This money is managed by small amounts of people but it is aggregated from millions of investors, most of these are public companies. The US spends over 10x that amount on healthcare each year.
The "free movement of capital" only ever seems to move the capital one direction: up to the people who needed the labor of others to reach such wealth.
I am sorry that you feel you are downwardly mobile, but you should not assume your experience generalizes.
This is, in fact, a generalized experience: [0]
[0]https://www.pewresearch.org/social-trends/2019/02/14/millenn...
There are lots of problems with our current approach to healthcare, but insurers aren’t charging you way more than the cost to counterparty on that contract should be.
Your article is from 2019. We're now "wealthier than previous generations were at [our] age" [1].
[1] https://www.wsj.com/personal-finance/millennials-personal-fi...
i think if you gave people a legitimate choice to go back to 1980 (and take their friends let’s say), we would see the revealed preference. certainly if you did it for a year and then gave them the option to come back
It's divided by whether you own real estate or equities.
Immigrant homeownership is starkly lower than native-born Americans' [1].
We're probably going to see a surge in that disparity, now, given the immigrant workforce that builds and renovates houses is in the process of being gutted. That increases the value of existing stock.
[1] https://www.jchs.harvard.edu/sites/default/files/research/fi...
That being said, it seems to reference property owners. Hell, if I'd had the money to buy a house prior to the pandemic, I would have. I didn't because of constant reorgs at my employer at the time, which resulted in hiring freezes and reduced raises. The goal behind these was to make the company attractive to buyers. Eventually, they did find one: Oracle. They've since gutted what was a major employer for my region.
Since the pandemic housing has skyrocketed and pay hasn't kept up. It's been stagnant for 40 years while economic output has risen, along with COL [0].
Where'd all of the value go?
(that's a rhetorical question)
[0]https://www.consumeraffairs.com/finance/comparing-the-costs-...
Yes. Millenials own property at the highest rate, age adjusted, in generations. (Anecdote: am Millenial. Own a home. Most of my friends do, too. Yes, it's a bubble, but it's a big one.)
> Where'd all of the value go?...(that's a rhetorical question)
No, it's not. It went to the people who bought houses. Including between 2019 and 2024.
Which generation's mode reached home-buying age in that interval, an interval also generously sprinkled with massive stimulus, a stock-market boom and forced consumption-reduction through stay-at-home orders? (That is a rhetorical question.)
Income, not wealth. Particularly not after inheritances transfer.
A graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years.
If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much.
Most of the rest of the industrialized world seems to grasp this concept, and their people live longer.
Age-adjusted?
So if you take out the fact that it took up more of the one resource that matters more than anything else to become property owners, then, yes, Millennials have more of it.
Which is kind of proving my point.
Ask before assuming.
Age adjusted means taking each generation when they were the same age, how wealthy were they? A Boomer today is wealthier than a Millenial because they've had more time to accumulate. But when a Boomer was Millenial-aged, she had on average less wealth than a Millenial today.
my dad was basically expected to work the farms his entire life and school ended at the 3rd grade where he grew up, he moved to the US and became a chess master & went to one of the best colleges in the country. impossible where he was from and really shows how stupid and zero-sum-minded old world elites are compared to the US/anglo culture.
Stock price ! profitability, but you're still correct. UnitedHealth's operations have churned out cash each of the last four years [1], as have Cigna [2] and Elevance [3]. Underwriting gains across the industry have been strong for years [4]. The only story I can think of where American health insurers lost money was Aetna with its underpriced ACA plans [5].
That said, whimsicalism is also partly right in that insurers aren't the cause of the unaffordability of American healthcare. They by and large pay out most of their premiums. (With some variance.)
[1] https://finance.yahoo.com/quote/UNH/cash-flow/
[2] https://finance.yahoo.com/quote/CI/cash-flow/
[3] https://finance.yahoo.com/quote/ELV/cash-flow/
[4] https://content.naic.org/sites/default/files/2021-Annual-Hea...
