Giant sucking sound in healthcare as HMO profit SKYROCKETS!

Discussion in 'Politics and News' started by BaliBabyDoc, Feb 24, 2005.

  1. BaliBabyDoc

    BaliBabyDoc Lifer

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    AMA News (extensive excerpts but I recommend you check the link)
    Hmm, must be those damn trial lawyers.

    We need tort reform!!

    Be aware that "growth in revenue" means mad $$ out of taxpayer and business pockets.

    Basically they cut you lose if you get sick and then they raise the rates on the healthy people leftover.

    This is a pretty standard bait-and-switch. There's plenty of evidence that disease mitigation efforts can improve care and reduce costs. But it takes YEARS to see such benefits. This article is talking about profit growth occuring over ONE YEAR.

    I'm not saying it's always a zero sum game . . . someone pays and someone else benefits. But Potter and his ilk are leeches in the system that are two to three orders of magnitude worse than an army of trial lawyers.

    I gave the last word to the MD b/c . . . well . . . those my peeps. IMHO, doctors and certainly the AMA has failed to serve the population very well over the past few decades. But having said that . . . at least we actually provide care. Doctors are becoming the elite college basketball player. In general, we get token compensation while we produce virtually ALL of the product/service of value. Fans/consumers demand more while complaining we get too much. In the meantime, a select group of individuals collect mad bank b/c they "facilitate" the transaction.
     
  2. dmcowen674

    dmcowen674 No Lifer

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    Topic Summary: MDs make less, patients paying more, government paying more . . . HMO and drug companies make bank

    You forgot Rich Republicans Rejoicing
     
  3. Zedtom

    Zedtom Platinum Member

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    We are focusing on Social Security, while the real crisis is with Medicare and Medicaid. The bottom line is: many people cannot afford health care. When they become ill, they are dependent upon the government to help them.
     
  4. BaliBabyDoc

    BaliBabyDoc Lifer

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    Actually the real crisis is sick, old people . . . in combination with a system of healthcare that's obsessed with treating diseases/injuries instead of people. If Medicaid was dedicated solely to poor, non-elderly people . . . there would be no crisis in Medicaid. The majority of Medicaid funding is paid to support people that already receive Medicare.

    We have to fix the fundamental issues in healthcare . . . ie FAR MORE preventative healthcare and health maintenance with FAR FAR LESS on interventional healthcare. IMHO, we've reached the point of no return. We cannot expend MILLIONS to keep ONE grumpy old man like Dick Cheney alive while treating flu vaccine like it's just another commodity. Reducing lead and mercury in our environment will cost billions each year but it will pay back many billions more. People with chronic health conditions need chronic healthcare. But that care can be planned and executed in a cost efficient manner. It's not happening right now.

    While I personally believe it's questionable to deny old people the care they need, I believe it's a greater moral lapse to deny children basic health protection (basic healthcare, nutrition support, environmental protection). Unfortunately, kids cannot vote. That's why we get BS like this from Bush . . .

    cnn
    As long as these people aren't eating Cheetos and Twizzlers, there's no excuse for underfunding nutrition programs. The school lunch and WIC programs cost less than $20B a year. They have serious flaws but why not give them MORE $$ to make the program a health maximizer instead of accelerating the race to the bottom by restricting funds?

    I still remember the good old days when people picked on the fat kid. You could do that b/c there was only ONE friggin' fat kid.

    Before I stray too far OT . . . HMOs sux, drug companies sux, our healthcare system sux, Congress sux, Bush sux, and fat people that smoke and don't exercise deserve to die an early death . . . but not a subsidized one. That's pure karma baby . . . ask Buddha . . . he was fat, too.
     
  5. BaliBabyDoc

    BaliBabyDoc Lifer

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    Here's where the "profits" come from
    I may have to move to Canada b/c THEY will have lower taxes.
     
  6. conjur

    conjur No Lifer

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    Premiums have gone up.
    Deductibles have gone up.

    (out-of-pocket expenses have gone up, iow.)

    Insurance companies reap record profits.


    Hmmm...yeah...tort reform is what we need. :roll:
     
  7. lozina

    lozina Lifer

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    Damn those trial lawyers... more profit for insurance corporations!

    *Draws devil horns on nearest picture of trial lawyer*
     
  8. Genx87

    Genx87 Lifer

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    Prime example of why we cant put the entire nation on a govt healthcare plan. SS is a crisis but Medicare is worse.

    Both social programs will bankrupt this country.

    These insurance companies would probably love nothing more than the govt foot the bill. Instead of trying to scam millions they just need to scam a few beauracrats in washinton and rake in trillions.

    Tort reform isnt the answer either. I think tort reform is nothing more than legislating margins for the insruance companies.

     
  9. Darkhawk28

    Darkhawk28 Diamond Member

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    I agree with your view on tort reform, but I don't think killing medicaid and medicare is the solution either. We need to tighten the screws on these insurance companies.
     
  10. SuperTool

    SuperTool Lifer

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    Price controls is what we need. If the government pays for something it should have the right to set a limit for the price it's willing to pay.
     
  11. Genx87

    Genx87 Lifer

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    The problem is how? I dont think letting them into the coffers of the tax system is a wise decision and would probably only increase the problem. But this time it will come out of taxpayers pockets.

