The inevitable math of healthcare

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Originally posted by: snidely333
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Originally posted by: pjstroh
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Originally posted by: alanleroy
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Originally posted by: billryan
80% of the premium must go to health care. The 20% is of premiums, not of the actual cost of health care. If health care cost go up, its eats up the premiums, leaving less for administration, not more. Are you experiencing a brain fart or something?
They base the premiums on their estimated costs. If their estimated costs go up, the premiums go up. If the premiums go up, their profits go up. Where is the incentive to lower costs?


The insurance companies dont determine cost of medical care. The healthcare providers do and the price is loosely based on supply/demand which is why urban premiums tend to be less expensive than rural ones.

The 80/20 rule stops insurance companies from jacking up rates especially in areas where competition is lacking.


Whenever I go to the Dr., my insurance company dictates how much the Dr. will get paid. My insurance company determines the cost of the healthcare. Dr. might bill me $400. Insurance pays them $42 and there is not further charge to me. I had some routine blood work done last month and due to a glitch, my insurance company denied the claim and the bill was $512. Insurance kicked in and paid $37 and that was that. Tell me again who determines healthcare costs?


The healthcare providers. Granted its a negotiation - which is in of itself a travesty. The ability for your insurance company to negotiate price is comparable to your ability to get a good deal on a new car. Insurance companies have leverage but only to some extent.

A rural hospital is going to charge a lot more to fix a broken arm than an urban hospital - largely because they are the only game in town. And all the negotiating skills in the world wont fix that.

I chose not to pay for Cobra.


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Originally posted by: billryan
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Originally posted by: IndyBoilerman
Billy, I was unemployed at one point and chose to go without insurance. The explains my tax for #1. While I have a zero deductible and premium plan now, while working for my previous employer I chose the high deductible plan as it allowed for a lower premium. I then had spinal fusion surgery, and the limits to my medical savings account cost me a substantial amount money...............taxed again.

#2 was quite simple. There used to be a plethora of over the counter stuff that you could pay with a medical savings account, but.........................a tax increase again.

Lie, lie, and lie. Of course there were additional lies, however only three of Obama's many lies cost me money.

Some argue that the 61 cent per pack of cigarettes was an Obamacare tax also. I smoke.

"A 156 percent increase in the federal excise tax on tobacco: On February 4, 2009, just sixteen days into his Administration, Obama signed into law a 156 percent increase in the federal excise tax on tobacco, a hike of 61 cents per pack. The median income of smokers is just over $36,000 per year."



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Originally posted by: billryan
So boils paid penalty for #1,not having insurance, and #3, which only applied to those with high deductible insurance policies.
I think he is confused.




I don't believe you. Cant make it any plainer. COBRA would have kicked in for you.


Snidely, if your insurance company chooses how much they pay the doctor, why don't they choose zero?


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Originally posted by: snidely333
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Originally posted by: pjstroh
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Originally posted by: alanleroy
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Originally posted by: billryan
80% of the premium must go to health care. The 20% is of premiums, not of the actual cost of health care. If health care cost go up, its eats up the premiums, leaving less for administration, not more. Are you experiencing a brain fart or something?
They base the premiums on their estimated costs. If their estimated costs go up, the premiums go up. If the premiums go up, their profits go up. Where is the incentive to lower costs?


The insurance companies dont determine cost of medical care. The healthcare providers do and the price is loosely based on supply/demand which is why urban premiums tend to be less expensive than rural ones.

The 80/20 rule stops insurance companies from jacking up rates especially in areas where competition is lacking.


Whenever I go to the Dr., my insurance company dictates how much the Dr. will get paid. My insurance company determines the cost of the healthcare. Dr. might bill me $400. Insurance pays them $42 and there is not further charge to me. I had some routine blood work done last month and due to a glitch, my insurance company denied the claim and the bill was $512. Insurance kicked in and paid $37 and that was that. Tell me again who determines healthcare costs?


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Originally posted by: billryan
Under TrumpCare, people who receive health insurance from their employers will now have it count as income and have to pay income tax on it. Then trump will claim that that income has gone up under his rule.
Under TrumpCare, a sixty year old multi- millionaire will get a bigger tax credit than a poor 25 year old. Preliminary reports say about seven million people will lose their Medicaid coverage.
But trump will watch out for the forgotten people and the military. Unless, of course, you think that closing down day care centers on military bases isn't a good thing.


Billy is now privy to the inner circle of Congress and knows what's in the final law? Funny, they don't even know what alls in it.


That was from the draft released that day. Guess it didn't filter down to the hinterlands.
Did you not notice the" preliminary reports" portion?
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Originally posted by: snidely333
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Originally posted by: pjstroh
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Originally posted by: alanleroy
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Originally posted by: billryan
80% of the premium must go to health care. The 20% is of premiums, not of the actual cost of health care. If health care cost go up, its eats up the premiums, leaving less for administration, not more. Are you experiencing a brain fart or something?
They base the premiums on their estimated costs. If their estimated costs go up, the premiums go up. If the premiums go up, their profits go up. Where is the incentive to lower costs?


The insurance companies dont determine cost of medical care. The healthcare providers do and the price is loosely based on supply/demand which is why urban premiums tend to be less expensive than rural ones.

The 80/20 rule stops insurance companies from jacking up rates especially in areas where competition is lacking.


Whenever I go to the Dr., my insurance company dictates how much the Dr. will get paid. My insurance company determines the cost of the healthcare. Dr. might bill me $400. Insurance pays them $42 and there is not further charge to me. I had some routine blood work done last month and due to a glitch, my insurance company denied the claim and the bill was $512. Insurance kicked in and paid $37 and that was that. Tell me again who determines healthcare costs?


The Insurance companies work out a rate with the health care providers, they can choose to be a provider for that network or chose another network to belong to. $512 for blood work, what the hell they test you for Snidely, drugs? (those tests only run about a few hundred at most)
I recently changed Doctors with my move, and the new one ordered a complete workup. Three pages of requests. Receptionist asked me if I'd gotten permission from my insurance. When I said I assumed my Dr had, she took my paperwork and disappeared. She came back a few minutes later and said we were all good. It was a lot of tests, but they only drew two small vials and asked for a urine sample.
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