Efficiency of Medicare vs Private Insurance

[xjx388]

As far as the assertion in the OP. There are opinions on both sides of this debate. I think my own experience and the evidence I've seen suggests to me that there is massive waste and fraud in taxpayer-funded healthcare: over-utilization, DME and Home Health waste, etc . That, together with the administrative burdens placed on doctors and hospitals makes it quite inefficient indeed.

 

[Darat]

But how do you do that without a free market? It's not as simple a question as you might think.

...snip...

How does a government negotiating negate a free-market? In the UK our national (and the international) pharmaceutical companies compete against one another.

 

[Neally]

I don't need insurance to cover contraceptives; never have, never will.
I don't need insurance for substance use disorders; no one in my family does drugs and if they did, I can pay for those services if and when they become necessary.
I don't need maternity and newborn coverage; I got a vasectomy -ain't gonna have no kids. On the off chance my 23 year old daughter gets pregnant, I am capable of taking care of her.

Therefore, ACA mandates coverage of three areas (see Essential Health Benefits) my family will never need. Like if I'm paying for convertible roof coverage on my car insurance . . . and I don't drive a convertible. Or if the government mandated that everyone can only wear size medium white t-shirts. There is no one size fits all health insurance solution; we all have different needs and wants. All I want is the freedom to select the benefits I want (specifically catastrophic only coverage, over $10k). I can pay for everything else.

Finally, someone here that gets it and sees beyond the "ACA is so wonderful with all these great new coverages..."

 

[DGM]

I don't need insurance to cover contraceptives; never have, never will.
I don't need insurance for substance use disorders; no one in my family does drugs and if they did, I can pay for those services if and when they become necessary.
I don't need maternity and newborn coverage; I got a vasectomy -ain't gonna have no kids. On the off chance my 23 year old daughter gets pregnant, I am capable of taking care of her.

Therefore, ACA mandates coverage of three areas (see Essential Health Benefits) my family will never need. Like if I'm paying for convertible roof coverage on my car insurance . . . and I don't drive a convertible. Or if the government mandated that everyone can only wear size medium white t-shirts. There is no one size fits all health insurance solution; we all have different needs and wants. All I want is the freedom to select the benefits I want (specifically catastrophic only coverage, over $10k). I can pay for everything else.

Fine, mandate everyone get insurance. But it's ludicrous to make everyone have the same kind of plan. There should be a lot more flexibility in available benefit packages.

 

[3point14]

I don't need insurance to cover contraceptives; never have, never will.
I don't need insurance for substance use disorders; no one in my family does drugs and if they did, I can pay for those services if and when they become necessary.
I don't need maternity and newborn coverage; I got a vasectomy -ain't gonna have no kids. On the off chance my 23 year old daughter gets pregnant, I am capable of taking care of her.

Therefore, ACA mandates coverage of three areas (see Essential Health Benefits) my family will never need. Like if I'm paying for convertible roof coverage on my car insurance . . . and I don't drive a convertible. Or if the government mandated that everyone can only wear size medium white t-shirts. There is no one size fits all health insurance solution; we all have different needs and wants. All I want is the freedom to select the benefits I want (specifically catastrophic only coverage, over $10k). I can pay for everything else.

Fine, mandate everyone get insurance. But it's ludicrous to make everyone have the same kind of plan. There should be a lot more flexibility in available benefit packages.

My guess would be so that the freeloaders don't just buy the minimum package in spite of the fact that they would need more coverage.

Unless a minimum coverage is mandated then it's likely that there'll be a whole lot of people under-insured and you're back to square one with the honest paying for the dishonest.

 

[Biscuit]

I don't need insurance to cover contraceptives; never have, never will.

I love how everyone opposed to the ACA knows the future. Contraceptives do more than just birth control

I don't need insurance for substance use disorders; no one in my family does drugs and if they did, I can pay for those services if and when they become necessary.

Where does the law mandate that?

I don't need maternity and newborn coverage; I got a vasectomy -ain't gonna have no kids. On the off chance my 23 year old daughter gets pregnant, I am capable of taking care of her.

Really? What's the cash in hand price for having a baby at a hospital? What's the total cost for maternity care? What if there are complications? What's the price for prenatal surgery to unwrap the umbilical cord from a unborn fetuses throat? What about spinal surgery on the unborn?

You say you are capable so what's the cash price for those things?

Therefore, ACA mandates coverage of three areas (see Essential Health Benefits) my family will never need.

Nonsense, unless you claim to know the future.

Like if I'm paying for convertible roof coverage on my car insurance . . . and I don't drive a convertible.

Still no. You can't wake up one day and through no effort of your own have car grow a convertible roof. Its a terrible analogy.

Or if the government mandated that everyone can only wear size medium white t-shirts. There is no one size fits all health insurance solution; we all have different needs and wants. All I want is the freedom to select the benefits I want (specifically catastrophic only coverage, over $10k). I can pay for everything else.

Fine, mandate everyone get insurance. But it's ludicrous to make everyone have the same kind of plan. There should be a lot more flexibility in available benefit packages.

All of this is silly conjecture without the exchanges being in place yet alone all the different aspects of the ACA being implemented.

 

[Biscuit]

My guess would be so that the freeloaders don't just buy the minimum package in spite of the fact that they would need more coverage.

Unless a minimum coverage is mandated then it's likely that there'll be a whole lot of people under-insured and you're back to square one with the honest paying for the dishonest.

Yup!

Like it or not other peoples health effects you in many different ways as does the health insurance they have.

Want it to stop hurting your pocket book and life? Support UHC.

 

[DGM]

Want it to stop hurting your pocket book and life? Support UHC.