     
  12. Genx87

    Genx87 Lifer

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    Sure but we are talking about the federal govt here. 5000 dollar toilet seats. They dont have the first clue on price control. I wouldnt trust them to keep the price down at all. Especially with the amount of lobbying the insurance industry does.

    Can anybody explain to me why you are required to have car insurance in states with no fault?

    Prime example of what the insurance industry can do.

     
  13. cKGunslinger

    cKGunslinger Lifer

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    Yep, cause we all know that Rich Republicans never fall into the [MDs, patients, or taxpayers] category - they are all HMO and Drug company CEOs! :roll:
     
  14. BaliBabyDoc

    BaliBabyDoc Lifer

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    Well AMA has largely been in the GOP camp for years. The GOP keeps promising medmal (tort) reform and increased reimbursements from Medicare/Medicaid. But the AMA is arguably one of the least reputable (and least intelligent) "unions" on the planet. Although medmal reform is "possible" it's highly unlikely that such reforms alone would dramatically improve the environment for purchasing liability insurance. And there's absolutely NO WAY that the government can afford to increase payments to physicians in our current environment.
     
  15. SuperTool

    SuperTool Lifer

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    I know how we can fix our medical system. Declare war on Canada, then immediately surrender :D
     
  16. cKGunslinger

    cKGunslinger Lifer

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    Which is why both unions and government-funded healthcare suck (or blow, whatever your preference.)
     
  17. cKGunslinger

    cKGunslinger Lifer

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    Fixed. ;)
     
  18. slash196

    slash196 Golden Member

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    Universal Health Care. Problem solved.
     
  19. Michael

    Michael Elite member

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    BaliBabyDoc,

    It wasn't long ago that HMO's were struggling, some were going under and being bought by other HMO's and the space basically was terrible to be in. Since then, the HMO's have concentrated on getting their business to a more stable footing.

    I don't mind the fact that MDs get less money (the AMA would complain and isn't exactly unbiased). The market used to be very, very inefficient with the MDs holding many of the cards. Now they're competing much more in a market where costs and pricing is much better understood.

    I do not disagree that more has to be done with preventative medicine, but the HMO's I have been involved in seem to do that more than other groups (Kaiser was a good example). When you're an HMO and getting a fixed fee per person regardless of how many doctor visits they make, then it makes sense to work on changing the health environment. When you're paid for doing things at every visit (typical PPO or hospital system), then there is no incentive to work on preventative medicine.

    I read your post as saying that you're unhappy because you're not being paid enough.

    Michael
     
  20. cKGunslinger

    cKGunslinger Lifer

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    Bzzzt. Try again.
     
  21. DealMonkey

    DealMonkey Lifer

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    I've thought about a solution to the medical coverage crisis for a while now. What do you think of this idea?

    We need to tear-down the layers of bureaucracy and middle-men sucking profit that exists between the patient and the doctors/nurses/hospitals. We do this by forming a non-profit organization that exists to insure people without making a profit. As people sign-up and pay their monthly coverage amounts (or businesses pay for their employees), the cash goes into a centralized slush fund that then gets paid out for claims as needed. The non-profit org would have to set up a series of minor co pays ($15 office visits, $20 drug co-pays, small yearly deductibles, etc.) to help discourage those covered from completely abusing the system, which they would probably do if everything was gratis.

    By eliminating the profit motive, coverage is more affordable and doctors and hospitals get paid what they deserve. You could even introduce a sliding scale of co-pays so that for the poorest patients, they don't pay much of anything, and for the wealthy, they pay a little more. If you did this at the state level, you could even have the state kicking in funds to subsidize the fund and/or guarantee the fund in case it dips low periodically.
     
  22. Michael

    Michael Elite member

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    DealMonkey - You're basically describing Blue Cross Blue Shield. This has been tried many times in the past. Government funded health care is another example of this.

    The base problem is that you tend to get what you pay for. With no profit motive, you lose out on attracting some of the best people to administer the program as you significantly cap their wealth potential.

    One theory is that many competing insurance comapies, even with a profit motive, drive the admin expenses down.

    Admin expenses will always be decently high in the medical profession because of the need for detailed medical records.

    Most doctors prefer to deal with insurance companies directly because it seriously cuts down the number of people they have to chase for collection.

    Michael
     
  23. charrison

    charrison Lifer

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    I visited a doctors office for the first time this week that did not have a great wall of paper records. Every exam room had a terminal in it for records entry. I am surprised it has taken this long to get there.
     
  24. DealMonkey

    DealMonkey Lifer

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    Well my personal feeling is that there is no great talent required to "administer the program" to begin with. I mean, we're talking essentially about [--> claims in --> payments out]. How difficult does it need to be?
     
  25. Michael

    Michael Elite member

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    DealMonkey - Have you ever worked in Health Insurance or the Healthcare field?

    There is a huge flow of cash that will happen. That alone means risk and professional management is needed.

    You need to protect privacy.

    You need tons of automation because of the high transaction volume.

    Someone has to negotiate with doctors, drug benefit providers, hospitals, etc.

    It actually is quite complicated.

    Michael