Comments on: Why Healthcare Is Killing America

By: SiFi

SiFi — Tue, 07 Jul 2009 22:26:22 +0000

Hundreds of millions of dollars are being syphoned out of the U.S. health care system by insurance companies and placed into their profit accounts. With the Blue Cross/Blue Shield plans who declare they are non-profit, that account is called reserve. In 1985, a friend of mine who worked at one of the BCBS plans told me that their plan had enough in reserve to pay claims until 2000 without collecting another penny in premiums. You have Medicare, Medicaid, VA and insurance companies. Combine them into a single payer system. Those with jobs can pay a single or family rate. Without the insurance companies syphoning their exorbiant profits, there would be plenty of money to provide services for the elderly, the infirm and those who need assistance. The next item would be regulation since the companies providing health care would try to do a scam just like the military contractors do with the government and hospitals do now with their supplies (have you seen the $40 aspirin bill on your hospital bill?). There is no mystery here on how to solve it. The challenge is removing the obstacles out of the way from implementing it.

By: Jimmy1920

Jimmy1920 — Mon, 06 Jul 2009 01:33:48 +0000

Robert,
I think you are confusing discounts with overhead.
Nevertheless, your observations about payments vs. charges touch on two of the most glaring flaws in our current system.
Why should payments to a provider be based on anything other than performance? Instead, we have a system where payment depends on who the patient is. if the patient is poor and medicaid is the insurer, payment is significantly below costs.
If the patient is old and the payer is medicare, payment is roughly equal to costs. So providers make up their needed shortfall, elsewhere – from those with private insurance and those with no insurance. Usually, those with no insurance involve substantial debt collection costs, which is only one reason why your providers are so willing to accept less than their “book rate”.
But there is another issue going on here, that has much more to do with the argument in your last paragraph. No one in our society accepts full responsibility for health care costs. There are too many examples here to enumerate – but just look at what goes on with employer sponsored health insurance – a topic that I have been professionally involved with for 25+ years.
See http://thehealthcaremaze.us

Employers continually search for ways to shift costs to employees, they offer incentives to elect their spouses coverage, they make it prohibitively expensive, they deny claims because they are work related and then workers’ comp denies the claim because it was a pre-existing medical condition. The list goes on. Meanwhile, government payers like Medicare and the VA chase after these same private payers who don’t want responsibility in the first place. See
http://www.cms.hhs.gov/mlnproducts/downloads/msp_fact_sheet.pdf

To eliminate the paper chase you refer to, we need a single payer system. Keep in mind that very few people have the means to pay for major health care services up front.

By the way,I would like to challenge you to the following. The next time (which I highly suspect will be the first time) you need major medical work (and I do hope it is elective), shop around in advance to find the best value and then get that facility to agree to a case rate reimbursement with a guaranteed service follow up. After all you would expect no less if you were paying $30,000 for a car.

By: How I Make $300 a Day Posting Links Online

How I Make $300 a Day Posting Links Online — Tue, 30 Jun 2009 21:10:37 +0000

Cool post, just subscribed.

By: Brent

Brent — Fri, 26 Jun 2009 22:35:32 +0000

$100,000 for a broken arm???

I’d like to see that bill. What in the world did they have to do to fix you up that cost six figures?

By: ibu guru

ibu guru — Fri, 26 Jun 2009 17:04:19 +0000

I’ve talked to a number of hospital administrators who tell me that over 1/4 of each hospital bill is costs shifted from illegal aliens (who refuse to pay their bills & cite HIPAA, etc, as their justification for not paying). Over 1/4 more is costs of insurance paperwork – sheer administrative costs, not time-value of money. How many more could afford their medical bills or insurance if the costs were cut by 50% or more? It is purely government malfeasance and insurance companies’ obfuscations that cause high medical care costs. On a pay-your-own-way basis, medical care costs would be slashed substantially. The more government “protects” us, the more it costs us and the less protection we actually have.

By: Sara

Sara — Tue, 23 Jun 2009 23:34:33 +0000

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I’ll be subscribing to your feed and I hope you post again soon!

By: Robert Balch

Robert Balch — Mon, 22 Jun 2009 21:35:12 +0000

60 percent of medical costs go to insurance overhead costs, including the interest that medical professionals pay on money borrowed to meet payroll, while waiting, up to 2 years, to receive payment on claims. As one of America’s 45 million self-insured individuals, I am regularly offered discounts of 40 to 60 percent, because I am able to pay at time of service. For xrays, I was offered an 80 percent discount. I realize, that even with discounts, the un-insured subsidize the insured (not the other way around as claimed by insurance companies seeking more profit). Self-insured individuals rarely use emergency rooms for treatment. 83 percent of ER patients have government insurance (medicare or medicaid,…). Less than one percent of ER visits are made by the un-insured.
Instead of forcing the self-insured to buy insurance, how about requiring the insurance companies to pay claims, without all the delays and run-arounds and buck passing. They ought to be required to service claims quickly, and pay the requested balance in full, if not handled within 30 days.