What does the health insurance industry add to the equation?
 

Does the health insurance industry build hospitals, do they build universities, do they train doctors? The first is probably true to some extent but certainly not in all cases.

The spectre of HMO execs making 6 figure incomes based on their efficacy at denying claims is sorta grotesque.

Imagine some loose knit rural community whose members helped their neighbors out in times of trouble - now imagine that someone had the bright idea to set up a small fund to enable communication with each other about who needed help. Further imagine that the fund was expanded to provide travel expenses for them providing the aid.

How would members of this community and the fund react if they discovered that the people administering the fund were getting rich by keeping the funds rather than using the money to perform the services it was founded for?

That's not far from the setup we have now. The need for health care is so intimate and vital that people will jump through whatever hoops they can to get it. The HMO industry taps into this pressing need to get rich.

Bill Frist is worth some $400 million behind this as are his father and brother. Did they provide some $1 billion plus in value? You don't want health care rationed by some govt. bureaucrat? But a hundred milliionaire exec rations health care and that's fine and dandy??

HMO's most ardent defenders, aka Republicans, howl about how much money all of this will cost, as if the nation as a whole isn't already devoting massive funds and climbing to health care. Large administrative costs are currently required just to determine who is or is not entitled to care.

Pre-existing condition? Sorry, you may have been pre-existing in your life before you came under the umbrella or our insurance scam, I mean industry, but you're on your own pal. What? Did you think that by buying health care insurance that your health would be cared for? In some cases, maybe. Read the fine print, pal.

So long as we have private health insurance, there will be people making money. It is a function of commercial existence - can you expand on your point? I feel like I'm missing something.

As much as I am opposed to a national health care plan, the insurance industry deserves most of the blame if we get one. Its not that I object to people making money, but the poor service, the claims they deny so that the top execs can get fabulous wealth. I just see that anyone deserves that kind of money.

Many good points in 3 sentences!
1. Unfortunately there is much more to the system than most people suspect. Part of the blame for sure though, no buts about it.

2. Service, always needs improvement, but it is on par with most companies handling the volume of customers/calls. Denied claims, 9 times out of 10 people who do not read their plan documents before scheduling an appointment.

3. Couldn't agree more. I work for a HI company and most the everyday people are overworked/underpaid while the execs get quite a bit. Profit margins for HI companies are extremely low however, despite popular opinion.

Disclaimer: I don't have ANYTHING to do with claims, money, service, etc. I help manage the website from an internal/business/database perspective and has nothing to do with the "important" stuff. So please don't flame me. FWIW I also personally/openly support healthcare reform.

I would prefer the whole health insurance system stay out of reform. It's time for a new model. I had a revelation the other day. Insurance companies employ two kinds of people. Those who sell you coverage and those who deny you coverage.

I'm thinking that something like single payer, at least for the bottom 2/3rds of society, would be a lot more efficient.

I understand that Medicare is actually quite efficient.

A lot of time and money is devoted just to determining who is allowed care under our current system.

Ok I see your point, thank you for clarifying. And you are correct in saying that a lot of time and money is spent on eligibility - but only a fraction of the money spent on claims overhead. If we prioritize savings, it would most likely be claims overhead (such as electronic claim submission networks - somewhat in play already), then eligibility. Many systems are already automated, but there are ALWAYS exceptions, most often because of billing/coding errors on the provider end, and that is one area that is sort of a thorn-in-the-side.

I do agree that a single-payer system would end up being more beneficial in the long run. The fate of my job/major companies is questionable with some of these reform plans...many of my co-workers and I are willing to give our jobs up for a more efficient system, though I don't think the company would like to hear that.

For the moment, no one's forcing anybody (except for one or two states) to buy health insurance. If you think they're crooked and/or overpriced. Don't buy it.

When I lost my civilian job, I had the option to continue coverage for a certain amount per month. This amount is a bit more than the typical cash price for a doctor's visit. After I considered the frequency with which I visit doctors for illness or injury (twice in this century-both service-related while serving on active duty) I concluded that I was better off without health insurance.

Skippy has a point no one is forcing people to buy health insurance. However my problems is with the people that do pay but get denied. My aunt had cancer (or has its in remission now) the insurance company said they would only cover X amount of dollars (can't remember how many think it was like 100,000) but the treatements cost well above that and the surgeries related to the cancer. This was a woman who paid THEIR salaries for years but when she had a real need....sorry lady tough was their answer.

No one forces you, but if something happens to you and you don't have it, you're f**ked. Have a mild heart attack, there's 25K. Need surgery? Choose between dying or going into debt the rest of your life. Develop cancer and you're dead. You'll never afford cancer treatment. Then, if by some miracle you manage to afford it, any heart related problem isn't covered because it's pre-existing.

yeah, and if one cannot afford health insurance and needs a quick trip to the ER, it pays to check out the hospital's history of litigation. some hospitals will let you make payments while others employ a strategic team of venomous lawyers to take a bite out of your a**. all while you are trying to recover from the trauma that took you to the ER in the first place. such compassion.

Its clear from this thread most people don't understand the issue even remotely.

Please educate us.

yes and the disgusting maggot riddled system is heading to our shores aswell, , filth bags should all be shot . ! as well as george bush , both of them !

Choosing to not have insurance is part of the problem. Under the current system the uninsured still get care for life threatening sickness or injury and I end up paying for it though higher premiums or taxes.

I have never been in a car accident, can I conclude that I don't need car insurance?