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Forum Post: Hospital costs are the problem - not the insurance carriers

Posted 11 years ago on March 6, 2013, 10:49 p.m. EST by Stormcrow1now (6) from Jersey City, NJ
This content is user submitted and not an official statement

There was an article this week in Time Magazine about the cost of helthcare. Everyone seems to think the reason for high healthcare costs is because of the insurance companies but that could be further from the truth.

Steven Brill wrote an article on this subject and also followed up with actually calling out the HC provider to find out why costs were so high for a couple who needed HC.

What he found out and is true with all HC providers is that they charge prices according to an internal "Chargemaster" price list that they use.

There is no rationality to how prices are determined. Medicare controls costs with HC providers who agree to their restraints. Insurance companies on the other hand are at the mercy of the HC providers because they have no leverage like Medicare/Medicade/US government has.

One other problem is that people who need HC don't understand how they are being charged and in most instances don't care.

As a result the HC providers are getting away with murder they can charge whatever they want to whomever they want when it comes to HC.

Here is the link and article that Time Magazine wrote - read it and understand that this is the reason for the high cost of Health Care -

It has nothing to do with insurance companies like we would all like to believe.

It's time to do something about it if we want the costs to come down -



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[-] 3 points by bensdad (8977) 11 years ago

Both are a problem
As long as the ins companies can give money to pols -
..............................................................................the 99% are screwed
As long as the hospital companies can give money to pols -
..............................................................................the 99% are screwed As long as the AMA can give money to pols -
..............................................................................the 99% are screwed
as the pill companies can give money to pols -
..............................................................................the 99% are screwed

just like almost everything else, it goes back to one fundamental problem
..............................................................................capitalism owns democracy
just like almost everything else, it goes back to one fundamental solution
...........................................overturn citizens united & corporate personhood

[-] 2 points by shoozTroll (17632) 11 years ago

I'm sorry, but it's two, two....two rip offs in one!!!!

YAY, they both get richer and send ever more profits to WallStreet.

Ooooops. I guess it's three rip offs in one.

[-] 2 points by alterorabolish1 (569) 11 years ago

When it comes to helping the sick, let's forget profits. Ideally there is no need for a health insurance industry, with the possible exception of luxury coverage that the rich might buy.

[-] 1 points by Stormcrow1now (6) from Jersey City, NJ 11 years ago
[-] 0 points by Justoneof99 (80) 11 years ago

Maybe WE are the real problem- READ THIS!

Dear Mr. President:

During my shift in the Emergency Room last night, I had the pleasure of evaluating a patient whose smile revealed an expensive Shiny gold tooth, whose body was adorned with a wide assortment of elaborate and costly tattoos, who wore a very expensive brand of tennis shoes and who chatted on a new cellular telephone equipped with a popular R&B ringtone.

While glancing over her Patient chart, I happened to notice that her payer status was listed as "Medic...aid"! During my examination of her, the patient informed me that she smokes more than one costly pack of cigarettes every day and somehow still has money to buy pretzels and beer.

And, you and our Congress expect me to pay for this woman's health care?

I contend that our nation's "health care crisis" is not the result of a shortage of quality hospitals, doctors or nurses. Rather, it is the result of a "crisis of culture", a culture in which it is perfectly acceptable to spend money on luxuries and vices while refusing to take care of one's self or, heaven forbid, purchase health insurance.

It is a culture based on the irresponsible credo that "I can do whatever I want to because someone else will always take care of me". Once you fix this "culture crisis" that rewards irresponsibility and dependency, you'll be amazed at how quickly our nation's health care difficulties will disappear.

Respectfully, STARNER JONES, MD

[-] 1 points by shoozTroll (17632) 11 years ago

Such a jerk you pick to prop up what position???

It's all about poverty Mr. libe(R)tarian Dr.


Where's that libe(R)tarian spirit of compassion?

This is all judgement.

I hope I am never seen by this Dr.


[-] 0 points by Justoneof99 (80) 11 years ago

What position? Personal responsibility and caring about our fellow man.

[-] -1 points by TrevorMnemonic (5827) 11 years ago

considering insurance is a way to take money out of health care, it most definitely is a problem.

