Healthcare should not be a PROFIT driven field

[Cecilie1200]

Ok. Just to put it bluntly: The ability to save a human life, or vastly improve their life, should NOT be one that is driven by profit.

Whats the answer? Im not sure. People have to get paid for their work, yes. But the HUGE profits being raked in by the pharma companies, hospitals, doctors, etc, at the expense of what?

I recently read of a new pill that can literally cure Hepatitis C. But....the pills are $1,000 each, and a person would need many of them, making the cost prohibitive to insurance companies.

So you have a big pharma company who developed the very expensive pill; And hospitals who can give the very expensive pill; And insurance companies who may have to pay for the pill. And insurance companies don't wanna pay for it.

Just one of many countless examples of how we humans COULD save or help someone.....but, is it profitable? The profit seems to matter more than the end result lately, and it is a bunch of nonsense.

The pure greed of this nation's population is what will destroy us. Not some cavemen in the Middle East.

While we're at it...

Everyone needs food. Farmers and grocery stores should be non-profits. To do otherwise is just plain greedy.
Everyone needs clothing. Clothing designers and stores should be non-profits. To do otherwise is just plain greedy.
Everyone needs housing. Building supply stores and contractors should be non-profits. To do otherwise is just plain greedy.

Right? I mean if we're going down this road, let's go down it.

LOL, you just ran all of the libs out of the thread. Reality always drives them off to hide behind a tree.

While simultaneously hugging it, naturally.

 

[Cecilie1200]

While we're at it...

Everyone needs food. Farmers and grocery stores should be non-profits. To do otherwise is just plain greedy.
Everyone needs clothing. Clothing designers and stores should be non-profits. To do otherwise is just plain greedy.
Everyone needs housing. Building supply stores and contractors should be non-profits. To do otherwise is just plain greedy.

Right? I mean if we're going down this road, let's go down it.

Heard this one on here before.

There's a big difference between food, clothes and housing and healthcare.

But i guess trying to make everything really nice and simple allows you to treat everything the same.

When people get cancer, it can be life and death. People who work a normal job can afford food, they can afford housing and clothes, they're a part of every day life. Cancer isn't a part of every day life for most people, but when it happens, it happens hard.

Do you see the difference?

Not eating and sleeping outside in freezing temperatures also cause death. Therefore, using your logic, food and shelter should be free to all and no one should ever make a profit on them.

once again your liberal "logic" fails.

Food, clothing, and shelter are also a HELL of a lot easier and cheaper to produce than effective cancer treatment, which is a big part of why they're cheaper to acquire.

When it comes to clothes, I can wear any rag off the rack at Salvation Army just fine, if I have to. I can also subsist largely on Ramen and hamburger, if necessary. Fleabag hotels with roaches are unpleasant, but won't actually do me any harm.

If I have cancer, on the other hand, I don't believe I'll be satisfied with bargain-basement. Would you?

 

[Iceweasel]

There's nothing "not working" about saying, "We're not paying for that." Truth is, they TOLD you they weren't going to pay for it when you signed up. If you didn't read the information packet, whose fault is that?

The insurance company has no reason or desire to deny valid claims, as a matter of fact. Paying for those things is what they DO, after all, and not paying for anything would result eventually in no one choosing to do business with them. Saying their business goal is to take your money and give nothing in return would be like saying that Safeway's business goal is to get you to spend your money and then not give you your bag of groceries as you leave the store. It's ludicrous.

Most prior authorizations that go through our company get approved, and those that get denied are mostly because the doctor did a crappy job of the paperwork or of explaining the clinical necessity, and are subsequently approved on appeal. If the insurance company REALLY just didn't want to cover the medication at all, they'd just leave it off the formulary.

Your insurance policy is a contract. At no time does the fact that you are paying for the insurance entitle you to anything other than what's specifically listed in the contract. As I said, if you didn't bother to read the contract and find out what that was, that's no one's fault but yours.

