Do you really think the medical profession would keep the cost low or
would they continue to keep jacking their price up to match the ones
that are charging the most?
> that will not accept insurance.
That's because they feel the "usual and customary" charges, agreed to by
those practicing and accepting the payment amounts the insurance
companies have negotiated, are too little and they don't like being
questioned when they overcharge.
How do they handle payment for the expensive things like surgeries,
cancer treatment, child births, hospital stays, etc.?
Competition drives down prices. With insurance paying for your care there
is no competition.
I suspect it is because they make more money and have lower costs extcept
for the extensive advertising.
A patient that is a member of one of the Houston area groups had a daughter
than needed arthroscopic knee surgery. He shopped the price and got quotes
in the $15,000 range. IIRC his group did the surgery for less than $3,000.
There will probably still be insurance for catastrophic needs if you feel
that living an extra year or two is woth having insurance for.
Quite a lot here, actually, anyway. All insurance companies I've dealt
with pay only the lowest bid w/ confirmation work is required either by
own inspection for really high-$$ jobs or simply photographic submittals
for lesser amounts.
I still say one's viewpoint of costs when dealing w/ major health care
isn't generally focussed on lowest bidder. For maintenance care such as
long-term medications, etc., sure, but for (say) cancer are you going to
the local GP or Hutchinson or Mayo or other specialty clinic?
It is the market forces at work regardless of the industry.
When the talent pool is limited and the demand high, price reflects
this whether you are dealing with show business talent, lawyers, or
the medical profession.
Quality, perceived or otherwise, has it's price.
Sure, but... :)
The point I was making was that imo there isn't much pricing competition
brought to bear in the selection of treatment process by most people in
search of medical care--in general they're more concerned about whether
they think they're going to find an effective treatment whatever the
cost. Thus I don't think competition is particularly effective in
holding down health care costs because I don't believe it's the driving
force in most decisions.
As long as private enterprise is involved in health care and are
allowed to limit the "gene pool" as a means of controlling their risk,
the problem will not be solved.
Some how, 100% of the population, no exceptions, must be covered, then
move forward to address and control the cost issues.
Limiting the "gene pool" is not a workable solution.
The insurance company "wants" to only pay the lowest bid. Read your
policy, there is generally no mention of where you have to get the car
repaired. If you choose to have the car repaired at a more expensive place
the insurance so is liable to pay for the repairs up to the value of the
car. Basically the lowest bid could still be thousands higher than the next
guy down the street. It is a game that the insurance companies play. They
try to make you and are very often successful at getting you to shop for
I didn't say anything about _which_ estimate you have to submit; only
that they will only pay the amount of the lowest that is submitted that
covers the required work.
Most body shops I've dealt with will come to within a few $$ of any
other; they all use one of a few software packages for estimating so
their labor estimates are all within a few tenths of hours/task and they
all use the same or nearly after-market parts markets as well. The
biggest differences I've seen is finishing but the highest here will
tell you when he makes the estimate it's higher than most other shops in
town because of that and he'll knock it down when the insurance company
balks (as they always do).
If it's a chromed piece I'll make it be OEM; otherwise anymore I can't
see any significant difference in the aftermarket parts of significance.
Just been thru it w/ Mr Buck that couldn't stay on the side of the
road where he belonged... :(
That is not true, they indeed have to pay what ever price the shop charges
that you choose. Been there and done that for years on end.
The insured calls the shots as to which repair shop does the work, the
repair shop may drop the price to play along.
Work around genuine and aftermarket and you will soon learn to tell the
difference. I bought and sold both for 15+ years. Basically you still get
better parts when you pay more. some times this will make a difference some
times not. After market sheet metal will dent easier and often rusts
sooner. Considering chrome, most often the repaired/rechromed bumper will
have a life time guarantee, the Body shop however will not often tell you
When I was in the business, there was basically no competition, in Houston
or Corpus Christi, in the 70's, 80's, and 90's. Because 99% of the cars
being repaired were covered by an insurance company. Basically we never
had to worry about a customer turning down an estimate.
