Page 25 of 37 FirstFirst ... 15202122232425262728293035 ... LastLast
Results 481 to 500 of 726
  1. #481  
    Quote Originally Posted by davidra View Post
    Do you want to "debate the topic" (the efficiency of Medicare) or whine? Let's have some facts, please.
    The first and most important 'bone of contention' would be how does one measure efficiency?

    Medicare advocates will certainly point to cost of processing claims vs. total claims paid out. Medicare has an advantage from this standpoint since it covers people who will naturally cost more (elderly, ALS patients, renal failure patients, etc.). The cost per claimant is drastically higher causing their 'efficiency' to appear 'better'.

    'Insurance' advocates will certainly point to some sort of per capita measurement. This makes 'insurance' appear significantly 'better'.
    ‎"Is that suck and salvage the Kevin Costner method?" - Chris Matthews on Hardball, July 6, 2010. Wonder if he's talking about his oil device or his movie career...
  2.    #482  
    Quote Originally Posted by Toby View Post
    The first and most important 'bone of contention' would be how does one measure efficiency?

    Medicare advocates will certainly point to cost of processing claims vs. total claims paid out. Medicare has an advantage from this standpoint since it covers people who will naturally cost more (elderly, ALS patients, renal failure patients, etc.). The cost per claimant is drastically higher causing their 'efficiency' to appear 'better'.

    'Insurance' advocates will certainly point to some sort of per capita measurement. This makes 'insurance' appear significantly 'better'.
    Medicare also is structured for health care reimbursement historically. Private insurers are not. I've already posted this once, but it addresses the historical failure of the private insurance companies to take the steps that would decrease their overhead.

    Social Security was, from its inception, a very efficient operation, devoted to doing its job at the least extra cost to the taxpayers. Their offices are spartan in the extreme: a Marines barrack looks like a Ritz-Carlton by comparison. Their procedures are what they are: remorseless, inflexible, and highly efficient.
    When Medicare was created in 1965, the Johnson administration realized that there was only one government agency that would be up to the immense administrative burden: Social Security. Medicare made the rules rigid and uniform, so that the discipline learned from Social Security of handling a high volume of relatively low value transactions could apply.
    So there is the root of the paradox. Medicare was, almost by historical accident, designed to be efficient at the business of health care funding. Driven both by competition within the industry and comparison to Medicare, private health insurance evolved into a condition where its overhead became ever higher.
    You don't use your auto insurance to buy gas for your car, but you expect the equivalent from your health insurance. It doesn't make sense. The private insurance industry knows it doesn't make sense. They know they run like an insurance company, not like the check processing department of a bank. They can't change, and they don't really know what to do about it.
    Dr. Philip Neches: The Paradox of Medicare Overhead
  3. #483  
    ....this healthcare financing/insurance law not healthcare access/affordability law....
    -- VZW Pre+ -- Uberk/Gov fixed @ 1ghz -- QPST gps mod -- stock battery (?mugen 3800?) --
  4. rjwerth's Avatar
    Posts
    16 Posts
    Global Posts
    23 Global Posts
    #484  
    Quote Originally Posted by davidra View Post
    Medicare's overhead is less than 5%. Private insurers are around 25%. As someone who bills both private insurers and Medicare, I can tell you that from my standpoint, there is little difference in efficiency. And the VA is more efficient than either. If you want some references on any of these, please feel free to read this very thread. Do you actually have any first-hand knowledge about these things, or are you just spouting rhetoric?
    Quoting overhead costs as a percentage is very misleading when you compare medicare to a private insurer as I know you are aware. How about discussing overhead in terms of $$ per customer? The numbers won't be nearly as pretty for you. The fact is, that once people are on medicare, they are using it--a lot. The more a person uses insurance, the more "efficient" the company that provides the insurance looks.

    I'd also like to see the actual balance sheet of Medicare to see if some costs a private company has to pay is being shifted to another department of government and not being counted....so if you have such info, please share.
  5. #485  
    Quote Originally Posted by jhodnettejr View Post
    ....this healthcare financing/insurance law not healthcare access/affordability law....
    ...silence....
    -- VZW Pre+ -- Uberk/Gov fixed @ 1ghz -- QPST gps mod -- stock battery (?mugen 3800?) --
  6. #486  
    Quote Originally Posted by davidra View Post
    And you work for Kaiser? That must be this Kaiser....



