And the Health Insurance Debate Rages On
Please, dear reader, consider this a follow up to Pat Edaburn’s excellent piece on Health Care reform.
Wow! What A Deal! Insurance companies agree to cover everyone, and not even charge ludicrous extra amounts for people who have been ill, but only if everyone is required to buy insurance. That’s right, the same highly profitable insurance companies that have caused the price of health care to spiral out of control in a system where nearly 1 out of every 5 workers has no insurance says they can control costs by making everyone buy their product.
The American public doesn’t want mandatory coverage. They don’t want to be told they have to buy something, particularly something that costs hundreds of dollars each and every month. The majority of Americans in poll after poll want “Medicare For All”, or as they euphemistically call it in Washington, “single payer.” And if the majority wants it, that makes it the moderate position; how dare politicians treat it as a “radical liberal” position espoused only by people like Howard Dean. Kindly pay no attention to the fact that Dr. Dean knows more about how health insurance really works than probably anybody else in America.
The people who want us to fear Medicare For All tell us that the government will control what medical care we are allowed to receive. I’ve already written about how this is no different from insurance companies controlling what medical care we are allowed to receive. Further, I challenge these critics to ask a few Medicare recipients about their experiences. Few have anything bad to say.
The people who want us to fear Medicare For All then tell us how terrible it will be for the economy, how taxes will have to rise and how our corporations will have higher expenses. I’ve written that there are at least 10 ways it will improve our economy, making our auto manufacturers more competitive and giving entrepreneurs a more even playing field.
In the end, it appears that Senate Democrats can use a procedural rule to avoid filibuster on the issue and force that “straight up or down vote” that Republicans made so popular in the previous administration when it comes to health insurance reform. Let’s hope that Harry Reid and company are willing to do the politically scary thing of giving the majority of Americans exactly what they want.
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60 Responses to “And the Health Insurance Debate Rages On”
Hemm, a little early in the morning to be hitting the conspiracy theory bong, isn't it?
If doctors lose money on medicare patients, of course they'll want to stop taking them. That doesn't require any collusion, it's just common sense.
Granted price caps stabilize prices, but they don't drive down the supplier's costs. You can cap what a doctor can charge for a treatment, but that doesn't make his rent any lower or his malpractice insurance payments any cheaper. His staff still has to manage the same paperwork–or more–and will still expect to be paid. So he's either going to stop giving the unprofitable treatment or shift the costs around by charging more for something else.
A doctor friend of mine reports that some of his medicare patients cover only 10% of the costs of treating them. He has to charge other patients more to make up the difference. And he's not part of a cartel.
So private hospitals committing fraud are the reason that Medicare is the problem? That's like blaming the victim for the crime, isn't it?
No, the Medicare bureaucracy is not the victim here, the American taxpayer is. And if the administrators of Medicare don't have adequate manpower and resources to prevent fraudulent claims from being paid out, then they are part of the problem.
Re the pricing discussion: both private insurance and Medicare's negotiated pricing have that same effect of raising the costs for the uninsured, Medicare even more so because it sets the pricest lower than the private market does in most cases.
That's why it makes no sense when people say, “Fine, let's not adopt a nationalized UHC system but instead let people voluntarily choose coverage under a government run plan, while others can continue with their traditional coverage.” That's not a sustainable situation because as govt begins feeling the pinch of rising costs, it's plan will continue to dictate low pricing which will then be subsidized by higher negotiated payments to the private insurance companies. So that approach makes no sense at all- you're not allowing some individuals to opt out of the government run program, not really- because they're going to pay for it one way or another. As soon as this becomes apparent, everyone will begin abandoning their private plans. We might as well skip the charade and go straight to universally mandated govt run insurance.
Wouldn't the problem be the people who refuse to give them those resources? In Missouri the Republican party proposed a bill to increase penalties for patients who defrauded Medicaid. When the Democrats proposed an addition that would also go after the businesses who committed fraud the Republicans refused to do it. Ths is a perfect example of their mindset. Screw the peasants, protect the wealthy.
