"My insurance will pay for it"..#1 reason for $600 billion in"defensive Medicine"

[healthmyths]

I've written several posts with substantiating studies showing that a major health care cost contributor of $600 billion is "defensive medicine" practices and I've blamed the lawyers for their $100 billion in fees from lawsuits!

I WAS WRONG!!!

The fault is the patient with health insurance!

Which is 95% of US!

The majority of us go along with the expert, "physician" and agree to further tests, etc. which the physician orders mostly out of fear of being wrong and not wanting to be sued even if he isn't!

And the reason is "oh well my insurance will pay for it"!

Stupidly we don't realize that ULTIMATELY WE PAY FOR IT!

Stupidly because we say oh the insurance companies have money let them pay for it! Well DUH!!!
Where do they get their money.. Premiums!

Stupidly we don't KNOW that audits show the average insurance company pays out 80% of premiums in claims!

Stupidly we think the companies just reduce their profits if claims increase!
WRONG!
They raise the premiums and as a result the companies profits AFTER deducting 80% in claims, 16% in operating expenses leaves ave. of 4% in profits after which paying 20% federal taxes leaves 3.2% most distributed in taxable dividends!
BUT THE POINT IS WE STILL PAY!
Even if we have employer insurance we pay!
Why do you think wages have stagnated? Employee costs have gone up including insurance! Unemployment taxes go up with unemployment and who ultimately pays ..WE DO!

I have a solution!

 

[JoeB131]

A couple of thoughts on that.

"My insurance will Pay for that" is an understanble position if you've paid for the insurance. (And yes, if insurance was part of the deal when you were hired, you are still paying for it.)

In 2007, I had two operations, and there were a lot of tests. Now, being the cheap bastard I am, I didn't even want to really pay the co-pays on these tests, but my doctor wouldn't go foward with the procedures before he did them.

Most of the 20 years I've worked in the private sector, I ran up far less in medical bills than the combination of employer and employee contributions. In 2007, I ran up some big medical bills.

And in 2008, I was one of the first people let go when the company I worked for started downsizing. Myself and two other employees who had run up large medical bills that year. My lawyer told me I had an excellent case for discrimination, but I had found a new job two weeks after losing that one.

Insurance is essentially gambling. BUt it's a rigged game. And when you have a company like Cigna who denies a 17 year old girl a liver transplant, but finds the money to pay their slimeball CEO a 72 million severance package, something is askew with that casino.

 

[healthmyths]

A couple of thoughts on that.

"My insurance will Pay for that" is an understanble position if you've paid for the insurance. (And yes, if insurance was part of the deal when you were hired, you are still paying for it.)

In 2007, I had two operations, and there were a lot of tests. Now, being the cheap bastard I am, I didn't even want to really pay the co-pays on these tests, but my doctor wouldn't go foward with the procedures before he did them.

Most of the 20 years I've worked in the private sector, I ran up far less in medical bills than the combination of employer and employee contributions. In 2007, I ran up some big medical bills.

And in 2008, I was one of the first people let go when the company I worked for started downsizing. Myself and two other employees who had run up large medical bills that year. My lawyer told me I had an excellent case for discrimination, but I had found a new job two weeks after losing that one.

Insurance is essentially gambling. BUt it's a rigged game. And when you have a company like Cigna who denies a 17 year old girl a liver transplant, but finds the money to pay their slimeball CEO a 72 million severance package, something is askew with that casino.

Congratulations on being a cheap bastard!
You tried to do what MOST people won't WHICH IS WHAT I pointed out as the high cost of insurance.. they don't have your mentality!
BUT the insurance companies are doing what any good business would do regarding analyzing risks!
NOW your statement essentially gambling is again one of those OLD TRITE worn out cliches so devoid of REALITY!

AND IF you idiotically think it is RIGGED the insurance companies WOULD NOT BE IN BUSINESS! THEY PAID out in 2010 $728 BILLION in claims!
THAT is NOT RIGGED!

