Millions can't find family doctor (Ah, The Joys of socialized medicine)

[Razorguns]

Damn, Matt -- Even *I*, being your biggest fan, gotta admit that was a good rebuttal. Dayum.

 

[MattTheSkywalker]

Damn, Matt -- Even *I*, being your biggest fan, gotta admit that was a good rebuttal. Dayum.

Thanks bor. I need to recharge the K before I hit you.

 

[Lao Tzu]

So there really is no opt out 'choice'. I knew that. There can never be an opt out choice. Every socialized program needs to screw rich people in order to survive.
I am all ears.

WOuld you like to tell me what will happen to the costs of administration once all of these federal employees on the administration side get unionized and get into the federal pension system? You ever been to a Social Security office? How about a DMV? Imagine that level of service in health care.

Now, specific points:

Administration is cheaper for Medicare because all of the administration is done by the private health care providers. There are jobs like "medicare billing/coding" which are done privately. These costs are not included in the 3% figure because the private sector eats the cost; doctors and prioviders pay their salaries. Once you socialize, all those people will be taxpayer funded, with retirement benefits too, and of course, the un-fire-ability of a federal job. Ever heard the expression "Federal Fridays?.

When you say administration in the private sector is 25%, all of these billers, etc are included. The 3% in Medicare is a misnomer, because those same costs are ignored since the private sector bears them.

If you are on Medicare or private coverage, your claim is processed the same way: a person fills out a form and bills the government. Whether they bill government or an insurance company, the process and costs are the same.

Do you think all those admin costs just vanish?



If this happens, drugs will get really cheap, because pharma companies will go out of business. WOn't that be nice?



Rich people already pay for their exclusive treatments. If I go to the Mayo clinic, they are outside my insurance plan, I have to pay. No change under your system.

The poor put stuff off and then they screw everyone else. Why do they deserve free healthcare? We don't give them a free car? Healthcare is a commodity, right?



Get the government out and the market fixes prices. You still haven't addressed the relationshio between third party payors and prices.



Top 5%? I'd kill myself.

You are right. My arguments are self-serving. I don;t want to pay for other people to do stuff. I don't want to bear the costs of other people. I'll pay for things we need that cannot be commoditized (military, etc.) but I don't want to pay for people's retirement, sickness, and other crap.

Do you? And if you do, then you are allowed to do so. Why are you allowed to compel me? And where do you get the sick notion that I should act in an other than self-serving manner? Whose life is this?



Bingo. Buy that man a Miller. Or a root canal!



Wrongo bongo. Admin costs will not change. Hopefully your lack of understanding of them has though.

True voluntary association will stop us from throwing $1T a year at Grandma. Grandma who cannot afford care, will die. Cheap! Grandma who can, will not.
Prices will drop as the bottomless third party payor (the fed) is out of the picture, and R&D will continue because market competition will be fierce for the people who can afford treatment.

Since the costs will have dropped, more people will be able to afford treatment.

Your "scenario" is a worst of all worlds without consideration for underlying economic principles or the real costs of healthcare.

This seems more like a libertarian fantasy though. I don't see anyone letting old people die because they lack money.

You still haven't explained why the US spends more per person than any other developed country, both as a % of GDP and in dollars if the private sector is nearly as efficient as you proclaim. If privitizatoin and 'everyone for himself' works so well then why has the US, which adopts this more than any developed country pays more than all the other developed countries for healthcare?

Can you back up the idea that medicare administration costs are higher than 3%?

You also didn't address the article i put up earlier about how private hospitals skimp on healthcare and instead spend money on administration and are more prone to corruption.

Admin costs would go up as there would be more paperwork. More people to deny coverage too, more loopholes to find and use, things like that. Again, explain why in the article i put up earlier private hospitals spend more than public on administration? Explain why canada spends about 14-16% while the US spends 25% of healthcare costs on administration?

 

[velvett]

Imagine how bad things will get when even these local yahoo's no longer have to fear competition because the Fed has taken over.

I don't mind paying for my healthcare - I like to know that it's there when I need it. Kinda like buying a car with good torque and a reasonable amount of horsepower - I don't need it all the time - but when I need power I know I've got it.

Unlike the car when I pay for my health insurance I don't always know what I'm getting because I can't control competency and availability of the doctor.

