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This is crazy! Health Care Insurance!

Joined
2 March 2003
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Location
San Francisco
What if you're a stockholder in some of these companies? Is this legal? How can the government just tell companies they have to chip in to pay for something? These things are just going to cost shift. I am sorry, but I just don't understand how things work anymore. I love how these proposed health insurance plans are going to save money when the government runs them.:rolleyes:

Please understand, I don't want to get "political" over this, but I just don't understand how these things work. How can the government take money from public companies that are in the business of making a profit. These companies are owned by individuals, pension funds, institutional investors, etc.

Schumer Vows to Make Insurers Help Fund Health Plan

By Laura Litvan and Kristin Jensen

July 15 (Bloomberg) -- Senator Charles Schumer said the nation’s health insurers should pay at least $75 billion to $100 billion over 10 years to help finance the overhaul of the U.S. health-care system.

Schumer, a New York Democrat and a member of the Senate Finance Committee, said private insurers should “pay their fair share.” He said panel members today discussed assessing a fee on insurers to help offset the cost of the overhaul, which may cost $1 trillion over a decade, and that the proposal likely will be included in legislation.

“We need the insurance companies to step up to the plate to be part of the solution,” he said at a news conference in Washington where he was joined by three other Democratic members of the committee.

Insurers such as UnitedHealth Group Inc. and WellPoint Inc. are the latest target as the finance panel works on a plan to overhaul the health-care system and meet President Barack Obama’s goal of signing legislation this year. Obama today vowed to hold the House and Senate to an August deadline to pass their versions and said a failure to act would threaten the financial stability of families, businesses and the government.

Significant differences between the House and Senate approaches remain unresolved, with much of the split focused on how to pay for the overhaul. Congress and the administration have been pressing health-care industries to help.

‘Not the Time’

America’s Health Insurance Plans, a group that represents insurers, said the industry already is doing its part and will oppose any new fees on it.

“As families and small businesses struggle during the current economic slowdown, now is not the time to impose new fees on health-care coverage that will make coverage less affordable,” Robert Zirkelbach, a spokesman for the group, said in an e-mailed statement.

WellPoint, the No. 1 health insurer by enrollment, also shot down the idea, saying it would “further exacerbate” cost shifting. “This proposal is another way of taxing health benefits for all Americans with private coverage,” the Indianapolis-based company said in a statement today.

Industry Agreement

The industry has already agreed to guarantee insurance for people with pre-existing conditions and to stop basing premiums on an individual’s gender or medical condition, Zirkelbach said. His organization proposed those changes in exchange for a requirement that everyone get coverage.

“Health plans are currently taxed at both the federal and state levels, including assessments that help fund high-risk pools in 30 states,” he said.

The Standard & Poor’s 500 sub-index of six managed-care companies rose 0.2 percent. Members include WellPoint and UnitedHealth, which is based in Minnetonka, Minnesota, and is the largest U.S. provider of health coverage by sales.

Schumer cited both drugmakers and hospitals as industries that have agreed to provide cost-savings. He and other Senate Democrats, including Debbie Stabenow of Michigan, expressed frustration at their news conference that insurers haven’t followed with their own voluntary agreement.

The hospital industry last week agreed to $155 billion in cost savings over 10 years, in a deal reached with the White House and Senate Finance Committee Chairman Max Baucus, a Montana Democrat.

$80 Billion Deal

Drugmakers announced June 21 they would spend $80 billion over 10 years, with part of the money used to help elderly Americans pay for medicines. In addition to insurance groups, three other sectors -- medical-device makers, doctors, and labor unions -- also are under pressure to cut deals.

Schumer said the 100 biggest U.S. insurance companies have seen their profits soar by more than 400 percent between 2000 and 2007, and they can afford to make sacrifices at a time when they stand to gain even more customers. A goal of the legislation advocated by Democrats is to expand insurance coverage to the 46 million Americans who lack coverage.

He said there is “broad support” among Democrats on the finance panel to include new fees on insurance premiums, and “some of the Republicans” have said they will consider it. While he declined to discuss how the plan might be structured, he said lawmakers want to find a way to prevent insurers from simply passing the fees on to their consumers.

“If there’s real competition, there’s less likelihood and ability to pass it through” to consumers, Schumer said. “Every other industry is kicking in. And for the insurance industry to stand aside is not fair.”

