Is the Obama administration waking up?

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MountainPharmD

custodiunt illud simplex
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http://www.msnbc.msn.com/id/33302234/ns/politics-washington_post

I thought this was a good article. Looks like they are finally starting to realize what the real problem is. I have said it for years. Insurance companies are the main reason our health care costs are out of control. You can add PBM's to that as well. Our for profit system cannot be reformed. It has to be completely changed.

The best gee ya don't say quote from the article;

"The insurance industry has decided to lead the charge against health reform, and everyone recognizes their motives: profits," said White House deputy communications director Dan Pfeiffer.
 
all for healthcare reform, but we need tort reform in there too
My friend is a PhD candidate in econ and we were just discussing this issue this past weekend. She said even accounting for defensive medicine, lawsuits only account for 4% of health care costs. That seemed like a pretty conservative estimate to me. I'd like to know how they (they meaning the authors of the health care economics textbook she was reading) came up with that figure. I would have guessed it was a lot more.
 
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Nice post!Totally agree but their political clout is too strong. You have to get Pharma, providers and insurance into a war so that you can isolate and kill to make social progress in helathcare for the Benefit of society be it nationalized or not.

BA Public Health- UC-Berkeley
PharmD candidate Pacific Pharmacy- Thomas J long 2010
 
Balderdash, look up their profits yourself on morningstar, or read this if you don't want to look up actual source data - their profit margin is around 4%.

http://www.usnews.com/money/blogs/flowchart/2009/08/25/why-health-insurers-make-lousy-villains

You guys are far too trusting. Nancy says they are the culprit, the economically illiterate media (and Krugman, who is literate but who is a 'ho) agree, so you must agree too?

The federal government makes up almost 50% of all health dollars thru Medicare. We aren't even talking Medicaid/Indian health/VA. But it's all "the other guy's fault?" Only if you are 1) corrupt 2) don't know any better or 3) have an agenda like the "social progress" poster above me. Shudder.
 
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I shouldn't even repond to someone who is calling people "'hos".

What do profit margins really mean though? Besides, aren't profits calculated after the sometimes gigantic salaries and bonuses? The point is, the overall costs are higher to administer private health insurance TODAY, partly because the overhead costs are higher than govt insurance programs. Some of that is the nature of the beast - private insurers have intrinsically higher costs because of the way their product has to be administered. But just because it's not "their fault" they have a higher overhead doesn't mean we can't look at a new way to administer health care coverage w/o all the overhead by a universal plan.

This problem is multi-factorial. No doubt about it, and no one is exempt from being part of the solution - we all need to be more judicious in our use of health care (i.e. not using the ER for primary care, living healthier lifestyles), pharma companies need to stop spending so much money on advertising to consumers and doctors, doctors need to stop practicing defensive medicine, we need tort reform, and the CEO of XYZ insurance needs to stop making multi-million dollar salaries.
 
Also re. overhead costs - a lot of that is based on state regs that require insurers to carry a certain percentage of $ as a cash cushion. This is reported as "administrative costs" as are building leases, etc. Uncle Sam however has no such petty regulations to trifle with, as the Feds are not under state regulation. So these same metrics are NOT counted for Medicare -- which is why it appears to have such a magically efficient (read: bogus) administrative overhead. The costs are there to be sure - but accounting rules differ in terms of categorization.
 
lawsuits only account for 4% of health care costs..

And if physicians had to pay waaaaay less for malpractice...and, thus, reimbursement could be less...it would then save....? The insurance companies got their hands in that, too.

The thing that pisses me off about insurance companies is that they use actuary calculations that essentially allow them to assume no real risk over time...and they make money providing no value to the system other than skillful money and resource manipulation. They have no use. If we got rid of them, it would be great...or at least regulated them heavily...
 
Balderdash, look up their profits yourself on morningstar, or read this if you don't want to look up actual source data - their profit margin is around 4%.

http://www.usnews.com/money/blogs/flowchart/2009/08/25/why-health-insurers-make-lousy-villains

You guys are far too trusting. Nancy says they are the culprit, the economically illiterate media (and Krugman, who is literate but who is a 'ho) agree, so you must agree too?

