Insurance Companies and profits

For someone with FIRST hand knowledge of Hospital Bills, Doctor Bills, Radiology, etc. The charges that I see on these bills are outrageous to begin with, but when they give the "Negotiated Price" to the insurance companies they are still outrageous but amazingly about 30% of the original total. Seen almost $3MM dollars in bills come thru my mail over the past 4 years and have looked at them and see Doctors that I never met or remember billing this and that, the hospital billing for every little wash cloth on top of the daily room charge, messed up. I don't know the answer but do know even with a pretty good medical insurance plan, we have still paid well over $5,000 out of pocket every year since 2003 and 2010 will not be any different for my sugery is in January just after the new year so the hospital will take the out of pocket deductible off the first surgery and stay. Looking at easily $40,000 to $50,000 out of pocket for us in the past 7 years total. To some people, $50,000 might as well be $5MM, not saying I am rich but am saying that we have spent every savings and other that I have to keep afloat with all my medical problems. Worked hard since I was 14 yrs old and spent evey nickle in savings and other due to medical bills. There has to be an equal median somewhere between the medical prices and insurance and the person that figures this one out is much smarter than me.

[QUOTE=know1;387616]See that's the thing. The way it is now, you can't afford not to have insurance because the insurance companies have driven the cost up so much and eliminated any real competition for services.

You wouldn't need to have anyone administer anything if people just paid for health care out of their own pockets.

Think about how much more money our companies could pay us in salary to afford health care if they weren't paying all those premiums. What if people put the money they pay in premiums into some sort of tax sheltered, growth investment from day 1 that they were employed. I figure I'd have about $75K sitting there right now when you add in modest growth and extract the money that I've actually spent on health care over the years.

Someone else said that you need the large pool of people in insurance to make the costs low, but if we talk about insuring everyone, then that goes out the window. The whole thing is like a giant panzi scheme destined to collapse.

I don't hate the insurance companies, but I recognize that their existence and our blind reliance on them, coupled with the fact that people don't actually pay for their health care is a significant part of our problems with the cost of health care.[/QUOTE]

Okay, without the giant ponzi scheme that is insurance what's your answer to a catastrophic illness that puts you in the hospital for several weeks or months? Elwood's situation is a good example.

Your 75k would be a pittance compared to the 2 or 3 million you'd owe. What would you do? How would you pay the bills?

Let's give you the benefit of the doubt. Say medical costs hadn't been inflated by insurance companies and the bill was only 2 or 3 hundred thousand bucks. Same question. How would you pay it?

[QUOTE=Devils Horse;387591]That makes way too much sense for the current administration to even consider. Let's take a system the overwhelming majority is covered under and reasonably happy with and put in a different system to try and cover a much smaller segment of the population. Nope, instead of starting a program to help those without insurance, let's just toss the whole enchilada and start over. The end result: A federal government controlled system that NOBODY is going to be happy with. The federal government can't effectively run the healthcare programs they have now, let alone a new one large as this.

Also never forget politicians (including our President) are lawyers, so lawsuit reform won't be happening.[/QUOTE]

Thanks for bringing me back to my senses.

[QUOTE=Devils Horse;387664]Okay, without the giant ponzi scheme that is insurance what's your answer to a catastrophic illness that puts you in the hospital for several weeks or months? Elwood's situation is a good example.

Your 75k would be a pittance compared to the 2 or 3 million you'd owe. What would you do? How would you pay the bills?

Let's give you the benefit of the doubt. Say medical costs hadn't been inflated by insurance companies and the bill was only 2 or 3 hundred thousand bucks. Same question. How would you pay it?[/QUOTE]

I think we really need to look into some sort of catastrophic insurance plans and let us pay directly the stuff that we use insurance to take our money and pay for us currently.

[QUOTE=know1;387668]I think we really need to look into some sort of catastrophic insurance plans and let us pay directly the stuff that we use insurance to take our money and pay for us currently.[/QUOTE]

There are people even unwilling to pay a few thousand dollars.......I have catastrophic insurance and would have a hard time paying the 4 thousand dollar deductable every year if I had to for say 2-3 years......but that 4k a year is a VERY small percentage of the overall bill for a catastrophic incident.

In my case, when ANYONE in my family visits the doctor, I tell them UP FRONT, that I'm paying this expense out of my HSA dollars. Sometimes it is cheaper because of negotiated rates, but most times it is not, but I KNOW what is being paid, because I'm PAYING it.

I do believe that some costs........most costs are elevated to some extent due to insurance.......this is simply because of all the Medicaid and MEDICARE business that is out there. Eliminate some of that WASTE and OVERBILLING, and maybe we will see the REAL cost for stuff......

