Yes, this is a very long post, but I have some experience in insurance and think these points should be shared for those who are unaware of some facts regarding insurance and hospital billing.
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Originally Posted by Tramik
The idea that the government is seeking health care reform to help the people is laughable. They have only one thing in mind - more money and more power. Make no mistake, they're not here to help you.
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I completely agree.
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One thing that concerns me is that the insurance companies and big pharma corps have already agreed to this - here's the kicker - why? The Obama Administration has yet to show any transparency as to what kind of deal these big corporations are getting. And even if they do tell you something, can you believe them? Do you honestly think both these huge corporate factions are willing to make less money to benefit you? As if!
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I am a licensed insurance agent and know a thing or two about how insurance works. I quit in February due to what was happening and my company not doing the right thing. I have sold alternative health insurance that covers emergencies, and a majority of areas people need coverage.
I can tell you that it is best to be self insured, period. To get self insured as young as possible while you are healthy, and you cannot be dropped for any reason as long as you pay your bill. Now, what as the problem? Pay $100.00 per month for the rest of your life, and you get coverage for 97% of medical situations.
Here are some facts:
80% of all hospital stays are less than $5000.00
17% are between $5000.00 and $30,000.00
That leaves 3% of the catastrophic situations. Now, you can choose to get a plan that is relatively inexpensive that covers 97% of the issues you will face, and hope you don't get one of the 3% situations. I can even see a special program we all pay into say $120.00 per year for an adult to cover any catastrophic problem, and you never worry about it. What most people do is not pay for self insurance, join a company and get group insurance which cannot be denied, then sometime as they begin to age they get a health issue. They lose their job and cannot qualify for self insurance or the rates go up due to the obvious cost this person will be to be insured. They then try to get with another large company for group benefits or stay in a job they hate so as not to lose those benefits.
Had they simply gotten one of the plans which I spoke of earlier, they would not have this problem. Those plans covered Doctor visits, blood work, hospital stays, surgery up to $100,000.00 per incident. Yes there was a reasonable deductible and co-pay. There was also a prescription card so drugs were not outrageous.
The plans exist, but young people don't want to pay while they feel young and healthy and probably won't need it and don't believe they will get hurt. THEY CHOOSE NOT TO BE INSURED! Oh, they can have a $600.00 car payment, $100.00 cell phone bill, $120.00 cable tv, $500.00 clothing bill (yes I am being cheap here), etc.. My point is, they can afford it, but they choose to not spend their money on it, then when they get older and have health problems they cry because it now costs them $400.00 per month to get the same plan which they could have had for $100.00 per month. Oh, and children were covered for about $45.00 per month.
I also sold a lot of plans that covered cancer and a young person qualified for about $17.00 per month. Again, they don't think they will get ill, and if they waited until they were in their 40's the plan cost about $45.00 per month.
There are a lot of issues within the insurance industry and medical industry. I am against different payments for the same treatment. If you have BCBS insurance or an HMO and you go to the hospital needing some stitches, you have about a $100.00 payment or less. If you are uninsured, good luck getting out for less than $500.00. I professed my disgust at this disparity to the hospital billing department and their answer was, "Well, if the uninsured payed their bills we would not charge that much"! My ex-husband was not insured at the time, and I said, "Give me a $100.00 bill and I will pay it right now", but they just laughed.
There is no way to create a competitive market in health care. Insurance clients do not see the whole bill, so they don't care to shop around, it's going to cost them the same where ever they go. Uninsured often do not have family doctors and use health clinics or the hospital (a huge bill). The lawyers sue over ever little thing thus driving up medical costs, and hospitals gouge like crazy on billing.
GO TO Hospital Victims
This site will tell you exactly how badly you are being screwed by your hospital for it's services. Here is one example in my town:
On average, Tallahassee Memorial Hospital charges 2.5 times what Johns Hopkins charges, ranked the finest hospital in America.
Radiology-Diagnostic
Mark-Up 548% Ratios 0.18 Costs $31,852,691 Charge $174,442,380
Laboratory
Mark-Up 716% Ratio 0.14 Costs $12,523,170 Charges $89,633,901
Go to :
Tallahassee Memorial Charges to get a complete look at what the most popular hospital here charges as compared to John Hopkins which is arguably one of the best hospitals in the world! These are supposedly NON-PROFIT hospitals!
LOOK AT THOSE MARK-UPS!!! Now you see why we need to fix health care not just on the part of Insurance, but on the part of profit seeking non-profit hospitals, frivolous lawsuits which drive up costs.
I am a business person. Look at what restaurants do to get you in the door. They say, "Kids under 12 eat free" to get you in there. They know kids meals cost very little, and the mark up on Adult meals is very high. They can eat that cost. Now what restaurant is going to stay in business if they say, everyone can eat for $4.99? They won't because you will have 250 pound construction workers (no offense to construction workers, it's just an analogy) come in and eat $25.00 worth of food and bankrupt the business.
Yes, we need something to help those with unusual health circumstances, but there are plans available for people who are responsible, that are reasonably priced. People who choose to fly by the seat of their pants for 20 years and not pay a dime, then get sick and complain really need to look in the mirror regarding their choices. We have a great health care system here in America, and we won't if it goes the way of socialized medicine. Oh, there will be private hospitals for the very wealthy, but the rest of us will have huge waiting periods, suffer physically and emotionally all because this issue has been ill managed and it's a power grab on some politicians part.
I won't even get into how we are being made ill on purpose so as to drive up the need for medical treatment and lifelong need for drugs. What has happened to our food, drugs, and medical system is very sad.
Why would the insurance companies go for this? A. They will drop people who are costing them too much. B. They will have a HUGE market for small specialty plans which will be tempting to get once people see the need due to the ridiculous health care debacle we will soon face! Pharm loves this because all drugs will be paid for, and they will make money!!!! Of course we will be a ruined nation due to over taxation and loss of jobs, but hey, they will get rich in the meantime.