Healthcare going forward

[KaraBulut]

To the claims that insurers aren't making profits on ACA plans:

Anthem used to be Blue Cross Blue Shield of California when they were a not-for-profit. They've, of course, changed to a for-profit company and they've had the highest premium increases in the nation.

Anthem is using these threats about pulling out of the ACA market to leverage their $48 billion purchase of rival Cigna.

Anthem expects a profit this year from ACA exchanges
To justify a 35% rate hike, Anthem expects Californians to use a lot more drugs next year
Anthem To Increase Premiums by Up to 25% for Grandfathered Plans

 

[ballcaphair]

That is too broad. Universal care subsidized and controlled by the government is socialism. You cannot change the substance by merely changing the words.

Congressmen have SOCIALIZED healthcare: no Insurance Premium Just For Starters...

 

[KaraBulut]

Congressmen have SOCIALIZED healthcare: no Insurance Premium Just For Starters...

Congress members and their immediate staff buy their plans from the District of Columbia ACA Marketplace (called the DC Shop) unless they get their coverage through their spouse's employer. These plans are heavily subsidized by taxpayers. Upon retirement from Congress, Congress members get lifetime coverage from the Federal Employees programs that active Federal employees use, again at taxpayers' expense.

Congress also has their own in-house physicians that provide services free of charge (The Office of Attending Physician of the United States Congress or OAP).

But also remember- many of the Senators are over 65 years old. They qualify for Medicare- the most popular socialized medicine program of all!

There are also a few like John McCain who are veterans and can get care through another socialized medicine program: the Veterans Administration.

 

[kallipolis]

^Well noted for it would appear that so called "socialised medicine" is a fashionable perk for those in Congress who are so determined that their benefits should not be available to the general public. The Greek word υποκρισία (hypocrisy) comes to mind.

 

[Benvolio]

^Well noted for it would appear that so called "socialised medicine" is a fashionable perk for those in Congress who are so determined that their benefits should not be available to the general public. The Greek word υποκρισία (hypocrisy) comes to mind.

The Federal government is an employer and, like most large employers in the US has a program for employees. Congressmen can be employees for that purpose.
Medicare is largely paid for by the individuals from their savings, i.e. their social security fund. It is socialism to the extent it is subsidized by the federal government.

 

[ballcaphair]

The Federal government is an employer and, like most large employers in the US has a program for employees. Congressmen can be employees for that purpose.
Medicare is largely paid for by the individuals from their savings, i.e. their social security fund. It is socialism to the extent it is subsidized by the federal government.

Ahem...The Federal government works for its citizens (us) so the employer (we the people) pay for our employees (them = congress). Just wishing for a little equity from our employees. For starters...
If you want to google equity, that's cool.

 

[gsdx]

^ People tend to forget that. The government is working for them and the people are working to pay the government's wages. The government tends to forget that, too.

 

[Benvolio]

^ People tend to forget that. The government is working for them and the people are working to pay the government's wages. The government tends to forget that, too.

Some of the people are working to pay those wages, and have no desire to support the rest of the country in addition.

 

[gsdx]

^ That is irrelevant. The government may be an employer, but Americans own the company and pay the wages of the people who run it. The government is supposed to work for the American people and not for themselves. After all, the American people are their bosses.

 

[KaraBulut]

^ That is irrelevant. The government may be an employer, but Americans own the company and pay the wages of the people who run it. The government is supposed to work for the American people and not for themselves. After all, the American people are their bosses.

Because he doesn't understand the difference between "socialized" and "socialism", he doesn't understand that the entire healthcare system is socialized. One of the reasons that we pay so much for healthcare is that everyone pays more to cover the uninsured- which is the definition of a socialized system. We also pay more because Medicaid is under-funded, so patients who can afford to pay will pay more in order to make up for the lower reimbursement for Medicaid patients..

Even the government gets in on the game by paying a "disproportionate share" premium to hospitals that accept a lot of uninsured patients. It's one of the reasons that repealing the ACA is likely to put a lot of rural hospital out of business but will increase the overall cost of the system.

And you are correct- we heavily subsidize government employee's benefits- even after they have retired, we continue to cover their health insurance costs. It's one of the reasons that the entire pension system is on the verge of collapse in most states and municipalities. Where a typical employer-based system splits 20% to the employee and 80% to the employer, government plans tend to be more expensive and the government usually pays a larger portion of the premium costs. Those costs are covered by income, property and sales taxes- another way of "socializing" costs.

Because we have the illusion that the American healthcare system is privatized, there's no effort made to deal with the cost issue except for government plans like Medicare or Tricare. There's a large number of for-profit companies who take advantage of the dysfunction by encouraging over-treating patients, over-selling unneeded equipment and charging ridiculous prices for drugs that have no proven therapeutic advantage over cheaper options.

 

[kallipolis]

Because we have the illusion that the American healthcare system is privatized, there's no effort made to deal with the cost issue except for government plans like Medicare or Tricare. There's a large number of for-profit companies who take advantage of the dysfunction by encouraging over-treating patients, over-selling unneeded equipment and charging ridiculous prices for drugs that have no proven therapeutic advantage over cheaper options.

