Sicko

[mykidslovedogs]

Quote:

Originally Posted by newguy888 Just kidding. But man nobody should go to the poor house if they get sick.

I totally agree. No one should go to the poor house if they get sick. Unfortunately, that can happen in our system. By the same token, no one should have to wait for service if they are critically ill, either, which can happen in a universalized system.

IMO, I choose the lesser of two evils. I'd rather spend a couple of days or weeks fighting over a claim with an insurance company regarding a critical illness after I've already gotten my services rather than a few months fighting with the prime minister of healthcare over when I can get my first diagnostic test!

Again, I really don't have much problem agreeing to subsidize care for those who slip through the cracks, but I don't want my right to private care taken away and I don't think everyone should be forced into a universal system.

[cute fuzzy bunny]

More Cowbell please!

I've actually found these discussions to be very educational. I was sort of on the fence about the matter until we completed this discourse.

Basically we have a bad system full of bureaucracy and screwed up/inconsistent rules.

Its so bad we have people like this apologist, who not only makes a handsome profit "helping" people navigate the waters...they're willing to wage a protracted troll on an internet discussion forum in some inexplicable attempt to change peoples minds.

Mine is changed. I'll vote for any candidate or proposal that gets rid of this mess and all the parasites involved.

Any of the other 3,999,999,999 of you also like minded?

[mykidslovedogs]

Quote:

Originally Posted by cute fuzzy bunny More Cowbell please! I've actually found these discussions to be very educational. I was sort of on the fence about the matter until we completed this discourse. Basically we have a bad system full of bureaucracy and screwed up/inconsistent rules. Its so bad we have people like this apologist, who not only makes a handsome profit "helping" people navigate the waters...they're willing to wage a protracted troll on an internet discussion forum in some inexplicable attempt to change peoples minds. Mine is changed. I'll vote for any candidate or proposal that gets rid of this mess and all the parasites involved. Any of the other 3,999,999,999 of you also like minded?

FYI to all of you....so you know what my handsome profit is. I don't mind publishing it here. I make 20% commission first year only. After that, I make 5%. So, on the average individual application I take, that amounts to about $30/mo first year, and then $5-10 a month after that. To get that commission, I do work a lot of hours.(approx. 9-10 hrs/day)...and I'm not ashamed of it. I spend a lot of time helping people with getting covg. through social programs too, for which I don't make any commission, and the gov't doesn't include the cost of my time in their cost of admin. figures either.

[cute fuzzy bunny]

Nice dodge, showing the fat commission and telling everyone about all the hours you work. But not breaking down the cost per app. Show us the fat end of the stick and the skinny end.

How about how long does it take you to process and manage an individual application for that 20%? How many hours of work to manage it year on year?

And lets not stray too far before pointing out that none of this overhead would be even relevant in a universal system.

For people who need health care and need you to help them just apply for it, YOU cost them an extra 20% the first year and an extra 5% every year after that.

For my family, that would be ~$2700 the first year and ~$680 a year after that. Almost $9000 for ten years. Paid to you by the insurers, who extract it in extra premiums from US.

Thanks for giving a nice living example of why health care costs so much.

[mykidslovedogs]

Quote:

Originally Posted by cute fuzzy bunny Nice dodge, showing the fat commission and telling everyone about all the hours you work. But not breaking down the cost per app. Show us the fat end of the stick and the skinny end. How about how long does it take you to process and manage an individual application for that 20%? How many hours of work to manage it year on year? And lets not stray too far before pointing out that none of this overhead would be even relevant in a universal system. For people who need health care and need you to help them just apply for it, YOU cost them an extra 20% the first year and an extra 5% every year after that. For my family, that would be ~$2700 the first year and ~$680 a year after that. Almost $9000 for ten years. Paid to you by the insurers, who extract it in extra premiums from US. Thanks for giving a nice living example of why health care costs so much.

Glad to. When we go universal, I won't be helping anyone out with enrolling onto the social programs either. That cost will have to shift back to the gov't, which I am sure they'll do a great job with.

On group insurance, we don't make as much first year as on individual insurance. In a group of say, 10 employees with a combined monthly premium of let's say, $8,000 for all individuals and family members in the group, we make about $20/employee/mo or $200. For that commission, we do all of their continuation of coverage paperwork for terminated employees or Cobra paperwork for groups of 20 or more...we also take care of all their employee additions, terminations, customer service issues and claims assistance. We also shop the group's renewal each year to make sure they are getting the best premiums...every season. We employ 4 employees and pay them generous salaries and benefits....so we do also contribute to the economy as well. The small businesses that we do business with don't need to hire an HR person to work on health insurance benefits, because we do all that work for them. I'm sure they are happy to pay a little bit more in premiums for the services we give to them. Not to many employees would work full time for $200/mo!

For individuals, we take care of any customer service problems or issues they have and also help them with any claims if they need it. They all know to come to us first, so they don't need to work directly with the insurance carrier.

processing an individual application can take anywhere from 1 or two days to several months, depending on health history.


