lets do this: end all obama care, and train 1million new docs

That does nothing to explain how charges for health care became proprietary information, protected from public disclosure because they are trade secrets. The health care reform laws passed in Massachusetts required a survey of prices that providers charge to insurers for various services. It took all the power of the state attorney general to accomplish this survey because providers outright refused, claiming that their pricing was a trade secret, proprietary information protected by intellectual property laws. After the threat of subpoenas to a grand jury inquiry into price fixing the providers finally coughed up their pricing. They had a very good reason to hide their pricing because the attorney generals report was proof that health care pricing was completely arbitrary, with prices varying by orders of magnitude within the same provider group for the exact same procedure depending on where the procedure was performed and who was paying for it. In one case there was a ten times difference in price at hospitals less than ten miles apart operated by the same provider.

There are some care organizations that have posted prices for routine activities like physical exams but not for anything that actually costs money, like a hip replacement or gall bladder surgery and those are subject to so many disclaimers and exceptions that they are entirely useless.

Medicare and Medicaid both still operate on a fee for service system. What they do is establish a schedule of payments for services and pay providers accordingly. Many providers do not accept Medicare and Medicaid patients because they object to the payment schedule. As far as cost shifting goes the biggest cost shifting occurs within the private sector. Dominant insurers can command huge discounts on care for their subscribers so providers shift costs to insurers who have no bargaining power but need to maintain care for subscribers in the area, usually as part of a global care agreement with a multinational company with far flung operations.

Here's the thing, providers have an economic model based on fee for service, insurers have an economic model of paying whatever they are charged and passing that along to subscribers. As such neither has much concern about cost and every incentive to increase them. This leaves Medicare and Medicaid as the only entities paying for care that must consider cost since their funding has constraints.

There are many private hospitals in the US that do not accept Medicare, Medicaid, or any other patients that require them to seek reimbursement from the government. They eliminate emergency rooms and urgent care facilities when they buy out hospitals that have them in order to do so. Their only patients are from private insurers and their pricing is a trade secret.

People talk with each other and there is things like the internet that allows people to look into stuff and gain information on other people's experiences. There is also asking. People ask US hospitals for information on the cost of routine procedures and, if they even get an answer subject to non-disclosure agreement, it is so ridiculously high and subject to so many exclusions and disclaimers that it is impossible to compare to prices overseas, which are generally all inclusive.

Yes, what is wrong with that? The nation I have lived in my entire life and paid decades of taxes to just kicks me to the curb when I need a medical procedure that I cannot afford. And you question my patriotism because I must go overseas because that is the only place I can afford it?

What do you want from me, that I should continue to suffer at home rather than go to a place that will bring relief at a price I can afford?
A price that is unavailable in the US.

Who paid for that?
You cost shifting freeloader.
Everyone in the US gets emergency care, that is the law.
Not everyone in the US gets care for their cancer, diabetes, high blood pressure, heart disease, even if they have insurance.

In many places in the US it is impossible to see a doctor if you do not have the right health insurance, and even if you do your appointment may be weeks away so many people go to the emergency room for care since by law everyone who shows up in an emergency room must be treated. People in Canada also have that option.

A friend of mine just waited 6 months to get knee surgery. Another friend of mine had a knee problem that was a pre-existing condition and had to wait for thirty years to get it fixed. He only got it fixed because pre-existing conditions could no longer be excluded from health insurance coverage in the state where he lived.

Waiting in Canada for three years vs. waiting for 30 years in the US?

Oregon had only so much money. It was enough to provide care for just so many people. They decided that the fairest way to do that was with a lottery. But that is all over with as Oregon had adopted Obamacare, which will bring care to many more people.

The biggest problem with the US health care system is that it is not a market at all. If it was there would be exchanges where prices could be discovered and made public at every level of exchange. There would be indexes and traders and arbitragers and funds. Health care providers would make offers for packages of services that would be open to public bid. Insurers and others could buy these packages an repackage them into schemes attractive to subscribers, whose bids would establish prices and the economy of the entire market, all in the public eye.

Obamacare has opened the door to an actual market for health care insurance with its exchanges, a model that is being rapidly adopted in the private insurance sector, where corporations are abandoning the old model of top secret negotiation with insurers to an open model where corporations set a criteria for coverage and pricing and allow any insurer to offer coverage through their private exchange. There is even some movement towards the consolidation of private corporate exchanges into one big mega exchange that would reduce corporate expenses and increase employee choices.

If anything, you should recognize that Obamacare is turning US health care insurance into an actual market because it has changed the point of purchase from private to public.

The next step is far more difficult and problematic, forcing the providers into the market economy. Their mantra is that health care should not be an economic decision but their spending is bankrupting the nation. There are 48 MRIs within twenty miles of Boston. The entire population could be easily served by 8. As each new MRI was built the cost of an MRI went up as hospitals tried to recover the cost of ever more underutilized expensive equipment. The reality is that providers have made it a matter of economy because they have vastly increased the cost of care through their ill thought spending sprees.

