How does United Health Care CEO make $46 million (rant)

Parent Cafe
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<p>And yes, our medical care system is based around cure, rather then prevention, and there is a complex web of factors that make it much worse. Government policy in terms of farm subsidies and such often works against preventative medicine (for example, the cheapness of HFC, irregardless of whether it is the same as sugar or not, thanks to government subsidies to farmers and agri businesses, means that HFC is used as filler in everything from McDonald’s hamburger buns to a variety of foods, including sadly, so called “low fat” foods). Likewise, government subsidies are part of the reason fast food like McDonald’s and such is relatively cheap, everything from the buns to the meat and such they use, to the french fries are subsidized in terms of cost…It is funny, we have the food pyramids and dinner plates, the FDA tells you portion sizes and such, yet we are often subsidizing the things it tells you to avoid.</p>

<p>Likewise, the same employers who complain about the cost of health care are helping add to those rate increases, intentionally or not, by the mania to cut the size of their work forces. People are working longer and longer hours, and that in turn adds to the eating of unhealthy foods (grabbing a sandwich at your desk, not going out for lunch and maybe actually walking for an hour or so) and with working more and more, there is less time for exercise and the like. Kids are so scheduled with homework, and mandatory EC’s, that many of them, other then the kids who plays sports, are sedentary (and with two parents working, often the kids don’t have someone telling them to get off their fanny and go outside and move and play). </p>

<p>And quite frankly unless there are all these miracle doctors out there, and based on the way they herd you through doctor’s offices, how much do doctors spend on prevention? I had a physical earlier this year, and it was a joke. Doctor’s tell you to loose weight, but they often are not very knowledgeable about nutrition or focus on weight rather then wellness, and quite frankly, being someone who struggles with my weight, it also isn’t far removed from the old idea that overweight is gluttony and such, that if someone is overweight it is because they ‘pig out’, rather then looking at the root causes or offering good advice…</p>

<p>Health insurers aren’t much better, while many of them offer information on healthy eating, and some subsidize gym memberships, on the other hand they will deny preventative screenings that may catch problems early or deny coverage of medicines that might reduce the risk of further problems that may cost more. I insurance companies paid for comprehensive physicals and nutritional counseling and the like, it might significantly cut down the major diseases like diabetes, heart disease and cancer that cost so much.</p>

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<p>“We have the best medical care – but the worst system of getting it paid for.”</p>

<p>We don’t even have the best. We spend the most per capita and lag behind every developed economy (and some developing economies) on almost every public health statistic.</p>

<p>The key to a good system appears to be to make it nonprofit. There are a wide variety of effective systems that range from socialized medicine in the UK to nonprofit, private coverage in Switzerland. </p>

<p>The US is the only country where you can go bankrupt over medical costs, and I believe that medical bankruptcy is the number one reason for bankruptcy.</p>

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<p>And I just noticed this in the Times:</p>

<p><a href=“Debt Collectors Take Places Alongside Hospital Staffs - The New York Times”>Debt Collectors Take Places Alongside Hospital Staffs - The New York Times;

<p>Debt Collector Is Faulted for Tough Tactics in Hospitals
By JESSICA SILVER-GREENBERG
Hospital patients waiting in the emergency room or convalescing after surgery could find themselves confronted by an unexpected visitor: a debt collector at bedside.</p>

<p>One of the nation’s largest medical debt-collection companies is under fire in Minnesota for having placed its employees in emergency rooms and other departments at two hospitals and demanding that patients pay before receiving treatment, according to documents released Tuesday by the Minnesota attorney general. The documents say the company also used patient health records to wrangle for more money on overdue bills.</p>

<p>The company, Accretive Health, has contracts with dozens of hospitals around the country. Since January, it has faced a civil lawsuit filed by Attorney General Lori Swanson of Minnesota alleging that it violated state and federal debt-collection laws and patient privacy protections. Ms. Swanson, though not bringing further charges on Tuesday, said she was in discussions with state and federal regulators to prompt a widespread crackdown on Accretive Health’s practices in other states.</p>

