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Heeeeeeere's Obamacare!

plague311 said:
Not at all what I asked, a strawman, and contradictory to the article that was posted, and that I am replying to. The hospital makes money, at least they claimed it made $2.2 million in the fiscal 2011-2012 year. It also doesn't state that they would take a loss in that article for dealing with any of the 3 we're talking about. It states that the compensation from the insurance company isn't what they want it to be. The state provides them with tax breaks and leniency in other forms for being state run. The hospital states that reimbursement from the plans on the exchange is between medicaid and medicare. They accept both and in the article do not claim either one requires them to take a loss.
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A hospital with 5,100 employees turned out a profit of $2.2 million?!?! Those fat cats! Hang 'em high! :mad:
 
eeyore1954 said:
I have never done any work in the insurance industry but can't the insurance company negotiate a price or specify a price they will pay. For example $.50 for an aspirin instead of $6.
I don't think they are blindly at the mercy of the hospital and whatever they want to charge for aspirin.
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It's not as simple as it sounds, unfortunately. I don't work in the network contracting area, so my information is going to be less than perfect.

For a given suburban area, there might be 2 hospitals. There are more like 5 or 6 insurance carriers, all competing for that hospital's services. The insurer can't just walk away from the hospital - if the hospital isn't in the network, then there's no place for the insurer's consumers to go when they need medical care, and most states have geographic access requirements as well. So the Hospital has an effective monopoly on supply, and is in very high demand. The insurers effectively compete against each other, giving the hospital the ability to pick and choose who they want to work with, and to play insurers against each other, thus raising the price.

Additionally, the negotiation isn't done on an item-by-item basis. It's done at some aggregate level (I don't really know the details). So I believe some of the smaller stuff gets really high markups, just like most retail stores.
 
Newtons Bit said:
A hospital with 5,100 employees turned out a profit of $2.2 million?!?! Those fat cats! Hang 'em high! :mad:
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Oh good, moving the goal posts and a new strawman, that's exciting. Props for putting a hyperbole inside of a strawman too, it's classy.

Point being he said that they were taking a loss, which is not stated anywhere in the article, and doesn't reflect the evidence available.
 
plague311 said:
Oh good, moving the goal posts and a new strawman, that's exciting. Props for putting a hyperbole inside of a strawman too, it's classy.

Point being he said that they were taking a loss, which is not stated anywhere in the article, and doesn't reflect the evidence available.
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No, that was just general mockery.
 
plague311 said:
Not at all what I asked, a strawman, and contradictory to the article that was posted, and that I am replying to. The hospital makes money, at least they claimed it made $2.2 million in the fiscal 2011-2012 year. It also doesn't state that they would take a loss in that article for dealing with any of the 3 we're talking about. It states that the compensation from the insurance company isn't what they want it to be. The state provides them with tax breaks and leniency in other forms for being state run. The hospital states that reimbursement from the plans on the exchange is between medicaid and medicare. They accept both and in the article do not claim either one requires them to take a loss.
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They don't need to state that explicitly; that's just reality. You have to ask: Why isn't the compensation from the ins co what they want it to be? Profit isn't their motive. They just want to keep their doors open and pay their employees a decent wage.
 
Newtons Bit said:
No, that was just general mockery.
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Because you've been so overly informative and correct in your information, that you feel mockery is helping your cause. Critical thinking, you're doing it wrong.

xjx388 said:
They don't need to state that explicitly; that's just reality. You have to ask: Why isn't the compensation from the ins co what they want it to be? Profit isn't their motive. They just want to keep their doors open and pay their employees a decent wage.
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Ok, more goal post moving, let me catch my breath here. So they don't have to state it explicitly because "that's just reality." However, they are keeping their doors open, as I showed above they're actually making a multi-million dollar profit. All that after they pay their employees a decent wage! Did you miss that part? Also, where in this next quote, which I pulled from the article (you know, the one I am referring too, not just your unsupported claims), states that they are losing money, or that they would lose money?

"We certainly support universal coverage and are hoping the exchange would be vehicle for that," Pasternak said. But, he said, the rates being offered are too low -- "below Medicare and approaching Medicaid," the latter generally considered a very low rate of reimbursement.
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I hilited the important part. If I am missing something, please let me know. I will retract what I say, but at this point I am not seeing anything contradicting my points. No matter how precious Newton's mockery gets.
 
plague311 said:
Ok, more goal post moving, let me catch my breath here. So they don't have to state it explicitly because "that's just reality." However, they are keeping their doors open, as I showed above they're actually making a multi-million dollar profit. All that after they pay their employees a decent wage! Did you miss that part? Also, where in this next quote, which I pulled from the article (you know, the one I am referring too, not just your unsupported claims), states that they are losing money, or that they would lose money?

