OT: Health Insurance

[skip dog]

One of the biggest problems with healthcare costs today is administrative spending. A study found that 34.2% of U.S. healthcare spending went toward administration, compared to just 17% in Canada. Think about it. When you visit a hospital, you'll likely receive three or four separate bills. That means multiple billing departments, insurance claims, and employees processing everything. All of that costs money. Now compare that to any other industry. Imagine going to dinner tonight and getting a bill from the restaurant, another from the food supplier, and another from the cleaning crew. Would you ever go back? Of course not! Yet somehow, we've accepted this as normal in healthcare. No wonder it's so expensive.

I do believe that one of the biggest issues in healthcare today is the amount of growth in the "C suite" of hospital administration. It's like they believe the more people the hire with a degree in hospital administration, the better they will do, when the reality is that most of the people in the C-suite have zero business experience / acumen

 

[CascillaCountryClub]

Get a part time job at Tractor Supply, or get your wife one… they offer medical insurance for part time work.

 

[skip dog]

Not trying to get into your personal life, but are you married? There’s a surprising number of jobs out there that may be on the lower end of the pay scale, but that are also low stress and that come with reasonable family healthcare benefits

I see a lot of couples go that route where one of the two has the job that pays the bills and the other has the job that provides them with health coverage

no......single dad for a very long time and have a wonderful teenager, that I have raised by myself, that is not to far from college......self employment and all that entails has always worked well for me.......but as I have gotten older, I have gotten more stubborn, and more aware of every penny, and what I know and what I don't know....... and, I have also made my health and peace priority, and b/c of the good health I have been blessed with, health insurance and it's cost have come under my cross hairs with a growing dedicated effort to find a better way

What I really need is a "sugar momma"

 

[johnson86-1]

For profit health insurers like UnitedHealth Group, Elevance Health, and CVS Health (which owns Aetna) are all publicly traded on stock exchanges.

How do you maximize profits for investors? Buy low, sell high.

Treatment does not follows scientific/medical guidelines. It follows the logic of commerce in a poorly regulated, imperfect market. Health insurers spend more on lobbying than the nation's defense contractors.

That is the model we operate in. Now with new and improved automated tools to limit, delay, and deny coverage. These insurers generate tens of BILLIONS of dollars in annual profits and direct massive amounts of capital toward stock buybacks and executive compensation. It's GREAT work if you can get it.

About a half dozen corporate giants dominate regional and national healthcare markets. That reduces choice. They get to push down payments for physicians based on location and increase the cost to maximize profits.

As someone who manages a rather small business, it still pissesmerighttheheloff that I am responsible for providing healthcare to my employees and paying for a large portion of it.

And who benefits from that? My employees?

Where does the money actually end up?

Think about it.

Not that health insurance companies aren't largely awful, but their profits represent about 2% of healthcare spending in the US. To the extent insurance is part of the problem, it's that there is too much of it. With 90% of US healthcare spending being third party paid, there are necessarily huge administrative costs to trying to keep fraud and overbilling in check.

 

[DoggieDaddy13]

Not that health insurance companies aren't largely awful, but their profits represent about 2% of healthcare spending in the US. To the extent insurance is part of the problem, it's that there is too much of it. With 90% of US healthcare spending being third party paid, there are necessarily huge administrative costs to trying to keep fraud and overbilling in check.

This includes more healthcare industry groups beyond insurers, but I found this interesting. https://www.healthcarefinancenews.c...tions-dont-reinvest-give-profits-shareholders

 

[Shmuley]

Anytime anyone anywhere links business with Christianity it’s a scam.

When I see the cross or the fish on business advertising, I instinctively reach to protect my wallet.

 

[CascillaCountryClub]

If we removed all the fraud and abuse from Government, we all could have medical insurance and pay lower taxes. #BothSidesScrewingTaxpayers

 

[L4Dawg]

A lot of mis information in this thread. Too much to even get into really. One thing to remember, the government basically dictates healthcare policy and prices, even in the private insurance market and delivery markets. One other thing to remember, healthcare delivered has to be paid for by someone, none of it is free and never will be. You get what you pay for.

 

[L4Dawg]

If we removed all the fraud and abuse from Government, we all could have medical insurance and pay lower taxes. #BothSidesScrewingTaxpayers

We could eliminate ALL government expenditure except entitlements and we would still be in the red. What you posted is myth.

 

[patdog]

We could eliminate ALL government expenditure except entitlements and we would still be in the red. What you posted is myth.

There’s no fraud in entitlement programs?

