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CBWx2

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« #30 : August 26, 2013, 08:13:32 PM »


2. Tremendous and inexplicable profits being earned for acting as a glorified middle man  that helps drive up the price of services for the consumer, and a system that limits access to individuals unless they pay these glorified middle men or are wealthy enough to not have to is quite another.

Care to explain to me how the food gets from the consumer to the producer without the middleman?

What middleman are you comparing insurance companies to, exactly?

The distributor.

The distributor is providing a service for the producers and the vendors. They are essential to both. Health insurance does not distribute anything.


spartan

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« #31 : August 26, 2013, 08:18:28 PM »


2. Tremendous and inexplicable profits being earned for acting as a glorified middle man  that helps drive up the price of services for the consumer, and a system that limits access to individuals unless they pay these glorified middle men or are wealthy enough to not have to is quite another.

Care to explain to me how the food gets from the consumer to the producer without the middleman?

What middleman are you comparing insurance companies to, exactly?

The distributor.

The distributor is providing a service for the producers and the vendors. They are essential to both. Health insurance does not distribute anything.

But they do act as a single point of contact and coordination point for the different kind of services, which is one of the roles of a distributor.

spartan

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« #32 : August 26, 2013, 08:25:59 PM »


So let me ask you a simple question, my simple-minded friend. If you are accusing me of being biased against for profit insurance because I work in the industry, how exactly would I be benefiting by pushing for single payer, given that the opportunity for financial gain in my profession is larger in the current system than it would be if we were to shape our system to look more like Canada's, just as an example? One of the reasons I believe in single payer is driven by the power of price control that such a system provides. How exactly does that make things more lucrative for healthcare and prescription drug providers, Vince?


Because that then would make you a Unionised Govt employee, which I am certain you would be ecstatic about.

Huh? How does it make being a provider more lucrative was the question, spartan.

And, as you are going on about the obscene profits of the Healthcare industry, most of the companies in the game are not for profit, and those that are for profit have an average profit margin of 3%, with the US average being 9.3%. Hardly pushing the envelope is it?

Link?

That bold bit. And I was being facetious.

http://www.marketwatch.com/story/high-profit-margins-hint-at-pain-to-come-2013-08-23?link=MW_latest_news

"U.S. corporations, on average, currently report a profit of 9.3 cents for every dollar of sales, according to U.S. Commerce Department data — a profit margin of 9.3%. "

http://www.cato.org/publications/commentary/truth-about-health-insurance-premiums-profits

"University of Michigan economist Mark Perry calculated that without the sale of NextRX, “WellPoint’s profit margin would have been only 3.9 percent, the industry average profit margin would have been closer to 3percent”— $100 per policy.”
« : August 26, 2013, 08:27:40 PM spartan »

CBWx2

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« #33 : August 26, 2013, 08:28:29 PM »


2. Tremendous and inexplicable profits being earned for acting as a glorified middle man  that helps drive up the price of services for the consumer, and a system that limits access to individuals unless they pay these glorified middle men or are wealthy enough to not have to is quite another.

Care to explain to me how the food gets from the consumer to the producer without the middleman?

What middleman are you comparing insurance companies to, exactly?

The distributor.

The distributor is providing a service for the producers and the vendors. They are essential to both. Health insurance does not distribute anything.

But they do act as a single point of contact and coordination point for the different kind of services, which is one of the roles of a distributor.

Do consumers have to pay the distributors directly before they are allowed access to shop at Publix?


Bucfucious

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« #34 : August 26, 2013, 08:32:53 PM »

 "The healthcare system cannot manage without doctors and hospitals. It can manage just fine without monopolistic health insurance providers."

Put the government's sterling record of management up against anyone, would you? Well, at least they're not "monopolistic."

Dolorous Jason

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« #35 : August 26, 2013, 08:53:41 PM »

"The healthcare system cannot manage without doctors and hospitals. It can manage just fine without monopolistic health insurance providers."

Put the government's sterling record of management up against anyone, would you? Well, at least they're not "monopolistic."

LOL , not at all.

