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OT Blue Cross

Nope. They aren't trying to kowtow to the insurance industry. That's just financing for yokels. The yokels should finance for a shorter term. Individuals looking for health insurance don't have an option.

Wes, this is a "free-market" deal. Republicans don't want to touch health care costs by applying pressure to the insurance industry. But everyone who's worked in the business knows that insurance companies are the ONLY ONES who are in a position to apply pressure. If you won't pressure insurers, your costs will keep spiraling up. That's because competition in that industry is a myth. Thus, the "free market" is a myth. But don't tell that to Republican legislators. They love their myths.

Insurance companies don't insure big companies. They collect fees. The companies self-insure. Cost increases are the insured companies' problem.

And the increased income to insurance companies due to cost increases are something like THREE TIMES what they could gain from increases in their number of insured (they call them "lives," as in "we cover a million lives"). Even significant losses in their numbers of insured don't outweigh the annual cost increases that pump up their bottom lines.

It comes out of taxes. Then we pay the insurance companies for our coverage. Then costs increase, and we pay them more. Welcome to the money machine.

They already have them. They'd love to have more, of course, if the government will force us to buy insurance from them with no compensating cost-cutting by the insurance companies. They want a deal like pharma got with Medicare Part D. The necessary thing, soon, is to enforce a scheme for reducing cost pressures. But the conservatives have extracted a "hands-off" policy, for now, in exchange for their vote.

It really sucks. The insurance companies have us by the balls, either way it goes.

Reply to
Ed Huntress
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Insurers pay bills submitted by medical providers. Why pick on the bill payer?

Look at who is submitting the bill and why it is so high.

Wes

Reply to
Wes

Because they took it upon themselves to do so, decades ago, when they started "managed care." Now they're the problem, because almost *all* insurance is managed care; they've become an oligopoly; and they have little or no incentive to reduce costs -- on their own.

It's like seatbelts in 1963. No manufacturer had an incentive to install them as standard equipment. As the big three (or four) said to Congress at that time, "if you don't force it, it's not going to happen."

Insurance companies have every reason to compete for the coverage they'll provide. So they keep covering more procedures. But they have no incentive to cut costs.

It's high because the insurance companies will pay. There is no economic reason for doctors or hospitals to cut their costs. None. That's why David Brooks described it as a system of "perverse incentives."

Those are the realities of health care. That's why we need heavy-handed health care reform, with plenty of regulation.

Reply to
Ed Huntress

Excuse me but "managed care" was their attempt to control costs.

I don't see how this applies.

Just for a moment, let us consider grants and student loans, to help the less financially fortunate attend college. Would you say that drives up the cost of a college education?

Yes, there will be a followup ;)

Where does Medicare, Medicaid, CHIP and any other government run health insurance fit into the escalation of medical costs? You seem to be focusing on only private health insurance.

Wes

Reply to
Wes

Go back and reread Gawande's New Yorker piece Ed. Basically, the doctors have purchased the equipment necessary to do testing themselves. It encourages increased testing. The same is true with HMO's and PPO's. They don't buy services from clinics affiliated with the hospitals which means they keep more of the pie in house.

Reply to
John R. Carroll

I don't have time to read something else about it now, John. But, having worked in the industry for about five years, writing specifically to the managed-care insurers (including Medicare and Medicaid), I can assure you that there is very little push-back from *any* insurers except for things that upset their actuarial projections -- QOL and EOL issues (quality-of-life and end-of-life). Those are the wild cards, and insurers don't take kindly to wild cards.

Sarah's "death panels" do exist. They're the Medical Directors and their staffs in the private insurance companies. They're put in an impossible ethical conflict between their medical oaths and their bonus programs. Some of them swing one way, and some swing the other.

Reply to
Ed Huntress

Well, you read it once and thought you might just remember.

Reply to
John R. Carroll

Nah. My memory is starting to worry me, in fact. d8-)

Reply to
Ed Huntress

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