Health Insurers Making Record Profits as Many Postpone Care

[Capt Bringdown]

The nation’s major health insurers are barreling into a third year of record profits.

The UnitedHealth Group, one of the largest commercial insurers, told analysts that so far this year, insured hospital stays actually decreased in some instances. In reporting its earnings last week, Cigna, another insurer, talked about the “low level” of medical use.

Yet the companies continue to press for higher premiums, even though their reserve coffers are flush with profits and shareholders have been rewarded with new dividends.

[RandomGuy]

And while the slowing down of demand is good for insurers, at least in the short term, the concern is that patients may be tempted to skip important tests like colonoscopies or mammograms. The new health care law will eventually prevent most policies from charging patients for certain kinds of preventive care, but some plans still require someone to pay $500 toward a colonoscopy.

In recent times, insurers have prospered by pricing policies above costs, said Robert Laszewski, a former health insurance executive who is now a consultant in Alexandria, Va. The industry goes through underwriting cycles where the companies are better able to predict costs and make room for profits. “They’re benefiting from a very positive underwriting cycle,” he said.

“Maybe managed care is finally working,” he said. “Maybe this is the new normal.”

Still, he emphasized, health care costs, even if they are rising at 6 percent or 7 percent a year, are increasing at a much faster pace than overall inflation. “We haven’t solved the problem,” Mr. Laszewski said.

That 6 or 7 percent a year will destroy your retirement savings. You almost certainly have not saved enough for health care in your waning years.

You have been warned.

[DMX7]

Don't worry, Paul Ryan's voucher has got you covered.

[boutons_deux]

“We haven’t solved the problem,”



They aren't even WORKING on the criminally exorbitant sick-care costs problem.

[Winehole23]

Too bad the Dems were too chicken to pass a health care reform bill that would rein in costs when they had the chance. Instead, Obama opted to give the store away to pharmaceutical and insurance companies.

Deal with it, boutons: Congress gave Obama the deal he wanted from the beginning. Single payer was never on the table.

[boutons_deux]

Barry was not getting any of the big items of health he campaigned on.

The sick-care industry was ready to "Harry & Louise" him with $100Ms if he dared touch their cheese.

The sick care vampire squid will continue to suck $Ts out of Human-Americans' pockets for decades, and there's no way to stop it.

YOU deal with the fact that USA is ed by UCA, and un able.

[TeyshaBlue]

Barry was not getting any of the big items of health he campaigned on.

lol....he didn't even ask for them.

The sick-care industry was ready to "Harry & Louise" him with $100Ms if he dared touch their cheese.

Yeah ok.

The sick care vampire squid will continue to suck $Ts out of Human-Americans' pockets for decades, and there's no way to stop it.

YOU deal with the fact that USA is ed by UCA, and un able.

unhinged rant achieved. congrats.

[Winehole23]

Barry was not getting any of the big items of health he campaigned on.

Barry did not fight for any of the things he campaigned on. Big difference there.

[boutons_deux]

yep, the first time the US elects a black Pres, and he blows the stereotype by being a eunuch in the service of UCA and capitalists.

[coyotes_geek]

yep, the first time the US elects a black Pres, and he blows the stereotype by being a eunuch in the service of UCA and capitalists.

Care to elaborate on this?

[TeyshaBlue]

lolz

[Agloco]

Still, he emphasized, health care costs, even if they are rising at 6 percent or 7 percent a year, are increasing at a much faster pace than overall inflation. “We haven’t solved the problem,” Mr. Laszewski said.

Confession time. I'm afraid I'm part of that problem.......

The thought that technology will always improve lives is a largely American phenomenon (based on my travels, which are quite extensive). There comes a point where that technology becomes unaffordable and begins to drain the economy. I believe we hit that point in the early 90's and are now reaping the rewards for our shortsightedness.

Anyone wanna venture a guess as to how much it costs to deliver and site a magnet? There's a reason that the scan of your leg costs 2 grand. Who's gonna pony up? You? Me? Of course not. Insurance will or John Q Public eats the cost (in urgent/emergent cases).

I can tell you, there's nary a gadget that I use which costs less than 5 figures. All of them are considered vital in the chain of care which we provide to patients. New technology = new treatments, but it also means new costs associated with those treatments. In the case of a typical rad onc treatment, that's the cost for the linear accelerator (or gamma knife, SRS, etc), CT, x-rays, labs, treatment planning and/or brachytherapy afterloaders, nurses, dosimetrists, and last but not least those greedy doctors (yours truly) who are responsible for ensuring that the entire platter gets delivered to your table properly.

