surprise, surprise. I would have never guessed the hospitals would have figured out a way to shift the costs to auto insurers. Next thing you know they will be shifting costs to the Gen Liab policies in every case they can. Ooops they already figured that out to. Oh well.
Used to be you could pretty much trust the Hospital bills as being inviolate. Not any longer. Here’s a thought, if you’re not comfortable with the health insurers’ attempts to pay a lower amount than your bill, then lower your bills to more respectible levels!
And that doesn’t even really consider the med pay only claims for HO policies and the like. It’s amazing how much is paid just because it would cost too much to fight it. I don’t blame the hospitals. They need to make more than pennies on the dollar but any which way you slice it, we all end up paying for it. Watch those premiums rise.
Medicare is SECONDARY payor….general liability and auto are usually PRIMARY. With the new MMSEA in place, you will see hospitals sending bills more to the auto carriers and GL carriers because that’s where they should be going before they go to Medicare. It sucks, but federal trumps state and private every time.
I’m a CA agent and have been an agent since ’68…and I’ll bet I can count on both hands all the Med Pay HO claims I’ve seen. All were ER type incidents turned in to us after the hospital ever knew there was some form of coverage. Normally they arose because a neighbor said, “You might talk to your insurance agent about that!” I have no idea if hospitals are getting wise to the Med Pay coverage and are questioning patients as to if the injury occurred on someone else’s property, etc. Doubt it…but the typical HO $1000 benefit isn’t going to make a dent in any hospital’s accts. receivables.
With the new healthcare plan, you can expect that there will be tremendous cost shifting to WC plans and the Section 111 self reporting on Auto, GL and every other casuatly plan will be increased exponentially as more and more people are forced onto state Medicaid plans and then transferred to Medicare. The entire insurance industry will see admin costs rise for compliance and that will drive insurance premiums upward. We have indeded entered the twilight zone courtesy of the United States Congress.
I a claims supervisor and we have already seen a rise in cost in compliance. The worse thing right now is the Sec 111 keeps changing and CMS doesn’t even have a handle on what they are doing. Computer programming has had to be changed, etc. WE pretty much need a full time person just to deal with compliance.
I worked in a personal injury firm. The only reason those personal injury lawyers can make a living is because they disguise their fees in the form of a medical bill. The hospitals overstate their medical bills to the insurance companies. Then the hospital and the lawyer “negotiates” so that the hospital takes a reduced fee leaving the remainder to be split among the lawyer & claimant.
The insurance company doesn’t care because they just raise their rates to the insured.
I doubt that insurance companies don’t care about cost as they just pass them through. There is a tipping point where insurance becomes too expensive and the market contracts in relation to that point. I have heard this argument before during the Obamacare debate. One need only ask Wellpoint in CA if raising rates has no consequences. In that case the insurer rate increase was used to demagouge the issue and obscure the reality of a situation where increasing provider costs and a shrinking risk pool created the need for the increase. Greed was not the need.
Hospitals have routinely shifted costs to non contract payers. Managed care is also responsible for this shifting not just the Medi’s. This is nothing new except to say that hospitals have found a new almost bottomless well from which to pick bucks.
Everybody’s going broke, they’re all looking for monies from whatever source they can mine. Eventually the whole shooting match is going to implode, and we’ll have to start from scratch.
Well, once again, we are seeing more evidence that Obamacare won’t lower medical costs in this country. (The President declaring that it will doesn’t make it so.) First, did they actually think that people would believe costs would be lowered by adding so many more people to the insurance rolls, especially without additional facilities and medical personnel to care for them? (And with reimbursements for services being cut, did they ever think that fewer people would enter the medical professions, while others leave?) Second, these cost shifting schemes will mask the fact that costs aren’t being lowered, while they’re being spread around. (Gee, I wonder if that has anything to do with “spreading the wealth”.) But, I’ll bet the administration will boast of lowered costs while much is being “buried” in other types of insurance. Inevitably, insurance costs to the working and tax-paying public will go up, so once again, we are being taxed. Although Congress and the President will never admit that, anything that raises costs via government fiat is in reality just another tax. Instead, they’ll either find some other euphemism for those costs or simply blame the insurance companies for raising their premiums. Then they’ll decide that it is time to kick private insurers out of the medical process and take it over at the federal level, which is what they really want anyway.
