Skip to content

Health Insurance Costs 2013 Question & Answers

2014 January 26
by Sarah Fields

Mandy asks…

Why have health care costs increased increased so exponentially in the last thirty or so years?

I’m looking for a detailed in depth answer and not the usual polemics and talking points. When I was younger I had jobs that did not provide health insurance and was able to incur some costs that would ruin me today , but did not in that time. What exactly has happened to get us into the unfortunate place we find ouselves now?

Sarah Fields answers:

It’s a combination of things, primarily governmental bad choices and the HANDFUL of large insurers who DOMINATE health care.

A FEW examples of how the government drives up costs:

the laundry list of nonsense states require in order to allow a plan to be sold in their state. There is NO good reason for this. If someone wants a “barebones” plan and the company is solvent, let it be offered, instead of stupidly DEMANDING that chiropractic care be offered, or something else that some people won’t want.

When we have government programs (and we have SEVERAL: Medicare, Medicaid, SCHIP, IHS, VA, as well as other programs that allow more income than Medicare, but that’s the concept), ALL should do everything possible to reduce costs. Example: the VA logically allows for negotiated prescription med prices, Medicare is prohibited. End result: far more expense for the taxpayer and the patient. ALSO those on Medicare a decade ago who had an HMO version typically got drug coverage that is BETTER than the current idiocy of the “donut hole” that they’ve all apparently converted to now. Thanks, Uncle Sam.

Freebies for “charity hospitals.” Fact is the bulk of hospitals have this designation and are tax-exempt. The idea was that they’d give back the equivalent of their tax pass to the public they are supposed to serve. Fact: the majority fail to do so. See CAGW–Citizens Against GovernmentWaste–also check out specifially IL AG’s Madigan’s attempt to get them to get on board with that.

AWP BS–AWP is the “Average Wholesale Price” of drugs. It’s a fictional story designed to bump up government payment to drug companies.

ERISA shield–most folks with insurance still get it through work. ERISA has been misapplied by the courts and folks with insurance that way can be denied treatment their plan SHOULD cover with impunity. IF they damage the patient, all they can be out in court is what the treatment that was denied would cost. IF they can win the “drag it out” lottery and the patient dies, they can’t even be fined! Read Jamie Cort’s book “HMOs: Making a Killing.”

See the testimony of Meidinger re: the routine bad accounting principles where they get GIFTS that other businesses and certainly PEOPLE would pay tax on and don’t: http://www.ftc.gov/reports/healthcare/040723healthcarerpt.pdf

Also government routinely tries to balance their Medicare Ponzi scheme on the backs of doctors–who are stopping taking this bogus system:

http://www.massmed.org/AM/Template.cfm?Section=vs_mar05_top&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=11037

“That dark cloud lurking over the shoulder of every Massachusetts physician is Medicare. If Congress does not act, doctors’ payments from Medicare will be cut by about 5 percent annually, beginning next year through 2012, creating a financial hailstorm that would wreak havoc with already strained practices.

Cumulatively, the proposed cuts represent a 31 percent reduction in Medicare reimbursement. If the cuts are adjusted for practice-cost inflation, the American Medical Association says Medicare payment rates to physicians in 2013 would be less than half of what they were in 1991.”
The media who refuse to report these facts wouldn’t take that kind of pay cut OR any pay cut.

Insurers bad faith is quite common. Examples include:

Linda Peeno, MD comes clean about how insurers deny claims to save money, NOT to follow the policy agreement:

http://www.thenationalcoalition.org/DrPeenotestimony.html

more bad faith, esp. With United Health Care:

http://www.newsmax.com/medicine_men/medical_insurance/2008/01/03/61543.html

attempted end runs to make sure they get their excessive demands met by now using flat out predatory lending practices:

http://www.businessweek.com/bwdaily/dnflash/content/nov2007/db20071120_397008.htm

I could go on–I’ve studied these things for some time now. On the bright side, the current system could be VASTLY improved with some sensible changes, including:

price transparency–no reason why prices can’t be posted up front and before the fact. Many expenses are NOT for emergencies and people should be able to shop around and make an INFORMED financial decision, which they are DENIED now, though this is the ONLY industry in which that is allowed. (If you’re a car repair shop and you don’t follow the law on estimates, not only are you SOL you may not be able to get ONE CENT for work done. You don’t see them laughing at the law much in those states on car repair.)

EVERYONE should be required for all non-emergency procedures, to give the patient the bottom line bill. The insurer should be legally required to pay what he says he will BARRING fraud. Any LIKELY procedures should be simarly costed out and locked in. Example: angiogram? Good chance you’ll need an angioplasty and the cardiologist might want to do it there and then. Have him do the medical informed consent AND have the bill costed out for JUST the angiogram AND the angioplasty IF needed–takes a lot of pressure off everyone as well. No reason for anyone to object. We all know if a patient codes on the table, there will be additional charges, but that doesn’t happen often and as it is a medical emergency, you have to treat it.

