Today there is a terrific post by economist Les Boden of Boston University School of Public Health over at The Pump Handle. It's about something many people here probably aren't interested in -- workers compensation. But the underlying issue should be of interest to everyone in the US and many other places.
It's about a giant and influential international industry. The insurance industry:
If something bad happens to an insured person or company, the insurer is supposed to help soften the financial blow. You need a $50,000 operation and your medical insurer is supposed to cover most, if not all, the cost. A restaurant burns to the ground and the property/casualty insurer is supposed to cover much of the cost of the damages.But insurers also are investment institutions. We pay the premium, they invest it, and then they pay it back to those of us who suffer losses. During the time between when we pay the premium and insurers pay policyholders for covered losses, the insurers invest the premium and get a return. In effect, for the months or years between premium payment and insurer payout, they borrow our money without paying us interest.
If insurers, on average, pay out 100% of premiums, it's a good deal for them. They have borrowed money interest-free and made money investing it. Of course, if they can pay out less than 100%, they have even a better deal. (Les Boden, The Pump Handle)
In other words, insurance companies are banks that borrow your money without paying you interest. Reading Boden's post is absolutely infuriating. It's about how insurance companies increase their already handsome profits from investing the money they borrowed from you without paying you interest -- by not paying that money back at all. You have to read the details to get the full flavor of how egregious this is, but it explains a lot of other things. Like why your insurance company takes its time paying your claims; why they spend inordinate amounts of money ("expenses") figuring out more ways to deny you your claims (and why this money, poorly spent from your point of view, is well spent from theirs); why they have lobbyists promoting "reform" (Boden's post is about how they cashed in when Governor Schwarzenegger instituted a "reform" of workers comp in California); why we haven't been able to get non private insurance-based universal health care in the US (the insurance industry would lose a huge pile of hapless "despositors" to their banks); and probably much more.
Grrrrr!
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Two things: 1) I clicked on your link and got a 404(page does not exist).
2) Suppose that you pay your first premium and then you get sick and need a $50,000 operation. And the insurance pays for it. I would say that you got your money back with interest.
If you criticize the fact that sometimes you don't get back from insurance as much as your premiums have been after years and years, then you are criticizing the whole concept of share the risk. Do you really mean to do that?
As to the other criticisms, I agree. Insurance companies sometimes become cheaters and weaselers. Amd I think it has been established that all insurance would be cheaper if it were all single payer. Isn't that what Hilary was trying to introduce?
Karl: I don't know what is wrong with the link. I'll have to go to the folks at TPH to find out why you can't get there from here. Meanwhile if you go to: http://thepumphandle.wordpress.com/
you'll see the post on the June 21 date. I have the right link but it isn't working from here.
Read it. It is really, really interesting. You'll get a better answer to your question there.
Worse yet, insurance company investments include hospitals and clinics.
Karl: Fixed now. Read Les Boden's post.
How about this. .
Unrealized gains on Dr. McGuire's (Founder & CEO) options totaled $1.6 billion, according to UnitedHealth's proxy statement released this month. (April 20, 2006)
Now that is OBSCENE! ! !
http://healthypolicy.typepad.com/blog/2006/04/united_health_g.html
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OK, I read it. Now, I don't want to get into a big argument with you BUT, it seems to me that what we have is an abuse of the system not a failure of the concept. It is because of this excess of premium over payout that there are insurance companies like Blue Cross - which is non-profit. (Disclaimer: I am retired from the local BC/BS company. But I was in the IT dept and had no input to rate setting or claims adjusting).
karl: If the system were just a system for risk pooling you would be right. But of course it isn't. Even non profits like BS/BC participated in abusing it in many ways. There are lots of ways to become "non profit" by getting rid of excess revenues and BC/BS has done it for decades. They are part of the problem along with the profit making insurance companies. You may disagree (and I expect you do). But they are not cheaper, do not keep costs down and are in bed with the medical industry (including the doctors). I am a doctor so I am criticizing my own. I also have worked for Universities who I think have not been such great role models as institutions. I love my job but that doesn't mean I think everything huge research universities do is good.
But its our right at this particular time to participate in the organized crime of insurance Revere. I own stock in the companies that I participate in. I pay a lot of money in insurance and not just for medical. Its a crap shoot for sure as you say. On the other hand, this relates to UHC I think is where you are heading with this. You believe that everyone has the right to healthcare. I dont. Its a frill that our forefathers didnt have and in the 40-90's was something that was included generally in employment packages. It was the THING that everyone wanted.
Okay, it lasted right up until the time that malpractice insurance claims went up and awards went out of this world. Drugs that were bullshit (different subject) and then we became uncompetitive in the world market. So employers decided to start limiting and then dropping insurance as part of the package. Thats the reason so many are uninsured now or the cost of coverage is out of the reach of so many. But its a right, in the Constitution, or law somewhere that everyone has to have insurance/healthcare.
