Isn't The Root Of Most Of Our Healthcare Problems - The Healthcare Insurers?......

[global1]

Seems to me that these are the companies that are causing most of the trouble we have in healthcare today. High premiums that people and companies can't afford. Lack of cooperation with people who do pay for healthcare insurance by trying in any way they could to deny coverage. Poor reimbursement to the providers which cause them to raise prices to compensate for what they are losing because the insurers poor reimbursement.

Given this situation - pharmaceutical and medical companies continue to raise prices - because they can - because when insurers do pay - they very rarely question the cost of product.

I don't know how many health insurers there are in this country - but I do know that there is very little standardization of forms used - which complicates matters for providers having to meet each insurers specific requirements. As such - more money is spent on administration - by both the provider and insurer.

The administrative costs alone to manage this are astronomical. Think of the money that can be saved we had one insurance source.

Is there any role for the insurers if we move to a universal and hopefully single source system?

[nxylas]

1. Supplementary insurance perhaps?

Kind of like BUPA in the UK, where people can pay for the bells and whistles that aren't always available to National Health patients (shorter wait times, private rooms etc.)

[dflprincess]

4. If it truly is just paying for bells and whistles.

Right now seniors need to by Medicare supplements just to cover necessary expenses - including, but not limited to prescriptions.

[Donnachaidh]

12. We need universal healthcare - if the insurers want to write policies

for vanity surgery (face lifts or silicon implants and such) let them do that. Everyone in the UK is covered by basic - and until that happens here with NO insurance company involved, we shouldn't even be *settling* for supplemental insurance.

[eridani]

31. I'm true blue single payer, and I have no problem with that

I could care less if Bill Gates has a state of the art alarm and sprinkler system in his mansion that I can't afford, just as long as we get the same fire engines in the event of an emergency.

[FiveGoodMen]

2. Yes, I think it is.

I'd like to see them out of the picture altogether.

[dflprincess]

3. Don't forget the millions of dollars paid out each month for insurance broker commissions.

Both for and non-profit insurers wind up paying someone to sell their products. This is an expense that would just go away with a single payer system.

[Cairycat]

5. Yes, because of their very nature

They are in business to make money. The only way to do that is to deny as much care as possible. Essentially, they are in business to ration care.

In doing this, they are telling physicians how to practice medicine. Really, it's tantamount to practicing without a license.

edited to insert missing word

[ayeshahaqqiqa]

8. Exactly right!

I work in a medical office, and time and time again the insurance companies try to not pay for office visits or procedures. What takes the cake for me, though, is that they often refuse to pay for prescription drugs and want to substitute other drugs--not generic (that would make sense), but other pricey name brands. With one patient, we go round and round every time we fill his scrip--because the brand his insurance wants him to take MAKES HIM SICK. But we have to explain that every time. Another time, a woman was told she couldn't take Drug X--the insurance company would only cover Drug Y. This even though Drug Y had known and proven side effects when taken with another medication the lady was taking. She opted to not buy any medicine--and it was for her heart! I can't see that as helping improve the quality of her life!

[Jackpine Radical]

25. The reason for that selective drug thing is usually becasue the ins co

is either owned by or has a deal with a given drug co, so they have their formulary loaded with whatever drugs that company makes.

[ejpoeta]

33. this is exactly why i laugh at the right's arguments about how awful

'socialized medicine' is. I mean, they claim that a beaurocrat in washington will decide what they will pay for. Ummm... doesn't a beaurocrat in the offices of the health insurance company do that now?? Only, s/he has an incentive to deny you... MONEY!! Oh, the government will decide which doctors you can see. Ummm. insurance company does that now, right? They go on and on trying to scare people into thinking that a single payer system is tantamount to a government agent coming in your home, donning rubber gloves and telling you to turn your head and cough.

This crap about canada and other systems and how awful they are is ridiculous. And while we may have not had the ability to check their bs stories in 93, we sure as hell have the internet to get the real story now!! We know that the people making the decisions on whether we get single payer or not, have themselves a GREAT plan. which WE pay for. A single payer plan wouldn't be different from what we have now, except that everyone would be paying into the same pool. Young and old.

