Do Conservatives know what health insurance is?

[The Derp]

Hell..half of the little ungreatful assholes on Medicaid refuse to call the benefits line to update their information so their bills can be processed.

So the natural Conservative response to that is to cut Medicaid?

 

[The Derp]

The price of an IV bag is part of a contract negotiated between three parties.

NO IT FUCKING ISN'T. The price of the IV bag is set by the hospital's chargemaster. What the insurer contracts with the provider for is the amount the insurer reimburses toward the price already set in the chargemaster. And chargemasters vary provider-to-provider. There is no set standard. A procedure at one hospital could cost $5K, but that exact same procedure at the hospital down the road could cost $15K. And because hospitals keep their chargemasters secret, you have no idea if what you're paying is a bargain or not. You're just relying on the blind faith that these for-profit corporations are cooperating with you and are concerned about your ability to pay. Because even if you don't pay, they're still gonna get paid. It's just gonna come out of everyone else's pocket.

So you think you're being clever, but you're not.

 

[The Derp]

It's part of a negotiated contract. You may pay more for an IV but in return get free OR soap, soap dispensers,maternity kits...and really cheap surgical gloves...etc.

Nope. That is not how it works. What is negotiated between the insurer and provider isn't the price of whatever procedures or supplies, but rather how much the insurer reimburses of that price which is in the hospital's chargemaster. Do you think hospitals have different chargemasters for each insurance company? Or do they have different reimbursement rates with each insurance company?

 

[The Derp]

Providers have nothing to do with the cost of a Tylenol.

Yes, they do. They set the price in their chargemaster. You don't know how any of this works, apparently. Everything seems to be just off the top of your head.

 

[BlueGin]

Medicare also doesn't pay out as much as Aetna does to your healthcare providers...which means you owe the majority of the bill.

Yeah, you know why? Because Aetna forces you to pay higher premiums. So that's why they reimburse more. So if we raised the Medicare tax, Medicare could reimburse more.

Most of the people paying into Medicare don't use it. Why should we raise the Medicare tax? Medicare also fines hospitals hundreds of millions yearly for what they deem "over treating". What are they doing with THAT money hmmm? Also the wages of the employees in Washington running Obamacare are outrageously high....100k a year for paper pushing?? Medicare actually needs to reign it in.

 

[The Derp]

Sutures are another thing hospitals negotiate for low cost ...since they use them constantly.

No they don't negotiate for low cost...they buy it cheap because it is cheap, but then mark it up to you and/or your insurer so they can maintain their profit margins.

 

[The Derp]

Hospitals pay a fee to a buying group that purchases all of their supplies from the vendors/distributors. Each buying group negotiates pricing contracts between vendors/distributors and hospitals

But that is different than the contract between the insurer and provider, which determines how much of the price in the chargemaster the insurer will reimburse. So you're conflating two things here. What the provider does with its suppliers has no bearing on what the provider does with its contracted insurers.

 

[BlueGin]

It's part of a negotiated contract. You may pay more for an IV but in return get free OR soap, soap dispensers,maternity kits...and really cheap surgical gloves...etc.

Nope. That is not how it works. What is negotiated between the insurer and provider isn't the price of whatever procedures or supplies, but rather how much the insurer reimburses of that price which is in the hospital's chargemaster. Do you think hospitals have different chargemasters for each insurance company? Or do they have different reimbursement rates with each insurance company?

Derp derp derp. Who said anything about the insurer? I said manufacturers/buying groups/hospitals.

You know what these are yes?

I worked these contracts for 10 years...you are the one who is confused...not me.

Chargemasters have nothing to do with the above.

Which I already explained also.

 

[RodISHI]

Insurance companies can sell insurance and the medical community sells their products to both insured or non insured would be a free market.

OK, couple things; Insurance companies are the exact opposite of a free market because they limit and restrict your choices as a patient to what will protect their bottom line. You don't have "free choice" with health care at all, and insurance companies are the reason why. Keep in mind the choice you are making is not who will give you health care, but rather who administers reimbursement for that health care. That's the choice you are making. The insurer is making the choice for you as to which providers you can and cannot see. And they contract with those providers to determine how much they will reimburse for a procedure according to the chargemaster document. This is what I mean when I say you people don't know what health insurance is, what insurance companies do, and how any of it relates to your actual health care.

So again, it doesn't seem like you have given this much thought. The medical community already does what you're saying. The part you don't seem to grasp is that the pricing that your providers give you or your insurance isn't based on what the actual cost of those products and services are, but rather what will make your provider the most money. It's called the "chargemaster" for a reason.

