High Healthcare Costs Impact Retirees and America's Economy

[eytonxav]

Interesting article that tries to make the case that Medicare is more efficient than privitized insurance:

http://www.nrln.org/documents/NRLN President's Forum Health Care Costs.pdf

Wish more was being done on the cost side of healthcare. As I've often said, fix the cost issue, then figuring out how to cover everyone is much easier.

 

[MichaelB]

Interesting article that tries to make the case that Medicare is more efficient than privitized insurance:

http://www.nrln.org/documents/NRLN President's Forum Health Care Costs.pdf

It sounds more like a position paper summary of a lobby group, in this case for retired people. Nothing really new here.

Wish more was being done on the cost side of healthcare. As I've often said, fix the cost issue, then figuring out how to cover everyone is much easier.

True, but a different choice was made and implementation is underway.

 

[eytonxav]

It sounds more like a position paper summary of a lobby group, in this case for retired people. Nothing really new here.

True, but a different choice was made and implementation is underway.

True, but the data quoted was interesting to me and thought it might be to others.

 

[ziggy29]

True, but a different choice was made and implementation is underway.

Agreed, though I do expect that PPACA will be tweaked and refined over the coming years as we realize what is working and what isn't. Assuming Congress doesn't get any more dysfunctional and polarized than it already is, anyway.

 

[photoguy]

Interesting article that tries to make the case that Medicare is more efficient than privitized insurance:

I thought this was a well known fact and widely accepted. From my recollection administrative costs for medicare are a couple percent vs 10-20% for private.

Maybe I am wrong

 

[ziggy29]

I thought this was a well known fact and widely accepted. From my recollection administrative costs for medicare are a couple percent vs 10-20% for private.

Maybe I am wrong

This sounds about right, but it ignores offsetting factors to some degree. For example, the general consensus is that there is significantly more fraud in Medicare and Medicaid than with private insurance plans. (The degree to which it is greater often depends on which source you consider, many of which have biases one way or the other.) To some degree, the higher administrative costs of private insurance go to reducing fraud.

Unfortunately, the reduced fraud in private plans due to added vigilance in the private plans also has a cost: the amount of time (and stress) many people deal with in order to fight with insurance bureaucrats over legitimate claims.

 

[eytonxav]

I thought this was a well known fact and widely accepted. From my recollection administrative costs for medicare are a couple percent vs 10-20% for private.

Maybe I am wrong

Personally, I have never viewed anything being run by the Gov't as a model of efficiency, so this surprised me a bit. On the private side its probably more like 30%+ in administrative cost and that is a well known fact to me and another reason to be exasperated over the year over year increases.

 

[noelm]

Frankly, the socialized medicine is portrayed so wrongly here and surprisingly, folks DO buy it. I REALLY wonder, how many of those opposing have really lived in a country with socialized medicine like Canada, UK, Sweden, Finland, Taiwan etc.

With current model, the one who wins is ONLY insurance company, neither the healthcare provider, nor the patient (DW works with mom-and-pop run Physical therapy facility employing about 30 in total). If govt. wants to employ socialized medicine, it needs to get good quality food in the stores, which it fails miserably at the moment. Improve infrastructure so that community can make use of it to their benefit (as simple as walking path, bike lanes, parks with wide exercise options etc.) and promote them (In Sweden, I used to get a leaflet every summer from local county office about bike and jogging paths). Once you have this system in place, the number of people using it will increase slowly and hopefully the ones using healthcare will start reducing. I have used Swedish healthcare and it does have its cons but it still rocks.

Even with this healthcare as it is, many go for medical tourism so why would you complain after socialized medicine (now you go because you can't afford, then you may go because of waiting period, STILL you will save tons)? There are lot of pros (than cons) but the discussion is out of scope for this comment (but I am willing to discuss if anyone is interested).

 

[dm]

I have a friend in the medical field and according to him he makes no money on medicare patients. He does service some, but he would not if that was all there was. What happens when there are no doctors that will accept the payments offered?

 

[MooreBonds]

I thought this was a well known fact and widely accepted. From my recollection administrative costs for medicare are a couple percent vs 10-20% for private.

Maybe I am wrong

Well, when each state has their own health insurance requirements and regulations (often varying widely from state to state), requiring a certain size overhead, and having to advertise and compete with other insurers for business just within that state....and you compare that with a single organization that has one (?) set of 'standards' that it applies to all 50 states, is it any surprise that it has the potential to be more 'administratively efficient' than private options? Add in the fact that 'most' healthcare providers accept medicare, versus insurance companies having to create and maintain networks, and dealing with all of that costs involved on an annualized basis?

Make health insurance have one set of standards applying equally to every state in the nation, roll out nation-wide private health insurers with just a few nationwide plans (versus up to 10 plans for each state), and see how at least some efficiency will naturally arise.

Will it be as low as the alleged single digit Medcare overhead? Perhaps not....but compare the combined overhead + fraud of both Medicare and a nationwide private insurer, and you might be far closer than it is now.

