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Old Yesterday, 11:17 PM
Kimstu is offline
Join Date: Dec 1999
Posts: 22,501
Originally Posted by GreysonCarlisle View Post
I don't know how the typical insurance company is organized. Just seemed to me that most of their workaday activity was enrolling new members and processing claims, both of which would still need to be done under single-payer.
The paperwork of health insurance and healthcare in general would be far more streamlined if it weren't for the current hodgepodge system of multiple insurers, profit-maximizing plan design and marketing, and aggressive claims denial:
Analysis: A Health Care Overhaul Could Kill 2 Million Jobs, And That’s OK

[...] The first casualties of a Medicare for All plan, said Dr. Kevin Schulman, a physician-economist at Stanford, would be the “intermediaries that add to cost, not quality.” For example, the armies of administrators, coders, billers and claims negotiators who make good middle-class salaries and have often spent years in school learning these skills. There would be far less need for drug and device sales representatives who ply their trade office to office and hospital to hospital in a single-payer system, or one in which prices are set at a national level. [...]

Robert Pollin, an economist at the Political Economy Research Institute of the University of Massachusetts-Amherst, is frustrated not just by the doomsday predictions but also by how proponents of Medicare for All tend to gloss over the jobs issue.

“Every proponent of Medicare for All — including myself — has to recognize that the biggest source of cost-saving is layoffs,” he said. He has calculated that Medicare for All would result in job losses (mostly among administrators) “somewhere in the range of 2 million” — about half on the insurers’ side and half employed in hospitals and doctors’ offices to argue with the former.
Given that the healthcare industry currently employs somewhere between 15 and 20 million people, a loss of 2 million jobs in the sector is not trivial. If half of those jobs are on the insurers' side, that suggests that over 10% of the total work currently done by health insurance industry employees is just the bureaucratic red tape associated with a for-profit multi-player system, and would become unnecessary in a more efficient single-payer setup.
Old Today, 12:09 AM
Northern Piper is offline
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Join Date: Jun 1999
Location: The snow is gone. For now
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Originally Posted by GreysonCarlisle View Post
I'll have to take your word for it. I don't know how the typical insurance company is organized. Just seemed to me that most of their workaday activity was enrolling new members and processing claims, both of which would still need to be done under single-payer.
In the Canadian single-payer system, I've been enrolled exactly once: by my parents when Medicare was brought in by the Douglas government. Now, most Canadians are enrolled at birth. You only have to change your enrolment if you move to another province. That doesn't take a lot of employees in the provincial Medicare offices.

As for processing claims, other consists of the doctor or hospital sending in a bill. Our system doesn't have the yin and yang of insurance adjusters challenging a claim, and the doctor's office arguing why it should be paid.
"I don't like to make plans for the day. If I do, that's when words like 'premeditated' start getting thrown around in the courtroom."
Old Today, 12:26 AM
Lord Feldon's Avatar
Lord Feldon is offline
Join Date: Dec 2010
Location: Central Ohio
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Originally Posted by DSeid View Post
I apologize for not reading this whole thread (the sniping gets tiresome) so maybe this has already been discussed, but how does the promise to eliminate private insurance square with fact that over a third (and rapidly growing) of Medicare coverage is now Medicare Advantage, run by private insurance companies?
It depends on the proposal, and there's no reason to think it would be enacted as-is, but the Sanders bill (the most commonly-discussed version of Medicare For All) doesn't put anyone on the current Medicare system, which is actually abolished in the plan, and replaced by a whole new and entirely public system also called Medicare.

Last edited by Lord Feldon; Today at 12:27 AM.


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