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This topic is not about the American Invasion of Iraq. Stop. - Page 23 |
Some interesting information for those wondering why this is an issue.
According to a study in the American Journal of Medicine, 62.1% of bankruptcies have a medical component.
"Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001"
http://www.amjmed.com/article/S0002-9343(09)00404-5/abstract
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On June 29 2012 14:21 Pillage wrote:Show nested quote +On June 29 2012 14:16 FabledIntegral wrote:On June 29 2012 13:50 Pillage wrote:On June 29 2012 13:38 Probe1 wrote:
Yeah, despite the crass ending white_horse is pretty damn spot on. A disproportionate amount of health care recipients are there for preventable, life style disorder/diseases. There's a fair few diabetics that, had they not swilled sugary colas and lived off M&Ms, would not need medical treatment. Same could be said for smoking and drinking related health issues.
It should not represent the majority of an argument but it is an important point. My issue with it is the fact that we are only squeezing out like 75 - 80 % efficiency from medicare and medicaid, and now we choose to spend even more money when all of the tools for pretty much fixing the situation are already in the toolbox. We have so many other options than simply throwing more money at the problem. Medical costs will rise sharply as a result of even more shitty subsidization by a government that has absolutely no idea how to get every penny out of the dollars it spends. What do you mean by squeezing out 75-80% efficiency? Do you realize that is the same average amount for insurance companies? For every premium dollar insurance companies take in, they pay about $0.75 to $0.80 back in claims on average. Then they have to pay a premium tax to the government (regardless if they make a profit or take a loss), pay the salaries of all the staff, pay overhead costs, etc. And if it's a mutual type of insurance company, a large portion of profits, if there are any that year, go directly back to the policyholders, as the policyholders are the ones that own the company in the first place. I should have elaborated more. By efficiency I meant that all of the money that goes toward fixing the problem actually plays a role in the treatment of whatever ailment is present. I understand that the overhead causes some money to be taken out but I'm strictly looking at money being used for treatment / doctor salary.
So sorry, I'm not following exactly, probably my fault as I haven't kept up with this thread too much but mostly glanced over it for the past few days.
You're trying to say that after all overhead costs, if you have $10,000 allocated for a treatment, only $8,000 gets paid towards it and the other $2,000 disappears somehow through inefficiency? If you're not accounting for overhead, where's the lack of efficiency?
On June 29 2012 14:26 Probulous wrote:Some interesting information for those wondering why this is an issue. According to a study in the American Journal of Medicine, 62.1% of bankruptcies have a medical component. "Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001"http://www.amjmed.com/article/S0002-9343(09)00404-5/abstract
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007.
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On June 29 2012 14:08 JonnyBNoHo wrote:Show nested quote +On June 29 2012 13:15 rogzardo wrote:On June 29 2012 13:09 JonnyBNoHo wrote:On June 29 2012 13:02 rogzardo wrote:On June 29 2012 13:00 JonnyBNoHo wrote:On June 29 2012 12:43 rogzardo wrote:On June 29 2012 12:41 JonnyBNoHo wrote:On June 29 2012 12:19 DoubleReed wrote:On June 29 2012 11:38 JonnyBNoHo wrote:On June 29 2012 10:47 DoubleReed wrote:
[quote]
Nope. You're only looking at it from the consumer perspective. You can certainly make a "profit" off of health insurance if you get unexpectedly sick. The insurance company pools the money from all it's funders, skims some off the top, and gives it to the sick people it's covering. That's actually how it works. To say it's "insuring against risk" or something is just putting fancy words on top of what is actually happening with the money. There is no way you can "just pay for yourself" with health insurance. It literally makes no sense.
The fact is that "pre-existing conditions" was bullshit from back to front. The healthcare companies used it to get out of paying people their dues or refusing from covering people who actually need healthcare. That's a serious problem. When healthcare companies are not covering people who actually need healthcare, there's a problem. They aren't doing their job. It doesn't matter how you rationalize it. I don't care that it isn't "fair" to the healthcare companies or the people's premiums. If the people who need healthcare can't get it then the system is broken. Healthcare is not health insurance. You do not need health insurance to get healthcare. No pre-existing conditions is the norm for all types of insurance. You cannot insure a boat that has already sunk!Insurance premiums are not calculated based on current costs, they are calculated based on predicted future costs. So it is indeed a form of risk management and not a pay as you go collective health payment scheme. Okay, health insurance. My post doesn't change when you put the right words in. Just a mistype. I understand that pre-existing conditions makes sense for other kinds of insurance. But we're not talking about other kinds of insurance, we're talking about health insurance. If pre-existing conditions does not make sense for health insurance, then it does not make sense for health insurance. If you are denying coverage to the people who actually need health insurance, then the system is broken. End of story. There's really nothing more to it than that. No, nobody NEEDS health insurance. They need healthcare. You can pay for healthcare in a number of ways that does not involve insurance. Ex. You could have all pre-existing conditions paid for by the government through Medicaid. I'm uninsured, and this is an honest question. How can I have my health care paid for? Cash. Some doctors / hospitals will even give cash discounts if you ask. Many will provide free or discounted care if you cannot afford it. If it is something simple, look for a free clinic nearby. Lol. If I had the fucking cash, I wouldn't need somebody else to pay for it, no? If johnny factory worker gets maimed by the bandsaw, and the surgery is 10 grand, I don't think a discount for paying cash is going to cut it. EDIT: And if I just don't pay, or the services are free, then the hospital is the one eating the bill. I'd much rather tax rich corporations slightly. Getting hurt in the factory would be covered by workers' compensation. Taxing 'rich corporations' largely gets passed on to consumers (to what degree depends on the industry). If you want that, fine, but you should know what you are asking for. Rich corporations being insurance companies, pharmaceutical companies, medical device sales, etc. They are corporations, and they're certainly rich. I agree some costs will inevitably trickle down, but it may not be as bad as you think. From whitehouse.gov.... [i]Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. The first rebates will be made in the summer of 2012. Pointless rule as it is easy to game. Just pile on more services (and higher premiums) so that your admin costs shrink as a percentage and health insurance co.'s walk away with fatter profits. Normally competition would keep profits low but the 80/20 rule will impact small co.'s more than large co.'s. Over time we'll be left with an oligopoly with expensive plans and fat profit margins.
