ObamaCare Blamed for up to 47% Hike in Insurance Rates

They are all numbers from the insurance company books - profit, administration expenses, premiums charged, etc and so forth.

They do not even approach - not by an order of magnitude, probably - the extra (overhead, not a part of the actual delivery etc) costs incurred by the US medical care delivery system in incorporating private medical insurance as it does. They do not, for example already given, include the large extra cost imposed on the system via its treating of neglected ordinary medical problems come to crisis in emergency rooms.

As pointed out, a basic and general overview using equivalent or better care delivery in systems without the US style of private corporation setups (any of the better European systems, say) seems to indicate that the entire private insurance industry in the US is superfluous - every nickel paid in private insurance premiums is apparently wasted, goes to overhead inefficiency.

So far, you don't seem to have figured out what my assertion is - you continue to claim that I have posted no factual observations in support, and none of your figures in claimed "response" have much to do with it, so I tend to think you just aren't paying attention.

OK, that would be at least a relevant response - and we notice that it would not persuade well, because you like everyone know better.

Similarly with the rest of my observations and arguments here - actual responses with actual objections would, I think (pending their appearance some day), appear similarly unrealistic and counterfactual, because we all (pretty much) know better. I'm not saying anything arcane or complicated or based on hidden evidence etc. The overhead costs imposed by the private insurance industry setup on the US medical care system are quite obvious, a part of almost everyone's experience in the US.

 

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I am paying attention ice, you say look at the European systems, they cost less and have better outcomes, therefore it's ALL TO BLAME on the fact that we have Private Health Insurance.

But you offer NO PROOF of that at all.

And yes, I've read the reports and they, like you, are all short on actual comparisons of WHY there are differences, only that there are.

Indeed, looking into it, I do find some proof that ours is more expensive, clearly you could do away with a lot of Admin overhead in a single payor system, but that is far too little to account for the difference. Now you say it's because of the cost of the underinsured, but again, no suggestion as to how this small part of the population costs so friggin much.

Indeed, I find this: approximately 90 percent of health care spending is for sicker patients spending $1,000 per year or more. Moreover, about 80 percent of health care spending is traced to patients with largely predictable health care needs and expenses: the chronically ill, which seems to indicate that maybe our problem with health care is we just aren't very healthy.

Arthur

 

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I don't say it's all any one specific factor - there are many areas of misfortunate influence from the US coddling of its corporate insurance setup, and posting examples is not claiming exhaustion of them. It's called evidence - you deal with it in the context of the argument, which requires that you be dealing in that context.

Evidence and argument, observation and implication.

The underinsured are maybe 2/3 of the US population under 65, compared with the normal level of insurance in First World systems. Let's just arbitrarily cut that in half - call it one third. Note that many of them are young - not just under 65, but under 25, with bad jobs or dependent on adults with bad jobs. The effects of poor care delivery in the young compound over years - a suggestive circumstance.

And their behaviors in the face of cost-exclusion or heavy penalty drive costs up for the whole system in many ways - by creating unnecessary competition for scarce and expensive crisis resources, by forcing inefficient and costly structure on delivery systems (such as too high a doctor/nurse ratio, too heavy a demand for top end gear and supplies, etc, from the predominance of crisis), and so forth.

It indicates that First World delivery systems obtain significant cost savings by providing medical care to people on demand - when it will prevent or delay the more expensive and extensive consequences of neglect - rather than waiting until they can pay the high prices created by similar delay in others (a self-reinforcing spiral), or until they are so desperate they don't care about even a huge financial hit, as the US does.

You don't actually believe the French and Germans and Swiss and Canadians and Japanese and Swedes and Australians and so forth are all - all of them, every single country with a First World setup - equally and that much naturally healthier than US people, do you? They don't live any longer, they don't have a record of suffering less from disease overall until maybe very recently. Granted we are becoming shorter and sicklier as our income inequality grows, while Europe and others catch up, but Americans had a big lead as recently as 1950 - we have been for a long time unusually tall and strong and athletic and long-lived, compared with others.

