Question:
Is the problem with health insurance, gov't or private, that all subscribers want more out than they put in?
anonymous
2009-05-26 13:06:41 UTC
Insurance is a contract where you pay a premium, and get reimbursed for expenses greater than you paid in. It's almost a bet...for you & the insurance company. The people who don't place claims pay for those that do. But if everyone wants more than they pay in, the system cannot sustain itself.

And healthy people, with healthy lifestyles do not want to carry those that aren't healthy & practice risky behaviors.

Thoughts?
Nineteen answers:
anonymous
2009-05-26 13:12:11 UTC
My thoughts? They are one of the largest lenders to the US government. Even by covering some things, they are the most profitable business in the nation.
thewon4
2009-05-26 13:18:24 UTC
The problem is that a majority of people end up discovering that self-insurance is actually cheaper than the hundreds they pay for coverage through their employer.



The problem with insurance is that it is a huge open ended bid to medical professionals for services.



If doctor's know they can create a $65,000 cure for cancer, it will be available to the public at $65,000. It makes doctors look like rip-off artists and it destroys the equity of the system because the healthy end up paying astronomical fees for catastrophic claims. Furthermore, the third-party-payment system doesn't work either. People end up making late-night runs to the e-room b/c they are worried about a bad case of the sneasels. They don't care about the cost b/c it is covered by someone else.



People need tax exemption so they can self-insure via HSA's then use high deductible cafe-plans at work to cover catastrophic illness that they can't self-insure against. Catastrophic illness/injury is usually more uniform across a sample population so small companies can bargain collectively.



Rx drugs are the sticky wicket.
Muerto Mujados
2009-05-26 20:01:58 UTC
I love you too death babe but you've got this slightly wrong. Yes insurance companies hope that more people pay money into the system than claim insurance coverage.



But insurance companies don't just leave that money sitting around in an account waiting for someone to make a claim. They invest it in stocks and bonds and real estate to make even more of a profit. This way they can cover almost any claim. As long as the investment side of their business is going well.



Your avid follower Mark.
Apple21
2009-05-26 13:15:22 UTC
Yes, and the insurance companies take all that premium you pay in. They put aside some for reserves for claims and costs and invest the rest. They make tens of times over what they pay out. Take a look at some records that are disclosed. Trust me, they aren't a non-profit. They don't sell insurance because they like us; it's becausey they turn a pretty profit.
goo_head_83
2009-05-26 13:18:29 UTC
Sadly, the wealthy you are the more money you will pay in insurance to cover things you don't need. There is an issue with the insurance companies and medical/pharmaceutical companies over charging people. I don't think government should control health insurance, but I think the government should investigate these companies and their unfair costs.
?
2016-10-05 09:40:56 UTC
We have already got government ran wellness care. we've medicare, and if that's no longer working what is going to greater government wellness care do, my wager is be a gloomy Faure additionally. What you're saying is the working human beings might desire to be taxed greater to pay for the folk who're no longer working. this is an extremely socialistic concept. How can those that are no longer working and living off the equipment purchase something? You advise if people who stay on the government dole are given wellness care. in simple terms like they're given loose utilities and loose nutrition and loose housing hello why no longer enable GM supply them Cadillacs too. whilst the working guy drags himself to artwork on a daily basis in his Pinto for the reason that's all he can take care of to pay for.
Damsell With Stress
2009-05-26 13:19:29 UTC
There is nothing fair in health insurance... Some pay all there life and never need it and others don't pay a dime and get a great deal of it.



Our system does need to be fixed.. Right now it is free Health Care for ALL that we charge for... Any body will get treated regardless if they have insurance or not...
Pfo
2009-05-26 13:19:44 UTC
Out of control managerial costs add additional and unnecessary costs to health care.



That, and the fact that private insurance companies really don't have any competition, and therefore, they have no incentive to lower rates. They are profit making companies, if you don't give them incentive to lower rates (like competition) then they won't.
anonymous
2009-05-26 17:15:18 UTC
nikki, the present sistem is to corrupted , and the people ho have insurance pay to muck to cover thous that do not have,and the pharmacies charging a lot of money, we must have some Control, if not the doctors and the pharmacies mack to much money the hospitals are charging double money to cove thous uninsured . from the upper class and the middle class,the Poor and illegals pay nothing.
anonymous
2009-05-26 15:06:51 UTC
That's exactly why we need universal health insurance. Insurance may have started out as a socialized concept, but it's long since become a profit-skimming endeavor. It's outlived its usefulness.
anonymous
2009-05-27 03:36:58 UTC
Everyone wants something for nothing. The US has been so successful and wealthy, that people have began at some point to take things for granted, so I suppose you are right.
Supercell
2009-05-26 13:12:48 UTC
Insurance is just that, a bet.

