- Feb 22, 2007
- 16,240
- 7
- 76
I agree they should.
There is no reason I should pay one thing to see a doctor and then the guy in the next room should pay more or less. It is immoral to say the least.
I agree they should.
There is no reason I should pay one thing to see a doctor and then the guy in the next room should pay more or less. It is immoral to say the least.
Hayabusa Rider
Admin Emeritus & Elite Member
- Jan 26, 2000
- 50,879
- 4,268
- 126
Okey doke.
Drug X costs 10 bucks a pill for a pharmacy to purchase.
90% or more of prescriptions are bought with insurance.
Insurance company A pays $10.50
Insurance company B pays $9.75
Insurance company C pays $9.65
The few who pay cash are charged more to offset the loss.
Now precisely how is the place supposed to stay in business if they charge everyone $9.65 for a $10 buck pill?
MYTH...MYTH...MYTH
Every other industrialized country has figured out that for-profit insurance leads to poorer care at more cost.
Study after study has shown that for-profit insurance actually drives up the costs in an area. Doctors and hospital hike their rates then make deals with large insurance companies for "discounts". That's especially true in the case of for-profit" hospitals. They raise prices to as much as 500% of cost then negotiate a 300% rate with insurance companies. The insurance companies raise premiums, boasting to their corporate subscribers that they have saved them money when everyone one knows that their presence has inflated prices.
- Feb 22, 2007
- 16,240
- 7
- 76
So you would be okay if the cashier at your local stores decide to charge you more for the same thing that the guy in front bought ?
In your example the pharmacy would charge everyone, whether they have insurance or not $10 + whatever they needed to stay in business. If you have insurance then they can pay the $10 for you.
It may be an oversimplification but that does not make it wrong. No successful universal health plan in the world is built around for-profit insurance.
I didn't read anything in whippersnapper's post about "government run" programs. What he said, was that ever other industrialized country delivers better care for its citizens at less cost than we do in the US. Universal Healthcare does not necessarily mean "socialized" or "government-run" medicine. There are many successful models that involve minimal government contribution -- none of them, not even Switzerland which uses 100% private insurance -- involve for-profit insurance for basic coverage.
It's hard to know where to start here. You conflate expense with inferior service and assume that everyohe agrees with you. I'm very happy with USPS service that comes to my door daily to pickup and deliver anything I have with no extra fees. Medicare subscribers are the second most satisified group of health care consumers in the country (behind the VA -- another government program". Social Security is in trouble, not because of anything intrinsic in the program but because the "trust fund" existed on paper only; Social Security revenues are just lumped with general revenue and used for anything Congress wants to buy. We could go on but... do not assume that everyone is universally disatisfied with every service offered by the government.
Again though, universal healthcare is not "government run".
We could use the German model -- supplement employer and employee contributions with less total government money that we are spending today in a system of nonprofit "sickness" funds -- and cover every man, woman, and child in the country. The use a similar model in France and include private supplementary insurance to cover things that aren't included in the national plan.
For those who think non-profit is equal to poorer quality: The French and German non-profits are extremely competitive. The difference is that they compete on service -- number of days to reimbursement (3 days vs the government mandated 7) and things like that.
I don't think insurance really have anything to do with healthcare cost... remember, people always have to option to go with no insurance at all and pay cash. Why would insurance increase the cost of overall healthcare, unkless it is the clinic and doctor that charge for too much money?
- Feb 22, 2007
- 16,240
- 7
- 76
To understand it you have to go back several decades before health insurance was necessary. Insurance started out as something to cover unexpected expenses like surgeries, not things like prescriptions. If you needed healthcare you paid for it cash.
As more companies got into healthcare they started to see the potential profits from the industry and prices slowly crept up. The insurance companies also saw a market and started to offer policies that covered more services. As insurance companies started to pay for more healthcare services, companies saw the profit and again prices increased. Insurance companies countered again by paying more and covering more.
Eventually it got to the point that competition was so great between insurance companies that they started brokering deals with health providers for different prices for their policy holders. It has now become so convoluted that doctors when providing service don't even know exactly what the persons insurance will pay so they inflate the cost to a point that they are assured to make money. The problem is the people without insurance are charged the same thing, not the price that people with insurance are billed.
The doctors in the article are cutting out the insurance company. You pay them directly. They know what you are paying and you know what they receive when you pay it. Really they are returning to the way things worked long ago.
