Per The Daily Caller:
http://dailycaller.com/2016/06/03/another-health-insurer-suing-feds-over-obamacare-losses/ (http://dailycaller.com/2016/06/03/another-health-insurer-suing-feds-over-obamacare-losses/)
Blue Cross and Blue Shield of North Carolina is yet another health insurer to file a lawsuit against the federal government, demanding $129 million in unpaid risk corridor payments.
Blue Cross and Blue Shield of North Carolina filed the lawsuit Thursday, claiming the federal government has paid less than 10 percent of the risk corridor payments they are owed from fiscal year 2014.
The risk corridor program is designed to hedge against sky-rocketing costs for insurance providers caused by high claims costs of new enrollees. Providers sought over $2 billion in 2014 in risk corridor payments, but the Department of Health and Human Services (HHS) paid out only $362 million.
BCBSNC is also asking that the federal government provide assurance that risk corridor payments for 2015 and 2016 will be provided in a timely fashion.
The suit is the latest in a string of claims made by health insurance providers against HHS. The lawsuit comes one day after Moda Health — of Portland, Oregon — filed a similar claim in federal court, seeking $180 million in risk corridor payments.
Nonprofit health insurer Highmark Inc. filed a lawsuit against the federal government Tuesday demanding roughly $223 million in payments it says it's owed under the Obamacare's risk-corridors program.
The Pittsburgh-based insurance provider – which plays a major role in the Pennsylvania, Delaware and West Virginia marketplaces – said by not making the payments, the government is in violation of the Fifth Amendment because it's not providing the company with the "just compensation" it was promised.
The risk-corridors program, which was created to limit insurers that provide qualified health plans losses by providing funding to companies facing high claims costs for enrollees, saw far more claims than initially expected. And the Department of Health and Human Services paid just $362 million in risk corridors charges of the $2.87 billion requested in 2014.
The Wall Street Journal reports Highmark lost roughly $85 million last year, largely due to ACA plans.
The problem is "for profit" health insurance companies.
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
Not so much, there are regulations that say what percentage of premiums insurance companies must spend directly on healthcare of the policy holders. These insurance companies aren't raking in huge percentages in profits.
Quote from: carpnter on June 04, 2016, 06:27:16 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
Not so much, there are regulations that say what percentage of premiums insurance companies must spend directly on healthcare of the policy holders. These insurance companies aren't raking in huge percentages in profits.
I don't know if that's true or not, but it's not the point, really. A universal, single-payer system wouldn't have this issue.
Quote from: carpnter on June 04, 2016, 06:27:16 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
These insurance companies aren't raking in huge percentages in profits.
I'm pretty sure that's the point
carpenter MusicMan is making. There shouldn't be any percentage. (Edited)
Before OC passed, this was one of my own personal sticking points. If you're going to require it, you're also going to have to eliminate the 'for profit' model. If we half-ass it and compromise just to get it passed, we're going to end up with a half-assed program that's going to end up costing more to fix.
Quote from: Non-RedNeck Westsider on June 04, 2016, 11:12:38 PM
Quote from: carpnter on June 04, 2016, 06:27:16 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
These insurance companies aren't raking in huge percentages in profits.
I'm pretty sure that's the point carpenter is making. There shouldn't be any percentage.
Before OC passed, this was one of my own personal sticking points. If you're going to require it, you're also going to have to eliminate the 'for profit' model. If we half-ass it and compromise just to get it passed, we're going to end up with a half-assed program that's going to end up costing more to fix.
Part of those profits are invested back into the company to allow for things like capital improvements, developing ways to streamline processes, etc... All profits are not paid out to shareholders.
Quote from: carpnter on June 04, 2016, 06:27:16 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
Not so much, there are regulations that say what percentage of premiums insurance companies must spend directly on healthcare of the policy holders. These insurance companies aren't raking in huge percentages in profits.
Whether or not you agree with Obamacare the % issue is counter productive to keeping costs down. The insurance companies are limited to 2% as a profit base over care provided so they prefer a 100k bill to a 10k bill. I know that is overly simplified but the insurance companies have great negotiating leverage with the care providers and the 2% plan seems to disincentvise lower costs.
Very interesting read here:
https://www.healthinsurance.org/blog/2016/03/01/no-obamacare-isnt-killing-the-insurance-industry/
Several big for profit insurance companies and their price per share have never been better.
Quote from: carpnter on June 05, 2016, 12:37:26 AM
Quote from: Non-RedNeck Westsider on June 04, 2016, 11:12:38 PM
Quote from: carpnter on June 04, 2016, 06:27:16 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
These insurance companies aren't raking in huge percentages in profits.