Some on the left look at insurance as a right, which it is not.
My Baby!
2009-05-26 13:13:01 UTC
I have private insurance and I pay way more than I get out of it. But it is a necessity.
anonymous
2009-05-26 13:12:57 UTC
I hardly ever go to the doctor... but I keep it just in case some clown slams into me in traffic and he's not insured, so I don't have to go bankrupt for my medical bills...



if you want to call that "wanting more than I put in"... so be it...
Same O
2009-05-26 13:11:34 UTC
People are called socialist for voting for lower health care insurance.
anonymous
2009-05-26 13:12:21 UTC
The problem I have with it is that it is run like a business rather than like a public service (e.i. fire department or a police station).
anonymous
2009-05-26 13:14:27 UTC
Yea right, that explains why it's so profitable...
anonymous
2009-05-26 18:18:10 UTC
Examples of Insurance Fraud Investigations FY2008 ..THE OTHER SIDE OF THE STORY ! .A Great unknown expense for the Insurance Company`s ? How many options do you think the insurance companies have in getting their money back that is lost by fraud in the Billions yearly !



The following examples of insurance fraud investigations are excerpts from public record documents on file in the court records in the judicial district in which the cases were prosecuted.



Former Auto Body Shop Owner Sentenced to 108 Months in Prison for Auto Insurance and Bank Fraud Schemes

On August 4, 2008, in Trenton, N.J., John V. Cotona, aka John Bruno, owner of a defunct Red Bank auto body shop, was sentenced to 108 months in prison for his leadership role of a million-dollar automobile insurance fraud, bank fraud and money laundering scheme. He was also ordered to pay $1.275 million in restitution and to serve five years of supervised release upon the completion of his prison term. On January 10, 2008, Cotona pleaded guilty to charges of conspiracy to commit mail fraud, conspiracy to launder money and bank fraud. At his plea hearing, Cotona stated that between January 2001 and June 2005, he operated Perfect Touch Auto Body in Red Bank. During this time period, Cotona conspired and agreed with others to submit false automobile property damage claims to various insurance companies. Cotona admitted that the false insurance claims included information that the subject vehicles suffered damage resulting from fictitious accidents. Cotona further admitted that, in addition to making claims for purported repairs, many of the cars involved in the fictitious accidents were actually owned by him and titled in the names of other people or various shell companies that he controlled. Cotona also admitted that he agreed to launder the proceeds of the scheme through bank accounts of the shell companies, which he controlled. In addition, Cotona admitted that from May through June 2005, he defrauded Commerce Bank of approximately $154,950 by depositing bad checks into accounts he controlled and then withdrawing the proceeds of the checks before the checks were returned for insufficient funds.



Three Texas Residents Sentenced in Insurance Fraud Scheme

On May 16, 2008, in Houston, Texas, three people were sentenced for their roles in a large insurance fraud scheme. Angela Armstrong was sentenced to 60 months imprisonment for conspiracy to commit mail fraud and mail fraud and 97 months for engaging in monetary transactions in criminally derived property. She was also ordered to pay $2.3 million in restitution. Debbie Rampiarie Ramcharan was convicted on the same charges and sentenced to 46 months imprisonment and ordered to pay $1.3 million in restitution. Daniel Hunger pleaded guilty to conspiracy to commit mail fraud and conspiracy to engage in monetary transactions in property derived from specified unlawful activity. She was sentenced to 12 months and one day in prison and ordered to pay $1.4 million in restitution. Armstrong, Ramcharan and Hunger filed false insurance claims for water damage to their property. They intentionally flooded properties with a water hose and allowed the water to stand for days. As a result, mold and mildew formed on the structure, which led to an increase in the amount of the claim. In addition, furniture and other household items were moved from a warehouse into the flooded property to embellish the contents claimed under the policy. A third claim under the policy was made for additional living expenses requiring the insurance company to pay for the insured’s living expenses while the intentionally flooded house was being repaired. In addition, Armstrong acted as an independent contractor in various other fraudulent claims and recruited family members to submit claims as well. Hunger also recruited others to file fraudulent claims and then worked as a construction contractor to rehabilitate some of the intentionally flooded properties.



Financial Planner Sentenced for Conspiracy in Offshore Insurance Tax Scam

On May 2, 2008, in Cincinnati, Ohio, Bruce M. Cohen was sentenced to 37 months in prison, followed by three years of supervised release, to perform 1,000 hours of community service, and ordered to pay a special assessment of $400. In May 2007, Cohen, of Louisville, Ky., pleaded guilty in a criminal case brought against the ex-owners and former in-house counsel of Buddy’s Carpets and their insurance agents. According to court documents, Cohen operated an insurance agency in Louisville called The Cohen Agency, as well as a marketing and consulting company called Creative Solutions Group. From 1996 to 2004, Cohen conspired with the principles, associates and clients of an insurance company in the U.S. Virgin Islands, called Caduceus Life and Security Trust, to sell sham “Loss of Income” insurance policies to U.S. taxpayers to aid them in committing tax evasion and other crimes. He and
Oppression Killah
2009-05-26 13:11:14 UTC
DO YOUR OWN HOMEWORK!


This content was originally posted on Y! Answers, a Q&A website that shut down in 2021.
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