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To: daniel1212

I remember distinctly an arguments against a single-payer system as being the long wait times and not being able to get what one needed. And it occurs to me that it is happening now with insurance companies.....Health Insurance companies = privatized single payers.


27 posted on 09/04/2024 7:50:54 AM PDT by iluvschnitzle
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To: iluvschnitzle

The large area hospital systems in the USA are in scope very much like the traditional ‘trusts’ of the British NHS.


28 posted on 09/04/2024 7:53:45 AM PDT by Brian Griffin ("Why didn’t she do it three and a half years ago?”)
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To: iluvschnitzle

“not being able to get what one needed”

This is due to premiums being numerically fixed by contract.

It is possible that an insurer might fund profits and administrative costs on a per claim basis and for care by billing insured amounts that vary by month.

The entry month premiums for a person of a certain age might be $800/month. The profit amount for each claim might be 5% of the Medicare allowable amount and the administrative amount for each claim might be $10 plus $1/Medicare eligible line item plus 8% of the Medicare allowable amount. The care and product amounts paid to providers would be as per contract.

In January and February, the premiums would be $800/month. In March, the premium might be $820. In April, the premium might be $787. In May, the premium might be $813. In June, the premium might be $826.

The ‘insurance’ company would simply act as a claim payer.

The financial risk would be borne by the covered persons.

The Medicare allowable amount might be $22,000. The ‘insurance’ company might have contracted to pay $27,000.


33 posted on 09/04/2024 8:09:53 AM PDT by Brian Griffin ("Why didn’t she do it three and a half years ago?”)
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To: iluvschnitzle

“not being able to get what one needed”

Preferred providers as listed in a writing provided to the covered person might get issued a check upfront, but with warning letters to the provider and insured stating why the care is not covered and that repayment plus 18% interest will accrue unless the check is returned to the insurer within 30 days of issue.

If I want to contest my property tax bill, I can only do so after paying the tax collector.

Pay first, argue later.


53 posted on 09/04/2024 9:48:48 AM PDT by Brian Griffin ("Why didn’t she do it three and a half years ago?”)
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