Both are problems. Most insurance companies come away with a 30% profit. Meaning people paid an additional 30% into a system that did not actually give them health care for that 30%

[-] -1 points by OTP (-203) from Tampa, FL 11 years ago

The entire industry is a scam.

And now we are all forced to participate.

Fuck that.

[-] 1 points by Gillian (1842) 11 years ago

We're better off just paying the penalty ( for now anyway). Read this..excerpt from Forbes:

ACA makes it illegal for insurance providers to deny coverage to anyone for any reason. This allows healthy people to drop insurance until they actually need it without incurring any risk. It’s like allowing homeowners to buy fire insurance after their houses burn down. To counteract these new free rider incentives, the law imposes “no insurance” penalties (also defined as taxes by the Supreme Court). The problem is that these “penaltaxes” (for lack of a better word) are insufficient to the task. In fact, Chief Justice John Roberts ruled the law constitutional precisely because the burdens were not high enough to compel behavior. (In other words, he thought the law was constitutional because it will be ineffective.) The numbers support his arguments. On average, in 2010, a typical healthy young person paid at least $2,500 per year for insurance (for a plan that would still involve significant out of pocket expenses). In some areas of the country, premiums were more than twice as high. When the program takes effect in 2014 the penaltaxes will be the greater of $95 or 1% of household income. A single person earning $40,000 per year who chooses to go uninsured would then be subject to a $400 penaltax.

The decision would be an easy one: drop the insurance, incur the penaltax and pay for any routine medical services out of pocket. In the unlikely event that he gets cancer or is hit by a bus, he can always buy insurance in the ambulance on the way to the hospital. Even in 2016, as the penaltax increases to the greater of $695 or 2.5% of household income, it will still not make sense for many people to buy insurance. The penaltaxes are capped at levels that equal the full cost of an average health plan. So even high income individuals are no worse off financially for not buying insurance. In addition, the IRS’ ability to actually collect these penaltaxes is limited to garnishing income tax refund checks. If an individual is not getting a refund, the IRS is impotent.

[-] 1 points by TrevorMnemonic (5827) 11 years ago

Let's say you get in a car accident. If you get insurance after the car accident, the insurance company is not liable for those bills. So you're argument is a "yes and no" situation. Maybe if you had an ongoing problem you could get coverage for the future costs. But you have to have the insurance before the bill came out.

Also in general there are no limits on premiums. And not everything is covered either.

Still doesn't help the working poor either, those who couldn't afford the coverage in the first place.

Public option is the solution. Hundreds of billions in subsidies to insurance companies is a scam. The money should be going directly to healthcare not for a 30% profit for an insurance company.

[-] 1 points by Gillian (1842) 11 years ago

Can't use auto or home owner insurance as a comparison really. There is no pre-existing condition in those industries. According to Obamacare law, the health insurers must pay for your pre-existing illnesses that were covered or identified by other policies. For those like myself who do not have a pre-existing condition thanks to no insurance, there isn't a problem- or is there? If I go to the doctor for a pain in my chest and it's a heart attack, that's no considered pre-existing However, here's the glitch that I suspect will occur since it's already occurring: Insurers will gladly offer you a policy but will probably not cover your particular illness anymore. They have already begun slashing benefits and charging more. I'll pay the penalty for now- as it's cheaper for me since I don't have regular out of pocket medical expenses and don't take prescription medications. Knock on wood. Single payer is the best solution but I won't live to see that happen in this country. Too many complacent sheeples who will suck it up and pay. You're right though...Obamacare is going to drive the poor into utter poverty like no one has ever seen. I'm very afraid for us.

[-] -1 points by TrevorMnemonic (5827) 11 years ago

A car accident where you got injured. I'm not talking about the car. I'm talking about the person in the car who had a random medical problem without health insurance. Even with many forms of car insurance, if it's your fault you got into a car accident, your medical bills are not covered.

I didn't say that Obamacare is going to drive the poor into poverty like no one has ever seen. I just said it does nothing to help the poor. It does nothing to limit premiums insurance companies can charge either. Basically it does nothing to solve the insurance company issue that extracts money from the actual health care.