I hilited the important part. If I am missing something, please let me know. I will retract what I say, but at this point I am not seeing anything contradicting my points. No matter how precious Newton's mockery gets.
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I don't think I'm being clear. What I'm saying is that each patient has a cost associated with treating them. When a doctor or hospital accepts medicare and medicaid patients, they understand that doing so comes at a loss or break-even point. In the past, the hospital was reimbursed by private insurers at a higher rate than Medicare. This higher rate, along with what they charge self-pay patients, makes up for the losses they incur treating Medicaid and Medicare patients.

So when you read an article where a hospital says that the new insurance reimbursement rates are too low, in between Medicare and Medicaid , that means that the amount they would get reimbursed is below the point at which the reimbursement matches the treatment cost. If they accept those rates, they will not pull a $2 million profit but will likely end up with a loss. The article doesn't explicitly state this but if you understand the basics of hospital reimbursement, you will understand why a rate between Medicare and Medicaid is unacceptable.

So, to your point, I don't think that you can say this hospital is exhibiting a political bias. It's just simple business, even for a non-profit.
 
plague311 said:
Oh good, moving the goal posts and a new strawman, that's exciting. Props for putting a hyperbole inside of a strawman too, it's classy.

Point being he said that they were taking a loss, which is not stated anywhere in the article, and doesn't reflect the evidence available.
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Just for consideration, $2.2 Million isn't necessarily a lot of profit. I don't have numbers for them, but it's conceivable that that's a relatively low percentage of profit. It's a lot of dollars, yes... but it might be only 2% or 3% profit margin. It's possible that the reduction in rates for that large a portion of its population would offset that percentage completely, and put them into a loss position.

I don't know for sure. I don't have all the facts. I'm merely pointing out that these sorts of things are more complicated than many people realize. It might be worthwhile to be slightly less antagonistic, and seek to discuss and learn.
 
Emily Cat said:
Just for consideration, $2.2 Million isn't necessarily a lot of profit. I don't have numbers for them, but it's conceivable that that's a relatively low percentage of profit. It's a lot of dollars, yes... but it might be only 2% or 3% profit margin. It's possible that the reduction in rates for that large a portion of its population would offset that percentage completely, and put them into a loss position.

I don't know for sure. I don't have all the facts. I'm merely pointing out that these sorts of things are more complicated than many people realize. It might be worthwhile to be slightly less antagonistic, and seek to discuss and learn.
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I will agree here. 2.2 mil for a large organisation seems vanishingly small. It is the sort of profit that tends to indicate either razor margins or massive inefficiencies in spending*.

* which may include ridiculous salaries for executives

For me, one of the things about the US healthcare system that seems to seldom be discussed is just how much malpractice insurance adds to overall cost.

Very few countries are as litigious as the US and I suspect that both the number and the size of the settlements in the US for malpractice cases form a sizable percentage of your seemingly crazy healthcare costs.

Is that accurate? Could one approach to reducing healthcare costs be some sort of legislation to try and reduce the liability doctors are exposed to? Would such legislation be possible? Easier to get through that UHC?
 
Octavo said:
For me, one of the things about the US healthcare system that seems to seldom be discussed is just how much malpractice insurance adds to overall cost.

Very few countries are as litigious as the US and I suspect that both the number and the size of the settlements in the US for malpractice cases form a sizable percentage of your seemingly crazy healthcare costs.

Is that accurate? Could one approach to reducing healthcare costs be some sort of legislation to try and reduce the liability doctors are exposed to? Would such legislation be possible? Easier to get through that UHC?
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It has been estimated that the cost of malpractice suits adds about 2% to the cost of medical care in the US. Medical costs are not significantly lower in states that have restricted malpractice suits.
 
Kestrel said:
It has been estimated that the cost of malpractice suits adds about 2% to the cost of medical care in the US. Medical costs are not significantly lower in states that have restricted malpractice suits.
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I've read (somewhere?) that the cost of CYA may be quite a bit higher than 2%. But it's still not "the reason" why healthcare is so expensive. There's a large number of factors that all add 2% here and 10% there.
 
Emily Cat said:
Just for consideration, $2.2 Million isn't necessarily a lot of profit. I don't have numbers for them, but it's conceivable that that's a relatively low percentage of profit. It's a lot of dollars, yes... but it might be only 2% or 3% profit margin. It's possible that the reduction in rates for that large a portion of its population would offset that percentage completely, and put them into a loss position.