Damn again dude. If you had quoted the very next paragraph of my post it said....
Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more.
It's almost like I saw into the future and answered your question before you asked, but then you just didn't read it.
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While I personally think the concept of Obamacare will work, some people have said that everyone will benefit. That is not true. Those who make over 200k already almost undoubtedly have health insurance, and their rates will probably not decrease at all. They may benefit, however, if they have to use a hospital in decreased overall medical costs. They also have to pay nearly a percent more of their income to government. I know that for some reason TL hates people who make over 200k, but we should at least realize that they are being hit with little to no benefit to them. However, most people will be positively affected by the bill. Some corporations will be impacted, but they will probably just raise their prices to compensate for tax. And the insurance companies that play their cards right will see increased profits from huge actuary pools.
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On June 29 2012 14:27 FabledIntegral wrote:Show nested quote +On June 29 2012 14:21 Pillage wrote:On June 29 2012 14:16 FabledIntegral wrote:On June 29 2012 13:50 Pillage wrote:On June 29 2012 13:38 Probe1 wrote:
Yeah, despite the crass ending white_horse is pretty damn spot on. A disproportionate amount of health care recipients are there for preventable, life style disorder/diseases. There's a fair few diabetics that, had they not swilled sugary colas and lived off M&Ms, would not need medical treatment. Same could be said for smoking and drinking related health issues.
It should not represent the majority of an argument but it is an important point. My issue with it is the fact that we are only squeezing out like 75 - 80 % efficiency from medicare and medicaid, and now we choose to spend even more money when all of the tools for pretty much fixing the situation are already in the toolbox. We have so many other options than simply throwing more money at the problem. Medical costs will rise sharply as a result of even more shitty subsidization by a government that has absolutely no idea how to get every penny out of the dollars it spends. What do you mean by squeezing out 75-80% efficiency? Do you realize that is the same average amount for insurance companies? For every premium dollar insurance companies take in, they pay about $0.75 to $0.80 back in claims on average. Then they have to pay a premium tax to the government (regardless if they make a profit or take a loss), pay the salaries of all the staff, pay overhead costs, etc. And if it's a mutual type of insurance company, a large portion of profits, if there are any that year, go directly back to the policyholders, as the policyholders are the ones that own the company in the first place. I should have elaborated more. By efficiency I meant that all of the money that goes toward fixing the problem actually plays a role in the treatment of whatever ailment is present. I understand that the overhead causes some money to be taken out but I'm strictly looking at money being used for treatment / doctor salary. So sorry, I'm not following exactly, probably my fault as I haven't kept up with this thread too much but mostly glanced over it for the past few days. You're trying to say that after all overhead costs, if you have $10,000 allocated for a treatment, only $8,000 gets paid towards it and the other $2,000 disappears somehow through inefficiency? If you're not accounting for overhead, where's the lack of efficiency?
Alot of it is tied up in preventative things. Tests that need to be ordered despite all evidence collected by the MD pointing against condition X. It doesn't disappear, it just doesn't get put to practical use that will treat the patient. Medicine is full of this stuff and it's more often than not a result of bad policy from Administration and Government. The rabbit hole actually goes quite deep :/
More problems arise due to misinformation resulting from poor medical records that prevent care from being administered in the optimal manner. This is a common problem at many of the older hospitals / clinics that are usually frequented by not the richest of folks. For example, a MD may order a test to be done, not knowing that the previous doctor for a patient ordered the same test but the results are now gone. This happens often individually with patients who either
- Travel / Move Frequently for Work
- Have pre-existing conditions
- Require extensive tests for certain conditions.
There is a ton of money to be made in optimizing hospital patient databases, I have several acquaintances that actually travel and do this for a living, and make damn good money in the process.
There are other things I'm sure you could think of, I'm too tried to come up with more off the top of my head.
Many people will look at these things and think that these are little things that don't matter. I will disagree and make the case that throughout every optimization process, every system that is curtailed to approach perfection, its the little things that matter the most more often than not because of the frequency of which they occur.
The bottom line is that we don't need more money, we just need to spend it smarter and give people the abilities to maximize their utility.
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On June 29 2012 14:35 rogzardo wrote:Show nested quote +On June 29 2012 14:08 JonnyBNoHo wrote:On June 29 2012 13:15 rogzardo wrote:On June 29 2012 13:09 JonnyBNoHo wrote:On June 29 2012 13:02 rogzardo wrote:On June 29 2012 13:00 JonnyBNoHo wrote:On June 29 2012 12:43 rogzardo wrote:On June 29 2012 12:41 JonnyBNoHo wrote:On June 29 2012 12:19 DoubleReed wrote:On June 29 2012 11:38 JonnyBNoHo wrote:
[quote]
Healthcare is not health insurance. You do not need health insurance to get healthcare.
No pre-existing conditions is the norm for all types of insurance. You cannot insure a boat that has already sunk!
Insurance premiums are not calculated based on current costs, they are calculated based on predicted future costs. So it is indeed a form of risk management and not a pay as you go collective health payment scheme.
