WTf, Health Insurance Companies

xoxoxoBruce · 03-17-2017, 12:00 AM

And Bertolini has the nerve to send me a letter saying my insulin I've been using successfully for years and they have been paying for, is not on their "formulary" and they won't pay for it unless I'm unsuccessful with two other drugs first, each of which will take me six months to test making adjustments on the fly. They must be good drugs because if I die they don't get paid every month, right? Ferris, anyone?

Griff · 03-17-2017, 06:39 AM

What's this overhead you speak of?

glatt · 03-17-2017, 09:37 AM

One of the most beautiful things about Obamacare is the Medical Loss Ratio 80/20 rule.

Insurance companies have to spend at least 80 percent of premium dollars on claims and activities to improve health care quality. 85% in large group markets.

So sure, these CEOs are getting huge salaries, but patients as a whole are still required by law to get 80% of their premium money back in actual health care. The profits and overhead of the insurance companies are capped by federal law.

BigV · 03-17-2017, 10:25 AM

I know of that rule, and it seems like a good rule.

Then I got to thinking, I know where I recognize that from. I remember driving through Nevada and seeing huge billboards proclaiming how appealing their payout ratios are. "Come gamble here, our slots payout 99%!". And if there's a money factory out there more efficient than a building full of slot machines, I don't know what it is. But there's a vastly greater margin allowed by that rule for insurance companies than the rates touted for the slots. You do the math.

Put a dollar in. Get $0.80 back in health care.

Something is wrong with that picture.

glatt · 03-17-2017, 11:01 AM

Sure. But it used to be completely unregulated and you would put a dollar in and get less than 80 cents back.

Flint · 03-17-2017, 11:30 AM

I can no longer imagine having an intelligent debate with anyone who thinks that unfettered, pure profit-driven capitalism will ever produce the best results--i.e. quality of life, humane living conditions, compassion and respect for our fellow man.

I've concluded that some people just don't share those goals.

It's not political, they're just bad people.

Sounds horrible, but, hey--prove me wrong!

Happy Monkey · 03-17-2017, 11:37 AM

I think that some people believe it in a religious way. Still won't be conducive to intelligent debate, though.

Flint · 03-17-2017, 11:39 AM

The political divide is complete and irrevocable.

classicman · 03-18-2017, 07:22 AM

Quote:

Originally Posted by glatt

One of the most beautiful things about Obamacare is the Medical Loss Ratio 80/20 rule.
Insurance companies have to spend at least 80 percent of premium dollars on claims and activities to improve health care quality. 85% in large group markets.

IIRC only two companies were outside that rule BEFORE the PPACA.

footfootfoot · 03-18-2017, 10:44 AM

If Cordani paid himself 2 million a year he could afford to hire 1565 people at $42,068.

What if corporate welfare was tied to a reasonable min/max salary ratio and CEOs who voluntarily capped their incomes at, say, 2 million bucks had a capped income tax limit of 10%? How might that affect the econony?

Clodfobble · 03-18-2017, 01:55 PM

Still better to get paid $54 million and pay back $27 million in tax, than it is to get paid $2 million and pay back $200,000 in tax.

footfootfoot · 03-19-2017, 04:35 PM

Depends how narrow your vision is.

ThomasTrig · 04-05-2017, 01:30 PM

Let me guess, most of this money comes from prescription medication right? Yeah this is called making money off killing people slowly. I can't believe some people here are actually 'defending' this (Obamacare ?? Really??). The issue is not just about numbers here, the issue is how they are making it.

BigV · 04-05-2017, 02:17 PM

Good guess, do you have some way to support your theory?

ThomasTrig · 04-06-2017, 01:37 PM

Quote:

Originally Posted by BigV

Good guess, do you have some way to support your theory?

Theory? . . . Wow . . . shocked to say the least . . .

Too many to list.

Google it on your own: "big pharma evidence".

03-17-2017, 12:00 AM	#1
xoxoxoBruce The future is unwritten Join Date: Oct 2002 Posts: 71,105	WTf, Health Insurance Companies And Bertolini has the nerve to send me a letter saying my insulin I've been using successfully for years and they have been paying for, is not on their "formulary" and they won't pay for it unless I'm unsuccessful with two other drugs first, each of which will take me six months to test making adjustments on the fly. They must be good drugs because if I die they don't get paid every month, right? Ferris, anyone? __________________ The descent of man ~ Nixon, Friedman, Reagan, Trump.

