Welcome to City-Data.com Forum!
U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > General Forums > Politics and Other Controversies
 [Register]
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
View detailed profile (Advanced) or search
site with Google Custom Search

Search Forums  (Advanced)
Reply Start New Thread
 
Old 10-25-2016, 07:40 PM
 
18,794 posts, read 8,420,430 times
Reputation: 4125

Advertisements

Quote:
Originally Posted by Yosh01 View Post
Yes, why wouldn't Medicaid (for pay) be the public option?
I think it would, but there will be subsidies here and there.
Reply With Quote Quick reply to this message

 
Old 10-25-2016, 09:11 PM
 
3,614 posts, read 3,871,447 times
Reputation: 2293
Quote:
Originally Posted by Yosh01 View Post
Your sarcasm aside, Medicare is actually run very efficiently compared to private insurance companies. Do some research.
Low admin <> efficient. Private medicare plans routinely provide the core medicare benefit for less cost than the government is able to through traditional fee-for-service medicare, despite higher admin load and often slightly higher payment rates.

Quote:
Originally Posted by Yosh01 View Post
Yes, why wouldn't Medicaid (for pay) be the public option?
Medicaid pays much less to providers. As a result, there are three types of providers:

1) Those that do not take medicaid

2) Those that take medicaid and lose money on it as a form of de facto charity or because they are hospitals and compelled by EMTALA

3) Those that gear their practice for medicaid (see as many patients as possible, do as little as possible for each one).

It could work if a limited number of people signed up, but large scale expansion of medicaid to people who otherwise would have purchased commercial insurance puts pressure on the quality and/or availability of healthcare.

Quote:
Originally Posted by Yosh01 View Post
No. You would not. "Public" does not mean paid for by the government. In this case it means the government takes on the role of a private insurance company and it can do that much more cheaply. Private insurance adds about 30% to the cost of health care. The government, as in Medicare, does it at 5-7%.

People who choose to buy the public option would pay their premium without subsidy. Of course when you hit the age of 65, the public option becomes Medicare and the premiums are subsidized and greatly reduced.
I don't even know why I am bothering since the statement that "private insurance adds about 30% to the cost of health care" shows you are wildly misinformed. One of the provisions of the Affordable Care Act is that an insurer that spends less than 85% of premiums on actual medical care and quality improving activities has to send a rebate to its customers for the difference. That 85% MLR requirement wasn't picked out of a hat either -- it was the level which large insurers were already meeting give or take, and so was able to be implemented and make the administration look good without getting too much industry push back since most big players were already achieving it.

Last edited by ALackOfCreativity; 10-25-2016 at 09:20 PM..
Reply With Quote Quick reply to this message
 
Old 10-25-2016, 09:21 PM
 
18,794 posts, read 8,420,430 times
Reputation: 4125
Quote:
Originally Posted by ALackOfCreativity View Post
It could work if a limited number of people signed up, but large scale expansion of medicaid to people who otherwise would have purchased commercial insurance puts pressure on the quality and/or availability of healthcare.
That's a fact jack! The plan will also have to be nice enough to us docs if it is to succeed.
Reply With Quote Quick reply to this message
 
Old 10-25-2016, 09:27 PM
 
3,614 posts, read 3,871,447 times
Reputation: 2293
Quote:
Originally Posted by Hoonose View Post
That's a fact jack! The plan will also have to be nice enough to us docs if it is to succeed.
Yup. At the end of the day, healthcare is provided by a doctor (or other provider). Not the government. Not an insurance company. You can be more or less efficient about administering it. You can source the funds differently. You can mess around with who is covered and how much. End of the day, if the system doesn't keep hospitals solvent and doctors better off than moving to a cash-model it's not going to work.
Reply With Quote Quick reply to this message
 
Old 10-25-2016, 09:44 PM
 
3,614 posts, read 3,871,447 times
Reputation: 2293
Quote:
Originally Posted by middle-aged mom View Post
5) Medicare is required by law to pay hospital costs, which includes their overhead. Nothing precludes hospitals from adding bells and whistles to the overhead and they do. Overhead could easily be capped.
I'm not aware of any such law on the aggregate (although don't know for a fact there isn't either). This is at the individual hospital level 100% false. Hospitals can and do both make and lose money on Medicare, depending on what the government pays them (which is only indirectly based on costs), how well they are run, and local market conditions.

Quote:
Originally Posted by Frank DeForrest View Post
The number #1 best way to promote weight control is having individuals bear the expense of their own health care.
You can be obese for a very long time until it causes health issues, and when it does it is often (of course not always) too late to fix all the damage done. Honestly I expect the motivating effect to be much smaller than the immediate shame and day-to-day life harm overweight people already face. People already have more than enough incentive to control their weight; you're better off helping them execute (since this is a healthcare coverage discussion, this in part means better coverage of weight loss support services which thankfully the government and industry are already moving toward).
Reply With Quote Quick reply to this message
 
Old 10-26-2016, 09:02 AM
 
18,794 posts, read 8,420,430 times
Reputation: 4125
Quote:
Originally Posted by ALackOfCreativity View Post
I'm not aware of any such law on the aggregate (although don't know for a fact there isn't either). This is at the individual hospital level 100% false. Hospitals can and do both make and lose money on Medicare, depending on what the government pays them (which is only indirectly based on costs), how well they are run, and local market conditions.