Okay, health insurance. My post doesn't change when you put the right words in. Just a mistype. I understand that pre-existing conditions makes sense for other kinds of insurance. But we're not talking about other kinds of insurance, we're talking about health insurance. If pre-existing conditions does not make sense for health insurance, then it does not make sense for health insurance. If you are denying coverage to the people who actually need health insurance, then the system is broken. End of story. There's really nothing more to it than that. No, nobody NEEDS health insurance. They need healthcare. You can pay for healthcare in a number of ways that does not involve insurance. Ex. You could have all pre-existing conditions paid for by the government through Medicaid. I'm uninsured, and this is an honest question. How can I have my health care paid for? Cash. Some doctors / hospitals will even give cash discounts if you ask. Many will provide free or discounted care if you cannot afford it. If it is something simple, look for a free clinic nearby. Lol. If I had the fucking cash, I wouldn't need somebody else to pay for it, no? If johnny factory worker gets maimed by the bandsaw, and the surgery is 10 grand, I don't think a discount for paying cash is going to cut it. EDIT: And if I just don't pay, or the services are free, then the hospital is the one eating the bill. I'd much rather tax rich corporations slightly. Getting hurt in the factory would be covered by workers' compensation. Taxing 'rich corporations' largely gets passed on to consumers (to what degree depends on the industry). If you want that, fine, but you should know what you are asking for. Rich corporations being insurance companies, pharmaceutical companies, medical device sales, etc. They are corporations, and they're certainly rich. I agree some costs will inevitably trickle down, but it may not be as bad as you think. From whitehouse.gov.... [i]Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. The first rebates will be made in the summer of 2012. Pointless rule as it is easy to game. Just pile on more services (and higher premiums) so that your admin costs shrink as a percentage and health insurance co.'s walk away with fatter profits. Normally competition would keep profits low but the 80/20 rule will impact small co.'s more than large co.'s. Over time we'll be left with an oligopoly with expensive plans and fat profit margins. Damn again dude. If you had quoted the very next paragraph of my post it said.... Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. It's almost like I saw into the future and answered your question before you asked, but then you just didn't read it.
They still had to justify it before hand. They just didn't have to do it publicly. And by justify I mean if they got audited by the state government, they had to have ALREADY documented it beforehand the reason for increases (or even decrease). Not to mention that the vast majority of states require all insurance companies submit to the state gov't whenever they want to change it, unless the changes are within a certain % of their existing rate. And increases are far more heavily scrutinized than decreases.
On June 29 2012 14:41 Pillage wrote:Show nested quote +On June 29 2012 14:27 FabledIntegral wrote:On June 29 2012 14:21 Pillage wrote:On June 29 2012 14:16 FabledIntegral wrote:On June 29 2012 13:50 Pillage wrote:On June 29 2012 13:38 Probe1 wrote:
Yeah, despite the crass ending white_horse is pretty damn spot on. A disproportionate amount of health care recipients are there for preventable, life style disorder/diseases. There's a fair few diabetics that, had they not swilled sugary colas and lived off M&Ms, would not need medical treatment. Same could be said for smoking and drinking related health issues.
It should not represent the majority of an argument but it is an important point. My issue with it is the fact that we are only squeezing out like 75 - 80 % efficiency from medicare and medicaid, and now we choose to spend even more money when all of the tools for pretty much fixing the situation are already in the toolbox. We have so many other options than simply throwing more money at the problem. Medical costs will rise sharply as a result of even more shitty subsidization by a government that has absolutely no idea how to get every penny out of the dollars it spends. What do you mean by squeezing out 75-80% efficiency? Do you realize that is the same average amount for insurance companies? For every premium dollar insurance companies take in, they pay about $0.75 to $0.80 back in claims on average. Then they have to pay a premium tax to the government (regardless if they make a profit or take a loss), pay the salaries of all the staff, pay overhead costs, etc. And if it's a mutual type of insurance company, a large portion of profits, if there are any that year, go directly back to the policyholders, as the policyholders are the ones that own the company in the first place. I should have elaborated more. By efficiency I meant that all of the money that goes toward fixing the problem actually plays a role in the treatment of whatever ailment is present. I understand that the overhead causes some money to be taken out but I'm strictly looking at money being used for treatment / doctor salary. So sorry, I'm not following exactly, probably my fault as I haven't kept up with this thread too much but mostly glanced over it for the past few days. You're trying to say that after all overhead costs, if you have $10,000 allocated for a treatment, only $8,000 gets paid towards it and the other $2,000 disappears somehow through inefficiency? If you're not accounting for overhead, where's the lack of efficiency? Alot of it is tied up in preventative things. Tests that need to be ordered despite all evidence collected by the MD pointing against condition X. It doesn't disappear, it just doesn't get put to practical use that will treat the patient. Medicine is full of this stuff and it's more often than not a result of bad policy from Administration and Government. The rabbit hole actually goes quite deep :/ More problems arise due to misinformation resulting from poor medical records that prevent care from being administered in the optimal manner. This is a common problem at many of the older hospitals / clinics that are usually frequented by not the richest of folks. For example, a MD may order a test to be done, not knowing that the previous doctor for a patient ordered the same test but the results are now gone. This happens often individually with patients who either - Travel / Move Frequently for Work - Have pre-existing conditions - Require extensive tests for certain conditions. There is a ton of money to be made in optimizing hospital patient databases, I have several acquaintances that actually travel and do this for a living, and make damn good money in the process. There are other things I'm sure you could think of, I'm too tried to come up with more off the top of my head. Many people will look at these things and think that these are little things that don't matter. I will disagree and make the case that throughout every optimization process, every system that is curtailed to approach perfection, its the little things that matter the most more often than not because of the frequency of which they occur. The bottom line is that we don't need more money, we just need to spend it smarter and give people the abilities to maximize their utility.
So it's not really medicare specific then? Is this typically related to how U.S. hospitals operate? I was always under the impression the United States system was significantly more efficient in terms of providing service, record keeping, etc. than other countries, but just charged a shitton for it.
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On June 29 2012 14:43 FabledIntegral wrote:Show nested quote +On June 29 2012 14:35 rogzardo wrote:On June 29 2012 14:08 JonnyBNoHo wrote:On June 29 2012 13:15 rogzardo wrote:On June 29 2012 13:09 JonnyBNoHo wrote:On June 29 2012 13:02 rogzardo wrote:On June 29 2012 13:00 JonnyBNoHo wrote:On June 29 2012 12:43 rogzardo wrote:On June 29 2012 12:41 JonnyBNoHo wrote:On June 29 2012 12:19 DoubleReed wrote:
[quote]
Okay, health insurance. My post doesn't change when you put the right words in. Just a mistype.
