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Old 10-17-2009, 10:20 AM   #41
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And another thing . . .

Who benefits from a continuation of the present inefficient health insurance market? Insurers benefit for the reasons noted previously, less efficient markets always provide bigger profits. Also, large corporations benefit to some degree. Because they can provide badly needed insurance to their employees at price the the employees could not obtain on their own in the present market, and because these employees often can't quit because they or their family members could not get insurance elsewhere, these employers almost certainly are able to pay these employees far less in wages than they otherwise would. I know large corporations are always screaming about the high cost of health care, but I also believe they benefit from the present system. After all--they could stop providing health insurance anytime they want to. These aren't charities, they are bottom-line focused businesses, and they provide this coverage because they get more value from it than it costs.

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Old 10-17-2009, 10:56 AM   #42
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Some thoughts, though I have a fussy baby distracting me:

Originally Posted by samclem View Post
* * *
2) All applicants must be accepted at the standard rate (This is a "societal requirement" because the American public now believes everyone should have medical care--even if someone else has to pay for it. ) Inclusion of this "societal requirement" will also necessitate a mandate that everyone buy insurance--I don't think there's any other way to do it.

This is similar to the Swiss. Here, the Finance Committee plan does bar underwriting and provides subsidies. The requirement to buy is rather watered down in current plans. I agree it is a must.

3) Provide coverage without regard for employment status (this is a "societal requirement" because delinkng medical care from employment makes the labor market more efficient and makes our industries more competitive worldwide)
I have favored this idea for a long time. It will help with the dysfunctional non-group market as well.

We know how to facilitate competition: Allow cross-state sales of insurance products, standardize policy types, give consumers access to information about customer satisfaction with the insurers and provide consumers with easy access to information on health care outcomes from various procedures at various providers, etc.
The finance committee plan allows interstate compacts for sales of insurance. Currently, states regulate insurance and the finance committee still contemplates some state regulation. If it was wide open sales then a mechanism would have to be put in place to subject insurance companies to some regulation. (You know, things like soundness of the company, fraud, etc) The finance committee proposal didn't seem too bad of a way of dealing with a complex issue. Policies are standardized to some extent.

We don't have either a free or an efficient market today, which is why prices are high and why profits for health insurers are where they are. Efficient markets always drive down margins, and this is a much more effective method of doing it than government committees. Lots of things make our present market inefficient (opacity of pricing information, layer upon layer of interconnected pricing interdependencies, the existence of a fourth player (the employer) in the already complex three-player market "game" of consumer, health care provider, insurance company).

Let the free market do its magic, but within a confine that serves the needs of society (as presently understood) as well as the needs of individual consumers.

(Editorial: I am not comfortable with this "greater needs of society" requirement, but purists must face the fact that this is where America is headed--it is what people want. Apparently the Constitution, as presently interpreted, does not protect us from building a nanny state. So, let's go there with as little damage to individual liberty as possible)
You really aren't far off from the Baucus plan. Got to go, the baby is crying.


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Old 10-21-2009, 12:38 AM   #43
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Originally Posted by ziggy29 View Post
Again, if the profit motive directly led to higher costs, why on earth would so many services cost more with the USPS than FedEx or UPS? Could it be that FedEx and UPS manage costs more effectively because of competitive pressures AND the need to show shareholders a profit?
Or could it be that the USPS has to go to EVERY mailbox to pick up mail, even if nothing is there, while FedEx/UPS only go to a pick-up site when something is to be picked up? FedEx/UPS can also cherry-pick their delivery locations; the USPS can't.

Poor comparison.
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Old 10-21-2009, 08:18 AM   #44
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Originally Posted by eridanus View Post
Or could it be that the USPS has to go to EVERY mailbox to pick up mail, even if nothing is there, while FedEx/UPS only go to a pick-up site when something is to be picked up? FedEx/UPS can also cherry-pick their delivery locations; the USPS can't.

Poor comparison.
It probably is a poor comparison. I guess you are saying that the USPS uses package delivery to subsidize the cost of mail delivery to each home, so therefore their package rates are higher? Maybe they should charge accordingly, then it would be a closer comparison.

OTOH, I suppose one could argue that the USPS has an advantage - they are *already* going to every door, paid for by daily mail, the packages go along at a small incremental cost. While FedEx/UPS has to make special trips to specific doors.

It is these kinds of "comparisons" that make me cringe when people talk about a public option for health care being more cost effective. With tricky accounting, who will ever know?


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