Recruiting Forum Off Topic Thread III

[MoCo_Vol]

The short time I used an HSA, I could barely find a bank that offered one, especially not one at 6%. LOL.

I'm not sure at all what you're saying... My HSA is through HealthEquity and any investment is done through traditional stock market investing. There isn't any bank involvement...

There is no individual mandate anymore so you don't have to buy health insurance if you don't want to.

Good to know!

 

[UT = Checkmate]

Made it out alive. Lost my business, about to lose house. Just being sick and unable to work caused that. Not sure the ass-whoopin I'm gonna get when it comes to the actual cost of the medical care. So glad to be alive though, lol.

Really, it's bad, but could be worse, things work out.

Just wanted to agree with charger and recommend making a plan for something bad, if anyone doesn't have a good one yet.

Glad you are better but you are definitely offering sound advice. It is a real issue in this country. The ACA tried to address this but unsuccessfully. We definitely need to do something though. Anywho, who do we have committing today?

 

[RikidyBones]

Don't know if applies to all but my Dr. specifically told me that the person denying my claims is awarded bonuses.
Still paying full price for 3 of my 4 medicines. My Dr. has personally been on the phone with them twice. They say it's handled, then I receive a denied letter shortly after.
Apparently they can stall long enough to get around any consequences of failure to meet obligations.

I'm in commercial insurance but our claims folks are not paid bonuses for their decisions either way. The problem isnt necessarily insurance. Insurance is a wet ceiling, hospitals and large medical groups inflate the rates in negotiations to subsidize the folks who dont pay which in turn creates more who dont pay which in turn creates higher negotiations the next time around and here we go in a circle of nonsense. When hospitals are negotiating to charge $50 for a box of gloves that wasnt fully used and can be purchased for 2.50 retail (no idea about wholesale which is their price) you cant blame insurance. Insurance is simple. What goes in vs what comes out and what is projected to go out.

I dont think insurance should cover basic things. auto doesnt cover car maintenance. Nor should it. But those visits should be cheap enough to not drive someone away for basic care. I think the Japanese have a similar model. Anyways, this is a long discussion and I'm not sure we want to fully dive into it or not so I'll just leave it there.

 

[VolunteerHillbilly]

I'm not sure at all what you're saying... My HSA is through HealthEquity and any investment is done through traditional stock market investing. There isn't any bank involvement...


Good to know!

I should add that some states, generally the most blue, are putting in state individual mandates to try and create their own universal-ish coverage. I'm in TN=no mandate.

 

[RikidyBones]

Not sure that's the best policy for a doctor that is getting paid by the insurance company. Bite the hand that feeds you.

that's like suing the drywall company for a roof leak.

 

[volatil]

I'm in commercial insurance but our claims folks are not paid bonuses for their decisions either way. The problem isnt necessarily insurance. Insurance is a wet ceiling, hospitals and large medical groups inflate the rates in negotiations to subsidize the folks who dont pay which in turn creates more who dont pay which in turn creates higher negotiations the next time around and here we go in a circle of nonsense. When hospitals are negotiating to charge $50 for a box of gloves that wasnt fully used and can be purchased for 2.50 retail (no idea about wholesale which is their price) you cant blame insurance. Insurance is simple. What goes in vs what comes out and what is projected to go out.

I dont think insurance should cover basic things. auto doesnt cover car maintenance. Nor should it. But those visits should be cheap enough to not drive someone away for basic care. I think the Japanese have a similar model. Anyways, this is a long discussion and I'm not sure we want to fully dive into it or not so I'll just leave it there.

Also they try to make up for Medicare reimbursement tied to patient satisfaction. There’s a lot of truth in your post as well.

 

[MoCo_Vol]

Health Insurance is a slippery slope. People confuse rights when talking health. It comes down to a matter of should someone be denied who can pay? The answer is no. For some reason though lots of people who can't pay think they have a right to the service, and make no mistake medical care is a service.

I feel like if you're not going completely (and fully) universal healthcare where every person is paying X through taxation and has X coverage (which is equal across the board) then you need to not get involved as a government.


It's muddied up though arguing over "rights".

