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Thread: Evil Health Insurance Companies

  1. #1
    Senior Member M&K's Retrievers's Avatar
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    Default Evil Health Insurance Companies

    I've been selling employee benefit programs for the past 35 years. During that time I have listened to clients bitch about rate increases and occasionally a few claim problems. For the most part my clients have been more than satisfied with the benefits they received in return for their premium dollar. Most people would rather not collect a dime because they are healthy while others complain that their plan didn't cover some minor crap.

    In the past couple of weeks I have been exposed to a couple of things that make me wonder how an insurance company could ever make a profit. A hunting guide/dog trainer friend of mine is a diabetic who is going through kidney dialysis. He is losing his eyesight. I have been taking him to an eye doc for shots (yep, in the eyes) once a month. These are covered but I don't have a clue how much the cost. The last time there the doc wanted to put a drop of something in each eye. $2,000 per drop! His insurance covered it all.

    Today I went for my semi annual haircut. The gal that cuts my hair 13 year old grand son has a form of ecoli. This has had him hospitalized for 16+ days. They had to transfer him 90 miles from Sherman, TX to Dallas. Cost $10,000. I asked why they had air medavac him. She said that was in an ambulance. If he has ahus ecoli, there is a shot that "may" help him. The cost is $450,000. One shot. One time. It works or it doesn't. Insurance will cover all of this.

    Both of these individuals have/will incurred claims in excess of $500,00-$750,000 which the insurance companies will reimburse the lions share.

    How can insurance companies budget for these types of expenses? Perhaps it not the insurance companies that are to blame. Just maybe the providers have a say in this. Ya' think?
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    Senior Member Terri's Avatar
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    I guess what you think is minor and what someone else things is minor could be very different. You think?

    Terri

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    Senior Member M&K's Retrievers's Avatar
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    Quote Originally Posted by Terri View Post
    I guess what you think is minor and what someone else things is minor could be very different. You think?

    Terri
    People should pay for the minor stuff themselves while relying on insurance to pay for major expenditures.
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  4. #4
    Senior Member Terri's Avatar
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    What is a major expenditure for one person can very from person to person. Some think that $250,000.00 a year is rich, it all depends on who you ask.

    Terri

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    Senior Member huntinman's Avatar
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    The insurance companies have just as much right to make a profit as any other business. People love to hate them sort of like the phone company or the cable company. We all pay them and pay them and think we are "wasting" money.... Till we need it... Then we are damn glad we have it. I'm with Mike, Obama and his minions have found an easy target because they know most people already distrust insurance companies... So they bash and bash (all while taking millions in campaign contributions). Then you have the gov't regulating them practically out of of business. Not only the Feds, but the States get in on the act too.

    What I don't understand is how any executive in the insurance industry backed Obama the first or second time?
    Bill Davis

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    Quote Originally Posted by M&K's Retrievers View Post
    I've been selling employee benefit programs for the past 35 years. During that time I have listened to clients bitch about rate increases and occasionally a few claim problems. For the most part my clients have been more than satisfied with the benefits they received in return for their premium dollar. Most people would rather not collect a dime because they are healthy while others complain that their plan didn't cover some minor crap.

    In the past couple of weeks I have been exposed to a couple of things that make me wonder how an insurance company could ever make a profit. A hunting guide/dog trainer friend of mine is a diabetic who is going through kidney dialysis. He is losing his eyesight. I have been taking him to an eye doc for shots (yep, in the eyes) once a month. These are covered but I don't have a clue how much the cost. The last time there the doc wanted to put a drop of something in each eye. $2,000 per drop! His insurance covered it all.

    Today I went for my semi annual haircut. The gal that cuts my hair 13 year old grand son has a form of ecoli. This has had him hospitalized for 16+ days. They had to transfer him 90 miles from Sherman, TX to Dallas. Cost $10,000. I asked why they had air medavac him. She said that was in an ambulance. If he has ahus ecoli, there is a shot that "may" help him. The cost is $450,000. One shot. One time. It works or it doesn't. Insurance will cover all of this.

    Both of these individuals have/will incurred claims in excess of $500,00-$750,000 which the insurance companies will reimburse the lions share.

    How can insurance companies budget for these types of expenses? Perhaps it not the insurance companies that are to blame. Just maybe the providers have a say in this. Ya' think?
    IMO - there needs to be a system where those getting treated have skin in the game.

    I grew up on a farm - RAW MILK (don't try to get that past the health inspector these days), ate stuff fresh from the garden by wiping the dirt off it, yet nobody got sick. I go in yearly for skin checkups - the gal there said I must have grown up on a farm, as I have no allergies, except to commercial stuff - You have to ask yourself, is the world kids are growing up in too sterile?

