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Buckland

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Nonprofit medical insurance companies; think about it. Currently, health insurance companies make hand-over-fist profits by raising premiums and lowering reimbursements. They even invest their earnings in the stock market and when their investments turn sour, guess who pays? Everyone does in terms of higher premiums and lower reimbursements. At the expense of patients and providers, health insurance companies operate solely for the benefit of increasing profits. It is wrong.

For the benefit of the people, our government must provide A TAX-FREE HAVEN FOR NONPROFIT MEDICAL INSURANCE COMPANIES. A tax free haven means that federal, state, and local government shall not collect any tax whatsoever (e.g. all expenses, property, utility etc.) from a nonprofit medical insurance company. To ensure nonprofit status, the companies must necessarily be subject to routine audits.

The solution works when we see that the money that would have gone towards profit (excess) will now be used to provide wider and healthier reimbursements (meaning shorter wait times at hospitals, better tests, longer face-to-face time with the doctor, more doctors in more places, etc.). The money that currently goes to various taxes – wage taxes, property taxes, sales taxes, all taxes – would be saved, allowing insurance premiums to decrease so that everyone can afford coverage: great coverage.

We, as a nation, do not need to be paying more taxes so that our government can supply everyone with healthcare. Furthermore, competition needs to exist. We also do not need to pay more taxes so that the government can give our money to for-profit medical insurance companies in order for them to provide “more affordable healthcare.” That is like being robbed twice. There is a lot of money that will pool into these nonprofit companies and the companies should provide their management and staff with very good salaries. This is advantageous because it will attract the best applicants as well as provide incentive for more nonprofit companies to start up and compete. This plan, our plan, is to keep the government’s and the fat cat profiteers’ hands off of the money that is meant for the healthcare of our nation.
 

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That's a brilliant idea, almost so good I'm surprised I haven't heard it suggested before. The problem is insurance lobbying is so enormous it would seem difficult for any politician to get behind it for fear of loss of campaign contributions, non-profits don't kick cash to the politicians who back them. The only one who would be benefitting is the consumers, and would they really hit the polls for this issue enough to compensate the loss of funding? I would love to champion this cause if I were in a position, I've even thought of writing my governor about it but he's a little busy running for pres 08, although I do know his daughter. It seems it would have to be done on a small scale, such as a state level, and proven to be reliable before it could even be put on the national table. Good post, thanks for the brain food.:thumbup:
 
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I think this may be one of the better plans I have heard but I do wonder just how affordable this would make insurance for the average person. In other words, what portion of an insurance company's gross revenue goes to taxes and profit?
 

Buckland

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From what I am finding online, federal corporate tax is at 35%. I don't know what the number would be when you tack on state and local taxes. Obviously, most of the savings and, therefore, benefit will come from the establishment of a tax-free haven for nonprofit medical insurance companies. Information about the profits of health care insurance companies can be found at this link:
http://money.cnn.com/magazines/fortune/fortune500/snapshots/1499.html
 

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But isn't only profit taxed not revenue? Since profit is only like 5-10% that is not a huge improvement. My economics are a bit rusty but this doesnt seem like a huge change.
 

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This is actually the fuctioning principle behind Universal Single Payor Health Insurance. Check out this article of the proposition in Maine:
http://www.mainepeoplesalliance.org/healthcare/single_payer.html
The benefits go far beyond simple profit sharing, the organization could collectively bargain with hospitals and possibly, if congress will allow it, with prescription drug companies to reduce costs in that regards. The simplicity of the system would also generate a streamlined system which would expedite reimbursements. Now some medical stud's don't like this idea because they believe it will bring down the incomes of doctors, however I'm not quite certain on the reasoning behind it. Imagine a hospital in which all of the patients pay their bill, and on time nonetheless. We would have less crowding of the emergency room and could virtually do away with EMTALA because patients would be going to see their own doctors instead of the ER.
 

