Socialize Medicine

[Segnosaur]

(Duplicate post)

 

[Segnosaur]

t is true that the WHO ranked the U.S. system much lower than the top western countries. However, their rankings were based on several criteria; quality of health care was only one component (costs, equality, etc. were also included.) The U.S. actually ranked #1 in at least part of the criteria for measuring the quality of health care (although they were ranked very low over costs, etc.)

I was talking about exactly the sort of thing the WHO was--but specifically our per-capita cost.

Well, would you be happy with cutting the costs in half, if it contributed to, lets say 1% more deaths? 5% more deaths? 50% more?

Frankly, I think its an unanswerable question. Up here in Ontario, Canada there was a recent case where someone was suffering from Fabry's disease. Treatment for the disease is around $250k/month. Their claims were initially turned down. (I'm sure some insurance providers in the U.S. may have denied the claim too....) The thing is, you can treat many diseases very easily/cheaply... however, the more extreme the case, the higher the per-capita cost seems to be.

I think the claim that a system can be considered the "best" even if it's only accessible to relatively few people is an abuse of the language.

Not sure if that's an accurate assessment either. In the U.S., most people either A: already have insurance (private, or through medicare/medicade) or can afford to pay for their own care. The number of people who don't have insurance (and can't really afford it) is relatively small.

That doesn't mean they should be ignored.... Its just wrong to suggest that health care is accessible to "relatively few".

So, the issue becomes...if the WHO is correct in their assessment of the quality of health care in the U.S., how much are you willing to risk affecting the majority in order to benefit the minority.

 

[King of the Americas]

You don't understand the benefit of pooling offsetting risks?

Or you don't understand why an intermediary should be a private profit-seeking institution?

Both.

We 'pool' our resources in an institution SOLELY designed to hold our premiums, and PAY claims. NO profit seeking allowed.

What benefit do we get by allowing a middle man to siphon off resources from those actually providing care???

 

[King of the Americas]

...

You are not taking out the middle man. You are just replacing private middle men with public ones.

I am replacing a high paid very profitable middle man, with a non-profit one.

Savings WILL ensue...

 

[King of the Americas]

But he said no medical claim should ever be rejected.

Slight correction. I said no "valid medical claim" should be rejected, and that we have to piggy back a strong fraud and abuse authority to oversee it...

But my claim IS that we are 'wasting' money on insurance companies who's sole job is to deny claims for profit.

 

[King of the Americas]

Whose theory is that? Marx?

The title IS "Socialize Medicine."

 

[King of the Americas]

This is the key.
Much of the concern in the States over government-run healthcare comes from the belief that claims will be denied on the basis of what's best for the country rather than what's best for the individual patient.
People believe they can pay a private insurer to look out for them more than they believe the government will.

So, which people think a private health insurer would rather look after a customer's health rather than the company's profits?

Because they'd be "dumb" to think this was true.

People get claims denied ALL THE TIME for profits.

What I DON'T understand is why people are blind to this fact...

 

[AvalonXQ]

So, which people think a private health insurer would rather look after a customer's health rather than the company's profits?

In a system with competition, the two will line up.
If you're an insurance company that never pays out, people will stop paying for you and choose one of your competitors that pays out.
If the government takes over and doesn't pay out (which, as we've seen in other countries, it won't if your treatments get too expensive), then what do you do?
Answer: you die.

 

[KoihimeNakamura]

"should" does not imply "is"

ALSO: False dichotomy fallacy.

 

[Segnosaur]

Both.
We 'pool' our resources in an institution SOLELY designed to hold our premiums, and PAY claims. NO profit seeking allowed.

What benefit do we get by allowing a middle man to siphon off resources from those actually providing care???

Once again... you are making the huge assumption that "profits" are the only difference between private insurance providers and a government/pubic system.

Often government employees are unionized and have higher salaries than their private sector counterparts. In addition, a government insurance provider may be less willing to make significant budget cuts (e.g. firing unneeded or incompetent staff) than a private provider might.

So, that means that while you may save on "profits", you will end up having those savings offset by increased costs.

So, which people think a private health insurer would rather look after a customer's health rather than the company's profits?

