Health Care Law already crimping job-based insurances?

[Bronzebow]

In the case of medical insurance, however, the cost of preventive maintenance that is covered in regular doctor visits is easily an insignificant pittance when compared to the costs of treatment and recovery associated with later-stage illnesses and conditions that could have been easily treated if caught sooner. If doctor's visits aren't covered, then people won't go, making the cost to the insurers rise astronomically for very little gain.

It is apples and oranges only because of how we have grown accustomed to how medical care and costs are handled almost exclusively through third parties. I agree that people who would generally keep up with doctor appointments would be more likely to take care of themselves, but that the visit is subsidized so commonly creates the situation where the visits themselves become more expensive.

Doctors can charge more because insurance carriers will pay it. It hurts the poor or those without insurance much more because they would then have to pay the cost that the insured do not see. Without this in effect, doctors would be forced to charge less in order to see more people. It's a delicate juggling act. My concern is that an overreaching of medical coverage for things like this exponentially impact the people who would need the most assistance.

At any rate, it's probably way too late to go back.

This very point is one of the main issues at the base of universal coverage. If we can get everybody covered for, at the least, basic medical checkups and minor treatments, then there will be an overall decline in the need for more costly treatments down the road.

I fully recognize this will branch off topic. I sincerely apologize in advance.

But it also creates the incentive to try to take control of what people do, eat, and participate in. You can already find plenty of examples of this, from regulation attempting to reduce salt in commercial foods (not realizing how cheap and effective it is as a preservative, and how it would only be replaced with chemicals you cannot even pronounce), to penalizing the consumption of sodas (subsidized via corn and high fructose corn syrup, only to turn around and be taxed so heavily in some areas that beer is cheaper than cola), to even forcing small businesses into bankruptcy via overreaching regulations conveniently worded to exclude big businesses (straight up corruption).

It becomes a question of purpose then: is it better to enforce more feel-good regulation, increase black marketing, and reduce personal freedoms in order to attempt to have a slightly healthier populace, or is it better to let people make their choices and live with their consequences, safety nets aside?



I agree about the craziness about ER's. I wouldn't even begin to know how to tackle that. Even with a truly effective overhaul, people are going to attempt to abuse the system, and how can you truly differentiate between people who genuinely need a safety net from the guy hogging up all the hospital's resources?

[FArchivist]

[QUOTE=KitterCat;69737]Considering that the profit margins for health insurance companies are at 3.3% or 2.2(depending on the chart your looking at) I wouldn’t say that they’re making record killings for the amount of money they handle.

Ah, but the question is not how much the profit margin is for a corporation, but how much is in the profit margin. According to the first chart, the profit margin for Oil & Gas Refining and Marketing is only 3.5%. Yet, the average yearly profit for such companies is extremely high:

ExxonMobil: $158.5 billion
Shell: $108.5 billion
BP: $89.2 billion
ChevronTexaco: $60.9 billion
ConocoPhillips: $46.9 billion

That's with only 3.5%. Imagine if it were 10%. As for the health insurance companies, despite all the poor-mouthing, they're doing just as well.

I think it would be a really good thing if the option for most people were to have some small amount taken from their paycheck and put on a similar card for everyday medical expenses. This would cut down on the need for doctors to need to go through the insurance companies and drop their prices. The catastrophic insurance would be use for things like breaking a bone, cancer, staff-infections.

How would this affect people who can't afford the insurance in the first place, if self-employed? Or even those who can't afford what their company offers? Or any reduction in their paycheck at all?

For those who can afford it, how would it be determined how much is taken out? Would it be mandatory? Who would enforce it? Would there be any provision to opt-out?

Thirdly, who would convince the doctors to lower their prices?

The next would be allowing issuance companies to sell across state lines. If I can find a better plan at a third of the cost in say Ohio, it shouldn’t matter that I live in Maryland. If enough people were to do that what ever insurance company that is in the area would start adjusting rates/services to entice customers. Currently due to laws we’re unable to do that.

And guess who had those laws put in place?
In US vs. Southeastern Underwriter's Association (1945), SCOTUS declared that insurance was an interstate issue and so subject to federal anti-trust legislation.

The next year saw the McCarran-Ferguson Act, sponsored by every insurance company in existence. It reversed the SCOTUS decision and made insurance on a state-by-state basis, forbidding it to be sold over state lines.

That portion of the McCarran-Ferguson Act has undergone several repeal attempts in the past. The insurance lobbyists have blocked it every time, because then they would lose their state monopolies. One good thing the Obamacare act did was repeal that portion. You WILL be able to buy over state lines.

