The cost of health insurance

I had no idea that the average primary care doctor has 3000 patients. How can he keep track of so many people? The program is interesting, but I don't understand how it interacts with insurance. I carry a high deductible Blue Cross, would my doctor charge me nothing other than the yearly fee regardless? If my doctor switches to this type of plan, I would have to consider it. I am not sure that I would want to change doctors just to get into this type of plan though. I have been with my doctor for a long time. I think that I will just wait to see how it works out over time before deciding.
 
MikeSchoren asks,

I carry a high deductible Blue Cross, would my doctor charge me nothing other than the yearly fee regardless?
---------------------------------

No. You pay the $1,500/year fee just to get the doctor to answer the phone. You still pay for an office visit when you actually see the doctor if your insurance doesn't cover it or you haven't met your annual deductible or co-insurance limit.

intercst
 
From the Washington Post article

http://www.washingtonpost.com/wp-dyn/articles/A35228-2003Jan23.html

Like the average primary care physician nationwide, Sheff and Pennington each had about 3,000 patients. Soon each will limit his practice to 600. A physician with a full MDVIP enrollment would collect $600,000 a year <b>and send $300,000 to MDVIP for its continuing oversight.</b>



I wonder what kind of "oversight" MDVIP does to deserve a $300,000 per physician fee? Or is this just another scheme for business to suck more money out of the health care system and increase executive bonuses and stock options?

intercst
 
In that case, I am glad that my doctor is not part of that system. He charges me much less than $1500 for my annual physical exam, and I can call his office with questions year round. I will just go to an immediate care clinic if I need something after hours.
 
We had a health insurance fiasco at work recently with a major area health care provider not renewing their contract at the last minute and making lots of people upset, so there were meetings that turned into gripe sessions about health care.

What I learned between the gripes, though, is that very few people really know how it works and that you (I) need to learn how your (my) plan works and watch out for yourself. The doctors are clueless about the plans and their office managers get confused, too. Each major HMO may have several separate agreements with the local doctors, and I found out that my company falls under a different agreement than the normal HMO or PPO and is handled a bit differently, and many of the complaints of my coworkers were results of them and the doctors misunderstanding the nature of the agreement.


REWannabe: The airline industry (passenger and cargo) frequently needs part time help over full time help due to scheduling, operational and flexibility needs. Several airlines offer full benefits to part timers, and many people take these jobs just for the health insurance and fringe travel benefits, although the pay ain't bad for unskilled entry level work. The work is usually manual labor--lifting/pushing boxes or baggage, driving ground support equipment--but not too intense. The cargo airlines usually are night shift or graveyeard positions. Some of the rest of the transportation industry likes part timers, but I don't know if they get full benefits.
 
I have spent much of today researching this issue.
I thought that the Health Insurance Portability Act
(HIPPA) aka Kennedy-Kassenbaum would solve my problem. Wrong! Although under certain conditions
various states mandate that the insurance companies
must insure all comers if certain conditions are met,
they do not say what premiums will be charged.
Thus, I have discovered that this law will not help me
at all as I can not pay the premiums. This is typical
liberal crap. Push through legislation which looks good
but has no substance. I will solve this myself somehow, but God deliver us from the liberals in government.
 
I have spent much of today researching this issue.
I thought that the Health Insurance Portability Act
(HIPPA)  aka Kennedy-Kassenbaum would solve my problem.  Wrong!  Although under certain conditions
various states mandate that the insurance companies
must insure all comers if certain conditions are met,
they do not say what premiums will be charged.
Thus, I have  discovered that this law will not help me
at all as I can not pay the premiums.  This is typical
liberal crap.  Push through legislation which looks good
but has no substance.  I will solve this myself somehow, but God deliver us from the liberals in government.

Please keep us posted. I'm also looking for hard info on rates. I was hoping to find demographics style maps of the country based on various ages.

We're considering moving from Michigan within the next year or two, but we might eventually be forced back for the health insurance. Michigan has a system I haven't seen in any other state (I haven't reviewed them all). If I understand it correctly, BCBS of Michigan provides the health insurance for state county and municipal employees and by law lumps individuals into the same group plan (in effect, not in administration).

I'm sure that this raises the costs that local governments pay for their employees, which in effect makes it tax subsidized. I'm also sure that the number of individual policies is a drop in the bucket compared to government employees.