I'm pretty sure that's the point carpenter is making. There shouldn't be any percentage.
Before OC passed, this was one of my own personal sticking points. If you're going to require it, you're also going to have to eliminate the 'for profit' model. If we half-ass it and compromise just to get it passed, we're going to end up with a half-assed program that's going to end up costing more to fix.
Part of those profits are invested back into the company to allow for things like capital improvements, developing ways to streamline processes, etc... All profits are not paid out to shareholders.
I could be wrong, but it's my understanding: If it's reinvested back into the company, then it's not a profit. If you're spending it on r&d, then it's not a profit. Profit is exactly what's paid out to shareholders. Bonuses to execs are typically tied directly to profits.
Quote from: Non-RedNeck Westsider on June 05, 2016, 10:36:30 AM
I could be wrong, but it's my understanding: If it's reinvested back into the company, then it's not a profit. If you're spending it on r&d, then it's not a profit. Profit is exactly what's paid out to shareholders. Bonuses to execs are typically tied directly to profits.
No, you're not wrong, that's exactly how it works.
Funny how some of the biggest cheerleaders for "free"-market capitalism don't even know how it works.
Quote from: finehoe on June 05, 2016, 11:06:13 AM
Quote from: Non-RedNeck Westsider on June 05, 2016, 10:36:30 AM
I could be wrong, but it's my understanding: If it's reinvested back into the company, then it's not a profit. If you're spending it on r&d, then it's not a profit. Profit is exactly what's paid out to shareholders. Bonuses to execs are typically tied directly to profits.
No, you're not wrong, that's exactly how it works.
Funny how some of the biggest cheerleaders for "free"-market capitalism don't even know how it works.
So using that basic concept, carpenter, what incentive, in a for-profit model no matter or any limit placed, is there for the company to reduce the price?
None. All the incentive is in reducing the actual cost of production while fighting tooth and nail to continue to raise pricing while crying 'poor mouth'.
This really is that simple. In fact, I would go on to say that there is no reason at all that any company contracted by the government should be 'for profit' as a government contract is guaranteed money. Why horde it? Why not continue to reinvest and find better means and methods & pay better salaries; offer better benefits?
Quote from: finehoe on June 05, 2016, 11:06:13 AM
Quote from: Non-RedNeck Westsider on June 05, 2016, 10:36:30 AM
I could be wrong, but it's my understanding: If it's reinvested back into the company, then it's not a profit. If you're spending it on r&d, then it's not a profit. Profit is exactly what's paid out to shareholders. Bonuses to execs are typically tied directly to profits.
No, you're not wrong, that's exactly how it works.
Funny how some of the biggest cheerleaders for "free"-market capitalism don't even know how it works.
Depends, I suppose on what is meant by 'profit'. I think Carpenter was likely referring to gross profit - not net profits.
Quote from: Adam White on June 05, 2016, 01:10:58 PM
Quote from: finehoe on June 05, 2016, 11:06:13 AM
Quote from: Non-RedNeck Westsider on June 05, 2016, 10:36:30 AM
I could be wrong, but it's my understanding: If it's reinvested back into the company, then it's not a profit. If you're spending it on r&d, then it's not a profit. Profit is exactly what's paid out to shareholders. Bonuses to execs are typically tied directly to profits.
No, you're not wrong, that's exactly how it works.
Funny how some of the biggest cheerleaders for "free"-market capitalism don't even know how it works.
Depends, I suppose on what is meant by 'profit'. I think Carpenter was likely referring to gross profit - not net profits.
I'm going to step out on another limb here, but simplistically speaking gross profits = Selling price - Cost of goods sold.
What are the cost of goods?
My point is simply that there is no tangible good being sold so how is it anything BUT net profit? And why should they receive any?
Rhetorical QotD: What incentive do insurance companies have in getting the health care providers to lower their costs when the insurance model is for profit? Set the percentage cap wherever you'd like, because they will always make more regardless as long as health costs stay high.
Quote from: Non-RedNeck Westsider on June 05, 2016, 03:48:29 PM
Quote from: Adam White on June 05, 2016, 01:10:58 PM
Quote from: finehoe on June 05, 2016, 11:06:13 AM
Quote from: Non-RedNeck Westsider on June 05, 2016, 10:36:30 AM
I could be wrong, but it's my understanding: If it's reinvested back into the company, then it's not a profit. If you're spending it on r&d, then it's not a profit. Profit is exactly what's paid out to shareholders. Bonuses to execs are typically tied directly to profits.
No, you're not wrong, that's exactly how it works.