CStanley: true, depending on the rules of a government-run insurance plan. If it competed honestly, negotiating prices with suppliers who were free to walk away, it wouldn't undermine private insurance companies. Unless it genuinely out-competed them, and there's little danger of that.
Wouldn't the problem be the people who refuse to give them those resources?
Yes- that's why I think it's a sham to claim that Medicare operates efficiently with 3% administrative costs. Those costs SHOULD be higher if they're unable to weed out fraudulent applications- then we wouldn't need the money on the back end to investigate the fraud. That's not to say I condone politicians who protect the perpetrators- it should be prosecuted and if GOP are refusing to do so they are wrong.
the annualized cost of medicare includes fraud, as does the cost of private insurance. even counting the fraud, medicare is a better deal. and many physicians prefer medicare because they know what it pays, for which procedures, which are allowed, and it is less costly for them to administer than the reticent insurers. physicians' offices pay the cost of paperwork on both private and government insurance, and they add it to their costs, so the private, or government insurer pays. there is no hidden cost in either case, and the paperwork cost would be a wash except private insurers have departments that fight against paying for their “customer's” care.
CStanley, there's no disparity in what I said. Lowering costs by deciding what procedures are or aren't covered does not require a decision on each patient to pay or deny payment. Procedure A is covered, or not, for diagnosis code B. Those decisions need be made only once, not per patient. And private insurers use the codes developed by the government, just as medicare does. Hence they actually are the beneficiaries of government spending, not the victims of it. Even with the government covering the full cost of developing the rules, private insurance is much more costly.
But we're talking in circles about comparatively trivial savings. If 80% of costs are on 20% of patients, and mostly in the last few months of life, it is THERE that we must save money. That's the toughest part of the debate, but it's sexier for you to passionately defend companies while trashing government. Government paid and controlled systems outperform globally, and to deny it is just disingenuous. We pay 3X as much for care that leaves us dead last in infant mortality, cancer, heart disease, diabetes, longevity and other measurable OUTCOMES of treatment. Governments can and do perform better globally at providing health care outcomes than our profit-driven model. You can deny it all you want, but you can't provide a single example in which a profit-driven system provides better OUTCOMES, regardless of cost.
We pay 3X as much for care that leaves us dead last in infant mortality, cancer, heart disease, diabetes, longevity and other measurable OUTCOMES of treatment
That's a patently false statement.
We don't lag in cancer survival (though this study shows that there's room for improvement in the US, particularly in certain states/regions and among minorities- but even with those negative factors we still don't lag generally as compared to other countries.) We're so far from dead last, it's absurd to claim that.
I'm not aware of any stats on comparing heart disease survival except a very limited focus one involving a few countries (Scandinavian, I believe) that have lower mortality rates in the immediate aftermath of a myocardial infarction. This could well be due to differences in severity of the disease itself based on lifestyle and genetic factors, though. If you have other stats showing across the board that the US survival rates for cardiovascular disease lag behind other countries, do share.
I've already debunked the longevity claim (that disparity goes away when you factor out violent or accidental deaths, which are not related to quality of healthcare delivery in any way.)
There are definitely things we can learn from other healthcare delivery models, and there are some narrower stats where we really do lag, as this article points out. But please stick to facts instead of propaganda. We do spend a lot more, and that has to change- but your claims about massive inferiority of our results is just not borne out in fact.
GreenDreams, of course private insurers have policies for what's covered and what's not. It's written into the contracts people sign. The case-by-case decisions start when people when people dispute the policies. The government has to have a similar appeals process, and it will be every bit as expensive as the private sector's.
You haven't missed the angry-villager dynamic in play here, have you? The Michael Moores of the world are aghast that the insurance companies have policies like this…beyond which treatment you need *will not be covered!* This is proof of the fundamental wickedness of the profit-minded insurance companies. How can you imagine that the government will be able to install a similar set of policies without facing a similar mob of torches and pitchforks?
Keith…
???????? – was interesting, thank you for posting it….