UnitedHealth warns it may exit Obamacare plans

[s0me0nesmind1]

The problem for health care in America continues to be that medical providers do not have set rates and do not provide estimates for services. Too many people keep expecting capitalism to work in an environment where the consumer is not allowed an informed choice.

truf.

In every other transaction the consumer is able to estimate and evaluate if the transaction makes logical sense.

In health care, you hand them your health insurance card and pray that the bill isn't too fucking huge. And you might start to get used to what is "normal" as an informed consumer that is able to recognize trends of data, but your average consumer doesn't track things like bills, average costs, etc... They hand them their insurance information and wait for the bill in the mail.

 

[s0me0nesmind1]

Quotes like "way to early to call it quits" and "once it stabilizes" don't exactly sing of confidence...

Personally I can't wait for friggen single payer at this point. We already have it, it's just the shittiest way of doing it.

Can you do me a favor here? Define exactly what the end of result of "Single Payer" is going to be.


A new "Single Payer" tax that all must pay (Like Social Security / Medicaid) ?
An increase % to Medicaid and the single payer system is under medicaid?
A universal increase in tax brackets all around?

Just curious. The problem with this is CLEARLY that you are trying to divide things while only having the needy pay. That's not how any insurance market works. If you only target the old, sick, and dying - then it's detined for failure as far as a market is concerned. This isn't surprising anymore. We saw this coming when it was first initiated but liberal nutjobs just wanted to stick their head in the sand yelling "LA-LA-LA-LA-LA I'M NOT LISTENING! OBAMACARE IS GOING TO SAVE US ALL!"....

Oh wait, like they are still doing in this very thread hahahahaha.

 

[s0me0nesmind1]

Ding ding ding.

The cost of health insurance is NOT the problem. The cost of healthcare is the problem. The more something cost the more it costs to insure it.

I disagree to a CERTAIN extent.

Health insurance is a man-in-the-middle that is entirely unnecessary that creates TONS of unnecessary work. Anyone that knows about uninsured care knows that people can actively go to the doctors and try to negotiate an uninsured bill - and it's often not as high as perceived. That is because they hand you a bill and you pay it. No paperwork. No quotes. No checks. Nothing. They hand you the bill, you hand them the cash. End of transaction. No one behind the scenes has to do magical work.

Insurance - and the entire system as a whole - is a bunch of bullshit laws and regulations. Some have their place - others are just paperwork that cost money.

 

[Zorba]

What is your solution?

One, there should be development of standards for what is necessary for various procedures. If one doctor can give a steroid shot in his office, and another requires an OR, there is a serious problem.

Two, doctors' offices and hospitals should be required to provide upfront pricing. They should have to provide you a detailed quote and a detailed bill. If the quote is wrong, and no procedures were added, they should eat the cost.

Three, the hospital should have to consolidate all billing, you should not receive 10 bills for one trip to the hospital. It would be like hiring a general contractor to build your house, and you paying each sub independently.

Four, electronic records that are global. No reason to fill out the same stupid paperwork everywhere you go.

Five, ban advertisements for prescription drugs.

Six, allow medicare to negotiate drug prices.

Seven, doctors and hospitals must bill all patients the same, except they can offer a cash discount.

Eight, allow nurses or PAs to screen people with minor illnesses and prescribe antibiotics.

Nine, break up local monopolies of medical chains, and prevent new ones from forming.

Ten, insurance companies should maintain and provide some index for cost of services from various places. Especially family practice and imaging centers.

There are some ideas off the top of my head.

 

[s0me0nesmind1]

One, there should be development of standards for what is necessary for various procedures. If one doctor can give a steroid shot in his office, and another requires an OR, there is a serious problem.

Two, doctors' offices and hospitals should be required to provide upfront pricing. They should have to provide you a detailed quote and a detailed bill. If the quote is wrong, and no procedures were added, they should eat the cost.

Three, the hospital should have to consolidate all billing, you should not receive 10 bills for one trip to the hospital. It would be like hiring a general contractor to build your house, and you paying each sub independently.

Four, electronic records and that are global. No reason to fill out the same stupid paperwork everywhere you go.

Five, damn advertisements for prescription drugs.

Six, allow medicare to negotiate drug prices.

