Rant at Doctors

Nemesis · 2020-05-21T13:28:47.478Z

anon91495210:

I don’t give a hoot who is getting that money, the issue is that it’s broken and needs to be fixed. I’d suspect that it has a LOT to do with government regulation and medicare. If that doctor bills you directly, the cost is no where near that. Putting more government in the middle is going to make the problem worse.

The reason for the high costs are multiple but in great part is because of the old style copay method of employer Sponsored insurance. If we needed a diagnostic test as a consumer we went to whatever facility was in network and paid our copay with no regard for the actual underlying cost.

This resulted in providers never having fo operate in a truly competitive marketplace.

Since the early noughties consumer driven health plans have become popular because they a) reduce the financial burden on employers and b) force us as users of healthcare services to be informed consumers. Of couse its not all about price, quality is a key part as well; however we are now seeing providers becoming more transparent with their pricing.

Many people do not realize that its highly likely their employer meets the full costs of the medical claims. All the insurance company is doing is processing the claim on behalf of the employer and Billing them on the backend.

This was one of my biggest criticisms of the ACA. It was health insurance reform and did nothing to address transparency of costs by the providers.

anon91495210 · 2020-05-21T13:39:12.631Z

No question, too many insurers in bed with government to prohibit competition.

Nemesis · 2020-05-21T13:40:26.585Z

anon91495210:

No question, too many insurers in bed with government to prohibit competition.

What does that even mean?

How are insurance companies prohibiting competition between providers?

anon91495210 · 2020-05-21T13:43:15.725Z

By driving government regulation.

Nemesis · 2020-05-21T13:48:21.660Z

anon91495210:

By driving government regulation.

What government regulation have they insisted upon and what was their reasoning?

Yes they use lobbyists but how is that different to any other industry?

anon91495210 · 2020-05-21T14:00:47.266Z

Shutting down competition is a major issue. In EVERY industry, larger companies often use legislation to limit competition. A great example. If we pass new regulations for BSEE in the oil industry that require us to develop a real time monitoring system, that drives a lot of legal issues. For a large company, they can engage a lawyer and it’s possibly 0.05% of their revenue. For a small company, engaging the same resource can be 5% of their revenue. It limits the ability to compete. Lack of competition drives cost UP.

Nemesis · 2020-05-21T14:26:41.645Z

anon91495210:

Shutting down competition is a major issue. In EVERY industry, larger companies often use legislation to limit competition. A great example. If we pass new regulations for BSEE in the oil industry that require us to develop a real time monitoring system, that drives a lot of legal issues. For a large company, they can engage a lawyer and it’s possibly 0.05% of their revenue. For a small company, engaging the same resource can be 5% of their revenue. It limits the ability to compete. Lack of competition drives cost UP.

Well yes thats always been a problem not a lot you can do about it. Large companies will always have a financial advantage over smaller ones. Thats why so many mom and pop stores have gone out of business , they cannot compete with the big boys like Walmart and Kroger.

On one hand your bitching about government legislation but on the other sounds like you want some legislation to address those issues!!!

anon91495210 · 2020-05-21T14:35:40.648Z

No sir. I don’t want more legislation. I want the regulatory burden reduced. That’s the ONLY way to restore some competition.

Nemesis · 2020-05-21T14:39:00.845Z

So what regulatory burden is stopping new insurance companies operating.

You do understand that a significant percentage of employer operated health insurance is self insured.

This means the employer determines the benefits and premiums. Not the insurance company. Some employers contract with a carrier to access their networks, utilization management, service etc and others just have a third party processor that is just basically a claims shop.

anon91495210 · 2020-05-21T14:46:12.987Z

For starters, the ACA sets a lot of rules that need to be backed out. The requirements of what insurance you have to provide should be left to the consumer and insurance company. Second, the requirement to force an employer to provide insurance needs to go away. Quite frankly, this is worthy of a book, not a few posts on a message board. I know what I’ve read and I’m no expert on insurance regulations but what I AM an expert on is BSEE regulations regarding BOP’s and if the medical industry is anything like ours, we would do well to dump it and start over.

DMK · 2020-05-21T17:20:52.990Z

anon91495210:

I don’t give a hoot who is getting that money, the issue is that it’s broken and needs to be fixed. I’d suspect that it has a LOT to do with government regulation and medicare. If that doctor bills you directly, the cost is no where near that. Putting more government in the middle is going to make the problem worse

Agreed.

Doctors need to be paid. The government and insurance pays them very little.

DMK · 2020-05-21T17:23:37.521Z

anon91495210:

No sir. I don’t want more legislation. I want the regulatory burden reduced. That’s the ONLY way to restore some competition.

A lot of doctors are going this route.

Hell if I want my info on a data base.

What is between me and my physician is private.

I’m on an actual WAITING LIST for a doctor who does not accept insurance.

Nemesis · 2020-05-21T17:30:44.439Z

anon91495210:

For starters, the ACA sets a lot of rules that need to be backed out. The requirements of what insurance you have to provide should be left to the consumer and insurance company. Second, the requirement to force an employer to provide insurance needs to go away. Quite frankly, this is worthy of a book, not a few posts on a message board. I know what I’ve read and I’m no expert on insurance regulations but what I AM an expert on is BSEE regulations regarding BOP’s and if the medical industry is anything like ours, we would do well to dump it and start over.

The ACA did bring in a lot of regulations and not everything about it is good.

As for coverage there is a misconception that somehow insurance companies offered cafeteria plans where you could pick and mix your benefits. Fully insured business cannot operate like that. It would be an underwriting nightmare. Same with employer plans. You got what you were given or had a choice of plans but the benefits were predetermined.

Prior to the ACA my health insurance plan had benefits for contraception and other female services that I would never use. Nobody had the option of dropping those for a cheaper premium.

Nemesis · 2020-05-21T17:31:37.294Z

DMK:

anon91495210:

No sir. I don’t want more legislation. I want the regulatory burden reduced. That’s the ONLY way to restore some competition.

A lot of doctors are going this route.

Hell if I want my info on a data base.

What is between me and my physician is private.

I’m on an actual WAITING LIST for a doctor who does not accept insurance.

There is no shortage of out of network doctors.

DMK · 2020-05-21T17:32:07.582Z

ACA absolutely sucks.

DMK · 2020-05-21T17:32:49.742Z

Nemesis:

There is no shortage of out of network doctors.

Um. I just said I’m on a waiting list.

Apparently, there is.

Nemesis · 2020-05-21T17:34:11.985Z

DMK:

ACA absolutely sucks.

Parts of it do and parts do not. The removal of pre-existing conditions was an excellent decision. Medical loss ratio not so much.

Nemesis · 2020-05-21T17:35:10.092Z

DMK:

Nemesis:

There is no shortage of out of network doctors.

Um. I just said I’m on a waiting list.

Apparently, there is.

You realize the United states is a huge country. How can you extrapolate your individual situation and assume it applies to everyone?

DMK · 2020-05-21T17:36:03.952Z

Nemesis:

You realize the United states is a huge country. How can you extrapolate your individual situation and assume it applies to everyone?

I didn’t. I clearly said “I”.

Nemesis · 2020-05-21T17:37:19.380Z

DMK:

Nemesis:

You realize the United states is a huge country. How can you extrapolate your individual situation and assume it applies to everyone?

I didn’t. I clearly said “I”.

Yawn.