The US is unique in its rationing of health care, it provides some care for 85% of its population through a combination of private and public insurance. The other 15% it leaves out only partially, by providing them emergency services at huge expense that everyone else bears one way or another. The other 85% who supposedly have care often find themselves unable to pay for the care they need and die of become bankrupts because their insurer denies payment. The single leading cause of bankruptcy in the US is health care expenses by people who have health care insurance.

 

Again, this isn't a difficult concept. Any time you have a system in which the end user, does not need the pricing information, the market will move in that direction. When you have people on government programs, who don't need to know the price, because it's passed on to government, then of course the suppliers will not want to provide prices. Because it doesn't matter to the user, and the person paying the bill is government.

And especially when government programs don't fund the full cost of health care, the natural result is that the hospital is going to try and recoup costs any way it can. Which includes $20 for a little bottle of juice. They don't want that information public of course, because that would be bad for public relations.

Then with the wide spread use of employer paid insurance, where all the bills were passed onto the insurance companies, again why post prices if the end user doesn't care? Why compete on prices, when the end users are not paying the bill anyway?

When you look at how health care operated before employer paid insurance, and government programs, doctors did post their prices. Hospitals did compete on prices. Because like any other market, the end user which had to fork up the money, wanted to know the cost. Now under our government screwed up system, the end user doesn't care. They are not paying the bill. The government, or the insurance company is.

I just stumbled upon this article, which ironically says exactly what I just said.
http://www.bostonglobe.com/business...l-cost-info/PQrvPTaVKR4LXR7zZd6PMP/story.html

That is EXACTLY why we are in the situation we are in. Of course they leave out the government program effects, but this right here is it. Never saw this article before in my life, and they said exactly what I knew was the problem.

http://www.surgerycenterok.com/pricing/
I don't know... that sure looks pretty extensive, and does include a price for gallbladder removal. Hip replacement is not listed, and I think I know why. The prices for hip replacements varies dramatically from person to person, and from type of surgery to type of surgery. It isn't one monolithic action. Some do a resurfacing, some have a bunch of hardware put in, and some just have some minor actions. Each type can drastically change the price, and so can the quality, condition, and age of the patient.

Not really. There was an interview with the CEO of a large hospital company in the mid-west, and he said there really isn't much difference in the discounts between companies. Insurance companies, as you might guess, easily find out what discounts other insurance companies are getting, and often negotiate for similar discounts. Of course they vary by percents, but not much. And of course hospitals can't charge different prices between insurance companies.

Further, there really isn't a ton of insurance companies out there. Not for the private insurance market. There are many government insurance companies. For example, Buckeye Community Health Plan, is an 'insurance' company that only deals with Medicare and Medicaid. If you do not qualify for either, you can't use them. When I punched in my information into eHealthInsurance, I was only qualified for exactly five companies, and all five are huge companies. Aetna, Humana, Anthem, United Health and Medical Mutual. No doubt all five have very similar discounts with hospitals. Sadly, that's down from 8 or 9 companies before ObamaCare was passed. Regulation always squeezes out competition, and protects the largest companies.

All that said, the only real cost shifting that is possible, is between government patients and private patients. Hospitals can charge whatever they want to private customers, but have no say in how much they get from government customers. Thus the cost shift is always from public to private.

Sort of. Insurers have to worry about costs, when competing against other insurers. Unfortunately, we have regulated the market, reducing the number of insurers. I'll give you an example. When I punch my information into eHealthInsurance for me, in Hilliard, just outside Columbus Ohio, I got 5 different companies, offering about 200 different plans, with some as low as $55 a month for catastrophic coverage.

Out of all the states in the Union, the one with the most regulation, the only state with universal health care coverage, is Massachusetts. So I punched in all the same exact information, except with the zip code for Somerville, just outside Boston Massachusetts. The results were one single company, which had a total of 15 plans, the lowest cheapest, crappy minimal plan, was $330 a month.

Yes to some extent your assessment is right. But that could be said of all insurance companies. Yet my life insurance is $5 a month. My auto insurance is $40 a month. My home owners is $25. Why isn't the same aspect causing the drastic increase in those premiums? I would say because of heavy free-market capitalist competition. The exact thing that regulation and controls and mandates by government, is driving out of the health insurance market.

Again, yes, the farther away the end user is, to the price, the worse the market system is going to work. But even in insurance there is market competition prices, unless you regulate the market away.

As the article said, and I agree, it's not a trade secret. It's simply the market where the end user doesn't care about the price, and thus hospitals don't provide those prices. I'm sure they said it's a trade secret, in order to avoid government scrutiny. No one likes having the government watch your every move, and I'd say the same thing to get moronic government bureaucrats off my back. But the truth is, the government system and insurance system created by government, has created a market where prices are not used. That will change, if we simply get back to a free-market system.

Now that I want to see. Where, who and what hospital required a patient to sign a non-disclosure agreement, in order to get a price?

Go back and reread that entire section, because what you said, had nothing at all to do with what I said. I asked you why a person in the UK, who paid taxes all his life, nearly 50% of his income, and was offered free health care by the UK, would fly to India to get health care. You said. "because he could afford it"... which makes no sense.

