People with Health Insurance Going Bankrupt

Off Topic Politics & World Issues
61

[quote]phaethon wrote:
Of course we don’t operate in a market based system. Insurance is meant to be based on risk profiles and it is meant to cover non-routine expenses.

If we did:

A healthy 25 year old would have to pay very little for healthcare.

Someone with a serious pre-existing condition would not be covered (for that condition anyway).

A 60+ year old person would have to pay a large amount.

An obese 25 year old would have to pay significantly more than the healthy 25 year old but probably not as much as the average 60+ year old.

A pregnant woman would have to pay a lot. So would a family with young children. On the other hand once the children were all older than 5 or 6 insurance would drop drastically.

Health Insurance could be very simple. A healthy 25 year old might have insurance that states if they get a serious illness they get a lump sum $500,000 and then they have to renegotiate a new insurance policy which will probably no longer cover that illness or related ones but will still cover other serious illnesses.

The 25 year old could decide they just want to spend the money on hookers and blow. More realistically they could decide to go to the hospital etc of their choosing in the location of their choosing. It is no longer “Sorry that clinic might be the best for your particular condition but they are not one of our preferred providers”. Let the free market work!

So what is stopping the people from embracing a free market in the United States? I would argue it is the lack of fairness, justice, and trust in the system. There is an understanding in this country that the system is biased towards those with the power (often considered “ok” by so called conservatives in the belief that it is for the good of the economy). And there is a lot of truth to it.

What can we do to fix it? Push for harsh measures upon corporations violating the integrity of the system.

A big bank launders money for terrorists? Either shut it down or nationalize it and jail the people directly responsible. Will that be bad for the economy in the short term? Too bad! Sometimes justice is bad for the economy.[/quote]

Not sure about the banking reference, but I agree with your assessment otherwise. But to be accurate, an insurance policy for a 25 yo male is significantly cheaper than the same coverage for a 48 yo male.

In addition, there is no competition currently allowed across state lines. I can’t shop for the best insurance deal because there are 50 government mandated collusion pools.

62

[quote]drunkpig wrote:

[quote]pittbulll wrote:
Before the 80s Most insurance was nonprofit and for profit plans had to compete with non profits . It was designed to maximize (CUSTMER/PATIENT) experience and not Corporate profit
[/quote]

uhm…

scroll down about halfway or so. There’s a whole section dedicated to health insurance.

I know it’s wikipedia, so take it for what it’s worth. But I couldn’t resist the ease with which your “most insurance companies were non-profit before the 80’s” position could be shot down.

Do you even try to research the pablum/propaganda you regurgitate with such lemming-like diligence?

From the wiki link above: “Commercial insurance companies began offering accident and sickness insurance (disability insurance) as early as the mid-19th century.”
[/quote]

I am curious if you even read your own posts or have the ability

“The first methods of transferring or distributing risk were practiced by Chinese and Babylonian traders as long ago as the 3rd and 2nd millennia BC”

Of course I know profit is required to make this possible but no where did it say they should stray from their mission to accomplish profit

63

[quote]pittbulll wrote:
I am curious if you even read your own posts or have the ability

“The first methods of transferring or distributing risk were practiced by Chinese and Babylonian traders as long ago as the 3rd and 2nd millennia BC”

Of course I know profit is required to make this possible but no where did it say they should stray from their mission to accomplish profit
[/quote]

Not sure what highlighting for-profit among Chinese and Babylonian traders 4-5 thousand years ago does to bolster your anti-profit position, but whatever.

You said that there was no profit in the health care insurance industry before Reagan. You do know that that’s what non-profit means right? NO PROFIT?

Now you seem to have jettisoned that lead vest of an idea and have moved on to attacking how the profit is made.

Regardless, the mission of every successful company in existence is first and foremost profit. Every business ever started only survives if they have more money coming in (sales) than they do going out (operating expenses, debt, taxes).

I submit that if the government would get their greedy, power-drunk fingers out of the healthcare industry (for that matter, every industry) and allow business to return to the simplicity of 3000BC Babylonian traders, the invisible hand would do more to fix what is broken than all of the progressives on the planet put together.

Profit, and pursuit of the same, is the only reason you’re not still carrying around a sharp stick hunting for food and a dry place to sleep.

64

[quote]drunkpig wrote:

Regardless, the mission of every successful company in existence is first and foremost profit. [/quote]

While a popular opinion it is not the only one. Regulation could allow the employees to profit and limit the Corp.

65

[quote]pittbulll wrote:

[quote]drunkpig wrote:

Regardless, the mission of every successful company in existence is first and foremost profit. [/quote]

While a popular opinion it is not the only one. Regulation could allow the employees to profit and limit the Corp.
[/quote]

It is not an opinion, it is a fact. Just because that one fact capsizes your apple cart does not mean you get to play fast and loose with it.