Oh and “compassionate entry” is costing us a LOT. The Border Patrol is told specifically to let in illegals who are sick for care they know the taxpayer will have to pay for:
“Dickson emphasizes that not all the free care is going to illegal aliens passing through on their way to other states. About half goes to Mexicans who use the Copper Queen as their personal emergency-care facility. In effect, the hospital, which performs general surgery, has become the trauma center for that stretch of northern Mexico. If an ambulance pulls up to the border-crossing point near Bisbee and announces “compassionate entry,” the border patrol waves it through, and the Copper Queen is compelled to treat the patient. It is one more program that Congress mandates but does not pay for. “If you make me treat someone,” says Dickson, “then you need to pay me. You can’t have unfunded mandates in a small hospital.” Although the Medicare drug act that passed last year provides for modest payments to hospitals that treat illegal aliens, Dickson says there is a catch that the U.S. Government has yet to figure out. “How do I document an undocumented alien? How am I going to prove I rendered that care? They have no Social Security number, no driver’s license.'”

http://www.time.com/time/magazine/article/0,9171,995145-7,00.html

Frankly, more can be said, but if you’re interested in a PLAN that makes sense (we need to do something with the huge sums we spend on the government programs we ALREADY have millions enrolled in), then here it is and it’s being ignored by the pols because there’s nothing in it for them apparently. (I found this months ago and sent a good summary and link to the FREE PDF and the federal level ones ignore the hell out of it.) Check it out and see what you think: no increased individual taxes, no mandates for employers, but a funding solution that solves another problem in the system:

http://www.booklocker.com/books/3068.html

Oh and that plan would work because when you get something close to a free market, it DOES work:

Check out LASIK prices over a decade–did they go up 120% like Medicare premiums did (1998: $43.80, 2008 $96.40) or did they drop like a rock? Why did they drop–few third-party payers involved.

Ditto plastic surgery–look at the cost of a “tummy tuck” which is MAJOR abdominal surgery and compare with a MEDICALLY NECESSARY uncomplicated appendectomy if you’re uninsured. The appy will bankrupt you in many cases.

Walk-in clinics (Wal-Mart, CVS, grocery stores) be seen in a short time and treated for around $100–from sprains to upper respiratory infections, strep throat, etc.

SimpleCare.org

http://www.azcentral.com/community/gilbert/articles/0217er17.html

The key is it is DOCTOR OWNED and DOCTOR RUN.

Ken asks…

Which is the cheapest health insurance in Prague,Czech Republic for International student for 3 years?

I am an international student going to Prague for Bachelor’s degree aged 19. I am on a very tight budget and need help in deciding which is the cheapest student health insurance available for three years. Any suggestion will be highly appreciated.

Thank you

Sarah Fields answers:

Anyone with residence in Czech Republic is required to have health insurance. I am not sure how it will exactly work for international student, but overall you will get either through your school or your sponsoring agency forms to file for the national health insurance card. The largest one is VZP which you can entered here:

http://www.vzp.cz/en/index.php

The cost of the insurance is derived from complex formula derived to the minimum income in the country and changes every year as the cost increases. For 2013, the cost is 1.748 Kč (1 USD = 19.2/ 1 EU = 25.6). The price increases are about 3% per year.
It is also possible that your school will pay for the insurance, which will be part of your total cost of the education.

George asks…

Why not lower heath care insurance than universal health care?

I pay $450 a month for my health insurance, why dont they just cut the cost in half?
Then people could afford it.
Its alot for me but worth it, i had spinal meningitis at 18 and without id be dead.

Sarah Fields answers:

Huh? Health care insurance is provided by PRIVATE INDUSTRY. The government can’t just demand they cut the price in half. IF they tried that, besides the court cases they would lose, that would result in: fewer insurance policies, lower benefits, higher co-pays, and more exclusions.
For the bogus government run programs like Medicare which the uninformed or disingenous claim is the answer, here are some facts:
In the US, Medicare is going bankrupt. In 1998, Medicare premiums were $43.80 and in 2008 will be $96.40–up 120%. “Medigap” insurance is common because of the 20% co-pay required for service. Medicare HMOs are common because they reduce that burden without an extra charge in many cases. HOWEVER, many procedures which used to have no or a low co-pay NOW cost the full 20% for the HMO Medicare patient. ALSO the prescription coverage they tended to offer has been REDUCED in many cases to conform to the insane “donut hole” coverage of the feds. Doctors are leaving Medicare because of the low and slow pay AND because the crazy government wants to “balance” their Ponzi scheme on the backs of doctors.
“That dark cloud lurking over the shoulder of every Massachusetts physician is Medicare. If Congress does not act, doctors’ payments from Medicare will be cut by about 5 percent annually, beginning next year through 2012, creating a financial hailstorm that would wreak havoc with already strained practices.

