Private health insurance can never, even in principle, compete with single-payer

[Jackpine Radical]

in providing cheap and effective health coverage.

For starters, private insurance costs about 25% more to administer than a single-payer system like Medicare. Furthermore, there are some other factors that generally don't seem to get figured in, one of which is the obscene profits the insurance moguls extract from the system. Another type of savings would occur in the billing departments of the providers. You wouldn't believe how much effort goes into just trying to get the insurance companies to pay up on what they're obligated to do. They hire people to obfuscate, "lose" paperwork, deny authorizations, renege on authorizations already given, etc. They have no motive to see that people get adequate health care. They only have motives to deny, reduce, and delay payment--anything to boost profits. You want good health care; your employer wants cheap insurance. Guess who wins?

And then there is the matter of the totally perverse incentives that operate in the field of health care. You may think it would be in the best interest of providers to pay for preventive care. An ounce of prevention and all that. Not so. The average client is with a given insurer for maybe 15 or 20 months (I don't know the exact current number, but it's in that range) before they move on somewhere else--the employer switches insurers, the employee switches jobs, the insurer gets merged with someone else--whatever. Therefore it is not cost-effective to spend money preventing a problem that is not likely to manifest in the next 20 months. This would not be the case with single-payer, because no matter what happens, you're not going away.

No matter what cobbled-up plan they come up with, unless a Medicare for All-type plan is on the table, we are going to get screwed again.

[Warpy]

1. No, but they buy crooks in government to attack public insurance

in two ways: first and most famously by underfunding it. Second, by restrictions that means test people who want it out of qualifying for it.

A two tier system will always fail because the people at the top won't use the public system and will always make sure it is underfunded and/or restricted.

[Jackpine Radical]

3. I've noticed that every time the conservatives get in power in Canada,

the waiting lines and complaints start reappearing, invariably because of the underfunding that they always do. How do the French manage? They seem to run a pretty good system. But then, as Michael Moore once pointed out, the difference between us and them is that there, the government is afraid of the people.

[dkofos]

40. The French take to the streets. Which is what we should do.

[Rosa Luxemburg]

2. now you are forgetting about those doctors in lucrative businesses

don't forget that aprt from the university hospitals (and I know they do some) many doctors and dentist operate for business. THEY DON"T CARE ABOUT THE PATIENTS they only CARE AVOUT MAKING MONEY.

[Jackpine Radical]

4. Yes, there's far too much greed everywhere in the system.

I have nothing against government-imposed cost controls. Believe me, at least in the mental health realm, the insurance companies are big on imposing cost controls on providers.

[LWolf]

5. I'm thrilled to see single payer

on the table in both the house and senate.

Will Obama sign it, if they send it to him?

[SemiCharmedQuark]

7. If it passes the House and the Senate, I think he will sign it.

[tonysam]

13. It'll Never Get There.

The Senate will see to it through filibusters and those so-called "blue dogs."

[PassingFair]

22. Over our dead (or DYING) bodies!

www.standwithdrdean.com

[Jackpine Radical]

8. If they can get it that far, I think he would have to.

There are few things that could actually cause the left wing of the party to sit out 2012, but that's probably one of them.

[LWolf]

16. I hope so.

Do you think he would actively encourage congress to get that bill to him, or discourage, or just ignore it until it passed?

[Jackpine Radical]

27. I think that's an excellent question.

My suspicion is that Obama doesn't consider single-payer feasible in America today because of the power of the insurance establishment, but that if he thought he could help it through at no great political cost to him, he would do so.

[LWolf]

36. Then it's up to us

to be persistently loud in support of both the senate and house versions currently on the table.

I can do that. ;)

[rhett o rick]

38. I don't think he will do either. He clearly isn't in favor of such a plan but knows

that it will never get through Congress.

[LWolf]

41. And if it did? nt

[Jackpine Radical]

43. If it did, I have little doubt he would sign it.

Just think what it would mean for such legislation to actually make it to his desk. There would have to have been 51 (or 60, depending on how they do it) Senators with wetted fingers in the air, all feeling gale-force winds of change blowing from the left.

