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Why the murder of Healthcare Insurance CEO should end Private Health Insurance

It's strange that people argue that the US system is better. Or that moving to a more universal healthcare system won't solve the problems when the evidence is overwhelmingly that it will.


Rdwight added to the conversation by showing a two year experiment which showed only a marginal improvement. But an improvement none the less. But just because results aren't instant that shouldn't be justification to say we've seen enough.
 
It is no secret that management of diabetes has improved considerably since 2013.

Now you. :sdl:
If you are not able to understand the conversation I don't know what to tell you. Darat is arguing UHC will not increase taxes or cause longer wait times. This study directly refutes it, in the USA, when the uninsured were added to government covered insurance.


What is the point of disputing something you have no intention of defending? Reading an overview of switzerlands health care does not at all refute what I said. I gave a contemporary study in the US which shows the obvious. Adding the uninsured will cost more money and take up more services. You can argue it is worth it but why make up a fairytale that it won't happen?



It's strange that people argue that the US system is better. Or that moving to a more universal healthcare system won't solve the problems when the evidence is overwhelmingly that it will.


Rdwight added to the conversation by showing a two year experiment which showed only a marginal improvement. But an improvement none the less. But just because results aren't instant that shouldn't be justification to say we've seen enough.
The problem is as I laid it out. We can argue the merit, effectiveness and on down the line. But for some reason the idea there will be tradeoffs seems a bridge too far.

And this all is in the back drop of this conversation which lays blame on insurance companies overwhelmingly. It's not that they are innocent, but the disconnect with the reality that most people.. like their insurance plans. Obama literally was trying to gain favor by expressing "if you like your plan you can keep your plan". When polled, large majorities like their insurance.

To change the current status, people need to have some level of education on what that would entail. Both the positive and the potential negatives. I throw out the low hanging fruit and it's simply denial of reality here.
 
The problem is as I laid it out. We can argue the merit, effectiveness and on down the line. But for some reason the idea there will be tradeoffs seems a bridge too far.

And this all is in the back drop of this conversation which lays blame on insurance companies overwhelmingly. It's not that they are innocent, but the disconnect with the reality that most people.. like their insurance plans. Obama literally was trying to gain favor by expressing "if you like your plan you can keep your plan". When polled, large majorities like their insurance.

To change the current status, people need to have some level of education on what that would entail. Both the positive and the potential negatives. I throw out the low hanging fruit and it's simply denial of reality here.
I don't lay the blame entirely on insurance companies at all. The pharmaceutical and the rest of the US medical system play a role.

That said, the insurance companies simply are not required. They add a layer of greed to the equation. For profit insurance requires there to be a profit. And the profit is not obtained by competition and innovation that conveys a benefit to customers. No, the profit will always be the result of seeking how to reduce benefits to the customers.

Insurance companies don't make money by paying claims. They make money by denying them.
 
I don't lay the blame entirely on insurance companies at all. The pharmaceutical and the rest of the US medical system play a role.

That said, the insurance companies simply are not required. They add a layer of greed to the equation. For profit insurance requires there to be a profit. And the profit is not obtained by competition and innovation that conveys a benefit to customers. No, the profit will always be the result of seeking how to reduce benefits to the customers.

Insurance companies don't make money by paying claims. They make money by denying them.
It's not about blaming entirely. It's just the misplaced anger being assigned to them. For example from these threads I've seen complaints about a colonoscopy that was charged at 8k but insurance will only cover 2k. Without knowing the specifics i will go by straightforward prices from Medicare. They allow that procedure with polyp removal for around $1369 in a hospital setting.

is it insurances fault the provider is charging 6x what medicare would pay? If their likely already overpayment isn't enough, why should the blame fall on them for not overpaying more?

Same with the complaint of a 7k hospital bill for 15 mins of facetime with a doc in an ER. When insurance doesn't cover an absurd charge, people complain about denials. But I don't see how spend will lower without a complete overhaul.

