T
The_GreyPilgrim
Guest
When you decide to buy insurance for whatever you need insurance for you sign an agreement from an insurance company(IC) to provide coverage based on the terms agreed to in the policy. Payments regularly made are called premiums and those premiums under the policy(depending also on the IC but most operate the same) are placed in the IC funding pool.
For this example I will used car insurance.
When you file an insurance claim-say for instance you have a car accident-per the policy you pay a small deductable(out of pocket cost) and the IC covers the rest. Normally the loger you go without a claim the more your premiums go down; I say “normally” but if there is for any reason an increased number of claims for the IC they have the right per the policy to increase your premiums to cover their costs for an indeterminate time to maintain their business. Each one of these claims has to be billed, mailed, received, verified, investigated, adjusted, paid, and filed.
The point of all this is that, and this cannot be overstated, insurance if any type is set up for rare or dire cases involving a catestrophic loss. There are extensive paperwork and man-hours involved in processing claims of any kind, and everything involved in processing these claims must be considered when any IC determines their costs.
The problem with health insurance(hi) is that this system has been misrepresented, first by Unions and then by the IC’s themselves as a promise to “cheap” health care. Sadly too many people have bought into the lie.
The IC’s grouped insurance packages for employers with the promise that large group packages with basic coverage would always keep costs down. For a while that was true. But people became enamored with it and desired more be covered in their basic coverage. IC’s must have known that this would necessarily increase claims and therefore increase costs. But it also provided a lucrative opportunity for expansion. Eventually you had IC’s merging with hospitals who were undergoing a crisis of their own in trying to remain technologically on par with medical advancements while at the same time treating those who were underprivledged and who got free care. They found that these IC’s could subsidize their technology and balance their budgets. The trade-off was that the merger meant that the IC’s-which later became known as HMO’s-set price for care, not the doctors, not the hospitals, but IC bureaucrats. And those same bureaucrats began denying care to those who-guess what-weren’t buying insurance-the poor and underprivledged.
Now, as I said before, each claim you file has extensive costs that go with it. Transfer this principle to health insurance. Say you’re a healthy person with insurance and as part of your policy you decide to take advantage of the physical benefit covered under the plan. After a year you have had two physicals. You have then filed two claims. Over five years you file 10 claims. By comparison with your car insurance, even if you’ve had a really terrible string of luck(say one accident per year), you’ve still filed twice as many claims for hc than for your car. Multiply that by the thousands of other healthy individuals who may have taken the same advantage.
Now let’s look further. Take the example of an elderly person who has declining health, of course. Say they were lifetime smokers. And now they’re in retirement and on a fixed income. Their kids are busy and don’t come to visit as often as he/she would like. So they decide to visit their doctor once or twice a week for a check-up and some nice company or conversation. They’ve paid their premiums and they’re entitled to it. That’s 26 claims in a year, maybe even more depending on other things. Multiply this by the thousands of elderly who do the same thing.
On top of these instances you have thousands of claims being filed for families. Even minor things like bruises and the common cold. They go to their primary care physician(pcp), pay their co-pay, and the claim is filed.
Tens, and I bet, even hundreds-of-thousands of claims are processed by health insurance providers each year. Not only do they have to pay hospital employees, doctors, administrative staff and other hospital staff but their own staff as well. They have to pay first responders salaries and supplies and maintenance for their vehicles. Pay for hospital eqiupment, materials and supplies, travel expenses for investgators and adjusters and VIP’s; all of the necessary costs of running a business. Just the costs for red tape alone has to be astronomical.
(If you think I’m lying next time your at the hospital ask your doctor how much an MRI scan costs? Most likely he/she will have no idea because they never see the price, its all set by the IC’s cost managers).
And everyone complains and wonders why their premiums go up year, after year, after year? You all wonder why you get less while continually paying more?
And now you think that the government will make the system better? A system that was fundamentally flawed to begin with?
For this example I will used car insurance.
When you file an insurance claim-say for instance you have a car accident-per the policy you pay a small deductable(out of pocket cost) and the IC covers the rest. Normally the loger you go without a claim the more your premiums go down; I say “normally” but if there is for any reason an increased number of claims for the IC they have the right per the policy to increase your premiums to cover their costs for an indeterminate time to maintain their business. Each one of these claims has to be billed, mailed, received, verified, investigated, adjusted, paid, and filed.
The point of all this is that, and this cannot be overstated, insurance if any type is set up for rare or dire cases involving a catestrophic loss. There are extensive paperwork and man-hours involved in processing claims of any kind, and everything involved in processing these claims must be considered when any IC determines their costs.
The problem with health insurance(hi) is that this system has been misrepresented, first by Unions and then by the IC’s themselves as a promise to “cheap” health care. Sadly too many people have bought into the lie.
The IC’s grouped insurance packages for employers with the promise that large group packages with basic coverage would always keep costs down. For a while that was true. But people became enamored with it and desired more be covered in their basic coverage. IC’s must have known that this would necessarily increase claims and therefore increase costs. But it also provided a lucrative opportunity for expansion. Eventually you had IC’s merging with hospitals who were undergoing a crisis of their own in trying to remain technologically on par with medical advancements while at the same time treating those who were underprivledged and who got free care. They found that these IC’s could subsidize their technology and balance their budgets. The trade-off was that the merger meant that the IC’s-which later became known as HMO’s-set price for care, not the doctors, not the hospitals, but IC bureaucrats. And those same bureaucrats began denying care to those who-guess what-weren’t buying insurance-the poor and underprivledged.
Now, as I said before, each claim you file has extensive costs that go with it. Transfer this principle to health insurance. Say you’re a healthy person with insurance and as part of your policy you decide to take advantage of the physical benefit covered under the plan. After a year you have had two physicals. You have then filed two claims. Over five years you file 10 claims. By comparison with your car insurance, even if you’ve had a really terrible string of luck(say one accident per year), you’ve still filed twice as many claims for hc than for your car. Multiply that by the thousands of other healthy individuals who may have taken the same advantage.
Now let’s look further. Take the example of an elderly person who has declining health, of course. Say they were lifetime smokers. And now they’re in retirement and on a fixed income. Their kids are busy and don’t come to visit as often as he/she would like. So they decide to visit their doctor once or twice a week for a check-up and some nice company or conversation. They’ve paid their premiums and they’re entitled to it. That’s 26 claims in a year, maybe even more depending on other things. Multiply this by the thousands of elderly who do the same thing.
On top of these instances you have thousands of claims being filed for families. Even minor things like bruises and the common cold. They go to their primary care physician(pcp), pay their co-pay, and the claim is filed.
Tens, and I bet, even hundreds-of-thousands of claims are processed by health insurance providers each year. Not only do they have to pay hospital employees, doctors, administrative staff and other hospital staff but their own staff as well. They have to pay first responders salaries and supplies and maintenance for their vehicles. Pay for hospital eqiupment, materials and supplies, travel expenses for investgators and adjusters and VIP’s; all of the necessary costs of running a business. Just the costs for red tape alone has to be astronomical.
(If you think I’m lying next time your at the hospital ask your doctor how much an MRI scan costs? Most likely he/she will have no idea because they never see the price, its all set by the IC’s cost managers).
And everyone complains and wonders why their premiums go up year, after year, after year? You all wonder why you get less while continually paying more?
And now you think that the government will make the system better? A system that was fundamentally flawed to begin with?
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