Medical insurance company RANT

[maat55]

To sum it up, this is why America needs a nationalized health plan like the other industrialized countries and even non-civilized societies like the U.S. Congress have.

Socialization is a disaster wherever it is attempted. If mexico and canada can sell drugs for 25% of the cost we pay, then red tape is the problem. Our government is corupted with lobbiest and frivolous lawsuits. This problem can be fixed with capitalism, but it may take a limited revolution.

[Exile]

Socialization is a disaster wherever it is attempted. If mexico and canada can sell drugs for 25% of the cost we pay, then red tape is the problem. Our government is corupted with lobbiest and frivolous lawsuits. This problem can be fixed with capitalism, but it may take a limited revolution.

See the post by DebbieL.

[disneysteve]

A point and a question:

Point: Mexico and Canada sell many more drugs over the counter that require a prescription here in the US, meaning patients don't need to see a doctor (or NP) to obtain many meds like they do here. Not saying if that is a good thing or a bad thing - I think it is a little of both - just pointing that out.

Question: Do Canada and Mexico allow direct to consumer advertising on the scale that is done here in the US?

[neguy11]

TI think high deductible plans and HSAs need to expand and become more common. One benefit to these plans is that they draw in the young, healthy patients who typically forego buying insurance because of the expense and figuring that they don't really need it. By doing that, you increase the insurance pool which improves things for everyone involved.

I have a high deductible plan w/HSA and love it! The premiums are a lot less than the other plan at my job and my employers puts $500 into my HSA if I get enough wellness points.

Of course my only expense last year was an ER visit and that ended up costing about $1000 but part of that was my fault because I took the ambulance and didn't realize it was $500!

My employer really pushes it and I am satisfied. So far I have about $1400 in my HSA, so health care expenses are just not something I worry about.

[JanH]

This is EXACTLY what I keep proposing, to make health insurance more like car insurance. My car insurance doesn't cover oil changes or new tires or detailing or replacing worn out floor mats. I pay for that out of pocket. Even though the routine maintenance stuff on your car is vital to the life of your vehicle, it isn't covered by insurance. Just the same, "routine maintenance" on your body is vital to your health, but that doesn't mean insurance should pick up all the costs.

We had an insurance policy like this in the eighties. It didn't cover well baby visits or Pap smears or the like. Any maintenance stuff other than being sick. It caused some people to skip the procedures because they wouldn't or couldn't pay for them. I think that now, that would include mammograms and prostate testing. I don't know how I feel about that. I know that a lot of people got their baby's shots at the county's clinic because they couldn't or wouldn't pay for all their shots. I had to pay out of pocket for all my kids' shots and well checkups. It wasn't easy to do at the time. I also had to pay for all my GYN checkups. I'm wondering how many people would have to give up these tests if they went back to that type of policy. Just a thought....

I guess that the shots should be figured into the cost of having a baby in that case. I was just clueless....

[maat55]

I saw a news report where you can go to mexico and see a doctor for 3 dollars and get the drugs you are prescribed here for a quarter if the cost.

I'm a big fan of HSA's. Before we got insurance through my wife's company, I had an HSA. I had a 7000 deductable for 164.00 a month and an accident rider of 25.50 to cover the first 5000. For someone paying 500 a month for insurance, you leave yourself 300 plus a month for office visits. I being healthy, saved a ton of money.

[LivingAlmostLarge]

I know many people who don't have insurance who skip routine care. So your proposal steve of making it like car insurance, how many more people will skip going to the doctor and paying for it because it's "low" on their priority list? Then when something major happens they will expect to be bailed out?

As far as prescription drugs, it's because the pharmaceutical companies are allowed to charge whatever they want in the US.

In Mexico, Canada, rest of the world, the governments step in and say you can't charge those outrageous prices. The US it's totally free market, so EVERY Pharmaceutical companies LOVES the US. They can charge $250k/year for treatments.

Um, yes the government needs to step in. But pharm will lobby and argue that they need to recoup the costs of drug development (true fact).

Read the book "the billion dollar drug". It discusses how much red tape and effort is put into developement. Hence pharma companies have to charge a lot more in the US to make a profit. In other countries they are limited to barely making a profit.

