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I’m a former health insurance CEO and this is what Obamacare repeal will do

Discussion in 'Politics Forum (Local/National/World)' started by Scorpio, Jan 3, 2017.



  1. ErrosionOfAccord

    ErrosionOfAccord #1 Global Warmer Gold Chaser Site Supporter ++

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    In addition.
    The hospital is one of my employers Centers of Excellence. In essence they cover meals, lodging and travel to the COE's for the caretaker and patient. Why would my employer provide a COE? It is claimed that they are the best facilities in the area, which may or may not be true. For cancer they will allow the Mayo Clinic. For fusions, it allows for Salt Lake City, Denver and Billing. I looked up the ratings for the places I could go for my procedure and they were kind of ho hum so I don't think excellence fits into the COE equation. What does fit is contract medicine wherein, the employer has a contract with certain facilities for a lower set price regarding certain procedures. I.E. I received fair treatment, the company got a discount and paid me to travel and lodge at their low cost provider. It's just a theory but I think I'm pretty close to the mark.
     
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  2. slackercruster

    slackercruster Seeker Seeker

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    Healthcare system we have in the US is broken. It will only keep spiraling out of control. Once healthcare turned into big biz it was put on a trajectory for destroying the ability of the average person paying for healthcare out of pocket.

    A 2 tier system, one for the rich as a fee for service and one for the average person that is gov supplied - aka socialized healthcare is the only way you can do it. The rich can have whatever they want and the poor can still get some healthcare. Socialized med wont be as good as rich med, but it can be doable. If you don't like it, get 3 jobs and pay for the rich healthcare.

    Socialized education is has served us for ages. The cost is in the RE taxes and even if you have no kids you end up chipping in. If you don't want to use the socialized education system then you can pay for private school. This is how the healthcare should be.

    Really, socialized med is hard to promote in the US. We are a capitalist country. The greedy special interests and rich will tear it down as communism. The only way it would work is to have a 2 tier system. The rich can pay for the best if they don't want socialized med. The average person can use the socialized plan. But you can never have success if you force the average person to pretend they are rich and force a high cost, unaffordable health plan on them.

    It is no different than having a high earner and a low earner in a marriage. You either live to the budget that is double of the lower earner if you want to split expenses down the middle or the high earner has to pay for the bulk of it if they want to live on a higher level. You can't force a low earner to be a high earner if it is not in them.

    Medicine prices started to skyrocket once the greedy learned they can hike up medicine costs by astounding percentages. They can hold the chronically ill by ransom...it is pay up or die. There is nothing wrong with that is there? This is textbook material on how a good capitalist should work. Get the highest price the market will bear for the product. If a pill cost .35 cents to make, why not mark it up to $1000 a pill? If an insurance company will pay for it why not $5,000 a pill? There is no law against making profits...
     
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  3. Joe King

    Joe King Gold Member Gold Chaser

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    I focus on the amount billed because by them massively overcharging it requres anyone seeking services to have to have insurance to cover it.
    If they want to play games with the billing, they should have a reasonable rate that's only for cash paying customers that only covers the services that person received.
    ...and have a different higher amount they use to play their games with the insurance companies and medicare.
     
  4. Joe King

    Joe King Gold Member Gold Chaser

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    The only problem with that is a little thing called the Hippocratic oath that Doctors take.

    Reposted from post #105

    Do plumbers take an oath that states they have a special obligation to their fellow human beings and patients? Do they take an oath that takes into account their "customers" economic stability?
    Doctors do take such an oath......and then immediately break it by colluding with the insurance companies to fleece their patients. They didn't use to do that, but once healthcare came to be seen as a cash cow for making obscene profits they certainly do.

    To charge $1000 for a .35cent pill is NOT having their patients best interest at heart. That's having their own best interests at heart.
     
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  5. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Joe my experience has shown that those without insurance don't pay the billed insurance price nor are they charged that so your argument is on shakey ground.


