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Old 05-31-2007, 11:15 AM   #141
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Insurance companies already negotiate HUGE discounts. As a member of any insurance PPO or HMO insurance plan, you don't have to negotiate discounts for deductible expenses. You are already entitled to the insurance company's discounts - even when you have to pay a deductible expense - you cannot be balance billed if you stay in the network.
About four years ago my wife had a bout of kidney stones so painful and sudden that it required a visit to urgent care overnight.

A couple of months later, after BCBS processed the claims, the hospital had billed BCBS about $3,400. The amount they paid -- per the negotiated rate -- was about $500.

Even if you have very high deductible insurance, just by having it you get the negotiated rate in network even if the insurance company doesn't pay one cent of it. You'd pay $500 in this case, whereas you'd be asked to pay $3,400 if you were uninsured.
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Old 05-31-2007, 11:18 AM   #142
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We are spending an unbelievable amount of money on a war -- one we are not sure will produce any favorable results -- yet we can't come up with the money for a basic human need?
So true. Actually, many people from the beginning made credible predictions that our entry into Iraq would produce the exact mess that is has, and at a staggering human and $ cost.

I saw a story yesterday, I think in WSJ, about impoverished Iraqi refugee families in Damascus being supported by the prostitution of their daughters and young mothers. Good going Mr. Family Values George!

This is without any doubt the worst debacle ever. One that we have created and are now mired in and one which will only end with us running in defeat.

We could have created a deluxe health insurance system and have money left over if we had just stayed out of this mess.

Ha
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Old 05-31-2007, 11:21 AM   #143
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mkld -

you have got to be kidding me right?

healthcare is not as expensive as it is made out to be in the US because of the wacked out system we have. take your head out of the US sand and look at other countries...

it's a system based on people having health coverage - the people who don't still receive emergency care - we all pay for that (unless you of course, advocate for turning people out of the emergency room, refusing 911 calls w/out proof of insurance!). in order to recoup costs for servicing the uninsured the hospitals inflate prices out the yin yang. then getting the friggin insurance companies to pay for the things they say they would pay for takes forever and a day - so the cash flow thing is a total mess.

the reformists are simply pointing to the fact that fixing this will lead to an "adjustment" that you can't seem to get your head around. how about reducing or eliminating insurance agents and their commission? there's a cost savings there! you seem to value your role in this whole game, and perhaps that is what is keeping you from imagining a world without insurance agents (and nobody's even proposing that but geez, your pov is very self interested) my dad sells insurance mind you.

all of your examples about worst case scenarios can be mitigated with reasonable rules and regulations about when, who what is covered...and mindful doctors who aren't scared out of their minds that they will be sued or lose their friggin' insurance...
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Old 05-31-2007, 11:25 AM   #144
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I agree - I just don't think it should be unlimited free access. I think people have got to have SOME out of pocket responsibility.
They do. It's called co-pay, deductible, and capped cost sharing.

Why don't you give up? You make utterly no sense, and your motivation is transparent and not real attractive.

Do you really think that people will be flocking to get un-needed colonoscopies? How about cardiac catheriterizations? Pelvic exams, that is another real crowd pleaser!

Ha
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Old 05-31-2007, 11:25 AM   #145
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About four years ago my wife had a bout of kidney stones so painful and sudden that it required a visit to urgent care overnight.

A couple of months later, after BCBS processed the claims, the hospital had billed BCBS about $3,400. The amount they paid -- per the negotiated rate -- was about $500.

Even if you have very high deductible insurance, just by having it you get the negotiated rate in network even if the insurance company doesn't pay one cent of it. You'd pay $500 in this case, whereas you'd be asked to pay $3,400 if you were uninsured.
This is interesting. So the uninsured who probably have very little money would pay $3,400. If a hospital can afford to provide their services for $500 to a person that has insurance why can't they provide the same services to someone for that price who is paying cash? As has been said before our health care system is crazy.
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Old 05-31-2007, 11:52 AM   #146
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mkld -
it's a system based on people having health coverage - the people who don't still receive emergency care - we all pay for that (unless you of course, advocate for turning people out of the emergency room, refusing 911 calls w/out proof of insurance!). in order to recoup costs for servicing the uninsured the hospitals inflate prices out the yin yang. then getting the friggin insurance companies to pay for the things they say they would pay for takes forever and a day - so the cash flow thing is a total mess.
Bright eyed - did you READ my last post?

"You are misguided as to why costs are so high. Insurance is expensive because HEALTHCARE is expensive. Contrary to popular belief, it's not the profits that are causing all of the inflation. Most healthcare inflation is due to high demand for high tech services combined with the willingness of people to pay for those services , cost-shifting (because of poor reimbursement levels for Medicare and Medicaid services and indigent care - IMO this is the biggest culprit!) and adverse selection - healthy people opting out of coverage because it's too expensive, and unhealthy people staying in because they need it."