I don't think our system need to be changed but it does need vast improvement in many other areas then what I've stated.

 

[Razorguns]

>Explain why canada spends about 14-16% while the US spends 25% of healthcare >costs on administration?

1) The US system is much more complex and larger in scope than Canada. 80% of canadians live in like 6 metro areas of the country.
2) The US system has much more instances of fraud, and as such -- a lot of manpower is dedicated to this area.

It's like comparing the complexity of running a city vs running a country. The US has 10x the population. It's not as easy as Canada's. Not even close.

 

[MattTheSkywalker]

This seems more like a libertarian fantasy though. I don't see anyone letting old people die because they lack money.

It is politically untenable.

You still haven't explained why the US spends more per person than any other developed country, both as a % of GDP and in dollars if the private sector is nearly as efficient as you proclaim. If privitizatoin and 'everyone for himself' works so well then why has the US, which adopts this more than any developed country pays more than all the other developed countries for healthcare?

I explained it THREE TIMES. We do not have a true free market. The costs of healthcare in the US are due to the presence of third party payors; almost no one pays for their own care directly. A free market will work well to control costs; it always does. Insurance companies are subject to the laws of the market too.

The cost of health care skyrocketed with the increased involvement of government. Government is a third party payor that is not subject to the market. The presence of this third party payor forced the hands of insurance carriers to keep up with ever rising costs.

Read about how President Johnson assreamed America, here http://www.cms.hhs.gov/about/history/ssachr.asp? It all went tits up in 1965.

Because the government was external to the market, the supply of money to pay for care was not limited by the market. Costs predictably skyrocketed. Good ol' government.

If you removed government from health care, prices would drop by defintion, since the supply of money to buy the stuff would decrease precipitously. .So would prices...they would have to. This would make private care affordable to more people.

Is that clearer?

Can you back up the idea that medicare administration costs are higher than 3%?

I explained this too - statstical misrepresentation is the answer. One more time:

When you go to the doctor or hospital, adminsitration costs for all patients are the same. Those costs, typically represented as "women behind the counter wearing purple" include things like billing, coding, claims administration, etc.

Those costs are all borne by a private entity: a hospital, a doctor's office, whatever. The doctor who owns the office (or hospital corporation) pays those salaries out of their revenues.

When the doc/hospital treats a Medicare patient or a patient with Aetna, those costs are exactly the same. Claims forms are filled out, coded, and sent either to "Aetna" or "medicare". Where do you think the different costs come from?

The insurer, whether Medicare or private, is irrelevant from a cost standpoint . The 25% vs 3% comes from this:

Those admin costs are borne by the provider. When calcuating the admin costs of private coverage, those figures are included. When calcuating the admin costs of Medicare, they are excluded, since the government is not paying them directly.

Itis statistical shenanigans, that is all.

Any true difference in administration is largely due to fraud investigation; fraud, as you know, is rampant. But aggressive fraud investigation SAVES people money. Naturally, the cost of investigations are always included in the COST of private coverage, but the savings never show up.

You also didn't address the article i put up earlier about how private hospitals skimp on healthcare and instead spend money on administration and are more prone to corruption.

Business is corrupt. People are shady. This is news?

You want corruption? That's choice A. Choice B is the DMV. At least A is subject to competition. The DMV sucked 20 years ago. It still sucks. It will suck in 20 years.

Admin costs would go up as there would be more paperwork. More people to deny coverage too, more loopholes to find and use, things like that.

This is crap, you're ranting now. Government creates loopholes, surely you know that. Loopholes are ways around governmentrestrictions onthe free market, nothing more. No government, no loopholes.

Are you comparing bureaucratic overhead in the private sector with the volume of paperwork the government can generate?

Again, explain why in the article i put up earlier private hospitals spend more than public on administration? Explain why canada spends about 14-16% while the US spends 25% of healthcare costs on administration?

I don't give a shit what Canada spends.

I do give a shit that you parade that 3% around like it is gospel without understanding its inherent fault, please stop doing that. I can explain it again if you want.

 

[Code]

The military is funded 100% by the government.
There is very little pure research done with government funding anymore. And I have no problem with government funded ventures, I see no reason *not* to run the government more like a business where there's an actual top line (aside from taxes).