It reminds me of years ago, I had a health scare and the wife called 911. I had 2 ambulances show up. 1 sat there the other came in to check me then brought me to the hospital about 10 mins away, a 4 mile ride. They both sent a bill for nearly 4k each. My insurance paid one around 2k, honestly not sure what happened with the other. Just an insane charge no matter how you slice it. If you were on the hook for the other 6k theoretically, which entity would you be mad at?
 
The problem as with all capitalism is lack of competition, due to capitalism's main effort being to undermine the market. This effort has been richly rewarded by Washington in the last decades, and it is the principle on which the biggest companies by market evaluation have based their business model on - a rethinking to the principles that Adam Smith already had to reign in profiteering would fundamentally alter the entire US economy, not just one sector, and so the resistance is basically insurmountable from within the system.
The best chance the US has is for EU regulations to make it impossible for US companies to operate profitably globally with their business model as it is.
But in the US, shooting people until they value money less than life seems to be a very long game to play.
 
It's not about blaming entirely. It's just the misplaced anger being assigned to them. For example from these threads I've seen complaints about a colonoscopy that was charged at 8k but insurance will only cover 2k. Without knowing the specifics i will go by straightforward prices from Medicare. They allow that procedure with polyp removal for around $1369 in a hospital setting.

is it insurances fault the provider is charging 6x what medicare would pay? If their likely already overpayment isn't enough, why should the blame fall on them for not overpaying more?

Same with the complaint of a 7k hospital bill for 15 mins of facetime with a doc in an ER. When insurance doesn't cover an absurd charge, people complain about denials. But I don't see how spend will lower without a complete overhaul.

It reminds me of years ago, I had a health scare and the wife called 911. I had 2 ambulances show up. 1 sat there the other came in to check me then brought me to the hospital about 10 mins away, a 4 mile ride. They both sent a bill for nearly 4k each. My insurance paid one around 2k, honestly not sure what happened with the other. Just an insane charge no matter how you slice it. If you were on the hook for the other 6k theoretically, which entity would you be mad at?
I beg to differ. It's not misplaced at all. Health insurance is a sleazy heartless business. To make one's fortune on the misfortune of others. There is a difference between fair profit and avarice. No doubt other's are guilty of greed and play a role in the suffering. The US health care system is a bloated with many parasites. We must clean the body America of them if we are to save it.
 
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If you are not able to understand the conversation I don't know what to tell you. Darat is arguing UHC will not increase taxes or cause longer wait times. This study directly refutes it, in the USA, when the uninsured were added to government covered insurance.



What is the point of disputing something you have no intention of defending? Reading an overview of switzerlands health care does not at all refute what I said. I gave a contemporary study in the US which shows the obvious. Adding the uninsured will cost more money and take up more services. You can argue it is worth it but why make up a fairytale that it won't happen?
Sorry that link wasn't meant to go to the Swiss health system, I had that bookmarked from an earlier post - was meant to go to the summary page where you can see all the many UHC systems that cost less in both taxation and GDP than the USA system. I do think the Swiss model would be the easiest for the USA to adopt as 1) it's a federated nation model with the cantons (states in USA parlance) having the freedom to decide how they deliver to the nationally agreed standards, 2) it would seem quite familiar to the USA folk. It is however one of the more expensive universal health systems but saying that it still costs a lot less as a percentage of GDP than the USA one i.e. around 10% of GDP v 15% of GDP for the USA.
 
And as a point some folk don't seem to know - even in some of the most "socialist" of universal healthcare systems - the UK's NHSs - plenty of companies make a profit from providing healthcare. Profit and healthcare don't have to be strange bedfellows. As the main political figure behind the creation of the then UK NHS said - "I stuffed their mouths with gold." - he was referring to how much he had to promise to pay consultants for their NHS work and still allowing them to have a private practice.
 
My insurance health care plan is fantastic. Co pays and deductibles are low. Facilities are modern and well equipped. Wait times are short. Staff are competent and polite at all levels. And I've never had a problem with a disputed claim. As far as I can tell, UHC would be a substantial downgrade for me.
 
