Everyone knows the health insurance companies wrote Obamacare, and Obama and Pelosi didn’t bother to read it. And now we’re seeing why…They get to charge 100%, 200%, or 300% more for insurance than before. They are going to make obscene profits, and ration care, all under the safety of Obama’s catastrophic abortion known as Obamacare.
Well, I was heartened by the article below, and what I’ve been hearing at meetings. Hospital systems are starting to offer their own health insurance and cut the HMO’s out of the loop. The HMO’s are middlemen, and like all middlemen, they are leeches. They provide no real service while skimming 50% profit off the top. If hospitals can end HMO’s, we’ll all be better off. And as I’ve been fond of saying, the solution to our healthcare system is to make it “not for profit”, and some hospital systems are already not for profit.
Obamacare may have the effect of taking down the HMO’s with it, into the pit of hell where it belongs. Good riddance to Obamacare and HMO’s.
Hospitals Plot the End of Insurance Companies
Rob Garver The Fiscal Times March 27, 2014
The problems with the implementation of the Affordable Care Act may be masking another major change in the way health care is delivered to U.S. consumers, experts believe.
At The Atlantic’s Health Care Forum in Washington on Thursday, health care and business professionals said that there’s an increasing trend in the industry toward cutting insurance companies out of the process entirely, as large, regional hospital systems move into the insurance business.
Related: Obamacare – Taxpayers in the Hole for $1.5 Trillion
Dr. Kenneth L. Davis, CEO and president of Mount Sinai Health System, the largest health care provider in the state of New York, said that starting next year, Mt. Sinai will begin offering its own Medicare Advantage plan. It will look for other opportunities to bring premium payments directly into the hospital system, rather than filtering them through insurance companies.
Davis said he expects organizations similar to his to move in the same direction. “Inevitably the large systems are going to move to take part of the premium dollar,” he said.
For both non-profit systems like Mt. Sinai and for-profit systems, he said, retaining more and more of the health care premiums paid by consumers is essential to providing a full spectrum of care. He said that his system’s St. Luke’s Hospital in New York runs a psychiatric program that loses $14 million per year.
It’s “not sustainable,” he said, so the system needs to cross-subsidize the money-losing services that it nonetheless must continue to provide, with income from more profitable services, such as orthopedic surgery.
The industry, he said, is facing “an entire reformulation of how we pay for services.” The point is not to squeeze more profit out of the system, but to preserve the system’s ability to provide care. “If we don’t put those dollars back into the underpaid discipline, you just end up with underpaid disciplines that can’t be cross-subsidized.”
Dr. Ezekiel Emanuel, chairman of the Department of Medical Ethics and Health Policy at the University of Pennsylvania and one of the architects of the Affordable Care Act, agreed, saying that we’re beginning to see what he called the “Kaiserification” of our health care system.
He was referring to the Kaiser Permanente health care consortium, which combines a health insurance company with subsidiary hospitals and medical practices to create a fully integrated health care delivery system. He noted that large insurer Wellpoint recently completed the acquisition of a health care company in California, apparently with an eye toward replicating the Kaiser model in some form.
Emanuel said we’re witnessing “the end of insurance companies as we know them” and that if they want to survive, they “will have to get into the business of providing care.”
He predicted that in the world of health care, “the wave of the future is integrated delivery systems – integrating insurance with delivery function.”
– See more at: http://www.thefiscaltimes.com/Articles/2014/03/27/Hospitals-Plot-End-Insurance-Companies#sthash.IdeSdmVA.dpuf
AWD,
I read this earlier today, and while it would be good to get rid of the middle man, i do not think it would stop the already predatory practices of the big hospitals. As they have been buying up smaller local and regional hospitals here in Massachusetts, and leveraging their size and monopolistic power to dictate to the health insurance companies that it is they who are in charge. They threaten to not accept certain insurances unless it is under their (the hospitals) terms. This may not always be in the best interest of the end consumer who is ultimately paying for all of this. We really need to remove most of the regulatory obstructions set up in the industry, open up competition, and drive down prices to where they should naturally be. With the government and big hospital regulating when and where healthcare should be made available, often sold to the highest bidder, it strictly becomes a money matter not a healthcare matter. In the comments section of the same article the commenter sites Karl Denninger’s argument with the Oklahoma City Medical cent that does not accept insurance and yet its rate are often multiple tomes lower. Real competition will drive pricing to the level that people can actually afford to pay.
Thank you I always enjoy and appreciate your posts.
Bob
Sorry about the misspellings “cent= center and tome=time”
Bob.
“We really need to remove most of the regulatory obstructions set up in the industry, open up competition”
And how is this supposed to happen? The government has a strangle hold on the industry, supporting HMO’s at the expense of hospital systems. Not all hospital systems are bad or predatory, and those that are need to be converted to “not for profit”.
This needs to be done in a stepwise manner: first eliminate the HMO’s, set up hospital/provider networks with competitiveness, then convert them to “not for profit”. Problem solved; using money spent on healthcare for healthcare, instead of tens of billions siphoned off by the HMO’s.
It seems to me that health insurance run by hospitals would be exactly the same as health insurance run by an insurance company. It’s not like you’d have doctors paying the claims, etc. I see no reason to think that hospitals would do the work of insurance companies (which is actual work, after all) for less money. The main thing we need to do is get rid of disparate billing. For most standard procedures the cost should be the cost. How it’s paid – insurance or cash – shouldn’t change the cost. A couple years ago I had a laparoscopic appendectomy. In and out of the hospital in ~ 16 hours. I had an 80/20 medical insurance set up at the time. The official cost was about $12,000, so my “20%” was ~$2,400. Except the real cost was probably about $6,000. So I really paid 40% and the insurance company only paid about $3,600, which they recouped in about 4 months’ worth of premiums for my family coverage (which is a lot more expensive now).
We can’t assess how to pay the cost of medicine while the true cost is still shrouded in mystery and bullshit. The cost should be the cost.
I don’t think most people are ignorant of the size and scope of health insurance companies.
United Healthcare, one of the “big five” has 70,000 employees. Considering all they do is collect premiums and (supposedly) pay out claims, why do they need 70,000 employees? Because 60,000 are data mining, refusing treatment, and figuring out ways to delay claims or not pay claims. They have massive PR departments, to quell all the negative publicity when somebody dies because they refused to pay for their medical care. They have massive marketing departments, to push people into thinking they are getting some value from their health insurance, when in fact they are getting screwed and will be lucky if their insurance company pays a dime for their healthcare. They have massive legal departments, to screw hospitals and doctors out of charges and payments. They are truly the evil empire in healthcare. But keep deluding yourself they are benign entities, their marketing and PR is working great.
I have a terrific medical plan.
1. Eat right.
2. Exercise.
3. Don’t get sick.