Why health insurance is so expensive (illegal, healthcare, premium, suspect)

[roysoldboy]

I keep trying won't soon stop unless I die, from natural causes or from help,
and I am sure that I won't have any success yet.

A large part of why health care is so high in this country has to do with the way Medicare payments are made. Once one reaches the age of 65 he is forced into Medicare although if he can afford to pay the rates others pay he can have both.

Medicare payments are determined by bureaucrats in state offices in all 50 states. That is ok but since only about 40% of what providers ask for gets paid by Medicare with another 10% from our medigap insurers. Now every insurance company gets asked for about the same amounts but they have to pay the whole thing. Of course, this has to influence how much they charge their customers.

One more time, Medicare tells providers what they will be able to get in payment and they can't charge one penny more. Keeeerist sakes people when will some of you understand this. I have been on Medicare for 14 years and have paid real attention to the quarterly statements from Medicare as to how much providers asked for and how much they pay.

Medicare is government and they decide what can be made by doctors and what they will pay but you people make all those noises about insurance companies not paying but they are being charged rates aimed at equalizing what Medicare pays. Whooooeeeee it makes me wonder.

[whogo]

Originally Posted by odanny

Say what? I think you are confused on how private health care works in the U.S.

Germany, England, Canada, those are national health care systems that actually work.

The U.S. system is highly profitable, and it can increase its profit margins by denying healthcare to the sick. Aint that compassionate? God Bless America

Government healthcare programs must ration healthcare. They do that by not treating the sick.

[Kkaos2]

Originally Posted by odanny

Say what? I think you are confused on how private health care works in the U.S.

No, he isn't. There's nothing to be confused about. Supply and demand is extremely simple. More supply, less demand = lower prices. More demand, less supply = higher prices. Government subsides increase demand without increasing supply and thus lead to higher prices. It's pretty basic stuff.

You liberals live in some invented fantasyland where massive government entitlements in the healthcare market since LBJ's Great Society somehow bear no relation to medical costs rising at rates far greater than other goods and services. Total coincidence.

You do realize your so-called "Affordable" Healthcare Act has had its costs adjusted upwards multiple times since its passage to the point where it is now costing literally hundreds of billions of dollars more than originally projected, right?

And if private insurance collapses, do you really think there's going to be a single payer system covering the better part of half a billion people without forced rationing? That's insane.

Germany, England, Canada, those are national health care systems that actually work.

So what? Who cares what works in Germany? This isn't Germany and Germany's system isn't Obamacare.

The U.S. system is highly profitable, and it can increase its profit margins by denying healthcare to the sick. Aint that compassionate? God Bless America

Newsflash for you: According to the American Medical Association, the government's rate of denying claims is DOUBLE that of private insurance. So how does your foot taste?

[nicet4]

Originally Posted by odanny

Say what? I think you are confused on how private health care works in the U.S.

Germany, England, Canada, those are national health care systems that actually work.

The U.S. system is highly profitable, and it can increase its profit margins by denying healthcare to the sick. Aint that compassionate? God Bless America

You get what you pay for and I am sick and tired about hearing how the German, British and Canadian systems are soooooooo much better.

Why do you suppose it is so many Canadians come to the Cleveland Clinic for heart surgery or cancer treatments? Hmmmmmmmmmmmmmm?

When is the last time you heard of an American going to Toronto for cancer treatment?

Here’s a Second Opinion

Ten reasons why America’s health care system is in better condition than you might suppose. By Scott W. Atlas.

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

snip (there's a lot more).

You want a medical system where the mortality rate, mortality is where you die, for breast cancer is 52% higher than the rest of the developed world?

[jambo101]

Why is health insurance so expensive?


Appendectomy Cost: $64,575 - SurgeryCosts.net (http://www.surgerycosts.net/price.php?medical=appendectomy - broken link)

[waterboy7375]

Its expensive because its ripe for the picking. Once dr,s know you have it they see you as a money tree.

[monkeywrenching]

Originally Posted by villageidiot1

With all the talk about overturning Obamacare, what is missing in the discussion is the fact that the private health insurance industry is expensive, inefficient and serves no real purpose. Pittsburgh has one of the most uncompetitive markets in the country for health insurance with Highmark Blue Cross' market share in Western Pennsylvania estimated to be in the 60 percent to 65 percent range. Pittsburgh spends more on hospital care per person than any other major U.S. city.

