[Rainger99]

United Healthcare dropped about 22% yesterday.

Reports are that Medicare Advantage is costing them much more than they expected.

Since Medicare Advantage costs are rising at twice the anticipated rate, I would expect that we might have significant cuts in UHC Advantage next year!

[mrf6969]

Originally Posted by Rainger99

United Healthcare dropped about 22% yesterday.

Reports are that Medicare Advantage is costing them much more than they expected.

Since Medicare Advantage costs are rising at twice the anticipated rate, I would expect that we might have significant cuts in UHC Advantage next year!

Will have to raise the co-pays and start charging a monthly premium.

[villagetinker]

They already are doing this!!!!

[CoachKandSportsguy]

huh! who would have thought that turning over a social support service to a profit oriented insurance company would result in increasing prices and costs? Insurance costs are a source of increasing cost of medical services in the medical industry.

The source of inflation is the capitalistic goal of profitability and then increased profitability. . does rent control increase apartments development? not likely as the payback doesn't work anymore. . What makes UHC a good investment? increasing profits. . .

So pick your poison -> increased wealth due to increased profitability? or a social service with a fixed flat rate, with a shared cost for all to be available for all retirees?

[Aces4]

Originally Posted by CoachKandSportsguy

huh! who would have thought that turning over a social support service to a profit oriented insurance company would result in increasing prices and costs? Insurance costs are a source of increasing cost of medical services in the medical industry.

The source of inflation is the capitalistic goal of profitability and then increased profitability. . does rent control increase apartments development? not likely as the payback doesn't work anymore. . What makes UHC a good investment? increasing profits. . .

So pick your poison -> increased wealth due to increased profitability? or a social service with a fixed flat rate, with a shared cost for all to be available for all retirees?

Bingo! And now the you-know-what hits the fan.

[tophcfa]

Originally Posted by CoachKandSportsguy

huh! who would have thought that turning over a social support service to a profit oriented insurance company would result in increasing prices and costs? Insurance costs are a source of increasing cost of medical services in the medical industry.

The source of inflation is the capitalistic goal of profitability and then increased profitability. . does rent control increase apartments development? not likely as the payback doesn't work anymore. . What makes UHC a good investment? increasing profits. . .

So pick your poison -> increased wealth due to increased profitability? or a social service with a fixed flat rate, with a shared cost for all to be available for all retirees?

It’s absolutely amazing the amount of stuff one gets in the mail starting six months before turning 65. After sorting through all the bull$hit, it becomes clearly apparent there is a very strong riptide trying to flush the recipient into the Advantage Plan cesspool. There is no attempt to guide the recipient in the direction of traditional Medicare with a supplemental (Medigap) plan. Read into that as you please, but I know how I interpret it.

[gatorbill1]

Probably a good buy right now

[JohnN]

I've had United Healthcare for 11 years now and for the most part, they've treated me straight,
even through several signifant surgeries.

My perspective is that anything the government runs - ANYTHING - ultimately becomes a boondoggle.
I know private businesses are built for profit, I worked for one. That said, they do have competition and
try to get a usable product out there.

[rustyp]

Originally Posted by mrf6969

Will have to raise the co-pays and start charging a monthly premium.

There appears to be some breathing room for a price hike. Like on average $200-$300/month ($2400-$3600/year) to equal an average Medicare supplemental plan. Where does one outlook the costs of supplemental plans are going in the near future. Good luck"doge---ing" that.

[Pugchief]

Originally Posted by CoachKandSportsguy

huh! who would have thought that turning over a social support service to a profit oriented insurance company would result in increasing prices and costs? Insurance costs are a source of increasing cost of medical services in the medical industry.

The source of inflation is the capitalistic goal of profitability and then increased profitability. . does rent control increase apartments development? not likely as the payback doesn't work anymore. . What makes UHC a good investment? increasing profits. . .

So pick your poison -> increased wealth due to increased profitability? or a social service with a fixed flat rate, with a shared cost for all to be available for all retirees?

Originally Posted by JohnN

My perspective is that anything the government runs - ANYTHING - ultimately becomes a boondoggle.
I know private businesses are built for profit, I worked for one. That said, they do have competition and
try to get a usable product out there.

Of course the ins co wants/needs to make a profit. I'm with John though; if not for all the govt interference in the market place, the bar to profit would be much lower. Remember that the first A in ACA (Obamacare) is for affordable. And it has been anything but.

[CoachKandSportsguy]

social services are for citizens, the problem here is that private corporate services are not the same, and to survive they have to be profitable. That being said, there is a very large infrastructure to UHC as well, and it might even be bigger in cost than the government, when you include in the cost of executives and bonuses, plus all the required reporting and documentation which the corporations have to do to comply with public company disclosures. .

So although one might think that the government is inefficient, the govt may not cost as much in total as the MA plans properly costed. . one may be making assumptions to fit their own beliefs. . I do not know, however, I do know that insurance companies deal in probabilities about the future. The probabilities might be correct, but they might get on the wrong side of the outcome enough to change the probabilities and therefore their cost curve back to us. .

Capitalism and competition is great for driving excess out of the system, but capitalism and competition requires rules and enforcement. otherwise, the consumer / citizens will lose out

[Pugchief]

Originally Posted by CoachKandSportsguy

So although one might think that the government is inefficient, the govt may not cost as much in total as the MA plans properly costed. .