The federal government makes up almost 50% of all health dollars thru Medicare. We aren't even talking Medicaid/Indian health/VA. But it's all "the other guy's fault?" Only if you are 1) corrupt 2) don't know any better or 3) have a pinko agenda like the "social progress" poster above me. Shudder.

You can't look at only margins. You have to look at the money that is wasted inherently through the system. Go look up administrative costs of the private insurers and, say, the VA. Then look up how much they spend per patient...THEN look up ot safety, satisfaction, and clincial outcomes measures...they don't even compare...the VA looks ingenious in comparison...
 
You can't look at only margins. You have to look at the money that is wasted inherently through the system. Go look up administrative costs of the private insurers and, say, the VA. Then look up how much they spend per patient...THEN look up ot safety, satisfaction, and clincial outcomes measures...they don't even compare...the VA looks ingenious in comparison...

Why are you bothering talking to someone who actually uses the phrase "pinko agenda?" The guy's off the reservation in Limbaugh-land.

People in Australia/Canada/the UK/France/Spain/Germany are just puzzled at our curious predicament. We are supposedly the wealthiest nation on earth yet we can't guarantee care for everyone except in the worst way possible (ie through EDs and EMTALA)? It's embarrassing that there are people who think it's worth defending our current system as the "best in the world."
 
My favorite new way to argue for UHC is to simply state that we should have TRICARE/VA for everybody. Then when the person gasps in horror have them try to explain why soldiers "deserve" care while the rest of us don't. For kicks ask them why active duty/retired military folks are forced into a single-payer NHS like system and if they think we should privatize it since the free market is best.
 
Also re. overhead costs - a lot of that is based on state regs that require insurers to carry a certain percentage of $ as a cash cushion. This is reported as "administrative costs" as are building leases, etc. Uncle Sam however has no such petty regulations to trifle with, as the Feds are not under state regulation. So these same metrics are NOT counted for Medicare -- which is why it appears to have such a magically efficient (read: bogus) administrative overhead. The costs are there to be sure - but accounting rules differ in terms of categorization.

I see your status as accepted..... to where? Have you actually practiced as a healthcare professional? If not, then you know nothing. Look at Kaiser for example:
"Non-profit"- no taxes.
Drugs at 340 prices.
Collects the highest premiums relative to any other healthcare major insurance (usually) compnay.
NEVER NEVER NEVER answer the phone.
Provide the *WORST* customer service
Advertise like CRAZY (where the money prob goes)
Screw people over in Medicare part D plans
CEO makes $$$$
Laying off RPHs now.
BAH! Im done.
 
Balderdash, look up their profits yourself on morningstar, or read this if you don't want to look up actual source data - their profit margin is around 4%.

Boy those margins are really tight!!!!!

http://blogs.webmd.com/mad-about-medicine/2007/08/ceo-compensation-who-said-healthcare-is.html

Data is a few years old but nothing has changed since then. Here is a little piece for you in case you do not want to read the link. I took out the pharmaceutical companies in the list they are a whole other issue. Yep as you can see those margins are so tight the CEO's from the 8 insurance companies listed below took in a total compensation of 595.6 million dollars over a five year period from 2002 to 2007. Thats over half a BILLION dollars in compensation over just a five year period paid out to only 8 people!!! **** you have got the CFO, vice presidents and eveyone else getting paid as well. You are out of your damn mind if you think insurance companies are not the problem.

United Health Group
CEO: William W McGuire
2005: 124.8 mil
5-year: 342 mil

Caremark Rx
CEO: Edwin M Crawford
2005: 77.9 mil
5-year: 93.6 mil

Aetna
CEO: John Rowe
2005: 22.1 mil
5-year:57.8 mil

Cigna
CEO: H. Edward Hanway
2005:13.3 mil
5-year:62.8 mil

Humana
CEO: Michael McAllister
2005:2.3 mil
5-year:12.9 mil

PacifiCare Health
CEO: Howard Phanstiel
2005: 3.4 mil
5-year: 8.5 mil

Well Choice
CEO: Michael Stocker
2005: 3.2 mil
5-year: 10.7 mil

WellPoint
CEO: Larry Glasscock
2005: 23 mil
5-year: 46.8 mil
 
My favorite new way to argue for UHC is to simply state that we should have TRICARE/VA for everybody. Then when the person gasps in horror have them try to explain why soldiers "deserve" care while the rest of us don't. For kicks ask them why active duty/retired military folks are forced into a single-payer NHS like system and if they think we should privatize it since the free market is best.