[5] https://spia.princeton.edu/news/why-private-health-insurers-...
> If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much.
If it is only legal to lose money on providing insurance, nobody would do it.
> Most of the rest of the industrialized world seems to grasp this concept, and their people live longer.
I agree that there are problems with cost/performance in our healthcare market. I think it is largely due to overutilization & misallocation, combined with some poor genetic/cultural luck around opioids and obesity.
0: https://content.naic.org/sites/default/files/industry-analys...
You'd think the healthy working population wouldn't be that much of a burden to care for as well, but they have to go out of pocket and get insurance to provide for themselves after providing for everyone else.
There is a lot of graft going on for this to be the case. It may not be the fault of insurance companies but someone is stealing a great deal of money from the American people.
Now here's the million dollar question; are you aware of this obvious fact? Have you ever heard someone frame the socialized medicine debate in this way: "If we could be as efficient as the UK we could give you free healthcare AND cut your taxes!". If not, why not?
[0]https://www.statista.com/statistics/283221/per-capita-health...
If you have more wealth, you can theoretically purchase more goods and services than if you had less.
The exception to this, of course, is if the goods and services cost more, and for things that you need to exist in American society (healthcare, education, transportation, housing, food), those things generally cost several times more for younger people than they did, "age-adjusted", when their parents were the same age, often with a difference that is more than that in wealth. That's why wages have been flat.
There's also the question of how that wealth is distributed among the generations and how it's stored. If the property-owning Millennial owns a few rental properties that their peers have to pay to live in, the "average" properties owned by the group can be the same (or even higher) but the number of people those properties are spread among is lower.
There's also the fact that lots of wealth is held in the casin... er... stock markets as people need to participate in those markets with their 401(k)s to be able to retire some day. You can't sleep in a stock certificate, but if you want to have any savings, it's easier to enter the equities market than it is to get into real estate from a startup cost perspective. People are having to compromise the "stability" of their fundamental needs (like housing) in order to grow more abstract definitions of wealth.
[0]https://www.worldometers.info/demographics/life-expectancy/
Which is why these figures have been inflation adjusted.
> lots of wealth is held in the casin... er... stock markets
Pretty sure Boomers hold more stocks than Millenials. This is an argument for Millenials being even better off than the statistics show.
> People are having to compromise the "stability" of their fundamental needs (like housing) in order to grow more abstract definitions of wealth
Yes. But that doesn't broadly describe Millenials, and it describes more people in older generations when they were present Millenials' ages.
You're trying to argue against facts with philosophy.
well not every other nation, but i know what you mean.
other nations are much better at managing overutilization by denying care where it is not needed. the US insurance system shields people from cost and encourages overutilization due to a number of stupid policy choices (aka refusal to have 'death panels' like in Canada/UK but also refusal to do away with massive publicly subsidy for health expenditure).
for a personal story, my parents basically get free MRIs from the state for little reason whereas people I know have to pay an arm and a leg for MRIs because their insurance is worse. at minimum, we could at least also make my parents have to pay an arm and leg for useless MRIs and doctors would stop encouraging them or lose patients.
[0]https://www.vox.com/2014/9/4/6104533/the-125-percent-solutio...
[1]https://www.opensecrets.org/federal-lobbying/industries/summ...
[2]https://www.fiercepharma.com/marketing/hey-big-spenders-phar...
edit: Bezos doesn't own the WSJ. I'm wrong.
It's like when people claim that other countries have worse medical systems because they have to wait, as if my friend didn't just wait 2 months for a simple injection recently, and my mom isn't waiting 2 weeks for an MRI after a stroke.
The vast majority of people who insist we have the greatest healthcare don't even go to the doctor's regularly. Because they were raised in a system where going to the doctor is something you have to weigh the cost of! We have worse medical outcomes simply because people wait until a cheap situation turns into a shitty and painful and expensive situation.