The only logical reason a person would do that, is if the UK health care sucked. When I pointed out that your statement "because he can afford it" was dumb, you replied with this. That makes no sense, and doesn't apply to the conversation. Re-read the prior two posts, and try responding again. This time, more logically.

Dude.... *I* paid for it. I got a bill. I paid the bill. And further, no you are wrong. I know a guy right now that had absolutely zero insurance, and zero money, and got cancer, and they started him on Chemo in the hospital. I went and visited him. No, you fail. Totally wrong on everything. And you are judgmental prick. Shut up when you don't know what you're talking about. I paid every single penny I owed to that hospital for my treatment. What a jerk you are.

I can't say I know what you are talking about. I have never had to wait weeks. The prior mentioned hospital visit was due to a strange illness that locked up my joints. Not all joints, but random ones. I'd wake up and not be able to walk. Or not be able to move my hand. Or not be able to straighten my arm. Crazy stuff. I went to my doctor. Then to a specialist. Then to my doctor again, and then to a different specialist. And during that time, I went to the hospital twice. For all four visits, I never had to wait longer than a week at the max. I think the longest wait was about 6 days total.

And by the way, Canadian government operated hospitals do not always treat you.
http://www.cbc.ca/news/canada/princ...i-western-hospital-emergency-meeting-584.html

So people show up, and too many patients, not enough doctors.... ooops sorry. We're closed. I read another story where a patient in an ambulance was transferred to five different hospitals, each one refusing to take them because they were full.

In a free-market capitalist system, the hospital loses money turning away customers. Thus more resources are poured into providing service, to help more people, which gains the hospital more money by treating customers.

Of course in a socialist government system, the hospital gets the exact same amount of money, no matter how few, or how many patients are served. So if there are not enough doctors, and too many patients.... sorry.... we're closed. Good bye.

I doubt that. Pre-existing condition clauses are time limited. After you have been on the insurance for a set time, you can get treated even for pre-existing conditions. The idea that pre-existing conditions are infinite, is just generally not true. In fact, I haven't yet found one single example of a pre-existing condition clause that was longer than 2 years. Not one. Not even one! Most are under 18 months.

So basically I'm calling you out on that one. Either your buddy lied to you, or you just made that up. Which ever it is, it's not true. Your story is false. Sorry.

As for the friend who waited 6 months, hm.... it's possible depending on where in the country he was, or what hospital he used. VA hospitals are notoriously horrible.... which of course is government health care. Shockingly socialized care is just as bad in the US, as it is in Canada. Also, if you happen to be in states with horrible health care regulations, notably Massachusetts, you again are going to have massive waiting times.

The problem is, something has to give. Just because they adopted Obamacare, doesn't mean magically they have the super money tree in the backyard to pay for everything. See, now instead of it only being Oregon with a money problem for health care, now it will be the entire freakin country that is strapped for cash, and can't afford health care for all.

http://www.oregonlive.com/health/index.ssf/2013/06/oregons_home_health_industry_f.html
Federal Government cutting Oregon Health Care.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/01/18/can-oregon-save-american-health-care/
Oregon short $1.9 Billion. Possible cuts to Doctor pay could result in refusal to serve Medicaid patients.
http://www.marketwatch.com/story/st...proposed-cuts-to-medicare-programs-2013-09-13
Oregon proposes cuts to cancer and other treatments under Medicare, Seniors urge to stop the cuts.

Yeah.... Obama Care fixed everything.... assuming you are blind and deaf to what is going on, I can see how you could make such a statement.

Not really. There are a number of problems with this plan. First off, if government would simply GET OUT of the health insurance and health care markets, these markets would be created on their own, without Obama needing to do anything. Remember the current model was created by government. Huge taxes and wage controls, pushed business to provide benefits, and this was compounded by massive tax incentives for corporations to provide employer insurance, all of which got us to where we are.

Second, you can't force companies into a government health exchange. The result is most companies are not going to join, leading to a situation where very few options are available. This defeats the entire purpose. Like I pointed out above, if you live in Somerville Mass, you have exactly ONE COMPANY to choose from. That's not going to get you any price reducing competition.

Third, regulations prevent cost cutting. Regulations that eliminate pre-existing condition clauses, drive up prices. Regulations the require insurance cover acupuncture, like California has, drive up prices. Regulations to prevent lifetime caps, drive up costs. All of these regulations are going to drive up costs, no matter what dumb 'health exchange' you create. You can't pass ten regulations that drastically drive up costs, and then create this one magic 'health exchange' and think that one semi-good thing is going to outweighs all the horrible things, and have a net positive result.

We've heard this before. We tried this strategy already. Remember California's energy exchange? That worked like a charm didn't it? Black outs, public utilities going bankrupt. Why? Because the price control regulations that drove the utilities into bankruptcy, were not magically mitigated by an energy exchange.

So I pull out a knife, cut you to ribbons, and then put a bandaid on one of the cuts. "You should thank me for fixing that slice there". Yeah, if I was as completely stupid as Forest Gump on drugs, I would absolutely recognize Obama Cares amazing successes. Unfortunately, I think independently of the talking points, and look at the facts of the situation. They are not a glowing as you seem to proclaim.

