Zomby Woof wrote: In reply to Duke: Obviously never worked for a body shop, or insurance company I see. Bad analogy for obvious reasons.
Why? I am an informed consumer of both insurance and repair services. Not my fault if others are not informed and don't know how to protect themselves.
Xceler8x wrote: With your last question, I'd imagine the cost will follow the same trajectory as auto insurance. In my state you have to have it by law or you pay a penalty. Same deal with health insurance now. Is the price of auto insurance inflated? It doesn't seem to be compared to other states. I'll leave this question unanswered as I'm sure someone know knowledgeable than me can answer it.
In some states (such as New Jersey, and others), the price became inflated (due to insurance laws) to such a point that more laws were required to regulate the cost of premiums. Many companies left the state. Those that stayed were effectively required to use profits from other states to subsidize losses generated by New Jersey's pricing and coverage regulations.
Besides, you can always opt out of the requirement to buy car insurance by just not driving a car. But even if you opt out of receiving health care, under the coming system, you cannot opt out of paying for it.
Duke wrote: *you cannot opt out of paying for it.*
You also can not opt out of being sick.
Funny enough, the US healthcare system highlights one of the many reasons that it has the largest gap between the haves and the have nots in the modern world.
Profiting off of someone's misfortune which is beyond their control is IMO an immoral ground to stand on. Profiting off of someone's misfortune which was within their control is not. Also, you seem to think that it will cost more to provide for everyone, which is hilariously inaccurate. One of the greatest battle cries you guys have is to look north. Guess what? If you look at the numbers, our taxation rates/typical government fees are no different than yours (and we have worse economies of scale AND everything is in general more expensive here due to our geographical location). And I can walk into a walk-in clinic and get checked out without a dime "leaving" my pocket. Healthcare isn't bleeding us dry up here for some reason, even though everything should naturally be more expensive, it hasn't magically driven up our tax rates to insane levels.
So I dunno. If it tickles you in the right places for some CEO to get paid 10's of millions of dollars to be a middleman, all the power to you.
Wxdude10 wrote: Since I heard about this recently on a radio show, I thought I would pass it along. In Portland, ME, there is a doctor (and I am sure there are more around like him) who has decided that he is not going to be playing the game. He is no longer going to accept any insurance. He is doing pay for service. He has all of his prices posted on the practice's website: http://www.ciampifamilypractice.com/Our_Prices.html You are getting better service (he does house calls!!!) and you are getting the middlemen (government/insurance companies) out of the problem. This is the way medical care used to be done in this country before Uncle Sam got involved in it. If you could find a practitioner like this, just pay the fine, and get some catastrophic coverage for a hospitalization and do some sort of HSA, you might be able to control the pain better. Here is a link to the audio from the talk show with Dr. Ciampi http://boston.cbslocal.com/2013/06/13/nightside-dr-michael-ciampi-takes-no-insurance/
I emailed that doc and got a useful response. FYI for anyone else curious:
"Hello -
First off, congratulations on making the shift in your business. It's a bold move, but one that I hope others pursue as well. To that end, I wanted to see if you were familiar with any doctors in my area (Northeast of Atlanta) following a similar model, or if there is a clearing house that you know of for finding medical providers who are following this business model.
Regards, Dave Hardy"
"Hello Dave,
Thank you for your feedback.
We recommend you look at the website for the American Association of Physicians and Surgeons (www.aapsonline.org). In their patient section, they do list cash friendly, direct pay practices.
We are hopeful more and more doctors and patients can re-discover this model of healthcare. It is simple, cheaper, and promotes privacy and good relationships.
Best Wishes, Ciampi Family Practice "
HiTempguy wrote:Duke wrote: *you cannot opt out of paying for it.*You also can not opt out of being sick.
So? I can't opt out of being hungry, either. Why does that make feeding me or curing me somebody else's responsibility, other than mine? Why is it a priori assumed without question that needing something = entitlement to it?