I beg to differ. It's not misplaced at all. Health insurance is a sleazy heartless business. To make one's fortune on the misfortune of others. There is a difference between fair profit and avarice. No doubt other's are guilty of greed and play a role in the suffering. The US health care system is a bloated with many parasites. We must clean the body America of them if we are to save it.
We were just going over this on the other thread. Thompson's $10m/yr pay amounted to 7 cents per year from each covered individual. Eliminating his CEO pay in its entirety wouldn't be noticed at that scale.

And the insurers are actually covering most claims, overwhelmingly. When my wife goes in for one of her myriad doctor things, our insurers pay the staggering and redundant billing. We really need some kind of quantifying of who is getting denied what, and under what rationale before demonizing the insurers wholesale.
 
I beg to differ. It's not misplaced at all. Health insurance is a sleazy heartless business. To make one's fortune on the misfortune of others. There is a difference between fair profit and avarice. No doubt other's are guilty of greed and play a role in the suffering. The US health care system is a bloated with many parasites. We must clean the body America of them if we are to save it.
i agree that it's not misplaced. whether it's providers overcharging for excessive profits, or the pharma companies overcharging for excessive profits, or the insurance companies overcharging for excessive profits, it makes sense to look at the insurance companies role in all those matters first and foremost, since they're basically the financiers for the entire system.
 
We were just going over this on the other thread. Thompson's $10m/yr pay amounted to 7 cents per year from each covered individual. Eliminating his CEO pay in its entirety wouldn't be noticed at that scale.

And the insurers are actually covering most claims, overwhelmingly. When my wife goes in for one of her myriad doctor things, our insurers pay the staggering and redundant billing. We really need some kind of quantifying of who is getting denied what, and under what rationale before demonizing the insurers wholesale.

i guess when they're not denying care they're simply being irresponsible?

i still see them as the problem

edit

plus, you're not giving everyone an extra 7 cents. $10m in life saving prodecures a year for a few hundred people. which, at scale, well who cares even about a hundred people. now we're thinking like a health insurance company.
 
i guess when they're not denying care they're simply being irresponsible?

i still see them as the problem
It surely seems like they should be, but after crunching the numbers (such as we have) I'm not so sure.

Insurers are running at about a 3% profit margin. So.if they dropped premium prices by 3%, they'd go bankrupt. Would 3% really make any difference in your monthly premium cost? All the denials v profits fall in this 3% range.

So is the problem really that the premiums need to be 3% higher so that no one gets denied? I mean seriously: is that the solution?
 
If you are not able to understand the conversation I don't know what to tell you. Darat is arguing UHC will not increase taxes or cause longer wait times. This study directly refutes it, in the USA, when the uninsured were added to government covered insurance.
If you are not able to read and understand a study, you shouldn't refer to it or try to summarize it.
Your claim was:
The Oregon Experiment
Studied the medicaid expansion. Increased medical utilization, cost and emergency department wait times.
It says nothing about "emergency department wait times."
Medical coverage resulted in an increase in the number of prescription drugs received and office visits made in the previous year; we did not find significant changes in visits to the emergency department or hospital admissions. We estimated that Medicaid coverage increased annual medical spending (based on measured use of prescription drugs, office visits, visits to the emergency department, and hospital admissions) by §1,172, or about 35% relative to the spending in the control group. Medicaid coverage also led to increases in some preventive care and screening services, including cholesterol screening (an increase of 14.57 percentage points; 95% CI, 7.09 to 22.04; P<0.001) and improved perceived access to care, including a usual place of care (an increase of 23.75 percentage points, 95% CI; 15.44 to 32.06; P<0.001). We found no significant effect of Medicaid coverage on the probability that a person was a smoker or obese.
And "increased medical utilization" is actually a positive change! It means that people who wouldn't otherwise get healthcare and prescription drugs because they can't afford them now get them, so it's no wonder that costs rise! They don't rise because healthcare gets more expensive. They rise because people get healthcare. Increased medical utilization is good - unless it's because people, for whatever reason, got more ill than they would otherwise have been, which doesn't seem to have been the case.

