doxcost

@LighthouseDPC @Dividend__Doc @Markroot14 Ok. CT I get. S threw me off….but I get the scan part….just not the acronym. Thank you.

@doxcost @Dividend__Doc @Markroot14 CT - abdominal/Pelvic CT, etc. It's like a 3 dimentional X Ray.

What are you spending your Health Insurance money on? 7.3% goes to your Doctor.

@LighthouseDPC @Dividend__Doc @Markroot14 I don’t claim to be a doctor. What is a CTS? Who sells it?

@doxcost @Dividend__Doc @Markroot14 When I buy $4000 CTS instead of $400 CT’s, I would imagine they make very little money.

@LighthouseDPC @Dividend__Doc @Markroot14 Optum earns a better return than UHC. UHC generates its revenue/income from Medicare and UMR, neither of which involve much insurance.

@doxcost @Dividend__Doc @Markroot14 Where does most of the profit come from?

@LighthouseDPC @Dividend__Doc @Markroot14 UNH is a very well-run company. If you’ve noticed, they are increasingly marketing Optum as a brand. I foresee Optum spinning off as its own entity to unlock the value - especially as the feds continue to get involved where states have had jurisdiction. Where will UMR land?

@doxcost @Dividend__Doc @Markroot14 Why is it smart to own a Health Insurance company when the “margins” are so low?

@LighthouseDPC @Dividend__Doc @Markroot14 Good question. What’s the return on invested capital? All you have to do is look where they put their money. Here is UNH’s most recent acquisition: optum.com/en/newsroom/he…

@LighthouseDPC @Dividend__Doc @Markroot14 75% of Americans do not have health insurance, so MLR does not apply. You forgot state premium tax…about 2-2.5%. SG&A about 9-10% This is why the conglomerates are downstream in the pharma business, buying physicians et al. Insurance makes very little money.

Which means, if your insurance company wants to make $15 they have to spend $100. If they want to make $15 million, they have to spend $100 million. Now everyone can understand why healthcare purchased through health insurance is now 18% the economy. Your health insurance is paid to spend your money not save your money. Healthcare purchase through health insurance cost one dollar out of every six dollars. We spend every single day. Health care purchase through health insurance cost more than food, energy, and military spending combined!

@LighthouseDPC @Dividend__Doc 85% MLR represents only 15% of the total market 80% MLR only represents 10% PPACA increased premiums 50% the minute it passed - which has zero to do with insurance company Where 30 cents of overhead represented 70% MLR, the law says it needs to be at least 80. .3/.2 = $1.50

@Dividend__Doc @LighthouseDPC You’re a little high. Margin is about 3 to 3.5 percent. You might have forgotten the tax paid by the insurance company that goes to the state. State premium tax is 2 to 2.5 percent.

Insurance companies have net margins of 5-6%. compared to other industries this small. the real issue is everything cost so much. get rid of insurance profit we still have a problem. it's the prices stupid. Insurers just passing those costs on via premiums. healthaffairs.org/doi/10.1377/hl…

Cheaper medicines exist — middlemen are keeping them out of reach thehill.com/opinion/health…

@LighthouseDPC @AtlasMD @Tesla I disagree with that, too. Our language needs agreed definitions, not dictionaries. Webster’s is one dictionary and opinion of many. Here’s what Grok says:

@doxcost @AtlasMD @Tesla The dictionary defines our language so we can communicate.

Health insurance now costs as much as a @Tesla "$37,824 a year" — that's what employer-sponsored healthcare costs for a family of 4 on a typical employer plan in 2026. The article drives this home with a comparison: "$37,824 buys you a Tesla Model Y. Every year." (and you never get the car) boardroom.hospitalogy.com/library/607c14… @Hospitalogy_HC #DirectCare

Independent Physicians get abused the same way indie pharmacies do. They need to get a lot louder.

@LighthouseDPC @AtlasMD @Tesla I totally disagree and could care less what the dictionary says. I do appreciate your point of view and our discussion.

@doxcost @AtlasMD @Tesla “insurance against loss through illness of the insured” it’s no longer just for unforeseen events. The very definition of health insurance has changed. merriam-webster.com/dictionary/hea…

@LighthouseDPC @AtlasMD @Tesla I still say no. Insurance has not changed. I can pay known costs with my HSA and not “use” my insurance. The fact is that people think they need to “use” insurance because the feds ensure that the insurance companies must pay for “Minimum Essential Coverage”.

@doxcost @AtlasMD @Tesla So then Health Insurance has changed.

@LighthouseDPC @AtlasMD @Tesla It was relatively inexpensive. There was no third party payor. The patient paid directly or was billed and then submitted their claim to the insurance company. The insurance company sent the check to the beneficiary, who is the patient. A gallon of leaded gas was 25¢

@doxcost @AtlasMD @Tesla I thought so. I was a kid. I don’t remember them complaining about the cost either. I wonder how much it cost? I think it was Blue Cross.

@LighthouseDPC @AtlasMD @Tesla Also, catastrophic is a misused term. Catastrophic Major Medical, better known as Excess Major Medical, is more like umbrella liability. You need an underlying medical policy in order for EMM to pay. Obamacare basically eliminated EMM. Existing are grandfathered.

@doxcost @AtlasMD @Tesla In the 70s my dad called it “hospitalization”. I guessed it was a catastrophic plan. Did they not have those back then?

@LighthouseDPC @AtlasMD @Tesla I totally agree and disagree, in part. Insurance has not changed. The law has. Beginning with Medicare, which is not insurance, all the way through to PPACA, which mandates what is payable. Insurance is for UNFORESEEN perils that cause UNDUE financial burden. That’s it.

@doxcost @AtlasMD @Tesla True. Except Health Insurance is no longer Insurance. It’s not a risk that you will get sick or have a chronic illness and need to see a Family Physician. Getting a Physical is not a risk. Family Medicine is not a risk. Half of Specialty Care is not a risk.

@LighthouseDPC @AtlasMD @Tesla Insurance contracts are annual. It’s not the money that is pooled, it is the risk. An actuary can take 1,000 people and tell you how many heart attacks will occur in next twelve months. That same actuary would have no idea if a single individual will have a heart attack.

Doesn’t Stop Gap insurance cover the loss? Health insurance is a gamble. Insurance is gambling. We don’t get sick with something really big. We are gambling that we do. The risk is spread by pooling your money. If have 20 employees over 10 to 15 years, the likelihood of someone getting cancer or a heart attack in one year may occur only out of one year. That’s a net win and money in the bank.

@LighthouseDPC @AtlasMD @Tesla Stop loss can certainly be purchased, either aggregate or specific - but not required. In the example, there is no loss. It’s break even = no profit. The point is that 10 employees and 20 total lives were covered with only 10 claims. Premium is paid to be covered.