IWETHEY v. 0.3.0 | TODO
1,095 registered users | 0 active users | 0 LpH | Statistics
Login | Create New User
IWETHEY Banner

Welcome to IWETHEY!

New Dixon posits a binary choice
Those who voted for Biden over the sage of Burlington are either callous/evil or they are ignorant/deluded. How did you read it?

cordially,
New I'll ask differently.
What does the legal requirement of having for-profit health insurance companies as an integral part of our health care delivery system contribute to the delivery of health care that makes tolerable the profit taking from the infirm?

I worked in the damnable health insurance industry, including a five year stint at a not-for-profit company that, remarkably, managed to make a profit every year. Leaving aside gambling on Wall Street, there is one and only one way a health insurance company makes money: they collect premium payments from their members for health care that their members never receive. The only way these companies make money is by withholding health care benefits from their members. And boy, howdy, do they make money!

The country's biggest health insurers raked in more than $11 billion in profit in the second quarter, particularly as recent mergers and newly-launched business lines began to bear fruit.

The clearest example of this trend is CVS Health, which posted a Q2 profit loss in 2018 but saw profits return to the black and revenues increase significantly following its acquisition of Aetna.

Cigna posted similar results, with its revenues skyrocketing from $11.5 billion in the second quarter of 2018 to $34.4 billion in Q2 2019, thanks in large part to its purchase of Express Scripts, the nation's largest pharmacy benefit manager.

CVS just edged out UHG in the second quarter for revenue, earning $63.4 billion, a figure that's nearly $20 billion more than the year before. UnitedHealth posted $60.6 billion in Q2 earnings, an increase year-over-year of about $4.4 billion.

https://www.fiercehealthcare.com/payer/big-8-health-insurers-q3-results

Note that these are profits in BILLIONS for a SINGLE QUARTER. How many Covid-19 tests do you think we could buy with the profits from these companies from just one quarter?
bcnu,
Mikem

It's mourning in America again.
New clarification?
You say:
there is one and only one way a health insurance company makes money: they collect premium payments from their members for health care that their members never receive
Do you differentiate between “health insurance companies” and HMOs? CaesarCare, my HMO, extracts a significant fraction of my monthly pension check, and since the turn of the century its rates have climbed steeply (at a conference a decade years ago I chatted up a CC representative, and asked her when they’d loaded up their board of directors with Enron alumni. She got very snippy). Nevertheless, when I had to go in for cardiac roto-rooter four years ago, my out-of-pocket costs were, as I recall, under a grand.

It could be argued, of course, that in a just system I ought not to have been on the hook for even that much, but that’s another discussion. You haven’t addressed the issue I raised: Dixon accuses all of us who did not vote for Sanders of being either indifferent to the suffering of others, or deluded. You appeared, in the OP, to endorse that take. Do you still?

cordially,
New I'd say uninformed.
How long do you think your vaunted HMO would remain in business if all, or even one-half its members had your health claims history? Do you think they "made money" on you? If not, how exactly did they turn a profit? Do you have any idea how many claims were denied (read: "Deemed not medically necessary") for your fellow members so that you could enjoy your benefit?

It is not a net zero game. Profitable health insurers *do not* spend 100% of total premiums on the delivery of health care. By design a minimum of 20% of health care premiums are *never* spent on anyone's health care. They're *supposed* to spend 80% of the premiums they receive on health care but with creative accounting voodoo many do not. By the way, if your HMO is a for-profit entity, do you know how much profit they made last year and what percentage that was of premiums received?

I'm not picking on you or your HMO. And, giving the devil his due, the 20% cut-off for "Administrative Services" was a part of the PPACA. Further, at least in the first year, many firms ended up giving refunds for exceeding this amount. But when you have $1,000 deducted from your check are you conscience of the fact that the maximum you are contributing to the cost of your health care is a sum of $800 whilst kicking in $200 to the insurance company?

Capping the medical loss ratio at 80% you likely view as a good thing. But, think about that for a minute. Medicare's administrative costs are around 2%. Given that the administrative costs of private, for-profit companies is around 16%, we have codified, in law, 4% of premiums paid going directly to the profit line of private insurers. Is it a good thing that a minimum of 4% of the over $700 Billion (over 28 Billion) spent in health care premiums in this country is legally ear-marked for profit?