Or propose a voucher for what the govt spends on Tricare to be applied towards private insurance and see how (not) far that money goes.

Even the most selfish bastard has got to realize that they would SAVE money with UHC! News flash: you are already paying for other people's health care. If you belong to a group insurance policy - guess what? You're paying for other people in your group. Even the fat ones! The lazy smoking ones! Oh noes! If you have no insurance and pay cash, guess what? The cost of uncollected bills in built into your overall costs!


Unless you're doing your own surgery with a box cutter and some superglue, you're paying for someone else's health care.
 
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all for healthcare reform, but we need tort reform in there too

Amen! I can't believe that tort reform isn't even being considered by the Dems. I heard a figure the other day...tort reform alone could save $80+ billion over 10 years.
 
Also, on the tort reform probelm...Texas and California both passed tort reform I think in 2003, and since they have reduced premiums by 30% and 40%.

[These numbers I heard were on the news and I believe it was a politician from Texas who was speaking. I can't remember if it was a senator or the governor, or what.]

Basically my point is that tort reform can reduce costs. It is one of the many aspects of healthcare reform that should be a no brainer.
 
We will never get "real" change as long as those in power (Congress) are getting money from those that dont want change (Insurance, Pharma, Lawyers, etc). That is the major problem within the whole system.

The only way to make Congress do something is to threaten their seat. That is the only thing they really care about. I used to work in politics....

We need to find a way to stop the financial influences of these groups. The whole thing is a "back scratching" mess.

Just look at the sweet insurance package that Congress gets!!!

We live in an "illusion" democracy. Almost all Congressman become influenced by the money of Special Interest. So, replace one snake with another one. The only vote that counts is that of the Special Interest that contributes to their campaign bid. We need to set limits from public dollars. You running for this office, here is a standard X amount for each candidate with an oversight committee responsible for watching their dollars. Lobbying as a profession should be banned.

We can vote it just doesnt make a difference because the system is broke...our voice is not loud enough unless we stand together in a more united front, ie; march millions on Congress to prove the point we are going to send "all" of you home and demand reform from those put in or they are going home too!! A real social uprest.....
 
Even the most selfish bastard has got to realize that they would SAVE money with UHC! News flash: you are already paying for other people's health care. If you belong to a group insurance policy - guess what? You're paying for other people in your group. Even the fat ones! The lazy smoking ones! Oh noes! If you have no insurance and pay cash, guess what? The cost of uncollected bills in built into your overall costs!


Unless you're doing your own surgery with a box cutter and some superglue, you're paying for someone else's health care.
👍

That's one of reasons why all other countries in the world that can afford it have adopted UHC.

Unless you're one of those free marketeers who believes you'll live completely healthy until you're shot by an outraged father at 102, you're going to require health care. Sharing the costs among all citizens is cheaper and more fair.
 
Or propose a voucher for what the govt spends on Tricare to be applied towards private insurance and see how (not) far that money goes.

Even the most selfish bastard has got to realize that they would SAVE money with UHC! News flash: you are already paying for other people's health care. If you belong to a group insurance policy - guess what? You're paying for other people in your group. Even the fat ones! The lazy smoking ones! Oh noes! If you have no insurance and pay cash, guess what? The cost of uncollected bills in built into your overall costs!


Unless you're doing your own surgery with a box cutter and some superglue, you're paying for someone else's health care.

You are right its kinda like car insurance. People that are actually good drivers are paying for idiots that can't drive. :laugh: UHC is fine, but it should still cheaper for people that are healthy and more expensive for people that are always sick and needy. Thats how car insurance operate like and yes it is extremely unfair that healthy good people have to pay for someone else's healthcare (yes, I am the type to believe that you should take care of your OWN problems and not depend on others to wipe your ass all the time). 🙄 I don't know whats worst paying for a idiot driver's accident or a lazy person's illness. :laugh: I am just glad I will never have either problems to worry about myself.
 
but it should still cheaper for people that are healthy and more expensive for people that are always sick and needy.

