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Where do the insurance companies get the money to pay these costs?
I'm sure that whatever you pay for your policy and deductables wouldn't begin to cover your healthcare costs if you had to pay out of pocket. So whose footing the bill for the rest of your healthcare? Unless you're on Medicare it isn't the public, it's the insurance companies.
I actually forgot to weight in the deductible and OOP, let's say the couple having a child covered by maternity has a 5K maximum OOP. This would be 2,500 deductible, + with a 85/15 maximum OOP of 2,500. For the pregnancy to birth they would pay on a 100% claim 5K, the insurance company would then pay 1,600 for that pregnancy that year. Using Ms. Flukes math the BC regimen would cost 3K minus a 10, maybe 20$ copay so that's a whopping 120-240$ subtraction from the 3K, meaning the company would be on the hook for over 2K.I know more than you think, and am not a fan of industry outsiders condescending to me. Pregnancy is a limited expense if covered considering a woman can get pregnant a maximum of once a year, yearly pregnancy is going to be rare. Birth control according to Ms. Fluke was around 3K a year, the average full term delivery is around 7,600, using Fluke's math if a woman has two kids in five years that's around 15,200 but if she has NO kids due to birth control in the same period of time it's 15K. So by that model without childbirth the savings are a whopping 200 dollars to the insurance company, BUT here is the problem you don't understand, and neither does Time magazine, the risk class for multiple consumers using the 3K/yr birth control are weighting the drug coverage UP which means increased premiums within the prescription pool.
Thanks for playing.
I'm sure that whatever you pay for your policy and deductables wouldn't begin to cover your healthcare costs if you had to pay out of pocket. So whose footing the bill for the rest of your healthcare? Unless you're on Medicare it isn't the public, it's the insurance companies.
Where do the insurance companies get the money to pay these costs?
Where do most private companies get their money?
Very good, so what are we arguing about?They get it from their customers, in exchange for whatever goods or services they are selling. In the case of insurance companies, they get it in the form of the premiums paid by their policyholders.
The policyholders who make less claims are still insuring against the risk that they might get sick or hospitalized. The one certain thing about life is that it's uncertain.Any insurance company, in order to stay in business, must take in at least as much revenue in the form of premiums as they pay out on claims, plus whatever other expenses they incur as part of running the business. On average, the customer will pay significantly more in premiums than he receives in claims. It is mathematically impossible for it to be otherwise. So, on average, your statement that “I'm sure that whatever you pay for your policy and deductables wouldn't begin to cover your healthcare costs if you had to pay out of pocket.” is flat-out wrong. Some policyholders may very well receive more in claims than they pay in premiums, but the difference is made up by other policyholders who receive less in claims than they pay in premiums.
Yes, I suppose you could look at that way. One of the first to use insurance to gamble was Lloyd's of London insuring cargo ships (mostly in the slave trade) and betting that more ships would arrive to their destinations with cargo than would sink.Insurance is actually, as I said before, a form of gambling. As with any casino or other organized gambling business, the odds are slanted in the house's favor, and the customer can, on average, expect to get less out than he pays in.
I actually forgot to weight in the deductible and OOP, let's say the couple having a child covered by maternity has a 5K maximum OOP. This would be 2,500 deductible, + with a 85/15 maximum OOP of 2,500. For the pregnancy to birth they would pay on a 100% claim 5K, the insurance company would then pay 1,600 for that pregnancy that year. Using Ms. Flukes math the BC regimen would cost 3K minus a 10, maybe 20$ copay so that's a whopping 120-240$ subtraction from the 3K, meaning the company would be on the hook for over 2K.
Of course that is using a 100% model when max. OOP is an immediate factor, but if that 5K has been reached on the year the company would be on the hook for more on the pregnancy, and still probably come out ahead in a five year birth period versus birth control.
No, it is those who pay for these policies who will be paying for the birth control pills. It is those who pay—whether through premiums or taxes. In other words, the public.
What if there are complications during the pregnancy that require special treatment? Does that include the costs of the actual delivery of the infant and hospital stay for the mother and infant? All of these expenses and potential expenses have to be included too, don't you think?
I've never denied that there are some companies that engage in unethical practices, but your father getting denied coverage is not equal to an elective treatment being mandated for this argument. I can just as easily state that the rate of denials went up with the amount of mandates, when the risk pool has more to cover the providers will find ways to cut costs.
It's not a strawman, you are using a media group article to argue with a former professional in the field. I couldn't care less what their opinions are.
Well for one, if it isnt medically indicated, then insurance companies shouldnt be forced by mandate to pay for it ... it should be elective coverage.
Birth control = less or no babies, you are the one saying "birth control is a benefit to society", well guess what, we are in a negative birth period in U.S. history right now, IOW we are not replacing ourselves at a sufficient rate. I don't think that it's my business to tell people whether or not they should start a family but I am NOT responsible for the direction they choose, nor for funding it.
