Do Conservatives know what health insurance is?

[The Derp]

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

No...Medicare supplement plans do. And who administers those supplement plans? Private insurance companies. So thanks for proving my point.

 

[The Derp]

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

No, you didn't. And no, they're not being billed less. They think they are because the hospital comes in with a high bill, knowing that they will negotiate down to the actual cost while making the patient think they're getting a discount. It's all about optics.

 

[The Derp]

I understand I need to compensate medical professionals for their services.

So what if you cannot? You don't get the bill before you get treated.

Parasites like you demand people give you free shit.

I have not, nor have I ever demanded that. I think we should have a single-payer system that everyone pays into via a payroll tax. If you think that means people "get something for free", then you don't know what the fuck you're talking about.

Go suck start a 12 gauge.

Funny you say this, because the people most likely to do that are people like you; underachieving, entitled, middle-class whites with no (or very little) education. They're the ones killing themselves in droves because waaaaaaaaaaaahhhhhhhhhhhhhhhhhhh life didn't work out the way they hoped or were promised it would waaaaaaaaaaaaaaaaaaaahhhhhhhhhhhh! Seriously, there is no whinier group in this country than the poor, disaffected, self-entitled middle-aged whites.

 

[The Derp]

No, that's what welfare is.

So you don't know what health insurance is either. Shocking.

 

[The Derp]

I hope the OP realizes that parroting Cenk Uygur doesn't make him sound smart or clever. It actually makes you sound like a parrot who is incapable of individual thought. It is progressives pushing for "single payer" (i.e.; no insurance carriers) who don't understand how the insurance industry works. Mandating coverage of preexisting conditions while not requiring the individual mandate to carry insurance, turns insurance into a massive welfare program. If you enforce a mandate for coverage, you drastically increase the risk pool which creates unrealistic deductibles and premiums.

Exactly...and why are those deductibles and premiums unrealistically high? Because insurers are trying to make a profit. Now we all know insurance companies have nothing to do with your health care. In fact, the role an insurance company plays in your health care is a apart of a transaction you aren't even a part of. They reimburse your provider after you've had your treatment, not before. So why does it matter to you who reimburses your provider? All insurance companies do is restrict your choices; they restrict which doctors you can see, what procedures you can get, and what medications you can be prescribed. And they do all that in service not of what's best for your health care, but what's best for their bottom line. They are administrators, nothing more.

nvoke price controls and the insurance carriers can't make a profit and have no incentive to remain in business.

Exactly. So it proves that insurance companies serve no benefit to your health care. So why have them at all? Why not just have one payor, that reimburses all providers at the same rate, which then forces providers to improve outcomes and reduce costs in order to attract patients. Isn't that what you want? Because that's what free choice in health care would actually look like. You're not choosing your health care when you buy insurance. You're choosing who reimburses the provider for the health care you receive. And what they reimburse and how much they reimburse is determined not by your needs, but by their profit margins. Health insurance companies are pointless and are the reason why health care costs are so expensive.

 

[BlueGin]

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.

Insurers have nothing to do with the price of a Tylenol or an IV. )You are the one who brought it up.)

Just what they will reimburse for the procedures in general.

Again...law requires charge masters to be updated yearly...so a standard mark up is applied across the board...yearly.

Doesn't mean all procedures go up in price. It means that the chargemaster isnt updated item by item listed....instead a mark up is applied across the board i.e. The charge masters are not accurate or " fixed".

 

[The Derp]

Most of the people paying into Medicare don't use it.

Virtually no one who currently pays Medicare tax uses it because Medicare is pay-go. Those currently on Medicare are being paid for by those who currently aren't. That's the entire concept of health insurance. Seems to go right over your head.

Why should we raise the Medicare tax?

For fuck's sake, you just complained that Medicare doesn't reimburse as much as Aetna. So why? Simple, because you're paying higher premiums so Aetna can reimburse your provider at a higher rate. So if you raise Medicare's premiums (payroll tax) you can then increase the amount Medicare reimburses.

Medicare also fines hospitals hundreds of millions yearly for what they deem "over treating". What are they doing with THAT money hmmm? .

