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Old 03-27-2017, 06:58 AM   #201 (permalink)
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Tell me: What value do insurance companies bring to the health care market, that can't be duplicated by organizing healthcare without so much "friction"?

By some estimates (the one I'm thinking of comes from Aetna), about 50% of medical procedures can be classified as "defensive medicine" to prove what's already known to ensure payment and to avoid potential litigation.

That's a tremendous waste, causes unnecessary discomfort to the patient, and is another reason our healthcare costs 2X that in the rest of the Western world. Tort and malpractice reform, along with standardization in billing and uniform coverage standards could go a long way to eliminating these expenses.

Everybody talks about not wanting to fuck up 20% of the U.S. economy.

I say, why the fuck should it cost 20% of our GDP to be healthy, when the majority of the world can do it for around 10%. Let's focus on getting that portion of the economy to shrink, as a % of GDP.


An actual educated response... Well, it goes back to what mickel and I were just discussing. The red tape and regulations for one add to the costs of health care. Health insurance companies reinvest their profits back into the market, thus playing a vital role in our economy. We all know if there's no contribution there's no growth. Health insurance companies want people to be healthy and if the regulations would allow them to reward those that take the extra step like gym memberships, quitting smoking etc like they can on group plans, that's lower costs as well.
You can't really do much about defensive medicine cause that's a moral problem within our country. No reform or regulation is going to change that mentality of blaming someone else for their lack of responsibility.
And to be frank, the reason why the Western world has better pretty much everything than us is cause we are to fuckin dumb to keep up. Forget health care for a second, our education system is complete shit. This has a trickle down effect on everything we are all talking about. We can't get out of our own way to get shit done.

Also, since you seem educated despite your beliefs different from mine, you should clearly understand that eliminating insurance companies puts 500,000 people out of job. Not to mention, they give access to Drs and Hospitals to customers who normally wouldn't have the means to see them. Keep in mind, insurance companies have networks, within those networks are negotiated rates they pay for a Dr visit or surgery or procedure. Without those networks those rates wouldn't be able to be negotiated. Insurance companies invest billions of dollars, hundreds of billions back into our economy m, these numbers are published and you can find them if you'd like. You think the govt would pay what these insurance companies are for some of these procedures? Or Rxs? Or specialized Drs?
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Old 03-27-2017, 07:06 AM   #202 (permalink)
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A brief comment that was made to me decades ago by an insurance individual that sums up the insurance industry in totality. "Insurance is for peace of mind not for making claims", .
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Old 03-27-2017, 07:13 AM   #203 (permalink)
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Also, since you seem educated despite your beliefs different from mine, you should clearly understand that eliminating insurance companies puts 500,000 people out of job. Not to mention, they give access to Drs and Hospitals to customers who normally wouldn't have the means to see them. Keep in mind, insurance companies have networks, within those networks are negotiated rates they pay for a Dr visit or surgery or procedure. Without those networks those rates wouldn't be able to be negotiated. Insurance companies invest billions of dollars, hundreds of billions back into our economy m, these numbers are published and you can find them if you'd like. You think the govt would pay what these insurance companies are for some of these procedures? Or Rxs? Or specialized Drs?
We should have no problem getting rid of 500,000 people who (to take it to the extreme) are a drag on our economy. An alternative, is health maintenance groups, like Kaiser Permanente, where the provider network is the same as the insurance company.

There's other options as well, such as separating catastrophic or chronic illness insurance from ordinary healthcare maintenance. Insurance is very good at actualizing the costs across a broad pool for the random large events that come along. To also expect insurance to pay day-to-day health maintenance, strains at what insurance can do.
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Old 03-27-2017, 07:16 AM   #204 (permalink)
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Alright I'm done here! I'm a drag on the economy as a health insurance agent?!? I make over 100k and spend money like a mad man, I invest, own a house among other things, but you're right I'm a drag on the economy. You're an idiot
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Old 03-27-2017, 07:25 AM   #205 (permalink)
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Alright I'm done here! I'm a drag on the economy as a health insurance agent?!? I make over 100k and spend money like a mad man, I invest, own a house among other things....]
Don't worry, you can be retrained.

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Old 03-27-2017, 07:28 AM   #206 (permalink)
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Not many folks can just whip out the credit card to pay for a $50,000 heart attack.

Just sayin'.
I can't afford to whip out the credit card to pay for the million dollars worth of injuries and damage I did when I drove my car into the busload of school children either. Since I didn't have inuance because I didn't need it, now that I do need it (because I can't afford to pay for my million dollar pre existing accident) I should be able to get it for the same $50 a month it would have cost me had I bought it last month BEFORE my accident happened. How was I supposed to know that by talking on my cell phone, while shaving and eating breakfast, and doing 85 in a 55 zone in the fog that I'd have a wreck and REALLY NEED insurance to pay for me?

