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Is the participation of insurers in health care immoral? (Original Post) chapdrum Mar 2016 OP
If they were simply administrators who made sure the books balanced, Ed Suspicious Mar 2016 #1
They have known the insurance system would not work since 1992 Baobab Mar 2016 #24
IMO, yes. ret5hd Mar 2016 #2
Not in and of itself. Buzz cook Mar 2016 #3
but they had the regulation before they joined the WTO. Baobab Mar 2016 #25
YES! Peace Patriot Mar 2016 #4
Yes, if they are "for profit" insurers. Vinca Mar 2016 #5
Unfortunately, most people don't select not-for-profits and a number of cooperatives went belly up Hoyt Mar 2016 #8
collecting money for years and then dumping them with huge bills when they get sick. Baobab Mar 2016 #27
Clearly, yes. MgtPA Mar 2016 #6
As a mental health provider I have seen some things, let me tell you. nolabear Mar 2016 #7
I hate having to deal with my insurance company TeddyR Mar 2016 #9
I've a sibling subject to migraine; chapdrum Mar 2016 #16
Sure TeddyR Mar 2016 #21
That's a really good point. surrealAmerican Mar 2016 #20
That's how they make their money, by denying payment. arcane1 Mar 2016 #26
uh, YES! Dont call me Shirley Mar 2016 #10
Is gambling immoral? Downwinder Mar 2016 #11
Betting that we'll get sick chapdrum Mar 2016 #14
Yes, the health industry is completely wrong and immoral... TheProgressive Mar 2016 #12
Yes because they only exist to deny healthcare and actually provide none of it Dragonfli Mar 2016 #13
Health insurance companies add no value WyLoochka Mar 2016 #15
Medicare billing is handled by private cos, often owned by insurers. There is no Medicare billing Yo_Mama Mar 2016 #22
That sucks WyLoochka Mar 2016 #29
Damn I hated hearing from a right wing nurse that Blue Cross administers Medicare in Texas Jim Beard Mar 2016 #31
Non-profit health insurers are doing a service and are not immoral. pnwmom Mar 2016 #17
Health insurance is just a systemically bad idea, really. DirkGently Mar 2016 #18
I wonder how a cooperative would work? Jim Beard Mar 2016 #32
Absolutely. At least the participation of profiteers. Doctor_J Mar 2016 #19
So what does everyone propose as an alternative TeddyR Mar 2016 #23
It has become so, yes. BillZBubb Mar 2016 #28
Well yes, but they are not alone. Rex Mar 2016 #30

Ed Suspicious

(8,879 posts)
1. If they were simply administrators who made sure the books balanced,
Sat Mar 19, 2016, 01:23 PM
Mar 2016

then no. Add in profit motive and you have a great Satan.

Baobab

(4,667 posts)
24. They have known the insurance system would not work since 1992
Sat Mar 19, 2016, 04:58 PM
Mar 2016

thats the last year a majority of working Americans (more than 50%) could afford adequate health insurance to prevent bankruptcy.

Now the percentage is tiny, its probably less than 15%. (the last figure I saw was more than 10 years ago and it was 14% then. And prices, especially drugs have soared since then, and health insurance has become MUCH more expensive.

But - we're stuck because of something horrible done in the Clinto era..

Buzz cook

(2,575 posts)
3. Not in and of itself.
Sat Mar 19, 2016, 01:27 PM
Mar 2016

Several European nations use a health insurance network, Switzerland and Germany for two iirc. Those countries have health care we should be envious of.

The problem we have in America boils down an abysmal lack of regulation and oversight. Or you could just say the profit motive is more important than lives in America.

Baobab

(4,667 posts)
25. but they had the regulation before they joined the WTO.
Sat Mar 19, 2016, 05:02 PM
Mar 2016

Canada has a single payer system because it was grandfathered in. We're trying to make new public services impossible.

Vinca

(50,893 posts)
5. Yes, if they are "for profit" insurers.
Sat Mar 19, 2016, 01:29 PM
Mar 2016

The only way to make a profit is to gouge the premium payers by either raising rates or denying care.

