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01-26-2014, 01:43 AM
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#1
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Valued Poster
Join Date: Jun 12, 2011
Location: Olathe
Posts: 16,815
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I said that I would explain health insurance to FuckZup...
I can try anyway.
First thing you have to understand is that health insurance is NOT the same thing as health care. You can have all the health insurance you can possibly carry but without a near by hospital or clinic you have nothing. Illegal immigration, Obamacare and the faltering economy have eliminated many sources of healthcare.
Okay, the lesson. We'll start with one thousand people who come from all walks of life and ages. At some point they all come to the conclusion that in order to protect themselves against illness they need health care. Fortunately for them someone figured out that providing COVERAGE for illness can be profitable and useful for the clients. They hire an actuary to figure out the chances of illness for everyone based on age and known family history.
Overall, the average cost per person is about $500 a year for people from 18 to 88. The younger you are the less it costs. Now they could go to the Obama model and charge everyone exactly the same thing for full coverage of everything. So a thousand people gather together $500,000 dollars every year but things have to be paid for so the insurance provider takes 6% off the top leaving $470,000 for coverage.
Out of this $470,000 and 1,000 people there were five heart attacks (this year), two babies, three strokes, one appendectomy, six minor car crashes, eight work place accidents, and one suicide attempt. The total for healthcare is $450,000 which leaves $20,000 to be divided as dividends among he investors. There could be a tornado and more people get hurt. The insurance provider takes it in the ass then.
To cover their collective asses the insurance company decides that they have to raise rates on the older people so they make $700,000 a year for healthcare coverage. Now the bean counters say that certain people are too sick to insure which means that they could be insured but the likelihood is that they will use so much money that the other 999 may not have any money to cover their costs. Understand that FuckZup? Those vast majority are being protected by not providing insurance to everyone who can walk, crawl, or wheel through the door. Sounds harsh but think of the life boat.
The insurance company grows and takes on more clients. They make more money, hire more staff, and pay more dividends to investors. Thousands of people get insurance coverage to pay for their healthcare needs. A few people can't get coverage. Some people develope illnesses that cause their rates to increase or they get cancelled because the needs of the many outweigh the needs of the few. That is how insurance works FuckZup.
Now this is where government comes in. We would like everyone to be happy and covered. So government can create a high risk pool (like the GOP proposed) where the possible patients get subsidies to pay for their coverage. No one is going to deny that these people are going to cost more during their lives and that is why tax payers dollars go to help them. The government spreads the cost of the few from the taxes of the many.
So the many can be covered by private insurance with the cost allocated by age and health issues. The problematic few get help being covered by government. Someone has to pay because (getting back to the first paragraph) the hospitals, nurses, and doctors deserve to get paid.
Using government to cover everyone takes away incentative to bargain for the best costs since it is not your money and you've not paying the full amount for what you get. Let someone else worry about it. Government likes one size fits all for paperwork simplicity. So a doctor who does a lumbar puncture in Wyoming gets paid the same as a doctor in Miami. Someone is going to get cheated or someone is going to be greatly overpaid. Government does one of two things, they either TELL the health industry what they will be paid (driving professionals from the business) or they let the healthcare business tell government what they want to be paid without investigation (resulting in waste and fraud).
Now let the sniping begin from people who can't explain it themselves.
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![Like](/images/like.png) | 2 users liked this post
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01-26-2014, 09:17 AM
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#2
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BANNED
Join Date: Aug 28, 2012
Location: Niagara
Posts: 6,119
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Think of the life boat...
Except, in this case, instead of not saving some one because it would endanger the lives of everyone, in the case of health insurance, they are not saving someone so that they can pay dividends, and buy an extra sweater for their lapdog who gets chilly when he eats caviar by the pool.
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![Like](/images/like.png) | 1 user liked this post
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01-26-2014, 09:29 AM
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#3
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BANNED
Join Date: Aug 28, 2012
Location: Niagara
Posts: 6,119
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I can explain insurance:
Jimmy's nervous in his new cell; the big mother fucker Ike threatened to fuck his ass raw in the laundry come Tuesday. But the head of the White Power Brotherhood, Franklin, visits Jimmy's cell and tells Jimmy, "Man, that guy Ike, he's a mean mother fucker, and he packs some heat. You know Jose in D block? Ike fucked him once and shit just drips out his ass now, he's got no o-ring. Some say the doc had to put his colon back in."