This is a tragedy knowing that money is wasted on unnecessary tests, and by extortionate charging for low cost items such as aspirin, or for medication that is more expensive than the generic option.

 

[Benvolio]

The overcharging is largely the result of government or insurance involvement, especially the negotiation of prices. Since the government or insurance companies "negotiate", i.e. demand a lower price than the "non-negotiated" price, the seller must overcharge the non-negotiated price. Any one who expects to negotiate a sale sets a high price to begin with begin with. In the case of medicine, the seller is then forced to continue to sell at the higher non-negotiate price to avoid losing ground on the next negotiation.

 

[ballcaphair]

The overcharging is largely the result of government or insurance involvement, especially the negotiation of prices. Since the government or insurance companies "negotiate", i.e. demand a lower price than the "non-negotiated" price, the seller must overcharge the non-negotiated price. Any one who expects to negotiate a sale sets a high price to begin with begin with. In the case of medicine, the seller is then forced to continue to sell at the higher non-negotiate price to avoid losing ground on the next negotiation.

You are on point, exactly here. As a clinician in a rural, no-frills, spartan clinic, I understand the math of insurance. Medicare and Medicaid have fixed reimbursements and we have adjusted our costs to meet these. Insurance companies, however, charge premiums from clients which have deductables that are paid by the client, but they also have "not covered costs." These become the client's responsibility. When the client is unable to pay the not coverd charges, we must absorb these and are not allowed to deduct them as a business expense. The insurance companies want the cream from the clients and providers. They leave us with the dregs.

 

[ballcaphair]

and I am a conservative, but believe that this is one thing I'll allow the government to manage. We know where we stand with medicare and medicaid. Private insurance is a middleman with pockets full of profits. As a conservative, I do not believe in universal insurance; I believe in universal healthcare. Insurance companies do no favors for our clinic. Our clinic is conservative.

 

[thewiz]

The overcharging is largely the result of government or insurance involvement, especially the negotiation of prices. Since the government or insurance companies "negotiate", i.e. demand a lower price than the "non-negotiated" price, the seller must overcharge the non-negotiated price. Any one who expects to negotiate a sale sets a high price to begin with begin with. In the case of medicine, the seller is then forced to continue to sell at the higher non-negotiate price to avoid losing ground on the next negotiation.

Under the Medicare Part D expansion of 2006, the Federal Government was PROHIBITED from negotiating drug prices. This was a way to get buy in from the pharmaceutical industry that was looking to maximize profits at the expense of citizens -- both directly from their pocket and through higher insurance costs covering reimbursement. The Federal Government has historically negotiated drug prices for the VA which results in some of the most reasonable costs. Progressive countries like Canada, the UK and most of the industrialized world negotiate drug prices and is why you can go on-line to a Canadian pharmacy and buy my Allegra-D for a fraction of the price that my insurance has to pay (and since my insurance company only covers the generic) -- or I have to pay out of pocket. The last time I got non-generic pharmacy strength, my cost would have been $850 for a 30 day supply. I got the same 30 day supply on my credit card for $98.75 by ordering through a Canadian pharmacy.

Tell me the bed time story again on how we are not being fleeced, Ben?

 

[gsdx]

The last time I got non-generic pharmacy strength, my cost would have been $850 for a 30 day supply. I got the same 30 day supply on my credit card for $98.75 by ordering through a Canadian pharmacy.

Tell me the bed time story again on how we are not being fleeced, Ben?

R&D and advertising. It's necessary to keep the drug companies in business.

 

[kallipolis]

R&D and advertising. It's necessary to keep the drug companies in business.

Worth repeating .

 

[gsdx]

^ I just had a horrible thought. Benvolio is going to post that "Finally! He agrees with me!"

 

[Kulindahr]

I've had 2 trips to hospital and both cost me $45 each. (It's not covered by my OHIP.) What does an ambulance ride cost in the States?

My mom's recent ambulance ride thirty miles from a nursing facility to a hospital cost $467.

 

[Kulindahr]

That is very misleading. The Social Security tax goes into a separate fund to be disbursed when people are able to begin collecting . Most people pay in less than the eventual receive. People who pay only that and not income tax are paying nothing to support the country. The top 20% of tax payers pay 84% of the federal income tax.https://www.google.com/url?sa=t&rct...674384&usg=AFQjCNFMnsSVoGLjoHgbrV_2soNNM_bAQQ

But taxes on the successful can never be high enough for the marxist/liberals. They gather votes by preaching hatred of the rich and claiming that the rich do not pay taxes.

If you read the post, it was plain that there are MANY of the rich who do not in fact pay taxes. What's needed is a minimum, maybe based on the next lower bracket, so no one will pay less than, say half the rate of the next lower bracket their income would fall into.


BTW, as for paying in less than they eventually receive, my Edward Jones investment advisor has pointed out repeatedly that the return most people get on Social Security is still less than they would have gotten if they'd invested in a market-average fund -- so of course they should get back more than they pay in!