Does anyone know if medical costs were more reasonable before the government first got involved?

[Viki63]

As long as no-one claims its free in Canada - all though if you don’t work - pay taxes it is free. You should see the tax coming off my pay check every payday - I’m paying for my medical coverage - instead of paying a monthly premium to an insurance company its taken from your paycheck in the form of tax.
.

I doubt you are paying as much in Canada as we pay in the US, because we are supporting the huge profits of the health insurance company. I pay premiums each month, plus a $7000 deductible this year, plus copays after that. On top of that the insurance companies do whatever they can to limit what they pay: ours promised x 4 to pay for my husband’s wheelchair, but then denied it when billed. We appealed it, they “lost” the paperwork- they try to discourage you to just giving up.
I would be fine with healthcare coming out of my paycheck, as long as it doesn’t go to profits for CEOs of insurance companies.

 

[markomalley]

I doubt you are paying as much in Canada as we pay in the US, because we are supporting the huge profits of the health insurance company.-

What huge profits?



I don’t call 5-7% profit huge.

On the other hand, if you’d like to see some “huge profits”:



But yet I don’t hear people complaining about the huge profits when they go out and buy a WIndows computer or buy their latest slave-labor manufactured iPhone or iPad (a/k/a Apple)

Don’t get me wrong, there are a LOT of things to criticize insurance companies about (such as their lobbying for Obamacare – for a full understanding of why they would do that, please study up on Porter’s Five Forces model – particularly the “barriers to entry” force)

But, as you can see from the charts, above, excessive profit margins are not one of those things.

 

[Peter_Plato]

What huge profits?

https://imgur.com/QLMaVyJ

I don’t call 5-7% profit huge.

On the other hand, if you’d like to see some “huge profits”:

https://imgur.com/rKUn2yq

But yet I don’t hear people complaining about the huge profits when they go out and buy a WIndows computer or buy their latest slave-labor manufactured iPhone or iPad (a/k/a Apple)

Don’t get me wrong, there are a LOT of things to criticize insurance companies about (such as their lobbying for Obamacare – for a full understanding of why they would do that, please study up on Porter’s Five Forces model – particularly the “barriers to entry” force)

But, as you can see from the charts, above, excessive profit margins are not one of those things.

Mark, you do realize that those figures actually support Viki’s point. If insurance companies are making < 5% profit currently and see a future opportunity under Obamacare to make +20% profit, then that would explain why they are so eager to lobby for the ACA. In fact, it could be argued that their lobbying is a clear sign that they recognize a gold mine when they see it. Viking is obviously talking about future profits, not the current state.

I would suggest that you hold on to those figures and check back in a few years to compare the state of things.

 

[markomalley]

Mark, you do realize that those figures actually support Viki’s point. If insurance companies are making < 5% profit currently and see a future opportunity under Obamacare to make +20% profit, then that would explain why they are so eager to lobby for the ACA. In fact, it could be argued that their lobbying is a clear sign that they recognize a gold mine when they see it. Viking is obviously talking about future profits, not the current state.

I would suggest that you hold on to those figures and check back in a few years to compare the state of things.

If I understand Ms VIki’s point correctly, she is advocating for a socialised medical system due to the unconscionable profit margin that insurance companies are making in the so-called free market system.

Of course, we know that it is not a free market system because of all the regulatory hurdles that must be overcome for an insurer to be able to operate in any given state (this situation exists already). As Obamacare kicks in full bore starting next year, we will see even greater government hurdles which will further impede competition (which is, of course, the goal).

Even in a single-payer insurance scheme (as opposed to fully nationalized healthcare, where all the means of production are owned and operated by the government), the few insurers who get government contracts to operate it will rake in money.

I agree that those few “winners” will see their margins go up, but I honestly don’t predict 20+%. They will probably rise to around 10% or so. Having said that, though, the actual stock values will increase significantly, even if the profit margin doesn’t go up all that much…that will reflect the increased number of transactions that are driven to a shrinking number of competitors.

So, no, I think that those charts make my point very well.

 

[Ridgerunner]

From what I have read on this forum Obamacare will cost about $20k for a family in a similar situation (earning $100k) in the US. That amounts to $12.3k more than what a typical Canadian family in Alberta pays for basic health care.

The question remains, “Why will Obamacare be so expensive?”

Part of it is that Obamacare is not a healthcare plan. It’s not even an insurance plan. It does nothing to address the costs of either. It’s fundamentally an income redistribution plan.