Obama Proposals

Obama has already proposed changes in health-care policy that would have an impact on insurers. His budget plan for this year calls for requiring Louisville, Kentucky-based Humana Inc., UnitedHealth, WellPoint and other companies to offer competitive bids to Medicare Advantage plans, which bundle benefits and add more services than what the elderly get when they obtain coverage directly from the government.

The Medicare proposal would save $175 billion over 10 years, starting with $11.2 billion in 2012, according to the budget plan. The insurance companies are paid on average 14 percent more than it costs Medicare to provide benefits directly, according to government estimates.
 
:eek:
 
looks like a lot of posturing for a strong starting point for negotiating health care reform (and quite likely, many other things going forward.) my sense is no matter where the negotiations lead, the industry will find a way to remain comfortably profitable, though they may have slightly tighter belts.

i think it'll be interesting to see what the "final" initial reform ends-up (and, of course, that will be modified over time +/-).
 
looks like a lot of posturing for a strong starting point for negotiating health care reform (and quite likely, many other things going forward.) my sense is no matter where the negotiations lead, the industry will find a way to remain comfortably profitable, though they may have slightly tighter belts.

i think it'll be interesting to see what the "final" initial reform ends-up (and, of course, that will be modified over time +/-).

I hear what you're saying Hal, but I guess my question is why this is a point for negotiations? Why in a capitalistic society is there a reason for the Federal Government and the private sector to enter into negotiations to pay for a governmental program? If there is a negotiated settlement that allows the insurance companies to maintain a "comfortable profit", what does that mean to the share holders, the pension funds, the institutional companies, etc.? So, now have you've limited the profits these public institutions are able to make? If so, I wouldn't invest in them, and I doubt any other institution would as well.

These private health care organization have NO control of Federal health care expenditures, but would be required to share in the expenses.:confused:

Again, I don't want to be "political" but is this legal? How does this happen?

Really, I've never heard of such a thing.:confused:
 
Maybe this is a first step to bullying the private insurance companies into an area they shouldn't be. Then when they start to go under, the government will buy those too? I'm only halfway kidding about this.
 
Also under this plan pretty much everyone is required to buy health insurance. The way I understand it is if you can afford it (whether through the gov program or your companies) if you don't have it you'll be fined (taxed) an additional $2,500 per year.

Welcome to change comrades

Edit:

I was wrong about the $2,500 (somewhat)

‘‘SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
‘‘(a) TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of—

‘‘(1) the taxpayer’s modified adjusted gross income for the taxable year, over
‘‘(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.
 
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I hear what you're saying Hal, but I guess my question is why this is a point for negotiations? Why in a capitalistic society is there a reason for the Federal Government and the private sector to enter into negotiations to pay for a governmental program? If there is a negotiated settlement that allows the insurance companies to maintain a "comfortable profit", what does that mean to the share holders, the pension funds, the institutional companies, etc.? So, now have you've limited the profits these public institutions are able to make? If so, I wouldn't invest in them, and I doubt any other institution would as well.

These private health care organization have NO control of Federal health care expenditures, but would be required to share in the expenses.:confused:

Again, I don't want to be "political" but is this legal? How does this happen?

Really, I've never heard of such a thing.:confused:
doug,

i returned (after a luxurious steak dinner, thank you very much :) because my answer was incomplete to the point of being handwavium.

didn't mean it to be, sorry.

i have no clue as to where this is all going and who / how we'll get there... and how long the changes will last once they're in place. and, as we discussed (briefly) at lunch last time, i believe the health care-related industries / insurance companies, etc, should be profit-generating enterprises.

(i could be wrong in this, but) it seems to me there is a long history of government involvement / directing / legislating specific industries / market segments to deliver what "the govt" thinks is needed to serve the needs of x, y & z constituents... which are always subject to change if / when the "new govt" comes in to play.

i'm interested in seeing what the final changes / rules end up being. in the meantime, i imagine the legality of these proposed changes will be challenged to some extent in the courts; otoh, perhaps some of the change candidates will be smart enough to figure out how to make the best of the new rules and profit accordingly.

purely hal opinion here: it seems to me as though much of the industries / systems we've relied on post-WWII are laboring pretty hard these past few years and things will need to be modified to address the country we are today and will be in the coming decades. change is usually hard and it seems the many changes we're likely to experience will be very, very difficult to deal with.

i realize it doesn't help one single iota, but many other countries are facing many of these same issues we're dealing with. sigh - there ain't no easy button here.
 
