Insurance or Scam?

[JackLuis]

Insurance companies, heros or villains?

 

[bronzeage]

Are those the only choices?

Insurance companies are in business to provide a service and make a profit. Without profits, there will be no service.

It sounds cold blooded, but somebody has to make a decision on what will be paid and what is excluded. I am sure that somewhere in the insurance policy a maximum lifetime pay out is listed. When the boy reaches the limit, it won't matter what procedure is recommended or available.

I am grateful not to be in the place of anyone in this story.

 

[Handley_Page]

Insurance companies, heros or villains?

A better reason for a decent Health System would be hard to find.

Bronzage:
Insurance companies are in business to provide a service and make a profit. Without profits, there will be no service.


I think that's morally wrong.
For whom should a company make a profit at the expense of the sick ?

 

[JackLuis]

I am sure that the fine print legally absolves the Insurance company, however the Hospital is doing the procedure needed and gets my applause!

Many hospitals have charity funds available to cover the truly needy. I guess this drives up the cost for the bill paying public, but it saves lives.

It surprises me that the disparity in compensation for Dr's and Nurses can be so large. Dr's have expenses too and running a medical practice is and art. A good office manager and staff can allow a DR. to see 20-30 clients a day. at $100 a visit say $2,500 a day, four days a week=~$440,000, with 8 weeks vacation time. less rent, personnel costs, medical equipment and such, the DR is not making 30% of his gross.

Drugs and Medical Equipment are the place you can clear 40% margins and hire pretty women to sell it, a winner!

 

[unregistered]

 

[Zeb_Carter]

A better reason for a decent Health System would be hard to find.

Bronzage:
Insurance companies are in business to provide a service and make a profit. Without profits, there will be no service.


I think that's morally wrong.
For whom should a company make a profit at the expense of the sick ?

Morally wrong to make a profit? On the sick? Every hospital is in business to make a profit. Every doctor is working at his profession to make a profit. Every nurse it working to make a profit. Every technician is working to make a profit. With out profit there are NO JOBS! With out profit there are NO TAXES PAID! You take it from there...

 

[DeeZire]

... the incompetence of the VA is legendary!

The fact that the VA has been underfunded since the Bush administration is also legendary.

 

[voluptuary_manque]

I don't think anyone -even the most rapid of the opposition- is saying that the American system can't be improved. But before we start talking about the glory of socialist medicine, come and spend a couple of years in the VA system with me. The US Federal government has had decades to get that system right and yet, the incompetence of the VA is legendary!

Funny how that always comes up. The problem is that VA care varies from hospital to hospital. I use the Long Beach VA and have absolutely no complaints. On the other hand, Elianna has a friend who has to use the Phoenix VA and may be lucky to be still alive. Not that there are any private hospitals with the same problems you understand, no none.

 

[patrick1]

That's nice. I didn't know people who worked for non-profits were exempt from taxes.

With out profit there are NO JOBS! With out profit there are NO TAXES PAID! You take it from there...

 

[JAMESBJOHNSON]

PATRICK

Our local rag examined profit and non-profit hospitals, and discovered that the non-profits cost more to operate and absorb more tax dollars. Around here its always the non-profits that get tagged by the Feds for stealing Medicaid money.

 

[Handley_Page]

I think I'd better define a few things before I get the stick.
I tried to mean that there IS a profit, a small one, to cover the usual expenses of a medical organisation, but not the egregious rip-off for the benefit of shareholders, which I believe is the case for Insurance companies.

" Jack Louis: I am sure that the fine print legally absolves the Insurance company, however the Hospital is doing the procedure needed and gets my applause!"


Hooray for a bit of charity.

 

[oggbashan]

Insurance is supposed to work like this:

A group of people face a risk. For example I'll use broken shop windows caused by accident or criminal damage.

The group of shopkeepers agree that each of them will put some money into a pot each year towards the cost of repairing broken windows. Whoever's window is broken claims the cost of repair from the pot of money.

If the pot of money is larger than the total cost of the claims then the group have made a profit. If the money isn't enough to cover the repair of broken windows, then they have made a loss. How do they cover that loss? Increased contributions from each of them, or carried-forward profit from "good" years?

But if the risk isn't so simple and there isn't an obvious local group would could organise?

