Quote: Original post by Mithrandir
... but then when it comes time to actually make payouts for the obligations they have they're going to cut every corner possible to provide the lowest payout they can get away with. Preferably $0 in their shareholders eyes.

I comp and write I'm inclined to go with a Nobel Prize winner of economics here, he's rather coherent in his opinions. Paul Krugman writes a few notes: Insurers only pull your coverage when it hurts and refers to a few other posts, 1° and 2°. Blatantly opinionated notes and reference picks, but rather well articulated even for a semi-clueless foreigner to understand.

Quote: ... cases in which insurance companies retroactively cancel your health coverage.

The industry would have you believe that it’s a minor issue, because only a small fraction of the insured experience rescissions in any given year. But as the post points out, a small fraction of the insured experience a large share of medical expenses — and you can bet that rescissions are concentrated on the people with big medical bills. So half a percent, if that’s really true, is a large fraction of people who really need coverage.

Quote: Original post by LessBread

Quote: Original post by Eelco
Perhaps its you who should excuse yourself from the discussion, because none of that seems to relate to my comment. The profit margins of private insurers are not what makes american insurance expensive. Why dont you just admit it?

Regardless of the nobility of not denying people care, how anyone can believe that extending care by itself will bring down costs is beyond me.

My remarks pertained to your question about leeching. I'm going to restate an item from the links that you avoided. Challenge to Health Bill: Selling Reform

Quote:
...
The United States now devotes one-sixth of its economy to medicine. Divvy that up, and health care will cost the typical household roughly $15,000 this year, including the often-invisible contributions by employers. That is almost twice as much as two decades ago (adjusting for inflation). It’s about $6,500 more than in other rich countries, on average.
...

The leeches suck $6,500 from each household every year.

Oh yeah, the only difference between the US and the rest of the world it its medical system. Oh wait: it isnt.

Quote:
Where does that money go? Into some fat cat's pocket.

We already established it does not: you are talking about a 50% difference, whereas overhead costs are estimated at 20% max, includng all expenses.

But dont let the facts stop your rethoric.

Quote:
As for those holy profits you worship...

Nice strawman.

Quote:
I seriously doubt you are familiar with the concept of medical loss ratio. That is an insurance industry term for the fraction of revenue from a plan's premiums that goes to pay for medical services. The fact that the term is seen as a loss says it all. Services provided aren't seen as a positive thing but as a negative thing. Those damn patients are spending our money!!!

What makes you think im not aware with the concept? Im not the one who thinks insurance companies are santaclaus; who thinks theyll give you more than they are contractually obliged.

Quote:
There you have it. The portion of the economy devoted to health care doubled at the same time that the medical loss ratio decreased. You would have to be willfully blind to not see the massive rip off in that. Either that or a criminal cheering on other criminals as they pillage and loot. Want to bring down costs? Start by doing away with the middle men sucking away 20 cents of every dollar spent on health insurance.

Im not sure these macroeconomic figures mean much at all. They can have various causes, such as changes in tort law, and so on.

20% overhead seems like a lot though, i agree. But its not the 50% difference you claim with the rest of the world, nor should you entertain the illusion that a government program does not have overhead costs.

Quote: Original post by Mithrandir

Quote: Original post by HostileExpanse

Quote: Original post by Eelco

Quote: Original post by HostileExpanse
Here's another fun fact:

Quote: This report looks at the 2003-2007 profits for the country’s major national health insurance companies (such as UnitedHealth Group and WellPoint), which sell health insurance through their subsidiaries. Over that period, their combined profits increased by 170.2 percent, reaching $12.6 billion at the end of 2007.

Wow, big numbers. Im scared.

Do you have an intelligent response to those "big numbers"?

No he usually doesn't. This is what happens when you don't actually have logic and reason on your side.

Throwing around big numbers is completely meaningless. PROFITS INCREASED 200%!!!11!!oneoneone.

Populist clowns.

Quote: Original post by Goober King

Quote: Original post by Chris Reynolds

Quote: Original post by HostileExpanse

Quote: Original post by Chris Reynolds
2.) Regarding physicians all being paid the same:

(A) PREFERRED PHYSICIANS.—Those physicians who agree to accept the payment rate
established under section 223

PARTICIPATING, NON-PREFERRED
PHYSICIANS.—Those physicians who agree not
to impose charges (in relation to the payment
rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C)

So all physicians that participate will be affected by this.

People will have to accept certain amounts for payment, AFTER they've agreed to accept payments on that basis for the year?!! OH THE HORROR!

Think of it this way. If you're a physician and this bill went into effect, you either agree to the payment terms, or you become a "non-preferred" "non-participating" physician. Which sounds better to you? Stuck between a rock and a hard place

So let's say I have something growing in my arm. It wasn't a big deal a few years ago. Then let's say I have tissue Doctor's wanted to cut out of my chest a few years ago. Then lets say I have asthma and it may be getting worse, or I may be coming down with something. An X-ray there is a given. I also could really, really use some of those fancy allergy shots I've always heard about. Let's also say I have Something going on with my stomach that effects my breathing but is likely just acid do to stress. Let's say I also have a wife with Diabetes. Heck we will also say she has a predisposition to cancer. We will leave it at that for now.

