ObamaCare Observation

This is just an observation I have had about the insurance companies providing coverage...

Ok so there is somthing called the 80/20 rule...

If an insurance company is participating in the market place and using tax payer dollars from the subsidies. Then it can only make 20% of the money they take in on premiums in profits. The other 80% they are required to use providing services..

If they make more than the 20% in profits, then they are required to refund the difference to their customers.


Well I have had Obamacare through humana since it started and every year I have gotten a refund check.

So obviously humana made their 20% in profits.

Well this year they have decided to pull out of the market place.

So logic would dictate that since they were already making their 20%. That would mean that 20% wasn't good enough for them right??


That 20% off the top of every dollar they handle, spent on healthcare wasn't enough for humana , even though they are not preforming a medical function?!?!?

Might that not be the reason healthcare costs are skyrocketing and have been for decades??

Because we are allowing middlemen to rape us for their profit margins... at the expense of people's lives no less..

a reply to: JoshuaCox

They have to pay everyone with that 20% and pay taxes (maybe) on all that prime real estate they have the skyscrapers with their name on.

I don't know the ins and outs, but 20% of the buckets of money they were getting seems like big bucks.

a reply to: JoshuaCox
The issue was , Obama's group wasnt fronting the subsidies as was stated by the Supreme Liar in Chief and his Dem cronies . Again , they stated one thing and did a 180 . Thats why the budget for the ACA looked low. FALSELY propagated.
And the numbers you hear about how many are signed up for the ACA. Total BULLSH** . I can tell you the reason for that firsthand. If you want to shop the ACA you have to create a login first. If you create a login , you are considered by the Liar in Chief's group of having ACA care . Whether or not you purchased a policy there .It took UHC a MONTH to get that straightened out for me where I could get a private policy with them. And the private policy was cheaper than anything within the ACA.
This piece of feces legislation needs to fail.

a reply to: Gothmog

Health care in the US is a massive goat screw, and the evidence is in other countries that do it much better for an affordable price.

We are lied to and health care is only one of the big lies.

a reply to: seasonal

Maybe the 20% is pretax, but I doubt it..they were involved in the initial negotiations. So I doubt their lawyers left an obvious hole like that..

I think more likely is the shareholders require constant growth to pay those buying stock that year..

A 20% cut is stagnant. They need 30% or 40% or constant expanding growth. That is the buisness model.



I don't see how they deserve anything, since they are just paper pushers taking a HUGE cut off the top...

But they definitely don't deserve more than 20%..


That's why we are the last modern country to use them. If you need to cut the fat, there is a big ole inefficient tube o lard right there.

a reply to: seasonal

I would like to apologize for calling you ultra conservative earlier. Might have been merging you with someone else..

My opinion on the topic remains but fair is fair.

a reply to: JoshuaCox

I agree, but their prices go up every year, so they do get more of that sweet sweet money.

I think it isn't enough. Hospitals charges are absolutely crazy with no rhyme or reason.

For profit medical is a horrible idea and it is going to crash because we no longer have the unbiased leadership to make a change.

a reply to: JoshuaCox

All good, if getting called an ultra conservative is all I get called it is a good day.


And for profit medical care is not going to work. It can't like you said, they need 3-6% every year increase. And until now everyone just thought it was because we are #1 and it cost alot to be #1.
The only thing we are #1 in is cost.

a reply to: Gothmog

The private policies are not their doing...

The policies are what the big insurance companies would agree to..

I really don't wanna spend any real time defending the ACA.. because the democrats totally caved when allowing the insurance companies in at all.

I do not doubt the plan was to install the ACA even if unsustainable just to get it started. Then swap to single payer later.


However the republican position is

"Y'all just continue to let the big insurance companies rape y'all because I'm in the payroll.. nothing to see here."

Even if people are literally dying in the streets in the most modern country on the planet.

originally posted by: seasonal
a reply to: JoshuaCox

I agree, but their prices go up every year, so they do get more of that sweet sweet money.

I think it isn't enough. Hospitals charges are absolutely crazy with no rhyme or reason.

For profit medical is a horrible idea and it is going to crash because we no longer have the unbiased leadership to make a change.

I think the insurance companies started a vicious cycle of people divorced from the costs of all the crazy unneeded tests and such.

Luxury items and all the everyday normal BS can be capitalism..

But the stuff that really matters have to be public..

Fire, police the military all would be disasters if privatized.. you would have corporate warlords and a real life dystopian future.

Well I would add healthcare to that list..


Pay all the drs., nurses file clerks , researchers. , exc .. but cut out all the insurance companies, shareholders and overall hospital profits.

originally posted by: seasonal
a reply to: JoshuaCox

All good, if getting called an ultra conservative is all I get called it is a good day.


And for profit medical care is not going to work. It can't like you said, they need 3-6% every year increase. And until now everyone just thought it was because we are #1 and it cost alot to be #1.
The only thing we are #1 in is cost.

It's very easy math...

a reply to: JoshuaCox

I don't see how they deserve anything, since they are just paper pushers taking a HUGE cut off the top... But they definitely don't deserve more than 20%..

I sincerely agree. The insurance companies are the middlemen for health care. Now it is illegal to refuse to put a middleman between me and my doctors. That's messed up in a country that claims to believe in freedom.

a reply to: diggindirt

Which was the far better option than the republican plan of..

