Question about Healthcare from the Idiot Class:

[MadBadger]

What happens to insurance companies if this country goes to single-payer?

[Lyric]

1. They downsize, with many of their employees moving over to work for the new

government healthcare bureaucracy. The reduced-size companies continue to sell "premium" insurance to the uber-wealthy, who want something more than the government provides...because we all know that rich people will never be content having the same health insurance as poor people. There will be a market for insurance that makes the wealthy feel properly superior, and that's what they'll cater to.

[MadBadger]

2. But wont many have to lose their job?

[Somawas]

4. I certainly hope so.

Evil little minions of corpocracy.

[Name removed]

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[Lyric]

6. Yeah, they will.

I think that most of the new government hires to administer the new program will probably come from the bureaucratic ranks of state and federal Medicare and Medicaid employees, who are obviously going to be first in line for jobs when those two programs are no longer necessary.

But Obama is also supposed to create millions of new jobs rebuilding infrastructure, and we'll need people to administer and maintain our new schools, roads, community centers, free nationwide wireless internet centers, etc. I think most of the people from private-sector healthcare who lose their jobs will have the opportunity to get another one--either with the new single-payer program or with one of the other programs that Obama implements.

[AllentownJake]

10. Most states don't administer their medicaid programs or their medicare programs for the poor

Look up Medicaid HMO

[Warren Stupidity]

18. medicare is not for the poor

look up medicare. It is for everyone.

However, it does seem to be true that medicare outsources much of its claims processing. I didn't know that. It seems quite likely then that the OP's argument, if indeed he is making an argument that we should be concerned about job loss in the insurance industry, is totally baseless. Claims processing jobs will remain more or less unchanged. The companies doing the processing might change, but the total number of claims processing jobs ought not to be hugely affected.

[AllentownJake]

22. Hey

people who are poor and disabled get additional medicare funding from the state. But you did not know that did you?

[Warren Stupidity]

29. Yes I knew that.

generally they are dual covered (medicaid and medicare eligible). Most, in fact the vast majority of medicare recipients, are people over 65 who are not medicaid eligible. Characterizing medicare as 'for the poor' is rather inaccurate, in my opinion.

[AllentownJake]

30. There are medicare programs for the poor and that was what I was talking about

and dual eligible programs are managed differently.

So there is your clarification smarty pants :rofl:

[FreakinDJ]

14. So that the "MANY" can have the economy back - yes

I don't think most of Americans realise how much the increased cost of Healthcare (200% of most industrialised countries) weighs down our economy and stagnates new businesses

[AllentownJake]

15. The claims processor and the coders

are such a small part of the payment scheme but seem to be the big villian on here. Most of those people are little more than blue collar clerks.

The executives,lawyers (working for the hospitals and the John Edwards of the world), and administrators are eating up most of the administration cost.

The claims processor making $10-$15 and hour or the coder making $15-20 is not the bad guy here.

Without claims please explain how you manage costs.

[FreakinDJ]

23. 2% "Should be" the max administration cost

We are getting RAPED with 16% admin cost and 20-30% profit margin

[AllentownJake]

28. Yes and it isn't the coders and claims processors

Trust me. the cost of an entire insurance claims division is half of that of their executive suite...not at my company because its difficult to explain but at the big insurance companies that is the case.

[FreakinDJ]

32. Clinton had no problem telling Steel workers "You'll be ReTrained"

and then hammered the final nail in the coffin with the "China Most Favored Nation Trading Status"

[ellacott]

35. I'm a coder

We definately are not the villians. Also, PE Obama has said that he wants to look into the insurance companies(FI's) who manage the Medicare programs for each state/region. He has mentioned that he would consider eliminating those FI's in order to save costs.

I have also thought about the future of claims processors along with others if we go to a Single Payor plan.

P.S. I've enjoyed reading your comments in this thread. :)

[CreekDog]

33. not those who actually deliver health care

:think:

[Warren Stupidity]

3. The loss of low paying insurance processing jobs

will be more than offset by an increase in good paying healthcare provider jobs.

Any other questions?

[CTyankee]

5. I'm not seeing that the two are fungible. I've worked in health care

and the people processing claims were very different from the people providing the care. Of course, people can be retrained but not everyone wants to do that, or has those talents...