It's just not fair that I can't get covered for the wreck I already caused, I can't afford to pay for the wreck myself, I'll loose all my toys, and my house, and my savings and retirement, and maybe even have to file bankruptcy, it'll ruin my credit.

It's just not fair that they would insure me last month for $50 a month, and now they won't insure me when I really need it...
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Old 03-27-2017, 07:35 AM   #207 (permalink)
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Don't worry, you can be retrained.

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Old 03-27-2017, 08:38 AM   #208 (permalink)
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What people tend to forget or think about, part of the reason health care costs are so high is the technology we now have to treat, detect and prevent conditions. There's a reason the survivor rate for cancers heart attacks and other major illnesses is higher. You have to take that into affect. It's no just all the negative shit people talk about. It's the machines, labs, studies to figure shit out that cost billions and billions to produce, buy and pay people who know how to use them. That's why going to single payor will never happen. There's too much money involved, both positive money and negative influential money.

Lest you forget that the good ol' US of A is flooded with preventable causes for needing hospital care. More so than what, almost every developed country in the world? Or every country in the developed world...




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Old 03-27-2017, 08:56 AM   #209 (permalink)
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What people tend to forget or think about, part of the reason health care costs are so high is the technology we now have to treat, detect and prevent conditions. There's a reason the survivor rate for cancers heart attacks and other major illnesses is higher. You have to take that into affect. It's no just all the negative shit people talk about. It's the machines, labs, studies to figure shit out that cost billions and billions to produce, buy and pay people who know how to use them. That's why going to single payor will never happen. There's too much money involved, both positive money and negative influential money.
but isn't that because Medtronic, Covidien, Striker, etc know how the insurance game is played and can charge top top dollar for these devices?
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Old 03-27-2017, 09:24 AM   #210 (permalink)
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I just don't understand how/why people think the government is somehow supposed to fix the healthcare problems when they created 90% of them...
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Old 03-27-2017, 09:27 AM   #211 (permalink)
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Again, I'm not saying I disagree with you and that's partially why RXs cost as much as they do but that's a whole other topic! Certainly there should be a way to produce these things at lower costs.
But you're actually proving my point. By simply eliminating insurance companies it won't bring down medical costs at all. There's a shit ton more involved
Don't get me wrong, I have nothing about the concept of insurance. My ideal system is one in which we pay for most everything out of pocket while we keep catastrophic insurance for big medical problems.

Having people pay for most of their healthcare expenses will give us cheaper and better services/products, as people spend their own money much more carefully. Those decreases in cost would greatly help those who have more extensive medical needs. My problem with insurance is that our options are artificially limited and that very often large insurance companies get very cozy with the government.

And as you mentioned earlier, calling Geico to buy a retroactive policy after you crashed your car is not insurance. I could be talked into some some gov't financed solution for those who are uninsurable, if that leaves a real free market solution for the rest.
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Old 03-27-2017, 09:32 AM   #212 (permalink)
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Don't get me wrong, I have nothing about the concept of insurance. My ideal system is one in which we pay for most everything out of pocket while we keep catastrophic insurance for big medical problems.

Having people pay for most of their healthcare expenses will give us cheaper and better services/products, as people spend their own money much more carefully. Those decreases in cost would greatly help those who have more extensive medical needs. My problem with insurance is that our options are artificially limited and that very often large insurance companies get very cozy with the government.

And as you mentioned earlier, calling Geico to buy a retroactive policy after you crashed your car is not insurance. I could be talked into some some gov't financed solution for those who are uninsurable, if that leaves a real free market solution for the rest.


You and I are on the same page then. Auto insurance doesn't cover brake jobs and oil changes, why should health insurance cover a Dr visit?! Pay it out of pocket. It'll keep the cost way down. Expanding HSA is what I thought trump was going to do and should do but fuck it, I don't expect shit out of them for health care reform
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Old 03-27-2017, 09:34 AM   #213 (permalink)
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but isn't that because Medtronic, Covidien, Striker, etc know how the insurance game is played and can charge top top dollar for these devices?


Eh, maybe. I don't deal with that side of things and I'm sure they can charge whatever they want cause hospitals and Drs don't want to left without offering the "latest and greatest". Again, I'm not saying it's right I was just refuting the statements of let's get rid of insurance companies as that's not the answer!
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Old 03-27-2017, 10:29 AM   #214 (permalink)
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Getting rid of insurance cos.............. Wonder what the actuaries would think of that?!

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Old 03-27-2017, 10:43 AM   #215 (permalink)
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Not many folks can just whip out the credit card to pay for a $50,000 heart attack.

