5 ms·

>It’s just that they pay it into a private insurance system that wastes large portions of it on rents and administrative redundancy. Would love to see a breakd

>It’s just that they pay it into a private insurance system that wastes large portions of it on rents and administrative redundancy. Would love to see a breakdown of real estate and admin costs for private insurance systems throughout the States to understand how much could be saved by eliminating redundancy. Not seeing this broken out in Anthem's Financials: https://ir.antheminc.com/static-files/73562e56-886c-4ff5-a365-d4324728524f https://ir.antheminc.com/static-files/73562e56-886c-4ff5-a36...

vonmoltke 8y ago
> Would love to see a breakdown of real estate and admin costs for private insurance systems throughout the States to understand how much could be saved by eliminating redundancy. I would love to see the same breakdown for the Netherlands, Germany, and Switzerland to see how they avoid it.
abalone 8y ago
According to a comprehensive study published in the New England Journal of Medicine, U.S. admin costs are double that of Canada.[1] More context in this NYT column, which features this quote: "'The extraordinary costs we see are not because of administrative slack or because health care leaders don’t try to economize,' said Kevin Schulman, a co-author of [another] study and a professor of medicine at Duke. 'The high administrative costs are functions of the system’s complexity.'"[2] Also, these studies don't take into account the time/opportunity cost to consumers of navigating this complicated system, which can be quite substantial. [1] https://www.nejm.org/doi/full/10.1056/nejmsa022033 https://www.nejm.org/doi/full/10.1056/nejmsa022033 [2] https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html?module=inline https://www.nytimes.com/2018/07/16/upshot/costs-health-care-...
dnautics 8y ago
Private healthcare insurance has margins well below most profitable companies, in the us. If anything I'd hazard that the poor treatment of consumers by these entities stems from being barely able to hold the line, not because of greed. Rising medical costs, I think, have the blame elsewhere, but insurance companies sure do make a good Boogeyman for politicians, because they are very poorly understood.
- analog31 8y ago
  Somebody's gouging us. Who? Everybody cries poor and points the finger at everybody else. Nobody knows where the money is actually going.
  - jimbokun 8y ago
    Doctors? Seems to be a huge reluctance for anyone in politics to place the blame on them. But I'm pretty sure they make far more in the US than anywhere else in the world.
    - bradknowles 8y ago
      And they pay huge amounts of their income to malpractice insurance. Hmm. There's that word "insurance" again.
      - AnimalMuppet 8y ago
        It's a very different form of insurance, though, with a very different cure: tort reform.
      - analog31 8y ago
        From what I've read, doctors are also substantial owners of the malpractice insurance companies. Also, their premiums are paid by their employers. In fact, salaries don't tell the entire story for doctors, since they are heavily invested in their own industry. For instance, at one point my health insurance provider advertised itself as being doctor-owned. As mentioned above, a problem is that the system is so opaque, seemingly by design. A potential benefit of a government run system is that there could simply be fewer business entities. For instance, doctors could just work for the government, for a decent salary.
    - SkyPuncher 8y ago
      > But I'm pretty sure they make far more in the US than anywhere else in the world. Yea, but the opportunity cost of getting there is huge. At graduation, most doctors are in the ballpark of $1MM behind where they'd be if they went straight into a professional career. Also, doctor's salaries only account for 8% to 20% of total healthcare costs.

vonmoltke 8y ago

> Would love to see a breakdown of real estate and admin costs for private insurance systems throughout the States to understand how much could be saved by eliminating redundancy. I would love to see the same breakdown for the Netherlands, Germany, and Switzerland to see how they avoid it.

abalone 8y ago

According to a comprehensive study published in the New England Journal of Medicine, U.S. admin costs are double that of Canada.[1] More context in this NYT column, which features this quote: "'The extraordinary costs we see are not because of administrative slack or because health care leaders don’t try to economize,' said Kevin Schulman, a co-author of [another] study and a professor of medicine at Duke. 'The high administrative costs are functions of the system’s complexity.'"[2] Also, these studies don't take into account the time/opportunity cost to consumers of navigating this complicated system, which can be quite substantial. [1] https://www.nejm.org/doi/full/10.1056/nejmsa022033 https://www.nejm.org/doi/full/10.1056/nejmsa022033 [2] https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html?module=inline https://www.nytimes.com/2018/07/16/upshot/costs-health-care-...

dnautics 8y ago

Private healthcare insurance has margins well below most profitable companies, in the us. If anything I'd hazard that the poor treatment of consumers by these entities stems from being barely able to hold the line, not because of greed. Rising medical costs, I think, have the blame elsewhere, but insurance companies sure do make a good Boogeyman for politicians, because they are very poorly understood.

analog31 8y ago
Somebody's gouging us. Who? Everybody cries poor and points the finger at everybody else. Nobody knows where the money is actually going.
- jimbokun 8y ago
  Doctors? Seems to be a huge reluctance for anyone in politics to place the blame on them. But I'm pretty sure they make far more in the US than anywhere else in the world.
  - bradknowles 8y ago
    And they pay huge amounts of their income to malpractice insurance. Hmm. There's that word "insurance" again.
    - AnimalMuppet 8y ago
      It's a very different form of insurance, though, with a very different cure: tort reform.
    - analog31 8y ago
      From what I've read, doctors are also substantial owners of the malpractice insurance companies. Also, their premiums are paid by their employers. In fact, salaries don't tell the entire story for doctors, since they are heavily invested in their own industry. For instance, at one point my health insurance provider advertised itself as being doctor-owned. As mentioned above, a problem is that the system is so opaque, seemingly by design. A potential benefit of a government run system is that there could simply be fewer business entities. For instance, doctors could just work for the government, for a decent salary.
  - SkyPuncher 8y ago
    > But I'm pretty sure they make far more in the US than anywhere else in the world. Yea, but the opportunity cost of getting there is huge. At graduation, most doctors are in the ballpark of $1MM behind where they'd be if they went straight into a professional career. Also, doctor's salaries only account for 8% to 20% of total healthcare costs.