Funny how some of the biggest cheerleaders for "free"-market capitalism don't even know how it works.
Depends, I suppose on what is meant by 'profit'. I think Carpenter was likely referring to gross profit - not net profits.
I'm going to step out on another limb here, but simplistically speaking gross profits = Selling price - Cost of goods sold.
What are the cost of goods?
My point is simply that there is no tangible good being sold so how is it anything BUT net profit? And why should they receive any?
Rhetorical QotD: What incentive do insurance companies have in getting the health care providers to lower their costs when the insurance model is for profit? Set the percentage cap wherever you'd like, because they will always make more regardless as long as health costs stay high.
I am not sure I understand (with regard to your questions about profit). Gross profit exists in all industries - including the service industry. It isn't limited to manufacturing, where it would calculated as selling price minus cost of goods sold. I would substitute the cost to provide the service. I am not an accountant or anything like that, so my understanding is rudimentary.
As far as why they should receive any profit - I suppose because they are for-profit companies. This is why this approach is flawed.
Quote from: Adam White on June 05, 2016, 05:02:46 PM
I am not sure I understand (with regard to your questions about profit). Gross profit exists in all industries - including the service industry. It isn't limited to manufacturing, where it would calculated as selling price minus cost of goods sold. I would substitute the cost to provide the service. I am not an accountant or anything like that, so my understanding is rudimentary.
As far as why they should receive any profit - I suppose because they are for-profit companies. This is why this approach is flawed.
Ha. That's ok, after re-reading it, I only understand it because I know the point I'm trying to make.
Bored, inside on a Sunday = free typing as I think.
Quote from: Adam White on June 04, 2016, 06:38:18 PM
Quote from: carpnter on June 04, 2016, 06:27:16 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
Not so much, there are regulations that say what percentage of premiums insurance companies must spend directly on healthcare of the policy holders. These insurance companies aren't raking in huge percentages in profits.
I don't know if that's true or not, but it's not the point, really. A universal, single-payer system wouldn't have this issue.
which version do you propose? If its like Canada and the UK, no thanks.
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
Take the profit out of health care, and you take the providers out of health care.
Quote from: fsquid on June 05, 2016, 08:37:41 PM
which version do you propose? If its like Canada and the UK, no thanks.
Spoken like someone who has no *real* idea how Canada/UK healthcare works...
As if UK/CA citizens are dropping like flies or something.
"Take the profit out of health care, and you take the providers out of health care."
WRONG. Health insurance companies provide NO healthcare. They collect premiums, skim off hundreds of billions of dollars, then pass along the rest to doctors, WHO ACTUALLY PROVIDE HEALTHCARE. I pay $1200 per month to BCBS of Florida, but I don't go to their office at SJTC for healthcare. I go to my doctor for that.
Quote from: Non-RedNeck Westsider on June 05, 2016, 05:16:20 PM
Quote from: Adam White on June 05, 2016, 05:02:46 PM
I am not sure I understand (with regard to your questions about profit). Gross profit exists in all industries - including the service industry. It isn't limited to manufacturing, where it would calculated as selling price minus cost of goods sold. I would substitute the cost to provide the service. I am not an accountant or anything like that, so my understanding is rudimentary.
As far as why they should receive any profit - I suppose because they are for-profit companies. This is why this approach is flawed.
Ha. That's ok, after re-reading it, I only understand it because I know the point I'm trying to make.
Bored, inside on a Sunday = free typing as I think.
I think we're probably sort of making the same point.
Quote from: fsquid on June 05, 2016, 08:37:41 PM
Quote from: Adam White on June 04, 2016, 06:38:18 PM
Quote from: carpnter on June 04, 2016, 06:27:16 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
Not so much, there are regulations that say what percentage of premiums insurance companies must spend directly on healthcare of the policy holders. These insurance companies aren't raking in huge percentages in profits.
I don't know if that's true or not, but it's not the point, really. A universal, single-payer system wouldn't have this issue.
which version do you propose? If its like Canada and the UK, no thanks.
I have no knowledge of the Canadian system, but I can answer any questions you might have about the UK system. I think you might be surprised by the reality. I honestly believe the quality of care I've received in the UK has been far better than what I received USA.
One of my best friends is from UK and he would agree with A White 100%. He lives here in San Marco and his wife is a physician. Every citizen in the UK is covered with a decent basic health insurance program, unemeployed, homeless, everyone. If you have money and want more comprehensive care it's available. But the basic plan is pretty damn good, and way cheaper per capita than here. Doctors there make less money for sure, but enjoy a high social status and get perks as benefits. Their schooling is basically free.
