Private health insurance regulation the key to fixing health care costs

Discussion in 'Health Care' started by hudson1955, Jul 7, 2018.

  1. hudson1955

    hudson1955 Well-Known Member

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    Health insurance companies have virtually been unregulated for several decades. Unlike other forms of insurance. The PPACA , Obamacare failed to regulate premiums or fully regulate covered care, allowing the insurance company to decide what they will or will not pay for. And the insured isn't given specific information upfront as Obama promised. So the patient finds the care they need isn't covered after the fact. I am sure many patients go to pick up their prescription only to find it is not covered or is suddenly no longer covered. For one example.

    Trumps/republicans discontinuance of protecting preexisting conditions hurts the insureds and lowers costs of insurance for the companies.

    To address the rising cost of insurance we must keep the "patient protection" part of the ppaca and place regulations and restrictions on insurance companies. Regulating cost of insurance commensurate to the premium paid and the deductible.

    Insurance companies, despite what they claim are the big winners under obamacare.

    Contrary to my former belief, I think medicare for all by establishing medicare part E, (everybody) with monthly premiums based on annual income, would work.

    What do you think?


    E
     
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  2. gamewell45

    gamewell45 Well-Known Member Past Donor

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    Cannot hurt to try and see how it goes; right now anything is better then what we've got for people.
     
  3. hudson1955

    hudson1955 Well-Known Member

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    Thanks for your response
     
  4. Lil Mike

    Lil Mike Well-Known Member

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    "Health insurance companies have virtually been unregulated for several decades."

    That's funny!
     
  5. Reiver

    Reiver Well-Known Member

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    I see your sense of humour continues to be problematic!
     
  6. Lil Mike

    Lil Mike Well-Known Member

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    I see your lack of contribution to the thread topic continues apace.
     
  7. Greenbeard

    Greenbeard Active Member

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    Given that the right has been working overtime to destroy insurance markets and the left is getting tired of being in the position of trying to save them, it's getting harder and harder to see things evolving in any other direction at this point.
     
  8. LiveUninhibited

    LiveUninhibited Well-Known Member

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    Health insurance companies are parasitic. Most companies provide services and products and make more money based upon the quality of those things. Health insurance companies make profit by cherry-picking healthy people who don't need health insurance, finding ways to deny paying for healthcare people thought would be covered, and taking more profit the fewer services they provide. And then having a flock of different insurance companies to deal with just means that hospitals have to hire more people to deal with all of these complicated billing/coverage schemes. The net effect is healthcare is more expensive for rich people and poor people just get emergency care.

    Overall, health insurance is one of the things that governments can do better than for-profit companies. That said, I think the best model is like France where everybody gets a basic plan that is publicly funded, but with options to get more coverage through something like insurance companies, but ideally non-profit. And these non-profits could pick up the slack of the government when evil republicans take over and slash funding for healthcare in order to spend more on the military than the rest of the world combined.
     
    Last edited: Jul 13, 2018
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  9. Wildjoker5

    Wildjoker5 Well-Known Member

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    Health insurance companies are on the back end of this economic cycle. The doctors set the price. Their price is the result of their education and student loans they MUST pay back and those costs have skyrocketed faster than anything else in the US. Their price also includes their malpractice insurance that is totally unregulated, and is the highest in the world. Their medical equipment is being taxed thanks to Obamacare, this also increases the costs to doctors who must pass the cost onto the consumer. Sorry, but you cant expect doctors and hospitals to lower their costs that would make it impossible to pay their expenses.
     
  10. Reiver

    Reiver Well-Known Member

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    Imagine you actually referred to health analysis and said something? Just imagine.
     
  11. kazenatsu

    kazenatsu Well-Known Member

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    The whole concept of comprehensive insurance, the expectation that the insurance company will have to pay for any and every treatment, no matter how expensive or questionably cost effective the particular treatment is, is what's driving up costs.

    The simple fact of the matter is a vast swath of the population can't afford cutting edge medical treatment in a top quality setting.
    Even spreading it out in a risk pool, it's still not something they can afford.

    We're going to have to make some difficult choices, and yes, death panels of some sort, especially with newborn babies born with congenital life-long disabling conditions or bedridden old people sucking up a lot of money.

    However, there's also an argument for free public payment for some types of medical treatment, because the gateway costs (going through an insurance company) consume a substantial amount relative to the actual cost of providing treatment. That is, for best value for the money, it would actually be free for the public to provide it, and just hand out to whoever wants it. (The same argument applies to public roads and parks, it's just too impractical to put up a toll booth on every road or a fence around every park)
     
    Last edited: Jul 23, 2018
  12. gamewell45

    gamewell45 Well-Known Member Past Donor

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    The answer is quite simple; the government should put a ceiling cap on treatments/meds/procedures that doctors/hospitals/providers may charge.
     
  13. hudson1955

    hudson1955 Well-Known Member

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    why is that funny?
     
  14. hudson1955

    hudson1955 Well-Known Member

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    Doctors don't set the price anymore, that ended with in the mid 90s. They can charge what they feel is fair, but because they are virtually forced to sign up with insurance plans if they want to see patients in their area, they are paid ridiculously low reimbursements set by insurance companies. The problem is not what doctors charge.
     
  15. hudson1955

    hudson1955 Well-Known Member

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    . Wow you have no clue. They can charge what they want but the insurance companies set the amount they will be paid, so it doesn't matter what they charge. 39 years in this profession, I know what I am talking about.
    Doctors should stop taking insurance, they could then charge far less because they would not have to comply with ridiculous costly regulations that have no benefit to patients.
     
  16. hudson1955

    hudson1955 Well-Known Member

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    I already said Medicare for all would be better for all concerned. But you have to realize it still won't be cheap for those under 65 or eligible for the current medicare insurance program. The individual, family, and employer premiums would be based, in my opinion, on earnings.
     
  17. Lil Mike

    Lil Mike Well-Known Member

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    Your assertion that private insurance companies have been unregulated for decades. It's so absurdly false it's funny!
     
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  18. kazenatsu

    kazenatsu Well-Known Member

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    And what happens if the ceiling cap is set at a low level? You do realize price fixing can lead to shortages.
    The ceiling cap might be a way to help prevent the consumer getting ripped off by unscrupulous hospital billing, but it's not going to be able to inherently lower medical costs.
     
  19. kazenatsu

    kazenatsu Well-Known Member

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    It's a common practice for doctors offices to contract out to medical billing companies, because it's too much work and trouble to deal with the insurance companies or Medicare directly. It's common for these medical billing companies to collect 10% of the doctors office revenue as their service charge. It's because of all the complicated reimbursement rules and procedures insurance companies and Medicare have.

    Not surprisingly, a lot of doctors offices are offering 10% discounts for patients who pay out of pocket directly.

    That of course doesn't even factor in all the additional administrative costs of an insurance company. For the average medical insurance company, about 40% of the insurance costs are eaten up in administrative expenses. That's money you're paying that's not actually going to medical care.
     
    Last edited: Jul 24, 2018
  20. hudson1955

    hudson1955 Well-Known Member

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    Obviously you don't understand. It doesn't matter what a doctor charges, they will be receiving what medicare and private insurance APPROVE and pay the percentage they contracted to in the patients policy and the doctor can only charge the patient the remaining of what they approved. I.e. approved 100$ paid 80$bpatient owes 20$. Regardless if the doctor charged And billed 200$. Low payments are driving doctors out of practice, forcing them to join large medical groups and losing their individuality, or going bankrupt/ retire early and possibly finding another profession.
     

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