Impeding changes to our Health Care system

[Clodfobble]

Originally Posted by ZenGum

I notice there is a dip each year around August/September.

Is that because health expenses are lower then, or is that when premiums get jacked up for the next year?

All the companies I've ever worked for have done their open enrollment and insurance plan changes at the start of the new year.

But it's a weird data set, now that you mention it. The cruxes of each line seem to happen definitively at months 3, 6, and 9, as if this chart is based on quarterly earnings reports but for some reason doesn't get to include the fourth quarter report in December each year. Missing data aside, this would mean that the September number is probably the amount spent in the months of June, July, and August combined.

I can see a few possible contributing factors for why summer would have lower costs. One, people don't want to screw up their vacation time with anything elective. Two, road accidents are down since all the ice and snow are gone. Three, people are holding off to see how the annual deductible/out-of-pocket numbers are looking towards the end of the year. Late Fall is the time to hurry up and squeeze in any elective procedures they've been waffling on, before everything rolls back to zero in January.

[Lamplighter]

Two, road accidents are down since all the ice and snow are gone.

Aren't MVA's (including medical) managed by the car insurance,
not via the personal health care insurance ?

[xoxoxoBruce]

Only for the other guy, not for you unless you have optional coverage.

[ZenGum]

Originally Posted by Clodfobble

But it's a weird data set, now that you mention it. The cruxes of each line seem to happen definitively at months 3, 6, and 9, as if this chart is based on quarterly earnings reports but for some reason doesn't get to include the fourth quarter report in December each year. Missing data aside, this would mean that the September number is probably the amount spent in the months of June, July, and August combined.

Indeed it is.

Well, it does say "Nine most recently reported quarters"

1st, 2nd and 3rd of 2007, 1st, 2nd and 3rd of 2008 and 1st, 2nd and 3rd of 2009.

Exactly what happened to the fourth quarter of each year remains a mystery.

That is quite weird.

[classicman]

Originally Posted by Lamplighter

Aren't MVA's (including medical) managed by the car insurance,
not via the personal health care insurance ?

In most cases medical damages incurred via a MVA are paid in this order:
1)Auto PIP (Personal Injury coverage). Most people, in fact the VAST MAJORITY of people only have $5,000 of PIP coverage.
Personal injury protection is coverage for medical and other expenses, such as wage loss and funeral expenses, which result from an auto accident.

2)Once that is used up (typically the transport TO the hospital is in the several thousand dollar range) it goes to the individuals personal health insurance coverage.

3) After that it goes to the individual them self.

For example, lets say a young man is driving a car and swerves off the road hitting a tree. He suffers traumatic injuries at the scene and is transported to the hospital where he stays for a month. After which he is transferred to a rehabilitation facility and stays for another four months.
Total Bill: $2,000,000
Auto insurance paid ......................$5,000
Personal medical insurance paid.....$1,800,000
Father is responsible for ...............$195,000

Yup.

[DanaC]

Jesus Christ. That's obscene.

[Spexxvet]

Originally Posted by DanaC

Jesus Christ. That's obscene.

Yeah, but we don't want to change things...

[classicman]

What has been done changes none of that. NONE.
ZERO cost controls on suppliers, providers, pharma, nor hospitals. The only cost control is on those evil insurance companies who have an average profit margin of just over 3%.

[Spexxvet]

Originally Posted by classicman

What has been done changes none of that. NONE.
ZERO cost controls on suppliers, providers, pharma, nor hospitals. The only cost control is on those evil insurance companies who have an average profit margin of just over 3%.

No kidding. It's the first step. It was difficult enough getting this passed (and repubicans want to repeal it). Do you think an act that went further would have been passed or accepted by Americans?

[classicman]

So you are admitting that the ACA doesn't have the cost controls it was sold to us with?

Depends upon the plan.

[Spexxvet]

Originally Posted by classicman

So you are admitting that the ACA doesn't have the cost controls it was sold to us with?

Depends upon the plan.

To what cost controls are you referring, specifically?

[classicman]

Originally Posted by Spexxvet

To what cost controls are you referring, specifically?

Originally Posted by classicman

ZERO cost controls on suppliers, providers, pharma, nor hospitals. The only cost control is on those evil insurance companies who have an average profit margin of just over 3%.

[Lamplighter]

Classic, is the word "control" the right word.

There have been many changes that affect the patient's costs,
such as the requirements for free preventative care, free vaccines, mammagrams, etc.
along with the soon-to-be-in-effect reductions in medicare costs.

That is, the ACA doesn't specifiy a maximum price on things
(which soon would become the minimum price), but instead
pushes management to implement changes that reduce costs.

Do such as these meet the definition of cost controls ?

[ZenGum]

I've mentioned this about a gazillion posts back, but ...

The US system spends around 25% of the "health care" budget on administration. In other OECD countries that is around 10%, in Taiwan, a tad over 1%.

The US system has the most extreme liability/compensation arrangements, adding huge liability insurance costs, and forcing doctors to do exhaustive and expensive testing to rule out those one-in-a-million diseases, to cover their asses.

AFAIK, the current changes address neither of these things.

[Lamplighter]

AFAIK, the current changes address neither of these things

FWIW, there are various "outcome assessments" to determine,
for example, which lab tests and procedures are most/more effective and efficient.
Part of the justification for looking at such outcomes is the idea
that physicians can/should stop ordering lab tests when their
reason is just to document or avoid malpractice.

Some recommendations get a lot of (negative) publicity,
while other changes are implemented without fanfare.
Blood test of men for prostate cancer and women's mammograms
are examples of recommendations that became highly public.

But as such, these don't fit my concept of a cost control, because
they are based more on the science than on the fiscal, even though
the financial costs are brought into the considerations.