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2009-03-01 09:37:26
PureFodder
Member
+225|6588

FEOS wrote:

PureFodder wrote:

FEOS wrote:

Where did you say that? Socializing the malpractice insurance does nothing about the costs of payouts.
Contrary to the spectacular masive sums you see on the front pages, the payouts of medical tort cases are really not that big.
If we take Tenneesee as an example because they actualy released their info:
http://www.dayontorts.com/medical-negli … youts.html
* Total medical malpractice verdicts against health care providers in Tennessee in 2004: 6

* Total judgments paid on those 6 cases: $1,958,648

* Total dollars paid in judgements and settlements: $110,292,183

* Average settlement or judgment amount in the 444 cases that were resolved by settlement or judgment in 2004: $243,944

* Cases closed with no payment whatsover: 1,916

* Average payment per case closed with or without payment: $45,904

If we assume Tennessee isn't wildly different to the rest of the country, as the average payout suggests, this indicates that total medical tort payouts for the counrtry are around $5-10 billion per year. The US healthcare costs are around $1-1.5 trillion more than most rich countries.

This even ignores the fact that other countries have their share of tort cases too and the fact that most large settlements are for death or serious permanent injury, hence totally justified.
Tennessee?! You pick one of the most conservative states as your case study to back your "low cost" thesis?! Seriously?!

Of course juries in a conservative state such as Tennessee will award less. Do a comparison of CA or New England states, then come back to me.
I used those values as the low end ($5 billion) the national average payout in 2006 was $308,706 as opposed to Tennessee's $244,000. Harldy a massive difference.
http://www.myfoxdfw.com/dpp/news/invest … Questioned
From various sites the estimated national total in medical tort payouts ranges from $5-30.3 billion depending on what is actually counted (eg. legal costs etc.) again showing nothing that could account for the massive costs of the US healthcare system, especially when you consider the fact that the majority of the high payouts are totally justified as malpractice resulted in death or permanent brain damage/paraysis/serious disability so you wouldn;t want to reduce them.

FEOS wrote:

PF wrote:

FEOS wrote:

The admin costs are not the bulk of the costs of the system. To ignore the biggest costs is to oversimplify the problem to fit your hypothesis.
The US spends almost as much per person on administering their healthcare system as most countries pay on their entire helathcare system.
That's a spectacular waste as it adds nothing to the quality of care that anyone recieves, it just pisses money away.
You keep saying that, but we haven't seen any data (not even from Tennessee) supporting that.
The United States spends six times more per capita on the administration of the health care system than its peer Western European nations.
http://www.nchc.org/facts/cost.shtml

FEOS wrote:

PureFodder wrote:

FEOS wrote:

Are you talking about "overall cost" or "relative costs"? They are two different metrics. Even if the per-capita tort costs are roughly equivalent, the overall cost of the system when scaled to a 350M+ population makes it unworkable.
Why? If the costs are 5 times larger and they are split between 5 times more people, the costs per person are the same.
So you are talking about relative (ie, per capita) costs. That's what I was asking.

The problem is that you assume a linear relationship between the individual and cumulative costs. That is not necessarily the case. Hence, why state (particularly smaller state) programs are more efficient (and effective) than larger ones. It's called bureaucracy, and you can't get away from it.
Centralized admin can be vastly cheaper than repeating the same process hundreds of times in smaller admin centres.

FEOS wrote:

PF wrote:

FEOS wrote:

You also overlook the tort costs associated with medical product development. They are also vulnerable to malpractice-like torts, which in turn raise costs to the consumer/patient.
Which also occurs in every other country with vastly cheaper healthcare. Also, it helps to prevent damage to people by providing a serious deterent for dangerous products. Remember that the vast majority of tort cases involve death or major permanent injuries and are very genuine.
I'm not saying they aren't valid. I'm saying that without reform--particularly on punitive damage awards, which are fairly arbitrary--the massive costs just get passed on to the consumer.

PF wrote:

FEOS wrote:

The problem is not as simplistic as you would portray it. For every layer you attempt to peel back, there are two or three more that you haven't addressed.
You haven't adressed the fact that most of these issues are the same for all countries, hence can't be the reason for Americas massive healthcare costs.
And you haven't proven that that's the case.
You haven't proven that tort cases are even a significant cost to the healthcare industry (estimated at 2% of healthcare spending btw.) In fact you haven't provided any links to prove anything.