 

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No you don’t – about 47% at most, actually.

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Interesting that you picked 2008. Why not 2009? Or 2007?

Besides, a % decrease in profits does not indicate a lack of profitability. What’s more – as has been mentioned way back in this thread, the end result for the 10 big players 2000 to 2009 is a cumulative profit increase of 250%.

As I said your data/methodology is completely wrong. If you don’t see why it’s wrong to base your calculations on the premise that 5 insurance companies are paying the nation’s entire medical costs, and that the difference is how much profit they are making, well what can I say.

I said:

You said:

In other words, you are agreeing with me – premiums are not included as a healthcare cost, they are included as a source of funds.

Exactly. So again, you are agreeing with me – that premiums are not included on the cost side of the equation. Or as I said back in post #66:

“insurance” does not contribute to medical costs except by way of a share of admin that can be linked to medical costs ultimately paid for by insurance companies. Rather, money coming from insurance companies is one of the sources of funding by which the nation’s medical costs are paid.”

Correct – a.k.a. the “net cost of previous health insurance”.

Except that this isn’t “the issue”, or at least not the prime issue.

The dominant issue is the impact on healthcare consumers of an expensive healthcare system combined with arbitrary health insurance business practices. Whilst there is no doubt that healthcare costs need to be reduced, at the same time there needs to be a minimum standard applicable to healthcare insurance policies. Healthcare reforms aims to achieve both.

Except that it’s all right for you to do it when presenting data from Forbes.

No one has suggested that it is - this “projection" is a creation of your own, based on peculiar and erroneous methodology which no one but yourself is using.

 

Gypsi,
Your graph includes NON-PROFITS, like BC-BS.

My chart is of the companies that make a profit, and the top 5 accounted for 90% of the profit in the industry, and that's what we are talking about.

The Non-profit costs are covered in the Admin & Net section.

No Gypsi, the SUM of all the Source of Funds, which includes the premiums is equal to the Total Healthcare cost.
It's a spreadsheet, take a look at it.
It will all become clear.

First they list the TOTAL COST
National Health Expenditures 2,338,747
Then they show where the money comes from:
First the private funds which include from the INSURANCE COMPANIES (which is what our premiums go for minus the NET overhead and profit)
Private Funds 1,232,030
Consumer Payments 1,060,935
Out-of-pocket Payments 277,778
Pvt Health Insurance 783,157 <== our premiums
Other Private Funds 171,095
Then the Public Funds. .
Public Funds 1,106,716
Federal Funds 816,936
State and Local Funds 289,781

I never said the insurance companies are paying the entire medical costs, I've just pointed out over and over again, that the PROFITS of the insurance companies account for about ONE HALF OF ONE PERCENT of the cost of our medical care.

So far you have NOT shown this to be wrong.

You've been going on about PROFITS and claiming the Insurance companies profits are responsible for the rise in medical costs, but without proof.

The top five health insurance companies did see profit increases of ~55% for 2009. However, the top 5 saw a 34% decrease in profits in 2008 in a particularly bad year, and thus the total profit increase from 2007 to 2009 was only 2.6%.

Maybe it would help to look at the profit margins of OTHER companies in the Health Care field and compare their margins to the Health Insurance field.

•Amgen (biotechnology): Profit margin, 30.6 percent
•Gilead Sciences (biotechnology): 37.6 percent
•Celgene Corp. (biotechnology): 11.9 percent
•Johnson & Johnson (drug manufacturer): 20.8 percent
•Pfizer (drug manufacturer): 16.3 percent
•GlaxoSmithKline (drug manufacturer): 17.4 percent
•Unitedhealth Group (healthcare plans): 4.1 percent
•WellPoint (healthcare plans): 4 percent
•Aetna (healthcare plans): 3.9 percent
•MedcoHealth Solutions (healthcare services): 2.1 percent
•Express Scripts (healthcare services): 3.7 percent
•Quest Diagnostics (healthcare services): 8.7 percent
•Medtronic (medical equipment): 14.9 percent
•Baxter International (medical equipment): 17.5 percent
•Covidien (medical equipment): 12.3 percent

http://money.usnews.com/money/blogs.../why-health-insurers-make-lousy-villains.html

Arthur

 

Didn't you realize you were meant to tot up the for-profits?