I understand that pre-existing conditions makes sense for other kinds of insurance. But we're not talking about other kinds of insurance, we're talking about health insurance. If pre-existing conditions does not make sense for health insurance, then it does not make sense for health insurance. If you are denying coverage to the people who actually need health insurance, then the system is broken. End of story. There's really nothing more to it than that.
No, nobody NEEDS health insurance. They need healthcare. You can pay for healthcare in a number of ways that does not involve insurance. Ex. You could have all pre-existing conditions paid for by the government through Medicaid. I'm uninsured, and this is an honest question. How can I have my health care paid for? Cash. Some doctors / hospitals will even give cash discounts if you ask. Many will provide free or discounted care if you cannot afford it. If it is something simple, look for a free clinic nearby. Lol. If I had the fucking cash, I wouldn't need somebody else to pay for it, no? If johnny factory worker gets maimed by the bandsaw, and the surgery is 10 grand, I don't think a discount for paying cash is going to cut it. EDIT: And if I just don't pay, or the services are free, then the hospital is the one eating the bill. I'd much rather tax rich corporations slightly. Getting hurt in the factory would be covered by workers' compensation. Taxing 'rich corporations' largely gets passed on to consumers (to what degree depends on the industry). If you want that, fine, but you should know what you are asking for. Rich corporations being insurance companies, pharmaceutical companies, medical device sales, etc. They are corporations, and they're certainly rich. I agree some costs will inevitably trickle down, but it may not be as bad as you think. From whitehouse.gov.... [i]Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. The first rebates will be made in the summer of 2012. Pointless rule as it is easy to game. Just pile on more services (and higher premiums) so that your admin costs shrink as a percentage and health insurance co.'s walk away with fatter profits. Normally competition would keep profits low but the 80/20 rule will impact small co.'s more than large co.'s. Over time we'll be left with an oligopoly with expensive plans and fat profit margins. Damn again dude. If you had quoted the very next paragraph of my post it said.... Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. It's almost like I saw into the future and answered your question before you asked, but then you just didn't read it. They still had to justify it before hand. They just didn't have to do it publicly. And by justify I mean if they got audited by the state government, they had to have ALREADY documented it beforehand the reason for increases (or even decrease). Not to mention that the vast majority of states require all insurance companies submit to the state gov't whenever they want to change it, unless the changes are within a certain % of their existing rate. And increases are far more heavily scrutinized than decreases.
That was a quote from whitehouse.gov.
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On June 29 2012 14:44 rogzardo wrote:Show nested quote +On June 29 2012 14:43 FabledIntegral wrote:On June 29 2012 14:35 rogzardo wrote:On June 29 2012 14:08 JonnyBNoHo wrote:On June 29 2012 13:15 rogzardo wrote:On June 29 2012 13:09 JonnyBNoHo wrote:On June 29 2012 13:02 rogzardo wrote:On June 29 2012 13:00 JonnyBNoHo wrote:On June 29 2012 12:43 rogzardo wrote:On June 29 2012 12:41 JonnyBNoHo wrote:
[quote]
No, nobody NEEDS health insurance. They need healthcare. You can pay for healthcare in a number of ways that does not involve insurance.
Ex. You could have all pre-existing conditions paid for by the government through Medicaid.
I'm uninsured, and this is an honest question. How can I have my health care paid for? Cash. Some doctors / hospitals will even give cash discounts if you ask. Many will provide free or discounted care if you cannot afford it. If it is something simple, look for a free clinic nearby. Lol. If I had the fucking cash, I wouldn't need somebody else to pay for it, no? If johnny factory worker gets maimed by the bandsaw, and the surgery is 10 grand, I don't think a discount for paying cash is going to cut it. EDIT: And if I just don't pay, or the services are free, then the hospital is the one eating the bill. I'd much rather tax rich corporations slightly. Getting hurt in the factory would be covered by workers' compensation. Taxing 'rich corporations' largely gets passed on to consumers (to what degree depends on the industry). If you want that, fine, but you should know what you are asking for. Rich corporations being insurance companies, pharmaceutical companies, medical device sales, etc. They are corporations, and they're certainly rich. I agree some costs will inevitably trickle down, but it may not be as bad as you think. From whitehouse.gov.... [i]Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. The first rebates will be made in the summer of 2012. Pointless rule as it is easy to game. Just pile on more services (and higher premiums) so that your admin costs shrink as a percentage and health insurance co.'s walk away with fatter profits. Normally competition would keep profits low but the 80/20 rule will impact small co.'s more than large co.'s. Over time we'll be left with an oligopoly with expensive plans and fat profit margins. Damn again dude. If you had quoted the very next paragraph of my post it said.... Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. It's almost like I saw into the future and answered your question before you asked, but then you just didn't read it. They still had to justify it before hand. They just didn't have to do it publicly. And by justify I mean if they got audited by the state government, they had to have ALREADY documented it beforehand the reason for increases (or even decrease). Not to mention that the vast majority of states require all insurance companies submit to the state gov't whenever they want to change it, unless the changes are within a certain % of their existing rate. And increases are far more heavily scrutinized than decreases. That was a quote from whitehouse.gov.
Mmm still doesn't make what I posted not true  .
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I'm currently can't afford any insurance so I hope they will pass this. I just need to go to hospital in any emergency calls. No need to do monthly check up or dentist or things like that.
