Health care pt5

[BKenn01]

Originally Posted by hahn

By itself, profit is not evil. Profiting off ill people, however, is. You're entitled to your morals, as warped as I find them to be.

It has nothing to do with my morals. Without profit in the system there is no incentive for innovation or advancement in new medical technology

Originally Posted by DeputyDave

I'm not a Republican but I haven't heard many claiming they want to make private health care insurance mandatory. Now, as a conservative I want nothing of the sort. Is that the newest statist talking point? Because you seem to be regurgitating all of the others.

I am a Conservative and I would argue that if the insurance companies are going to have to cover preexisting illness, you have to require it OR wave the requirment on people who have been uninsured for a period of time to eliminate people putting off getting insurance till they need it.

[hahn]

Originally Posted by maxfisher

So you think it's just totally irrelevant that United Health Group's revenues were over 350% of Apple's in 2006 and over 300% of Apple' in 2007?

Also, who do you think that 'gigantic chunk of change' goes to? Who do you think owns the health insurance companies? Do you really believe those owners don't deserve a return on their money?

No, it's not irrelevant. That was the point. They have a smaller profit margin, but huge revenues. Thus, their profits are huge. The previous argument was their profits weren't very big. My argument is that they ARE. See what I wrote below in response to your claim that the owners "deserve a return on their money". It's fairly basic economics here. Healthcare costs. Quality healthcare costs more. Healthcare insurance companies that have shareholders are under pressure to grow profits. That is the whole point of being a for-profit healthcare insurance company. You can do that either by getting more people to sign on, OR you can cut costs. Or do both. Cutting costs leads to...you get the idea.

This sounded ridiculous, so I looked into the last decade for ten big ones. Half them had posted losses at least once.

Aetna posted losses of $2.5 billion in 2002 and $279 million in 2001.

Humana posted a loss of $382 million in 1999.

Cigna posted a loss of $398 million in 2002.

Amerigroup posted a loss of $50 million in 2008.

Centene posted losses of $9 million in 1999 and $43 million in 2006.

Guess I didn't look back far enough. Still, that doesn't change the fact that they can control their costs by simply denying more claims. Since the topic of justifiable claims is so complex and twisted, they get away with it pretty easily. There's not much an individual can do to force a healthcare company to pay up if they don't want to. Sure you could take them to court, but they've got deeper pockets and better lawyers than you. Most wouldn't take it that far.

For those who believe that healthcare insurance companies "deserve" to profit, I would ask, "based on what?" What are they contributing to healthcare that helps people? And how much profit do they deserve for whatever you think their contribution is to healthcare? While I'm against the idea of healthcare insurance, I'll admit I'm not sure what a better idea would be. But if we have to have healthcare insurance, there shouldn't be companies skimming profits just for being able to spread the money around. That's why I think that government should be at least partially involved. At the very least, these companies should be regulated a lot more than they are.

[Sdallnct]

Originally Posted by hahn

Out of curiosity, to those of you who are arguing in support of private healthcare insurance - have any of you or your family members/close friends ever actually had a major illness that required expensive tests and/or treatments? I'm talking about needing tens or hundreds of thousands of dollars.

Yes.

As I have mentioned, I have had several different health insurance over the last 20 years. But in no way will health insurance ever make money on me, my kids or their kids.....

And when I did not like the service I got from one company during one issue, after it was all done, I left them and went to another.

I like choice. I like options. I like shopping around. The best insurance I ever had was a HMO. And YES we used it. I'm not using a HSA...I liked it for 2 years, but out of pocket more than I'd like this year. So I might switch.

[Sdallnct]

Originally Posted by hahn

No, it's not irrelevant. That was the point. They have a smaller profit margin, but huge revenues. Thus, their profits are huge. The previous argument was their profits weren't very big. My argument is that they ARE. See what I wrote below in response to your claim that the owners "deserve a return on their money". It's fairly basic economics here. Healthcare costs. Quality healthcare costs more. Healthcare insurance companies that have shareholders are under pressure to grow profits. That is the whole point of being a for-profit healthcare insurance company. You can do that either by getting more people to sign on, OR you can cut costs. Or do both. Cutting costs leads to...you get the idea.


Guess I didn't look back far enough. Still, that doesn't change the fact that they can control their costs by simply denying more claims. Since the topic of justifiable claims is so complex and twisted, they get away with it pretty easily. There's not much an individual can do to force a healthcare company to pay up if they don't want to. Sure you could take them to court, but they've got deeper pockets and better lawyers than you. Most wouldn't take it that far.

For those who believe that healthcare insurance companies "deserve" to profit, I would ask, "based on what?" What are they contributing to healthcare that helps people? And how much profit do they deserve for whatever you think their contribution is to healthcare? While I'm against the idea of healthcare insurance, I'll admit I'm not sure what a better idea would be. But if we have to have healthcare insurance, there shouldn't be companies skimming profits just for being able to spread the money around. That's why I think that government should be at least partially involved. At the very least, these companies should be regulated a lot more than they are.