Putting it right back into the system. And what Medicare is actually doing isn't "fining" hospitals, it's refusing to reimburse hospitals for care for conditions that arose after the patient was already there for treatment. For example, you go in for a hip replacement, but then develop a staph infection while in recovery. Pre-ACA, Medicare would pay for the hip replacement and the staph infection treatment. But Obama put a stop to that by saying to providers that you have to do a better job treating people so they don't get secondary conditions from being in their care. So since Obamacare, Medicare pays for the hip replacement, but then forces the provider to pay for the staph infection because in Medicare's eyes, the provider fucked up and should be responsible for bearing the cost of that fuckup. That's how you improve outcomes. The private insurance system doesn't do that.

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.

You're a fucking idiot. You don't know what the fuck you're talking about. Medicare's administration is 1% of its entire budget. Contrast that with Aetna, whose admin costs are 17% of its entire budget. So which is less? 1% or 17%?

 

[The Derp]

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

Which has nothing to do with what we're talking about, nor does it relate to my OP.

You are trying to make the conversation about something else because...because...you don't know what the fuck you're talking about but feel it imperative to share your uninformed opinion anyway.

I worked these contracts for 10 years...you are the one who is confused...not me. Chargemasters have nothing to do with the above.

Exactly. Which is what I've been saying. You're throwing a red herring into this debate. I wasn't talking about how providers purchase from suppliers. I was talking about how providers contract with insurers to determine how much the insurer will reimburse the price set in the hospital's chargemaster. That's where the markup is happening. It's also the part of the process that you don't seem to want to acknowledge or even discuss.

 

[The Derp]

Insurers have nothing to do with the price of a Tylenol or an IV. )You are the one who brought it up.)

They have everything to do with it because the insurer is contracting with the provider to reimburse a portion of the cost of the IV or tylenol that is set in the chargemaster. So the insurance company jacks the cost of the IV bag so the insurer pays more money for it.

ust what they will reimburse for the procedures in general.

Reimburse a % based on what? The fee in the chargemaster. So what happens is insurers go to the provider, demand a discount, so the provider cooks up an inflated price and then discounts on that inflated price to a less-inflated (but still inflated) price that maintains their profit margins. That's what it's all about; profit margins. Not health care.

uAgain...law requires charge masters to be updated yearly...so a standard mark up is applied across the board...yearly.

Right, even when the cost between the supplier and provider doesn't change. So why are they marking up the price if the price they're buying it for doesn't change? TO MAKE PROFITS. That's why health care companies are extremely profitable and why they spend more lobbying Congress than the Defense and Oil industries combined.

 

[BlueGin]

Most of the people paying into Medicare don't use it.

Virtually no one who currently pays Medicare tax uses it because Medicare is pay-go. Those currently on Medicare are being paid for by those who currently aren't. That's the entire concept of health insurance. Seems to go right over your head.

Why should we raise the Medicare tax?

For fuck's sake, you just complained that Medicare doesn't reimburse as much as Aetna. So why? Simple, because you're paying higher premiums so Aetna can reimburse your provider at a higher rate. So if you raise Medicare's premiums (payroll tax) you can then increase the amount Medicare reimburses.

Medicare also fines hospitals hundreds of millions yearly for what they deem "over treating". What are they doing with THAT money hmmm? .

Putting it right back into the system. And what Medicare is actually doing isn't "fining" hospitals, it's refusing to reimburse hospitals for care for conditions that arose after the patient was already there for treatment. For example, you go in for a hip replacement, but then develop a staph infection while in recovery. Pre-ACA, Medicare would pay for the hip replacement and the staph infection treatment. But Obama put a stop to that by saying to providers that you have to do a better job treating people so they don't get secondary conditions from being in their care. So since Obamacare, Medicare pays for the hip replacement, but then forces the provider to pay for the staph infection because in Medicare's eyes, the provider fucked up and should be responsible for bearing the cost of that fuckup. That's how you improve outcomes. The private insurance system doesn't do that.

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.

You're a fucking idiot. You don't know what the fuck you're talking about. Medicare's administration is 1% of its entire budget. Contrast that with Aetna, whose admin costs are 17% of its entire budget. So which is less? 1% or 17%?

I wasn't complaining about Medicare. I was stating a fact. They cover less and pay out less.

BTW I was offered a job in Washington working Medicare...I know what they pay. And the paper pushers make two/three times what the market rate is for other healthplans across the country.

 

[BlueGin]

Insurers have nothing to do with the price of a Tylenol or an IV. )You are the one who brought it up.)