Quote from: ben says on June 05, 2016, 08:57:49 PM
Quote from: fsquid on June 05, 2016, 08:37:41 PM
which version do you propose? If its like Canada and the UK, no thanks.
Spoken like someone who has no *real* idea how Canada/UK healthcare works...
As if UK/CA citizens are dropping like flies or something.
so why do Canadians go to the US and Brits go to France when they need something non-routine? Or they go when a government worker says they have to wait in line for a procedure?
Quote from: stephendare on June 06, 2016, 01:12:50 AM
Quote from: fsquid on June 05, 2016, 08:52:33 PM
Quote from: MusicMan on June 04, 2016, 03:06:39 PM
The problem is "for profit" health insurance companies.
Take the profit out of health care, and you take the providers out of health care.
um. wow.
What does federal funding of insurance companies have to do with health care providers? Last I checked they were two separate industries. its like saying that if you took the profits out of auto insurance, mechanics would disappear.
On the other hand, people might actually pay mechanics.
I'm assuming that if you take the insurance companies out of the equation and have one insurance company (the Gov't) then doctor pay will fall substacially. You then will no longer get the best and the brightest as doctors. I kind of want the best and the brightest when I'm in dire straights.
Quote from: MusicMan on June 05, 2016, 09:12:48 PM
"Take the profit out of health care, and you take the providers out of health care."
WRONG. Health insurance companies provide NO healthcare. They collect premiums, skim off hundreds of billions of dollars, then pass along the rest to doctors, WHO ACTUALLY PROVIDE HEALTHCARE. I pay $1200 per month to BCBS of Florida, but I don't go to their office at SJTC for healthcare. I go to my doctor for that.
correct. The actually have to skim that money (not billions) because the state they are in makes them have reserves which are checked by regulators on some basis.
You pay $1200? I thought premiums were supposed to go down under this law?
Quote from: MusicMan on June 06, 2016, 07:55:46 AM
One of my best friends is from UK and he would agree with A White 100%. He lives here in San Marco and his wife is a physician. Every citizen in the UK is covered with a decent basic health insurance program, unemeployed, homeless, everyone. If you have money and want more comprehensive care it's available. But the basic plan is pretty damn good, and way cheaper per capita than here. Doctors there make less money for sure, but enjoy a high social status and get perks as benefits. Their schooling is basically free.
Single-payer/single-provider systems are no less with the the bucks than insurance companies. They are actually more stingy. That's why health care costs are lower in those systems. And they have a lot less flexibility to deal with the problems. They spend what's in the budget. If what you are sick with is not in the budget, they send you home to wait until it is.
Quote from: fsquid on June 06, 2016, 09:23:19 AM
Quote from: ben says on June 05, 2016, 08:57:49 PM
Quote from: fsquid on June 05, 2016, 08:37:41 PM
which version do you propose? If its like Canada and the UK, no thanks.
Spoken like someone who has no *real* idea how Canada/UK healthcare works...
As if UK/CA citizens are dropping like flies or something.
so why do Canadians go to the US and Brits go to France when they need something non-routine? Or they go when a government worker says they have to wait in line for a procedure?
I have never heard of Britons going to France because for medical treatment. That said, there is a very large ex-pat British community in France (primarily in the south) and they may have to use the French system. I think maybe you've got your wires crossed there.
I
did read something about officials in Kent contracting with a hospital in Calais to serve some of their patients - though it appears this particular hospital took part in the tendering process and met the criteria. This wasn't about patients not being able to see doctors in the UK and being forced to seek healthcare abroad.
Quote from: Adam White on June 06, 2016, 10:32:37 AM
Quote from: fsquid on June 06, 2016, 09:23:19 AM
Quote from: ben says on June 05, 2016, 08:57:49 PM
Quote from: fsquid on June 05, 2016, 08:37:41 PM
which version do you propose? If its like Canada and the UK, no thanks.
Spoken like someone who has no *real* idea how Canada/UK healthcare works...
As if UK/CA citizens are dropping like flies or something.
so why do Canadians go to the US and Brits go to France when they need something non-routine? Or they go when a government worker says they have to wait in line for a procedure?
I have never heard of Britons going to France because for medical treatment. That said, there is a very large ex-pat British community in France (primarily in the south) and they may have to use the French system. I think maybe you've got your wires crossed there.
I did read something about officials in Kent contracting with a hospital in Calais to serve some of their patients - though it appears this particular hospital took part in the tendering process and met the criteria. This wasn't about patients not being able to see doctors in the UK and being forced to seek healthcare abroad.