But see, in a free-market capitalist system, you don't need to worry about how many MRIs there are. Now if you are in a socialize system, yeah you do. Because, as with any government agency, they are going to spend as much money as you give them. If you give them a billion dollars, they'll find something to blow it on, even if it's 100 MRIs. They are going to spend the money somehow.

But in a free-market system, the hospital loses money if they purchase an MRI that they never use. And it's Ironic that you mention Boston, given that Boston has the most socialized health care system in the entire country. You are looking at problems caused by a non-free-market system, at the effect of RomneyCare, which was what Obama Care was based on. If you are seeing this as a problem of Romney Care, why are you singing the praises of Obama Care?

Actually that's not true. The report that this claim was based on, is garbage. For example, they counted anyone that went bankrupt from missing work due to illness, as a medical bankruptcy. So you have insurance, and you go to the hospital and miss a month of work. You have no large bills because you have insurance.... but because you missed 1 month, you are broke, and file bankruptcy.

How would that change in a socialized system? You would still miss work. You would still have your health care covered. And you would still file bankruptcy because you missed a month of work, and couldn't pay your bills.

Zero medical bills, and they called it a medical bankruptcy.

Sorry. Not a medical bankruptcy.

Another is that they included people with $500 in hospital bills, as being a medical bankruptcy. Do you know anyone anywhere in this country that filed bankruptcy on $500? Of course not. See, they didn't even look at how much debt they had. They could owe $100,000 in credit cards, or $500,000 in a mortgage, and for that whooping $500 bucks, they called that a medical bankruptcy.

That's not a medical bankruptcy.

So the whole report, was complete and utter trash. Garbage.

Health care expenses are not the single leading cause of bankruptcy. Just not true. Of course people believe what they want to believe, and never read those reports to see if their true. It takes someone like me, who is not a lemming, to actually think for myself, and read the freaking report, to learn the truth. We have become a nation of lemmings. I swear.

 

The initial impetus for employer provided health care came about because labour unions were able to negotiate health care funding for their members, usually a negotiated annual lump sum payment into a health care fund managed by the union for union workers and retirees. To combat unionization many employers instituted their own company managed health care systems, often operating their own clinics and even hospitals for their employees.

There is a myth that the wage controls of WW2 were the proximate cause of employer provided health care. The reality is that employer provided health care expanded rapidly during WW2 simply to meet the massive increase in non-union employment with mechanisms that employers already had in place. Kaiser, the largest health care provider in California, is a legacy of an existing health care system expanded by Kaiser Industries during WW2 to provide health care services to its hugely expanded workforce. For Kaiser it was not a matter of meeting employee demands for more compensation, it was a matter of keeping the workers they had on the job in a time of massive labour shortage. The reality of the time was that most of the new labour force had been malnourished and underfed for a decade because of the great depression and getting them healthy was an imperative.

Some economists interpreted the huge increase in employer health care spending as a substitute for wage increases simply because it occurred at the same time as wage controls but with a little closer look it becomes quite obvious that this was not the case. Correlation is not causation.

Every hospital has a charge master schedule and they are completely irrelevant to what is actually paid for care and totally unrelated to costs. If you believe that anyone ever actually pays those prices you must also believe in Unicorns. You will never find out the average or median price paid for anything on a charge master schedule. They are entirely fictitious inventions created because years ago some economist convinced the medical industry that they needed to create a price list but there was never any guidance or rules or regulations on how to do so.

A dominant health care provider has a lot of market power and in the mid-west there are large areas that have only one provider so insurers have little negotiating power. In other parts of the US where there are more providers large insurers have the market power and the negotiating clout to gain large discounts. This causes providers to shift costs to insurers with less power to negotiate. In some cases this causes insurers to leave. A few years ago Kaiser stopped renewing policies in some areas of California where is had few subscribers because providers had raised charges to ten times the cost of going to a Kaiser operated facility. The reason they gave was that providers had shifted costs to them because they had so little market presence. They were unable to negotiate the same discounts as the dominant private insurers.

If you want to buy your own health insurance in Massachusetts the only place to go is the state run Health Connector Commonwealth Choice web site where you will find extremely comprehensive health care plans from a number of private insurers. If you are under thirty you can get comprehensive coverage with co-pays and deductibles for about $90 a month. If you are 55 you can get the same coverage for about $400 a month. There are more expensive plans with zero co-pays and deductibles and no out of pocket expenses but all plans have the same coverage. The absolute maximum out of pocket for any plan is $5,000. These plans are not subsidized by the government and freely offered by private insurers. There is no medical exclusions, none. If you sign up and pay you are covered. The only requirement is that you are a resident of Massachusetts.

Though it is open to any health insurer willing to meet its coverage criteria eHealthInsurance has declined to participate in Commonwealth Choice since it opened in 2006 and does not make available any of the health care plans offered through Commonwealth Choice.