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On June 29 2012 14:35 rogzardo wrote:Show nested quote +On June 29 2012 14:08 JonnyBNoHo wrote:On June 29 2012 13:15 rogzardo wrote:On June 29 2012 13:09 JonnyBNoHo wrote:On June 29 2012 13:02 rogzardo wrote:On June 29 2012 13:00 JonnyBNoHo wrote:On June 29 2012 12:43 rogzardo wrote:On June 29 2012 12:41 JonnyBNoHo wrote:On June 29 2012 12:19 DoubleReed wrote:On June 29 2012 11:38 JonnyBNoHo wrote:
[quote]
Healthcare is not health insurance. You do not need health insurance to get healthcare.
No pre-existing conditions is the norm for all types of insurance. You cannot insure a boat that has already sunk!
Insurance premiums are not calculated based on current costs, they are calculated based on predicted future costs. So it is indeed a form of risk management and not a pay as you go collective health payment scheme.
Okay, health insurance. My post doesn't change when you put the right words in. Just a mistype. I understand that pre-existing conditions makes sense for other kinds of insurance. But we're not talking about other kinds of insurance, we're talking about health insurance. If pre-existing conditions does not make sense for health insurance, then it does not make sense for health insurance. If you are denying coverage to the people who actually need health insurance, then the system is broken. End of story. There's really nothing more to it than that. No, nobody NEEDS health insurance. They need healthcare. You can pay for healthcare in a number of ways that does not involve insurance. Ex. You could have all pre-existing conditions paid for by the government through Medicaid. I'm uninsured, and this is an honest question. How can I have my health care paid for? Cash. Some doctors / hospitals will even give cash discounts if you ask. Many will provide free or discounted care if you cannot afford it. If it is something simple, look for a free clinic nearby. Lol. If I had the fucking cash, I wouldn't need somebody else to pay for it, no? If johnny factory worker gets maimed by the bandsaw, and the surgery is 10 grand, I don't think a discount for paying cash is going to cut it. EDIT: And if I just don't pay, or the services are free, then the hospital is the one eating the bill. I'd much rather tax rich corporations slightly. Getting hurt in the factory would be covered by workers' compensation. Taxing 'rich corporations' largely gets passed on to consumers (to what degree depends on the industry). If you want that, fine, but you should know what you are asking for. Rich corporations being insurance companies, pharmaceutical companies, medical device sales, etc. They are corporations, and they're certainly rich. I agree some costs will inevitably trickle down, but it may not be as bad as you think. From whitehouse.gov.... [i]Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. The first rebates will be made in the summer of 2012. Pointless rule as it is easy to game. Just pile on more services (and higher premiums) so that your admin costs shrink as a percentage and health insurance co.'s walk away with fatter profits. Normally competition would keep profits low but the 80/20 rule will impact small co.'s more than large co.'s. Over time we'll be left with an oligopoly with expensive plans and fat profit margins. Damn again dude. If you had quoted the very next paragraph of my post it said.... Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. It's almost like I saw into the future and answered your question before you asked, but then you just didn't read it.
1) They can still add in more 'stuff' to justify the rate increases and earn a margin on each additional 'service' they add in. Most debate around health insurance is people saying things like 'the poor can't afford cancer drugs!' and other catastrophic health issues yet so much of health insurance is about routine payments for checkups and affordable/inexpensive drugs as well as other 'wellness' perks (ex. gym memberships).
2) Less competition will give them more stability (more like utilities) so that every dollar of profit they earn will be more valuable on a risk-adjusted basis.
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On June 29 2012 14:43 FabledIntegral wrote:Show nested quote +On June 29 2012 14:35 rogzardo wrote:On June 29 2012 14:08 JonnyBNoHo wrote:On June 29 2012 13:15 rogzardo wrote:On June 29 2012 13:09 JonnyBNoHo wrote:On June 29 2012 13:02 rogzardo wrote:On June 29 2012 13:00 JonnyBNoHo wrote:On June 29 2012 12:43 rogzardo wrote:On June 29 2012 12:41 JonnyBNoHo wrote:On June 29 2012 12:19 DoubleReed wrote:
[quote]
Okay, health insurance. My post doesn't change when you put the right words in. Just a mistype.
I understand that pre-existing conditions makes sense for other kinds of insurance. But we're not talking about other kinds of insurance, we're talking about health insurance. If pre-existing conditions does not make sense for health insurance, then it does not make sense for health insurance. If you are denying coverage to the people who actually need health insurance, then the system is broken. End of story. There's really nothing more to it than that.
No, nobody NEEDS health insurance. They need healthcare. You can pay for healthcare in a number of ways that does not involve insurance. Ex. You could have all pre-existing conditions paid for by the government through Medicaid. I'm uninsured, and this is an honest question. How can I have my health care paid for? Cash. Some doctors / hospitals will even give cash discounts if you ask. Many will provide free or discounted care if you cannot afford it. If it is something simple, look for a free clinic nearby. Lol. If I had the fucking cash, I wouldn't need somebody else to pay for it, no? If johnny factory worker gets maimed by the bandsaw, and the surgery is 10 grand, I don't think a discount for paying cash is going to cut it. EDIT: And if I just don't pay, or the services are free, then the hospital is the one eating the bill. I'd much rather tax rich corporations slightly. Getting hurt in the factory would be covered by workers' compensation. Taxing 'rich corporations' largely gets passed on to consumers (to what degree depends on the industry). If you want that, fine, but you should know what you are asking for. Rich corporations being insurance companies, pharmaceutical companies, medical device sales, etc. They are corporations, and they're certainly rich. I agree some costs will inevitably trickle down, but it may not be as bad as you think. From whitehouse.gov.... [i]Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. The first rebates will be made in the summer of 2012. Pointless rule as it is easy to game. Just pile on more services (and higher premiums) so that your admin costs shrink as a percentage and health insurance co.'s walk away with fatter profits. Normally competition would keep profits low but the 80/20 rule will impact small co.'s more than large co.'s. Over time we'll be left with an oligopoly with expensive plans and fat profit margins. Damn again dude. If you had quoted the very next paragraph of my post it said.... Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. It's almost like I saw into the future and answered your question before you asked, but then you just didn't read it. They still had to justify it before hand. They just didn't have to do it publicly. And by justify I mean if they got audited by the state government, they had to have ALREADY documented it beforehand the reason for increases (or even decrease). Not to mention that the vast majority of states require all insurance companies submit to the state gov't whenever they want to change it, unless the changes are within a certain % of their existing rate. And increases are far more heavily scrutinized than decreases. Show nested quote +On June 29 2012 14:41 Pillage wrote:On June 29 2012 14:27 FabledIntegral wrote:On June 29 2012 14:21 Pillage wrote:On June 29 2012 14:16 FabledIntegral wrote:On June 29 2012 13:50 Pillage wrote:On June 29 2012 13:38 Probe1 wrote:
Yeah, despite the crass ending white_horse is pretty damn spot on. A disproportionate amount of health care recipients are there for preventable, life style disorder/diseases. There's a fair few diabetics that, had they not swilled sugary colas and lived off M&Ms, would not need medical treatment. Same could be said for smoking and drinking related health issues.