Get paid off to deregulate the insurance companies..

a reply to: JoshuaCox

I can't say it's a partisan issue. I say both parties are wrong because the federal government has no business meddling in my health care if I am paying the bill. I'm a free market libertarian. Regulation of the insurance companies is the affair of the government because they are authorized to regulate business. The rub comes when they are paid off by the very people they're supposed to be watchdogging. Both parties are paid off so I don't see the difference. The Republicans don't really want to repeal the current mess. That has become abundantly clear. A pox on both their houses! Good docs who actually got into medicine to help people are leaving the profession rather than have an insurance company dictate how they will treat a patient. The paperwork has become so cumbersome that it is practically impossible to have an independent private practice. Payments are slow and now revenues are dropping because all those folks who couldn't afford insurance aren't able to pay their deductibles. My doc is seeing patients in his office now that he formerly treated at the local free clinic. Now that they have insurance they don't qualify for services at the free clinic. But they're still just as broke and can't pay the deductible for the insurance so he has to write that debt off in his practice. That just makes more paperwork for his staff. He was behind Obamacare 100% until the law of unintended consequences hit him.
It's a people issue but as long as the politicians are fat, happy and get the very best of health care, we the people are pretty much screwed. They've convinced a majority of people that your health should be controlled by the government.

originally posted by: JoshuaCox
a reply to: Gothmog

The private policies are not their doing...

The policies are what the big insurance companies would agree to..

I really don't wanna spend any real time defending the ACA.. because the democrats totally caved when allowing the insurance companies in at all.

I do not doubt the plan was to install the ACA even if unsustainable just to get it started. Then swap to single payer later.


However the republican position is

"Y'all just continue to let the big insurance companies rape y'all because I'm in the payroll.. nothing to see here."

Even if people are literally dying in the streets in the most modern country on the planet.

You really need to read my post. (which you didnt)

a reply to: diggindirt

Then prices would and have continued to climb and insurance companies would have continued denying people's claims as a policy....


You only have 2 choices...

A) trust big buisness

B) trust the government


There is no third option....

It is either or and at least the government is beholden to us through the voting process..

Big buisness is beholden to nothing but profits and profits tend to be better the more predetory your buisness practices.


Our problem with healthcare didn't start under obama care.. it reached the tipping point.

Why do you think we are the last modern country to use insurance companies.

a reply to: Gothmog

Oh I did...

I'm just pointing out that the republican plan of "pretend there is no issue and continue allowing insurance companies to rape and pillage" is worse than the ACA...

For all its faults having subsidies, pre existing conditions and eliminating the policies that pretend to cover you but do not. Is at least progress..

The GOP plan is always...

"Deregulate them and they will decide out of the goodness of their hearts to pay more and provide better services!"

Which has never, ever been the case.

a reply to: JoshuaCox
Okay, if you believe the politicians are beholden to us....I don't know what to say.
I believe they are beholden to the large corporate entities that pour literally millions of dollars into their campaigns.
That's why I believe we would actually be better off if we simply held a lottery of eligible voters to decide who represents us in DC. Drawing names from the voter lists would keep down the numbers of actual crooks. Limiting terms would relieve us of folks like Moneybags Mitch and Nutso Nancy.

a reply to: diggindirt

I've got 2 words for you if you think politicians are not beholden to us..

Donald Trump...


None of the establishment wanted him and he won..


That isn't to say that the system is not broken.. corruption has been a problem and far too profitable for most of human history.. but for the first time in history we actually have the technology to stop it..

We can track every government dollar to its source..

So now they have swapped the argument from being..

" the problem with government is corruption"

To

"The problem is government!"

Which is patently ridiculous.. everything comes from the government..

All ownership all everything..

If there is no government there is no ownership..

Without the government you don't own your house, the local warlord owns your house..

Most of conservative policies are based around that logical fallacy..

It's not that corruption in unions is wrong, no it is unions that are inherently evil.


Government is the only check on big buisness. And buisness has no voters to cater to.. they operate solely on profit and for some reason raping and pillaging society is inherently profitable.


I think as automation and technological advancement continue to take jobs, we get to rethink everything..but sadly a lot of people will feel a lot of pain before we adapt or die.

a reply to: JoshuaCox
Donald Trump is one guy. It's the other 535 political representatives who can be bought off that worry me. They are the ones who can collude with big business (Too big to fail?) and merge corporate and government for the fascist mess in which we now find ourselves immersed. When the corporate entities, be they BigBanks, BigInsurance, BigPharma or BigAg, get themselves big favors from elected officials....that one guy...the president, is actually not very powerful. It wasn't Obama who made me into a criminal, it was Congress.
You are entirely correct to say that the problems with our health care industry didn't begin with Obamacare. It actually began with Medicare. I'm old enough to remember when it was still a fairly new thing in the early '70s when I entered the health care field. My boss warned me that by the turn of the century, I would be working for the government. He didn't miss it by much...but I avoided it by changing careers and getting out of the Medical-Industrial Complex. Today's medical personnel are much more concerned with following protocol than with the actual health of their patients. Making a mistake on paperwork can be disastrous.
There was a time, in living memory, when a simple visit to the doc didn't cost you a day's pay. There was a time, in living memory when health insurance was mainly for hospitalization and didn't cost half a year's pay. In 1963 my Dad paid $36.00/yr for insurance for a family of four. By 1973, when I purchased my first family policy it was $160/yr. What changed? Medicare was visited upon us with government telling docs what their charges should be and loading them down with paperwork that they had to hire people to fill out and submit. This was the time that government started handing out "free" lunches and actually got people to believe that food was "free." As my Dad said at the time, "If the people will believe that they'll believe anything." He's been proven correct.