[Warren Stupidity]

16. That is correct.

Some of the processing people will get absorbed into whatever government agency does the processing, but many of these people will simply lose their jobs. On the other hand a mostly different set of people will gain employment providing healthcare rather than processing forms. In addition, consider the potential upside to the large corporations struggling to continue to provide decent healthcare benefits to their employees. This is a trade off that from a utilitarian perspective is clearly positive.

All sorts of government policy decisions result in winners and losers, in jobs gained and jobs lost for example. A major change to how we provide healthcare would also obviously result in an economic remix. Again, it is difficult to view the economic impact as anything but positive, even if some people are negatively impacted. "But some people will lose their jobs" is a real poor argument against universal healthcare.

[AllentownJake]

7. The Government would probably outsource administration

to the existing companies rather than create a new total beauracracy of their own.

Take a look at Medicaid, very few states administer their medicaid programs they outsource it to HMOs.

Of course it depends on what you mean by Single Payer. Do you mean a government run insurance program for everyone or do you mean a system where the Government directly pays the salary of healthcare providers?

[Warren Stupidity]

17. The government handles medicare just fine

and at very low cost. It could easily expand medicare to cover everyone and add personnel and equipment to the existing medicare claims system in short order to cover the expansion. Not that we will do this: it makes too much sense, would be too easy to do, and would have a very good chance of being wildly successful.

[leftyclimber]

9. If it's anything like it was when I lived in Ontario a few years back

the insurance companies will retool to provide coverage for things like prescriptions (still considerably less expensive than the US due to the province buying in bulk) and dental (not covered for adults). If people want to pay out-of-pocket because they think their hangnail is more important than someone else's gangrene, they are free to go to another country to get treatment ahead of the sick people.

I have a mortal fear of the Repubs doing everything they can to fuck up UHC to make it a disaster, somewhat like Mike Harris did in Toronto when he shut down all but 5 emergency rooms in a city of 2 million people, then issued a press release to United States media outlets using the emergency room overload (caused by him, but not mentioned thus in the press release) as an example of how the Canadian health care system was failing. Even my freeper father, who spouts lies about the Canadian health system with a disgusting facility, was appalled at that maneuver. :grr:

This is one area where we CANNOT offer ANY concessions to the Repubs. They will want a two-tier system (rich people pay for private service), they will want to make single-payer administration a nightmare, and they will pull any and all of the same shit that they've pulled to trash the rest of our social services.

[AllentownJake]

12. Best way to do that is to co-opt the insurance companies

State takes the risk, Insurance companies take a small profit for administration and providing services like utilization management (PCP, drug utilization, DME etc). You allow for competition among the companies for members so customer service doesn't suffer. Its actually a pretty sound business model used by most states for Medicaid and since business is involved you create a nice special interest group that doesn't want the hospitals to shut down.

[HamdenRice]

11. Hospitals will also fire thousands of people who do nothing but send in claims

but that overall is a good thing. The claims processors both on the health care side and on the insurance side were a dead weight cost serving no purpose.

[Name removed]

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[HamdenRice]

19. Sorry you will be affected, but really, there is no economic defense of that function

as it is currently carried out. A professor of medicine I talk to regularly is outraged by how much cost is absorbed in overhead at her hospital, most of it dealing with the many forms of the many insurance companies. I certainly don't think that claims processors are evil as people, but their function, as defined by the companies, is pointless. It also is not a small cost. As you correctly point out, much of the cost goes to upper management, but if the entire function is gone, so is upper management of that function.

Paul Krugman has pointed out repeatedly that private insurance administration and overhead cost is immense, sometimes estimated as high as 20% of health care expenditures, and if a Medicare/Medicaid system was in place, that cost would fall to about 3%, effectively helping finance universal health care. Contrary to what you argue up thread, it is not a good business model for society.

While your function is obviously valuable to you, it's not worth preventing us from getting universal health care -- without the pointlessly denied claims, the previously existing conditions, second guessing, proliferation of claims forms and so on.

[AllentownJake]

24. I actually won't be that effected

I'm an auditor and certified with Sarbanes experience. I just have seen the system and believe that the Medicaid HMO system where consumers have a choice in which administrator they have works best and guts the GOP argument against it.

Our overhead cost are well below 20% and it depends on how you define overhead.

[PBS Poll-435]

34. psst...

affected

[NYC_SKP]

20. Correct me where I'm wrong...

Because I think you know tons more than I do.

