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Is The High Cost Of Health Care And Insurance The Result Of...??

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Is The High Cost Of Health Care And Insurance The Result Of...??

Postby Jinny » Fri Aug 11, 2017 1:01 am

malpractice suits or profiteering on the part of HMO's and insurance companies?
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Is The High Cost Of Health Care And Insurance The Result Of...??

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Is The High Cost Of Health Care And Insurance The Result Of...??

Postby Colbert » Fri Aug 11, 2017 8:17 pm

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Is The High Cost Of Health Care And Insurance The Result Of...??

Postby Akihiko » Fri Aug 11, 2017 8:26 pm

It's a little like asking whether unemployment is caused by poor education, a weak economy, or overpopulation.
The answer is, "all of the above," but some of the issues are easier to address than others.

Yes, insurance companies make large profits.
Yes, the cost of malpractice suits is high.
Also, we now have surgeries, lab tests, and "procedures" which are more sophisticated and expensive than the kind of medical care available in the past.

From a practical standpoint, the question is not what was the "cause," but what we should focus on as the solution.
I think most of us would prefer not to reduce standards of health care, so that would be a last resort.
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Is The High Cost Of Health Care And Insurance The Result Of...??

Postby Chasud » Sat Aug 12, 2017 12:25 am

Most of it is insurance company greed:

"While growing into a colossus, UnitedHealth has repeatedly failed to perform its basic job of paying medical bills. UnitedHealth, which covers 70 million Americans, has been sanctioned in nine states for paying claims slowly; shortchanging doctors, hospitals, or patients; or poorly handling complaints and appeals.

One Nebraska woman complained to state regulators that UnitedHealth's computers had incorrectly rejected claims related to her son's surgery six times.

At one point, UnitedHealth owed Dr. George Schroedinger, an orthopedic surgeon, $600,000. He and his clinic sued UnitedHealth of the Midwest in 2004.

Deciding for the clinic, U.S. District Judge Stephen Limbaugh of Missouri declared that the company's claims processing systems were "flawed in many ways, denying, reducing, and improperly processing claims on a regular basis. And despite innumerable requests, United was unwilling to remedy the underlying errors in its systems" (Star-Tribune Dec. 12, 2007).

Payment troubles continued after the verdict, and Dr. Schroedinger filed a second lawsuit. "These people can never get it right, which says to me that they just plain lie," he said in an interview.

Failure to pay isn't the only complaint. The insurer also gives incorrect information on which physicians are in its network, creating enormous problems for physicians' staff.

The AMA said that no other insurer has prompted as many complaints as UnitedHealth about abusive and unfair payment practices. AMA officials have met with UnitedHealth executives 16 times since 2000, with little to show for it.

"They have always got a new plan to fix it," said Dr. William G. Plested III, past president of the AMA. But "nothing ever happens."

It seems to us that this case is just the tip of the insurance iceberg. More and more stories are appearing daily in the news media about how insurance company are instructing employees their jobs are to deny claims and/or delay payments.

With such a high percentage of medical premiums and other costs going to the legal profession, to maintain compliance with endless government rules/regulations and being hoarded by the insurance companies and executives ? is it any wonder medical costs are increasing so dramatically?

It's time to take a closer look at the medical insurance companies.

UnitedHealth Group is not the first medical insurance company to rob patients, hospitals and clinics to pay obscene salaries to their executives.

It's a modern day robbing patients to pay pimps.

Michael Arnold Glueck, M.D., comments on medical-legal issues and is a visiting fellow in economics and citizenship at the International Trade Education Foundation of the Washington International Trade Council.

Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. " http://www.newsmax.com/medicine_men/medi...


"the vast majority of health insurance policies are through for-profit stock companies. They are in the process of ?shedding lives? as some term it when ?undesirable? customers are lost through various means, including raising premiums and co-pays and decreasing benefits (Britt, ?Health insurers getting bigger cut of medical dollars,? 15 October 2004, investors.com). That same Investors Business Daily article from 2004 noted the example of Anthem, another insurance company. They said the top five executives (not just the CEO) received an average of an 817 percent increase in compensation between 2000 and 2003. The CEO, for example, had his compensation go from $2.5 million to $25 million during that time period. About $21 million of that was in stock payouts, the article noted.

A 2006 article, ?U.S. Health Insurance: More Market Domination, More CEO Compensation?

(hcrenewal.blogspot.com) notes that in 56 percent of 294 metropolitan areas one insurer ?controls more than half the business in health maintenance organization and preferred provider networks underwriting." In addition to having the most enrollees, they also are the biggest purchasers of health care and set the price and coverage terms. ??The results is double-digit premium increases from 2001 and 2004?peaking with a 13.9 percent jump in 2003?soaring well above inflation and wages increases.?" Where is all that money going? The article quotes a Wall Street Journal article looking at the compensation of the CEO of UnitedHealth Group. His salary and bonus is $8 million annually. He has benefits such as the use of a private jet. He has stock-option fortunes worth $1.6 billion."