But that involves reading, decision making and stuff right? Libs believe the big greedy insurance companies want their customers to die. LOL.

 

[frigidweirdo]

Why the FUCK is government involved at all? Guess they love to abridge Liberty of the individual....

Why is govt involved in anything at all? Why have govt in the first place? The answer to that one, you're going to have to figure out for yourself.

My personal point of view is how far should the govt go. With healthcare, I see the role of the govt as the one who takes the taxes, puts it into healthcare so that there is a healthcare system that doesn't require payment for essential healthcare.

But then again, I don't really listen to the millions of dollars being spent by the healthcare system which tells me it should be private.

But get this. The US govt spends about the same amount of its GDP on healthcare as the UK govt. One has the NHS the other has medicare. Spot the difference?

 

[Cecilie1200]

Republicans will tell you that profit ensures excellence.

It makes sense. If you don't reward excellence, you will get incompetence.

This is true. But it ignores what Republicans have been taught to ignore, namely that profit incentivizes corruption as much as it does excellence. This is why drug companies pay doctors to push high profit drugs or unneeded servives.

When making money is the only value, people do whatever is necessary to make more money, including using the centralizing power of government to imprison consumers in an anti-competitive market of limited options.

Nice try, but profit also incentivizes the elimination of corruption. This is why drug companies spend billions on producing better, safer drugs, and on improving and even recalling drugs that prove defective.

As to profit inducing people to use the power of government to feed their greed, I guess you've just explained your attitude toward forcing others to pay for your healthcare, haven't you?

 

[Cecilie1200]

For the record, the decisions about which medications are on the insurance companys' formularies, which aren't, and which list the ones which are fall on are made by a panel of doctors, pharmacists, and actuaries employed by the insurance company. The same is true for the prescription benefit manager for whom I work. The policies by which claims are processed are likewise made by people MUCH further up the food chain than the front-line agents who get the joy of telling the patients about those decisions. They get paid a hell of a lot more than I do, and have commensurate educations in their specific fields. My job as an agent is to do one thing only: read the information on the screen and explain it to the doofus on the other end of the phone. I don't decide jack squat, and I'm perfectly happy with that.

That makes more sense than some customer relations dweeb deciding that you had your alloted blood pressure medication.

The things they believe....and they vote!

Truth is, I've hardly seen any policies in my job that I thought were silly, pointless, or arbitrary. The insurance companies we work with do everything they can to try to make policies that cover every eventuality, because even in this over-regulated and -micromanaged field, they still have competitors who would be happy to step in and take their market share.

 

[Cecilie1200]

There's nothing "not working" about saying, "We're not paying for that." Truth is, they TOLD you they weren't going to pay for it when you signed up. If you didn't read the information packet, whose fault is that?

The insurance company has no reason or desire to deny valid claims, as a matter of fact. Paying for those things is what they DO, after all, and not paying for anything would result eventually in no one choosing to do business with them. Saying their business goal is to take your money and give nothing in return would be like saying that Safeway's business goal is to get you to spend your money and then not give you your bag of groceries as you leave the store. It's ludicrous.

Most prior authorizations that go through our company get approved, and those that get denied are mostly because the doctor did a crappy job of the paperwork or of explaining the clinical necessity, and are subsequently approved on appeal. If the insurance company REALLY just didn't want to cover the medication at all, they'd just leave it off the formulary.

Your insurance policy is a contract. At no time does the fact that you are paying for the insurance entitle you to anything other than what's specifically listed in the contract. As I said, if you didn't bother to read the contract and find out what that was, that's no one's fault but yours.

But that involves reading, decision making and stuff right? Libs believe the big greedy insurance companies want their customers to die. LOL.

How silly. You get more premiums out of living people, obviously, and the odds are that most people are going to spend a LOT more on premiums in their lifetime than they ever use in benefits.

 

[Redfish]

There's nothing "not working" about saying, "We're not paying for that." Truth is, they TOLD you they weren't going to pay for it when you signed up. If you didn't read the information packet, whose fault is that?