1HF
 
Hello Happy Fool! Now this is interesting!

In my research, Michigan is the only place I found
with the system you describe. I was not even aware of it. Anyway, I lived/worked in Michigan for many years
and really like the state (except for the weather).
We too may be "forced back", although there are
some advantages to me in that event. Bottom line
is that I may have to swicth my relo route by 180 degrees. Oh well, got to stay flexible :).
 
I think PA may have a similar approach, but I have land and family roots in MI.

1HF
 
Well, I too have roots in Michigan, as does my wife.
However, the winters are not what I had envisioned
for my twilight years. Still, the prospect has some appeal. I am quite conflicted at present.
To be continued.........................................
 
"Retirees Face A Health Care Crunch" in the Washington Post - It's about health care costs after 65 - but I imagine most of us are hoping to get there.

A 65-year-old living where Medigap premiums are moderate, such as Arizona or the District of Columbia, who retired this year with no employer-sponsored coverage, would need $47,000 in savings to pay just the premiums for Medicare Part B coverage and the most comprehensive of the 10 standard Medigap policies -- Plan J -- between now and age 80, the study figures. It would take $66,000 to remain covered to age 85. That doesn't include nursing-home care.

In Florida, where Medigap insurance is particularly expensive, such a retiree would need the equivalent of $82,000 to make it to 80 and $115,000 to 85.

These figures assume that insurance costs (inflation combined with the effect of growing older, which makes coverage more expensive) rise at only 7 percent a year. If these costs rise at, say, 14 percent -- which may seem high but is hardly impossible -- a retiree this year would need $335,000 in savings to pay the premiums.

http://www.washingtonpost.com/ac2/wp-dyn/A45349-2003Feb21

arrete
 
If the politicians really cared what happened to people, the best way to reduce medical costs would be to remove all taxes on medicine. Doctors, nurses, etc... should not pay any income tax on money earned in medicine, as this goes right on your hospital bill (or insurance premium). There should be no property tax on medical buildings, sales tax on medical supplies, etc... since all of these costs are added directly to doctor bills (and insurance premiums). It won't happen, but it would go a long way towards slowing the rate of medical inflation. Since it won't happen, I guess that we will just have to figure that medical costs will continue to markedly outpace the CPI-U, and plan accordingly. Indeed, it may get more expensive for those over 65 when the boomers start relying on Medicare in numbers, as the system will get a lot more expensive for Washington.. Overweighting health care stocks in the portfolio may help some. We have to find a way to survive under various likely economic scenarios, and continued high health care inflation seems to be a high probability.
 
Nice thought but that's not how capitalism works.
If I were suddenly relived of taxes but I know you still have the same amount of money to pay me I would have no incentive to lower prices. Health care is not optional. People will get it any way they can. It is what Adam Smith called a "necessary". Even he admitted his whole market theory could only function reliably with things that were not necessay. AND in a state of "perfect freedom" and acknowledges that no state of perfect freedom could ever exist

Even Dick Armey recently made this same point. Last yr or the yr before when gasoline prices were shooting up, there was a suggestion to temporarily remove the .25 cent per gallon federal gasoline tax. Of course congress didn't do this and Armey said it wouldn't work because gas stations and oil companies would just raise their prices (and proifit margins) by the amount of the tax. And he's a Republican! he knows how the bread gets buttered.

Unfortunately it can't be as simple as we'd like it
 
area 52 has it just right. I was in business my whole life
and any money I saved in that way would go right
to my bottom line. By the way, I think Dick Armey is great, but then my politics make Rush Limbaugh look
like a bleeding heart liberal, so.......................

And another thing :), although frustrated no end with
this problem, I don't expect/demand that anyone
bail me out of it. I assume that the government will
screw up whatever they touch. I also believe
I can offset that with brainpower and willpower.
 
By the way, I think thingy Armey is great, but then my politics make Rush Limbaugh look
like a bleeding heart liberal, so


Heh heh, actually that was a sloppy
edit. I meant to say Dick Armey but I guess you got my drift. Must have been thinking of Darrel Hammond's Chris Matthews impersonation on Sat Night Live

Well here's the bad part... I haven't disagreed with anything JohnGalt has said so far but as far as The Limbovian crowd being too Lefty....?