I don't know for sure. I don't have all the facts. I'm merely pointing out that these sorts of things are more complicated than many people realize. It might be worthwhile to be slightly less antagonistic, and seek to discuss and learn.
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It's about $430/employee. I think that's closer to about 0.2% to 0.3% profit.
 
xjx388 said:
I don't think I'm being clear. What I'm saying is that each patient has a cost associated with treating them. When a doctor or hospital accepts medicare and medicaid patients, they understand that doing so comes at a loss or break-even point. In the past, the hospital was reimbursed by private insurers at a higher rate than Medicare. This higher rate, along with what they charge self-pay patients, makes up for the losses they incur treating Medicaid and Medicare patients.

So when you read an article where a hospital says that the new insurance reimbursement rates are too low, in between Medicare and Medicaid , that means that the amount they would get reimbursed is below the point at which the reimbursement matches the treatment cost. If they accept those rates, they will not pull a $2 million profit but will likely end up with a loss. The article doesn't explicitly state this but if you understand the basics of hospital reimbursement, you will understand why a rate between Medicare and Medicaid is unacceptable.

So, to your point, I don't think that you can say this hospital is exhibiting a political bias. It's just simple business, even for a non-profit.
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Which all makes sense, and Emily had mentioned something briefly below my original comment. It looks like I missed it until I went back and read the thread. I took the information from the article, since that's what was provided, and spoke to it. The way it was phrased and presented was another form of "obama isn't letting me keep my doctor, he lied." Which is what I was speaking too, no one from Obama's office is denying anyone care or making it so they cannot get care. The insurance companies and the hospital are in negotiations to come up with a proper reimbursement rate.

Emily Cat said:
It might be worthwhile to be slightly less antagonistic, and seek to discuss and learn.
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Thanks, I'm fine the way I am. I learned perfectly well, and am more than fine apologizing when I am wrong. I wasn't wrong, I took the information presented and responded to it.
 
plague311 said:
Because you've been so overly informative and correct in your information, that you feel mockery is helping your cause. Critical thinking, you're doing it wrong.



Ok, more goal post moving, let me catch my breath here. So they don't have to state it explicitly because "that's just reality." However, they are keeping their doors open, as I showed above they're actually making a multi-million dollar profit. All that after they pay their employees a decent wage! Did you miss that part? Also, where in this next quote, which I pulled from the article (you know, the one I am referring too, not just your unsupported claims), states that they are losing money, or that they would lose money?
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They didn't state it explicitely but the income you point out is an example of it. If a hospital with a budget of its size makes less than $2,000,000 a year and they have a mix of lower reimbursement plans (medicaid and medicare) and higher reimbursement plans doesn't it make sense they are losing money on the lower end and making it up on the higher end.
By the way where did you find the figures about their income? Maybe it was right in front of me but I do not see it.

They are keeping their door open because the medicaid reimbursements are offset by profits from other patients insurance. They accept medicaid because they are required to and because they want to help the community.

Anecdotal but when my granddaughter was there we met several families who were there with premature babies with no insurance. The hospital never once hasseled these people over money they did whatever was required usually to the tune of well in excess of $100,000.

Here are some quotes and articles about hospitals losing money on medicaid reimbursements
Most hospitals lose money on every Medicaid patient they treat.

The Fragile State of Hospital Finances

But hospitals say they are losing money on Medicare patients, to the tune of nearly $24 billion a year, according to Caroline Steinberg, vice president of the American Hospitals Association, an industry trade group.
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Kestrel said:
It has been estimated that the cost of malpractice suits adds about 2% to the cost of medical care in the US. Medical costs are not significantly lower in states that have restricted malpractice suits.
Click to expand...

Newtons Bit said:
I've read (somewhere?) that the cost of CYA may be quite a bit higher than 2%. But it's still not "the reason" why healthcare is so expensive. There's a large number of factors that all add 2% here and 10% there.
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This fits my recollection... but I admit to being to lazy to go look it up :D

Neither malpractice insurance nor malpractice suits add a huge amount overall - although I feel it's important to point out that the cost of a malpractice suit to an individual doctor can be devastating. It's similar to how the cost of house fires doesn't add a lot to the cost of home ownership in the US, but can be catastrophic to an individual home owner.

What I recall, however, is that the type of defensive medicine practiced to avoid the possibility of a lawsuit adds a not-insignificant amount to the overall cost of health care in the US.
 
Emily Cat said:
This fits my recollection... but I admit to being to lazy to go look it up :D

Neither malpractice insurance nor malpractice suits add a huge amount overall - although I feel it's important to point out that the cost of a malpractice suit to an individual doctor can be devastating. It's similar to how the cost of house fires doesn't add a lot to the cost of home ownership in the US, but can be catastrophic to an individual home owner.

What I recall, however, is that the type of defensive medicine practiced to avoid the possibility of a lawsuit adds a not-insignificant amount to the overall cost of health care in the US.
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That's the aspect that seems to lack numbers from verifiable analysis.

And certainly the cost of dr visits includes a premium over what it could be to pay for malpractice ins.
 
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