They have everything to do with it because the insurer is contracting with the provider to reimburse a portion of the cost of the IV or tylenol that is set in the chargemaster. So the insurance company jacks the cost of the IV bag so the insurer pays more money for it.

ust what they will reimburse for the procedures in general.

Reimburse a % based on what? The fee in the chargemaster. So what happens is insurers go to the provider, demand a discount, so the provider cooks up an inflated price and then discounts on that inflated price to a less-inflated (but still inflated) price that maintains their profit margins. That's what it's all about; profit margins. Not health care.

uAgain...law requires charge masters to be updated yearly...so a standard mark up is applied across the board...yearly.

Right, even when the cost between the supplier and provider doesn't change. So why are they marking up the price if the price they're buying it for doesn't change? TO MAKE PROFITS. That's why health care companies are extremely profitable and why they spend more lobbying Congress than the Defense and Oil industries combined.

What part of the actual pricing for the customer is less because the prices on all items don't change but the required mark up that is reported does ...across the board ....isn't penetrating your thick skull??

 

[BlueGin]

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

Which has nothing to do with what we're talking about, nor does it relate to my OP.

You are trying to make the conversation about something else because...because...you don't know what the fuck you're talking about but feel it imperative to share your uninformed opinion anyway.

I worked these contracts for 10 years...you are the one who is confused...not me. Chargemasters have nothing to do with the above.

Exactly. Which is what I've been saying. You're throwing a red herring into this debate. I wasn't talking about how providers purchase from suppliers. I was talking about how providers contract with insurers to determine how much the insurer will reimburse the price set in the hospital's chargemaster. That's where the markup is happening. It's also the part of the process that you don't seem to want to acknowledge or even discuss.

I already explained both to you. you just don't know what you are talking about.

 

[Toddsterpatriot]

That one works for me. Does it work for you?

It's what I've been saying this entire time. And you've been simultaneously denying and accepting it. Hence, the goalpost shifting.

Nope. Never said that. Not even once.
Allowing people to get "insurance" after they get sick isn't health insurance. It's welfare.

Of course, people don't just pick up insurance at any given time. They can't. Because insurance companies have this thing called "enrollment periods". For plans offered on the Obamacare Exchanges, that period runs October through January. Once the period ends, you cannot enroll in coverage. So someone getting sick and then getting insurance isn't something that can even happen. This is what I'm talking about when I say you don't know what health insurance is, don't know what insurance companies do, and don't know how any of it relates to delivery of health care.

No. My definition has been consistent, whether you're too stupid to understand it or not.

No, it hasn't because you haven't given it any thought, haven't bothered to learn anything about it, and don't understand how it works.

Every time I started a new job, I got the opportunity to get new insurance, immediately..

Yeah, you know why??? Because your employer buys a group plan. You can't buy insurance individually after open enrollment periods. So what you were saying, that people wait until they get sick to buy insurance, isn't something that can even happen given how individuals buy insurance in the marketplace. So you deliberately conflate employer-provided, group insurance plans with individual insurance. That's because you don't know what health insurance is, don't know what insurance companies do, and don't know how any of it relates to delivery of health care.

Wrong. I say Obamacare, where you can buy a policy after you're sick, is not insurance.
The insurance we had before Obamacare fucked things up was actual insurance.

Again, you can't do that. You can't buy an Obamacare exchange plan at any given time. You can only enroll in those plans during the Open Enrollment period. So thanks for proving to me that you don't even know the first thing about that which you speak. But that's really your M.O.; you run your mouth, then have to walk everything back later. Pathetic.

It's what I've been saying this entire time

Then you agree, Obamacare with the pre-existing condition option isn't insurance.
Glad you can finally admit your error.

For plans offered on the Obamacare Exchanges, that period runs October through January.

Can I be diagnosed with cancer in September and buy "insurance" for the first time in October?

So someone getting sick and then getting insurance isn't something that can even happen.

But it can, see above.

This is what I'm talking about when I say you don't know what health insurance is

I posted the definition of insurance. Do you agree with it or not?
Because it looks like you're moving the goalposts again.

No, it hasn't

Are you telling me you don't see the conflict between the definition I posted and Obamacare? Seriously?

Yeah, you know why??? Because your employer buys a group plan.

So when you said I can't get it anytime I want, you were wrong in my case.

