Rule discussion 2 - Universal Healthcare

[Marc]

Uh oh. Is this a political statement....?

We're getting quite warm... 'Universal Healthcare' is something that I believe can be discussed if people keep the politics out of it, but the line will be close, and the language one uses will have to be focused on the perceived merits / failure modes / etc. without resorting to 'blaming' one political party or the other for 'problems' with the current and/or proposed systems. Because the ideological links of each to a specific US political party is quite clear, people will have to think, and possibly research, before they post with respect to what many people still label 'Socialized Medicine'.

 

[Wes Bucey]

We're getting quite warm... 'Universal Healthcare' is something that I believe can be discussed if people keep the politics out of it, but the line will be close, and the language one uses will have to be focused on the perceived merits / failure modes / etc. without resorting to 'blaming' one political party or the other for 'problems' with the current and/or proposed systems. Because the ideological links of each to a specific US political party is quite clear, people will have to think, and possibly research, before they post with respect to what many people still label 'Socialized Medicine'.

I wasn't looking to be political so much as cite the basic unfairness of discounts accorded to insurance companies versus the price charged to an individual patient by health care providers. Note the main reason health insurance prices are rising is NOT increased cost of health care, but the fact the insurance companies have taken such a beating in their investments. So-called "nonprofit" health care providers have similarly seen a decline in their endowments and in the annual donations which subsidized health care in the past.

I wonder, too, if a rigorous "root cause" examination of many of patient lawsuits for "malpractice" would turn up contributory causes including confusion by healthcare workers over paperwork jungles created by insurance companies and efforts by Preferred Provider Organizations to contain costs within the heavy discounts demanded by insurance companies.

I consider myself a "sophisticated consumer" by virtue of education and training, yet I have a difficult time understanding the billing I get for my family between health care and insurance. I know that I am finding one or two errors in every bill and I haven't even attacked the problem of being charged $6/day (rather than the dollar it costs in the drug store) for a box of generic brand Kleenex in the hospital room when the same box sat on the side table for a whole week without being replaced once.

Our issue was initially privacy of personal health information when offered a teaser deal by the employer. It is easy to see by now that the issue is all wrapped up in costs, insurance, and who has access to, or is barred from, adequate health care by the decisions made between employers and insurance companies. The issue is further complicated by the fact that insurers continually push privacy boundaries in an effort to root out potential costly patients and prevent them from being insured or in many cases, even employed. I have heard of many employers refusing to hire folks rejected by insurance companies. (no data, just anecdotal)

 

[Mike S.]

Marc said "Because the ideological links of each to a specific US political party is quite clear, people will have to think, and possibly research, before they post with respect to what many people still label 'Socialized Medicine'."

"Every strike in the past decade has been over health-care issues," said Greg Denier, a UFCW spokesman. "It's a growing problem. The system is collapsing. More and more employers are abandoning their employees, shifting millions of dollars in costs on them."

How important is healthcare? Some thoughts...

http://www.bayarea.com/mld/mercurynews/news/7051869.htm"

Wes said"Note the main reason health insurance prices are rising is NOT increased cost of health care, but the fact the insurance companies have taken such a beating in their investments."
_____________________

After all of the talk, warnings to keep politics out of the forums, and a week of setting groundrules, all because of Marc's decision that the politics have to go, Marc is the one to sanction a political thread in just a week! So, politics is okay as long as people "think and research" before they post? Like, no one did that in the past? Or only certain people here are capable of acceptable thought and research? Okay, Wes, where did you get your facts (where did you research) to come to the conclusion of your statement above?

If this discussion isn't political, it is on a darn slippery slope, IMO.

 

[Wes Bucey]

My Sources

Wes said"Note the main reason health insurance prices are rising is NOT increased cost of health care, but the fact the insurance companies have taken such a beating in their investments."
. . .

Okay, Wes, where did you get your facts (where did you research) to come to the conclusion of your statement above?

If this discussion isn't political, it is on a darn slippery slope, IMO.

Mike is partly correct - I was making a demagogic point.

I realize fully that there are many factors which go into the high cost of health insurance and the disparity between prices charged by health care providers to individuals and to insurance companies for the same procedures (and, in fact, have researched this topic extensively while trying to determine the best balance for our company between health insurance with low copay and high copay. High copay is where our company separately subsidizes employees outside of the insurance company process. - see my source list in red at the bottom of this post.)