So now lets also say my "insurance" plan has gotten amended in the last couple of years. I now have to pay for every dime until I've paid $2500. Then they say they will pick up the remaining tab. Now I'm not sure if that thing in my arm could turn into a problem one day. I'm not real sure if the thing in my chest could either. My grandmother did die of stomach cancer and I have stomach issues so maybe I should watch that, but I don't really know when or if that will be an issue. My breathing situation could be better. I think its getting worse, but maybe I just need to be more hard core about my meds or get my dose upped. Maybe it has turned into emphysema but who knows.

Now I don't know how bad my pre-existing conditions are at this point. I'm not at Doctor. What I do know is that if I go see a Doctor I get to pay for it. Up to $2500 worth. That almost $200 a month that I do not have. My wife isn't even insured at all. Going unmonitored for a very serious disease right now. If it comes down between me paying $200 a month on something I'm not too sure about or me dying, I'm dying. I don't know what that thing in my arm is doing to me, I DO know what $200 dollars a month would do to me.

If you want talk about rocks in hard places, there is one. I personally don't have a whole lot of concern about some Doctor's right to maximize his paycheck. I really don't care what he makes but it better not be the reason I can't care for myself. Somebody better have a damn good alternative if they are going to sand in the way of trying to overhaul this thing. Because as it stands I don't get much of a choice and it could be killing me.

2500$ a year: i bet you spend more on, well, anything. 'my health is not important enough to me to justify even waiting some tables once every two weeks, so why dont you other suckers pay for it?'

You go girl, you have the majority, go make other people bend over for you. At least you are honest about it, and arnt resorting to populists nonsense of the 'OMFG profits increased 200%' kind.

Quote: Original post by Eelco
What makes you think im not aware with the concept? Im not the one who thinks insurance companies are santaclaus; who thinks theyll give you more than they are contractually obliged.

So, you suggest improving legislation and the executive branch of justice so that the laws of a modern contract society could be more fully enforced (as intended)? Like in the sense that root causes are perhaps ill-formed laws concerning consumers (that is, laws skewed toward insurance companies in this particular case) and the problems that ordinary citizens have when they're trying to get justice: either they don't know their rights or what they were getting themselves into or they don't have the money to lawyers or the justice process is functioning too slowly for them. Mind you, I'm not opposing at least this particular idea. Just seeking for clarification.

Quote: Original post by Naurava kulkuri

Quote: Original post by Eelco
What makes you think im not aware with the concept? Im not the one who thinks insurance companies are santaclaus; who thinks theyll give you more than they are contractually obliged.

So, you suggest improving legislation and the executive branch of justice so that the laws of a modern contract society could be more fully enforced (as intended)? Like in the sense that root causes are perhaps ill-formed laws concerning consumers (that is, laws skewed toward insurance companies in this particular case) and the problems that ordinary citizens have when they're trying to get justice: either they don't know their rights or what they were getting themselves into or they don't have the money to lawyers or the justice process is functioning too slowly for them. Mind you, I'm not opposing at least this particular idea. Just seeking for clarification.

Yes, i think a well-functioning legal system accessible to all is fundamental to a free society. All countries i know of a significantly lacking in this regard. You pretty much need big money just to get heard in court. Thats bullshit, and it opens the door for all kinds of abuse.

Smeone once owed my a few thousand euros, and there is as an individual pretty much nothing you can do about it. Cant appeal to a court without paying 'protection money' to a lawyer, and them scratching their butt will cost you more than the money you are owed.

There definitely is a power imbalance problem here, where it pertains to contracts and loopholes and playing the legal system. Some measures to counteract loopholes and conditions that people would simply not have agreed upon, had they been aware of them, seems like a good thing to me. As i said, if an insurer is to refuse care, the burden of proof for that should be on him. Hed better have that specified in bold, in a list of conditions not covered or somesuch. Vague interpretable claims need not apply.

To solve these problems by demanding insurers can not refuse new clients, or refuse payment for conditions not specified in the contract, is however the end of insurance in any meaningfull term of the word. If redistribution relative to the current status quo is the aim (and it is), there are ways to do it without making insurance effectively illegal. Set price controls on medical practicioners, and outline a minimum coverage plan that you will subsidize as a government. Now im not saying i am looking forward to the long term unintended consequences of that, but it seems like the least invasive way to redistribute.

Quote: Original post by Eelco

Quote: Original post by LessBread

Quote: Original post by Eelco
Perhaps its you who should excuse yourself from the discussion, because none of that seems to relate to my comment. The profit margins of private insurers are not what makes american insurance expensive. Why dont you just admit it?

Regardless of the nobility of not denying people care, how anyone can believe that extending care by itself will bring down costs is beyond me.