Seven, doctors and hospitals must bill all patients the same, except they can offer a cash discount.

Eight, allow nurses or PAs to screen people with minor illnesses and prescripe antibiotics.

Nine, break up local monopolies of medical chains, and prevent new ones from forming.

Ten, insurance companies should maintain provide some index for cost of services from various places. Especially family practice and imaging centers.

There are some ideas off the top of my head.

Overall excellent points - and at the very least, a good starting point.

 

[Meghan54]

Can you do me a favor here? Define exactly what the end of result of "Single Payer" is going to be.


A new "Single Payer" tax that all must pay (Like Social Security / Medicaid) ?
An increase % to Medicaid and the single payer system is under medicaid?
A universal increase in tax brackets all around?

Just curious. The problem with this is CLEARLY that you are trying to divide things while only having the needy pay. That's not how any insurance market works. If you only target the old, sick, and dying - then it's detined for failure as far as a market is concerned. This isn't surprising anymore. We saw this coming when it was first initiated but liberal nutjobs just wanted to stick their head in the sand yelling "LA-LA-LA-LA-LA I'M NOT LISTENING! OBAMACARE IS GOING TO SAVE US ALL!"....

Oh wait, like they are still doing in this very thread hahahahaha.

First, how do you figure ACA was targeting only the old, sick, and dying? It was targeting anyone without insurance. True, it got sick people. But why? Maybe because they (the "sick and old"), in part, represented those that were denied coverage due to pre-existing conditions or were deemed too high risk and premiums were too expensive to afford. C'est la vie....an insurance company crying about their billions in profit being compromised by a few percent.


Second, about paying for a single payer model of health care....let me pose this question.

Where is all the money that employers spend on health insurance for their employees going to go if a single payer system is established? As of 2014, the average annual health ins. premiums were $6,251 for single coverage, $17,545 for family coverage.

Will that money just go back in the employer's pocket as pure profit? Shouldn't, since that money that is/was being spent was a benefit and part of the employee's compensation.

So, that money should go right to the employee, giving the employee an immediate pay raise. After all, you're already being "given" that money in the form of health insurance, right? So, shouldn't that just just go to the employee as cash/wages?

And do you think taxes would go up $6K to $17K per year per taxpayer to pay for a single payer health ins. plan/coverage? Shouldn't matter then, because you're already paying that amount. In fact, most would probably see more money coming into the household, provided the employers don't abscond with the ins. premium payments they've been making for their employees.

 

[JEDIYoda]

I despise this crap. A democrat planned passed by democrats is really a republican plan. And when it fails will be republicans fault. This is the problem I have with the useful idiots of these parties. They will never ever take responsibility for their party pushing and passing a failed policy.











__________________

aawwwww

 

[WhipperSnapper]

This whole thing is a complete disaster. We keep trying to shift who pays for medical care, but we're not working on lowering the cost of that care.

I despise this crap. A democrat planned passed by democrats is really a republican plan. And when it fails will be republicans fault. This is the problem I have with the useful idiots of these parties. They will never ever take responsibility for their party pushing and passing a failed policy.

The reason people say it's a Republican Plan is because the Republicans are the ones standing in the way of actually addressing the problem of the costs of health care, which means addressing our actual health care system (private insurance companies, private doctors, private hospitals, no regulation of pharmaceutical prices).

The Democrats Plan was not exactly what the Democrats really want, or at least not what the Progressives want (addressing the cost of health care) but rather a big band aid to try to alleviate the shortcomings of the Republicans' plan.

Don't forget these older news stories:

http://www.newyorker.com/reporting/2012/06/25/120625fa_fact_klein

Republicans Had a Plan to Replace Obamacare. It Looked a Lot Like Obamacare

25 Republicans Who Supported Obamacare Before Obama

 

[WhipperSnapper]

Are you that unable to comprehend the message. UHC is saying that they took a $500 million hit by being on the exchange. They would have been just as well to stay out and just donate half a BILLION. At least then they could get a tax break.

That's just one player. How much have the other groups lost?

Someone still has to pay the bill.