 

[mstateglfr]

If we removed all the fraud and abuse from Government, we all could have medical insurance and pay lower taxes. #BothSidesScrewingTaxpayers

Ok there, PDH.

 

[mstateglfr]

yes, the healthcare industry has just about been ruined, and I simply can not morally & ethically buy into something that is subsidized by the government. It's not working

Do you not use gasoline, electricity, or buy groceries?

 

[Walkthedawg]

You answered your question -- the high cost is directly related to the for profit insurance system we've set up. Not only are they for profit, but they assume no real risk.

Well the problem is.. we have for profit insurance companies that want to pay the least.... we have hospitals with the management structure of a national corporation that wants the most it can get... and we have government with their finger on the scale doing what government does, Which is make everything less affordable and less efficient.

if you get insurance to cover more... the hospitals are going to just going to hire more administrators and keep their hands out. If the insurance pays less, the hospitals cry that they are almost bankrupt, you get the government to mediate and then you get higher insurance and worse care.

For example, a few years ago, North Mississippi Medical center fired a bunch of nurses while crying about expenses.. immediately after that they bought Gilmore in Amory. Well hell... where did that money come from?

 

[L4Dawg]

There’s no fraud in entitlement programs?

Yes. There is fraud in everything, but not enough to make much dent in things overall. The scale of federal expenditure is just immense. The emphasis on fraud is a smoke screen, a distraction from the real problem. We spend WAY more than we collect, and that problem has got WAY worse under Trump and the current GOP in Congress. It would be worse under the Democrats. They are both complicit. Inflation is the solution from both. Why do you think they are doing all they can to provoke it? Why do you think the both hat an independent federal reserve? Think about it.

 

[mstateglfr]

Well the problem is.. we have for profit insurance companies that want to pay the least.... we have hospitals with the management structure of a national corporation that wants the most it can get... and we have government with their finger on the scale doing what government does, Which is make everything less affordable and less efficient.

I fully agree that government involvement can lead to higher prices in certain situations.

With that said, your comment in red seems to indicate healthcare would be cheaper and better without government involvement.
I am skeptical of that claim(whether you are claiming it or not).

There is nothing that I have seen or read that would lead me to believe healthcare costs would be lower or that health insurance would be cheaper/better without government involvement.
As a simple example, there was a time in recent history where people were denied coverage for pre-existing conditions or charging higher rates for pre-existing conditions because insurers were able to do that.
Insurance companies had a choice and chose to deny coverage or charge some crazy high rates.

Its not like healthcare and health insurance would be some mythical well functioning free market that works for all parties, if only the government would quit meddling.

To be clear, I want to see a total overhaul of healthcare and health insurance. I think the reason why so many dislike healthcare and health insurance is because it was not set up decades ago to do what it is asked to do now, so all the changes since then have been less than ideal because its all just bandaids and lipstick on pigs.

 

[skip dog]

To be clear, I want to see a total overhaul of healthcare and health insurance. I think the reason why so many dislike healthcare and health insurance is because it was not set up decades ago to do what it is asked to do now, so all the changes since then have been less than ideal because its all just bandaids and lipstick on pigs.

I fully agree with this statement, and as to your other comment above about my "moral / ethical" issue, and your question of do I also buy electricity, gasoline, groceries...........

first........17 u

of course I do, but I also, as one of my businesses, work in a support capacity to a product in some hospitals.......so, I get a almost front row, maybe second row seat to aspects of contracts, purchasing, waste, mismanagement and the reality of physicians and providers wanting to help people all while the business of doing good business it shredded in attempts to exercise stupidity..........To be very frank, my efforts at living a healthier life are directly influenced by never wanting to be dependent or have to be in the hospital. Everything healthcare has become just a cash grab

my intent today was to see if there was anything out there I had not thought of as a way of protecting this aspect of my family w/o what my "books" show as throwing money to the wind for the past 10-12 years.

there is probably not a single person on this board today that would say that they have 100% confidence in their health insurers ability to meet there needs if that time arose

So for me, it is a full throttle effort to find a way to better control this expense, and meet whatever need may arise

 

[HRMSU]

Yes. There is fraud in everything, but not enough to make much dent in things overall. The scale of federal expenditure is just immense. The emphasis on fraud is a smoke screen, a distraction from the real problem. We spend WAY more than we collect, and that problem has got WAY worse under Trump and the current GOP in Congress. It would be worse under the Democrats. They are both complicit. Inflation is the solution from both. Why do you think they are doing all they can to provoke it? Why do you think the both hat an independent federal reserve? Think about it.

