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Healthcare going forward

Kabluey said:
Not for profit doesn't mean they don't pay their executive staff extravagantly.

Millions of dollars that could go towards treatment are swallowed by the boardroom.
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The ACA has a lot of stuff in it that didn't get advertised. For example, insurers are required to contribute 80-85% of premium income toward the expenses of their members which limits administrative costs to 15-20% of premiums. If an insurer spends more than 20% on administrative costs, they have to send out rebates for the difference.

As ridiculous as CEO salaries are in the payer market, they are not as high as the salaries on the provider side. For example, UPMC paid its CEO $6.55 million in 2014 and it compensated 30 employees at least $1 million in the fiscal year ending June 30, including 7 employees who were paid more than $2 million.

If you look at the public documents for your state university, you will find that the university president probably makes about $500K per year but the CEO of university hospital will be >$2 million plus bonuses.


Sausy said:
Even one of the biggest GOP "solutions" for helping lower the cost of health care through the market, allowing interstate competition between health plans, has been looked at in more independent studies as doing little, if any, to help contain costs. The market approach doesn't tend to work well here.
Stardreamer said:
The major problem as I understand it with the let them get insurance from other states plan is that current insurance companies control costs through the use of networks and if your insurer doesn't already operate in your state, they are not going to have a network you can use.
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That's exactly the problem- PPO and HMO plans are dependent upon contracts with "in-network" providers where negotiated lower prices are offset by increased patient volumes. In other words, your doctor probably charges about $150 for a 15 minute visit. Your insurance company probably pays about $60-80 for that visit. Your doctor accepts that lower payment on the assumption that an increase number of in-network patients will offset the lower revenue per patient.

Most most provider networks don't spam multiple states. So, if you live in Los Angeles, it's unlikely that you would ever go to Las Vegas to see a physician, so what incentive does a Las Vegas provider have to negotiate to become part of a plan that insures people in Los Angeles?

Multi-state plans exist in cities like Kansas City where part of the city is in Kansas and part of the city is in Missouri. Beyond that rare exceptions, providers and insurers focus on markets in a single state. And the regulation of these plans is handled by state insurance commissions and boards- there's no "insurance regulator" at the federal level.
 
Kabluey said:
Not for profit doesn't mean they don't pay their executive staff extravagantly.

Millions of dollars that could go towards treatment are swallowed by the boardroom.
Click to expand...

It's my understanding that fraternal insurance companies, such as those run by/for churches, are seriously limited in compensation for directors. I know the execs at the one where I have insurance are lower than what the U.S. President got before the last raise.

Other NfP, I don't know, but it could be put into such a law.
 
Stardreamer said:
The major problem as I understand it with the let them get insurance from other states plan is that current insurance companies control costs through the use of networks and if your insurer doesn't already operate in your state, they are not going to have a network you can use. What good is buying a cheaper plan from Florida for me if I have to fly to Miami to see a doctor?
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I already have a problem because almost all the network providers for my mental health insurance are in cities of 100k or more. Just driving to get to one of their providers costs me more than the co-pay for out of network!

It limits how many visits I can afford to seriously less than the number my provider would like.
 
KaraBulut said:
The ACA has a lot of stuff in it that didn't get advertised. For example, insurers are required to contribute 80-85% of premium income toward the expenses of their members which limits administrative costs to 15-20% of premiums. If an insurer spends more than 20% on administrative costs, they have to send out rebates for the difference.

As ridiculous as CEO salaries are in the payer market, they are not as high as the salaries on the provider side. For example, UPMC paid its CEO $6.55 million in 2014 and it compensated 30 employees at least $1 million in the fiscal year ending June 30, including 7 employees who were paid more than $2 million.

If you look at the public documents for your state university, you will find that the university president probably makes about $500K per year but the CEO of university hospital will be >$2 million plus bonuses.
Click to expand...

My insurance is through a church outfit, which farms out most things now (makes it confusing; I have difference actual insurance companies for doctors, mental health, prescriptions, dental, vision....). It imposes a limit on what those companies can make; the goal is always to keep all overhead to single digits so that at least 90% of plan money gets spent on the plan members.

If they can do it, with a couple of million members, others can do it, so that should be part of any law encouraging fraternal and NfP companies.
 
Kulindahr said:
I already have a problem because almost all the network providers for my mental health insurance are in cities of 100k or more. Just driving to get to one of their providers costs me more than the co-pay for out of network!

It limits how many visits I can afford to seriously less than the number my provider would like.
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My town is two and a half times the size of your town, but there's also the very real truth that people who live in smaller towns can *DIE* from inadequate options. For the third time in less than 26 months, I've found out TODAY about somebody I knew, who died because of needing to be airlifted to a larger city. In his case, he had to be airlifted from Evansville, Indiana to Indianapolis.