You simply have no concept of insurance. Your same argument could apply to home or auto insurance. Need to make more money? Just deny more claims. Insurance companies are in the business to pay claims. They set their premiums to be able to pay those claims. Most profits come from investments and how efficient they can pay claims and run their business. Insurance is arguable the most regulated industry.

And even if there was some truth to what you say, your automatically thinking the government would be better. So your saying the National Flood program has never denied a claim? Ok lets talk medical, you thing Medicare has never denied a claim? Of course they have.

[kvrdave]

[quote=hahn;9802637]
Guess I didn't look back far enough. Still, that doesn't change the fact that they can control their costs by simply denying more claims.
[quote]
So can the government, and that is what governments with national health care do.

For those who believe that healthcare insurance companies "deserve" to profit, I would ask, "based on what?" What are they contributing to healthcare that helps people? And how much profit do they deserve for whatever you think their contribution is to healthcare? While I'm against the idea of healthcare insurance, I'll admit I'm not sure what a better idea would be. But if we have to have healthcare insurance, there shouldn't be companies skimming profits just for being able to spread the money around. That's why I think that government should be at least partially involved. At the very least, these companies should be regulated a lot more than they are.

Why do hospitals deserve profit? Why do doctors deserve to make as much money as they do? Simply make all hospitals non-profit and set wages for doctors just like they are trying to do for CEOs. What's wrong with that?

[Birrman54]

In 2007 Apple had an operating revenue of ~$24B, leading to $3.5B net income. United Healthcare made $3.5B on ~$45B in revenue. Google pulled in ~$17B in revenue and profited over $4B.

United Healthcare has 75,000 employees - 40K more than Apple, 55K more than Google.

So Apple is almost twice as profitable as this evil insurance company, Google is significantly more profitable. How can anyone actually make an argument that profit as a % of total revenue has no significance when determining what counts as 'excessive'?

[orangecrush]

Originally Posted by Birrman54

In 2007 Apple had an operating revenue of ~$24B, leading to $3.5B net income. United Healthcare made $3.5B on ~$45B in revenue. Google pulled in ~$17B in revenue and profited over $4B.

United Healthcare has 75,000 employees - 40K more than Apple, 55K more than Google.

So Apple is almost twice as profitable as this evil insurance company, Google is significantly more profitable. How can anyone actually make an argument that profit as a % of total revenue has no significance when determining what counts as 'excessive'?

Because it doesn't support their argument. Besides, large numbers scare people more than percentages.

[wildcatlh]

Just got a hold of HR 3962, the "Affordable Healthcare for America Act". It's the new leadership-sponsored bill.

It's 1,990 pages long.

Not only is there a requirement that you buy health insurance, but there's also a "voluntary" new health insurance entitled the CLASS program, for long-term care for individuals requiring community living assitance services. I use "voluntary" in quotations because it's an opt-out program, not an opt-in program (Title XXXII, Section 3204, page 1575)

[taa455]

Originally Posted by hahn

By itself, profit is not evil. Profiting off ill people, however, is. You're entitled to your morals, as warped as I find them to be.

I guess hospitals and doctors shouldn't be making a profit either. Let's just put them all on the government payroll!

[shifrbv]

Here's a summary of the bill:

http://edlabor.house.gov/blog/2009/1...lth-care.shtml

I still don't understand why changes are taking 5 years to kick in. And small business doesn't need to comply until 2018.

Does congress believe companies can survive 30% increases every year for the next 5 years?

This bill looks weak to me. It looks like it's trying to please everybody. Even raising Medicaid reimbursements to Medicare levels (which Medicare is broke right now).

Kvrdave is right on, why do doctors need to make so much money? Everybody else in this country has seen a decrease in pay or wage stagnation. Why should they be immune from the pain?

[X]

Originally Posted by shifrbv

I still don't understand why changes are taking 5 years to kick in. And small business doesn't need to comply until 2018.

That's how you get the 10 year cost estimate down. Notice they don't say what it costs the 2nd 10 years?

[X]

Originally Posted by shifrbv

Kvrdave is right on, why do doctors need to make so much money? Everybody else in this country has seen a decrease in pay or wage stagnation. Why should they be immune from the pain?

How about athletes and movie stars? I suppose we need to go after their obscene salaries. It's only "fair".

[JasonF]

And administrators for DVD websites. Those guys are totally overpaid.

[shifrbv]

Originally Posted by X

How about athletes and movie stars? I suppose we need to go after their obscene salaries. It's only "fair".

If taxpayers were footing the bill for those guys, like they are for Medicare, Medicaid, and now a new "Exchange", then they should be allowed a say.

[shifrbv]

Originally Posted by X

That's how you get the 10 year cost estimate down. Notice they don't say what it costs the 2nd 10 years?

This is bothersome to me. You can't give everybody subsidized care at today's prices (and the guaranteed increases that healthcare professionals demand) and not expect it to lead to some serious financial issues down the road.

I saw a quote online from Obama's healthcare expert Peter Orzsag talking about deficit costs in the "out years" and everybody was making jokes about what that meant. Most said it would be the years they were all out of office.