And just why do you think a government-run system, where the ultimate control rests with politicians interested in getting re-elected (and thus catering to their own voter base rather than your individual wishes), and where the system is administered by bureaucrats who have no need to "keep you happy" in order to keep their job, is going to be any better?

As someone else pointed out, if you don't like the service provided by a private insurer you can seek out other companies. If we had a single government-run system? Well, you're stuck.

 

[Professor Yaffle]

If the government takes over and doesn't pay out (which, as we've seen in other countries, it won't if your treatments get too expensive), then what do you do?
Answer: you die.

And the other party gets in at the next election with a manifesto promise of improving the health service...

 

[King of the Americas]

Once again... you are making the huge assumption that "profits" are the only difference between private insurance providers and a government/pubic system.

Often government employees are unionized and have higher salaries than their private sector counterparts. In addition, a government insurance provider may be less willing to make significant budget cuts (e.g. firing unneeded or incompetent staff) than a private provider might.

So, that means that while you may save on "profits", you will end up having those savings offset by increased costs.

First, profits would be a HUGE difference between private vs. non-profit providers. Second, while there ARE high paying government jobs, the private sector is more than renown for offering high salaries, so that would be an additional point of savings. The third area of savings would be the expenditures spent on the fraud and abuse wing. *Hopefully this would find more abuse or fraud than it cost to run the program.

Lastly, I don't assume things. My shop teacher taught me better than that.

And just why do you think a government-run system, where the ultimate control rests with politicians interested in getting re-elected (and thus catering to their own voter base rather than your individual wishes), and where the system is administered by bureaucrats who have no need to "keep you happy" in order to keep their job, is going to be any better?

As someone else pointed out, if you don't like the service provided by a private insurer you can seek out other companies. If we had a single government-run system? Well, you're stuck.

I AM on a government provided health care system. Given my pre-existing condition, the cost of a Cobra Plan to stay on my father's insurance plan, after I turned 21 was...*wait for it *... over $300 a month and that was with the highest deductible. Who can afford that? Other carriers were much higher, still.

I'd think you just made my point for me. "If you don't give me better health care, I'll vote you OUT!"

What recourse do you have against the health care industry? "If you don't process this claim, I am gonna go get denied by another insurance provider!"

 

[JoeTheJuggler]

Not sure if that's an accurate assessment either. In the U.S., most people either A: already have insurance (private, or through medicare/medicade) or can afford to pay for their own care. The number of people who don't have insurance (and can't really afford it) is relatively small.

One person's "relatively small" is another person's "my life".

The U.S. scores particularly low on accessibility of healthcare, and pays a higher per-capita cost than any other nation.

 

[JoeTheJuggler]

People get claims denied ALL THE TIME for profits.

Indeed:
http://energycommerce.house.gov/Press_111/20090616/rescission_supplemental.pdf

 

[Segnosaur]

First, profits would be a HUGE difference between private vs. non-profit providers.

No, they're not.

According to Yahoo. the average profit margin for health insurance providers is 3.4%.

http://biz.yahoo.com/p/sum_qpmd.html

Second, while there ARE high paying government jobs, the private sector is more than renown for offering high salaries, so that would be an additional point of savings.

Actually, not its not.

The private sector may offer high wages (plus things like stock options) to its top executives, but the fact is, those people make up only a small portion of a company's pay structure. (I once worked out that for Canada's largest business, the Royal Bank, executive pay amounted to less than 5% of the total. Even a small increase in the average salary would easily beat out the combined pay of all of the top executives.)

http://www.usatoday.com/news/washington/2007-06-24-fedpay_N.htm
http://www.cfib-fcei.ca/cfib-documents/WW_MB.pdf

The third area of savings would be the expenditures spent on the fraud and abuse wing. *Hopefully this would find more abuse or fraud than it cost to run the program.

Ummm... Why exactly are you assuming this?

After all, in the public sector (where there is a certain amount of job security), what would be the incentive to seek out cases of fraud? You don't get paid for each and every case of fraud, and its probably easier to just let questionable cases slide.

On the other hand, in the private sector, any employee that is lax in their job (including insurance adjusters) may find themselves unemployed.

Lastly, I don't assume things. My shop teacher taught me better than that.

