An Inconvenient Truth

[FRPLG]

Originally Posted by Hog1

Soooo, actually the insurance companies are.................the GOOD guys?

Why do there have to be good guys and bad guys? You think there are groups of people sitting around thinking "Hey lets stick it to our customers again!". No they are making money which is their job. Good or bad it is the way it is. Remember: money drives the whole issue both positively and negatively.

[FRPLG]

Originally Posted by Hog1

It IS a complex issue.
It is one of the MOST F..... up things in this country today. If it can be fixed, there is fault somewhere and needs to be addressed. As it is, it is a mess. Millions of Americans do without. If it can't be fixed, let's start over. Now, back to my original premise..............

REALISTIC solution is??????????

I honestly don't think there is a realistic solution that can satisfy all the needs and wants of society. An adjustment of expectations is what is needed as well as changes to mee the more realistic wants.

[Hog1]

Originally Posted by FRPLG

Why do there have to be good guys and bad guys? You think there are groups of people sitting around thinking "Hey lets stick it to our customers again!". No they are making money which is their job. Good or bad it is the way it is. Remember: money drives the whole issue both positively and negatively.

Honestly, I believe that with this kind of $$$ involved, and the types of profits being realized by the insurance companies, to surmise there are no bad guys reaping gigantic gains is rather naive. With money "driving the whole issue" you can.............."bank" on there being bad guys

[Hog1]

Originally Posted by FRPLG

I honestly don't think there is a realistic solution that can satisfy all the needs and wants of society. An adjustment of expectations is what is needed as well as changes to mee the more realistic wants.

Adjusment of expectations=somebody's gettin' screwed

[FRPLG]

Originally Posted by Hog1

Honestly, I believe that with this kind of $$$ involved, and the types of profits being realized by the insurance companies, to surmise there are no bad guys reaping gigantic gains is rather naive. With money "driving the whole issue" you can.............."bank" on there being bad guys

No I don't think it naive. Notice I didn't there are bad guys but rather there aren't groups of these guys meeting on Friday night to play poker and figure out other devious ways to make money. There are bad guys everywhere in all walks of life. I think I just didn't make it clear that as far as insurance companies go they aren't really the bad guys in and of themselves. They exist to make money. Nothing else. Their service is designed to make them money. Making money isn't some nice little offshoot of it.

I come from the mindset that companies are in business to operate efficiently and make money. I think this because it is the ultimate motivation for them to do a good job(not that they do but at least the environment is created so that they can). When they have the motivation taken away them they don't even have the chance to do a good job because why would they?

I don't begrudge any company from making money. As it is, to me, there's no economic system that will satify the wants and needs of everyone without flaws. I think that is the main reason that there isn't a healthcare system in the world that works 100%

As bad as our system seems to work all the state run healthcare systems around world have problems that, while different from ours, are in most cases just as serious.

[FRPLG]

Originally Posted by Hog1

Adjusment of expectations=somebody's gettin' screwed

Adjusment of expectations = knowing that not everyone can have the same stuff in life. Including the same healthcare. That's sucks and yes I guess someone gets 'screwed'. But getting 'screwed' infers that everyone is entitled to the same thing. Is everyone entitled to the same healthcare?

[Hog1]

Originally Posted by FRPLG

Adjusment of expectations = knowing that not everyone can have the same stuff in life. Including the same healthcare. That's sucks and yes I guess someone gets 'screwed'. But getting 'screwed' infers that everyone is entitled to the same thing. Is everyone entitled to the same healthcare?

I think everyone should be able to get health care. The SAME health care is a different matter. You want to pay more for better, so be it. Naturally, It gets far more complex, when you factor in welfare issues, illegal immigrants, etc. Everyone gets healthcare in parts of Europe. I have no personal experience with that. The people I know that do, say it takes forever to get an appt, but everyone gets seen, and it's................maybe ok, not great.

[MTK]

Originally Posted by Hog1

It IS a complex issue.
It is one of the MOST F..... up things in this country today. If it can be fixed, there is fault somewhere and needs to be addressed. As it is, it is a mess. Millions of Americans do without. If it can't be fixed, let's start over. Now, back to my original premise..............

REALISTIC solution is??????????

Realistic solution? Who knows, I'm not sure that there really is a realistic solution that will cure all the woes of the system. It's too far gone, it would need a complete reform which in all likelihood isn't realistic.

[JoeRedskin]

Originally Posted by FRPLG

No I don't think it naive. Notice I didn't there are bad guys but rather there aren't groups of these guys meeting on Friday night to play poker and figure out other devious ways to make money. There are bad guys everywhere in all walks of life. I think I just didn't make it clear that as far as insurance companies go they aren't really the bad guys in and of themselves. They exist to make money. Nothing else. Their service is designed to make them money. Making money isn't some nice little offshoot of it.

I come from the mindset that companies are in business to operate efficiently and make money. I think this because it is the ultimate motivation for them to do a good job(not that they do but at least the environment is created so that they can). When they have the motivation taken away them they don't even have the chance to do a good job because why would they?

I don't begrudge any company from making money. As it is, to me, there's no economic system that will satify the wants and needs of everyone without flaws. I think that is the main reason that there isn't a healthcare system in the world that works 100%

As bad as our system seems to work all the state run healthcare systems around world have problems that, while different from ours, are in most cases just as serious.

