Is State Run Insurance better then Private Insurance?

[GingerSnaps]

What would the pro's and con's be on each one and what is your opinion on them?

[Vincardog]

1. The Government administers a program at a 7% cost. The margin on private

insurance is 30%. If we went to single payer insurance we would immediately save 23%.

[Rjnerd]

5. Not only is the program low overhead

but the decisions on treatment are made by actual MD's that have examined the patient. Not someone with no explicit certification, in a distant office, somewhat blindly applying cost containment rules.

-dp-

[ewagner]

2. Mixed blessing, I think

If government was only the collector/distributor of funds then things could be pretty efficient....and the profit motive is eliminated (from the insurance side only)

BUT

Under that scenario, medical establishments have absolutely no incentive to be efficient or cut costs......so the result could likely be more spiraling health costs.

That's just off the top of my head.

[papau]

7. have absolutely no incentive to be efficient or cut costs - true of gov

workers - all such workers, as in at the State house, in the EPA, - so the medical staff might have EPA type cost over-runs -

but I have not heard of EPA cost over-runs.

Perhaps a GOP myth?

:-)

[ewagner]

13. btw

did you know that payment for medicare are outsourced to EDS? At least the payments from government to providers....

[central scrutinizer]

17. yep, that's how Ross Perot got to be a billionaire

he was charging medicare $15 per transaction but the actual cost was closer to 50 cents.

[papau]

21. Part B has always been outsourced - each state plus gov is a

separate contract.

These are Administrative services only contracts that only carry a 6 or 7% margin - not like a 30% "insurance" overhead - and go out to open bid every few years for each contract separately.

[sherilocks]

27. Mine come from something called

Centers for Medicare and Madicaid Services. Is that EDS? I knew they were contracting it out, but now I'm curious.

[ewagner]

29. That's CMS

which, I believe is the government agency responsible for administration.........I think it's located in Mass.

[dpibel]

15. If I'm not mistaken

Medicare sets the rate of reimbursement, not the other way around. I think doctors beef about Medicare because they don't pay enough.

Seems like "you get paid what you get paid" is a pretty powerful way of keeping people efficient and cutting costs.

[ewagner]

18. Yes, true

but there is also an annual "rate review" which determines the amount of reimbursement...there is required "cost data" too.

[NewJeffCT]

3. The big CON the RW propagates

Is that we'd have rationed health care where you'd drop dead in line waiting for your doctor and you'd have to have a waiting list to get certain operations.

My counter to that is that Canadians generally have better access to their primary doctors, live longer & have a lower infant mortality rate.

[papau]

8. Do you drop dead faster in a line - or at home with no insurance?

all these unanswered questions!

:-)

[shoelace414]

11. we have waiting lists in USA.

[TO Kid]

12. We have a shortage of GPs in Canada

Outside of Toronto it's impossible to find a GP who is accepting new patients, in the city it's pretty difficult. Chalk up another one to central planning- about ten years ago the bureaucrats decided we had too many doctors, so they cut the number of places in med schools. Now we don't have enough and the number is dwindling due to retirements, emigration to the USA and too few new grads.

[GingerSnaps]

14. Would you prefer to have no insurance as opposed to having state run?

:shrug:

[Telly Savalas]

26. How the fuck isn't the U.S. already rationing healthcare?!?!?!?

Rich people with good insurance get quality care, uninsured people get poor, if any, care. Despite what those assholes in the GOP might try to tell you, this is rationing, so let's start calling it that.

[NewJeffCT]

28. I know that, but they use rationing to create fear

We hear stories about how Canadians have to wait months to get critical operatons or how the French system has this problem or the German system has that problem, etc, etc.

We don't hear bad things about the US system unless it is a grievous tragedy or a 'supposedly' frivolous lawsuit.

I've had good health insurance for years, yet I have not seen my primary doctor for well over 5 years now. It's not that I haven't been sick these past five years, but his schedule is so backed up that if I'm sick with the flu or some respitory virus, and I want an appointment within the next few months, I have to see the nurse practioner instead of the doctor. While she is a very competent woman (and much prettier than the doctor), she is not a doctor.

[Telly Savalas]

30. We need to take the word "rationing" back from them

As per all the talk here (and even more so at DailyKos) about framing the issues, this "rationing" meme of the Right needs to be exposed for the crock of shit that it is. The GOP can only use rationing to create fear if we let them. What I'm arguing is that the "rationing" buzzword should be turned against them. Everytime some dickhead from the CATO institute starts babbling about rationing on one of those duelling talking heads shows, our guy needs to explain that the U.S. system rations healthcare by leaving 45 million people uninsured. Health care isn't an infinite resource. No matter how we organize delivery, there will be rationing. So the question is do we want to have rationing where everyone gets care, or should we rig our system to exclude people like we do now.

