UnitedHealth warns it may exit Obamacare plans

[Zorkorist]

No, you're not pushing reality...your'e pushing your ideology.

Getting the government "out of healthcare" would entail dismantling the ACA along with Medicare/Medicaid and other sundry programs that support many millions of people. To propose such a thing is not working within the bounds of political reality. It's pure fantasy.

LOL, no.

Healthcare begins and ends with an individual. It is not hard to do.

-John

 

[Zorkorist]

Heh. United's problem is that they can't compete. They can't do what other companies do for the same money or don't want to. That doesn't correlate with another company coming in at higher rates.

Their problem is that the Government is now cheaper than them. I expected they would figure this out BEFORE they gladly accepted Obama's healthcare fantasy plan.

They're just figuring it out today. The Government spends into debt.

-John

 

[Zorkorist]

<- Looking for a Government Health Care plan that spends wildly on me, and makes my children pay for it later.

 

[theeedude]

"Oh my God, it cut off his head! It was supposed to take out his tonsils!"

"Uh . . . Yeah, we're gonna fix that with the next patch. In the mean time, I'm going to need him to . . . Um, I'm going to need you to fill out this bug report for him."

Most doctors aren't surgeons though. Mostly it's about fitting symptoms to a diagnosis, that is pattern recognition, which is perfect for machine learning.
This is coming in a huge way. I would not want to be training to be a radiologist now.

 

[Zorkorist]

Until this country removes insurance companies' ability to immorally profit from peoples' ills, our system will never work. And yes I'm talking about ending the debauched health insurance industry. So getting the system to work will never work given the power of their lobby.

I hear you, and you are right.

-John

 

[Zorkorist]

There wouldn't be any "Medicaid", there would simply be a national health care program under true socialized medicine.

One of the big myths that the free market dogmatists are spreading is the notion that Americans would end up spending more money on health care because new taxes would be required to fund it -- completely ignoring the fact that Americans are already spending gobs of money on health care and that the new taxes would merely be taking the money Americans would otherwise spend on insurance premiums and out-of-pocket.

Ironically, the total tax revenue needed to fund the health care system would end up being less than what is already being spent based on the percentage of GDP (and per capita) of the nation that has the most expensive socialized medicine program.

In short, Americans would collectively pay less in taxes than they are currently paying out of pocket while receiving more medical care. (Tremendous cost savings can be had by eliminating those insurance company middlemen and other economic inefficiencies of our pseudo-market system.)

One Gob of Money is as good as another Gob of Money.

-John

 

[Zorba]

2.) This can't be done unless we fundamentally change how care is paid for because every procedure, drug, and treatment given has a separate charge. If you need a central line installed to deliver IV drugs, would you refuse and prefer receive individual injections for each one because it's cheaper? Or do you just listen to your doctor's orders? From receiving the IV line, the puncture itself, the needle used, the type of IV all have separate charges and codes that are billed. The total itemized list becomes dizzying. One option is to have a capitized "bundle" that includes all in one charge--but then you're leaving out the possibility for exceptions to the norm.

I agree, in many situations upfront pricing would be hard. But it shouldn't be hard for an office visit, imaging or basic out patient surgery. Even if you can get them to give you a price range, it is generally way off and after insurance. Changing how the system works, though, would also reduce cost. If instead of charging for each and every item, you had a general overhead rate and materials rate for basic items (like most industries) it would drastically reduce the complexity of billing and accounting.

3.) Agreed. But depending on where you receive care and from whom, if the doc you see is an internist versus a clinic that is with another system, etc.

Every other industry has figured out how to handle the prime/sub issue and manage to provide the customer with a single invoice. The sub bills the prime and prime bills the customer. Imagine if say American Airlines bought a new 737 from Boeing and got a separate bill from all 2500 vendors that produce parts for the aircraft.

4.) Since the US left all EMR up to private companies, there are competing standards that are not inter compatible.

This was a mistake and if single payer ever comes, is hopefully fixed. Although I know that people who have no problem with the NSA listening to every phone call, freak out about the government seeing their medical history.