Government intrusion would not change a business’ goal of making a profit. It certainly changes how much profit a company makes, or in which state or even country said profit is made. People can’t leave California fast enough. People can’t seem to get to Texas, or South Dakota fast enough. Ever wonder why that is? Hmmm?

Employees have no right to a company’s profit beyond that which they negotiate for when entering into a contract to exchange their labor for money or any other resource.

66

[quote]drunkpig wrote:
Not sure about the banking reference, but I agree with your assessment otherwise. But to be accurate, an insurance policy for a 25 yo male is significantly cheaper than the same coverage for a 48 yo male.
[/quote]

I wouldn’t know. I do know my company pays a fairly similar amount for coverage per employee regardless of health etc of the employee. Maybe they look at the overall demographics at the company but they don’t drill down to the individual level.

67

[quote]drunkpig wrote:
Employees have no right to a company’s profit beyond that which they negotiate for when entering into a contract to exchange their labor for money or any other resource.[/quote]

For the most part I agree. However, I would argue that any time the contracts terms are ambiguous the courts should side with the “weaker” party (almost always the employee).

68

[quote]Zeppelin795 wrote:

[quote]2busy wrote:

[quote]Zeppelin795 wrote:
But it doesn’t help when you have corporations that purposefully sell junk with a “bliss-point” to help addict people to their garbage foods just to make a buck. Cigarettes? How about the purposeful manipulation of the facts that industry has covered up for decades in order to get people hooked. Do you care and criticize them at all?
[/quote]

Um… let’s see…

Seems I have known for decades junk food and cigarettes isn’t good for you.

Again, personal responsibility.

And let’s not use the classical “change the subject” bit.

You made a statement as FACT that the US Healthcare system kills people.

It’s your opinion. Nothing more.

Also, I find it interesting you have decided you have the moral authority to decide what’s right or wrong?

What do you base that morality from?[/quote]

The morality ought to fall on the produces of said garbage instead of hiding the truth from the public. You don’t see anything wrong with that ? You don’t see anything wrong with producers seeking to establish a “bliss point” in order to get you addicted to their foods?

[/quote]

You seem to have lots of conspiricy theories…

I will guess you don’t approve of fluoride in the water.

69

[quote]Zeppelin795 wrote:

[quote]2busy wrote:
Look, Zep, you’re a left wing ideologue who molds truth to fit your views.

Let’s just look at this claim.

[quote]Zeppelin795 wrote:
More people die overall in the U.S. because of our healthcare systems.
[/quote]

Really?

The number one cause of death in the US is Cardiovascular issues.

http://www.cdc.gov/nchs/fastats/lcod.htm

What causes Caridovascular disease?

“Atherosclerosis is the most common form of this disorder. Atherosclerosis is also the most common cause of cardiovascular disease, and it’s often caused by an unhealthy diet, lack of exercise, being overweight and smoking. All of these are major risk factors for developing atherosclerosis and, in turn, cardiovascular disease.”

"Causes of heart arrhythmia
Common causes of abnormal heart rhythms (arrhythmias), or conditions that can lead to arrhythmias include:

Heart defects you’re born with (congenital heart defects)
Coronary artery disease
High blood pressure
Diabetes
Smoking
Excessive use of alcohol or caffeine
Drug abuse
Stress
Some over-the-counter medications, prescription medications, dietary supplements and herbal remedies
Valvular heart disease"

From http://www.mayoclinic.com/health/heart-disease/DS01120/DSECTION=causes

So the US Healthcare system is causing people to have eat an unhealthy diet, not exercise, be fat, and smoke?

How about, people are not being responsible for themselves?

You can’t blame Jiffy Lube for your car engine shelling its bearings because you chose to change the oil every 50,000 miles.

I’m convinced you need to move to Cuba. You will be happy there.

And look, it will reduce the amount of stress in your life. You know, that’s one of those factors that can cause heart arrhythmia.[/quote]

Even if your heart disease statement is true it doesn’t deflate my statement. Read it again.
[/quote]

Oh, were you trying to say malpractice deaths?

Please explain your statement.

And please provide comparisons to other countries on some generally accepted common denominator, say fatalities per 1,000. Along with links to the statistics.

And, exactly what would you consider to be a “true” source of heath statistics in the US?

You don’t consider the CDC to be accurate?

70

[quote]drunkpig wrote:

[quote]pittbulll wrote:

[quote]drunkpig wrote:

Regardless, the mission of every successful company in existence is first and foremost profit. [/quote]

While a popular opinion it is not the only one. Regulation could allow the employees to profit and limit the Corp.
[/quote]

It is not an opinion, it is a fact.

