Study: 'Medicare for all' projected to cost $32.6 trillion[W:174]

[Taylor]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

You answered your own question.

I see. So you just want to leave it as you simply leaped to a conclusion not supported by the source you provided.

 

[Greenbeard]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

No, it has to do with the administration of it. Not actual health care delivery.

I don’t know what hair you’re trying to split but I was responding to the statement that all they do is “administer payment from the premium pool.” If you’re now acknowledging that they play a direct role in supporting care delivery, okay.

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

The chargemaster resides with the provider. Prices, on the other hand, are negotiated between insurers and those providers.

With a focus toward....?

During times of aggressive managed care competition (eg, the mid ‘90s and the past several years), price growth slows considerably as insurers exert downward pressure on the prices of the providers they’re negotiating with.

If prices are rising, then pressure is not being pushed downward on the prices. Rising costs at a lower rate are still rising costs.

And those costs are rising to serve what focus...?

But arguably the more important role they can play is in shaping decision making by providers via contractual payment incentives and for consumers via product designs and other decision support tools.

Product designs = insurance plans.

So again, this is all about administration, not actual health care delivery.

All we are talking about here is who is doing the adminstration that serves the delivery of health care.

And the focus of insurance companies and providers is toward...?

 

[RSHERMR]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Great, it's timed you Obama-lovers got to see the true costs of all his promises. Forcing others to pay for your insurance AND their own is an abomination. Obama lied from the start and you guys swallowed the Kool-Aid.

Are you timing obama lovers?

By the way, me brilliant con, did you know that if you have private insurance your payment goes into a pool and pays others as well as your medical costs?

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

I don’t know what hair you’re trying to split but I was responding to the statement that all they do is “administer payment from the premium pool.” If you’re now acknowledging that they play a direct role in supporting care delivery, okay.

That is all they do...all the other functions you mentioned serve that singular task.

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

I don’t know what hair you’re trying to split but I was responding to the statement that all they do is “administer payment from the premium pool.” If you’re now acknowledging that they play a direct role in supporting care delivery, okay.

Supporting health care delivery by administering payments to providers.

Everything else you mentioned is a function of that singular task and role insurance companies play in health care.

Your insurer does not take your temperature.
Your insurer doesn't deliver your baby.
Your insurer doesn't perform bypass surgery.
Your insurer doesn't write a prescription.
Your insurer has absolutely nothing to do with your actual health care.

All they do is administration.

For this, they take as much as 20% of your premium.

Bad deal.

 

[prometeus]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

In any event, I suppose it depends on your goal. If one's primary goal is to want the best care for either the poor or rich

Why should care be different? Is the illness different or their dignity? Do the poor deserve to be less healthy or healed to only to a lesser degree? How about just the best care that is appropriate for the illness that is being treated?

 

[prometeus]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Your insurer does not take your temperature.
Your insurer doesn't deliver your baby.
Your insurer doesn't perform bypass surgery.
Your insurer doesn't write a prescription.
Your insurer has absolutely nothing to do with your actual health care.

It depends how you look at it. If you consider sexual activity being part of health then they do contribute, they screw you every chance they get.

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

It depends how you look at it. If you consider sexual activity being part of health then they do contribute, they screw you every chance they get.

Touche.

I was going to say something about how they don't check your prostate, but I knew another clever poster here would come up with a better joke.

 

[prometeus]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Income taxation is (largely) based on one's perceived ability to pay

No, it is based on the reward that society makes possible.

why that is seen as a good idea escapes me. From each according to their ability (to pay more income taxes), to each according to their need (for 'free' goods/services) is nowhere in our constitution.

That is because you have latched on to an ignorant talking point instead of reality. As for the Constitution, it does say "welfare" so maybe you should concentrate on that.

 

[trixare4kids]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Are you timing obama lovers?

By the way, me brilliant con, did you know that if you have private insurance your payment goes into a pool and pays others as well as your medical costs?

That's a given but it doesn't negate bullseye's point about "forcing others to pay for your insurance and their own is an abomination. Keyword is force as in mandate just in case you missed the context.

 

[prometeus]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

That is a crock and you know it.

No, that is REALITY simple fact.

It is income redistribution - plain and simple.

Now this IS crock, just a moronic talking point.

 

[trixare4kids]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Supporting health care delivery by administering payments to providers.

Everything else you mentioned is a function of that singular task and role insurance companies play in health care.

Your insurer does not take your temperature.
Your insurer doesn't deliver your baby.
Your insurer doesn't perform bypass surgery.
Your insurer doesn't write a prescription.
Your insurer has absolutely nothing to do with your actual health care.