6.) CMS already does negotiate. Although they could take hardline stances, I guess? I'd be in favor of cheaper drugs, but I also recognize the immense cost of developing drugs. That said, it makes me sad that drug development is a for-profit business. I wish the environment here was more academic and less business-y. It's very jarring to us in the R&D areas. We're also the first ones to be laid off whereas business and sales staff are (almost) never affected

I was under the impression medicare couldn't negotiate pricing on drugs, if the can already great. I agree with you about making the R&D more academic.

 

[umbrella39]

There is a lot of competition in the Detroit market and costs are gasp... going down slightly.

Feds: Detroit area health costs dip slightly in 2016

http://www.detroitnews.com/story/business/2015/11/20/health-costs-drop-detroit-area/76128792/

Health insurance costs will be down slightly in Metro Detroit during 2016, despite price hikes in much of the country, according to federal data.

Experts said prices are holding steady in the state because of robust competition between 14 insurers offering plans at healthcare.gov.

&#8220;A big driver (of lower rates) is competition amongst insurance companies,&#8221; said Michael Mahoney, senior vice president of consumer marketing for GoHealth, a Chicago-based company that powers a private health insurance exchange and an approved health insurance enrollment partner with the federal government.

&#8220;Michigan has 14 insurers; 12 of those are in Detroit. That&#8217;s a lot. Oklahoma, for example, only has two insurers, and rates there went up 37.5 percent.&#8221;

 

[pcgeek11]

There is a lot of competition in the Detroit market and costs are gasp... going down slightly.

Feds: Detroit area health costs dip slightly in 2016

http://www.detroitnews.com/story/business/2015/11/20/health-costs-drop-detroit-area/76128792/

That is just an educated guess. It isn't even 2016 yet.

 

[glenn1]

There is a lot of competition in the Detroit market and costs are gasp... going down slightly.

Feds: Detroit area health costs dip slightly in 2016

http://www.detroitnews.com/story/business/2015/11/20/health-costs-drop-detroit-area/76128792/

The starting baseline is important also - Detroit going down slightly while OKC goes up 37% might reflect costs that were 50% cheaper to start with in the later. Happy to give credit where it's due but that's important context.

 

[s0me0nesmind1]

There is a lot of competition in the Detroit market and costs are gasp... going down slightly.

Feds: Detroit area health costs dip slightly in 2016

http://www.detroitnews.com/story/business/2015/11/20/health-costs-drop-detroit-area/76128792/

Detroit contains a ridiculously high amount of poor people that are likely to be on max subsidies. It's essentially a prime market.

 

[Jaskalas]

Healthcare begins and ends with an individual. It is not hard to do.

-John

You mean the individual pays his costs?

• That'll be $10,000 for 6 hours in the ER.
• $20,000 to remove a kidney stone too large to pass.
• $100,000 for a week in the hospital.

Those are actual costs incurred by a family member this past year. I'm sure regular Americans can randomly and immediately afford such expenses, and not die otherwise. Eh?

 

[WhipperSnapper]

Primary education is "universal" and "socialized" in the U.S. and yet we still spend far more than other nations while still getting worse results. Plus without recognizing any of the benefits to scale or "fewer middlemen" than you're claiming. Hell, the amount of administration personnel vs. teachers has exploded over the years making the costs even higher than before.

So please explain why U.S. healthcare would provide all these claimed benefits if universalized/socialized when direct experience shows the exact opposite with education?

You have a very good point. The big difference is that medical treatment is a realistically attainable goal. Doctors really can provide effective treatment.

In contrast, trying to take kids who have awful parentage and no interest in education and transforming them into college-ready high school graduates is a much more daunting and often impossible task. On top of that, our public schools are supposed to indoctrinate them with mamby-pamby political correctness, so they have to be taught to value and respect other cultures, to be nice to women, and to not use the N-word, etc, and we're throwing gobs of money at it.

In short, the reason why our education system is failing and costing us tons of money is because our society is trying to attain impossible goals. We're trying to take people who are mentally cut out to be ditch diggers and turn them into college-ready high school graduates. We're trying to increase people's IQ's and g-factors, essentially change their genetic makeup and brain structure though public education, and it simply can't be done.

