Blue Mass Group

Reality-based commentary on politics.

Where do the premiums go?

By

Folks, we are being looted for corporate profits.

How else do you explain these spending numbers.

Total spending on health care, per person, 2007:

United States: $7290

Switzerland: $4417

France: $3601

United Kingdom: $2992

Average of OECD developed nations: $2964

Italy: $2686

Japan: $2581

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  1. That’s been my experience.

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    p>I’ve been with Blue Cross for seven years, and for years, my plan has included a fitness benefit to refund my gym membership.  Every year I send them the receipts and the proper form from the same gym I’ve gone to for seven years.

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    p>Last year they denied me the benefit for a reason (handwriting too small) and when I called, the customer service person said, “I can read it, so we’ll send the benefit.”

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    p>This year they denied it claiming the receipt I sent was handwritten.  It was not a handwritten receipt.  I called and the customer service person said, “oh, it’s not handwritten.  We’ll send the benefit.”

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    p>So, in both cases, since the denial was based on something that the company immediately backed down on, it gives the impression Blue Cross is just denying benefits for any old reason hoping that some customers don’t have time to complain and the company can keep the money.

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    p>These insurance companies do not treat us like customers.  They treat us like cows, milking every penny they can out of us.  That’s why healthcare is so expensive here.

    • Randomly deny claims for no good reason.  Enough people just accept the denials that it’s a “good” business practice.

    • Administrative costs of health insurance are driven up by having to pay a person to process reimbursements for gym memberships.

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      p>Regular exercise will make you healthier. According to a 2005 study, 85% of gym members visited the facility only 4.8 times per month.
      Source: http://www.benefitsbuzz.net/20…

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      p>And what about joggers or others who exercise and keep fit without visiting a gym?

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      p>It seems to me these perks are more marketing than anything else. And unless a person actually becomes healthier as a result of the free or subsidized gym membership, it does nothing to drive down the cost of health care. Just the opposite due to increase administrative costs.

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      p>The health insurance agency is like the airline industry before Southwest. Southwest had to muscle its way in to get gates at major airports. It had to battle the big players to get approval for long routes. But it made it, and as a result we’ve seen an increase in quality and quantity of low cost carriers.

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      p>I’m all for reducing premiums as an incentive for people to avoid smoking, drugs, and the excesses of life that are major contributors to health problems. I’d also like to see lower cost plans that have no or less coverage for treatments that do not impact health.

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      p>I think the government can play a role in opening up new markets for such plans while strengthening consumer protections so that if you think you are paying for a catastrophic care plan with a low deductible, the terms are standardized, well-defined, and easy for consumers to understand.

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      p>

      • We do not spend twice as much (or more) per person because of gym memberships. That’s the silliest thing I’ve read today.

  2.  but if you are at all serious it would not be hard to check profitability of the big insurers, which is fairly low on the industry profitability totem pole.

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    p>You think a CEO pulling in millions of dollars explains where 16% or 17% of the US GDP goes?  Hah.  Millions, billions, trillions, all quite different!

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    p>Here’s a start for you:

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    p>http://1.bp.blogspot.com/_otfw…

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    p>and

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    p>http://www.politifact.com/trut…

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    p>Why do we spend so much on health care?  Hint:  its not because of insurance company profits (3%) or CEO pay (negligible).  Do some math sometime, then pass it on.

    • Please explain the difference in spending per capita. The US spends twice as much as France. They cover everyone, we don’t. Our outcomes are not as good as theirs by many measures. We are not twice as healthy or getting twice as good care, so why the huge difference? Are you content to keep on being robbed of health and wealth?
      Anyone who is content to have others go without health care, deserves to go without health care themselves

      • Let’s look at some facts about the French health insurance system to understand how they achieve the lower costs and increased coverage. Keeping in mind France does not have a “single payer public option”, which of the characteristics of the French system do you think we should adopt:

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        p>(1)Reimbursement rates are lower

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        p>(2)You cannot get a long-term visa without insurance

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        p>(3)Less items are covered, or cost controls provide less access

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        p>Please feel free to add other contributing items. The French are also concerned about their rising medical costs. Just saying “lower cost and higher quality” doesn’t provide enough information to further the discussion.

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        p>I do also wonder about the geographical size and socio-economic diversity and its contributing factors to cost. Some systems or some aspects of systems don’t scale.

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        p>Sources:
        http://www.ess-europe.de/en/fr…
        http://www.americansinfrance.n…
        http://www.medicalnewstoday.co…

        • The first says that that costs are growing too fast in France and they are trying measures to control them. Frenach costs are too high? We already spend twice as much!
          The second says that you must buy health insurance to get a visa to live … in FRANCE
          The third says fertility treatments are higher in France because they will not allow people to sell human eggs.