What is your point? I was wrong? Ok. You win. I was wrong.

           

CBWx2

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« #36 : August 26, 2013, 09:03:33 PM »


So let me ask you a simple question, my simple-minded friend. If you are accusing me of being biased against for profit insurance because I work in the industry, how exactly would I be benefiting by pushing for single payer, given that the opportunity for financial gain in my profession is larger in the current system than it would be if we were to shape our system to look more like Canada's, just as an example? One of the reasons I believe in single payer is driven by the power of price control that such a system provides. How exactly does that make things more lucrative for healthcare and prescription drug providers, Vince?


Because that then would make you a Unionised Govt employee, which I am certain you would be ecstatic about.

Huh? How does it make being a provider more lucrative was the question, spartan.

And, as you are going on about the obscene profits of the Healthcare industry, most of the companies in the game are not for profit, and those that are for profit have an average profit margin of 3%, with the US average being 9.3%. Hardly pushing the envelope is it?

Link?

http://www.cato.org/publications/commentary/truth-about-health-insurance-premiums-profits

"University of Michigan economist Mark Perry calculated that without the sale of NextRX, “WellPoint’s profit margin would have been only 3.9 percent, the industry average profit margin would have been closer to 3percent”— $100 per policy.”

Your comment that "most" private insurance providers are not for profit is not substantiated in this piece. It says that non-profit BCBS plans make up a third of the industry, not that they make up a majority of plans. Also, non-profit plans is a bit of a misnomer. They do make profits off of these plans (they are allowed to keep profits for reserve funds), they are just not allowed to stockpile over a certain amount of profits, but they often times exceed these limits with little to no penalty. Not surprising, the CATO piece left this inconvenient fact out.

As far as the profit margin, a 7.3 billion dollar profit certainly seems pretty substantial to me for a company that does what a true non-profit insurer can do for a mere fraction of the cost.

Lastly, this article is criticizing Obama for blaming the insurance companies for rising healthcare costs. I only partly blame them. Obviously, whenever you throw another profit seeking entity into an equation where consumers are involved, it's foolish to suggest that it doesn't raise the price. My problem with for profit insurance is that it's not necessary. The government, or any other real non-profit entity could do the exact same thing. There is absolutely nothing that for-profit insurance companies do that Medicare/Medicaid don't do. The major difference being, those two programs implement cost control measures. Private companies don't, which is why MD's and hospitals love them much more than the government programs. They can bill them for more crap. Here's why:

Most places only have a few hospitals and MDs for patients to choose from. Depending on the size of the community, competition isn't very stiff. In order for a for-profit insurer to make a profit, they have to negotiate with providers in a particular area to accept their product. No person or company is going to purchase insurance that isn't accepted by the health care providers in their area. For this reason, the hospitals and MD's go into negotiations with these companies with most of the leverage. They tend to be fine with this, however, because they can recoup costs by simply raising premiums or lowering coverage by way of raising deductibles. They make money either way, so it's little skin off of their teeth.

Medicare and Medicaid, however, are not for profit, and are generally under scrutiny to keep costs down. They go into negotiations with a completely different amount of leverage, and a substantially lower level of apathy regarding raising service costs. The more people they cover, the more leverage they have.
« : August 26, 2013, 09:12:01 PM CBWx2 »


CBWx2

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« #37 : August 26, 2013, 09:07:12 PM »

"The healthcare system cannot manage without doctors and hospitals. It can manage just fine without monopolistic health insurance providers."

Put the government's sterling record of management up against anyone, would you? Well, at least they're not "monopolistic."

You seem to be thinking that I want government managed insurance. I don't. I want single payer healthcare. I don't want a government monopoly on the industry. I want the word "industry" to no longer apply to health care coverage.


CalcuttaRain

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« #38 : August 26, 2013, 09:12:18 PM »

For profit insurance providers neither have the power nor the motivation to control costs. They make huge profits either way.

WTF are you talking about?

