Health care vote

[Reality]

[quote=harvey]

Why would a third of total healthcare spending just disappear simply because the government is paying the bill instead of insurance companies or private consumers?
[/quote]

Don’t know about a third, but spending will go down just because the government will pay less than commercial insurance, just like Medicare does now.

[Anonymous]

[quote=Reality]Don’t know about a third, but spending will go down just because the government will pay less than commercial insurance, just like Medicare does now.[/quote]

Well then, we can’t reduce spending!

No matter, it’s going to be a while before anything happens.

The position of the party that controls the federal government is that they are waiting for a plan from Hillary Clinton.

No, I’m not joking.

“We’ve got to fix what’s broken.” Where's your plan, @HillaryClinton? pic.twitter.com/CmRB4mCsZd

— GOP (@GOP) July 5, 2017

[no_such_reality]

[quote=Reality][quote=harvey]

Why would a third of total healthcare spending just disappear simply because the government is paying the bill instead of insurance companies or private consumers?
[/quote]

Don’t know about a third, but spending will go down just because the government will pay less than commercial insurance, just like Medicare does now.[/quote]

For major health insurance companies like United Health Group cost of services is 65%. Profit, administration, marketing, etc is 35%. UH is a fairly good company.

[quote=livinincali]

I’m not saying free market system don’t have their consequences. Every system has in consequences to various degrees. In very socialized system you wait a long time for elective procedures or you don’t get them at all. In other system you die if you can’t pay and charity refuses to save you. In our system everyone gets treated and almost everyone has access to the latest and best procedures but at a tremendous cost.

Our system’s biggest problem is it doesn’t allow for free market forces to force competition and drive down costs.[/quote]

I think the population of the country have been pretty clear about letting people die on hospital door steps. We just have a mental schism regarding paying for it.

My last trip to the ER pre-ACA had six people in the ER while I was there. It was pretty clear I was the only person with insurance coverage. A couple scans and couple hours and we shouldn’t be surprised the bill showed up north of $20,000…

Given our society’s view, IMHO, the solution is to provide basic health care via single payer like Medicare to all that coverage your basic health services, maintenance for illnesses and proven cost efficient services for things like cancer.

Elective insurance for things like proton therapy, ‘conceirge’ doctors, PPO like services, short wait times, etc.

[SK in CV]

[quote=no_such_reality]
For major health insurance companies like United Health Group cost of services is 65%. Profit, administration, marketing, etc is 35%. UH is a fairly good company.

[/quote]

Not sure where those numbers are coming from. By law, the medical loss ratio for qualified health plans must be at least 80% for individual and small group policies and 85% for large group policies. If MLR is lower than those numbers, premiums must be rebated.

Not an entirely fair comparison since Medicare spends almost nothing on premium collection or sales, but Medicare overhead is less than 2%

[no_such_reality]

[quote=SK in CV][quote=no_such_reality]
For major health insurance companies like United Health Group cost of services is 65%. Profit, administration, marketing, etc is 35%. UH is a fairly good company.

[/quote]

Not sure where those numbers are coming from. By law, the medical loss ratio for qualified health plans must be at least 80% for individual and small group policies and 85% for large group policies. If MLR is lower than those numbers, premiums must be rebated.

Not an entirely fair comparison since Medicare spends almost nothing on premium collection or sales, but Medicare overhead is less than 2%[/quote]

It comes from UHG’s 10-K. It’s across all their business lines. The ACA law requires the 80% to be for health care claims and quality improvements for credible plans.

The part that is really obscured is how much of the cost of providing services, the part paid to providers, is administrative costs from dealing with all the different insurance companies, billing requirements and authorizations etc.

I don’t think there will be clear numbers between the efficiency/inefficiency of the Government bureaucracy versus private corporation bureaucracy and inefficiency and induced bureaucracy in the providers.

[SK in CV]

[quote=no_such_reality]
It comes from UHG’s 10-K. It’s across all their business lines. The ACA law requires the 80% to be for health care claims and quality improvements.[/quote]

80% for individuals and small groups. 85% for large groups. Their overall MLR for all QHP is between the 2 since they sell in both markets. The 35% margin originally referenced included products other than qualified health plans.

[Anonymous]

Lol, you guys are discussing healthcare implementation, tradeoffs, objectives like it’s an actual business endeavour run by people with management skills.

Of course it is, but this thread is about the “Health care vote.”

So far there’s no evidence that Trump even understands the basics of this domain. Or that he’s even trying.

There are probably more than a few Republicans in congress that get it, but their primary objective is only to undo anything that Obama did.

It will be a goddamn mess that will get far worse before it starts to get better. We are literally going to see unnecessary suffering and death for thousands of Americans.

All out of spite.

[SK in CV]

[quote=harvey]Lol, you guys are discussing healthcare implementation, tradeoffs, objectives like it’s an actual business endeavour run by people with management skills.

Of course it is, but this thread is about the “Health care vote.”