    Secondly, part of the idea behind group contract amounts/discounts has to do with volume. If BCBS can tell a facility that it has 25,000 patients that will use you facility, said facility will offer discounts knowing they have a huge client base. Similar to the company that buys 10,000 bolts for 25 cents each despite the fact that average Joe that comes in and buys 2 gets billed $1 each. Do you support that practice, cause it really is the same thing.
     
  6. Irons

    Irons Deep Sixed Site Supporter Mother Lode

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    %#@$*& Rand Paul get with the program. Idiot.


    BREAKING: U.S. Senate Approves Measure Launching Obamacare Repeal Process

    Ryan Saavedra Jan 12th, 2017 1:34 am 23 Comments

    [​IMG]
    The Beginning Of The End For Obamacare
    The U.S. Senate on Thursday took the first major step toward dismantling Obamacare, voting at 1:30 a.m. to instruct key committees to draft legislation repealing President Barack Obama’s disastrous health insurance program.

    The vote was 51-48. The resolution now goes to the House of Representatives, which is expected to vote on it this week. Ending Obamacare is one of the top priorities for the Republican party which has seen a major resurgence in the wake of a President that is falling apart as he nears his last day in office in just 8 days.

    From Reuters:

    Republicans have said that the process of repealing Obamacare could take months, and developing a replacement plan could take longer. But they are under pressure from Trump to act fast; he said on Wednesday that the repeal and replacement should happen “essentially simultaneously.“…

    …Republicans have launched repeated legal and legislative efforts to unravel the law, criticizing it as government overreach. They say they want to replace it by giving states, not the federal government, more control.

    The resolution approved Thursday instructs committees of the House and Senate to draft repeal legislation by a target date of January 27. Both chambers will then need to approve the resulting legislation before any repeal goes into effect.

    Senate Republicans are using special budget procedures that allow them to repeal Obamacare by a simple majority; this way they don’t need Democratic votes. Republicans have a majority of 52 votes in the 100-seat Senate; one Republican, Senator Rand Paul, voted no on Thursday.

    But Republicans say the system is not working. The average Obamacare premium is set to rise 25 percent in 2017.

    We are putting in place the tools necessary to keep our promise to repeal #Obamacare. pic.twitter.com/JQdkqx5dQQ

    — Paul Ryan (@SpeakerRyan) January 12, 2017



    As we repeal Obamacare, we would be wise to vote on its replacement at the same time. Read more: https://t.co/VCFqSBnfYZ pic.twitter.com/GSpZhlsL8h

    — Senator Rand Paul (@RandPaul) January 12, 2017



     
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  7. andial

    andial Sir Midas Member Site Supporter

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    WTF is with Rand Paul? if it's not one repulican sabatoging you it's another.
     
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  8. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    http://www.vanityfair.com/news/2017/01/rand-paul-obamacare-repeal

    I know vanity fair.com....

    Paul voted no because at the time there is no suitable replacement. Repeal and delay is a kick the can down the road. The whole situation is a quagmire.

    From the article, Trump supported Paul's vote.

    Essentially, we have a damn that is being plugged by a little boys thumb. That ain't gonna cut it long term. But pulling his thumb out and hoping to patch the damn in 3-4 years ain't even a solution near term.
     
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  9. Irons

    Irons Deep Sixed Site Supporter Mother Lode

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    As we repeal Obamacare, we would be wise to vote on its replacement at the same time. Read more: https://t.co/VCFqSBnfYZ pic.twitter.com/GSpZhlsL8h

    — Senator Rand Paul (@RandPaul) January 12, 2017

    We don't want it replaced Mr Paul, thanks for paying attention for the past 7 years. Your party is just as capable of totally fucking up everything it touches as the democrats are. Maybe even more so.
    Your instructions are and have been simple. Get rid of it.
    .
     
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  10. Joe King

    Joe King Gold Member Gold Chaser

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    As has been already posted, it's illegal for them to charge cash paying customers a lower price than that billed to an insurance company for equal treatment.
    ...and after you've been billed, the best you'll get is a 10% discount on a bill that was 500% too high to begin with.


