"No one should make profits off of our healthcare"

[lendaddy]

This is what I heard Michael Moore say in an interview on CNN and I've heard others here say the same.

To me this shows a fundamental lack of understanding in regards to the capitalist system and the superior results that are it's fruit.

If you believe the title phrase then you must believe that capitalism is an inferior system in regards to results. I don't understand how anyone can say such a thing. I think it's just an emotional response to problem that requires anything but emotion, it certainly isn't an intellectual one.

[Nathans_Dad]

You can't be surprised by this, Moore lives in a world, but it isn't reality...

[lendaddy]

To add, he used Medicare/aid as an example of how well socialized medicine is already working in the US. This might even make a little sense if it were a stand alone program, but it's not. It gets all the benefits of the doctors, equipment, facilities, advances, etc that the capitalist system created.

[onewhippedpuppy]

Reasonable profits are fine, but in many cases in our country it amounts to price gouging. The entire industry - health care, insurance, perscription drugs, and malpractice, is in dire need of reform.

Health care is one area where pure supply and demand is not sufficient, because the demand is a constant. Someone facing death will pay, regardless the price. In the past, professional integrity kept costs fair, but those are foreign words in this age. Controlling the insane malpractice suits, and putting in place cost ceilings would be a good start. Drug costs, care for illegals, and the insurance system are also a real joke.

Edit: Moore is a socialist loonie, and I don't even begin to agree with him. But the system is out of control.

[Porsche-O-Phile]

Yep. I disagree with the notion of socialized medicine, but I also disagree with the way our system is run. When a pill that costs 20 bucks in Canada or any other country in the world costs $6,000 here in the U.S., something is MAJORLY out of whack.

[hardflex]

Are you comfortable with the fact that Insurance co. employees are paid bonuses for denying payment of claims to insured people? People who paid who paid premiums and thought they were covered? Is this the type of Capitalism that brings out the best in Humanity, that inspires people to forsake greed and do what's best for others? I'm not.

[MRM]

What insurance company employees are paid bonuses for denying covered claims? Can you cite an example?

[kach22i]

Nixon and HMO's are in the very first part of the movie "Sicko", everyone needs to see this film. It contains many historic facts, and on tape!

[widebody911]

Originally posted by MRM
What insurance company employees are paid bonuses for denying covered claims? Can you cite an example?

You didn't see the movie, did you?

[lendaddy]

Originally posted by hardflex
Are you comfortable with the fact that Insurance co. employees are paid bonuses for denying payment of claims to insured people?

Capitalism is not a license to steal, crimes are still crimes. If a company were paying bonuses to people for denying legitimate claims, then they should be in jail. Corruption is everywhere and we have laws for such things.

[CurtEgerer]

>>>Are you comfortable with the fact that Insurance co. employees are paid bonuses for denying payment of claims to insured people?<<<

And the US government blew up the WTC ..... that is total bull*****. I've worked with insurance adjusters on a daily basis for over 15 years. What's your reference - Mikey Moore's schlockumentary or a personal injury lawyer billboard

[onewhippedpuppy]

Costs of medicine is just one example. Why is it that the hospital wrote off $6000 of an $8500 bill for our recent child, leaving Blue Cross with a mere $2500 bill? A friend of mine's brother recently had a child out of pocket, and it cost him nearly $9k. How is that fair or just?

[Porsche-O-Phile]

No more or less reprehensible than insurance companies trying to weasel out of paying ANY claim - Katrina comes to mind, as do hurricane victims in Florida and the gulf states (plenty of people that were left homeless by Charley, Ivan, Wilma, etc. still fighting their cases and living in trailers to this day).

Insurance companies are the scum of the earth. I avoid them like the plague. Nobody should be FORCED to carry insurance. Massachusetts is trying that with a minimum health care coverage requirement for all residents now. I find this to be little more than a suck-up to the insurance industry. I say keep it personal choice, but regulate the hell out of them, tax the schit out of them and when they screw up (such as when they play games of trying to "string along" claimants and out-last them because their pockets are deeper), make it public record. No more of these "no admission of guilt" settlements. Then you'd see some reform and some competition on what they ought to be competing on - service and premiums.

[hardflex]

Are you saying there is NO Company that paid Bonuses? Or that in your experience you have seen none. Can you make a blanket statement for the whole industry?

[kach22i]

Originally posted by CurtEgerer
What's your reference - Mikey Moore's schlockumentary or a personal injury lawyer billboard

The Congressional record, sworn testimony of insurance workers.

Yea, it's in the film Sicko, I guess you assume it was just a staged reenactment?

[lendaddy]

Originally posted by hardflex
Are you saying there is NO Company that paid Bonuses? Or that in your experience you have seen none. Can you make a blanket statement for the whole industry?

Bonuses for denying claims that should be denied is fine, that's their job. If you can show me a company policy giving bonuses for legitimate claims denied then you'll have something. Even then you should be upset with your gov for not prosecuting such obvious crime.

[hardflex]

Dr. Linda Peeno...

"But I left Humana, and I went to a nonprofit HMO that was owned by hospitals, thinking that things would be different, that it would be more patient-centered. And it’s interesting, in the movie SiCKO, there’s actually an account of a young man who was denied, and it was through the employer, which was a hospital. And so, that was the beginning of my education about just the way in which managed care worked, that you made money to the extent that you denied, limited, substituted or obstructed care. And it wasn’t patient-centered."

[MRM]

No, I didn't see the movie. The statement was that insurance company employees were paid bonuses for denying claims. I find that statement remarkable and if true would revoke the license of that insurer in any state.

Most large insurers paid their executives bonuses last year based on the profitability of their company. Some companies have bonus or stock option programs for employees based on the profitability of the company. I have never heard of companies tying an individual employee's compensation to the type or number of claims they deny. I suppose you could argue that companies are more profitable if individual adjusters deny claims, but the incremental effect of denying any claim in negligble to the average insurer with billions of dollars in premiums and reserves.

[lendaddy]

Another point, if proof of such denial is so available then why isn't every P/I lawyer in the US beating a path to these folks?

[911teo]

The capitalist system and free market are wonderful but sometimes their caractheristics are not suitable for and should not be accepted by a modern and mature society.

Example:There are regions (in any country) that are not profitable to serve. It is a net loss to get electricity, phone, water, trains, busses, roads, police, firebrigades, school, postal etc. services to small little villages/cities in the middle of nowhere.

Should we just write these towns off and force the people to move? Our capitalistic system should tell us that the people that live there should either pay an exorbitant price or move.. Well school are free everywhere in the US, I pay the same if I want to send a letter to NYC or to the middle of nowhere in Nebraska etc.

You see we already have some socialized services in our free and capitalistic society. Everybody pays a little more but in this way the little cities can have the same services people in NYC, Boston etc enjoy.

The health care system albeit more complex is a perfect example where a pure capitalistic approach is not applicable because of its side effects.

It is a shame that someone cannot realize that bad things can happen to anybody and you can prepare as much as you want but when the brown matter hits the fan then you are deep in it. And usually then it's when a capitalistic system leaves you high and dry.

Why should an insurance company not take advantage of a little clause in the contracts that allows them to refuse coverage for a risky and costly operation? They are there to make money. Their shareholders (me/you/everybody) would be upset if they lost money because they allowed and expense that could be avoided.

But it this is not how it should work...