The means being what? If there are insurers who are not paying claims in good faith, according to the terms of the contracts issued, they should be dealt with harshly by the appropriate regulator. That does occur, and there are means of dealing with it. String 'em up, I say. Companies have gone out of business because of dishonest claim practices, and good riddance.
But if by that you mean that people should not be denied some form of coverage, despite the fact that they didn’t actually, you know, pay for it, that’s a horse of a different color.
But if you like Stratocasters, you must be a clear thinker and have already arrived at this completely logical conclusion.
Not as easy as you think. Any group health insurance policy offered by an employer is governed by the federal ERISA statutes, which prohibit any monetary damages beyond restoration of denied benefits. It is in the insurance companies’ interest to deny as many benefits as possible, because the only consequence is that some of their customers might have the means to pursue a lawsuit all the way to a settlement or judgement, and get no attorneys fees, no punitive damages, nothing but the benefits they should have gotten in the first place. Patients are dying while these lawsuits are being pursued; that is what the insurance companies are counting on, and that is what they paid for when they backed the candidates who wrote these pernicious statutes.
The United States has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc. Because the U.S. does not have a unified system that serves everyone, and instead has thousands of different insurance plans, each with its own marketing, paperwork, enrollment, premiums, and rules and regulations, our insurance system is both extremely complex and fragmented.
The Medicare program operates with just 3% overhead, compared to 15% to 25% overhead at a typical HMO. Provincial single-payer plans in Canada have an overhead of about 1%.
In 2003 the U.S. will spend $399.4 billion ($1,389 per capita) on health bureaucracy, out of total expenditures of $1660.5 billion ($5,775 per capita). The states could save $286.0 billion dollars in 2003 if they streamlined administration to Canadian levels by adopting a single-payer national health insurance system. The potential savings are equivalent to at least $6,940 for each of the 41.6 million Americans uninsured in 2001.
These potential administrative savings are far higher than recent estimates of the cost of covering the uninsured. For instance researchers from The Urban Institute estimate that covering all of America’s uninsured with an “average” private insurance policy would cost $69 billion annually (Hadley and Holahan, Health Affairs, May/June, 2003). Thus, the $286.0 billion in administrative savings could cover all of the uninsured, with $217 billion left over to upgrade coverage for Americans who are currently under-insured - e.g. to offer first dollar drug coverage to seniors. http://www.medicalnewstoday.com/articles/8800.php
The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country’s insurance markets are defined as “highly concentrated,” according to Justice Department guidelines. Predictably, that’s led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.
Yes, actually, I do. I have a number of opinions that are not strictly logical, being based on a sense of morality. And any morality must, ultimately, be based on an assumption, something that cannot be proved, a dogma, if you need to see it that way. Otherwise, its just “turtles all the way down”.
My wildly irrational dogma is that the answer to Cain’s question is yes, you are your brother’s keeper. For me, logic is the servant, not the master, logic is the means by which I determine what is the best means for my morality to be made manifest, it is not the means by which I determine that morality.
Hewitt Associates has an office complex a little way down the road from me, and a half-dozen others in various US cities and a dozen more overseas. This is a company with annual revenues in the $2bn range, 80% of which comes from employer outsourcing of health benefit plans.
It’s just one of dozens giant multinational corporations that makes money by navigating the incredibly complex waters of the US healthcare system on behalf of its clients- and yet government administered healthcare is supposed to be inefficient.
This flies in the face of facts and common sense. Why would a for-profit firm permit 31% of its revenue to go to unnecessary paperwork when they could otherwise put the money in their pockets? Your cite defies basic logic, and the axe they have to grind is apparent–the money-mad, profiteering health insurance companies are likewise flushing easy $$$ down the toilet. Um, okay. (And you might want to put direct quotes between quote tags, BTW.)
Health insurers rack up revenues of $723 billion a year, according to data from the Centers for Medicare & Medicaid Services. So you might think they make money hand over fist.
But with the costs of health care and prescription drugs rising every year, health insurers generally eke out only about a 3% profit. Health insurers would, in fact, make a bigger profit by selling toys to children. <snip> The federal data show that almost 86 cents of every dollar you pay for health insurance premiums goes to pay for medical services such as doctor visits, prescription drugs and hospital costs.