    As I already posted several times, but it keeps getting ignored, there is a little thing called a Hippocratic Oath that Doctors take, in which they vow to take into account their patients financial well being. What other industry does that?
    Hence, healthcare is different.



    F' that. Put me in there and first day I'd get rid of it and sign an EO rescinding all other EO's from their inception. As if they never existed. That's what we need to have happen.



    We don't need a replacement. There's enough socialism in this nation as it is. Last thing we need is more of it. What we need is a system that forces providers to charge prices their customers can actually afford to pay.
     
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  11. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    I have never seen an EOB that was 500% higher then the contracted assigned amount for an office visits, minor procedure or significant procedure.
     
  12. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Repeal with out replacement is not an option when facilities are required to treat. Remove that mandate and move to a practice of facilities providing service based on your ability to pay wether via insurance, Medicare/Medicaid, or proof of cash bond and you will see people's priorities start to straighten out.
     
  13. Joe King

    Joe King Gold Member Gold Chaser

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    In reality it's probably more like 1000% higher. Surgery center in OKC bills a tenth of the price the regular hospital charges.



    They are not required to give equal treatment, but rather are only required to stabilize the patient. Ie: make sure they don't die right then, not give million dollar treatment.
     
  14. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    But here is the rub....

    My mom worked in OB. She said her hospital "wrote off" almost $200k A MONTH in unclaimed OB charges associated with deliveries (mostly white girls knocked up by illegal Mexicans but I digress).

    Now we all know they did not write if $200k. They padded the bills of paying patients to make up the difference.

    So now what do we do? Tell the non-paying mom to go to the barn and have her kid in the pen next to the pigs? I know tge smart ass answer is keep your legs closed and don't have kids, but that really ain't solving the issue.

    I really don't have any answers unfortunately.
     
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  15. andial

    andial Sir Midas Member Site Supporter

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    Why aren't the demoscums being called out by fag republicans to come up with some "replace" ideas it was them who supposedly gave a shit about health care now no help?
     
  16. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Jk I can show you umpteen thousands of my EOBs. Surgeon bills $1200. Actual amount paid is about $650. Facility charge us $13k but amount paid is around $6000. Anesthesiologist bills $500 but paid $300. Office visit billed at $125, paid $90. I can go on and on. I got a whole stack I can quote from experience. Even the RX is not on the scale of 500%
     
  17. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Charge prices that people can pay? From each according to ability to each according to ability. Sound familiar?

    And f the H-oath. This is and will alwYs be a pay to play world.
     
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  18. GOLDBRIX

    GOLDBRIX God,Donald Trump,most in GIM2 I Trust. OTHERS-meh Site Supporter Platinum Bling

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    DAMN ! DAM ? WRONG DAMN DAM. :gracious:
     
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  19. Joe King

    Joe King Gold Member Gold Chaser

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    Who's saying they all have to charge the same? They can charge whatever they want, but if they charge too much, they'll go out of business.

    My point on this is that seeing as they do take that oath, they should abide by it. Otherwise they are just blowing smoke up our collective hind quarters. Can't have it both ways. Hippocratic oath is what makes healthcare different than all other types of capital venture.
     
  20. GOLDBRIX

    GOLDBRIX God,Donald Trump,most in GIM2 I Trust. OTHERS-meh Site Supporter Platinum Bling

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    I know of NO Hospital Administrator that takes the Hippocratic oath. Those that are doctors have their PHd outside of Medicine or quit practicing medicine long ago.
     
  21. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Chick or egg?

    I sat in a meeting with the CEO of our local hospital. He said prices could be cut by over 60% if 100% of clients paid their bills. So he admits that the new bill for paying clients is pushed upwards because of leeches, which creates a vicious catch 22 of increasing prices as more people quit paying. But even with a 60% price reduction, i guarantee huge numbers of non-paying clients.