It should not represent the majority of an argument but it is an important point. My issue with it is the fact that we are only squeezing out like 75 - 80 % efficiency from medicare and medicaid, and now we choose to spend even more money when all of the tools for pretty much fixing the situation are already in the toolbox. We have so many other options than simply throwing more money at the problem. Medical costs will rise sharply as a result of even more shitty subsidization by a government that has absolutely no idea how to get every penny out of the dollars it spends. What do you mean by squeezing out 75-80% efficiency? Do you realize that is the same average amount for insurance companies? For every premium dollar insurance companies take in, they pay about $0.75 to $0.80 back in claims on average. Then they have to pay a premium tax to the government (regardless if they make a profit or take a loss), pay the salaries of all the staff, pay overhead costs, etc. And if it's a mutual type of insurance company, a large portion of profits, if there are any that year, go directly back to the policyholders, as the policyholders are the ones that own the company in the first place. I should have elaborated more. By efficiency I meant that all of the money that goes toward fixing the problem actually plays a role in the treatment of whatever ailment is present. I understand that the overhead causes some money to be taken out but I'm strictly looking at money being used for treatment / doctor salary. So sorry, I'm not following exactly, probably my fault as I haven't kept up with this thread too much but mostly glanced over it for the past few days. You're trying to say that after all overhead costs, if you have $10,000 allocated for a treatment, only $8,000 gets paid towards it and the other $2,000 disappears somehow through inefficiency? If you're not accounting for overhead, where's the lack of efficiency? Alot of it is tied up in preventative things. Tests that need to be ordered despite all evidence collected by the MD pointing against condition X. It doesn't disappear, it just doesn't get put to practical use that will treat the patient. Medicine is full of this stuff and it's more often than not a result of bad policy from Administration and Government. The rabbit hole actually goes quite deep :/ More problems arise due to misinformation resulting from poor medical records that prevent care from being administered in the optimal manner. This is a common problem at many of the older hospitals / clinics that are usually frequented by not the richest of folks. For example, a MD may order a test to be done, not knowing that the previous doctor for a patient ordered the same test but the results are now gone. This happens often individually with patients who either - Travel / Move Frequently for Work - Have pre-existing conditions - Require extensive tests for certain conditions. There is a ton of money to be made in optimizing hospital patient databases, I have several acquaintances that actually travel and do this for a living, and make damn good money in the process. There are other things I'm sure you could think of, I'm too tried to come up with more off the top of my head. Many people will look at these things and think that these are little things that don't matter. I will disagree and make the case that throughout every optimization process, every system that is curtailed to approach perfection, its the little things that matter the most more often than not because of the frequency of which they occur. The bottom line is that we don't need more money, we just need to spend it smarter and give people the abilities to maximize their utility. So it's not really medicare specific then? Is this typically related to how U.S. hospitals operate? I was always under the impression the United States system was significantly more efficient in terms of providing service, record keeping, etc. than other countries, but just charged a shitton for it.
Alot of it just centers around our current policies toward medicine. I can say that the US is very good with it's care quality as well as the expedience of many of the procedures. There are three great things about having a private Medical Industry, everyone knows what they're doing, they're experienced, and they'll fix you up fast as hell. I'm not sure about how well it handles the "paperwork" relative to Single Payer countries but I'd bet is a little bit better because the government lets it do its own thing.
The main issue is the fact that when you introduce government into the equation it's "one more phone call you need to make" if you know what I mean. The introduction of bureaucrats slows the process down, as they don't really know what's going on, they're just a check-step for all of the procedures. Hospital administrators are just as guilty too for slowing things down, but they often can see all of the pieces on the board when a patient is being treated, and serve their purpose for 'conducting the orchestra" on a day to day basis. That is the inevitable result of subsidization though, things become more expensive for everyone and overall quality drops because the government must serve the lowest common denominator that requires 80% of all of the work.
If there is one thing I like about the law its the fact that it forces the insurance companies to speed the process up by paying for shit right away regardless of what's going on with the patient. That's the way it should work. The doctor gives his orders, the orders are obeyed, the proper money is given for the treatment, and the patent goes home feeling fine. The dynamic between insurance and MD is at the front lines of determining the price of the treatment. You have the insurance company trying to fulfill it's end of the contract while trying to keep costs low, and you have the doctor doing the diagnosis and trying to find the best treatment options for the patient. This is honestly where I don't think any regulation needs to exist anymore, as the IC must pay regardless of what is going on. Chopping off existing regulations here streamlines the process, and I'm disappointed that the bill did no such thing.
On another note one more benefit is that it also prevents them (the IC) from blowing off patents who have easy to fix things that if left untreated will go to the ER and jack the bill up for the taxpayers. The law is structured in an ok manner is this regard, there are some other things that are concerning, but i'm too tired to nitpick right now.