If you compare the net difference between a person in the U.S. making $100,000 and one making $40,000, you see that. If you combine the income tax difference and the Obamacare difference, the seeming $60,000 difference in net disposable income is only $10,000 in reality. The remaining $50,000 goes to the government or to costs of health insurance.

And because of mandates, combined with the “do it all, right away, and with the best” orientation of the U.S. medical system, those who are not subsidized are bearing a lot of the cost burden for others.

 

[Ridgerunner]

If I understand Ms VIki’s point correctly, she is advocating for a socialised medical system due to the unconscionable profit margin that insurance companies are making in the so-called free market system.

The only government healthcare system in the U.S. that is not presently administered by private insurance companies is V.A.

The government pays insurance companies to administer the rest. Is it 5%? I don’t know, but it would be some profit margin or other or the insurance companies wouldn’t do it.

 

[markomalley]

The only government healthcare system in the U.S. that is not presently administered by private insurance companies is V.A.

The government pays insurance companies to administer the rest. Is it 5%? I don’t know, but it would be some profit margin or other or the insurance companies wouldn’t do it.

I think CHAMPVA is actually operated by contractors.

The norm for a T&M contract is somewhere between 6 and 8 per cent fee. The norm for a firm fixed price contract for services is between 10 and 15 per cent (with a T&M contract, the risk belongs to the government, for a FFP the risk is on the vendor…that’s why the higher fee)

 

[Bobby_Jim]

If you are paying cash, and shop around, you would be able to get steep discounts off “list price” in the US as well. This is what the Amish, and other groups who don’t believe in insurance, do.

The “list price” is so high because many people have insurance to pay, so don’t care what the price is.

I have limited experience with “shopping around” but my experience has been that medical practitioners are generally unable to tell you in advance how much something costs. Maybe I don’t talk to the right people? But it seems the answer is always an “I don’t know” or “It depends on…” or “I think we usually bill XYZ and then insurance decides ABC…” But even for taking my kids to the pediatrician when they’re sick, exactly how they code it for insurance seems to vary from one time to the next. I don’t think the people who do the billing even know what they’re doing. Maybe if you say up front you are paying cash they will be more willing to say something conclusive? Even with insurance it matters because I have a high deductible which I rarely meet so it is still worth it to me to know what things are going to cost.

Certainly with more elaborate things like a hospitalization it gets very complicated when there is a separate charge for the admission, the nursing, the room & board, each doctor that visits you, every single pill, lab test, or medical device, etc etc.

The one exception I have found is my dentist, where there is basically a set menu of services and prices. To my knowledge there are also a smaller number of dental insurers so maybe that makes it easier for the dentist to set prices?

 

[JimG]

There is at least one family practice clinic in my area which takes no insurance whatever. Not Blue Cross, not Aetna, Not Medicare. nothing but cash. My understanding is that you can pay them a monthly fee for pretty much unlimited service, but you will still need insurance when a referral to a specialist is needed. And the fees are cheaper, because there is less overhead. A LOT less overhead.

 

[livingwordunity]

There is at least one family practice clinic in my area which takes no insurance whatever. Not Blue Cross, not Aetna, Not Medicare. nothing but cash. My understanding is that you can pay them a monthly fee for pretty much unlimited service, but you will still need insurance when a referral to a specialist is needed. And the fees are cheaper, because there is less overhead. A LOT less overhead.

This is what I was thinking was probably the case.

 

[Mickey_Finn]

I think of when, for example, I found out that the government was paying over $20 for a small, I think 15 or 20 ounce, bottle of rubbing alcohol. Also, one time when my daughter had to ride in an ambulance the cost was around $4,000 in 2004 that probably wasn’t any more than a half hour trip from one hospital to the next. Fortunately, it was covered by my medical insurance. But seeing how people tend to take advantage of the government by jacking up prices sky-high whenever they know the government is paying for it, can anyone be surprised if the so-called “affordable health care” bill makes medical costs even more outrageously ridiculous than they already are? Ultimately, it’s not the government that will pay for it since the government pays for it by taking money from taxpayers. So, we will ultimately be the ones paying for it. But if the prices get jacked up even higher it means we will be paying more not less. The minute the government touches anything the prices always go through the roof.

As long as I remember health care, and other cost have risen. When something is wrong is when we tend to see a drop. You mention a few anicdotal examples which do not serve ti highlight your question well. Medical transports between seperate facitities whether to repatriate, or in search of specialized care. Are billed based on the care provided. They are very expensive, and have been so for many years. We’ll have to wait and see if there are any positive or should I say negative changes in medical fees post ACA. It’s really too early at this point.

The rest of your post is a sort of TEA Party rant. So there is no need to comment.

ATB