Combined with "a reduction in financial strain from medical costs," there's nothing but improvement And it says nothing about increased wait times!!!! Expanding Medicaid was an improvement!

Medicaid coverage decreased the probability of a positive screening for depression (-9.15 percentage points; 95% confidence interval, -16.70 to -1.60; P=0.02), increased the use of many preventive services, and nearly eliminated catastrophic out-of-pocket medical expenditures.

I know from experience that you are not a big fan of providing documentation for your claims, but still ....

Now you!
 
It surely seems like they should be, but after crunching the numbers (such as we have) I'm not so sure.

Insurers are running at about a 3% profit margin. So.if they dropped premium prices by 3%, they'd go bankrupt. Would 3% really make any difference in your monthly premium cost? All the denials v profits fall in this 3% range.

So is the problem really that the premiums need to be 3% higher so that no one gets denied? I mean seriously: is that the solution?
well, yes 3% would make a difference, but it's much more than that. you said it yourself, they're paying out redundant billing and a bunch of unnecessary expenses on top of it, and still making a 3-5% profit margin after paying out their excessive executive pay and bonuses. so we can check a bunch of boxes before we get to where you are.

edit

if we are at a point where they're being efficient in their claims processes and with the money, everyone is at a livable wage, and the profit margins are low, then we could conceivably say insurance companies are doing what they can. they're doing none of those things now.
 
It surely seems like they should be, but after crunching the numbers (such as we have) I'm not so sure.
Insurers are running at about a 3% profit margin. So.if they dropped premium prices by 3%, they'd go bankrupt. Would 3% really make any difference in your monthly premium cost? All the denials v profits fall in this 3% range.
So is the problem really that the premiums need to be 3% higher so that no one gets denied? I mean seriously: is that the solution?
The solution is that the profits and the outrageous CEO salaries should be eliminated! They only contribute to the price of healthcare. They do nothing to improve the quality of healthcare.
 
well, yes 3% would make a difference, but it's much more than that. you said it yourself, they're paying out redundant billing and a bunch of unnecessary expenses on top of it, and still making a 3-5% profit margin after paying out their excessive executive pay and bonuses. so we can check a bunch of boxes before we get to where you are.
What I've always heard is that hospitals and docs do the redundant billing thing to people with strong insurance, to kind of allow them to take the loss for those whose insurance won't cover procedures and not bill the patients directly. That would kinda sorta be nationalizing coverage on their own, in a way?

But yeah, all in, we need a global overhaul. Even if we had an expanded Medicaire to take care of the poor, and people like stanfr above who got billed for being "out of network". Then employers could offer additional Cadillac Coverage as an employment incentive.
 
The solution is that the profits and the outrageous CEO salaries should be eliminated! They only contribute to the price of healthcare. They do nothing to improve the quality of healthcare.
Thompsons outrageous salary cost policy holders twenty cents per year each. Even having him work for free is not going to fix anything.
 
We were just going over this on the other thread. Thompson's $10m/yr pay amounted to 7 cents per year from each covered individual. Eliminating his CEO pay in its entirety wouldn't be noticed at that scale.

And the insurers are actually covering most claims, overwhelmingly. When my wife goes in for one of her myriad doctor things, our insurers pay the staggering and redundant billing. We really need some kind of quantifying of who is getting denied what, and under what rationale before demonizing the insurers wholesale.
How much does the 22,3 billion of yearly profits of United Healthcare make up?
 
How much does the 22,3 billion of yearly profits of United Healthcare make up?
We did that on the other thread, too. About $167 per insured person per year.

The problem is the staggering volume of insured people. It makes the raw numbers seem huge, when really their percentage in terms of personal premiums is not as significant as it would seem. Reduce that profit to dead zero (and insurer goes belly up) knocks the premium for the family care plan down about $42/month (out of the $2000+ monthly cost).

