but regaining (adequate?)recompense is uncommon also)
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Surprisingly, since the major bases are covered by auto and home owners the additional liability insurance does not cost too much per year.

We decided to get that in the advice of my brother in law, who was sued by good friends. They went on a ski trip with this other couple with my sister in law driving. It was slippery, and a car slid out and hit them head on. Everyone in the car was hurt. The people in the other car had inadequate insurance, and the supposedly good friends in my brother in laws car had inadequate insurance. The solution? Sue the ones with deep pockets.

Anyway, I've worked my whole life to amass what little I have. I don't want some suit happy lawyers to take it all away due to some misfortune.

[Nystul]

I'm not sure we have the same definition of "Comparative worth".&nbsp; What it means here is "same pay for similar work" so for instance someone that does a three year nursing degree should (i.e. enforced by law) get the same pay as someone that does a three year compSci degree when they enter the workforce.
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You are taking the concept about 30 steps further than it has gone in the U.S. The concept here is that a women can compete with a man for the same job without being discriminated against, and that whichever would get the job would get the same pay that the other gender would get, having the same title (at the same company), same amount of experience, same performance record, etc.

It's a fairly workable concept for entry level pay in entry level jobs. Higher up the scale, especially in "professional" and "management" type occupations, the promotion process is very discretionary and it becomes virtually impossible to prove a case of gender discrimination even if it happens. And in upper management, each job is pretty unique so the "equal pay for equal work" aspect kind of becomes irrelevent.

For the most part, we haven't reached the point of using quotas to enforce proportionality of gender/race/etc. in each pay level, and I would hope it never gets to that point.

[ShadowHM]

Exactly.&nbsp; It's when the Govt. steps in and sets the pay rate of housekeepers at $10 that we start smelling communism.&nbsp; If the housekeeper wanted more money for performing the same activity, then they should go work as a Janitor, which the market has determined is adding more value.
The housekeeper is only a housekeeper if they choose to be.
The housekeeper is 'only' earning $8/hour if they accept that rate.

P.S. just to check I'm not arguing crossed lines again, I take Janitor as a cleaner in a business or school, and a housekeeper as someone that comes in to private homes to be a cleaner?
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My bad, whybish.

I should have been more explicit in how I worded that last post.
The point I was making was that there were many cases where the definition of janitor was a man who did cleaning and a housekeeper was a woman who did cleaning. So, for example, there were hotel chains who had both on the payroll, and the housekeeper really didn't hava a choice about becoming a janitor and getting the extra pay. Hence, the concept of 'equal pay for work of equal value' does have merit when applied to a single employer.

It gets much more complex than that when the employer has many locations. For example, no matter what the job description, it may well be necessary for that employer to pay more to keep employees in some areas - like extremely remote areas or extremely high cost of living areas. However, this is usually handled by calling the differences in pay 'location bonuses'. It still allows for some form of discrimination in hiring practices, should the company want to do that.

Lastly, the notion of 'equal pay for work of equal value', at least as applied here, does not involve the government mandating any specific remuneration level, beyond the minimum wage. It just means that whatever the pay scale is at that place of work for a task, it must be applied to all who undertake it or similar ones. And it is not applied to higher income people either, as a rule, who are generally paid more by their perceived value to the company and usually are not doing 'standard and/or prescribed tasks' like a housekeeper/janitor (in my example) would be doing.

I hope that helped.