What we're going to discover is that if our current health care system (private insurance, private doctors, private hospitals, unregulated pharmaceutical prices) has 100% coverage, the cost will be MORE than the about 18% of GDP that we've been spending on health care. We'll discover that if we have 100% coverage*, that we'll end up spending even more than 18% of GDP on health care. That makes the contrast between the American system and the European "people's states" evil socialist systems even more glaring. Instead of being able to say that the US spends about 18% of its GDP on health care, the number will be more like 20% or 22% compared to, say, 12% in a nation with evil socialized medicine.

(*and that's for shitty coverage)

It's a fucking failure after just the first year and as the insurance companies drop out one by one we will be forced to a single pay system controlled by the government that likes to spend $50 for a hammer and $180 for a toilet seat.

Obamacare was destined to be a failure because it was never designed nor even intended to address the fundamental problem. In fact, Obamacare isn't even a health care system. It's just a small tweak to insurance coverage.

Obviously, Americans will need to grow up and elect less corrupt politicians who won't give $50/hammer kickbacks to their buddies.

 

[sportage]

You have to realize what united health is really saying here.
Not enough greed for them, so they want more, or they want out.
What united health wants is the option to DROP people that get sick, or deny people with pre-existings, and basically take the money BUT offer little in benefit.
Does THIS sound familiar?????
It was our healthcare for profit system before Obamacare.
Surely we haven't forgotten how THAT worked ???
Good grief Charlie Brown.....

 

[WhipperSnapper]

Why is single player the answer?

Compare the stats:

United States:

•18% of GDP and growing spent on health care
•Tens of millions uninsured or under-insured
•Insured people living in terror of losing their jobs and health insurance
•Hundreds of thousands of medical bankruptcies each year, many of whom had insurance
•Businesses burdened by insurance concerns and costs.
•Wealthy insurance executives (and a thriving yacht industry)

Nations with Real Socialized Medicine:

•Much smaller percentage of GDP spent on health care
•100% coverage
•Zero medical bankruptcies
•Often more doctors per capita
•A more content populace
•Businesses not burdened by insurance concerns
•Fewer wealthy insurance executives (oh noes! Whatever will happen to the yacht industry?)

 

[WhipperSnapper]

Perhaps we shouldn't let anyone make money when people desperately need their service.

The problem is not simply that some people are making money. There's nothing wrong with doctors, nurses, radiologists, hospital janitorial staff, and construction industry personnel who build hospitals making money.

The problem is when you have tons of people who push paper around but who don't deliver any actual health care making money off of health care--insurance companies, company benefits plan administrators, advertising agencies, medical billing specialists, etc.

The problem is that free market health care is inherently inefficient. We spend too much money figuring out who should and shouldn't have access to health care and exactly who should pay for it and how much when that money would be better spent providing actual health care.

 

[WhipperSnapper]

Can you do me a favor here? Define exactly what the end of result of "Single Payer" is going to be.


A new "Single Payer" tax that all must pay (Like Social Security / Medicaid) ?
An increase % to Medicaid and the single payer system is under medicaid?

There wouldn't be any "Medicaid", there would simply be a national health care program under true socialized medicine.

A universal increase in tax brackets all around?

One of the big myths that the free market dogmatists are spreading is the notion that Americans would end up spending more money on health care because new taxes would be required to fund it -- completely ignoring the fact that Americans are already spending gobs of money on health care and that the new taxes would merely be taking the money Americans would otherwise spend on insurance premiums and out-of-pocket.

Ironically, the total tax revenue needed to fund the health care system would end up being less than what is already being spent based on the percentage of GDP (and per capita) of the nation that has the most expensive socialized medicine program.

In short, Americans would collectively pay less in taxes than they are currently paying out of pocket while receiving more medical care. (Tremendous cost savings can be had by eliminating those insurance company middlemen and other economic inefficiencies of our pseudo-market system.)

 

[ThisIsChrisKim]

One, there should be development of standards for what is necessary for various procedures. If one doctor can give a steroid shot in his office, and another requires an OR, there is a serious problem.

Two, doctors' offices and hospitals should be required to provide upfront pricing. They should have to provide you a detailed quote and a detailed bill. If the quote is wrong, and no procedures were added, they should eat the cost.

Three, the hospital should have to consolidate all billing, you should not receive 10 bills for one trip to the hospital. It would be like hiring a general contractor to build your house, and you paying each sub independently.

