COVID 19, Hospitals, and the insurance companies. A question:

[bogey21]

For those that can afford it low cost Catastrophic Coverage and paying cash makes sense until Medicare eligible...

George

 

[geekette]

That will be a failure of capitalistic medicine. There are pluses and minuses to both systems, we are currently seeing the failure of the capitalist medicine system. There can also be a failure in a socialized medical system, see Italy.

These aren't system failures, they are nature of the business - nobody builds a 10000 bed hospital Just In Case someday they need 10000 beds. Has nothing to do with who is paying the bills. Just like any other business, nobody builds more than they need on a regular basis. No one keeps in inventory thousands of pieces of pricey equipment Just In Case.

Manufacturers do not have 100000 sq ft production areas if they only need a quarter of that for normal business.

It doesn't make sense, so nobody does it. Hospital or any other business. Just like I do not have 10000 Tylenol tabs, in case someday I need A Lot.

 

[T-Dot-Traveller]

.......some ways the medical supply companies have already failed

(looking at you 3M),

and there is a public outcry on how everyone completely messed up... maybe.

To add information-

Harmac Pacific in Nanaimo -British Columbia - CANADA
is the only plant in the world that produces K10S pulp - used in the mfg. of surgical masks and gowns.


3M is a global manufacturing company . They have said that “not shipping USA made N-95 masks to
Canada and Latin America (Mexico) - could reduce the supply of medical supplies to the USA”

The Canadian Government continues to discuss this and other critical trade shipments with trade partners .
SO FAR - the concept of export controls on K10S pulp has not been raise - publicly

(read between the lines). / think globally .
we were all taught about sharing - in Kindergarten

**********
absolutely : no criticism to any TUG readers or those posting intended - just information sharing .

 

[Sapper]

These aren't system failures, they are nature of the business - nobody builds a 10000 bed hospital Just In Case someday they need 10000 beds. Has nothing to do with who is paying the bills. Just like any other business, nobody builds more than they need on a regular basis. No one keeps in inventory thousands of pieces of pricey equipment Just In Case.

Manufacturers do not have 100000 sq ft production areas if they only need a quarter of that for normal business.

It doesn't make sense, so nobody does it. Hospital or any other business. Just like I do not have 10000 Tylenol tabs, in case someday I need A Lot.

I never suggested that someone should have built 10,000 bed hospitals. Though, the military most certainly does have some interesting facilities “just in case”... and the military is the closest thing we have to socialized medicine.

I said there were failures of the capitalist medical system. Take a look at how businesses are selling in demand items to the highest bidder. California seems to have no problem outspending many others despite their liberal ideals. I understand you say that is the “nature of the business”, and that is exactly my point. If the US were to go socialized medicine, it would have to have vertical control of the entire system. Development, construction / production, storage, distribution, etc. Everything would need to be controlled, and Americans do not currently have the will to take on this problem and make changes.

Unfortunately, this discussion will quickly become a political one (as in Capitalist vs Socialist vs Communist), actually I think we are already there... and I would rather not get it shut down, so I’m going to stop on that subject.

 

[Sapper]

To add information-

Harmac Pacific in Nanaimo -British Columbia - CANADA
is the only plant in the world that produces K10S pulp - used in the mfg. of surgical masks and gowns.


3M is a global manufacturing company . They have said that “not shipping USA made N-95 masks to
Canada and Latin America (Mexico) - could reduce the supply of medical supplies to the USA”

The Canadian Government continues to discuss this and other critical trade shipments with trade partners .
SO FAR - the concept of export controls on K10S pulp has not been raise - publicly

(read between the lines). / think globally .
we were all taught about sharing - in Kindergarten

**********
absolutely : no criticism to any TUG readers or those posting intended - just information sharing .

While the plant in Nanaimo is the only plant in the world that makes the K10s product, there are other plants which make similar blends which can be used for the same purpose.

Vancouver Island pulp mill supplies materials for medical protective equipment in both Canada and U.S.

Company president Levi Sampson said restricting trade of medical supplies across the border won’t help anyone

www.theglobeandmail.com

Also, the N95 masks everyone is so desperate to get their hands on do not contain any wood pulp sourced fiber. It’s polypropylene.

https://multimedia.3m.com/mws/media/1425070O/3m-particulate-respirator-8210-n95-technical-specifications.pdf

Having said all that, a trade war at this point in time is not beneficial for anyone.

 

[Brett]

I never suggested that someone should have built 10,000 bed hospitals. Though, the military most certainly does have some interesting facilities “just in case”... and the military is the closest thing we have to socialized medicine.

I said there were failures of the capitalist medical system. Take a look at how businesses are selling in demand items to the highest bidder. California seems to have no problem outspending many others despite their liberal ideals. I understand you say that is the “nature of the business”, and that is exactly my point. If the US were to go socialized medicine, it would have to have vertical control of the entire system. Development, construction / production, storage, distribution, etc. Everything would need to be controlled, and Americans do not currently have the will to take on this problem and make changes.

Unfortunately, this discussion will quickly become a political one (as in Capitalist vs Socialist vs Communist), actually I think we are already there... and I would rather not get it shut down, so I’m going to stop on that subject.

Ok .... glad I'm on Medicare

 

[bbodb1]

It has been sad to read the ever increasingly frequent stories of more layoffs of nurses while big insurance remains........quiet.