The converse of that, and what I don't really like, is the fact that the companies will have to pay out the ass to prevent every little thing that's possible from happening to Mr. Smith. This is inevitably what will happen with a large government presence in healthcare, due to the fact that government gives zero fucks about how much money it spends. When the government has that much power over insurance companies, no one will be able to pay for their own healthcare. Are we there yet now? I'm pretty sure we're not, but the direction its going in plus everything else I see in the media today makes it seem to be looming in a more obvious manner.
I fundamentally refuse to accept a single-payer system here, as it will obliterate the quality of medicine we've worked so hard to build here and send many prospective doctors into other fields. We need smart people in medicine, as mistakes here are punished through the loss of life on a daily basis, not many other professions can say the same.
The bill has some good ideas in it, but my faith in the the effectiveness of their implementation is small, government here has never been known to execute their plans in an effective degree, and I don't see why new legislation is needed when the pieces are already there (Medicaid). The bill also fails to cut regulations in other areas that I deem important now that the bill is law. This is why I don't like new legislation in the first place really, because government can't clean up after itself when it gets a new toy.
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On June 29 2012 15:26 Thylacine wrote:
Good.
On June 29 2012 14:37 PhoenixDark wrote:
Good
Bad.
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The poles speak for the travesty that is Obamacare. 58% are for it and 50% think that it is not constitutional. Wake up and realize that Obamacare is not free and you will pay for it for four years before you get to use it. Read the fine print and realize that you are giving away your rights to the government. Your right to live is potentially at stake when you have the money for the procedure and yet, you cannot have it because there is a waiting list. If this passes, we are no different than the rest of the world. Those who are showing disdain towards the CEO's and such for their paycheck and the small business owners who make over that 200K paycheck are ignorant to the fact that these people pay for your jobs. The rich pay the vast majority of the taxes in the U.S. Socialism/Communism is perfect on paper, but this is the real world. Wake up and stop dreaming.
A good analogy of how Social/Communism does not work.
http://www.humanevents.com/2010/04/03/campus-communism/
Also, there is a story I heard some time ago about a college professor showing the follies of Communism and yes, Obamacare is Socialism and Socialism is the path to Communism.
This professor decided to experiment with the concept of communism with his students by attempting to illustrate the illogical approach of Communism. He told the students on the first day of class that rather than the students earning individual grades, the students would instead earn their grades based on the average grade of the entire class. The scholarly students were skeptical and the slacker students thought this was a great idea, but no one said anything and they went along with policy. The first test came and went. The scholarly students studied for many hours and did well on the test and the slackers, knowing they would get their grades averaged with the grades of their peers put forth little to no effort. The grades came back and the students made a B- as a class. The scholarly students were disappointed as they should have made an A, but the slackers were thrilled since they made a B with little effort. The second test came around and the scholarly students put forth less effort since they realized their efforts were for naught and the slackers put forth almost no effort since they were carried by the scholars. The second test was graded and the grade was just a 70. The scholarly students were crushed as their efforts did not matter and the slackers having done no work at all were content with merely passing the class. The third test came towards the end of the semester. The scholars had given up since all their hard work was just stolen from them and distributed equally amongst the other students despite their lack of effort. The scholarly students did not study since they had mostly given up and the slackers, per usual behavior did absolutely nothing this time around. The test was graded and the grade was an F. The professor explained that the experiment shows how Communism is just a fallacy in logic as your hard work is taken and the government then takes what you have earned and attempts to distribute it equally amongst everyone.
The government makes no sense. I come from a lower middle class family who could not afford college if it were not for scholarships. I knew that I could not have an education had I not had and maintained the HOPE scholarship. My family did without. A lot. We did not go out to eat and we lived meagerly. We had the necessities and we were a one income family. My mother stayed at home to be a home maker and take care of the children and my father worked long hours to provide for us. Needless to say, college is expensive and HOPE was the only reason I was able to afford college. I also worked all the way through college doing temp jobs and then working in food services to help pay for my college. I now have my degree and I am a working professional in my field with multiple certifications added on to my degree in my area of specialization. This being said, there were many families that were able to get scholarships since they had debt. My family did not have debt. Why? The reason is that my family never really went on vacation and we never owned a boat, four wheelers, or brand new cars. So, HOPE covered less of my tuition because my family had no debt since we did without.
Moral of the story? It pays to be a hedonist in America and expect others to work for your selfish life style. That is the ideal that we are teaching. We are not teaching responsibility and hard work, we are teaching entitlement. The youth of today just expect life to be handed to them. The apathy is like a plague and people see no reason to try harder and succeed when "good enough" or "pass" is all that matters. So many of them are just trying to survive. Socialism, this concept of entitlement is going to kill the American Dream. The ideal that anyone can be something great as long as they have the dream and they can work for it. I have a several "social problems," but the field I am in requires that I am in constant contact with hundreds of individuals on a daily basis. Impressionable individuals that need leadership and I must fight against what I am to live my dream of helping the world become a better place and enlightening those I come in contact with.
Why would it be fair to take the glory of someone who has struggled and worked so hard to achieve their goals? It isn't. Be proud of what you earned and do not take from others. This life is your dream and you should live it as such. Merely surviving is not good enough, you have to live the dream and make the world a better place. Do not lose sight of the American Dream.
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It is telling that the people opposing the ACA in this thread have literally no arguments but ideological talking points that are completely disconnected from reality. Every time they try arguing their position with arguments based on the real world, they end up being wrong (impact of the ACA on the deficit, on the economy, on the quality of care, etc.). What it boils down to is this: you do not want to be paying taxes (and this applies to everything, not just healthcare). We get it.