Rusty, you couldn’t be more right or on point. We are about to see a system wrecked to achieve a goal of insuring only 5% of the 10% who are uninsured. Of course, uninsured does not mean uncared for but in this case the end, social justice, is so lofty a goal that crashing the system on an economic reef is justified. I keep scratching my head on how we got to this point.
I’ve been seeing smaller clinics and hospitals in my area doing this for over 25 years. I’ve also been seeing this from health insurance carriers for over 25 years. In many cases their attempt to subrogate ends when we fax them a PIP or Medical payment rejection form which was signed by the insured.
I heard our President state that healthcare goal (socialized medicine) took 100 years to achieve. Does anyone else wonder why if something is sooooo good for everyone that it takes 100 years to get it in place. The sky must be some other color than blue in Wash D.C.
Once more people are insured, the hospitals will have to subro less, and everyone’s rates will go down. You will just have to wait and see haters, since you lost in the legislative process. Stop hatin’ speculatin’.
There’s a big difference between going without car insurance and going without health insurance. One is illegal and punishable by impounding of auto and revocation of license. Not to mention inability to renew registration, renew license, get inspections etc. On the other hand, its perfectly legal to have no health insurance.
I have customers that have no health insurance and use the emergency room as needed, but keep up on their auto insurance payments.
Well maybe they are wise in WI because I see it all the time – or it could be because there are so many uninsured people around here. And not all policies are capped at $1k. I’m an adjuster and I pay med pay limits everyday. I am getting claims forms straight from the med facilities too – sometimes as the first report of a claim.
I guess I don’t get the analogy of car insurance and health insurance. If there is a syllogism in there, I missed it. One is for the benefit of third parties who may have been harmed by a first party, the other is for the sole benefit of a first party. And, by the way, Obamacare now makes not having insurance “illegal” via the assessment of fines. At least Cngress removed the jail time that was in the orignal bill.
TIE, I can’t quite understand how the discussion could devolve into casting aspersions about “hate”. I would hope that an attitude of disagreeing can occur here without being disagreeable. Simply expressing an opposite view should not be couched in terms of hate. What next, disagreement will be equated to racism! With respect to your argument about costs going down when adding 31 million new “customer” and not enlarging the provider pool or allowing for coverage to be purchased as you go into a hospital for major surgery makes that argument incomprehensble. If you have any example of where this has happened, bring it forward.
*Here’s a thought, if you’re not comfortable with the health insurers’ attempts to pay a lower amount than your bill, then lower your bills to more respectible levels!*
The point is that the govt doesn’t fully reimburse the companies for medicare, medicaid, etc, so they try to get higher payments from insurers.
Aside from doing away with communist healthcare programs entirely, what we could do is allow hospitals to go after the patient for the difference between what they bill and what e.g. medicare pays. That way, my insurance company wouldn’t be overcharged for my care to pay for some welfare queen’s emergency room visit.
FHB. What greed are you referring to. Government greed for power and control. Ohhh, I suspect you mean corporate greed ala the 3% profit Healthcare companies make, that must be it. And, insurance premiums have nothing to do with the underlying cost of the services provided; nor the cost shifting from underpayment of those services by the biggest insurer on the block, Medicare/Medicaid. I am sure you think the government’s new program will lower cost with this new program by covering 5% more people. Ask yourself this, it that is really the case, why didn’t they add the remaining 5% of uninsureds. If they had, think of all the money that would be saved. Republican rhetoric aside, common sense and logical analysis trumphs the simplistic banal idealogy of powerful dark forces within the private sector that act as puppetmasters who control an ignorant and pliable populace. “Greed” smiled Marx.
Tom, I think all the wall street big wigs thought the movie “Wall Street” and Michael Douglas’ talk on greed was meant for them to help themselves and their self serving interests to rape the average american citizen.
FHB, as you know, movies are not reality. If, however, you want to use movies as a metaphor for life of want to pit private sector v. public sector behaviour, might I suggest a rental list that includes, Three Days of the Condor or All the President’s Men. The point is that “greed” for money, or power, knows no boundries. For me, I recognize the fact that the greed of government invovlemnt in our lives is much more to be feared as governments can more easliy erode freedom, both personal and economic. Don’t get me wrong, government does play a role in limiting the abuses of the private sector but like heeping a tiger as a pet, one must be very leery that the cat doesn’t decide to feast on its owner.
Give it up, Tom….you will never get through to FHB. He is simply another in a long line of individuals who believe every word from the mouths of politicians. He cannot even articulate a position on the matter let alone win a debate. Why else would the script from which he operates simply instruct him to pull out accusations and name-calling such as GREED?