Again, you're pointing out the obvious.

Yes - so as I have been saying - private health insurance premiums appear as an INCOME item. Why do you keep repeating this?

This is meaningless, erroneous nonsense, for reasons that I have already explained.

I have been claiming that insurance companies are responsible for unjustifiable premium increases - the impact on joe citizen's wallet. Their negative impact as a major component of the health care system is a different matter, and one I've barely touched on though I see iceaura is somewhat patiently attempting to get you to address this. And with this in mind, I'm not going to address your (mis)interpretations, convolutions and bizarre methodologies any further.

Take this as a capitulation if you will - I really don't care. This is all cut from the same cloth used in other threads (unintentional pun), including your scramblings around for scraps of contrary "evidence", confounding your own peculiar calculations with "evidence", and propensity for "stating the obvious with such a sense of discovery", as someone famous once said.

The bottom line is, you continually refute things that others have never said, whilst denying things that you have said. And no, I am not going to provide you with some examples. Just re-read all your own posts.

(Apologies to everyone else for my contribution to the tedium.)

 

Gypsi, you post a graph that includes BOTH for profit and non-profit insurance companies to try to support your explanation that the 5 top insurance companies don't equal 90% of the for profit insurance companies.

Sorry, no dice.

The Forbes figures are accurate, the top 5 represent 90% of the profits in the FOR PROFIT insurance world.

And the profits of the top 14 represent ONE HALF OF ONE PERCENT of the total cost of our health insurance.

To bad you don't like the facts, but they are still the facts.

http://money.cnn.com/magazines/fortune/fortune500/2009/industries/223/index.html

Read em and weep.

QUOTE=Gypsi]I have been claiming that insurance companies are responsible for unjustifiable premium increases - the impact on joe citizen's wallet. Their negative impact as a major component of the health care system is a different matter[/QUOTE]

Gypsi, you can't have it both ways. Either they are making unreasonable profits or the premium increases are justified. There is no other option. But, as we have seen, the insurance industry profits are ONE HALF OF ONE PERCENT of our total medical costs is a proven fact. Indeed, they have been essentially that same amount for the last decade.

Yes our health care costs a lot, and yes it is growing each year, but the growth in our costs is not because of excessive profits from the insurance industry. Indeed, the total profit increase from 2007 to 2009 was only 2.6% for the top 5 (90% of the for profit insurance industry).

Why do you continue to assert something to be true which has been proven over and over again to be false?

Indeed, I showed you the medical companies that are in fact posting huge profits, why do you ignore them and focus on the insurance industry with it's very low profit margin?

•Amgen (biotechnology): Profit margin, 30.6 percent
•Gilead Sciences (biotechnology): 37.6 percent
•Celgene Corp. (biotechnology): 11.9 percent
•Johnson & Johnson (drug manufacturer): 20.8 percent
•Pfizer (drug manufacturer): 16.3 percent
•GlaxoSmithKline (drug manufacturer): 17.4 percent
•Quest Diagnostics (healthcare services): 8.7 percent
•Medtronic (medical equipment): 14.9 percent
•Baxter International (medical equipment): 17.5 percent
•Covidien (medical equipment): 12.3 percent

Arthur

 

The other option is that the increased premiums are driven by structural factors inherent to a for-profit, privatized, piecemeal health insurance system. That universal systems in use in other parts of the world do not exhibit similar problems is decent evidence that this is, in fact, the real issue.

One driver of exploding healthcare costs is healthcare provider consolodation. The relevant anti-trust rules were weakened a couple of decades back in order to... actually I'm not sure what the idea was there. But the result has been that hospitals and healthcare providers have become increasingly consolodated, and so are in a strong bargaining position relative to the insurance companies. I.e., by weakening regulations, we have artificially boosted the competitive position of hospitals, and they are returning the favor by gouging the insurers, who in turn pass the costs on to us.

