The Obamacare Debacle. The First Victims? Children.

[^_^ 5,021]

Sort of, but the 'pooled' money is hardly ever enough to pay for the amount of people on the system. That's why insurance companies don't make their "money/profits/payouts" off of premiums, but off the investments that take place with said premiums and the returns on them.

I work for an insurance company. Approximately a decade ago, our claims paid/premium ratio was over 1. The BOD fired the CEO and we got brand new management. Today, claims paid/premium is in the vicinity of 0.8 and our investors are happy and our CEO is being rewarded for a job well done and is now buying up one home after another.

The moral of the story being, claims paid/premium should be below 1 in a well run insurance company. Most health insurance companies today (UHC and Aetna being prime examples) have been below 1 for a very long time. Obamacare mandates that the ratio be no less than 0.75 if I recall.

Do they make money on investments too? Yes, of course they do. AIG is a great example of an insurance company that didn't make much money at all on premiums and made a lot with exotic investment vehicles. We all know how that ended up.

[HAL 9000 96]

The exit polls have nothing to do with it. Neither this administration nor the GOP have any intention of reigning in the insurance companies at this point. The GOP I can understand. But this administration had the opportunity to incorporate said controls in the Bill, but withdrew them. Why?

I said at the time, and I'm even more certain now, that this Bill was a "legacy" item, something to say "Look, we passed Healthcare Reform!" despite the content falling woefully short of what this country needs and deserves from its elected representatives. It is a sham, a sell-out, a sop to vested interests, weighed down with opt-outs, buy-offs and sweetheart deals made to buy enough votes to pass the Bill.

And if you think that this administration being in bed with the insurance companies makes a lie of the GOP's opinion that Obama hates business, you need to take off those rose-tinted spectacles. Just make sure your insurance covers them.

I'm flabbergasted, seriously. The GOP claims its got the pulse of the voting electorate on this health insurance issue. I think it may be much more complex than that. So ask single-issue voters as well as multiple-issue voters at the time of voting and still claim that the electoral process won't have anything to do with 'it.' Yeah... uh huh...

Then again you do cover yourself by reminding us that its precisely opinions ... (*perhaps not your perspective from this point on*) which are being taken for fact by some groups of people that have nothing more constructive to do with their news time than to accept partisan soundbytes as fact.

[Heracles 417]

Sweetie is no different than calling one ignorant.

I am guessing she's about 25ish but certainly no sweetie.

You can get 300 x-rays each year if you want but the insurance company has only agreed to pay for 6 of them. This is the contract that you or your provider/employer signed, if you don't like then pay more for better coverage.

It really is that simple.

Funny how none of us under a NHS had this dilemma. You guys claim the US system is the best of the best, yet in reality I see communistic style rations and fail. I also work for a Fortune 20 company and have two max coverage policies. Both policies, which most Americans do not have, are significantly crappier when compared to what I had back in AUS.

Edited September 24, 2010 by Heracles

[Dan J 277]

I work for an insurance company. Approximately a decade ago, our claims paid/premium ratio was over 1. The BOD fired the CEO and we got brand new management. Today, claims paid/premium is in the vicinity of 0.8 and our investors are happy and our CEO is being rewarded for a job well done and is now buying up one home after another.

The moral of the story being, claims paid/premium should be below 1 in a well run insurance company. Most health insurance companies today (UHC and Aetna being prime examples) have been below 1 for a very long time. Obamacare mandates that the ratio be no less than 0.75 if I recall.

Do they make money on investments too? Yes, of course they do. AIG is a great example of an insurance company that didn't make much money at all on premiums and made a lot with exotic investment vehicles. We all know how that ended up.

The mandated MCR is .8 under the new health care bill. But to be competitive in the world it really should be around .95. Of course we need to make sure 20% of our health care premiums go to buy the executives more stuff. Thats the american way.

[^_^ 5,021]

The mandated MCR is .8 under the new health care bill. But to be competitive in the world it really should be around .95. Of course we need to make sure 20% of our health care premiums go to buy the executives more stuff. Thats the american way.

Claims paid/premiums being 0.95 leaves very little $$ for operating expenses. Mandate something that high and you'll see insurance carriers do what AIG once did - invest in risky instruments hoping to make up the difference.

[Dan J 277]

Claims paid/premiums being 0.95 leaves very little $$ for operating expenses. Mandate something that high and you'll see insurance carriers do what AIG once did - invest in risky instruments hoping to make up the difference.