Now as far as Cigna's CEO and $72 million severance????
FACTS
IT WASN;T CIGNA.. AETNA!!!
In 2010, his final year on the job, former Aetna CEO Ronald A. Williams received $72 million in total compensation — including $14.3 million in stocks that vest later and depend on performance.

The largest source of pay for Williams was $50.4 million realized through the exercise of options granted in 2001, which would have expired in early 2011. He also received $1.1 million in salary, $2.75 million in incentive pay, an additional $2.3 million in pension value and other compensation of $299,838.


NOW I'm going to explain some very fundamental business/equity concepts which evidently you have NO IDEA of what you are writing about!
A) Total salary and bonus $3.86 million AND???
Why don't you be as mad at Oprah, $200 million. Manning $90 million!
all paid by people like! and you resent the CEO's $3.86 million salary?
B) THIS CEO PAID out of his pocket for stock that was worth more then what he would have to pay for.. BONUS for making the stock worth more!
What the hell is wrong with making stock worth more and therefore get rewarded for it???
BUT you and the ignorant press translate that to out of pocket cash paid!
WRONG!!!

Finally.. the 17 year girl

CIGNA CAPITULATES TO PATIENT REVOLT - Following Massive Protest, Insurer Authorizes Transplant for 17-year-old Nataline Sarkisyan

…In a Dec. 11 letter to CIGNA’s transplant department, four UCLA physicians said that Nataline “currently meets criteria to be listed as Status 1A” for a transplant and urged the company to “urgently re-review her case” and their denial.

CIGNA said it denied the care because their benefit plan “does not cover experimental, investigational and unproven services,” to which the doctors replied, “Nataline’s case is in fact none of the above.”

AGAIN you depending on 30 second sound bites for your opinion making jumped to conclusions forced on you ignorance to dig deeper into the 17 yr old story!!!


Meanwhile, representatives of UCLA and Cigna said they were hamstrung because the family had not signed a statement waiving privacy protections. Without the signature, they say, they cannot answer specific questions about the girl's treatment.

Geragos said he would not approach the Sarkisyans for permission before Nataline's funeral on Friday.
17- year-old girl needs liver transplant, CIGNA denies - Page 11 - Nursing for Nurses

WARNING DON'T JUMP to conclusions till you have MORE Information!!!!!

 

[Inthemiddle]

I give you credit for looking more into the matter and adopting a new position that reflects a better understanding of how the health car system operates.

 

[Mad Scientist]

The local Dentist wanted to pull out 4 of my wife's teeth, we objected but the Doc said "Don't worry, your insurance will cover it!". Never mind whether my wife want's her teeth pulled. So we went to her old Dentist in California who ended up having to pull two teeth but saved the others.

Made me imagine this possible scenario in a Hospital somewhere:

Doc: "Mr Smith, it looks like we're going to have to amputate both of your legs"
Mr. Smith: "OMG! Can't you do something? Can't you save my legs?"
Doc: "Don't worry, your insurance will cover it!"
Mr Smith: "Oh well if my insurance will cover it that's fine! Go ahead and saw them off!"

 

[healthmyths]

I give you credit for looking more into the matter and adopting a new position that reflects a better understanding of how the health car system operates.

Unlike most posters here I try to make comments based on substantiated FACTS and here is a FACT most people evidently don't know or the few that do seem to forget!

1) Projections for 2010 from U.S. Census Bureau National Health Expenditures--Summary, and Projections
Type of Total % of
Payer in Billions Total
Private Insurance $ 879 34.4%
Medicare 864 33.8
Medicaid 321 12.5
Out of pocket 298 11.6
Other 193 7.5
The 2012 Statistical Abstract: Health Expenditures
The above shows govt is biggest payer @45% insurance 34.4% or
nearly 80% of payments not coming directly out of our pockets.. BUT
indirectly i.e. lower wages due to higher insurance, higher medicare paycheck deductions do to higher Medicare claims..etc...
So in the end if we ALL understood WE pay directly or indirectly MAYBE we'd be more cautious when Doctor out of fear wants to do more tests!