You do not get to set the pricing anymore than you would be able to tell me I would make or paint you a master piece at the price you wanna pay.

So basically, you are blindly accepting the pricing your provider gives you. In fact, you're probably paying above the pricing in your providers chargemaster, if you have no insurance, because how are you possibly going to bargain with a major, massive, corporate provider all by your lonesome. So what they do is make you think you're getting a deal, when you're probably paying far more than even your insurance would.

If the drug companies charge too much for their shit people do not have to buy it.

Well that's just fucking stupid. The drug companies charge so much because Medicare isn't allowed to use its leverage as the largest purchaser of prescription drugs to bargain for cheaper prices. Now why would that happen? Simple; Conservatives love drug companies and did everything in their power to protect their profits. Hence, the restriction on Medicare in the Part-D legislation Conservatives voted for and passed in 2003.

Secondly, many of those prescriptions are vital to keep someone alive. Heart medication, etc. I agree that there are too many medications out there that people don't necessarily need. But there are also plenty of medications out there that people do need. If Medicare were allowed to collectively bargain for cheaper drugs, a lot of those problems would get solved very easily.

No one gets to force vaccines or any other product onto the public.

Not vaccinating yourself or your children is tantamount to biological warfare, and you are knowingly and deliberately sending either yourself or your child as a dirty bomb into society. I don't understand why on earth anyone would be opposed to vaccines. It's just pure stupidity, laziness, and recklessness at this point that ends up costing society in the long run. There is no reason you should voluntarily forego a vaccine for yourself or your child. It is pure stupidity to do that. And selfish. And inconsiderate. And dangerous.

And you do not get to require a license for anything other than standards in testing for competence. Vaccine makers and all other drug pushers are fully and totally liable for their product in a free market so attorneys will have to work for their money if they want to sue the doctors, hospitals, clinic or pharmaceutical giants and chemical companies.

So you are doing that thing again where you just spout random nonsense off the top of your head because you haven't given this subject enough serious thought. You need to review drug copyright laws and protections because it's clear you don't know what you're talking about. And BTW - Conservatives won't allow class action lawsuits against drugmakers. So one little person going against a billion-dollar company and their legal team...how do you think that's gonna turn out?

You do spend a lot of time typing in or copying off your typical bs of attempting to confuse an issue.

Free market means you have the choice whether to buy or not buy.

Per vaccines, it is insanity to cram foreign matter into healthy bodies via a syringe for non life threatening diseases and illnesses. I have never had a vaccine and do not plan on ever getting one at this late stage in my life. People of all ages are walking around as carriers for diseases they would have never been exposed to if the pharmaceutical companies had not lobbied and propagandized society to promote their crap via vaccines in order to create a market to be able to profit off of/treat people with chemicals from cradle to grave.

 

[BlueGin]

Sutures are another thing hospitals negotiate for low cost ...since they use them constantly.

No they don't negotiate for low cost...they buy it cheap because it is cheap, but then mark it up to you and/or your insurer so they can maintain their profit margins.

The buying groups buy the supplies...the hospitals pay them a fee specifically for belonging to the specific buying groups...already explained this to you also. Not my fault you don't follow along .

 

[The Derp]

What's worse is that the charts and links you provide are nothing but propaganda.

How so? Explain. How is actual bankruptcy data "propaganda"? I think you're just throwing out that word because you don't know what the fuck you're talking about.

The chart at the end of this post can't possibly account for the fact that economy which was in the tank in 2010 was steadily getting better.

The chart does account for that. But the larger issue; medical bankruptcies, have declined because of the ACA. If you bothered to read the article I linked to, you'd know that. But you don't. It's obvious why.

 

[BlueGin]

Hospitals pay a fee to a buying group that purchases all of their supplies from the vendors/distributors. Each buying group negotiates pricing contracts between vendors/distributors and hospitals

But that is different than the contract between the insurer and provider, which determines how much of the price in the chargemaster the insurer will reimburse. So you're conflating two things here. What the provider does with its suppliers has no bearing on what the provider does with its contracted insurers.

No...you are conflating the two.

I also already explained why the chargemaster fees are not set in stone.

 

[The Derp]

1. There are no statistics of who was successful with these catastrophic plans. If your vaunted 45% is 1% of those who had and used plans...than there is no shitload (except your post).

Moron...do you think that of the 75% of people who filed for bankruptcy because of medical bills despite having insurance didn't use their insurance?????? This is what I mean when I say you people have no idea what health insurance is, what insurance companies do, and how it relates to health care delivery.