One thing I learned is that hospitals and other health care providers create a "list price for their services" to maximize their tax writeoff when the non-insured patient defaults on the cost, an outcome those providers have been conditioned to expect.

Another thing is that insurance companies have been devastated by two main factors:
1) "Baby Boomers" are much more demanding of health care than previous generations and have skewed the actuarial tables against the insurers
2) Insurers have actual investment losses and potential losses (not recognized because they are not "marked to market" like publicly traded stocks and bonds. - These unrecognized losses include real estate, investments in leases on planes, trains, and ships, portfolios of credit card and other consumer debt, etc.) They are in a desperate race to catch up by increasing premiums to bolster their reserves.

Yet another factor is the pharmaceutical sector which has a whole separate dynamic. Increased government regulation and scrutiny adds costs to the process of introducing a new drug. The company has only a few years to exploit the drug before competitors can bring out generic copies. Advertising generates pressure through patients and on providers to prescribe expensive new drugs. New drugs are subject to social and political pressures in addition to pure health and economic factors. Lest they be legislated out of existence or boycotted by powerful segments of society (for birth control pills, among others), drug companies are forced to spend millions to counter legislation and boycotts.

When I looked at all these factors, I, and I alone, concluded that the most visible and accountable rise in costs to the average person or company was directly attributable to insurance company premium rise. The premium rise far outstrips the actual rise in fees for actual health care (doctors' and nurses' take home pay, mortgages on health care facilities [rates actually went down], paperwork handling [computers are great record keepers and are cheap compared to human clerks]), especially when you consider the REAL discounts the insurers negotiate on those published increases.

This information has been compiled from varied sources like

• the Wall Street Journal,
• insurance and drug company prospectuses and annual reports,
• hospital prospectuses and annual reports,
• various polls and other studies conducted by respected entities like Massachusetts Institute of Technology, University of Chicago, Small Business Administration, American Medical Association, and others.

I apologized once for creeping into political territory. I am, however, also aware that this is a forum where most members do not make a statement unless they are pretty sure they can back it up when challenged. I consider myself in that category, but rarely have the time to write and cite as if for a scholarly publication. I also recognize my opinion will have little impact on the world or even on the group who visit here unless it makes sense in the experience of most readers.

 

[Icy Mountain]

Mike,
I'll back Wes on this one. I have life, automobile and homeowner's insurance with the same mutual insurance company (they also offer health). They limit their profit margin and also their profit deficits to a set goal by either refunding a percentage of premiums or raising premiums, respectively. I recently received a letter that explained their recent premium hike vs. years of refunds by pointing to a recent spate of natural distasters in areas where they are the leading insurer and "investment losses in our risk diversification portfolios" among other things.

 

[Mike S.]

Mike,
I'll back Wes on this one. I have life, automobile and homeowner's insurance with the same mutual insurance company (they also offer health). They limit their profit margin and also their profit deficits to a set goal by either refunding a percentage of premiums or raising premiums, respectively. I recently received a letter that explained their recent premium hike vs. years of refunds by pointing to a recent spate of natural distasters in areas where they are the leading insurer and "investment losses in our risk diversification portfolios" among other things.

So your life, auto, and/or homeowners insurance went up recently, while for several previous years you got a partial refund, correct? And you got a letter of explanation from the company citing "a recent spate of natural distasters in areas where they are the leading insurer and investment losses".

Is this, IYO, proof that "the main reason health insurance prices are rising" is investment losses? Were health insurance prices also rising in years when you got a refund?

 

[Wes Bucey]

I'm not saying you are wrong in your point, but, especially considering Marc's latest admonition, I'd like to see specifically where one (or preferably more) of these respected researchers like MIT actually came out and said what you said, that "the main reason health insurance prices are rising is NOT increased cost of health care, but the fact the insurance companies have taken such a beating in their investments." Strong statement. But listing a bunch of places where they talk about medical/insurance issues in general does not prove to me that anyone other than you came to this conclusion. Again, not saying you are wrong. Just skeptical.

And because I am still not comfortable making political statements, comments, references, or opinions of any sort or strength on these forums -- I'll just ask questions of those who do have the courage or permission.

Perhaps you missed my direct statement that it is MY conclusion
When I looked at all these factors, I, and I alone, concluded that the most visible and accountable rise in costs to the average person or company was directly attributable to insurance company premium rise. The premium rise far outstrips the actual rise in fees for actual health care (doctors' and nurses' take home pay, mortgages on health care facilities [rates actually went down], paperwork handling [computers are great record keepers and are cheap compared to human clerks]), especially when you consider the REAL discounts the insurers negotiate on those published increases.