This issue really burns me. And what gets me the most is regular people who should know better who are so afraid of the government taking over their lives. They would rather have no insurance than single payer. The thing is, they DO have insurance. So they seem to not care about those out there without it. Well, i have insurance, so screw the rest of you.

Do you really think people don't have insurance BY CHOICE!!! Outside of younguns who don't know any better, who are healthy and aren't concerned with getting sick.... I don't know anyone who doesn't want insurance. But when you can't afford it... You just hold your breath and pray. I've been there. And it's a lonely place to be.

[dkofos]

6. It used to be.

I think you can add hospital mega corporations to the list now.

[Greyhound]

26. All of them. Nobody is happy with the system except them, so it seems obvious. n/t

[ayeshahaqqiqa]

7. You hit the nail on the head

Insurance companies are out to make money for their shareholders. Doctors and other health care providers are out to help people get and stay healthy. The two just aren't compatible.

The role for insurance companies if we go single payer is to provide insurance for those services not covered by the government.

[Auggie]

11. "Not covered by the government" -- like boob enhancements?

[nbsmom]

14. That's not quite right

You can't tell me that some of the draconian cost-controls in our current system aren't there as a result of some past crazy-ass accounting by doctors and other health care providers (don't get me started with some of the shenanigans pulled by doctors/chiropractors/labs etc.)

About 15+ years ago, doctors thought they could bypass the insurance companies and keep more of the money for themselves. As a result, you saw a large number of medical groups file for bankruptcy because of the unforeseen high risk cases (e.g., premature triplets).

Even when large groups decide that they want to self-insure (keep the majority of the risk and cut out collecting premiums), they still hire an insurance company to administer the plan and the benefits. Doctors still need to be paid for their services, and system monitoring (to make sure that care billed actually occurred, for example) is still necessary. I would imagine that any type of universal healthcare plan would want to incorporate some behavior modifications for both drs. and people (so that the drs. aren't incented to treat only 'sick' people, but instead form partnerships to help people stay healthy and need fewer drugs and medical treatment as they age.)

[global1]

19. Good Point On The Behavior Modification Comment.....

there would need to be an emphasis on Wellness and Prevention. I wish there was somehow a way to incent people to live a healthy lifestyle and keep them from having to avail themselves to the system.

My girlfriend is working for a company now that has implemented a 'walking program'. All employees are given pedometers and are encouraged to walk and incented with cash - if after a certain period of time they walk a certain amount of steps. They download their progress into a computer program - as the pedometer connects to a computer. There are ranges and the more they walk - the more cash they get. I'm surprised at how this has changed her habits. She never liked to do too much walking. Now I can't stop her. This winter we'd go to a shopping center just to rack up steps.

Perhaps if people don't have to use the health insurance provided by the government - they get some cash back. It is still cheaper to incent people this way then to have them sick and having to use the system.

There should be a concentrated effort to provide good 'health education' to the public as well. Emphasis on nutrition, infection control, no smoking, safety at home, etc. You get the idea.

MD's should be incented to keep people healthy.

I'm sure if we put our collective minds to it - we'd come up with all sorts of ways to keep people healthy and living a healthy lifestyle.

We don't have a healthcare system - we have an 'illness care' system. Even the insurance companies now could be doing some things in the way of healthcare screening so that things could be caught early before they become a costly drain on both the system and the patient.

[ayeshahaqqiqa]

23. Check out my boss then

right here: http://www.futurevisionsfoundation.org

to quote you: "form partnerships to help people stay healthy and need fewer drugs and medical treatment at they age"

That is EXACTLY what we are about at Future Visions! Check out the website!

[Triana]

9. YEP. Insurance companies are purely there to interfere with the dr/patient relationship...

...to act as middleman/gateway/go-between/controller/arbitrator and MOST OF ALL to PROFIT from that interference - which runs up health care costs and decreases - greatly - the quality of care.

WE


DON'T


NEED


THEM!

[global1]

18. Yet Didn't I Just Hear From The Repugs That Obama Wants To Interfere With.....

the Dr/Patient relationship with government run health insurance?