Additionally we did not accept payment from insurance companies unless it
was MIC insurance sold by GM. We charged every one the same price whether
the insurance company was involve or not. When we had to accept MIC
insurance we had to discount parts $30% and give a hefty discount on labor.
We stayed busy.
The competition comes into play with the insurance providers. When I
choose my medical insurance plan one of the major considerations is
which doctors participated in each of the plans that are available.
The lower priced plans had fewer participating doctors and specialists.
I don't know that I'd always want my medical treatment to go to the
It doesn't take a catastrophe to end up with astronomical medical bills.
I don't foresee any major reduction is the cost of medical care
regardless of who foots the bill.
As proposed in Swingman's original post:
"Each American citizen shall be able to exclude from taxation the amount
of $5000 per year (adjusted for inflation) for deposit in his or her
Health Savings Account, with catch up contributions allowed if the prior
year's expenses exceeded this amount. There shall be no limit to the
total amount of capital the citizen can accumulate in his or her HSA. .... "
How does this work for a hypothetical married couple with three young
children and one wage earner making minimum wage? Obviously they won't
be able to put $25,000 per year into their HSA.
"8. Citizens with income below the poverty level will be provided yearly
with a "tax rebate" from the Federal Government, deposited directly into
their HSA..... "
A "tax rebate" would indicate the citizen is paying federal tax. A
family of five earning $13,624 per year ($6.55 per hour x 40 hours x 52
weeks) does not pay federal income tax.
"10. Citizens who become ill before they have accumulated sufficient
funds in their HSA to cover the "gap" (whose HSA balance falls below
zero in a given year) will be LOANED the needed funds by the Federal
government, to be repaid with interest in the future. This loan will
show up on their credit report and will influence their ability to
borrow for other purposes until it is repaid. .... "
Let's bury the hypothetical family in debt and take away all incentive
to work. Tim and I can cover all their expenses with out tax dollars.
Agreed and these guys are probably makin more off of the procedure than
those having to collect from an insurance company. Remember insurance
companines get deep deep discounts and often don't pay. Basically HMO's and
insurance companies are more like agents for many doctors. I think I would
probably have more faith in a doctor that does not rely on an insurance
company to bring in it's patients.
Don't for get the major point here, insuranc companies make more than the
health care system does and what overhead does an insurance company have
other than an office for record keeping?
Take the insurance company out of petty coverage and every one saves, except
the insurance company.
It sound to me like the insurance companies are keeping the cost down.
> doctors. I think I would probably have more faith in a doctor that
> does not rely on an insurance company to bring in it's patients.
The insurance companies rely on their participating doctors list to
bring in the customers.
Medical insurance companies are gambling that the coverage premium they
charge along with any returns on there investments made with your money
will exceed the medical payments they make in your behalf. By them
making a profit it shows that on the average they're right.
Your key word above is "petty". If you take the insurance company out
of the picture you'd better hope that you're one of the customers that
make their "average" profitable.
Would you use an insurance company to hep you buy electricity, groceries,
clothing? They don't keep costs down, often they perpetuate the problem.
I have never heard of any one including myself choosing an insurance company
based on its doctors list. Most employees insurance is provided through
their employeer. The employeer decides which insurance company to go with
and you choose from the list of doctors.
But dont be fooled into thinking that every claim is not scrutinized by the
insurance company. More often than not th winsurance company disallows
I do not want the insurance company completely removed, just remove them
from the petty, normal, illnesses by simply raising the deductible. I lower
my auto and home owners, and flood insurance by paying a higher deductible.
If the average person had a $2000 deductible I suspect the cost of primary
care would go down when the insurance claims became fewer in number.
Exactly! I believe that insurance costs are sky high because of abuse.
IMHO insurance should only be used of those events that you could no
possibly afford, not normal trips to the doctor for the regular illness.
On first glance looks good, but when you dig deeper has a major flaw.
When insurance covers regular services of a person's primary giver,
illnesses are detected earlier and can be handled with the lowest cost
When insurance does not covers regular services of a person's primary
giver, illnesses are not detected as early as they should be often
resulting in higher cost services to overcome the advanced problem.
Health care insurance is a tad different than other insurance
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