at least obama is depicting insurance companies as evil...

[Dr McSteamy]

he's said it many times.

but he said it again last night on letterman.

insurance companies try to keep healthy customers whom they don't need to pay out for. and they drop people who develop a major illness, or have a preexisting condition.


I am glad he's driving that message home, and I hope he continues to do so.


I just don't understand the economics of health insurance.

Everyone's premium is going up and up, yet, doctors' reimbursements are going down.
that means the insurance companies are pocketing more of the money that should've gone to the doctors.

over the last few years, the biggest insurance companies have made nearly $2 billion profit per year by screwing over both parties they deal with- the payers and the doctors.


at this point, i think i'd rather see a government-run insurance alternative that is non-profit. Put those $billion$$$$$ in collective profits back into doctors' pockets. Give doctors more motivation to provide better healthcare, rather than 2-minute office visits.

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[RGMSU]

Yep, except he's also been depicting doctors as evil or at least greedy and willing to put people through unnecessary treatments to make money. Some are, but hopefully most are not.

 

[docB]

over the last few years, the biggest insurance companies have made nearly $2 billion profit per year by screwing over both parties they deal with- the payers and the doctors.

So if the insurers are making billions by screwing the little guy why don't you (and everyone else) go invest in these publicly traded companies and reap your share of the profit?


http://www.marketwatch.com/investing/stock/AET

http://www.google.com/finance?client=ob&q=NYSE:UNH

http://www.google.com/finance?q=NYSE:HUM

http://www.google.com/finance?q=NYSE:CI

 

[meister]

So if the insurers are making billions by screwing the little guy why don't you (and everyone else) go invest in these publicly traded companies and reap your share of the profit?


http://www.marketwatch.com/investing/stock/AET

http://www.google.com/finance?client=ob&q=NYSE:UNH

http://www.google.com/finance?q=NYSE:HUM

http://www.google.com/finance?q=NYSE:CI

'cause I like to sleep at night?

 

[docB]

'cause I like to sleep at night?

So is it immoral for anyone to profit from the provision of health care?

 

[meister]

So is it immoral for anyone to profit from the provision of health care?

Not necessarily.

 

[RGMSU]

Not necessarily.

Hah, so it's just immoral for doctors to profit from it. Insurance companies profiting from it is ok? I'd rather see the people doing the work and making the sacrifices profit personally. That's really all that has happened in recent years. Profit in medicine has shifted from doctors to insurance companies and lawyers.

 

[meister]

Hah, so it's just immoral for doctors to profit from it. Insurance companies profiting from it is ok?

Who said that? It's immoral when it is done to the patient's detriment. If a doctor profits from a treatment that benefits the patient then that's just business. When an insurance company denies treatment or rescinds someone's policy to increase profit, that's immoral and should be illegal.

So I agree with you.

 

[deleted50478]

Sure. Insurance companies are 'evil' because they donate to Republicans.
Pharmaceutical companies are 'evil' because they donate to Republicans.
Tort lawyers are not 'evil' because they own the Democrat party.
Don't confuse Obama for someone who cares about right and wrong just because he uses the language of morality when it is politically convenient.

 

[meister]

False equivalence between PhRMA/insurance companies and tort lawyers is pretty laughable in terms of societal harm. I'm not defending trial lawyers, but you need to get a grip on reality.

 

[RGMSU]

Who said that? It's immoral when it is done to the patient's detriment. If a doctor profits from a treatment that benefits the patient then that's just business. When an insurance company denies treatment or rescinds someone's policy to increase profit, that's immoral and should be illegal.

So I agree with you.

Does anybody really believe physicians will be able to control their profit margin when their reimbursement rates are monopolized by either the insurance companies and/or the governmnent? Ability to set reimbursement rates has already been curtailed and is, in fact, often overridden by third parties (eg, they almost never give what is requested as payment), and the problem will only worsen as a single entity (the insurance industry or government) or both gain more centralized control over medicine.

 

[docB]

Not necessarily.

Who said that? It's immoral when it is done to the patient's detriment. If a doctor profits from a treatment that benefits the patient then that's just business. When an insurance company denies treatment or rescinds someone's policy to increase profit, that's immoral and should be illegal.

So I agree with you.

I know where you're coming from. It's not really wrong for an industry to exist that profits from insuring the health of people it just seems like our insurance industry has gone bad. I don't really disagree with that. I am just convinced that the alternative, government option would be even worse. The fact that resisting the advent of socialized medicine places us in the position of having to support the insurance industry is...problematic. I do support changes to the industry such as allowing people to buy nationally, etc.