The insurance company has no reason or desire to deny valid claims, as a matter of fact. Paying for those things is what they DO, after all, and not paying for anything would result eventually in no one choosing to do business with them. Saying their business goal is to take your money and give nothing in return would be like saying that Safeway's business goal is to get you to spend your money and then not give you your bag of groceries as you leave the store. It's ludicrous.

Most prior authorizations that go through our company get approved, and those that get denied are mostly because the doctor did a crappy job of the paperwork or of explaining the clinical necessity, and are subsequently approved on appeal. If the insurance company REALLY just didn't want to cover the medication at all, they'd just leave it off the formulary.

Your insurance policy is a contract. At no time does the fact that you are paying for the insurance entitle you to anything other than what's specifically listed in the contract. As I said, if you didn't bother to read the contract and find out what that was, that's no one's fault but yours.

But that involves reading, decision making and stuff right? Libs believe the big greedy insurance companies want their customers to die. LOL.

How silly. You get more premiums out of living people, obviously, and the odds are that most people are going to spend a LOT more on premiums in their lifetime than they ever use in benefits.

Under obamacare they will spend even more and get even less--------except those who are on medicaid and get the govt to subsidize their premiums. Those who pay will pay for those who do not, just like now. But now we also have to pay for a new huge inefficient govt beaurocracy.

its fricken lunacy

 

[Katzndogz]

Republicans will tell you that profit ensures excellence.

If you don't reward excellence, you will get incompetence.

This is true, to an extent. But it ignores what Republicans have been taught to ignore, namely that profit incentivizes corruption as much as it does excellence. This is why drug companies pay doctors to push high profit drugs. This is why the system is designed to push unneeded treatments, diagnostic services and medicines.

When making money is the only value, people do whatever is necessary to make more money, including using the centralizing power of government to imprison consumers in a rigged market of limited options.

profit only incentivizes corruption in criminals, criminals go to jail---madoff, abramoff, blago, etc.


the drug companies make obscene profits because of long patent durations, cut patents on new drugs to 3 years then let generics in, the prices will drop drastically.


we pay for unnecessary medical tests and treatments because of malpractice laws and lawyers, put caps on malpractice awards and that will stop..

the problem with you libs is that you think the fix for everything is to turn it over to the govt to manage----------that is exactly the opposite of what needs to be done.

Cut patent protection to three years and the prices during those years will go up astronomically. That is if anyone bothers to develop them. Under a cost analysis if the company can't get their money back during the protection limitation time they won't bother at all.

 

[frigidweirdo]

The unknowns of health is why people BUY insurance. once again your attempt at logic is an abject failure

Of course they do. I'm not saying they don't. My point isn't that insurance doesn't work. My point is that it shouldn't be about for profit insurance for healthcare.

Some countries have non-profit insurance. You buy, you receive.
Other countries you pay tax, and then you receive.
The US, you pay insurance, you waste loads of money on insurance companies making huge profits while some people get nothing.

http://www.hks.harvard.edu/fs/mspar...lobal Report on Corruption--2006--pp16-22.pdf

"Despite the extraordinary level of spending, health care economists have traditionally paid very little attention to corruption, fraud, waste and abuse in the US health care delivery system."

"Medical suppliers and providers constitute main loci of corruption. The principal opportunity for theft lies with providers rather than patients"

MMS: Error

"In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada."

"Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)"

"In 1999 U.S. private insurers retained $46.9 billion of the $401.2 billion they collected in premiums. Their average overhead (11.7 percent) exceeded that of Medicare (3.6 percent) and Medicaid (6.8 percent). Overall, public and private insurance overhead totaled $72.0 billion — 5.9 percent of the total health care expenditures in the United States, or $259 per capita"

So, basically (if you look at table 1) you see the per capita spending per person on ADMIN is $1,000. That's three times higher than in Canada.
So you spend $666 dollars every year (if you're Mr Joe Average) on paying for administration you don't need. And why? Because the healthcare industry is taking you for a ride.

