Thread: And We Thunk the Republican Party Was Collapsing One Year Ago!

Individual health-care premiums to soar up to 60% | Physicians for a National Health Program

insurance premiums going up 60% for individual policy owners and with more employers no longer offering health insurance in efforts to curb their overhead, there is no hope for the middle class to purchase their own policies once their company abandons them in this area.

Originally Posted by bandaidwoman

medicare and private medical insurance is not a good way of looking at the differences between private and government.

Medicare pays me in two weeks, no less, private insurance pays me on average in three months.
I spend 33-50 dollars on paperwork ( hiring office staff) for every 100 dollars private insurance pays me, I spend 3 dollars for every 100 dollars medicare pays me, for the record 1/3 of my private carriers pay me less than Medicare allowable and I have had to fire 4 private carriers since none of them paid me in 1 year. ( I made more seeing medicaid since they paid me something) . So let's not go down that road. We have four doctors and 45 employees, most of them to deal with paperwork crap by the private insurers.

The free market does not apply to private insurance. When there is less demand, they raise their prices, unlike other businesses.... wellpoint blue cross just increased theire premiums 39% on individual policies due to declining demand despite 4 billion profit. They don't respond to free market principles like other goods and services.

I am not a socialist , someone who makes close to 300 grand is not a socialist.

What we need is not more regulation, what we need is better regulation. That is the difference. It seems people want too much ( the current democrats) or absolutely none.

I love it when there's an issue and a person who is in the industry tells it like it is.
If it's a topic about cops and a member happens to be a cop of course I'll take listen to what the cop has to say...I may not believe all of it but he would know more than a person from the outside.

Originally Posted by bandaidwoman

medicare and private medical insurance is not a good way of looking at the differences between private and government.

Medicare pays me in two weeks, no less, private insurance pays me on average in three months.
I spend 33-50 dollars on paperwork ( hiring office staff) for every 100 dollars private insurance pays me, I spend 3 dollars for every 100 dollars medicare pays me, for the record 1/3 of my private carriers pay me less than Medicare allowable and I have had to fire 4 private carriers since none of them paid me in 1 year. ( I made more seeing medicaid since they paid me something) . So let's not go down that road. We have four doctors and 45 employees, most of them to deal with paperwork crap by the private insurers.

The free market does not apply to private insurance. When there is less demand, they raise their prices, unlike other businesses.... wellpoint blue cross just increased theire premiums 39% on individual policies due to declining demand despite 4 billion profit. They don't respond to free market principles like other goods and services.

I am not a socialist , someone who makes close to 300 grand is not a socialist.

What we need is not more regulation, what we need is better regulation. That is the difference. It seems people want too much ( the current democrats) or absolutely none.

sounds like your clearinghouse service sucks. you may want to take a look at that.

I can't count how many C level healthcare executives i talk to who are worried that their payer mix is moving towards medicare/medicaid and away from private insurance.

I absolutely agree with the bolded portion of your statement

Originally Posted by bio-chem

sounds like your clearinghouse service sucks. you may want to take a look at that.

I can't count how many C level healthcare executives i talk to who are worried that their payer mix is moving towards medicare/medicaid and away from private insurance.

Why would they be worried?
That's guaranteed money, when I was with Motorola we survived on the government projects. The private companies always stiffed us.

Originally Posted by min0 lee

Why would they be worried?
That's guaranteed money, when I was with Motorola we survived on the government projects. The private companies always stiffed us.

it's guranteed money both ways. the hospital always takes your insurance card immediately, don't they? they know what they are going to be reimbursed before they do anything. It's like getting pre-approved for a loan.

healthcare is very screwed up right now in how things are paid out. medicare/medicaid basically dictates how much they are going to pay you for a procedure. regardless of it's actual cost. (private insurers pay similarly, but there is a negotiation involved)

lets say that you need an MRI for your knee. how much the hospital gets is dependent upon the negotiated rate with the private insurer, or how much medicare/medicaid decide how much they are going to reimburse the hospital/imaging center for providing the scan and read. In most cases medicare/medicaid pays less.

bandaidwoman mentioned that her accounts payable days is considerably less with medicare/medicaid. that could be due to a lot of different factors, one I mentioned is the service that makes sure paperwork is in proper order for submission to the different insurers/medicare/medicaid

private insurance companies generally pay more than medicare/medicaid to healthcare providers.

