Why do we need healthcare reform before killing the insurance industry

[slipperymongoose]

If the government and the insurance companies get out of healthcare who is gonna run it? The hospitals??? I can just see some wealthy conglomorate comming along and running it more tightly and completly into the ground worse than before. There needs to be a completly indapendant  body to run the health system (yes I realise in this day that is a pipe dream), recieving government funding to cover every man woman and child for everything they need, sure they need to contribute to this but at least you dont face the choice of which finger they re attach when you get three chopped off like in 'Sicko'. You get em all re attached!

[The Buddha]

No one needs to run health care, cos there will be no healthcare. Who runs fast food ? OK fine pepsi and coke run it.
However they are chasing each other to the bottom. That will occour unless the big companies are colluding. That will be a "cartel" and there fore illegal. Competition is good. Just needs to be a true competition.

Fast food is held in check due to the fact that they have to publish prices. No we'll do this for you and send you a bill later, we dunno how much what is ... but we'll bill your insurance company and get paid, all is cool ... makes it all very expensive.

When you walk in you know you're out for 3-4-5 bucks depending on what you are eating. Same with a hospital.

Cool.
Buddha.

[Dr.McNinja]

If the government and the insurance companies get out of healthcare who is gonna run it? The hospitals??? I can just see some wealthy conglomorate comming along and running it more tightly and completly into the ground worse than before. There needs to be a completly indapendant  body to run the health system (yes I realise in this day that is a pipe dream), recieving government funding to cover every man woman and child for everything they need, sure they need to contribute to this but at least you dont face the choice of which finger they re attach when you get three chopped off like in 'Sicko'. You get em all re attached!

The easiest most economically sound policy for Americans is open cross-border healthcare and do away with so much malpractice insurance. Make malpractice suits harder to get. The competition will drive prices down and you can be as long as the government kept a keen eye on collusion it would be better. Before this though, pre-existing has to be the first thing to go. The last thing anyone needs is an unqualified suit receiving benefits for every person he turns away.

The current healthcare industry is beyond the most corrupt and under-regulated industry in America. It stands second only to the gas companies.

[The Buddha]

I dont think malpractice can be done away with. But the lie we have heard is that, that is what makes doctors visits so $$$ ...
Sorry calling their bluff, they happily work for 25-30 bucks per patients visit and they have like a good 3-4 people pushing paper ... instead we give them 25-30 bucks and get rid of insurance, nothing else changes. Does not need to.
I think paying the doctor on the spot gives the doctor the right sense of loyalty.
Cool.
Buddha.

[thecdn]

No one needs to run health care, cos there will be no healthcare.

I'm trying to understand your position but I'm having a hard time because what I think you are saying makes absolutely no sense.

I'm riding home from work tomorrow and get hit by some 80 year old late for bingo. It's a bad accident, I'm unconscious and have life threatening injuries. An ambulance arrives and takes me to the nearest trauma center. After several days of great (and expensive) treatment I regain consciousness. I'm told I'll probably be in the hospital for about another two weeks and then have therapy for months afterward.

My bill to this point is $50,000 with another $50,000 - $60,000 in the future (totally made up numbers, I have no idea).  Since I have no insurance and the government isn't involved in this libertarian utopia of yours I get to pay this myself? How? Not being a forum moderator I don't have that kind of money lying aroung. How about if one of my kids developed cancer? I can pay for the drugs and chemo out of my pocket? How about if my mother needs a hip replacement, or a heart replacement.

As much as I despise the current US system of for profit medicine with insurance as compared to the system in my native Canada at least the insurance allows those that have it a way to pay for treatments and procedures they wouldn't otherwise be able to afford. Are you saying that if I'm not paying my $600/month in medical insurance that I'll suddenly be able to pay for things outright?

I don't really understand your position on this.

[The Buddha]

That's easy, 80 year old pays hospital bills via her insurance. That is auto insurance, that will be needed.

You get a cold, you go to doctor ... they ask for your insurace and say pay up 20. Then they spend 12 man hours recovering the negotiated rate of $25 so its $5 more from insurance.

Instead, you'd pay 25 and they dont do nothing. They dont even ask for insurance. Its that negotiated rate that is the killer. It also is what puts the self payers out of the picture, and it is what gets the huge staff the doctor has to waste time getting that $.

Not libertarian theoretical garbage, That system is alive and well in many countries, India is a good example, have you heard of medical tourism, look it up, un insured its cheaper to fly to India and get a procedure done instead of doing it here with insurance.
Cool.
Buddha.

[The Buddha]

And shockingly ... my MIL has 2 knee's replaced. She paid for them herself, and guess what they cost. Somewhere near $1000 installed. Yea a grand. They are not used knees either, proper new chinese made knees just like the ones you get here.
Your deductible here will be over 5g. That is after the 1000 bucks insurance will pay in negotiated rate.

Cool.
Buddha.

[Toogoofy317]

Where is this?

