i keep seeing libs write "medicare is run better than private..."

[Lord Xar]

Over and over...

Medicare is more successful... less wasteful than private counterparts etc...
True?

[Zippyjuan]

From a paperwork standpoint (and paperwork accounts for nearly 30% of medical expenses in the US- a substancial amount), yes. With a single payer, there is one form you can use for everybody and send it to one place for reimbursment. What is covered and not covered is also very easy to figure out. With the way the insurance industry is today, each patient probably has a different plan each with different coverage and different things they require the medical provider to send it in order to get payment. Not filled in properly or used the wrong form or left off the proper supporting documents and you have to file again. Each individual case requires a completely different way of producing the paperwork and who to send it to.

The easiest comparison would be between the US and Canada. We have simliar economies yet very different healthcare systems. Theirs is single payer ours relies on a complex system which combines private and public insurance programs.
http://www.pnhp.org/news/2003/august...tive_costs.php

The authors found that bureaucracy accounted for at least 31 percent of total U.S. health spending in 1999 compared to 16.7 percent in Canada. They also found that administration has grown far faster in the United States than in Canada. Between 1969 and 1999, administrative and clerical personnel in the United States grew from 18.2 percent to 27.3 percent of the health work force. In Canada, those personnel grew from 16 percent in 1971 to 19.1 percent in 1996.

Harvard/Public Citizen Report Finds National Health Insurance Would Save $286 Billion on Administration in 2003 - Enough to Cover All Uninsured and Seniors� Drug Costs

The researchers also released a second report co-authored with Dr. Sidney Wolfe, director of Public Citizen�s Health Research Group. This report, based on data adjusted to reflect estimates of 2003 spending, found that health bureaucracy now consumes at least $399.4 billion annually and that national health insurance could save about $286 billion in administrative costs. This is equivalent to $6,940 for each of the 41.2 million people uninsured in 2001 (the most recent figure available for the uninsured). In addition to providing health coverage for the uninsured, these savings could provide drug coverage for the nation�s seniors.

The high U.S. administrative costs can be attributed to three factors. First, private insurers have high overhead in both nations but play a much bigger role in the United States than in Canada. Second, doctors and hospitals in the United States must deal with hundreds of different insurance plans (at least 755 in Seattle alone), each with different coverage and payment rules and referral networks that must be tracked. In Canada, doctors bill a single insurance plan, using a single simple form, and hospitals receive a lump sum budget.

Does such a system produce the optimal allocation of medical resources? That would be a different quesition all together. What would constitute an "optimal allocation?" Who gets to decide? In a truely free market, the people decide what they want to spend their money on. But all payment systems have some sort of rationing. You don't get to pick if you want to include certain proceedures in your coverage or not. You don't know if you will need them in the future. It is not possible to have equal access to all healthcare treatments for all people. The costs would simply be too great and if they were paid for by individuals, they would not be able to afford them and if they were all covered by insurance individuals would tend to over-use the system since they weren't bearing the full costs directly. When costs of something are artificially low (as would be the case if the consumer did not pay directly for their healthcare) then it tends to get over- consumed.

[furface]

The biggest share of medical expenses for seniors is in the last few months of their lives. That's what Medicare is to a large extent, an end of life giveaway to the medical industry. It's easy money. Very few malpractice questions. No questions about payments, just a lot of procedures and then goodbye. In other countries the government doesn't put up with it. So from that point of view, Medicare is very poorly managed. Certainly private individuals wouldn't pay that kind of money for end of life procedures, nor would they pay the insurance premiums to cover them.

I've heard docs say that they like senior Medicare patients because they rarely sue, but they don't like to take younger ones because they're always looking for easy money by suing.

[LibForestPaul]

Medicare is more successful... less wasteful than private counterparts etc...

It is successful?
1. At having doctors opt out all together?
2. At confiscating my monies at gun point and giving it to others?
3. At keeping seniors gums healthy and mouths fully dentulous?

[cubical]

To say our healthcare system is a private system now is far from the truth. You can't fault private companies for all the problems caused by government intervention.

[John F Kennedy III]

Medicare loses hands down.

[matt0611]

I'm not expert on heatlhcare, but when medicare pays for things don't the payments not even cover all of the cost many of the times?
And don't many doctors not accept it?

Doesn't sound very successful to me.

[ronpaulhawaii]

Anytime I see this rear its head I remember looking at charts. The high cost of healthcare looks directly attributed to government involvement. (And I agree that gluttonous bureaucracy is the first thing that needs some stapling... )

Most people connect the HMO act of 1973 with the skyrocketing of costs. We see that in this 100 year chart:



But the visual story goes back further, with precipitous rises from earlier government interventions

Roosevelt's irksome Revenue Act of 1942 opened Pandora's Box and incubated the quasi public monstrosity we see today. It gave tax incentives to businesses for Healthcare "benefits", it did not include any such incentives to individuals... So lets look at a smaller section of that chart from that era - 1910 to 1960





The next foray by the socialists was the Medicare Act of 1965, so lets look at that time frame:



What is kinda disturbing is how moderate the pre Medicare rise looks compared to the former chart, which ends where the latter begins...

Which brings us to the HMO Act of 1973, which actually doesn't show such a drastic rise (and my layman's mind attributes to the onerous nature of these cumulative interventions with the corresponding avalanche of paperwork bureaucracy pushes to justify its existence)



which brings us back to the first chart, only lets bring it as far back as we can go - 1792 to 2010



Looks to me like government meddling is the problem

It should also be noted that during the entire history of the US, we have been close to the top among countries for life expectancy. Further, it was mainly the Nordic countries that we trailed as the avg has risen worldwide and it has basically been since the time frames mentioned in the above charts that the rest of the world has been catching up and overtaking. A tool to see that is here:

www.bit.ly/coSUs8

Charity is good - Mandates are bad.

[Black Flag]

The problem is that there is no methodology that can calculate whether government run health care is better.

The free market uses profit/loss - those that are profitable mean they are able to deliver satisfactory and valuable service at a good price. Those that have losses means they are too expensive or their quality is too low.

Government has no profit and loss to measure - they are flying blind, unable to know whether such a service is even economical or valuable.

[tttppp]

Am I missing something, or can all insurance just be done online without the use of any bullshit paperwork? I've audited some insurance companies before, and they are incredibly inefficient. Its one bullshit procedure after another with them. Just put all this shit online and eliminate all the staff that just pushes papers around.