You need a group of people, aka insurance company, to pool money together to be able to afford medical care. Medical care is more than just going to your family doctor. There is prescriptions, surgeries, routine tests, bloodwork, etc that you need insurance for. No one on this board can afford to pay for his or her healthcare with a cash type system. Its a myth as well as a joke. With experience in working for a hospital, I can say flatout first hand, 99.7% of folks can't afford a cash pay system. Some of these doctors graduate with couple hundred grad easy of debt. Thats just your ordinary family physician. If you think you'll see $15 visits your smoking crack.
Well I agree the US health insurance is convoluted but I don't think the proposal in the article is the answer either. Like you said yourself, you still need insurance to pay big expense item like surgery or special care. So you just can't say you retain a doctor and be done with it. Right now I pay ~$250 a month health insurance that covers the whole family for all medical procedures, anywhere in the US. You just can't have that kind of coverage with the idea proposed.
The problem is the complexity and the inefficiency of US healthcare insurance. It's not that healthcare insurance is not needed, it is. It is just not done right in the US. Instead of getting rid of it, some one should think about ways to fundamentally redo the healthcare insurance to make it more standardized, transparent, and easily accessable to all.
DrPizza
Administrator Elite Member Goat Whisperer
Number of doctors is finite. AMA controls the number of doctors. Without more doctors, that load has to go somewhere.
coloumb
Diamond Member
- Oct 9, 1999
- 4,069
- 0
- 81
Does he buy laptop's on ebay? [joke].
So basically going back to the old western style of doctor treatment? Doctor makes house calls so you don't have to wait in a waiting room full of other "sick" people or children? I like it.
You'll [and your family] get more personalized treatment - rather than just some 15 minute scripted chat.There are many, many ways that insurance increases costs. Let's consider just one: The reimbursement policies of insurance companies generally do not allow for multiple procedures during one office visit or reimbursements for telephone prescriptions. That means that many people end up visiting the doctor multiple times for things that could have been handled in other ways -- and pay for each visit separately.
While it is true that many, many people "go bare", very few of those people people have the wherewithall to withstand a medical emergency.
BS. I don't want that, I want a doctor who treats people because it's his calling in life and he desperately cares about his fellow man. I don't like people who want to make money, I find them ignorant and think they're generally bad people.
Now, we have opposite views, so where are we in the discussion?
Because so long as insurance companies exist he providers and suppliers can charge gouging prices knowing an agency exists to pay them. Were they forced to deal with individuals with less economic resources they would be forced to either lower prices or get out of business.
I don't think insurance is the ONLY reason for high health care (and other) costs, but they are a HUGE part of the problem and should be eliminated and outlawed.
Wrong, wrong and wrong. Whether or not the insurance company pays, the price of health care is high. If your insurance doesn't pay, the provider will still collect from you. Health insurance companies use leverage to get lower prices for their members, not higher ones.
It's that kind of thinking that has us in this huge hole: trying to "outlaw" the symptom rather than adressing the cause.
Well, for starters, Nebor would be able to actually find a doctor, and you'd have just about no luck finding one.
- Feb 22, 2007
- 16,240
- 7
- 76
How did health care get so expensive though ? Look back on charts over time and you can see that as insurance companies started to cover more cost the prices increased more and more. How is it fair that one person pay different rates for the same service from the same doctor all because the first persons insurance company has more muscle to twist the doctors arm ?
I doubt you would be okay with paying for gas at a different price than the car in front.
StageLeft
No Lifer
- Sep 29, 2000
- 70,150
- 5
- 0
Sounds like they are just going to end up making the middleman profit the insurance company does. Why would I pay a set amount up front in case I need him? That's insurance. Anyway, nobody is going broke getting their yearly checkup, and for real medical events none of us can really pay out of pocket without some smoothing effect like with insurance, just like none of us would want to pay out of pocket if we got in a car accident.
ebaycj
Diamond Member
- Mar 9, 2002
- 5,418
- 0
- 0
The pharmacy sells Drug X for $10 (standard price) with a MASSIVE PROFIT MARGIN included in that price.
Really, the pharmacy cost is $0.50. Their "normal" price is $10.
The insurance companies get a discount to $9.75 / $9.50 / $9, whatever....
The pharmacy still makes $8.50 a pill on the "largest discount" they offer.
Pharmacies are *NOT* losing money on the negotiated contract rates they have with various insurance companies. If they were, why would they negotiate a contract in which the contract rates they are allowed to charge, lose them money?
The same thing applies for doctors / hospitals and "procedures". The standard rate for a broken leg is $5000. The true cost to that doctor / hospital is really $1000. Insurance companies negotiate various rates, say $4000, $4200, $3500, etc...
