Max Baucus (D) Says He Fears Obamacare Is Headed For 'Huge Train Wreck'

[jnevin]

It blows me away how Americans don't understand simple math.

Most hospitals operate on a -1% to 1% operating margin. Let's just call it zero (Tennessee is at -1% right now).

20% of their customers are no-pay/self-pay = 0% cost recovery / 100% loss
40% of their customers are Medicare = 90% cost recovery / 10% loss

They make-up the difference with their private pay insurers. So to get them back to even:

40% x ? = 100*20% + 10%*40%

? = 50%

So they have to get a 50% margin (not mark up... margin) on their cost to cover the no-pays and the Medicare short-pays. Private insurance is their premium customer.

Medicare is going bankrupt even with hundreds of billions of dollars a year in subsidies coming from the private sector -- let alone the taxes that employees and employers pay into the system.

Cliffs Notes: Nationalization would fix US health care about as well as bombing Canada would fix the war in Afghanistan.

Well, some individual hospitals may post those numbers, but if they're part of companies like HCA, etc, their profits are pretty fucking solid. Using HCA as an example, their audits usually show $30-100MM in revenue per facility, per year. Net income is usually $5-10MM. HCA itself is in the billions.

If you're talking smaller private hospitals, I could agree, but those are either being shut down or bought up.

 

[mrplunkey]

I wasn't saying bullshit because healthcare expenses are on the rise, I was saying bullshit because you said it needs to be spread across the board. Fuck paying for some morbidly obese piece of shit diabetic's expenses, same with paying for smokers, etc. Why should their unhealthy lifestyles become my financial burden?

Massachusetts, Rhode Island, Vermont and DC have already banned tobacco surcharges in their exchanges.

They've classified smoking as an addiction and decided that non-smokers should subsidize non-smokers as a matter of public policy.

Remember how ObamaCare was supposed to encourage all that healthy living?

Think again.

 

[john stossel's mustache]

I'm just glad my beach house was paid for, twice.

 

[mrplunkey]

Well, some individual hospitals may post those numbers, but if they're part of companies like HCA, etc, their profits are pretty fucking solid. Using HCA as an example, their audits usually show $30-100MM in revenue per facility, per year. Net income is usually $5-10MM. HCA itself is in the billions.

If you're talking smaller private hospitals, I could agree, but those are either being shut down or bought up.

HCA's 5%-7% operating margins are the absolute envy of the industry.

If they find themselves in a bad payer mix or in a weak market position, they'll just sell the hospital. Plus, they're non-nonsense when it comes to policies and products -- it's their way or nothing.

I admire that.

 

[Mr. dB]

I wasn't saying bullshit because healthcare expenses are on the rise, I was saying bullshit because you said it needs to be spread across the board. Fuck paying for some morbidly obese piece of shit diabetic's expenses, same with paying for smokers, etc. Why should their unhealthy lifestyles become my financial burden?

If you subscribe to health insurance, they already are your burden. The only difference is how big the pools are. For group insurance, isn't it generally accepted that bigger pools get better rates?

 

[mrplunkey]

If you subscribe to health insurance, they already are your burden. The only difference is how big the pools are. For group insurance, isn't it generally accepted that bigger pools get better rates?

No, not at all.

The better the pool, the better the rate.

I could pool every uninsurable person in the country into one massive group and we'd have a nightmarishly bad group. It's like we say in acquisitions: When you combine two dogs, all you get is a bigger dog.

 

[gjohnson5]

If you subscribe to health insurance, they already are your burden. The only difference is how big the pools are. For group insurance, isn't it generally accepted that bigger pools get better rates?

This is exactly what I was trying to say in my last post. The people filing bankrupcies for medical costs are people WITH insurance , not ones without. So the costs for those people's creditors is already being passed on you. Not only that but the people who have higher healthcare costs who the insurance company keeps increase the cost on everyone.

It makes no sense to say lower insurance costs are best if everyone in the pool is health. That simply is an impossible example. In a large enough pool someone is going to be sick. Saying screw sick people doesn't make sense and is inhumane

 

[Mr. dB]

No, not at all.

The better the pool, the better the rate.

I could pool every uninsurable person in the country into one massive group and we'd have a nightmarishly bad group. It's like we say in acquisitions: When you combine two dogs, all you get is a bigger dog.

But you'd have to go out of your way to select members for that bad group. Even with random selection you'd do much better.

 

[gjohnson5]

No, not at all.

The better the pool, the better the rate.

I could pool every uninsurable person in the country into one massive group and we'd have a nightmarishly bad group. It's like we say in acquisitions: When you combine two dogs, all you get is a bigger dog.

This is not true at all. Most uninsured people are those who believe they don't need it , hence they don't pay for it. This is mostly younger people and college students who don't make the money to afford and don't have the health problems to need insurance.

Once again the people who are filing bankruptcy due to medical problems are people WITH HEALTH INSURANCE.

Medical bills prompt more than 60 percent of U.S. bankruptcies - CNN.com


Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine.

"Unless you're a Warren Buffett or Bill Gates, you're one illness away from financial ruin in this country," says lead author Steffie Woolhandler, M.D., of the Harvard Medical School, in Cambridge, Mass. "If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that's the major finding in our study."

 

[gjohnson5]

OOh , I forgot this part

http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/

"That was actually the predominant problem in patients in our study -- 78 percent of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services," says Woolhandler. "Other people had private insurance but got so sick that they lost their job and lost their insurance." Health.com: Where the money goes -- A breast cancer donation guide