Governments heavily regulate all insurance markets, all. Insurers must pay for what they insure and, as it turns out health care is very expensive so insurers need to charge high premiums so they can pay for what they say they will. One thing that Obamacare does is force insurers to spend at least 80% of the premiums they collect on actual health care for subscribers and rebate any excess. States are allowed to set higher levels.

Health care is loosing its attraction as a high margin investment for hedge funds and investment banks. The debt laden consolidation of health care providers has ground to a halt and with that there is some prospects that as health care providers debts are paid off costs can come down.

There is a lot if inherent barriers to price discovery in the private health insurance market. The health care exchanges eliminate many of these barriers and allow consumers to easily compare offerings by standardizing offerings and making them public and available in one place. A number of insurers have asked to lower their pricing offers on the exchanges due to open in a number of states after the initial price offerings of all private insurers were publicized.

You can blame the government for making this mess all you want but you cannot deny that they are doing something about making it into a market.

The government did not create the private health insurance industry so you should really stop saying that.

If you have the money and don't want to wait for care and you can afford to go elsewhere for immediate care you will and many people do all over the world regardless of whatever health care system they live under.

If your employer has you in a group plan you can have a waiting period for a pre-existing condition. If you are buying your own insurance you were denied any insurance at all for a pre-existing condition or if you could get insurance your pre-existing condition was excluded permanently from whatever coverage you could get. If you were self employed business it was a common thing to get health insurance for everything but your ailment. I had more than one friend with diabetes who could only get health insurance for them and their family if they paid for their diabetes care themselves. The insurance would not cover it.

Of course, that was the old way that went on for decades but now that Obamacare has made it illegal to deny coverage for pre-existing conditions insurers have changed their tune so it is now impossible to find insurance coverage with those sorts of exclusions.

Massachusetts instituted universal health care coverage in 2006 and state spending to pay for it has increased only 2% over 6 years. State spending on health care was projected to increase 6% a year over the next decade before the state health care reform was passed. As it turns out, extending health care insurance to a greater portion of the population with the same amount of state and federal money previously used for only the poorest has reduced the growth of health care costs across the board. Emergency room visits have declined considerably as many people with chronic health problems got on insurance plans that got them into managed care programs. Health care premiums have stopped rising.

It now costs more for the average family health insurance plan in Texas than it does in Massachusetts despite the huge difference in wages and median income. Texas has a huge problem with unreimbursed emergency care for the 40% of its population without health insurance. The vast majority of these expenses are passed on to the 60% of people in Texas that have health insurance because state reimbursement is so pitiful. It is something that Texans appear to be entirely ignorant of.

Sure, there's plenty of things wrong with Obamacare but doing nothing is even worse. The reality is that the government cannot get out of health care because it pays for about 50% of all the health care provided in the US.

There seems to be plenty of companies signing up for the health care exchanges, 17 in New York alone, even more in California. If you live in Somerville, Mass, you have 5 health insurance companies that have been offering over 30 different plans to choose from at Commonwealth Choice since 2006. Over 40,000 individuals and small businesses choose to buy their own health insurance with their own money through Commonwealth Choice. Starting next month they will be able to buy dental insurance. Competition is increasing, prices are going down. There is a lot of interest in this 40,000 individual and small businesses demographic, mostly self employed and high paid skilled trades working at small specialized companies, enough to get the dental community to negotiate entrance.

People need health care because otherwise they die. Do you think people should die because they have a pre-existing condition or reached their lifetime cap or simply cannot afford insurance?
That is the choice.
You make the choice of who lives and who dies. You draw the line.
Then think about being on the wrong side of it in the nation that spends far more of its wealth on health care than any other.

 

Interesting. Probably the reason these hospitals are willing to lose money caring for Medicare patients is because most hospitals are non-profit. In some cases, they may not be losing money, but the compensation payments are just not enough to proportionally cover the fixed overhead expenses.

 

I'd be interested in reading that, given it contradicts other sources. Citation?
I'm open. Maybe it's not as they say, but I'd sure like more evidence.

Of course not. According to the CEO of the hospital system, those numbers reflect the natural increases required to offset the negotiated discounts to all the private insurance companies..... which I said before.

And no, there doesn't need to be guidance or rules or regulations on how to create a price list, anymore than government needs to come up with guidance, or rules, or regulations on how the Wendy's menu prices are made. If you simply let the free-market system work in health care, it will work just like it does in every other market. In fact, the same way it does in international medical tourism. Those free-market capitalist private hospitals in India, Singapore, and elsewhere, are not regulated, guided, or following rules. They are not regulated by the government the way the government hospitals of those same countries are, yet they have a price list just like you would expect in a free-market capitalist system.

I'm just telling you, you are wrong. If you were not wrong, then you should see a drastic difference between the prices of one insurer, over another insurer. That isn't the case.

Seriously, if you were right.... then when I punch in my information, I should find that company A has super cheap rates, and company B with the exact same policy, would have super expensive rates. I do not find this. If that was the case, then everyone would switch to the company with the lower rates, and the company that failed to negotiate the discount would be out of business.

But again.... that isn't the case. Which oddly matches exactly what the CEO said, that all the companies get roughly the same discount. There is no cost shifting between private insurers. Not like between public and private.