Highmark has recently experienced the firing of their CEO after he was arrested for a fistfight with the husband of his employee/mistress. This woman had recently negotiated a $15M sponsorship contract between Highmark and the PGA for the exclusive right to sponsor, equip and staff medical trailers at PGA Tour golfing events nationwide for the next four years. A recent article in the Pittsburgh Post Gazette states: "The deal is irksome given that Highmark sought a nearly 10 percent rate hike in July for its lowest-income insurance product (eventually pulling back to 4.9 percent). It outsourced 150 back-office jobs 16 months ago, and is pursuing an aggressive drug formulary that will save employers money on generics but put specialty medicines beyond most people's reach."

See the article at: Remind us, Highmark: Why sponsor national PGA golf events?

health insurance is so expensive because the federal goverment makes it that way on purpose. because they limited citizens to only buy insurance in the state that they reside in, the citizen has to buy what their state requires them to at a minimum.

[odinloki1]

I think Obamacare is a problem in the way it was instituted. Mainly because of the lack of 1 A public option or 2 Mandatory purchase of not-for profit plans.

Anybody who has any openness left in their mind should read T.R. Reid's book "The Healing of America". He looks into the pros and cons of many different systems.

We need comprehensive change

1. Removal of for profit companies. No more waste on profit, dividends, or the beauracracy of office workers meant to do such. It could also get rid of some of the waste spent on workers handling billing and coding.

2. Tort reform. Particularly malpractice insurance. In many states malpractice insurance rates can be raised for a frivilous lawsuit that gets tossed out. Lawsuit filed, bam, rates go up because you're a liability

3. Cutting tuition or making student loans interest free, providers have huge student loans on graduation right now. I'm a medical provider and over 50% of my income goes to my student loans right now, a lot of that is the interest. It just makes me look for the best paying job and leaving the instant I can find it. Which drives up the cost.

4. Universal EMR. Less time, paper and staff spent on records.

5. Elimination of for profit pharmaceuticals. Substantial government grants for biochemists who develop drugs that work. Non for profit companies that wish to can manufactur the drugs, or the government can. Pay the people developing the drugs and manufacturing them, not the CEOs and stockholders.

those are 5 big steps I'd take to reducing costs of health care. Get rid of the excess waste that doesn't need to be there.

[Grim Reader]

Originally Posted by whogo

Government healthcare programs must ration healthcare. They do that by not treating the sick.

Since its not possible to give everyone infinite goodies, everything in existence is rationed. However, not everything is rationed equally harshly. Since government healthcare programmes are far more efficient than the American model, they ration treatments less, and get better results.

Originally Posted by nicet4

You get what you pay for and I am sick and tired about hearing how the German, British and Canadian systems are soooooooo much better.

Then maybe taking it onboard may be an idea? They get better results with far less resources spent. That is "better" for any meaningful definition of the word. Move on.

Originally Posted by nicet4

Why do you suppose it is so many Canadians come to the Cleveland Clinic for heart surgery or cancer treatments? Hmmmmmmmmmmmmmm?

Why do you think any Canadians do?

Canadians use of US medical facilities.

And why do you suppose 15 times as many Americans leave America for medical treartment as the number of foreginers coming to America for treatment? If the America system wors so well, why does the patient stream run so overwhelmingly the other way?

Originally Posted by nicet4

When is the last time you heard of an American going to Toronto for cancer treatment?

You do realize you don't get to buy your way onto residents care in other countries, right?

Originally Posted by nicet4

Here’s a Second Opinion

Ten reasons why America’s health care system is in better condition than you might suppose. By Scott W. Atlas.

You want a medical system where the mortality rate, mortality is where you die, for breast cancer is 52% higher than the rest of the developed world?

Dude. That thing is a joke, thats been doing the rounds for a bit. There is a reason they no longer list the references. Read it)) Seriously, you just posted your self that the 52% figure, (Which is old but from the Lancet) only compares to Germany, not the developed world. You want a system where the amendable ortaltiy rate is lower than most of the developed world? Infant mortality, organ transplant mortality maternal mortality? Remember, mortality is where you die. And Americans die sonner than Europeans and have fewer years of good health.