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Nonprofit medical insurance companies; think about it. Currently, health insurance companies make hand-over-fist profits by raising premiums and lowering reimbursements. They even invest their earnings in the stock market and when their investments turn sour, guess who pays? Everyone does in terms of higher premiums and lower reimbursements. At the expense of patients and providers, health insurance companies operate solely for the benefit of increasing profits. It is wrong.

...

There are some out there (google to find them). Sometimes they are small HMO's that serve a very specific market. In principle this could be a good idea. In practice, it might be difficult to raise the capital to start these non-profits on a large scale to where they could solve issues such as millions of uninsured and to attract the best administrators (who may be motivated to take a job with a better paycheck). As one person said in this thread, this is the idea behind a single-payer system -- that the government runs a non-profit health "insurance" by forcing everyone to pay into it with a tax.
 

Buckland

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It is like the single payer system, however, with the important difference of being run by private nonprofit companies that do not get taxed by anyone. Therefore, competition still may exist which will reduce the inevitable unnecessary bureaucratic growth (waste of money) found in government programs. To start off this program, the government may provide low interest rate loans to new nonprofit medical insurance companies. These new companies that pay no taxes would definitely out-compete for-profit insurance companies. [Notice for-profit companies are never made illegal]. There will be lots of money coursing through these nonprofits. I think the management should be/will be paid well (see my first statement). People will want to be involved.
 

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It is like the single payer system, however, with the important difference of being run by private nonprofit companies that do not get taxed by anyone. Therefore, competition still may exist which will reduce the inevitable unnecessary bureaucratic growth (waste of money) found in government programs. To start off this program, the government may provide low interest rate loans to new nonprofit medical insurance companies. These new companies that pay no taxes would definitely out-compete for-profit insurance companies. [Notice for-profit companies are never made illegal]. There will be lots of money coursing through these nonprofits. I think the management should be/will be paid well (see my first statement). People will want to be involved.

Keep in mind that an important way of compensating executives is stock options. A non-profit cannot do that. I seem to remember that Blue Cross Blue Shield was a non-profit at some point (at least in Texas). It isn't now, and they seem to have grown since then. Also, note how a lot of non-profit hospitals are going "for-profit." It's really hard for a non-profit to compete against for-profits for staff, management, and capital. Also, if the government provided low-interest loans, many entrepreneurs would jump on the cash, do very little work, spend it on their own wages, and then default on the loans. Beyond that, the money would go to cronies of government officials who have little ability when it comes to running insurance companies. This is really a very inefficient way to do single payer.

Taxes are not really that big a deal. Many large companies have "tax minimization" strategies under which they pay much less tax than you would imagine (most if not all pay little or no income tax). Private insurance companies are some of the most competitive businesses out there. People do compete against them, but it's pretty tough. The big companies have networks that basically cover all the physicians and there is little real incentive for employers to switch. The health insurance sales business is very tough with very long lead times. Many health insurance companies eke out an existence with a handful of large companies making basically all the profits.
 

Buckland

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It is disappointing to receive such nay saying. It appears as though you, like many others, do not believe change can occur. However, today is no different in its ability to change than it was 200 years ago. What I am trying to do is get out some new ideas; to make people think again. It is wrong to assume that everyone is a crook and that nobody would want to work for (let’s say) a million year without stock options. It is wrong to think that there is some small pool of capable CEO’s out there (not to mention ridiculous). It is incredibly wrong to be so afraid of how competitive big insurance companies are that you try to dissuade anyone from even trying. Everyday, we hear on the news of how expensive it is for corporations to supply their employees with health care. Your last post says there is very little incentive for employers to switch? I must be misunderstanding you. Lastly, I believe you underestimate the value of being tax-free. Again, this plan I am proposing calls for the exemption of local, state, and federal taxes as well as cutting out any excessive wealth and redistributing it back into lowering premiums and, perhaps, increasing reimbursements. This is the fundamental argument: Money spent on health care should only go to the people managing insurance and those who provide the care. It should not go to any bureaucrat or to any profiteer. It has to work.
 