2. There is nothing that says what kind of insurance that 45% had.

So OK, now you're admitting that those people had insurance. Now, if the concept of insurance is to insure against financial ruin, why then are people with insurance still going bankrupt? What would be the reason for that? Think critically.

3. As already mentioned...the wads who spout that article can't differentiate how much of that 17K was due to medical bills..

You fucking moron...that $17K is all medical debt. That is what the article clearly articulates. I don't think you know how to comprehend things you read. Or you do and are just playing at being obtuse. Not sure which is better. They're both awful.

 

[The Derp]

And yet insurance didn't protect everyone (by your own admission). And it wasn't catastrophic plans.

Yes, it fucking was catastrophic plans because catastrophic plans have lifetime caps. Do you even understand what a lifetime cap is? Do you know how it works? We already know you don't know what health insurance is, so how can you possibly know what a catastrophic health insurance plan is!?

There is nothing that says it is financial ruin for most Americans. Sorry......

If you are filing for bankruptcy, then you are in financial ruin. For 60% of people, they filed for bankrupcty because of medical bills. Of those 60%, 75% of them had insurance. So if someone has insurance, yet still files for bankruptcy because of medical bills, what does that say about their insurance coverage?

You pat $200/month only if you get subsidies (again...cost shifting bullshit).

No, it's taxing the wealthy to pay for the poor and middle class. You're not wealthy, obviously, so it doesn't affect you. So what you've done instead is prove yourself a useful idiot of the wealthy and spring to their defense even though doing so undermines your own best interests. There's a word for that; stupidity.

And you'll pay a huge deductible.

So Conservatives constantly say that people should be more responsible for their health care, and should "put more skin in the game", which is precisely what deductibles do. So you are screeching against the very thing you say you support. If high deductibles don't force people to "put more skin in the game", then what does??? Have you given that any thought? Obviously not.

Early on, anyone who had paid into an HSA at a reasonable rate could have afforded the operation.

Bullshit. What middle class person can save $33K to pay for an appendectomy? And once you spent that $33K, what do you have left over? Nothing. HSA's work if you can save. Most middle class people cannot. In fact, most middle class people are in the opposite position; facing high debt loads (thanks mostly to Bush the Dumber).

 

[The Derp]

The charge master is not "fixed"

It's fixed in the sense that it's the same for every insurer. The variable is how much the insurer reimburses of that charge in the chargemaster.

while it is required to be updated every year for reporting purposes a lot of times a standard yearly mark up is applied across the board for all items and services listed...when in reality pricing hasn't changed at all on some of the items and services on the chargemaster.

Exactly...so they're not paying any more for it, yet they're increasing the charge to you. This is the problem. Using the IV bag as the example, it costs less than $1 for the hospital and that price most likely doesn't change year-to-year. But the chargemaster inflates the price to patients and insurers to $137 and keeps increasing that price in order to achieve higher profit margins. So yes, they do change the price in the chargemaster, even if the price the provider actually pays for it remains the same.

Again...why some prices for procedures will vary due to patients being billed less than was reported.

The patients aren't getting billed less. They think they are because the provider lies to them. But they're not. They're paying the same price your insurer pays. In fact, they're paying more than the insurer pays because the insurer is only reimbursing a certain % of the fee, with the patient picking up the remainder. Remove an insurance company from the equation, and the patient pays 100% of the charge in the chargemaster.

 

[BlueGin]

And yet insurance didn't protect everyone (by your own admission). And it wasn't catastrophic plans.

Yes, it fucking was catastrophic plans because catastrophic plans have lifetime caps. Do you even understand what a lifetime cap is? Do you know how it works? We already know you don't know what health insurance is, so how can you possibly know what a catastrophic health insurance plan is!?

There is nothing that says it is financial ruin for most Americans. Sorry......

If you are filing for bankruptcy, then you are in financial ruin. For 60% of people, they filed for bankrupcty because of medical bills. Of those 60%, 75% of them had insurance. So if someone has insurance, yet still files for bankruptcy because of medical bills, what does that say about their insurance coverage?

You pat $200/month only if you get subsidies (again...cost shifting bullshit).

No, it's taxing the wealthy to pay for the poor and middle class. You're not wealthy, obviously, so it doesn't affect you. So what you've done instead is prove yourself a useful idiot of the wealthy and spring to their defense even though doing so undermines your own best interests. There's a word for that; stupidity.

And you'll pay a huge deductible.

So Conservatives constantly say that people should be more responsible for their health care, and should "put more skin in the game", which is precisely what deductibles do. So you are screeching against the very thing you say you support. If high deductibles don't force people to "put more skin in the game", then what does??? Have you given that any thought? Obviously not.

