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About that "World's Best Healthcare System" the U.S. is supposed to have...

The GPs aren't the problem, either.

Where is the excessive profit in HC? Certain specialties? Hospitals? SNF? Pharmacies? Insurers? Whats a BKF approved profit margin in health care? Is there one?
 
Obviously, you already privately understand what I am talking about...or you couldn't have named so many of the obvious candidates: Specialists, Pharma, Insurers & Hospitals, etc.

Bob, out of curiosity, do you own any stock in any pharmacutical or health care companies? How about any mutual funds that have those holdings? Additionally, as a financial advisor/consultant, do you steer your clients towards or away such investments?
 
Obviously, you already privately understand what I am talking about...or you couldn't have named so many of the obvious candidates: Specialists, Pharma, Insurers & Hospitals, etc.

So what is an acceptable margin or salary in your opinion? No agenda here, just curious.
 
That is such a broad question as to be unanswerable. Let's just say considerably less than it is now.

And this problem is not a recent one. I will give you an example. Way back in March of 1990....24 years ago....an elderly (86-years old) silent partner in our family business fell ill while at a dinner at the Pinewood Country Club south of Asheboro on Thursday night, March 29th. He was taken by ambulance to Cone Hospital in Greensboro, where he died on Saturday, March 31st....less than 48 hours later. His total hospital bill was almost $50,000.

Billed and allowed are 2 very different amounts but I understand your point. I just like to hear whats too much....Is an insurers 4% margin too high? Is $1M for a ortho surgeon too high?

Ive long been a fan of outcomes based reimbursement. Base outcomes on total cost/quality/result and pay as a result.
 
Based on outcomes?

So if an ugly woman gets plastic surgery and is still ugly after having the work done, she wouldn't have to pay?
 
Billed = cost for a person without insurance
Allowed = cost for a person who has insurance
 
Where is the excessive profit in HC? Certain specialties? Hospitals? SNF? Pharmacies? Insurers? Whats a BKF approved profit margin in health care? Is there one?

Hospital margins are 5.5-7.5%. Average SNF margins are 1.8%.
 
"Profit" is a curious word.

How many millions do the top managers make at insurance companies? How many millions are wasted on marketing? How many millions are spent on meetings/conventions?
 
Billed = cost for a person without insurance
Allowed = cost for a person who has insurance

Haha, okay. Does that include the write-offs that the provider takes when the person without insurance doesn't pay all or any of it?
 
"Profit" is a curious word.

How many millions do the top managers make at insurance companies? How many millions are wasted on marketing? How many millions are spent on meetings/conventions?

Good point. I read somewhere recently that the government employee who runs the entire health insurance system for a Canadian province makes $350,000 a year. It's bigger than most US health insurance companies. From info cited in my earlier posts, I'm guessing it gets health outcomes at least as good as American companies, and costs a lot less per capita. So just talking about "profit margins" for US private companies is not terribly instructive in this arena unless you also take into account executive compensation and all the other spending by those private companies that would be avoided in a government single-payer system. It's not the whole answer to higher health costs in America but it's a piece. Big Pharma and medical equipment profits - which again, don't even count all the executive comp and so forth - are another big piece.
 
Here are some nice tidbits of how your "insurance premiums" were spent:

http://aishealth.com/archive/nhpw050712-03

"Five of the nation’s largest publicly traded health insurers collectively spent $366.8 million on advertising last year — up 51.6% from 2010 (see chart, p. 3), according to data provided to HPW by Kantar Media, a marketing and branding firm that also monitors advertising spend."

And:

"In other forms of media, Humana Inc. increased its magazine advertising 1,424% from $2.2 million to nearly $34 million year over year. And Cigna more than doubled its television spend from $5.4 million to $12.2 million.

However, both Humana and UnitedHealth Group were the biggest spenders on television in 2011 with, respectively, $57.5 million and $59 million. And by a huge margin, television remained the undisputed king of insurer advertising media in 2011."
 
"Profit" is a curious word.

How many millions do the top managers make at insurance companies? How many millions are wasted on marketing? How many millions are spent on meetings/conventions?

Of the three things you mention, compensation of top managers throughout the healthcare and healthcare insurance industries is something I also question. The consolidation of facilities (hospitals, clinics and SNF's) by large companies has produced some really big compensation packages. One way of controlling this from the Medicare/Medicaid standpoint is limiting the % of allowable costs going towards administrative costs.
 
Of the three things you mention, compensation of top managers throughout the healthcare and healthcare insurance industries is something I also question. The consolidation of facilities (hospitals, clinics and SNF's) by large companies has produced some really big compensation packages. One way of controlling this from the Medicare/Medicaid standpoint is limiting the % of allowable costs going towards administrative costs.

Which results in an entire industry making big bucks figuring out how to circumvent those rules.

Seriously, just go to single-payer and have done with it. Private insurance is a sucky way to deliver health care, tying it to employment is a burden on the private sector, and Obamacare doubles down on all the suck and adds an extra layer of cost spread like bad jelly on top of it.
 
The other myth is that allowing people to "buy across state lines" would lower costs. All allowing this to happen would create is mass consolidation of the healthcare industry. There would fewer and fewer choices and less competition. The big boys would further carve up the delivery systems to have more virtual monopolies.
 
Which results in an entire industry making big bucks figuring out how to circumvent those rules.

Seriously, just go to single-payer and have done with it. Private insurance is a sucky way to deliver health care, tying it to employment is a burden on the private sector, and Obamacare doubles down on all the suck and adds an extra layer of cost spread like bad jelly on top of it.

Not sure you understood that I was referring to providers, not insurance companies.
 
Not sure you understood that I was referring to providers, not insurance companies.

Sure, I was conflating two thoughts in one post which is not always wise.

Some similar principles apply in the provider world. Part of the reason we pay our doctors so much is because it costs so much for the doctors to get their education. Why on earth do we make our doctors take out a quarter million in student loans to pay for their education (backed by the government) then turn around and have that same government (through Medicare) pay exorbitant doctor salaries so the doctors can afford to pay back their loans?

Most every other civilized country on earth understands that availability of doctors is a public good, they ought to be educated by the government. They can certainly still be well paid, and are well paid in most countries (certainly top quartile and usually top decile of all earners), just not to the extreme level some doctors are paid here. That doesn't even get to the insanity of directing all the money at specialists while primary care doctors barely scrape by.

Again not exactly what you are talking about but just more discussion of the general economic nuttiness of our system.
 
923, good points about doctor pay. The US makes talented people jump through a lot of financial hurdles in order to do jobs crucial to our nation.
 
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