If everyone had at least a catastrophic plan, we wouldn't BE cost-sifting so much for indigent care, because INSURANCE would pay the Dr's above the deductible, instead of the Drs having to write off those expenses as bad debt and then passing it onto the insured. Geesh - why don't you try to get your head around what I have been saying all along?
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Old 05-31-2007, 11:58 AM   #147
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don't get your panties all in a twist.

i did read what you wrote, unfortunately. but you said it's "healthcare that is expensive" then you said cost-shifting - that is not the same thing. i was replying to your first assertion - better yet i'm going to stop reading your posts until they reflect some - uh reflection? i always wondered why folks kept egging you along, and here i go falling into it...what a trap!

apparently you have a hard time realizing when a room full of people disagree with you maybe you should take a back seat and LISTEN or stop repeating yourself to death. you must be fun at cocktail parties...
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Old 05-31-2007, 12:03 PM   #148
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They do. It's called co-pay, deductible, and capped cost sharing.

Why don't you give up? You make utterly no sense, and your motivation is transparent and not real attractive.

Do you really think that people will be flocking to get un-needed colonoscopies? How about cardiac catheriterizations? Pelvic exams, that is another real crowd pleaser!

Ha
When people don't have to meet a good-sized deductible for expensive tests - yes - they do get unnecessary tests. They don't double check, they don't ask for second opinions, they don't even ask why they need the test in some cases. They don't look for competitive pricing..they just pay their $20 or $50 copay and they get the test at the nearest, most expensive hospital. When there's no reason for providers to compete for business, they keep inflating prices. Once providers know that people are shopping around, they will be more apt to make pricing more transparent and yes, they will have incentive to try to bring to their doors by keeping pricing competitive instead of continuing to inflate it year after year. Also, when consumers become more active in their care, perhaps this will keep over the top high tech services in check too, because there won't be
as much demand for that.

Sorry - that's just the way I feel. I really feel that admin costs and broker commissions have very little to do with the rapid inflation in the healthcare industry.
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Old 05-31-2007, 12:12 PM   #149
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I think that universal health care would be a wonderful thing for all of us.

However, I don't think that it's realistic to expect the government to solve this problem or to fill this need. I can't think of a single person in Washington that I would trust with this...regardless of party affiliation.

If the government wants to bring some experts together and then butt out of the process, I'm all for it. But to have a bunch of congressmen tinker with the system scares the heck out of me.
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Old 05-31-2007, 12:50 PM   #150
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They do. It's called co-pay, deductible, and capped cost sharing.

Why don't you give up? You make utterly no sense, and your motivation is transparent and not real attractive.

Do you really think that people will be flocking to get un-needed colonoscopies? How about cardiac catheriterizations? Pelvic exams, that is another real crowd pleaser!

Ha
Ohhh. Ohhh. Could I have another colonoscopy please. It's only been a few months, but I really like the taste of that pink fluid.
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Old 05-31-2007, 12:52 PM   #151
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The healthcare system currently in the U.S. puts the value of a dollar bill above the value of a human life. The level of moral corruption and the inhumanity in our system is really unfathomable for a society as wealthy and advanced as ours. How access to affordable healthcare is not a basic human right in America is beyond me.

Some things to think about for the shiny coin crowd:

Healthy people function better. Do healthy people help the economy?

How much more productive would an employee be if they worked a job they enjoyed instead of a job don't like, but that provides enough health coverage for their family. Does a healthy more productive employee help the economy?

How much violent crime could be prevented if a mother (or father) was able to spend more time at home with their children during their formative years instead of working 2 jobs to pay family medical bills. Is lower violent crime good for the economy?

How many lives could be saved because the elderly wouldn't have to skip their pills because they can't afford the prescriptions. If the elderly could live longer, could they contribute to the economy?

How many new jobs could be created if more people could afford to start their own businesses because they don't have to pay astronomical rates for private health insurance, if they get coverage at all? Is job creation good for the economy?

If you answered NO to any of the above, pick up your toys and go home.
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Old 05-31-2007, 12:53 PM   #152
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Ohhh. Ohhh. Could I have another colonoscopy please. It's only been a few months, but I really like the taste of that pink fluid.
You guys are scaring me...

I need to schedule one of those things next week as the tail-end (pun intended) of my annual physical. Yuck.
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Old 05-31-2007, 02:44 PM   #153
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Do you really think that people will be flocking to get un-needed colonoscopies?
Ha
I think I need one or two of those!
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Old 05-31-2007, 03:16 PM   #154
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Healthy people function better. Do healthy people help the economy?