The worst part of this whole fiasco in my view is that doctors, like mine, waste a lot of time dealing with insurance crap that they can't focus their best on the patients. Maybe it's because he is a small private practice but every other time I visit it seems he get's interrupted by phone calls involving a provider not covering this or that. I would hate to have to own a business where it's a gamble knowing how much you're going to get paid from one service to the next.....

Originally Posted by maniclion

The worst part of this whole fiasco in my view is that doctors, like mine, waste a lot of time dealing with insurance crap that they can't focus their best on the patients. Maybe it's because he is a small private practice but every other time I visit it seems he get's interrupted by phone calls involving a provider not covering this or that. I would hate to have to own a business where it's a gamble knowing how much you're going to get paid from one service to the next.....

doctors make good money, but for their education, and the services they provide they are severely underpaid in my opinion

some doctors are crooks.
Thank god I don';t have anymore copays!!

Originally Posted by bandaidwoman

and as a small business so is having to pay over half a million just to provide health insurance for my employees, how many small businesses like mine will become financially insolvent if their premiums go up another 178% like mine did over the last 12 years?

Your grandchild will only afford medical insurance if they work for a large company or the government, the days of upstart, innovative small companies are going to be history, they can't afford to attract employees without health insurance

we spend 400 billion dollars a year on paperwork for health insurance. Duke university has 500 hospital beds and five hundred coders, that is one coder for each bed, they don't have that many nurses!

single payer with privatized subsidization of seconday insurance will be the way to go.

You are right, and you aren't even talking about the cost that go along with managing the insurance data.

I work for a company that manages health care IT. I spend 40 hours or more per week on hospital servers keeping the data moving. Do you know that financial data dwarfs clinical data on every hospital server.
I would say that clinical data is less than 25% of the total data managed.

If a hemotology machine isn't resulting orders, no big deal, we will get it fixed in a few days. If a BC&BS interface isn't transmitting claims for approval, that shit better be working in a few hours.

In our software we have 3 databases which are called the holy trinity. One database manages AR information, one manages insurances, and the final one manages orders like pharmacy or labs orders.

You can pretty much lose any data on the server, and the hospital will live with it. If we lose 1 single AR record or insurance record, somebody is getting on a plane that day, and somebody else's job is probably in Jeopardy.

The amount of money we charge to manage a hospital's information systems is fucking insane! People want to blame doctors for high prices. Well doctors salaries are a drop of water in the lake of health care cost.

Originally Posted by bio-chem

it's guranteed money both ways. the hospital always takes your insurance card immediately, don't they? they know what they are going to be reimbursed before they do anything. It's like getting pre-approved for a loan.

healthcare is very screwed up right now in how things are paid out. medicare/medicaid basically dictates how much they are going to pay you for a procedure. regardless of it's actual cost. (private insurers pay similarly, but there is a negotiation involved)

lets say that you need an MRI for your knee. how much the hospital gets is dependent upon the negotiated rate with the private insurer, or how much medicare/medicaid decide how much they are going to reimburse the hospital/imaging center for providing the scan and read. In most cases medicare/medicaid pays less.

bandaidwoman mentioned that her accounts payable days is considerably less with medicare/medicaid. that could be due to a lot of different factors, one I mentioned is the service that makes sure paperwork is in proper order for submission to the different insurers/medicare/medicaid

private insurance companies generally pay more than medicare/medicaid to healthcare providers.

PRIVATE VS MEDCARE.
the real question is who will get the better service? private...they have neg a price already medicare says this is it live with it....