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Buckland

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That is a very radical idea. Let's try not to divert discussion away from the original topic. Please, I would like to hear more about what people think of the plan I have put forth.
 

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Oh my. So without "profit" what is the incentive to cut costs and increase efficiency. While this is a little better than having the govt do it there is still not incentive to keep costs low and without that you will simply see costs rise cause this non-profit firm can just raise prices.

Oh and dont forget paying the CEO 800K or so.. Thats what the United way and other giant "non-profits" do.
 

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It is disappointing to receive such nay saying. It appears as though you, like many others, do not believe change can occur. However, today is no different in its ability to change than it was 200 years ago. What I am trying to do is get out some new ideas; to make people think again. It is wrong to assume that everyone is a crook and that nobody would want to work for (let's say) a million year without stock options. It is wrong to think that there is some small pool of capable CEO's out there (not to mention ridiculous). It is incredibly wrong to be so afraid of how competitive big insurance companies are that you try to dissuade anyone from even trying. Everyday, we hear on the news of how expensive it is for corporations to supply their employees with health care. Your last post says there is very little incentive for employers to switch? I must be misunderstanding you. Lastly, I believe you underestimate the value of being tax-free. Again, this plan I am proposing calls for the exemption of local, state, and federal taxes as well as cutting out any excessive wealth and redistributing it back into lowering premiums and, perhaps, increasing reimbursements. This is the fundamental argument: Money spent on health care should only go to the people managing insurance and those who provide the care. It should not go to any bureaucrat or to any profiteer. It has to work.

Many large corporations pay very little or nothing in taxes so the "tax free" part is very little incentive, except perhaps to disguise a "for profit" corporation as a "non-profit" to avoid paying all taxes.
http://www.rawstory.com/news/2007/WalMart_pays_itself_rent_get_large_0201.html

http://www.ombwatch.org/article/articleview/2450/1/291
"[This]... is confirmed by a new study recently released by Citizens for Tax Justice and the Institute on Taxation and Economic Policy. The study by Bob McIntyre and T.D. Coo Nguyen looks at federal income taxes paid by 275 of the nation's more profitable Fortune 500 companies from 2001-2003 and reveals that:

"Eighty-two of the 275 companies paid zero or less in federal income taxes in at least one year from 2001-2003. The companies who paid "less" experienced multiple tax-free years. In the years they paid no income taxes, these companies earned approximately $102 billion in pretax U.S. profits. Due to excessive tax breaks, the firms were handed tax rebate checks from the U.S. Treasury totaling $12.6 billion.

"Loopholes and other tax subsidies enjoyed by the 275 companies reduced federal revenues by $43.4 billion in 2001, $60.8 billion in 2002, and $71 billion in 2003.
In three years, these companies received $175.2 billion dollars worth of tax breaks. Half of these tax break dollars went to just 25 of the companies.


Also, with respect to CEO's your remarks suggest a lack of experience with business beyond the footsoldier level. There are very few people who can do a good job in a CEO position of a non-trivial health insurance company. The people who have this skill set can pretty much name their price and go where they want to. They are not going to be interested in making $800K/yr at a non-profit. That's why many non-profits have so many scandals because they are forced to take CEOs that are 20-30 tiers down from a health insurance CEO and may not be honest or able to detect fraud. Many of these companies spend millions finding the right person and even then sometimes fall down ... let alone make a profit, generate funding, and talk to Wall Street analysts. It is an extremely tough job that makes the typical physicians' job look like a cakewalk (granted these are different skill sets, so it's not a fair comparison). To justify this and put it into perspective, there are only 500 CEOs for all the Fortune 500 companies (which employ millions of people). The are part of a group that is even much more selective than becoming a physician (which is nevertheless a noble, worthwhile, and very difficult/high-stress job as well). If a physician's job was like a CEO's job, a physician would be responsible for all the patients at, say 100 hospitals around the country, did not have time to do any of the work him or herself (eveything is delegated) and lose his/her job if almost all patients did not come out of those hospitals in excellent health (or, heaven forbid, die). A CEO has to attract and then lead excellent managers capable of overseeing huge operations (more rare leaders & managers with egos and agendas), a task that is probably about the most difficult job I can think of that doesn't involve the possibility of losing life or limb or doing hard manual labor. S/he has to manage a board that make politics at a hospital look tame. Your remarks suggest you don't really understand what a CEO or a large company does and why it is difficult.