How much more productive would an employee be if they worked a job they enjoyed instead of a job don't like, but that provides enough health coverage for their family. Does a healthy more productive employee help the economy?.
I am sure healthy people function better and are more productive. A national catastrophic plan with preventive care benefits not subject to a deductible would be a great solution here. It gives people portable coverage, protection from bankruptcy, and incentives to seek preventive care. It also still makes them responsible for SOME of their own healthcare costs, which helps keep inflation in check.

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How much violent crime could be prevented if a mother (or father) was able to spend more time at home with their children during their formative years instead of working 2 jobs to pay family medical bills. Is lower violent crime good for the economy?
There are a lot more reasons why people work two jobs besides just to pay for medical care. Feminism, big houses, fancy cars, fun vacations, etc...A HUGE portion of the population can already qualify for affordable coverage...only a small percentage cannot. I'm skeptical that changing an entire healthcare system would result in lower rates of crime, but I totally agree with you that lower crime rates would be advantageous to the economy....I just don't think our healthcare system has much to do with that. Crime is also a function of racial discrimination, the breakdown of the family unit (divorce rates), drug and alcohol abuse, etc....and I don't think that's a problem that's easily resolved by nationalizing healthcare.

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How many lives could be saved because the elderly wouldn't have to skip their pills because they can't afford the prescriptions. If the elderly could live longer, could they contribute to the economy?
Medicare Part D coverage (prescription drug coverage for the elderly) costs about $30.00 a month ..and the copays range from $0-$70 generally on that plan. (most drugs that people take fall into the lower copay range.) Are you saying that's not enough? Who should we tax to pay for all of the costs?

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How many new jobs could be created if more people could afford to start their own businesses because they don't have to pay astronomical rates for private health insurance, if they get coverage at all? Is job creation good for the economy?
How many jobs would be lost if we tax "wealthy" business owners to a point where they can't afford to keep their employees anymore? Is unemployment good for the economy? How many people would bother starting up a business if they knew that success would result in the highest tax rates that they have ever paid?
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Old 05-31-2007, 03:24 PM   #155
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I seriously doubt that Obama has any idea what his plan would ultimately cost, nor does he really care. And that's because he realizes that he is promising the impossible. I wish that were not the case, but we have to remember, after all, that he's running for President and that most promises made in a campaign year never again see the light of day.
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Old 05-31-2007, 03:42 PM   #156
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I think I need one or two of those!
Just had mine .... feel free to take my next one ... 5 yrs from now.... talk about a PITA.
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Old 05-31-2007, 05:29 PM   #157
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Hmm...last time I looked at the breakdowns of health care costs, the actual cost of the health care wasnt the fast rising category. Overhead and bureaucracy were.

So in summary: The doctors here think universal health care is a good idea. The prospective patients here think universal health care is a good idea. The insurance people dont like the idea and are maniacally throwing up clouds of misinformation to create FUD.

Sounds about right.
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Old 05-31-2007, 05:35 PM   #158
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How many jobs would be lost if we tax "wealthy" business owners to a point where they can't afford to keep their employees anymore? Is unemployment good for the economy? How many people would bother starting up a business if they knew that success would result in the highest tax rates that they have ever paid
Are you ignoring the fact that we are going to pay back billions of dollars from the war - i.e. higher taxes? I think you should worry about that before you take aim at some form of universal healthcare coverage. A lengthy war with unclear goals/outcomes will suck the life out our society before universal healthcare coverage will.
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Old 05-31-2007, 05:46 PM   #159
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Hmm...last time I looked at the breakdowns of health care costs, the actual cost of the health care wasnt the fast rising category. Overhead and bureaucracy were.

So in summary: The doctors here think universal health care is a good idea. The prospective patients here think universal health care is a good idea. The insurance people dont like the idea and are maniacally throwing up clouds of misinformation to create FUD.

Sounds about right.
I'd love to see those breakdowns on admin. costs vs. cost of the actual insurance over the past 7 years, can you send them to me? If you PM me, I'll send you my email address....

I do know that Broker commissions have been the same since I started 10 years ago. 20% first year for individual insurance dropping to 5% thereafter as long as the policy exists, and we get a flat average of $20 per member per month for primary only on groups - Kaiser only pays $11/member per month for the primary insured. Admin. has become more and more automated (ie...internet apps/internet claims review, electronic claim submission, cutting back of service reps. because of the capabilities of members to review and obtain their own info on the internet, etc..), so it's hard for me to believe that the general admin. costs are outpacing inflation...but, if you send me the hard data, I'll consider it!
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Old 05-31-2007, 05:49 PM   #160
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. . .
So in summary: The doctors here think universal health care is a good idea. The prospective patients here think universal health care is a good idea. The insurance people dont like the idea and are maniacally throwing up clouds of misinformation to create FUD.

Sounds about right.
Yeah, yeah yeah. But would you like an extra colonoscopy? :confused:
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