I work in the insurance regulation business and, I gotta tell ya, your right - I don't think the insurance co.'s sit around in rooms say "ah ha - we can screw those consumers (our customers) this way and that. But, I would say that insurance co.'s are VERY aware that the best business plan is to take in as much money as possible and pay out as little as possible and have considerably more resources than consumers to ensure that they can take advantage of "the system".

[firstdown]

Originally Posted by Hog1

I agree, who are you with?

I'm with Anthem but what you need is a person who only writes health ins. and let them shop prices for you. The lady I use will contact us about 1 month or so before renewal and lets us know of any changes and we can decide which policy & coverages are best for us.

[MTK]

Originally Posted by JoeRedskin

I work in the insurance regulation business and, I gotta tell ya, your right - I don't think the insurance co.'s sit around in rooms say "ah ha - we can screw those consumers (our customers) this way and that. But, I would say that insurance co.'s are VERY aware that the best business plan is to take in as much money as possible and pay out as little as possible and have considerably more resources than consumers to ensure that they can take advantage of "the system".

Personally I don't see it that way. I've been in the insurance industry for 5+ years now and as I see things, insurance companies pay when they are obligated to do so and a claim is deemed compensable. Yes they are careful and diligent when examining and adjusting claims to ensure they are paying what is due within the policy terms and limits, but that's just good business and it's not some sort of exclusive practice limited to insurance companies.

[firstdown]

I think you both are right and an insured should not complain when their Co. is making money that means that they can keep rates level and some may even take a rate decrease to drive more business toward them.

[JoeRedskin]

Originally Posted by Mattyk72

Personally I don't see it that way. I've been in the insurance industry for 5+ years now and as I see things, insurance companies pay when they are obligated to do so and a claim is deemed compensable. Yes they are careful and diligent when examining and adjusting claims to ensure they are paying what is due within the policy terms and limits, but that's just good business and it's not some sort of exclusive practice limited to insurance companies.

I actually agree that at the claims level, on an individual basis, yes this is pretty much true. Providing prompt service is part of being a profitable business.

With that said, however, insurance companies pay huge amounts to lobbyists who target laws beneficial to consumers that may end up costing the companies more. Likewise, when there is an ambiguity in the law, count on the company not to do what's "right" but what is cost effect from a policy (not insurance policy but policy as general practice) standpoint. The concern being that consumers do not necessarily have the economic clout to challenge the underlying legislative/policy issues and may not even have the basic knowledge that alternative applications/issues exist.

Don't get me wrong. I am not slamming companies (though there are some that truly deserved to be slammed - just like there are some consumers who game the system). Instead, I am simply pointing out that consumers and insurance companies have opposite profit motives (consumers want more for less and companies want to provide less for more) and that insurers are better equipped to marshall their considerable resources in order to protect and promote their profit motive.

[MTK]

Originally Posted by JoeRedskin

I actually agree that at the claims level, on an individual basis, yes this is pretty much true. Providing prompt service is part of being a profitable business.

With that said, however, insurance companies pay huge amounts to lobbyists who target laws beneficial to consumers that may end up costing the companies more. Likewise, when there is an ambiguity in the law, count on the company not to do what's "right" but what is cost effect from a policy (not insurance policy but policy as general practice) standpoint. The concern being that consumers do not necessarily have the economic clout to challenge the underlying legislative/policy issues and may not even have the basic knowledge that alternative applications/issues exist.

Don't get me wrong. I am not slamming companies (though there are some that truly deserved to be slammed - just like there are some consumers who game the system). Instead, I am simply pointing out that consumers and insurance companies have opposite profit motives (consumers want more for less and companies want to provide less for more) and that insurers are better equipped to marshall their considerable resources in order to protect and promote their profit motive.

I agree, thanks for the clarification. I was just too focused on your comment about them taking advantage of the system, but what you're saying here I agree with.

[Hog1]

Originally Posted by FRPLG

No I don't think it naive. Notice I didn't there are bad guys but rather there aren't groups of these guys meeting on Friday night to play poker and figure out other devious ways to make money. There are bad guys everywhere in all walks of life. I think I just didn't make it clear that as far as insurance companies go they aren't really the bad guys in and of themselves. They exist to make money. Nothing else. Their service is designed to make them money. Making money isn't some nice little offshoot of it.

I come from the mindset that companies are in business to operate efficiently and make money. I think this because it is the ultimate motivation for them to do a good job(not that they do but at least the environment is created so that they can). When they have the motivation taken away them they don't even have the chance to do a good job because why would they?

I don't begrudge any company from making money. As it is, to me, there's no economic system that will satify the wants and needs of everyone without flaws. I think that is the main reason that there isn't a healthcare system in the world that works 100%

As bad as our system seems to work all the state run healthcare systems around world have problems that, while different from ours, are in most cases just as serious.

I just had lunch with my commercial insurance guy (who has done very well with it). He corrected me as I accused him, and the spawn like him of racketeering, profiteering, and wearing an earring. His contention is that the insurance co's are getting what they need to stay in the game.
Live to fight another day Matty.
Closer to the heart, he tells (which I know is true, as I am dealing with it) the insurance co's are pulling out of Florida because of the loss's and liability related to wind/flood damage. He is accustomed to ins co's beating down his door courting him to offer their product. Taking him on trips, long golf weekends, Dolphin tickets, etc. He says, that is GONE. Never hears from anyone like that. His opinion is the atty's are reaping the fruit of the land. Far be it from me to me to protect the atty's.
THEY are the BAD guy's