[/quote]

Bullshit , you need to check the definition of fact

71

[quote]pittbulll wrote:
Bullshit , you need to check the definition of fact
[/quote]

Bullshit. You need to check the definition of definition.

72

Population of Canada = 30 million

Population of Australia = 22.6 million.

Population of Cuba = 11.2 million.

Population of the US = 311.5 million (and 1/3 of them are obese, while another 1/3 are overweight).

What could go wrong here ?

73

The “Europe vs America” argument visualized…

74

[quote]MaximusB wrote:
The “Europe vs America” argument visualized…[/quote]

I dunno Max, I saw a lot of nasty fatties in Europe as well.

75

[quote]MaximusB wrote:
Population of Canada = 30 million

Population of Australia = 22.6 million.

Population of Cuba = 11.2 million.

Population of the US = 311.5 million (and 1/3 of them are obese, while another 1/3 are overweight).

What could go wrong here ?
[/quote]
You know what’s funny is I’m part of the 1/3 that’s “obese” hahahaha.

76

[quote]csulli wrote:

You know what’s funny is I’m part of the 1/3 that’s “obese” hahahaha.[/quote]
Based on BMI?

Medical billing is part of my job. As such, I can attest to the fact that insurance companies can be very unethical and will take advantage by underpaying/not paying a claim whenever they can. Of course, the unethical-ness extends to certain providers as well, who purposely mis-code procedures in order to get higher reimbursements. It’s a mess.

77

[quote]kpsnap wrote:

[quote]csulli wrote:

You know what’s funny is I’m part of the 1/3 that’s “obese” hahahaha.[/quote]
Based on BMI?

Medical billing is part of my job. As such, I can attest to the fact that insurance companies can be very unethical and will take advantage by underpaying/not paying a claim whenever they can. Of course, the unethical-ness extends to certain providers as well, who purposely mis-code procedures in order to get higher reimbursements. It’s a mess.[/quote]

Back in 2007, I had surgery, which was cleared by my insurance company. So no biggie, or so I thought.

Then, 9 months later, they rescind their payment, and claim the surgery was experimental. I was now stuck with a bill for $22k. FUCK THAT. I filed an appeal, and had to go to court with Anthem Blue Cross. The surgery I had was approved by the FDA only 5 years prior to that, and so I won my appeal.

I had people from Anthem calling me, threatening me, saying they would appeal the decision. I said “bring it on”, but it never happened.

Moral of the story, insurance companies will always try to sucker someone.

78

[quote]phaethon wrote:

I wouldn’t know. I do know my company pays a fairly similar amount for coverage per employee regardless of health etc of the employee. Maybe they look at the overall demographics at the company but they don’t drill down to the individual level.[/quote]

This is how insurance works.

You spread the risk across a pool of inputs. In Health Insurance, or what we should call it a Health Maint Plan, you have a large pool of people that put money, premiums, into the pool of money. This pool of money is used to pay out benefits that are used. Since Health Insurance, Health Mint Plan, pays doctors visits and all that stuff for everyone because everyone believes if they are paying they should at least have a check up every year, then payments are paid out all the time. The older someone gets the more benefits used and the less they have to pay for it, on a premium to benefit ratio.

On Health Insurance your company has, the Insurance company looks at all the inputs, employees ages and past history of the plan, and charges a premium. There are a lot of different plans, and I could write a long post to cover them all, but this is it in a nut shell.

Insurance Companies take all the premium and invest the premiums an hopefully make a return on investment so the amount of money in the pool is greater. They then take a piece for admin costs and profit. Even Not for Profit companies do this. Everything else is used for paying out benefits. If the benefits paid out are more than the premium was taken in then next years premium will be increased. If the benefits are less then premium will stay the same or might decrease. Since Health Insurance is a Maint Plan then the benefits almost always outweigh the premiums so we get higher and higher premiums.

High Deductible plans are much more cost effective for Insurance Companies that is why the premiums are much lower.

You want to know what your company pays for you to have insurance through them? Ask your HR Manager what COBRA costs. Subtract what you pay in premium and the left over is what your company is paying for.

I hope this all made sense.

79

Lets clarify Not for Profit. Not for Profit does not mean that the company does not want to make money. All it means is 100% of profit must be used in the year it was made. So for example, Insurance Companies they just build a new building, expand into new markets, or pay out one big bonus to everyone to use up the money. For Profit Companies have more leeway to use the profits how they wish because they are taxed on the profit and what is left over can be used for anything. The IRS Tax Code has a whole bunch of regulations for what can be done for actual FOR PROFIT and NOT FOR PROFIT companies.

CountingBeans could probably do a better job at this than me.