I think you are misunderstanding my point. In the last 15 years (in particular) the regulatory burden imposed by the govt onto health care has driven up costs substantially. Some examples include EMR, prohibiting denial of coverage due to preexisting conditions and expanding Medicaid eligibility. Also required coverage for random thing like pediatric dental, birth control, and soon, maybe IVF. All of those things drive up the cost of healthcare, causing premiums to spike bc:

Ins Co PROFIT = PREMIUMS - PAYOUTS - OVERHEAD

I'm saying if the govt had not inserted itself into the free market with all of these requirements, payouts would be lower (prob overhead too, bc less rules), so you could lower premiums and still make the same profit.

[JohnN]

Here's a recent scary example. I have had severe cardiological issues (stents).
I have a superb cardiologist and I'm fortunate to have him. Here were some things he said to me.

Ultrasounds - 50% effective, flip a coin. But per medicare, you have to get one before anything else.
CT Scan - 80% effective. Better, almost really good, but not with my life o5n the line.
Angiogram - 99.9% effective, and should be mandatory serious about their cardio system.

If you're really bad off, you have to go through all 3 of these. Government (medicare) required

[Aces4]

Originally Posted by JohnN

Here's a recent scary example. I have had severe cardiological issues (stents).
I have a superb cardiologist and I'm fortunate to have him. Here were some things he said to me.

Ultrasounds - 50% effective, flip a coin. But per medicare, you have to get one before anything else.
CT Scan - 80% effective. Better, almost really good, but not with my life o5n the line.
Angiogram - 99.9% effective, and should be mandatory serious about their cardio system.

If you're really bad off, you have to go through all 3 of these. Government (medicare) required

If you are really "bad off", the most effective test will be run first. I don't see the issue with going through the series of tests to rule out issues seeing the angiograms are not without risk, even though low, such as heart attack causation, stroke or puncture during the procedure, reaction to the contrast material, kidney damage and radiation exposure from the procedure. Sounds like it should be considered carefully which I am sure a competent cardiologist would do.

[CoachKandSportsguy]

Originally Posted by Pugchief

I think you are misunderstanding my point. In the last 15 years (in particular) the regulatory burden imposed by the govt onto health care has driven up costs substantially. Some examples include EMR, prohibiting denial of coverage due to preexisting conditions and expanding Medicaid eligibility. Also required coverage for random thing like pediatric dental, birth control, and soon, maybe IVF. All of those things drive up the cost of healthcare, causing premiums to spike bc:

Ins Co PROFIT = PREMIUMS - PAYOUTS - OVERHEAD

I'm saying if the govt had not inserted itself into the free market with all of these requirements, payouts would be lower (prob overhead too, bc less rules), so you could lower premiums and still make the same profit.

Taken in total isolation, without looking at any benefits, you might (very slight probability) have a point, but I highly doubt it. CoachK, my wife, works in regulatory reporting, helps make sure the systems do what is needed, that the data is correct, and sends filings to many regulatory agencies. . From our discussions for many years about EMRs, etc. since we both are professional geeks and nerds at different points in our careers, there is a ton of misconceptions in this post.

4 years ago, I transitioned my mom from a local doctor's office to a gerontologist. When trying to get records sent to the gerontologist's system, I was given a stack of paper documents about 3 inches thick to hand deliver. While at her practice, i asked about the last tetanus shot due to a hospital stay, and they didn't know that there is a central state immunization database required for all immunizations given to all state residents. They said it will take some time to read through the documents to find the information.

At the gerontologists office, the documents were all scanned and data extracted into a standardized format, and the questions were all able to be electronically queried. .

If one perceives the hospitals as only break fix locations, and that medical histories aren't important to an ER room for correct diagnosis when time is of the essence, then yes, paper records are fine, wherever they may be found when needed to be used.

However, if you want more than just break fix services at medical offices, then you are looking for evidence and outcome based medicine. That requires standardized medical records, detailed medical records, the more history for trend analysis, etc than just a point in time break fix situation. the EMR is not just a collection of data points, but also able to make calculations with the data, present warning flags for deficient conditions, all instantaneously for the doctor to send less time reading paper records to help prepare for a better outcome.

However, there is a trade off for great medical care with great records for both analysis and quick retrieval: data entry takes human time, and humans are lazy self centered creatures who can't all understand the benefits of whole systems having integrated medical records available, especially when not involved. . humans make mistakes, and humans don't always want to be bothered when they being self centered with a medical emergency. . .

we all are the beneficiaries of the best medical system in the world, due to the electronic processes having been brought to the the medical field. There are no longer people reading doctor's scribbles in notes to get to historical diagnosis, etc. yes there is a trade off of data time entry, and system costs of implementation. . but that is also the private sector, free market enterprise helping create these great modern systems, wanting to get payback for their investment . . .

And there are also so many benefits in the medical back office that patients take for granted because they can't see them, and medical records are much more detailed with time stamps for each step, interactions, etc, than one can imagine just being a patient. .

Finally, because of the legal cost of "malpractice', which is also a very real part of the cost equation, EMRs are used as proof for events happening, steps occurring to mitigate legal costs of deposing a doctor, putting him on the stand, reading scribble to see if certain standards of care were missing. . something you might want if you are getting a second opinion or wanting to be litigious. .

So, there's a lot of ignorance and solely cost based beliefs in a vastly huge world of medicine, and systems, and break fix versus outcomes. . and good outcomes not only comes from good drug trials, but also from good procedures, and constant monitoring of human processes within medical systems for the best outcome. .

go watch "The PITT" with noah wylie and tell me that technology there isn't helpful to save lives, when looking at each human's medical records looking for situations to avoid to which could be catastrophic. .