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That’s a rosy hypothetical in which people get lower costs and better service through a change in payors. That doesn’t change the fact that the costs of health

by adolph 3y ago

That’s a rosy hypothetical in which people get lower costs and better service through a change in payors. That doesn’t change the fact that the costs of healthcare will still be “foisted disproportionately on employers and their employees” because those are the revenue generating population. Government is already the largest payor in healthcare through Medicare and Medicaid [0] (funded by taxes “disproportionately on employers and their employees”). You’d think that they would already have the market power to do whatever they’d like with prices. 0. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet https://www.cms.gov/research-statistics-data-and-systems/sta...

shadowgovt 3y ago
The government has quite a bit of power to set cost, but not as much as in other countries because in the United States private health insurance is a huge industry and makes up a huge alternate payer. This includes health insurance coupled directly to hospital networks, which is almost certainly double dealing itself in a way that makes the numbers meaningless.
- adolph 3y ago
  Is your claim that the rosy picture of low transaction costs and price controls is only achievable when government payouts control 17% more of healthcare spending? The 49% already performed by federal and state govt isn’t enough? From the above link: The private business share of health spending accounted for 17 percent of total health care spending,
  - shadowgovt 3y ago
    That plus the private spending. So you'll be looking at a number closer to like 90, 95% of the entire market. Because in terms of how many employees companies can afford to hire, it also matters when employees are getting sick all the time because they don't have a basic standard of health care due to either the company not offering insurance or the employee being unwilling to pay the premiums; people who pay their own way for medical costs tend to defer spending on preventative therapy and wind up costing a lot more because they end up in the emergency intervention train.
    - adolph 3y ago
      Wait, the private spending number is stuff people pay out of pocket for, like OTC, deductible, co-ins, and copay, right? Those are the mechanisms intended to balance availability with discretion to not over-consume. For additional clarity, I probably need to find the data source for what CMS describes on that link.

by adolph 3y ago

shadowgovt 3y ago

The government has quite a bit of power to set cost, but not as much as in other countries because in the United States private health insurance is a huge industry and makes up a huge alternate payer. This includes health insurance coupled directly to hospital networks, which is almost certainly double dealing itself in a way that makes the numbers meaningless.

adolph 3y ago
Is your claim that the rosy picture of low transaction costs and price controls is only achievable when government payouts control 17% more of healthcare spending? The 49% already performed by federal and state govt isn’t enough? From the above link: The private business share of health spending accounted for 17 percent of total health care spending,
- shadowgovt 3y ago
  That plus the private spending. So you'll be looking at a number closer to like 90, 95% of the entire market. Because in terms of how many employees companies can afford to hire, it also matters when employees are getting sick all the time because they don't have a basic standard of health care due to either the company not offering insurance or the employee being unwilling to pay the premiums; people who pay their own way for medical costs tend to defer spending on preventative therapy and wind up costing a lot more because they end up in the emergency intervention train.
  - adolph 3y ago
    Wait, the private spending number is stuff people pay out of pocket for, like OTC, deductible, co-ins, and copay, right? Those are the mechanisms intended to balance availability with discretion to not over-consume. For additional clarity, I probably need to find the data source for what CMS describes on that link.