 

[chargervol]

I'm in commercial insurance but our claims folks are not paid bonuses for their decisions either way. The problem isnt necessarily insurance. Insurance is a wet ceiling, hospitals and large medical groups inflate the rates in negotiations to subsidize the folks who dont pay which in turn creates more who dont pay which in turn creates higher negotiations the next time around and here we go in a circle of nonsense. When hospitals are negotiating to charge $50 for a box of gloves that wasnt fully used and can be purchased for 2.50 retail (no idea about wholesale which is their price) you cant blame insurance. Insurance is simple. What goes in vs what comes out and what is projected to go out.

I dont think insurance should cover basic things. auto doesnt cover car maintenance. Nor should it. But those visits should be cheap enough to not drive someone away for basic care. I think the Japanese have a similar model. Anyways, this is a long discussion and I'm not sure we want to fully dive into it or not so I'll just leave it there.

Yeah, Doc seemed annoyed with this personal company. They have fought everything and I mean every part of a claim becomes a bitter fight.
But anyway, I don't put all the blame on insurance companies. I haven't looked into any one part of the system without walking away disgusted. Had a nurse say "let me change your band aid before you go" when I was 19. Showed up as a $86 charge on the bill breakdown.
Medical equivalent, treatment, coverage and pharmaceuticals. Prices jumping all over the place for the same products and so on.

Either way, it's broken.

 

[VolunteerHillbilly]

It becomes emotional when you have a personal relationship with someone who cannot afford lifesaving treatment. I've seen it happen and it's strained my libertarian sensibilities to the breaking point.

 

[VolGee4]

I'm not sure at all what you're saying... My HSA is through HealthEquity and any investment is done through traditional stock market investing. There isn't any bank involvement...


Good to know!

I didn't have one for that long, but the only options I could find was a local bank and an online company that offered those accounts. Maybe I didn't look hard enough. But I was getting virtually no interest on it.

 

[chargervol]

Health Insurance is a slippery slope. People confuse rights when talking health. It comes down to a matter of should someone be denied who can pay? The answer is no. For some reason though lots of people who can't pay think they have a right to the service, and make no mistake medical care is a service.

I feel like if you're not going completely (and fully) universal healthcare where every person is paying X through taxation and has X coverage (which is equal across the board) then you need to not get involved as a government.


It's muddied up though arguing over "rights".

My company and I pay for my coverage, our obligation has always been met, theirs hasn't.

 

[MoCo_Vol]

I mean I don't know...it's weird to me kids who are just starting to work or school can take on loans of absurd amounts of money for cars, houses, education...all kinds of things ya want it someone somewhere will loan the funds.

And it's like with medical you basically don't have any coverage and one bad break = ruin your life....or you're paying the premium and carrying coverage and STILL one bad break could ruin your life. Like where do you get ahead?

Ultimately the cost markup has ruined the US. The health insurance companies aren't going to eat it, and the hospitals/staff aren't going to eat it so it all gets passed down/on to the patient eventually through some way. I feel like supplies shouldn't be billed at a cost greater than fair market value.

A single band aid is at best a few cents and the one in the hospital isn't any better than what I can buy at Walgreens.

 

[RikidyBones]

Yeah, Doc seemed annoyed with this personal company. They have fought everything and I mean every part of a claim becomes a bitter fight.
But anyway, I don't put all the blame on insurance companies. I haven't looked into any one part of the system without walking away disgusted. Had a nurse say "let me change your band aid before you go" when I was 19. Showed up as a $86 charge on the bill breakdown.
Medical equivalent, treatment, coverage and pharmaceuticals. Prices jumping all over the place for the same products and so on.

Either way, it's broken.

It is and it has been for a while. It compounds itself and it's because hospitals used patient debts to recoup. Heres a timeline.

