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Thread: Pay now, care later

  1. #31
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    Quote Originally Posted by splansing View Post
    EXACTLY. It's about PERCENTAGES. If you're allowed to keep 20% of the pie, how do you get more pie? YOU MAKE THE PIE BIGGER.

    The insurance companies are incentivized to make everything cost more. And they have the clout and the collusion to get it done.
    The onus is on you then to prove there is a vast conspiracy whereby insurance companies are colluding with one another and with health providers to jack the price of the care so that they can justify higher premiums (next year) so that their 20% cut for administering the entire business (next year) happens to be more (hopefully).

    Insurance companies can only set their premiums once per year, so if they wanted care to cost a lot more, and colluded with provider organizations to make sure it did, it would risk running huge losses in any given year.

  2. #32
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    Quote Originally Posted by bajisima View Post
    I think so too. Fixing it involves massive coordination with the insurers. Can we trust them now??? They could agree to anything and then find some tiny hole and screw us. Like they did with the ACA. I find it ironic that now Americans are mandated to carry health insurance but the insurers aren't mandated to stay, they can pull out anytime, anywhere. Really? No one thought of that? So basically here pay a fine for healthcare you wont have if all the insurers decide to pull out of your state.
    Really, the only answer for middle class, middle age people is Medicare For All...that is, if the government wants to keep us around longer. There are still a few tax dollars they can squeeze out of us...at least another 10 years. Imagine who would pay for everything once we start dying off...the wealthy would have to get a tax increase...but they would just move their money somewhere it cannot be touched.

  3. #33
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    Quote Originally Posted by bajisima View Post
    Yes for a family.
    So what is the individual deductible among those in the family (if applicable)? And what do the premiums cost per month? What is the co-insurance rate and out-of-pocket max?

  4. #34
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    Quote Originally Posted by Thx1138 View Post
    "but it requires them to spend thousands of dollars before their insurer kicks in a dime."

    Yes, and Trumpcare would have been even more so.

    Just one of many reasons we need UHC...

    Cut out the middle-men, the big insurers, provide HC to everyone and see how many more people employers can hire!

    Thx
    Well this isn't new. I guess compared to our old system where you paid insurance companies thousands of dollars whether you needed insurance or not. At least in this case you are paying for services rendered.
    I'm not sure of the answer, I'm not even sure, in context, if trumpcare would have been worse. For some, sure. For others, not so sure. And I'm sure that uhc would fit into the same category.
    What I am pretty confident in, is that the best solution won't come with a house divided. Congress needs to work together to start a plan, start with an objective and come up with a solution, but it's going to take both sides cooperating with each other.

  5. #35
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    Quote Originally Posted by Neomalthusian View Post
    The onus is on you then to prove there is a vast conspiracy whereby insurance companies are colluding with one another and with health providers to jack the price of the care so that they can justify higher premiums (next year) so that their 20% cut for administering the entire business (next year) happens to be more (hopefully).

    Insurance companies can only set their premiums once per year, so if they wanted care to cost a lot more, and colluded with provider organizations to make sure it did, it would risk running huge losses in any given year.
    First of all, insurers do not have to collude with providers. Just with each other. I defy you to come up with an apples-to-apples comparison of one insurer to another and demonstrate a meaningful difference in the premiums. What a coincidence.

    But that's not really all that relevant. The bottom line is, the incentive is what I said it is (which you brought up). Corporations are profit-driven. What I suggest is not a conspiracy theory. It's just a company acting like a company. If the insurance company leadership fails to deliver profits, they'll get fired. Period. And deliver profits they most certainly do. Increasing overall revenue is the only way they can increase profits. There are lots of ways they can do that.

  6. #36
    the "good" prag pragmatic's Avatar
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    Quote Originally Posted by Neomalthusian View Post
    The onus is on you then to prove there is a vast conspiracy whereby insurance companies are colluding with one another and with health providers to jack the price of the care so that they can justify higher premiums (next year) so that their 20% cut for administering the entire business (next year) happens to be more (hopefully).