All they do is administration.

For this, they take as much as 20% of your premium.

Bad deal.

If it were true, it'd be a bad deal, but it's not true.

Average insurers’ overhead costs are about 12.4 percent, according to an April 2017 Annals of Internal Medicine article by Steffie Woolhandler and David U. Himmelstein. A February report from the Center for Economic and Policy Research totaled overhead costs for private individual and employer based plans at 12.3 percent in 2015. And America’s Health Insurance Plans found that 17.8 cents of every premium dollar goes to operating costs.

But those are averages looking across health care markets.

When the Congressional Budget Office broke those costs down, they put administrative costs in the nongroup market at 20 percent, small-group market at 16 percent and the large-group market at 11 percent.

They have caps, as my article states but that's not what you wrote above.

Federal caps on administrative costs reflect this range. Group market insurers have a 15 percent cap and individual market insurers have a 20 percent cap. If exceeded, insurers have to pay a rebate to policyholders under the Affordable Care Act.

Oh, and jfyi... Politifact rated his statement as half true..

Sanders said, "Private insurance companies in this country spend between 12 and 18 percent on administration costs. The cost of administering the Medicare program, a very popular program that works well for our seniors, is 2 percent. We can save approximately $500 billion a year just in administration costs."

Government and independent researchers corroborate the percentage figures Sanders cited, but the researchers who came up with the $500 billion savings admitted that "any such estimate is imprecise."

Also, the administrative costs of private insurance and Medicare cover different types of costs. Experts told us that a single-payer system for the United States would have lower administrative costs than today’s private insurance, but it likely wouldn’t be able to achieve administrative costs as low as the existing Medicare program. Finally, the figures are misleading because lowering administrative costs wouldn’t necessarily lower overall costs. In fact, administrative costs sometimes help make the delivery of health care more efficient.

https://www.politifact.com/truth-o-...ing-administrative-costs-private-insurance-a/

 

[AlbqOwl]

https://abcnews.go.com/Health/wireStory/study-medicare-bill-estimated-326-trillion-56906940

Also, when has a government plan ever come at or under budget?

AND. . .we would have whatever health care the government decided we should be allowed rather than what we choose to pay for as the remainder of our private healthcare system, or what is left of it, would be destroyed. And not only when has our government ever come in at or under budget, but when has it ever done ANYTHING as efficiently or effectively or economically as private competition produces?

 

[Bullseye]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Are you timing obama lovers?

LOL, I meant it was TIME.

By the way, me brilliant con, did you know that if you have private insurance your payment goes into a pool and pays others as well as your medical costs?

Of course, and it's usually a pool of employees of a company I work with or members of an organization I belong to. Either way we each pay our own way with money we've each earned. I don't pay my premium and help some other employee pay his.

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

If it were true, it'd be a bad deal, but it's not true.

Then your link goes on to say:

When the Congressional Budget Office broke those costs down, they put administrative costs in the nongroup market at 20 percent, small-group market at 16 percent and the large-group market at 11 percent.

So back when I said...

They take as much as 20%

...I was being accurate.

And what is all this for? Profits and administration. Not health care.

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

They have caps, as my article states but that's not what you wrote above.

I didn't write this...you quoted it:

When the Congressional Budget Office broke those costs down, they put administrative costs in the nongroup market at 20 percent, small-group market at 16 percent and the large-group market at 11 percent.

And I said they take "as much as 20%"...check the thread.

Aetna, for example, takes about 17%, according to their own quarterly earnings report.

 

[Surrealistik]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Outcomes are a measure of what the population will, on average or typically get...

...I suppose it depends on your goal. If one's primary goal is to want the best care for either the poor or rich tail ends of distribution that is one view. For my part, I'd prefer a system that provide the best care for the average or median typical user - the those nearer the most numerous center of the wealth bell curve.

Median yes; the mean can conceal some truly terrible realities: remember the theoretical example of 20% of the population being nigh immortal and the rest neglected? Obviously that's an extreme theoretical, but it illustrates that averages, while useful, by themselves aren't sufficient and need supplementation by the mean. This is also why breadth of coverage matters.

Second, my goal is indeed the best possible care for the population overall, and that isn't the American system. Even if we were to accept that US healthcare does have a marginal edge over other UHC countries in terms of outcomes strictly, which again is very questionable, they obviously spend their money far more efficiently, and would thus be likely to surpass any minor advantage we have were spending increased to similar levels; even a partial increase in spending should see them surpass any advantages we enjoy.

And we differ in that I wish to provide the best quality health care system for most (but not all)...