03-17-2017, 06:39 AM	#2
Griff still says videotape Join Date: Feb 2001 Posts: 26,813	What's this overhead you speak of? __________________ If you would only recognize that life is hard, things would be so much easier for you. - Louis D. Brandeis

03-17-2017, 10:25 AM	#4
BigV Goon Squad Leader Join Date: Nov 2004 Location: Seattle Posts: 27,063	I know of that rule, and it seems like a good rule. Then I got to thinking, I know where I recognize that from. I remember driving through Nevada and seeing huge billboards proclaiming how appealing their payout ratios are. "Come gamble here, our slots payout 99%!". And if there's a money factory out there more efficient than a building full of slot machines, I don't know what it is. But there's a vastly greater margin allowed by that rule for insurance companies than the rates touted for the slots. You do the math. Put a dollar in. Get $0.80 back in health care. Something is wrong with that picture. __________________ Be Just and Fear Not.

03-17-2017, 11:30 AM	#6
Flint Snowflake Join Date: Mar 2006 Location: Dystopia Posts: 13,136	I can no longer imagine having an intelligent debate with anyone who thinks that unfettered, pure profit-driven capitalism will ever produce the best results--i.e. quality of life, humane living conditions, compassion and respect for our fellow man. I've concluded that some people just don't share those goals. It's not political, they're just bad people. Sounds horrible, but, hey--prove me wrong! __________________ **************** There's a level of facility that everyone needs to accomplish, and from there it's a matter of deciding for yourself how important ultra-facility is to your expression. ... I found, like Joseph Campbell said, if you just follow whatever gives you a little joy or excitement or awe, then you're on the right track. . . . . . . . . . . . . . . . . . . . . . . . . . . Terry Bozzio**

03-17-2017, 11:37 AM	#7
Happy Monkey I think this line's mostly filler. Join Date: Jan 2003 Location: DC Posts: 13,575	I think that some people believe it in a religious way. Still won't be conducive to intelligent debate, though. __________________ _________________ \|...............\| We live in the nick of times. \| Len 17, Wid 3 \| \|_______________\| [pics]

03-17-2017, 09:37 AM	#3
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	One of the most beautiful things about Obamacare is the Medical Loss Ratio 80/20 rule. Insurance companies have to spend at least 80 percent of premium dollars on claims and activities to improve health care quality. 85% in large group markets. So sure, these CEOs are getting huge salaries, but patients as a whole are still required by law to get 80% of their premium money back in actual health care. The profits and overhead of the insurance companies are capped by federal law.

03-17-2017, 11:01 AM	#5
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	Sure. But it used to be completely unregulated and you would put a dollar in and get less than 80 cents back.

03-17-2017, 11:39 AM	#8
Flint Snowflake Join Date: Mar 2006 Location: Dystopia Posts: 13,136	The political divide is complete and irrevocable. __________________ **************** There's a level of facility that everyone needs to accomplish, and from there it's a matter of deciding for yourself how important ultra-facility is to your expression. ... I found, like Joseph Campbell said, if you just follow whatever gives you a little joy or excitement or awe, then you're on the right track. . . . . . . . . . . . . . . . . . . . . . . . . . . Terry Bozzio**

03-18-2017, 10:44 AM	#10
footfootfoot To shreds, you say? Join Date: Aug 2004 Location: in the house and on the street-how many, many feet we meet! Posts: 18,449	If Cordani paid himself 2 million a year he could afford to hire 1565 people at $42,068. What if corporate welfare was tied to a reasonable min/max salary ratio and CEOs who voluntarily capped their incomes at, say, 2 million bucks had a capped income tax limit of 10%? How might that affect the econony? __________________ The internet is a hateful stew of vomit you can never take completely seriously. - Her Fobs

03-18-2017, 01:55 PM	#11
Clodfobble UNDER CONDITIONAL MITIGATION Join Date: Mar 2004 Location: Austin, TX Posts: 20,012	Still better to get paid $54 million and pay back $27 million in tax, than it is to get paid $2 million and pay back $200,000 in tax. __________________ My book My other book My spirit animal

03-19-2017, 04:35 PM	#12
footfootfoot To shreds, you say? Join Date: Aug 2004 Location: in the house and on the street-how many, many feet we meet! Posts: 18,449	Depends how narrow your vision is. __________________ The internet is a hateful stew of vomit you can never take completely seriously. - Her Fobs

04-05-2017, 01:30 PM	#13
ThomasTrig Rapscallion Join Date: Apr 2017 Location: Vancouver Posts: 5	Let me guess, most of this money comes from prescription medication right? Yeah this is called making money off killing people slowly. I can't believe some people here are actually 'defending' this (Obamacare ?? Really??). The issue is not just about numbers here, the issue is how they are making it.

04-05-2017, 02:17 PM	#14
BigV Goon Squad Leader Join Date: Nov 2004 Location: Seattle Posts: 27,063	Good guess, do you have some way to support your theory? __________________ Be Just and Fear Not.

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