How does my having private insurance hurt my life? Besides that, how much will I save with UHC? Numbers please.

 

[Ziggurat]

How does a government negotiating negate a free-market?

We weren't discussing government negotiating prices within a free market. We were discussing government deciding prices in place of a market.

 

[Ziggurat]

The ACA does a great deal to control cost, from mandating efficiency to fighting fraud.

History is littered with the corpses of victims of mandated efficiency. The failures here are not going to be as dramatic, but it's still going to fail, and for the same reason.

 

[Biscuit]

History is littered with the corpses of victims of mandated efficiency. The failures here are not going to be as dramatic, but it's still going to fail, and for the same reason.

Perhaps you could read up on that segment of the ACA before you doom it to some anonymous past failure?

There are all kinds of different ways the ACA seeks to lower costs on this website.

 

[leftysergeant]

You can get a reasonable measure of the cost this way, but it's the cost of doing something in a very specific way. The problem is that the way you're currently doing it (or even what you're doing) isn't necessarily optimal. Fixing the price will tend to freeze the process as well. It stifles innovation. Why become more efficient, or do things in a more efficient manner, if you can't earn more money by doing so? Why do things better if you can't charge a premium for it?

Doing it better and more efficiently at the same rate is more profitable. Not rocket science, okay?

The "private sector" in health care in the US didn't resemble a free market before Obamacare, and it severely distorted price signalling. Like I said before, it had the worst properties of a free market but without the benefits.

It worked fine until the insurance comapnies were allowed to turn a profit. The "free market" which allows the vulture capitalists to hold people hostage for their health care sucks tremendously. Slime like Bill Frist get richer while working people are bled dry.

My only gripe about the health care fix is that Obama dropped the public option.

 

[leftysergeant]

oops!

 

[leftysergeant]

History is littered with the corpses of victims of mandated efficiency. The failures here are not going to be as dramatic, but it's still going to fail, and for the same reason.

Care to cite an example that would be relevant to this discussion?

 

[JoeTheJuggler]

Fine, mandate everyone get insurance. But it's ludicrous to make everyone have the same kind of plan. There should be a lot more flexibility in available benefit packages.

Good thing there is no mandate that everyone have the same kind of plan.

Remember, the ACA defines minimum essential coverage. You're free to get better coverage than that. (Although the "cadillac plans" will cost you even more at some point.)

In fact, what I think makes sense is defining grades of plans so that the market can function better. An individual customer shopping for insurance plans will be able to make meaningful comparisons among plans. As it is now, it's almost impossible to compare the premiums of two different plans without having to wade through tons of minutia and then at some point making decisions about how to compare apples to oranges.

 

[JoeTheJuggler]

There are all kinds of different ways the ACA seeks to lower costs on this website.

I can point to two of them immediately.

One is setting up state insurance exchanges to broaden the risk pool for people in the individual insurance market.

The other is the effective cap on profits the ACA sets on insurers. (It's actually described as a limit on how high premiums can be relative to the amount of money paid out in benefits, so it effectively caps profits, money spent on marketing, etc.)

 

[Kestrel]

As it is now, it's almost impossible to compare the premiums of two different plans without having to wade through tons of minutia and then at some point making decisions about how to compare apples to oranges.

The other problem for an individual is that insurance companies required a detailed health history before quoting a price for an insurance plan. If I understand the new rules correctly, in 2014 the price for a specific policy will only depend on the age of the insured.

 

[Cl1mh4224rd]

2 & 3 don't apply to me. Thanks to Obamacare I now pay for something I don't want or need.

I don't need insurance to cover contraceptives; never have, never will.
I don't need insurance for substance use disorders; no one in my family does drugs and if they did, I can pay for those services if and when they become necessary.
I don't need maternity and newborn coverage; I got a vasectomy -ain't gonna have no kids. On the off chance my 23 year old daughter gets pregnant, I am capable of taking care of her.

And I'd only like to pay for maintenance on the roads I use, but guess what...?

 

[xjx388]

I love how everyone opposed to the ACA knows the future. Contraceptives do more than just birth control

In the highly unlikely event that my wife might need it, we can pay for it. My daughter already does. For medical purposes I assume... No thanks, Uncle Sam, I'd rather not pay for that coverage.

Where does the law mandate that?

I'm on my phone now so it's hard to post links. But Google 'essential health benefits,' and you will see the 10 coverage areas that are mandated.

Really? What's the cash in hand price for having a baby at a hospital? What's the total cost for maternity care? What if there are complications? What's the price for prenatal surgery to unwrap the umbilical cord from a unborn fetuses throat? What about spinal surgery on the unborn?

Ok, calm down. That stuff is extremely rare. That's why I pay for catastrophic only. A normal delivery is about $6k. C-section about $10k. But I have catastrophic coverage so $10K is the most I would pay out of pocket per year.

[/Quote]Still no. You can't wake up one day and through no effort of your own have car grow a convertible roof. Its a terrible analogy.[/quote]its perfect. I guarantee you that I will not wake up tomorrow with a raging drug addiction or pregnant wife. Why should I pay for coverage I don't need?

[/Quote]All of this is silly conjecture without the exchanges being in place yet alone all the different aspects of the ACA being implemented.[/QUOTE]
No, it's the law of the land. No need for conjecture.

 

[PhantomWolf]

We weren't discussing government negotiating prices within a free market. We were discussing government deciding prices in place of a market.

No, we were discussing the providers determining the prices in the marketplace by working out where the fair price lay. Having the Government determine the price is silly because they don't have any idea of the costs, the providers doo, and by having a group of them involved instead of just one or two, there is competition in the prices they work through to determine the final recommendations.