This is the total opposite of how it should work. The people that are "sick and needy" are most likely those most unable to pay. Furthermore, trying to audit every single person to determine who gets the "healthy person" rate and who doesn't is ridiculous and a waste of time, not to mention incredibly unfair if you think about the entirety of genetics.
 
This is the total opposite of how it should work. The people that are "sick and needy" are most likely those most unable to pay. Furthermore, trying to audit every single person to determine who gets the "healthy person" rate and who doesn't is ridiculous and a waste of time, not to mention incredibly unfair if you think about the entirety of genetics.

Its not hard to audit. Car insurance companies do it everyday. If you drive like a idiot and get into many accidents/have 10 points on your license you will have to pay more money than someone that has NEVER been into a accident or have points on their license. It should work the same way for health insurance. If you are one of those that are on a million RX you should pay more than a healthy good person that has never taken a RX in their lives. Same reasoning. Do you think its fair for YOU to pay the same amount in car insurance as compare to someone with a porche thats been in 3 accidents in one year and never follows the law???? I think not! :laugh:
 
Its not hard to audit. Car insurance companies do it everyday. If you drive like a idiot and get into many accidents/have 10 points on your license you will have to pay more money than someone that has NEVER been into a accident or have points on their license. It should work the same way for health insurance. If you are one of those that are on a million RX you should pay more than a healthy good person that has never taken a RX in their lives. Same reasoning. Do you think its fair for YOU to pay the same amount in car insurance as compare to someone with a porche thats been in 3 accidents in one year and never follows the law???? I think not! :laugh:

But what if your car is hit by someone for no fault of yours? What if you suddenly get an attack of appendicitis, or are get into an accident for no fault of yours? So in the future, you are paying a higher premium for something that wasnt your fault?

I'm wondering if there is a way to have the insurance premiums for preventable and non-preventable causes of disease.
 
But what if your car is hit by someone for no fault of yours? What if you suddenly get an attack of appendicitis, or are get into an accident for no fault of yours? So in the future, you are paying a higher premium for something that wasnt your fault?

I'm wondering if there is a way to have the insurance premiums for preventable and non-preventable causes of disease.

If your car is hit by someone else's car then that person's insurance will pay for your damages. So if you are paying car insurance and you never been into a accident you are paying for other people accidents, you are not helping yourself at all. Same with health insurance.
 
Its not hard to audit. Car insurance companies do it everyday. If you drive like a idiot and get into many accidents/have 10 points on your license you will have to pay more money than someone that has NEVER been into a accident or have points on their license. It should work the same way for health insurance. If you are one of those that are on a million RX you should pay more than a healthy good person that has never taken a RX in their lives. Same reasoning. Do you think its fair for YOU to pay the same amount in car insurance as compare to someone with a porche thats been in 3 accidents in one year and never follows the law???? I think not! :laugh:

Yeah...I have the option of not driving. I don't have the option of not living.

The car insurance analogy is really pretty f*cking dumb. Please don't ever use it again.
 
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meister said:
Its not hard to audit. Car insurance companies do it everyday. If you drive like a idiot and get into many accidents/have 10 points on your license you will have to pay more money than someone that has NEVER been into a accident or have points on their license. It should work the same way for health insurance. If you are one of those that are on a million RX you should pay more than a healthy good person that has never taken a RX in their lives. Same reasoning. Do you think its fair for YOU to pay the same amount in car insurance as compare to someone with a porche thats been in 3 accidents in one year and never follows the law???? I think not! :laugh:

Yeah...I have the option of not driving. I don't have the option of not living.

The car insurance analogy is really pretty f*cking dumb. Please don't ever use it again.

Actually you do have the option of not living.. or at the very least dying young. Plenty of people choose this option everyday when they smoke, get fat and drink too much. Genetics aside, on principle shouldn't these people pay more for their health insurance?
 
Yeah...I have the option of not driving. I don't have the option of not living.

The car insurance analogy is really pretty f*cking dumb. Please don't ever use it again.