Franklin sees Jimmy is getting nervous and after a little more small talk he offers: "For a carton of smokes a week, me and the WPB can make sure Ike doesn't get at you with his baby's arm." Jimmy agrees, but eventually somebody from the Croatian mob fucks him anyway. Meanwhile Franklin and the WPB get six packs of smokes a week, Ike gets two, and the guards get two as a tax.
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![Like](/images/like.png) | 1 user liked this post
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01-26-2014, 09:53 AM
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#4
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BANNED
Join Date: Jan 3, 2010
Location: Clarksville
Posts: 60,189
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Holy shit, JDIdiot. How have I EVER survived without your incredibly insightful help.
I am well aware of the differences between insurance and medical care, and have posted hundreds of times on the subject, addressing the viewpoints, of patient, provider and insurance company. You on the other hand can't seem to tell the difference between your asshole and your elbow and whine on and on every day about Benghazi. It is refreshing to see you delve into uncharted waters, like YOUR knowledge of health insurance under the clusterfuck known as ACA.
Please explain why pharma prices are so much lower everywhere than they are in the US if single payor systems have no bargaining power?
Paying attention JDIdiot?
Please explain how with Medicare/Medicaid setting the benchmarks for fluctuations in the provider reimbursement scale provide doctors any incentive to be competitive from a standpoint of cost or quality, considering the collusive nature of that industry? When Congress cuts reimbursement to docs, the health plans follow suit.
Got that, JDIdiot?
Explain why the trend in large insurance companies for the past decade or so has been to not accept more risk but charge management fees for self insured corporations and organizations? Your policy at your job is more than likely funded entirely by your employer, JDIdiot, and Aetna or whomever tacks on 20-25% to tell you no. I say probably, be ause there is no evidence that you are employed.
Are you paying attention JDIdiot?
You don't know JACK SHIT about health care, health insurance or public health policy and your simplistic, ignorant rant above is absolute proof ... Just like most of your idiotic rants.
JDIdiot, I advocate universal health care under a single payor system, like every other civilized country on this planet provides ... it is truly amazing to read one of your explanations, but you are completely ignorant, narrow minded and ... I might add... A blustering asshole.
Do you understand, JDIdiot? BLUSTERING ASSHOLE.
At least you have the good sense to call me a name, not a paragraph.
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![Like](/images/like.png) | 2 users liked this post
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01-26-2014, 10:22 AM
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#5
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Chasing a Cowgirl
Join Date: Oct 19, 2013
Location: West Kansas
Posts: 30,918
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Three words, a math equation, and a thought
Insurance = gambling bookies.
Should comments about Obamacare be in the Comedy section?
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![Like](/images/like.png) | 1 user liked this post
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01-26-2014, 10:22 AM
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#6
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Valued Poster
Join Date: Feb 9, 2010
Location: Here
Posts: 14,191
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JD explaining anything to anyone ...
now that's funny
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![Like](/images/like.png) | 2 users liked this post
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01-26-2014, 10:39 AM
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#7
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Account Disabled
Join Date: Jan 20, 2011
Location: kansas
Posts: 28,773
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+100
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![Like](/images/like.png) | 1 user liked this post
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01-26-2014, 01:10 PM
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#8
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BANNED
Join Date: Oct 22, 2013
Location: Clarksville, Austin, Tx.
Posts: 728
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Quote:
Originally Posted by JD Barleycorn
I can try anyway.
First thing you have to understand is that health insurance is NOT the same thing as health care. You can have all the health insurance you can possibly carry but without a near by hospital or clinic you have nothing. Illegal immigration, Obamacare and the faltering economy have eliminated many sources of healthcare.
Okay, the lesson. We'll start with one thousand people who come from all walks of life and ages. At some point they all come to the conclusion that in order to protect themselves against illness they need health care. Fortunately for them someone figured out that providing COVERAGE for illness can be profitable and useful for the clients. They hire an actuary to figure out the chances of illness for everyone based on age and known family history.
Overall, the average cost per person is about $500 a year for people from 18 to 88. The younger you are the less it costs. Now they could go to the Obama model and charge everyone exactly the same thing for full coverage of everything. So a thousand people gather together $500,000 dollars every year but things have to be paid for so the insurance provider takes 6% off the top leaving $470,000 for coverage.
Out of this $470,000 and 1,000 people there were five heart attacks (this year), two babies, three strokes, one appendectomy, six minor car crashes, eight work place accidents, and one suicide attempt. The total for healthcare is $450,000 which leaves $20,000 to be divided as dividends among he investors. There could be a tornado and more people get hurt. The insurance provider takes it in the ass then.
