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re: Data for you to ponder tonight: insurers are not the villain. Providers are
Posted on 12/11/24 at 9:50 pm to JohnnyKilroy
Posted on 12/11/24 at 9:50 pm to JohnnyKilroy
quote:
Where the hell are all these docs?
The Northeast and the cities that most would call “desirable,” mostly.
0
Posted on 12/11/24 at 9:51 pm to deeprig9
Deeprig,
You state clearly that providers “take 95% of your insurance premiums” in your diatribe about your crooked relatives.
The first graph shows $371 B in premiums collected. $241 B in total medical costs.
If all of these medical costs were paid to physicians , then that would be 65% of their premiums , already way less than your aunties 95%.
But wait, there’s more.
It’s generally accepted that physician payments represent about 20% of health care dollars spent.
So 20% of 241 B is likely what actually goes to physicians. That’s about $48b.
That’s about 2X the profit of the insurance company itself ($23B) . So all the doctors who took care of all the patients with United insurance made about 2x what the insurance company did for the fiscal year in question.
The insurance company provided ZERO medical care or knowledge. It took zero risk. It handled ZERO emergencies. And still made half as much profit as all the money it paid to doctors.
And FYI, I’m about as right wing as they come. I’m not sure how you got anything left wing out of my statement. But clearly you aren’t the brightest. Maybe have a different aunt or uncle help you with this?
You state clearly that providers “take 95% of your insurance premiums” in your diatribe about your crooked relatives.
The first graph shows $371 B in premiums collected. $241 B in total medical costs.
If all of these medical costs were paid to physicians , then that would be 65% of their premiums , already way less than your aunties 95%.
But wait, there’s more.
It’s generally accepted that physician payments represent about 20% of health care dollars spent.
So 20% of 241 B is likely what actually goes to physicians. That’s about $48b.
That’s about 2X the profit of the insurance company itself ($23B) . So all the doctors who took care of all the patients with United insurance made about 2x what the insurance company did for the fiscal year in question.
The insurance company provided ZERO medical care or knowledge. It took zero risk. It handled ZERO emergencies. And still made half as much profit as all the money it paid to doctors.
And FYI, I’m about as right wing as they come. I’m not sure how you got anything left wing out of my statement. But clearly you aren’t the brightest. Maybe have a different aunt or uncle help you with this?
Posted on 12/11/24 at 9:58 pm to tigerfan4120
quote:
I'm sorry but how stupid are you, HailMichigan?
How much time you got?
I will never understand people who simp for companies, especially ones notorious for being terrible.
What do they even gain from it? It's not like UHC is going to give you better treatment because you take their side. They could give a shite, that's the whole point.
Posted on 12/11/24 at 10:02 pm to HailHailtoMichigan!
If anyone thinks payments to doctors are the problem in this healthcare equation, than they literally don't have a f-ing clue how this works.
If someone is using insurance, doctor's don't get to decide how much they get to charge a patient. That number is set by Medicare- i.e. the federal government. All insurance companies base their payment to doctors as a percentage of the medicare allowable. Sometimes it's a little higher than the Mediare allowable, but often times it is significantly less. Since 2001 physician payment from Medicare (and therefore insurance companies) has drop 29% when adjusted for inflation.
How many other industries are getting paid 29% less than they did 20 years ago?
If someone is using insurance, doctor's don't get to decide how much they get to charge a patient. That number is set by Medicare- i.e. the federal government. All insurance companies base their payment to doctors as a percentage of the medicare allowable. Sometimes it's a little higher than the Mediare allowable, but often times it is significantly less. Since 2001 physician payment from Medicare (and therefore insurance companies) has drop 29% when adjusted for inflation.
How many other industries are getting paid 29% less than they did 20 years ago?
Posted on 12/11/24 at 10:03 pm to EYEDOCNO
quote:
How many other industries are getting paid 29% less than they did 20 years ago?
Quite a few unfortunately
Posted on 12/11/24 at 10:14 pm to EYEDOCNO
quote:
If anyone thinks payments to doctors are the problem in this healthcare equation, than they literally don't have a f-ing clue how this works.
If someone is using insurance, doctor's don't get to decide how much they get to charge a patient. That number is set by Medicare- i.e. the federal government. All insurance companies base their payment to doctors as a percentage of the medicare allowable. Sometimes it's a little higher than the Mediare allowable, but often times it is significantly less. Since 2001 physician payment from Medicare (and therefore insurance companies) has drop 29% when adjusted for inflation.
How many other industries are getting paid 29% less than they did 20 years ago?
One of the problems with the conversation is people are conflating the term "doctor" and "provider". It's not necessarily the literal doctors running away with the bag of money, they show up and do their job and get the salary/pro-sal and they, for the most part, earn it. It's the provider owners that are the potential villain. It's my point in this thread that a health insurance company, as large as they are, with a 6% profit margin, aren't the problem.
There's definitely a systemic problem. At no point in this thread have I said "everything is fine". It's definitely not fine.
Posted on 12/11/24 at 10:22 pm to deeprig9
quote:
It's my point in this thread that a health insurance company, as large as they are, with a 6% profit margin, aren't the problem.
Why didn’t you just say that instead of making up a bunch of shite that’s not true?
Posted on 12/11/24 at 10:27 pm to Mingo Was His NameO
quote:
Why didn’t you just say that instead of making up a bunch of shite that’s not true?
I have said it 100 times on this board, and at least twice in this thread.
Posted on 12/11/24 at 10:28 pm to HailHailtoMichigan!
quote:
The data is screaming at you.