The game isn't just in the profits. It's mostly in the obscene cost of the care in the first place, making it a multi freaking trillion dollars per year game.
 
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The solution is that the profits and the outrageous CEO salaries should be eliminated! They only contribute to the price of healthcare. They do nothing to improve the quality of healthcare.
In some perverse ways money is sometimes used to improve healthcare delivery, but it's in a kind of bizarre way. I'm thinking about accountable care mandates, there are certain healthcare measures that, when met, the insurors (if they've made this deal with the providers) kick money back. Like diabetes management: if the patient gets their A1C measured at the appropriate intervals and it's within certain ranges, it means the providers are managing that patient's diabetes appropriately, which means the patient is being healthier (or at least not getting worse). Their insurance recognizes and incentivizes this by throwing their provider money. If the patient doesn't meet the metrics the insuror doesn't do this. The idea is that this potential income stream will encourage the doctors to stay on top of the patient's care, get them in regularly, and handle their diabetes, causing a win-win-win situation for all: the patient has better health, the provider gets paid, and the insuror reduces their potential future expenses from a patient with uncontrolled diabetes. I can see the logic of this but it does seem roundabout and weird to use money this way.
 
What I've always heard is that hospitals and docs do the redundant billing thing to people with strong insurance, to kind of allow them to take the loss for those whose insurance won't cover procedures and not bill the patients directly. That would kinda sorta be nationalizing coverage on their own, in a way?

But yeah, all in, we need a global overhaul. Even if we had an expanded Medicaire to take care of the poor, and people like stanfr above who got billed for being "out of network". Then employers could offer additional Cadillac Coverage as an employment incentive.
i’m not really sure why they’re so frivolous with their billing.

whole concept that a less regulated private market insurance program will be more efficient in financing healthcare hasn’t really proven to be true. i’d assume any kind of overhaul is going to start with questioning that concept at least. what is private insurance doing right? tough question to answer
 
I see the insurers as co-conspirators in this crime. Everyone is in on it. So don't rock the boat.
 
I see the insurers as co-conspirators in this crime. Everyone is in on it. So don't rock the boat.
well to me if the argument is through the invisible hand of the free market private insurance will find the most efficient way to finance the system, and you tell me the problem is everything is too expensive and we need government regulation to check the out of control costs private insurance is supposed to be superior at controlling, i wonder what purpose private insurance serves

while they’re not the only beneficiaries of the state of things, they seem to be where it broke down. even the other players, providers and pharma, are enabled by insurances failure to do its job. imo
 
Private insurers have to balance the checkbook, and people get fired or sued when they ◊◊◊◊ up. Government just prints more money when they ◊◊◊◊ up, to everyone's detriment.
 
yeah, the checkbook is balanced with incredible inefficiency and they pay themselves handsomely for doing it and pass the cost off to their customers. to everyone’s detriment
 
i agree that it's not misplaced. whether it's providers overcharging for excessive profits, or the
pharma companies overcharging for excessive profits,or the insurance companies overcharging for excessive profits, it makes sense to look at the insurance companies role in all those matters first and foremost, since they're basically the financiers for the entire system.
Hey they have to charge those ridiculous prices to pay for all that sales and marketing, it isn't cheap - marketing and selling a drug you know!
 
Twenty cents per policy holder per year for the highest paid CEO? Doesn't sound so draconian to me.

And all their corporate net profits, without which they don't exist, are... $167 per insured annually? Not seeing this as in the realm of malice.
 
well the other much more significant part of that is how badly they’ve mismanaged controlling costs. you’re only looking at how much they’ve rewarded themselves.
 
well the other much more significant part of that is how badly they’ve mismanaged controlling costs. you’re only looking at how much they’ve rewarded themselves.
Is this criticism ever leveled against government mismanagement / waste of taxpayers' money? And when government / bureaucrats fail, do we fire them or just reward them with even more taxpayer money to waste?
 
Is this criticism ever leveled against government mismanagement / waste of taxpayers' money? And when government / bureaucrats fail, do we fire them or just reward them with even more taxpayer money to waste?
This. I don't find government to be financially responsible at any level, historically.