[Triana]

27. Likely. The opposite is true with gov't run insurance - it would REMOVE interference...

...between dr/patient by insurance companies. National healthcare in the UK/Canada don't have much issue (from what I've heard) about any interference from their gov't-run insurance between dr/patient - NOT like for-profit insurance companies do.

[Lugnut]

29. Yes and it makes my head explode.

Insurance companies have been interfering with that relationship for several years. It's obvious that Repugs don't have the same health care insurance coverage the rest of us have.

[Turbineguy]

10. The insurers could be set up

as private not-for-profit foundations.

People working there could still get good salaries, they can compete for clients, and compete on service. Patients who are willing and able to pay more for higher level of service (private rooms in hospitals and such) can do so.

Instead of being financed by stock equities, they can sell bonds (tax-free interest) to raise money, much the same way municipalities do.

Good health care should be viewed as a social good, not a cost.

And making a profit off the misery of others is wrong.

[Froward69]

13. Pharmaceutical companies TOO!

Pharmaceutical companies routinely gouge Americans... the cost of producing drugs goes down, demand remains steady. yet the cost goes up and up and up. More than half the cost of my week in the hospital was drugs.

[glinda]

15. I believe it is the Insurance Companies, big Pharma and

a few who hold patents possibly also. My husband and I with no children paid 1300/mo for Blue Cross Blue Shield. This money made possible by taking out of his retirement. He was an early buy out and the University screwed up his paperwork so we paid big time. During this time also BCBS raised our rate three times. Now husband is on Medicare. Since the changeover which has been about two months, BCBS has raised my rate twice. His meds used to not be covered. They were 275 every month and a half. Now they are 45. At least so far.
DO NOT TRUST INSURANCE COMPANIES OR DRUG COMPANIES. THEY WILL END UP LIKE THE BANKS AND ASK FOR A BAIL OUT IF THEY ARE INVOLVED. MARK MY WORDS!

[glinda]

16. Oh and leave the Chamber of Commerce out of it because it is run by

Republicans and large Pharma and Insurance Companies.

[tbyg52]

17. Yes. This all started when health insurance became "for-profit."

[ConcernedCanuk]

20. YUP - look north - we Canuks cover EVERYBODY for almost 50% of what y'all pay down there

.
.
.

from cradle to grave

we are covered, no matter how poor you are

USA is slow to learn some things -

like constant WAR sorta pisses the World off,

and rapes the taxpayers of dollars that could be used for housing and health-care

What the fuck is the USA so paranoid about that they have to have bases allover the fucking globe?

USA has more nukes than the rest of the World put together

Why can't they just stay home and be happy?

Imagine how much those TRILLIONS OF DOLLARS WASTED ON AN IMAGINED GLOBAL DOMINATION COULD DO FOR THEIR OWN CITIZENS AT HOME

Heck

Th USA has managed in the last decade to piss off everybody in the whole world

Including their own citizens

And now the government is paying unsolicited bribes to the moneylenders that raped the country

wow

[jtrockville]

21. Health INSURANCE is a scam. We need health CARE.

Does anyone know of any developed nations that allow profit to be taken on essential health care?

[Triana]

28. Nope. n/t

[JimWis]

22. Health care insurers need to go away.

[Laelth]

24. Um ... yes. n/t

:dem:

-Laelth

[Juche]

30. I've heard poor management and high overhead

We lose about $300 billion in overhead by not having single payer and $100 billion in higher prices since we can't negotiate medicine and medical supplies for all 300 million of us.

I have also heard something like $500-700 billion in medical care is for care that does nothing to make people healthier, or makes them sicker.

So yeah, you are right. A streamlined, single payer system will save hundreds of billions. If we run it intelligently and study what works and what doesn't well save hundreds of billions more.

But that is socialism.

[global1]

35. Your "But That Is Socialism" Comment.......

are you saying that "tongue in cheek" or are you serious and wouldn't support it?

[santamargarita]

32. The real problems are Republicans, centrists and the fascist news media

:think:

[JCMach1]

34. It's the whole damn system... not just the insurers...

Healthcare can never be free market by the very nature... so time to get out of that mode before it bankrupts everyone.