Which is exactly my point. You can manage that in a public system, and many countries do. Companies in a private system would have to be seriously efficient to manage that, and there is no incentive to do so. The incentive is to stay at the 80% as much as possible.

[^_^ 5,021]

Which is exactly my point. You can manage that in a public system, and many countries do. Companies in a private system would have to be seriously efficient to manage that, and there is no incentive to do so. The incentive is to stay at the 80% as much as possible.

The only reason you can manage it in a public system is because pension costs for employees are handled by a different government entity and within a different budget and essentially don't count as part of your OpEx. Private companies don't have that luxury.

[Heracles 417]

Claims paid/premiums being 0.95 leaves very little $$ for operating expenses. Mandate something that high and you'll see insurance carriers do what AIG once did - invest in risky instruments hoping to make up the difference.

There is one option that would bring down costs, a public system to compete with a private system; something that undoubtedly adds competition. Without it is why the same procedures costs many times over here, than having them performed under NHS.

Of course, a piece to this cost puzzle is litigation and the threat of it. It's why doctors are forced to conduct unnecessary tests than be sued. Whereas, doctors could be fined or lose their license for doing the same under NHS.

Edited September 24, 2010 by Heracles

[spookyturtle 9,465]

I am guessing she's about 25ish but certainly no sweetie.

Funny how none of us under a NHS had this dilemma. You guys claim the US system is the best of the best, yet in reality I see communistic style rations and fail. I also work for a Fortune 20 company and have two max coverage policies. Both policies, which most Americans do not have, are significantly crappier when compared to what I had back in AUS.

Why don't you get a job at a company that provides a good health care plan? There are plenty of them.

[Pooky 3,783]

I'm flabbergasted, seriously. The GOP claims its got the pulse of the voting electorate on this health insurance issue. I think it may be much more complex than that. So ask single-issue voters as well as multiple-issue voters at the time of voting and still claim that the electoral process won't have anything to do with 'it.' Yeah... uh huh...

Then again you do cover yourself by reminding us that its precisely opinions ... (*perhaps not your perspective from this point on*) which are being taken for fact by some groups of people that have nothing more constructive to do with their news time than to accept partisan soundbytes as fact.

Wow! The arrogance on display here is truly outstanding, but oh, so predictable. Your jaundiced, partisan worldview, where anyone disagreeing with you has to be deriving their opinions from right-wing soundbytes, is getting old and tired, not to mention hopelessly off-target. When will you get your head out of your butt and realise that the "healthcare" sham has got absolutely nothing to do with the GOP?

Presented with a once-in-a-generation opportunity to effect real, tangible change, this administration squandered its opening, when the GOP did not have enough votes to mount a filibuster in the Senate. Instead, the sitting Democrats, along with the unions and other vested interests, fairly climbed over each other to grab whatever they could from the administration in the way of opt-outs, pay-offs and sweetheart deals in return for votes. Fearing that the legislation would not get through Congress and the Senate, this administration allowed it to became so watered down that its main selling point these days is that you can't be denied coverage for a pre-existing condition. The price controls got lost in the mix and the insurance companies are laughing all the way to the bank, because now you have to pay them, or get a fine.

What this country deserved, and what this administration singularly failed to deliver, despite being handed the tools to do so by a hopeless GOP campaign in 2008, was a single-payer system that removed the insurance companies from the primary level of coverage. Insurance companies are, by the role they play, an inefficiency in the system. Their primary function is to make money for their shareholders. This money is lost from the system, gone for good. With the figures being quoted elsewhere in this thread, that's a 20% drain. And this administration just acted as a facilitator.

I could go on, but I've said all this and more before, on numerous occasions.

So keep your snide remarks to yourself next time and don't put words in people's mouths. Look outside of your black and white, left and right, North and South world and understand that prejudging people just makes you look like a fool.

[HAL 9000 96]

Wow! The arrogance on display here is truly outstanding, but oh, so predictable. Your jaundiced, partisan worldview, where anyone disagreeing with you has to be deriving their opinions from right-wing soundbytes, is getting old and tired, not to mention hopelessly off-target. When will you get your head out of your butt and realise that the "healthcare" sham has got absolutely nothing to do with the GOP?

Presented with a once-in-a-generation opportunity to effect real, tangible change, this administration squandered its opening, when the GOP did not have enough votes to mount a filibuster in the Senate. Instead, the sitting Democrats, along with the unions and other vested interests, fairly climbed over each other to grab whatever they could from the administration in the way of opt-outs, pay-offs and sweetheart deals in return for votes. Fearing that the legislation would not get through Congress and the Senate, this administration allowed it to became so watered down that its main selling point these days is that you can't be denied coverage for a pre-existing condition. The price controls got lost in the mix and the insurance companies are laughing all the way to the bank, because now you have to pay them, or get a fine.