See above. Efficiency in value per dollar can translate into better performance overall, since you spend less to get the same results or more; if we were achieving similar results at half cost, that gives us a lot of money with which to do better. There are many reasons US healthcare is an absolute money pit, ranging from price gouging/fixing, to administrative bloat, to middle men insurers and defensive medicine; most of these being due to fractured payers that don't have the clout and economy of scale as a large govt payer, single or otherwise while creating massive admin bloat to reconcile with the myriad labyrinth of plans, suppliers/providers that are permitted by the politicos they bought to run rampant in terms of price setting, and for profit elements that see large quantities of money being channeled (wasted) into things like marketing.

Every reform since WWII has been a "current system has to go" bromide...

Mainly due to a combination of political cowardice and corruption; the drug and insurance industry have spent billions lobbying against it, or skewing any proposed solutions in their favour with sadly predictable results. That said, if there's anything that makes me leery of UHC, and its viability in the States, it is indeed this culture of venal plutocracy and regulatory capture that has set in since the 70s.

I am skeptical of all "more government" solutions not only because government got us into this status quo "system"...

The rest of the first world doesn't seem to have issues with shortages or quality of care; UHC systems work by providing the fundamental infrastructure to eliminate most of the inefficiencies that bleed so much value out of US healthcare spending. As above, govt typically works towards better solutions that are inevitably twisted/interdicted by vested interests in the healthcare industry, with the death of the public option being a recent notable case.

Better yet we should, along with most folk familiar with the literature, dismiss Cuba's communist state ginned statistics as more fiction than fact .

I'd be more inclined to disbelieve Cuba's results if not for its prostrate survival rates; maybe they're playing three dimensional chess by letting a 'real' fact slip to create the illusion of honesty, but it definite undermines the idea they're fabricating these statistics, and I've seen nothing that undermines their account. Besides, that, it's a pretty strange thing to systemically and with nuance, lie about. Bottom line remains intact though: you can't go off cancer survival rates as a definitive measure of overall outcomes/quality. Moreover, which people are dismissing Cuba's results and are they doing it on an evidentiary basis?

Cont.

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Federal caps on administrative costs reflect this range. Group market insurers have a 15 percent cap and individual market insurers have a 20 percent cap. If exceeded, insurers have to pay a rebate to policyholders under the Affordable Care Act.

So, just like I said before...they could take as much as 20%.

What was the point of you responding if not to help me continue to make my point?

And for what service are we paying as much as 20% to an insurance company? To administer payment to your provider; a function that literally takes a keystroke.

So all insurance companies do is move money from the premium pool you pay into, to your provider, while taking as much as 20% for themselves.

Bad deal.

 

[Surrealistik]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

Cont.

First, using individual and homogeneous populations of tiny countries as a comparison to the US doesn't tell us much...

I don't think comparing like to like on the most important basis, economics and infrastructure, is 'cherrypicking' persay.

Second, I examine systems by size. The UK, Germany, France, and Italy are at least larger (although still much smaller that the US). The whole of Europe is the largest experiment, comparable to the US.

The problem with this approach is the obviously huge disparity in wealth and infrastructure between EU countries (that exceeds those between states), and thus fails every like to like test other than population.

Third, I remain skeptical of cost comparisons for two reasons: first, cost is also a function of consumer preference...

If you look into any academic analysis of cost as it relates to US healthcare, you will immediately see most of it is bound up in inefficiencies that don't actually improve outcomes, not consumer choice (including when they don't even count the waste that accrues to insurers).

Moreover, if there were glaring discrepancies in accounting that would account for any significant chunk of the ~2 : 1 per capita disparities in spending, it would have absolutely come out in a meta analysis/study, but no such study has been produced to my knowledge.

 

[Bullseye]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

You have all the choice in the world. If you don't want any, you pay a small tax on your income taxes. The reason for this is that most people that don't have insurance end up in ER rooms with big medical bills and then never pay them, forcing everyone else to foot the bill. So it was an incentive to get people to buy health insurance. Provide assistance to those that can't afford it, levy a tax on those that choose to skip it all together. Saying that you don't have a choice on health insurance is like saying you don't have a choice to have a kid, the government is forcing you to have one because you pay less taxes if you have a dependant. It's a stupid argument.

LOL, all this is is a disingenuous smoke screen. IF you don't like the law, ignore it. And, no, this feature wasn't to lighten the load in ER's, forcing participation was the only way the financing could possibly work out. And it worked out so well providers bailed out in droves. And millions elected to pay the fine rather than buy the over-priced ACA plans.

Good. We agree that the government needs to be involved. But now you're arguing that the government shouldn't let me buy insurance from a company that they don't think has the resources to handle claims, why the **** is that? Am I not smart enough to make that decision for myself? You should learn some independence from that government teet etc. etc.