http://www.kellogg.northwestern.edu/news/hits/011104tbg.htm
"CEO turnover has been accelerating for the last 10 years," said John T. Challenger, who heads the firm. "CEOs find themselves in very difficult situations these days, from dealing with economic uncertainty to employees who want better salaries. The CEO is in the middle of all those battles, which makes it tough to survive."

"A generation ago, it was not unusual for an executive who reached the top job to serve for decades. Jack Welch, the chairman and CEO of General Electric Co., held those jobs for 20 years by the time he retired last summer.

"But corporate boards and shareholders have become more demanding than ever. And the boom of the 1990s created a culture that celebrates the chief executive when all is well but paints a bull's-eye on his or her back when the numbers turn sour, as they have for many companies during the economic downturn.
...
"James Goodwin lost his job at United after a long struggle with union leaders, and a blunt warning to employees that the carrier was burning though money and could "perish" sometime next year. When his letter was made public, the stock price declined 25 percent over 10 days.

"In recent years, many other high-profile CEOs have seen their time in the corner office similarly cut short, after only a few years or less. Michael Bonsignore, CEO of Honeywell, left after a failed merger with GE. Lucent Technologies sacked CEO Richard McGinn after a series of failed acquisitions and some troublesome loans to vendors. Xerox fired Richard Thoman 13 months into the job, after an unsuccessfull realignment of the sales force.



I'm not being negative. This is the way the business world is. Top leaders are generally going to do what generates the most cash for themselves and their buddies. It's no more negative than the fact that people get old and die. It's part of life. You can interpret it as negative, but that's subjective.

I believe change can happen. For example, I would prefer a single-payer system with optional private health insurance (supplemental & backup) to create essentially a two tier system. This is how most industrialized countries manage their healthcare financing, and they cover everyone in their country, unlike the U.S. Much of the work in such a system could be outsourced to what is left of the health insurance industry under controlled margins (maybe a 3% processing fee instead of 30%). Why mess with a non-profit company at all? There are proven systems out there; let's use them instead of reinventing the wheel.

Also, even a non-profit can generate a profit in the sense of wages, paid consultants, sweetheart contracts, etc. For example, let's say that in a for-profit health insurance company, the top executives make around $50 million per year in compensation as a group and post a net profit of around $250 million. One way to turn this into a non-profit (conceptually; I'm not an accountant so don't quote me) is just to pay the executives and "consultants" $300 million and show no profit. If the health insurance company takes in $1 billion and spends $300 million figuring out how to deny claims per year, that leaves $400 million to actually pay physicians, hospitals, pharmacies, and the like for the ~300000 subscribers with a burden of $600 million essentially in waste. This is more extreme than what is going on (the real burden of a private health insurance is probably more like 30%), but you get the idea.

Going to health insurance companies for help is like going to the Hells Angels to provide daycare for your 2-year-old. They aren't interested in it except to the extent that they can make a fast buck (they'll take your money gladly but don't expect good or for that matter any care), and there are plenty of better options out there (starting with the gov't). Granted, I see them as a supplemental and backup to the gov't, but I would not use them as primary healthcare financiers.
 

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One of the major insurers here in ohio is a "non-profit". Ohio Health. They also own pretty much all of the hospitals of any size in ohio. "Non-profit" is just something they hide behind. The executives still get huge compensation packages, but there are no shareholders to worry about.
 

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One of the major insurers here in ohio is a "non-profit". Ohio Health. They also own pretty much all of the hospitals of any size in ohio. "Non-profit" is just something they hide behind. The executives still get huge compensation packages, but there are no shareholders to worry about.