I don;t trust the private sector any more than I would trust the Gov and in fact have less reason to trust them.

They dont want the gov running things because they are afraid of rationing. Well ME TOO! I did 20 in the mlitary and belive me YOU DONT WANT GOV RUN or SINGLE PAYER medical insurance. At leat not like THAT!

BUT... the Business Class insists on rationing but they want to do it on the basis of "who's got the most money in thier hands RIGHT NOW" So if they dotn't care about yhe othet 99% of societyt why do they get so ticked when all those regular people seem to have a hard-on when it comes to the big money interests?

yes, I have lived my live succeeding on brain power and willpower.. but the preresquitie is that there be "where-with-all" available to be accessed or actuated WITH your brain/will power.

You can't make a silk purse out of a sow's ear. Now, sometimes a "sow's purse" will do just fine, so screw the silk..... but there are times when you really need the "good sht" or God forbid "help" with something

When it gets to that level is when I get concerned.




_________________________________
area 52 has it just right. I was in business my whole life
and any money I saved in that way would go right
to my bottom line. By the way, I think thingy Armey is great, but then my politics make Rush Limbaugh look
like a bleeding heart liberal, so.......................

And another thing , although frustrated no end with
this problem, I don't expect/demand that anyone
bail me out of it. I assume that the government will
screw up whatever they touch. I also believe
I can offset that with brainpower and willpower.
Logged

 
Heh heh, actually that was a sloppy  
edit.  I meant to say thingy Armey but I guess you got my drift.

This looks like a message board profanity filter edit to me. It makes for interesting converstaions sometimes, especially when talking about people with names like Dick Armey and John Hancock. (Spelled correctly at posting time as the recently retired House majority leader and a prominent signer of the Declaration of Independence.)

Limbaugh a liberal? Ouch.

Edited 2-23-2003: Dory36 changed the profanity filter; for the benefit of future readers, before this any mention of Dick Armey showed as "thingy Armey" and my example of John Hancock came out as "John Hanthingy".
 
This looks like a message board profanity filter edit to me

It is. I just noticed that I made the EXACT same mistake TWICE! Not possible since I had it proofed.

I am glad to see no one is in phoney baloney high dudgeon about CENSORSHIP!
 
This looks like a message board profanity filter edit to me


Does this mean that people from northern New England can't use their favorite expression for people who move up from MA and screw up the local politics. I'll try it:

massholes

That should come out something like Massachusetts holes.
 
Well, I too have roots in Michigan, as does my wife.
However, the winters are not what I had envisioned
for my twilight years.  Still, the prospect has some appeal.  I am quite conflicted at present.
To be continued.........................................

When we decided to retire to MI, we didn't let the cold winters deter us. If they get bad enough, you can always take a trip during the worst part to someplace warm. This gives you something to look forward to, some relief from the cold, and when you get back, spring is on it's way. This winter has been the toughest of the three so far. Many days where the high didn't get above 20. We still haven't felt the need to become snowbirds. We both like spring and fall and cooler summers. You probably already know about the Great Lakes being climate moderators. Think hard about whether baking in the summer sun is better than snowbirding or cabin fever. We lived in VA and found it hard to do anything strenuous outdoors between 10 AM and 5 PM for about four months of the year.

1HF
 
Fist of all, I wish to clarify my comment about Rush Limbaugh
being to my left politically. There was a bit of hyperbole
there, but not much.

As far as Happy Fool's Michigan remarks, I lived and worked there (all over the state) from 1976 to 1993.
It is my favorite northern state and I have been in all of them. Plus, my wife lived there her whole life until she
hooked up with me. I'm tempted to return, but most
reluctant to give up the "dream" (Margaritaville on the
Gulf). I lived in Texas from 1994 to 1998 and loved it.
I believe this is the most difficult decision I've faced
since I retired. As Gilda Radner said "It's always something!"
 
This looks like a message board profanity filter edit to me

Heh -- the filter comes with the software that operates the forum. It's configurable, but I'd never bothered until now.

I took out "dick" -- not sure why the authors felt it needed to be in there, as all the rest were clearly unusable at the dinner table.

So now you can talk about thingy Armey as Dick Armey.