[LWolf]

44. I'd certainly love to see that happen,

likely or not.

THAT would be change I can believe in. ;)

[BrklynLiberal]

6. I believe something like 76% of the people in this country are for it, but

the insurance companies and big pharma have stronger lobbies than the voters.

[Jackpine Radical]

9. Lobbies are always stronger than apathetic voters.

But there's something about the smell of torches burning in the night...

[PassingFair]

23. www.standwithdrdean.com They will find us somewhat less than apathetic this time.

www.standwithdrdean.com

[Jackpine Radical]

24. Been there done that.

Damn Right!

[PassingFair]

25. I'm into personally applying pressure on this issue!

:thumbsup:

[BrklynLiberal]

33. Signed and forwarded it to 20 others.

[RB TexLa]

10. dupe, DU error

[RB TexLa]

11. Medicare keeps its administrative cost down by accepting a high fraud rate.

[Jackpine Radical]

12. I'd like to see data on that.

Certainly there have been some well-publicized cases of fraud; nevertheless, my impression is that they have been rather quick to label simple billing errors as fraud.

[RB TexLa]

14. It accounts for at least 20% of the medicare budget, I'm sure that's low. Probably $40 or $50B

stolen per year.

But remember those doctors honestly feel they deserve that money.

[Jackpine Radical]

21. Here are 2003 statistics.

Again note that billing ERRORS count as fraud.

http://www.hollandharthealthcare.com/healthcare/2003/11/government_issu.html

$11.6 billion is not $50 billion.


CMS raises the specter that Fraud and Billing Errors is running amuck in the Medicare program to the tune of about $11.6 Billion per year. That is a lot of fraud and billing errors. There is no breakdown as to what is or is not inadequately documented, medically unnecessary or improperly coded. Because a claim is inadequately documented, does that mean that it cannot be adequately documented or the service was not provided? What percentage of coding errors work in favor of the government? Why is the concept of fraud woven into the number when the government is unable to delineate what is or is not fraud? Without finetuning and further explanation, these kind of statistics tend to be inflammatory and useless.

WASHINGTON (AP) - Fraud and billing errors in the Medicare program cost the government an estimated $11.6 billion last year, a slight improvement over previous years, the agency that runs the program said Friday.

The error rate - claims that were medically unnecessary, inadequately documented or improperly coded - was 5.8 percent, down from 6.3 percent the year before, the Centers for Medicare and Medicaid Services said. The error rate was as high as 13.8 percent in 1996.

But the CMS report was immediately attacked by a Republican senator who asserted it understates the problem and is "not statistically valid."

Sen. Charles Grassley, R-Iowa, said CMS adjusted the results of its annual review to avoid showing a spike in improper payments in Medicare, the government-run health care program for 40 million older and disabled Americans.

"It appears that the 'unadjusted' error rate of close to 10 percent was too high for CMS - almost 4 ercentage points higher than the previous two years," Grassley wrote in a letter to Dara Corrigan, the acting inspector general for the Department of Health and Human Services, which includes CMS.

[rhett o rick]

37. "High" as compared to what? It is expensive to eliminate all fraud. Private insurers

have lower fraud rates because they choose to error on the side of themselves. They turn down legitimate claims, some on a routine basis.

[Cronus Protagonist]

15. I think we should call it what it is: EMPLOYER BASED healthcare

Because, as we all know, private insurance outside of employment is so unaffordable as to be non-existent. The purpose behind this method is to push people into wage-slave servitude using health-care as leg-irons. Business, for all its whining about the costs, doesn't want to throw out the leg-irons - heaven forbid you could quit your job and not suffer any health care consequences! Gosh! People would leave bad employers like rats leave a sinking ship!

[subterranean]

17. Wouldn't the lack of claim denials in single-payer offset the

savings in administrative costs and other areas? In other words, if it paid for everything, no questions asked, that might offset the lower operating costs. I don't know, but to say it would be cheaper seems to ignore that factor.