They have to cover their malpractice insurance to help cover themselves when people sue them for the stupidest things left and right. That goes back to the education of the people, and I think that there really needs to be some kind of tort reform for doctor lawsuits.

Tort reform is very, very dangerous. The reason it hasn't been done is because it's too easy to twist tort reform preventing people from being able to sue into large-scale immunity from lawsuits, period. You WILL get doctors who will make mistake after mistake and just cover it up, unable to be blamed for their incompetence or made to pay for their mistakes.

It's a two-edged sword. Personally, I'd rather have the ability to sue at the drop of a hat rather than people walking around immune.

There could be a lot of work done to the cost of medications too, but that's a rant for another time.

*shrugs* Pharmacorps want to make a profit.

That this Obamacare doesn't even touch hospitals and what they charge is pretty disturbing, but it's about par for a federal bandaid fix.

Most hospitals are private entities, incorporated in their own right. An attempt by the federal government to regulate prices for medical services would be price-fixing and would actually be illegal. The prices you have are the result of a capitalistic market focused on profit. The only way to have them lowered is for the people charging the prices to voluntarily lower them...and that is not likely to happen on a large scale no matter what you do.

[KitterCat]

Ah, but the question is not how much the profit margin is for a corporation, but how much is in the profit margin. According to the first chart, the profit margin for Oil & Gas Refining and Marketing is only 3.5%. Yet, the average yearly profit for such companies is extremely high:

ExxonMobil: $158.5 billion
Shell: $108.5 billion
BP: $89.2 billion
ChevronTexaco: $60.9 billion
ConocoPhillips: $46.9 billion

That's with only 3.5%. Imagine if it were 10%. As for the health insurance companies, despite all the poor-mouthing, they're doing just as well.

So what would you consider an acceptable amount? 1%, maybe .5%? Of course their dollar amounts are going to look high. They deal with huge amounts of money. Or maybe their CEO’s should all take pay cuts, or have their salaries dictated to them by the government. Come on, if you do that why not just dictate what every ones salaries are to be so that we don’t end up with actors who do nothing but make movies making millions.

Look at the amount of money these industries have to put out just to make things work. Using your own example with the oil companies. Oil refineries, the equipment to drill, bring up the oil, transport it, refine it, none of that’s cheap.

How would this affect people who can't afford the insurance in the first place, if self-employed? Or even those who can't afford what their company offers? Or any reduction in their paycheck at all?

Its personal responsibility. Its not suppose to be the governments job to take care of your responsibilities or to make other people have to take care of them for you. If you cant afford it and still want something you have to either figure out what items you have to have or find another way of paying for it.

who would convince the doctors to lower their prices?

You do know that most doctors do have lower prices now if your willing to pay upfront? It means that they don’t have to waist time dealing with the insurance companies. They’d rather have their secretaries be doing something else after all.

he next year saw the McCarran-Ferguson Act, sponsored by every insurance company in existence. It reversed the SCOTUS decision and made insurance on a state-by-state basis, forbidding it to be sold over state lines.

That portion of the McCarran-Ferguson Act has undergone several repeal attempts in the past. The insurance lobbyists have blocked it every time, because then they would lose their state monopolies. One good thing the Obamacare act did was repeal that portion. You WILL be able to buy over state lines.

I find governmental more at fault than the lobbyists. Of course lobbyists are going to lobby for what’s in their interests. It is their job after all. However when the government officials are pretty much willing to be paid off to have a piece of legislation passed I cant help but look at them with disdain. Their job is suppose to be to look at the best interests of the public, not be given a donation ::cough paid off:: to pass a companies wet dream of a bill.

Tort reform is very, very dangerous. The reason it hasn't been done is because it's too easy to twist tort reform preventing people from being able to sue into large-scale immunity from lawsuits, period. You WILL get doctors who will make mistake after mistake and just cover it up, unable to be blamed for their incompetence or made to pay for their mistakes.

It's a two-edged sword. Personally, I'd rather have the ability to sue at the drop of a hat rather than people walking around immune.

It’s a two edged sword that’s put to much on the courts and makes it to easy for people to bring up suites at the drop of a hat. That sword edge is not currently balanced. Its why doctors have to have medical liability insurance for $90,000, $250,000 per year (from two doctors I know) Those costs get passed back to the patients.

Most hospitals are private entities, incorporated in their own right. An attempt by the federal government to regulate prices for medical services would be price-fixing and would actually be illegal. The prices you have are the result of a capitalistic market focused on profit. The only way to have them lowered is for the people charging the prices to voluntarily lower them...and that is not likely to happen on a large scale no matter what you do.