Brits have been going to France for years when the wait in the UK for a procedure was longer than what the consultant advised. This woman sued the NHS and won so now the UK has to pay when their people go overseas to get procedures done that the NHS either denies or puts them in too long a line.
http://news.bbc.co.uk/2/hi/health/4985190.stm
Quote from: fsquid on June 06, 2016, 10:44:56 AM
Quote from: Adam White on June 06, 2016, 10:32:37 AM
Quote from: fsquid on June 06, 2016, 09:23:19 AM
Quote from: ben says on June 05, 2016, 08:57:49 PM
Quote from: fsquid on June 05, 2016, 08:37:41 PM
which version do you propose? If its like Canada and the UK, no thanks.
Spoken like someone who has no *real* idea how Canada/UK healthcare works...
As if UK/CA citizens are dropping like flies or something.
so why do Canadians go to the US and Brits go to France when they need something non-routine? Or they go when a government worker says they have to wait in line for a procedure?
I have never heard of Britons going to France because for medical treatment. That said, there is a very large ex-pat British community in France (primarily in the south) and they may have to use the French system. I think maybe you've got your wires crossed there.
I did read something about officials in Kent contracting with a hospital in Calais to serve some of their patients - though it appears this particular hospital took part in the tendering process and met the criteria. This wasn't about patients not being able to see doctors in the UK and being forced to seek healthcare abroad.
Brits have been going to France for years when the wait in the UK for a procedure was longer than what the consultant advised. This woman sued the NHS and won so now the UK has to pay when their people go overseas to get procedures done that the NHS either denies or puts them in too long a line.
http://news.bbc.co.uk/2/hi/health/4985190.stm
That was 10 years ago! I've not heard of anything since I moved to the UK in 2007. That doesn't mean it
hasn't happened, but it means that if it has, it's quite rare. The Mail, Sun, Express, etc would be making a big deal about it if it were.
I realize that anecdotal evidence only carries so much weight, but here you go:
February 2007 - having been in the country for about a month and a half, I pulled a muscle in my shoulder when moving furniture. I called the NHS and they referred me to Charing Cross hospital. I walked in, waited 10 minutes, saw a nurse and was given an injection and a prescription (which cost me about £7). I was out of there in about 30 minutes and there was no charge. And I didn't even have to show ID.
December 2008 - I hadn't bothered registering with a GP and had an abscess on my hip that was extremely painful and making me ill. I went to A&E at Homerton hospital and saw a doctor. He prescribed me antibiotics and scheduled a follow-up for a week later. I went to the follow-up visit and was immediately admitted to the hospital for surgery. I was knocked out and under the knife within hours. I spent the night in hospital and went home the following day. I had to have the dressing changed every day for the first few weeks - and since xmas was coming up, they sent a nurse to my house over the holiday to do it there. No wait and no charge.
January 2012 - spent the night in hospital due to stabbing pains in my head (I'm a migraine sufferer). Saw a neurologist the next day.
I've also had an MRI, echocardiogram, chest CT and ongoing treatment for my migraines (still happening, as a matter of fact). The longest I ever had to wait for anything was about 8 weeks to get my eyelids sorted out once.
Of course, if I didn't like using the NHS, I could get private health insurance (like BUPA). So everyone is able to use the NHS, but no one is stopping you from using a private health insurance provider (and private doctors and hospitals).
I hate to break it to you, but Americans have been going overseas (and borders) as well for all types of surgeries and procedures and cheaper prescriptions.
Interesting article:
http://www.theguardian.com/society/2015/aug/25/gp-appointment-waiting-times-in-us-worse-than-nhs
Apparently people can wait long times for basic appointments in the USA, too.
I think judging an entire health system by worst case scenarios is ridiculous. I remember when Tampa General amputated the wrong leg (by mistake). Horror story - but I wouldn't use that as an example of what healthcare is like in the USA as a whole.
Quote...opponents of the Canadian system gained considerable political traction in the United States by pointing to Canada's methods of rationing, its facility shortages, and its waiting lists for certain services. These same opponents also argued that "refugees" of Canada's single-payer system routinely came across the border seeking necessary medical care not available at home because of either lack of resources or prohibitively long queues.
This paper by Steven Katz and colleagues depicts this popular perception as more myth than reality, as the number of Canadians routinely coming across the border seeking health care appears to be relatively small, indeed infinitesimal when compared with the amount of care provided by their own system. Katz is an associate professor in the Departments of Medicine and Health Policy and Management at the University of Michigan. Karen Cardiff is a research associate at the University of British Columbia's Centre for Health Services and Policy Research. Also at the University of British Columbia are Morris Barer, professor and director at the Centre for Health Services and Policy Research's Department of Health Care and Epidemiology, and Robert Evans, professor at the Centre for Health Services and Policy Research's Department of Economics. Marina Pascali is a Dallas-based health care consultant.
