Re: OT - Ah, yes. National health care.



witfal wrote:

On 2008-01-06 15:13:10 -0800, "larry moe 'n curly"
<larrymoencurly@xxxxxxxxxxx> said:

How are YOU going to guaranty that those with EARNED benefits are not
going to see a reduction in services, quality of care, or see an
increase in costs?

Supplemental insurance, as is sold now for Medicare recipients? But
you're implying that health care plans are sort of like pension plans
where people pile up benefits, but health care plans are actually pay-
as-you-go systems.

Supplement. At cost. You've failed.

But I'm assuming that universal health care will cost less than
private insurance.

What kind of things do you expect universal coverage to leave out from
your current private coverage?

The only health care plans I've heard of are:

1. Keep the status quo. But the Economist has said the US health care
system is bankrupt.

2. Get government completely out of the health insurance business.
This wouldn't help poor people but would reign in costs for the rest,
making it more like dentistry, which has had relatively low inflation,
except maybe for cosmetic procedures.

3. Force private insurers to cover everybody at the same cost and not
allow them to reject anybody. Hillary, Mitt, and Arnold are some
politicians who favor this.

4. Make Medicare universal. This is the best plan to me because the
needed bureaucracy is already in place, it seems to be the lowest cost
system we have, it would get rid of Medicaid, which is poorly run by
most states, and it would keep out an extra layer of bureacracy from
the private sector, which has proved to be a higher cost provider for
Medicaid than the federal government has been.

So which of these do you like the most or hate the most? And these
are the only choices.

Number one is so because of abuse. Clear it up. Have the government
show it's capable of running health care, not the trainwreck we call
Medicare.

How can Medicare be considered a worse train wreck than private plans
when it's cheaper, charges everyone of a given age the same, and
covers them regardless of preconditions? Show me some private plans
that are superior in these respects, even if they're only for people
under 65.

Until they can do so, they've not earned our trust enough to make it
even more complex and costly. This is just plain common sense.

How can universal Medicare be more costly when it's shown to be
cheaper, and how can it be more complex compared to having most
doctors handle hundreds of different plans with hundreds of different
rules? Doctors spend 1-2 hours a day on the phone and employ at least
one extra office staffer to sort through all those plans.

Number two. Better. Keep the present system, clean it up, and offer
it to the poor. Leave others alone. Free is free. You can't complain.

You're talking about the insurance business, which, except for life
insurance, is the most bureaucratic and inefficient business there is,
where the private sector is so bad that the federal government is
almost always able to beat it on costs.

Just how do you plan to clean up the present system?

Number three. You'll end up with the same fate every other entity has
had when price controls were force upon it. Read some history,
starting with the first major blunder along those lines. Remember
Nixon's wage and price freezes?

I wasn't alive back then, but I know that Nixon tried to stop
"runaway" 4.0-4.5% inflation and ended up doubling it through wage-
price contols and making rebates a common marketing technique.

However universal health care plans don't intend to introduce price
controls but merely stop price fixing by drug companies and use the
scale of the federal government to get better deals on health care
expenses.

Number four. Lowest cost? My friend and his wife are physicians.
Talk to any you might know about Medicare and fraud. I have.

I don't know about Medicare, but for Medicaid the fraud rate was 8-12%
several years ago, with the rate about double for mental care.

As far as efficiency goes, Medicare has been cheaper than private
insurers, including HMOs. Medicare may be why Sun City's hospital,
which has one of the highest rates of coverage from the federal
government rather than the private sector, is one of the cheapest in
the Phoenix area, whether you consider patients of all ages or just
senior citizens. The cheapest hospital here was the county's, and it
used to be an outright cash cow that allowed county deficits to be
covered by hospital profits.

Please explain to me why private insurers should be more efficient
that the Medicare bureacracy when the insurance business has some of
the highest overhead of any industry, and none of the innovations in
health insurance in the past 20-30 years have come from the private
sector but from Medicare, which the private industry has copied (one
being DRGs instead of cost for service).

Do your physician friends work for an HMO or refuse to handle medical
insurance claims, meaning they deal with only one set of rules, or are
they in private practice and deal with dozens or even hundreds of
different sets of rules from all the insurers? And do they, like
most American doctors, employ 1-2 extra office staffer than their
Canadian collegues do for the same size practice?
.

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