If you have the ability to examine every insurance company's financial standings and ensure through actuarial analysis they will be able to meet their obligations for the foreseeable future, more power to you. Oh, and monitor that financial condition for every company offering any plan you or anyone else may be interested in buying.

I think the government definately has a role to play to ensure that if people are paying for an insurance plan that it actually serves a purpose. The overwhelming majority of insurance plans prior to ObamaCare met the standards set forth in obamacare. Those "catastrophic" plans that didn't qualify generally didn't help anyone. The deductables were so high that if someone got sick the people couldn't even afford the deductable, so they skipped on the medical bills leaving it to the rest of us to foot the bill. But like I said, this only affected a small minority of the plans.

Which is why so many dropped out, they couldn't provide the services ACA demanded at the cost the government demanded EVEN with risk corridor supplemental payments.

As for the "you only get three choices of plans!" complaint that you had earlier, that's false. You could contact an insurance company and get private insurance that had nothing to do with obamacare, and as long is it met the relatively low standards of obama care, you could buy it and be happy.

Yeah, I'm sure MILLIONS of people had the time and expertise to actually do that. :roll:

Only plans sold on the exchanges had to be 1 of those 3. The reason for this is to make the comparisons of the plans simple and easy.

My point exactly. Classic prog thinking:
"we decide what the common people need".

It made the insurance companies have to compete alittle more. You couldn't lower the rate and then not cover a bunch of crap and hide it all in the fine print. If you sell a silver plan, you need to cover this stuff, period. But like I said, you didn't have to purchase from the exchange. And most people don't purchase from the exchange because they get it through work. If you look at the actual reasons for everything, it makes general sense. I'm sure some things could have been done better, but when trying to fix a big system, you don't get everything perfect, and you don't make everyone happy.

And MORE prog "we know better than ANYONE" BS.

Good for him. If you don't care about what he promised, that's your prerogative.

No politician will ever live up to every promise, but acting as though the american electorate shouldn't speak out when they make unbelievably wide and impossible to achieve promises and utterly fail to deliver is antithetical to basic american principles.

And I never said or implied anything like that so put a lid on your lying.

Also, blaming it entirely on congress is insane. Trump ****ed up every negotiation along the way. He would agree to something, change his mind, make threats, then back track.

LOL, and the Dems negotiated in good faith for the benefit of the people, right?

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

LOL, all this is is a disingenuous smoke screen. IF you don't like the law, ignore it. And, no, this feature wasn't to lighten the load in ER's, forcing participation was the only way the financing could possibly work out. And it worked out so well providers bailed out in droves. And millions elected to pay the fine rather than buy the over-priced ACA plans.

Providers didn't "bail out" since the plans offered on the ACA are plans offered by insurance companies, and aren't government plans. Insurers may have bailed out, but we found out they did so largely because they were playing politics and their reasons were suspect and meant to deceive weak-minded Conservatives.

But millions more signed up via the ACA...24,000,000 of them.

How many millions opted to pay the fine?

Do you even know?

 

[The Derp]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

If you have the ability to examine every insurance company's financial standings and ensure through actuarial analysis they will be able to meet their obligations for the foreseeable future, more power to you. Oh, and monitor that financial condition for every company offering any plan you or anyone else may be interested in buying.

See, this is the problem. You're still married to some ridiculous dogma that insurance companies have anything to do with your health care delivery. They don't. Their sole function is to move money from the pool to the provider. That's all they do. Nothing else. Any other functions they may perform all ultimately serve that singular role they play in health care; administration.

And for this "administration" they take as much as 20% of your premium.

Is that a good deal in your mind?

 

[Bullseye]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

But millions more signed up via the ACA...24,000,000 of them.

How many millions opted to pay the fine?

Do you even know?

What difference would that make? How many signed up because they didn't want to break the law?

By the ways this says 8.8 million signed up for ACA

 

[Plus Ultra]

Re: Study: 'Medicare for all' projected to cost $32.6 trillion

But millions more signed up via the ACA...24,000,000 of them.

That was the deal with expanded Medicare, it's "free"!

How many millions opted to pay the fine?

Hard to know without that "individual mandate".

Sanders’ plan assumes health care providers will only be paid at current Medicare rates.

healthcare providers including hospitals, physicians, and others will be reimbursed for all patients at Medicare payment rates, which are projected to be roughly 40% lower than those paid by private insurers during the first 10 years https://spectator.org/bernie-sanders-medicare-for-all-scheme-would-double-your-federal-taxes/