      • Bill there is endless material out there on all of this – my only point was that the money isnt secretly being stolen by the insurers as you seem to suggest.

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        p>Its easy to cut costs when the government controls everything, just say the word and presto, costs are lower.  Then you get rationing and fun stuff like having babies in cars and closets.  Granted, those are UK examples not France but that is what you are trying to move towards.

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        p>Why aren’t people healthy?  Guess what – health care doesn’t make people healthy on the whole, only fixes them when something goes wrong.  Health comes from your lifestyle, which has nothing to do with how much government or insurance companies collect or spend on health care.

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        p>Two more reasons (of many) that things are costly here:  lawsuits, and innovation.  One bad, the other good.  Tort reform could really help – not just in reducing costs but also in preventing unnecessary treatments!  Because who wants to be sued for making the no-treatment call when its 50/50?  How bout when its 20/80?  Still no one?  That’s right.

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        p>The rest of the world piggybacks on US innovation (and for that matter, protection) but without us inventing the majority of new drugs, medical technologies and techniques, where would they be?  

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        p>You can only forcibly take goods and services for so long before people decide it is simply not worth going into those lines of business.  Its too bad we tend to demonize the folks who provide the most value to us, though.  Gonna turn everyone into lawyers, or worse.

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        p>

        • Tort reform of some sort has passed on 28 states and there is no difference in costs between those states and ones that have not.
          Innovation? Where were hip and knee replacement technologies developed? En France, mon ami. What country is the world leader in preventative care techniques? Merry old England and her NHS.
          What do pharmaceutical companies spend the most on, R&D?
          Sorry, pal, it’s advertising. Ask your doctor when the last time was that you saw a soap commercial on teevee. Half the commercials are for drugs that make you dance or take baths. Then ask your accountant how we are going to afford all those innovative pitches for pharmaceuticals.
          Look, the Republicans have no plan and the country is being looted. Get on board and let’s change this.
          What about my original question. WHERE DOES ALL THE MONEY GO? Watch the video again for clues.

          • Since you seem to pull facts from the air with little or no support, allow me to help you understand your world slightly better:

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            p>Bill says:

            What do pharmaceutical companies spend the most on, R&D?
            Sorry, pal, it’s advertising.

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            p>But, businessweek seems to say:

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            p>

            Pfizer Facts
            …
            — Pfizer’s 2004 R&D budget was $7.7 billion — nearly as much as the combined budgets of Intel and HP
            Data: Pfizer Inc., Intel Corp., Hewlett-Packard Co.
            …
            — Pfizer’s annual advertising budget is $3 billion — the fourth-largest in the U.S. as of 2003
            Data: Advertising Age

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            p>Ask your doctor when the last time a new cholesterol reducing soap was invented.

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            p>”We” don’t afford pharma ads, the pharmas do, precisely because it brings in more revenue with which to run and build their business.  Not hard to understand.  Next time you or anyone you know is helped by a medicine, please remember the vitriol your type likes to heap upon the inventors of same.  I almost wish they could withhold it from you.

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            p>WHERE DOES ALL THE MONEY GO?  You think I’m going to inspect some silly propaganda video for clues?  If you’re so confident in the answer, then please, bring us all out of the dark and say it.

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            p>vous ne savez pas très bien en mathématiques

            • Big Pharma Spends More On Advertising Than Research And Development, Study Finds

              ScienceDaily (Jan. 7, 2008) – A new study by two York University researchers estimates the U.S. pharmaceutical industry spends almost twice as much on promotion as it does on research and development, contrary to the industry’s claim.

              The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion.

              • Pharma revenue comes from sales of drugs.  We pay a huge margin for drugs in the US as compared to other markets for exactly the same drugs. Pharma spends a ton on marketing here in the US to increase sales of its overpriced drugs.

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                p>In Massachusetts, most plans offered via the connector include pharmas benefits whether you want it or not.    

            • Votre logique est merde!

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              p>$7490 in the US vs. $2964 on average for the rest of the world

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              p>Where is the money going? We’re not twice as healthy, we only pay twice as much.

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              p>What is the moral imperative to maintain corporate profits over the health needs of those who provide the money?

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              p>Anyone who is content to have others go without health care, deserves to go without health care themselves

        • From the CIA world book, US infant mortality, 6.3 per 1000 live births, UK 4.8

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          p>Anyone who is content to have others go without health care, deserves to go without health care themselves

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