Health Care Thread

Vaclav

Vaclav

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Xequecal_sl said:
The fact is that 60% administrative costs got you insurance a lot cheaper than you would have had to pay for it otherwise. Those auditors and lawyers wouldn't have been hired if they didn't save the company more than the company had to pay them in salary, and 3-5% profit margin means those savings were necessarily being passed to the consumer. It kind of sucks that the doctors/hospitals have to deal with the fallout but the consumer doesn't see this aspect. In addition, I can't see how these auditors can be all that detrimental. They force the doctors, pharma companies, and medical supply companies to keep costs down if they want stay in business. Besides, there's a limit to how much the insurance companies can shortchange the doctors. If they do it too much, the doctors will go broke. If that happens, their plan is now worthless and nobody will buy it, because there's no doctors left on it for their customers to go to.
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There's been dozens of reports that say otherwise and none that share your "facts" that I'm aware - including just watching the trends on pharmaceuticals before and after insurance got involved with covering pharmaceuticals in healthcare plans. (You know those ridiculous markups you talk about? Pharmaceuticals have demonstrated similar spiraling, but yet used to be quite cheap back in the 50's even for the equivalent name brand meds before insurance got involved in the equation - almost completely in line with the increases in administrative costs. And of course note that again on pharmaceuticals since it's an easy part of the formula to note: in the EU where their adminstrative costs are a fraction of ours, their pharma costs are also in line with that. [And before the "b-b-but the FDA costs" argument - England is nearly as expensive, (less on direct costs to the health ministry, but require a much higher paid test group for a longer duration, but the application costs are lower - but manpower actually costs more - only thing that keeps us more expensive and only slightly at that is when a drug manufacturer gets sued hard, which is a rarity - additionally England doesn't charge for REAPPLICATION for the rare drug that fails it's first trials whereas the FDA does) and almost all of them compile the same costs between places for the initial costs - it's largely buttressing because of the screwed up way US insurance works by every estimation including those that the FDA and DoH have done here]
 
Vaclav

Vaclav

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Medicare D isn't Medicare and it was something added by Republican request that wasn't in the compromised final ACA. So grats on believing Hot Air which often completely distorts shit?

Medicare D is planned to sunset anyhow and isn't "increasingly popular" either, enrollments have been negative since 2009. And SSA doesn't even provide info on it for years now.

It's a bad program that needs to die, the only bad thing to me is that they're trying to scale it back if anything it should sunset sooner.
 
fanaskin

fanaskin

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medicare advantage is medicare part D? . where did you see part D even mentioned?
Medicare Advantage (MA) is a United States health insurance program of managed health care (Preferred Provider Organization(PPO) or Health maintenance organization(HMO)) that serves as a substitute for "Original Medicare" Parts A and B Medicare benefits.
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Skanda

Skanda

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I click that Hot Air link, look to the right at their latest "articles" and realize it's just some conservative version of The Onion because those headlines sure as hell can't be serious.
 
Skanda

Skanda

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Well, to be fair I read your posts pretty much as the Rerolled version of The Onion so I guess I should have expected as much from any link you posted.
 
fanaskin

fanaskin

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what was factually incorrect, because yeah the world is complex to disagreeing with narrative or interpretation is expected but the onion is specifically factually incorrect.
 
Skanda

Skanda

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I'm sorry. You seem to have mistaken me as someone interested in engaging in debate with you. I'm here to laugh at the sideshow, not speak with the clowns.
 
Vaclav

Vaclav

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fanaskin_sl said:
medicare advantage is medicare part D? . where did you see part D even mentioned?
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Medicare Advantage is the problem part of Part D. And that's where a large money hole in Medicare currently is. A/B (Called C for Medicare Advantage) parts of Medicare Advantage are operating pretty much as expected (although worse than Medicare proper) - but the D part is posting terrible losses with terrible service on top of it. If Medicare Advantage was C only it wouldn't be much of an issue - nor would Part D be much of a problem overall without the Medicare Advantage issue with it. [Medicare Advantage costs the Fed more than Part D in how much they subsidize it per person, while it costs the consumer more and generally provides no greater benefit on RX costs - the C operates well though, if the restrictive networks to most work out for the consumer, but again usually at a much higher cost than the $105/mo Medicare normally costs]

But technically I brainfarted earlier - I did mean to state C, was on my smartphone sitting around waiting for a traffic cop to come because I had just had an accident. C vs. D is an easy error to make when you're post-accident, no?

