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george
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 Posted: Wed Oct 14, 2009 8:27 am Post subject: Shocked, shocked |
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Todays little editoral on the health insurance industry gave me a nice laugh. The editor, like many others, overlooks the continued rise in health care COST that drive the insurance cost ever higher.
If you want health care reform thatn reform health care, not the insurance industry. Why does car insurance cost so much more today the years ago? It due to the ridiculous price of cars and car parts. As long as their costs go up insurance firm will pass those cost on to us.
Most of the problems with health care start with us. We are the fattest most out of shape generation ever. We smoke, do drugs, partake in risky behavior (unprotected sex for one), drink to excess. If you want lower health care cost, take care of your self.
They should make health insurance risk based. If you are over weight or smoke, have a DUI or STD you pay a higher premium, if you are clean you pay lower. Require yearly physicals, as behaviors change premimums will go up or down.
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Cylinsier
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| Posted: Wed Oct 14, 2009 8:57 am Post subject: |
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ellipses
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| Posted: Wed Oct 14, 2009 9:22 am Post subject: |
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I don't really think that the price of cars is ridiculous... You can get a car for 12 grand all the way up to a million...
Car insurance isn't really all that expensive either...
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george
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| Posted: Wed Oct 14, 2009 10:58 am Post subject: |
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| Cylinsier wrote: | |
Wrong Cy. Trying to control health cost by fixing insurance cost is wrong when the issue is HEALTH CARE COST. Besides, I have never beaten my horses.
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ellipses
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| Posted: Wed Oct 14, 2009 11:02 am Post subject: |
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If the payer (insurance company or public plan) would only pay X for care, the cost of care would have to come down to X
It's semantics... do you lower costs first or lower payments first?
If you lower costs first... let's say you cut the cost of an MRI in half by imposing a price ceiling... costs for insurance would follow, but not immediately.
Insurance companies would, for a while, try to charge the same premiums as they did before, while paying out half for MRI's... eventually, someone would lower premium prices to attract more customers and the others would follow... but there would be a lull there where insurance companies would see their profit margins explode.
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george
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| Posted: Wed Oct 14, 2009 11:08 am Post subject: |
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| ellipses wrote: | If the payer (insurance company or public plan) would only pay X for care, the cost of care would have to come down to X
It's semantics... do you lower costs first or lower payments first?
If you lower costs first... let's say you cut the cost of an MRI in half by imposing a price ceiling... costs for insurance would follow, but not immediately.
Insurance companies would, for a while, try to charge the same premiums as they did before, while paying out half for MRI's... eventually, someone would lower premium prices to attract more customers and the others would follow... but there would be a lull there where insurance companies would see their profit margins explode. |
The government (medicare/medicaid) has tried that and many hospitals either closed (rural ones) or are now losing money and cutting staff and doctors are refusing anymore medicare/medicaid patients. So I guess
we just tell hospitals or doctors they can't make money.
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Cylinsier
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| Posted: Wed Oct 14, 2009 11:10 am Post subject: |
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| george wrote: | | Wrong Cy. Trying to control health cost by fixing insurance cost is wrong when the issue is HEALTH CARE COST. Besides, I have never beaten my horses. |
What I meant was the argument you are making is beating a dead horse. You've made it a hundred times already.
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ellipses
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| Posted: Wed Oct 14, 2009 11:14 am Post subject: |
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| george wrote: | | ellipses wrote: | If the payer (insurance company or public plan) would only pay X for care, the cost of care would have to come down to X
It's semantics... do you lower costs first or lower payments first?
If you lower costs first... let's say you cut the cost of an MRI in half by imposing a price ceiling... costs for insurance would follow, but not immediately.