A private insurers profit is in the $42 range out of a $2000+/month average family plan premium. Pretty sure nuking the private insurerers out to being on food stamps is not solving the problem.
 
again, the problem is that private insurance has been abysmally bad at keeping healthcare costs under control. they rub that in by making $42 out of out grossly inflated $2k per month average household cost that they don’t have a problem charging you.

i mean, financially responsible? they’re the worst in the world by a large margin.
 
Adam Ruins explains why healthcare is so expensive. Essentially, it's a collusion between the insurance companies and providers.

 
again, the problem is that private insurance has been abysmally bad at keeping healthcare costs under control. they rub that in by making $42 out of out grossly inflated $2k per month average household cost that they don’t have a problem charging you.

i mean, financially responsible? they’re the worst in the world by a large margin.
I don't get what you're saying here. Insurance providers reimburse. They have no say in the charges levied, only in the premiums. They don't say to doctors "hey check it out man...howzabout you work for the equivalent of $50 grand a year? Huh? Great, yeah?" The doctors say "Howzabout you suck my dick and pay the ◊◊◊◊◊◊◊ bill, bitch?"
 
I don't get what you're saying here. Insurance providers reimburse. They have no say in the charges levied, only in the premiums. They don't say to doctors "hey check it out man...howzabout you work for the equivalent of $50 grand a year? Huh? Great, yeah?" The doctors say "Howzabout you suck my dick and pay the ◊◊◊◊◊◊◊ bill, bitch?"
it seems like you're saying that insurance companies don't negotiate prices
 
it seems like you're saying that insurance companies don't negotiate prices
They do, but it's within noise range. The care providers largely stick to their guns and don't come down much. That's why the average doctor is pulling $350k per year. They are not being paid by cash and carry patients, man. They get the lion's share of that money from the insurance providers.
 
I beg to differ. It's not misplaced at all. Health insurance is a sleazy heartless business. To make one's fortune on the misfortune of others. There is a difference between fair profit and avarice. No doubt other's are guilty of greed and play a role in the suffering. The US health care system is a bloated with many parasites. We must clean the body America of them if we are to save it.
This is just not accurate. They provide a service that the majority of people are happy with. They profit by increasing their customer base. People upset that they don't receive what they think they deserve can't just be distilled down to 'evil insurance'.

What are some of the most egregious cases you've seen? There are definitely outliers but almost everytime i see a complaint of their heartless actions the accusation doesn't really hold up to scrutiny.

Sorry that link wasn't meant to go to the Swiss health system, I had that bookmarked from an earlier post - was meant to go to the summary page where you can see all the many UHC systems that cost less in both taxation and GDP than the USA system. I do think the Swiss model would be the easiest for the USA to adopt as 1) it's a federated nation model with the cantons (states in USA parlance) having the freedom to decide how they deliver to the nationally agreed standards, 2) it would seem quite familiar to the USA folk. It is however one of the more expensive universal health systems but saying that it still costs a lot less as a percentage of GDP than the USA one i.e. around 10% of GDP v 15% of GDP for the USA.
Yes, other UHC systems do it cheaper. I am talking about what would happen here. Our baseline is much higher. Everytime we have expanded access, cost and wait tims have increased.

Even with your Swiss example it doesn't appear their costs decreased. Percentage of gdp up, cost per citizen up. Wait times appear to be fine but we are talking about a population under 9 million in a much smaller area to service. You can say it's worth it but can't we start with the understanding there is a cost?
 
This is just not accurate. They provide a service that the majority of people are happy with. They profit by increasing their customer base. People upset that they don't receive what they think they deserve can't just be distilled down to 'evil insurance'.
Nonsense. I know of no one that is happy with the service of their health insurance company. And my experience with insurance companies my entire life has never been good. They seem to be efficient when it comes to collecting premiums and difficult when it comes to ever paying a claim. That is if they pay it. Or should I say, when the partially pay it.
 
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