Four, electronic records that are global. No reason to fill out the same stupid paperwork everywhere you go.

Five, ban advertisements for prescription drugs.

Six, allow medicare to negotiate drug prices.

Seven, doctors and hospitals must bill all patients the same, except they can offer a cash discount.

Eight, allow nurses or PAs to screen people with minor illnesses and prescribe antibiotics.

Nine, break up local monopolies of medical chains, and prevent new ones from forming.

Ten, insurance companies should maintain and provide some index for cost of services from various places. Especially family practice and imaging centers.

There are some ideas off the top of my head.

1.) There are "standards" in place by various bodies (government, medical, legal, etc.) all with competing interests. Government wants to control costs--so capitation. Medical bodies want to optimize survival so treat every condition until patient is dead. Legal wants to make sure there was zero negligence, so docs are so afraid of lawsuits that overuse of diagnostics and tests are standard of practice.

2.) This can't be done unless we fundamentally change how care is paid for because every procedure, drug, and treatment given has a separate charge. If you need a central line installed to deliver IV drugs, would you refuse and prefer receive individual injections for each one because it's cheaper? Or do you just listen to your doctor's orders? From receiving the IV line, the puncture itself, the needle used, the type of IV all have separate charges and codes that are billed. The total itemized list becomes dizzying. One option is to have a capitized "bundle" that includes all in one charge--but then you're leaving out the possibility for exceptions to the norm.

3.) Agreed. But depending on where you receive care and from whom, if the doc you see is an internist versus a clinic that is with another system, etc.

4.) Since the US left all EMR up to private companies, there are competing standards that are not inter compatible.

5.) Agreed.

6.) CMS already does negotiate. Although they could take hardline stances, I guess? I'd be in favor of cheaper drugs, but I also recognize the immense cost of developing drugs. That said, it makes me sad that drug development is a for-profit business. I wish the environment here was more academic and less business-y. It's very jarring to us in the R&D areas. We're also the first ones to be laid off whereas business and sales staff are (almost) never affected

7.) Not sure of details, but sounds good.

8.) Already happens. But AMA opposes more autonomy to PAs and NPs.

9.) Good idea

10.) Cool. Sure.

 

[glenn1]

There wouldn't be any "Medicaid", there would simply be a national health care program under true socialized medicine.

One of the big myths that the free market dogmatists are spreading is the notion that Americans would end up spending more money on health care because new taxes would be required to fund it -- completely ignoring the fact that Americans are already spending gobs of money on health care and that the new taxes would merely be taking the money Americans would otherwise spend on insurance premiums and out-of-pocket.

Ironically, the total tax revenue needed to fund the health care system would end up being less than what is already being spent based on the percentage of GDP (and per capita) of the nation that has the most expensive socialized medicine program.

In short, Americans would collectively pay less in taxes than they are currently paying out of pocket while receiving more medical care. (Tremendous cost savings can be had by eliminating those insurance company middlemen and other economic inefficiencies of our pseudo-market system.)

Primary education is "universal" and "socialized" in the U.S. and yet we still spend far more than other nations while still getting worse results. Plus without recognizing any of the benefits to scale or "fewer middlemen" than you're claiming. Hell, the amount of administration personnel vs. teachers has exploded over the years making the costs even higher than before.

So please explain why U.S. healthcare would provide all these claimed benefits if universalized/socialized when direct experience shows the exact opposite with education?

 

[Strk]

Can you do me a favor here? Define exactly what the end of result of "Single Payer" is going to be.


A new "Single Payer" tax that all must pay (Like Social Security / Medicaid) ?
An increase % to Medicaid and the single payer system is under medicaid?
A universal increase in tax brackets all around?

Just curious. The problem with this is CLEARLY that you are trying to divide things while only having the needy pay. That's not how any insurance market works. If you only target the old, sick, and dying - then it's detined for failure as far as a market is concerned. This isn't surprising anymore. We saw this coming when it was first initiated but liberal nutjobs just wanted to stick their head in the sand yelling "LA-LA-LA-LA-LA I'M NOT LISTENING! OBAMACARE IS GOING TO SAVE US ALL!"....

Oh wait, like they are still doing in this very thread hahahahaha.