Just sayin'.
And thanks to payment plans, you don't have to.
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Old 03-27-2017, 10:47 AM   #216 (permalink)
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You can't be that dumb right? No offense but where do you think insurance makes money off of a heart attack?! Your logic is lacking a lot of thought and brains
You do realise that insurance companies don't make money off procedures, but off the lack of procedures being performed? It's the same with car insurance. They make money when you don't have an accident.

Cash rates for medical procedures are less than what is billed to insurance companies. What the insurance pays out may or may not be less.
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Old 03-27-2017, 10:51 AM   #217 (permalink)
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You do realise that insurance companies don't make money off procedures, but off the lack of procedures being performed? It's the same with car insurance. They make money when you don't have an accident.

Cash rates for medical procedures are less than what is billed to insurance companies. What the insurance pays out may or may not be less.


Yes I am aware of that, I sell insurance. Cash rates aren't less than what insurance companies pay. What happens when a claim goes through, regardless of the claim, it get repriced for being in network. That repriced amount can be as much as 75-80% less than what's billed. Sometimes, very little at all. Example, client had stage 4 colon cancer. Total bills for 8 days in hospital $110k, UHC ended up paying out 35k. It benefits the hospital to accept UHC and give that big of a discount because of how large UHC is, that hospital will be able to have access to more patients and vise versa.
That's why I responded the way I did cause it makes no sense that an insurance company would make money off a claim they pay?!?
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Old 03-27-2017, 12:20 PM   #218 (permalink)
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"And as you mentioned earlier, calling Geico to buy a retroactive policy after you crashed your car is not insurance."

Think about it more like: we want write a policy on a car older than 7 years.
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Old 03-27-2017, 04:30 PM   #219 (permalink)
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This will go absolutely nowhere, but good on him.

Rep. Mo Brooks files bill to repeal Obamacare | AL.com

Text of the bill:

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"Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted,"
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Old 03-27-2017, 04:40 PM   #220 (permalink)
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This will go absolutely nowhere
Nor should it. Solve the problem.
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Old 03-27-2017, 06:12 PM   #221 (permalink)
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I just don't understand how/why people think the government is somehow supposed to fix the healthcare problems when they created 90% of them...
Me and my wife have this conversation regularly. She works for a probiotic company. I tease her all the time she's in the business of selling a dirt pill to people. This age of hyper sanitation is not doing our bodies any good. For people like me probiotics do nothing because I tend to accidentally eat a lot of dirt at work.

Just take a look at history. What has changed to create all these sick people, increased allergies, ibs etc. 50-60 years ago there was not antibacterial everything. People ate what they grew and killed, no ultra processed food containing who knows what. For example, I just got back from a long weekend vacation. We ate out every meal, by the end of the trip my guts were destroyed. I could not wait to get home and get back to the home grown and cooked meals.
You cannot tell me all these processed foods are doing our bodies any favors.

Fixing this problem would cut a ton of health related problems and would be a step in the right direction. Heaven forbid if we hold the Cheeto eating, sweet tea guzzling people accountable for their actions.
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Old 03-27-2017, 08:39 PM   #222 (permalink)
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Nor should it. Solve the problem.
It won't solve the problem that existed before Obamacare, but it would eliminate the forces that took my insurance from good and $390 a month to shitty and $1200 a month with a 6k deductible per person.

Obamacare will destroy itself. Its like not even having insurance at all. We need to bring back catastrophic insurance and let people buy other coverage al la carte at will from wherever they want.
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Old 03-28-2017, 04:55 AM   #223 (permalink)
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It won't solve the problem that existed before Obamacare, but it would eliminate the forces that took my insurance from good and $390 a month to shitty and $1200 a month with a 6k deductible per person.

Obamacare will destroy itself. Its like not even having insurance at all. We need to bring back catastrophic insurance and let people buy other coverage al la carte at will from wherever they want.
In essence, that is the plan that you have, yet, you're not happy. Absolutely agree the price is absurd, as are all plans now.
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Old 03-28-2017, 06:08 AM   #224 (permalink)
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In essence, that is the plan that you have, yet, you're not happy. Absolutely agree the price is absurd, as are all plans now.
That is absolutely the polar opposite of the plan I have. You could not be more wrong. I mean seriously, do you even know what your talking about?

The plan I USED to have was catastrophic and Obamacare made that illegal. Then forced me to replace it with plans that cover breast pumps (don't have tits), contraception (fixed), depression (not my problem) ect, ect. This is one of the MAIN REASONS the prices skyrocketed.

Jeebus, do some reading before you post on this stuff.
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Old 03-28-2017, 06:30 AM   #225 (permalink)
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Hahaha yup! You're 100% accurate but you can tell this guy anything. Fawk him
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