- “…the United States, government has no rights. Government has only authority.” Ok, I’ll agree to that statement. It still doesn’t change the spirit of what I said.
Wrong again. It changes almost everything you said. Absent ‘rights’, the government has only the authority assigned to it. That does not include defining who gets what health care, or when. It does not include redistributing wealth by way of robbing Peter to pay for Pauline’s abortions – or even her annual physical.
Based on that fact, pretty much all the rest of what you’ve written is moot. But let’s see where you tried to take this. We’ll take the biggest fantasy first…
- Health insurance companies use their collective bargaining power on behalf of their customers (and themselves) to negotiate lower tariffs.
Sorry, that’s just not supported by objective reality as we know it. Health care costs have risen at rates multiple times that of inflation for decades because comprehensive insurance companies have destroyed the economic relationship between health care providers and consumers. A similar relationship keeps all other commodity costs down. Only with health care do we have this utterly broken economic model – partly because people like you have been duped into believing it’s someone else’s responsibility to pay for it.
But this is only part of the problem.
As we’ll see, the insurance companies themselves are the biggest factor pushing health care costs higher and higher. In fact, an enormous portion of what we pay for “health care” is actually supporting the insurance companies, not the health care industry. I know. I have worked on the software that processes member payments as well as their medical claims. I’ve seen the numbers and run reports on them directly from the databases where your insurance statements and medical records are stored. You would be dumbstruck at how utterly, completely wrong you are on this.
Using your premiums (and, likely, those paid by your employer), along with those paid by tens of thousands of other members, insurance companies pay the claims submitted to them – which are few relative to the number of actual premium payers. They have to be few in order for companies the enormous size of CIGNA, Anthem, Wellpoint and others to even exist. Claims payment is, ostensibly, these companies’ primary function. But of course that’s not all there is to it.
Using your premiums, insurance companies ALSO pay tens of thousands of direct employees who process the claims, maintain the computer systems, write the software, produce the sales brochures and training materials, manage the hundreds of departments and sweep the floors of the offices in which they work. And relative to other industries, insurance companies pay quite well, overall. And they get consistent raises just like most other sectors. In addition to paying whatever claims you submit, your premiums are paying their salaries. And bonuses. And holiday parties. And flex spending allowances. And tuition reimbursement. And matching 401-K benefits. And their health benefits.
Using your premiums, insurance companies ALSO purchase real estate to develop the gargantuan campuses that house their operations. Here’s a shot of the enormous CIGNA campus in Bloomfield, CT. The golf course off to the upper-right was developed using premium payers’ dollars, and sold off at a profit – profit you didn’t see reflected in any premium reduction if you’re a CIGNA customer. If you scroll north across Rt. 218 you’ll see the rest of the property CIGNA bought with its customers’ premium payments. That property used to have offices but is now being converted to a neighborhood of condos, apartments and more golf courses – all of which will be sold at a profit to CIGNA, funded by your premium payments (if you’re a customer). So in addition to paying whatever claims you submit, your premiums are paying for mega-development real estate deals which profit the insurance companies and their stockholders – not their customers or those in the health care industry. Oh, and let’s not forget that your premiums are also paying the enormous property taxes on these facilities – money that’s going in this case to maintain Bloomfield’s town properties and pay its employees, rather than paying for the maintenance on your doctor’s aging EKG equipment.
Using your premiums, insurance companies ALSO pay what are known as “claims clearing houses”, which provide services that bundle and scan medical claims from thousands of providers so that each provider doesn’t have to go through the expense of testing and certification required to act as a direct electronic claims submitter. This is a cost they typically split with health care providers – with providers footing the larger part of the bill (thus, driving health care costs up further). Most health care providers of any size have had to add an entire department dedicated only to dealing with insurance companies and the constant changes to their submission rules, form changes and associated HIPAA regulations – regulations that were required, primarily, because of new risks inherent in the electronic processing and handling of your medical records required for insurance claim reimbursement. This further increases health care costs. In addition to paying whatever claims you submit, your premiums are also – either directly or indirectly – paying the employees of these clearing houses, as well as paying for the cost of their systems, networks and physical infrastructure required to process the claims electronically. And those in particular are no small potatoes: Most of these places maintain multiple redundant dedicated high-speed data networks rivaling many financial and internet data centers. Your health care insurance premiums are paying for that as well, which provides profit for companies like AT&T… instead of going to your doctor or remaining in your wallet.
Using your premiums, insurance companies ALSO pay hundreds of temporary contractors (I was once one of these) for projects that come and go. These contractors are typically paid through an agency whose rates vary from between $75/hr and $185/hr, depending upon the skill involved and the locale (New York and Stamford see rates billed as high as $210/hr – or did until a few years ago). Contractors, of course, only receive a portion of that. So in addition to paying whatever claims you submit, a huge chunk of your premiums are actually going directly into the pockets of the ‘pimps’ and ‘flesh-peddlers’ (as we contractors affectionately refer to them) who run temp. contracting outfits. Some of these outfits, which I’ve worked for, have openly bragged to me personally about how they can make a “killing” providing temp. workers to companies like CIGNA, Aetna, et al. Nice, huh?
Using your premiums, insurance companies ALSO hire thousands of foreign nationals who work here on H1-B visas for years – sometimes decades – replacing Americans who might otherwise do those jobs. They hire additional thousands of foreign nationals through consulting firms in India, outsourcing many more jobs (typically, customer service) that would happily be done by Americans here in the U.S. Most notably, these foreign nationals have direct access to all of YOUR medical records, in a country where HIPAA regulations have no jurisdiction whatsoever. In addition to paying whatever claims you submit, your premiums are also paying employees whose income is sent in large part outside the U.S., and whose employment replaces an individual here in America.
Finally, and perhaps most egregiously, using your premiums, insurance companies ALSO pay CEO salaries, incentives and bonuses that would make AIG’s famous derivative traders blush. While I worked for CIGNA, the CEO there was averaging well over $15,000,000.00 per year in total compensation. That’s Fifteen Million Dollars. Every year. His direct reports and their direct reports in the company’s organization received similarly outrageous compensation. And Caremark RX’ CEO had him beat by more than a factor of two. This is to say nothing of the outrageous dividends paid out to stockholders based on “profits” from their operations. Why outrageous? Why quote “profits”?? Because every single dollar of that compensation and those dividends came from money paid by a customer who is convinced they can’t afford health care any other way.
This is the wonderful system that has allowed health care costs to skyrocket, creating a situation where only the insurance companies benefit (see TheNewGuy‘s blockquoted comments below). Eliminate comprehensive health insurance companies and you will handily fix the problem of “affordable” health care without involving the government in areas where it has no Constitutional authority to act.
- You make it sound like we’re one legislation away from North Korea!
No. That’s your straw man. You’ll have to defend it yourself. After ten years of living under a government which has usurped control over your health – and, along with it, control over any liberty or behavior that “affects” the cost of maintaining your health – do get back to me on that “freest country on the planet” thing, m’kay?
So the government has the authority to force hospitals to work for free.
Surprise!!! Yes Chileno, they do. Ask any ER doc or primary care physician. You can start with the comments here. A sample…
As for being “paid either way,” that’s most certainly not true. As an ER doc, I flat-out give away a huge chunk of the care I provide, either because the patient has medicaid and the reimbursement is just that poor, or because they’re self-pay and I never see a dime (either way, federal law says I have to see them and treat them). Every single doc I know sees patients for free, and they write off all kinds of uncollectable AR.
[emph. added]
- Our ERs are clogged with non-critical patints precisely because the uninsured use it like a primary care facility, driving up costs (which I will have to pay).
Yes, they are clogged. This is one of the points I’ve been beating on for years. And it’s worse than even you realize, because it’s not only the uninsured who do this – it’s the insured patients as well. In fact it’s MOSTLY the insured patients who do this.
That is a far bigger part of the problem, because that is a huge part of what causes overall health care costs to increase, and what causes your insurance premiums to constantly increase. And no, you won’t be paying anything toward other people’s care once the ER ceases to be the de facto service point for most minor health care issues (both insured and uninsured), and consumers begin paying for these services directly rather than through a proxy monopoly.
- When “the facility” covers a cost, it’s basically transferring it to me, the paying customer.
No, it’s not. Because the FACT is that YOU are NOT the “paying customer” any more. There is no significant economic relationship between the provider and the consumer any longer. That’s the whole point: There is no more ‘individual customer’. There is only the collective of insurance company customers, whom those companies exploit as I’ve outlined above.