I'm sorry... you are just flat out wrong. You just making stuff up now.

If one insurance company was charging drastically higher premiums (because they got a fraction of the discount of other companies), then no one would use that company. I wouldn't. My company shops for insurance coverage. If they got a quote that was drastically higher, they wouldn't use them. That company would go out of business, and then there wouldn't be any companies for hospitals to cost shift too....accept from public patients to private patients.

I love it. This is great. Some days are just too good.

So I'm open minded. I could be wrong. So I went to the site.
https://www.mahealthconnector.org/portal/site/connector

Hit Find insurance.... Individual or Family.... family size 1.... Asked me what my income was, clicked continue.....



Hmm..... Enrollment is Closed..... A government sponsored health insurance system has closed enrollment?

And I love this...... "Coverage of plans purchased today will end on March 31, 2014. You will have to shop for a new plan by March 24, 2014." I have a private health insurance plan. Want to know when my insurance plan ends? It doesn't... until I cancel it.

So the government sponsored insurance system, has plans that are limited to one year or something?



Nevertheless, I did for the sake of argument, click on browse, and as you have said, there were a few more option. But, as I already knew, the prices were still absolutely insane. The lowest high deductible plan they offered was $250 a month.

That was the lowest cheapest, most crappy plan they offered. Five times more expensive than here in Ohio. In fact, $250 a month would buy you a fairly extensive high quality plan here in Ohio. The extensive plans in MassHealth are up in the $400 plus range. I doubt you could even find a health plan for $400 a month in Ohio (for a single person my age).

And you think this is good? The only way insurance companies can lower rates is if they have a higher amount of capital savings. If you are forced by government to make sure that you spend money.... then they have less ability to cut premiums. Unbelievably stupid.

You are contradicting yourself. If you force companies to spend more on expenditures, logically you have less money to pay down debt. If you have fewer investors, you are less able to offset risk.

I'll give you an obvious example. GEICO, had a small 2% of the auto insurance market. Today it has 9%. Part of the reason is because of Buffet, who invested heavily in Geico. That investment, from buying out the company, allowed them to lower their premiums. I got a much cheaper deal from Geico for my auto insurance, than I did from the insurance I as with. I had state minimum coverage, for about $55 a month. Today with Geico, I have a half million liability, full collision, uninsured motorist coverage, and $100K medical... for $54 a month.

Lower price, and double the coverage. Apparently that evil investor, sucking out huge profits from GEICO resulted in me getting a better deal on insurance. What a horrible profit motivated capitalist!

Yet you think that getting rid of investors, and forcing the company to spend 80% of their income, is going to pay off debt and lower premiums? No, the exact opposite is true.

I don't believe you. Name the company, or companies, and in which state it happened. I'd love to see it, especially with wide spread rate hikes going down.
http://www.nytimes.com/2013/01/06/b...ee-sharp-rise-in-premiums.html?pagewanted=all

Yes, the same way that California made an energy market. You can force people into a system, that's not a free-market system. And when you regulate the hell out of them in the process, it defeats the entire purpose. If I was a betting man, I'd give this a 90% chance of failure. There is a small chance they do something that works by luck, but I wager it won't.

Socialized care drives up taxes, at the same time that it drives out private health care. The result is that private care is more expensive, at the same time that people are less able to afford it because their money was taxed away.

Canadian's pay more in taxes, and have fewer low-cost private health care options. That is why they have Timely Medical, a company that provides them a service to find health care in other countries.

Well no kidding!.... gah.. what is wrong with you people. Sometimes I feel like I'm debating a freakin 2-year-old. Do you understand what insurance is?

INSURANCE: Definition......
"Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss."

You are insuring against the *RISK* of an *UNCERTAIN LOSS*..... Insurance is not, I pay you $10 dollars to cover my millions of dollars in known expenses. You insure the possibility of a future contingent. CONTINGENT = subject to chance!

........If you.... *HAVE DIABETES NOW, IT IS NOT A CHANCE! @#$(&@#($ Gah.... what is wrong with you people!

It's stuff like this the explains why the country is failing. When people can make statements like this, and not see how absolutely moronic it is, that is direct proof America will decline. How anyone can say statements like that and still breath, is beyond me.

Put yourself in the place of an insurance company. Hey Mr unrealist42! I would like to buy auto liability insurance to cover my truck in case I run over someone, and cause millions of dollars in damage, which I just did last night! Ha! Wow! And no pre-existing condition clause! So where do I send my $100 check, before you spend millions on my "chance" accident?

What a great system of "insurance" you have there unrealist! How absolutely brilliant! "Insurance" that covers known "contingent" expenses! By the way, I'm going to cancel my "insurance" before my next premium payment. Now this is just DARN GOOD "insurance" we have here!

Oh and I also want the policy to cover the 'chance' an accident (I in fact did have), could possibly have damaged my truck (which it did)! Wow, Unrealist! You are an absolutely wonderful "insurance" salesman. We need you in government! This is politician level wisdom right here on the forum. [/sarcasm]

So... um.. moving on. Wow I feel so much better right now. Mocking stupidity sure is a cathartic experience.