 

Hoyt

(54,770 posts)
8. Unfortunately, most people don't select not-for-profits and a number of cooperatives went belly up
Sat Mar 19, 2016, 01:33 PM
Mar 2016

last year. I was fine with Kaiser when I had it, but most people would howl.

Baobab

(4,667 posts)
27. collecting money for years and then dumping them with huge bills when they get sick.
Sat Mar 19, 2016, 05:05 PM
Mar 2016

Thats a guaranteed winner.

Simply wasting half of every health care dollar helps a lot with making it seem much more unaffordable than it should be. But the #1 reason things are so bad is this:.

"For the purposes of this Agreement…

(b) 'services' includes any service in any sector except services supplied in the exercise of governmental authority;

(c) 'a service supplied in the exercise of governmental authority' means any service which is supplied neither on a commercial basis, nor in competition with one or more service suppliers.

nolabear

(43,145 posts)
7. As a mental health provider I have seen some things, let me tell you.
Sat Mar 19, 2016, 01:32 PM
Mar 2016

We get our diagnoses and treatment choices challenged all the time by evaluators who have never laid eyes on the patient. Countless unpaid hours are spent trying to carefully dot every i, cross every t and predict what the next claim will be that denies insurance for treatment and recommends a drug or some cheaper, far less effective treatment instead. If ever you think we make too much money, you can cut most of our pay by at least a third as we fight insurance companies on our patients' behalf.

 

TeddyR

(2,493 posts)
9. I hate having to deal with my insurance company
Sat Mar 19, 2016, 01:46 PM
Mar 2016

And have had many a dispute over denied claims. At the same time, they do provide what is for us a valuable service. For example, our daughter needed surgery last year for migraines and the insurance company worked with us on making sure everything was covered.

With respect to denied coverage, there are providers who recommend unnecessary treatment or excessively expensive treatment when something less expensive might work. I think that is rare but it does happen. And of course there are individuals who seek treatment with out of network providers and coverage is denied for that reason. That was the primary concern with my daughter's migraine surgery -- making sure we could find an in-network facility.

 

chapdrum

(930 posts)
16. I've a sibling subject to migraine;
Sat Mar 19, 2016, 02:34 PM
Mar 2016

if you're inclined, I'd be interested to learn of what the surgery entails.

Thanks.

cd

 

TeddyR

(2,493 posts)
21. Sure
Sat Mar 19, 2016, 04:36 PM
Mar 2016

The surgery involves implanting an electrical stimulator -- basically a battery -- in the upper chest and running wires the under the scalp that receive electrical impulses that block the pain. Our daughter had suffered from migraines for about three years and received immediate relief following this surgery, and the relief lasted for about a year. However, the migraines recently returned so we are exploring how to correct.

surrealAmerican

(11,475 posts)
20. That's a really good point.
Sat Mar 19, 2016, 03:58 PM
Mar 2016

You would have more time to spend on your patients if you didn't have to "work with" insurers.

 

arcane1

(38,613 posts)
26. That's how they make their money, by denying payment.
Sat Mar 19, 2016, 05:05 PM
Mar 2016

How could an industry like that be anything but amoral?

Downwinder

(12,869 posts)
11. Is gambling immoral?
Sat Mar 19, 2016, 01:50 PM
Mar 2016

They are netting you are going to be well.

You are betting that you are going to get sick.

 

TheProgressive

(1,656 posts)
12. Yes, the health industry is completely wrong and immoral...
Sat Mar 19, 2016, 01:56 PM
Mar 2016

Health insurers are noting but money-changers who do not provide one iota of 'health care'.

That's immoral enough, but then add in the fact they do everything possible to not pay for
the health care you do receive.

The health insurance industry is a crime against humanity...

Dragonfli

(10,622 posts)
13. Yes because they only exist to deny healthcare and actually provide none of it
Sat Mar 19, 2016, 02:17 PM
Mar 2016

Not a single health insurer employee so much as applies a band aid, they are a completely unnecessary middleman.

They actualy profit off of misery every time they stand between the patient and the care needed from a doctor. Sometimes they even kill people by doing so.

They are nothing more than vampires that feed off our illness and misery.

