Health insurers are (sort of) the good guys (really!)

  • Thread starter Thread starter superrific
  • Start date Start date
  • Replies: 48
  • Views: 526
  • Politics 
superrific said:
Well, it sounds as though the system worked in the end. The main cost seems to have been hassle for you, and perhaps anxiety. Neither of those factors should be ignored (anxiety is real!), but they also aren't the worst outcomes.

Some insurers use (or at least used to) hassle as a cost control feature. Think about it: having gone through that experience, will you ever again accept expensive care without checking if insurance covers it? If possible, that is. And so this can be a way for insurers to push back on over-utilization without actually denying anyone care. If they make it unpleasant to receive the care, people will only use it if strictly necessary.

I'm not saying this is a good strategy. I'm just reporting it as fact, and people can make their own judgments. I do think there is something to be said for it. There might be more to say against it. And it wouldn't surprise me if it has fallen out of favor. It would make marketing departments pull their hair out. "Wait, your goal is to make our product as annoying as you can, and to frustrate the consumers as a matter of policy?"
Click to expand...
It did work out but it doesn’t for a lot of people.

Also many people aren’t sophisticated enough to fight this.
 
superrific said:
No, doing that would be far more expensive and it would put health care beyond the reach of most Americans. Plus it is way more expensive to skimp on preventive care (which would happen if people were paying out of pocket) than to socialize the cost.

If you're not really seeing this, I'd encourage you to read the first post.
Click to expand...

What do you mean out of reach for most Americans? You can design any system to be any way you want it to, we exist in this current paradigm but imagine you could redesign the entire system, how can you possibly predict things to be far too expensive for most Americans? If you haven't noticed, everything is ALREADY FAR TOO EXPENSIVE for most Americans.

Your original post doesn't make a whole lot of sense because it assumes from the first point that the doctor is motivated solely by squeezing the patient to make the most money. To the extent they are, they already do this vis-a-vis being quasi drug salesmen, you think having the pharma industry behind them makes the current crop somehow noble? No, it doesn't. However, all that aside, if you leave America from time to time and venture to a country which doesnt have as whacked out of a health care industry as we do, doctors dont make nearly as much money, but have motives that are more in line with honor and prestige, social status, etc. I know this may surprise you, but not everyone in the world gets into a line of work purely for money, especially if they're already well compensated. So this idea that its all about "leverage" is ridiculous because you are assuming the worst here, while ignoring that pre-modernity did have doctors and they had essentially the same status as they did today. Go to even ancient societies, the idea of the healer or medicine man was always a prestigious role, so this really hasn't changed and honestly its totally misguided to think that changing our system will change who we motivate to become doctors, if anything removing the power of outside motivations (like pharma or insurance) from the picture would return to the field drawing the most honest people into the field once again, rather than todays group where many have entered the field and either had questionable motives from the get-go or had hteir values challenged because the insurers & pharma powers force them into a direction they wouldn't have gone had they not been there. This idea that removing powerful moneyed interests would make the doctor more likely to screw over the patient is just ridiculous.
 
Just a couple of generic thoughts:

  • Insurance is sold for basically anything and everything because it makes the insurer money
  • Insurance should be for large events, not how it's used now
  • Medical consumers need to be more discerning with their medical care usage and "shop" for medical care.
 
Is there any topic that superrific can't create a 5000k word essay explaining why he knows all there is to know about it?
 
uncgriff said:
Is there any topic that superrific can't create a 5000k word essay explaining why he knows all there is to know about it?
Click to expand...
Here's a tip: if you spent less time whining about people knowing things, and more time learning, then you too could know things!
 
I'm not an expert, but I don't see how insurance companies are not a major contributor to healthcare cost.

I've spoken with my doctors, and they talk about the extra staff needed to deal with and file insurance claims. The headache of deal I ng with insurance companies.

I've also had near family members receive major cost savings by paying cash for their procedures instead of using insurance.

Just looking at the overhead of an insurance company, how does it not add cost.

Edit to correct phone typing issues. :mad:
 
Last edited:
Nothing in health care should be for profit.
Fair compensation, cool.

I could make some sort of an argument for medical devices and biopharma being profitable because those innovations are massive. But for profit insurance is not good.
 
Last edited:
aGDevil2k said:
I could make some sort of an argument for medical devices and biopharma being profitable because those innovations are massive. But you cannot make an argument of for profit insurance being the good guys....not a good argument at least.
Click to expand...
Well, I just did. What's wrong with it?

I mean, look: the thread has a caveat in it, right there in the title. "(sort of)" And the sort of is a nod to the actual operation of the market today, as opposed to 75 years ago or in theory. I would say that private health insurers, all else being equal, help control costs and improve patient care. There's nobody else who can represent patients' interests collectively. But all else is not equal, right? I pointed to the way employers are involved in paying for care, and how that has made our system greatly suboptimal.

Some research I did a long time ago with my gf at the time (she has since made a career as a health policy expert) also showed that employer-based health insurance disincentivized preventive care. Basically, the idea is that insurance companies would be happy to invest and even encourage preventive care for their insureds. . . . except they have no idea whether their insureds are still going to be insured by them in their healthier futures. Because employers' shop around for insurance, and people are generally not free to continue with their existing plan if the employers change insurers, insurers can't reasonably invest in preventive care. There will be an insurer who doesn't pay for preventive care, and then swoops in to grab patients from other insurers who did invest in preventive care, and this free riding problem discourages preventive care.

So I'm very far from being an apologist for our current system, which is not the way anyone would design it from the ground up in today's world. It is important, though, to put responsibility where it belongs. Insurance companies get way too much of the blame and hate for what people hate about our health system. They are a necessary part of that system and are captive to it just like providers and patients. They aren't necessarily evil. In our system, they perform a valuable function and a cost-saving one (compared to the baseline alternative, at least). One reason people hate them is that they are the bearers of bad news. And the system also helps make them monstrous.