My insurance still had to pay $17,000 of my 10 minute life flight that price would be 28,000. Also, Buddha you are entitled to an estimate from the hospital before they do any services I did that at NEMC when I was going there the first time in case I did have to pay out of pocket. But, in an emergency is that something you really want to think about?

Primary doctors really aren't making that much money my doc has had to file for bankruptcy because her malpractice insurance is approximately 30% of her income which comes out after her taxes, she is still paying off her school loans, and her retirement was wiped out in the economic down turn. She was a 4th year resident at the hospital closest to the World trade center.

Mary

[yamahonkawazuki]

No one needs to run health care, cos there will be no healthcare. Who runs fast food ? OK fine pepsi and coke run it.
However they are chasing each other to the bottom. That will occour unless the big companies are colluding. That will be a "cartel" and there fore illegal. Competition is good. Just needs to be a true competition.

Fast food is held in check due to the fact that they have to publish prices. No we'll do this for you and send you a bill later, we dunno how much what is ... but we'll bill your insurance company and get paid, all is cool ... makes it all very expensive.

When you walk in you know you're out for 3-4-5 bucks depending on what you are eating. Same with a hospital.

Cool.
Buddha.

and if youre broke, do you just go die?

[thecdn]

and if youre broke, do you just go die?

Now you are starting to get it.

[The Buddha]

Where is this?

My insurance still had to pay $17,000 of my 10 minute life flight that price would be 28,000. Also, Buddha you are entitled to an estimate from the hospital before they do any services I did that at NEMC when I was going there the first time in case I did have to pay out of pocket. But, in an emergency is that something you really want to think about?

Primary doctors really aren't making that much money my doc has had to file for bankruptcy because her malpractice insurance is approximately 30% of her income which comes out after her taxes, she is still paying off her school loans, and her retirement was wiped out in the economic down turn. She was a 4th year resident at the hospital closest to the World trade center.

Mary

You're entitled to a price list, in fact you should see prices on the wall.
I dunno about flights etc cos In India we dont have that, no example to go off of.
However ambulances in India are pretty similar to taxicabs. They run close to 2-3X of a taxi but the rest all is the same.

Yamahon: By that example - "and if youre broke, do you just go die?" - people in India should be dropping dead like flies.
I hate to tell you this over and over and over, medical is expensive because thyere is no accountability. If you kill insurance guess what will happen - your doctor will settle into what is reasonable in the location you are in. You dont see stores selling burgers for $5 do you ... OK so you wont see doctors charging $150 per sneeze ... Docs make less than 30 bucks per patient. 20 from the patient they get in an instant, and then they waste 4 hours trying to get the other 10. Kill that system. We are wasting doctors time, charge 30 bucks @ the door and no one needs insurance the doctor gets to run on a smaller staff and you pay 30 bucks and it ends there.

Once again - IT IS EXPENSIVE COS THERE IS NO PRICE DISCOVERY.

Prices on the wall and no insurance will drop this into the reach of everyone as well as make doctors more $ by cutting off the overhead. I know for 10 doctors and 12 nurses my local place uses 25 more paper pushers. Dont need it. 4 paper pushers max for 10 doctors and 12 nurses.

You dont need to be hit with a 30,000 bill for being hooked up to a dialysis machine, we have those in India and I dount they charge you any more than 50-100 equivalent. Insurance is the problem, and worse yet they are also squeezing doctors on the other side.

If you were broke and had no insurance now, you go die.
If you're broke and there was no insurance at all ever, the doctor will see you with whatever you can pay them, that's the worlds basic rule - aka supply and demand thrown in with a bit of human tendency. Seriously, without insurance I'll pay my doctors with fork braces or round covers if I was broke.

Cool.
Srinath.

[Toogoofy317]

See there is price discovery we are just too lazy to get the price. Since, you like using fast food lets use this analogy fast food restaraunts would never put the calories of their food on the wrapper and that was the excuse for our obesity pandemic. So, several states mandated it thinking if people knew the calories they were ingesting that they would calm down. Guess what happened? Nothing and it will be the same thing with hospitals price boards. If my heart is acting up and I need an EKG and ORMC across the street from where my chest pain started said an EKG was $250 but I know if went across town and had it done at my PCPs office where with my insurance co-pay would be $0. Do you think I'm going to do that? NO, because I could go into cardiac arrest trying to drive my dumb a$$ over or sitting in the PCPs office for 2 hours in pain because I didn't have an appointment.

Putting a price on the wall isn't going to change that much because 1) People don't care 2) People can't afford to care 3) They could very well die trying to save a few bucks.
Mary

[The Buddha]

That price on the wall should be fixed. No insurance nothing ... 100 bucks is 100 bucks. Dont care what insurance you got.
You do know when that gets mandated insurance companies will drop that hospital. That will simply put get that hospital into the street ... unless it was mandated it will be stuck as the only one.

Seriously it costs you 250, but your insurance only pays them 20. You pay 20 deductible, that makes it 40 that the hospital gets ... that is why insurance exists. Inflated prices wont be helped just by discovery, it needs to be set as the price, no insurance garbage. Heck I'd say publish all of those too. Your price 100, BCBS price $25, Cigna $30, Aetna 25, humana 30 ...
Publishing 1 is being unfair to that 1 ...