Early on, anyone who had paid into an HSA at a reasonable rate could have afforded the operation.

Bullshit. What middle class person can save $33K to pay for an appendectomy? And once you spent that $33K, what do you have left over? Nothing. HSA's work if you can save. Most middle class people cannot. In fact, most middle class people are in the opposite position; facing high debt loads (thanks mostly to Bush the Dumber).

FYI...Medicare also has lifetime caps on hospital stay days.

Lifetime reserve days and when you use them up...you get no more. Period.

 

[BlueGin]

The charge master is not "fixed"

It's fixed in the sense that it's the same for every insurer. The variable is how much the insurer reimburses of that charge in the chargemaster.

while it is required to be updated every year for reporting purposes a lot of times a standard yearly mark up is applied across the board for all items and services listed...when in reality pricing hasn't changed at all on some of the items and services on the chargemaster.

Exactly...so they're not paying any more for it, yet they're increasing the charge to you. This is the problem. Using the IV bag as the example, it costs less than $1 for the hospital and that price most likely doesn't change year-to-year. But the chargemaster inflates the price to patients and insurers to $137 and keeps increasing that price in order to achieve higher profit margins. So yes, they do change the price in the chargemaster, even if the price the provider actually pays for it remains the same.

Again...why some prices for procedures will vary due to patients being billed less than was reported.

The patients aren't getting billed less. They think they are because the provider lies to them. But they're not. They're paying the same price your insurer pays. In fact, they're paying more than the insurer pays because the insurer is only reimbursing a certain % of the fee, with the patient picking up the remainder. Remove an insurance company from the equation, and the patient pays 100% of the charge in the chargemaster.

The patients are being billed less because the markups on items listed on the chargemaster are not always accurate...and I already explained why.

 

[The Derp]

You do spend a lot of time typing in or copying off your typical bs of attempting to confuse an issue.

I haven't done that. You're the one who is confused because you don't understand what health insurance even is. You don't understand what health insurance companies do. You don't understand how any of it relates to health care. And you refuse to learn and/or accept it. So the predictable result is that you have a muddied, confused understanding of health care that is kinda, sorta informed by your vague, general understanding of economics. Then you lash out at me when I point that out while playing the victim of your own illegitimate argument. Grow up.

Free market means you have the choice whether to buy or not buy.

LOL! So, OK, that is what you think a free market is? The freedom to have the choice whether or not to buy...what? Health insurance or health care? Because why would you choose to not get life-saving treatment? How would you even make that choice if you're unconscious and being taken to the hospital? This is what I mean when I say you haven't given this any serious thought. All this seems to be in service of your ego and vanity now. For shame.

Per vaccines, it is insanity to cram foreign matter into healthy bodies via a syringe for non life threatening diseases and illnesses.

What a fucking idiot.

I have never had a vaccine and do not plan on ever getting one at this late stage in my life.

First of all, I don't believe you. Secondly, even if you haven't been struck down by those things vaccines protect against doesn't mean others won't. This is what I mean when I say you're a sociopath. You completely lack empathy. You have an inability to put yourself in someone else's shoes. Why? Who knows? Probably because your parents did such a shitty job raising you.

People of all ages are walking around as carriers for diseases they would have never been exposed to if the pharmaceutical companies had not lobbied and propagandized society to promote their crap via vaccines in order to create a market to be able to profit off of/treat people with chemicals from cradle to grave.

That is complete and total bullshit. So there were no measles before the measles vaccine? There was no polio before the polio vaccine? You don't know anything you're talking about.

 

[The Derp]

The buying groups buy the supplies...the hospitals pay them a fee specifically for belonging to the specific buying groups...already explained this to you also. Not my fault you don't follow along .

WHich has nothing to do with what we're talking about. You don't know what we're talking about. I'm not talking about the contract between providers and suppliers, I'm talking about the contract between providers and insurers. They contract with insurers for reimbursement rates for prices in the chargemaster. Suppliers have nothing to do with providers setting the price in the chargemaster. All you're doing is proving these companies are making ridiculous profits at the expense of your personal health. Clueless.

 

[The Derp]

No...you are conflating the two.

You're the one who brought up suppliers. Which has nothing to do with what providers are setting the price in their chargemaster.

I also already explained why the chargemaster fees are not set in stone.

Sigh...hospitals only have one chargemaster. What differs is how much insurers will reimburse of that charge in the chargemaster. Providers don't have dozens of different chargemasters for the dozens of insurance carriers they contract with. They only have one chargemaster and what differs is how much insurers will reimburse.

This is what I mean when I say you don't know what the fuck you're talking about.