HiTempguy wrote: If it tickles you in the right places for some CEO to get paid 10's of millions of dollars to be a middleman, all the power to you.
It doesn't tickle me that our system is broken. But I don't think that the answer to fixing it is to beat on it even harder with the same hammer that berked it up in the first place.
My doc does cash for most things. Used to be $60 a visit.. now it is $75. It works out though, she always gives me all the freebies that pharma guys leave behind rather than making me pay out the nose at a pharmacy
If the grocery industry worked like the medical industry, our food prices would be similiarly berkeleyed.
They have us by the balls. They have way more money for lobbyist and purchasing politicians. The medical industry will never work for us until we have politicians that give a flying berkeley about us. There are very few, after all they are guaranteed free medical insurance for the rest of their lives. Why would they fight for something that has zero affect on them, other than the lining their pockets with medical money?
HiTempguy wrote:Duke wrote: *you cannot opt out of paying for it.*You also can not opt out of being sick. Funny enough, the US healthcare system highlights one of the many reasons that it has the largest gap between the haves and the have nots in the modern world. Profiting off of someone's misfortune which is beyond their control is IMO an immoral ground to stand on. Profiting off of someone's misfortune which was within their control is not. Also, you seem to think that it will cost more to provide for everyone, which is hilariously inaccurate. One of the greatest battle cries you guys have is to look north. Guess what? If you look at the numbers, our taxation rates/typical government fees are no different than yours (and we have worse economies of scale AND everything is in general more expensive here due to our geographical location). And I can walk into a walk-in clinic and get checked out without a dime "leaving" my pocket. Healthcare isn't bleeding us dry up here for some reason, even though everything should naturally be more expensive, it hasn't magically driven up our tax rates to insane levels.
Ok, cool. I am responsible for a planned pregnancy but an unplanned one no one can profit on.
Or maybe; they can profit on a pregnancy, but no profit on cancer....until they show that in lab rats in California that type of cancer has a probability of happening if you drink Mountain Dew out of an aluminum can.
Yeah; the moral ground is simple.
Duke wrote: Umm, hello?
What's up with the attitude? I'm trying to see your point of view not antagonize you. How about you do the same.
Cone_Junky wrote: If the grocery industry worked like the medical industry, our food prices would be similiarly berkeleyed.
Monsanto.
Xceler8x wrote:Duke wrote: Umm, hello?What's up with the attitude? I'm trying to see your point of view not antagonize you. How about you do the same.
Wasn't intending to be a dick, but assuming I succeeded anyway, I'm sorry.
mtn wrote:Cone_Junky wrote: If the grocery industry worked like the medical industry, our food prices would be similiarly berkeleyed.Monsanto.
A perfect example of why the failure of the US system is not related to capitalism.
alfadriver wrote:Duke wrote:Here's an honest question.... Is it right that there is an entire industry that makes money and all they do is take money and decide how it is paid out to the actual health care providers. By doing that, they don't actually make your health better, just take your money, decide how to use it, and then pay it out to doctors, nurses, and hospitals. Do you feel it's moraly correct to profit on sick people? We complain that many don't like the idea of a government burocrat deciding one what care I get, but we seem perfectly ok with a corporate burocrat with the interest of making money for shareholders doing the exact same thing. We complain about socialized healthcare, without really understanding that insurance, by it's very nature, is socailzied payout of money- we pool it all together, and the needy are the ones who use it. How it's different that I pay Blue Heath Special vs. medicare, and I get a return back- I don't understand. At some point, it's a black box- money in to money out that can be used for health service. Tax is apparently evil but payments to profit companies that do the same thing is ok..... It's the same thing, money goes to a fund, someone decides how it's spent, you get a benefit. What I DO understand- when I pay Blue Health Special, they may have operating costs of 3% vs. Medicare's 5-7%, but since they also take out 10-20% for profit, the net money that I can get out is LESS than Medicare. IMHO, healcare is a national security concern. If we want viable businesses, we need to keep our people healthy. Go over the death numbers- if we are willing to fight and die, and spend billions if not trillions of dollars when a few people are attacked and killed, why are we not spending the same amount on preventable diseases that kill far far more Americans than any terrorist have. Anyway, back to the original question- are you ok with an industry that takes your hard earned money, decides on how it's paid out, AND also makes profits for it's shareholders? For YOUR healthcare.Xceler8x wrote: Med care has to change. That's about all we can do. The profit taking is out of control. One medical companies profits (cough McKeeson! cough) has been up 8% in the last 5 years. Net profit of $521 million. Revenue is $30 Billion.By my calculations, that's a profit margin of 17.36%. A good margin, indeed, but hardly usurious, evil, or "out of control". That also says nothing about ROI. How long have they had the money committed that is making that profit also affects the real value of that profit margin. If that's the end result of a 5-year investment, the actual return is considerably lower than if it was a 6-month windfall.