Your argument is based on tort representing a massive cost for the medical industry, but haven't in any way shown that to be the case.

FEOS wrote:

PF wrote:

FEOS wrote:

Your source has also excluded the largest source of cost in medical torts: punitive damage awards.
see above, the total costs of payouts are a tiny fraction of healthcare spending and other countries that have far cheaper healthare systems have these costs too.
I was addressing tort reform specifically. You are neglecting the cascading effect of significant tort reform in determining price points for care. If the threat of exorbitant payouts is lower, the price of the drug/equipment/service can be lowered. Thus, when looking at an economy of scale, you get massive decreases in expense over the entire program.

That is not to say that the administration could not be streamlined, but that does not require a nationalized system to do that.
Exorbitant payouts are almost entirely involved in serious permanent injuries or death, ie. the cases where you want the peson injured to win. When genuine malpractice results in someone needeing constant lifelong care, the costs of that care can be huge. Again, these are true in other countries too.

FEOS wrote:

PF wrote:

There simply is no aspect of the tort system that can account for the $1 trillion+ extra costs of the US healtcare system in comparison to the tort systems of other countries.
See above. You haven't proven anything with data. All you have shown is what you think...the only facts you provided showed that tort costs in the medical field increased at a faster rate than other medical costs. Doesn't exactly support your thesis, now does it?
Nothing you have presented has shown that tort is even a significant cost for the US health industry, let a lone driving a $1 trillion cost increase in comparison to other countries with similar systems.
2009-03-01 16:48:19
Diesel_dyk
Object in mirror will feel larger than it appears
+178|6297|Truthistan

FEOS wrote:

Diesel_dyk wrote:

By the way, professionals are usually an S corp and that means that the income is taxed as if its in the owners hands so there just like individual owners.
Then your earlier argument is moot. However, here's a compromise: Have the owners document the amount of their income they reinvest in their company, then tax the remainder at the personal income level. Best of both worlds.
My comment is moot. How So? when I'm talking about small business I'm including lawyers, doctors, other professionals with mom and pop stores. You are making blanket assertions that an increase in tax will lead to less jobs. I pointed out that that might not necessarily be the case. To which you pointed out that professionals are incorporated so somehow they don't count.  Then I pointed out that professional incorporate under S corp taxation laws. But the simple fact is that a incorporated professional is still a small business owner.

Perhaps you need to define for everyone here what your defintion of a small business is because I get the feeling that i am trying to squeeze jello here.

What I am trying to do is challenge the assumptions of your argument. Challenging these assumptions would be to challenge engrained Republican't logic of the past 25 years but robust statements about hurting a nebulus group like small business owners deserves a more thorough examination. What segment of this group would be harmed by higher taxation? (that's not an invitation to blurt out higher taxation is harm- taxes are a necessary evil and someone has to pay them.)

Two assumptions that you are making
1. that taxes on small businesses will harm employment and
2. that low tax results in economic stimulus

First
The idea that a small business will hire less people if their taxes go up does not necessarily apply to small business engaged in providing services. They require a certain amount of hands to provide the service and MY POINT is that those jobs are not as sensitive to tax increase of tax decrease as you would like to assume. Service oriented businesses require a certain amount of staff to function properly regardless of the level of taxation. Your assumption on harm to small business is too robust to with stand scrutiny.

Second
Another of your assumptions is that the tax breaks in the 1980s resulted in the growth in the economy. What happened in the 1980s is that businesses engaged in a capital strike against Jimmy Carter. Reagan brought a lower tax regime to reward those groups that supported the Republicans. Businesses applauded the removal of Jimmy Carter and began spending again. The lower taxes were not a stimulus, they were a reward for political support and in return businesses began spending money to show support for the Republican party. What I see developing right now is that businesses are engaging in a capital strike against Obama's presidency. If that is the case, then Obama should increase taxes on these groups, because if these groups refuse to spend, the the govt should take the tax money from them and spend it to keep the economy going. This analysis is as valid as any you have put forward. Just look at how Republican'ts treat unions and employee rights. The right to strike is a powerful tool for ordinary people and one which the Repbulican'ts actively try to curtail to reward their supporters. Tax increases in the face of a capital strike is the mirror image of creating laws to curtail strikes by labor. Businesses should not be permitted engage in a capital strike and crash the economy. If strikes are detrimental to the economy then it is a detriment whether labor or capital engages in it. Increased taxation amounts to forced spending just as removing the right to strike amounts to forced labor.