Then an insurance broker comes in. The broker finds a group of people who will accept money into the "pot" and pay out if the covered risk happens. However someone has to pay for the services of the insurance broker. The group of people have to be fairly sure that over time, their pot of money will not make a loss. That group of people, the insurance company, has to pay its staff and its owners, the shareholders. If there are no profits, only losses, eventually there is no pot of money to pay out from.

It will always be more expensive to buy insurance from a company than to organise mutual cover among people who face the same risk - because there are people to be paid and investors/shareholders who want income from their money.

What insurance companies do is cover for stated and agreed risks. They don't cover risks that aren't stated. Would you complain if you bought a car without air conditioning when air conditioning was an extra you hadn't paid for? It's the same with insurance. You only get what you pay for BUT insurance companies are not good at being explicit about what you haven't paid for and what you are NOT covered for - until you make a claim that they say is not in the covered risks!

Og

 

[SumLightCat]

And mutual insurance can actually work quite well for a lot of things. Just like worker ownership of companies can, given the right work culture. If you think about it, what's the difference between law partners owning their firm and workers in a commercial green-house owning their green-house? Not much at all ...

Insurance is supposed to work like this:

A group of people face a risk. For example I'll use broken shop windows caused by accident or criminal damage.

The group of shopkeepers agree that each of them will put some money into a pot each year towards the cost of repairing broken windows. Whoever's window is broken claims the cost of repair from the pot of money.

If the pot of money is larger than the total cost of the claims then the group have made a profit. If the money isn't enough to cover the repair of broken windows, then they have made a loss. How do they cover that loss? Increased contributions from each of them, or carried-forward profit from "good" years?

But if the risk isn't so simple and there isn't an obvious local group would could organise?

Then an insurance broker comes in. The broker finds a group of people who will accept money into the "pot" and pay out if the covered risk happens. However someone has to pay for the services of the insurance broker. The group of people have to be fairly sure that over time, their pot of money will not make a loss. That group of people, the insurance company, has to pay its staff and its owners, the shareholders. If there are no profits, only losses, eventually there is no pot of money to pay out from.

It will always be more expensive to buy insurance from a company than to organise mutual cover among people who face the same risk - because there are people to be paid and investors/shareholders who want income from their money.

What insurance companies do is cover for stated and agreed risks. They don't cover risks that aren't stated. Would you complain if you bought a car without air conditioning when air conditioning was an extra you hadn't paid for? It's the same with insurance. You only get what you pay for BUT insurance companies are not good at being explicit about what you haven't paid for and what you are NOT covered for - until you make a claim that they say is not in the covered risks!

Og

 

[SumLightCat]

Well, you're oversimplifying there ... if a community decides to fund their health care as a social-service for that community out of their taxes, then by default their "hospital" is no longer in business to make a profit but to care for the community's sick people.

Also, a lot of taxes come out of VAT, which has nothing to do with profit. It's basically a consumption tax.

On the other hand, our economic system is terminally unsustainable in it's current form for one simple reason - the second law of thermodynamics.

Morally wrong to make a profit? On the sick? Every hospital is in business to make a profit. Every doctor is working at his profession to make a profit. Every nurse it working to make a profit. Every technician is working to make a profit. With out profit there are NO JOBS! With out profit there are NO TAXES PAID! You take it from there...

 

[Zeb_Carter]

I think I'd better define a few things before I get the stick.
I tried to mean that there IS a profit, a small one, to cover the usual expenses of a medical organisation, but not the egregious rip-off for the benefit of shareholders, which I believe is the case for Insurance companies.

" Jack Louis: I am sure that the fine print legally absolves the Insurance company, however the Hospital is doing the procedure needed and gets my applause!"


Hooray for a bit of charity.

The profit margin for health insurance providers is what? Does anyone know what their profit margin is? Anyone? Bueller?


The largest health insurance providers profit margin is ... 2.5%. That's less then most banks pay on CD's now a days.

 

[Zeb_Carter]

That's nice. I didn't know people who worked for non-profits were exempt from taxes.

I typed a long response to this but then I realized it doesn't deserve an answer.

 

[stephen55]

(131)Iodine metaiodobenzylguanidine ((131)I-MIBG) is a radiopharmaceutical

I never came across this stuff when/where I was working. It's apparently more expensive than divorce and has similar side effects. At least I suffered low platelet and white blood cell counts after having to deal with a divorce lawyer.

