Hospital Gowns On FIRE

[GRG55]

Re: Hospital Gowns On FIRE

Any way you try and rationalize and slice it, this is mostly about deception. The insurance companies know good and well that people don't pay into insurance thinking they'll get just room and board covered and not much else. They are counting on people not reading the policy carefully. This has become the American way. If you can't make an honest buck, then make it by fooling people. I agree there may be more to the story, but the fact is, if our elected officials were doing their jobs this kind of chicanery wouldn't even be possible. People should be able to have a REASONABLE expectation that their insurance company isn't out to screw them. They shouldn't have to search policies for exclusions that allow them to. American companies are becoming less and less able to compete on a fair and level playing field, so expect to see more of this crap.

I've asked the question of exactly what benefit insurers such as Aetna or Cigna derive from misleading either their policy holders or the hospitals. So far I've not seen a satisfactory explanation.

Instead, what I am picking up on this thread is another extension of the "loss of confidence" momentum. Society's loss of confidence is spreading beyond the politicians, appointed high officials, real estate brokers, Big Oil, bankers & financiers, and the overpaid CEOs of select mis-managed "industrial" corporations [e.g. GM] Now the corrosive effects are spreading to parts of the economy and society that people have normally come to depend on in times of difficulty...such as the "I" in FIRE...Insurance.

When I see signs that there is widespread loss of confidence in the police and the judiciary I'll take it as a sign that the USA is truly decending into a "third world" state of affairs in some key respects. :eek:

BTW, the "third world" contains some of the most truly capitalist societies on earth. One trip to Lagos, Nigeria will convince you of this. If you want reliable electricity you buy your own generator and arrange for fuel. If you want reliable telephone you install a sat antenna on the top of your office. And so forth. Basically you end up running your own private utilities for pretty well everything and depend on the government for absolutely nothing. Let's hope the USA pulls itself out of this downward spiral before it gets anywhere near the hellish Nigerian state of affairs.

[World Traveler]

Re: Hospital Gowns On FIRE

Grg55,

I think the answer you are looking for can be found in the movie "Sicko", about the U.S. health care system, where the methods health insurance companies use to avoid paying out on claims is documented. They employ people to scour claimants's health records back to childhood to look for minor, irrelevant illness in the past, then cancel the policy and refuse to pay for a current hospitalization or major treatment, for example, by declaring that the claimant did not disclose a case of shingles he had as a teenager, when he applied for the independent health policy, and therefore they are cancelling the policy. Often after the claimant has paid premiums for many years before this happens. Or they declare a treatment as "experimental", and refuse to pay for it, even if other insurance companies will cover the treatment. Their attitude is "see you in court (if you live long enough!)". It's a gamble they're willing to take because it often pays off for them.

The benefits that insurance companies derive from being unethical, deceitful, and parsimonious is KEEPING MORE MONEY BY PAYING OUT LESS, and using it for:

1. executive pay and stock options
2. appeasing Wall Street by higher dividends and a rising stock price, and higher earnings per share
3. lobbying Congress and campaign contributions to favored candidates.

One of the best documented cases on how American insurance companies operate today is actually about auto insurance, but health insurance operates the same way. In mid-1990's, McKinsey, the famous consulting company, "taught" Allstate how to minimize ato insurance payouts. They called it from "good hands" to boxing gloves.

... Allstate deploys a variety of systems set in place by McKinsey to make sure it pays the minimum necessary -- and it plays hardball with those who seek more.... In the decade after Allstate instituted the McKinsey program in 1995, the amount of money it paid out per premium dollar in car accident cases declined from about 63 cents to 47 cents, according to A.M. Best..."

http://www.businessweek.com/magazine...8/b3982072.htm

[BiscayneSunrise]

Re: Hospital Gowns On FIRE

GRG, You correctly get to the heart of the matter with the "loss of confidence" idea.

Whether some insurance companies are acting responsibly nationwide, I can not say (although my personal experience with auto, health, homeowners, etc. has been excellent)

However, to me, the larger and more dangerous issue is that some media outlets (Michael Moore comes to mind since WT mentions him) are irresponsible. In order to sensationalize or push personal political agendas they create this idea in people's minds that various institutions are not to be trusted. Everything from rampant police brutality to evil oil companies. From baby killer soldiers to the latest crisis du jour.

One should always be skeptical to a certain degree but only to a point. If one wants to kick the legs out from underneath a society what better way than to get the public to doubt its' fundamental institutions?