The government gets most of their money back from school grants, with the exception of the Pell Grant of course. I didn't use the Pell,(or any grants per se) and I see no reason why anyone would need to if they were willing to work *and* go to school.

I doubt the country would fall apart, sure it would shock the economy into a nasty lull if we went cold turkey. And no one is suggesting that, I'm merely suggesting the government *not* force companies to set prices lower to accomodate the poor.

And possibly pay farmers to retire early, because large farming consortiums are what's forcing the smaller farms to demand financial intervention. Or shit, send "future farmers" to vocational school to teach them something else.

There are other ways to remove government funded social programs, like off-loading the burden to the states. At which point each state would have a referendum on what social programs they want/need. For instance, you can bet Connecticut would opt out of most welfare programs and California would opt in heavily.

.

What will happen to the millions of farmers who don't get subsidies so they remain competitive
what about the fact that 75% of students couldn't afford college anymore if state subsidies went away
what about all the medical advances that wouldn't happen w/o government funding.
what about all the military advances that wouldn't happen w/o government funding.

etc. The entire country would fall apart. Maybe it was designed that way (alot of conspiracy theorist libertarians choose to believe that) but its true at this point.

 

[Lao Tzu]

Yup, thats clear. Its also not something i agree with for 2 reasons.

The first is medical care costs 10x more because there is 10x more of it to use. We also spend much more on many more types of entertainment. You can't compare the world of 40 years ago to the world of today as there are many more options and processes to choose from nowadays. Treatments were not as advanced and there weren't as many of them, this makes up a large % of medical cost increases.

Your explanation still doesn't hold water because no other country spends as much as the US does on healthcare even though government pays a larger percentage of healthcare costs in those places. Am i to understand more privitization will end this? You are skirting the issue on the fact that an independent article says your idea of privitization is more corrupt and inefficient than a government sponsored program.

http://www.reuters.co.uk/newsArticle.jhtml?type=healthNews&storyID=5365605&section=news

"And experts who wrote a commentary on the study said converting all investor-owned hospitals to nonprofit status could have saved $6 billion in 2001............Investor-owned hospitals charge outrageous prices for inferior care"

As far as your views on medicare overhead, I don't consider you unbiased enough to be a trustworthy person on issues of government interventions (its like asking Rush Limbaugh who i should vote for) so i don't take your explanations seriously without independent proof. 'your explanation' is just that as far as i'm concerned until i see independent evidence. I am trying to find something online by using the words 'medicare 3% overhead myth' but can't find anything.

 

[Lao Tzu]

Also explain this

http://www.consumeraffairs.com/news04/health_plan.html

National Health Plan Could Save Billions in Paperwork: Study

January 14, 2004
A study by researchers at Harvard Medical School and Public Citizen finds that health care bureaucracy last year cost the United States $399.4 billion.

The study estimates that national health insurance (NHI) could save at least $286 billion annually on paperwork, enough to cover all of the uninsured and to provide full prescription drug coverage for everyone in the United States.

The study, to be published in the forthcoming International Journal of Health Services was based on the most comprehensive analysis to date of health administration spending, including data on the administrative costs of health insurers, employers' health benefit programs, hospitals, nursing homes, home care agencies, physicians and other practitioners in the United States and Canada.

The authors found that bureaucracy accounts for at least 31 percent of total U.S. health spending compared to 16.7 percent in Canada. They also found that administration has grown far faster in the United States than in Canada.

The potential administrative savings of $286 billion annually under national health insurance could:

1. Offset the cost of covering the uninsured (estimated at $80 billion)
2. Cover all out-of-pocket prescription drugs costs for seniors as well as those under 65 (estimated at $53 billion in 2003)
3. Fund retraining and job placement programs for insurance workers and others who would lose their jobs under NHI (estimated at $20 billion)
4. Make substantial improvements in coverage and quality of care for U.S. consumers who already have insurance

Looked at another way, the potential administrative savings are equivalent to $6,940 for each of the 41.2 million people uninsured in 2001 (the most recent figure available for the uninsured at the time study was carried out), more than enough to pay for health coverage. The study found wide variation among states in the potential administrative savings available per uninsured resident.

Texas, with 4.96 million uninsured (nearly one in four Texans), could save a total of $19.5 billion a year on administration under NHI, which would make available $3,925 per uninsured resident per year.

