Why so serious...winners and losers of health-care reform.

Because that's the job of underwriting, to project losses in the future to figure out what the premiums should be.

Spreading the losses is the reason why every single insurance policy in the universe exists.

Ever.

 

But now everyone must be covered by in some way the government or an insurance company.

Won't that increase projected losses?

 

These doctors, clinics and hospitals make a fortune. Its primarily because every test and procedure is billed to some insurance company or medicaid and so people don't care. They are also scared of getting sued so they do every test which makes them more money and less risk.

If it was a free system where someone had to write a check everything would be cheaper and they would scrutinize the cost/need of everything.

 

The only thing that will increase losses for insurance companies is the pre existing conditions and all the other regulations of not dropping people.

• Starting six months after enactment, requires all health insurance plans to maintain dependent coverage for children until they turn 26; prohibits insurers from denying coverage to children because of pre-existing health problems.
• Bars insurance companies from putting lifetime dollar limits on coverage, and canceling policies except for fraud.
• Reduces projected Medicare payments to hospitals, home health agencies, nursing homes, hospices and other providers.

But they don't put the big one out until the mandaes come around. Which is supposed to offset the additional costs.

• Prohibits insurers from denying coverage to people with medical problems, or refusing to renew their policy. Health plans cannot limit coverage based on pre-existing conditions, or charge higher rates to those in poor health. Premiums can only vary by age (no more than 3-to-1), place of residence, family size and tobacco use.


But the penalty part of the mandate is quite low the first few years so I guess they accept an increase in premiums.

 

All of that looks to drive up prices quite a bit for insurance companies which turn around and raise rates for us. All of this means more and more expenses to the little guy who one day wants to spend less on everything save some money and one day start his own business.

 

yeah, I quoted the things that will cost more. then explained they won't be rolled out until other cost saving plans are in place. All except the mandate fines which are to small to offset costs when the large changes take place.

 

While increasing premiums (more buyers) and spreading the risk out even more (more young people, for instance, who are very profitable)

And using AIG as an example for your argument doesn't make sense. AIG's insurance operation is as profitable as ever, it was the CDS issues that screwed them (well, they screwed themselves)

 

I get what you're saying but that's not how doctors/clinics make their money. When it comes to lab testing, lab companies work out what we call "special pricing" for physicans and hospitals. What these physicans and hospitals do is bill patients at much higher rate than what the lab companies charge.

Good example... If a woman goes to her local doctor for her annual pap smear check up. If this patient doesn't have insurances, the doctor will charge maybe $80-$100 for the test. Guess how much that doctor is being charge by the lab company? Anywhere from $20-$27 and they get to pocket the rest. That doesn't happen to patients that have insurances. Insurance companies will make sure they get the lowest price possible because it's all negotiated.

That's why its important for people that who are uninsured get some type of coverage. I see far too many people being taken advantage of when it comes to lab testing/surgery.

 

Exactly. I remember when I had my surgery. The insurance company flat out refused to pay what the hospital charged and negotiated it down to something like 1/4 of the original price. Insurance companies have really high leverage over hospitals that they just negotiate prices that are way lower than what you get as an individual consumer. It's simply absurd to not have health insurance. If you ever get a serious injury you will be bankrupt unless you are a millionaire. Hospitals can just milk you for everything and you wont have a company with hundreds of thousands of clients to negotiate the price down for you.

 

I went through the same thing. Hospital tried to charge me $34,000 for my knee surgery. I only ended up paying a total of $200 for the whole thing.

The biggest knock against these insurance companies besides being dropped or certain tests aren't being covered is how much they go up every year for coverage. If you don't work for a large company like I do, it's hell for anyone to be able to afford it. PPO's are changing now where it's like a HMO. Co-pays are going up. What also sucks are individuals that have been laid off from their company. The former employee can enroll into programs like Cobra but that is a big joke within itself.

I know this bill isn't finish but I do hope as many have stated in this thread and others that the total cost for insurance goes down. The current cost doesn't affect me or people in the medical field or oil field because we're given a discount. But I know others that have insurance through their companies and they are paying out the ass for insurance.

 

I had an emergency appendectomy about 1.5 years ago. I took a look at the bill and a few numbers had jumped out at me:

Out-of-network cost: $31,000
In-network cost: $8,900
What I said: $3,100 (I have a high deductible).

Without any health insurance, an appendectomy (and associated tests, hospital stay, etc.) would have been an unavoidable $31,000 cost. That is absolutely insane to me. How could anyone not have health insurance and feel secure?

 

Fixed.

 

How else to you want to reform health care?
Taking health insurance away from 30 million people instead?

You increase the pool of buyers so you can lower overall cost. You then put rules in the book to control Insurance companies.

 

What should have been done in the first place a public option.

 

I think the point being lost is that the quasi-socialized system we have now leads to price hikes like above.

Hospitals deal with huge percentages of non-pays because they are forced to by the government. So you have to offset their losses and quality and competition are not present to bring prices down as they're pretty fixed.

If McDonalds doubled the cost of a big mac, many people would simply go to Burger King. You need competition based on quality and pricing and this brings down prices for all. If people can walk into McDonalds and eat and leave then your burger will cost more. If you're an informed consumer you'll go to where the best quality per cost business.

An apendectomy probably takes a half hour of the doctors and nurses and some hospital time and bed rest. In a free market system, it would cost much, much less as a free market always brings down prices. Physicians make a fortune giving bad services, extra work and rushing procedures and the market would probably erode their salaries quite a bit.

 

Yes, there are many more things we can do for health care including a public option but you can not fight all the battles at one time.

 

I agree. A public option would've forced some competition to bring prices down. I agree with you that such a thing would be helpful.

 

All I want to know is, when do my premiums go up?

I also thought I heard the 30 million is not accurate, that roughly half are qualified for medicaid right now?

 

we're not done yet...

 

One theory I heard from the head of the Ohio State Med school was that overall medical costs should come down. Since most everyone will have health insurance, more people would get preventative health care and would seek earlier treatments, before their conditions become catastrophic and exponetially more expensive.

In the case of twenty-somethings that believe they are healthy and don't need to pay for health insurance, sure , that's true, until they have something go wrong. Then they will certainly be charged the exhorbinant "uninsured" rates, they will probably be unable to pay and the ultimate costs of their treatments will fall to the taxpayers.

In a sense, anyone without health insurance poses a capital risk to taxpayers and is scaming the good will of the people. (since we don't just kick them out to die)