 

[davidvel]

As this crisis continues, we are constantly hearing reports of hospitals facing financial difficulties.

If that is true (and I am not suggesting otherwise), why aren't insurance companies fronting the funds needed for hospitals to continue operations?

With as much money as the insurance companies rake in, they depend on hospitals as the primary source of their cash flow. They should be propping up hospitals during this time - not the federal government.

Any thoughts?

I'm lost. Insurance companies pay hospitals, not the other way around. They get "cash flow" from subscriber premiums. What do you mean by "[Insurance Companies] depend on hospitals as the primary source of their cash flow"?

 

[davidvel]

I wouldn't be surprised if the next shoe that drops are health care insurance bail-outs. 10+ days in an ICU with a ventilator and the numbers of patients must be very expensive. I am sure the insurance companies never planned for this kind of loss. Who will pay these claims?

95% of COVID hospitalizations are likely paid by Medicare or Medicaid, given the demographics, so not much insurance payment except Part B plans.

10 days in ICU would be billed at about $500,000, with Medicare and part B paying only about 50k, and the balance is wiped out.

 

[simpsontruckdriver]

In my Medicare post, I posted that most insurers were covering Coronavirus testing and treatment 100%, meaning your copay is $0. That includes Aetna, AARP/United Healthcare (UHC), and Humana. UHC and Humana expanded that to ALL doctor visits, telemedicine, and outpatient mental health. UHC is doing that until at least September, Humana is doing that until the end of the year. Essentially, check your insurer's website to find out what they cover in terms of Coronavirus.

TS

 

[bbodb1]

I'm lost. Insurance companies pay hospitals, not the other way around. They get "cash flow" from subscriber premiums. What do you mean by "[Insurance Companies] depend on hospitals as the primary source of their cash flow"?

While not all health care is delivered there, hospitals are the main source of health care provided in this country. If a hospital ceases to exist, what good is insurance if you have nowhere to obtain health care? Now that is a very simplistic look at the relationship, but it is essentially correct. But let's take this even further.

Many hospitals have doctor's offices attached to them (not necessarily physically, but very proximate) for many reasons. If the hospital ceases operation, many doctors (likely specialists more than general practitioners) have no anchor facility in which to practice medicine that just can't be done in a doctor's office. These doctors are likely to relocate should this occur.

If health care is not available in an area, what function do the health insurance companies provide? My point here is insurance companies need hospitals in order to exist because without the hospitals, there is very little (if any) health care. Hospitals do NOT need health insurance companies. HIC have a vested interest in the continuing existence of hospitals in order to maintain consumer demand for their insurance. HIC are indeed dependent on the continued existence of hospitals for their own existence. HIC's should be taking ever measure possible to ensure hospitals can continue operation because it ensures the need for HIC.

 

[geekette]

....HIC's should be taking ever measure possible to ensure hospitals can continue operation because it ensures the need for HIC.

They don't care, so long as they've got masses of people believing that they *must* have health insurance. If claims aren't coming in, all the better, lay off staff, save more for exec bonuses.

It is not going to be possible to force insurance companies to care about anything other than their bottom line. All income, few expenses? Freaking Yippee!

 

[davidvel]

While not all health care is delivered there, hospitals are the main source of health care provided in this country. If a hospital ceases to exist, what good is insurance if you have nowhere to obtain health care? Now that is a very simplistic look at the relationship, but it is essentially correct. But let's take this even further.

Many hospitals have doctor's offices attached to them (not necessarily physically, but very proximate) for many reasons. If the hospital ceases operation, many doctors (likely specialists more than general practitioners) have no anchor facility in which to practice medicine that just can't be done in a doctor's office. These doctors are likely to relocate should this occur.

If health care is not available in an area, what function do the health insurance companies provide? My point here is insurance companies need hospitals in order to exist because without the hospitals, there is very little (if any) health care. Hospitals do NOT need health insurance companies. HIC have a vested interest in the continuing existence of hospitals in order to maintain consumer demand for their insurance. HIC are indeed dependent on the continued existence of hospitals for their own existence. HIC's should be taking ever measure possible to ensure hospitals can continue operation because it ensures the need for HIC.

That is a completely different argument than "[Insurance Companies] depend on hospitals as the primary source of their cash flow," but one that I still disagree with.

With no hospital care needed to be paid by HIC, they make boatloads of money as their outlay for that care dries up, in the short term. Also, plenty of people get a lot of care outside of the hospital. I doubt many people are intentionally cancelling their insurance in the current environment.

As to your second argument, hospitals need insurance payments to survive. Elective (ie non emergency and non icu) hospitalizations and surgery are the only place they make money, and where insurance companies pay a lot to the hospitals. They are currently bleeding money, needing to be even more subsidized, as they are not receiving a lot of that insurance money now.

 

[Miss Marty]

"Medically Necessary Beds for Seniors"
Medicare and Health Insurance Question

Are Hospital elevated beds for use at home and/or Adjustable beds covered by Medicare Part B under the section of "DME" durable medical equipment?

Will Medicare pay for purchase or rental with no out of pocket expense?
Will secondary health insurance coverage pickup the 20% balance.

Learn rules & understand when Medicare will help with costs
@ Medicare. gov