Surprisingly few Canadians travel to the United States for health care, despite the persistence of the myth.
http://content.healthaffairs.org/content/21/3/19.full
Quote from: finehoe on June 06, 2016, 11:14:40 AM
Quote...opponents of the Canadian system gained considerable political traction in the United States by pointing to Canada's methods of rationing, its facility shortages, and its waiting lists for certain services. These same opponents also argued that "refugees" of Canada's single-payer system routinely came across the border seeking necessary medical care not available at home because of either lack of resources or prohibitively long queues.
This paper by Steven Katz and colleagues depicts this popular perception as more myth than reality, as the number of Canadians routinely coming across the border seeking health care appears to be relatively small, indeed infinitesimal when compared with the amount of care provided by their own system. Katz is an associate professor in the Departments of Medicine and Health Policy and Management at the University of Michigan. Karen Cardiff is a research associate at the University of British Columbia's Centre for Health Services and Policy Research. Also at the University of British Columbia are Morris Barer, professor and director at the Centre for Health Services and Policy Research's Department of Health Care and Epidemiology, and Robert Evans, professor at the Centre for Health Services and Policy Research's Department of Economics. Marina Pascali is a Dallas-based health care consultant.
Surprisingly few Canadians travel to the United States for health care, despite the persistence of the myth.
http://content.healthaffairs.org/content/21/3/19.full
It's worth considering that a lot of this 'health tourism' or whatever you might want to call it, comes down to convenience. If you live close to the US border (or maybe just across the channel from France), you might decide to go pay to get the procedure done rather than wait a few weeks or months.
One thing I've always found ridiculous is the notion that a) people only have to wait in single-payer systems and b) it's only in a single-payer system that bureaucrats are making decisions about what you can and can't get done .
People will always have to wait, regardless of the system. And someone is always going to make decisions about what is or isn't covered - whether that is a public employee or a guy working for an insurance company. The only people who will always be able to get what they want, when they want are the people who are rich enough to pay for it out of pocket at the going rate.
I have no wish to get involved in this debate, but in the 90s one of my relatives went to Germany from England for a needed heart operation that he couldn't get at home. If he hadn't done that, the other options were France and the US. Their perception is that the UK has created a two-tiered system, where people who could afford better treatment or insurance (or spend their life savings for it) can get it privately, and the masses get ok but universal insurance they have to wait in line for.
The benefits of the UK system, which my relatives understandably don't really see, is that there are *much* lower costs per capita, and universal coverage, which theoretically provides for better average outcomes. The thing with US healthcare is the costs. No matter what side of the debate you're on, we pay by *far* the most on healthcare in the world, without appreciably better outcomes.
More food for thought is healthcare research. Private companies fund a lot of research in the US. If they weren't making money on it, they'd cut back and that would take a lot to replace (the US alone historically performs about half of all healthcare research in the world). Our government is already heavily subsidizing research as well so it won't be a matter of just shifting the funding to the public sector. Europe and some Asian countries are increasing their output, but still aren't remotely close. If American research declines, either other countries will have to subsidize a lot more than they've historically been used to, or it won't happen at all.
Quote from: Tacachale on June 06, 2016, 11:50:30 AM
More food for thought is healthcare research. Private companies fund a lot of research in the US. If they weren't making money on it, they'd cut back and that would take a lot to replace (the US alone historically performs about half of all healthcare research in the world). Our government is already heavily subsidizing research as well so it won't be a matter of just shifting the funding to the public sector. Europe and some Asian countries are increasing their output, but still aren't remotely close. If American research declines, either other countries will have to subsidize a lot more than they've historically been used to, or it won't happen at all.
Scratch that, it's only Asia that's increasing. The Europeans and the US government are sitting on their hands, and US private entities are going backwards. There's not even been much net gain from 2007-2014 across the world. Not a good trend.
http://www.nejm.org/doi/full/10.1056/NEJMp1311068?query=featured_home&
Quote from: Tacachale on June 06, 2016, 11:50:30 AM
Their perception is that the UK has created a two-tiered system, where people who could afford better treatment or insurance (or spend their life savings for it) can get it privately, and the masses get ok but universal insurance they have to wait in line for.
That's probably correct. You can get it if you want to pay for it. That's the same way it is in the USA, really. Prior to Obamacare, you'd essentially bankrupt yourself if you had to seek medical help and weren't lucky enough to be insured. My friend Roy has an unpaid medical bill for about $30K because he broke his arm and didn't have insurance.
