Ron78 Posted June 28, 2017 Share Posted June 28, 2017 14 minutes ago, AsburySkinsFan said: @Ron78that's how hospitals work in Guatemala, but imagine having to pay $15,000 to leave the hospital. Insurance is just pre-healthcare financing. The problem is that politicians and the healthcare industry aren't doing a damn thing to address healthcare costs, instead they just want to find ways to pay for continually exploding healthcare costs. Republicans wouldn't dream of ever putting rate caps on services because in captialism everyone deserves the right to be able to ransom their neighbor's life for small fortunes. $15,000 to leave? That is not how the direct pay model works. You pay a monthly fee for "membership" to a provider instead of paying an insurance premium (and all the overhead that comes with insurance). Insurance companies cost both medical providers and patients tons of money. If you could work out a system that eliminates the need for medical insurance, you could reduce the cost of Health Care. Link to comment Share on other sites More sharing options...
AsburySkinsFan Posted June 28, 2017 Share Posted June 28, 2017 1 minute ago, Ron78 said: $15,000 to leave? That is not how the direct pay model works. You pay a monthly fee for "membership" to a provider instead of paying an insurance premium (and all the overhead that comes with insurance). Insurance companies cost both medical providers and patients tons of money. If you could work out a system that eliminates the need for medical insurance, you could reduce the cost of Health Care. I see so little difference between that and insurance other than one being managed by a third party. Link to comment Share on other sites More sharing options...
Ron78 Posted June 28, 2017 Share Posted June 28, 2017 Just now, AsburySkinsFan said: I see so little difference between that and insurance other than one being managed by a third party. It cuts out the middle man. Insurance companies make money by assessing high premiums, deductibles, co-pays, and co-insurances. Also, by negotiating discounts with providers and delaying or outright denying payment to providers. If you could eliminate the insurance companies, it would reduce costs for both patients and providers. It has been tested in really small markets with success. If you implemented it on a large scale, I am willing to bet it would be more successful because of greater pooling. Link to comment Share on other sites More sharing options...
visionary Posted June 28, 2017 Share Posted June 28, 2017 Link to comment Share on other sites More sharing options...
AsburySkinsFan Posted June 28, 2017 Share Posted June 28, 2017 2 minutes ago, Ron78 said: It cuts out the middle man. Insurance companies make money by assessing high premiums, deductibles, co-pays, and co-insurances. Also, by negotiating discounts with providers and delaying or outright denying payment to providers. If you could eliminate the insurance companies, it would reduce costs for both patients and providers. It has been tested in really small markets with success. If you implemented it on a large scale, I am willing to bet it would be more successful because of greater pooling. What's to stop the healthcare provider from just pocketing the difference? Link to comment Share on other sites More sharing options...
Ron78 Posted June 28, 2017 Share Posted June 28, 2017 Just now, AsburySkinsFan said: What's to stop the healthcare provider from just pocketing the difference? Competition on the free market. You would have options. What's to stop insurance companies from pocketing the difference? They make out like bandits. Link to comment Share on other sites More sharing options...
AsburySkinsFan Posted June 28, 2017 Share Posted June 28, 2017 3 minutes ago, visionary said: Trump doesn't understand the healthcare bill There you go GOPers, there's your hero. But then you don't care because Trump doesn't need to understand anything just so long as he is your empty suit. 4 Link to comment Share on other sites More sharing options...
Dan T. Posted June 28, 2017 Share Posted June 28, 2017 (edited) Surprise that Trump has no grasp of this health care bill. Sad. Edited June 28, 2017 by Dan T. 2 Link to comment Share on other sites More sharing options...
Bozo the kKklown Posted June 28, 2017 Share Posted June 28, 2017 @ABQCOWBOYhas had a shocker in this thread. Wow! Link to comment Share on other sites More sharing options...
AsburySkinsFan Posted June 28, 2017 Share Posted June 28, 2017 44 minutes ago, Ron78 said: Competition on the free market. You would have options. What's to stop insurance companies from pocketing the difference? They make out like bandits. If that were true then it would happen with insurance companies. Instead the prices are all foing up uniformly. The insurance companies already pocketbthe difference, and they are all in competition with one another yet their products remain very similar. What you would end up woth under your plan is a 21 year old healthy stud paying nickles for his "membership" whereas the 70 year old senior get milked. There's nothing in your pman that would help even the drastic swings that take place. Link to comment Share on other sites More sharing options...