[-] 1 points by Gillian (1842) 11 years ago

Indeed, if premiums continue to increase, those who cannot currently afford it will certainly not be any better off. It seems utterly absurb to make someone pay for insurance when they can't afford to put a meal on the table or afford the gas to get to work.
If a person carries enough liability auto insurance, the injury should be covered even if it's your fault. If your insurance is not covering that, then you need new insurance/better coverage. It's up to the consumer to force these issues with the underwriters. I carry one million of liability that does cover the other party and anyone riding in my vehicles. However, under ACA, an injury would be covered anyway. Aside from all of the above...Obamacare does absolutely nothing to help anyone. He's forcing everyone to pay for the worst general medicine in the world with the worst outcomes of any industrialized nation. Would anyone be stupid enough to pay for a car that doesn't run properly? Yet, Americans are willing to pay for medicine that does not produce safe and effective outcomes? I'll pay the penalty if I must. Besides, they won't get a penny from me anyway because I never get a tax refund and that's the only way to collect the penalty at this time. Of course, that could change once they catch on.
I would recommend that everyone who works and does not want to pay for ACA, adjust their withholdings so that they don't get a refund.

[-] -1 points by TrevorMnemonic (5827) 11 years ago

If you broke your arm without health insurance and went to the hospital and had a 5000 dollar bill to correct it. You could not get that bill paid for by insurance a month later when you got insurance. If you had therapy costs for the future, that is a different story.

[-] 1 points by Gillian (1842) 11 years ago

I see. I'm not sure how that will work. I know that emergency rooms must accept patients but not sure if ACA would cover it or not. I'm not worried about paying for a broken arm though. I'm more concerned about major medical incidents...heart attack, stroke.cancer. Currently, anyone who lacks insurance can pay on a sliding scale. I had a situation back in 03 where I contracted SARS ( remember that epidemic?) and I was admitted to emergency by my doctor and kept there for 2 days until I walked out ( they were literally killing me with Tequin) I paid that bill on a sliding scale with monthly payments. It was only a hundred a month for 24months which is a lot cheaper than insurance would have cost me and ironically, I got better treatment than people who were insured. I was stunned at how I got a hospital room immedately and those who were insured were sitting on the floor in hallways. Had I still been covered at that time, my premiums would have cost me that much for 5 months. A woman I know had breast cancer and treatments and she paid on a sliding scale as well...still cheaper than the insurance would have cost her and she also had some sort of vein surgery the same way. When we hear about medical bankruptcies, it's most always involving people that were insured- only about 20 percent of bankruptcies involve uninsured. So, what's the damn point of buying it? Really! It's better to put your money into a money market savings acct. or some other interest earning account where you can earn enough to offset the penalty.
Don't misunderstand...if we were paying what other citizens pay for universa/socializedl healthcare, I wouldn't mind nearly as much. But, I absolutely refuse to pay a penny into this half-baked Obama ruse. It's just another attempt to turn Americans into lenders and I'm NOT a bank who can make loans to a government that continues to abuse and devalue our tax dollars. No bank would lend me a penny if I managed my finances that way.

[-] 1 points by TrevorMnemonic (5827) 11 years ago

Whatever bills you had before you got the insurance would not be covered.

So heart attack. First day in hospital. 5,000 dollars. That is not covered. Neither is day 2 or day 3. None of the days before your coverage starts will be covered.

If you had therapy afterward and you got insurance, that would be covered. But there is nothing saying the insurance company cannot charge you an arm and a leg for coverage either.

[-] 1 points by Gillian (1842) 11 years ago

That makes sense to me. I don't see why they should cover anything that has already occurred. But, if you find out that you have cancer, you can always get ACA. If you have a heart attack, you might get stuck with several thousands of dollars but again, you can arrange payments on a sliding scale for anything that you incur prior to ACA coverage. Yes, the fact that our coverage may be from private insurers leaves us very vulnerable to policy changes in coverage. I don't believe that ACA addresses this issue. Many insurers today are refusing coverage for many illnesses and chronic diseases. This is another reason not to waste your money on paying premiums.

[-] -3 points by jrhirsch (4714) from Sun City, CA 11 years ago

When there's an abundance of money available for a product, whether from health insurance as in the healthcare industry, or by student loans for the education industry, prices will continue to rise as fast as the supply of available money increases. Demand drives cost. Throwing more money at either healthcare or education will raise costs as surely as gasoline thrown on a fire will grow ever higher. Remove the fuel, money, and it will put out the fire.