Exactly, this is just a ruse. I think pre-meds or those with little background or experience in business think people in non-profits are angels. it is simply a way to get little old ladies and teens to give of their time while those at the top profit.

Hmm maybe I am becoming a little more cynical! :D:laugh:
 

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This is not a radical or new idea. Blue Cross Blue Shield of South Carolina is non-profit. Doctor's don't like it b/c compensation is so low but they have to accept it b/c so many patients are on it. Patients don't like it because of all the limitations. And like any insurance company that pays for nearly everything, the bureaucracy is huge causing costs to increase.
 

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This is actually the fuctioning principle behind Universal Single Payor Health Insurance. Check out this article of the proposition in Maine:
http://www.mainepeoplesalliance.org/healthcare/single_payer.html
The benefits go far beyond simple profit sharing, the organization could collectively bargain with hospitals and possibly, if congress will allow it, with prescription drug companies to reduce costs in that regards. The simplicity of the system would also generate a streamlined system which would expedite reimbursements. Now some medical stud's don't like this idea because they believe it will bring down the incomes of doctors, however I'm not quite certain on the reasoning behind it. Imagine a hospital in which all of the patients pay their bill, and on time nonetheless. We would have less crowding of the emergency room and could virtually do away with EMTALA because patients would be going to see their own doctors instead of the ER.


there needs to be competition.. all single payor will do is let the government and politicians rip us off with nowhere to turn.. BAd idea
 

OncoCaP

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there needs to be competition.. all single payor will do is let the government and politicians rip us off with nowhere to turn.. BAd idea

Maybe public education provides a model? Most people use the public education system, but there are also private schools that compete with them for students. However, without public education we would be a developing country instead of where we are today. We could similarly make progress with a two-tier system similar to our educational programs. This is similar to what we are seeing in Spain, for example, where private hospitals are being built to supplement the public ones and provide faster care for those who can afford it. Overall, the Spanish system is quite good and improving. The Danish, Swedish, Swiss, and Austrian healthcare systems also seem to be working very well (those are single-payer systems). Our mostly private system is broken.
 

EctopicFetus

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Maybe public education provides a model? Most people use the public education system, but there are also private schools that compete with them for students. However, without public education we would be a developing country instead of where we are today. We could similarly make progress with a two-tier system similar to our educational programs. This is similar to what we are seeing in Spain, for example, where private hospitals are being built to supplement the public ones and provide faster care for those who can afford it. Overall, the Spanish system is quite good and improving. The Danish, Swedish, Swiss, and Austrian healthcare systems also seem to be working very well (those are single-payer systems). Our mostly private system is broken.
Our system isnt any worse today than it was 20 years ago. Somehow we still survived. most people who dont have insurance can get it if they want. There are sacrifices that must be made to have a change to our system and I am afraid most people dont understand that basic concept.
 

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there needs to be competition.. all single payor will do is let the government and politicians rip us off with nowhere to turn.. BAd idea

Now I consider myself to be as cynical as the next guy but seriously, should our motive force be to avoid being ripped off by the government. And who are we anyways, doctors or american citizens? If you mean american citizens if you believe your not being ripped off in this healthcare system, not only are you not looking hard enough, I'm willing to bet you're not looking at all. If you mean doctors are being ripped off then I understand your concern that doctors compensation will go down but that issue is one that will be addressed by the broader medical community, by organizations and hospitals which have a serious amount of clout when speaking with a unified voice. The divisions which exist now would have to be broken as all medical professionals would have a like goal, and a like enemy(in the loosest definition you can imagine). Bad idea if your pulling in a family income of 100K with no kids and can afford quality health care already, good idea if your at 50K with 3 kids and can't afford to spend a quarter of your paycheck insuring you whole family.
 
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Nonprofit medical insurance companies; think about it. Currently, health insurance companies make hand-over-fist profits by raising premiums and lowering reimbursements. They even invest their earnings in the stock market and when their investments turn sour, guess who pays? Everyone does in terms of higher premiums and lower reimbursements. At the expense of patients and providers, health insurance companies operate solely for the benefit of increasing profits. It is wrong.

