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Thread: hospital cost shock

  1. #11
    Senior Member Oddity's Avatar
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    They are required to spend 85% of all premium revenue directly on reimbursements for medical services and products. Everything else comes from the remaining 15%. Most big payers run 10-12% operational costs with 3-5% profit; IF they are run well. Medicare is right about 10% operations cost, so there is no big efficiency bonus there. Costs need to be controlled where they are set. (Assuming you could do away with the entire cost of managing the provider/patient/payer process, by 'eliminating' insurance, that is barely $500Bn. There are estimates of up to $1.4Tn of non-medical related expenses in the entire industry right now. Everyone needs to take a haircut before we give anyone seconds IMO.)


    I posted a Forbes article, last year some time, that said (iirc) ~7 of the top 10 hospitals in the US were "non-profit" corporations in the year studied. Most of the $ was put back into building facilities. Many of which are minimally staffed, even less, at some. So much waste.



    Quote Originally Posted by Mize View Post
    Great point funklab. And remember, insurance companies have their "profit" capped at something like 5% of expenses...with battalions of executives and board members pulling in 7 figures. If we took insurers out of the healthcare equation it would pull nearly a trillion dollars off the cost of healthcare while still paying hospital executives their 7 figures.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

  2. #12
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    I still have my bill from when I got hurt 2001 it was a little over 100k. but I got my bill detailed right away I started challenging so far 6k also pill I was charge for I refused to take like anit reflux never have hd it

    some pill for bloody diarea did not tae anything but warfin an zidine <SP> iv they said I had no I did no stress test on 2 nope cancled same with urolgy bill they double charge so...

    it pays to go over it but 2k a day for a room that s wrong

  3. #13
    Quote Originally Posted by Mize View Post
    Great point funklab. And remember, insurance companies have their "profit" capped at something like 5% of expenses...with battalions of executives and board members pulling in 7 figures. If we took insurers out of the healthcare equation it would pull nearly a trillion dollars off the cost of healthcare while still paying hospital executives their 7 figures.
    I vote for this. And the only way to do that is a single payer system. I?ve been saying this for a decade, before it was cool to be socialist and want Medicare for all. It won?t happen in this country short of some kind of apocalyptic event like World War III but that doesn?t make it a bad idea.

  4. #14
    I am a supporter of the Medicare for All 2019 (HR 1384) bill proposed by Rep. Pramila Jayapal (D-Wash.) and 80 other sponsors in the House. Not a big supporter of Bernie's bill of the same name proposed in the Senate. I personally think that the title "Medicare of All" is unfortunate, as neither of these bills would in fact be Medicare, but a much improved universal health care single payor system which would include many important services not currently covered by Medicare, such as vision, hearing, long term care, etc.

    It is not "socialized medicine"...physicians and hospitals can still be in private practice and are not employees of or owned by the government. Health insurance companies would be closed down (there is even a feature in HR 1384 for job retraining for those who currently work in billing and the insurance industry). Prior authorization would be gone too...if your provider orders a medication, test, or procedure, it will be paid for. You can choose any physician you want, and go to any hospital or other provider you want as well. No copays, no deductibles. It would replace Medicaid and Medicare and does not require that you be employed. It will partially paid for by a payroll tax that will be significantly less than employers who provide health insurance for their employees have to pay now in premiums.

    You can get a lot more information here about this bill: https://www.healthcare-now.org/legislation/hr1384/

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  5. #15
    Senior Member pfcs49's Avatar
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    I have been saying we need a single payer system for a long time.
    I had a small business for 45 years and always provided 100% of their health insurance..........
    until ~2008 when my cost for a family of three with a Blue Cross/BS policy went from the current $18,300 a year to $22,000!!
    At the time McCaine was a candidate and saying that the average cost per family was $5,000/year!
    More than most, I really get how broken the current system is and how badly we need a huge paradigm shift.
    69yo male T12 complete since 1995
    NW NJ

  6. #16
    Senior Member Oddity's Avatar
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    It's a bad idea by virtue of it being a meaningless misdirection, back onto an industry that is the perhaps the least relevant contributor to the core issue with US healthcare (which is: doctors charge too much).

    A better next idea would be to give everyone the same haircut we already gave insurers: No markup, industry wide, more than 15%. 85% of the price, for every transaction, should be directly for covering the actual cost of medically necessary services or products.

    Without a fundamental shift in the nature of the provider/payer/patient transaction, nothing will change. A single payer won't change it. Where the money comes from won't change it. The heart of the entire industry: the fact it is a TRANSACTION in the first place, is the issue. The fact healthcare is transactional, and costs more than most people can afford, rests squarely on the provider side. Insurance would never have been invented if providers didn't want as much money as they could get in exchange for helping people.

    Pricing is the problem, not which (or how many) places pay the bill. The "insurance" part of the pricing equation is the best thing we have going for us; without it, we'd all be royally fucked by the provider side of the equation.


    Quote Originally Posted by funklab View Post
    I vote for this. And the only way to do that is a single payer system. I?ve been saying this for a decade, before it was cool to be socialist and want Medicare for all. It won?t happen in this country short of some kind of apocalyptic event like World War III but that doesn?t make it a bad idea.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

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