Which is exactly why premiums are going up 22% in many states. This is another "Forest Gump could figure this out" moment... You have someone who refuses to get insurance. Then they get sick. They apply for insurance. The insurers are required by law to cover them. The insurers thus must increase premiums to cover the risk of people applying for insurance with pre-existing conditions, who have not paid into the system up to that point.

Way to go sparky. Another brilliant move.

Wrong wrong wrong wrong wrong!
http://www.reuters.com/article/2011/06/02/us-health-reform-er-idUSTRE7514VX20110602

Wrong!
http://www.mass.gov/bb/h1/fy10h1/prnt10/exec10/pbudbrief20.htm

Governor of Mass Proposal.

Wrong!
http://www.sentinelandenterprise.co...udy-mass-health-care-costs-rise-benefits-fall

WRONG! YOU ARE WRONG SIR! Give it up! The evidence is consistent and non-stop. You have been wrong about EVERYTHING this entire thread! How many times do the facts have to hit you in the face before you just shut up with your lying crap?! Huh? Even a dog can figure out when to stop barking and hide in the corner.

 

No, that's not it. It has nothing to do with non-profit. Non-profit is actually meaningless. A for-profit company, and non-profit company, operate exactly the same, with no difference whatsoever.

There are two reasons Hospitals are willing to take Medicare patients. First, Medicare, as with any government program, has a tendency to change over time. So congress passes a law increasing the payouts. Now Medicare is profitable, and since almost half their patients are medicare, they want that profit. Then over time, as things get more expensive, the medicare payouts are set in stone. They gradually become less and less, and even unprofitable. Then congress fixes it, and things get better. And of course there are also times when congress cuts payments, and things get drastically worse.

So Medicare is not 100% always a money loser. Now Medicaid.... is always a money loser. And often hospitals will do as little as possible for a medicaid recipient. For example, if you crush your finger, and you are on Medicaid, you are likely to have your finger amputated instead of saved. A lot of people don't know that.

The second reason is because the cost of not taking the medicare patients is greater than the cost of taking them. Specifically this has to do with ER. As you know, a patient that shows up in a hospital with an ER, must be treated, no matter what. So if the patient is a Medicare patient, the hospital can either treat the patient for free, or treat the patient for what Medicare gives them.

Which is worse? Getting paid a little, or getting paid nothing? This is why quite a few hospitals end up closing their ERs. Closing the ER, allows the hospital to avoid money losing patients. Then you can refuse medicare and not be hammered by it.

That said, the Mayo Clinic (which gained the praises of Obama), has recently decided to refuse Medicare. Apparently the money losses on Medicare is so much that they believe they can save money refusing Medicare, even with charity ER care.

Additionally, there is an offset. The government has a program called Disproportionate Share Hospital (DSH). It's a sleight offset to the cost of treating government patients, based on what percentage of patients are Medicaid, Medicare, and other government programs. This is why the cost shift from public to private isn't 1:1. If Medicare pays $10 less than profit, Private care is not charged $10 more. Instead, if Medicare is $10 less, then Private is charged maybe $6 to $7 more, and the rest is made up by DSH.

By the way, this DSH offset also includes costs for totally uninsured patients who refuse to pay their bill.

Lastly, refusing Medicare isn't just Medicare. It's literally everything government. If you refuse medicare patients, you refuse medicaid, CHIP, and VA, and even government grants. The government often grants money to hospitals to offset the cost of expanding, or research into cancer and such. But you lose all of that too. You lose everything. So choosing to deny Medicare, isn't some light choice. I'd be interested in seeing why the Mayo Clinic felt it was worth it.

 

I'm sorry... you are just flat out wrong. You just making stuff up now.

If one insurance company was charging drastically higher premiums (because they got a fraction of the discount of other companies), then no one would use that company. I wouldn't. My company shops for insurance coverage. If they got a quote that was drastically higher, they wouldn't use them. That company would go out of business, and then there wouldn't be any companies for hospitals to cost shift too....accept from public patients to private patients.



I love it. This is great. Some days are just too good.

So I'm open minded. I could be wrong. So I went to the site.
https://www.mahealthconnector.org/portal/site/connector

Hit Find insurance.... Individual or Family.... family size 1.... Asked me what my income was, clicked continue.....



Hmm..... Enrollment is Closed..... A government sponsored health insurance system has closed enrollment?

And I love this...... "Coverage of plans purchased today will end on March 31, 2014. You will have to shop for a new plan by March 24, 2014." I have a private health insurance plan. Want to know when my insurance plan ends? It doesn't... until I cancel it.

So the government sponsored insurance system, has plans that are limited to one year or something?



Nevertheless, I did for the sake of argument, click on browse, and as you have said, there were a few more option. But, as I already knew, the prices were still absolutely insane. The lowest high deductible plan they offered was $250 a month.

That was the lowest cheapest, most crappy plan they offered. Five times more expensive than here in Ohio. In fact, $250 a month would buy you a fairly extensive high quality plan here in Ohio. The extensive plans in MassHealth are up in the $400 plus range. I doubt you could even find a health plan for $400 a month in Ohio (for a single person my age).