I don't know the answers, but I do know NO GOVERNMENT ENTITY can manage health care better than the existing health care companies.

* I'd love to see the gubment CRUSH anyone abusing the system........Destroy any company or business overbilling Medicare and Medicaid.

* CRUSH any PERSON abusing the system.......throw their asses in jail.

* Doctors overbilling and defrauding the system should lose their licenses, and be JAILED.

* Fraudulent Lawsuits.......THROW the lawyer and the perp in JAIL......get tough on this CRAP.


If we eliminate FRAUD, eliminate WASTE, eliminate Lawsuits, etc, etc......we can clean up the system, and GENERATE savings for the public.....THOSE are easy things to accomplish without a 1500 page ******** bill.

Later,

Geo

Health insurance probably does drive up some costs, some of the time. But I don't think it has nearly as much of an effect as the exorbitant cost of malpractice insurance, especially for OB/GYN's. Many of them have had to close down their practices because of it.

[QUOTE=GeoFisher;387700]I don't know the answers, but I do know NO GOVERNMENT ENTITY can manage health care better than the existing health care companies. [/QUOTE]

On this we can agree. There is no doubt that ANY government involvement in this will make it worse.

Seems to me a lot of the time the government gets involved for the purpose of [B][U]protecting us from ourselves[/U][/B]. I wonder what a plumber's bill would be if they charged the way some medical facilitites do.
[B][U]Plumber comes to do a 1 hour job to install a faucet:[/U][/B]
- $5.00 gas to your house and back again.
- $15.00 as a part of his monthly payment on his truck
- $20.00 to cover his truck insurance.
- $20.00 to cover his truck registration and taxes for the year.
- $20.00 to cover a portion of the tools he bought to be a plumber, now benefitting the customer.
- $30.00 to help pay back his plumber's union fees.
- $7.00 for his breakfast before he came to your house.
- $2.00 for the tip he left the blond waitress.
- $400.00 for 1 hour labor(has to be high to help pay back the loan he took to go to trade school).
- $200 for the $46.00 faucet, because he had to call to order it, drive to get it, take time to do that, then maintain the records of the expense to pass on to you.
- $20.00 to offset his income tax preparation fees this year.
- $10.00 to help maintain and acquire the clothing he wore to the work site.
- $50.00, because he came to install the faucet after 3 pm, when he would have normally been off duty and at the golf course.

But for free as he completes the job, he gives you 2 sentences on how to use the faucet, not how to maintain it, or how to avoid needing one in the future, but hands it to you on 4 pieces of paper covered with advertizing that someone else paid him for so they could get their name in front of your face.

- Grand total: $799, for a 1 hour job and a $46.00 faucet. He presents the bill to you. You bulk and send it to your homeowner's insurance company. Insurance company negotiates and pays the plumber $96.00 ($50 labor and $46.00 for the faucet). Insurance company having paid much less, now jacks up your homeowner policy by 40%, just in case the plumber screwed up and has to do it again, and to discourage you from being so brave as to expect coverage you paid for.

Yep........time somebody with some clout gets involved. I don't believe the government will get it 100% right. Tell me the private insurance companies have it anything better than about 60% right? Government is "not for profit, for the people and by the people". The only goal a private business has is to achieve profit and to grow market share. All that other "Customer Care Guarantee, Patient Bill of Rights, etc mumbo jumbo is the same line of hype one expects from the local car dealership.

Before I get wrongly accussed, I have great respect for the very dedicated and talented medical personnel of all types, from the guy who pushes the broom, to the guy or gal who does the brain surgery. I have less respect for the medical business managers and their accompilices, the insurance companies. High profits on mecial bills make the med business managers happy, and the insurance companies might bulk to retain cash flow and liquidity, but will gladly pay to much know they can pass it on to the consumer and get even greater cash flow and liquidity. Cost effectiveness makes sense in medical matters because a buck saved is available for care to save more lives. Profiteering that drives costs to the point that some folks can't afford to get the care they need, both preventative and remedial, is just flat wrong.

But that's just my opinion, I could be wrong.

[QUOTE=RoadToad;387837]Health insurance probably does drive up some costs, some of the time. But I don't think it has nearly as much of an effect as the exorbitant cost of malpractice insurance, especially for OB/GYN's. Many of them have had to close down their practices because of it.[/QUOTE]

I also agree medical malpractice has gotten out of hand. But to me, this just seems to follow the same trend of stupid lawsuits that the "me" generation has bestowed upon us. Baseball bats, hot coffee.......are now financial liability risks instead of being enjoyed tools of our life style.