What you DON'T understand is that Blue Health Special is limited in terms of profit percentages and said percentages are nowhere even close to the 10-20% that you used as an example.
There's a percentage of every dollar that comes in, that has to be paid out. It's only the 10-15% left (depending on ASO vs. fully insured) that has to pay everyone that works for the company, the buildings, utilities, basically ALL operating costs...
And then whatever is left over is profit.
This is a business that operates on some of the LOWEST profit margins in the world.
This is a business that's there to protect YOU if you have some sort of catastrophic event from bankruptcy.
This is a business that negotiates ridiculous provider rates down so you can afford to see said provider.
This is a business that actively seeks to detect and stop healthcare fraud. It's to cover their own asses, but if you think it would stop if insurance would go away, you've got another think coming.
You think providers would charge significantly less if it weren't for insurance? I GET member-submitted claims from non-networking providers regularly. Their prices aren't anywhere close to what's negotiated by insurance companies with contracting providers. Not even close.
Then who controls the provider's charges if insurance isn't there? The government? The people who couldn't properly distribute $40 tv boxes? Seems legit.
There's no reason they shouldn't keep their 1-3% profits. Because trust me, you don't want to see something like the $387k claim i just processed in bill form.
Zomby Woof wrote: In reply to alfadriver: I said it before, and I'll say it again. As long as the insurance companies are involved, you will always have a second rate healthcare system. If that's what you "free market" guys want, then more power to you. I LOL at you guys sometimes. Just like the copyright discussion. You think there's only one way to do things. Anything else can't possibly work. Have a look around. How's it working out for you?
I'm curious to see how you think that insurance has any impact on Quality of Care.
Duke wrote:Zomby Woof wrote: In reply to alfadriver: I said it before, and I'll say it again. As long as the insurance companies are involved, you will always have a second rate healthcare system. If that's what you "free market" guys want, then more power to you.Works OK with my car insurance. My car got hit, I took it to a guy I trust who runs a body shop, he did a good job fixing it, and insurance paid me back with some of the money I put in. In addition, if I hit somebody, they will get put right and my insurance company has a ready pool of my cash available to make sure that person isn't punished for my mistake. I don't think my car repair was either second rate OR too expensive, just because my insurance was involved in the transaction.
That model doesn't work so well in health insurance.
Car insurance pays for damages, not the repair.
Health insurance pays for repairs, not damages.
If you break your leg, Blue Cross Blue Shield doesn't cut you a check after you a get a quote.
For the record, and to cap off my quadruple post:
I do NOT believe that our current system works.
I do NOT believe that the "new" system will work.
I'm NOT making a statement as to whether or not insurance companies should exist.
BUT, if a real change needs to be made, then EVERYTHING, not just insurance companies, EVERYTHING will need to be government regulated and run.
Might work for other countries to an extent, i don't EVER see it happening in the US the way it should be, so arguing about it, ESPECIALLY just focusing on the insurance companies is like running around in a circle.
Canadians: You've made your point. The US sucks. Certainly helps Nick to point that out. More of us would like to try a system like yours than you'd think. Talking about it on a message board does absolutely nothing.