I want our insurance companies to just take all of our money.

Originally Posted by min0 lee

I want our insurance companies to just take all of our money.

the reason the raised the rate is to the dems can say ..see we need this and your going to like No love it we had no choice..think about this big dug companys instead of getting 60-70% of the market they get 100% from the cradle to the grave...it is good bizz... get rid of the private sector and it will happen the who live and die's will happen in 15-20 years but it will

Originally Posted by bandaidwoman

and as a small business so is having to pay over half a million just to provide health insurance for my employees, how many small businesses like mine will become financially insolvent if their premiums go up another 178% like mine did over the last 12 years?

Your grandchild will only afford medical insurance if they work for a large company or the government, the days of upstart, innovative small companies are going to be history, they can't afford to attract employees without health insurance

we spend 400 billion dollars a year on paperwork for health insurance. Duke university has 500 hospital beds and five hundred coders, that is one coder for each bed, they don't have that many nurses!

single payer with privatized subsidization of seconday insurance will be the way to go.

I don't see why the govt can't just get out of bed with the insurance companies and let them compete with one another interstate, also seperating health insurance from the employer. Of course insurance companies don't want that, but you don't think that giving individuals more bargaining power would bring costs under control more so than simply handing the bill over to the govt (i.e. taxpayers)?

Originally Posted by GearsMcGilf

I don't see why the govt can't just get out of bed with the insurance companies and let them compete with one another interstate, also seperating health insurance from the employer. Of course insurance companies don't want that, but you don't think that giving individuals more bargaining power would bring costs under control more so than simply handing the bill over to the govt (i.e. taxpayers)?

And now ya know and knowing is half the battle

The other day I was riding in Florida (with no helmet Doms! OOOOHHH SWEET FREEDOM) when I saw a bumper sticker that really made me think.

"BEWARE! There are Republicans and Democrats posing as real Americans!"

Our 2 party system is shit. The fact that we only nominate long time politicians to the position only feeds the corruption. We need a man from the people to do the job. Not a millionaire with an agenda. I think the internet could be a great tool for an everyman to reach out to the people without having millions of dollars to campaign, and I hope to see it in my lifetime.

Originally Posted by jmorrison

We need a man from the people to do the job. Not a millionaire with an agenda. I think the internet could be a great tool for an everyman to reach out to the people without having millions of dollars to campaign, and I hope to see it in my lifetime.

Awe, come on! We got that now. Obama was just a regular guy from Chicago from a middle class family. He just managed to raise more campaign $ than Bush and Kerry combined in 2004. Isn't that what hope and change is all about?

Ron Paul rasied more $ at the grass roots level than anyone else has, but that doesn't begin to compare to the kind of $ that comes from big special interest groups with deeper pockets.

Originally Posted by KelJu

You are right, and you aren't even talking about the cost that go along with managing the insurance data.

I work for a company that manages health care IT. I spend 40 hours or more per week on hospital servers keeping the data moving. Do you know that financial data dwarfs clinical data on every hospital server.
I would say that clinical data is less than 25% of the total data managed.

If a hemotology machine isn't resulting orders, no big deal, we will get it fixed in a few days. If a BC&BS interface isn't transmitting claims for approval, that shit better be working in a few hours.

In our software we have 3 databases which are called the holy trinity. One database manages AR information, one manages insurances, and the final one manages orders like pharmacy or labs orders.

You can pretty much lose any data on the server, and the hospital will live with it. If we lose 1 single AR record or insurance record, somebody is getting on a plane that day, and somebody else's job is probably in Jeopardy.

The amount of money we charge to manage a hospital's information systems is fucking insane! People want to blame doctors for high prices. Well doctors salaries are a drop of water in the lake of health care cost.

thats a huge issue right now behind the whole government push towards "meaningful use" you are situated in a good spot right now for work stability.

bandaid woman. in your opinion what would be the outcome if health insurance was regulated the same as car insurance?