Correct me if your wrong, but your trying to intone that making a profit in the medical world is wrong. Why? For hospital bills one of the problems isn’t necessarily the people making the prices, but also the people who don’t pay their bill. If more than half of your patients aren’t paying then the gap has to be filled unfortunately by the people who will.

[FArchivist]

So what would you consider an acceptable amount? 1%, maybe .5%?

There is no 'acceptable' amount. I just don't feel sorry for a corporation that's paying the CEO and Board of Directors millions of dollars in salary and then they get to have orgies on top of their multi-million profits while they put people out to die in the street because of their rescission practices. I really can't muster the sympathy, y'know. Not when you have breast cancer patients being dropped by insurance companies because that treatment is just too expensive and would impact profit.

Look at the amount of money these industries have to put out just to make things work. Using your own example with the oil companies. Oil refineries, the equipment to drill, bring up the oil, transport it, refine it, none of that’s cheap.

This isn't a good point to make when the profits are what you have after you cover those costs. Basic accounting; profits are what's left over when you subtract the debits from the credits.

Its personal responsibility. Its not suppose to be the governments job to take care of your responsibilities or to make other people have to take care of them for you. If you cant afford it and still want something you have to either figure out what items you have to have or find another way of paying for it.

What I hear when you say this is: "Sorry, Mr Smith, but your daughter has leukemia and because the treatment is expensive we're retroactively canceling your insurance 6 months previous to onset (as the laws let us do) on a spurious reason. Too bad for your daughter. You'll just have to figure out another way of paying for chemo. Maybe you should've practiced bootstrapping some more."

You do know that most doctors do have lower prices now if your willing to pay upfront? It means that they don’t have to waist time dealing with the insurance companies. They’d rather have their secretaries be doing something else after all.

Not in my city of Atlanta. If I pay cash, I can expect to pay $200-300 per doctor visit, maybe getting away with $75-100 if I go to a cheapie mall clinic and wait 3-4 hours. That's not including prescriptions and the like. While I'm lucky enough to be able to afford that without insurance, I know a lot of people who can't. A lot of people who can't even afford the ER visit, since they'll send the debt monkeys hounding after them. People who just splint a broken bone themselves and hope for the best.

However when the government officials are pretty much willing to be paid off to have a piece of legislation passed I cant help but look at them with disdain. Their job is suppose to be to look at the best interests of the public, not be given a donation ::cough paid off:: to pass a companies wet dream of a bill.

We had the chance to do something about this at the beginning of the century under Teddy Roosevelt and the Progressives of the 1920s. We failed to do it. So I say we can't complain about Big Business and Corporate Masters running the government. Like it or not, we CHOSE that route. I don't blame the politicians at all. Their job USED to be looking out for the public; now it is looking out for the profits of corporations. And we're responsible for that. Go capitalism!

It’s a two edged sword that’s put to much on the courts and makes it to easy for people to bring up suites at the drop of a hat. That sword edge is not currently balanced. Its why doctors have to have medical liability insurance for $90,000, $250,000 per year (from two doctors I know) Those costs get passed back to the patients.

I would rather have those costs than have Mr Drunk Surgeon who is immune to a malpractice lawsuit because of tort reform. Some of my objections to tort reform can be found here.

Correct me if your wrong, but your trying to intone that making a profit in the medical world is wrong. Why?

My Catholic faith informs me that it is hypocritical to profess the Hippocratic Oath and yet act like a sociopath in the pursuit of profit. You're either in the business of helping people or in the business of screwing them to make money. Choose one. I'm not a hypocrite; I work for a corporation. I'm in the business of screwing people for profit.

For hospital bills one of the problems isn’t necessarily the people making the prices, but also the people who don’t pay their bill. If more than half of your patients aren’t paying then the gap has to be filled unfortunately by the people who will.

When medical services are targeted for the wealthy, this is unsurprising. My question is, if we supposedly have a better medical system, why does Germany (for instance) do so much better than we at it?

[Bronzebow]

Most hospitals are private entities, incorporated in their own right. An attempt by the federal government to regulate prices for medical services would be price-fixing and would actually be illegal. The prices you have are the result of a capitalistic market focused on profit. The only way to have them lowered is for the people charging the prices to voluntarily lower them...and that is not likely to happen on a large scale no matter what you do.

I wasn't inferring that it is the federal government's job to decide what hospitals are to charge; I was lamenting the focus and demonization of the insurance side of the coin while discussion on the hospital and doctor side was practically nonexistent.

It a stretch to call hospital pricing capitalistic, considering the sorts of lobbying and laws that give hospitals the power in the hospital/insurance dynamic. When you have government regulation preventing new competition, you don't have free market pricing.