 

Actually you produce no evidence, only anecdote, as the REST of your post attests to.

FIGURES

That's what you need and yet you have none.

To say ours is more expensive but not to say where or how means nothing.

2/3s of the US population is under insured? Where did you pull that number from?

Actually suggestive of very little. Young people, under 25, tend to be very healthy and have much lower medical needs.

Nice story, got facts?

Nice story, got facts?

Why YES, I do.

Why YES, they do,

http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

BUT, only because our HOMICIDE rate and our TRANSPORTAION rate makes ours lower, take those two away, and people in the US live longer than any one else in the OECD.

http://www.aei.org/docLib/20061017_OhsfeldtSchneiderPresentation.pdf

Slide 18

BUT, we are also the most obese and have the highest rates of diabetes, so the net is our CHRONIC diseases last longer and take a HUGE toll on the cost of our health care since so much of it is spent on the last few years of life.

1950s is ancient history.

Arthur

 

Not a single anecdote, so far, from me. Observation, factual observation, and argument or implication only. You have provided none at all against mine - your numbers have been irrelevant to the issue. So all the presented relevant facts on this matter have come from me.

Do the estimate yourself, back of envelope - I said 1/3, btw, as that is safe and enough for my argument. The comparison would be with any of the better First World systems, such as France's, (note, for example, high deductibles are not found in those systems).

That's why they can be treated (and are, under better systems) without costing the system much - thereby avoiding the compounding of neglected minor issues of the young into the more expensive and often chronic issues of the older. The US system is penny wise and pound foolish. So how is it that the cheapest and most easily covered people, and the ones most efficiently treated with the greatest benefit long term, are not treated in the US?

If you are willing to state, clearly, what exactly you doubt about my "nice story" - the exact claim you personally think is wrong - I'll go linkshopping. Most people find the observation that the poorly insured tend to postpone medical care until crisis uncontroversial, and the observation that crisis care is disproportionately expensive unexceptional.

I quoted the factual observation, the evidence, from you - the same facts, exactly, you posted.

I posted a link on the French, popping some of the illusions regarding the supposed health of those smoking, drinking Frenchmen. Similar considerations apply to the others.

The people in their last few years of life now, were in their healthy, youthful twenties and thirties in the 1950s and 60s. That's when those European countries, formerly sicklier and shorter and shorter lived than the US, started their systems of medical care, and the US chose to entrench the corporate insurance setup it's had since. Now we see neglected problems costing us lots of money (not obesity/diabetes yet - that wave is more recent and hasn't hit the old yet), and US emergency rooms strained by things like childbirth and the flu, and best practices in medicine scrapped for competitive edge and legal defense, and costs rocketing, and so forth. Now bums sleeping in French parks get better medical care than many people working two jobs in the US - and the French pay half. Total. Likewise the Swiss - with a completely different setup than the French, btw. Likewise the Germans, again a different setup. The Canadians, Danes, Swedes, Norwegians, Australians - different systems, but one aspect in common: no private, profiting, corporate insurance.

 

Funny, you left out the one part that shows that's just happy horseshit.

Only because our HOMICIDE rate and our TRANSPORTAION rate makes ours lower, take those two away, and people in the US live longer than any one else in the OECD

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Arthur

 

So? I'm beginning to suspect you of deliberate tactics, with this constant posting of silly irrelevancies in supposed response to my posts.

 

No Ice, I'm quite tired of arguing with someone who only post anecdotes.

You clearly are convinced you are right and you don't want any facts to get in the way of your beliefs.

I just posted data that shows our 5 year survival rates for cancer blows away Europe, but of course, that kind of increase in survival rates doesn't come CHEAP.

But you totally ignore it, apparently claiming that it's a "silly irrelevency".

Well it isn't if you've got one of those cancers!