Americans are using education as a proxy for solving economic and social problems -- if only everyone had a college degree all of our problems would magically disappear, including racial inequality, etc. So American society is trying to educate kids at seemingly almost all costs to attain those goals.

Fortunately, the goals of medical care are attainable. It's not that amazingly difficult to fix a broken arm or to diagnose an infection and prescribe antibiotics or to remove a gallbladder. In contrast, if the goal were to provide Americans with immortality at any cost or to make sure that no one ever drowns or dies in a car accident, then it would be expensive and unworkable, just like our education policy.

 

[Svnla]

Another thing about health care, more Americans are getting older and those seniors are using more and more health care resources, driving the cost sky high.

Those sickest seniors account for more than 41% of the $324 billion spent on traditional Medicare.

As Baby Boomers begin to move into the Medicare years, they are &#8212; by the measure of medical diagnoses &#8212; sicker than their predecessors, researchers say.

Yet they also are living longer, leaving them to grapple with diseases such as diabetes, asthma, high blood pressure, high cholesterol, heart failure, depression and even Alzheimer's for years &#8212; sometimes decades. The result: neither the medical system nor most seniors are prepared for the financial and emotional crisis ahead.

http://www.usatoday.com/story/news/...sts-seniors-sick-chronic-conditions/27390925/

If we do not control the rising cost, nothing else will matter.

 

[Darwin333]

You are naive. They have been in bed with politicians for ages. It is in their interest that American people don't decide to change the system away from private insurance to single payer. If they want to make perfect, cherrypicking only healthy and profitable customers, the enemy of their own long term good, that is their business. But Americans are paying twice as much as other countries are paying for health care, and those countries are covering everyone. If private insurance can't deliver at least full coverage, then the American people have a right to use the political system to change the health care system, as citizens in other democracies have done.

Again, our health insurance costs aren't out of control our healthcare costs are out of control. Are you honestly arguing that insurance companies want to pay more out, reducing profits, in the hopes of raising rates just to get the same profits they were before while having to jump through all kinds of hoops and getting hell from the public at the same time?

Single payer negotiates drug prices directly with its purchasing power. As the only game in town, that's hard to beat. Private insurance does it by forcing the consumer to try to reduce costs, by using a deductible as an incentive. I am sorry you don't understand basics of various health care systems, but your opinion is still valuable.

Yeah, we can't even get the .gov to let our current HUGE .gov medical plans like medicare and medicaid to negotiate drug costs or allow importation of drugs. Somehow single payer will change that?

I know that you are looking for the best case scenario but I'm simply looking at what is realistic. Not to mention, drug prices aren't the things driving healthcare costs way the hell up. Hell, simple tests/procedures cost 5X as much from one place to another with no explanation at all and getting a price upfront is like pulling damn teeth. By the way, that's illegal in just about every other industry but the medical industry gets a pass.

 

[Darwin333]

Can you do me a favor here? Define exactly what the end of result of "Single Payer" is going to be.


A new "Single Payer" tax that all must pay (Like Social Security / Medicaid) ?
An increase % to Medicaid and the single payer system is under medicaid?
A universal increase in tax brackets all around?

Just curious. The problem with this is CLEARLY that you are trying to divide things while only having the needy pay.

No, I simply realize the reality of the situation. We virtually already have single payer. When some poor sap goes to the hospital and he can't pay his bill, our insurance rates go up due to cost shifting. Same thing with medicare and medicaid, if the .gov gets all pissy and starts reducing payments then our insurance costs go up again.

See the reality my friend, we are already paying for everyones healthcare, we just do it in a really shitty way that hits the average working family the hardest.

Then we have the law of exponents. If healthcare costs continue to rise at a faster rate then inflation/wages, which has been a long term trend, eventually most people won't be able to afford it.

 

[theeedude]

Again, our health insurance costs aren't out of control our healthcare costs are out of control. Are you honestly arguing that insurance companies want to pay more out, reducing profits, in the hopes of raising rates just to get the same profits they were before while having to jump through all kinds of hoops and getting hell from the public at the same time?



Yeah, we can't even get the .gov to let our current HUGE .gov medical plans like medicare and medicaid to negotiate drug costs or allow importation of drugs. Somehow single payer will change that?

