Interesting Health Care Poll

[Iwritecode]

Even before this bill there were some protections for people with pre-existing conditions. If you had insurance for 5 years or more, and needed to switch carriers due to a job or loss thereof, the new company couldn't deny you because of a pre-existing condition. What they could do is say if you were uninsured for 6 years, then developed diabeties and tried to get insurance to cover it, you were screwed. Like trying to buy a bullet proof vest after you have already been shot.

 

I don't understand the thinking behind that. I haven't had insurance for many years simply because we couldn't afford it. So because of that, I haven't been to the doctor for years. I'm worried to go get checked out for anything because if they find something then suddenly I have a pre-existing condition.

 

If I do have something and don't know it, does it count as a pre-existing condition?

[Texsox]

I don't understand the thinking behind that. I haven't had insurance for many years simply because we couldn't afford it. So because of that, I haven't been to the doctor for years. I'm worried to go get checked out for anything because if they find something then suddenly I have a pre-existing condition.

 

If I do have something and don't know it, does it count as a pre-existing condition?

 

 

Yes. No. It could be up to a judge to decide at some point. Hence the problem with the old system. An insurer could deny coverage, then you could gamble on an attorney to contest it.

[EvilMonkey]

5 years or more is way too long. What if you start a job and get laid off before 5 years? The protections should be much stronger than they are, and you can do that without the mandate.

I wasn't touting that as an end-all, just stating that there were some sort of pre-existing coverage in place before all this hype began. It is nto perfect, but it certainly covered the situation of people switching jobs. And the coverage didn't have to be continious with one company, just more or less 'continuous' as in you didn't take a few years off because you felt bullettproof. If you switched jobs every 2 years and had insurance at each, that worked.

[jasonxctf]

Insurance Profits up an average of 41% from 2009.

 

http://www.huffingtonpost.com/2010/11/10/h...-_n_781636.html

[Balta1701]

Insurance Profits up an average of 41% from 2009.

 

http://www.huffingtonpost.com/2010/11/10/h...-_n_781636.html

And the number of uninsured went up by 4 million compared to 2008.

[Y2HH]

Insurance Profits up an average of 41% from 2009.

 

http://www.huffingtonpost.com/2010/11/10/h...-_n_781636.html

 

While all true, the fact remains that health insurance profits are still the lowest in the industry, but nobody seems to care. I said early on in this thread that health insurance companies are raising premiums to price in the unexpected that will come from the reform laws (this report shows that), but once again, because the Health Insurance Lobby points out that their profits are far less than any other area of the industry, it's ignored.

 

They keep attacking the insurance companies because it's easy, but it's not resulting in much savings for the people (if any at all), and it won't until they start going after the other key areas of the industry, too, which continue to be ignored.

[Y2HH]

Oh, and I thought part of the reform was preventing insurance companies from raising rates unless they can justify why...

 

So much for that.

[jasonxctf]

i agree. the whole system is out of whack.

 

- doctors bill way too much

- hospitals charge way too much

- insurance companies are a gigantic nightmare

- lawsuit awards are way too high

- drug companies charge us citizens much more than other worldwide citizens for the same drugs

 

nursing home costs are insane too. My grandmother was being charged $9k/month at a Sunrise private nursing home facility. That was for everyting. Drugs, Room, Meals, etc. The caregivers, were only earning $16/hr.

 

For example, I've seen the financial statements for a for-profit hospital in the Chicagoland area. Do you think posting a 9.7% bottom line profit margin, is a bit steep?

[EvilMonkey]

My grandmother was being charged $9k/month at a Sunrise private nursing home facility. That was for everyting. Drugs, Room, Meals, etc. The caregivers, were only earning $16/hr.

ONLY? Is that not a living wage? Out of the $9k comes saleries, meds, insurance (a HUGE bill for them), the cost of the buildings and upkeep, food, etc. I know it isn't cheap. FYI, I used to have several Sunrise locations as customers, and was privy to some of the information on their balance sheets as we copied and distributed those for them. I DO recall that the insurance portions of their expenses seemed impossibly huge to me.

 

But I agree with the general premise of your post, I'm just sayin.

[Balta1701]

ONLY? Is that not a living wage?

That comes to approximately $33k per year on a 40 hour a week basis. That is a decent wage for an unskilled worker, but it's a poor wage if significant training or skills or experience are required.

[jasonxctf]

My point being, for someone to pay $81,000 a year, with the actual caregiver (who splits their time amongst 10-12 patients) getting $33,000 a year, there's a huge hole.

 

Now, I'm not picking on Sunrise. I know that they got hit with a huge accounting scandel a few years ago driving their share price down from $41/share to $4/share.

 

I'm sure the costs are similar, elsewhere.

[Controlled Chaos]

Oh, and I thought part of the reform was preventing insurance companies from raising rates unless they can justify why...

 

So much for that.

From my work...

BCBS PPO

Due to Health Care Reform and other factors, such as medical trend costs, claims experience,

etc., many employers are experiencing unprecedented rate increases (generally over 30%) for

2011, and we are no exception. Our initial BCBS plan renewal called for an overall rate increase

of 33%. Applying a portion of our current rate stabilization reserve balance and other plan

changes allowed us to reduce this cost to 23.8%.

 

 

[Iwritecode]

That comes to approximately $33k per year on a 40 hour a week basis. That is a decent wage for an unskilled worker, but it's a poor wage if significant training or skills or experience are required.