You guys are confusing what the service is originally priced @ vs what they actually get for it, they have to publish everything.

Cool.
Buddha.

[The Buddha]

And of course it has to be the law. They're not going to publish that you pay 250 while if you has BCBS they will take $25. In fact the guy/gal @ the desk where you check in they dont even know. They put in a code and the back office guys send it and eventually they see what shows up.

They have to publish everything ... in any other case it wont work.

BTW doctors make over 1/2 their $ from your deductible and put in less than 1/100th the work getting it.

Cool.
Buddha.

[yamahonkawazuki]

fair enouhg. then do we make medical school 1/10th the cost of what it curently is?, and re-imburse those whove already graduated?

[The Buddha]

fair enouhg. then do we make medical school 1/10th the cost of what it curently is?, and re-imburse those whove already graduated?

Hell no. The doctors dont make that much $ right now. This plan will get rid of 50% of the paper pushers in the doctors office, 100% of the paper pushers in the insurance industry and give doctors the same anout of $, save the patients lots of $, time and hassles supporting this bureaucrazy.

The tuition fees being super high etc is another independent story.

The basic premise is this - you pay 500 a month to insurance co, then pay 20 bucks @ every doc visit. The doc has a $200 per visit rate which they want to charge you. Of course insurance pays them something like $10 after they send them bills a 100 times. That is $30 the doc makes. Its cost you $520 cos you pay insurance, essentially the $500 to insurance to have them strongarm the doctor into taking 10 bucks where they were asking for 200.
Screw that ... you pay the doc say the same 30 and they dont have the 20 paper pushers, it really will make them more $.

What they need to do in the first place is that full price discovery - mainly cos sometimes even they dont know what they get paid. I know cos I went though this garbage in 2006 to fight against labcorp. They get $3 for a $300 test on average. The bigger and more $ tests they get smaller percentage. A $5000 test will get them 25 bucks maybe. They made some lousy error when I took my son for a battery of tests. I had insurance for the first 3 draws, which had to be in 4 draws cos the labcorp Idiots couldn't classify and add, anyway they tried to charge me for the last draw wiht rather conveniently were 2 tests that listed for 5000 and 4000. I rifled through a ton of paperwork and found out they got like $3 for a 300 test and that was that ... I crushed them. I offered them 90 bucks and they said they dont bother, will close teh case in a round about way.

Cool.
Buddha.

[Toogoofy317]

Don't have a deductible, never had one even with Disney. So how are they getting half of nothing? More and more people are going this route. I also have no co-pays so my doc is only getting the $45 that Medicare schedules them. So, they get $22.50 per patient at 4 an hour for 7 hours 1 hour lunch  would be $630 total. Subtract 30% for malpractice insurance leaves $441 a day to pay staff such as RN assistants, reciptionist, referrals, and lab costs. So, not seeing where they make a lot of money. The reason I'm using Medicare is because she told me 80% of her patients use Medicare. If they didn't have to pay anyone else or taxes at $78.50 and hour it would be eh for 10+ years of schooling.

Mary

[The Buddha]

Don't have a deductible, never had one even with Disney. So how are they getting half of nothing? More and more people are going this route. I also have no co-pays so my doc is only getting the $45 that Medicare schedules them. So, they get $22.50 per patient at 4 an hour for 7 hours 1 hour lunch  would be $630 total. Subtract 30% for malpractice insurance leaves $441 a day to pay staff such as RN assistants, reciptionist, referrals, and lab costs. So, not seeing where they make a lot of money. The reason I'm using Medicare is because she told me 80% of her patients use Medicare. If they didn't have to pay anyone else or taxes at $78.50 and hour it would be eh for 10+ years of schooling.

Mary

More like 10 an hour, when did you get 15 mins with a doc. Mine is always in and out in 5 min max, in fact I barely spend 15 @ the doc in the room 5 min with nurse, 5 wait and 5 with doc. I'd put it close to 15 patients per hr, but your math is good.

Docs dont make much $, we pay tons to insurance, the $ has to go some where.

Cool.
Buddha.

[yamahonkawazuki]

ive been lucky to even see a doc. most of the time it was a nurse or CPA ( certified physicians assistant. ) and my kidneys continue to fail. hoping disability pans out. had my case/hearing on the 3rd. THEIR witness ended up agreeing in my favour.

[The Buddha]

Yea for my son too, once the treatment is set, the regular visits are taken up by the nurse, and in a way they are phenomenal. This one my son sees is pretty old, and very experienced and I'd easily put her against most doctors. More importantly she will check things on us that are bothering us and treat or give us advice even though we are there for my son's treatment.

Seriously guys, if insurance were to die a sudden death this system will correct and heal itself and get back on course.

When you need your car fixed what do you do - pay for it, when you need your house fixed what you do - pay for it, why the Fruck is it any different when you need your body fixed.

Cool.
Buddha.