I've been living in Canada for 3 years, and in my experience the health care system here is vastly superior to that of the United States. The scaremongering about waiting lists and "rationing" is pure exaggeration. In Canada doctors decide what is best for patients, not insurance companies. Furthermore, Canadians (and Europeans for that matter) pay a much smaller percentage of their GDP on healthcare than do Americans.

Since the mid-1990's the Democrats have had their tail between their legs on this issue. It's got to stop. The GOP is completely full shit regarding health care so we need to go on the attack.

The talking points are simple:

*Take the choices out of the hands of insurance companies, and put them in the hands of doctors.

*The U.S. pays more for health care than any other industrialized nation, yet it doesn't cover all its citizens. Clearly our system is broken and needs fixing.

*We need to stand up for American families by guaranteeing that every one of them has access to basic medical care. How can the GOP claim to be pro-family when they allow 45 million Americans to suffer without medical insurance?

*Is it right that someone has to sell their home to pay for a loved one's cancer treatment?

*Let's stop the rationing of health care by insurance companies, and introduce a system where EVERYONE is covered.

*How can Republicans sleep at night knowing that there are sick children in this country who aren't seeing doctors because their parents can't afford it, even though they are working their asses off.

This issue is a winner for us. We're right, they're wrong.
YYYYYYEAAAAAAAAHHHHH!!!!

[Blue_Tires]

4. speaking from experience

ANYTHING is better than blue cross of RI

[Name removed]

6. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Warpy]

9. Private insurance seeks to reduce risk

which is annoying with car insurance, but heck, you can always ride a bicycle. With healthcare it means that anyone with a chronic illness is denied coverage, often by barely legal means, to reduce the risk that a company would not make a profit on the coverage.

Also consider that when profit is sucked out of any system, service degrades as much or more than when a state system is underfunded. This is annoying in Walmart but fatal in healthcare.

So we start off with a different philosophy at the beginning combined with different operating strategy. As long as the rich are not permitted to opt out of a single payer system, we can keep it funded to acceptable levels, although some care like liver transplants for active alcoholics and heroics for premies under a pound would probably have to be rationed.

Consider that Cuba has what most would consider a very primitive health care system, yet they've been able to match our maternal and neonate survival statistics and have come very close to our longevity statistics. Why? Universal coverage.

[cattleman22]

20. RE:"As long as the rich are not permitted to opt out of a single payer...

system,"




This is what bothers me. I can not support any system in which it is a crime for an individual and a doctor to reach a mutual decision about how much that individual will pay the doctor in order for the doctor to treat that individual.

[papau]

22. Say what? - A Crime??? Optional insurance - or payment and fee in

excess of schedule is always allowed.

You just can not opt out as an MD and still expect gov ins customers.

As a customer you can have both the national health - and private ins or just pay cash.

But gov health - national health - means go to a doc that has not opt'ed out.

This "crime" was a bull shit lie that I first saw in 1993 - is it back circulating again?

[cattleman22]

23. I was replying to the sentence about the rich

The only way to force the "rich" to be in single payer network is if it is a crime for them to go outside of it.

[papau]

24. true - but the rich rarely buy ins or worry-the near rich buy supplemental

ins

At least they do in Canada, the UK, and the USA.

[GingerSnaps]

10. I am not sure if i understand what state run is

Is state run policy's Medicaid, Medicare and VA or is it just Medicaid?

[Vincardog]

16. State run is like Social Security everybody working pays in a fixed amount

everyone is covered.

[central scrutinizer]

19. unqualified yes

I used to work for a private health insurance company.
1. They want their loss ratio to be 60% - that means for every dollar taken in, they want to pay no more than 60 cents out in claims.
2. To do this, they do everything possible to limit coverage, deny coverage, challenge coverage, etc., through a process called underwriting. When an application came in, we would write to doctors and get copies of medical records. If something seemed fishy, we would write for more records, then more records. This was to check for pre-existing conditions and hopefully the applicant would get too scared about the delay in insurance and go see the doctor on their own dime, then we could start all over again requesting updated medical records, etc.
3. If somebody tried to use their benefits, their premiums would go way up, or the payment would be delayed while we asked for medical records to see if the person actually had a pre-existing condition and was running a scam. And if their payment was a tiny bit late, then they would be canceled and we would start all over again with asking for medical records, etc.
4. All of this was to deal with risk - you want a lot of healthy low-use people to pump in lots of money to pay for the few sick people. All of this would be avoided with universal health care - the sick would seek care before it became too expensive.

[GingerSnaps]

25. Sounds very unfair

They are Jerks :grr: