My health insurance just got cancelled

Lindberg said:
But you don't vote different from me; you're a Republican, remember?
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Who said I vote a straight ticket? Why would I allow anyone to take my vote for granted and assume they can do stuff not in my best interest?


Do you vote a straight ticket?
 
JoseCuervo said:
I will take it slower.


When somebody doesn't pay a bill to the hospital, for services rendered, what is the accounting treatment of the bad debt?
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I will take it even slower, if someone can't pay, how does giving them insurance reduce costs, they can't pay?
 
PaulS said:
I will take it even slower, if someone can't pay, how does giving them insurance reduce costs, they can't pay?
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well, isn't it obvious? With the (free) insurance, they'll get to use more services that they won't pay for. It's all free.

 
Lindberg said:
You claim to be well off, successful, and paying a lot of taxes. I've met a successful business person who harbors this type of resentment for those with more success.
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I don't change my lifestyle when I incur bad debts. Why would a Dr?

I price my products and services to account for xx% bad debts, cost of collections, credit risk, insurance against risk, etc... It all goes into my overhead, which is paid by the customers who DO pay as agreed.


If I know that 5% of my revenue will never be collected, if the market will allow, I will mark up my price on the other 95% such that it covers the 5% not collected, providing an acceptable rate of return.


And, I will do things to make sure the x% doesn't sink me, diversifying products, services, projects into various markets, limiting reliance on customers, clients, and contracts that exceed xx%, etc. All those types of things increase my costs of doing business, and, those costs get passed along to all of my customers.

Just as a Dr would.

The only times I see Dr's selling cabins and Jaguars is when the ex-wife wants them sold, and the new nurse wife needs new toys. That has nothing to do with uninsured patients.
 
PaulS said:
I will take it even slower, if someone can't pay, how does giving them insurance reduce costs, they can't pay?
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You weren't able to understand the accounting treatment of bad debts?


I apologise for going too fast for you.
 
Bob Noel said:

well, isn't it obvious? With the (free) insurance, they'll get to use more services that they won't pay for. It's all free.
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Weren't they using those services previously? (thru the emergency room with "bad colds" and "sore throats" that had been left untreated too long).
 
JoseCuervo said:
Weren't they using those services previously? (thru the emergency room with "bad colds" and "sore throats" that had been left untreated too long).
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were they?

Hint: What services does insurance cover that isn't required to be provided by the ER?
 
JoseCuervo said:
All those types of things increase my costs of doing business, and, those costs get passed along to all of my customers.

Just as a Dr would.
.
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That is an incorrect statement. Doctors and other health care professionals can NOT just mark up their prices/fees due to cost increases. The have contracts with the health care companies which set their rates.

That is why NONE of our local doctors, along with the majority of ALL other doctors will NOT take ANY insurances on the exchange..................
 
Which is it? Your first statement or your second statement?

1RTK1 said:
That is an incorrect statement. Doctors and other health care professionals can NOT just mark up their prices/fees due to cost increases. The have contracts with the health care companies which set their rates.
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vs.

1RTK1 said:
That is why NONE of our local doctors, along with the majority of ALL other doctors will NOT take ANY insurances on the exchange..................
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First you say they don't set rates, and then have to take what the insurance companies give them..


Then, you contradict and say they won't take what the insurance companies offer them and go off and set their own prices.



Let me know when you decide which way you are going to argue.
 
JoseCuervo said:
If the person incurring the charges, the only other group to cover the expenses would be the other customers (thru higher charges to account for xx% bad debts a hospital/provider incurs) or, if a public hospital, the taxpayers. Their pricing models were sophisticated to account for expected bad debts. To think otherwise is folly.
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This shows that you have zero knowledge about how healthcare is paid for.

Charges are irrelevant. The amounts paid/collected for services are governed by either law (for medicare, tricare and medicaid) or by contract (for 'commercial' insurance, HMOs, self-insured plans). The 'charge' number on the top of the bill is relevant to the final payment in a very small percentage of cases where either an insurance or the patient just pays the charge without any discount (in the last 5 years I can remember one account where actual charges were paid by insurance, and the insurer was the government of Kuwait).
If 5 or 10% of patient accounts in a hospital remain unpaid, it has zero impact on how much the hospital gets paid on the bulk of their claims that are governed by medicare DRGs or insurance contracts. If those accounts didn't go uncollected, the hospital would be more profitable (or incur a lower loss in many cases).

Do you really think Dr's just went and sold their Jaguars every time somebody stiffed them on a bill? Do you think the hospital administrators sold their cabins on the lake?
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Oh so witty.

If there was no need to see patients pro-bono, the practices would be either more profitable or the docs would cut their hours.

There was a reason medical costs are so much when you had 17 million more people wandering in without insurance, and no ability to pay.
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Those 17mil contribute only a small amount to the overall cost of healthcare. Insured patients incur higher healthcare cost than the uninsured.
 
JoseCuervo said:
If anybody actually cares what "apples to apples" increases look like for 2016, instead of just relying on anecdotes of what somebody's uncle's sister's bosses's gardener's drycleaner's cashier's aunt's bartender heard.....


http://kff.org/health-reform/fact-s...able-care-acts-health-insurance-marketplaces/
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The KFF numbers are being disputed. The plan providers know that all comparisons are run based on the 'second lowest silver plan' and artificially depress the price of that plan accordingly. Across the board, under inclusion of gold and bronze, price increases for next year are around 20%.
 
I have not yet met a working physician who has expressed any faith in the ACA system, for a whole lot of reasons (based both upon the laws' and regulations' impact upon how care is delivered, and the absurd business model upon which the whole construct is based).

Again, the notion that a "health care" policy administered by the Internal Revenue Service could ever be expected to successfully function is... well, silly.
 
I remember back when HillaryCare was being proposed. A buddy of mine, vehemently opposed to Federal Government involvement into health insurance said, "Back in the old days, if you got sick and couldn't afford a doctor, you died. Times were hard, but by God so were the people!"
 
weilke said:
The KFF numbers are being disputed. The plan providers know that all comparisons are run based on the 'second lowest silver plan' and artificially depress the price of that plan accordingly..
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Doesn't sound like you are disputing any of the KFF numbers, just attempting to argue their methodology does not fit your agenda.

Then smart consumers should flock to 'second lowest silver plan'.

Do you have an equivalent study for gold or bronze?


Across the board, under inclusion of gold and bronze, price increases for next year are around 20%
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20% is a long ways from the "400%" and other wild anecdotes earlier in the thread. Thanks for making my point.
 
SCCutler said:
I have not yet met a working physician who has expressed any faith in the ACA system, for a whole lot of reasons (based both upon the laws' and regulations' impact upon how care is delivered, and the absurd business model upon which the whole construct is based).

Again, the notion that a "health care" policy administered by the Internal Revenue Service could ever be expected to successfully function is... well, silly.
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Odd, but I never met a working physician that enjoyed for a single minute having to hire a bunch of medical billing specialists, collections, insurance people, etc to try and get paid for services rendered.

Hell, every business and career has less enjoyable parts of the process.
 
weilke said:
Charges are irrelevant. The amounts paid/collected for services are governed by either law (for medicare, tricare and medicaid) or by contract (for 'commercial' insurance, HMOs, self-insured plans). The 'charge' number on the top of the bill is relevant to the final payment in a very small percentage of cases where either an insurance or the patient just pays the charge without any discount



.
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And there you summed it up nicely. The charges at the top of the bill were irrelevant, because the old pricing mechanisms settled on some other level.

In no way was that an efficient model.
 
Matthew said:
I remember back when HillaryCare was being proposed. A buddy of mine, vehemently opposed to Federal Government involvement into health insurance said, "Back in the old days, if you got sick and couldn't afford a doctor, you died. Times were hard, but by God so were the people!"
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Isn't there some study/fact out there that we pay more for a patient's last 6 months of life than we pay for their entire previous medical expenses?

We do a good job of extending people's lives for their loved ones.
 
JoseCuervo said:
Isn't there some study/fact out there that we pay more for a patient's last 6 months of life than we pay for their entire previous medical expenses?

We do a good job of extending people's lives for their loved ones.
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Death Panels fix that.

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I haven't read the small print on all the different State by State premium increase (or decrease) charts. Are those numbers before or after the subsidies are applied?
 
JoseCuervo said:
Which is it? Your first statement or your second statement?
vs.
First you say they don't set rates, and then have to take what the insurance companies give them..


Then, you contradict and say they won't take what the insurance companies offer them and go off and set their own prices.



Let me know when you decide which way you are going to argue.
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Not to mean, but what the hell are you talking about?????? What don't you understand??? No one can be that confused by simple English, let me try one more time..............

#1 ALL insurance companies set the reimbursements and are either accepted or rejected by healthcare professionals. PERIOD

#2 The market place planes aka obammmacare/ACA contracts SUCK so NO doctors in our area and most others in the USA will NOT accept people on those plans because they reimburse so poorly.......

#3 Doctors can not just raise their fees if they need to make more money because of increasing overhead as you stated that you do in your business............Their fees, again, are fixed by the insurance company and are not negotiable.............

#4 I am directly involved with the health care system, what I have stated is fact NOT fiction.........
 
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Matthew said:
Death Panels fix that.

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I haven't read the small print on all the different State by State premium increase (or decrease) charts. Are those numbers before or after the subsidies are applied?
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The study I linked, which was dismissed by somebody who thought a study should have every policy in the population, instead of just sampling the "silver" policies shows before and after tax credits.

Depending on how you want to look at the data.
 
1RTK1 said:
Not to mean, but what the hell are you talking about?????? What don't you understand???

#1 ALL insurance companies set the reimbursements and are either accepted or rejected by healthcare professionals. PERIOD

#2 The market place planes aka obammmacare/ACA contracts SUCK so NO doctors in our area and most others will NOT accept people on those plans..

#3 Doctors can not just raise their fees if they need to make more money or lose less money as you stated that you do in your business............

#4 I am directly involved with the health care system, what I have stated is fact NOT fiction.........
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Regarding #2, what state is that that " NO doctors in our area " will accept insurance obtained thru the exchanges?

One would think that would be huge news if "NO doctors" were seeing patients in an area.
 
JoseCuervo said:
Doesn't sound like you are disputing any of the KFF numbers, just attempting to argue their methodology does not fit your agenda.
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Its not much of a study to look at the price label for one isolated product among a basket of products, particularly if that product is only chosen by a small minority of consumers. The exchanges only cover a small portion of the overall health insurance market and the majority of plans sold are of the bronze variety.

Then smart consumers should flock to 'second lowest silver plan'.
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What if those plans stink and consumers rather wish to have the network access and deductible structure of a gold plan or the lower cost and catastrophic coverage of a bronze plan ?

20% is a long ways from the "400%" and other wild anecdotes earlier in the thread. Thanks for making my point.
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Cost was supposed to go down, remember ?

This is an average number across a market. Those increases are also for the exchange plans and not for employer funded plans. An average increase of 20% in the exchange market does not invalidate the experience people posted about their rate increases in the employer based market. Most of the drastic increases are related to people being forced from a plan they wanted to one they dont want.
 
JoseCuervo said:
Odd, but I never met a working physician that enjoyed for a single minute having to hire a bunch of medical billing specialists, collections, insurance people, etc to try and get paid for services rendered.
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Totally agree!

The ACA has massively increased the record-keeping burden for physicians, to the extent that many are now hiring "Scribes," essentially, roving secretarial types with portable computer setups (on a monopod, kinda interesting), to take notes and try to get the coding right, lest they get paid nothing.

One reason why my primary care physician is a cash-only dude, now. I pay less, get more doctor time and he gets paid (net) much more.

JoseCuervo said:
Hell, every business and career has less enjoyable parts of the process.
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All, except statutorily-mandated bureaucracies - they're forever self-perpetuating.
 
JoseCuervo said:
And there you summed it up nicely. The charges at the top of the bill were irrelevant, because the old pricing mechanisms settled on some other level.

In no way was that an efficient model.
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The basic system how healthcare is billed and paid for has not been changed with the ACA.

Lets say I bill $200 for a service, the medicare allowable may be $125, blue cross $160 and a United HMO plan $85. Those contracted amounts will not go up or down depending on how many uninsured patients I see for either free or cash.

It is very efficient. The claims go to the payors electronically and the payors return a file with the discounts and allowables in a standardized format. The only inefficient part is if we have to bill individual patients for deductibles and coinsurance.
 
weilke said:
Its not much of a study to look at the price label for one isolated product among a basket of products, particularly if that product is only chosen by a small minority of consumers. The exchanges only cover a small portion of the overall health insurance market and the majority of plans sold are of the bronze variety.

What if those plans stink and consumers rather wish to have the network access and deductible structure of a gold plan or the lower cost and catastrophic coverage of a bronze plan ?

Cost was supposed to go down, remember ?

This is an average number across a market. Those increases are also for the exchange plans and not for employer funded plans. An average increase of 20% in the exchange market does not invalidate the experience people posted about their rate increases in the employer based market. Most of the drastic increases are related to people being forced from a plan they wanted to one they dont want.
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Right, most of the those "drastic increases" were people moving from "junk" apples to an oranges policy.


Thank you for supporting my argument.
 
weilke said:
The basic system how healthcare is billed and paid for has not been changed with the ACA.

Lets say I bill $200 for a service, the medicare allowable may be $125, blue cross $160 and a United HMO plan $85. Those contracted amounts will not go up or down depending on how many uninsured patients I see for either free or cash.

It is very efficient. The claims go to the payors electronically and the payors return a file with the discounts and allowables in a standardized format. The only inefficient part is if we have to bill individual patients for deductibles and coinsurance.
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Who pays your $200 rate?
 
PaulS said:
I pay $13,800 per year plus my deductibles and co-pays, so I guess I pay that rate.
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I wasn't asking you.


I would guess you "pay" the rate that is contracted by your insurer with the provider.

Do you think your policy is paying the providers the highest rate imagined?
 
JoseCuervo said:
Regarding #2, what state is that that " NO doctors in our area " will accept insurance obtained thru the exchanges?

One would think that would be huge news if "NO doctors" were seeing patients in an area.
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It is huge news, the market place plans sucks and everyone in the health care industry is shunning it. I am sure you understood what I said/meant but have no other constructive retort.............


I do not know of any private practice docs that will take ANY market place plan here in california. I'm sure some do just don't know of any.....

In fact no local private practice docs will take new Medicare or Medicaid (welfare) patients unless they were in their care previously under accepted plans.

Every heard of a concierge doctor?? There are many going to this type of practice too......
 
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1RTK1 said:
It is huge news, the market place plans sucks and everyone knows it....
That's why very few will take it across the country........

I do not know of any private practice docs that will take ANY market place plan here in california. I'm sure some do just don't know of any.....

In fact no local private practice docs will take new Medicare or Medicaid (welfare) patients unless they were in their care previously under accepted plans.

Every heard of a concierge doctor?? There are many going to this type of practice too......
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What is your zip code?
 
JoseCuervo said:
Right, most of the those "drastic increases" were people moving from "junk" apples to an oranges policy.


Thank you for supporting my argument.
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You keep calling it junk without knowing what the parameters of the plans were. Lots of people were happy with a 10k deductible plan and just paid whatever came up during the year (pap smears, mammograms, immunizations) out of pocket. Insurance was just a backup, not a pre-paid service plan. Now they have to pay for a full service maintenance plan that they may or may not need or want.
 
JoseCuervo said:
Who pays your $200 rate?
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In the last 5 years there has been one insurance company that paid that rate, no questions asked. And that was a plan provided by the government of Kuwait.
 
weilke said:
You keep calling it junk without knowing what the parameters of the plans were. Lots of people were happy with a 10k deductible plan and just paid whatever came up during the year (pap smears, mammograms, immunizations) out of pocket. Insurance was just a backup, not a pre-paid service plan. Now they have to pay for a full service maintenance plan that they may or may not need or want.
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Yes sir, just like pediatric dental coverage, none of my employees have the need for it nor do I.
 
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1RTK1 said:
Yes sir, just like pediatric dental coverage. Only $241 per employee per month..........
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Ever seen a orthodontist bill ? :hairraise:



You'll think that $241 is a steal.
 
I have not used my insurance in years. When I lived in Prague, I paid my doctor in cash... $40 for a 30 minute visit. I paid for my wisdom tooth removal in cash too: $1500. When I needed an MRI for the FAA with no insurance, the hospital did not know how to tell me the price and once they figured it out they had trouble even taking payment.
 
weilke said:
In the last 5 years there has been one insurance company that paid that rate, no questions asked. And that was a plan provided by the government of Kuwait.
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So, how is a pricing model efficient that only has been used 1 time in the last 5 years?


You don't see the problem with that system?
 
weilke said:
Ever seen a orthodontist bill ? :hairraise:

You'll think that $241 is a steal.
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Let me clarify, I already have dental coverage for my employees.

This is an extra tax added through obammmcare to cover the required pediatric dental whether you have a pediatric or not........

My company pays this without any means of utilization. Goes back to what you said about purchasing the insurance that fits ones needs.
 
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