Comments on: Medical Loss Ratio http://www.ravinglunacy.org/index.php/2009/07/12/medical-loss-ratio/ where memes come to die Tue, 27 Sep 2011 21:42:22 +0000 hourly 1 http://wordpress.org/?v=3.2.1 By: Ken Shumaker http://www.ravinglunacy.org/index.php/2009/07/12/medical-loss-ratio/comment-page-1/#comment-8650 Ken Shumaker Thu, 23 Jul 2009 16:01:09 +0000 http://www.ravinglunacy.org/?p=699#comment-8650 For-profit health insurance companies have added nothing but costs and aggravation to the American health care system. I worked in health care information systems for 40 years and observed the complications and delays introduced by insurance companies as they drove profits by reducing risk. The "medical loss ratio" was clearly slanted at Wall Street and insurance companies worked diligently to minimize the dollars that went to hospitals, doctors, nurses, therapists, etc. At the same time they produced pain and suffering for healthcare providers, they lined the pockets of executives, built elaborate headquarters, and cultivated Wall Street investors to increase the value of their stock options. Even worse than the "Medical Cost Ratio" charade though were the costs forced on hospitals and doctors as they had to add clerical staff to cope with denials, approvals, and the evil machinations of the insurance industry. Another ratio not talked about in the current health care debate is the quadrupling of the clerical staff in hospitals and doctor's offices to cope with the insurance demands. Harder to quantify is the agony of patients and their families as they are bombarded by separate bills and statements from hospital, anesthetist, surgeon, pathologist, radiologist, physical therapist and are forced to learn a new language of co-ordination of benefits, usual and customary charges, co-pays, deductibles, gatekeepers, etc. If a patient is sick when they enter the medical gauntlet, they have a relapse when they exit the health care system and face the scourge of paperwork spawned by our flawed health system. The United States needs a universal, nationwide, consistent health system. The Medicare medical loss ratio is higher than for-profit and even non-profit insurers. (A higher percentage of money actually pays for health care.) The government plans have lower costs and less patient and provider aggravation. Congress needs (for once) to fight off the lobbying dollars of the insurance companies and put in place a government specified and administered public plan. It is absolutely true that the nationwide public plan will be cheaper than the private insurance plans in the long run. In the short run, however, it may be more expensive as the private insurers dump their sickest and neediest patients on the public plan while milking healthy patients and families for profits. There is no reason for private insurers in health care. There is no reason to have Wall Street profits dominate our two most important industries - health care and education. For-profit health insurance companies have added nothing but costs and aggravation to the American health care system. I worked in health care information systems for 40 years and observed the complications and delays introduced by insurance companies as they drove profits by reducing risk. The “medical loss ratio” was clearly slanted at Wall Street and insurance companies worked diligently to minimize the dollars that went to hospitals, doctors, nurses, therapists, etc. At the same time they produced pain and suffering for healthcare providers, they lined the pockets of executives, built elaborate headquarters, and cultivated Wall Street investors to increase the value of their stock options.

Even worse than the “Medical Cost Ratio” charade though were the costs forced on hospitals and doctors as they had to add clerical staff to cope with denials, approvals, and the evil machinations of the insurance industry. Another ratio not talked about in the current health care debate is the quadrupling of the clerical staff in hospitals and doctor’s offices to cope with the insurance demands.

Harder to quantify is the agony of patients and their families as they are bombarded by separate bills and statements from hospital, anesthetist, surgeon, pathologist, radiologist, physical therapist and are forced to learn a new language of co-ordination of benefits, usual and customary charges, co-pays, deductibles, gatekeepers, etc. If a patient is sick when they enter the medical gauntlet, they have a relapse when they exit the health care system and face the scourge of paperwork spawned by our flawed health system.

The United States needs a universal, nationwide, consistent health system. The Medicare medical loss ratio is higher than for-profit and even non-profit insurers. (A higher percentage of money actually pays for health care.) The government plans have lower costs and less patient and provider aggravation.

Congress needs (for once) to fight off the lobbying dollars of the insurance companies and put in place a government specified and administered public plan. It is absolutely true that the nationwide public plan will be cheaper than the private insurance plans in the long run. In the short run, however, it may be more expensive as the private insurers dump their sickest and neediest patients on the public plan while milking healthy patients and families for profits. There is no reason for private insurers in health care. There is no reason to have Wall Street profits dominate our two most important industries – health care and education.

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