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In what universe is nationalized health coverage efficient? The one where Medicare's overhead costs are in the single-digit percentages (like 3%), while privat

In what universe is nationalized health coverage efficient? The one where Medicare's overhead costs are in the single-digit percentages (like 3%), while private insurers have overhead rates well into the double digits. You can measure the efficiency of an insurance company by dividing the claims paid out by the premiums (e.g. what's the expected payout of taking the policy?). In most insurance industries, it's common to score above 100 (because the premiums are invested and accrue interest, this does not contradict profit for the insurer). Health insurers are closer to 70-85. Insurance companies, not because they're evil (although they are), have to cherry-pick and screen if they want to stay alive. It's the nature of the business-- adverse selection happens otherwise. However, this is a time-consuming process. Government, which is not driven by the profit motive, doesn't have to cherry pick and can insure all citizens (at a cost). Also, government-run health care and the elimination of the fee-for-service model will reduce the amount of unnecessary testing and make health care cheaper in the long run.

anamax 17y ago
> The one where Medicare's overhead costs are in the single-digit percentages (like 3%), while private insurers have overhead rates well into the double digits. They're not defining overhead the same way. Note also that medicare doesn't count its fraud costs while private insurers do. > Insurance companies, not because they're evil (although they are), have to cherry-pick and screen if they want to stay alive. Actually, they don't. They merely have to keep payouts plus expenses lower than revenues plus investment gains. > Government, which is not driven by the profit motive, doesn't have to cherry pick and can insure all citizens (at a cost). Govt is definitely driven by a profit motive. Govt doesn't have infinite resources, so there will be limits. You won't like the ones applied to you, and you won't have the money to do anything about it because it will be taken from you and spent on someone else. Oh, and certain folks will have very different limits. That's how govt works. > Also, government-run health care and the elimination of the fee-for-service model will reduce the amount of unnecessary testing and make health care cheaper in the long run. There's nothing stopping a private organization from doing something other than fee for service today. In fact, Kaiser doesn't, and I'll bet that they're not the only one. "Unnecessary testing" is in the eye of the beholder. When are mamograms unnecessary? Of course, there are defensive tests, for liability reasons. If you're arguing that govt healthcare shouldn't be liable for mistakes....
anamax 17y ago
Which reminds me. Would you rather raise a dispute over coverage with a govt agency or with a private insurer? You can fire a security company that fails to protect you. You can't fire the police for failure to protect. Do you think that health care will be any different?

anamax 17y ago

> The one where Medicare's overhead costs are in the single-digit percentages (like 3%), while private insurers have overhead rates well into the double digits. They're not defining overhead the same way. Note also that medicare doesn't count its fraud costs while private insurers do. > Insurance companies, not because they're evil (although they are), have to cherry-pick and screen if they want to stay alive. Actually, they don't. They merely have to keep payouts plus expenses lower than revenues plus investment gains. > Government, which is not driven by the profit motive, doesn't have to cherry pick and can insure all citizens (at a cost). Govt is definitely driven by a profit motive. Govt doesn't have infinite resources, so there will be limits. You won't like the ones applied to you, and you won't have the money to do anything about it because it will be taken from you and spent on someone else. Oh, and certain folks will have very different limits. That's how govt works. > Also, government-run health care and the elimination of the fee-for-service model will reduce the amount of unnecessary testing and make health care cheaper in the long run. There's nothing stopping a private organization from doing something other than fee for service today. In fact, Kaiser doesn't, and I'll bet that they're not the only one. "Unnecessary testing" is in the eye of the beholder. When are mamograms unnecessary? Of course, there are defensive tests, for liability reasons. If you're arguing that govt healthcare shouldn't be liable for mistakes....

anamax 17y ago

Which reminds me. Would you rather raise a dispute over coverage with a govt agency or with a private insurer? You can fire a security company that fails to protect you. You can't fire the police for failure to protect. Do you think that health care will be any different?