So we raise the minimum wage three times in the last 12 years. Hmmm. makes us more uncompetitive. The spiral will increase vertically for costs the second they implement it, and more will go out of work. Social Security is bust. Now lets add something that will give us cash flow BUT we still have to pay the bills at the end of the road. That road will end with the generation thats coming up now. They wont be able to support S.Security, the difference in costs against income in UHC, AND raise a family. In ten years the housing market also collapses as the oldies start to die off. Used houses will flood the market. So the one industry that has always lead us out of recession, will be the one that leads us into depression. In the 50's when Detroit got a cold, the world felt the chill. If the insurance companies get knocked out of the re-investment of premiums you'll see the market fall easily 2-3000 points.
They arent stupid Revere and they see UHC coming. They are going to start to get very friendly, very soon. If they dont, they'll go by the wayside just as they did in TennCare. The end result is a huge pool of elderly sick people and someone is going to have to pay the short falls and that means taxpayers. Since there will be so few of them they wont be able to. So who do you think they will tag? The bonds but alas all the bonds will be worthless due to inflation. Paper chasing paper. No real worth. Thi is the reason I say that UHC will be our downfall. But, it will be the last thing that goes. All social programs will be gone, all research and grant money for universities gone, space program gone. But the people that will suffer will be the poor. Medicine will become rationed by the government as the costs outweigh the income. It will happen very, very quickly. It will be just like Social Security. Too many people dragging on the system. You'll disagree. But the USGovernment doesnt manage Medicare/Medicaid, the VA or anything else very well and you want to hand them a new barrel of money to steal from. The insurance companies will simply move into investments and secondary or primary insurance for those who opted out.
You also will be handing maybe not this election or the one after that to the Republicans, but surely number 3 will usher in a whole new era. They will dump it and move ahead with plans to make it a states issue rather than a federal one.I know I wont particiapte in it if I am able. But there's the biggest problem. They wont give us the option and therefore it will be a tax, just as S. Security used to be optional. If I had all the money I had dropped into S.Security and I had gotten even 3% interest, I could have retired two years ago. All ambiguous because they just take the money and deliver nothing for it. Just like this will be.
I don't know about most of what Kruger said except for this:
"If I had all the money I had dropped into S.Security and I had gotten even 3% interest, I could have retired two years ago."
I am retired and receive SS. I paid into it for 50 years. the total I paid into it was about $60K. If I had invested that $1000/yr at 3%, I would now have about $116K which, at current rates (about 5%) would be earning me $5800/yr. I now receive from SS about $1700/mo, that's about $20K/yr. How many years will it take for me to get back to even? If I live another ten years, how will I do?
That line about SS not being worth it is a base canard.
Karl, most of what Kruger says is unsupported by reality. I've seen I don't know how many posts of his saying that Universal Health Care will completely ruin the country and the economy, and not once has he addressed the fact that every single industrialized nation in the world except us already has it and somehow managed to avoid his prophecies of doom and gloom.
There are valid arguments against Universal Health Care, I admit, and those have to be addressed, but Kruger generally depends on throwing out so many invalid and off-the-wall claims that no one really wants to argue with him. This is actually one of his shorter posts, if you can believe it.
Karl, I am already well past 80K paid into it. To take care of me during my retirement years which are about 15 into the future if it stays where it is now for retirement, the system will be broke before I reach it. 80 K into the stock market from the time I was 18 would have generated about 15% annually. When the system goes broke it means inflation, thus increasing the actual money needed to survive by what some say will be half. In otherwords too many people on the dole. They will tax what they already taxed to cover the shortfalls and then roll it over...again. But if you add UHC into the program and it goes insolvent, this will put a double whammy on the economy because the only way they will be able fund the shortfalls is via taxes and increasing that single payer rate...as they have in all of those industrialized nations that Captboorshi speaks of. Their industrial bases are sinking, just as they are here and their standard of living is decreasing as well. This is another one of those invalid arguments that the Capt. isnt aware of. The Germans have had to cut services in their UHC AND increase the rates in the last two months. Why? People are moving back into traditional insurance because their doctors have had enough paperwork and slow payment from the government.
"Single-payer health care is a system of paying for health care, in which a single government entity pays for all health care costs, usually from taxes. Private hospitals and doctors' practices may remain private. Single-payer health care is distinct from socialized medicine, in which hospitals are run by the government and medical professionals are employed by the government."
The rates are negotiated by the govt and doctors. Just as they did here in Tennessee. CaptB as far as I know didnt participate in this program, but it sure bankrupted the state budget. Again, I dont know what I am talking about though. Previous posts that came from more than 3 sources showed it was a disastrous undertaking and ended up putting a lot of doctors and companies out of business. Some never got paid by the state run operation under "single payer." Almost a billion dollars worth.
Revere is right though. Insurance is a racket and the banks and the Ins. companies are in cahoots. You cant finance anything without insurance on it if its past about 5000 in value. Many companies now self insure for about 1 million by going to the bond market.
I suppose one could always take the Ned Flanders route: "Ned doesn't believe in insurance. He says it's a form of gambling."
While reading this post I was just handed our company's monthly invoice for medical insurance. We cover 33 employees with our group plan (an even mix of family and single coverage) for a total of $18,000 per month, or $216,000 per year. The premiums work out to $4,909 per individual covered. Coinsurance, Copays and deductibles account for 20% of claims.
The insurance companies that we have had quote our business over the years have consistently told us that the target claim to premium ratio is 75% (+/- 2%). Thus a gross margin of 25% before expenses.
Just an FYI post.