[Jim Nickerson]

Re: Hospital Gowns On FIRE

GRG, You correctly get to the heart of the matter with the "loss of confidence" idea.

Whether some insurance companies are acting responsibly nationwide, I can not say (although my personal experience with auto, health, homeowners, etc. has been excellent)

However, to me, the larger and more dangerous issue is that some media outlets (Michael Moore comes to mind since WT mentions him) are irresponsible. In order to sensationalize or push personal political agendas they create this idea in people's minds that various institutions are not to be trusted. Everything from rampant police brutality to evil oil companies. From baby killer soldiers to the latest crisis du jour.

One should always be skeptical to a certain degree but only to a point. If one wants to kick the legs out from underneath a society what better way than to get the public to doubt its' fundamental institutions?

Just what might be our "fundamental institutions?"

Certainly the public would be amiss to ever doubt the US political system and who actually appears to me to be controlling it--the monied interests of this country.

No one should doubt our healthcare system or might some skepticism be appropriate? https://www.cia.gov/library/publicat.../2102rank.html Spend a few seconds and locate the USA on the list. Nothing like spending a lot on healthcare and not apparently getting that much in return. http://www.nchc.org/facts/cost.shtml or from an insurance insider http://www.cnn.com/2009/US/07/02/ins...ing/index.html

Who thinks the FIRE economy is dead, in the throes of death, is incurably ill but perhaps will survive for some years, has only had a hiccup?
http://baselinescenario.com/2009/07/...ienate-people/ and http://baselinescenario.com/2009/07/...for-big-banks/

Anyone who does not seriously doubt the "fundamental institutions" of the USA is either stupid, a Republican, or incapable of engaging in any thought process resembling objectivity.


"If we ever pass out as a great nation we ought to put on our tombstone, 'America died from a delusion that she has moral leadership." W. Rogers.

[BK]

Re: Hospital Gowns On FIRE - How about Hospitals

I do not work for the Insurance Industry - but, Insurance Companies are just trying to make a living- pay their employees and earn money for stockholders. Many hospitals run up the Bill for any patient that enters their doors.

A 75 year old family member was admitted to the hospital on Friday night because of any illness that the doctors couldn't diagnose. The hospital spent the entire weekend running tests and having specialist visit her. She was pulled out of the hospital on Monday and taken to her Dentist. Within 5 minutes the Dentist diagnosed that the cause of the illness was a bacterial infection in the mouth.

The Hospital was able to charge $35,000 for this weekend stay - and their terrible diagnostic skills. The Hospital system has an incentive to do a terrible job diagnosing problems in a timely fashion. **Disclaimer - there are lots of great doctors and excellent hospitals*** There are some rotten hospitals and rotten doctors that are could any running up the meter. The insurance companies are just trying to survive and make a buck.

[World Traveler]

Re: Hospital Gowns On FIRE

Biscayne Sunrise,

I have also had very good health care experiences. Got the treatment I needed when I needed it, same for the family, and insurance covered the costs.

But it's because I'm retired from a huge, profitable U.S. corporation, and I've always had a group coverage plan, where the corporation pays 2/3 of the premium, and I pay 1/3. Even now in retirement. When I qualify for Medicare in 4 years, this corporation will continue to provide my Medicare Supplemental. A dream situation in the U.S. today.

However, my premiums keep going up. I paid $400 a month in 2007 for family coverage (son in college), and now it's up to $500. And back in 2000, I paid only $176 a month.

What we have in the U.S. is called cost-shifting. U. S. hospitals are notorious for the ridiculous rates they charge on procedures. It's because hospitals provide so much unpaid health care to uninsured and under-insured, and because Medicare plays hardball on some re-reimbursement rates. So the rates they charge the insured are raised to cover those costs, and as a result health care premiums continue to go up, way above the inflation rate.

This situation can't go on indefiltely, just like the bubble and credit-based FIRE economy couldn't go on indefinitely. It toppled from its own weight.

When firms, from Walmart to small businesses, get behind health care reform, change is a-coming. Even American companies can no longer afford the current system. Their portion of employee health care premiums is seriously hurting their bottom line.

[GRG55]

Re: Hospital Gowns On FIRE

...Anyone who does not seriously doubt the "fundamental institutions" of the USA is either stupid, a Republican, or incapable of engaging in any thought process resembling objectivity.

I used the word "corrosive" in my last post, as it seems to be a good description of what's transpiring.