However, I did notice that there were a couple of words omitted that, when uttered, caused me some concern. I added them. Now, an early-retiree who must earn wages again might be said to go back to w*rk, or get a j*b.

(Just joking. If you want to talk about - gulp - getting a job, go ahead!)

D*ry36
 
area52 wrote:

If I were suddenly relived of taxes but I know you still have the same
amount of money to pay me I would have no incentive to lower prices.

Mike replies:

Competition is what keeps providers from charging more than cost plus a reasonable profit. Food is also necessary, but quite inexpensive, because machines do most of the work today. Farmers do not charge exhorbitant prices, despite food's absolute necessity, because people can simply buy from another farmer. Labor intensive services by contrast cost a lot. No labor intensive provider can charge less, because all labor is heavily taxed. Insurance companies would aggressively negotiate lower fees if medical workers no longer had to pay income tax, etc... We can agree to disagree on this topic if you like, since the tax on medicine will never be removed in this country to test our theories. :)
 
Yes food is a necessity but it's underlying mode of production is different than seeing a practitioner so it's not a clean comparison to medical care.

Also, the biggest reason why food production is so copious and inexpensive is because of massive federal subsidies (Farmers are businessmen) directl;y and indirectly PLUS.. all the inovations in techniques, sciencs and machienry over the last 100 yrs has been paid for totally or partially by the government. The costs were socialized.The ensuing money to be made was privatized. The Holy Grail of the Business Class.

(By the way this is also true of medical advancements. And most electronics and nearly all computer technology)

No labor intensive provider can charge less, because all labor is heavily taxed. Insurance companies would aggressively negotiate lower fees if medical workers no longer had to pay income ,

Well, I agree with that. Why labour is taxed to death but the sources of wealthy for people who already have most of the money is taxed less IS something we need to work on! I don't see why they need to invent :classes of wealth or income" Tax labour like free pickens but hold off on the dividends and cap gains. what's so magical about that? The way it ought to work is, as Jefferson and Adam Smith concluded, don't tax anything below a certain limit. THEN tax in graduated proportions, anything above that.

As far as insurance companies aggressively negotiating lower fees. Well, maybe. Or maybe Drs will extort the people (running to the government first) by going "on strike" for more take-home pay like they're doing now in several states. I guess it's only good when people who make a lo of money and have "professional status" do it. But when Ralph Kramden throws his weight around for more take-home pay he's a *----ing communist.

Competition? People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices" Adam Smith
 
Well, I don't begrudge the rich their money, regardless
of how they made it, and I am in full support of striking doctors. Their insurance premiums are ridiculous.
This is America and I think "every man for himself" and
"the less government the better" is the way it oughta
be". We need a little more rugged individualism and a little less "some one needs to take care of me."

BTW, Ralph Kramden probably was a f--king commie!
 
I don't begrudge anybody their wealth no matter how it was derived. But the middle class has their wealth begrudged all the time. Speacial treatment for everything exept teh fruits of going to work every day And the wealth of the wealthy was created by other people. I dont confuse working people who do something with "The Rich"

I have no inherent problem with teh doctor thing. The real problem is insurance. And it IS an insurance problem. But when lesser folk cant afford it it gets a big yawn. When dr's and now businesses in general are complaining about the cost, it's a cause celebre.
And of course they run to the first refuge of any "American Capitalist Businessman": The Government

Business buys the Gov and Dr's feel free to extort. And it IS because of take home pay. The patients pay the bills and the dr's go on strike. Or maybe they need to find different work? No, they LIKE being Dr's and making shtloads of bread. Or hey, here's one. When the middle class cant afford medical insuarnce the trendy thing for the econo-kooks and Limbovian ecomists is to say :Life ain't fair. (Implied: Do your civic duty and just die for me)

Hey, doc. Life ain't fair? Upgrade your skills so you can earn more money (nobody can afford them now)

There's no moral or economic consistency. It's all justified on whose ox is being gored or whose ox you can gore. That was my point

As far as Ralph Kramden.... not a commie circa 1956. Now...I'd say it's debatable

But he makes a living driving that bus creating wealth for Mr Marshall who inherited and million dollar (1956 dollars) operation. If I had to begrudge anybody it'd be Marshall. He's not creating anything or assuming any risk at all except on the links to his rotator cuff
 
Back
Top Bottom