Other than a possible co-pay, YOU don’t pay ANYTHING to the facility if your services are “covered” by comp. health insurance. The insurance company has already worked out a payment schedule for those services. The only direct cost you incur right now is the cost of your health insurance. So any loss the facility incurs – particularly given the sums insurance companies spend on everything but claims payment – has no direct effect on the cost of your health care. None.
- … “tax savings” means revenue lost for the government, which offsets this loss by using more of my tax dollars on its public endeavors.
Nonsense. This is precisely the foolish attitude that has allowed a professional political class to flourish.
The fact that our Congress sees business as nothing more than a “revenue source” is one thing that will have to change if our Republic is to survive. In a world where politicians were actually held accountable for their actions (and trust me, that’s coming, one way or another), “lost” tax revenue would result in lowered government spending. So, sorry, your assertion here is based on the myth that the government should be allowed to spend as much as it likes and that we have to simply keep pumping money into the Treasury to cover it. At some point (likely soon), that myth will make itself felt in very real, very ugly ways.
- Same goes for taxpayer subsidies.
As already stated, this is the only part that comes directly out of the taxpayer’s pocket.
- How do you define “welfare”? By your logic, isn’t that government intervention? You say the government has no right (sorry, authority) to cover basic necessities like food/shelter/medicine, and yet imply welfare programs should exist? What should they provide?
More straw man B.S. Do you live on a farm, by any chance? Read what I wrote, not what you wish I wrote.
I recognize that welfare programs exist. They’re the vestigial remains of FDR’s so-called New Deal – much of which was found unconstitutional and scrapped almost as soon as it was implemented – most notably, his “Recovery Act”. These programs will likely always exist whether or not they are Constitutional in the strictest sense. That’s not the point. The point is that you want to expand them; you and people just like you who think the government has “rights”, and who fail to understand how our government works… vs. how it’s supposed to work.
When you can figure out how to prevent welfare programs from being abused – like they are now – and from wasting billions of dollars due to fraud, corruption, ineptitude and bureaucratic inefficiency – like they do now – come back with your plan to expand them further. History, which you seem to have very selectively studied, shows clearly what happens when too much money, too much control and too much responsibility is concentrated into the hands of too few corrupt career politicians and career bureaucrats.
If you have tuberculosis…
Unbelievable. Please explain how socialized anything is going to STOP an epidemic. And study up on this topic if you’re going to try to swing it as a club. 1918 saw the worst epidemic in U.S. history – during the singular period in our past that most closely resembles the current administration’s liberal/fascist “vision” for America.
There’s no conceivable reason you can offer that absolves individuals of the responsibility for paying their own way for these things. None. Part of your responsibility as a citizen is to maintain your health to prevent exactly the sort of epidemics you’re trying to pretend are the issue. Government provides the information, helps to fund the necessary research and organizes the means. Individual citizens – at least in a free society – are responsible for taking the action and incurring the costs, individually.
- Sorry, but if you don’t take care of your health, how exactly will you have life??
This is my point exactly. Emphasis on the YOU taking care of YOUR health. It’s called individual responsibility.
- The cost of replacing a car is predictable. Healthcare costs are not.
Really? Do you know ahead of time precisely when you’re going to need a new car? Hardly. It’s just something you plan for. Conversely, you don’t have an annual physical? You don’t know you’ll probably need some basic health care during a given year? What planet do you live on?
And don’t confuse the issue by conflating day-to-day, commodity health care with specialized services like cardiac bypass. Those services are what catastrophic policies are intended to cover – and DID cover back when people paid for the vast majority of health care out-of-pocket. Cat’ plans are available today. IMHO, they’re all that should be legally available, because comprehensive insurance has created the fiasco we’re trying to solve. You can’t solve the problem by amplifying what caused the problem in the first place, and then turning it over to a corrupt, inept government. You have to bite the bullet and eliminate it. If you don’t, you’re doing the same as trying to eliminate the federal debt by multiplying it, as our marxist president and socialist Congress are currently doing.
- I don’t want to live in an excessively socialized society…
Sure you do. You just don’t want to openly admit it. Instead you accuse others – who don’t agree with your fantasies – of being anarchists. Insisting that people pull their own weight is not “libertarianism”, it’s simple common sense. You want individual liberty, exercise individual responsibility. You want welfare on the taxpayers’ dime – get a government job. Or move to Canada, if they’ll have you.
