Thread: Universal care cheaper and better than private insurance.

Originally Posted by Tarek Morgen

We have public and private health care here. You can "browse and shop" in each. We have over 200 publics to choose from.

That's interesting. Are these public cares non-profit or do they take government reimbursement?

The democrats here want what they refered to as "a single payer" universal health care system. Which basically means a gigantic bureaucracy the covers all Americans whether they want it or not.

Disclaimer: I am not an expert on this field and not everything I write might be correct, I'll do my best

to the best of my understanding..they are both. One difference between our private and publics one is that in the private ones you pay a fee based on yourself (gender, age, health, risk etc) while in public the amount you pay is based on your income. When the public ones are making deficits they have to rise that percantages of your incomem and if nothings helps they get help with tax money. Currently the finances of the publics one arent looking that good (thoug overall in has improved with the reforms under Schröder, but that does not mean that those reforms did not bring new problems) which have (imho) two reason. The absortion of the GDR and suddenly 16 million new people to cover (over 20% of the population, I dare to claim that any system which covers every citizin would get into trouble by that, and it went far better then one could expect) and a huge increase in managing cost.

At least the bureaucracy cost could be addressed with a further decrease in numbers of public insurance groups (I want to have options but we dont need 200 differrent public ones) and by internal reforms. The oither things is simply something we have to live with, and should be rather a unique German problem.

Our system usually has enough capaticies and it is not unuasal for countries like denmark to send some of the patients over the border to us because they lack them. (Costs are payed by their government), but it also has downsides. It is a two class system. Private patients are more profitables with doctors and hospitals and have often shorter wait times and more get more "luxus" (single bed room instead of two men bedroom for example), but everything you need will be covered (and in time) and even a few things that should not be covered (imho).

During my unemployed months I did some research on buying my own health insurance.

I found out the cost of employer paid and self paid are roughly the same. If I buy out of my pocket, I would have to pay around $4k to $5k for myself, for comparable benefits. That was on par with the money spent by my employer on the company policy.

Based on this research, I believe that we can contain our health care cost if we transfer the responsibilities of buying health insurance from the employer to the employees. Of course the money spent on company policies would be paid out to the employees.

Instead of always opting for the most expensive treatment like we do now, we would actually weigh the situation vs cost incured for fear of future rising rates. Needless treatments would decrease. Needless "expensive" or "overnight" results from the lab would also decrease. Insurance carriers would actually compete for business because the payment is no longer automatic. There would be many more tiers of services catered to different income and age groups.

But that's just me.

I agree. I kind of see it like breaking up Ma Bell. You might be satisfied with a cheap plastic phone that rattles and hisses, or you might want a solid desk phone that you could use to club a bull elephant to the ground and still reach the moon.

Why should the health care market be any different?

-dale

Originally Posted by gunnut

There's one problem with your theory. In a market driven solution, people can shop around for a lower price, just like any other business.

We all need food to live. Why don't we see abnormally high food prices from the greedy farmers?

Why do we see abnormally high labor costs charged by union workers? American Axle was paying assembly line workers roughly $140,000 a year to built transmissions.

The answer is the presense of a market distorting force.

The insurance industry gets paid by employers directly. We don't even see teh bulk of the charges. As a result, we (the people) tend to abuse the system since 80% of the cost is not borne by us. Year after year, these charges accumulate and we have our sky high insurance cost today.

Why do employers pay insurance carriers directly? Government mandates.

Oh,Gunnut
You are so very wrong comparing these things.
Food, gear boxes, bookshelves, houses are material, physical things while health is a virtual category since it has no material characteristics. With a material goods such as food and machinery you have a precise parameters such as materials used, processes used, energy spent etc and according to those parameters you can calculate the price

With health it is a different thing. Laws applied there are not the same as they are for other things.

Originally Posted by Versus

Oh,Gunnut
You are so very wrong comparing these things.
Food, gear boxes, bookshelves, houses are material, physical things while health is a virtual category since it has no material characteristics. With a material goods such as food and machinery you have a precise parameters such as materials used, processes used, energy spent etc and according to those parameters you can calculate the price

With health it is a different thing. Laws applied there are not the same as they are for other things.

I beg to differ. Doctors' hours, nurses' hours, capital cost of equipment at the hospital, research cost of a pharmaceudical company, material used for testing, surgeries...etc. all cost money and can be calculated.

Unless you're saying anything that doesn't generate a physical output cannot be measured. In that case, how much should a lawyer charge? How about the labor union official? Radio DJs? Political analysts? They generate virtually ZERO physical product yet some of them are compensated with outrageous salaries.