WyLoochka

(1,638 posts)
15. Health insurance companies add no value
Sat Mar 19, 2016, 02:33 PM
Mar 2016

They drain value being that they are basically unnecessary duplicative billing offices. As such, they add a staggering amount of inefficiency when one considers it would be much more cost effective to simply use the billing office we already have for folks 65+ - Medicare - and just open it to all of us, cradle to grave.

Medicare operates at around 3-4% admin cost. Before the ACA, private insurance operated at 30-40% admin cost. The ACA required private insurers to improve their efficiencies so as to operate at 20% admin cost.

It was a step in the right direction but that padding of 16-17% to prop up unnecessary, value siphoning, private, for profit corporations is still a huge waste of money that could be better used to pay the actual health care providers.


Yo_Mama

(8,303 posts)
22. Medicare billing is handled by private cos, often owned by insurers. There is no Medicare billing
Sat Mar 19, 2016, 04:39 PM
Mar 2016

office. They bid for the service contract by area.

Some of them are pretty bad, too. Private companies take the claims and process or deny them, then they forward the net to CMS and CMS issues the check. They also set policies and so forth.

Here's a pretty current list of the MACs (Medicare Administrative Contractor).

So, take Highmark, which became Novitas Solutions, which is owned by DSO, which is wholly owned by a Blue Cross Blue Shield.
http://www.govhealthit.com/press-release/novitas-solutions-starts-medicare-jh-contract-work-jobs-coming-soon

You have to follow the legal spaghetti, but in the end these are insurance cos.

pnwmom

(109,466 posts)
17. Non-profit health insurers are doing a service and are not immoral.
Sat Mar 19, 2016, 02:43 PM
Mar 2016

They should all be non-profit.

DirkGently

(12,151 posts)
18. Health insurance is just a systemically bad idea, really.
Sat Mar 19, 2016, 02:44 PM
Mar 2016

As someone else here noted, someone probably has to connect patients with health care providers. The huge problem comes when that administration is done as a for-profit business that must, by the very nature of the thing, somehow extract billions of dollars from the process.

Sure, they could make things "profitable" by encouraging efficiency, but that only goes so far, and nothing is ever far enough when it comes to corporate profits.

So the profit ultimately comes by reducing care to patients, and compensation to providers. The whole framework of reimbursement for discrete services is not a health care model, but rather a way to pin down costs in rigid ways that can then be chiseled away, inevitably again by reducing care and provider payments.

None of the touted benefits of free enterprise apply in a system like this. There is no real competition, because people can't really "shop" for health insurance; even under the ACA, they mostly take what their employer gives them, period. And there are so few insurance providers to begin with that they can easily prevent any kind of superior way of doing business from emerging.

It's not even really "insurance." Insurance is a pooled distribution of risk, like the risk of car accidents or fire. Health care problems happen to everyone -- more so to some people, like the elderly -- but ultimately health problems aren't a "risk;" they're an inevitable cost of staying alive for literally everyone.

What we've got is a forced brokerage system, where a multi-billion-dollar industry dictates how health care works on both the patient and the provider sides to ensure it gets richer every year. Their "customers" will never walk away, because (haha) they can't.

No one has to twist their mustache for evil to happen. All it requires is the ungoverned application of normal human greed and short-sightedness, and the unwillingness of enough people to do something about it.

 

Jim Beard

(2,535 posts)
32. I wonder how a cooperative would work?
Sat Mar 19, 2016, 08:58 PM
Mar 2016

Starting during the Populist and Progressive Eras, Farmers started marketing their grains and cotton through area co-ops. Each farmer was paid market but at the end of the year, any profits were returned to the producers. I don't know how the ratio is figured. I still get divided checks from my Depression Era Telephone and now internet provider and my electric provider. ( The electric provider spent money on a power plant and didn't pay for several years.

There would have to be a larger real insurance company to cover losses.

May not work because profit isn't the motive but losing less is.

 

TeddyR

(2,493 posts)
23. So what does everyone propose as an alternative
Sat Mar 19, 2016, 04:40 PM
Mar 2016

To insurance companies providing health insurance? I'm far from an expert on health insurance, but I think our system often -- certainly not always -- works well. I have no idea how England's system compares to ours, but here's a story about the failures that occur in England's system -- http://www.liverpoolecho.co.uk/news/liverpool-news/20-month-old-birkenhead-tot-11065383

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