Healthcare Costs Rising

[John Adams]

<br />fixed<br />

 

Working for a hospital hospice unit. Yeah, that's tangential. Way to undermine your argument.

[Rob's House]

Which is why the decision should not be left up to the patient unless they are the ones footing the bill. Insurance should have a futile care provision.

 

I say bring on the death panels.

I was going to suggest the same thing. Someone in the know correct me if I'm wrong, but I believe insurance companies are legally mandated to cover most of these long-shot/futile procedures.

 

It seems the type of insurance most are concerned about people having would be a lot more affordable if policies were more customized to the people being served by them, which would largely mean that people who can't afford those procedures to extend their lives that extra 1-2 years would die.

 

Enter the "he who can't pay dies" crowd demanding government run health care because the poor have to watch grand ma die. I can see Keith Olbermann now looking into the camera with his outraged expression asking indignantly, "How dare you, Sir?"

[GG]

it was revenue over the next 10 years largely do to the increasing enrollment estimates from the new health care bill. my point is that there is no need for this money to be spent. the existence of insurance companies isn't producing better or cheaper care. they just get in the way of efficiently and rationally allocating finite resources. this is $200 bn additional (to lord knows how many 100's of billions to start with) serving no purpose.

 

And you're showing your bias because you deal with insurance companies who you believe are with holding payments from you on a whim. Insurance companies could lead to cheaper & better care if they operated in an environment where the market incentives weren't distorted by a government bureaucracy or the buyers of insurance knew the costs involved. Health insurance is the only industry where the average Joe has no idea of the true cost of providing service nor the true cost for them of paying for the service. That's why you said that you work out a different payment schedule for insured vs unisnsured people. How many industries could get away with that?

 

Obamacare will add to the abomination because it still will not put individuals in charge of their medical costs, and you will further the mentality of "free" medical care because you're covered by insurance. But those plands are not insurance, but an entitlement. As long as you bury the medical cost, people will consume more of the product without rationalizing their care or taking preventative care.

[birdog1960]

And you're showing your bias because you deal with insurance companies who you believe are with holding payments from you on a whim. Insurance companies could lead to cheaper & better care if they operated in an environment where the market incentives weren't distorted by a government bureaucracy or the buyers of insurance knew the costs involved. Health insurance is the only industry where the average Joe has no idea of the true cost of providing service nor the true cost for them of paying for the service. That's why you said that you work out a different payment schedule for insured vs unisnsured people. How many industries could get away with that?

 

Obamacare will add to the abomination because it still will not put individuals in charge of their medical costs, and you will further the mentality of "free" medical care because you're covered by insurance. But those plands are not insurance, but an entitlement. As long as you bury the medical cost, people will consume more of the product without rationalizing their care or taking preventative care.

 

i'm not "getting away" with anything. that would be the standard practice of charging list price to the uninsured and would be much more profitable. i'm charging them the same as the insured who have the benefit of a price negotiator. and i don't feel insurance companies are witholding payments from me. they pay on average about 20% more than medicare. btw, how many industries have virtually all of their pricing structure negotiated by a third party? you see this as an advantage to medicine?

 

but it's been that way for much longer than i've practiced and was a given entering this profession. i'm not complaining about that aspect. i'm pointing out the cost and inefficiency of having a large profit taking middleman involved in health care. you admit their failings re cost control but still support their existence. what value do you see insurance companies providing? i suspect you see little. it's just that you are anti government run health care and you can't imagine an alternative other than commercial insurance.

Edited September 29, 2011 by birdog1960

[Alaska Darin]

i'm not "getting away" with anything. that would be the standard practice of charging list price to the uninsured and would be much more profitable. i'm charging them the same as the insured who have the benefit of a price negotiator. and i don't feel insurance companies are witholding payments from me. they pay on average about 20% more than medicare. btw, how many industries have virtually all of their pricing structure negotiated by a third party? you see this as an advantage to medicine?

 

but it's been that way for much longer than i've practiced and was a given entering this profession. i'm not complaining about that aspect. i'm pointing out the cost and inefficiency of having a large profit taking middleman involved in health care. you admit their failings re cost control but still support their existence. what value do you see insurance companies providing? i suspect you see little. it's just that you are anti government run health care and you can't imagine an alternative other than commercial insurance.

What alternative to government run/commercial insurance are YOU proposing? Or are you being hypocritical?

 

Changing how things are paid for isn't going to fix ANY of the issues that currently make health care in this country expensive. That's barely even an issue. Maybe we could get DoD's contracting arm to negotiate health care. We all know how good they are at getting things "better, faster, and cheaper."

[birdog1960]

What alternative to government run/commercial insurance are YOU proposing? Or are you being hypocritical?

 

no alternative. i'm all for single payer (gov't run) as i've frequently stated. expert panels could then decide appropriate care levels and safe harbor practices immune from malpractice claims, cutting down on unneeded testing and procedures. changing reimbursement from volume based to outcome based would also result in savings and improved efficiency. obviously, cutting out profit from the insurance companies (and that represents a very large amount) would result in direct, immediate savings. i don't see how anyone can deny that.