 

[meister]

I know where you're coming from. It's not really wrong for an industry to exist that profits from insuring the health of people it just seems like our insurance industry has gone bad. I don't really disagree with that. I am just convinced that the alternative, government option would be even worse. The fact that resisting the advent of socialized medicine places us in the position of having to support the insurance industry is...problematic. I do support changes to the industry such as allowing people to buy nationally, etc.

A big problem with buying plans nationally is that insurance companies will just relocate business to the most lax state, just like credit card companies do in Delaware. I don't think that'll solve a damn thing unless the federal government regulates the hell out of them, which I don't see any but a handful of Congressmen voting for.

Therefore, it is extremely unlikely to get a functioning, moral, socially just, and affordable health care delivery system with for-profit corporations insuring over half the population. So my preferred solution is an American NHS, but I would be willing to negotiate that away in exchange for non-profit private insurance companies that are regulated to hell, with a national EMR system to eliminate wasteful overtesting.

But we have neither option, and instead are just propping up Wall Street. Just like every other bill that our Congress vomits forth. It's disgusting.

 

[deleted50478]

False equivalence between PhRMA/insurance companies and tort lawyers is pretty laughable in terms of societal harm. I'm not defending trial lawyers, but you need to get a grip on reality.

That's true. Both insurance companies and pharmaceutical companies both provide a beneficial service! Tort lawyers rape the system, taking an average of 60% of damages, but mostly just get settlements due to harassment of defendants. I didn't mean to imply any equivalence in terms of societal harm, tort lawyers are many times worse!

 

[meister]

That's true. Both insurance companies and pharmaceutical companies both provide a beneficial service! Tort lawyers rape the system, taking an average of 60% of damages, but mostly just get settlements due to harassment of defendants. I didn't mean to imply any equivalence in terms of societal harm, tort lawyers are many times worse!

I see what you did there!

 

[docB]

A big problem with buying plans nationally is that insurance companies will just relocate business to the most lax state, just like credit card companies do in Delaware. I don't think that'll solve a damn thing unless the federal government regulates the hell out of them, which I don't see any but a handful of Congressmen voting for.

Therefore, it is extremely unlikely to get a functioning, moral, socially just, and affordable health care delivery system with for-profit corporations insuring over half the population. So my preferred solution is an American NHS, but I would be willing to negotiate that away in exchange for non-profit private insurance companies that are regulated to hell, with a national EMR system to eliminate wasteful overtesting.

But we have neither option, and instead are just propping up Wall Street. Just like every other bill that our Congress vomits forth. It's disgusting.

Well the idea of letting people buy insurance nationally is that many states require specific sweetheart deal coverage for particular things that drives up the cost. If people could go out of state then they could buy insurance that is more appropriate for them.

I don't know that it's a reasonable goal for a business to be held responsible for achieving "social justice." I'm not even sure that I would agree that "social justice" as it's commonly defined in contemporary society, ie. equality of outcome, is a good thing. I also think that government regulation of industries tends to cripple them and make them useless. Now in this case that is the goal from the left. The current strategy seems to be that if we can't just enact NHS and we can't indirectly enact NHS with some "public option" we'll just hobble the industry to the point where it collapses and we will get NHS at that point.

 

[meister]

I don't know that it's a reasonable goal for a business to be held responsible for achieving "social justice."

Of course it's not, corporations should not and will never be thinking about such things.

The current strategy seems to be that if we can't just enact NHS and we can't indirectly enact NHS with some "public option" we'll just hobble the industry to the point where it collapses and we will get NHS at that point.

To the contrary, the national GOP seems content to obstruct at all times and hope that hindrance of any substantive reform will result in the collapse of what they lovingly refer to as the "welfare state." Starving the beast and all that. Do you deny that?

I understand conservative objections to 100% government-administered healthcare. To a certain extent I can sympathize, considering how awful governments usually are or can be. That's why it would be refreshing to have an actual national debate with different sides that can agree on a "reality." As it is now, we have one side that seemingly refuses to seriously discuss the issues at hand and is just using the entire mess as a political football in the hopes that 2010 is the new 1994. It's all so very cynical. And on the other side we have a weak president and an extremely weak congressional leadership that refuse to do what they were elected to do, and that is effect meaningful reform.

To be quite honest I think this is all a symptom of a much larger problem. The filibuster in the senate and privately funded political campaigns are preventing the real exercise of democratic power. The GOP and W should have been able to do whatever they wanted for most of his term, they won the elections! (They actually did, for the most part.)

Similarly, a president with 50%+ of the national popular vote and a party that controls both chambers by huge margins should be able to do what they want. Instead, we are stuck in perma-quagmire.