....and your welcome for the example.. I'd like to see the gov't take on the surrogate Human Resources job that we do for all of our clients in a timely and efficient manner.

[cute fuzzy bunny]

All of which is completely unnecessary in a universal healthcare system.

Thank you again for pointing out some of the reasons why our current system is bad and one of the reasons why it costs so much.

Sounds like a flea pointing out that its really not taking that much blood from the dog, so whats the problem?

[mykidslovedogs]

Quote:

Originally Posted by cute fuzzy bunny All of which is completely unnecessary in a universal healthcare system. Thank you again for pointing out some of the reasons why our current system is bad and one of the reasons why it costs so much. Sounds like a flea pointing out that its really not taking that much blood from the dog, so whats the problem?

So you are saying that enrollment problems, billing problems, & claim issues would not exist in a universal system? Have you ever had to work with Medicare on any of the above mentioned issues?

[Mach]

I think we need both + more.
A safety net insurance to cover basic needs, and for example children, who may or may not be fortunate enough to have good or able parents. This has the odd effect of lowering overall health care costs for everyone...preventative health care reduces your rates, whether you care or not.

Serious overhaul of regulations/inventives for small businesses to offer health care more affordably. Small businesses employe 50% of the work force, and only 50% offer health insurance. That's 25% right there in the current employer drive health insurance model. It's not good.

Private insurance for much of the rest of it. If we don't have some significant private health-care, we'll lose a lot of the drive for innovation, which is necessarily fueled by profit motive. And if I have a heart attack, I want people to teleport me to the hospital bed IMMEDIATELY. I don't want to wait for an ambulance

-Mach

[Beststash]

An excerpt from Physicians for a National Health Program -

The private insurance industry spends about 20 percent of its revenue on administration, marketing, and profits. Further, this industry imposes on physicians and hospitals an administrative burden in billing and insurance-related functions that consumes another 12 percent of insurance premiums. Thus, about one-third of private insurance premiums are absorbed in administrative services that could be drastically reduced if we were to finance health care through a single non-profit or public fund. Indeed, studies have shown that replacing the multiplicity of public and private payers with a single national health insurance program would eliminate $350 billion in wasteful expenditures, enough to pay for the care that the uninsured and the underinsured are not currently receiving.
Such a single payer plan would make possible a set of mechanisms, including public budgeting and investment planning, that would allow us to address the real sources of cost increases and allow us to rationalize our health care investments. The drivers of high cost such as administrative waste, deterioration of our primary care infrastructure, excessive prices, and use of non-beneficial or detrimental high-tech services and products could all be addressed within such a rationalized system.
In sum, we will not be able to control health care costs until we reform our method of financing health care. We simply have to give up the fantasy that the private insurance industry can provide us with comprehensive coverage when this requires premiums that average-income individuals cannot afford. Instead, the U.S. already has a successful program that covers more than forty million people, gives free choice of doctors and hospitals, and has only three percent administrative expense. It is Medicare, and an expanded and improved Medicare for All (Medicare 2.0) program would cover everyone comprehensively within our current expenditures and eliminate the need for private insurance. This is the direction we must go.

[cute fuzzy bunny]

Quote:

Originally Posted by mykidslovedogs So you are saying that enrollment problems, billing problems, & claim issues would not exist in a universal system? Have you ever had to work with Medicare on any of the above mentioned issues?

Of course not, but as we can see from this piece of information:

Quote:

Originally Posted by Beststash The U.S. already has a successful program that covers more than forty million people, gives free choice of doctors and hospitals, and has only three percent administrative expense. It is Medicare

Hmm, so ALL of the administrative costs of medicare are less than the second year and continuing commission overhead paid to just the insurance broker in our current system. In fact, your first year commission pays for almost seven years of medicare administration. And thats for ALL of it, not just the brokerage fees!

Wow, thanks AGAIN for continuing to prove the point that our current system for health care is ridiculous and needs to be replaced.

I think that...

[Webzter]

Back to the point at hand... isn't my dog (see avatar) the cutest thing you've ever seen?

[mykidslovedogs]

Quote:

Originally Posted by cute fuzzy bunny Of course not, but as we can see from this piece of information:

That picture is hilarious!

But seriously, don't forget that I spend a good portion of my time helping our clients out with Medicare issues, Medicare Part D enrollment, signing up for CHP Plus for children, and signing up for Cover Colorado...none of which I receive a commission for and NONE of which is counted in the govt's 3% figure for Medicare admin.

All of those costs would have to fall back on the gov't. They may not reach 30%, but I'll bet it would add at least another 10% to their figures when you combine the services that agents and brokers across the USA contribute to the administration of social programs for free right now.

Now take those figures and add the figures for the time that Drs and hospitals spend on Medicare admin (those aren't counted in the 3% either....)...OK...it's starting to add up now....hmmmm.