I still contend this bill looks like it kicks the can down the road.

[wildcatlh]

I'm still wondering why they're not being required by the CBO to use the same 75-year amortization schedule that Medicaid and Social Security use.

[kvrdave]

Originally Posted by shifrbv

I still don't understand why changes are taking 5 years to kick in. And small business doesn't need to comply until 2018.

Because Obama wants it to be budget neutral, and the only way to do that is to collect taxes for 10 years and have the system go for 5 years. Then they declare victory. It's a shell game.

edit -X already got it.

[Birrman54]

Originally Posted by shifrbv

If taxpayers were footing the bill for those guys, like they are for Medicare, Medicaid, and now a new "Exchange", then they should be allowed a say.

Taxpayers most certainly foot the bill for various stadium constructions through the country.

Speaking of athletics and obscene salaries.

http://www.americasbestonline.net/in...idcoaches.html

A lot of state schools on that list. How much should these coaches be profiting from a game!

[DeputyDave]

Well, I guess this proves the Democratic party is still in the pocket of the trial lawyers. Any hope of real reform goes out the window.

[Superboy]

Originally Posted by maxfisher

This sounded ridiculous, so I looked into the last decade for ten big ones. Half them had posted losses at least once.

Aetna posted losses of $2.5 billion in 2002 and $279 million in 2001.

Humana posted a loss of $382 million in 1999.

Cigna posted a loss of $398 million in 2002.

Amerigroup posted a loss of $50 million in 2008.

Centene posted losses of $9 million in 1999 and $43 million in 2006.

Those are accounting losses, not economic losses. Those are two very different concepts. Those losses aren't generated by expenditures that aren't met by profit; they're met by expenditures that are given tax benefits.

For that matter, what do you think their "losses" were from? the health insurance and pharm industries are incredibly profitable for two reasons:

1. Their goods/services are inelastic

2. Their costs are mostly variable costs.

These two factors put together cook up the perfect recipe for a monopoly, or its slightly less attractive but still massively profitable sister, the oligopoly.

[wildcatlh]

Originally Posted by Superboy

Those are accounting losses, not economic losses. Those are two very different concepts. Those losses aren't generated by expenditures that aren't met by profit; they're met by expenditures that are given tax benefits.

For that matter, what do you think their "losses" were from? the health insurance and pharm industries are incredibly profitable for two reasons:

1. Their goods/services are inelastic

2. Their costs are mostly variable costs.

These two factors put together cook up the perfect recipe for a monopoly, or its slightly less attractive but still massively profitable sister, the oligopoly.

But it's a government-sponsored monopoly (as a result of restrictive laws on entering the market and the anti-trust exemption that prevents a national insurance market from forming). So this becomes another case where government intervention creates a large problem, and the government is able to convince people that the only way to solve that problem is with more government intervention.

[wildcatlh]

via Reason, an interesting caveat on the end of the CBO's score of HR3962 (in which they stated it would reduce the deficit)

Those longer-term projections assume that the provisions of H.R. 3962 are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation. For example, the “sustainable growth rate” mechanism governing Medicare’s payments to physicians has frequently been modified to avoid reductions in those payments, and legislation to do so again is currently under consideration in the Congress. The bill would put into effect (or leave in effect) a number of procedures that might be difficult to maintain over a long period of time. It would leave in place the 21 percent reduction in the payment rates for physicians currently scheduled for 2010. At the same time, the bill includes a number of provisions that would constrain payment rates for other providers of Medicare services. In particular, increases in payment rates for many providers would be held below the rate of inflation (in expectation of ongoing productivity improvements in the delivery of health care).

[X]

It would leave in place the 21 percent reduction in the payment rates for physicians currently scheduled for 2010.

That's how Congress is keeping the cost under $1 trillion and making it appear "budget-neutral" so Obama can keep his promise of not increasing the deficit with this bill.

They will introduce a separate $250 billion bill to restore the payments after the health care bill is signed. Your government at work. And people go for this?

[Birrman54]

So physicians are just supposed to absorb a 21% reduction in payment?

I'm sure that won't affect supply at all.

[maxfisher]

Originally Posted by Superboy

Those are accounting losses, not economic losses. Those are two very different concepts. Those losses aren't generated by expenditures that aren't met by profit; they're met by expenditures that are given tax benefits.

For that matter, what do you think their "losses" were from? the health insurance and pharm industries are incredibly profitable for two reasons:

1. Their goods/services are inelastic

2. Their costs are mostly variable costs.

These two factors put together cook up the perfect recipe for a monopoly, or its slightly less attractive but still massively profitable sister, the oligopoly.

Let's ignore the fact that you're apparently smarter than the market, seeing as how most of these companies' stocks took hits in the years they posted losses. Are you claiming that the profit margins for health care companies are far in excess of what they actually state? Looking at the Fortune 500 list of the 43 industries that were profitable in 2009, health insurance ranked 35th. If that's incredibly profitable, I'm curious what kinds of adjectives would get pulled out for industries in the top 10.