    Or this Kaiser statement:



    Kaiser Permanente Comments on House Passage of the Health Care & Education Affordability Reconciliation Act and the Patient Protection and Affordable Care Act | Kaiser Permanente News Center


    Kaiser Permanente Health Care Reform

    Sounds like you may want to find somewhere else to work. Kaiser has been very supportive of health care reform. Good luck with your search.
    Sorry to disappoint, Kaiser is going to hurt from this. They know it and are putting on a good face because they know it is inevitable. Also, I wasn't talking about Kaiser as a company, I was talking about myself and my coworkers. As it is, it takes a month to get a doctors appointment. With this reform in place, it's going to take months. None of the people I work with (besides the ignorant, uninformed minority) are okay with Obamacare.
  7.    #487  
    Quote Originally Posted by blue duck butter View Post
    Sorry to disappoint, Kaiser is going to hurt from this. They know it and are putting on a good face because they know it is inevitable. Also, I wasn't talking about Kaiser as a company, I was talking about myself and my coworkers. As it is, it takes a month to get a doctors appointment. With this reform in place, it's going to take months. None of the people I work with (besides the ignorant, uninformed minority) are okay with Obamacare.
    Hilarious. The "ignorant uninformed minority" that happen to run the organization? Kaiser has put out support for the expansion of health care since it's inception. Halvorsen has been on the record for some time in favoring much more invasive changes in health care delivery (such as increasing tobacco taxes considerably) that would be laughed at by republicans. He also favors universal coverage. But hey, don't let that reality stand in the way of your own politics.

    And it's really unfortunate that it takes so long to get a doctor's appointment. Of course, that is in the current health care non-system, right, since no provisions of the bill have been enacted that could have that effect...unless all the appointments are being taken up with sick children who were denied coverage in the past. I doubt that. The current system does not work.
  8. #488  
    Quote Originally Posted by davidra View Post
    It's very interesting that the natural extension of your own arguments are the following:
    1. No more employee-sponsored health care insurance
    2. Provide care for all so that people will be able to afford "more important things"...like food and shelter....by not having to buy health insurance.

    You must be coming around.
    Sorry....my "more important things" comment is what people must think when they can afford to pay for cigarettes but not $13 per week for insurance. All I'm saying is that many people, especially people who have been getting healthcare for "free" (free to them, not to us), don't feel compelled to spend $13 per week on health insurance. Yes, there are people who can't possibly afford health coverage for themselves and their family and I have no problem with a state sponsored subsidy (funded by everyone through something like a gas tax or sales tax)....I've explained this countless times....but I also know some people would rather spend their money for the cable bill, or go out to lunch every day, or new "rims" for their car, or whatever vs paying for health insurance......especially if they have been relatively healthy. For you to deny that is just not being realistic. I have no doubt that you see the horrible cases where people end up in the hospital with no insurance, but I see the cases where they refuse coverage and could have afforded it IF they wanted to. It does happen whether you want to believe it or not. You accuse me of being uncaring, but why should I be worried about the group of people who choose not to get health coverage, to not make it a priority, and yet who cry when they then get sick? Is it a tragedy? Yes, but sometimes people make stupid decisions. It's like the guy who chose not to pay $75 for fire protection and everyone watched his house burn down. That was his decision and it was a horrible way to learn a lesson....there is stupidity out there. But davidra, I've said it before, I am all for helping those who NEED the help on their premiums. Of course, I also feel that having an HSA plan should be an option for someone who can't afford it in order to limit their loss exposure. Obviously obama and the dems thought the same thing as the plan under the PCIP program is an HSA.
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