[cute fuzzy bunny]

Quote:

Originally Posted by mykidslovedogs I'll bet it would add at least another 10% to their figures

I dont want to put that figure past MY sniff test. I think I know where it came from

[mykidslovedogs]

Quote:

Originally Posted by cute fuzzy bunny I dont want to put that figure past MY sniff test. I think I know where it came from

You are dreaming if you think the gov't can do it for only 3%. There are a lot of hidden costs that aren't added into that hard, budgeted figure.

[donheff]

Quote:

Originally Posted by mykidslovedogs IMO - it doesn't take a PHD to figure out how to make an appeal. If you don't have a broker who can help you, the only requirement is that you know how to read the appeal instructions on your EOB and follow the instructions. Is it too much to ask that our general population learn how to read and follow instructions?

That is because you are too close to it -- it is your business. I spent thirty years successfully maneuvering in the Federal bureaucracy yet the hassles I encountered with Blue Cross tried my capabilities. I didn't have to read and follow instructions, I had to de-construct medical documents to prove that BC was misreading the claims.

[mykidslovedogs]

Quote:

Originally Posted by donheff That is because you are too close to it -- it is your business. I spent thirty years successfully maneuvering in the Federal bureaucracy yet the hassles I encountered with Blue Cross tried my capabilities. I didn't have to read and follow instructions, I had to de-construct medical documents to prove that BC was misreading the claims.

I don't understand why people try to do it on their own when there are a lot of good brokers out there willing to help. It costs you the same premium regardless of whether or not you hire a broker. If you don't hire a broker the insurance company keeps the extra money as profit. You might have been able to save yourself a lot of time by hiring a good broker to help you out.

[cute fuzzy bunny]

Quote:

Originally Posted by mykidslovedogs Is it too much to ask that our general population learn how to read and follow instructions?

Quote:

Originally Posted by mykidslovedogs I don't understand why people try to do it on their own when there are a lot of good brokers out there willing to help.

I'm a little confused...is everyone supposed to learn how to read and do it themselves, or get you to do it and cause everyone to pay increased premiums because we needed an 'expert' to undo the mess made by the insurance company, who then charges us both for the incompetent bureaucracy AND the expert hired to fix it?

Quote:

It costs you the same premium regardless of whether or not you hire a broker. If you don't hire a broker the insurance company keeps the extra money as profit. You might have been able to save yourself a lot of time by hiring a good broker to help you out.

Again I'm confused...are the insurance companies extracting excess money from its customers that they would otherwise pocket indiscriminately, or are they charging their customers extra in order to offset the brokers fees?

[mykidslovedogs]

Quote:

Originally Posted by cute fuzzy bunny Again I'm confused...are the insurance companies extracting excess money from its customers that they would otherwise pocket indiscriminately, or are they charging their customers extra in order to offset the brokers fees?

Insurance companies charge the same premiums regardless of whether someone uses a broker or not. If people don't use a broker, then the insurance companies need to hire more service people, so I guess they figure it's a wash.

Insurance companies have tried separating premiums in the past and offering "the price if you use a broker" vs. "the price if you go direct". Insurance companies found that it was less expensive for them to pay broker commissions than to hire service people to do the extra work, so now they just all charge the same price whether or not you use a broker. They prefer if you use a broker, because ultimately, it costs them less money (particularly in training costs) if you go through a broker than try to go direct to them for their services. This is a high employee turnover industry and there are a lot of laws and regulations that employees need to be aware of. Training on these things alone is a huge expense. Insurance companies don't have to pay to train brokers. Brokers pay for their own licensing and training. Additionally, being commissioned sales people, brokers tend to be much more efficient, motivated to do a good job, and know how to get answers to customers faster and with better results than hourly employees.

[cute fuzzy bunny]

And you think all these requisites for 3rd party "helpers" and extra premiums charged to pay for them whether they're internal or external is the sign of a healthy system?

[dumpster56]

Quote:

Originally Posted by mykidslovedogs Insurance companies charge the same premiums regardless of whether someone uses a broker or not. If people don't use a brokers, then the insurance companies need to hire more service people, so I guess they figure it's a wash. Insurance companies have tried separating premiums in the past and offering "the price if you use a broker" vs. "the price if you go direct". Insurance companies found that it was less expensive for them to pay broker commissions than to hire service people to do the extra work, so now they just all charge the same price whether or not you use a broker. They prefer if you use a broker, because ultimately, it costs them less money (particularly in training costs) if you go through a broker than try to go direct to them for their services. This is a high employee turnover industry and there are a lot of laws and regulations that employees need to be aware of. Training on these things alone is a huge expense. Insurance companies don't have to pay to train brokers. Brokers pay for their own licensing and training. Additionally, being commissioned sales people, brokers tend to be much more efficient, motivated to do a good job, and know how to get answers to customers faster and with better results than hourly employees.

Bottom line when my doctor ordered a few tests he should not need to call an insurance company mine to make sure I could get the test. That is plain BS!But it happens all the time. When did the person on the insurance end of the phone line get their medical degree?? They didn't!