CBW, if you think private insurers are not motivated to keep healthcare costs down then you have no idea how insurance works. Private health insurers are VERY motivated to have lower healthcare costs. You seem to think that insurers are, essentially, "marking up" health care costs to make a profit? Is that what you think? You understand that is not how insurance works, right?

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CBWx2

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« #39 : August 26, 2013, 09:14:07 PM »

For profit insurance providers neither have the power nor the motivation to control costs. They make huge profits either way.

WTF are you talking about?

CBW, if you think private insurers are not motivated to keep healthcare costs down then you have no idea how insurance works. Private health insurers are VERY motivated to have lower healthcare costs. You seem to think that insurers are, essentially, "marking up" health care costs to make a profit? Is that what you think? You understand that is not how insurance works, right?

I've  covered this already. Read below.

Lastly, this article is criticizing Obama for blaming the insurance companies for rising healthcare costs. I only partly blame them. Obviously, whenever you throw another profit seeking entity into an equation where consumers are involved, it's foolish to suggest that it doesn't raise the price. My problem with for profit insurance is that it's not necessary. The government, or any other real non-profit entity could do the exact same thing. There is absolutely nothing that for-profit insurance companies do that Medicare/Medicaid don't do. The major difference being, those two programs implement cost control measures. Private companies don't, which is why MD's and hospitals love them much more than the government programs. They can bill them for more crap. Here's why:

Most places only have a few hospitals and MDs for patients to choose from. Depending on the size of the community, competition isn't very stiff. In order for a for-profit insurer to make a profit, they have to negotiate with providers in a particular area to accept their product. No person or company is going to purchase insurance that isn't accepted by the health care providers in their area. For this reason, the hospitals and MD's go into negotiations with these companies with most of the leverage. They tend to be fine with this, however, because they can recoup costs by simply raising premiums or lowering coverage by way of raising deductibles. They make money either way, so it's little skin off of their teeth.

Medicare and Medicaid, however, are not for profit, and are generally under scrutiny to keep costs down. They go into negotiations with a completely different amount of leverage, and a substantially lower level of apathy regarding raising service costs. The more people they cover, the more leverage they have.
« : August 26, 2013, 09:18:00 PM CBWx2 »


Dolorous Jason

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« #40 : August 26, 2013, 09:17:58 PM »

...and we officially have entered the vortex of another of Comrade's blackholes..

What is your point? I was wrong? Ok. You win. I was wrong.

           

CBWx2

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« #41 : August 26, 2013, 09:22:27 PM »

...and we officially have entered the vortex of another of Comrade's blackholes..

Care to elaborate on what you think makes this a black-hole discussion? Is it because SNAP and Medicare/Medicaid only operate the exact same way in your mind?


Dolorous Jason

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« #42 : August 26, 2013, 09:25:14 PM »

I cant see it spinning into an oblivion of nonsense that will never end already.

What is your point? I was wrong? Ok. You win. I was wrong.

           

CBWx2

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« #43 : August 26, 2013, 09:26:34 PM »

Vince, if you want to find out who seeks to lower costs to the consumers more between public and private insurance plans, just ask anyone who does medical billing. Ask them who requires more information to justify services provided and services ordered between public and private insurance plans. I suspect the answer will be one that may be a bit shocking to you.


CalcuttaRain

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« #44 : August 26, 2013, 09:35:26 PM »

For profit insurance providers neither have the power nor the motivation to control costs. They make huge profits either way.

WTF are you talking about?

CBW, if you think private insurers are not motivated to keep healthcare costs down then you have no idea how insurance works. Private health insurers are VERY motivated to have lower healthcare costs. You seem to think that insurers are, essentially, "marking up" health care costs to make a profit? Is that what you think? You understand that is not how insurance works, right?

I've  covered this already. Read below.

In order for a for-profit insurer to make a profit, they have to negotiate with providers in a particular area to accept their product. No person or company is going to purchase insurance that isn't accepted by the health care providers in their area. For this reason, the hospitals and MD's go into negotiations with these companies with most of the leverage. They tend to be fine with this, however, because they can recoup costs by simply raising premiums or lowering coverage by way of raising deductibles. They make money either way, so it's little skin off of their teeth.