Think about it. That scheme is a non-starter in 1905 America. Today? It's killing us and there's no stopping the train, the insurers know this. Keep in mind I speak only about my sub-specialties (Radiation Oncology, Radiology, Nuclear Medicine). This conundrum applies all across the board to a greater or lesser degree.

“We haven’t solved the problem,”



They aren't even WORKING on the criminally exorbitant sick-care costs problem.

How do we solve this? I'm all ears.

[Agloco]

yep, the first time the US elects a black Pres, and he blows the stereotype by being a eunuch in the service of UCA and capitalists.

[lazerelmo]

There comes a point where that technology becomes unaffordable and begins to drain the economy.

Only when the cost is subsidized so the price can be artificially inflated. I believe we reached that point on July 30, 1965.

[baseline bum]

Barry did not fight for any of the things he campaigned on. Big difference there.

The Obama presidency in a nuts .

[boutons_deux]

How do we solve this? I'm all ears.

universal public (no-profit) health insurance. Available to everybody, nobody can opt out. Paid for out of income deductions, no cap.

Citizens would be have the option of having their health insurance premiums reduced by participating in wellness programs, with wellness factors tested annually. No malus for self-inflicted fat s who smoke and drink, but fit and lean people would have a serious bonus (deduction) for staying that way.

Anybody could buy for-profit supplementary insurance to be treated in 5-star for-profit medical facilities. But they couldn't opt out of govt health insurance, only add to it.

salaried doctors working in no-profit govt clinics and hospitals. No more need for independent docs to generate $250K a year just to cover overheads. All they do is practice medicine, draw a salary.

Universal electronic medical records.

Subsidized doctor education to address the huge and ever increasing gap in primary care docs. Free medical education in return for 20 year commitment to being a govt primary care doctor.

govt health patients would obtain drugs and medical supplies/devices only from govt no-profit dispensaries.

For govt medical specialists, more free specialists education to be matched by longer commitment to being a govt employee. They would of course get higher salary.

Kill Medicare Advantage.

Medicare/medicaid/VA would be replaced by universal health care.

Govt as hard-assed single-buyer of drugs/devices for the govt health system.

Make illegal direct-to-consumer medical marketing.

This is not govt takeover of private operations, but a govt-run health insurance/care system in parallel with the for-profit sick-care/insurance corps.

[Wild Cobra]

That 6 or 7 percent a year will destroy your retirement savings. You almost certainly have not saved enough for health care in your waning years.

You have been warned.

Well, maybe people should work on staying healthy in the first place.

[Wild Cobra]

I agree with Agloco. Technology is advancing at a faster pace than it becomes affordable. We are finding more and more ways to cure people of things that would kill them in the past, and this extension of life is becoming unreasonably expensive.

The hard facts are it will come down to the "have's" and the "have-not's" for who gets what. We simply cannot afford to give everyone the best care.

[ElNono]

Confession time. I'm afraid I'm part of that problem.......

The thought that technology will always improve lives is a largely American phenomenon (based on my travels, which are quite extensive). There comes a point where that technology becomes unaffordable and begins to drain the economy. I believe we hit that point in the early 90's and are now reaping the rewards for our shortsightedness.

Anyone wanna venture a guess as to how much it costs to deliver and site a magnet? There's a reason that the scan of your leg costs 2 grand. Who's gonna pony up? You? Me? Of course not. Insurance will or John Q Public eats the cost (in urgent/emergent cases).

I can tell you, there's nary a gadget that I use which costs less than 5 figures. All of them are considered vital in the chain of care which we provide to patients. New technology = new treatments, but it also means new costs associated with those treatments. In the case of a typical rad onc treatment, that's the cost for the linear accelerator (or gamma knife, SRS, etc), CT, x-rays, labs, treatment planning and/or brachytherapy afterloaders, nurses, dosimetrists, and last but not least those greedy doctors (yours truly) who are responsible for ensuring that the entire platter gets delivered to your table properly.

Think about it. That scheme is a non-starter in 1905 America. Today? It's killing us and there's no stopping the train, the insurers know this. Keep in mind I speak only about my sub-specialties (Radiation Oncology, Radiology, Nuclear Medicine). This conundrum applies all across the board to a greater or lesser degree.

I don't doubt one second what you say. Now let me ask you this, why does an x-ray (by all means ancient tech) costs nearly 10x as much in the US than in a third world country? Heck, even MRIs are fairly old tech these days.

[Wild Cobra]

I don't doubt one second what you say. Now let me ask you this, why does an x-ray (by all means ancient tech) costs nearly 10x as much in the US than in a third world country? Heck, even MRIs are fairly old tech these days.

It's the enhanced resolution of the machines I think. It could also be added regulation costs, calibration time frame requirements, paying full price rather than the state buying them, or several other factors.