Of course, even if a single-payer system costs the same or a little more, it would be worth it because the money would go toward providing care instead of overhead, paperwork, profits and seven-figure CEO salaries.

[RB TexLa]

18. What makes you think a single payer system would pay for everything billed to it

"no questions asked"?

[subterranean]

20. What I meant was it would pay all legitimate claims

instead of trying to weasel out of paying like private insurers often do. So presumably it would pay out more.

[cascadiance]

19. If we get single payer "option", would the current "open enrollment" periods be a problem?...

I wonder if we suddenly put in place single payer health plans, if all of the companies would instantly make a "special" open enrollment period to give employees the option to enroll in the newer single payer plan. You'd think they'd do so, so that they could reduce their costs, but one wonders what might happen. And also if many employers were to whittle down their "paid insurance plans" down to the low end of the totem pole so that they wouldn't have to pay much for employees that do sign up for insurance plans compared to the employees that go to single player. And if people get "locked in" to these plans for months on end and suddenly discover that their newer insurance plans offer less than what the single payer does, what would happen then?

I'm still trying to see how the insurance plans would compete with single payer plans that don't put costs on the company, but I have to believe that the insurance companies will connive something to keep themselves in the ballgame.

[DonCoquixote]

26. question

Down in Florida, we have Canadians who come down to get med care they say they cannot get up north. What is the response to people who are afraid that the government might hang them in limbo for surgery they need?

[cascadiance]

30. I'm not concerned about bureaucracy causing problems, but corporate lobbyist stealth...

... trying to screw things up.

They've certainly found other ways to control our politicians and have them play games with us to keep us voting for us while corporate interests are being supported instead of the people's.

Other companies outside of the health insurance lobbyists have probably mixed concerns about this. On the one hand, they probably would like to find a way to no longer be saddled with health insurance costs. On the other hand, they probably are concerned of the precedent that a decent single payer health care system run by the government that kicks out the health insurance companies and destroys their lobbies in congress might do to their ability to control legislation in congress as well.

So if the health care industry offers them some creative solution that they can get the best of both worlds, even if it screws the rest of us, they'd probably take it. We have to be leery of that happening.

[Jackpine Radical]

32. What kind of care would that be, plastic surgery?

Here's a reasonably objective look at the situation:

10 Myths About Canadian Health Care, Busted

By Sara Robinson
TomPaine.com
February 5, 2008

3. Wait times in Canada are horrendous.
True and False again — it depends on which province you live in, and what’s wrong with you. Canada’s health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don’t plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that’s just as true in any rural county in the U.S.

You can hear the bitching about it no matter where you live, though. The percentage of Canadians who’d consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country’s health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland’s grandfather.). In spite of that, though, grousing about health care is still unofficially Canada’s third national sport after curling and hockey.

And for the country’s newspapers, it’s a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it’s on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it’s certainly one of the things that keeps the quality high. But it also makes people think it’s far worse than it is.

Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I’m finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It’s the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.

[booley]

39. I can only think of one example

A canadian friend needed an eye specialist and the only one available was in the US.
So the Canadian government paid for his trip and operation.

But that's not really argument against Canada's health care system.

IF I needed to see that same specialist I would have to travel too and it would all come out of my own pocket.

[Faryn Balyncd]

28. K&R-(That's why the dark side wants to PRIVATIZE MEDICARE & eliminate all public options for us all)

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x5205651


Howard Dean knows the VERY REAL threat of a 100% privatized mandatory insurance scheme will DOOM real reform.

[Phoebe Loosinhouse]

29. And the insurance companies know that as well. nt.

[Jackpine Radical]

31. Of course they know it.

They no doubt perceive themselves as in a life-and-death struggle.

[cooolandrew]

34. I think the plan will do for the moment and the congress the President has BUT single payer or bust.

[Jackpine Radical]

35. The problem is, how do we get there from here?

[DonCoquixote]

42. answer

Simply put, we need to castrate the Blue Dogs. As much as the GOp can try to be obstructionist, they have had their teeth busted by the 2008 election, but the Blue Digs are the ones saying "You know we will never let this pass, right?"