Our disagreement appears to be concerning the true purpose of a health care premium. I submit (and I think Ben would agree) that health insurance premiums are monies spent for health care. If that's true, then clearly the at least 28 Billion ear-marked for profit is clearly from money spent for health care that was never delivered.
bcnu,
Mikem

It's mourning in America again.
New Just so I’m clear…
Voters who favor Biden over Sanders are “uninformed.” Got it.

cordially,
New Or fearful.
bcnu,
Mikem

It's mourning in America again.
New Re: “uninformed.”
You are conflating the final goal with the path to it.

I do not have a problem with Bernie's goal.

Bernie is looking for a revolutionary change which voters will not accept. Trump can easily and successfully paint it communist! Bernie would lose the election and we would have a minimum of 4 years of Trump, possibly followed by Queen Ivanka.

Biden is proposing an evolution via the "public option". If the public option is successful by eliminating the need for profit for stockholders and perhaps needless paperwork bureaucracy, over time the commercial insurance companies would shrink to only providing insurance for exotic services.

Personally, I do not believe obscene profits should be made in providing essential medical services.
Alex

"There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge."

-- Isaac Asimov
New The public option is the surest path to never having an NHS here.
Why? Because only the folks priced out of the private market will buy into it, making it unsustainable. Medicare's current problem is that roughly 70-80% of all medical costs for Americans are incurred during their final handful of months alive. Guess how old they are, on average? Medicare does not currently have the healthy people in the pool and so the risk is dramatically higher than anything in the private sector. There's a reason why, for all the Harry & Louise advertisements, the private insurance sector never talks about taking over the above 65 population. Private health insurers are not in the business of paying medical claims. They are in the business of collecting premiums.

Bernie's plan incrementally expands Medicare until it covers everyone, just as it was originally designed. But the public option will be loved by the private sector for when it inevitably fails they can say, "See. Single Payer will never work here."
bcnu,
Mikem

It's mourning in America again.
New I know we've been through some of this before, but...
the public option has to be made attractive enough for companies to buy for their employees. Companies are always interested in lowering their costs.

I agree that younger and healthier people have to be part of the equation. The "mandatory health insurance" part of Obamacare was addressing that need.
Alex

"There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge."

-- Isaac Asimov
     Benjamin Dixon gets it about right. - (mmoffitt) - (21)
         Well, then . . . - (Andrew Grygus) - (5)
             Because the politically enlightened in this country are a very tiny minority. -NT - (mmoffitt) - (4)
                 Well.. if the POTUS*/Veep ever get Tested and are [+] for virus.. ... - (Ashton)
                 So then, if they "go our separate way" . . . - (Andrew Grygus) - (2)
                     But, but, but, we got Trump because a few Bernie Bros did not vote. No? -NT - (mmoffitt) - (1)
                         we got Trump because clinton -NT - (boxley)
         Benjamin Dixon is a mind reader. Not. - (rcareaga) - (14)
             I vote that you Win the Intarweb for today. - (Ashton)
             Oh, come on. This isn't hard, is it? - (mmoffitt) - (12)
                 You misspelled "obvious ONLY to the most myopic of minds." HTH! -NT - (CRConrad) - (1)
                     Said the man with a national health system already. So, NO, it doesn't help. -NT - (mmoffitt)
                 "What we have here is", [cue tape] "a failure to c'mun-i-cate" - (Ashton)
                 Dixon posits a binary choice - (rcareaga) - (8)
                     I'll ask differently. - (mmoffitt) - (7)
                         clarification? - (rcareaga) - (6)
                             I'd say uninformed. - (mmoffitt) - (5)
                                 Just so I’m clear… - (rcareaga) - (4)
                                     Or fearful. -NT - (mmoffitt)
                                     Re: “uninformed.” - (a6l6e6x) - (2)
                                         The public option is the surest path to never having an NHS here. - (mmoffitt) - (1)
                                             I know we've been through some of this before, but... - (a6l6e6x)

I could go on Oprah touting his evilness. Write articles. I would be famous. Fat, but famous.
357 ms