I watched as my teacher union negotiated health care plan went from supreme full coverage in 2000 to I can't afford the worst plan without chipping in $140/month.

The rising costs cannot only be attributed to higher costs of goods and services, I attribute them more to the numbers of people accessing care without insurance and those costs being passed on to those who can pay.

I'm certain that this is true of hospital emergency rooms, but the effect must be present throughout the system.

I'm sure that there's greed and overcompensation at work, too, and corruption in the way meds are sold to us and the high profits for pharma corps.

In California we have a large number of undocumented workers and families, and we have an aging population, and both groups seem to access services without insurance or with plans that are inadequate, so the costs are passed on to a shrinking number of people (as a percentage) who do have health care plans.

What else would explain the crazy exponential rise in costs for the same plan at the same job?

How to fix it, I've no idea, but my doctor has said Single Payer all these years, and I trust him.

NYC_SKP

[AllentownJake]

25. The biggest problem in our system right now

Is the lack of people seeing a PCP (Primary Care Physician) people without insurance will wait till an illness reaches the critical phase and than go for treatment in an emergency room where the cost are extreme. If they require hospitilization they will have even more costs.

So instead of treating a sore throat you end up treating something worst. Instead of treating high cholesteral you end up treating a heart attack.

An HMO system where the government takes the risk allows for competition among several administration firms so customer service stays important. The one thing a medicaid HMO does is assign a primary care physician and educates people on seeing them when they feel sick. The Dr. recieves a capitation payment just for having the member on his roles in addition to a lower fee for service when needed than with normal insurance.

Other than Dr. Howard Dean...I would not trust the Drs. to design the system by themselves.

[HamdenRice]

26. I have a personal health care horror story that explains a lot of it

I know it's always dangerous to generalize from our own experiences, but what the hey!

When I used to work in finance, I also was married, and my ex-wife became gravely ill. Fortunately, modern medicine saved her life, if not our marriage.

Anyway, we had very good insurance, and I assumed that my family was costing the plan much more than most other employees. One day the company called us together to discuss insurance and explained just how much their premiums per employee were. Bizarrely, they were paying more for the two of us in premiums that the total cost of all my wife's treatment! If they were making money on us, imagine how much they were making on your typical healthy family. It made no economic sense. We could have self insured more cheaply.

At the same time, I was doing some "private placements" which involved documenting investments by institutional investors like banks and insurance companies. I realized that a lot of people in finance made jokes about how dumb the investors from the insurance companies were. You basically in the industry fed them shit that no other intelligent institutional investors would buy. It was explained to me that they didn't really care as much whether their investments made money because they could always just raise premiums.

So the high cost of health insurance comes from (1) stupidity and carelessness in investing, (2) executive salaries which are a mind-bogglingly high proportion of where our insurance dollars go, (3) bureaucratic costs -- everything from the cost of avoiding paying claims to excluding people from plans (a la "Sicko), (4) lobbying Congress to keep this horrible system in place, and (5) advertising to the public about how great their plans are.

Not a lot actually comes from the uninsured, because those costs are swallowed by hospitals, not insurance companies, and ultimately picked up by government in the form of subsidies to hospitals that agree to (1) teach interns and residents and (2) treat the poor.

[AllentownJake]

27. and without revealing who I work for

I can tell you this, I work for a private non-profit. Our CEO earns a good CEO but not a ridiculous one. We give the money we earn back into the community and charities that founded us.

We aren't the bad guys. People are mad and I understand that, however there are good guys out there.

[CTyankee]

21. Right. Industries are always dying due to modernization. It is called progress.

People will always gravitate to the next job and skills market.

I saw this happen at a local college, which had been a private women's Catholic school from its founding to 1986 when it felt it necessary to admit men in order to compete. When that didn't fully do the job, it turned to an Accelerated Degree Program to help older students obtain or finish getting their degrees in a program designed around working peoples' lives. Then it expanded into a degreed Business program. It's doing wonderfully now...

[Vinca]

31. Basically, the insurance companies can go fuck themselves

as far as I'm concerned, but if they want to stay in business, they can always sell "super duper" coverage plans so those who can afford it can have their privates rooms, private nurses and big screen TV. As for care, triage and treatment must never depend on ability to pay. If I need chemo worse than Bill Gates needs chemo, I get chemo first.