The nasty reality of health care in America is that we have more demand for health care than supply. That's true for a number of reasons (including the supplier inducement I described earlier, but not only that), but the point is that it has to be rationed. We currently ration by ability to pay (except in Medicare, and even then there's some of it), which is a lousy way to ration. But rationing is never fun. People get denied care in other countries as well, and sometimes they come to the US to get it. And if they don't -- well, they become unhappy with the health care system because rationing is no fun.
 
uncgriff said:
Lol. You don't want to go there
Click to expand...
I'll go anywhere I want. Why did you post a nasty, malicious comment about me? If you don't like the thread, then don't read it. I just don't understand why people insult me because I share what I've learned and/or figured out. It's a fucking message board. Don't read the messages you don't like. I'm not polluting the board. I'm not clogging threads (to the contrary -- this thread is unclogging others). I'm not saying anything offensive.

There are really only a couple of explanations for those types of posts: 1) jealousy; 2) malice; 3) some combination. I would certainly never consider making a comment like that, and I think that has something to do with valuing knowledge.
 
uncgriff said:
Nope. Purely annoyance.
Click to expand...
So you're not ignorant, you're just an asshole. Cool.

It really is astonishing how ready people are to pile on me, when all I do is share knowledge, express my own considered views, and write with clarity (which accounts for much of the length of my posts). I'm used to it by now -- way more than used to it -- but it's still perplexing and alienating.
 
superrific said:
Well, I just did. What's wrong with it?

I mean, look: the thread has a caveat in it, right there in the title. "(sort of)" And the sort of is a nod to the actual operation of the market today, as opposed to 75 years ago or in theory. I would say that private health insurers, all else being equal, help control costs and improve patient care. There's nobody else who can represent patients' interests collectively. But all else is not equal, right? I pointed to the way employers are involved in paying for care, and how that has made our system greatly suboptimal.

Some research I did a long time ago with my gf at the time (she has since made a career as a health policy expert) also showed that employer-based health insurance disincentivized preventive care. Basically, the idea is that insurance companies would be happy to invest and even encourage preventive care for their insureds. . . . except they have no idea whether their insureds are still going to be insured by them in their healthier futures. Because employers' shop around for insurance, and people are generally not free to continue with their existing plan if the employers change insurers, insurers can't reasonably invest in preventive care. There will be an insurer who doesn't pay for preventive care, and then swoops in to grab patients from other insurers who did invest in preventive care, and this free riding problem discourages preventive care.

So I'm very far from being an apologist for our current system, which is not the way anyone would design it from the ground up in today's world. It is important, though, to put responsibility where it belongs. Insurance companies get way too much of the blame and hate for what people hate about our health system. They are a necessary part of that system and are captive to it just like providers and patients. They aren't necessarily evil. In our system, they perform a valuable function and a cost-saving one (compared to the baseline alternative, at least). One reason people hate them is that they are the bearers of bad news. And the system also helps make them monstrous.

The nasty reality of health care in America is that we have more demand for health care than supply. That's true for a number of reasons (including the supplier inducement I described earlier, but not only that), but the point is that it has to be rationed. We currently ration by ability to pay (except in Medicare, and even then there's some of it), which is a lousy way to ration. But rationing is never fun. People get denied care in other countries as well, and sometimes they come to the US to get it. And if they don't -- well, they become unhappy with the health care system because rationing is no fun.
Click to expand...
BECAUSE IT IS FOR PROFIT.

And that profit is unnecessary. Profits are beneficial for the need to reinvest. Not for making as much money as possible. Insurance has no need for profits!!!!!!
 
Purple Nurple said:
So, doctors, providers, are the problem? I often thought that insurance companies shouldn’t be vilified the way they are. It”s providers that charge so much that we have to seek out 3rd parties to pay.
Click to expand...
I believe it's some of both.

If people had to pay for their own medical coverage they would be outraged. They would probably go to the doctor less and the lower demand could decrease prices. Of course they may also miss a life treating condition and die.

Insurance companies buffering that cost keeps the outrage down. It also keeps the general public unaware of the actual cost.
People are content paying their premium and there copays, until something major happens and they have to pay out of pocket.

People don't want the responsibility of medical bills, but they want the service.

Insurance should be a way to socialize the cost of care, but they are not the doctors. Oversight for overcharged has to be controlled and the insurance shouldn't be making diagnostic decisions.

Because it has transformed into being more about profit than being about socialized payment, we are where we are.

By involving the government the healthy people who can postpone the insurance payments cannot opt out of the government single payer system.
 
BlooVooDoo said:
Yeah, what does a UNC trained physician with a couple decades of experience know about anything related to healthcare?
Click to expand...
Couple of decades? You are too kind.

Current role is director of value based care analytics for one of the largest systems in the state.
 
StrangePackage said:
Damn. I was hoping Super would dig his hole a little deeper before Griff dad-dicked him.
Click to expand...
I didn't dig any hole. Nothing I said on this thread is wrong. The only thing that happened is that an asshole poster decided to insult me for no reason. Also, keep in mind that doctors don't know shit about health care economics. Physician participation in these debates is consistently mocked by health policy people, who have to deal with their unreflective generalizations from their own experience being constantly asserted as fact.

And this guy is an employee of a medical provider. Gee, I wonder why he doesn't like a thread that doesn't worship providers. If I said anything incorrect, he can express his opinion to the contrary. But he didn't. He just attacked me.
 
You must log in or register to reply here.
Back
Top