Cumulatively, the proposed cuts represent a 31 percent reduction in Medicare reimbursement. If the cuts are adjusted for practice-cost inflation, the American Medical Association says Medicare payment rates to physicians in 2013 would be less than half of what they were in 1991.”

http://www.massmed.org/AM/Template.cfm?Section=vs_mar05_top&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=11037

The problem really is NOT the cost of health care insurance, the problem is that the system has been HIJACKED by a handful of insurers who violate antitrust and contract law with impunity. More than half of the bankruptcies every year in the US are over medical bills AND 75% of those folks are insured. OK? Insurance is NOT saving them at all. Why? Because the government allows (refuses to enforce the law) big insurers to violate contract law and routinely deny legitimate claims:
. Linda Peeno, MD testified that SHE had often denied treatment JUST to save the insurance company money (http://www.thenationalcoalition.org/DrPeenotestimony.html)

Furthermore:
“the vast majority of health insurance policies are through for-profit stock companies. They are in the process of “shedding lives” as some term it when “undesirable” customers are lost through various means, including raising premiums and co-pays and decreasing benefits (Britt, “Health insurers getting bigger cut of medical dollars,” 15 October 2004, investors.com). That same Investors Business Daily article from 2004 noted the example of Anthem, another insurance company. They said the top five executives (not just the CEO) received an average of an 817 percent increase in compensation between 2000 and 2003. The CEO, for example, had his compensation go from $2.5 million to $25 million during that time period. About $21 million of that was in stock payouts, the article noted.

A 2006 article, “U.S. Health Insurance: More Market Domination, More CEO Compensation”
(hcrenewal.blogspot.com) notes that in 56 percent of 294 metropolitan areas one insurer “controls more than half the business in health maintenance organization and preferred provider networks underwriting.” In addition to having the most enrollees, they also are the biggest purchasers of health care and set the price and coverage terms. “’The results is double-digit premium increases from 2001 and 2004—peaking with a 13.9 percent jump in 2003—soaring well above inflation and wages increases.’” Where is all that money going? The article quotes a Wall Street Journal article looking at the compensation of the CEO of UnitedHealth Group. His salary and bonus is $8 million annually. He has benefits such as the use of a private jet. He has stock-option fortunes worth $1.6 billion.”
–Save America, Save the World by Cassandra Nathan pp. 127-128

“While growing into a colossus, UnitedHealth has repeatedly failed to perform its basic job of paying medical bills. UnitedHealth, which covers 70 million Americans, has been sanctioned in nine states for paying claims slowly; shortchanging doctors, hospitals, or patients; or poorly handling complaints and appeals.
One Nebraska woman complained to state regulators that UnitedHealth’s computers had incorrectly rejected claims related to her son’s surgery six times.
At one point, UnitedHealth owed Dr. George Schroedinger, an orthopedic surgeon, $600,000. He and his clinic sued UnitedHealth of the Midwest in 2004.
Deciding for the clinic, U.S. District Judge Stephen Limbaugh of Missouri declared that the company’s claims processing systems were “flawed in many ways, denying, reducing, and improperly processing claims on a regular basis. And despite innumerable requests, United was unwilling to remedy the underlying errors in its systems” (Star-Tribune Dec. 12, 2007).
Payment troubles continued after the verdict, and Dr. Schroedinger filed a second lawsuit. “These people can never get it right, which says to me that they just plain lie,” he said in an interview.
Failure to pay isn’t the only complaint. The insurer also gives incorrect information on which physicians are in its network, creating enormous problems for physicians’ staff.
The AMA said that no other insurer has prompted as many complaints as UnitedHealth about abusive and unfair payment practices. AMA officials have met with UnitedHealth executives 16 times since 2000, with little to show for it.
“They have always got a new plan to fix it,” said Dr. William G. Plested III, past president of the AMA. But “nothing ever happens.”
It seems to us that this case is just the tip of the insurance iceberg. More and more stories are appearing daily in the news media about how insurance company are instructing employees their jobs are to deny claims and/or delay payments.
With such a high percentage of medical premiums and other costs going to the legal profession, to maintain compliance with endless government rules/regulations and being hoarded by the insurance companies and executives — is it any wonder medical costs are increasing so dramatically?
It’s time to take a closer look at the medical insurance companies.
UnitedHealth Group is not the first medical insurance company to rob patients, hospitals and clinics to pay obscene salaries to their executives.
It’s a modern day robbing patients to pay pimps.
Michael Arnold Glueck, M.D., comments on medical-legal issues and is a visiting fellow in economics and citizenship at the International Trade Education Foundation of the Washington International Trade Council.
Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons.

Http://www.newsmax.com/medicine_men/medical_insurance/2008/01/03/61543.html

This is yet another reason why UHC CAN NOT work. It does NOT address the actual problems.

If you want to see a plan that WOULD work:

http://www.booklocker.com/books/3068.html

Read the PDF, not the blurb, for the bulk of the plan. Book is searchable on Amazon.com
Cassandra Nathan’s Save America, Save the World

No coercion. No wage garnishment. No forcing costs on employers. No room for graft, corruption, or patronage–no wonder it can’t get off the ground.

Powered by Yahoo! Answers

Leave a Reply

Note: You may use basic HTML in your comments. Your email address will not be published.

Subscribe to this comment feed via RSS