1. Negotiations happen
the prices start at the base level and x amount of people cant afford it so they dont pay.
2. Negotiations happen
Figures include the Bill's that weren't paid by x
Prices go up
insurance goes up because prices go up
People dont just stop seeking medical services normally so now group x2 who now cant pay the recent prices forms.
x+x2 havent paid their Bill's
3. Negotiations happen
Figures include the Bill's that weren't paid by x+x2
Prices go up
insurance goes up because prices go up
People dont just stop seeking medical services normally so now group x3 who now cant pay the recent prices forms.
x+x2+x3 havent paid their Bill's
4. rinse and repeat until a 4 gloves from a box of 30 gloves is used and $50 is the price charged. some where in there both sides have called the other "ridiculous"

Both sides are to blame because both had an option of hitting pause button and saying "ok this isnt working and all we are doing is pricing more people out and causing more unpaid bills". no one did. here we are.

this is a simple version. it's much more complicated of course but the idea is the same.

 

[VolunteerHillbilly]

My PCP keeps toying with going to concierge care. He's asked me about a price point in the 200-300 per month range. I don't know what his patient cap would be. Dollarwise, his premium plus a catastrophic plan would be about the same as my current plan costs. The big difference is I only pay 25% of my premium and the other 75% is a company benefit.

 

[chargervol]

I mean I don't know...it's weird to me kids who are just starting to work or school can take on loans of absurd amounts of money for cars, houses, education...all kinds of things ya want it someone somewhere will loan the funds.

And it's like with medical you basically don't have any coverage and one bad break = ruin your life....or you're paying the premium and carrying coverage and STILL one bad break could ruin your life. Like where do you get ahead?

Ultimately the cost markup has ruined the US. The health insurance companies aren't going to eat it, and the hospitals/staff aren't going to eat it so it all gets passed down/on to the patient eventually through some way. I feel like supplies shouldn't be billed at a cost greater than fair market value.

A single band aid is at best a few cents and the one in the hospital isn't any better than what I can buy at Walgreens.

There's an issue with fake charges also, was reading about it not long ago. People requesting their bill breakdown and nonexistent terms and unperformed procedures and tests on them. Often, patients don't know and insurance companies don't know that it wasn't performed.
It's all messed up, every part.

 

[Cosmo Kramer]

Im self employed and my health insurance is now almost $1200 per month for my family. About 10 years ago is was $450

 

[thunderduck17]

I work in hospital administration, so my views are probably biased, but I just don't see the purpose of health insurance companies. Patients are expected to pay a premium, then...meet a deductible....then, depending on their plan, they may get everything else covered, or they still have a portion of the bill they are responsible for. Meanwhile, I can speak with 100% certainty that hospitals are not walking away with huge profit margins. At my hospital alone, we write off millions of uncompensated care on a monthly basis.

I just can't wrap my head around why a health insurance company, that provides no actual care to the patient, is making big profits in this current system. Then, they turnaround and fight the hospitals on every single thing to pay as little as possible. That is what is driving up the costs for the actual consumers. If hospitals want to stay open, they have no choice but to increase the costs and the patients are the ones that have to bear it.

I consider myself a Conservative, but working in hospital administration makes it difficult not to wonder what would happen if private for-profit insurance companies were eliminated. I work in a state that did not expand Medicaid and that is just another burden on the hospital's plate. We can't turn away someone that shows up to our ER, regardless of payment. Even if we could, I don't think it would be right to do so.

 

[RikidyBones]

I work in hospital administration, so my views are probably biased, but I just don't see the purpose of health insurance companies. Patients are expected to pay a premium, then...meet a deductible....then, depending on their plan, they may get everything else covered, or they still have a portion of the bill they are responsible for. Meanwhile, I can speak with 100% certainty that hospitals are not walking away with huge profit margins. At my hospital alone, we write off millions of uncompensated care on a monthly basis.

I just can't wrap my head around why a health insurance company, that provides no actual care to the patient, is making big profits in this current system. Then, they turnaround and fight the hospitals on every single thing to pay as little as possible. That is what is driving up the costs for the actual consumers. If hospitals want to stay open, they have no choice but to increase the costs and the patients are the ones that have to bear it.

I consider myself a Conservative, but working in hospital administration makes it difficult not to wonder what would happen if private for-profit insurance companies were eliminated. I work in a state that did not expand Medicaid and that is just another burden on the hospital's plate. We can't turn away someone that shows up to our ER, regardless of payment. Even if we could, I don't think it would be right to do so.

they dont make profit off of premium. they profit off the capital being invested. without that investment, in 2018, they lose about 3%. Its called a combined ratio, which is 97% according to NAIC. The combined ratio is premiums/expense. Over 100% is a profit on premiums while anything below is a loss. So no. Insurance companies arent driving up the price. that makes no sense with a loss.