For the benefit of the people, our government must provide A TAX-FREE HAVEN FOR NONPROFIT MEDICAL INSURANCE COMPANIES. A tax free haven means that federal, state, and local government shall not collect any tax whatsoever (e.g. all expenses, property, utility etc.) from a nonprofit medical insurance company. To ensure nonprofit status, the companies must necessarily be subject to routine audits.

The solution works when we see that the money that would have gone towards profit (excess) will now be used to provide wider and healthier reimbursements (meaning shorter wait times at hospitals, better tests, longer face-to-face time with the doctor, more doctors in more places, etc.). The money that currently goes to various taxes – wage taxes, property taxes, sales taxes, all taxes – would be saved, allowing insurance premiums to decrease so that everyone can afford coverage: great coverage.

We, as a nation, do not need to be paying more taxes so that our government can supply everyone with healthcare. Furthermore, competition needs to exist. We also do not need to pay more taxes so that the government can give our money to for-profit medical insurance companies in order for them to provide “more affordable healthcare.” That is like being robbed twice. There is a lot of money that will pool into these nonprofit companies and the companies should provide their management and staff with very good salaries. This is advantageous because it will attract the best applicants as well as provide incentive for more nonprofit companies to start up and compete. This plan, our plan, is to keep the government’s and the fat cat profiteers’ hands off of the money that is meant for the healthcare of our nation.

That plan sounds good a priori, but can you really see that being enacted on a large scale? If there's money to be made, people will make it happen....especially in America. A big chunk of education in America is non-profit and people say it's sagging as well...leaving behind the millions who live in destitute areas. What you suggest is so naive.
 

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There are many non-profit insurance and HMO companies.

Just for the record.

Nonprofit medical insurance companies; think about it. Currently, health insurance companies make hand-over-fist profits by raising premiums and lowering reimbursements. They even invest their earnings in the stock market and when their investments turn sour, guess who pays? Everyone does in terms of higher premiums and lower reimbursements. At the expense of patients and providers, health insurance companies operate solely for the benefit of increasing profits. It is wrong.

For the benefit of the people, our government must provide A TAX-FREE HAVEN FOR NONPROFIT MEDICAL INSURANCE COMPANIES. A tax free haven means that federal, state, and local government shall not collect any tax whatsoever (e.g. all expenses, property, utility etc.) from a nonprofit medical insurance company. To ensure nonprofit status, the companies must necessarily be subject to routine audits.

The solution works when we see that the money that would have gone towards profit (excess) will now be used to provide wider and healthier reimbursements (meaning shorter wait times at hospitals, better tests, longer face-to-face time with the doctor, more doctors in more places, etc.). The money that currently goes to various taxes – wage taxes, property taxes, sales taxes, all taxes – would be saved, allowing insurance premiums to decrease so that everyone can afford coverage: great coverage.

We, as a nation, do not need to be paying more taxes so that our government can supply everyone with healthcare. Furthermore, competition needs to exist. We also do not need to pay more taxes so that the government can give our money to for-profit medical insurance companies in order for them to provide “more affordable healthcare.” That is like being robbed twice. There is a lot of money that will pool into these nonprofit companies and the companies should provide their management and staff with very good salaries. This is advantageous because it will attract the best applicants as well as provide incentive for more nonprofit companies to start up and compete. This plan, our plan, is to keep the government’s and the fat cat profiteers’ hands off of the money that is meant for the healthcare of our nation.
 

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Profits are often replaced by high pay for organizational leadership at non profits.

I think if the health insurance market were more competitive the insurance companies would be forced to compete with better reimbursements and lower premiums; an added advantage is that the very useful profit incentive would not be eliminated. One problem now is that insurance is primarily obtained through groups policies which tend to be hard to change and which shrink the individual insurance market. If the individually purchased health insurance market were bigger we would see far more competition between insurers as people shopped around for the best long term plans. Additionally people wouldn't feel stuck to a job because they can keep their coverage as long as they pay their premiums.