Most companies will not deny coverage when a physician makes the case correctly, however there are unethical companies. That said denying critical care coverage is not an argument for mandating electives. Not even close to in the same ballpark.You're right it's not equal, but the fact that such practices are not only out there, they are apparently common, does open the door for such mandates. Especially when the "elective treatment" being discussed happens to be one that is often not covered even when deemed medically necessary by a doctor due to those practices.
Tucker, it is not nonsense. The nonsense is the claim that it is cost neutral, it is not, the numbers do not hold up which is why it isn't covered by every company to begin with.As far as the mandate goes, I'm relatively agnostic, to be honest. My biggest issue in this debate is the nonsense about having to pay for other people's contraception based on that mandate. The money that goes into the pool is not your money anymore. You are paying for something you receive, which is healthcare coverage, not for what others receive. That's just a fact of life.
Not a proper analogy. Tucker, let me explain it again, when you join a risk pool you agree to covered/not covered and you also agree to whatever conditions are contained in the policy. This means you pay to be risked with everyone else agreeing to be in the pool and you pay for the pool, meaning whatever liabilities the company incurs. So no matter what Obama and Sebilius claim YES you do pay for a birth control mandate.For example, if I gave you $20 for a service that you provided me, I can't say that I paid for whatever you spend that money on. I spent my money on the service which you provided me. End of story. It's no longer my money, it's your money.
Not the same thing. Complications are going to be a smaller risk and covered whether there is a maternity rider or not.What if there are complications during the pregnancy that require special treatment? Does that include the costs of the actual delivery of the infant and hospital stay for the mother and infant? All of these expenses and potential expenses have to be included too, don't you think?
Necessarily, not entertaining this anymore because you aren't even listening.Not necessarily...it could equal the same amount of babies just raised in the right environment for the to succeeed.
There is a cost to you and society for any decision made. The thing about this policy requiring INSURANCE companies to cover the cost of birth control pills....just like they do for limp dick pills....is that it provides an added amount of control and makes it easier for women to decide when the right time for them to have a child. Our biology isn't keeping up with the advancement of modern society. Sure when you worked at a farm and got married at 15 popping out 10 kids before the age of 25 was pretty useful.
Now not so much!
I worked in the industry, they didn't. Could care less how you weight my opinon.I'm using a media group to bring up polling data. Both your opinions and theirs are irrelevant. You still haven't addressed any of my arguments.
I worked in the industry, they didn't. Could care less how you weight my opinon.
Plenty. It's called risk tables.Do you have data that contradicts theirs?
Plenty. It's called risk tables.
Tucker, it is not nonsense. The nonsense is the claim that it is cost neutral, it is not, the numbers do not hold up which is why it isn't covered by every company to begin with.
Not a proper analogy. Tucker, let me explain it again, when you join a risk pool you agree to covered/not covered and you also agree to whatever conditions are contained in the policy. This means you pay to be risked with everyone else agreeing to be in the pool and you pay for the pool, meaning whatever liabilities the company incurs. So no matter what Obama and Sebilius claim YES you do pay for a birth control mandate.
You know what, do your own homework. It should be painfully obvious what the main usage of contraceptives are, it's in the name. Realistically you are trying to be difficult here and when I left the industry I got rid of all my info due to burnout issues, I'm not digging again. There isn't even a copay requirement in the law so companies are on the hook MORE for birth control pills than statin drugs, my numbers hold up.And risk tables show that fewer than 58% of women using birth control use it for reasons other than birth control? Do you have a link?
Tuck, no one should be forced to pay for electives by law, period.I didn't say it was cost neutral. The cost you pay for services could certainly increase (although in this particular case, not all that significantly), but that just means that the cost of the services you receive has increased. It's been happening at an alarming rate without this mandate anyway, and this mandate will not have a large impact on the cost either.
As far as complaints about rising costs of health insurance go, mandating BC is WAY down on the list.
You pay a pittance for the BC mandate, but you do not pay for others BC (just like you don't pay for anyone else's cancer treatments). You pay for the services you are receiving.
Saying "My costs for health insurance could increase slightly because of the BC mandate" is very different from saying "The BC mandate means I have to pay for other people's birth control".
One is an honest and accurate statement, the other is saying you pay for other people's birth control.
You know what, do your own homework. It should be painfully obvious what the main usage of contraceptives are, it's in the name. Realistically you are trying to be difficult here and when I left the industry I got rid of all my info due to burnout issues, I'm not digging again. There isn't even a copay requirement in the law so companies are on the hook MORE for birth control pills than statin drugs, my numbers hold up.
Your research is based upon third party information. I don't accept it based upon my recent work history in the industry, you make claims that the birth control mandate is a sum good, you have to back that up because frankly the real numbers suck in the aggregate.I already did my own research. You suggested that it was invalid, and now you can't be bothered to demonstrate why? That's pretty pathetic, dude.
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