 

[Tadpole]

Kraft Moving Off The Dow; United Healthcare Moves In - KWQC-TV6 News and Weather For The Quad Cities -

There are big changes in the stock market that are affecting some local companies. Later this month, UnitedHealth Group is going to replace Kraft Foods on the Dow Jones Average of 30 Industrials. The parent company of UnitedHealthcare is the first health insurer to be included in the blue chip index.

Just saying.

 

[M Paquette]

I have a friend in the medical field and according to him he makes no money on medicare patients. He does service some, but he would not if that was all there was. What happens when there are no doctors that will accept the payments offered?

Medicare moves from being an expense center to a revenue center, and we don't have to worry about the Medicare Trust Fund being drained. Problem solved!

What?

 

[Mulligan]

This sounds about right, but it ignores offsetting factors to some degree. For example, the general consensus is that there is significantly more fraud in Medicare and Medicaid than with private insurance plans. (The degree to which it is greater often depends on which source you consider, many of which have biases one way or the other.) To some degree, the higher administrative costs of private insurance go to reducing fraud.

Unfortunately, the reduced fraud in private plans due to added vigilance in the private plans also has a cost: the amount of time (and stress) many people deal with in order to fight with insurance bureaucrats over legitimate claims.

I was watching on CNBC the other night and a program that was dealing with Medicare fraud. The government have basically armed swat teams go in and make busts on various rings of healthcare fraud. On a specific case they showed excessive billing on aides such as wheel chair and equipment ordering fraud. One lady reported it because she noticed she had received a medicare bill receipt from government with a bunch of services and prosthetics for her amputated legs. The trouble was, she had both legs. People were stealing old peoples Medicare numbers and charging government for services not rendered or even the patient being aware of it. The program showed the agency working hard on these busts, but I am sure they are way understaffed. This group even went to Puerto Rico to bust some people.
On a side note, I am still 17 years from Medicare but was curious. It appears that even if you have health insurance at 65, companies assume you are on Medicare and they declare themselves secondary coverage without your consent. So does this mean everyone is trapped in Medicare even if it gets to the point that doctors won't accept Medicare patients?

 

[photoguy]

I know the government has some pretty aggressive goals for cutting fraud in medicaid/medicare, especially after a number of very embarrassing new stories (like a physician billing for more operations than physically possible in a 24 hour time slot, dentists pulling the same teeth, etc.). I'm guessing that by now they have systems in place to catch all of the obvious stuff.

One thing that always surprised me though, is what is the motivation for a dentist or physician to commit fraud? They already have high earning potential so the marginal utility of extra income must be relatively small.

 

[Alan]

On a side note, I am still 17 years from Medicare but was curious. It appears that even if you have health insurance at 65, companies assume you are on Medicare and they declare themselves secondary coverage without your consent. So does this mean everyone is trapped in Medicare even if it gets to the point that doctors won't accept Medicare patients?

I believe that by law Medicare becomes the primary insurance company.

At least that is what I recall hearing from our HR department.


PS
see here

http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf

If you are over 65 and retired then Medicare pays first

 

[crispus]

I am very lucky to have company retirement health insurance. Costs have skyrocketed the last three years. Each year our dollar outlay has doubled, along with higher drug costs. I am wondering if some of this huge increase is due to obamacare?

 

[Midpack]

I am very lucky to have company retirement health insurance. Costs have skyrocketed the last three years. Each year our dollar outlay has doubled, along with higher drug costs. I am wondering if some of this huge increase is due to obamacare?

I'm going to find my 10 foot pole before Porky appears...

 

[eytonxav]

I'm going to find my 10 foot pole before Porky appears...

Well did you find it and are you now ready to touch it

 

[Hamlet]

One fundamental problem with private health insurance is that it has somewhat perverse incentives compared to a normal capitalist enterprise.

Normally, the hope of return business is a strong incentive for a company to keep a customer happy. If I go to McDonald's and they mess up, they will do anything reasonable to make it right, because they know that I will be making fast food purchases for decades into the future.

It doesn't work that way with health insurance though. If I get cancer, the insurance company knows that I will be a money loser for the forseeable future. They have a strong financial incentive to either find an excuse to drop me as a customer, or to give me such bad service that I leave. Basically, insurance companies don't compete to keep customers happy, they compete in culling sick customers from their rolls.

Another huge problem in our system is that most people don't choose their insurance company. They get their insurance through work, so even if they are relatively healthy, the insurance company doesn't have a strong incentive to make the end user happy. That end user isn't the customer, the company benefits person is. That doesn't make for a responsive system.

People who automatically assume that a government system will automatically be worse than a private one are using assumptions that I don't believe hold true in the area of health insurance.

 

[Katsmeow]

I believe that by law Medicare becomes the primary insurance company.

At least that is what I recall hearing from our HR department.


PS
see here

http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf

If you are over 65 and retired then Medicare pays first

Yes, however, note that if someone is 65 or older and still working and the employer has more than 20 employees then the group health plan pays first.

 

[obgyn65]

It's called greed. A real disease.

One thing that always surprised me though, is what is the motivation for a dentist or physician to commit fraud?