<p>“I have every reason to believe that what they are doing in Minnesota is simply company practice,” she said in an interview, but declined to be more specific.</p>

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<p>Might also be a reason for high blood pressure, stroke, cardiac events, clinical depression, anxiety, panic attacks, gastrointestinal upsets, headaches, backaches, traffic accidents, and suicide. All “caused” by our best in the world medical system.</p>

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<p>Yeah so free market system. “Hello hospital A? I’m having a heart attack. What will you charge me for treatment? I am calling 5 hospitals to cost compare before I decide which one to go to.” “Hello hospital A? I’m traveling for work across the country and have food poisoning. I’m calling 5 hospitals to determin who shall be the lucky one to earn my business.” </p>

<p>Only in America. Used to mean something else.</p>

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<p>The diet and exercise thread is all about losing weight and getting fit and looking good. It’s also about dealing with busy schedules, travel, exercise logistics, equipment, nutrition, cooking and support. If your doctor won’t, you’re always welcome to join us.</p>

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<p>I have a friend who, after struggling for six years, is finally “being planned” for a liver transplant. It took him two years to get SS Disability, during which time he basically had to sleep at his desk every afternoon. (He has worked his entire life.) Following his approval, he couldn’t get a check from them for 5 1/2 months. (That’s standard - nothing unusual there - the unusual thing is that he got approved on first request; more commonly, they automatically deny the first time, hoping/expecting you’ll die before the appeal succeeds.)</p>

<p>Sigh - we found him enough shared leave so he could pay the mortgage. But after he gets retired, he no longer has any health insurance (for him, his wife, and family), there’s no way he could pay for Cobra, and Medicare won’t provide them with health care for TWO YEARS (after he is approved for SSDI). If he has no insurance, he gets taken off the transplant list. </p>

<p>So he has to get on the state’s Medicaid program. But in order to do that, he basically has to have no resources. It’s called the “Medicaid spend-down”. So he has to schedule an appointment with the transplant center the day after he gets SS Disability, because just the cost of the appointment will deplete all their resources. Once they have no money, he can apply for Medicaid.</p>

<p>Over the course of two years, he talked to dozens of caring, wonderful people working for the state and federal government, and consumer advocates, and etc., etc. They all told him the same thing: the system was designed so that he would be dead before he received the health care services he required. They all could name dozens of people in similar condition to his who died while waiting, and none could remember one who managed to live long enough…to live. We’re rooting (and working) for him.</p>

<p>Anyhow, the hospital (a well-known, well-regarded university hospital) has a social worker, whom they told him to visit. He did - only to discover that the social worker’s only duty was to figure out how to get money out of him. Her first suggestion was that he should sell his house. “Where would we live?” he asked. “Oh, the community will find a way.” was her only response. Then she gave him a list of Section 8 housing (minimum waiting time two years). He asked whether other people in his condition had sold their homes. “Some,” she said, “But most people in your condition don’t live that long.” (There’s more to the story, but 'nuf said.)</p>

<p>Best medical care in the world.</p>

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<p>mini, Why doesn’t he just move to one of the countries that you find so superior to this one? Problem solved, right?</p>

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<p>I imagine you meant the question to be snarky, but I think it is a fair question. It has MORE than crossed the family’s mind. But in order to immigrate to British Columbia, he’d have to be able to hold a job, and have a job offer in hand. (And, remember, he’d need the money to move!) Currently, he is simply wasting away.</p>

<p>He could also go to India to get a liver transplant. The cost would be about $70k (as opposed to $375-$500k) here, and their reported success rates are about the same as they are here. But even if he could survive the trip, he doesn’t have $70k. (If he were working for some major U.S. corporations, they’d actually pay him to do so, as they do with many heart patients needing surgery these days. It’s cheaper for them, and they get equal or better results.) The state is certainly not going to pay him to do so, as they are betting that he is going to die (and have worked hard toward that end) before he receives the services he needs.</p>

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<p>^mini : I am sorry about your friend. I hope he get the care he needs soon. Healthcare is one major reason why I am living in Canada and not the US right now. I wish everyone in the US could have access to the kind of healthcare system I have.</p>