Interest Groups | OpenSecrets

Healthcare spent $65 million dollars as interest groups.
It spent $128 million on lobbying.
It spent $27 million on PACs giving to political parties.

Where does this money come from? Yeah, it comes from people who pay insurance to get healthcare. What they end up funding is the healthcare system paying (with your money) to keep everything sweet and rosy for itself and for its profits.

Why do you think this all happens? This all happens because of vaguly regulated privatization that is costing people a fortune. But because they spend quite a lot of this money on telling you that's it's great and fantastic, you accept it all.

So my question to you is this.

Do you like being taken for a ride? Your 2 bucks that you lost today (assuming you have the average insurance policy) could probably have been spent more wisely, and probably by you. Don't you agree?

 

[frigidweirdo]

profit only incentivizes corruption in criminals, criminals go to jail---madoff, abramoff, blago, etc.


the drug companies make obscene profits because of long patent durations, cut patents on new drugs to 3 years then let generics in, the prices will drop drastically.


we pay for unnecessary medical tests and treatments because of malpractice laws and lawyers, put caps on malpractice awards and that will stop..

the problem with you libs is that you think the fix for everything is to turn it over to the govt to manage----------that is exactly the opposite of what needs to be done.

See, I'm not always in favor of govt run things. I know the govt isn't exactly the greatest, and I've seen the govt do plenty of really poor things. HOWEVER, there are systems out there where healthcare is allowed to get on with things, without govt interfering, but also without capitalism getting involved and making a whole mess of it as well.

Simply said, it's about a balance that works.

 

[boedicca]

See, I'm not always in favor of govt run things. I know the govt isn't exactly the greatest, and I've seen the govt do plenty of really poor things. HOWEVER, there are systems out there where healthcare is allowed to get on with things, without govt interfering, but also without capitalism getting involved and making a whole mess of it as well.

Simply said, it's about a balance that works.

I call shenanigans.

What balanced working (functional) health care system is there that is completely free of government interference and the effects/products of capitalism?

 

[bripat9643]

profit only incentivizes corruption in criminals, criminals go to jail---madoff, abramoff, blago, etc.


the drug companies make obscene profits because of long patent durations, cut patents on new drugs to 3 years then let generics in, the prices will drop drastically.


we pay for unnecessary medical tests and treatments because of malpractice laws and lawyers, put caps on malpractice awards and that will stop..

the problem with you libs is that you think the fix for everything is to turn it over to the govt to manage----------that is exactly the opposite of what needs to be done.

See, I'm not always in favor of govt run things. I know the govt isn't exactly the greatest, and I've seen the govt do plenty of really poor things. HOWEVER, there are systems out there where healthcare is allowed to get on with things, without govt interfering, but also without capitalism getting involved and making a whole mess of it as well.

Simply said, it's about a balance that works.

So private corporations aren't involved and government isn't involved, so how is it done?

Also, can you give one example of something you don't want the government to do?

 

[frigidweirdo]

One is voluntary, the other isn't.



I did above. It's inconsistent to support the taxing and funding of one and not the other. What drives cost down is competition. This state added requirements every year to insurance companies so there were few options. Even then it bumped up a good bit every year. Greed? It cost more to cover more, period. I have to pay for drug treatment, alcohol treatment, mental health, etc. With no option to cross state lines. You are only willing to consider one aspect and refuse to look at the whole problem.

One is voluntary, but you kind of need it, so it isn't that voluntary.

Rule one. It's illegal to commit suicide, so you are kind of forced to buy food, or at least forced to eat.
Rule two. It's illegal to walk around naked. So you kind of need to have clothes.

While it appears voluntary, something at the back say it isn't. It's a perception of being voluntary.

As for not willing to look at other aspects, I disagree. You've made a vague statement about what, supposedly, I don't look at, it isn't enough for me to actually comment on though.

 

[boedicca]

One is voluntary, the other isn't.