    "It's good to be the King" - Mel Brooks, History of the World, Part 1

    "I would rather have a German division in front of me than a French one behind me." General George S. Patton
  9.    #489  
    Quote Originally Posted by clemgrad85 View Post
    Sorry....my "more important things" comment is what people must think when they can afford to pay for cigarettes but not $13 per week for insurance. All I'm saying is that many people, especially people who have been getting healthcare for "free" (free to them, not to us), don't feel compelled to spend $13 per week on health insurance. Yes, there are people who can't possibly afford health coverage for themselves and their family and I have no problem with a state sponsored subsidy (funded by everyone through something like a gas tax or sales tax)....I've explained this countless times....but I also know some people would rather spend their money for the cable bill, or go out to lunch every day, or new "rims" for their car, or whatever vs paying for health insurance......especially if they have been relatively healthy. For you to deny that is just not being realistic. I have no doubt that you see the horrible cases where people end up in the hospital with no insurance, but I see the cases where they refuse coverage and could have afforded it IF they wanted to. It does happen whether you want to believe it or not. You accuse me of being uncaring, but why should I be worried about the group of people who choose not to get health coverage, to not make it a priority, and yet who cry when they then get sick? Is it a tragedy? Yes, but sometimes people make stupid decisions. It's like the guy who chose not to pay $75 for fire protection and everyone watched his house burn down. That was his decision and it was a horrible way to learn a lesson....there is stupidity out there. But davidra, I've said it before, I am all for helping those who NEED the help on their premiums. Of course, I also feel that having an HSA plan should be an option for someone who can't afford it in order to limit their loss exposure. Obviously obama and the dems thought the same thing as the plan under the PCIP program is an HSA.
    So my only question is how do you tell those two groups of people apart? Even if it's true that I see a biased population, and you do as well, there are millions of people that just can't afford it, as you say. So given you want to provide for them, the simple, easy solution is to provide care for everybody. There would be no "choices" that put everyone else in the payor's seat if they choose to not buy insurance. Everyone would pay. There would no employee-sponsored anything, increasing the bottom line for every large corporation in the US. Paperwork would be dramatically decreased. No more premiums. No more dealing with multiple payors which would decrease every provider's overhead. Those who want more simply pay for it themselves, or employers could choose to offer additional coverage as a benefit. There would be co-pays to help deal with overuse. With one payor, fraud prevention would be amazingly easier. Of course, you favor paying for it by a sales tax or gas tax which everyone knows will punish lower income families more than the rich, but whatever. And insurers can go back to insuring cars, homes and lives. Sounds great to me. Maybe not to some of my colleagues, and definitely not to health care insurance companies, but too bad. It makes sense.
  10. #490  
    Quote Originally Posted by davidra View Post
    So my only question is how do you tell those two groups of people apart? Even if it's true that I see a biased population, and you do as well, there are millions of people that just can't afford it, as you say. So given you want to provide for them, the simple, easy solution is to provide care for everybody. There would be no "choices" that put everyone else in the payor's seat if they choose to not buy insurance. Everyone would pay. There would no employee-sponsored anything, increasing the bottom line for every large corporation in the US. Paperwork would be dramatically decreased. No more premiums. No more dealing with multiple payors which would decrease every provider's overhead. Those who want more simply pay for it themselves, or employers could choose to offer additional coverage as a benefit. There would be co-pays to help deal with overuse. With one payor, fraud prevention would be amazingly easier. Of course, you favor paying for it by a sales tax or gas tax which everyone knows will punish lower income families more than the rich, but whatever. And insurers can go back to insuring cars, homes and lives. Sounds great to me. Maybe not to some of my colleagues, and definitely not to health care insurance companies, but too bad. It makes sense.
    We are close but also soooo far apart. The biggest difference is you want the Federal Goverment to become the insurance company and I just don't see where that is listed as one of the roles of our government, to be the health provider for all. I'm sorry, there is nothing you can say that will ever change my mind on that. I've posted this before, but it is an interesting read on how Social Security got past the Supreme Court:
    Is Social Security Constitutional? by John Attarian So in my opinion, Social Security is unconstitutional, but, FDR was determined to change the landscape and he did. So now, most people believe that the Federal Government is responsible to take care of us. Please note I keep referencing to what I believe the Federal government can or cannot do. The states are a totally different situation. The Constitution gives them the power to do that which is not granted to the Federal government. I know you disagree with that, but it is important to point this out when I discuss anything like a Federally run health insurance plan. If we don't stick to the Constitution, which again, can be changed, then we might as well get rid of it.
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

    "It's good to be the King" - Mel Brooks, History of the World, Part 1

    "I would rather have a German division in front of me than a French one behind me." General George S. Patton
  11.    #491  
    Quote Originally Posted by clemgrad85 View Post
    We are close but also soooo far apart. The biggest difference is you want the Federal Goverment to become the insurance company and I just don't see where that is listed as one of the roles of our government, to be the health provider for all. I'm sorry, there is nothing you can say that will ever change my mind on that. I've posted this before, but it is an interesting read on how Social Security got past the Supreme Court:
    Is Social Security Constitutional? by John Attarian So in my opinion, Social Security is unconstitutional, but, FDR was determined to change the landscape and he did. So now, most people believe that the Federal Government is responsible to take care of us. Please note I keep referencing to what I believe the Federal government can or cannot do. The states are a totally different situation. The Constitution gives them the power to do that which is not granted to the Federal government. I know you disagree with that, but it is important to point this out when I discuss anything like a Federally run health insurance plan. If we don't stick to the Constitution, which again, can be changed, then we might as well get rid of it.
    Arguing the constitution with you will get nowhere. I think it was a wonderful document for it's time, and parts of it are timeless and will always be valuable, but parts of it just are not relevant to today's world. Militias? Not really.

    The Kerr-Mills act is the perfect example of why what you propose will not work. It was implemented in 1960 with the intention of staving off Medicare. It was a program that provided federal funding to states so that they could provide health care for the elderly poor. Unlike Medicare, there was a means-based requirement (so the rich elderly were not eligible). Sounds good, right?

