Obamacare/Trumpcare Horror Stories

[nate]

Also, do you really think doctors would make MORE money in a single payer system???  Doctors in the US make way more money than any other country.  It isn't even close.

[mp170.6]

That is less than 100 dollars per person per year.

 

Meanwhile the drug companies profits are in the trillions.

 

Insurance is an industry, it has to make money.  Everything about Obamacare is about making more money for doctors and drug companies.  Not driving down costs... increasing costs.

 

For starters, where did you pull the $100 figure from?

 

Second, how can you possibly defend the insurance companies earning $100 in profit, per person, per year?  We're not talking insurance company revenue here, but profit.  Nothing the insurance companies accomplish is worth that much. 

 

Tell me something Nate, if Obamacare is enriching doctors, why are doctors either (1) retiring earlier than expected or (2) starting to refuse to accept insurance altogether, and moving to a cash-only practice?

[nate]

You keep saying that but other than your Oklahoma example you can't provide anything.  Also, malpractice insurance is 100x more costly for doctors than whatever administrative fees they pay.

 

Without insurance, if you get seriously sick you are ****ed, you can't pay for it, with insurance you can...  You don't think that is worth 100 dollars a year?

 

It is the definition of insurance.

 

Think about it.  What does Obamacare do?  It mandates much more coverage by insurance companies.  It provides cheaper insurance to people who still cant afford it but now have to or they pay a fine.  It increases the amount of services covered by insurance therefore increases the amount of money doctors make.

 

If the cost of medical school is so prohibitive then maybe the government should be helping subsidize that.

[nate]

By the way, anyone who has a major procedure done by a doctor that doesn't have malpractice insurance is desperate or stupid.

[mp170.6]

Also, do you really think doctors would make MORE money in a single payer system???  Doctors in the US make way more money than any other country.  It isn't even close.

 

I never once advocated for a single payer system. 

 

Health care costs would be reduced exponentially if insurance companies were excluded from covering primary care, routine tests, and pharmaceutical drugs.  The problem is that Americans expect health insurance to pay for everything nowadays, and they don't care how much it costs because insurance gets the bill. 

 

Costs would be lower if we cut out the middleman -- the insurance companies -- and paid for the more minor and routine medical expenses with cash or HSA/FSA accounts.

 

Insurance companies have a place, but it should be reserved for more extreme procedures and hospitalization. 

[nate]

Lol...  Next time you go to the doctor, check out how much your doctor is charging, then check out how much the insurance negotiated rate is.

 

Insurance companies negotiate rates lower than usual for doctors in order for them to be in network, thus getting more business.  You can have fun paying 250 dollars for a visit.

 

Insurance brings down the cost of care, not increases.  You really think that if your care was 5% less it would be affordable?  Medical costs are up more than 10X in the last 10 years.

[mp170.6]

Lol...  Next time you go to the doctor, check out how much your doctor is charging, then check out how much the insurance negotiated rate is.

 

Insurance companies negotiate rates lower than usual for doctors in order for them to be in network, thus getting more business.  You can have fun paying 250 dollars for a visit.

 

Insurance brings down the cost of care, not increases.  You really think that if your care was 5% less it would be affordable?  Medical costs are up more than 10X in the last 10 years.

 

You're really clueless about how it works. 

 

I've been paying $75-90 cash for doctor's visits for almost 5 years.  The cost would be substantially more had these visits been billed through insurance because the doctor has to pay three or four people to do insurance billing, plus the insurance company wants their cut of the pie.

 

I don't know what to say hearing your claim that "insurance brings down the cost of care".  That's so ludicrous that I have to sincerely wonder about your sanity.  That's like saying 1 + 1 = 0.5

[mp170.6]

Nate doesn't like the "Oklahoma" video, so I'll share it again.  Keep in mind the insurance companies refuse to do business with this surgery center whose prices are often 10% of what hospitals charge.  Gee, I wonder why that would be?

 

There are lots of surgery centers like these popping up around the country, but this one gets the most press.

 

[nate]

You have no clue how it work too then.  Insurance claims are incredibly simple now.  They are all done electronically and the software to do it is free.

[nate]

Nate doesn't like the "Oklahoma" video, so I'll share it again.  Keep in mind the insurance companies refuse to do business with this surgery center whose prices are often 10% of what hospitals charge.  Gee, I wonder why that would be?

 

There are lots of surgery centers like these popping up around the country, but this one gets the most press.

 

 

I already told you, it is because they don't have malpractice insurance.

[nate]

Also, do you really think that members not paying and having to constantly bill them then send them to collections is cheaper than submitting a claim to the insurance company.

 

Literally all they do is login to a website, put in the member ID and group number, choose a drop down list the services rendered and hit submit.  The claims are automatically accepted 98% of the time and payment is made electronically the next day.  The same person that takes the appointments handles all of the claims.  Those same systems issue invoices to the member for any responsibility they may have.

 

The systems were created jointly by the insurance companies and doctors and offered for free because it cuts down costs for doctors and insurance companies.

[mp170.6]

You have no clue how it work too then.  Insurance claims are incredibly simple now.  They are all done electronically and the software to do it is free.

 

Then why does the insurance industry need such a markup on healthcare costs?

[mp170.6]

I already told you, it is because they don't have malpractice insurance.

 

Did you read that somewhere, or are you just guessing? 

[mp170.6]

Also, do you really think that members not paying and having to constantly bill them then send them to collections is cheaper than submitting a claim to the insurance company.

 

The doctors' offices and surgery centers that operate on the cash model require payment on the day of service.  Either cash or credit card.  That eliminates the need for billing and collections agencies. 