You can be obese for a very long time until it causes health issues, and when it does it is often (of course not always) too late to fix all the damage done. Honestly I expect the motivating effect to be much smaller than the immediate shame and day-to-day life harm overweight people already face. People already have more than enough incentive to control their weight; you're better off helping them execute (since this is a healthcare coverage discussion, this in part means better coverage of weight loss support services which thankfully the government and industry are already moving toward).
Medicare pays hospitals using the DRG payment system for inpatients. With outpatients hospitals have the system and payments tripled and totally up their sleeve.

https://www.google.com/#q=drg

With the obese we might get away with higher premiums, but about the only things that work are supports and positive incentives. Proper food choices and exercise are about the bulk of it. I work out at the gym most days the last 50 years. And I see WAY more locals exercising than ever before.
Reply With Quote Quick reply to this message
 
Old 10-26-2016, 09:26 AM
 
Location: Long Island
32,816 posts, read 19,431,094 times
Reputation: 9618
Quote:
Originally Posted by Yosh01 View Post
Your sarcasm aside, Medicare is actually run very efficiently compared to private insurance companies. Do some research.
uhm

the myth of medicare being more efficient is just that a myth

Many people wrongly believe that Medicare is more efficient than private insurance; that view was often stated by champions of Obamacare during the debate preceding the law’s enactment. These advocates argued that Medicare’s administrative costs — the money it spends on expenses other than patient care — are just 3% of total costs, compared to 15% to 20% in the case of private, employer-sponsored insurance. But these figures are highly misleading, for several reasons.
Forbes Welcome
Reply With Quote Quick reply to this message
 
Old 10-26-2016, 09:51 AM
 
353 posts, read 440,038 times
Reputation: 889
Quote:
Originally Posted by ALackOfCreativity View Post

I don't even know why I am bothering since the statement that "private insurance adds about 30% to the cost of health care" shows you are wildly misinformed. One of the provisions of the Affordable Care Act is that an insurer that spends less than 85% of premiums on actual medical care and quality improving activities has to send a rebate to its customers for the difference. That 85% MLR requirement wasn't picked out of a hat either -- it was the level which large insurers were already meeting give or take, and so was able to be implemented and make the administration look good without getting too much industry push back since most big players were already achieving it.
This is an article from Bloomberg. It's from 2013 and maybe out of date.
The Reason Health Care Is So Expensive: Insurance Companies - Bloomberg
Reply With Quote Quick reply to this message
 
Old 10-26-2016, 10:13 AM
 
18,794 posts, read 8,420,430 times
Reputation: 4125
Quote:
Originally Posted by workingclasshero View Post
uhm

the myth of medicare being more efficient is just that a myth

Many people wrongly believe that Medicare is more efficient than private insurance; that view was often stated by champions of Obamacare during the debate preceding the law’s enactment. These advocates argued that Medicare’s administrative costs — the money it spends on expenses other than patient care — are just 3% of total costs, compared to 15% to 20% in the case of private, employer-sponsored insurance. But these figures are highly misleading, for several reasons.
Forbes Welcome
There are some efficiencies with Medicare over the privates. Looking from the patient and HC delivery side.

I am not in complete agreement with the Forbe's article. The older, sicker and more complicated Medicare patient has many more medical steps and encounters in any one time frame than the younger. The younger might have 0-1 or maybe a few medical encounters per year. The Medicare patient typically more, and more complicated. And in so many cases, MANY more. Many more is very unusual for the younger, but not at all unusual with Medicare. So the average of administrative needs has to be higher.

Of course bang for buck to the patient is typically much better with Medicare. Much easier administration and payments. Easier with testings and treatment. Typically less hassle with approvals for just about anything. Much cheaper for patients than if Medicare were private/for profit.

Bang for buck may be better for primary care docs. Worse for specialists. As primary care I find it lucrative enough and much easier to work with Medicare vs the gamut of private payers.

Bang for buck may be worse for hospital inpatients. Because of the DRG cost control payment system. And required quality measures that not only consume resources, they might cancel payments in some cases of complications or if the patient is readmitted to the hospital too soon. Hospitals by and large make this up with approved and bloated outpatient charges.
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:

Over $104,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > General Forums > Politics and Other Controversies

All times are GMT -6. The time now is 09:08 AM.

© 2005-2024, Advameg, Inc. · Please obey Forum Rules · Terms of Use and Privacy Policy · Bug Bounty

City-Data.com - Contact Us - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37 - Top