The takeaway from this article is simple: significant cost shifting is necessary for the hospitals since they lose money on Medicare and Medicaid, which have reimbursements that re not sufficient to cover costs. If people are fired up about cost hifting to Auto policies, then where is the outrage relative to private health insurers? Shifting to Auto policies has to be a drop in the bucket compared to shifting to health insurers.
Obamacare will, very simply, result in an increasing percentage of health care services provided for individuals coverage by government plans. This will result in even more cost-shifting to private health insurers until the insurers are out of business. At that point, Obama will achieve his dream of a single payer system. Reimbursements to the providers for ALL services will be very low, but there will be no private health insurers to which to shift costs. Health care providers / services will, therefore, be less plentiful, quality will decrease and rationing will have to occur. It is so painfully obvisous, but there are millions who have bought into the snake oil put forth by politicians.
Anything short of full repeal of Obamacare will result in certain doom. Take it to the bank….the government-controlled bank, that is.
Buckeye, you hit the nail on the head. For all those who think this will save money by lowering rates, please check out the Medicare Actuary’s recent report on costs as well as the Congressional Budget Offices new estimates on cost. In support of Buckeye’s comments on running insurance out of business, you need only look to recent actions by Maine’s Insurance Commish and MA governor who want to choke off insurance rates by fiat. In Maine, the comish ruled against a rate increase on individual policies as “people” hurting from the economic times all against the backdrop of statistical proof that they were losing money. Incredibly, the Comish told them they had a duty to lose money in these tough times. Look for more of the same from Congress. They want to control rates so they don’t look so bad when the huge increases start to kick in. Obfuscate, misdirect and demagouge, that three legged stool that Obamacare is built upon. Repeal and re-start is the only solution to a problem made worse by the social engineering of this admin.
surprise, surprise. I would have never guessed the hospitals would have figured out a way to shift the costs to auto insurers. Next thing you know they will be shifting costs to the Gen Liab policies in every case they can. Ooops they already figured that out to. Oh well.
Used to be you could pretty much trust the Hospital bills as being inviolate. Not any longer. Here’s a thought, if you’re not comfortable with the health insurers’ attempts to pay a lower amount than your bill, then lower your bills to more respectible levels!
And that doesn’t even really consider the med pay only claims for HO policies and the like. It’s amazing how much is paid just because it would cost too much to fight it. I don’t blame the hospitals. They need to make more than pennies on the dollar but any which way you slice it, we all end up paying for it. Watch those premiums rise.
Medicare is SECONDARY payor….general liability and auto are usually PRIMARY. With the new MMSEA in place, you will see hospitals sending bills more to the auto carriers and GL carriers because that’s where they should be going before they go to Medicare. It sucks, but federal trumps state and private every time.
I’m a CA agent and have been an agent since ’68…and I’ll bet I can count on both hands all the Med Pay HO claims I’ve seen. All were ER type incidents turned in to us after the hospital ever knew there was some form of coverage. Normally they arose because a neighbor said, “You might talk to your insurance agent about that!” I have no idea if hospitals are getting wise to the Med Pay coverage and are questioning patients as to if the injury occurred on someone else’s property, etc. Doubt it…but the typical HO $1000 benefit isn’t going to make a dent in any hospital’s accts. receivables.
With the new healthcare plan, you can expect that there will be tremendous cost shifting to WC plans and the Section 111 self reporting on Auto, GL and every other casuatly plan will be increased exponentially as more and more people are forced onto state Medicaid plans and then transferred to Medicare. The entire insurance industry will see admin costs rise for compliance and that will drive insurance premiums upward. We have indeded entered the twilight zone courtesy of the United States Congress.
I a claims supervisor and we have already seen a rise in cost in compliance. The worse thing right now is the Sec 111 keeps changing and CMS doesn’t even have a handle on what they are doing. Computer programming has had to be changed, etc. WE pretty much need a full time person just to deal with compliance.
I worked in a personal injury firm. The only reason those personal injury lawyers can make a living is because they disguise their fees in the form of a medical bill. The hospitals overstate their medical bills to the insurance companies. Then the hospital and the lawyer “negotiates” so that the hospital takes a reduced fee leaving the remainder to be split among the lawyer & claimant.
The insurance company doesn’t care because they just raise their rates to the insured.