[disneysteve]

We had an insurance policy like this in the eighties. It didn't cover well baby visits or Pap smears or the like. Any maintenance stuff other than being sick. It caused some people to skip the procedures because they wouldn't or couldn't pay for them.

I know many people who don't have insurance who skip routine care. So your proposal steve of making it like car insurance, how many more people will skip going to the doctor and paying for it because it's "low" on their priority list? Then when something major happens they will expect to be bailed out?

Sorry. I wasn't clear on this. I'm not suggesting that insurance not cover appropriate preventative care. I DO think Pap smears, mammograms, standard vaccines, disease screening and such should be covered. It would prevent a lot of higher costs down the line. What I don't think should be covered are things like minor illnesses, prescription medications that are available in OTC form, brand name drugs when generics exist, etc.

For example, when I have a cold, I buy store-brand Nyquil. If I get mosquito bites, I use OTC cortisone cream and some generic antihistamine. If I get sunburn, I apply aloe lotion and take some ibuprofen. If I hurt my back lifting something, I take ibuprofen and put the heating pad on. There is no reason for medical insurance to cover these types of ailments and therapies, but millions get spent each year for this kind of stuff. Medical testing shouldn't be covered unless there is a valid, documented reason for the test. I know people who get an annual chest x-ray just because they want one and are able to get their doctor to order it. No good reason for it, but insurance covers it. This is the kind of nonsense that needs to change.

[LivingAlmostLarge]

True, but people in general are cheapskates. They expect 100% care for 0 cost. So they want to have care when they need it, but they refuse to pay for it. Hence why I like socialized care because it forces people to pay and be covered. They don't get to skate along, not saving anything into an HSA and whammo, suddenly they need help?

And they have no assets, nothing saved because they CHOOSE to do so. No way, if they are working, why shouldn't they be paying something?

I know tons of people who refuse to pay for health insurance and they can afford it.

[jc3900]

Looks like socialism has it savingadvice!

I posted this in the other thread, so I thought I would do the same here.

The cause of the U.S. health-care mess is governmental interference. The solution, therefore, is not more governmental control, whether via nationalized medical insurance or a government takeover of medicine.

Health insurance costs so much today because the government, on the premise that there exists a “right” to health care at someone else’s expense, has promised Americans a free lunch. When a person can consume medical services without needing to consider how to pay for them—Medicare, Medicaid, or the individual’s employer will foot the bill—demand skyrockets. The $2,000 elective liver test he or she would have forgone in favor of a better place to live suddenly becomes a necessity when its cost seems to add up to $0.

As the expense of providing “free” health care erupts accordingly, the government tries to control costs by clamping down on the providers of health care. A massive net of regulations descends on doctors, nurses, insurers, and drug companies. As more of their endeavors are rendered unprofitable, drug companies produce fewer drugs, and insurers limit their policies or exit the industry.

Doctors and nurses, now buried in paperwork and faced with the endless, unjust task of appeasing government regulators, find their love for their work dissipating. They cut their hours or leave the profession. Many young people decide never to enter those fields in the first place.

What happens when demand skyrockets and supply is restricted? The price of medicine explodes. What was once to serve as a free lunch for everyone becomes lunch for no one.

The solution? Remove all controls. Recognize each citizen’s right and responsibility to pay for his or her own health care, and return to insurers the entrepreneurial freedom to come up with innovative products.

True freedom would bring health care into the reach of the average U.S. citizen again—just as it has done for other goods and services, such as computers, cell phones, and food.

Focus on this part

The solution? Remove all controls. Recognize each citizen’s right and responsibility to pay for his or her own health care, and return to insurers the entrepreneurial freedom to come up with innovative products.

I think we should make our semicapitalistic/socialist healthcare system and make it completely free market. That means all government healthcare programs our out including medicare and medicaid. Some of you might say, OH THE POOR PEOPLE WHAT ABOUT THE POOR. Well guess what, there is this thing called a charity. There is a reason for the saying save 10% give 10%. The thing about charities is that they are a LOT better at giving money away as they don't have to go through 20 departments in washington and back.

[PrincessPerky]

I hate to point out PP, but what happens if you need an emergency C-section? What will that cost you? Can you handle it? I hate it when people have no insurance and then an emergency happens and who do they expect to pay for it?