    Now define stablilizing a patient? My brother is a paramedic in a mid/major sized city. He personally responds to 5-7 GSWs each month that require emergency surgery just to stabilize. Numerous knife attacks, numerous drug ODs. Numerous traumatic car accidents. All requiring fairly expensive stabilizing treatments and all that somehow happen to people that can't pay bill. So what happens? the druggie and gang banger's bill get pushed on to everyone else and all that was done was stabilized the guy/gal with emergency surgery at $15-$30K a crack. I jokingly tell my brother that they need to drive slower and take a much longer route.

    And don't get me started on Medicare and end of life care that pays way below market. YOu know damn (did i use it write this time,lol) good and well that other payers and subsidizing the low reimbursements that Medicare pays.
     
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  22. Uglytruth

    Uglytruth Gold Member Gold Chaser

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    THE UNKNOWN; If prices were reduced 60% how many could afford healthcare then? How many would NOT BE IN MEDICAL BILL TROUBLE? How many would just pay the bill.
    How many would have a catastrophic policy with a 10K or 20K deductible. How many companies would self insure with a catastrophic policy as backup?

    What came first the gouging by healthcare companies that are in it to profit or it being so expensive no one can afford it?
    It's like gas prices. At $4.50 a gallon the economy all but stopped. At $2 a gallon life moves on.

    I really hate the write this without more thought but go ahead and pick it apart. Why not something simple. IF PRICING WAS SIMPLE AND FAIR.
    Like a law that says medical services rendered will be paid in full or by a payment plan at a set 5% interest or paid by insurance or a automatic lien is placed against titled assets, bank accounts, wages etc.....
    Not perfect but it would reduce the free loaders. But might cause a problem like student loan debt.

    We would not be in this place except for govt messing around with wage freezes but not benefits freezes during the 30's or 40's.

    Watch Antique Road Show all the time people say my grandfather was a Dr. and was paid with this item. Why do we need an army of paid collectors between the patient and the Dr?
     
    Last edited: Jan 12, 2017
  23. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Do you not read the news stories? 69% of people have less then $1000 in savings, so with that in mind how would a $10K or $20K deductible make a difference?

    http://www.forbes.com/sites/niallmc...han-1000-in-savings-infographic/#54ad6af291ee

    Sometimes I think the group mindthink of GIM gets us thinking that everyone shares a similar ideology on most everything including the value of saving money. Truth is GIM represent only a small fraction of the American hivemind. While many here could manage a $10K deductible I assure the vast majority of people that don't visit this site never could.
     
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  24. Usury

    Usury Gold Chaser Platinum Bling

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    Well that's what they're getting on an ACA policy today. The deductibles and out of pocket amounts are ridiculous compared to the premiums charged.
     
  25. southfork

    southfork Mother Lode Found Mother Lode

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    Will they lay off the tens of thousands of .gov workers they hired to administer oatsamacare? That alone will save a fortune, but alas as we all know rates will never go back to pre oatsama care rates just like taxes never go down
     
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  26. the_shootist

    the_shootist I self identify as a black '69 Camaro Midas Member Site Supporter ++

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    8 days left before we're finally rid of the gay Halfrican Chia Pet

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  27. Uglytruth

    Uglytruth Gold Member Gold Chaser

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    AND COUNTING!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!:2 thumbs up:
     
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  28. CrimsonGuardJay

    CrimsonGuardJay Silver Member Silver Miner

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    Yes I know, I'm just saying, the "parts and labor" cost couldn't possibly be more than that. It's sick how padded bills have become because THEY CAN.
     
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  29. the_shootist

    the_shootist I self identify as a black '69 Camaro Midas Member Site Supporter ++

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    Thanks to the Big Bear for posting the Countdown to TEOTWAWKI on the site!

    Very kewl!!!
     
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  30. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    I have a novel solution...medical debt prison. For every $1000 you welch on equals 6 months time served. No early release for good behavior.
     