Wxdude10 wrote: Since I heard about this recently on a radio show, I thought I would pass it along. In Portland, ME, there is a doctor (and I am sure there are more around like him) who has decided that he is not going to be playing the game. He is no longer going to accept any insurance. He is doing pay for service. He has all of his prices posted on the practice's website: http://www.ciampifamilypractice.com/Our_Prices.html You are getting better service (he does house calls!!!) and you are getting the middlemen (government/insurance companies) out of the problem. This is the way medical care used to be done in this country before Uncle Sam got involved in it. If you could find a practitioner like this, just pay the fine, and get some catastrophic coverage for a hospitalization and do some sort of HSA, you might be able to control the pain better.
Dang... I just looked over the price list he has posted. A basic office visit is just $75, and an 'extended' one with a more complex issue is only $100. Given I just had a visit with the doctor (or more accurately, 'physician's assistant'- I've never actually seen the actual Doctor whose practice I go to- but then have also never really been THAT sick...) and have the exact amounts since I'm on a high-deductible plan and have to use my HSA to pay for non-preventative visits I know how much it cost me to go- and it was better than three times the 'extended' visit, knocked down (so to speak) to about 2.5 times the extended visit rate. The lab tests from a followup visit were also similarly much more expensive- and ostensibly I live in a less expensive part of the country than Maine...
Swank Force One wrote: Canadians: You've made your point. The US sucks. Certainly helps Nick to point that out. More of us would like to try a system like yours than you'd think. Talking about it on a message board does absolutely nothing.
Actually, the US does many things "right" that we do "wrong". The only thing that "sucks" about the US is how it treats its less fortunate, and brushes off how not everyone can be rich (for there to be rich, there needs to be poor).
I also find it quite callous to think that everyone doesn't have a right to live, which for all intents and purposes, is what Duke advocates. It's cool that he is fine with human suffering, I'm not. And the rich could still be grossly, disgustingly rich with enough money to do whatever they wanted for the rest of their lives, while the poor could be helped to sustain some modicum of living. But the whole system (a big part of which is healthcare) doesn't allow that.
As the OP has shown, the new system put into place actually makes it WORSE for the middle class, not better. It's hilarious in a not funny way.
P.S I've never had a job where I've had to pay out of pocket for my benefits besides extended ones (dental, life insurance). Private or government, blue or white collar.
HiTempguy wrote: As the OP has shown, the new system put into place actually makes it WORSE for the middle class, not better. It's hilarious in a not funny way.
This is the part that I do not understand. Nobody likes this new system, so far as I can tell, right or left.
HiTempguy wrote:Swank Force One wrote: Canadians: You've made your point. The US sucks. Certainly helps Nick to point that out. More of us would like to try a system like yours than you'd think. Talking about it on a message board does absolutely nothing.Actually, the US does many things "right" that we do "wrong". The only thing that "sucks" about the US is how it treats its less fortunate, and brushes off how not everyone can be rich (for there to be rich, there needs to be poor). I also find it quite callous to think that everyone doesn't have a right to live, which for all intents and purposes, is what Duke advocates. It's cool that he is fine with human suffering, I'm not. And the rich could still be grossly, disgustingly rich with enough money to do whatever they wanted for the rest of their lives, while the poor could be helped to sustain some modicum of living. But the whole system (a big part of which is healthcare) doesn't allow that. As the OP has shown, the new system put into place actually makes it WORSE for the middle class, not better. It's hilarious in a not funny way. P.S I've never had a job where I've had to pay out of pocket for my benefits besides extended ones (dental, life insurance). Private or government, blue or white collar.
Not everyone can be Robin Hood.
mtn wrote:93EXCivic wrote: Seriously guys? A member is asking for advice and we end up in politics.Bound to happen, because nobody really knows (not even my girlfriends dad, who sells health insurance to individuals and small businesses) because of the politics.