To cover their collective asses the insurance company decides that they have to raise rates on the older people so they make $700,000 a year for healthcare coverage. Now the bean counters say that certain people are too sick to insure which means that they could be insured but the likelihood is that they will use so much money that the other 999 may not have any money to cover their costs. Understand that FuckZup? Those vast majority are being protected by not providing insurance to everyone who can walk, crawl, or wheel through the door. Sounds harsh but think of the life boat.
The insurance company grows and takes on more clients. They make more money, hire more staff, and pay more dividends to investors. Thousands of people get insurance coverage to pay for their healthcare needs. A few people can't get coverage. Some people develope illnesses that cause their rates to increase or they get cancelled because the needs of the many outweigh the needs of the few. That is how insurance works FuckZup.
Now this is where government comes in. We would like everyone to be happy and covered. So government can create a high risk pool (like the GOP proposed) where the possible patients get subsidies to pay for their coverage. No one is going to deny that these people are going to cost more during their lives and that is why tax payers dollars go to help them. The government spreads the cost of the few from the taxes of the many.
So the many can be covered by private insurance with the cost allocated by age and health issues. The problematic few get help being covered by government. Someone has to pay because (getting back to the first paragraph) the hospitals, nurses, and doctors deserve to get paid.
Using government to cover everyone takes away incentative to bargain for the best costs since it is not your money and you've not paying the full amount for what you get. Let someone else worry about it. Government likes one size fits all for paperwork simplicity. So a doctor who does a lumbar puncture in Wyoming gets paid the same as a doctor in Miami. Someone is going to get cheated or someone is going to be greatly overpaid. Government does one of two things, they either TELL the health industry what they will be paid (driving professionals from the business) or they let the healthcare business tell government what they want to be paid without investigation (resulting in waste and fraud).
Now let the sniping begin from people who can't explain it themselves.
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This is a good explanation, but the insurance companies and their greed gets in the way. So, the above would work with government regulation. So, why not just let Obama dictate to the insurance companies like in Obamacare, and everything will work well within the year, once we workout the few small bumps along the way.
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![Like](/images/like.png) | 1 user liked this post
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01-26-2014, 02:00 PM
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#9
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Account Disabled
Join Date: Jun 19, 2011
Location: Dixie Land
Posts: 22,098
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Quote:
Originally Posted by JohnnyCap
I can explain insurance:
Jimmy's nervous in his new cell; the big mother fucker Ike threatened to fuck his ass raw in the laundry come Tuesday. But the head of the White Power Brotherhood, Franklin, visits Jimmy's cell and tells Jimmy, "Man, that guy Ike, he's a mean mother fucker, and he packs some heat. You know Jose in D block? Ike fucked him once and shit just drips out his ass now, he's got no o-ring. Some say the doc had to put his colon back in."
Franklin sees Jimmy is getting nervous and after a little more small talk he offers: "For a carton of smokes a week, me and the WPB can make sure Ike doesn't get at you with his baby's arm." Jimmy agrees, but eventually somebody from the Croatian mob fucks him anyway. Meanwhile Franklin and the WPB get six packs of smokes a week, Ike gets two, and the guards get two as a tax.
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well said... and funny! "got no o-ring"
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![Like](/images/like.png) | 1 user liked this post
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01-26-2014, 03:15 PM
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#10
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Valued Poster
Join Date: Jun 12, 2011
Location: Olathe
Posts: 16,815
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My explanation is the ideal. It does leave out things like government regulation, excessive greed of executives, and unethical behavior (which can be challenged in most states) of dropping someone after they get sick but before they get treatment. There are safety measures in place for many of those things before Obamacare.
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![Like](/images/like.png) | 1 user liked this post
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01-26-2014, 03:29 PM
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#11
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Valued Poster
Join Date: Jan 16, 2010
Location: Texas
Posts: 51,038
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Gentlemen, there has been "government regulation" within the States.
Here's one "regulator" .. http://www.tdi.texas.gov/
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![Like](/images/like.png) | 2 users liked this post
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01-26-2014, 11:06 PM
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#12
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BANNED
Join Date: Aug 28, 2012
Location: Niagara
Posts: 6,119
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Quote:
Originally Posted by JD Barleycorn
My explanation is the ideal.
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Careful, I don't need rates going up because you pull a muscle blowing yourself.
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