I doubt that insurance companies don’t care about cost as they just pass them through. There is a tipping point where insurance becomes too expensive and the market contracts in relation to that point. I have heard this argument before during the Obamacare debate. One need only ask Wellpoint in CA if raising rates has no consequences. In that case the insurer rate increase was used to demagouge the issue and obscure the reality of a situation where increasing provider costs and a shrinking risk pool created the need for the increase. Greed was not the need.
Hospitals have routinely shifted costs to non contract payers. Managed care is also responsible for this shifting not just the Medi’s. This is nothing new except to say that hospitals have found a new almost bottomless well from which to pick bucks.
Everybody’s going broke, they’re all looking for monies from whatever source they can mine. Eventually the whole shooting match is going to implode, and we’ll have to start from scratch.
However, the market for auto insurance cannot contract because auto insurance is state mandated.
Well, once again, we are seeing more evidence that Obamacare won’t lower medical costs in this country. (The President declaring that it will doesn’t make it so.) First, did they actually think that people would believe costs would be lowered by adding so many more people to the insurance rolls, especially without additional facilities and medical personnel to care for them? (And with reimbursements for services being cut, did they ever think that fewer people would enter the medical professions, while others leave?) Second, these cost shifting schemes will mask the fact that costs aren’t being lowered, while they’re being spread around. (Gee, I wonder if that has anything to do with “spreading the wealth”.) But, I’ll bet the administration will boast of lowered costs while much is being “buried” in other types of insurance. Inevitably, insurance costs to the working and tax-paying public will go up, so once again, we are being taxed. Although Congress and the President will never admit that, anything that raises costs via government fiat is in reality just another tax. Instead, they’ll either find some other euphemism for those costs or simply blame the insurance companies for raising their premiums. Then they’ll decide that it is time to kick private insurers out of the medical process and take it over at the federal level, which is what they really want anyway.
People can, and do, elect to go without insurance when the cost becomes too high and another cost shift occurs to UM/UIM
Rusty, you couldn’t be more right or on point. We are about to see a system wrecked to achieve a goal of insuring only 5% of the 10% who are uninsured. Of course, uninsured does not mean uncared for but in this case the end, social justice, is so lofty a goal that crashing the system on an economic reef is justified. I keep scratching my head on how we got to this point.
anybody else hear that “Giant Sucking Sound?”
I’ve been seeing smaller clinics and hospitals in my area doing this for over 25 years. I’ve also been seeing this from health insurance carriers for over 25 years. In many cases their attempt to subrogate ends when we fax them a PIP or Medical payment rejection form which was signed by the insured.
The sound is the singing of the Sirens.
I heard our President state that healthcare goal (socialized medicine) took 100 years to achieve. Does anyone else wonder why if something is sooooo good for everyone that it takes 100 years to get it in place. The sky must be some other color than blue in Wash D.C.
Once more people are insured, the hospitals will have to subro less, and everyone’s rates will go down. You will just have to wait and see haters, since you lost in the legislative process. Stop hatin’ speculatin’.
Good try — but we can all recognize sarcastic comments.
BTW — … exactly what kind of expert are you?
There’s a big difference between going without car insurance and going without health insurance. One is illegal and punishable by impounding of auto and revocation of license. Not to mention inability to renew registration, renew license, get inspections etc. On the other hand, its perfectly legal to have no health insurance.
I have customers that have no health insurance and use the emergency room as needed, but keep up on their auto insurance payments.
Well maybe they are wise in WI because I see it all the time – or it could be because there are so many uninsured people around here. And not all policies are capped at $1k. I’m an adjuster and I pay med pay limits everyday. I am getting claims forms straight from the med facilities too – sometimes as the first report of a claim.
I guess I don’t get the analogy of car insurance and health insurance. If there is a syllogism in there, I missed it. One is for the benefit of third parties who may have been harmed by a first party, the other is for the sole benefit of a first party. And, by the way, Obamacare now makes not having insurance “illegal” via the assessment of fines. At least Cngress removed the jail time that was in the orignal bill.
TIE, I can’t quite understand how the discussion could devolve into casting aspersions about “hate”. I would hope that an attitude of disagreeing can occur here without being disagreeable. Simply expressing an opposite view should not be couched in terms of hate. What next, disagreement will be equated to racism! With respect to your argument about costs going down when adding 31 million new “customer” and not enlarging the provider pool or allowing for coverage to be purchased as you go into a hospital for major surgery makes that argument incomprehensble. If you have any example of where this has happened, bring it forward.
