Thank you for the useful citations.
So much for private sector relative efficiency, at least as far as HC administration goes.
No, but I have played Canasta with a goat.
Which is what efficiency means. Absolute dollars per patient makes absolutely no sense as a metric, since Medicare patients will on average have a lot more doctor visits than younger patients.
Yeah, it is horrific. The sad part is many people really didn’t care until recently because by and large most people don’t need that much health care. Most people go years with only minor medical expenses, and it is only when something serious happens that you find out how messed up our system is. Luckily that hasn’t happened to me yet. But who knows. A major reason people are waking up is probably twofold. One is that health expenses have grown so much that people can’t keep up. Premiums for a family run 12k a year and fewer and fewer companies offer health insurance, and those that do offer less subsidies for it. So the costs go more and more to the employees and customers (insurance premiums go up 10-40% a year). Another is probably that there is more media devoted to our failed health care system now. At least in my view that is the case.
Someone with a good income and good insurance can lose everything. If you are truly chronically sick you will probably lose your job. Once you lose your job you lose your insurance, unless you have $1200 a month or more for COBRA insurance.
The ‘advocates’ of the system, from what I have seen, consist of 2 people. People who make money on the status quo (insurance companies, Rx companies) and people who assume because we are Americans that whatever we do is automatically world class and who by and large do not use the health care system that much (like I said earlier, many people don’t find out how messed up our system is until it is too late). It sucks. Suckers and millionaires. The insult has a grain of truth to it.
Who won?
For everyone who thinks they can’t afford insurance call an insurance agent and ask about temporary health insurance. It’s very affordable.
Of course it is, it is temporary - from an underwriting point of view it is good risk for the insurance compsny. Just like flight insurance.
Instead, ask for a policy for a self-employed individual or family. IMHO, a more realistic scenario with fewer companies offering group insurance or hiring only contractors.
I think too many people forget this–it only takes one major setback to wipe out whatever savings you have so prudently set aside. It isn’t always through irresponsibility that people wind up in dire financial straits. IMHO, the people who think health care is a privilege for the financially deserving have never lost their access to it, or seen that happen to a loved one.
How big a retirement fund do you expect a 26-year-old person to have, when he earns $1600 a month? (Honestly, I thought truck drivers made a bit more than that!)
The private sector doesn’t even need to be inefficient. The mere fact that there are half a thousand different kinds of coverage makes sure there will be large administrative costs. Doctors over here don’t need anybody handling the paperwork. They fill themselves a paper or “online” (not on the internet, on another network) standard form where they have to fill a code corresponding to what they did, the amount charged, and I think it’s about it. That’s one salary less to pay for every doctor or cabinet, which probably amounts to quite a lot of money on a national scale.
You can add the profit margin of the insurance companies, the advertisement costs for the same, etc… and even an incredibly efficient private company will create more overhead than a single payer system.
Insurance companies’ profit margins are usually wafer thin, but their overhead is huge.
Yes, I have, but they drive a hard bargain.
Not that I expect either the OP or the subject to have some huge amount of bank, just demonstrating how very, very, far from anything like a tween they really are.
That’s true, but not really relevant. Insurance companies just funnel money from consumers to healthcare providers. Assuming their underwriters are clever enough to figure out expected payouts, and their lobbyists clever enough to get their rates set high enough, there is little that can go wrong. There aren’t a lot of unexpected disasters in this business - no hurricanes or earthquakes which force them to set aside reserves. Overhead helps them justify a bigger base and thus more profits.
I know - I started my career as part of the Bell Systems overhead, and each dollar they paid me they increased their allowable profits. I highly recommend it.
My advice was for people who cannot afford regular coverage and think they have no options. Of course it would be better to have permanant coverage but for poeple who can’t afford that or are between jobs the temporary can mean the difference between no insurance and something. It’s also better than being uninsured if you lose your job and can’t afford COBRA. It’s unbelievable the number of people who take a chance being uninsured for a few months between jobs and think this is an acceptable risk or do not know they have options.
We used to have to pay for our own insurance, a regular policy at that time was Over $800/ month, when we had to temporarily pay for our own insurance a year later it was under $250/ month for extremely similar coverage.
Lobbyists set rates for health insurance companies? In all my dealings with health insurers, their rates seem to be set by either competing directly for insureds in the marketplace or bidding on groups of employees, where the employer is looking for the lowest cost. Having a huge overhead is a competitive disadvantage. A competitive advantage might be denying claims or negotiating lower reimbursement rates for doctors, labs, pharmaceutical companies or pharmacies.
No insurance regulation in your state? I didn’t say lobbyists set the rates, I said they got them set, obviously working through legislators. In California at least, thanks to term limits, the lobbyists are more experienced than the legislators, and write a lot of bills.
Sure there is real negotiation when they are making deals with big employers who have market power and specialists in insurance. Not so much for individuals, as we’ve seen, especially since for this insurance bigger is naturally better. Barriers to entry are pretty high.
I agree that negotiating lower prices from doctors and hospitals is a competitive advantage - another reason why big players have an advantage. Overhead? If someone is looking at your rate of return, and overhead gets counted in the base, the more overhead you have the more profit you make. If a large company decided to forgo profit to lower prices enough to get a potential competitive advantage then maybe we’d see reduction in overhead, but that is risky and not likely to happen. It is not like you can eliminate it entirely, and the overhead of people denying or delaying claims clearly has a good RoI. So I don’t see much incentive for this to happen. Some overhead reduction is now mandated by the healthcare law (to get overhead within required limits) and we’ll see if the industry falls apart.
Until very recently, getting insurance work done on my car was a lot more paperless and high tech than getting insurance work done on me.
I totally agree. I live in the UK, where bitching about the National Health Service is something of a national hobby, but on the rare occasions I’ve had to use it it has been fast, effective and FREE.
So hearing about people being put at risk of bankruptcy for having the temerity to require surgery just seems so incredibly backward.
And yet when anyone dares to suggest that universal healthcare might just possibly be a nice idea in America, they’re run out of town as a dirty communist. I don’t get it, I really don’t.
I live in Massachusetts, and every two years we (the company I work for) put out an RFP for Health Insurance and Prescription Drug Insurance. The process for buying it seems (to the naked eye) pretty similar to what we do for other services. If Blue Cross is a better deal we go there, otherwise Cigna or someone else. There are very few providers who offer plans in the scale we need (thousands of employees), but there does appear to be competition. Maybe it’s all an illusion, and something behind the scenes makes the whole competitive bidding process a sham. It is not strictly a low price decision, we compare the size and quality of the provider networks as wel. But there does seem to be competition.
Or maybe you are talking about plans that are offered to individuals or very small businesses. Perhaps in that case the rates are set by some regulatory authority just like utility rates. I don’t know.
Really? I think universal healthcare as a concept has majority support. Any particular interpretation of it, and the roadmap to get there on the other hand, has much less support.
The misinformation spread about the various proposals certainly don’t help either. Nor does a general mistrust of the government as a provider of services or controller of costs. That medicare and medicaid (the existing government programs for retirees and the poor respectively) are quite efficient seems to carry very little weight, surprisingly to me.
I work for a company headquartered in Europe. Our European colleagues bitch and moan about the tax rates they have, and the layers and layers of taxes, but they all accept that the government should ensure or even provide universal healthcare and free (to the student) higher education. They seem to be as oblivious to the connection between the spending and taxation levels as Americans.