 

 

Literally all they do is login to a website, put in the member ID and group number, choose a drop down list the services rendered and hit submit.  The claims are automatically accepted 98% of the time and payment is made electronically the next day.  The same person that takes the appointments handles all of the claims.  Those same systems issue invoices to the member for any responsibility they may have.

 

The systems were created jointly by the insurance companies and doctors and offered for free because it cuts down costs for doctors and insurance companies.

 

Oh yeah, this works so well that in a recent survey, doctors said they spend 12-15 hours per week on paperwork and phone calls to the insurance companies.  

 

Stop drinking the Koolaid from your employer, nate.   

[nate]

What survey?  How much of that paperwork is for the health insurance companies?  How many of those doctors are just stuck in their ways refusing to adopt technology?

 

Insurance companies don't markup healthcare costs, we make a 5% profit remember.  Doctors make 60%+ profit.  Drug companies make 300% profit.

 

Again, explain to me how insurance companies are the problem in that equation.

 

Health insurance companies will never put a doctor in their network that does not have malpractice insurance.

 

It isn't koolaid... I just happen to know how things work, rather than reading some blog that is obviously biased against insurance companies.

 

Also, taking payment up front is nice and all... who has $12k for surgery just laying around?  That is the purpose of insurance, most people don't.  And, doctors being who they are, immediately mark up their procedures a ton as soon as they can get moneybags insurance companies to pay.

[Angel Oracle]

We would have to supply him with some Jolt Cola and a shitload of Spandau Ballet albums.

Nah, it'll take a bunch of Taco albums.

[Angel Oracle]

I am just soooo in love with the government telling us what coverage we will have.

Yes sir, commander-in-s_it!

[Tank]

can someone explain briefly what a single-payer option is? somehow in all of the debates i missed this part.

[nate]

Means only one entity pays the claims.  In this case it would the the government.  In other words, England's method.

[mp170.6]

What survey?  How much of that paperwork is for the health insurance companies?  How many of those doctors are just stuck in their ways refusing to adopt technology?

 

http://www.physiciansfoundation.org/uploads/default/Physicians_Foundation_2012_Biennial_Survey.pdf

 

 

Insurance companies don't markup healthcare costs, we make a 5% profit remember.  Doctors make 60%+ profit.  Drug companies make 300% profit.

 

Again, explain to me how insurance companies are the problem in that equation.

 

I didn't say they marked it up.  Physicians have to charge more to cover the costs of dealing with insurance. 

 

Your comparison of profit margins on a percentage basis is extremely flawed because the different players are not equals.  The inherent nature of any small business requires a higher profit margin because revenues are smaller.  Do you not realize that large corporations such as Walmart have a profit margin around 3.6%?  There's no reason the insurance companies deserve any more for their services.

 

As far as pharmaceuticals go, I agree with you -- there's lots of greed and abuse.  On the other hand, without generous profit margins would innovation into new drugs come to a halt? 

 

Health insurance companies will never put a doctor in their network that does not have malpractice insurance.

 

Why do you bring this up?

 

Also, taking payment up front is nice and all... who has $12k for surgery just laying around?  That is the purpose of insurance, most people don't.  And, doctors being who they are, immediately mark up their procedures a ton as soon as they can get moneybags insurance companies to pay.

 

Most financial advisors in this country say you should have a rainy day fund for unexpected healthcare, car, house, or other expenses just in case.  I know people who don't (or can't), but there's also many people who live hand to mouth, wasting money on all kinds of crap they don't need. 

 

Besides, we're not even talking $12k for the majority of surgical procedures with the Oklahoma example I offered.  Almost all of their surgeries are in the $3000 - 6000 range. 

[Adam]

http://reason.com/blog/2013/11/19/woman-who-obama-cited-as-obamacare-succe

[Blarg]

If you look at the "Affordable Health Care" options for California you will find they are not affordable at a starting price of about $3,200 a year and provide no services until you've reached the $6,000 deductible. Basically low income people are better off paying the fine than the premiums and buying their own band aids and Ibuprofen from Rite Aid.

[nate]

That survey is from the Physicians lobby... nice.

 

Walmart's costs don't fluctuate nearly as much as health insurance costs do.

 

For example, when the H1N1 outbreak came, most insurance companies lost money that year.  All those billions... gone.  Not to mention most of those profits get reinvested into the company for research to lower costs.

 

How many people do you know that have a 3-6k rainy day fund set aside for health care costs?

 

Like I said, now a days, the clerk that takes the appointments also handles all insurance claims now.  So if he/she spends on average 2 hours a day and makes 35k a year, that is $8750 per year spent on "dealing" with the insurance companies.  If they see on average 10 patients a day, and work 50 weeks a year, that is $3.50 per office visit to "deal with the insurance company."

[nate]

If you look at the "Affordable Health Care" options for California you will find they are not affordable at a starting price of about $3,200 a year and provide no services until you've reached the $6,000 deductible. Basically low income people are better off paying the fine than the premiums and buying their own band aids and Ibuprofen from Rite Aid.

 

I know someone that makes $38k per year and his wife makes about as much, she is retired and all her money comes from SS.  If he wanted to get the Silver plan, which is the lowest plan worth a damn, his premium would still be over 500 dollars a month.  Not affordable in Southern CA.

[Blarg]

Not affordable in America, this is a sham. All that it will accomplish is to force feed the government income in the way of fines to the people who can't afford the insurance plans offered. In other words stealing from the poor to feed the political machine. The new poor is defined by being middle class and subjected to purchase something that is only affordable for the upper middle class. The lower class hasn't a chance in hell.

Edited November 20, 2013 by Eric Notti