--Save America, Save the World by Cassandra Nathan pp. 127-128

As to lawsuits--

Victor Schwartz, ATRA's General Counsel, told Business Insurance (July 19, 1999) that "Many tort reform advocates do not contend that restricting litigation will lower insurance rates, and I've never said that in 30 years.?


"A very informative article ran in the Dallas Morning News on 17 June 2007 by Eric Torbenson and Jason Roberson. It shows some pluses and minuses to the change of capping non-economic damages (such as pain and suffering and loss of companionship) at $250,000 against a physician and $750,000 total. First, there has been no cost savings passed on to the consumer with the caps according to Bernard Black, a law and finance professor at the University of Texas. The cost of malpractice claims, including their defense, was probably about 2 cents. As to actual awards, before the caps the average was $1.21 million; after the caps it was $880,000. What it has done, however, is cut the number of malpractice lawsuits in half. ... For the working poor or elderly, who are not going to get any significant, if any ?economic losses? money, their potential judgment would have been the pain and suffering element, so their cases simply aren?t ?worth? hearing. ... the Texas Medical Board has been given more money and power and is investigating and disciplining more doctors. By the way, another article estimated that a medical malpractice case can have costs of $300,000 and more to lodge (Cohen, ?From PI to IP,? November 2005, iplawandbusiness.com).

On the other hand, Texas had been losing doctors and after the cap came in, the number of physicians in Texas increased 50 percent, noted the Dallas article. The $250,000 cap is in place in California (they led the way in 1975), ...Twenty states have no such caps on pain and suffering. Insurers are profiting from the caps in the law. The Texas Department of Insurance began following malpractice profits in 1992. In 2004, the first profits for malpractice policies were noted at $156 million; in 2005 the profits were $83 million. Before that, losses ranged from $59 to $189 million. None of those figures involve profits (or losses) from investment of the float. Also nearly one-third of the doctors in Texas are insured through the state?s Texas Medical Liability Trust which uses a different system to report such information.

... Bob Hunter, the Texas insurance commissioner for former Governor Richardson, looked at 30 years of malpractice suits and stated that for 22 years, when amounts were adjusted for inflation, malpractice awards had been flat. Hunter stated one reason for the rise in malpractice premium costs were insurers were trying to make up for losses from the post-9/11 stock market ...malpractice premiums had been lowered for several years and they needed to be readjusted for one of the typical cycles in insurance. ...

As to malpractice premiums, there have been reductions, though those savings are not being passed on to consumers. The Texas Medical Liability Trust cut its rates 26.5 percent since 2003. In 2006, the state?s commercially insured doctors saved $49 million according to the Texas Alliance for Patient Access. Hospitals have saved millions?the Texas Health Resources one in Dallas-Fort Worth saw a reduction of 41 percent in its premium. ...

Contrast the Texas experience with another article (azinjurycenter.com) which notes: ?According to the Health Care Financing Administration, doctor's salaries went up 41.7 percent from 1988 to 1998 while medical malpractice costs only went up 5.7 percent during this same period of time. Health care costs went up 74.7 percent.? The article points out that states that do cap such claims, such as California, had only an 8 percent difference in malpractice insurance premiums and that nationally such rates went up 0.2 percent, but 0.4 percent in California between 1991 and 2000. Then it was stated that a dozen years after passage of the Medical Injury Compensation Reform Act that malpractice premiums increased 190 percent and that in California their healthcare costs grew by 343 percent. "

--Save America, Save the Worldy by Cassandra Nathan, pp. 150-153
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Is The High Cost Of Health Care And Insurance The Result Of...??

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Is The High Cost Of Health Care And Insurance The Result Of...??

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RE Is the high cost of health care and insurance the result of...??

malpractice suits or profiteering on the part of HMO's and insurance companies?
Posts: 57
Joined: Fri Jan 03, 2014 5:13 pm

Is The High Cost Of Health Care And Insurance The Result Of...??

Postby Conley » Tue Aug 15, 2017 6:17 pm

Most of it is administrative costs.
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Is The High Cost Of Health Care And Insurance The Result Of...??

Postby Chavivi » Wed Aug 16, 2017 4:31 am

Add to your list the profiteering of the Pharmaceutical companies.
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Is The High Cost Of Health Care And Insurance The Result Of...??

Postby Blaize » Thu Aug 17, 2017 1:10 am

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RE Is the high cost of health care and insurance the result of...??

malpractice suits or profiteering on the part of HMO's and insurance companies?
Posts: 45
Joined: Sat Feb 15, 2014 4:10 am


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