My remarks pertained to your question about leeching. I'm going to restate an item from the links that you avoided. Challenge to Health Bill: Selling Reform

Quote:
...
The United States now devotes one-sixth of its economy to medicine. Divvy that up, and health care will cost the typical household roughly $15,000 this year, including the often-invisible contributions by employers. That is almost twice as much as two decades ago (adjusting for inflation). It’s about $6,500 more than in other rich countries, on average.
...

The leeches suck $6,500 from each household every year.

Oh yeah, the only difference between the US and the rest of the world it its medical system. Oh wait: it isnt.

It's actually worse if you compare the per capita spending between the US, Canada, France and the UK as Krugman did back in 2006: The Health Care Crisis and What to Do About It. Check out this table. 2002: US $5,267 UK $2,160 France $2,736 Canada $2,931. If you want to crunch the latest figures, the OECD makes them available here. Please don't waste time claiming that the US and Canada, France and the UK are so different that they can't be compared.

Quote: Original post by Eelco

Quote:
Where does that money go? Into some fat cat's pocket.

We already established it does not: you are talking about a 50% difference, whereas overhead costs are estimated at 20% max, includng all expenses.

But dont let the facts stop your rethoric.

If only your lack of reading comprehension stopped your rhetoric. In the snippet from the NYT article, did you see the part where it says "twice as much as two decades ago" -- the overhead has increased as the portion of gdp increased. There's a compounding there. Also check out the section of that Krugman article where he addresses "The "consumer-directed" diversion".

The excess cost isn't solely from insurance company leeches. I target them because they're the most obvious source of inefficiency. They aren't the only leeches. Big Pharma deserves blame too.

Quote: Original post by Eelco

Quote:
I seriously doubt you are familiar with the concept of medical loss ratio. That is an insurance industry term for the fraction of revenue from a plan's premiums that goes to pay for medical services. The fact that the term is seen as a loss says it all. Services provided aren't seen as a positive thing but as a negative thing. Those damn patients are spending our money!!!

What makes you think im not aware with the concept? Im not the one who thinks insurance companies are santaclaus; who thinks theyll give you more than they are contractually obliged.

You haven't brought it up for starters. No one believes that insurance companies are Santa Claus. Far from it. No, they're more like the Grinch, except his heart grew and he changed his tune.

Quote: Original post by Eelco

Quote:
There you have it. The portion of the economy devoted to health care doubled at the same time that the medical loss ratio decreased. You would have to be willfully blind to not see the massive rip off in that. Either that or a criminal cheering on other criminals as they pillage and loot. Want to bring down costs? Start by doing away with the middle men sucking away 20 cents of every dollar spent on health insurance.

Im not sure these macroeconomic figures mean much at all. They can have various causes, such as changes in tort law, and so on.

20% overhead seems like a lot though, i agree. But its not the 50% difference you claim with the rest of the world, nor should you entertain the illusion that a government program does not have overhead costs.

Medicare overhead is something like 3%. What happens when overhead grows from 5% to 20% at the same time that health care costs for the typical household double?

         overhead   cost 	overhead * cost	initial   0.05	     X           0.05 * X  = 0.05 * X	final     0.20       2X          0.20 * 2X = 0.40 * X

That suggests an 8 fold increase in overhead dollars over the last two decades. Maybe it's not as simple as that, but maybe it is.

Wow, according to this Stephen Hawking is dead.

http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877

Quote:
People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

HURF DURF NO ONE IMPORTANT COULD POSSIBLY LIVE ANYWHERE OTHER THAN AMERICA HURF DURF

Quote: Original post by Stab-o-tron
Wow, according to this Stephen Hawking is dead.

Or that he would be dead if he lived in the UK. I glanced quickly over another article from the pages Shovel-Ready Health Care.

Quote: Oregon resident Barbara Wagner might beg to differ — as she begs to stay alive. Last year, the 64-year-old received news that her cancer, which had been in remission, had returned. Her only hope was a life-extending drug that her doctor prescribed for her.

The problem was that the drug cost $4,000 a month. The state-run Oregon Health Plan said no, that it was not cost-effective. Oregon's equivalent of a "death panel" sent her a letter saying it would cover drugs for a physician-assisted death. Those drugs would cost only $50 or so. Oregon could afford that.

"It was horrible," Wagner told ABCNews.com. "I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die.

"But we won't give you the medication to live."

So, the drug was too expensive to her and the state of Oregon and by this reasoning public health care is bad? Or are they, what it seems to be, to take the little offer of help and distort the message to mean they want her to die? It sure looks like that to me, which in that case is a deliberate lie.

<edit...
One could argue that if Wagner would not have been taxed out of her money, she could afford the life extending drug. Or more generally, the state took her money and spent it so she couldn't use it more productively to either collect more resources or to just save it to be used in incidents like this.

[Edited by - Naurava kulkuri on August 11, 2009 7:38:22 AM]

Quote: Original post by Naurava kulkuri

Quote: Original post by Stab-o-tron
Wow, according to this Stephen Hawking is dead.

Or that he would be dead if he lived in the UK

That's my point, if Stephen Hawking would be dead if he lived in the UK, then Stephen Hawking must be dead.

Yep, dead as a doornail