Slowly but steadily a healthy scepticism and critical questioning of our institutions has progressed to the view that:

• all politicians are worthless, philandering crooks;
• all bankers are out to enrich themselves at the expense of everyone else including their own mothers;
• all CEOs run their companies solely to gun the stock, cash in their options and then collect their excessive severance...shareholders be damned;
• all real estate agents are liars;
• Big Oil's only objective is to manipulate the oil supply to drive up the price;
• and now...all insurance companies are out to screw their clients and other stakeholders.

Not surprising given what has transpired in recent years and is now being revealed.

I must admit that I was in what EJ calls "suspended disbelief" about the extent to which Wall Street influences [controls?] Washington. But the behaviour of the current Democratic "Change" Administration put paid to that illusion. Despite that "awakening" I am not yet ready to subscribe to a wholesale belief in all of the above...:p

[Jim Nickerson]

Re: Hospital Gowns On FIRE - How about Hospitals

I do not work for the Insurance Industry - but, Insurance Companies are just trying to make a living- pay their employees and earn money for stockholders. Many hospitals run up the Bill for any patient that enters their doors.

A 75 year old family member was admitted to the hospital on Friday night because of any illness that the doctors couldn't diagnose. The hospital spent the entire weekend running tests and having specialist visit her. She was pulled out of the hospital on Monday and taken to her Dentist. Within 5 minutes the Dentist diagnosed that the cause of the illness was a bacterial infection in the mouth.

The Hospital was able to charge $35,000 for this weekend stay - and their terrible diagnostic skills. The Hospital system has an incentive to do a terrible job diagnosing problems in a timely fashion. **Disclaimer - there are lots of great doctors and excellent hospitals*** There are some rotten hospitals and rotten doctors that are could any running up the meter. The insurance companies are just trying to survive and make a buck.

Interesting anecdote.

I'm interested in the highlight. Is your disclaimer issued so as not to piss off any of the doctors who contribute here, or do you have a basis for actually knowing "there are lots of great doctors and excellent hospitals?"

Interestingly, the companies that might cover the $35K, I guess for sure Medicare would be the one responsible, will pay the dentist zero.

I'll see your anecdote and up it one. Within the last couple of weeks a nurse friend of wife's called me asking about her mother who was hospitalized with oral bleeding from around a tooth, she too would be a Medicare patient. The woman was on an anticoagulant--coumadin--because she has atrial fibrillation which is or can be associated with throwing off clots that could lead at least to strokes. This great big relatively new HCA hospital in large metro area had not one single oral surgeon on the staff, though there are many in the city--some sort of failure there whether due to the oral surgeons or the hospital.

The woman got out and saw an oral surgeon, who had seen her before as I understand but he did not make any recommendations about her doing anything preventive or anything that seemed to mandate treatment. Turns out this "old woman" has been on one of the bisphosphonates http://en.wikipedia.org/wiki/Bisphosphonate (if you watch any commercial TV, surely you have seen Boniva [I believe it is] touted by Sally Fields as a preventative treatment for osteoporosis). There are a number of these drugs available these days for for oral administration, apparently frequently prescribed, and used. As I recall, perhaps incorrectly, they are in the top ten of prescribed drugs in the US. Correction of my recall welcomed.

The jaw problem caused by these bisphosphonates is that after prolonged usage, the mandible, lower jaw, especially becomes vulnerable to infections to the extent that its natural manner of reaction to infection is severely suppressed. These problems did not exist when I practiced, but apparently they have become a significant issue. Turns out the "old woman" had a periodontal pocket that was associated with her oral bleeding, so the oral surgeon "punted" her to a periodontist, who as I understand is attempting to treat the perio problem [probably the most efficient resolution to her problem in a patient not on bisphosphonates would be to extract the tooth]. Whether or not the woman gets a further problem following the three months of perio. treatment, during which she remains off her coumadin, with jaw necrosis remains to be seen.

If a mandible is irradiated in a treatment for cancer in the head and neck, the jawbone if infected or for some reason exposed becomes incapable of healing itself with or without any attempts by doctors to get it to heal. This has to do with destruction of its blood supply as a secondary effect of the radiation. I took out a necrotic mandible on a man years ago because of this osteoradionecrosis, and resections of such bone is not (or was not then) readily amenable to a reconstruction in fields of radiation.

