Maybe this should be pushed to Chit Chat as it is part rant, but also truth.
I believe the health insurance model we have drives up the costs of healthcare in at least 2 different ways. First of all it is similar to the model of the government getting into the student loan business. As a result of a guarantee to get money from the someone, be it insurance company or consumer, prices can continue to rise unchecked by a free market system. If the insurance company feels a pinch to profit from these rising prices they simply pass it on to the end consumer who pays more in premiums and deductibles. The consumer has no choice or option other than forgoing care, so continues to pay more for services that rise well above the cost of normal inflation, let alone the low inflation rates we have been in for years now. Similar to how Universities continue to raise tuition well above the rate of inflation as a result of guaranteed payments as a result of our government backed loan system that doesn't allow defaults.
My second thought is how insurance companies rely on the rebate model companies use to lure people into a purchase. Companies know that a large percentage of people fail to follow through on the mail in rebates, and /or use them to pretend a deal is being offered when in reality the price is all ready greater as a result of the rebate and there is no real deal being had. I would love to see a study on how many people actually look at their medical bills and insurance settlement statements and then take the time to get after the insurance company for incorrect settlements, and medical providers for incorrect billings. My guess is as with the rebate model, very few actually follow through and both the medical provider and insurance company pocket the money as profit, and know full well that is what they are doing. As an example of this strategy, we have one child who has been away at school. As a result we file paperwork each year to insure if he needs medical care he can be in network where he lives. Unfortunately every year he has had a reason to go in for medical care, and every year I've had to go through statements and call the insurance company to advise them they processed the claims incorrectly. The reps I have worked with, in every case, every year, have been able to see the paperwork we filed and admit that yes, the claim needs to reprocessed. They can't explain why it wasn't done correctly in the first place. I am on year 5 of this crap with the same insurance company. This year without due diligence the tab would have been tremendous as a result of an issue he is having. Not only is it an apparent scam, it also cuts into my workday, which with trading can be f---ing significant at times.
Another aspect of the costs being driven up by healthcare insurance is the additional staff medical providers have as a result of dealing with the claims system. The processing, reprocessing and questions from patients about incorrect billings somewhat due to the complexity of the coding system used by the insurance companies in dealing with claims is completely ridiculous. Any number of times I have called in to check on a bill only to find out it needed to recoded for the service provided. I wish I could find the article, but I know I have read at least once, I believe in the Wall Street Journal about the fairly high cost of the system to doctor offices and hospital systems.
Anyway, that's my hopefully coherent rant for the day. Maybe my wife won't have to listen to me say F--- insurance for the rest of the today.
Peace
I believe the health insurance model we have drives up the costs of healthcare in at least 2 different ways. First of all it is similar to the model of the government getting into the student loan business. As a result of a guarantee to get money from the someone, be it insurance company or consumer, prices can continue to rise unchecked by a free market system. If the insurance company feels a pinch to profit from these rising prices they simply pass it on to the end consumer who pays more in premiums and deductibles. The consumer has no choice or option other than forgoing care, so continues to pay more for services that rise well above the cost of normal inflation, let alone the low inflation rates we have been in for years now. Similar to how Universities continue to raise tuition well above the rate of inflation as a result of guaranteed payments as a result of our government backed loan system that doesn't allow defaults.
My second thought is how insurance companies rely on the rebate model companies use to lure people into a purchase. Companies know that a large percentage of people fail to follow through on the mail in rebates, and /or use them to pretend a deal is being offered when in reality the price is all ready greater as a result of the rebate and there is no real deal being had. I would love to see a study on how many people actually look at their medical bills and insurance settlement statements and then take the time to get after the insurance company for incorrect settlements, and medical providers for incorrect billings. My guess is as with the rebate model, very few actually follow through and both the medical provider and insurance company pocket the money as profit, and know full well that is what they are doing. As an example of this strategy, we have one child who has been away at school. As a result we file paperwork each year to insure if he needs medical care he can be in network where he lives. Unfortunately every year he has had a reason to go in for medical care, and every year I've had to go through statements and call the insurance company to advise them they processed the claims incorrectly. The reps I have worked with, in every case, every year, have been able to see the paperwork we filed and admit that yes, the claim needs to reprocessed. They can't explain why it wasn't done correctly in the first place. I am on year 5 of this crap with the same insurance company. This year without due diligence the tab would have been tremendous as a result of an issue he is having. Not only is it an apparent scam, it also cuts into my workday, which with trading can be f---ing significant at times.
Another aspect of the costs being driven up by healthcare insurance is the additional staff medical providers have as a result of dealing with the claims system. The processing, reprocessing and questions from patients about incorrect billings somewhat due to the complexity of the coding system used by the insurance companies in dealing with claims is completely ridiculous. Any number of times I have called in to check on a bill only to find out it needed to recoded for the service provided. I wish I could find the article, but I know I have read at least once, I believe in the Wall Street Journal about the fairly high cost of the system to doctor offices and hospital systems.
Anyway, that's my hopefully coherent rant for the day. Maybe my wife won't have to listen to me say F--- insurance for the rest of the today.
Peace