*DISCLAIMER* I have previously worked as a DBA in a large healthcare billing company. I have lots of inside knowledge in this area, and have seen mountains of data to back it up. I'm not saying I'm a 100% expert, but if you truly believe that *ANYONE* is losing money due to insurance contract rates, you are absolutely deluding yourself.
The only instances (which, actually, happen VERY VERY often) in which providers (pharmacies hospitals and doctors) lose money, is when they DO NOT KNOW what rate they were supposed to be paid at, and the insurance company significantly under-pays. In fact the company i worked at helped hospitals recover this money that was un/underpaid but was rightfully theirs. They get so used to the whole "recieve any payment at all, and write off the rest of the cost", that they simply execute that procedure, and write off more than they should have (due to the underpayment).
- Feb 22, 2007
- 16,240
- 7
- 76
I just read a very informative document on the history of health insurance and why things are the way they are:
http://www.wpri.org/Reports/Volume19/Vol19no10.pdf
It was put out by a non profit in Wisconsin. It is a bit long but well worth a read.
They make the argument how insurance companies are not a win for consumers because they remove the ability of the consumer to control prices. When the consumer pays his premium he has no idea how much the doctor is really being paid. When the premium goes up the next year the consumer pays for the increase thinking it was an increase in cost when it may have been due to anything from wanting increased profits to poor management.
They favor a system where the doctors bills would come to the patient, not the insurance company. The consumer would have an account that the bills could be payed out of after the deductible was met. The account has no direct cash value so it cannot be abused in that way. The consumer is directly in control of when they go to the doctor and who they pick. The doctor would set the price that all patients receive and the insurance company would go back to its role of preventing someone from catastrophic loss.
They compare it to fire insurance. When someones house burns down the insurance pays the person a lump sum . Then the person can pick who builds the house and how it is spent. The only involvement the insurance company has is to pay the amount agreed upon. They don't get involved in politics or with the doctor themselves.
Required paperwork drops to zero for hospitals and doctors for filing claims. They can go back to just sending consumers a bill. If one hospital or doctor decided to charge more for their services, consumers can decide if they want to pay it or if they want to go elsewhere, that increases competition.
So for a single person that pays $1000 a year in insurance. For that they get an account with a $700 limit on payment for routine care and lab cost + $20,000 of inpatient coverage. The insurance company makes money and the consumer stays in control of how they spend the money.
If you want to go to the doctor every day for a headache you are free too, but will use up your benefits and the rest will come out of pocket. It controls cost and keeps the consumer in control. I like it but the system is set up too much for profit and this would hurt that and make it very competitive.
Thank you. I was going to say the bigger medical service providers in the Minneapolis are are also non-profit.
People dont seem to realize that 80% of health care providers are non-profit yet our costs keep going up. Obviously profit is not the underlying driver here.
Actually, it is part of the problem. As Maggie Mahar illustrates in her book Money Driven Medicine non-profits have to compete with for-profits to avoid going into the hole due to adverse selection.
Her chapter on non-profit hospitals is especially enlightening: no hospital can survive if most of its patient population is un- or underinsured. In order to get financing in the bond market, non-profit hospitals have to demonstrate an ability to repay the bonds; they can't just project losses into the future. That means they are competing with for-profit hospitals for those patients with better coverage; patients who are attracted to hospitals with the latest equipment and more luxurious suites. Competition in the hospital market has little to do with actual care; it more often comes down to marble floors, better parking, and wasteful duplication of specialty services -- all of which increase the cost of care for everyone.
Also, the fact that a holding company is non-profit doesn't mean that it's components are. In the case of Kaiser Permanente for example, the Kaiser Health Plan and the Kaiser Hospital Foundation are non-profit but they contract with the Permanente Medical groups for physican services ...and the medical groups are for-profit. The physicians may be salaried but the group is still a for-profit practice. I'm not criticizing the physicians, I'm just saying that things are not as transparent as you imply.
TRENDING THREADS
-
Discussion Zen 5 Speculation (EPYC Turin and Strix Point/Granite Ridge - Ryzen 9000)- Started by DisEnchantment
- Replies: 25K
-
Discussion Intel Meteor, Arrow, Lunar & Panther Lakes + WCL Discussion Threads
- Started by Tigerick
- Replies: 24K
-
Discussion Intel current and future Lakes & Rapids thread- Started by TheF34RChannel
- Replies: 23K
-
-
Facebook
Twitter