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Joe Hage
🔥 Find me at MedicalDevicesGroup.net 🔥
September 2015
Healthcare Insurance, is this really insurance at all
< 1 min reading time

As originally asked by Anthony Wunsh.

You will pay $700,000 in a lifetime to a company that not only is betting they won’t have to pay near this in benefits and then gets to drop you at age 65 when you will most need the benefits.

https://www.linkedin.com/pulse/healthcare-insurance-really-anthony-wunsh/


Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
I agree we have to start talking 1% per year reduction in government spending, but that means Social Security & other social programs too, with delayed entry into those programs. The alternative is 127 Trillion in unfunded obligations will take down the country.

Unfortunately, it is so lucrative being a politician, that few dare support scaling back promises.

Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
Fred, I don’t think the overall recognition has hit most people yet that the average US citizen has been “downsized” by its government over the last half dozen years. A double epochal event occurred and most of the press doesn’t talk about it:

1. Inflation adjusted wages are down double digits.

1. Insurance, copays, deductibles, non-covered items are up double digits for all & triple digits for some people (plus they are restricted to fewer providers now.)

Collectively, this is a major reduction in the standard of living.

Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
To answer Anthony’s heading which started this thread at the very top: No!

Politicians want giveaways so they and their party members can get reelected. That is a fact. That fact is also why we have 120 Trillion promised by government that we know has no actuarial method for payment. Those situations lead to what happens in countries like Zimbabwe and others.

The ACA was called “Insurance”, when in fact insurance in the past (before government got involved) is based on risk analysis as with auto insurance today. If you are a bad driver, or have a record of a lot of citations, or you have dementia or seizures, you have relatively high insurance rates (if you can get it at all.)

We ought to insist that the government & politicians stop calling Obamacare “Insurance.” Obamacare is a redistributionist healthcare plan that takes money from healthy ‘subscribers’ to pay for those who are not healthy. The overhead (inefficiency) managing such a system skims off incredible amounts of money.

I think there is social justice in providing a form of redistribution for this purpose, but not the way it has been done. It has been stated by some people that we could have just simply given healthcare coverage (not insurance) to 40 million people for less than the cost of Obamacare. Then the problem is that once people know there friends got something “for free” then they scam the system to get something for free also. There is no free lunch.

Paul Baim
PMP Engineering Executive Product Development Greater Boston
Anthony,

We don’t have to agree on the solution yet because, as I said, nothing can change until some fundamentals change that impact many aspects of life in this country. Let’s put our energy into figuring THAT problem out so we then have the ‘luxury’ of fixing health care.

Anthony Wunsh
President/CEO at Welcome Marketing, Inc
And for the record more than 75% of the new sign ups are Medicaid enrolees

In addition insurance does not equate to care. Giving a low income person insurance which carries a $3,500 deductible is not going to get them to the doctor more often.

Anthony Wunsh
President/CEO at Welcome Marketing, Inc
Sorry format changed the numbers should read 18 million under age 35, 14 million already eligible for medicaid and 10 million immigrants.

Paul Baim
PMP Engineering Executive Product Development Greater Boston
Anthony,

I think you see disagreement where there isn’t any. You are absolutely right that, from an abstract economic standpoint, ACA made the system worse by making it bigger without fixing anything. However, more people have coverage now than ever before and if the stonewalling in many states ended, even more would be covered. What I’m saying is that a true fix (e.g., single payer) can’t even begin discussion until more fundamental issues are resolved. Focus on those issues first.

Anthony Wunsh
President/CEO at Welcome Marketing, Inc
Spending increases for 2007 through 2009 was below 3%. Last year 5.4%.

But after reading your link, I have to point out a couple of things we can agree or disagree on.

First there are at least 20 videos of the President and his designates saying publicly that PPACA would reduce the cost of insurance for current policy holders by $2,500 a year. You must have seen them in the news all last year.

Next cost of care in total went from 2.3 trillion in 2009 to 3 trillion last year, while this by itself is troublesome, the real challenge is encounters are down as people are putting off care and bed days are down as hospitals are trying to reduce fines. So the only conclusion is the cost per unit price is rising far faster than ever before. You simply can’t sell less and generate almost a 30% increase in total costs without coming to this conclusion.