  31. searcher

    searcher Mother Lode Found Site Supporter ++ Mother Lode

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    'We're going to have insurance for everybody': Trump heralds GOP's Obamacare alternative as Rand Paul reveals it will focus on low-cost policies
    • President-elect Donald Trump revealed new health care plan will cover everyone
    • Trump has said repealing Obamacare will be the first thing he does as president
    • Senator Rand Paul said the bill will cover the most amount of people at low costs
    • Trump said he will also target pharmaceutical companies to lower drug prices
    • Senator Bernie Sanders and Kamala Harris have led protests across the country to save the Affordable Care Act


    Read more: http://www.dailymail.co.uk/news/article-4123456/Donald-Trump-says-new-health-care-plan-insurance-access-everyone.html#ixzz4VvGdy38z
    Follow us: @MailOnline on Twitter | DailyMail on Facebook
     
  32. Rusty Shackelford

    Rusty Shackelford Midas Member Midas Member

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    Searcher,

    On drug companies. Is it reasonable to have a bill requiring all drug manufactures that sell RX in the US to be required to offer their product in the US at the lowest cost they provide to any other developed nation?

    What about $0 RX for Americans that the RX has any amount of government funds tied up in its development until .gov has been paid back the amount money used on R&D?
     
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  33. searcher

    searcher Mother Lode Found Site Supporter ++ Mother Lode

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    Yes to both questions.

    As for my own personal beliefs:

    I feel that every American citizen should have the same exact health care that our elected officials have and I believe it should be paid for the same way our elected officials health care is paid for. Why should any human being who begs other human beings to elect him into a position of power have any better health care than the very people who they beg to put them into office? Does being voted into office some how make them any better than the people who voted for them? Does being elected into office make them any more deserving of health care than the people who voted for them? Not in my opinion.

    Something is drastically wrong when someone can beg you to vote them into a position where they can vote themselves bookoo bucks for pay and super duper health care and then turn around and literally shit all over those who put them into office. When our bought and paid for elected ones voted to give us the ACA they literally shit on everyone in this country while exempting themselves and their underlings from what they knew was a royal screwing of the American citizenry. How does that work? In my opinion what they did was treason. They literally sold us down the drain to big business.

    Hopefully Trump and his peeps will get us outta this health care nightmare. I'm looking forward to seeing what they actually come up with.
     
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  34. Professur

    Professur Midas Member Midas Member Site Supporter ++

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    I'm still seeing Homer and those 2 aliens.
     
  35. Joe King

    Joe King Gold Member Gold Chaser

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    Exactly.
    If I had my way, anyone who actually wants (or pursues getting) the job of Senator/Congressman/POTUS would not be permitted to hold the office. Rather, those positions would be filled from a list of randomly selected people from the populace that is then voted on by the People. The winners have to do the job and are told if they do a good job, they'll only have to do it for four years. If they screw up, it'll be eight years. lol
    Ie: treat it akin to jury duty where you typically end up with people who don't want to be there and who are looking to fulfill the duty as quickly and as efficiently as possible so they can get back to the business of their own lives sooner.
     
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  36. Howdy

    Howdy Silver Member Silver Miner

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    A random selection couldn't possibly be any worse than what we have had in the last 3 decades.
     
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  37. Uglytruth

    Uglytruth Gold Member Gold Chaser

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    You mean "random" like the F job bernie got?
     
  38. Usury

    Usury Gold Chaser Platinum Bling

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    That's the irony....nobody worth doing the job well would have it to begin with. There was a reason that originally it was viewed by the founders as a burden, but also a duty and responsibility.
     
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  39. Usury

    Usury Gold Chaser Platinum Bling

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    Just had a frustrating realization. I've often said medical care is the only business where you go to an "expert" to be treated with no idea what you are going to have to pay them as they can charge you whatever they want, with no up front notice or acknowledgment and then can sue you into bankruptcy if you don't/can't pay. It now just dawned on me that a lot of software vendors (especially business software) fall into that same group. They over-promise, under-deliver and want to charge X $100 per hour to "fix" all the stuff that should work right out of the box, with no real commitment on either the cost or time-frame to make it right.

    Where's the Affordable Software Act?

    /rant off/
     

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