Health insurance companies predate the weakest consummer

[JS80]

Obviously you had Money to Pay, what happens if you don't?

Then I pay for it. Why do you care you're in Canuckistan.

 

[sandorski]

Then I pay for it. Why do you care you're in Canuckistan.

When you can't Pay?

 

[theeedude]

I think we should let BCBS raise its rates as much as they want, if only to demonstrate yet again that private health insurance is the wrong model for a health care system. Unfortunately more people will have to be hurt (and some probably die) before people realize this, but there is no other way it seems.
The only impetus for reform is more people being priced out of health coverage.

 

[Hayabusa Rider]

When you can't Pay?

There is a solution. Increase taxes by 30% on everyone and then they'll have free health care. They won't miss it if the government takes it.

Not directed at you, but it seems that about 5 people on the forum understand health care at all, and the remainder take a wild stab at it. Kind of like Congress

 

[Hayabusa Rider]

I think we should let BCBS raise its rates as much as they want, if only to demonstrate yet again that private health insurance is the wrong model for a health care system. Unfortunately more people will have to be hurt (and some probably die) before people realize this, but there is no other way it seems.
The only impetus for reform is more people being priced out of health coverage.

So what happens when the government does the same thing, because it costs the providers more every year.

Now you can avoid it of course. Let them eat cake.

 

[theeedude]

So what happens when the government does the same thing, because it costs the providers more every year.

Now you can avoid it of course. Let them eat cake.

Government has more negotiating power. You are gonna tell me it costs several hundred dollars for doctor to see me for 5 minutes and prescribe Zmax? Because that's what he bills.

 

[JS80]

Government has more negotiating power. You are gonna tell me it costs several hundred dollars for doctor to see me for 5 minutes and prescribe Zmax? Because that's what he bills.

Government also has an unlimited balance sheet and no accountability.

 

[Hayabusa Rider]

Government has more negotiating power. You are gonna tell me it costs several hundred dollars for doctor to see me for 5 minutes and prescribe Zmax? Because that's what he bills.

He can bill eleventy billion dollars. He's going to get paid the contract price. There is no free market health care.

Even so I wonder if you understand how much it costs to run a professional office.

My wife has a friend that had her own practice in MD. The costs of running the business went up every year, and the reimbursements went down.

After a while she had to spend money out of her savings to keep the business going. Her husband helped her with the finances of the practice. He made his living as a financial adviser for health care professionals, and he was very good. There simply wasn't enough to pay the bills. Ironically, her practice was increasing, but that just meant she lost money faster. She retired to teach part time at a small college where she has a modest, but positive income.

That's why there are few private practices. Associations are a survival strategy.

 

[theeedude]

He can bill eleventy billion dollars. He's going to get paid the contract price. There is no free market health care.

Even so I wonder if you understand how much it costs to run a professional office.

My wife has a friend that had her own practice in MD. The costs of running the business went up every year, and the reimbursements went down.

After a while she had to spend money out of her savings to keep the business going. Her husband helped her with the finances of the practice. He made his living as a financial adviser for health care professionals, and he was very good. There simply wasn't enough to pay the bills. Ironically, her practice was increasing, but that just meant she lost money faster. She retired to teach part time at a small college where she has a modest, but positive income.

That's why there are few private practices. Associations are a survival strategy.

Does it cost $1000/hr/patient? If he's going to get paid contract price, I'd rather he get it paid by the government that's not going to take a 30% cut for its own overhead like a health insurer will. CA law currently only requires that insurer spend 70% of what they take in on health care. Now maybe the insurer is getting raped on what the doctors charge them, but they can get away with raping you (1/0.7)-1 = 43% more.
So if you are for 43% more rape, then yeah, private health insurance is great.

 

[Patranus]

7% profit margin what a travesty

Google has a 27% profit margin. Search engine reform NOW!!!

 

[theeedude]

Government also has an unlimited balance sheet and no accountability.

Last I checked, we actually have elections here where we can hold government accountable, if we so choose.

 

[theeedude]

Google has a 27% profit margin. Search engine reform NOW!!!

Profit margin is not whole story. If insurers add 30+% overhead to secure a 7% profit, then I am getting screwed for the whole 30% to keep them in business, I don't really care if they waste it on their overhead or pay it out to shareholders, I don't want to spend 30% of health care spending on a company that provides ZERO actual health care.

