About Health Insurance

All health insurance is, when you think about it, is that it is simply a pool of money put in by people and some companies, that each person can draw upon if they need treatment.
The people running the pool try to keep expenses down by fighting hospitals and doctors for their charges, and doctors and hospitals fight insurance companies to get the amount paid raised.
So, with the experience that we have garnered so far with those battles, it apparently costs about $15,000 per year for a family to have major medical coverage.
This is no problem for people earning sufficient wages to either pay for it all, or pay some portion of it for those who's company contributes. Company contributions are however shrinking every year.
There are a few exceptions, where some companies pay for everything including dental and sight problems. These people are usually executives, Pilots (used to be), and a handful of others.
Yet, there are an estimated 45,000,000 people in the USA who have little or absolutely no health insurance. This number is above those covered with Medicare and Medicaid and some state children's insurance. The children's insurance and the disabled veteran's insurance, etc., are pretty skimpy and scarce, also.
What all that explains is that there are far too many people who are uninsured and most of them are working according to the administration. This means companies aren't paying for insurance of much benefit to lower paid workers or part-time workers.
What are we to do about this shame?
If there is a way for the 45,000,000 to pay for $15,000 worth of insurance on a $20,000 dollar earnings, or less, I don't know what it is!
May we talk a minute about efficiency and Medical Professionals salaries?
One hundred bed hospitals have 1500 employees, not counting doctors, and are wanting many more!
Doctors with 2-5 years experience practicing general medicine average wages in the lower, upper class range. Specialists higher. Professors go to school that long also.
I don't know the percentage who do not earn such wages, but I venture to say it is according to their savvy and business sense when it is lower.
Many (Doctors, Dentists, etc.) now work for Corporations (another pool) who pay them according to their "sales."
Those are nearly the facts with some mistakes, I'm sure, but not far off.
I have insinuated that hospitals are lazy and poorly managed and that doctors make too much money.
I'm sure some of that at least is true, but there must be more to it somewhere.
Is it immediate service (except on Fridays, holidays, and week-ends) or is there something else? ($10 Tylenols also help). Have you ever looked at a
hospital bill in detail? Prescriptions?
Do you have any further suggestions?

What health insurance does for you

Submitted by mapleleaf on Wed, 08/01/2007 - 7:13am.

Health insurance gets you two benefits: (1) protection from excessive charges, and (2) reimbursement of at least part of the knocked-down charge.

Here’s an example. The hospital sends you a bill for $1000. The insurance company gets you a “contractual adjustment” of $400 that knocks the bill down to $600. Then it pays $450, and you’re left to pay $150. If you’d been without insurance you would have been dunned for the whole $1000 until you had paid it, though chances are you’d have been made to pay it up front, before services were even rendered.

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not to be rude mapleleaf

Submitted by teetaw on Wed, 08/01/2007 - 8:30am.

You basically explained how health insurance works in your post, was that supposed to be a "pro" of the capitalist health insurance system?

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Fixed Health Prices that are flexible

Submitted by dollaradayandfound on Wed, 08/01/2007 - 4:54pm.

When Richard Nixon fixed prices during his realm, the medical professionals in particular got caught in a bind.
Their fees were simple and easy to understand. One person wasn't robbed and another let off easy---they used price averaging mostly, that is a filling was $20 whether it was big or little. An office visit was $20, whether it took 5 minutes or 15, etc, however Nixon's freeze didn't allow them to raise those simple prices gradually as their costs went up.
So the AMA at the insistence of doctors, dentists, etc. worked up an enormous code system where hangnails could be added in at $50 if they so chose to do so. A dentist could sell fillings by the gram and by four sides, and by tops, and by embedded, and by. etc.
Four or five kinds of office visits and consultations were formed, everything from say, $60 to $160.
Backrooms were filled with finance specialists, aides, assistants, etc., just like car dealerships, as another way to make money, and of course create jobs since there were no manufacturing jobs starting about then.
The organization stated that "Never gain will be stuck with a certain fee."
Same thing has been happening as Universal care looms.

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