You'd be shocked at the volume of healthcare spending by the government that is at list price or minimally discounted off list. If they negotiated better or in some cases were allowed to negotiate and we also could make a dent in fraud it would go a long way.

The problem is this topic is way bigger than the few entities you guys mention and the majority of the players in this industry all have competing interests. It's one of the most complex industries there is hence the results we get.

 

[johnson86-1]

I fully agree that government involvement can lead to higher prices in certain situations.

With that said, your comment in red seems to indicate healthcare would be cheaper and better without government involvement.
I am skeptical of that claim(whether you are claiming it or not).

There is nothing that I have seen or read that would lead me to believe healthcare costs would be lower or that health insurance would be cheaper/better without government involvement.
As a simple example, there was a time in recent history where people were denied coverage for pre-existing conditions or charging higher rates for pre-existing conditions because insurers were able to do that.
Insurance companies had a choice and chose to deny coverage or charge some crazy high rates.

It's not that insurance companies had a choice, it's that you cannot insure against a pre-existing condition.

Its not like healthcare and health insurance would be some mythical well functioning free market that works for all parties, if only the government would quit meddling.

Regulated insurance works fine when you allow it to generally operate as insurance. With one, pretty significant exception, If we had a reasonably free market, insurance would mostly work fine. What would not work is that people would generally not save a bunch of money in their 20's and 30's (and 40's?) when health insurance is cheap to be able to afford health insurance when it continually gets more expensive in their 40's through 60s. But the insurance would work fine. It wouldn't stop being a pain in the *** and it would need to be regulated.

The significant exception would be that I don't know how the insurance market would handle long term illness/healthcare. Once an insured develops something that requires long term treatment, the incentive for the insurance company is to treat them as ****** as possible without getting sued for bad faith. The customer will forever be a loser for them but realistically cannot go anywhere else. If you do something that mandates that other insurance companies cannot risk rate you as long as you were insured when you develop the condition, you are just incentivizing insurance companies to compete on being unpleasant for the chronically ill.

But we can't even have functioning health insurance outside of that situation because we view health insurance not as a way to actually insure against risk but to finance and subsidize healthcare and regulate its costs.

To be clear, I want to see a total overhaul of healthcare and health insurance. I think the reason why so many dislike healthcare and health insurance is because it was not set up decades ago to do what it is asked to do now, so all the changes since then have been less than ideal because its all just bandaids and lipstick on pigs.

That's all basically true, but it comes back to trying to get health insurance to be one of if not the primary ways to regulate healthcare, instead of trying to let actual health insurance exist for the things it can do well, and then try to have the government directly do the things it wants to do that are not insurance (i.e., subsidize care; redistribute money from the more to less affluent).

 

[DawgNsuds]

Anytime anyone anywhere links business with Christianity it’s a scam.

I don't even get that far in my evaluation process, I just find it personally offensive that company's would commercialize their faith in Christ. My interpretation is against that, but to each his own.

 

[Maroon Eagle]

Do you not use gasoline, electricity, or buy groceries?

People forget about rendering unto Caesar…

Even Jesus said the government is alright with Him… ($1 to the Doobies)

 

[Dawgbite]

All I know is you youngsters just need to put your nose to the grindstone and keep working. I’m so close to that gubment health insurance and that gubment check I can nearly taste it and since they’ve already spent my money I’m gonna need supported.

 

[Duggar Hall Desk]

In my job, I deal with filing insurance claims every day. And every day, I am more convinced that health insurance is a racket. You have to have it in the US, but it certainly qualifies as a necessary evil in my book.

 

[mstateglfr]

I fully agree with this statement, and as to your other comment above about my "moral / ethical" issue, and your question of do I also buy electricity, gasoline, groceries...........

first........17 u

of course I do, but...

Not sure why '17 u' is in order here.

You said you morally and ethically can't support something that is subsidized by the government, so asked if you support those other government subsidized industries.
...and as you said, of course you do support them.

Just accept that you can support government subsidized industries. It'll be a lot easier. Way less contorting required.

 

[CascillaCountryClub]

People forget about rendering unto Caesar…

Even Jesus said the government is alright with Him… ($1 to the Doobies)

If 10% is good enough for Jesus, 10% should be good enough for the Government

 

[skip dog]

Not sure why '17 u' is in order here.

You said you morally and ethically can't support something that is subsidized by the government, so asked if you support those other government subsidized industries.
...and as you said, of course you do support them.

Just accept that you can support government subsidized industries. It'll be a lot easier. Way less contorting required.

well the "17 u" is in order, b/c frankly, it's just a very appropriate reply to you

other than that, I hear ya