Questions about US health care

[Brunic]

Hi,

I was reading about US health care system, and I want to be sure to understand it well. I have a few questions:

-Basically, you pay for health care. If you go see the doctor, you pay the bill, if you have an operation, you pay the bill like any other normal bill from any other service, correct?

-Since health care cost can be insane, you have insurance companies, who offer to pay the bill in exchange of a premium. I suppose they are like any other insurance companies(like home insurance, car insurance or life insurance). It seems they offer a good deal for big business, so it's really valuable to get a job with health care. Are all these insurances companies are for-profit organization? Is there is some sort of cooperative insurance or government insurance you can buy? Or the market is completely dominated by for-profit insurance companies?

-Who owns the hospitals? Are they owned by the government? Or are they private property of for-profit organization? Do you have any "community" hospital or hospital owned by a cooperative?

-Can you buy stock of health insurance companies? Is there an open market for that, or they are only privately-owned companies? Is is the same thing about hospital(in the case that they are for-profit organization)?

I think it could be a wonderful market for speculation, but I want to be sure to understand how it works.

Thanks!

[justusranvier]

Hi,

I was reading about US health care system, and I want to be sure to understand it well. I have a few questions:

-Basically, you pay for health care. If you go see the doctor, you pay the bill, if you have an operation, you pay the bill like any other normal bill from any other service, correct?

-Since health care cost can be insane, you have insurance companies, who offer to pay the bill in exchange of a premium. I suppose they are like any other insurance companies(like home insurance, car insurance or life insurance). It seems they offer a good deal for big business, so it's really valuable to get a job with health care. Are all these insurances companies are for-profit organization? Is there is some sort of cooperative insurance or government insurance you can buy? Or the market is completely dominated by for-profit insurance companies?

-Who owns the hospitals? Are they owned by the government? Or are they private property of for-profit organization? Do you have any "community" hospital or hospital owned by a cooperative?

-Can you buy stock of health insurance companies? Is there an open market for that, or they are only privately-owned companies? Is is the same thing about hospital(in the case that they are for-profit organization)?

I think it could be a wonderful market for speculation, but I want to be sure to understand how it works.

Thanks!

The US has a fascist monstrosity of a health care system where bureaucrats make the real decisions but so-called private companies implement all of them. It only looks like a free market if you don't pay attention to the government controlling a significant majority of the spending and don't look at how they use tools like the tax code to push the system in the direction they want, to the determent of everyone except their cronies.

Believe it or not the US once had affordable, high quality health care before the government decided to "help" but the people who remember that are dying out.

[hashman]

-Basically, you pay for health care. If you go see the doctor, you pay the bill, if you have an operation, you pay the bill like any other normal bill from any other service, correct?

In theory, yes, however in practice mostly the payments are made through third party agreements.  See your question 2.

-Since health care cost can be insane, you have insurance companies, who offer to pay the bill in exchange of a premium. I suppose they are like any other insurance companies(like home insurance, car insurance or life insurance). It seems they offer a good deal for big business, so it's really valuable to get a job with health care. Are all these insurances companies are for-profit organization? Is there is some sort of cooperative insurance or government insurance you can buy? Or the market is completely dominated by for-profit insurance companies?

Yes, these insurance companies are for profit.  In fact their profit margins are consistently one of the largest in any business.

-Who owns the hospitals? Are they owned by the government? Or are they private property of for-profit organization? Do you have any "community" hospital or hospital owned by a cooperative?

Some are privately owned, some are public companies.  I'm not aware of any owned by governments directly, but there may be a few coops around.  

-Can you buy stock of health insurance companies? Is there an open market for that, or they are only privately-owned companies? Is is the same thing about hospital(in the case that they are for-profit organization)?

 

Yes you can.  These guys get close to 20% of GDP (largest health care costs in the world are in USA).  Valuations already reflect that.  Check out Berkshire Hathaway's holdings, apparently Warren Buffet has thought health sector was oversold and was moving out of it a bit.  

I think it could be a wonderful market for speculation, but I want to be sure to understand how it works.

Good luck with that.  Most of the big decisions are behind closed doors and very political, I have very little idea all the players involved.  You might be interested in this article however:

http://community.nasdaq.com/News/2012-06/leveraged-etfs-for-the-obamacare-ruling.aspx?storyid=151336

[RodeoX]

Hi,

I was reading about US health care system, and I want to be sure to understand it well. I have a few questions:

-Basically, you pay for health care. If you go see the doctor, you pay the bill, if you have an operation, you pay the bill like any other normal bill from any other service, correct?

Without insurance, that is basically it.  If you show up in the emergency room you will still be treated. Later a big bill will come to your home.