 

[thunderduck17]

they dont make profit off of premium. they profit off the capital being invested. without that investment, in 2018, they lose about 3%. Its called a combined ratio, which is 97% according to NAIC. The combined ratio is premiums/expense. Over 100% is a profit on premiums while anything below is a loss. So no. Insurance companies arent driving up the price. that makes no sense with a loss.

The point is, insurance companies are making any profit off of care provided to people. Why?

Cut them out, let actual providers control the healthcare market. Competition will keep costs down. Right now, nobody knows the actual costs of any services provided by providers because it goes through all the confusion that is insurance. Payers are controlling the market right now.

 

[Ron Swanson]

Years ago a friend of mine worked for a very large for profit operator of health care facilities in this country. He told me that if someone went to the doctor, had a surgery or whatever, and used their insurance and their spouses (as secondary) and both paid as primary on the EOB that the company would keep the overpayment instead of returning it to the insurance company.

So if you had a procedure that cost $100k and your BCBS and your wife's UHC both paid the primary contracted rate but on the EOB UHC recognized that they were secondary, this company would just keep the overpayment. And apparently that was/is legal. Blew my mind.

 

[thunderduck17]

Honestly, the number way we could cut healthcare costs substantially is by telling 90 year old pappy that we aren’t going to rack up $500k worth of care over the last 6 months of his life. Vast majority of healthcare costs can be attributed to end of life care. Places like Japan accept death much easier than us Americans do. We are fighters by nature, but that causes a ton of costs for not much return to be honest. That’s a shift in cultural ideas though, not necessarily the healthcare system itself.

 

[AF_VOL]

Honestly, the number way we could cut healthcare costs substantially is by telling 90 year old pappy that we aren’t going to rack up $500k worth of care over the last 6 months of his life. Vast majority of healthcare costs can be attributed to end of life care. Places like Japan accept death much easier than us Americans do. We are fighters by nature, but that causes a ton of costs for not much return to be honest. That’s a shift in cultural ideas though, not necessarily the healthcare system itself.

That's what makes Americans great, we don't give up easy!

 

[Rishvol]

That's what makes Americans great, we don't give up easy!

Screw that seppuku crap

 

[barrylee]

Honestly, the number way we could cut healthcare costs substantially is by telling 90 year old pappy that we aren’t going to rack up $500k worth of care over the last 6 months of his life. Vast majority of healthcare costs can be attributed to end of life care. Places like Japan accept death much easier than us Americans do. We are fighters by nature, but that causes a ton of costs for not much return to be honest. That’s a shift in cultural ideas though, not necessarily the healthcare system itself.

I'm guessing you're young??

 

[Kingston Vol]

I work in hospital administration, so my views are probably biased, but I just don't see the purpose of health insurance companies. Patients are expected to pay a premium, then...meet a deductible....then, depending on their plan, they may get everything else covered, or they still have a portion of the bill they are responsible for. Meanwhile, I can speak with 100% certainty that hospitals are not walking away with huge profit margins. At my hospital alone, we write off millions of uncompensated care on a monthly basis.

I just can't wrap my head around why a health insurance company, that provides no actual care to the patient, is making big profits in this current system. Then, they turnaround and fight the hospitals on every single thing to pay as little as possible. That is what is driving up the costs for the actual consumers. If hospitals want to stay open, they have no choice but to increase the costs and the patients are the ones that have to bear it.

I consider myself a Conservative, but working in hospital administration makes it difficult not to wonder what would happen if private for-profit insurance companies were eliminated. I work in a state that did not expand Medicaid and that is just another burden on the hospital's plate. We can't turn away someone that shows up to our ER, regardless of payment. Even if we could, I don't think it would be right to do so.

Yep. I think we’d all pay more in taxes if it meant 1) elimination of health insurance premium 2) we (and our loved ones) are taken care of it when we need it and 3) the money is spent more effectively.

Medicare for all checks all of those boxes. There are warts in the system - of course there are. But drastic measures have to be taken so people are taken care of.