These bisphosphonates are causing a similar problem to osteoradionecrosis to occur in the mandible, and I recently saw in an oral and maxillofacial surgeon's office a supplemental edition of the J. of Oral and Maxillofacial Surg. devoted to updating the specialty about this problem--supplemental issues are a rarity. I did not and will not likely read it, but to my understanding there is no good answer to dealing with these infected mandibles if something leads to their becoming infected. In one discussion I had with a guy--doctor--who generally is a pretty smart dude--suggested that the science of assessing bone density is rather weak, though such testing apparently is the basis for decisions leading physicians to prescribe these medications. If you search the web on bisphosphonates, you'll no doubt pickup on what is probably going to be a class action lawsuit with regard to the problem of jaw necrosis. I just did, here is one link http://bisphosphonates.tripod.com/ My impression is that women should not look upon taking these drugs as though there is only an upside with prevention of osteoporosis with little else about which to worry.

Another anecdote. I came to Fort Worth after practicing elsewhere. Here I knew no physicians. After 12 years here, I needed a physician to evaluate and treat my hypertension. Finding a doctor for me has been a scary situation. I know of no way to assess the seriousness with which any healtcare provider practices. I do not think they all are equally smart, equally dedicated, and equally worth what they charge. It is a big dilemma, so BK, tell me how you know there are good doctors and hospitals, and more importantly, how does anyone really figure out just who these "good" people, institutions are?

[GRG55]

Re: Hospital Gowns On FIRE - How about Hospitals

...My impression is that women should not look upon taking these drugs as though there is only an upside with prevention of osteoporosis with little else about which to worry...

Probably a good approach for everyone to any drug, even non-prescription medications...

...I know of no way to assess the seriousness with which any healtcare provider practices. I do not think they all are equally smart, equally dedicated, and equally worth what they charge. It is a big dilemma, so BK, tell me how you know there are good doctors and hospitals, and more importantly, how does anyone really figure out just who these "good" people, institutions are?

Good question. As someone who has received both lousy and excellent [purely my judgement] service at the hands of doctors, lawyers and accountants I wish I had a good answer. It seems to depend more on serendipity than I would care to admit...

[Munger]

Re: Hospital Gowns On FIRE

GRG, You correctly get to the heart of the matter with the "loss of confidence" idea.

Whether some insurance companies are acting responsibly nationwide, I can not say (although my personal experience with auto, health, homeowners, etc. has been excellent)

However, to me, the larger and more dangerous issue is that some media outlets (Michael Moore comes to mind since WT mentions him) are irresponsible. In order to sensationalize or push personal political agendas they create this idea in people's minds that various institutions are not to be trusted. Everything from rampant police brutality to evil oil companies. From baby killer soldiers to the latest crisis du jour.

One should always be skeptical to a certain degree but only to a point. If one wants to kick the legs out from underneath a society what better way than to get the public to doubt its' fundamental institutions?

Do you know anyone who works in the insurance industry? I had a good conversation with a friend's wife who does. She is paid to reject claims. That's it. She said she's never allowed one. In five years. She gets all the info their research could dig up then she figures out how to deny the claim. Unfortunately, it is cheaper to hire a person to mindlessly reject claim after claim than to pay anything out.

I also thought this was a very interesting post:

George F. Will Admits Public Option Will Cut Costs

by Nate Silver @ 4:23 PM

Share This Content

George Will's latest:

The puzzle is: Why does the president, who says that were America "starting from scratch" he would favor a "single-payer" -- government-run -- system, insist that health care reform include a government insurance plan that competes with private insurers? [...]

Assurances that the government plan would play by the rules that private insurers play by are implausible. Government is incapable of behaving like market-disciplined private insurers. Competition from the public option must be unfair because government does not need to make a profit and has enormous pricing and negotiating powers. Besides, unless the point of a government plan is to be cheaper, it is pointless: If the public option conforms to the imperatives that regulations and competition impose on private insurers, there is no reason for it.

Emphasis in original. Will's argument is apparently this: The government does not need to make a profit and will have greater leverage with providers; therefore it will deliver the same service for less money. That's unfair!

Is this really the best argument that one of the most prominent intellectual conservatives can mount against the public option?

I'm a big believer in the profit motive in 99 percent of all cases. If the government decided to open a non-profit hamburger stand, I doubt that it would compete successfully against Five Guys. If it tried to open a non-profit airline, I doubt that it could offer the same value as JetBlue. Insert joke about General Motors and/or the Post Office here. The point is, I think the profit motive is generally well worth it in terms of the incentives it creates to cut costs, develop new products, improve customer service, and so forth.

But health insurance is not like those things.