 

[JS80]

Last I checked, we actually have elections here where we can hold government accountable, if we so choose.

Unfortunately, voters will not vote to have a govt program be sustainable, but will vote to increase entitlements. Please try again.

 

[JS80]

Profit margin is not whole story. If insurers add 30+% overhead to secure a 7% profit, then I am getting screwed for the whole 30% to keep them in business, I don't really care if they waste it on their overhead or pay it out to shareholders, I don't want to spend 30% of health care spending on a company that provides ZERO actual health care.

First off, gov't would not do any better in admin costs. They are not "adding" overhead. It's required. Why the fuck would they "add" it when they can have 37% profit margin.

REGARDLESS of the "30%" in your supposedly unnecessary overhead costs, it is a drop in the bucket.

 

[theeedude]

First off, gov't would not do any better in admin costs.
[/q]
Only if you believe your ideology more than the fact that Medicare has a much smaller overhead.
[q]
They are not "adding" overhead. It's required. Why the fuck would they "add" it when they can have 37% profit margin.
[/q]

Because that "overhead" is their salaries. Why would someone want to get paid a nice fat salary instead of paying it out to shareholders as profit? Is that what you are asking?

[q]
REGARDLESS of the "30%" in your supposedly unnecessary overhead costs, it is a drop in the bucket.

No, that is 30% cut that insurer can take of overall spending on health care. Not a drop in the bucket by a long shot. Look at what payout ratio is.

 

[Argo]

And this is precisely the part you guys will never understand. HEALTHCARE SHOULD NOT BE A FOR PROFIT BUSINESS.

I know this makes you free market types cringe, because as far as you guys are concerned healthcare is the "perfect" business because the normal laws of supply and demand don't work so it has become the bottomless pit of profit, the cash cow of all cash cows.

America needs to decide whats more important
1. The healthiest populace
2. The most profitable healthcare industry

We can't have both, and so far we have sacrificed #1 for #2 at every possible turn

Why do you think the normal laws of supply and demand not apply?

 

[xj0hnx]

Actually, I grew up a military kid and was in it as well. Care there is just as I've experienced by private industry. You can get good and bad in both as it is up to the individual doctor treating you.

Oh yea, it's great, but they are serving barely 3 million of the healthiest people in the country, it isn't a model that will work for all of America. And it isn't always the smartest system either, I found it quite ironic that they sent me to Walter Reed to get heart surgery so that they could send me to Iraq to get shot at. The military medical system isn't to promote general good health for the sake of good health, it's to make sure that military members are fit for their mission. And if it isn't mission essential than don't count on being able to just go to the doctor anytime you want, and when you do, hope your stomach can take Ibuprofen.

 

[HumblePie]

He can bill eleventy billion dollars. He's going to get paid the contract price. There is no free market health care.

Even so I wonder if you understand how much it costs to run a professional office.

My wife has a friend that had her own practice in MD. The costs of running the business went up every year, and the reimbursements went down.

After a while she had to spend money out of her savings to keep the business going. Her husband helped her with the finances of the practice. He made his living as a financial adviser for health care professionals, and he was very good. There simply wasn't enough to pay the bills. Ironically, her practice was increasing, but that just meant she lost money faster. She retired to teach part time at a small college where she has a modest, but positive income.

That's why there are few private practices. Associations are a survival strategy.

The big part of that is because everyone there thinks that being a "doctor" or being in the healthcare industry in America is so damn profitable. The fact that everyone thinks that is why every thing that supplies doctors overcharge them. When doctors get overcharged $3000 for a stethoscope for example, they have to pass that bill on to someone. It just ends up in an ever increases volume of money being shuffled around at the consumers expense.

You regulate the prices, you regulate the supplies, you regulate everything that touches the industry and universal healthcare is obtainable. Other countries do it with no problem. The fact is, some people need to get over their desire to all be living in mansions and driving expensive foreign cars because they are part of the healthcare industry. Yes, I know not everyone does that, but many do.

The whole thing needs to be redone in my opinion from the bottom up. From schools teaching healthcare professionals, to suppliers of healthcare items, to workers, to lawyers going after the malpractice suits, to basically anything and everything trying to shake down as much money as they can out of the system which throws everything else out of whack.