I am not a fan of healthcare reform. The middle class will probably get screwed again...as usual.
 
It's a democracy. Most people supposedly wanted this or at least thought they wanted it. Be careful what you ask for. However, it is and will remain a catastrophic waste of resources just like social security and medicare. Anyone who thinks otherwise is not a rational being unless they know a significant amount of information I do not have access to.

This is one of many steps to change the very architecture of american society.
 
A few things to consider:

- How will mandatory health insurance impact already struggling manufacturing businesses? After this legislation is passed, the cost/benefit of overseas outsourcing will materially improve. (More labor unions "solves" this problem, but introduces its own new ones. Like rising protectionism, higher consumer prices, and lower stock market values) Great idea!

- A 5% tax on couples earning > $1M is not "5%" but more like 10%. If you've already given up 50% of your income to Fed, State & Local taxes, then another 5% on top of that equates to a full 10% of what you previously had been making (after tax, and assuming the 5% is for total AGI). Very fair.

- Private health insurers that are "forced" to accept unhealthy participants will just result in higher costs for everyone else that is healthy. No problem if folks are unhealthy due to bad luck/genetics, but why should healthy people subsidize the healthcare of obese, fast food inhaling, promiscuous alcoholic chain smokers? Nothing in the current proposed plans addresses this core healthcare problem.

- Whatever. Get used to it. Can't wait to see what's next on the socialist menu.
 
Look at England if you want to see what's coming next.

Most likely we won't have a single payer system soon but I believe the estimates of cost are way off. It will probably cost at least 500% more.

So we'll see new taxes on everything starting with soda w/ sugar, alchohol, foods not deemed healthy and then federal VAT.

I warned plenty of people about this but they wanted "change". Well change can be for the worse you know.
 
Disgraceful. Completely and utterly disgraceful. :rolleyes:
 
I will put my political feelings aside in a box for a moment.....

Being in the medical field, right now everybody is forming their alliances. I happen to be in a VERY volatile field (nuclear) and I am starting to see the light at the end of the tunnel. The truth is that we can not extend complicated medical services to everyone in the country, regardless of economic status. In truth, this is what is desired by our current administration. Good intentions indeed. But this has already been going on for the past 20 years (Medicaid) and has been a dismal business model. As opposed to squelching the dynamic differences between the rich and the poor, they will only accelerate it at a rate that is unfathomable. In an effort to make things "fair", we will be crushing medicine under the weight of politics until certain practices will disappear all together. I personally handle nearly a thousand patient doses a day in my practice. My counterparts in England can only handle roughly 80 patients a day, thanks to government regulations that have shackled them. Now spread this philosophy across the board to every sector. Now extrapolate that out into the fields that deal with medical, like insurance.

By not allowing the free market to drive innovation and patient service, we are assuring ourselves failure. I am lucky enough to have a license that can carry me anywhere within my field, so shut one door on me, I will just walk through another one. But a lot of others in my field will end up on the public doll as soon as it is realized that we can't afford to be in business with BIG Government.

I thought it, but I didn't realize how dangerous a Pandora's Box and all democratic House would be. Our forefathers never would have thought the countrymen of this Republic to be so stupid as to vote in a completely one sided "democracy". Fours years won't come soon enough to save us from impending disaster. Smoke'em if you got'em.
 
The Obama presidency is looking for ultimately a totally government run healthcare system. Doctors will be on payroll. How else can you explain this. When you ask private companies to help pay the cost of their own replacement. Once the health insurance companies are out of business who pays then? And if Joe paycheck thinks that only those peope making more than $350,000 can pay for everything they re sadly mistaken, but as long as most people think that someone else will pay for it they don't care.
 
I don't understand the model myself.

Once EVERYONE has healthcare.....*free* healthcare to some - demand is going to just go through the roof.

What they hell do they think is going to happen to prices?

Government employed doctors? Are you kidding me? Who wants to be a Dr. when you have a pay cap? Where's the incentive.