I did above. It's inconsistent to support the taxing and funding of one and not the other. What drives cost down is competition. This state added requirements every year to insurance companies so there were few options. Even then it bumped up a good bit every year. Greed? It cost more to cover more, period. I have to pay for drug treatment, alcohol treatment, mental health, etc. With no option to cross state lines. You are only willing to consider one aspect and refuse to look at the whole problem.

One is voluntary, but you kind of need it, so it isn't that voluntary.

Rule one. It's illegal to commit suicide, so you are kind of forced to buy food, or at least forced to eat.

And yet, people commit suicide everyday. It's rather difficult to convict a corpse. So your response here is nonsense.

Rule two. It's illegal to walk around naked. So you kind of need to have clothes.

If one is truly opposed to clothing, then one is perfectly free to join a nudist colony.

While it appears voluntary, something at the back say it isn't. It's a perception of being voluntary.

As for not willing to look at other aspects, I disagree. You've made a vague statement about what, supposedly, I don't look at, it isn't enough for me to actually comment on though.

Based on this, you have no concept of the drive of a living being to stay alive of its own volition. You think that we only take care of ourselves because the government forces us to. What a moron.

 

[frigidweirdo]

Great post.
Many Americans are whiny crybabies that are responsible for nothing and act like they are special and demand to be treated as such. It doesn't take a rocket scientist to figure out why you can't take a medication indefinitely without supervision. They would be the first to sue if complications developed. They're spoiled brats and some of the elderly are the worse ones.

Perhaps people just want things to work for them.

When things don't work, you have to wonder why they're not being fixed.

Why are things made with hoops to jump through, places to get caught out, problems to solve for no reason other than an insurance company wants to stop people being able to claim money from them so they can make high profits?

Yes, people in western countries are spoiled, that's what comes from having a good life. You have expectations about the good life, and one of those is not to be screwed over by people.

I answered that above. Which part of that escapes you? If a patient continues a medication unmonitored they could develop problems. Then they may blame the doctor. Or pharmacy. Or insurance company that helped pay for it, etc.

Your attitude exemplifies the problem, Some people think if they don't get their way it's a conspiracy to keep them down and they deserve a good life. And if the company doesn't loose money or break even they were ripped off.

My attitude is part of the problem because I actually want things that WORK. Hmm. That's interesting. We should have a major bureaucratic system (paying $1000 a year for people to be administrators of our healthcare when this is clearly unnecessary) and it should have hoops that are not necessary, and we should have things in the way, that aren't necessary because..... well because that's how it works.

When you've lived in countries that are simply crazy for bureaucracy, you get fed up with it. It get fed up with the endless nonsense that is there for the sake of being there with no one willing to say "hey, this is not right".

But there's a big difference between a company making money, and massive amounts of corruption taking place, which is the case right now.

Think about how much you spend on health insurance. Then take about 30% or 40% of this and figure out how much you throw at people who do something that is corrupt or completely unnecessary.
Think what you would have done with your $2 today that you spent on unnecessary administration.

 

[Londoner]

the problem with you libs is that you think the fix for everything is to turn it over to the govt to manage----------that is exactly the opposite of what needs to be done.

False. I would rather see a competitive market than government control - but I don't think it makes sense to divide the world into mythological opposites (market or government); Why? Because the market and government are deeply intertwined, partly because the government supplies infrastructure, some defense of overseas supply chains/trade routes, patent protection, legal protection and plenty of regulatory and financial support (subsidies/bailouts).

But yes, aside from kindergarten bifurcations, I think markets are better at allocating resources because they are more responsive to actual demand (whereas government lacks the information to set prices and the incentive to meet budgets and innovate).

So obviously, I don't think the answer is to turn everything over to government. I don't know what the answer is, but it starts with getting the market/government relationship right. This means, for instance, that you need enough legal and regulatory machinery to prevent corruption, but not so much that you impose too many burdens on suppliers that undermine investment and innovation.