Quote from: Adam White on June 06, 2016, 11:58:23 AM
Quote from: Tacachale on June 06, 2016, 11:50:30 AM
Their perception is that the UK has created a two-tiered system, where people who could afford better treatment or insurance (or spend their life savings for it) can get it privately, and the masses get ok but universal insurance they have to wait in line for.
That's probably correct. You can get it if you want to pay for it. That's the same way it is in the USA, really. Prior to Obamacare, you'd essentially bankrupt yourself if you had to seek medical help and weren't lucky enough to be insured. My friend Roy has an unpaid medical bill for about $30K because he broke his arm and didn't have insurance.
It's still like that under Obamacare. The major difference is that more people are insured now (89% as of 2016, up from 82% just a few years ago). For those that do have coverage (especially those with private insurance), they won't face problems like that the vast majority of the time. However *everyone* is paying a lot more in total than they do in any other First World country, and the uninsured are basically screwed.
Quote from: Adam White on June 06, 2016, 11:58:23 AM
Quote from: Tacachale on June 06, 2016, 11:50:30 AM
Their perception is that the UK has created a two-tiered system, where people who could afford better treatment or insurance (or spend their life savings for it) can get it privately, and the masses get ok but universal insurance they have to wait in line for.
That's probably correct. You can get it if you want to pay for it. That's the same way it is in the USA, really. Prior to Obamacare, you'd essentially bankrupt yourself if you had to seek medical help and weren't lucky enough to be insured. My friend Roy has an unpaid medical bill for about $30K because he broke his arm and didn't have insurance.
One friend of mine got cancer. Rang up over 300k in medical bills. Had no insurance. Declared BK and then negotiated down with all of the providers post BK and in reality spent around 45k.
Another friend of mine got really sick and found out he was HIV positive. He couldnt afford the treatments and had no insurance. The hospital financial advisor recommended he quit his job, file for disability and bankruptcy and then welfare would pay for his HIV meds until it was fully suppressed. He did just that and he paid zero for his health care.
This is way before the ACA existed. So there are plenty of ways to deal with it.
One single woman I knew had no insurance for her and her daughter. She simply called the different hospitals when she needed something and asked to quote her the non-insured cash price of a procedure. Then she asked if they offered payment plans, almost all providers did. Many made very good financing offers like "$500 down and $100/mo at 3% interest. She got some really great deals. As far as she was concerned, health care was like buying a car and when I did a compare, one year cost her less than having private insurance and a deductable.
So there are other ways to tackle health care. Its just that all of the negotiations on the pricing are hidden. Those with private policies usually only see the premium and deductables.
Quote from: spuwho on June 06, 2016, 12:23:38 PM
One friend of mine got cancer. Rang up over 300k in medical bills. Had no insurance. Declared BK and then negotiated down with all of the providers post BK and in reality spent around 45k.
Another friend of mine got really sick and found out he was HIV positive. He couldnt afford the treatments and had no insurance. The hospital financial advisor recommended he quit his job, file for disability and bankruptcy and then welfare would pay for his HIV meds until it was fully suppressed. He did just that and he paid zero for his health care.
This is way before the ACA existed. So there are plenty of ways to deal with it.
One single woman I knew had no insurance for her and her daughter. She simply called the different hospitals when she needed something and asked to quote her the non-insured cash price of a procedure. Then she asked if they offered payment plans, almost all providers did. Many made very good financing offers like "$500 down and $100/mo at 3% interest. She got some really great deals. As far as she was concerned, health care was like buying a car and when I did a compare, one year cost her less than having private insurance and a deductable.
So there are other ways to tackle health care. Its just that all of the negotiations on the pricing are hidden. Those with private policies usually only see the premium and deductables.
Are you serious? So we all should declare bankruptcy and/or quit our jobs and go on disability/welfare to deal with a health care issue? These are the "other ways" to tackle health care? :o
Quote from: finehoe on June 06, 2016, 01:26:38 PM
Quote from: spuwho on June 06, 2016, 12:23:38 PM
One friend of mine got cancer. Rang up over 300k in medical bills. Had no insurance. Declared BK and then negotiated down with all of the providers post BK and in reality spent around 45k.
Another friend of mine got really sick and found out he was HIV positive. He couldnt afford the treatments and had no insurance. The hospital financial advisor recommended he quit his job, file for disability and bankruptcy and then welfare would pay for his HIV meds until it was fully suppressed. He did just that and he paid zero for his health care.
This is way before the ACA existed. So there are plenty of ways to deal with it.