One of the major flaws in the argument Bernie gets hit with when he talks about universal coverage is that there will be no change in health care costs.

There are a few major flaws with that argument. Our government alone already spends more than the average other developed countries spend on health care (private spending is about the same too, which is even more pathetic). While I doubt universal coverage would cut our costs in half, we could be similar to countries with systems I prefer. Germany, which I like to use for a few examples of social programs that work, doesn't cost half as much, but they aren't exactly far from it. It is also not exactly universal coverage either. However, everyone is covered. While I don't think we should model ourselves after Canada or the UK, I think a system like Germany's would be awesome (same with their higher ed stuff, but different topic).

 

[WackyDan]

I despise this crap. A democrat planned passed by democrats is really a republican plan. And when it fails will be republicans fault. This is the problem I have with the useful idiots of these parties. They will never ever take responsibility for their party pushing and passing a failed policy.

Except the plans were both engineered by insurance companies themselves. That is where your disconnect is.

 

[Sonikku]

Compare the stats:

United States:

•18% of GDP and growing spent on health care
•Tens of millions uninsured or under-insured
•Insured people living in terror of losing their jobs and health insurance
•Hundreds of thousands of medical bankruptcies each year, many of whom had insurance
•Businesses burdened by insurance concerns and costs.
•Wealthy insurance executives (and a thriving yacht industry)

Nations with Real Socialized Medicine:

•Much smaller percentage of GDP spent on health care
•100% coverage
•Zero medical bankruptcies
•Often more doctors per capita
•A more content populace
•Businesses not burdened by insurance concerns
•Fewer wealthy insurance executives (oh noes! Whatever will happen to the yacht industry?)

People like you are the reason fewer people can park their boat... into their other boat.

Are you proud of yourself? :'(

 

[senseamp]

We'll see how it plays out. If private insurance doesn't work as a model for ensuring all Americans, we'll try something else.

 

[bshole]

This may be the solution...

AS a former physician, I shivered a bit when I heard Dr. Vivek Wadhwa say he would rather have an artificial-intelligence doctor than a human one. “I would trust an A.I. over a doctor any day,” he proclaimed at a recent health innovation conference in San Francisco, noting that artificial intelligence provided “perfect knowledge.” When asked to vote, probably a third of those in attendance agreed.

But it made sense: Dr. Wadhwa is a professor, entrepreneur and technology visionary. What’s more, the conference took place in San Francisco, where faith in the power of technology and data to solve problems holds unshakable sway.


There was certainly plenty of innovation on display at the conference’s rooftop reception, called “Health by the Numbers”: One device attaches to your iPhone and turns it into an otoscope so you can see if your child has an ear infection; another allows it to check your blood alcohol level. Attendees could check out home cholesterol test kits, and a wearable device to track the “quality” of their breathing.

http://www.nytimes.com/2014/09/21/sunday-review/high-tech-health-care-useful-to-a-point.html

 

[bradly1101]

Until this country removes insurance companies' ability to immorally profit from peoples' ills, our system will never work. And yes I'm talking about ending the debauched health insurance industry. So getting the system to work will never work given the power of their lobby.

 

[senseamp]

If you look at the cost curve relative to other countries, the health care system has been going off the rails since the Nixon HMO act.

 

[werepossum]

Obama set this up as an economic failure.
The ONLY possible move from here is single payer, or a lot of hurt Americans.

Yep. Although I don't think this is a death blow; if one company gets out then another will step in at higher rates. Anyway, my guess is that this is a bluff trying to win some particular concession from the bureaucracy.

 

[Jhhnn]

Yep. Although I don't think this is a death blow; if one company gets out then another will step in at higher rates. Anyway, my guess is that this is a bluff trying to win some particular concession from the bureaucracy.

Heh. United's problem is that they can't compete. They can't do what other companies do for the same money or don't want to. That doesn't correlate with another company coming in at higher rates.

 

[werepossum]

This may be the solution...


http://www.nytimes.com/2014/09/21/sunday-review/high-tech-health-care-useful-to-a-point.html

"Oh my God, it cut off his head! It was supposed to take out his tonsils!"

"Uh . . . Yeah, we're gonna fix that with the next patch. In the mean time, I'm going to need him to . . . Um, I'm going to need you to fill out this bug report for him."