Medicare and Medicaid, however, are not for profit, and are generally under scrutiny to keep costs down. They go into negotiations with a completely different amount of leverage, and a substantially lower level of apathy regarding raising service costs. The more people they cover, the more leverage they have.

wow, I can understand having a political point of view, but if that is what you think  its no wonder your view is so **CENSORED**ed up. That description is what you get when you have someone from the medical profession/field looking at things from the outside BUT ONLY FROM THE PERSPECTIVE OF THE CARE PROVIDER .  . and thinking he has figured it out.  Holy crap.

CBW, that is so wrong I have to think about where to start. This is a total waste of my time so I am going to make this brief. Let's start with this:

In order for a for-profit insurer to make a profit, they have to negotiate with providers in a particular area to accept their product. No person or company is going to purchase insurance that isn't accepted by the health care providers in their area. For this reason, the hospitals and MD's go into negotiations with these companies with most of the leverage. They tend to be fine with this, however, because they can recoup costs by simply raising premiums or lowering coverage by way of raising deductibles. They make money either way, so it's little skin off of their teeth.

Insurers pay for network and out of network coverage precisely because everyone is not in a network (ie negotiate rates). You seem to think everything is negotiated rates when that is not true at all.  You are also leaving off the biggest issue impacting profits, which is CLAIM EXPERIENCE.  Insurers not just tacking on a surcharge, they are collecting premiums from as wide a group as possible and hoping most do NOT have claims. This is why oreventative healthcare and insurance don't work well. but insurer profits are greatly impacted by big care expenses too and contrary to this comment - "they can recoup costs by simply raising premiums or lowering coverage by way of raising deductibles. They make money either way, so it's little skin off of their teeth"  -- insurers are COMPETING with other insurers so "raising premiums" and "lowering coverage" and "raising deductibles" means they lose business to a competitor.  (By the way, who does Medicare compete with?).  Health insurers absolutely care about healthcare costs and do have leverage, that is why you have stuff like this happen:

"Hartford Hospital and UnitedHealth Group, the nation's largest health insurer, are in a hard-fought contract negotiation that could leave thousands of customers facing higher out-of-pocket expenses if the current agreement expires Oct. 28."Hartford Hospital wants consumers to pay 30 percent more over the next three years for services received at their facilities," said Daryl Richard, spokesman for UnitedHealth Group. "In practical terms, that means the average cost for a two-day hospital stay after delivering a baby would increase by as much as $650, and the average cost of outpatient surgery, such as arthroscopic knee surgery, would increase by almost $300."

If your description was right this would never happen. If your description was accurate, UHC would have just accepted the hospitals new rates ("little skin off their teeth" you called it) and raised deductibles, rased premiums and reduced coverage etc.  They didnt do that though because UHC was under competitive pressure from the MANY other insuers that private private coverage to Hartford Hospital:

Aetna
Blue Cross
Cigna
ConnectiCare
Connecticut Health Plan
Franklin Health Plan
Healthcare Compare / Affordable Health / First Health
Health Care Value Management
Health CT
Health Direct
Health Management Center
Health New England
Health Net
Health Strategies
Managed Health Network
Multiplan Managed Care
Northeast Health Direct
Occupational Health Services
Olsten Health Care
One Health Plan of Southern New England
Oxford Health Plan
Private Health Care Systems
United Healthcare
United Payors & United Providers

http://www.harthosp.org/PatientVisitors/PatientFinancialServices/InsuranceManagedCareInformation/InsurancePlansAccepted/default.aspx


you dont have a clue what you are talking about because you are describing your perception instead of reality.
« : August 26, 2013, 09:53:27 PM VinBucFan »

Show the bravest of the brave kids that you have their back.  Go to http://www.childrenscancercenter.org/

Just check out the site or maybe like them on Facebook . .  or Share the site on Facebook, re-tweet one of their tweets.  Not everyone can give money to support this great cause, but its easy to give 10 seconds of your time to help spread the word about The Children\\\\\\\'s Cancer Center
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