Originally Posted by gunnut

During my unemployed months I did some research on buying my own health insurance.

I found out the cost of employer paid and self paid are roughly the same. If I buy out of my pocket, I would have to pay around $4k to $5k for myself, for comparable benefits. That was on par with the money spent by my employer on the company policy.

Based on this research, I believe that we can contain our health care cost if we transfer the responsibilities of buying health insurance from the employer to the employees. Of course the money spent on company policies would be paid out to the employees.

Instead of always opting for the most expensive treatment like we do now, we would actually weigh the situation vs cost incured for fear of future rising rates. Needless treatments would decrease. Needless "expensive" or "overnight" results from the lab would also decrease. Insurance carriers would actually compete for business because the payment is no longer automatic. There would be many more tiers of services catered to different income and age groups.

But that's just me.

Mortality would increase as people avoided tests that might otherwise have saved thier lives.

Originally Posted by zraver

Mortality would increase as people avoided tests that might otherwise have saved thier lives.

That's only a conjecture, not a proven fact.

People also said that without rent control, poor and old people would be kicked out of their homes and there'd be massive housing shortages.

I can also say mortality would decrease as more people actually have insurance and know more about health related issues than to pile everything onto an employer funded system and be done with it.

Originally Posted by gunnut

I beg to differ. Doctors' hours, nurses' hours, capital cost of equipment at the hospital, research cost of a pharmaceudical company, material used for testing, surgeries...etc. all cost money and can be calculated.

Unless you're saying anything that doesn't generate a physical output cannot be measured. In that case, how much should a lawyer charge? How about the labor union official? Radio DJs? Political analysts? They generate virtually ZERO physical product yet some of them are compensated with outrageous salaries.

Yes, that was the point. But the whole "problem" is too complex to be simplified like this.

Originally Posted by gunnut

During my unemployed months I did some research on buying my own health insurance.

I found out the cost of employer paid and self paid are roughly the same. If I buy out of my pocket, I would have to pay around $4k to $5k for myself, for comparable benefits. That was on par with the money spent by my employer on the company policy.

Based on this research, I believe that we can contain our health care cost if we transfer the responsibilities of buying health insurance from the employer to the employees. Of course the money spent on company policies would be paid out to the employees.

Instead of always opting for the most expensive treatment like we do now, we would actually weigh the situation vs cost incured for fear of future rising rates. Needless treatments would decrease. Needless "expensive" or "overnight" results from the lab would also decrease. Insurance carriers would actually compete for business because the payment is no longer automatic. There would be many more tiers of services catered to different income and age groups.

But that's just me.

That could work but only if you raise the minimum wage rate to be between 35$ and 45$ per hour.

Originally Posted by Versus

Yes, that was the point. But the whole "problem" is too complex to be simplified like this.

Maybe it's simpler than you think. You just don't want to go for the obvious solution because you don't agree with it.

Originally Posted by Versus

That could work but only if you raise the minimum wage rate to be between 35$ and 45$ per hour.

Of course raising minimum wage will have no effect whatsoever on the cost of EVERYTHING.

Originally Posted by gunnut

Maybe it's simpler than you think. You just don't want to go for the obvious solution because you don't agree with it.



Of course raising minimum wage will have no effect whatsoever on the cost of EVERYTHING.

Ok,ok about the wages.
If you said that you will need between 4000$ and 5000$ to pay for the insurance, did you mean that, you need to pay that amount per month or over a longer period? Cause, if I take my example, (working two jobs in SF one is 1300$ after taxes and other one is 630$ after taxes) I don't see how I can pay 5000$ for the health insurance if it is paid per month.

Originally Posted by Tarek Morgen

But you can find them here. There have been several post here describing the German model. I would like to know what you dislike (if this is the case) about it.

Tarek,

I haven't read enough about the German model, but I am intrigued about its performance and am curious whether it might not be a pretty good mix of market and regulation. I still owe it to JAD to watch the Frontline special - I've also tried finding a good comparative health economics book, but I haven't come across anything that does a good job of looking across countries thus far. I will be interested to see how the reduction in the # of available plans affects outcomes.

Originally Posted by zraver

Mortality would increase as people avoided tests that might otherwise have saved thier lives.

Most research shows that we are "overtreated" and that the vast majority of tests are either unnecessary (e.g., to avoid litigation) or don't change medical outcomes. In the short-term, increase in mortality would be statistically insignificant, and in the long-term, you could see resources shifting to provide better outcomes.