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View Diary: GOP Hospital Executive Calls For Single-Payer (Medicare For All) As Solution To Health Care Crisis (173 comments)

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  •  What is health insurance anyway? (5+ / 0-)

    At its most basic level health insurance is a system where a large group of people get together and divide the cost of their health care between them.   In effect, we all get together, add up last year's health care costs, assign a certain weight to each member of the group (let's call the group a pool) based on age and perhaps some other risk factors (smoker, gender, whatever we decide) add something base on what we think the increase in cost for the coming year are and divide.  That becomes each persons premium cost for the next year.  Now when you have an insurance company in the middle of this, you have to add the administrative costs, the profit, the sales commissions, etc. to the premium. The ACA requires that 80% of premiums go towards paying claims, but that still leaves 20% going towards something that is not paying for care.  And of that 80% going to providers, a good deal is being spent dealing with getting the insurance companies to pay.  The overall cost of this private insurance is significant and adds very little value.  It makes no sense, no one who understands the system thinks it is the most efficient way to go about things.  That it will collapse on itself is inevitable.  The ACA will delay this a while, but it will happen.  It makes no sense not to just move to the end and do away with it, replacing it with Medicare for all.  

    It is not socialism for citizens to decide that the best way to provide a service is to do it as a joint venture using a democratically elected government as the mechanism to accomplish their goal.  It is just a rational decision by a self-governing people.  

    The difficulty lies not so much in developing new ideas as in escaping from old ones! - John Maynard Keynes

    by Do Something on Tue Jun 11, 2013 at 08:20:38 AM PDT

    •  Health insurance is an oxymoron (2+ / 0-)
      Recommended by:
      james321, DSPS owl

      I work in the industry and I'm an economist. Insurance is supposed to be for something that is rare and unlikely - like a car accident. Healthcare is something we all need at least annually, so the insurance model is ridiculous.

      It gets worse because we have built in even more inefficiency by having employers purchase healthcare coverage. Each employer has to have staff and spend $$ to select and to manage the healthcare benefit for their employees. Many employers also customize their benefit packages, so insurers have to distinguish among hundreds of potential benefit packages - which is why your claims get screwed up so easily.

      A single payer system, even if it still used insurance companies (as Medicare does, so the administrative costs of the Medicare program are actually higher than estimates, because some of the insurer overhead is also paid for by Medicare) would eliminate these two huge sources of inefficiency.

      A government that denies gay men the right to bridal registry is a facist state - Margaret Cho

      by CPT Doom on Tue Jun 11, 2013 at 11:13:34 AM PDT

      [ Parent ]

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