[Alaska Darin]

no alternative. i'm all for single payer (gov't run) as i've frequently stated. expert panels could then decide appropriate care levels and safe harbor practices immune from malpractice claims, cutting down on unneeded testing and procedures. changing reimbursement from volume based to outcome based would also result in savings and improved efficiency. obviously, cutting out profit from the insurance companies (and that represents a very large amount) would result in direct, immediate savings.

You're an idiot.

i don't see how anyone can deny that.

Why don't you give us a few examples of the government taking over something and making it cheaper and more efficient. You know, since this is such a good idea.

[GG]

i'm not "getting away" with anything. that would be the standard practice of charging list price to the uninsured and would be much more profitable. i'm charging them the same as the insured who have the benefit of a price negotiator. and i don't feel insurance companies are witholding payments from me. they pay on average about 20% more than medicare. btw, how many industries have virtually all of their pricing structure negotiated by a third party? you see this as an advantage to medicine?

 

but it's been that way for much longer than i've practiced and was a given entering this profession. i'm not complaining about that aspect. i'm pointing out the cost and inefficiency of having a large profit taking middleman involved in health care. you admit their failings re cost control but still support their existence. what value do you see insurance companies providing? i suspect you see little. it's just that you are anti government run health care and you can't imagine an alternative other than commercial insurance.

 

Medical insurance should be similar to any other insurance, hence be true insurance policies where premiums pay the losses, and still leave enough on the table for the insurance company survive to see another day. The reason that insurance exists is because most people can't afford to pay for a catastrophic event, so they pool many people's premiums together to manage the risk. Today's medical insurance is not quite like regular insurance because most of the market is price controlled by an entity that will pay the medical costs as long as the service provider meets the criteria for the payment. That criteria is living past 65.

 

I can certainly imagine a world without commercial insurance, but it's not a pretty world because most people won't have enough savings for critical medical care. I do imagine a world with commercial insurance, but in that world people know exactly what their insurance costs are and exactly what their medical bills are, instead of the current employer paid premium and $20 copay no matter what the procedure is.

[birdog1960]

Medical insurance should be similar to any other insurance, hence be true insurance policies where premiums pay the losses, and still leave enough on the table for the insurance company survive to see another day. The reason that insurance exists is because most people can't afford to pay for a catastrophic event, so they pool many people's premiums together to manage the risk. Today's medical insurance is not quite like regular insurance because most of the market is price controlled by an entity that will pay the medical costs as long as the service provider meets the criteria for the payment. That criteria is living past 65.

 

I can certainly imagine a world without commercial insurance, but it's not a pretty world because most people won't have enough savings for critical medical care. I do imagine a world with commercial insurance, but in that world people know exactly what their insurance costs are and exactly what their medical bills are, instead of the current employer paid premium and $20 copay no matter what the procedure is.

unfortunately, it's not working out that way currently. even among the insured, catastrophic illness is a leading cause for bankruptcy. and currently, about 50 million lives remain uninsured causing cost shifting and higher prices for both insurers and individuals when those patients require care (largely in the er or hospital, which are the most expensive access points). those costs are passed on. they don't just disappear.

 

with a larger risk pool, there's more ability to spread risk. 330+ million insured lives would include many patients requiring little care. the current system excludes many of the high risk patients from commercial insurance leaving the taxpayers to "insure" the expensive train wrecks. that's great for insurers and terrible for taxpayers. it's another form of corporate welfare for a very successful industry. from the viewpoint of the taxpayers, how does that make sense?

Edited September 30, 2011 by birdog1960

[GG]

unfortunately, it's not working out that way currently. even among the insured, catastrophic illness is a leading cause for bankruptcy. and currently, about 50 million lives remain uninsured causing cost shifting and higher prices for both insurers and individuals when those patients require care (largely in the er or hospital, which are the most expensive access points). those costs are passed on. they don't just disappear.

 

with a larger risk pool, there's more ability to spread risk. 330+ million insured lives would include many patients requiring little care. the current system excludes many of the high risk patients from commercial insurance leaving the taxpayers to "insure" the expensive train wrecks. that's great for insurers and terrible for taxpayers. it's another form of corporate welfare for a very successful industry. from the viewpoint of the taxpayers, how does that make sense?

 

It's not working out right now because the market is distorted where everyone knows that the government will step in as a last resort. That is not insurance, but an entitlement. If you want to talk about corportae welfare, look no further than the medical profession, because a big portion of your revenues comes from government mandates.

 

The point that you are missing is that the insured consumers abuse the medical system because to them healthcare is free, or at best is only limited to the copays & deductibles. Very few people reconize that their policies cost $2k/month for a family coverage.

 

There's no doubt that getting more people covered would solve a lot of the issues. But that should be done largely through commercial methods, rather than through a govrenment bureaucracy. Not so much from the well intentioned move to provide more coverage to more people, but from a consistent truism that a government behemoth, especially as large as the healthcare monster will turn into, will improve healthcare and keep costs down.