 

[meister]

And just so you know I'm not a fair-weather fan of democracy, George W. Bush should have been able to select any legally qualified nominee for any federal judgeship in the country. The nuclear option and filibustering judicial nominees as well as other officers who must be confirmed by the senate is pretty terrible.

I may have disagreed with W on like 95% of what he wanted or thought, but he won two elections. He gets what he wants, and if he f*cks up royally, well, maybe we shouldn't have reelected him. But that's how democracy is supposed to work.

 

[Dr McSteamy]

So if the insurers are making billions by screwing the little guy why don't you (and everyone else) go invest in these publicly traded companies and reap your share of the profit?


http://www.marketwatch.com/investing/stock/AET

http://www.google.com/finance?client=ob&q=NYSE:UNH

http://www.google.com/finance?q=NYSE:HUM

http://www.google.com/finance?q=NYSE:CI

i don't like the idea of having to do extra work (playing with stocks) to recoup the money that should have been paid to me in the first place.

also, with falling reimbursements, it's harder to come up with enough cash to buy enough stocks.

let's say insurance companies are hacking 30% of your billed fees from your $200k gross salary. To get back that $60k, and assuming profit of $10 per share, you'd need to buy 6000 shares.

6000 shares x $30/share = $180k locked up in the stock market.

fok that. just gimme my money up front and stop docking my fees.



until then, i guess we all have to participate in the endless cycle of screwing over the little guy.

insurance companies screw the doctors. the doctors screw the patients, order more tests, etc.... to squeeze out a little more cash..

oh well.

 

[RGMSU]

The nuclear option would be one of the biggest mistakes the Democratic party ever made. If they refuse to release the contents of the healthcare bill before it is voted on, refuse to listen to public sentiment about it, and force people to accept the terms of it in one of the most personal realms of everybody's lives (their own health), I pity them the next time elections roll around. I also pity the Democratic party when this thing becomes the next Medicare that results in increased taxes and reduced benefits. People are going to be seriously pissed when their tax rates go up and they don't get to receive the kind of treatment they expect to receive. Someone will pay at the election booths, I can tell you that. They may get their way, but to the victors will NOT go the spoils on this one. Also, if they drive a bunch of older docs out of business and reduce the number of quality young folks wanting to enter the field, people will not be happy about the existing doctor shortage made even worse, and they will not be happy with having whoever the government feels is an appropriate substitute for their usual doc.

 

[docB]

Of course it's not, corporations should not and will never be thinking about such things.

To the contrary, the national GOP seems content to obstruct at all times and hope that hindrance of any substantive reform will result in the collapse of what they lovingly refer to as the "welfare state." Starving the beast and all that. Do you deny that?

No I totally agree. The real definition of conservative means opposing change from the status quo. In the post Reagan era it has come to mean opposed to increasing the role of government in social engineering. And we do hope that the welfare state will eventually give way. I recall Newt Gingrich talking about Medicare “withering on the vine” at one point. We all thought that would be great.

To be quite honest I think this is all a symptom of a much larger problem. The filibuster in the senate and privately funded political campaigns are preventing the real exercise of democratic power. The GOP and W should have been able to do whatever they wanted for most of his term, they won the elections! (They actually did, for the most part.)

Similarly, a president with 50%+ of the national popular vote and a party that controls both chambers by huge margins should be able to do what they want. Instead, we are stuck in perma-quagmire.

And just so you know I'm not a fair-weather fan of democracy, George W. Bush should have been able to select any legally qualified nominee for any federal judgeship in the country. The nuclear option and filibustering judicial nominees as well as other officers who must be confirmed by the senate is pretty terrible.

I may have disagreed with W on like 95% of what he wanted or thought, but he won two elections. He gets what he wants, and if he f*cks up royally, well, maybe we shouldn't have reelected him. But that's how democracy is supposed to work.

I appreciate the nod that W won two elections. Those who are still harping on the “stolen” election of 2000 really make the left look just as silly as the idiot birthers are making us look now.

I agree that Obama has the mandate and the Congress and should be able to unilaterally implement his long promised change. I think that he and the congressional Democrats are reluctant to do so because they know they’ll be blamed for the ills under whatever system emerges. And I think most of us agree that while most people will be equal and will be covered they will also be unpleasantly surprised when they experience the details of any of the proposed systems.

I think the worst thing to happen to American politics in the last decade is the advent to the 36 month campaign. If you thought we favored the rich, well connected and well funded back when the campaigns started the winter before the election it’s way worse now. Now only those who can raise enough money to campaign for YEARS will make the cut.