If you are attempting to apportion blame within a broken system don't forget one of the major players. Fat fricks that exercise means 12 ounce curls, getting the fork from the plate to their mouth and shuffling and wheezing to the bathroom while they light their 26th Marlboro red of the day.
Also, it is time for us to unfortunately consider when we spend on care at end of life. The last few months of healthcare often total more than was spent on a person in the previous 30 or more years. Often this is just extending life with extremely low quality of life. While it sounds like a "death panel" and I suppose it is at some level it may be one of the things that makes healthcare sustainable. If someone told me I could live 3 more months spending $600k of "someone else's money" I might indeed say yes (depending on my pain level etc) but that is a shitty ROI for humanity unless I was on the verge of solving cold fusion or curing cancer both of which I can assure you will not be the case when I'm slipping into the grave.
While I suppose it is a shitty analogy I remember after a conversation with someone that used the oft repeated phrase "I would die for my kids" it struck me how many of us would be willing to trade a few months at the end and die for the collective children. I do admit if you ask me now or ask me then the answers might be diametrically opposed.
This post was edited on 12/12/24 at 1:30 am
Posted on 12/11/24 at 10:28 pm to deeprig9
quote:
I have said it 100 times on this board, and at least twice in this thread.
You didn’t answer the question
Posted on 12/11/24 at 10:34 pm to HailHailtoMichigan!
Us Americans have horrible eating and fitness habits and expect a pill to fix it all.
Posted on 12/11/24 at 10:40 pm to HailHailtoMichigan!
Insurance should be non-profit, at least health and home.
Posted on 12/11/24 at 10:42 pm to deeprig9
You keep saying that 6% profit is ok. And I would generally agree.
Do you think that United’s $54B per year operating cost is providing that kind of value in services for its patients?
I would submit they are (like most companies of its size) a bloated corporate behemoth and don’t provide value worth their cost.
Do you think that United’s $54B per year operating cost is providing that kind of value in services for its patients?
I would submit they are (like most companies of its size) a bloated corporate behemoth and don’t provide value worth their cost.
This post was edited on 12/11/24 at 10:44 pm
Posted on 12/11/24 at 10:55 pm to deeprig9
quote:
It's the provider owners that are the potential villain. It's my point in this thread that a health insurance company, as large as they are, with a 6% profit margin, aren't the problem.
The problem with your point is that many provider owners (i.e., the hospitals and health systems) have crummy margins too.
Most hospitals aren't pulling in much different margins than the insurance companies.
Posted on 12/11/24 at 10:59 pm to rintintin
Most have no profit margin at all.
Posted on 12/11/24 at 11:05 pm to Mingo Was His NameO
quote:
Medical care would be so expensive if it wasn’t all billed through insurance and PBM’s. And yes, the CEO “only” got paid $10 million cash, but he was paid 10s of millions in stock and had access to the private jet, etc. Knighting for insurance companies certainly ain’t the lane I’d pick
I’m playing devils advocate here but if you don’t off stock options and you don’t offer a plane then you get a worse candidate to run the company. It’s capitalism. Medical cost can be lowered but doctors and hospital pay a lot for med mal practice as well. The lawyers go wild with this stuff it’s a vicious circle.
Posted on 12/11/24 at 11:07 pm to TigerGM
quote:
It’s capitalism
No it’s not
Posted on 12/11/24 at 11:18 pm to JohnnyKilroy
quote:
Most have no profit margin at all.
Correct
Most people don't know that most hospitals only make profit on a few service lines and only with commercially insured patients.
We typically see hospitals with payer mixes of maybe 25-35% commercial, which have to make up the difference for the rest of patients.
And the poster who brought up how services are priced based on Medicare is spot on. The Gov't essentially sets the prices for all services.
This post was edited on 12/11/24 at 11:20 pm
Posted on 12/12/24 at 12:03 am to Jim Rockford
quote:
Those relatively modest margins come from a risk free revenue stream.
The modest margins are because health insurance is incredibly heavily regulated and anything in excess of the number results in paybacks in premiums.
I’d focus less on profit and more on deductions to judge them.
Posted on 12/12/24 at 12:52 am to Volvagia
As has been reiterated throughout this thread, doctors salaries are not the problem. OP, wild take. Doctors salaries accountant for a small % of healthcare dollars.
You have no idea what it’s like to go 300k in med school debt, sacrifice your 20s, work your arse off for the government and insurance companies to tell you how much your time is worth.
Malpractice as a solo provider? Last check I wrote was 45k for the year. It is near impossible to make money working for yourself.
Yes extra tests get ordered. That’s to keep the scumbag attorneys off me and my family. 50%+ of the test/imaging I order I know will be negative.
Also a lot of unnecessary testing is done per pt request bec the customer is always right now. Sure you want your knee MRI tonight in the ER? Don’t be surprised to get a $5000 bill when that test outpt is $500. Can’t have your cake and eat it too.
You have no idea what it’s like to go 300k in med school debt, sacrifice your 20s, work your arse off for the government and insurance companies to tell you how much your time is worth.
Malpractice as a solo provider? Last check I wrote was 45k for the year. It is near impossible to make money working for yourself.
Yes extra tests get ordered. That’s to keep the scumbag attorneys off me and my family. 50%+ of the test/imaging I order I know will be negative.
Also a lot of unnecessary testing is done per pt request bec the customer is always right now. Sure you want your knee MRI tonight in the ER? Don’t be surprised to get a $5000 bill when that test outpt is $500. Can’t have your cake and eat it too.
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