I do not agree that talking about this, educating people, getting patients and providers to rise up and say enough is enough is a waste of energy. In fact I can’t think of a better cause than advocating for a system that provides the most possible care, to the most possible people at the lowest possible price.

By the way, insurance premiums have risen almost 200% since passage, look at your own, and try and compare like plan to like plan with equal deductible, co-pay and co-insurance. Also patient direct pay has gone up over 400%. Both records over a four year period.

This law took a bad system and made it worse.

You have to read my other posts, I cite source and data to confirm these statements.

Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
Anthony’s last sentence above, is an inditement of what has evolved in the US.

It is a continuation of having Medicare & Social Security systems that are fundamentally not supported by actuarial tables, meaning they are fiscally unsound and will eventually collapse if not seriously changed quickly. $120 trillion in unfunded liabilities will take this country into collapse followed by a revolution if it is not changed.

Everyone is afraid to address these issues honestly. Politicians decide these things and all they want is to get their congressional pension and healthcare and leave it to “the next guy.”

I think Anthony’s original headline question is valid to ask and that implies we talk about the real issues and what solution or solutions might exist. We citizens did not create this mess.

Paul Baim
PMP Engineering Executive Product Development Greater Boston
There was never (AFAIK) a promise to reduce the cost of insurance. The promise was to reduce the rate of growth, which it has (see, for example, http://content.healthaffairs.org/content/25/2/w61.full).

The results are still contaminated by much of the country fighting enactment of any parts of ACA they can.

It’s fine to complain that something must be done but until we change the physics of the government and the industry, it’s all just so much wasted energy.

Anthony Wunsh
President/CEO at Welcome Marketing, Inc
The third party payer system adds about 50% of the cost charged for medical care. I have done this math and broke it down in several posts. It is the driver of cost because it controls, supply, price and services allowed.

And Paul you are 100% accurate, all ACA did was build off an already broken system. A new model from the ground up is needed if we are to reverse this, that does not however excuse the false promises to reduce cost of insurance and care by adding PPACA.

CMS release a ten year care cost prolection last week stating they expect care to grow to 5.4 trillion by 2024, despite all the centralized changes this new law brought to bear with the promise to reduce cost. The increase is a record for a ten year period averaging over 5% per year.

In addition CBO reports PPACA new price tag over the next ten years prior to the CMS report which now means it under estimates due to the fact as care costs rise so does insurance cost. But aside from that, they predict a 2.6 trillion dollar price tag now, compared to the 900 billion dollar promised cost, and that projects collecting some 900 billion in fines from business and tax payers.

We are at the point of no return, these numbers coupled with insurance premiums will be 50% of GDP.

Paul Baim
PMP Engineering Executive Product Development Greater Boston
Bo, your energy is good but I think it’s misdirected. Anthony’s ‘revelation’ was true before ACA was ever considered. In fact, the economics of health insurance were worse because people who had paid in for many years could be dumped *because they got sick*, to be paid for by medicaid. ACA had to leave the insurance system in place while extending coverage to as many of the left out as possible. The physics of that was not determined by Pelosi (or Obama for that matter). It was well known that ACA would funnel an enormous windfall into the insurers. That’s why they supported it (they did, you know).

Look, the economics of this really is pretty simple. Everyone pays into a huge pool of funds and the funds are then spent on those who need them at any given moment. The two leaks in the current system are profits and surrender. Profits taken by the insurers that never gets to help anyone get well, and the surrender of the unspent funds whenever anyone graduates to medicare. Plug the two leaks and you have a much more cost effective system. That’s pretty much it.

Anthony Wunsh
President/CEO at Welcome Marketing, Inc
Sorry mis-spoke Paul. Yes Joel, my error.

Paul Baim
PMP Engineering Executive Product Development Greater Boston
Joel thinks it’s heated. Not me. I just think Bo is heated 🙂

Anthony Wunsh
President/CEO at Welcome Marketing, Inc
There is absolutely nothing political in my post, and people have the right to comment as they see fit, agree, disagree, ignore or counter argue. That is what debate is about. To me it appears Mr. Clawson is pretty passionate about his opinion on PPACA, and he is not alone. I have been in threads where people get down right ignorant, you learn to deal with it. Paul if you think this is heated, boy is that a surprise.

Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
Economics is not political. Economics is what should help decide whether government programs are effective for citizens. When political favors decide the economics, it is not the fault of economics.

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