Re: So you want to raise my taxes to increase my costs

Orange Blooded [2692]

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for-profit insurance doesn't care what the costs are

Feb 20, 2020, 9:56 AM

they just care about getting their slice out of the contract. In this model, why should an insurance company care what the costs are? Also why health care stocks for companies like Gilead are going through the rough. They know when they've got us over a barrel.

I liked this excerpt from a great article on the history of the insurance biz.

In 1993, before the Blues went for-profit, insurers spent 95 cents out of every dollar of premiums on medical care, which is called their “medical loss ratio.” To increase profits, all insurers, regardless of their tax status, have been spending less on care in recent years and more on activities like marketing, lobbying, administration and the paying out of dividends. The average medical loss ratio is now closer to 80 percent. Some of the Blues were spending far less than that a decade into the new century. The medical loss ratio at the Texas Blues, where the whole concept of health insurance started, was just 64.4 percent in 2010.

The framers of the Affordable Care Act tried to curb insurers’ profits and their executives’ salaries, which were some of the highest in the U.S. health care industry, by requiring them to spend 80 to 85 percent of every premium dollar on patient care. Insurers fought bitterly against this provision. Its inclusion in the ACA was hailed as a victory for consumers. But even that apparent “demand” was actually quite a generous gift when you consider that Medicare uses 98 percent of its funding for health care and only 2 percent for administration.

Why did EmblemHealth agree to pay nearly $100,000 for each of Jeffrey Kivi’s infusions, even though they cost only $19,000 at another hospital just down the street? First, it’s less trouble for insurers to pay it than not. NYU is a big client that insurers don’t want to lose, and an insurer can compensate for the high price in various ways — by raising premiums, co-payments, or deductibles. Second, now that they suddenly have to use 80 to 85 percent rather than, say, 75 percent of premiums on patient care, insurers have a new perverse motivation to tolerate such big payouts. In order to make sure their 15 percent take is still sufficient to maintain salaries and investor dividends, insurance executives have to increase the size of the pie. To cover shortfalls, premiums are increased the next year, passing costs on to the consumers. And 15 percent of a big sum is more than 15 percent of a smaller one. No wonder 2017 premiums for the most common type of ACA plan are slated to rise by double digits in many cities, despite economists’ assurances that the growth of health care spending is slowing.

To some extent insurers do better if they negotiate better rates for your care. But that is true only under certain circumstances and in a limited way. “They are methodical money takers, who take in premiums and pay claims according to contracts — that’s their job,” said Barry Cohen, who owns an Ohio-based employee benefits company. “They don’t care whether the claims go up or down 20 percent as long as they get their piece. They’re too big to care about you.”

https://stanmed.stanford.edu/2017spring/how-health-insurance-changed-from-protecting-patients-to-seeking-profit.html

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a year into our healthcare system. And yes, they have lesser payouts and coverage on some things, and add coverage for a lot of other things. But the poor non-payers CAN be cared for at near-market rates.

THAT leaves the rest of the private sector, who can afford it, to be bilked for even more.

Same thing happens in colleges. Scholarships, state funding, and lottery money are flowing in, not to mention research money funded largely by debt. Plus low debt interest rates (subsidized also) allows more people than ever to afford college with student loans. That leaves them free to bilk the heck out of the people who can pay out of pocket for as much as possible. What's the incentive to cut costs if you're guaranteed a certain profit on the non-payers? Colleges are not going to relax admissions standards, so it's a growing pool of qualified people, paying for a finite admission standard that's largely subsidized, making the remainder who are wealthy and qualified pay more.

Show me a college campus or hospital campus that's not having a construction boom now.

Defense spending is much the same.

You either have to stick to free markets, or take over total control. There is no hybrid socialist/capitalist system that doesn't run costs through the roof. Have 100% government hospitals and 100% government schools, or 100% private. Mix the two and costs skyrocket.

Cost of Health Insurance 2020

Of course, you got a 12.5%+ raise this year, right...? ;~)***

A few years ago our step increases (COL increase)

Re: A few years ago our step increases (COL increase)

Re: A few years ago our step increases (COL increase)

Everybody should get a 12.5% raise for doing worse work***

Insulin manufacturers got a 100% raise in 2012 alone for

for-profit insurance doesn't care what the costs are

Exactly... and exactly why something needs to be done.***

If you want to cap costs, you will be called a socialist

So you want to raise my taxes to increase my costs

who said anything about raising taxes?

Honestly, I'd wager the crux of the problem is low interest

You touched on the most frustrating part about this...

Health care is expensive. The 'fix' is where people disagree

Yea, right...?***

Re: Health care is expensive. The 'fix' is where people disagree

BS... What you have is those three colluding/price fixing.

Collusion is illegal.***

And your sarcasm is cute...***

It has nothing to do with requiring hospitals and doctors

Great point... Do away with all that admin overhead...***

Then you may want to start with getting rid of the

There will still need to be administration... It just won't

Yeah, because companies have no reason to operate

It is amazing to me that you can argue that the

yes, Americans are weak peasants, always with hands out

Re: You touched on the most frustrating part about this...

Medicare operates with an~2% overhead and predetermined

Also, taking away regulations doesn't always allow

Capitalism is apparently non-existent in the rest of the

It's socialists. Unless it's Bernie.

It's scare tactics for the feeble-minded....***

Re: Also, taking away regulations doesn't always allow

Medicare and Medicaid combine to insert $1.3 TRILLION

"Bilked" by who...? Costs ARE currently skyrocketing. I

Are you referring to healthcare?

The K-12 education model works in some areas

K-12 does not apply because your two options are

oddly enough, it wasn't that long ago in Austraila

My experience was in 1997. They had private policies

You obviously understand the problem but you seem to want to

I think the Left will get their wish and then they will see for themselves.

It isn't working now... Time for a change.***

They'll just blame Republicans. See Obamacare***

Re: Cost of Health Insurance 2020

My company pays

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