One of the reasons docs in Canada have fewer headaches than their American counterparts is that we don't have to put up with this type of bullshit. Patients needing treatment get it. If a drug is considered new and experimental and a doc decides to go with it, a call is made to some branch of Health Canada and the drug is released. Insurance company bean counters have no say in the matter. Provincial Ministry of Health bean counters...ditto.

As much as the private insurance company in this case wants to keep a lid on money going out and is using standard insurance company logic, I say fuck the whole system and do what's right. Pay for the treatment and jack everyone's premiums up a few cents to cover it. Oops...I forgot...health insurance companies are run by bean counters.

 

[JackLuis]

Blue Cross raises rate 39%.

"But Health and Human Services Secretary Kathleen Sebelius isn't buying the explanation proffered in a letter delivered to her Thursday."

So because people can't afford health insurance, they have to raise the rate so fewer people can afford it? Oh, I get it, basic marketing?

 

[Handley_Page]

The profit margin for health insurance providers is what? Does anyone know what their profit margin is? Anyone? Bueller?

The largest health insurance providers profit margin is ... 2.5%. That's less then most banks pay on CD's now a days.

from AP:
WellPoint Inc. reported a $4.75 billion profit in the last quarter of 2009.

and this benefits whom ?

 

[voluptuary_manque]

The profit margin for health insurance providers is what? Does anyone know what their profit margin is? Anyone? Bueller?


The largest health insurance providers profit margin is ... 2.5%. That's less then most banks pay on CD's now a days.

Really? Got documentation? I am unaware that insurance companies ever release their profit margins. Since they aren't required to by law, they might find it embarrassing to do so. Otherwise, why not?

 

[Dragonlipz]

The profit margin for health insurance providers is what? Does anyone know what their profit margin is? Anyone? Bueller?


The largest health insurance providers profit margin is ... 2.5%. That's less then most banks pay on CD's now a days.

That's more bullshit from the Bullshitter......your lack of knowledge is only exceeded by your outrageous allegations........
How's that Cobra workin' fer ya????

 

[Dragonlipz]

I typed a long response to this but then I realized it doesn't deserve an answer.

More Bullshit from a proven bullshitter.......get a new line because that old tired crap ain't catchin' anything anymo'..........................

 

[Zeb_Carter]

from AP:
WellPoint Inc. reported a $4.75 billion profit in the last quarter of 2009.

and this benefits whom ?

Really? Got documentation? I am unaware that insurance companies ever release their profit margins. Since they aren't required to by law, they might find it embarrassing to do so. Otherwise, why not?

Not profits...profit margins...if the company makes $1 billion and there profit margin is 10% then they made $100 million. So if they made a $4.75 billion profit then there gross was approx. $190 billion.

Who do profits benefit...Shareholders, employees and policy holders if the company is a mutual company. Profits can be used to research a multitude of things. Profits allow the company to ride out a downturn and still pay for you doctors visits. Do I go on????

Proof...profit margin by industry...private health insurance is #86.

http://1.bp.blogspot.com/_otfwl2zc6Qc/SoMLoWBKM4I/AAAAAAAAK4g/wKdZyg5LxQ0/s1600-h/profits.bmp

I was off a .08 %

http://www.lockergnome.com/swordofd...it-health-insurance-companies-really-so-evil/

try this one it explains profit margin very good...

And being public companies the are required by law to release there profits and any first year economics student can back into their margin. *shakes head*

 

[Boxlicker101]

from AP:
WellPoint Inc. reported a $4.75 billion profit in the last quarter of 2009.

and this benefits whom ?

That is much too high. Here is the actual amount from their financial statements:

http://ir.wellpoint.com/phoenix.zht...rticle_financial_invest&t=Regular&id=1379438&

ETA: The biggest part of their profit was from the sale of a subsidiary.

 

[JackLuis]

Not to dampen the enthusiasm, but all I hear is talk about Insurance. Never in the Health Care Debate have I heard anything about the base costs of the health support system, blamed by the Insurance Co's for raising rates.

Bandages and syringes all going up in cost. Medical office space spiraling up.


Inflation is just making it worse. Don't tell me "the Dollar is Sound" cause I don't think that is true, not after flooding the Market with Billions! That will have an impact sooner or later.

Nobody ever talks about making sure that the preventative care everyone needs is being covered. Early detection is key to reducing the overall expense of medical care.