First of all, I find that rather ironic that you'd give me that advice, considering all the assumptions you make (not to mention faulty information)... that government insurers would be better at finding fraud (no evidence of that), that profits make up a big part of the cost of insurance (it doesn't), etc.

Secondly, I never actually assumed anything. I know that average government wages are higher for government workers than private sector workers. I know that profits make up a very small amount of the cost of insurance. The only reason why I didn't come right out and say "you're wrong" because I recognize that there are many factors involved.

I AM on a government provided health care system. Given my pre-existing condition, the cost of a Cobra Plan to stay on my father's insurance plan, after I turned 21 was...*wait for it *... over $300 a month and that was with the highest deductible. Who can afford that? Other carriers were much higher, still.

Yes, insurance in the U.S. can be rather expensive.

But hey, look at Canada... The average cost of health care is roughly $5,000/year. Most of that is paid for by our taxes. If I had the choice of paying $300 or whatever taxes are deducted from my paycheck to pay for health care, I'd probably be better off to pay the $300.

I'd think you just made my point for me. "If you don't give me better health care, I'll vote you OUT!"

Except for one problem (one that I thought I explained well enough, but you didn't quite catch)... A politician does not have to make everyone happy. They only need to make enough people happy in order to get elected. And there are more issues than just health care. For example, a politician might find himself more likely to be re-elected if he campaigns on a cost-cutting platform if that is the issue that bothers more voters.

What recourse do you have against the health care industry? "If you don't process this claim, I am gonna go get denied by another insurance provider!"

Somebody else already explained that to you...

If an insurance company has a habit of always denying claims, they will likely find people leaving their company to buy insurance from their competitors.

 

[Segnosaur]

In the U.S., most people either A: already have insurance (private, or through medicare/medicade) or can afford to pay for their own care. The number of people who don't have insurance (and can't really afford it) is relatively small.

One person's "relatively small" is another person's "my life".

And once again, yes it would really suck if you were in that "relatively small" portion of people who can't get insurance coverage.

On the other hand, it would also really suck if you were part of the majority who could afford insurance, but because of government mismanagement, you could no longer get the treatment you wanted/needed.

(Now, whether this would happen depends on whether we're dealing with a government-run system only, or a mixed government-private system.)

The U.S. scores particularly low on accessibility of healthcare, and pays a higher per-capita cost than any other nation.

Yes they do.

But as I pointed out, they also score high in user responsiveness (dealing with patients, new technology, etc.) So, is it worth paying a little more per capita if it meant the system could deal with rarer cases?

 

[JoeTheJuggler]

But as I pointed out, they also score high in user responsiveness (dealing with patients, new technology, etc.) So, is it worth paying a little more per capita if it meant the system could deal with rarer cases?

Paying more per capita than we already do to have more expensive technology that a substantial portion of the population will never be able to benefit from? No.

 

[JoeTheJuggler]

If an insurance company has a habit of always denying claims, they will likely find people leaving their company to buy insurance from their competitors.

Again, under the status quo, shopping for another insurer isn't an option if the company practices rescission. (See the memo I linked to above--post #54.)

But as I said, no matter what else we get by way of healthcare reform, this practice will soon be abolished.

 

[ARubberChickenWithAPulley]

First, profits would be a HUGE difference between private vs. non-profit providers.

48% of people with insurance are on a non-profit plan.

And if this is your main issue, then why not just demand that you be allowed to by plans across state lines? Then you could go buy any non-profit plan you want. There are plenty around the country.

The third area of savings would be the expenditures spent on the fraud and abuse wing. *Hopefully this would find more abuse or fraud than it cost to run the program."

It would be hard to do worse than the government does now with fraud and abuse.

 

[Darat]

In a system with competition, the two will line up.
If you're an insurance company that never pays out, people will stop paying for you and choose one of your competitors that pays out.
If the government takes over and doesn't pay out (which, as we've seen in other countries, it won't if your treatments get too expensive), then what do you do?
Answer: you die.

Just like in the USA if your insurance company doesn't pay out.

However this ignores how universal systems actually tend to be implemented. In many countries that do offer universal health care systems, from the UK to Australia, you can opt to pay for additional insurance above any mandatory level (assuming of course that the private insurance company will pay for the treatment). or just pay out of pocket if it is something not covered by your universal system