    Insurance companies can only set their premiums once per year, so if they wanted care to cost a lot more, and colluded with provider organizations to make sure it did, it would risk running huge losses in any given year.
    Insurance is an incredibly regulated industry. Some of those claiming gouging are just uninformed.

  7. #37
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    Quote Originally Posted by HCProf View Post
    Really, the only answer for middle class, middle age people is Medicare For All...that is, if the government wants to keep us around longer.
    Obamacare is exceedingly generous to older Americans because it makes the subsidy thresholds one-size-fits-all. If I'm 30 with a household income of $100,000 and insurance premiums for me and my wife actually cost $10,000 per year, but because of the subsidies I only pay $9,500 per year (9.5% of income), then thanks Obama, you saved me $500.

    But if the guy in the office next to me is 59 and has household income of $100,000, what his insurance premiums actually cost for him and his wife are $40,000 per year, but because of the subsidies he only pays... $9,500 per year, 9.5% of income. Because of his age, his insurance should cost quadruple what mine does, but 1) the law requires insurance companies charge no more than triple, AND 2) the subsidies make it so that he and I pay the same. Why should I have to pay the exact same at age 30 as the 59-year old guy next to me who has the same income I do? We're paying the same amount for something that should cost him 4x more. Obamcare is saving me $500 as a 30-year old while saving the 59-year old with the same income as me $30,500.

    Because the older you are, the more super special privileges and handouts you should have, according to American laws.

    Whatever is changed, older people need to pay more than younger people, and richer people need to pay more than poorer people. This means Medicare benefits need to be dialed back and contributions into the system need to take into account a combination of income AND age.
    Last edited by Neomalthusian; 13th April 2017 at 01:58 PM.

  8. #38
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    Quote Originally Posted by pragmatic View Post
    That sucks. Have you looked into Health Savings Accounts? Are you and your family relatively healthy....??
    Health savings accounts expand your health care dollar by the effective rate you pay on income. So, if you pay 28%, a HSA will allow you to buy $1.28 of care.

    Not exactly a solution for the systemic problems. (And not free of costs; money remaining at 12/31 is lost forever.)

  9. #39
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    Quote Originally Posted by splansing View Post
    First of all, insurers do not have to collude with providers. Just with each other. I defy you to come up with an apples-to-apples comparison of one insurer to another and demonstrate a meaningful difference in the premiums. What a coincidence.
    The actuarial analysis of covering the same services for the same population of people doesn't vary that much. It's the same math. They can network a little differently to try to save their clients some money but their policy loses attractiveness if the network is narrow and people can't go where they want to get health care. You want there to be this scapegoat.

    But that's not really all that relevant. The bottom line is, the incentive is what I said it is (which you brought up). Corporations are profit-driven. What I suggest is not a conspiracy theory. It's just a company acting like a company. If the insurance company leadership fails to deliver profits, they'll get fired. Period. And deliver profits they most certainly do. Increasing overall revenue is the only way they can increase profits. There are lots of ways they can do that.
    The net cost of private insurance is a small chunk of total American expenditures on health, and it hasn't grown that much in the last 15 years. The cost of and expenditures on actual health care have grown, enormously. Your assumption that the reason health care costs and expenditures are all the fault of private insurance companies is not well supported here. Rising costs might help justify future premium increases, but they also pose much greater near-term risks of huge operating losses. The revenue they make in a given year is pretty much determined at the beginning of that year. What they have to pay out could easily cut deeply into what they need just to operate. They take on that risk. They also have a risk of adverse selection. Colluding with providers to hike prices so that they'll be able to hike premiums next year is not a safe way for them to make money. You really are at the level of a conspiracy theory with all this. The data is showing that health care provision (not insurance) is driving the the cost growth.
    Thanks from pragmatic

  10. #40
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    Quote Originally Posted by pragmatic View Post
    Insurance is an incredibly regulated industry. Some of those claiming gouging are just uninformed.
    Mehmm...yes and no. Even before Obamacare, there were myriad reindeer games to be played.

    Actuarial "science" can certainly be done for the benefit of the insurance companies. The states' departments of insurance, and their actuaries, are not uniformly fabulous at pushing back.

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