Posted on 07/25/2017 7:38:21 AM PDT by Kaslin
Very interesting. Thanks for the info.
I’m on the verge of 65 (despite my youthful appearance) and I’m getting a lot of junk mail from companies that want to sell me supplemental insurance. I will get supplemental insurance from my former employer so I haven’t bothered to check into it.
I live in Michigan. I don’t know if the supplemental insurance solicitors are in-state or not. I’m guessing not, but I don’t know that for sure. It’s likely I will get more solicitations so I’ll try to pay more attention to whence they come from.
I have worked in hospitals for decades.. premise one is false.. poor people go to the ER for congestion after an ambulance ride because they can’t wait for an appointment. Won’t go to an urgent care because it isn’t free. Trust me, it’s not just poor people coming in for congestion.
Premise two.. doesn’t matter what your charged, it only matters what you get reimbursed..Because employees don’t get paid by your taxes, they get paid by your cash flow. You can charge someone 100 dollars, but you will get ten.
Now, you aren’t paid for services provided to a patient, you are paid based on their diagnosis code. So you are not allowed to, or you eat the costs of individualized care.
Every hospital provides and itemizes care they have provided to the very poorest and uninsured. That is good stewardship to your employees who go without raises.. So they can see the dollars and time they provided their community in good faith.
The only people who come to the ER with congestion are those who have never gotten a bill.. They are often young and just loooking for free meds, remember why your cough and cold medicines are locked away in the pharmacy.
Choice? Whose choice, and to choose what?
Competition? Competition over what? How little an insurance plan can cover and still be legal? Over how much cash a company can retain for bonuses?
Cost reduction? Whose cost? What costs?
How can you or anyone else guarantee that without knowing the details of what the plan covers and what it does not? Or what the deductible is? Or what limitations it places? The President and the Vice-President and the HUD secretary are out there promising the moon on this without any clue on how to accomplish most of it.
The only time numbers like that should be used is when they are absolutely provable in a form understandable to idiots.
OOPS. Forgot the < /I > and the < p >.
And their deductible? Paying that much regardless of health, you can't afford NOT to be sick!
If all else fails, take it apart piece by piece.
We have already lived through a perfect example of what happens when you open the market. Telecommunications...now even the poorest can afford a mobile hand held personal computer/phone.
Before this the only “duplex” mobile phones anyone saw were on TV and in movies. Technology exploded and prices dropped to a small fraction of what they were for this “Luxury”.
Open competition WORKS. They will be fighting each other to give you the best deal and get your business.
It would be almost twice that if their work didn’t help. Their current home mortgage payment is also 1,200 a month. They both have decent careers and they are still tight on food and living paycheck to paycheck because of this cost of healthcare.
Healthcare should NEVER cost as much or more as buying a home... There is a huge problem here...
Only if they can make money doing it. And they can't.
Sure they can. The telecommunications industry is HUGE in profits! You mean the “Corporate Officers” can’t make as much doing it. Well tough luck...that’s business. There is a CEO in Alabama who is willing to take less and sell his product for less to get your business. :)
You must be in the healthcare insurance industry.
No, I just read the statement I get from my insurance company every time I file a claim and I've read the details about my coverage. I'm guessing you do not.
Of course I do... But when talking free markets there is a better example to read, The Sunday Paper. It is stuffed with fliers from stores who are offering discounts, sales, and coupons to lure you to come shop at their store.
This vey same thing would be the case in an open healthcare market. They would be bending over backwards to lure you to their store with “bets rates, best coverage, lowest copays, and better choices”.
I don’t know how old you are, but it was once like this already in the past and it worked well, we had the best healthcare in the world at the time and most folks could even afford to self pay unless it was catastrophic.
And the insurance companies that were offering insurance did not have the right to be an “insurance adjuster” middleman between you and your doctor.
That is no example at all.
This vey same thing would be the case in an open healthcare market. They would be bending over backwards to lure you to their store with “bets rates, best coverage, lowest copays, and better choices”.
You ignore the major difference and that's the way the insurance companies operate. Insurance companies control their costs by establishing a network of providers - doctors, hospitals, pharmacies - with whom they have negotiated a set price to be paid for their services. This allows them to keep their costs lower and more predictable. The insurance companies encourage their customers to use this network by offering a lower co-pay, a lower deductible, and paying a higher percentage of the bill. They discourage out of network providers by doing the opposite, higher co-pays, higher deductibles, covering a lower percentage of the costs. If an insurance company is not currently doing business in my state then they have no network established. They have no way of controlling costs. So their chances of making money off a policy they sell me is close to zero. Quite the opposite, I could quite likely be a drain on their profits. And so long as the business from my state is in the form of a single policy here or a single policy there then there is no incentive for them to go through the time and considerable expense of setting up their own network. So since they pay more on claims and I pay more in deductible and co-pays and charges then were is the incentive for either side to enter into the lose/lose proposition?
This isn't just theory on my part. Five states currently allow the purchase of insurance across state lines - Kentucky, Georgia, Wyoming, Maine, and Rhode Island. Two of those began doing it before Obamacare was enacted. And two date, or as of February 2017 at least, not a single insurance company took advantage of the law and not a single person bought a policy. That should be clear evidence that allowing the sale will do nothing to lower premiums.
What you are describing are the old HMO plans that came around during the open market era. And yes they were cheaper but they were optional and all parties had a choice to purchase or not knowing there would be limitations in care. You got what you pay for...
But what we have now is HMO style coverage in even the best and most expensive of plans mandated by government so there is no longer a “choice” of what kind of care and benefits you will receive for your money. You are going to get limited care with an insurance “adjuster” in between you and your doctor no matter what.
We have to remember cause and effect in this. When a market gets competitive like this the “suppliers” also have to become competitive, ie Hospitals, Medical product suppliers, Doctors, Etc. will also have to readjust their super inflated prices in order to attract business from the insurance companies. Truly, the market will adjust throughout all the way up the chain.
Example...A disposable plastic water pitcher and small washtub will no longer cost 400 dollars as currently billed by hospitals.
May I ask who your health insurance carrier happens to be?
I get my health insurance through my employer. Cigna manages it.
I had Cigna for awhile through work but it’s been awhile back. I know exactly how they work and how much they were actually paying out at the time. Have you had any non-emergency “Procedures” needing to be done though them yet? Did you have to get an “adjuster” to approve it first?
I work for a large company and like virtually all large companies they self-insure and contract to companies like Cigna to administer. So my company sets the policies on whether pre-approval is needed and I can honestly say that I have never had any issues with any claims I've ever had to make. And since my company self-insures then changes in premiums are controlled by how much they expect to pay out for a give year. That's why in my 13 years with them I've never had a premium increase greater than four or five percent for a given year, and why there have been several times when my premium went down from the year prior.
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