Insurance companies would, for a while, try to charge the same premiums as they did before, while paying out half for MRI's... eventually, someone would lower premium prices to attract more customers and the others would follow... but there would be a lull there where insurance companies would see their profit margins explode. |
The government (medicare/medicaid) has tried that and many hospitals either closed (rural ones) or are now losing money and cutting staff and doctors are refusing anymore medicare/medicaid patients. So I guess
we just tell hospitals or doctors they can't make money. |
And medicare/medicaid/VA is only something like 40% of the coverage market... If 60% of coverage pays 2,000 for a procedure and 40% pays 1,000... there isn't a price consensus or enough predictability in what to charge... do you charge 2k and potentially lose money if the 40% over-visit your hospital or do you charge closer to 1,000 and leave Aetna money on the table?
Single payer creates consensus on cost. In Japan, the national health insurance payer pays 85 dollars for an MRI... therefore, an MRI costs 85 dollars and MRI operators still make money.
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george
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| Posted: Thu Oct 15, 2009 10:17 am Post subject: |
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| ellipses wrote: | | george wrote: | | ellipses wrote: | If the payer (insurance company or public plan) would only pay X for care, the cost of care would have to come down to X
It's semantics... do you lower costs first or lower payments first?
If you lower costs first... let's say you cut the cost of an MRI in half by imposing a price ceiling... costs for insurance would follow, but not immediately.
Insurance companies would, for a while, try to charge the same premiums as they did before, while paying out half for MRI's... eventually, someone would lower premium prices to attract more customers and the others would follow... but there would be a lull there where insurance companies would see their profit margins explode. |
IThe government (medicare/medicaid) has tried that and many hospitals either closed (rural ones) or are now losing money and cutting staff and doctors are refusing anymore medicare/medicaid patients. So I guess
we just tell hospitals or doctors they can't make money. |
And medicare/medicaid/VA is only something like 40% of the coverage market... If 60% of coverage pays 2,000 for a procedure and 40% pays 1,000... there isn't a price consensus or enough predictability in what to charge... do you charge 2k and potentially lose money if the 40% over-visit your hospital or do you charge closer to 1,000 and leave Aetna money on the table?
Single payer creates consensus on cost. In Japan, the national health insurance payer pays 85 dollars for an MRI... therefore, an MRI costs 85 dollars and MRI operators still make money. |
Then why did the dems just announce they would raise the medicare/medicaid acceptable fee rates to doctors/hospital? See you can't demand a rate!
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ellipses
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| Posted: Thu Oct 15, 2009 10:19 am Post subject: |
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Why can Japan pay 85 bucks for an MRI?
I explained why they can't dictate price... because the "payer market" is split so you can't determine a consensus on price.
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george
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| Posted: Mon Oct 19, 2009 8:52 am Post subject: |
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| ellipses wrote: | Why can Japan pay 85 bucks for an MRI?
I explained why they can't dictate price... because the "payer market" is split so you can't determine a consensus on price. |
Did you notice the UPMC is closing UPMC Bradock ? This hospital took mostly mediciad/medicare patients and lost 30 million dollars over the past 5 years. The government tried to set the price it would pay for care, it did not work. It will not work. If the government gets into health care it can't set the price it wants without shutting down marginal hospitals and there are many in that position.
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Cylinsier
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| Posted: Mon Oct 19, 2009 9:10 am Post subject: |
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The reasons they gave on the news is that 4/5 Braddock residents had stopped going to the hospital. It sounds like a lack of patients that sunk the hospital.
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ellipses
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| Posted: Mon Oct 19, 2009 9:11 am Post subject: |
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You still didn't answer the question as to why 85 dollar MRI's are profitable in japan...
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george
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| Posted: Mon Oct 19, 2009 11:04 am Post subject: |
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| ellipses wrote: | | You still didn't answer the question as to why 85 dollar MRI's are profitable in japan... |
You will have to ask hospial adminiatrators why the charge so much. they set the rates.
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2aa
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| Posted: Thu Oct 22, 2009 2:04 pm Post subject: |
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| Japan has invented a smaller and more basic MRI machine, which costs about one-tenth of the cost of the machines used in the United States but produces a lower quality image. |
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