And you think this is good? The only way insurance companies can lower rates is if they have a higher amount of capital savings. If you are forced by government to make sure that you spend money.... then they have less ability to cut premiums. Unbelievably stupid.



You are contradicting yourself. If you force companies to spend more on expenditures, logically you have less money to pay down debt. If you have fewer investors, you are less able to offset risk.

I'll give you an obvious example. GEICO, had a small 2% of the auto insurance market. Today it has 9%. Part of the reason is because of Buffet, who invested heavily in Geico. That investment, from buying out the company, allowed them to lower their premiums. I got a much cheaper deal from Geico for my auto insurance, than I did from the insurance I as with. I had state minimum coverage, for about $55 a month. Today with Geico, I have a half million liability, full collision, uninsured motorist coverage, and $100K medical... for $54 a month.

Lower price, and double the coverage. Apparently that evil investor, sucking out huge profits from GEICO resulted in me getting a better deal on insurance. What a horrible profit motivated capitalist!

Yet you think that getting rid of investors, and forcing the company to spend 80% of their income, is going to pay off debt and lower premiums? No, the exact opposite is true.



I don't believe you. Name the company, or companies, and in which state it happened. I'd love to see it, especially with wide spread rate hikes going down.
http://www.nytimes.com/2013/01/06/b...ee-sharp-rise-in-premiums.html?pagewanted=all



Yes, the same way that California made an energy market. You can force people into a system, that's not a free-market system. And when you regulate the hell out of them in the process, it defeats the entire purpose. If I was a betting man, I'd give this a 90% chance of failure. There is a small chance they do something that works by luck, but I wager it won't.



Socialized care drives up taxes, at the same time that it drives out private health care. The result is that private care is more expensive, at the same time that people are less able to afford it because their money was taxed away.

Canadian's pay more in taxes, and have fewer low-cost private health care options. That is why they have Timely Medical, a company that provides them a service to find health care in other countries.



Well no kidding!.... gah.. what is wrong with you people. Sometimes I feel like I'm debating a freakin 2-year-old. Do you understand what insurance is?

INSURANCE: Definition......
"Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss."

You are insuring against the *RISK* of an *UNCERTAIN LOSS*..... Insurance is not, I pay you $10 dollars to cover my millions of dollars in known expenses. You insure the possibility of a future contingent. CONTINGENT = subject to chance!

........If you.... *HAVE DIABETES NOW, IT IS NOT A CHANCE! @#$(&@#($ Gah.... what is wrong with you people!

It's stuff like this the explains why the country is failing. When people can make statements like this, and not see how absolutely moronic it is, that is direct proof America will decline. How anyone can say statements like that and still breath, is beyond me.

Put yourself in the place of an insurance company. Hey Mr unrealist42! I would like to buy auto liability insurance to cover my truck in case I run over someone, and cause millions of dollars in damage, which I just did last night! Ha! Wow! And no pre-existing condition clause! So where do I send my $100 check, before you spend millions on my "chance" accident?

What a great system of "insurance" you have there unrealist! How absolutely brilliant! "Insurance" that covers known "contingent" expenses! By the way, I'm going to cancel my "insurance" before my next premium payment. Now this is just DARN GOOD "insurance" we have here!

Oh and I also want the policy to cover the 'chance' an accident (I in fact did have), could possibly have damaged my truck (which it did)! Wow, Unrealist! You are an absolutely wonderful "insurance" salesman. We need you in government! This is politician level wisdom right here on the forum. [/sarcasm]

So... um.. moving on. Wow I feel so much better right now. Mocking stupidity sure is a cathartic experience.



Which is exactly why premiums are going up 22% in many states. This is another "Forest Gump could figure this out" moment... You have someone who refuses to get insurance. Then they get sick. They apply for insurance. The insurers are required by law to cover them. The insurers thus must increase premiums to cover the risk of people applying for insurance with pre-existing conditions, who have not paid into the system up to that point.

Way to go sparky. Another brilliant move.



Wrong wrong wrong wrong wrong!
http://www.reuters.com/article/2011/06/02/us-health-reform-er-idUSTRE7514VX20110602

​

Wrong!
http://www.mass.gov/bb/h1/fy10h1/prnt10/exec10/pbudbrief20.htm

Governor of Mass Proposal.

Wrong!
http://www.sentinelandenterprise.co...udy-mass-health-care-costs-rise-benefits-fall

​

WRONG! YOU ARE WRONG SIR! Give it up! The evidence is consistent and non-stop. You have been wrong about EVERYTHING this entire thread! How many times do the facts have to hit you in the face before you just shut up with your lying crap?! Huh? Even a dog can figure out when to stop barking and hide in the corner.[/QUOTE]

 

Now that there is a good post! Haven't seen a post that good in a long time. Direct evidence proving the leftists wrong. Clear cut logic based on economics. Direct contradiction of false claims. And I love how you mocked the failure to grasp what insurance is. That was smooth.

Way to go! First good post I've seen from you yet. Poor leftists likely don't know what hit them.