[First accident since I was a teenager too - about 20 years or so without an accident was a good run I guess...]
 
Xequecal

Xequecal

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Vaclav_sl said:
There's been dozens of reports that say otherwise and none that share your "facts" that I'm aware - including just watching the trends on pharmaceuticals before and after insurance got involved with covering pharmaceuticals in healthcare plans. (You know those ridiculous markups you talk about? Pharmaceuticals have demonstrated similar spiraling, but yet used to be quite cheap back in the 50's even for the equivalent name brand meds before insurance got involved in the equation - almost completely in line with the increases in administrative costs. And of course note that again on pharmaceuticals since it's an easy part of the formula to note: in the EU where their adminstrative costs are a fraction of ours, their pharma costs are also in line with that. [And before the "b-b-but the FDA costs" argument - England is nearly as expensive, (less on direct costs to the health ministry, but require a much higher paid test group for a longer duration, but the application costs are lower - but manpower actually costs more - only thing that keeps us more expensive and only slightly at that is when a drug manufacturer gets sued hard, which is a rarity - additionally England doesn't charge for REAPPLICATION for the rare drug that fails it's first trials whereas the FDA does) and almost all of them compile the same costs between places for the initial costs - it's largely buttressing because of the screwed up way US insurance works by every estimation including those that the FDA and DoH have done here]
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The point is that the 80/20 rule has been implemented without any other fundamental changes in how the system works. Insurance was at 3-5% profit without being hamstrung by it, with it they must raise prices.

You'd hope that increased payments to doctors would let them expand and offer better care, but all the extra money is just going to get soaked up by pharma and medical supply companies raising the prices on their monopoly or vendor locked-in products because they know the hospitals have more money now.

Tell me, why did the costs on employer- run group plans go up so much? Every major employer is complaining about it and obama has bern forced to delay implementation of the mandate twice now. It was already illegal for these plan to discriminate based on pre existing conditions, so that can't be it. The 80/20 rule is the prime culprit here.
 
Vaclav

Vaclav

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Employer-run plans went up quite a bit recently because of the fact that they were LOCKED for the past few years - the actual rate that they went up this year was HALF the expected rate it should've increased.

They were projected to go up 4% a year over the past few years and this years rise (which covers MULTIPLE YEARS of being locked) was just over 2.5% per year or so roughly half of what the projection had been.

The other side of things is that many employer based plans are going out of their way to CHANGE THEIR COMPENSATION amount to make things look worse to their employees changing a 60% that they cover of insurance to 30% or whatever else.

But when it comes to the total cost of employer-based plans the rate is much less than what it was projected to be without the ACA interfering. But sure, any marginal increase per year is going to look substantial when it's locked in place for multiple years and then the lock comes off.
 
Vaclav

Vaclav

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Big Phoenix_sl said:
Why did Obama push back the employer mandate a full year?
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He didn't, the Director of the division did. Obama just put his stamp of approval on it (not that it was needed, but Directors often do like the President to agree since he's the one that can replace them...).

And apparently they didn't like how the numbers were going to work out, that's a large part of what the Director is supposed to do - adjust things as needed to make the numbers work best.
 
M

Merlin_sl

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Vaclav_sl said:
He didn't, the Director of the division did. Obama just put his stamp of approval on it (not that it was needed, but Directors often do like the President to agree since he's the one that can replace them...).

And apparently they didn't like how the numbers were going to work out, that's a large part of what the Director is supposed to do - adjust things as needed to make the numbers work best.
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Yea I'm sure Obama didn't know. Poor guy. He's the most misinformed president of out time. He never knows anything until he hears it in the news.

IRS, didn't know.
Benghazi, didn't know
Fast and Furious, didn't know
General Services Administration, had no idea
Solyndra, no idea green companies not going so well
 
Vaclav

Vaclav

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Stamp of approval = not aware.... O.....K....

All I meant was that the buck stops with the Director - if Obama wanted it and the Director was opposed it wouldn't happen, and v.v. if the Director wanted it and Obama didn't it would still happen. They were both on the same page, but the decision was ultimately the Director's to make.
 
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