So far there’s no evidence that Trump even understands the basics of this domain. Or that he’s even trying.

There are probably more than a few Republicans in congress that get it, but their primary objective is only to undo anything that Obama did.

It will be a goddamn mess that will get far worse before it starts to get better. We are literally going to see unnecessary suffering and death for thousands of Americans.

All out of spite.[/quote]

I’m not positive that’s going to happen, (the “far worse before better” part) but you’re dead on with the motivation. Republicans (and others) spent 7 years complaining about Obamacare, but can’t come up with a plan to make it better. The problem they face is that way too many now know that it IS far better than nothing, so repealing without replacing is DOA.

Of course they can make it better. And it isn’t that complicated. 1st by restoring what they’ve already broken by defunding parts of the original law. 2nd by adding a public option, allowing those over 55 to buy into medicare everywhere at actuarially sound rates, and allowing a medicare buy in markets where there are fewer than 3 options on the state or federal exchanges. Simple. Infrastructure already in place.

But republicans in office will hate it. Not enough people will die.

[no_such_reality]

They can’t fix it because the fix is “big guvment” and meddling regulations that would prevent things like Shrekeli doing what he did and Mylar doing what it does and other doing what their doing with coupons. It also requires plans to be able to say limited no. Item. Certain drugs aren’t covered until other options are exhausted.

I used UHG as an example since they provide a plethora of health related services but other than their pharmacy operations don’t provide actual health services. We’re taking 35% of our health dollars off before it even gets to the actual providers

As for the people they’re stuck believing the problem is freeloaders, bad choicers, and government bereaucracy akin to zootopia’s sloth filled DMV

The reality is our system has too many layers, too much administrative conplexity and too many profit levels coupled with a relatively unhealthy population

Our prior system is great if you’re not oldish, not sick, or covered by a decent employer provided plan other wise it pretty much sucked shit

[livinincali]

[quote=harvey][quote=livinincali]Health care spending is included in the measurement of GDP. If GDP is 15 trillion and health care is 3 trillion of that then reducing health care spending by 1 trillion reduces GDP by 1 trillion.[/quote]

You do understand that government spending is included in GDP?

Why would a third of total healthcare spending just disappear simply because the government is paying the bill instead of insurance companies or private consumers?

Where does this trillion dollars in economic activity go?[/quote]

I agree that if we continue to spend 3 trillion per year on health care then changing who pays that 3 trillion dollars doesn’t do anything to GDP. However everybody here seems to think single payer or some other government fix would be to reduce the total spending on health care, not who pays for it. If we do indeed reduce spending on health care in aggregate then GDP would go down and we’d have a recession.

Ultimately Obamacare really just changed who’s paying to some degree. Overall health care spending didn’t go down because of. It did buy a couple years of a slower growth but recently health care spending is going up at the previous ~6% per year. Obviously that growth in health care spending can’t continue forever so something will happen but I don’t know what that will be. At some point you need to remove some of the overhead and layers of profit in health care and when you do it will effect the economy on the whole.

When we embark on that path it’s going to be disruptive in the economy and it’s one of the reasons the politicians don’t really want to do anything. They are all smart enough to realize a major overall of health care is going to disrupt a couple million jobs maybe more. Trump did get elected in part because people are still upset about that manufacturing job or mining job they lost in the 90’s. We put a bunch of billing coders and administrators and insurance agents out of a job with single payer they are going to hold it against you for a very long time. Will we be better off in whole, certainly, but it won’t be fun for the people that have to deal with the disruption.

[FlyerInHi]

Livin’ we don’t usually lower costs by cutting spending. We hold proportional spending down as the economy grows and as we enact reforms. It’s a process.

I hope we can do the same for military spending. Maybe we can reallocate money for the military to health care and education.

[spdrun]

Getting rid of typewriter mechanics and 75% of clerical personnel didn’t crash the economy — we adapted. Also: what about the effect of people having more disposable income without being robbed by private insurapigs?

It will just reallocate income, not destroy it.

[FlyerInHi]

[quote=spdrun]Getting rid of typewriter mechanics and 75% of clerical personnel didn’t crash the economy — we adapted. Also: what about the effect of people having more disposable income without being robbed by private insurapigs?

It will just reallocate income, not destroy it.[/quote]

Exactly. And the budget for the secretarial pool is reallocated to IT. Productivity is improved which allows the company to take on more business.

[FlyerInHi]

Oh God…. the people in West Virginia really need government run health care. They can’t even deal with Obamacare and the complications of insurance.
But they voted for Trump and the Republicans who should take care of them and make America great again.

[Anonymous]

There was a vote!

And it passed!

A vote to proceed to debate….to debate legislation that nobody likes.

Trump tweeted that he has “pen in hand” ready to sign… Sign the legislation that might pass … sometime in the future, after the debate that can happen now because they voted.

Wow, that’s progress! … sorta …. I guess.

[Author]

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