This administration is the biggest bunch of spendthrift tree hugging do-gooders i've ever seen. This robin hood mentality needs to be stopped before this country fails.
 
Once EVERYONE has healthcare.....*free* healthcare to some - demand is going to just go through the roof.

I'm not defending the Democratic plan, but in fact everyone does have health care now and it is free to some. The problem is that uninsured now goes to the emergency room to be treated for top dollar rates.

Then when they can't pay they go bankrupt and all the rest of us end up paying with higher costs for our own healthcare.

I don't have any great answers myself for how it should change, but something has got to change. The way we're spending now to cover the uninsured is costing way more than it should.
 
Then when they can't pay they go bankrupt and all the rest of us end up paying with higher costs for our own healthcare.

This is not a major problem with the system. If you can't afford to pay they will determine so and put you on the appropriate government program. If you do not qualify for a program and are expected to pay they will attempt to work out a payment plan that you can manage. If you become overwhelmed with bills (owed to whomever) you declare bankruptcy. That's what it's for.

I know many people who choose not to carry health insurance who fully understand they may fall into the above category if something happens.

I love the commercial with the guy who has an accident mountain biking who didn't have insurance and was overwhelmed by his bills. Yeah, I'll take up a high risk sport and not carry insurance.

A much bigger problem which increases cost is that Medicare underpays for services provided which is then passed on to private insurance companies. Expanding Medicare will only make the problem worse. But that's what they want to happen.
 
Just like the telecommunication industry, if the government imposes fees, the health insurance companies will just pass them on to us.

Very few (if any) industries pay new levies or taxes or fees out of their own profits. They pass them on to their customers.

In the end, we the people get screwed.
 
This is not a major problem with the system. If you can't afford to pay they will determine so and put you on the appropriate government program. If you do not qualify for a program and are expected to pay they will attempt to work out a payment plan that you can manage. If you become overwhelmed with bills (owed to whomever) you declare bankruptcy.
so, who exactly pays for bankruptcy?
 
I will put my political feelings aside in a box for a moment.....

Being in the medical field, right now everybody is forming their alliances. I happen to be in a VERY volatile field (nuclear) and I am starting to see the light at the end of the tunnel. The truth is that we can not extend complicated medical services to everyone in the country, regardless of economic status. In truth, this is what is desired by our current administration. Good intentions indeed. But this has already been going on for the past 20 years (Medicaid) and has been a dismal business model. As opposed to squelching the dynamic differences between the rich and the poor, they will only accelerate it at a rate that is unfathomable. In an effort to make things "fair", we will be crushing medicine under the weight of politics until certain practices will disappear all together. I personally handle nearly a thousand patient doses a day in my practice. My counterparts in England can only handle roughly 80 patients a day, thanks to government regulations that have shackled them. Now spread this philosophy across the board to every sector. Now extrapolate that out into the fields that deal with medical, like insurance.

By not allowing the free market to drive innovation and patient service, we are assuring ourselves failure. I am lucky enough to have a license that can carry me anywhere within my field, so shut one door on me, I will just walk through another one. But a lot of others in my field will end up on the public doll as soon as it is realized that we can't afford to be in business with BIG Government.
thx for the feedback from your professional perspective... it'd be great to hear what other medical folks are thinking, too.
 
so, who exactly pays for bankruptcy?

This has always been a fact of the current system. The only way to lessen the blow to people who have to declare bankruptcy is to lower costs of healthcare. This plan does nothing to achieve that.

Most people who declare bankruptcy due to high medical costs have health insurance. If you're responsible for $15k on a large bill due to your coverage and get into a situation where you can't afford it then declare bankruptcy. That is what it's for. The hospital will write off the loss (yeah I know who pays for that).

I scuba dive but carry supplemental insurance to cover costs I may incure due to an accident at sea. I carry this insurance so that I don't get hit with $30k worth of bills that my health insurance won't cover. If you don't like your coverage pick up supplemental insurance.

My point was that this is not a major strain on the system making costs skyrocket. It is a minor problem compared to other major issues this plan does nothing to address.

I'm not against expanding government health care coverage in some form to account for the 8 million or so who fall through the cracks. I am 100% against this plan though which will be very expensive and necessarily result in additional taxes and a system which will probably be worse than what we deal with today.
 
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