Massachusetts, which has very high per capita health administrative spending and a relatively low rate of uninsurance, could save a total of $8.6 billion a year, which would make available $16,453 per uninsured person.

California, with 6.7 million uninsured, could save a total of $33.7 billion a year, which would make available $5,016 per uninsured person. (See accompanying chart for details on other states.)

Last week, the government reported that health spending accounts for a record 15 percent of the nation's economy and that health care spending shot up by 9.3 percent in 2002. Insurance overhead (one component of administrative costs) rose by a whopping 16.8 percent in 2002, after a 12.5 percent increase in 2001, making it the fastest growing component of health expenditure over the past three years. Hence the figures in the Harvard/Public Citizen Report (which was completed before release of these latest government figures), may understate true administrative costs.

The authors of the International Journal of Health Services study attributed the high U.S. administrative costs to three factors. First, private insurers have high overhead in both nations but play a much bigger role in the United States.

Second, The United States' fragmented payment system drives up administrative costs for doctors and hospitals, who must deal with hundreds of different insurance plans (for example, at least 755 in Seattle alone), each with different coverage and payment rules, referral networks, etc.

In Canada, doctors bill a single insurance plan, using a single simple form, and hospitals receive a lump sum budget, much as a fire department is paid in the United States. Finally, the increasing business orientation of U.S. hospitals and insurers has expanded bureaucracy.

The Medicare drug bill that Congress passed last month will only increase bureaucratic spending because it will funnel large amounts of public money through private insurance plans with high overhead.

"The recent Medicare bill means a huge increase in administrative waste and a big payoff for the AARP," said study author Dr. David Himmelstein, an associate professor of medicine at Harvard and former staff physician at Public Citizen's Health Research Group.

"At present, Medicare's overhead is less than 4 percent. But all of the new Medicare money * $400 billion - will flow through private insurance plans whose overhead averages 12 percent. So insurance companies will gain $36 billion from this bill. And the AARP stands to make billions from the 4 percent cut it receives from the policies sold to its members."

Dr. Steffie Woolhandler, a study author, associate professor of medicine at Harvard and a founder of Physicians for a National Health Program, said that. "Hundreds of billions are squandered each year on health care bureaucracy, more than enough to cover all of the uninsured, pay for full drug coverage for seniors and upgrade coverage for the tens of millions who are underinsured. U.S. consumers spend almost twice as much per capita on health care as Canadians who have universal coverage and live two years longer. The administrative savings of national health insurance make universal coverage affordable."

Dr. Himmelstein described the real-world meaning of the difference in administration between the United States and Canada by comparing hospitals in the two nations. Several years ago, he visited Toronto General Hospital, a 900-bed tertiary care center that offered an extensive array of high-tech procedures, and searched for the billing office. It was hard to find, though; it consisted of a handful of people in the basement whose main job was to send bills to U.S. patients who had come across the border. Canadian hospitals do not bill individual patients for their care and so have no need to keep track of who receives each Band-Aid or an aspirin.

"A Canadian hospital negotiates its annual budget with the provincial health plan and receives a single check each month to cover virtually all of its expenses," Himmelstein said. "It need not fight with hundreds of insurance plans about whether each day in the hospital was necessary, and each pill justified. The result is massive savings on hospital billing and bureaucracy."

 

[Razorguns]

>"A Canadian hospital negotiates its annual budget with the provincial health plan and >receives a single check each month to cover virtually all of its expenses,"

Yeah, that's EASY to do when 80% of your health-care budget is like 5 hospitals in the province. It's pretty easy to drive up and check up on how things are going.

Add another few HUNDRED MILLION people to the mix, a few THOUSAND more hospitals, INCREASE crime, and add MILLIONS of illegals hellbent on abusing the hell out of it -- and even Canada's beloved "wait 8 hours to see a doctor" health system would crash and burn.

And we're not EVEN getting into the logistics of pricing levels, profit incentives, and administrative costs like Matt explained exhaustively.

I've used that Canadian system. Honestly, the only advantage it gives is for people who live in rural far away areas who don't have much money to be able to fly in a helicopter from Yukon to Calgary for a heart transplant. The rest of the 90% of the population -- it is a nightmare system based around 1950's technology. Toronto is probalby the worst place to get medical treatment right now.

While you're doing your little internet searches -- look up "Canadian hospital crisis financial fund drive" while you're at it.