Driving is not an option unless you live in a big city like NYC. I am sorry if I don't support lazy fat asses that are too damn lazy to get a job and pay for their own health insurance. (or at least go to the gym once in a while, so they won't have health issues in the first place 🙄)
 
actually you do have the option of not living.. Or at the very least dying young. Plenty of people choose this option everyday when they smoke, get fat and drink too much. Genetics aside, on principle shouldn't these people pay more for their health insurance?

+1

I don't care if people want to smoke, get fat or die, they just need to get a JOB and pay for their own problems.
 
Driving is not an option unless you live in a big city like NYC. I am sorry if I don't support lazy fat asses that are too damn lazy to get a job and pay for their own health insurance. (or at least go to the gym once in a while, so they won't have health issues in the first place 🙄)
-1 This doesn't even make sense.
 
Actually you do have the option of not living.. or at the very least dying young. Plenty of people choose this option everyday when they smoke, get fat and drink too much. Genetics aside, on principle shouldn't these people pay more for their health insurance?

That's a slippery slope. How often does one have to smoke/drink/eat fast food to be charged extra? What does the fat content of a meal have to be to increase your premiums? Meister has it right. Trying to audit everyone is ridiculous.

I hate smoking, but I also like personal freedom. It's unfortunate that we have to use so many of our resources to treat people who choose to live an unhealthy life, but what can we do? I was an emergency room medic for a couple years at a cardiac facility, and I saw it all the time. It's frustrating to treat people who screw their lives up repeatedly, when there are people out there that need real help from unpreventable illnesses. I think all we can do is keep promoting good health. People will continue to live however they want for years to come.

It's okay; soon we will be creating designer babies that are perfect and have no pre-disposed illnesses. All of the "real" babies will be inferior. source:Gattaca :meanie:
 
-1 This doesn't even make sense.

What doesn't make sense? I am against cost sharing of health insurance, car insurance, etc. etc. It punishes people that are actually responsible. why should someone thats good and healthly and RESPONSIBLE pay a high insurance premium b/c other people are too damn lazy to take care of their own health? Like I mention before I could care less if someone gets fat, smokes, eats fried chicken everyday, etc. etc. Just make sure that same person gets a JOB and pay for their own health problems down the road. Expecting other people to pay for their sloppy mistakes is crazy.

If we all have to pay for health insurance the LEAST the government can do is charge MORE for the people that are on 10+ RX and go to the doctor 5+ times a year. The people that are responsible and are on NO RX and only go to the doctor once a year for preventive services should be charge the lowest. The same reasoning with cars, like I said before. If you have a DUI, 10 speeding tickets and 5 accidents in the past 3 years then you should pay MORE than someone that is a responsible driver and have NEVER gotten into an accident. What doesn't make sense about this logical?
 
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What doesn't make sense? I am against cost sharing of health insurance, car insurance, etc. etc. It punishes people that are actually responsible. why should someone thats good and healthly and RESPONSIBLE pay a high insurance premium b/c other people are too damn lazy to take care of their own health? Like I mention before I could care less if someone gets fat, smokes, eats fried chicken everyday, etc. etc. Just make sure that same person gets a JOB and pay for their own health problems down the road. Expecting other people to pay for their sloppy mistakes is crazy.

Because it's ridiculous to actually try and follow everyone's eating/exercise habits. You make it sound like every disease is caused by being lazy.
 
Because it's ridiculous to actually try and follow everyone's eating/exercise habits. You make it sound like every disease is caused by being lazy.

Who say anything about following???? You don't even need to meet the person. Just look at their health records it should be clear to you. If they are on 5 of the most expensive drugs on the market then they should pay a higher health insurance premium. Just like if you pull up a driving record and saw a record of 3 accidents and a DUI thats automatically a higher car insurance premium. NO following is needed.
 
Because it's ridiculous to actually try and follow everyone's eating/exercise habits. You make it sound like every disease is caused by being lazy.

I have asthma. My parents smoked tobacco, cannabis, crack, and whatever else they could find laying in the house around me all the time. Therefore, I have asthma because I was too lazy to move out at age 4. And my premiums should be higher.

Hell, makes sense to me.
 
I have asthma. My parents smoked tobacco, cannabis, crack, and whatever else they could find laying in the house around me all the time. Therefore, I have asthma because I was too lazy to move out at age 4. And my premiums should be higher.

Hell, makes sense to me.