That's the biggest problem. That people don't think they need insurance until they actually need it! Then they expect others to clean up the mess.

I'm okay if you buy an HDHP, but if it doesn't cover as much as you expect, then are you fine footing the bill?

I would foot it, I of course don't want to, but if I paid 10K over the last 9 months I wouldn't be able to pay for a the kids normal delivery...(and the cost of the C section would be WELL more than the 10K)

Yeah it is a risk, but I have never asked you nor any member of the USA to foot the bill for my risks..just done a whole lot a prayer....

In the meantime I am saving more than most, I am eating healthier, and I am VERY aware that everything I do effects my baby. I know MANY women who think nothing of lousy eating and bad habits while pregnant...any complications that occur, would be covered by insurance. Of course insurance or no, I find them a big deal (this is my baby's health at stake you now!).

[PrincessPerky]

I think we should make our semicapitalistic/socialist healthcare system and make it completely free market. That means all government healthcare programs our out including medicare and medicaid. Some of you might say, OH THE POOR PEOPLE WHAT ABOUT THE POOR. Well guess what, there is this thing called a charity. There is a reason for the saying save 10% give 10%. The thing about charities is that they are a LOT better at giving money away as they don't have to go through 20 departments in washington and back.

While many complain that if it wasn't 100% covered no one would go, the truth is many folk do not see routine care as an option without health insurance, and due to the socialistic problems the cost is out of proportion to the need. Whereas oil changes are seen as a need, one that can be done (red carpet or driveway). Medical care is seen as too expensive...no coverage, no care. Which is sad. but if I went to a dr right now for a 'checkup' would I get to look at a list of options and price match? of course not, Doc would say 'well it all depends on how it goes...

On the other hand dental care is actually semi competitive. prices vary from dentist to dentist a bit (course so does the level of care - just like with a mechanic) And prices are easy to find up front (I just did lots of calling, every dentist knows what they charge for what procedure, only iffies are in which procedures you need...and a 'consultation' fee covers the finding what you need. with a probable list you can estimate the cost easily.

I personally think if folks stopped thinking this mess was the governments job (and the government took their noses out of it) than more people would spend more on their own health care.... well less total prolly, but more on simple preventative items...like healthier foods.

But then at the same time, many people burn out a motor before they realize oil does need changed. Maybe the trouble is we only have one 'motor' and burning it out is not so easy to get past.

[zetta]

I think we should make our semicapitalistic/socialist healthcare system and make it completely free market. That means all government healthcare programs our out including medicare and medicaid.

There is a myth that completely unfettered free markets are always the most efficient. In truth, even free markets need a certain amount of regulation to ensure that they work properly. Proper regulation ensures that costs are upfront and transparent, quality is visible to the consumer, and the supplier cannot exert monopoly or cartel power. That's why car and home insurance is heavily regulated, and there are building codes.

We can't just scrap the current system overnight and tell everyone to fend for themselves. The whole system would go into massive shock and probably collapse. There would be much suffering from both financial ruin and early death.

It's not enough to change the payer from employer-based insurance to either HSA or socialized medicine -- there also have to be changes in the hospitals and doctors offices. The sad thing is I don't see much being done to address the problems in the supplier side of this market.

[Scanner]

I am inclined to agree with Zetta, especially the Medicare population.

Medicare is best served to stay a welfare state.

Look at it this way - if you were an insurance co. and a 80 year old person came to you and said, "I wanna sign up", would you insure this person?

Would you?

Or a person with a major disability came to you and asked to get insurance?

No, of course you wouldn't.

It would be an immediate loss, unless you had a ridiculously high premium.

This is why the Republican idea to privatize Medicare is so bad. It won't work.

You don't force sick people into a healthy risk pool.

You force healthy people into the sick people risk pool.

[atomicrc11]

I love the idea of an HSA, and in fact it is going to save me a ton of money. I get to shelter $5300 from the IRS, plus I put money into my 401k thus reducing my tax liability by over $10,000. Too bad all the sick people who need my money to keep premiums low are losing it, but why should I pay ever rising insurance rates when I can keep them to a minimum with an HSA and only pay for the care I actually use? Plus I save an extra $800 on my taxes so even I pay out more, I'm still saving. I agree people should get health care but there is no good way to control it. Either way we will be paying out the nose.