Common wisdom here is that "You'd better not have a heart attack here"...one of the reasons I'm DONE with small-town living. (One of the other two people was indeed airlifted from my town, to Peoria, and died.) Living in a big city is no guarantee, but it should prevent distant airlifts at least. (I've pretty much decided to move to Chicago now.)
 
Obama's plan needed to be tweaked like social security and medicare were ---when politics worked in the USA. Obamacare is working for tens of millions of americans---but to prove that americans are dumb asses---a conservative asshole argued on line that we must repeal Obamacare and save the ACA which is great insurance and working for him.:rotflmao:

The repub dumbass didn't know they were the fucking same thing. He thought ACA was the repub FIX of Obamacare. This is all you need to know about what this country is made up of. Like the old 85 year old repub asshole who said keep your government hands off my Medicare.:rotflmao: We need fucking health care for all---and big BUSINESS and money making can't be a big consideration or people will die plain and simple.

Meanwhile people are on the Obamacare websites signing up in numbers bigger than last year. But if you voted for repubs and trump---fuck you dummies.
 
Benvolio said:
Much of health insurance is by mutual companies which are in effect, not for profit. Policy holders are in theory stockholders and profits are paid to policy holders/shareholders in the form of reduced premiums. Blue Cross, for instance, and Mutual of Omaha.
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In the U.S. for-profit companies dominate:

According to the National Association of Insurance Commissioners, stock insurers held about 78% of the total cash and invested assets maintained by U.S. insurers at the end of 2013. Only 18% of those assets were held by mutual insurers. Two of the largest property/casualty mutual companies in the U.S. are State Farm and Nationwide Insurance.
source
 
Kulindahr said:
It's my understanding that fraternal insurance companies, such as those run by/for churches, are seriously limited in compensation for directors. I know the execs at the one where I have insurance are lower than what the U.S. President got before the last raise.

Other NfP, I don't know, but it could be put into such a law.
Click to expand...

There are some NFP healthcare CEOs who are on very healthy packages. Up to $15m in 2015 www.modernhealthcare.com/article/20150808/MAGAZINE/308089988
 
Remember that with an annual deficit near a trillion, we are borrowing for Obamacare and will need to borrow for your grandeous schemes
 
I heard on the news this morning that, if the Republicans drop Obamacare as soon as Trump gets to sit in the Big Boy's Chair, it could be months before they come up with a replacement. The expert said that thousands could die because they have no health coverage.

I bet, if you offered every employee in the United States that, for $10 per month paid directly to a state healthcare system knowing that it would provide coverage for them and their families, very few would turn it down. That healthcare system would also provide coverage for every citizen of each state.
 
gsdx said:
I heard on the news this morning that, if the Republicans drop Obamacare as soon as Trump gets to sit in the Big Boy's Chair, it could be months before they come up with a replacement. The expert said that thousands could die because they have no health coverage.

I bet, if you offered every employee in the United States that, for $10 per month paid directly to a state healthcare system knowing that it would provide coverage for them and their families, very few would turn it down. That healthcare system would also provide coverage for every citizen of each state.
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Unfortunately you are asking too much from Republicans.
 
MakeDigitalLove said:
Unfortunately you are asking too much from Republicans.
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$10 would not begin to cover it. Medicare costs several hundred a month and the government subsidizes it. 10 obviously would not cover preexisting illnesses. No, many would not pay the 10 per month unless forced to do so, which it would cost more than the 10 to administer. Worse, more illegals would flood in.
We would have to borrow billons each year and what will happen if we can no longer borrow to give health care?
 
Benvolio said:
$10 would not begin to cover it.
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I guess my point should have been a little closer to the ground. It flew right over your head.

It seems to be more important to you for needful Americans to die than to even consider a suggestion and then blame the rest on illegals.

Canada has free healthcare, but we also have health cards. No card? No healthcare.
 
Benvolio said:
Remember that with an annual deficit near a trillion, we are borrowing for Obamacare and will need to borrow for your grandeous schemes
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opinterph said:
Your number is significantly overstated.
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Benvolio said:
The national debt increased by more than a billion. http://www.thenewamerican.com/econo...ebt-increases-by-1-054-647-941-626-91-in-2016. It is not the same as the budget deficit.
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So you're being sloppy with terminology.

It's intriguing that by all reports, the deficit this year was $411 billion, while if you do the math with Treasury numbers the debt increased by (to be precise) $1,054,647,941,626.91. Rounding, that's a difference of $643 billion. How does that large a discrepancy emerge?

This might be worth its own thread....
 
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