So the point I was making there, in the rest of the paragraph, was that we artificially raised the price of health care and decided the fix was to have more people covered by overstretched insurance companies. Bureaucracy at it's finest.

[KitterCat]

What I hear when you say this is: "Sorry, Mr Smith, but your daughter has leukemia and because the treatment is expensive we're retroactively canceling your insurance 6 months previous to onset (as the laws let us do) on a spurious reason. Too bad for your daughter. You'll just have to figure out another way of paying for chemo. Maybe you should've practiced bootstrapping some more."

You do realize under our current medical makeup that don’t happen. People are given medical care wither or not they can afford it at hospitals. Especially when it comes to life threatening illness. I myself am proof of that. 6 surgeries. 7 years in and out of one of the most famous hospitals in the country as a child and all without my parents paying for it. Did it destroy their credit? Heck yah, but a lot of that was due to them never doing anything to help pay for the costs. Such as applying for medical aid, negotiating with the hospital prices. Hell getting health insurance during one of my clean bill of health periods.

Your taking what I pointed out of context. You asked.
FArchivist
How would this affect people who can't afford the insurance in the first place, if self-employed? Or even those who can't afford what their company offers? Or any reduction in their paycheck at all?

Which is a personal responsibility problem, not the governments. As for saying that health insurance companies retroactively canceling insurance. Of course they should not be allowed to do that. And having one or two items on the health care bill dose not mean that I agree with it as a whole.

My Catholic faith informs me that it is hypocritical to profess the Hippocratic Oath and yet act like a sociopath in the pursuit of profit. You're either in the business of helping people or in the business of screwing them to make money. Choose one. I'm not a hypocrite; I work for a corporation. I'm in the business of screwing people for profit.

Most doctors aren’t sociopaths. Most are trying to work through one of our most regulated jobs in the country to make a living. Plenty are also leaving the profession due to this. Does that mean that they make more than most people. Yes. They also have more time & money put into their education (4 years college, 4 years medical, 8 years specialty on average) To then try to portray them as criminals because they are making more than you is a sign of envy.

[FArchivist]

You do realize under our current medical makeup that don’t happen. People are given medical care wither or not they can afford it at hospitals. Especially when it comes to life threatening illness. I myself am proof of that. 6 surgeries. 7 years in and out of one of the most famous hospitals in the country as a child and all without my parents paying for it. Did it destroy their credit? Heck yah, but a lot of that was due to them never doing anything to help pay for the costs. Such as applying for medical aid, negotiating with the hospital prices. Hell getting health insurance during one of my clean bill of health periods.

I just don't consider that a valid price to pay, especially with our debtor/credit collection laws getting closer and closer to the old "debtor's prison" concept. Morally and ethically I have a problem with the idea that, in order for you to live, you have to be reduced to poverty and suffer social shame from bad credit.

Think about it. The practical thing for your parents to do, all things being equal, would have been to let you die from your ill health and try again with another child. And since in the USA, practicality = morally correct, it would also have been the right thing to do. I just find that unacceptable, but I'm an old throwback to the outdated Catholic concepts of charity and mercy.

Which is a personal responsibility problem, not the governments.

I'm not taking it out of context. You are saying it's those people's fault they can't afford health insurance because they don't make enough money. That your parents are to blame for being poor and unable to afford your treatment. That they should have bootstrapped more.

Let me put it this way: If it's a problem of personal responsibility and not the government, then we shouldn't regulate at all and let the corps do as they please.

As for saying that health insurance companies retroactively canceling insurance. Of course they should not be allowed to do that. And having one or two items on the health care bill dose not mean that I agree with it as a whole.

If it's a problem of personal responsibility, why SHOULDN'T they be allowed to do that? If it's not government's problem, then I don't see why corporations should be restricted.

Most doctors aren’t sociopaths. Most are trying to work through one of our most regulated jobs in the country to make a living. Plenty are also leaving the profession due to this. Does that mean that they make more than most people. Yes. They also have more time & money put into their education (4 years college, 4 years medical, 8 years specialty on average) To then try to portray them as criminals because they are making more than you is a sign of envy.

I don't envy them at all. It's why I didn't become a doctor.

And no, most doctors aren't sociopaths. But corporations are. Heck, capitalism and the whole idea of profit in business is sociopathic. If doctors are in it to make money, then that means dumping all those cute ethics at the side of the road in the name of Profit. The shareholders demand it, you know.

I'm not even saying being sociopathic is a bad thing; it all depends on your point of view. But let's not pretend that are ethics and nobility in the pursuit of profit.