Sadly, yes.
I was thinking about this during my drive home last night. It's possible the whole thing is meant to make things crazy for awhile in order to force a change.
Those with insurance tend not to care how much health care costs: generally speaking, the insurance pays for it. Thus we end up with a silly spiraling of costs where providers do this silly dance with the insurance companies with what they "bill", what the insurance company pays, and the true cost of what they need to survive and make soem level of profit.
Now if we as users are forced to pay more of the true cost of care, then maybe, just maybe, people will take a more active role in what procedures Dr's prescribe. I know that since I've been on an high deductible HSA plan and much of the costs are paid by ME, I try like hell to spend as little money as possible.
While many readily admit the current system is very broken and out of control, much of the problem comes from question of how to fix it? It's a huge system with billions (trillions?) of dollars involved. You can't just flip a switch and affect a change in a system with that much financial inertia. No amount of change will be easy or painless for everyone invloved.
Datsun1500 wrote: They make the money investing the premiums, not short changing the providers. They take the risk that If I pay them $X that they will make enough off of $X to justify paying $Y on my behalf. I have no issue with that. If I stay healthy, they win. If I need a bunch of stuff, they lose.
No, they make money by paying out as little as possible.
Example: My friend does not have good health insurance. Her doctor requested a test that she (the doctor) felt needed to be performed. The doctor sent a written letter to her insurance company to "pre-authorize" said procedure. The insurance company refused to pay for the test, saying that my friend would have to suffer certain "confirmed" symptoms three times before this test would be authorized.
Those symptoms could be life-threatening.
It should be a crime to be a health insurance company. Health insurance executives should be taken out and executed. Publicly.
Sky_Render wrote:Datsun1500 wrote: They make the money investing the premiums, not short changing the providers. They take the risk that If I pay them $X that they will make enough off of $X to justify paying $Y on my behalf. I have no issue with that. If I stay healthy, they win. If I need a bunch of stuff, they lose.No, they make money by paying out as little as possible. Example: My friend does not have good health insurance. Her doctor requested a test that she (the doctor) felt needed to be performed. The doctor sent a written letter to her insurance company to "pre-authorize" said procedure. The insurance company *refused* to pay for the test, saying that my friend would have to suffer certain "confirmed" symptoms three times before this test would be authorized. Those symptoms could be life-threatening. It should be a crime to be a health insurance company. Health insurance executives should be taken out and executed. *Publicly*.
Your friend always has the option of having the services rendered anyways. I'd never suggest letting money get in the way of serious health issues.
Swank Force One wrote:Sky_Render wrote:Your friend always has the option of having the services rendered anyways. I'd never suggest letting money get in the way of serious health issues.Datsun1500 wrote: They make the money investing the premiums, not short changing the providers. They take the risk that If I pay them $X that they will make enough off of $X to justify paying $Y on my behalf. I have no issue with that. If I stay healthy, they win. If I need a bunch of stuff, they lose.No, they make money by paying out as little as possible. Example: My friend does not have good health insurance. Her doctor requested a test that she (the doctor) felt needed to be performed. The doctor sent a written letter to her insurance company to "pre-authorize" said procedure. The insurance company *refused* to pay for the test, saying that my friend would have to suffer certain "confirmed" symptoms three times before this test would be authorized. Those symptoms could be life-threatening. It should be a crime to be a health insurance company. Health insurance executives should be taken out and executed. *Publicly*.
Not if the test is too expensive. My point is that health insurance companies basically have the right to say "No, your doctor is incorrect; you don't need that procedure/test/whatever."
A company, whose best interest is to keep as much money as possible and thus provide you as little service as possible, is making your healthcare decisions for you, not your doctor.
Execute them.
Sky_Render wrote: It should be a crime to be a health insurance company. Health insurance executives should be taken out and executed. *Publicly*.
So everyone pays for their medical bills out of pocket without even the option of it being covered by insurance?
Sounds like that would really solve the issue you are mad about.
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