 

Actually it's closer to $31k per year assuming paid vacation time.

 

Sadly, that's not much lower than what I was making at my last job after 11 years.

[jasonxctf]

From my work...

BCBS PPO

Due to Health Care Reform and other factors, such as medical trend costs, claims experience,

etc., many employers are experiencing unprecedented rate increases (generally over 30%) for

2011, and we are no exception. Our initial BCBS plan renewal called for an overall rate increase

of 33%. Applying a portion of our current rate stabilization reserve balance and other plan

changes allowed us to reduce this cost to 23.8%.

 

and that doesn't surprise me. We want to eat unhealthy, not exercise, smoke/drink/do drugs and have the best medical care in the world, all without paying for it.

[Jenksismyhero]

i agree. the whole system is out of whack.

 

- doctors bill way too much

- hospitals charge way too much

- insurance companies are a gigantic nightmare

- lawsuit awards are way too high

- drug companies charge us citizens much more than other worldwide citizens for the same drugs

 

nursing home costs are insane too. My grandmother was being charged $9k/month at a Sunrise private nursing home facility. That was for everyting. Drugs, Room, Meals, etc. The caregivers, were only earning $16/hr.

 

For example, I've seen the financial statements for a for-profit hospital in the Chicagoland area. Do you think posting a 9.7% bottom line profit margin, is a bit steep?

 

Ya know, I feel I have to defend my craft here a bit. While there are SOME cases where the rewards are out of whack, the numbers that people get on settlements or even verdicts (less so) aren't just made up figures.

 

For example, if you get into MVA and have just soft tissues injuries, you're looking at 5k minimum in healthcare costs. Few thousand for the hospital, doctor, radiology, etc, 4-500 for your couple of follow up appointments. That case gets settled for a max of about 1500 bucks more than the medical bills for "pain and suffering." Take that basic case and extend it out, and that's what it is. The bills get higher, but the percentage of the settlement for pain/suffering and whatnot doesn't really go up.

 

Once you bring in loss of income (or god forbid loss of life), that's when you see the big awards, but id' say 95% of the time it's justified. It's a system that requires evidence (because despite people claiming their owed a zillion dollars, the other side doesn't want to pay a dime, so they're going to fight whatever you're demanding), so you can't very well make up something that's not true. And while juries sometime go overboard, more often than not those awards get lessened on appeal.

 

Lawsuits aren't really the problem in my opinion. It's the crazy billing.

 

 

 

[Balta1701]

Lawsuits aren't really the problem in my opinion. It's the crazy billing.

Another part is that we actually have a ridiculously high rate of actual malpractice in the first place.

[StrangeSox]

Ya know, I feel I have to defend my craft here a bit. While there are SOME cases where the rewards are out of whack, the numbers that people get on settlements or even verdicts (less so) aren't just made up figures.

 

For example, if you get into MVA and have just soft tissues injuries, you're looking at 5k minimum in healthcare costs. Few thousand for the hospital, doctor, radiology, etc, 4-500 for your couple of follow up appointments. That case gets settled for a max of about 1500 bucks more than the medical bills for "pain and suffering." Take that basic case and extend it out, and that's what it is. The bills get higher, but the percentage of the settlement for pain/suffering and whatnot doesn't really go up.

 

Once you bring in loss of income (or god forbid loss of life), that's when you see the big awards, but id' say 95% of the time it's justified. It's a system that requires evidence (because despite people claiming their owed a zillion dollars, the other side doesn't want to pay a dime, so they're going to fight whatever you're demanding), so you can't very well make up something that's not true. And while juries sometime go overboard, more often than not those awards get lessened on appeal.

 

Lawsuits aren't really the problem in my opinion. It's the crazy billing.

 

Yes.

 

Tort reform to limit the amount of damages limits the amount of compensation for actual, legitimate victims of malpractice. Aside from not really affecting overall health costs anyway (study after study show fractions of a percent), we're punishing the victims and protecting bad doctors.

 

Another part is that we actually have a ridiculously high rate of actual malpractice in the first place.

 

Also this.

[lostfan]

Ya know, I feel I have to defend my craft here a bit. While there are SOME cases where the rewards are out of whack, the numbers that people get on settlements or even verdicts (less so) aren't just made up figures.

 

For example, if you get into MVA and have just soft tissues injuries, you're looking at 5k minimum in healthcare costs. Few thousand for the hospital, doctor, radiology, etc, 4-500 for your couple of follow up appointments. That case gets settled for a max of about 1500 bucks more than the medical bills for "pain and suffering." Take that basic case and extend it out, and that's what it is. The bills get higher, but the percentage of the settlement for pain/suffering and whatnot doesn't really go up.

 

Once you bring in loss of income (or god forbid loss of life), that's when you see the big awards, but id' say 95% of the time it's justified. It's a system that requires evidence (because despite people claiming their owed a zillion dollars, the other side doesn't want to pay a dime, so they're going to fight whatever you're demanding), so you can't very well make up something that's not true. And while juries sometime go overboard, more often than not those awards get lessened on appeal.

 

Lawsuits aren't really the problem in my opinion. It's the crazy billing.

You won't get a whole lot of resistance from the left on this... FWIW. They're pretty used to trying to debunk claims that tort reform is a magic bullet.