1) Americans do have slightly higher cancer survival than Europeans. But notice how he cherrypicks his stats? Breast cancer compares to Germany, prostrate to the UK. That should be a red flag. Why not compare prostrate cancer to Germany and breast cancer to Norway? Because suddenly the US does not look so good any more. Why not compare mortality to all countries, instead of looking hard for someone the US can look good in comparison to?
Because then the US does not look as good all of a sudden.

Also, he is doing 5-year survival rates, which makes the US look extra good on prostrate cancer, and picking his years.

2) Cancer again, and again a different country. You know, its not difficult to look good in cancer stats if you get to pick the typer of cancer to compare, and the country to compare to.

3) Americans use more statins than many other nations because of higher rates of obesity and diabetes. There is actually nothing that shows that Americans have better access to drugs for chronic conditions, quite the opposite. Why do you think two million Americans buy their drugs in Canada if American access is better?

4) Cancer again. He is quoting a discreditied study, and the couple that did it wasn't qualified health care research professionals either. Heh, just for strarters they eliminated the lowest socioeconomic third of the US from the study before comparing.

5) Same study, and relying on self-reported measures, which says more about the populations expectations of health than conditions.

6) Same study. Also, cherrypicking again. Why isn't Norway and Germany objects of comparison any more? Because that would bust the notion of the US doing well. Why pick hip replacements and radiation therapy? Same reason.

7) Now this on is interesting, because it is a direct lie. The study he references showed the US to be by far the most dissatisfied, and other nations to be far more happy.

8) Same study, same model. He is actually saying Canadians expect more from the system.

9) Yeah...not actually true either. The US does have more CT scanners and MRI machines, but that does not translate into better access. A big cost adder in the US system is overinvestment in equipment and underutilization. Also, once again cherrypicking. No mention of Japan or Germany? Hm.

10) The US were for a while responsible for most medical breakthrough. That was after WW2, when the US had the money for research and intact hospitals. Nobel prizes lag the research that gets them by decades. Today the US still pulls more than its weight per person in reasearch, biomedical research spending roughly even with the EU.

There does not seem to be any attempt to link the current US system with the research results either. I mean, the overspending in the US system is 15 times the biomedical research budget of the planet.

In short, what this actually says is that the US does sightly better on cancer results, and if you ook hard, you can find some areas where the US does better than one or two countries. Not exactly a recommendation.

It is sortof like doing well in Freanch and failing every other class. You're still failing.

Point is, anyone can cherrypick stats that make one country look good. FGor example, patients in Canada are twice as likly to recieve a kidney transplant as a US patien (Ongoing dialysis have a higher profit margin).

Mortality rate for renal disease is 47 % higher in the US than in Canada.

Low income Canadians have significantly higher survival rates than low-income Americans for 13 out of 15 cancer types.

US patients have far higher liklihood of invasive, expensive procedures after a heart attack than Canadians. Coronary bypass surgery, percutaneous transluminal coronary angioplasty, coronary angiography...all 5 -10 times as frequent in the US. Results are identical to the Canadian ones.

Canadians are more likley to recieve a bone marrow transplant if in need of one.

Canada has better survival rates than the US on leukemia, colorectal cancer, and organ transplants.

See how easy that was? And it says nothing. (Except the bit about US patients getting far more invasive and expensive procedures than Canadians)

When a health care professional or health care economist compares the performance of systems, very broad measures are used, often covering thousands of procedures. If you want to see which system is better, compare child mortality, average lifespan, average health lifespan, DALYs, maternal mortality and amendable mortaltiy.

Cherrypicking just indicates desperation.

[geofra]

Maybe if insurance companies (including Medicare), who want to pay out as little as they can get away with, and health care providers, who want to get paid as much as they can get away with, declared a truce... who am I kidding, that won't happen.

As in all wars, things escalate and rising healthcare prices indicate this war is no different.

We patients are caught in the middle, little understanding what is happening, except that it is costing US more money.