What this country deserved, and what this administration singularly failed to deliver, despite being handed the tools to do so by a hopeless GOP campaign in 2008, was a single-payer system that removed the insurance companies from the primary level of coverage. Insurance companies are, by the role they play, an inefficiency in the system. Their primary function is to make money for their shareholders. This money is lost from the system, gone for good. With the figures being quoted elsewhere in this thread, that's a 20% drain. And this administration just acted as a facilitator.

I could go on, but I've said all this and more before, on numerous occasions.

So keep your snide remarks to yourself next time and don't put words in people's mouths. Look outside of your black and white, left and right, North and South world and understand that prejudging people just makes you look like a fool.

Right on! So arrogant that language, that you fail to notice conditional speech, AND the particularity of being given the benefit of doubt. I guess your rant obscured that.

:secret:You may want to keep your partisan 'analysis' (opinion, just so you don't confuse it again as fact) outside the debate. Notice how I am neither applauding nor condemning the Health Care Legislation, but your consistent pedantic rants against most anything Obama do say quite a lot about where your preferences lie. Am I mistaken?

[Usui Takumi 1,562]

To those who claim that "rationing" will occur under a gov. system, why do you think that will occur?

A. There will be an actual shortage?

B. The money won't be there to cover certain items because of the need to admin costs etc?

If its B then its exactly like most health insurance companies, they can't cover certain things because they have to protect the bottom line. Okay so its not rationing because you can go out an buy it yourself? Fair enough, that's true with something like the NHS, you can still go buy it yourself too.

Edited September 25, 2010 by Sousuke

[Heracles 417]

Fair enough, that's true with something like the NHS, you can still go buy it yourself too.

And at 1/4 the price. Any generic test I or my wife have had here, costs about three to five times the cost of conducting the same tests under NHS. Most of these tests have zero copay under NHS might I add.

Though I personally did have my own supplemental insurance back there, just to receive platinum service and I was able to utilize any private hospital around the country.

[Pooky 3,783]

Right on! So arrogant that language, that you fail to notice conditional speech, AND the particularity of being given the benefit of doubt. I guess your rant obscured that.

:secret:You may want to keep your partisan 'analysis' (opinion, just so you don't confuse it again as fact) outside the debate. Notice how I am neither applauding nor condemning the Health Care Legislation, but your consistent pedantic rants against most anything Obama do say quite a lot about where your preferences lie. Am I mistaken?

Ummm ... yes

I notice how you phrase things and find it disingenuous at best and dishonest at times. You like to try your word games, couching your arguments in insinuations and implied comments, but your politics are clear for all to see. What irks you the most is when people don't fit neatly into your political pigeon holes. You have no idea about my politics, because it doesn't fall neatly into one of your categorisations, as amply evidenced by your asking me to classify myself at the end of your personal rant. Too bad. I guess I'll just have to leave you wondering.

As for telling me what I can post, don't make me laugh. If you don't like to hear the truth, too bad, so sad. You can't change facts by telling people not to put them out there for everyone to see. What is worse, for you at any right, is that the truth in this instance is like getting hit by a sucker-punch left hook, when you were expecting a straight right. Partisan, my ###!

[Gary and Alla 3,694]

I am guessing she's about 25ish but certainly no sweetie.

Funny how none of us under a NHS had this dilemma. You guys claim the US system is the best of the best, yet in reality I see communistic style rations and fail. I also work for a Fortune 20 company and have two max coverage policies. Both policies, which most Americans do not have, are significantly crappier when compared to what I had back in AUS.

any such comparison ignores the fact that the US government is not the ___________________ government. That someone else can "do it" (which is debatable) is irrelevent. The US government was specifically designed NOT to do such things and everything they touch turns to ####### in 3.5 seconds. They are ####### addicts. They want to make ####### out of everything. They see potential ####### everywhere they look. We need to reduce #######.

American politicians do not care about Americans or health care, they care about power. Money equals power. Controlling larger parts of the economy equals power. Controlling the government that controls a larger portion of the economy equals power. Austrailian politicians have, well, no such power concerns because, well,...it is Australia. Same with Canada, besides the US is piking up the tab for their defense budget and for Canadians we are treating a large poriton of their citizens in our health care facilities...the ones that can pay for it. But, as I said, the abilities are debatable...it is the US and the government can't even deliver the mail competively with private business.