One specific source which says investment income is related to premium raise is
http://www.weissratings.com/News/Ins_General/20030624lh.htm
where Weiss writes
"PALM BEACH GARDENS, Fla., June 24, 2003 - The nation's life and health insurers experienced a 52.6 percent decline in net income during 2002, earning $7.3 billion compared to $15.4 billion in 2001, according to Weiss Ratings, Inc., the nation's leading independent provider of ratings and analyses of financial services companies, mutual funds, and stocks.
The continuing downturn in the equity market was responsible for the industry's profit decline as insurers suffered a staggering $15.5 billion capital loss on the sale of invested assets, on top of a $4.4 billion capital loss in 2001.
. . . [deleted table of actual insurance company earnings]
"Insurers continue to get beaten up by the equity markets, and we expect to see more of the same when early 2003 data come in," commented Melissa Gannon, vice president of Weiss Ratings, Inc. "These losses impact the industry's ability to maintain adequate reserves and consequently drive rate increases."

So, Mike, why are you so skeptical of MY opinion? Do I seem like some wild-eyed crackpot in my writing? Incidentally, I found the Weiss comment just in the last half hour - it did not go into my own previous analysis and conclusion.

 

[energy]

You read that?

So, politics is okay as long as people "think and research" before they post?
If this discussion isn't political, it is on a darn slippery slope, IMO.

Help me out here, Mike. Marc's post was to Lucinda's joking remark asking if she was making a political statement. Marc merely said research the subject deeper to keep from making statements that can be construed political. I took it as a caution. A warning. Like, Lucinda was asking? We already have many tongue in cheek remarks about making or not making political statements. You know, the kind? Like little kids saying, "It's a good thing I can't say the bad words or I would." It is quite evident that some are having a hard time with the new mandate. Tough. I also think that your post borders on the "personal" attack side and is out of line. You say things that you see like they are the absolute fact. I didn't read it that way. I read yours that way. Does that make me right? Does that give me the right to lambast you here because I "think" I am right? Take a deep breath.

 

[Icy Mountain]

Is this, IYO, proof that "the main reason health insurance prices are rising" is investment losses? Were health insurance prices also rising in years when you got a refund?

I was simply offering anecdotal evidence that WB's position, based on his research, makes sense to me. There are always the "spate of natural distasters" and "among other things" and I got premium refunds. The stock market tanks and I get a premium hike. No, I haven't done a chi-square DOE to prove it, but it makes sense. :truce:

 

[Mike S.]

I also think that your post borders on the "personal" attack side and is out of line. You say things that you see like they are the absolute fact. I didn't read it that way. I read yours that way. Does that make me right? Does that give me the right to lambast you here because I "think" I am right? Take a deep breath.

Personal attack? Oh puh-leeze. Maybe you should re-read my post. I did not state any facts, let alone like they were the absolute truth. Not since the supposed new rules went into effect. It is supposed to be a new ballgame now, right?

I did not "lambast" anyone. I asked some simple questions of a person who made factual statements (at least the original statement, made by Wes, a "sophisticated consumer by virtue of education and training" was made as a statement of fact, not opinion). I had not heard this reason for premium increases myself. So I asked of this person who touted his knowledge in this area, "where did you get your facts"? Is that a personal attack? Gimme a break. In the next post I even said "I'm not saying you are wrong in your point..." and again " Again, not saying you are wrong. Just skeptical" -- I just wanted to see the facts (from the quoted sources) if they existed.

This statement (investment losses are the MAIN cause of health insurance premium increases), if true, kinda ticks me off at the insurance companies, and I never heard it elsewhere, so I wanted to see the source. Wes, I'm no more skeptical of your opinion than one of my relatives, so don't take it personally. But your first post was stated as fact, not opinion. I'm not like some famous senator who goes around yelling "lies, lies, lies, lies" or something like that, I just asked questions. I thought that was legal. No insults, no cuss words, no "you're an idiot". I didn't even say "you're wrong" or "I disagree".

Show me, Energy, specifically, where my post bordered on "personal attack". I have no problem with anyone asking a source on anything I state as fact, a position I took long ago when "politics" was a legal subject here, and always provided such sources upon request if not in the original post. And I did not take the request as an attack. If what I posted bordered on "personal attack" IMO someone has gotten waaaay too thin-skinned recently.