DM72 Posted June 28, 2017 Share Posted June 28, 2017 46 minutes ago, Dan T. said: Surprise that Trump has no grasp of this health care bill. Sad. It's sad, but not surprising. I'm not exaggerating when I say, there's people in this thread that would have a better grasp of a health care bill than Trump. 2 Link to comment Share on other sites More sharing options...
Sacks 'n' Stuff Posted June 28, 2017 Share Posted June 28, 2017 1 hour ago, BenningRoadSkin said: @ABQCOWBOYhas had a shocker in this thread. Wow! 3 Link to comment Share on other sites More sharing options...
Larry Posted June 28, 2017 Share Posted June 28, 2017 (edited) 6 hours ago, Ron78 said: Eliminate the middle man (commercial insurance companies) and you will reduce the cost of health care. I keep hearing this claim made. But I'm not really certain that it's all that clear. One of the things about Obamacare, is that it mandated that for every dollar the insurance companies take in, they had to pay our 80 cents to health care providers. This is a clause which I note the Republicans intend to repeal. However, it's also a target which, supposedly, most insurance companies were already meeting, before Obamacare. Which might make one think that eliminating the insurance companies would reduce costs by 20%. But I'm certain that a good chunk of that 20% goes towards paying overhead costs. The army of paper pushers who do all of the work to turn a claim into a payment. And I don't have any confidence at all in the thought that the federal government will be vastly more efficient at pushing paperwork, than private insurance companies are. Get rid of the private bureaucracy, and you've simply replaced it with a government one. Yeah, in theory, if you eliminate BCBS, you've eliminated the cost of the BCBS CEO. But how much of BCBS' revenue does the CEO get? 1%? 0.5%? I really don't buy the casual assertions that having the government replace insurance companies really gets rid of a whole lot of costs. (Now, maybe, if people could produce some actual statistics, maybe I could be convinced. For example, what percentage of the money taken in for Medicare, gets spent on overhead? Show me that Medicare, right now, is running, say, 5% overhead, and maybe I'll believe that assertion.) Now, I could believe that transitioning to a single payer system might reduce overhead costs, by creating one single billing and accounting system, for everybody. i look at a doctor's office or a laboratory, and the impression I have is that, for every person actually providing health care, they have two people coordinating the billing with the insurance companies. I don't think it's guaranteed, but it does feel likely, to me that if we go to single payer, maybe medical offices could cut their billing staff in half, simply because there would be only one billing system, and one set of rules. And every employee would know those rules, and how to work them. I could believe that maybe going to single payer might result in reduced overhead costs on health care, as a result of standardization. Edited June 28, 2017 by Larry 1 Link to comment Share on other sites More sharing options...
Ron78 Posted June 28, 2017 Share Posted June 28, 2017 (edited) 16 hours ago, AsburySkinsFan said: If that were true then it would happen with insurance companies. Instead the prices are all foing up uniformly. The insurance companies already pocketbthe difference, and they are all in competition with one another yet their products remain very similar. What you would end up woth under your plan is a 21 year old healthy stud paying nickles for his "membership" whereas the 70 year old senior get milked. There's nothing in your pman that would help even the drastic swings that take place. The insurance company still represents a "middle man" that has to pay its employees and score a profit. You remove that from the equation and the savings can be huge. Plus, we don't get as much competition among insurance companies as we would like because there is a lack of competition across state lines. Reimbursement from Medicaid and Medicare would still probably have to exist in some form. Edited June 28, 2017 by Ron78 1 Link to comment Share on other sites More sharing options...