But here's the problem with figuring out how to get government intervention right. It starts by educating the well meaning people who don't think government has any role in the economy. These folks don't understand that our expensive patent system, which is so crucial to incentivizing investment, is run by the nanny state. Nor do these people understand how dependent our financial system is on the legal system, also supplied by government. Nor do these people understand the kind of market distortions that originate from the private sector capture of government. There is a reason why they invests trillions into Washington for "competitive advantages". Talk Radio listeners only get one side of the story. They don't understand the degree to which the oil industry or the pharmaceutical industry has influenced the regulations and entrance barriers that apply to their industries. Nor do they understand the no-bid contract that was awarded to Eli Lilly in 2003 drug bill, which locked the taxpayer into above market drug costs for Medicare. So many market failures stem not only from bureaucrats, but the capture of the state by corporations, some of whom have paid handsomely for captive customers. Study telecom, specifically how Internet providers have divided the country mostly into fixed no compete zones, allowing them to raise prices and decrease services without being disciplined by competitors.

 

[Iceweasel]

One is voluntary, the other isn't.



I did above. It's inconsistent to support the taxing and funding of one and not the other. What drives cost down is competition. This state added requirements every year to insurance companies so there were few options. Even then it bumped up a good bit every year. Greed? It cost more to cover more, period. I have to pay for drug treatment, alcohol treatment, mental health, etc. With no option to cross state lines. You are only willing to consider one aspect and refuse to look at the whole problem.

One is voluntary, but you kind of need it, so it isn't that voluntary.

Rule one. It's illegal to commit suicide, so you are kind of forced to buy food, or at least forced to eat.
Rule two. It's illegal to walk around naked. So you kind of need to have clothes.

While it appears voluntary, something at the back say it isn't. It's a perception of being voluntary.

As for not willing to look at other aspects, I disagree. You've made a vague statement about what, supposedly, I don't look at, it isn't enough for me to actually comment on though.

You can take your chances, even now, so health care insurance is voluntary. I don't know if every state has a law against suicide (sorta doubt it, do any?) but I haven't heard of anyone successfully being prosecuted for it. I didn't mention clothes but you could run around in a burlap sack. Housing isn't a law either, lots of homeless around.

Go ahead and spin the wheel again, might get lucky.

 

[dblack]

Heard this one on here before.

There's a big difference between food, clothes and housing and healthcare.

But i guess trying to make everything really nice and simple allows you to treat everything the same.

When people get cancer, it can be life and death. People who work a normal job can afford food, they can afford housing and clothes, they're a part of every day life. Cancer isn't a part of every day life for most people, but when it happens, it happens hard.

Do you see the difference?

Not eating and sleeping outside in freezing temperatures also cause death. Therefore, using your logic, food and shelter should be free to all and no one should ever make a profit on them.

once again your liberal "logic" fails.

Food, clothing, and shelter are also a HELL of a lot easier and cheaper to produce than effective cancer treatment, which is a big part of why they're cheaper to acquire.

When it comes to clothes, I can wear any rag off the rack at Salvation Army just fine, if I have to. I can also subsist largely on Ramen and hamburger, if necessary. Fleabag hotels with roaches are unpleasant, but won't actually do me any harm.

If I have cancer, on the other hand, I don't believe I'll be satisfied with bargain-basement. Would you?

Try comparing apples to apples. Life saving cancer treatment is more on par with building a sky-scraper than a single family home. Likewise, our day-to-day health care needs aren't that demanding, and there's no reason they shouldn't fit into and ordinary family budget. But they don't, because we've tried to treat health care like it's something special, like it's a humantarian gift that no one should have to pay for. Our delusion is childish and, quite literally, killing us.

 

[dblack]

Why the FUCK is government involved at all? Guess they love to abridge Liberty of the individual....

Why is govt involved in anything at all? Why have govt in the first place? The answer to that one, you're going to have to figure out for yourself.

No. In fact, that's the one question we have to agree on. At least if you're talking about compulsive state government that we're all forced to pay for.