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<p>Thanks.</p>

<p>I don’t mean to give the impression that getting a liver transplant would be easy anywhere. There are waiting lists in every country that I know of, a function of lack of compatible organs. (The ethics of how they are doled out in the this country would take up an entire thread by itself).</p>

<p>But this is the only country that I know of where, essentially, he has to bankrupt himself and his entire family to pay for healthcare in the process of getting one.</p>

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<p>I feel for your friend mini. This has me considering moving to a country (like Canada or Norway) where my healthcare/basic life and monetary needs are covered by the government. The state of this country is so bad, I need to find a better one.</p>

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<p>mini, I think your friend should have talked with an elder care or trust attorney. There is a way he could have kept his house until he and his spouse had died, at which time Medicaid would have expected to be repaid. I think the arrangement needs to be done in advance of needing the Medicaid by several years (so it doesn’t look like an obvious tax dodge) but I would still consult with an attorney. And it is good to know for other people you may run across is the future. Maybe now he could use a HELC, and put off Medicaid for several years.</p>

<p>I’m not a lawyer so I can’t say for sure.</p>

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<p>I just discovered that last year my wife and I had the same lab work done in Houston. The lab billed about $600, UHC paid them about $70. They were happy.</p>

<p>The hospital billed $1,400 they were paid about $300 and they still want another $300 !!!</p>

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<p>^^^^Having something done at a hospital is always going to be more expensive than if it is at a private outpatient facility…</p>

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<p>“mini, I think your friend should have talked with an elder care or trust attorney. There is a way he could have kept his house until he and his spouse had died, at which time Medicaid would have expected to be repaid”</p>

<p>Oh, done a long, long time ago. No, Medicaid won’t take his house. In Washington State, you can keep your house, and your car (I think if it is worth $5k or less) and still be on Medicaid. The issue was the hospital trying to wring money out of him before the Medicaid spend-down. Even with his insurance (which he loses May 1st), visits cost him out-of-pocket, $5k or more a pop. After May 1, what will happen is that the hospital and the labs will end up billing him $20-$25k, which he doesn’t have, and won’t ever be able to pay. They will take all available cash, and at that point, he applies for (and gets) Medicaid. The hospital is simply trying to wring out every last dollar (and will be under stricter cost controls under Medicaid, which doesn’t make them particularly happy). We have planned this very, very, very carefully - and it has taken us two years. (And there is no question in my mind that without his “planning team”, he’d be dead already.)</p>

<p>There is Medicaid “planning” that can go on prior to these things happening (many of them illegal in our state, though people try them all the time). But again, in our state, he won’t lose his house or his car (a 1983 Imperial!), and SSI will be enough to live on - just not pay for any medical expenses.</p>

<p>Best medical care in the world.</p>

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<p>mini, your friend’s story should be required reading for everyone who opposes single-payer. </p>

<p>musicprnt, great analysis of our health care system, by far the most dysfunctional in the developed world. I totally agree with you that we’re heading for a two-tiered system of health care where the haves get that “best care in the world” which private-market advocates are so fond of talking about, while everyone else gets substandard care if they’re lucky enough to get any care at all. </p>

<p>Great countries don’t treat their sick people like this. We should be ashamed.</p>

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<p>Given a choice between rationing care today but being fiscally solvent and providing care and passing the bill off to grandchildren, I always favor the former. First demonstrate there isn’t another Ponzi in the making before we create another hole to dig out of.</p>

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<p>Fiscally solvent is code for screw everybody who can’t afford health care…I can.</p>

<p>Every other first world country has universal health care…and it is done cheaper than we do it…</p>

<p>So…it must be possible for the US to provide universal health care at lower costs than we pay now.</p>

<p>This universal health care is not pie on the sky stuff…</p>

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<p>What would the cost of healthcare be if we were to eliminate the 12+ million illegals?</p>

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<p>True - but first demonstrate you have the spine to do it here, and then ask for more responsibilities.</p>