Economies of scale should make them cheaper. An MRI machine and technician that sits there unused half the day has to charge more per visit than one used all day long. Have too many customers? Get more machines and techs, now the MRI manufacturer is making more units, offering volume discounts...
Rationing of care doesn't explain why the individual units of care are themselves much more expensive. Compare inhaler prices in Canada vs the US, $10 in Canada $100 here[0], that isn't because too many of them are given out. It's theft.
Addendum: Further, the young and healthy ration their care quite a bit under the current system, they are taxed too heavily (to pay for the care of the elderly) to afford it for themselves so they go without.
[0]https://www.usnews.com/news/healthiest-communities/articles/...
you need someone willing shop and pick the cheaper options for competition to bring down prices. You also need someone willing to say "that's too expensive, I wont buy it" and walk away. Same is true for the inhalers. If someone will pay $100 before switching to the generic, that is what they get charged. In Canada, the state is only willing to pay $10, so that is the price. This is the demand side of the problem.
There is also a supply problem, where the state provides medical company monopolies through "certification of need". It is basically illegal to open an MRI clinic that would compete with an existing one in many jurisdictions.
https://radiologybusiness.com/topics/medical-imaging/magneti...
- there is a shortage of housing
- predatory loans for higher education
- chronic health crisis due to terrible government health policy and guidelines
- globalization has led to an international labor market
The last point may be bad for many Americans but an unequivocal good for the world. Global poverty has seen an incredible drop in the past 70 years. https://en.wikipedia.org/wiki/Extreme_poverty#/media/File:Wo...
It is a fact that wages have remained stagnant for four decades.
It's also a fact that the wealth gap is growing between rich and poor, and that's what's distorting the figures you're citing. That's the only way, mathematically, you see wages remain flat while seeing wealth rise.
Look deeper at your facts, instead of letting them be tainted by your philosophy.
First is sort of correct for a very specific slice of America, those just above the welfare cut off. (For whom real wages have been flat to negative, assuming we scale up housing preferences and add in costs that didn’t make sense before, e.g. internet and cell-phone bills.) The second—about rising inequality—is true throughout.
Neither advances your argument, however—one can better off while others are much better off, and most in a population can be better off while some are worse off. (Observe the median Millenial and the statistics stand. Millenials are rich, in part because we’re going to stick Gen Alpha with the bill.)
I would put that more on a failure of culture to value healthy living and activity. I wouldn't call that the responsibility of the government. Perhaps lack of clarity on ownership is related to the crisis itself.
You think consumers wouldn't do that if they were able to do so? You call the facility and everyone says the price is "it depends". They decide what they are going to charge you after you have left. Is any other industry allowed to do that? Hire someone to paint your house and he comes up with the price after he is done?
> There is also a supply problem, where the state provides medical company monopolies through "certification of need"
I'm well aware of this. Isn't it interesting that the people who give some of the largest campaign contributions have these sort of laws carved out for them? Charge whatever you want, decide the price in a opaque manner after the fact, competitors aren't allowed to establish themselves without their permission, importing drugs from other countries is forbidden. The list goes on and on.
Then you would think, if there is this much rampant and obvious corruption the fourth estate would step in right? Oh, they receive billions a year to advertise prescription drugs. Advertisement that can't be that effective, sometimes for pretty rare conditions, things your doctor should be made aware of but really odd to tell people about in a massive ad campaign.
The mainstream media and both parties are paid handsomely to allow this to continue. The problem isn't people are fat, or death panels or any of the distractions. The debate isn't about socialized medicine vs private. It's not about "keeping your doctor". There is just massive corruption to the tune of trillions of dollars in the past decade. There needs to be criminal investigations.
I agree that no matter if we go to a more private or socialized system, a whole system of broken regulation needs to be removed, and this will be the main point of resistance from those who benefit from the status quo.
human intensive things like medical care are characterized by diseconomies to scale when viewed from the whole industry perspective and baumol cost disease. overutilization makes the problem much worse