Profit is not the problem, it is the basis of economic incentive and thus efficiency. Without the profit incentive leadership pay would rise without as much regard to performance, providers would be allowed to bill whatever they choose, and attention will not be paid to the costs relative to the value of procedures and treatments. The problem is inefficient, sticky, hindered, and slow moving markets.
 

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What about limiting the number of hospitals that an insurance company could do business with in a given location? And what about limiting the number of hospitals in a given radius that could be linked by a unified system? If insurance companies couldn't saturate given places in the market, and hospitals couldn't dictate to patients what insurance they had to carry in a given area, would that not force competition? Is there some kind of legal way to bring this about? I'm new to the healthcare improvement game so forgive my ignorance.
 

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Maybe public education provides a model? Most people use the public education system, but there are also private schools that compete with them for students. However, without public education we would be a developing country instead of where we are today. We could similarly make progress with a two-tier system similar to our educational programs. This is similar to what we are seeing in Spain, for example, where private hospitals are being built to supplement the public ones and provide faster care for those who can afford it. Overall, the Spanish system is quite good and improving. The Danish, Swedish, Swiss, and Austrian healthcare systems also seem to be working very well (those are single-payer systems). Our mostly private system is broken.

Our "mostly private" system is almost 50% public, regulated heavily, and wasn't considered "broken" when it actually was mostly private in the 60s.
 

Miami_med

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What about limiting the number of hospitals that an insurance company could do business with in a given location? And what about limiting the number of hospitals in a given radius that could be linked by a unified system? If insurance companies couldn't saturate given places in the market, and hospitals couldn't dictate to patients what insurance they had to carry in a given area, would that not force competition? Is there some kind of legal way to bring this about? I'm new to the healthcare improvement game so forgive my ignorance.

That's dangerous. It would reduce competition, as there would be fewer insurance companies able to pay a particular hospital. It would instead set up little defacto perverse incentives with a particular insurance company sending all patients to a limited number of hospitals regardless of quality and not covering emergencies at other hospitals.
 

PriorityMed

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That's dangerous. It would reduce competition, as there would be fewer insurance companies able to pay a particular hospital. It would instead set up little defacto perverse incentives with a particular insurance company sending all patients to a limited number of hospitals regardless of quality and not covering emergencies at other hospitals.

Yeah, I guess that's the opposite of the effect that I was thinking it would have. How do you increase competition between insurance companies then?
 

Miami_med

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Yeah, I guess that's the opposite of the effect that I was thinking it would have. How do you increase competition between insurance companies then?

Deregulate the insurance industry to promote competition. Reduce artificial barriers to entry to the market. Deregulate hospitals, so that people can open viable competition, creating more competition within the market to increase quality. We should also get together at some point and create an insurer ourselves, where taking care of the patients and supporting doctors would be top priority, because the owners would be the doctors. Catastrophic coverage should also be promoted, lowering the cost of market entry for the consumer while simultaneously diminishing the amount of beauracracy that a company would need to implement in order to handle claims. Competition diminishes price and tends to increase salaries for skilled positions as people compete for a limited talent pool. Hospital competition would in and of itself minimize hospital profits and more evenly distribute medical dollars to physicians and others that those hospitals had to compete with.
 

mysterious.mr.x

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The problem with the suggestions above are that they do not solve the fundamental barriers in improving our healthcare system namely making healthcare equitable (I am not talking about access equality.) All these plans do is cost-shift without improving the fundamental value in Health. The fact remains that the US spends the most on health care because it can afford to spend the most (Health care is economically a luxury service see Newhouse et. al. 1977) What we need to focus on is making sure we get the most bang for our buck (arguably for the privleged few we do.) As some have suggested, competition in Health care is a GOOD thing, consolidating payers is only going to drive down value. This is the prime arguments of one of my idols Dr. Michael Porter. Check this out if you want to know more:

http://www.nihp.org/events/MARS/MARSKickoff/redefining%20competition.pdf

http://www.isc.hbs.edu/
 
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