 

[HumblePie]

Oh yea, it's great, but they are serving barely 3 million of the healthiest people in the country, it isn't a model that will work for all of America. And it isn't always the smartest system either, I found it quite ironic that they sent me to Walter Reed to get heart surgery so that they could send me to Iraq to get shot at. The military medical system isn't to promote general good health for the sake of good health, it's to make sure that military members are fit for their mission. And if it isn't mission essential than don't count on being able to just go to the doctor anytime you want, and when you do, hope your stomach can take Ibuprofen.

Umm what? You had a mediocre set of experiences then. I was Air Force though so maybe your branch just sucks I've been to the VA as well afterward. I've had one bad experience with my recent shoulder surgery due to a incompetent anesthesiologist not knowing their drugs, but that was about it. I've had knee surgery while I was in the AF and foot surgery from the VA as well. More than a few surgeries before I even joined as a kid too.

 

[xj0hnx]

Umm what? You had a mediocre set of experiences then. I was Air Force though so maybe your branch just sucks I've been to the VA as well afterward. I've had one bad experience with my recent shoulder surgery due to a incompetent anesthesiologist not knowing their drugs, but that was about it. I've had knee surgery while I was in the AF and foot surgery from the VA as well. More than a few surgeries before I even joined as a kid too.

I'm not talking about the quality of the health care in the military, I'm saying the model won't work for the whole country.

 

[piasabird]

This is the same thing they do in the Computer business. It is called economy of scale. If an organization is purchasing 600 computers they may get a better deal than the average joe.

 

[GuitarDaddy]

Why do you think the normal laws of supply and demand not apply?

Because normal supply and demand laws are based on the real/percieved value of a commodity. In the case of healthcare the commodity is "your health" or basically a human life which most of us will agree is priceless. With a normal commodity if the price gets too high people decide the commodity is not worth that much so they choose not to buy it and when the demand drops so does the price. But since we value our health as "priceless" simply not seeking healthcare because the price is too high is not an option, so the natural forces that keep commodity prices in check just don't happen and the price always goes up.

Another factor that drives price in a normal supply/demand relationship is comparative price shopping, if you don't like the price one seller is selling the commodity for you shop around and find someone willing to sell the same item for less. This is just not possible in healthcare for several reasons.
1. For emergency care the time critical urgent nature eliminates any ability to price shop
2. Even for general or routine procedures getting accurate upfront pricing quotes is all but impossible, as medical billing has gotten so convuluted that most doctors can't or won't honestly tell you up front what the costs will be


To put is more simply, A HUMAN LIFE is not a commodity like a toaster or a big screen TV and can't be priced based on the principles of free market capitalism. And that is exactly why our current system is broken and costs are sky rocketing out of control

 

[theeedude]

This is the same thing they do in the Computer business. It is called economy of scale. If an organization is purchasing 600 computers they may get a better deal than the average joe.

There are big intrinsic savings to producer by selling 600 computers to one person instead of 1 computer to 600 guys. There is no savings to a hospital to deal with insurance company compared to dealing with a patient who pays cash, so there isn't really a good reason for a cash paying patient to be charged more than the insurance company.

 

[her209]

This is the same thing they do in the Computer business. It is called economy of scale. If an organization is purchasing 600 computers they may get a better deal than the average joe.

What if 600 people got together for a group buy?

 

[mattpegher]

There are big intrinsic savings to producer by selling 600 computers to one person instead of 1 computer to 600 guys. There is no savings to a hospital to deal with insurance company compared to dealing with a patient who pays cash, so there isn't really a good reason for a cash paying patient to be charged more than the insurance company.

Unfortunately the system leads to inflation of the cash price. In order to charge, say $100 to the insurance company, invoice price needs to be set at $160. If you set the price at $100, the insurance company will give you $60. It is only recent that we are allowed to give a discount for cash pay. It took some senators son to get sick without insurance before the law was changed.

This is actually backwards, because cash pay patients that pay at the time of service actual cost less to see. Insurance submission, resubmission and write-offs actually cost much more. We actually have to employ two office staff just to fight with the insurer and chase down outstanding bills.