Ron78 Posted June 28, 2017 Share Posted June 28, 2017 (edited) @Larry I completely agree with you that if what we meant by "eliminate the insurance companies" was instead give our money to the government and let them administer our Health Care, that would not be an ideal situation because the government has a tendency to mismanage the money we give them (just look at social security). You have missed what the concept "Direct Pay Health Care" represents. It is explained in the article I posted. Basically you are paying a monthly "membership fee" to providers to mitigate risk instead of a monthly premium to insurance companies. If you eliminate insurance companies from the equation, it could be a huge savings. You are right that insurance companies have always allowed about 80% of what providers billed them (an allowance is a combination of what the insurance company pays and what the patient pays out of pocket), but that doesn't factor in what the insurance companies deny. Insurance companies outright deny coverage sometimes (for a variety of reasons) and that costs providers or patients huge sometimes. You would obviously eliminate those denials with Direct Pay. Also, the portion of the 80% that is patient liability is so high sometimes (due to the affordable care act) that patients are not paying everything they owe. Hospitals are taking a hit nationwide because of this. Also, I think you're wrong about Hospitals being able to cut their staff under a single payer system. Medicare, for example, is so inefficient and complex that it requires special staff with a special understanding of that payer. A single government payer would probably require more attention (not less). Edited June 28, 2017 by Ron78 Link to comment Share on other sites More sharing options...
@DCGoldPants Posted June 28, 2017 Share Posted June 28, 2017 Trumpcare (Ryan Version) didn't go over well. Trumpcare (McConnell Version) is also deeply unpopular 17%!?!?!?! That's almost Cheney turf. Probably lower than Congress right now too. Link to comment Share on other sites More sharing options...
LadySkinsFan Posted June 28, 2017 Share Posted June 28, 2017 (edited) The Roundup of the bills and the ACA Edited June 28, 2017 by LadySkinsFan Link to comment Share on other sites More sharing options...
visionary Posted June 28, 2017 Share Posted June 28, 2017 Link to comment Share on other sites More sharing options...
Llevron Posted June 28, 2017 Share Posted June 28, 2017 10 minutes ago, visionary said: Honestly, they have more vacations than I do with half the work. 1 Link to comment Share on other sites More sharing options...
Bang Posted June 28, 2017 Share Posted June 28, 2017 Oh come on,, it's not a vacation. McConnell needs time to kidnap the kids of holdout congressmen so as to make a proper threat for them to do what literally almost no one in the country wants them to do. "representative government' my ass. ~Bang 2 Link to comment Share on other sites More sharing options...
No Excuses Posted June 28, 2017 Share Posted June 28, 2017 (edited) 4 minutes ago, Bang said: "representative government' my ass. ~Bang I disagree. They represent their constituents well. We shouldn't dismiss the political leanings of people too dumb and arrogant to understand that they are the biggest losers of this entire ideology. Edited June 28, 2017 by No Excuses Link to comment Share on other sites More sharing options...
HOF44 Posted June 28, 2017 Share Posted June 28, 2017 18 minutes ago, Bang said: "representative government' my ass. ~Bang Oh it's a representative government all right. The people need to wake up and realize who is being represented. It aint the masses for sure. 3 Link to comment Share on other sites More sharing options...
gbear Posted June 28, 2017 Share Posted June 28, 2017 Ron, One problem with the membership model is portability of benefits. I will start with the rosiest of situations, living in the DC/Baltimore corridor where we have more doctors per thousand people than anywhere in the U.S. Let's assume I buy a membership to the large healthcare provider, John Hopkins. Great, they have doctors to treat just about everything. Does that mean I must stay in MD or risk some huge medical bill if something happens to me when I leave the area? Now to make matters worse, most of the U.S. doesn't have access to a healthcare network as extensive as Hopkins. Most have access to primary care doctors or internists, and many of those aren't close. So would they buy a member ship for those and just pray nothing happens the local membership doc can't treat? The access to care issue is exacerbated under these models unless the network is huge with agreements to treat anywhere, at which point the networks become a lot like standard insurance with in and out of network providers. The local network membership model only works where doctors and specialists are plentiful. That said, my wife had Hopkin's insurance when she was a nurse there, and it was better than my BCBS in terms of coverage and costs. However, it was a perk and not a system offered outside of employees and their families. 2 Link to comment Share on other sites More sharing options...
visionary Posted June 28, 2017 Share Posted June 28, 2017 1 Link to comment Share on other sites More sharing options...
Renegade7 Posted June 28, 2017 Share Posted June 28, 2017 (edited) 14 hours ago, AsburySkinsFan said: There you go GOPers, there's your hero. But then you don't care because Trump doesn't need to understand anything just so long as he is your empty suit. They don't care about Trump, they just need someone to sign their bills into law. Edited June 28, 2017 by Renegade7 1 Link to comment Share on other sites More sharing options...
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