I know that you are looking for the best case scenario but I'm simply looking at what is realistic. Not to mention, drug prices aren't the things driving healthcare costs way the hell up. Hell, simple tests/procedures cost 5X as much from one place to another with no explanation at all and getting a price upfront is like pulling damn teeth. By the way, that's illegal in just about every other industry but the medical industry gets a pass.

You don't need to wait for single payer to allow Medicare to negotiate lower drug prices. GOP just doesn't want to do it.

 

[Slew Foot]

Lol, you guys think that a single payer system in the US is going to negotiate prices. The politicians will carve out exemptions for anyone thats a campaign donor.

 

[Strk]

You don't need to wait for single payer to allow Medicare to negotiate lower drug prices. GOP just doesn't want to do it.

Sadly, this one is bipartisan.

 

[ivwshane]

Primary education is "universal" and "socialized" in the U.S. and yet we still spend far more than other nations while still getting worse results. Plus without recognizing any of the benefits to scale or "fewer middlemen" than you're claiming. Hell, the amount of administration personnel vs. teachers has exploded over the years making the costs even higher than before.

So please explain why U.S. healthcare would provide all these claimed benefits if universalized/socialized when direct experience shows the exact opposite with education?

That's an interesting way to look at it. So which school systems around the world provide better and cheaper education that aren't socialist?

Or was your point that our particular government isn't very good at socialism? And if that was the point then why do you think that is? Why is it other nations that practice some sort of socialism do a better job than us?

 

[boomerang]

Sadly, this one is bipartisan.

Don't waste your breath. His guys are always the good guys.

It doesn't help that virtually every piece of legislation gets a whole bunch of other shit tacked onto it. Every piece then becomes an "if you want that, you've got to accept this". When whichever side balks and digs in their heels, it then becomes a reason to paint that side as a bunch or morons, uncaring bastards, or whatever language is suitable.

People with some intelligence see through that bullshit for what it is. People like senseamp, well, they don't.

 

[pcgeek11]

Don't waste your breath. His guys are always the good guys.

It doesn't help that virtually every piece of legislation gets a whole bunch of other shit tacked onto it. Every piece then becomes an "if you want that, you've got to accept this". When whichever side balks and digs in their heels, it then becomes a reason to paint that side as a bunch or morons, uncaring bastards, or whatever language is suitable.

People with some intelligence see through that bullshit for what it is. People like senseamp, well, they don't.

This is why we need to only pass bills as stand alone with No Added crap. I know that they never will, but they really need to in order to get past the stalemates.

 

[Meghan54]

Primary education is "universal" and "socialized" in the U.S. and yet we still spend far more than other nations while still getting worse results. Plus without recognizing any of the benefits to scale or "fewer middlemen" than you're claiming. Hell, the amount of administration personnel vs. teachers has exploded over the years making the costs even higher than before.

So please explain why U.S. healthcare would provide all these claimed benefits if universalized/socialized when direct experience shows the exact opposite with education?

Maybe because our education system is dominated by local districts which do not emphasize the same course work, etc., as other districts, instead of a national standardized curriculum?

Take southern schools. Horrid reputation. Way too much political influence in designing their curricula. So why do you think the educational system will be in any way a predictor for universal/single payer health care?

 

[cubby1223]

Primary education is "universal" and "socialized" in the U.S. and yet we still spend far more than other nations while still getting worse results. Plus without recognizing any of the benefits to scale or "fewer middlemen" than you're claiming. Hell, the amount of administration personnel vs. teachers has exploded over the years making the costs even higher than before.

So please explain why U.S. healthcare would provide all these claimed benefits if universalized/socialized when direct experience shows the exact opposite with education?

In terms of education, the problem, I believe, is more on the willingness of the students to want to learn. I don't believe there will be that same issue in healthcare, people showing up to doctors & hospitals not wanting to get better.

 

[Jaskalas]

In terms of education, the problem, I believe, is more on the willingness of the students to want to learn. I don't believe there will be that same issue in healthcare, people showing up to doctors & hospitals not wanting to get better.

But no healthy young person is going to pay the mandate if they don't have to.

Isn't the entire point of insurance to enact socialized costs?
The healthy pay for the sick.