[baseline bum]

To reduce health care costs we also need to drastically improve our diets and activity levels. I am not at all for a sin tax on high fat or sugary food, but these are a couple of steps I would take:

* End the corn subsidies. Perhaps that would eliminate some of the HFCS that is put in every single piece of processed food one can buy at the store. Cut the ing ethanol fuel subsidy too. Ethanol is crap as fuel.

* Eliminate sodas, candy, chips, and fried foods at K-12 schools. There is no way our schools should be pushing kids into eating junk food when their parents aren't around. No fake juice loaded with extra sugar either.

[Wild Cobra]

To reduce health care costs we also need to drastically improve our diets and activity levels. I am not at all for a sin tax on high fat or sugary food, but these are a couple of steps I would take:

* End the corn subsidies. Perhaps that would eliminate some of the HFCS that is put in every single piece of processed food one can buy at the store. Cut the ing ethanol fuel subsidy too. Ethanol is crap as fuel.

* Eliminate sodas, candy, chips, and fried foods at K-12 schools. There is no way our schools should be pushing kids into eating junk food when their parents aren't around. No fake juice loaded with extra sugar either.

I'm with you on much of that. I would say eliminate those in the school lunches, but allow the purchase of some items still.

Be authoritarian if you like that political choice, but I believe in personal responsibility.

[boutons_deux]

personal responsibility of kids is a loser against the sinister power of food marketing and its food-like engineered substances.

[Agloco]

I don't doubt one second what you say. Now let me ask you this, why does an x-ray (by all means ancient tech) costs nearly 10x as much in the US than in a third world country? Heck, even MRIs are fairly old tech these days.

It's the enhanced resolution of the machines I think. It could also be added regulation costs, calibration time frame requirements, paying full price rather than the state buying them, or several other factors.

WC hits on a few of the reasons. Let me be clear Nono, I in no way endorse freely spending more for what appears to be the same tech, but the devil is in the details here. X-ray, CT or any other modality using ionizing radiation walks a fine line with the FDA. The regs are about to tighten once again as a matter of fact. So yes, an X-ray costs less in a third world country, but you get what you pay for: significantly more missed diagnoses, and higher radiation burden over time. The second is really not all that bad (provided you're not getting serial CT's inappropriately), but here in the US the mere mention of the word is enough to send giant balls of red tape flying from every imaginable nook and cranny.

MRI? Siting a magnet typically runs 1 million per Tesla of field strength, plus the special floor, ceiling, and wall design required for the Faraday Cage and cryogen storage. About 12-15 million all told. Sure it's a non-ionizing modality thats been around for a while, but to maintain clinical field strengths of 1.5T or 3T requires superconducting coils, which in turn requires near absolute zero temps. Cryogen installment and their replacement are the single most expensive upkeep cost for a magnet (besides me ). A quench will run you a cool 75k. Newer self shielding magnets are hitting the floor now, as well as mini models that might not require cryogens. That will definitely reduce cost.

Also, keep in mind that cancer clinics are in compe ion with one another. I can't get away with planning your radiation therapy on outdated/cheaper equipment. I guarantee you won't like the bargain you got. Imagine me coming into your room: "Well Mr. ElNono, I think we've hit most of the tumor, but I cant tell if I also got some of your aorta with this equipment. If only we had the same planning platform as that clinic on the other side of town......". That holds true for Radiology (STRIC, etc. ), Nuc Med, Interventionals both Radiology and Cardiology, etc. About the only department that can get away with using outdated inferior equipment at times is the ED, for obvious reasons.

The tech monster knows no boundaries. My sub-specialty is the proud owner of the most expensive piece of equipment...impressive no?

http://www.mdanderson.org/patient-an...ter/index.html

Look up the cost of building one of these puppies.

To reduce health care costs we also need to drastically improve our diets and activity levels. I am not at all for a sin tax on high fat or sugary food, but these are a couple of steps I would take:

* End the corn subsidies. Perhaps that would eliminate some of the HFCS that is put in every single piece of processed food one can buy at the store. Cut the ing ethanol fuel subsidy too. Ethanol is crap as fuel.

* Eliminate sodas, candy, chips, and fried foods at K-12 schools. There is no way our schools should be pushing kids into eating junk food when their parents aren't around. No fake juice loaded with extra sugar either.

BB sees it correctly. Back to basics. Preventative social behavior helps out quite a bit.

[boutons_deux]

The $100M+ costs of proton machines plus $Ms/year in operating/maintenance costs increases the risk that the proton machines will be used to the max, even when cheaper alternatives exist.

Has proton beam therapy, still very recent, been proven to deliver better cancer control with less collateral damage, in any term?