[ucodegen]

Funny thread title Arraya! LOL

Unfortunately it is true.. read some of the news on this all the way through.

[ucodegen]

Funny thread title Arraya! LOL

Unfortunately it is true.. read some of the news on this all the way through.

[ucodegen]

Funny thread title Arraya! LOL

Unfortunately it is true.. read some of the news on this all the way through.

[ucodegen]

Hobie wrote:
Say what? Guess intentions win over accomplishment.

Which of the nominees would you say is more deserving?

Question taken seriously:
They listed that one of the candidates was a woman doing work for woman’s rights in Afghanistan. How about her? She is putting her life at risk to try to implement change.

[ucodegen]

Hobie wrote:
Say what? Guess intentions win over accomplishment.

Which of the nominees would you say is more deserving?

Question taken seriously:
They listed that one of the candidates was a woman doing work for woman’s rights in Afghanistan. How about her? She is putting her life at risk to try to implement change.

[ucodegen]

Hobie wrote:
Say what? Guess intentions win over accomplishment.

Which of the nominees would you say is more deserving?

Question taken seriously:
They listed that one of the candidates was a woman doing work for woman’s rights in Afghanistan. How about her? She is putting her life at risk to try to implement change.

[ucodegen]

Hobie wrote:
Say what? Guess intentions win over accomplishment.

Which of the nominees would you say is more deserving?

Question taken seriously:
They listed that one of the candidates was a woman doing work for woman’s rights in Afghanistan. How about her? She is putting her life at risk to try to implement change.

[ucodegen]

Hobie wrote:
Say what? Guess intentions win over accomplishment.

Which of the nominees would you say is more deserving?

Question taken seriously:
They listed that one of the candidates was a woman doing work for woman’s rights in Afghanistan. How about her? She is putting her life at risk to try to implement change.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

Ucodegan, it appears you’re arguing against having insurance, that it’s cheaper just to pay discounted rates for care instead. In some cases I’m sure that’s correct. The whole idea of insurance (any kind of insurance) is to cover otherwise unaffordable losses.

Yes and no. I am arguing that paying direct for most of the regularly occurring ‘stuff’ and insuring for catastrophic. I am also trying to state that for most people, self-pay is actually cheaper.

What I am paying per month has nothing to with whether or not insurance companies pay full charges, which is what I believe you originally said.

True, but they can also ‘game’ the numbers they present to you so that it looks like you are saving. “Here at Scripts, this is what it would cost, but since you are with a Scripts plan, this is what we(our insurance/HMO arm) really paid us(our medical arm).” I do notice that you are with Aetna, not Scripts.. What you are paying every month does have real implications as to the cost to people. Part of the problem is comparing the cost of self-pay vs HMO/PPO insurance. I know what my numbers would be, and self-pay is better. Even when I was quite ill and jaundiced(when I had the MRI and crap load of blood tests), it was better for self-pay. I don’t know everyone else’s numbers though. You stated that your employer pays $450/month, do you have a monthly insurance fee? So far:
pay-in = $450/month – employer premium
$50/month – prescription co-pay
total = $6000 – for year

Determining the real payout by the insurance co is the problem as well as determining what would have been paid out if it was cash pay. Your listed total was $3884. You mentioned that this did not include prescription charges..? What it would have been as cash-pay, I don’t know.

Which is why, if I lost my employer sponsored insurance, I would probably be uninsurable due to pre-existing conditions (all very controllable, but require regular maintenance. It’s a bitch getting old.)

I was laid of by my employer at the start of this downturn (shortly after I got ill than recovered). This is why I am very sensitive to the ‘company plan’ issue. Instead of spending the diff between what I would have paid on health insurance, I invested it. If I had paid into their plan, I would not be covered and would not have the money as well. I just wish that I could have invested the money in a pre-tax form. I also agree with its a bitch getting old(er).

Your final statement about the loss ratio is not even an argument I’ve ever seen made in the reform debate. Nor does it make any sense. Too much premium dollar goes to insurance company bottom line.

And the loss ratio is one way to see how much money is going to the insurance bottom line (combined with overhead and bad investment decisions) as a percentage of paid in. I do agree with the need for competition.

[ucodegen]

It’s not a fallacy, it’s real. I just checked my summary of charges for 2008. My total charges were $3,884. My insurance (Aetna) paid $1,972.91, and I paid $170. Providers (for this year, coincidentally, it was 100% Scripps Clinic) took a discount of $1,741.90 or 44.8%. For 2009, the numbers are similar (total of $2827, insurance paid $1606, i paid $90, net discount of $1131 or 40%).

You also did not include what you are paying per month for the insurance. What were the charges for? Your total is a lot higher than what I spent when I had ‘complications’.. you have kids?.. just trying to figure out how you incurred $3,884.

Those are mostly incurred regardless of cash payers or third party payers. (There would be some savings obviously if they didnt have to process all the insurance/medicare stuff.)

The insurance involves more than ‘some’ of the overhead. This is why several doctors are going cash pay.

If it was anywhere near 1, we wouldn’t need reform.

And people are falling for the same argument that was applied to no-fault auto insurance… if everybody was insured the costs would be lower. This proved to be untrue and the insurance commissioner position was created in California to try to address that.

[ucodegen]

It’s not a fallacy, it’s real. I just checked my summary of charges for 2008. My total charges were $3,884. My insurance (Aetna) paid $1,972.91, and I paid $170. Providers (for this year, coincidentally, it was 100% Scripps Clinic) took a discount of $1,741.90 or 44.8%. For 2009, the numbers are similar (total of $2827, insurance paid $1606, i paid $90, net discount of $1131 or 40%).

You also did not include what you are paying per month for the insurance. What were the charges for? Your total is a lot higher than what I spent when I had ‘complications’.. you have kids?.. just trying to figure out how you incurred $3,884.

Those are mostly incurred regardless of cash payers or third party payers. (There would be some savings obviously if they didnt have to process all the insurance/medicare stuff.)

The insurance involves more than ‘some’ of the overhead. This is why several doctors are going cash pay.

If it was anywhere near 1, we wouldn’t need reform.

And people are falling for the same argument that was applied to no-fault auto insurance… if everybody was insured the costs would be lower. This proved to be untrue and the insurance commissioner position was created in California to try to address that.

[Author]

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