http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/ ...politics, pictures, pugs and all that jazz Fri, 03 Feb 2012 08:24:00 +0000 hourly 1 http://wordpress.org/?v=3.3.1 http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/comment-page-1/#comment-51859 tuckspop Tue, 30 Dec 2008 21:47:56 +0000 http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/#comment-51859 Well, I am an ex insurance agent. You are absolutly right about a couple of things. The employer is drowning under the burden of providing good health care, especially the small employer. 50 employees or less. He can't compete with the bigger companies offerings. I used to manage a large insurance trust for the auto parts industry in Texas. I got to see the claims reports and costs. Even though we were collecting $500,000 a month in premiums, our costs were $550,000 per month. We almost went broke. Drug costs are outrageous. The drug companies are making a fortune. But lets look at the small employer with 10 employees. Let's say he is paying $1000 per family a month (employees contribute their share), so the monthly premium is $10,000. Most of these cases now have a ded of around $2,000 per person, somewhere around $6000 per family. 80 % co insurance. The chances of having serious health issues in a ten person group is pretty high. Diabetes, heart problems or cancer are the main causes of high claims. I had a hospital stay of a week this month and the total cost was about $25,000. Not a lot of testing either. That basically eats up two months of premium. Agents now make about 5% commission. On $10,000 that $500 per month. For the service they provide, you wouldn't work for less. Granted there are bad agents, but the good agents give good service and pay for themselves in reduced costs. Most of the time this size of group has a loss ratio of 75 to 85%. That means claims take up that much of the premium. <br>I don't have a dog in this hunt anymore, but I agree that heatlh care is of upmost importance. I can promise that no one will be happy with the outcome, but we can't go on this way. The adoption of a Medicare type system won't work. Most of the doctors won't take new Medicare patients. They don't get paid enough. Now in workers' compensation, we have the same problem. The docs get paid medicare rates and the specialists won't work for that. It's hard to find a good orthopedic doctor that takes work comp cases. My opinion is that everyone is to blame in the current system. We all need to come to the table and be ready to negotiate. Patients, doctors, and insurance companies. We are having a mild crisis here as many rural hospitals are going broke. Not enough paying patients. <br>Mike Well, I am an ex insurance agent. You are absolutly right about a couple of things. The employer is drowning under the burden of providing good health care, especially the small employer. 50 employees or less. He can't compete with the bigger companies offerings. I used to manage a large insurance trust for the auto parts industry in Texas. I got to see the claims reports and costs. Even though we were collecting $500,000 a month in premiums, our costs were $550,000 per month. We almost went broke. Drug costs are outrageous. The drug companies are making a fortune. But lets look at the small employer with 10 employees. Let's say he is paying $1000 per family a month (employees contribute their share), so the monthly premium is $10,000. Most of these cases now have a ded of around $2,000 per person, somewhere around $6000 per family. 80 % co insurance. The chances of having serious health issues in a ten person group is pretty high. Diabetes, heart problems or cancer are the main causes of high claims. I had a hospital stay of a week this month and the total cost was about $25,000. Not a lot of testing either. That basically eats up two months of premium. Agents now make about 5% commission. On $10,000 that $500 per month. For the service they provide, you wouldn't work for less. Granted there are bad agents, but the good agents give good service and pay for themselves in reduced costs. Most of the time this size of group has a loss ratio of 75 to 85%. That means claims take up that much of the premium.
I don't have a dog in this hunt anymore, but I agree that heatlh care is of upmost importance. I can promise that no one will be happy with the outcome, but we can't go on this way. The adoption of a Medicare type system won't work. Most of the doctors won't take new Medicare patients. They don't get paid enough. Now in workers' compensation, we have the same problem. The docs get paid medicare rates and the specialists won't work for that. It's hard to find a good orthopedic doctor that takes work comp cases. My opinion is that everyone is to blame in the current system. We all need to come to the table and be ready to negotiate. Patients, doctors, and insurance companies. We are having a mild crisis here as many rural hospitals are going broke. Not enough paying patients.
Mike