    I don't have an answer but it seems that those who run up the biggest bills seem to be those who abuse themselves the most, am I wrong?

    Again, it's easy to ask for the best when someone else is paying. When you may have to give up something, you think twice about the expense.

    And to think, this all started because of wages being froze - Intended or unintended consequences?
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  7. #7
    Senior Member Jason Glavich's Avatar
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    Quote Originally Posted by M&K's Retrievers View Post
    I've been selling employee benefit programs for the past 35 years. During that time I have listened to clients bitch about rate increases and occasionally a few claim problems. For the most part my clients have been more than satisfied with the benefits they received in return for their premium dollar. Most people would rather not collect a dime because they are healthy while others complain that their plan didn't cover some minor crap.

    In the past couple of weeks I have been exposed to a couple of things that make me wonder how an insurance company could ever make a profit. A hunting guide/dog trainer friend of mine is a diabetic who is going through kidney dialysis. He is losing his eyesight. I have been taking him to an eye doc for shots (yep, in the eyes) once a month. These are covered but I don't have a clue how much the cost. The last time there the doc wanted to put a drop of something in each eye. $2,000 per drop! His insurance covered it all.

    Today I went for my semi annual haircut. The gal that cuts my hair 13 year old grand son has a form of ecoli. This has had him hospitalized for 16+ days. They had to transfer him 90 miles from Sherman, TX to Dallas. Cost $10,000. I asked why they had air medavac him. She said that was in an ambulance. If he has ahus ecoli, there is a shot that "may" help him. The cost is $450,000. One shot. One time. It works or it doesn't. Insurance will cover all of this.

    Both of these individuals have/will incurred claims in excess of $500,00-$750,000 which the insurance companies will reimburse the lions share.

    How can insurance companies budget for these types of expenses? Perhaps it not the insurance companies that are to blame. Just maybe the providers have a say in this. Ya' think?
    They wont pay that amount, most likely they will pay about 60% of the total cost through negotiations with the hospital. If they took the route of some surgery centers and reduced the admin staff making six figures they could reduce cost. Those shots are most likely sold to the hospital for 1/1000 of the cost they pass onto the patient.
    My Father,My Friend,My teacher,and now My Angel~ 04/21/1956-03/21/2011 You will always be missed. I hope to learn half of the stuff you knew.

    ~Blessed are those who mourn for they shall be comforted~

  8. #8
    Senior Member M&K's Retrievers's Avatar
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    Quote Originally Posted by Jason Glavich View Post
    They wont pay that amount, most likely they will pay about 60% of the total cost through negotiations with the hospital. If they took the route of some surgery centers and reduced the admin staff making six figures they could reduce cost. Those shots are most likely sold to the hospital for 1/1000 of the cost they pass onto the patient.
    You should say insurance company. Without insurance the cost usually drops dramatically.
    M&K's HR UH Tucker of Texoma JH
    M&K's SHR Prime Black Angus
    M&K's Miss Jessie Girl JH
    Sir Jacob of Lakeview-Jake
    Freeway JYD

    Mike Whitworth

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    Senior Member Daniel J Simoens's Avatar
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    Quote Originally Posted by M&K's Retrievers View Post
    You should say insurance company. Without insurance the cost usually drops dramatically.
    I just had sinus surgery. Before surgery they explained what the charges would be. For the surgery itself, the cost was going to be $6393 but because I had UnitedHealthcare insurance, the negotiated charge was $998. They explained that the difference would be 'written off."

    I've heard stories of a lady in LA going to the ER 200+ times in a year with her children for things such as the common cold. Why? because she had a $0 copay for ER.
    That's my boy "Blue"!!!! Flyin High in the Passenger Side x Katie May of Belgrade

  10. #10
    Senior Member Jason Glavich's Avatar
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    I choose urgent care over my regular doc for 2 reasons, first reason is I do not feel like waiting for 2 weeks to be seen for a problem, 2nd reason is the copay is cheaper for urgent care than my GP.

    I find it funny how no insurance brings the cost down so quickly(surgery centers do this quite a bit, surgery center of OK is a great example.), when a bill is 40k and the insurance pays only 5k and it is all covered shows the real cost, the rest is just moving money around that doesnt exist.
    My Father,My Friend,My teacher,and now My Angel~ 04/21/1956-03/21/2011 You will always be missed. I hope to learn half of the stuff you knew.

    ~Blessed are those who mourn for they shall be comforted~

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