*Here’s a thought, if you’re not comfortable with the health insurers’ attempts to pay a lower amount than your bill, then lower your bills to more respectible levels!*
That’s ridiculous. I know: let’s just nationalize healthcare! Oh wiat, we just did… and it’s going to increase the cost of everything http://hotair.com/archives/2010/04/23/surprise-obamacare-will-increase-expenses-says-medicare-actuary/
The point is that the govt doesn’t fully reimburse the companies for medicare, medicaid, etc, so they try to get higher payments from insurers.
Aside from doing away with communist healthcare programs entirely, what we could do is allow hospitals to go after the patient for the difference between what they bill and what e.g. medicare pays. That way, my insurance company wouldn’t be overcharged for my care to pay for some welfare queen’s emergency room visit.
Rusty, you listen to too much republican rhetoric.
You all wonder how things got this way? Hello, it is called GREED!!
FHB. What greed are you referring to. Government greed for power and control. Ohhh, I suspect you mean corporate greed ala the 3% profit Healthcare companies make, that must be it. And, insurance premiums have nothing to do with the underlying cost of the services provided; nor the cost shifting from underpayment of those services by the biggest insurer on the block, Medicare/Medicaid. I am sure you think the government’s new program will lower cost with this new program by covering 5% more people. Ask yourself this, it that is really the case, why didn’t they add the remaining 5% of uninsureds. If they had, think of all the money that would be saved. Republican rhetoric aside, common sense and logical analysis trumphs the simplistic banal idealogy of powerful dark forces within the private sector that act as puppetmasters who control an ignorant and pliable populace. “Greed” smiled Marx.
Tom, I think all the wall street big wigs thought the movie “Wall Street” and Michael Douglas’ talk on greed was meant for them to help themselves and their self serving interests to rape the average american citizen.
FHB, as you know, movies are not reality. If, however, you want to use movies as a metaphor for life of want to pit private sector v. public sector behaviour, might I suggest a rental list that includes, Three Days of the Condor or All the President’s Men. The point is that “greed” for money, or power, knows no boundries. For me, I recognize the fact that the greed of government invovlemnt in our lives is much more to be feared as governments can more easliy erode freedom, both personal and economic. Don’t get me wrong, government does play a role in limiting the abuses of the private sector but like heeping a tiger as a pet, one must be very leery that the cat doesn’t decide to feast on its owner.
Give it up, Tom….you will never get through to FHB. He is simply another in a long line of individuals who believe every word from the mouths of politicians. He cannot even articulate a position on the matter let alone win a debate. Why else would the script from which he operates simply instruct him to pull out accusations and name-calling such as GREED?
The takeaway from this article is simple: significant cost shifting is necessary for the hospitals since they lose money on Medicare and Medicaid, which have reimbursements that re not sufficient to cover costs. If people are fired up about cost hifting to Auto policies, then where is the outrage relative to private health insurers? Shifting to Auto policies has to be a drop in the bucket compared to shifting to health insurers.
Obamacare will, very simply, result in an increasing percentage of health care services provided for individuals coverage by government plans. This will result in even more cost-shifting to private health insurers until the insurers are out of business. At that point, Obama will achieve his dream of a single payer system. Reimbursements to the providers for ALL services will be very low, but there will be no private health insurers to which to shift costs. Health care providers / services will, therefore, be less plentiful, quality will decrease and rationing will have to occur. It is so painfully obvisous, but there are millions who have bought into the snake oil put forth by politicians.
Anything short of full repeal of Obamacare will result in certain doom. Take it to the bank….the government-controlled bank, that is.
Buckeye, you hit the nail on the head. For all those who think this will save money by lowering rates, please check out the Medicare Actuary’s recent report on costs as well as the Congressional Budget Offices new estimates on cost. In support of Buckeye’s comments on running insurance out of business, you need only look to recent actions by Maine’s Insurance Commish and MA governor who want to choke off insurance rates by fiat. In Maine, the comish ruled against a rate increase on individual policies as “people” hurting from the economic times all against the backdrop of statistical proof that they were losing money. Incredibly, the Comish told them they had a duty to lose money in these tough times. Look for more of the same from Congress. They want to control rates so they don’t look so bad when the huge increases start to kick in. Obfuscate, misdirect and demagouge, that three legged stool that Obamacare is built upon. Repeal and re-start is the only solution to a problem made worse by the social engineering of this admin.