Medical Costs Are the Only Thing More Outrageous Than Insurance Costs

This morning, I started thinking about those 'co-op' proposals and started putting together a small model.

Let's say you took a random pool of 100 people, and charged them $100 a month for coverage - that seems reasonable to me. It totals out, though, to $120k per year.

Let's say each of those 100 people get a once-yearly check up, at a cost to the fund of $150 for each. Now we're down to $105k. And let's say 15 of those 100 give birth, at today's costs of about $8k a piece. WHOOPS! We've just gone $15k in the hole!

"Tort reform! Tort reform!"

Is anyone here stupid enough to think that any savings from a reduction in malpractice costs (which is what we SHOULD be calling it - not "tort reform") will actually be passed onto the patients?

Honey, I got a house in Belle Meade to sell you if you think that's true.

Or will it just be turned to profit?

The only way to really regard this is to have entities set firm, non-negotiable per service rates, such as single-payer does. Otherwise, no matter how much you reform the insurance industry, the delivery end can still run amok.

And that's just talking cases where fraud hasn't yet come into play.

a 10-minute acute visit for possible strep throat should cost about $20 for the visit and another $30 for the culture, followed by $10 worth of generic antibiotic. If you actually look at your EOB for that visit, you'll see about $400 for the visit & culture, and the patented antibiotic another $150. This is because the insurance companies have figured out a way to get $350 of profit from the visit with their bookkeeping and friendly legislation.

For paying cash?

my SIL made a deal with her doctor and paid about 50% of the "list price" for routine stuff, by paying cash. So you can glean from that that a health insurance company makes about a 100% mark up.

the insurance companies exist only to make money for their shareholders and they do this by finding ways to collect your premium and deny your claims.

(... speaking of fraud ...)

They were fined $1.7 BILLION in Medicare fraud.

Insurers are needless. It might be expensive to get care at a hospital but the hospital provides a service with value.

Insurers are needless middlmen. We can get rid of them. When we do our healthcare system will be better off.

Those screams we hear will be the sound of millions of people wondering why they agreed to get an $800 (I hear it's gone down a bit) MRI for an already obvious cyst. Then, maybe we'll get some real goddamn reform.

That we should be second guessing our doctors!

An MRI won't cost $800 under a single payer system b/c the hospital will get a yearly budget amount and will not charge Medicare on a per-service basis. Then you have the administrative savings.

Republicans are really into having "market forces" lower costs.

As if there is a free market in medical services. Who here second guesses their doctors?

So your numbers are a little off. Also, 100 is not enough to smooth out random influences. You need more like 1,000,000 and 10,000,000+ would be best.

For everyone?

true about the enrolled numbers, but that's why birth rate was chosen for the expense - something that would probably hold across the trends. OTOH, 10,000,000 strikes me as a bit large for a small co-op.

insurance companies is part of the problem