I think she may be a lost cause. At least we're trying.
 
I think she may be a lost cause. At least we're trying.

I get what you are saying, but I still don't think someone that is healthy and does not want to get insurance right now should have to get it. I haven't taken any RX in many years and haven't been sick in over 10 years. I am in school right now and when I get out I will have loans to pay back. Since my chances of getting sick or injuried (I have never been in a car accident either) is slim to none I decided that I do not want insurance until I have graduated and pay back all my debt. I think thats a decision that everyone should be able to make. Forcing healthy people to pay the same high premium as someone with cancer, aids, diabetes, etc. is just not fair.
 
I get what you are saying, but I still don't think someone that is healthy and does not want to get insurance right now should have to get it. I haven't taken any RX in many years and haven't been sick in over 10 years. I am in school right now and when I get out I will have loans to pay back. Since my chances of getting sick or injuried (I have never been in a car accident either) is slim to none I decided that I do not want insurance until I have graduated and pay back all my debt. I think thats a decision that everyone should be able to make. Forcing healthy people to pay the same high premium as someone with cancer, aids, diabetes, etc. is just not fair.

And if you should get cancer? Or meningitis? Or break a leg? Or get hit by a driver who doesn't have insurance?

Not smoking, not drinking, eating well, and exercising is not the recipe for a panacea that will magically protect you from all illness or injury. Should, God forbid, something beyond your control happen, and you end up in the emergency room because you don't have insurance, guess who's paying for your care.

No really. Go on. Guess.
 
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.....haven't been sick in over 10 years..

So what does that have to do with anything? I guess that means you won't get the flu, or pnemonia or cancer or any other random illness.

.....Since my chances of getting sick or injuried (I have never been in a car accident either) is slim to none I decided that I do not want insurance...

Your chances are slim to none? Oh to by young naive and invincible again. There is so much wrong with this statement I do not know where to start. First its called insurance for a reason. You have it in case something bad happens. Its purchased before you need it not after you need it.


.....Forcing healthy people to pay the same high premium as someone with cancer, aids, diabetes, etc. is just not fair.

This is what is wrong with the current system. It is a for profit system. Insurance companies could care less about you. All they care about is if you are healthy or not. A risk pool full of healthy people paying premiums is profit for the insurance company. A risk pool with people who have cancer, aids, diabetes, etc cost the insurance company money therefore they jack up the premiums for everyone. They do this so thay can continue to make profit. The problem is our for profit system.
 
And if you should get cancer? Or meningitis? Or break a leg? Or get hit by a driver who doesn't have insurance?

Not smoking, not drinking, eating well, and exercising is not the recipe for a panacea that will magically protect you from all illness or injury. Should, God forbid, something beyond your control happen, and you end up in the emergency room because you don't have insurance, guess who's paying for your care.

No really. Go on. Guess.

I will get insurance when I start making 100K a year with no student debt. I should be around 30-32 when that happens...Just old enough to start needing it! :laugh:
 
This is what is wrong with the current system. It is a for profit system. Insurance companies could care less about you. All they care about is if you are healthy or not. A risk pool full of healthy people paying premiums is profit for the insurance company. A risk pool with people who have cancer, aids, diabetes, etc cost the insurance company money therefore they jack up the premiums for everyone. They do this so thay can continue to make profit. The problem is our for profit system.


Everyone/everything functions for a profit. No one will ever work for "free". so I don't think any system will ever work without any profits (benefits to themselves). The point of working is to gain profits.
 
I will get insurance when I start making 100K a year with no student debt. I should be around 30-32 when that happens...Just old enough to start needing it! :laugh:

Oh, okay. Good thing no one has ever gotten sick or injured before the age of 30. No one who's under the age of 30 has ever been rear-ended, side-swiped, or t-boned by a driver with no insurance. That never happens! Good thing you don't have to worry about breast cancer, type I diabetes, or a broken ankle.
 
Everyone/everything functions for a profit. No one will ever work for "free". so I don't think any system will ever work without any profits (benefits to themselves). The point of working is to gain profits.

So all those non-profit organizations must not exist. They don't get anything done. No one works for Harvard, right? Or Columbia? The University of California? And we all know Kaiser Permanente doesn't do anything!