    Except that only 28 states agreed to fund the program, even though they were given federal money to do so. This program was supported by the AMA. It was the failure of this program that led to Medicare. If the states had done the right thing in 1960 there might never have been Medicare. The fact is that the states do not always provide for their constituents in a reasonable manner. Can you ever see South Carolina implementing something like Massachusetts? Regardless of cost issues, the percent of people uninsured in South Carolina is massive compared to those in Massachusetts. Is that the kind of inconsistent health care the population should have? So the quality of your care, and whether or not you are bankrupted if you get sick, should be determined by which side of a state line you live on? I think not. And in my opinion, state legislatures are the only organized body with less concern about their constituents than congress. They are simply a bunch of snakes with no vision and respond only to the most recent polls, to a much greater extent than congress. If they weren't forced to provide Medicaid, most states wouldn't. By and large, they are pathetic. I trust the feds much more than the state legislature in my state, for dam n sure.
  12. #492  
    ...the problem is davidra is arguing for something that does not exist yet....and the legislation assed by this congress do none of the things he says he is for... Bait and switch....
    -- VZW Pre+ -- Uberk/Gov fixed @ 1ghz -- QPST gps mod -- stock battery (?mugen 3800?) --
  13.    #493  
    Quote Originally Posted by jhodnettejr View Post
    ...the problem is davidra is arguing for something that does not exist yet....and the legislation assed by this congress do none of the things he says he is for... Bait and switch....
    You're right, this legislation did not provide what I would like to see....but:
    1. It's much better than what we have now for 30 million people
    2. Because the private sector will not be able to come around and become more efficient and compete, what I do want will be in our future at some point.

    Those two things make me just happy as a clam with the current bill. And if it just so happens that the privates can modernize, compete by cutting their overhead, etc, and actually provide the care, that's fine too. It's the outcome that's important to me, not the process.
  14. #494  
    Quote Originally Posted by davidra View Post
    You're right, this legislation did not provide what I would like to see....but:
    1. It's much better than what we have now for 30 million people
    2. Because the private sector will not be able to come around and become more efficient and compete, what I do want will be in our future at some point.

    Those two things make me just happy as a clam with the current bill. And if it just so happens that the privates can modernize, compete by cutting their overhead, etc, and actually provide the care, that's fine too. It's the outcome that's important to me, not the process.
    ...the amount of trust and power you assign to the federal govt is simply astonishing...
    -- VZW Pre+ -- Uberk/Gov fixed @ 1ghz -- QPST gps mod -- stock battery (?mugen 3800?) --
  15.    #495  
    Quote Originally Posted by jhodnettejr View Post
    ...the amount of trust and power you assign to the federal govt is simply astonishing...
    And I'll say the same about the for-profit healthcare insurance corporations. I deal with Medicare on a regular basis....and they do just fine. Ask any recipient.
  16. #496  
    Quote Originally Posted by davidra View Post
    And I'll say the same about the for-profit healthcare insurance corporations. I deal with Medicare on a regular basis....and they do just fine. Ask any recipient.
    ...my grandmother sure complains alot...and so does my father who has worked in NOT for profit hospitals for the past 30y....
    -- VZW Pre+ -- Uberk/Gov fixed @ 1ghz -- QPST gps mod -- stock battery (?mugen 3800?) --
  17. Micael's Avatar
    Posts
    736 Posts
    Global Posts
    739 Global Posts
    #497  
    Quote Originally Posted by davidra View Post
    And I'll say the same about the for-profit healthcare insurance corporations. I deal with Medicare on a regular basis....and they do just fine. Ask any recipient.
    So not-for-profit healthcare insurance corporations are ok in your book.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  18. #498  
    ...healthcare providers and health insurance/financing are completely different things that seem to be interchangable is the current debate....
    -- VZW Pre+ -- Uberk/Gov fixed @ 1ghz -- QPST gps mod -- stock battery (?mugen 3800?) --
  19. Micael's Avatar
    Posts
    736 Posts
    Global Posts
    739 Global Posts
    #499  
    Quote Originally Posted by jhodnettejr View Post
    ...healthcare providers and health insurance/financing are completely different things that seem to be interchangable is the current debate....
    That may be so, but clearly the teeth of this bill was focused on insurance.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  20. #500  
    I haven't followed this whole topic...and I don't feel like reading through all 24.5 pages, but here's my take. I work at a very large hospital, and we stand to lose a good chunk of change because of some of the stuff in the bill.....a lot of which still needs needs to be determined by the Secretary of Health.

    Work views, aside, here's how I feel. Some of the stuff in there I agree with (mainly the whole "pre-existing conditions" stuff), but It should not be mandated by the government. They just shouldn't have that type of power. But I'll give some nice clear numbers...for me at least. The price of my health insurance just went up 17% (more than $400) for next year. I don't think it would have gone up that much had this not passed.
    Last edited by pezman726; 10/22/2010 at 12:26 PM.

Posting Permissions