Interesting Article on Health Insurance Rates

[clt_capt]

Don't get me wrong - and no disrespect meant towards PAs and NPs - My point was that the majority of ER cases do not require Trauma Trained personnel and the associated costs - but the ERs HAVE to take everyone - A serious waste.

You are right about poor docs - they need to go elsewhere...

[longfisher]

...but the thrust of the article was the price of health insurance skyrocketing and the gov't being powerless to do anything about it.

...Don't misunderstand me, without a doubt the insurance companies brought government control on themselves. My perception of the problem is that nothing was done to address the reasons that healthcare is so expensive, which is the rationale the ins. co.s use to justify their rates....

...Health Care reform is definitely required, but until we're willing to honestly address all the issues, forcing people to buy health insurance, taxing everybody to pay for it and utilizing forced price controls is a setup for failure.

The principle reason that the "government" appears to be incapable of doing anything about health care costs, particualrly insurance costs, is that health insurance is regulated by the states...not the federal government....by law.

So, a better topic might be what is the Federal government doing to encourage states to regulate health insurance. Quite a bit actually. And, maybe all that they can do under the law, as shown in the following article:

http://cciio.cms.gov/resources/facts...act_sheet.html

As the article suggests, there have been savings in many states already.

I don't pretend to understand how the Federal government did the following trick, but, PPACA (Patient Protection and Affordable Care Act) apparentlly allows the Federal government to step in and directly regulate rates in states where inadequate regulatory power exists to regulate rates or where inadequate will to regulate rates exists.

In that article there's a list of states and territories and their suboordinate programs where Federal regulation is deemed necessary and where it's not (most states where you guys and I come from are not on the list of those needing Federal regulation of rates). Those requiring Federal reguation of rates in at least one program include:

Alabama, Arizona, Idaho, Louisiana, Missouri, Montana, Pennsylvania, Virginia, and all the territories but for the Virgin Islands (for a total of 10).

State regulatory bodies are deemed adequate in all other states (and in the Virgin Islands). So, the Federal Government has set aside $250 million to the states that needed and accepted help in beefing up their regualtory efforts to examine insurance rate increases.

The House Republicans are trying to eliminate these funds. I'm wondering who they work for?

LF

[Avenger]

I don't really have time to get into a long discussion about this, and I'm sure this will seem simplistic to you but;

They can "regulate" all they want. Hold insurance companies to certain profit margins based on their costs or whatever. As long as nothing is being done to address those costs insurance is still going to be expensive. NY's insurance is highly state regulated and as an employer I can tell you from experience that every time we had a plan that was remotely affordable the state would "change the regulations" and the affordable plans would disappear and what was left got more expensive. There's a lot of things I could get into here, from insurance companies playing both sides, malpractice and care, to the gov't and lawyers being in their hip pockets as well as growing consumer expectations that when they get a fart caught sideways they need a $10 copay doctor visit and a prescription for Gas-X all paid for by someone else, but as I said, I just don't have the time.

[longfisher]

I don't really have time to get into a long discussion about this, and I'm sure this will seem simplistic to you but;

growing consumer expectations that when they get a fart caught sideways they need a $10 copay doctor visit and a prescription for Gas-X all paid for by someone else, but as I said, I just don't have the time.

Too bad you don't have the time, Avenger. I was sort of interested in how one got a fart caught sideways in the first place. But I was certainly interested in what the medical profession could do about it.

Funny anyway,

Thanks,

LF

[-Æ-]

Too bad you don't have the time, Avenger. I was sort of interested in how one got a fart caught sideways in the first place. But I was certainly interested in what the medical profession could do about it.

Funny anyway,

Thanks,

LF

It really doesn't matter, as the procedure to rectify (punn intended) the twisted fart isn't covered by insurance so no one can afford it.

[seapower]

Business, I have many Doc's as customers. Have a couple that are friends, they aren't exactly rolling in money. One is an OB Doc, I wouldn't have his job. By the way, he's just about as broke as I am most of the time. Simply put, the liability he has would make me steer clear of that job. Never mind the hours, days and the absolutely "through the roof" liability insurance premium he has to pay. It just isn't what many think it is. I would just as soon be seen by a PA or a NP anyday. The medical field (at least in my area) isn't a get rich profession. Takes special folk's and I'm glad there are those that still want to pursue it. JMO, Frank

[longfisher]

It really doesn't matter, as the procedure to rectify (punn intended) the twisted fart isn't covered by insurance so no one can afford it.

But they'll go to the ER to treat it, I'll bet. Hahahaha.

LF

[-Æ-]

Business, I have many Doc's as customers. Have a couple that are friends, they aren't exactly rolling in money. One is an OB Doc, I wouldn't have his job. By the way, he's just about as broke as I am most of the time. Simply put, the liability he has would make me steer clear of that job. Never mind the hours, days and the absolutely "through the roof" liability insurance premium he has to pay. It just isn't what many think it is. I would just as soon be seen by a PA or a NP anyday. The medical field (at least in my area) isn't a get rich profession. Takes special folk's and I'm glad there are those that still want to pursue it. JMO, Frank

No where in the medical profession is anyone getting rich, except for the lawyers. Where Drs do make money is in the areas where insurance isn't accepted (plastic surgery and cosmetic dentistry). Those are out of pocket fields and they do pretty darn good.

[longfisher]

No where in the medical profession is anyone getting rich, except for the lawyers. Where Drs do make money is in the areas where insurance isn't accepted (plastic surgery and cosmetic dentistry). Those are out of pocket fields and they do pretty darn good.

...I am often contacted not by the Doctor but by the Doctor's staff from a clinic or free-standing office about health insurance. It's never a sale, because the staff don't have any suck, only the doctor does.

But when I finally get to talk to the doctor all I hear about is diminishing reimbursements, insurance company mandated fee schedules, etc. There's never a good motivation for installing a health insurance plan.

I used to think this was all garbage and that the doctors still took him $250,000 a year and just covered it up with B.S. But the guy who lives behind me is the Director of the Neonatal Care unit at a large local hospital. He cuts his own grass, shops at discount food stores and has the most putrid pool I've ever seen (I've complained about the mosquitos to the county on several occassions). If he's making lots of money you sure wouldn't know it based on how he lives.

I think it all ends up in the hands of insurance companies and then in the hands of Wall Street, but that's just my predjudice, I suppose.

LF