Insurance exists because of the decreasing marginal utility of income: most people would rather have a 100% chance of paying $300 a month than a 1% chance of paying $30,000 a month. In fact, our hypothetical customer -- let's call him Frederick, after George F. Will's middle name -- might very well accept a 100% chance of paying $400 a month rather than take 1% chance of having to pay $30,000, which he might not be able to afford. This is true even though Frederick will lose $100 on this deal in an average month.

There's nothing wrong with this arrangement -- the customer has improved his marginal utility and the insurance company has made $100. It's a win-win.

The thing is, though, that the insurer hasn't had to work particularly hard for his $100. He hasn't had to figure out how to cook up tastier fries or save you a few bucks off the cost of your next flight to Orlando. All he has to do is to have a bunch of money pooled together, such that he has a different marginal utility curve than you do. He has the luxury to accept the risk of unlikely outcomes, particularly if he can hedge his position by making the same deal with other customers, most of whom won't wind up requiring an angioplasty or cataract surgery, even if Frederick does.

Now, what's supposed to happen in the free market is that another company will come in and offer Frederick a better deal: they'll offer him the same coverage for $350 a month, accepting a smaller profit, and Frederick will happily take the deal. There are at least a couple of reasons, however, why this may not be happening in the insurance industry. The first is that Frederick might not realize he's paying $400 every month for insurance. That's because if he's like the majority of Americans, he's getting his insurance through his work, and except when the HR lady gave him a shiny brochure on his first day at the office, he's probably never thought very much about what this insurance is costing him in terms of foregone salary. This is particularly so because health insurance benefits, unlike other types of income, aren't taxed, and so Fredrick is less cognizant of them if show up on his paycheck at all. Not only, then, is the free market maxim of perfect information violated, but it's violated in such a way that creates artificial profits for the insurance industry: the government is effectively subsidizing every dollar that Frederick's company is willing to spend on his insurance benefit.

The profits the insurance industry is making, of course -- profits artificially boosted by an enormous backdoor tax subsidy -- don't seem to be buying the customer much of anything in terms of improved service or cost savings. On the contrary, health care costs are rising by as much as 9-10 percent per year, without any concomitant increase in the level of service. If JetBlue were raising the cost of its fares by 10 percent per year, they'd be out of business.

The reason the insurers are staying in business, though, is because barriers to entry in the health insurance industry are in practice quite high. Insurers benefit from pooling risk. The larger the pool, the better in terms of the insurer's ability to hedge its risk and build negotiating leverage with its providers. That makes it very difficult for a Five Guys or a JetBlue type of start-up to compete: they'll have trouble getting together enough customers to pool their risk adequately, and even if they do, they won't have as much negotiating leverage as the big guys. Health care providers may demand a better deal or refuse to accept them. As such, they'll never get off the ground.

Insurance, in other words, is a volume business, the main requirements for which are that (1) you have a lot of money pooled together and that (2) you've been around for awhile.

CIGNA and Aetna have a lot of money pooled together and they've been around for awhile -- but they don't have as much money, nor have they been around as long, as the federal government. It's possible, certainly, that the profit motive in the insurance industry has driven more innovation than we're giving it credit for. But that isn't my bet, and it isn't George Will's: There's no obvious reason that the government couldn't provide more for less. And if we are wrong, we would find out soon enough: if the public option can't deliver more bang for the buck than private insurers, it wouldn't gain much market share from them, and Will will have nothing to worry about.

What Will's position reflects instead is ideology: who cares that the federal government could build a better mousetrap? They're the government and that's bad. His argument is really no more sophisticated than that. If a libertarian conservative wants to make this argument, more power to them, but they absolutely should not be turning around and suggesting that a public option would raise health care costs. They're saying, rather, that they're morally opposed to the cost savings that would ensue.

If you've been reading me for a while, you'll know that, as compared with most self-described liberals, I'm unusually sympathetic toward the notion of the profit motive and private industry; I've defended Wall Street bankers and the AIG bonuses at various points during the financial crisis, among other things. It's my belief that private industry is usually able to deliver more efficient outcomes to the consumer than the government could.

But usually isn't always. And health insurance, as Will seems to admit, is one of those exceptions.

http://www.fivethirtyeight.com/2009/...tion-will.html

[GRG55]

Re: Hospital Gowns On FIRE

Do you know anyone who works in the insurance industry? I had a good conversation with a friend's wife who does. She is paid to reject claims. That's it. She said she's never allowed one. In five years. She gets all the info their research could dig up then she figures out how to deny the claim. Unfortunately, it is cheaper to hire a person to mindlessly reject claim after claim than to pay anything out...