One single woman I knew had no insurance for her and her daughter. She simply called the different hospitals when she needed something and asked to quote her the non-insured cash price of a procedure. Then she asked if they offered payment plans, almost all providers did. Many made very good financing offers like "$500 down and $100/mo at 3% interest. She got some really great deals. As far as she was concerned, health care was like buying a car and when I did a compare, one year cost her less than having private insurance and a deductable.
So there are other ways to tackle health care. Its just that all of the negotiations on the pricing are hidden. Those with private policies usually only see the premium and deductables.
Are you serious? So we all should declare bankruptcy and/or quit our jobs and go on disability/welfare to deal with a health care issue? These are the "other ways" to tackle health care? :o
Nowhere did I say this was a recommended course of action.
I was providing examples of how different people dealt with catastrophic or just general health care events.
Filing BK was simply a means by which someone can reorganize their debts while undergoing a life change of some kind, in this case, the kind that they need to stay alive.
What I did want to share is that many providers will work with you. Filing BK is strictly a personal decision, not the ultimate option.
Quote from: spuwho on June 06, 2016, 05:53:57 PM
Quote from: finehoe on June 06, 2016, 01:26:38 PM
Quote from: spuwho on June 06, 2016, 12:23:38 PM
One friend of mine got cancer. Rang up over 300k in medical bills. Had no insurance. Declared BK and then negotiated down with all of the providers post BK and in reality spent around 45k.
Another friend of mine got really sick and found out he was HIV positive. He couldnt afford the treatments and had no insurance. The hospital financial advisor recommended he quit his job, file for disability and bankruptcy and then welfare would pay for his HIV meds until it was fully suppressed. He did just that and he paid zero for his health care.
This is way before the ACA existed. So there are plenty of ways to deal with it.
One single woman I knew had no insurance for her and her daughter. She simply called the different hospitals when she needed something and asked to quote her the non-insured cash price of a procedure. Then she asked if they offered payment plans, almost all providers did. Many made very good financing offers like "$500 down and $100/mo at 3% interest. She got some really great deals. As far as she was concerned, health care was like buying a car and when I did a compare, one year cost her less than having private insurance and a deductable.
So there are other ways to tackle health care. Its just that all of the negotiations on the pricing are hidden. Those with private policies usually only see the premium and deductables.
Are you serious? So we all should declare bankruptcy and/or quit our jobs and go on disability/welfare to deal with a health care issue? These are the "other ways" to tackle health care? :o
Nowhere did I say this was a recommended course of action.
I was providing examples of how different people dealt with catastrophic or just general health care events.
Filing BK was simply a means by which someone can reorganize their debts while undergoing a life change of some kind, in this case, the kind that they need to stay alive.
What I did want to share is that many providers will work with you. Filing BK is strictly a personal decision, not the ultimate option.
I think it's a real shame that a person dealing with, say, cancer would have to spend time trying to work out a payment plan or something to deal wiht the ludicrous (and completely unnecessary) debt.
One issue that has not been mentioned is this: politicians, the people who actually bring health care laws and policy to reality, get fantastic health insurance policies 'gratis' through their jobs, which are completely different than the policies they subject the rest of us to. If Senators and Congressman had to get health insurance the same way ordinary citizens do (i.e. write a monthly check for the policy and be subject to annual physicals to determine their premiums), the entire health care system in this country would change overnight.
Quote from: MusicMan on June 07, 2016, 08:20:46 AM
One issue that has not been mentioned is this: politicians, the people who actually bring health care laws and policy to reality, get fantastic health insurance policies 'gratis' through their jobs, which are completely different than the policies they subject the rest of us to. If Senators and Congressman had to get health insurance the same way ordinary citizens do (i.e. write a monthly check for the policy and be subject to annual physicals to determine their premiums), the entire health care system in this country would change overnight.
It might - but then again, I think the current salary for US Congressmen is $174K.
Quote from: MusicMan on June 07, 2016, 08:20:46 AM
One issue that has not been mentioned is this: politicians, the people who actually bring health care laws and policy to reality, get fantastic health insurance policies 'gratis' through their jobs, which are completely different than the policies they subject the rest of us to. If Senators and Congressman had to get health insurance the same way ordinary citizens do (i.e. write a monthly check for the policy and be subject to annual physicals to determine their premiums), the entire health care system in this country would change overnight.
Actually, since 2014, all members of Congress and their staffers have to purchase coverage through an online exchange, just like everyone else who doesn't receive insurance from an employer.
Nearly 13,000 members of Congress and staffers are currently enrolled in gold-level Small Business Health Option Program plans on the Washington, D.C., exchange.
http://www.latimes.com/business/la-fi-laz-congress-members-health-insurance-20150218-story.html