]]> http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/comment-page-1/#comment-42279 tuckspop Tue, 30 Dec 2008 14:47:56 +0000 http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/#comment-42279 Well, I am an ex insurance agent. You are absolutly right about a couple of things. The employer is drowning under the burden of providing good health care, especially the small employer. 50 employees or less. He can't compete with the bigger companies offerings. I used to manage a large insurance trust for the auto parts industry in Texas. I got to see the claims reports and costs. Even though we were collecting $500,000 a month in premiums, our costs were $550,000 per month. We almost went broke. Drug costs are outrageous. The drug companies are making a fortune. But lets look at the small employer with 10 employees. Let's say he is paying $1000 per family a month (employees contribute their share), so the monthly premium is $10,000. Most of these cases now have a ded of around $2,000 per person, somewhere around $6000 per family. 80 % co insurance. The chances of having serious health issues in a ten person group is pretty high. Diabetes, heart problems or cancer are the main causes of high claims. I had a hospital stay of a week this month and the total cost was about $25,000. Not a lot of testing either. That basically eats up two months of premium. Agents now make about 5% commission. On $10,000 that $500 per month. For the service they provide, you wouldn't work for less. Granted there are bad agents, but the good agents give good service and pay for themselves in reduced costs. Most of the time this size of group has a loss ratio of 75 to 85%. That means claims take up that much of the premium. <br>I don't have a dog in this hunt anymore, but I agree that heatlh care is of upmost importance. I can promise that no one will be happy with the outcome, but we can't go on this way. The adoption of a Medicare type system won't work. Most of the doctors won't take new Medicare patients. They don't get paid enough. Now in workers' compensation, we have the same problem. The docs get paid medicare rates and the specialists won't work for that. It's hard to find a good orthopedic doctor that takes work comp cases. My opinion is that everyone is to blame in the current system. We all need to come to the table and be ready to negotiate. Patients, doctors, and insurance companies. We are having a mild crisis here as many rural hospitals are going broke. Not enough paying patients. <br>Mike Well, I am an ex insurance agent. You are absolutly right about a couple of things. The employer is drowning under the burden of providing good health care, especially the small employer. 50 employees or less. He can't compete with the bigger companies offerings. I used to manage a large insurance trust for the auto parts industry in Texas. I got to see the claims reports and costs. Even though we were collecting $500,000 a month in premiums, our costs were $550,000 per month. We almost went broke. Drug costs are outrageous. The drug companies are making a fortune. But lets look at the small employer with 10 employees. Let's say he is paying $1000 per family a month (employees contribute their share), so the monthly premium is $10,000. Most of these cases now have a ded of around $2,000 per person, somewhere around $6000 per family. 80 % co insurance. The chances of having serious health issues in a ten person group is pretty high. Diabetes, heart problems or cancer are the main causes of high claims. I had a hospital stay of a week this month and the total cost was about $25,000. Not a lot of testing either. That basically eats up two months of premium. Agents now make about 5% commission. On $10,000 that $500 per month. For the service they provide, you wouldn't work for less. Granted there are bad agents, but the good agents give good service and pay for themselves in reduced costs. Most of the time this size of group has a loss ratio of 75 to 85%. That means claims take up that much of the premium.
I don't have a dog in this hunt anymore, but I agree that heatlh care is of upmost importance. I can promise that no one will be happy with the outcome, but we can't go on this way. The adoption of a Medicare type system won't work. Most of the doctors won't take new Medicare patients. They don't get paid enough. Now in workers' compensation, we have the same problem. The docs get paid medicare rates and the specialists won't work for that. It's hard to find a good orthopedic doctor that takes work comp cases. My opinion is that everyone is to blame in the current system. We all need to come to the table and be ready to negotiate. Patients, doctors, and insurance companies. We are having a mild crisis here as many rural hospitals are going broke. Not enough paying patients.
Mike

]]> http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/comment-page-1/#comment-42271 dbmurdoch Mon, 29 Dec 2008 21:29:24 +0000 http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/#comment-42271 My husband has been a family physician for 20+ years. He has an offer to go corporate and has to decide in 2 wks what he will do. He has a life calling to be a physician, this is awful for him. Simplify? How about working w a patient for an hour to find what meds are covered, or tests they need, fighting w insurance companies on their behalf, he has to do it, not a helper because it is too complicated to argue. In our area of the state a doc gets $42 for a reg visit from BC/BS, which owns 75% of the market. Medical asst at $20/hr. Front office person $18/hr. Benefits for all. Malpractice (ugh). Rent, phones, supplies - it costs HIM money to see patients many times. Now our kids are starting college. Can't do it anymore. It is so sad. The system rewards production, fast fast visits, sore throat? Here's a pill. Goodbye. What if he sees something more? No extra money just extra time and lost money from another patient. What if he wants to use electronic medical records and needs to input critical information? No extra money, just extra time he would be paid if he saw another patient. Extra time, but he would never turn away a problem, and he insists on quality of care and inputting to electronic medical records. 99th percentile every time he takes the specialty boards. He loves his calling. But nobody pays for this kind of care. He cannot do it any more, it is choosing between our kids in college or him seeing patients. Very sad. My husband has been a family physician for 20+ years. He has an offer to go corporate and has to decide in 2 wks what he will do. He has a life calling to be a physician, this is awful for him. Simplify? How about working w a patient for an hour to find what meds are covered, or tests they need, fighting w insurance companies on their behalf, he has to do it, not a helper because it is too complicated to argue. In our area of the state a doc gets $42 for a reg visit from BC/BS, which owns 75% of the market. Medical asst at $20/hr. Front office person $18/hr. Benefits for all. Malpractice (ugh). Rent, phones, supplies – it costs HIM money to see patients many times. Now our kids are starting college. Can't do it anymore. It is so sad. The system rewards production, fast fast visits, sore throat? Here's a pill. Goodbye. What if he sees something more? No extra money just extra time and lost money from another patient. What if he wants to use electronic medical records and needs to input critical information? No extra money, just extra time he would be paid if he saw another patient. Extra time, but he would never turn away a problem, and he insists on quality of care and inputting to electronic medical records. 99th percentile every time he takes the specialty boards. He loves his calling. But nobody pays for this kind of care. He cannot do it any more, it is choosing between our kids in college or him seeing patients. Very sad.

]]> http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/comment-page-1/#comment-42262 arthurat Sun, 28 Dec 2008 20:58:51 +0000 http://www.drumsnwhistles.com/2008/12/28/fix-health-care-fix-the-economy/#comment-42262 Other items that are the problem<br>Cost of providing health care for those without insurance. The money needs to come from some where. The someone is those with insurance.<br>Cost of new technologies and treatments. Remember, we are a capitalistic society. The ability to generate a profit for your work is vital.<br>Utilization of services will also drive cost up, remember supply and demand. Other items that are the problem
Cost of providing health care for those without insurance. The money needs to come from some where. The someone is those with insurance.
Cost of new technologies and treatments. Remember, we are a capitalistic society. The ability to generate a profit for your work is vital.
Utilization of services will also drive cost up, remember supply and demand.

]]>