So, did you ask her which insurer provides her medical coverage? ;)

[Jim Nickerson]

Re: Hospital Gowns On FIRE - How about Hospitals

Probably a good approach for everyone to any drug, even non-prescription medications...



Good question. As someone who has received both lousy and excellent [purely my judgement] service at the hands of doctors, lawyers and accountants I wish I had a good answer. It seems to depend more on serendipity than I would care to admit...

Well, GRG, you might best face up to the fact and call a spade a spade. It is serendipity to a large extent.

Perhaps BK will provide a suitable and realistic answer, but my bet is neither he nor anyone else will.

What doctors change and what insurance companies reimburse for the charges or allow as further billable to patients has nothing to do with the benefit that the patient might have received from the "service." Since it probably is near impossible to determine the actual benefit from the patient's perspective, the rationalized argument is that the only way for the doctor to be compensated is based on what he apparently does--which in reality might be or have been the provision of "good medicine" or "bad medicine." Who rightfully knows, I bet you it is not the average or even above average patient?

To my thinking the only solution is to put all doctors on salaries, offer some incentive if it can be determined there is truly some superiority of care by some, and make care available to everyone.

The rationing and waiting lists arguments as related to a national healthcare system in the US are bullshit as far as I see. Right now there are 48M Americans on a waiting list because they do not have insurance and thus whatever care they may receive is certainly rationed.

[flintlock]

Re: Hospital Gowns On FIRE

Well GRG55, what they have to gain is not paying out on claims while collecting premiums of course. That's fairly obvious. But I'm not convinced its only about profit. I think its sometimes just in response to what they see as being taken advantage of. The hospital runs up the bill, the insurance company rejects it, and they settle somewhere in the middle. Its all tit for tat between the two businesses while the patient becomes an afterthought.

Unfortunately, there's no performance requirement in medicine. If you pay me to install a new light fixture, it had better work, or I don't get paid. But medicine doesn't work this way. Of course this is hard to apply to medicine but sometimes I think we'd see a lot better job being done if it did apply.

I've seen an interesting phenomenon concerning insurance and how it works when applied to something like home repair. People buy these Home warranties. There's a $50 deductible and they cover named items that may break on the home. Sounds great right? But what I've seen over the years is many people complaining about them. They either flat out refuse coverage based on silly exemptions or they send out the absolutely least qualified individual to "diagnose" the problem. They spend five minutes knocking around, without so much as putting on a tool belt, proclaim it to be a non-covered item, collect their $50 and their off. I've seen them. So called plumbers working out of a mini pickup with a small toolbox in the back. That's because they have no intention of fixing anything. They are there for the quick $50. And the insurance company can always claim they had a "licensed contractor" check it out, so they have no incentive to help.

Well you often get the same thing these days with medicine. Revolving door service, with very little real attempt to help the patient. And a lot of the effort they do put in is more about avoiding legal problems than helping the patient. This one price for everybody thing seems to just kill the incentive to do a good job.

Not all health care providers are that way, probably not even a majority, but there's a lot more than there used to be. They seem jaded. I've had some really good and some really bad experiences. The good ones I really admire.

World traveler, thanks for being honest about your coverage. I think reasonable people realize it when they have good insurance , and that not everyone has it that good. And those who think they aren't paying much for health care just don't realize what they really are paying. You're paying for it, every time you write that check to the IRS, you are paying.

Fact is, the current system is broken. It doesn't work efficiently. It's beginning to lose effectiveness. For every miraculous knee replacement surgery, there's a person dying from some stupid oversight. I don't really know what the answer is, but I can tell you what we have now won't continue to work and we can't afford it to boot.

[Munger]

Re: Hospital Gowns On FIRE

So, did you ask her which insurer provides her medical coverage? ;)

I mean, it's really not that difficult of a concept. Certain people with certain risk profiles simply do not make enough money to pay the cost of their insurance. If you've had cancer, for example, 99% of the population is not going to be able to afford the premiums. There is thus zero reason for the insurer to actually pay your cancer treatment bills and thus keep you as a satisfied client: They don't want your business anymore, and they will do most anything to keep from paying.

[don]

Re: Hospital Gowns On FIRE

Note on the Aetna $10k procedure/$150k room & board limits policy that launched this thread.

According to an Aetna spokesperson it is no longer being offered.

So much for the the excuses....