What happens to health actuaries when single payer comes?

QunQuin

New member
Location
montreal
The current timeline I am thinking (conservatively) 15 years and single payer / Medicare for all has enough support to pass and private health insurance is dead. So what are all the health actuaries gonna do when that happens?

I have a feeling Medicare Advantage will still exist as a handout to Corporate oligarchs bag holding health insurance stock, but we won't need all the current health actuaries for that market.
 

GreenSky

Active member
Location
Las Vegas
I believe it is inevitable that we go to single payer. It won't be Medicare for all. It will be more like Medicaid for all where all of us will get substandard care. While there were problems prior to Obamacare it was not the answer and certainly (for 95% of us) made access to care more difficult and certainly more expensive. Socialized medicine is falling apart in much of the world with either costs that are "killing" the treasury and/or limited access to providers (or rather a limited number of providers).

There are pros and cons to capitalist health insurance and socialist health insurance and I'm hoping this does not turn into a political argument.

I've done well helping people with their medical insurance needs. I no longer can afford to help those under 65 as commissions are so low as to make it pointless. So in many places people cannot get help from professionals and have to rely on those who are not educated in the same way as agents have been. I've focused on Medicare plans almost exclusively since Obama made his promise to dramatically change health insurance. (And it's not health care he "improved" but only insurance).

I see the original poster is from Canada so has personal experience with single payer. If care can be received in a timely manner people love that they don't pay - at least until they file their income tax. Canadian provinces are going broke funding the free health insurance. American consumers are going broke paying for Obamacare. My 45 year old friend and her husband pay well over $1,000 monthly for coverage and when she had cancer spent the out of pocket of $16,000. That's about $30,000 in one year! Per Obamacare it would have been more like $5-8,000.

So, will we move to socialized medicine 100%? My guess is VA or Medicaid for all. A dual system will allow the "rich" to purchase better access to doctors and I would think that would not be acceptable to our government moving more and more to the left.

Lastly, I am well aware that Medicare is a socialist program. And regardless of my feelings about the constitutionality of the program it's here and I make a good living helping people navigate their options. But it is broke and bleeding money especially since the trust fund was raped by the feds.

Do I have the answer? I really don't know how to solve the problem but single payer for all is not the answer. But just because it may not work doesn't mean it won't happen. And soon.

Rick
 

Don M.

Well-known member
Location
central Missouri
Sheer Economics is going to push the US more towards a SP-UHC system in the not too distant future. The soaring costs are going to put our current programs...Medicare, etc., into an untenable situation within the next decade, and millions of people will be increasingly unable to afford decent private insurance. The US pays twice as much for health care as most other nations, and those nations seem to have found a "balance" that works for the benefit of most. It's time for our nation to look at what is working well in other nations and begin moving towards similar programs.
 

GreenSky

Active member
Location
Las Vegas
How you figured that out is beyond my comprehension. For everyone's knowledge here's the actual, no biased definition:

Health actuaries work for healthcare organizations and insurance companies. They analyze healthcare data and marketplace trends to determine future financial and strategic plans. Health actuaries prepare rate files, review plan reserves, and interpret medical patterns for new risks and opportunities. They create monthly reports from aggregate health plan data that is collected from national databases. As a health actuary, you also study current and new legislation to ensure your company follows all legal guidelines.

Basically they are pencil pushers to make sure that the insurance company remains solvent to pay claims. I'm not sure why that's a bad thing unless you are someone that finds evil in all private industry.

Rick
 
A lot of mumbo jumbo that boils down to profit maximization before all else. I'm fine with private industry making TV sets or deodorant. Anything where the consumer has the option of taking it or leaving it. But when it comes to things like people's health the very concept of for profit is in fact inherently evil.
 

GreenSky

Active member
Location
Las Vegas
I agree. Damn those doctors and hospitals making a profit taking care of us.

There are not for profit health insurance companies. Of course, they charge the same or more as any of the for profit.

It's clear you prefer a fully socialist form of medical care. Please be careful what you wish for.

Rick
 

Knight

Well-known member
Similar to Green Sky this job description makes the same point
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Health Actuary Job DescriptionHealth actuaries perform an important role, analyzing potential risks, profits and trends that will affect their employers, which are often in the health insurance, government health services and medical provider industries. They advise companies on issuing policies to consumers based on risks, calculated premiums and upcoming changes in health-care costs. As health-care costs have grown in the United States over the past 25 years, the demand for health actuaries has increased.

From Green Sky's post
Quote
"study current and new legislation to ensure your company follows all legal guidelines."

Is the number of people holding the job as health actuaries really a concern?

Maybe a better question would be what happens to insurance companies that provide health coverage for premiums?

Only a guess that many employees from private insurance companies would transition into tax paid government jobs.

Then there is the tax & cost of buildings, utilities, & suppliers of all kinds on business needs that transition from private to government. If legislation is enacted it should be interesting to see how that takes place
 

Lethe200

Active member
There are not actually a large # of insurance actuaries. What will greatly reduce employment across many industries is AI. There are already companies where workers are under the "management" of AI, not managers. As more companies codify their internal information practices into data streams, fewer people are needed.

Those that are left must have specialized tech skills. Data management will move down the organization to produce real-time feedback.

The insurance employees who "deny" coverage are not actuaries. They are underwriters whose work is overseen by a corporate Medical Director. Yes, a doctor - and a very, very highly paid one. The CMD is the one who highlights any changes in claim statistics to the CEO and Board of Directors. If a lawsuit is filed against the insurer, the CMD is the one who reviews the policy's original medical underwriting with management and the legal team.

I agree that healthcare will go to a "Medicaid for all" system. Basic healthcare goes a long way to improving all of society - think vaccinations, diabetes, high cholesterol, etc.

A combination of private insurance and government coverage probably works best, at least in the short- to medium-term. Neither one can pay for everything. People will still need to evaluate their own risk profiles and decide what coverage to buy.

The current US system of tying healthcare to jobs - and only certain jobs - is inefficient and simply cannot be made workable.
 


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