 

[BlueGin]

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

No...Medicare supplement plans do. And who administers those supplement plans? Private insurance companies. So thanks for proving my point.

Medicare has lifetime reserve days and reserve half days.

 

[BlueGin]

Insurers have nothing to do with the price of a Tylenol or an IV. )You are the one who brought it up.)

They have everything to do with it because the insurer is contracting with the provider to reimburse a portion of the cost of the IV or tylenol that is set in the chargemaster. So the insurance company jacks the cost of the IV bag so the insurer pays more money for it.

ust what they will reimburse for the procedures in general.

Reimburse a % based on what? The fee in the chargemaster. So what happens is insurers go to the provider, demand a discount, so the provider cooks up an inflated price and then discounts on that inflated price to a less-inflated (but still inflated) price that maintains their profit margins. That's what it's all about; profit margins. Not health care.

uAgain...law requires charge masters to be updated yearly...so a standard mark up is applied across the board...yearly.

Right, even when the cost between the supplier and provider doesn't change. So why are they marking up the price if the price they're buying it for doesn't change? TO MAKE PROFITS. That's why health care companies are extremely profitable and why they spend more lobbying Congress than the Defense and Oil industries combined.

Insurers reimburse based on procedures...not the supplies used.

Hence they are only billed using procedure codes. Not itemized lists of supplies i.e. "Tylenol" or " IV bags".

 

[The Derp]

I wasn't complaining about Medicare. I was stating a fact. They cover less and pay out less.

Fine. But why do they do that? Because of how much is paid into it. So the reason Aetna reimburses more than Medicare in some cases, is because you're paying higher premiums for Aetna and thus, Aetna can reimburse more. So if you raise the Medicare tax, that leads to more money able to be spent toward reimbursement. So why not just do that, and do away with private insurance altogether? Medicare-for-all is 100% portability, which you don't get with private insurance. So if you are on Medicare you can go to any doctor nationwide that accepts Medicare. If you are on Aetna, you can only go to the doctor in your geographically-limited area, and even then the doctor has to be a part of that insurance network, which isn't a guarantee.

BTW I was offered a job in Washington working Medicare...I know what they pay. And the paper pushers make two/three times what the market rate is for other healthplans across the country.

First of all, Medicare doesn't do Medicare administration. Thanks to the 2003 Medicare Part-D legislation Conservatives passed, all CMS services are done by private companies. So when you say you were "offered a job to work for Medicare", what specifically are you talking about?

 

[The Derp]

Medicare has lifetime reserve days and reserve half days.

The supplement plans administered by private companies do. You seem allergic to that distinction. How come?

 

[BlueGin]

Medicare has lifetime reserve days and reserve half days.

The supplement plans administered by private companies do. You seem allergic to that distinction. How come?

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c05.pdf
Medicare benefits policy chapter 5

Lifetime reserve days.

 

[The Derp]

Insurers reimburse based on procedures...not the supplies used.

They reimburse for everything that is covered by the plan. So cotton swabs, bandages, advil and procedures...it's all priced out in the chargemaster. Otherwise, from where do you think they are determining how much insurance reimburses?

Hence they are only billed using procedure codes. Not itemized lists of supplies i.e. "Tylenol" or " IV bags".

Fine. Whatever. Changing the word doesn't change what's happening. If you want to make a semantic argument, fine. Just know it's still an inaccurate argument you're making. The only way you can is to shift the goalposts.

 

[The Derp]

What part of the actual pricing for the customer is less because the prices on all items don't change but the required mark up that is reported does ...across the board ....isn't penetrating your thick skull??

No part is less. The patient isn't getting a discount if they don't have insurance and elect to pay cash. They're paying more than the insurer pays for the same procedure. So say X procedure is listed as $50K in the chargemaster. If you have an 80/20 insurance plan, the insurer is paying $40K, and you're paying $10K. If you don't have insurance, X procedure still costs $50K. And instead of only paying $10K, you're paying the full $50K because there is no other payor. So what hospitals do is they intially bill you $75K, and you then apply or ask for a "discount", and the hospital very "generously" reduces your bill to $50K. Which is what your insurance would have paid 80% of anyway, only now you're voluntarily paying what their share would be on top of what you're also paying out-of-pocket, but you're very obliviously paying what the rate is anyway while walking away thinking you got the better of the provider. You didn't. You got hosed.

That's how it works.