According to a 2006 PricewaterhouseCoopers study conducted for America’s Health Insurance Plans, an industry trade group representing about 1,300 companies, the remainder of your premium dollar is spent on the following:
[ul][li]5 cents for policyholder services such as prevention, disease management, care coordination and investments in health information technology, plus provider support and marketing.[/li]
[li]About 6 cents for insurers’ administrative costs, including claims processing and compliance with government regulations. [/li]
[li]3 cents for health insurance plan profits.[/ul][/li][/quote]
Why is it so unbelievable that private enterprise could be so wasteful? I’m going with the actual studies and numbers on this rather than information from the insurers themselves.
It is absolutely unbelievable that private enterprise would leave easy money on the table. Why? Because firms in the private sector like money. It soothes their nerves.
In a field so crowded with competitors, some firm would find the obvious efficiencies your cite is imagining, efficiencies that would permit them to price more favorably while simultaneously increasing profits, knocking out the less-efficient firms. It has nothing to do with a noble desire to be cost-effective in serving the public, and everything to do with wanting to make more money. Firms have enormous affection for such things–I know, it’s shocking. It is the very nature of the free market, in an industry with a large number of competitors. The public sector, on the other hand, has no such inherent mechanism for efficiency. Efficient programs run by the Federal government are aberrations. If the Feds don’t have a trillion or two laying around handy when they sense the need, they just take a vote and produce some cash like magic. The prerequisite need to actually have the revenue to support what they want to do is a troublesome detail they leave to future generations.
And the “actual studies” for your overhead number–where are they? Your 31% figure appears to be an unsubstantiated factoid from a “Physicians for a National Health Program” cite (and your biased cites disagree with each other materially–for example, with regard to administrative costs for Canada’s health care; should we just pick the figure we like best?). The figures I provided were from analysis from an independent auditing firm. Price Waterhouse Coopers, you may have heard of them. Sheesh.
Canada is an extremely different country from the US. In attitude, in population density, in the fact they have had their versions of UHCs for a very long time. Also, the Wiki article seems to indicate that Canada developed their UHC because there were areas where there was no healthcare for hundreds of miles.
This doesn’t seem to prove that I would end up paying less than I am now and doesn’t even touch whether or not the services would be at least as good. It doesn’t do me any good to pay less if I am getting far less for the money.
And the difference between growing up that way, and growing up in squalor, perhaps abused and/or ignored, in a crime ridden neighborhood, with their TAXPAYER-FUNDED upbringing is? You don’t need to wait 15 years to point to the results of that…
Where is this competitive free market healthcare system you speak of? We don’t have a competitive system, we have a series of local monopolies.
The government runs a super efficient social insurance system, one other governments around the world copy or want to copy. They just need to so health insurance the way they do social security and everything would be fine.
You got your numbers from insure.com, an organisation set up by insurance companies. We have no idea of the terms of reference PWC were working under when they came up with their numbers.
There’s plenty of variation in the numbers, but credible studies I already linked show that there are huge savings to be made by switching to a single payer system.
I didn’t read it at all - I don’t remember it but I think it was some side issue that I wasn’t interested in; Palin is a twit. Not real sure what that has to do with the thread title tho.
I would assume some of the waste comes from having various rules in various states plus having to deal independently with many providers because the providers aren’t able to learn a single system.
If every insurance company simply followed precisely what Medicare does (in other words, getting rid of all of the variance and having a single plan), I’d imagine their administrative costs would go down significantly.
Dealing with Medicare was so incredibly easy because all of the providers knew where they stood. The rules weren’t shifty.
Medicare is paid for by the US government, right? And Canada is sufficiently like America for the purposes of this discussion. Your services wouldn’t change. You’d be using the exact same services, just paying less as big chunks of profit would be removed from the system.
I have never lived in an area that has had an insurance company with a monopoly. OTOH, United Healthcare seems to be trying to create a monopoly the way they are buying up smaller companies. I don’t know why you are complaining about it tho, since a UHC would be a monopoly.
Our government? The USA? Social Security??
I couldn’t get past the idea that the government would have less administrative waste than any private company.