Then in your last post you are saying our problem goes back to the 50s, so we are fucked any how.

So what's the point of this discussion?

What you apparently want isn't even on the table.

Arthur

 

I haven't posted a single anecdote here.

You posted data from twenty five years ago, about one form of cancer that is among the most variable in incidence and malignancy in the world, didn't even post the overall mortality stats, and overlooked the demographic class issue - comparison of Americans with incomes similar to some of those Europeans (such as black Americans) shows no such blowing away in survival rates.

Here, argue from more recent and relevant stuff - notice I didn't take the obvious tack and just look at cancer overall, or other disease, or demographic class:

http://www.conferenceboard.ca/hcp/details/health/mortality-cancer.aspx
http://jnci.oxfordjournals.org/content/95/17/1258.full
http://www.sciencedaily.com/releases/2010/09/100912202145.htm
http://caonline.amcancersoc.org/cgi/content/full/59/6/366

And while you are arguing, don't forget that the argument was about bang for the buck in overall medical care - in colorectal cancer the private insurance business has been dodged, partly, because most such patients are old enough for Medicare: with socialized medicine handling the great majority of that particular affliction we see money spent on prevention and other lower cost stuff. When you say "doesn't come cheap", you overlook the fact that the early detection and precancerous therapy involved in socialized medicine are much cheaper than the treatment of the mature disease. The US has not only better treatment, but better prevention of that cancer (declining incidence, declining severity at first diagnosis) - because at that age Medicare supplants employer based insurance.

Those kinds of savings are had by Switzerland, Belgium, Holland, etc, throughout their care delivery systems.

 

That's about all you do post.

Nope,
It's on the 5 year survival, and thus the data it to 93, so it's 17 years ago, but do you really think our medical system is that different?
Of course not.

Indeed, I've been going back over your posts and clearly they don't hold up.

For instance, your main assertion:

BUT

When you look at the numbers, Private insurance only pays 33% of our medical bills, so it seems pretty hard to figure out how something which only controls 1/3 of our medical spend can somehow cause the entire system to be over priced by 40%.

Arthur

 

Get a dictionary, look up words you don't know.

It's pretty easy, actually - the evidence, illustrative circumstances, etc., took no research at all, drew from common experience. The various connections are immediate and visible. The comparison with other systems of various kinds was simple and crude to begin with - and since it was never challenged with argument, no elaboration or qualification has proved necessary.

But no one can make you pay attention - you have to do that on your own.

The five year survival rates for cancers in other systems have changed a lot in the past twenty five years - and the five year survival rate for most cancers is a fragile stat, heavily dependent on things like diagnosis practices and demographic status of the afflicted.

And the data was from diagnoses before 1986 - the latest date at which the evaluation of the medical system in that stat could begin. The meter started running twenty five years ago.

Try making your argument from the more solid and much more recent mortality stats I linked variously.

 

I used the term exactly how it is defined.
http://en.wikipedia.org/wiki/Anecdotal_evidence

Which is a dead ringer for how you describe it as well:

Arthur

 

Well earlier this week I got my healthcare bill for next year. My healthcare insurance will cost 6% more next year than it does this year...including all of the so called Obamacare changes.

And I have one of those so called cadilac healthcare insurance plans. While my healthcare cost next year is about three times higher than the nations growth in income, it is in line with previous years.

 

The term you used was "anecdotes". That would invoke this meaning of "anecdotal evidence", the first or primary one:

BTW: that second meaning you chose is the silliest definition of "anecdotal evidence" I ever saw - it would apply to certain invalid syllogisms, even. Wikipedia is not a dictionary. Back to this:

Meanwhile, someone simply declaring evidence or arguments to be inadequate is not saying much against them. Nobody's stopping you from making declarations, but they aren't backed by authority. I am arguing that the overhead cost of incorporating private health insurance companies into the US system is very large, 40% or more, and pointed to several quite different pieces of evidence for that. That would be the issue to address, some day, if responding to my posts here seems worth the time.

 

This is one of the failings of your debate.