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On June 29 2012 16:49 Scorm wrote:The poles speak for the travesty that is Obamacare. 58% are for it and 50% think that it is not constitutional. Wake up and realize that Obamacare is not free and you will pay for it for four years before you get to use it. Read the fine print and realize that you are giving away your rights to the government. Your right to live is potentially at stake when you have the money for the procedure and yet, you cannot have it because there is a waiting list. If this passes, we are no different than the rest of the world. Those who are showing disdain towards the CEO's and such for their paycheck and the small business owners who make over that 200K paycheck are ignorant to the fact that these people pay for your jobs. The rich pay the vast majority of the taxes in the U.S. Socialism/Communism is perfect on paper, but this is the real world. Wake up and stop dreaming. A good analogy of how Social/Communism does not work. http://www.humanevents.com/2010/04/03/campus-communism/Also, there is a story I heard some time ago about a college professor showing the follies of Communism and yes, Obamacare is Socialism and Socialism is the path to Communism. This professor decided to experiment with the concept of communism with his students by attempting to illustrate the illogical approach of Communism. He told the students on the first day of class that rather than the students earning individual grades, the students would instead earn their grades based on the average grade of the entire class. The scholarly students were skeptical and the slacker students thought this was a great idea, but no one said anything and they went along with policy. The first test came and went. The scholarly students studied for many hours and did well on the test and the slackers, knowing they would get their grades averaged with the grades of their peers put forth little to no effort. The grades came back and the students made a B- as a class. The scholarly students were disappointed as they should have made an A, but the slackers were thrilled since they made a B with little effort. The second test came around and the scholarly students put forth less effort since they realized their efforts were for naught and the slackers put forth almost no effort since they were carried by the scholars. The second test was graded and the grade was just a 70. The scholarly students were crushed as their efforts did not matter and the slackers having done no work at all were content with merely passing the class. The third test came towards the end of the semester. The scholars had given up since all their hard work was just stolen from them and distributed equally amongst the other students despite their lack of effort. The scholarly students did not study since they had mostly given up and the slackers, per usual behavior did absolutely nothing this time around. The test was graded and the grade was an F. The professor explained that the experiment shows how Communism is just a fallacy in logic as your hard work is taken and the government then takes what you have earned and attempts to distribute it equally amongst everyone. The government makes no sense. I come from a lower middle class family who could not afford college if it were not for scholarships. I knew that I could not have an education had I not had and maintained the HOPE scholarship. My family did without. A lot. We did not go out to eat and we lived meagerly. We had the necessities and we were a one income family. My mother stayed at home to be a home maker and take care of the children and my father worked long hours to provide for us. Needless to say, college is expensive and HOPE was the only reason I was able to afford college. I also worked all the way through college doing temp jobs and then working in food services to help pay for my college. I now have my degree and I am a working professional in my field with multiple certifications added on to my degree in my area of specialization. This being said, there were many families that were able to get scholarships since they had debt. My family did not have debt. Why? The reason is that my family never really went on vacation and we never owned a boat, four wheelers, or brand new cars. So, HOPE covered less of my tuition because my family had no debt since we did without. Moral of the story? It pays to be a hedonist in America and expect others to work for your selfish life style. That is the ideal that we are teaching. We are not teaching responsibility and hard work, we are teaching entitlement. The youth of today just expect life to be handed to them. The apathy is like a plague and people see no reason to try harder and succeed when "good enough" or "pass" is all that matters. So many of them are just trying to survive. Socialism, this concept of entitlement is going to kill the American Dream. The ideal that anyone can be something great as long as they have the dream and they can work for it. I have a several "social problems," but the field I am in requires that I am in constant contact with hundreds of individuals on a daily basis. Impressionable individuals that need leadership and I must fight against what I am to live my dream of helping the world become a better place and enlightening those I come in contact with. Why would it be fair to take the glory of someone who has struggled and worked so hard to achieve their goals? It isn't. Be proud of what you earned and do not take from others. This life is your dream and you should live it as such. Merely surviving is not good enough, you have to live the dream and make the world a better place. Do not lose sight of the American Dream.
TL DR? Seriously though, I am very curious why so many Americans are completely allergic to socialism? People go into a frenzy when the word is mentioned and it almost feels like a brainwashing thing. There is a difference between socialism and a social democracy.
And believe me, in a social democracy you are much more capable to reach something similar to the American Dream. For one a good education is more accessible giving you a chance to outgrow your social position without having a $100.000 debt to pay off. In the end when you are successful all that is asked is for the strongest shoulders to carry a bit more weight. But that concept is completely lost on the USA these days (it wasn't 50 years ago) considering how much tax the rich pay.
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so strange that usa is the ONLY western country without free healthcare , in europe there is 5€ or 10€ for medicin (no matter how much) and even kuba have 2cent for something that kost120€ in usa (medicine, the doc is free there aswell ... only amerca send you ill away if you have no money) i really dont get it
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On June 29 2012 17:16 CoR wrote:
so strange that usa is the ONLY western country without free healthcare , in europe there is 5€ or 10€ for medicin (no matter how much) and even kuba have 2cent for something that kost120€ in usa (medicine, the doc is free there aswell ... only amerca send you ill away if you have no money) i really dont get it
Don't spread incomplete information. You have to spend a certain percentage of your income for the health system, i. e. medicine and more (the value usually talked about is ~14%, but obviously there are a lot of calculation rules and your emplyer pays a part of it). So you are actually paying much more for medicine here.
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On June 29 2012 18:00 Mafe wrote:Show nested quote +On June 29 2012 17:16 CoR wrote:
so strange that usa is the ONLY western country without free healthcare , in europe there is 5€ or 10€ for medicin (no matter how much) and even kuba have 2cent for something that kost120€ in usa (medicine, the doc is free there aswell ... only amerca send you ill away if you have no money) i really dont get it Don't spread incomplete information. You have to spend a certain percentage of your income for the health system, i. e. medicine and more (the value usually talked about is ~14%, but obviously there are a lot of calculation rules and your emplyer pays a part of it). So you are actually paying much more for medicine here.
Wow, is it really 14% in Germany?
In Australia, the cost of universal healthcare is funded by 1.5% of taxable income, called the Medicare Levy.
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EPT