-Since health care cost can be insane, you have insurance companies, who offer to pay the bill in exchange of a premium. I suppose they are like any other insurance companies(like home insurance, car insurance or life insurance). It seems they offer a good deal for big business, so it's really valuable to get a job with health care. Are all these insurances companies are for-profit organization? Is there is some sort of cooperative insurance or government insurance you can buy? Or the market is completely dominated by for-profit insurance companies?

There may be some not-for-profit insurers, but by far most are highly profitable companies. My first day as a paramedic my partner explained it this way. "Insurance companies do not make their money by writing checks, and they have a lot of money. It's all about not writing you a check."

-Who owns the hospitals? Are they owned by the government? Or are they private property of for-profit organization? Do you have any "community" hospital or hospital owned by a cooperative?

Giant parent companies who are totally beholden to their wealthy investors. When you get sick, they get paid. If you cant pay.... Bye.

-Can you buy stock of health insurance companies? Is there an open market for that, or they are only privately-owned companies? Is is the same thing about hospital(in the case that they are for-profit organization)?

Some may be publicly traded, but generally they don't want your investment money. They will hold out for the money you will give them when you are sick. Much more profitable that way.

I think it could be a wonderful market for speculation, but I want to be sure to understand how it works.

Thanks!

[nevafuse]

Here is a foxnews.com article with reference to a few insurance companies & hospitals that are publicly traded.

http://www.foxnews.com/us/2012/06/28/hospital-stocks-jump-after-health-care-ruling/

[MoonShadow]

Hi,

I was reading about US health care system, and I want to be sure to understand it well. I have a few questions:

-Basically, you pay for health care. If you go see the doctor, you pay the bill, if you have an operation, you pay the bill like any other normal bill from any other service, correct?

No, not normally.  The problem with the current system is that health care coverage is generally tied to employment, so six months after a layoff (or immediatly after a fire) both the employee and his family lose their insurance coverage because it's illegal for a seperated employee to continue to pay for his coverage via the health care plan he had with his former employer.

-Since health care cost can be insane, you have insurance companies, who offer to pay the bill in exchange of a premium. I suppose they are like any other insurance companies(like home insurance, car insurance or life insurance). It seems they offer a good deal for big business, so it's really valuable to get a job with health care. Are all these insurances companies are for-profit organization? Is there is some sort of cooperative insurance or government insurance you can buy? Or the market is completely dominated by for-profit insurance companies?

It's dominated by for-profit insurance companies, but that doesn't prevent non-profits from existing.  But there are regs that make it hard for any employer to favor a non-profit unless the employer is also a non-profit.  Since very few people work for non-profits in the USA, very few non-profit insurance agencies exist.

-Who owns the hospitals? Are they owned by the government? Or are they private property of for-profit organization? Do you have any "community" hospital or hospital owned by a cooperative?

They used to be owned by religious organizations, primarily, and still generally keep their legacy names (There is a Jewish Hospital in every city, for example) However, laws pased during the 70'sunder Carter forced most of these non-profit hospitals to sll out to for-profit corporations.

-Can you buy stock of health insurance companies? Is there an open market for that, or they are only privately-owned companies? Is is the same thing about hospital(in the case that they are for-profit organization)?

Mostly closed ownership, but you can buy stock into some mega-medical investment groups that own stock in uge numbers of different hospitals.

[Brunic]

Thanks for your answers guys! It is a lot clearer now.

Last question: Is it possible for an insurance company to also own an hospital?

[MoonShadow]

Thanks for your answers guys! It is a lot clearer now.

Last question: Is it possible for an insurance company to also own an hospital?

Probably, but there are laws that prevent any hospital from favoring patients due to their insurance company, so an insurance company would have little to gain from owning a hospital itself.  These are old laws that were put into place in order to undermine 'mutual benefit associations' from the 1920's and earlier.  Such associations were as close to a heath care cooperative as could have existed, and some were powerful enough to hire their own general practitioners; thus running their own practice for the benefit of their membership.  Both doctors' associations & insurance companies lobbied governments to 'regulate' such practices on such arguments as "demeaning employment" to the young doctors who took such positions to "anti-competitive" non-profits killing the insurance companies.  There is a small resurgence of this kind of thing today under a different legal description, concierge medical practices, but they are developed by the doctors themselves, not a non-profit cooperative.  The end results are similar, though.  On such practice association is SimpleCare.  (http://simplecare.com/index2.asp)  They all claim to only be 'cash only' practices, but most of them have an 'annual membership fee' that is somewhere between $200 and $3000 dollars, depending upon all that it includes and the repuation of the doctor.  At the high end of that range, you often end up with your new doctors actual cell phone number, and an agreement that he will respond to at least a minimum number of emergency calls per year.