Oh yah and "That's asinine Democrat talking points." Semantics are wonderful, Both sides can twist anything. Please keep on bringin the "asinine Republican'ts talking points on the story of no" so we can examine those assumptions that are being made. If you say something often enough people will believe it as fact.
2009-03-04 16:31:32
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

PureFodder wrote:

Nothing you have presented has shown that tort is even a significant cost for the US health industry, let a lone driving a $1 trillion cost increase in comparison to other countries with similar systems.
Really? How's this:

http://www.protectpatientsnow.org/site/ … _Abuse.htm

A recent study by Blue Cross/Blue Shield in “crisis” states found that huge jury verdicts were the primary driver of higher medical liability premiums.11 Average medical liability premiums rose 18 percent in 2003 alone – more than twice the rate of overall health care spending per person.12 By 2003, medical liability costs reached $26 billion – a 2,000 percent increase over 1975.
Medical liability costs are rising far more rapidly than overall medical costs. From 1975 to 2000, medical costs rose 449 percent; medical liability costs rose by 1,642 percent.14 Since 1975, medical liability costs have risen at four times the rate of inflation and twice the rate of medical care inflation.
Or this:
http://aspe.hhs.gov/daltcp/reports/mlupd2.htm

Interest groups supported by trial lawyers argue that the recent crisis in the medical litigation system is only a reflection of an "insurance cycle": they claim that the management practices of the insurance industry have caused the crisis. But their claims are not supported by facts. Comparisons of states with and without meaningful medical liability reforms provide clear evidence that the broken medical litigation system is responsible.
Or this:
http://www.heartland.org/policybot/resu … _Says.html

Medical malpractice liability--"the 'tort tax' on doctors and hospitals, whose costs constitute the majority of health expenses," as it is described in the report--has grown much faster than overall health care inflation, according to 2004 data from the global management corporation Tillinghast-Towers Perrin. Medical malpractice liability alone constitutes more than 10 percent of the U.S. tort tax, which by 2003 represented more than $3,300 for the average family of four, according to Tillinghast-Towers Perrin.
https://www.heartland.org/apps/images/imgPics/HCN1.06_9_1.jpg

The drug maker Wyeth, for example, has set aside a reserve of $21 billion to deal with litigation related to the obesity medication Fen-Phen. Merck's exposure to Vioxx lawsuits may total as much as $50 billion, the report notes.

"Such figures are astronomical in comparison with these companies' individual budgets, representing nine to twelve times each company's annual research and development costs," the report notes. "In fact, since each drug was widely used for only about four years, the approximate annualized liability cost of these two drugs comes to almost $18 billion--equivalent to 10 percent of the annual revenues for the pharmaceutical industry as a whole."
The direct costs of health care litigation only scratch the surface of the toll such lawsuits exact on the U.S. economy and on health care, the Manhattan Institute report emphasizes. "Med-mal lawsuits tend to inflate health care costs by encouraging 'defensive medicine'--unnecessary procedures and referrals that doctors and hospitals prescribe in order to limit their exposure to future litigation," explains the report. "Studies suggest that defensive medicine costs are several times higher than the direct liability costs themselves."
Or this:
http://www.howardgroupinc.com/clients/l … s_2005.pdf

The cause of this crisis is an out-of-control legal system that allows for excessive, non-meritorious litigation and skyrocketing jury awards in medical liability lawsuits. The excesses of this system have led to sharp increases in physicians’ liability insurance premiums and have
caused most medical liability insurers to abandon the Illinois market because of huge losses, despite costly premiums.
A personal impact story (relayed via testimony to Congress) regarding the crisis induced by medical litigation.

There's much more out there. So no...my position is not without foundation.
“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-04 21:02:38
Bevo
Nah
+718|6824|Austin, Texas
Look out Sweden, America is the new Socialist hotspot!

Next step communism! Maybe if we're lucky, facism!

YES WE CAN! CHANGE IS HERE!
2009-03-05 02:58:46
PureFodder
Member
+225|6588

FEOS wrote:

PureFodder wrote:

Nothing you have presented has shown that tort is even a significant cost for the US health industry, let a lone driving a $1 trillion cost increase in comparison to other countries with similar systems.
Really? How's this:

http://www.protectpatientsnow.org/site/ … _Abuse.htm

A recent study by Blue Cross/Blue Shield in “crisis” states found that huge jury verdicts were the primary driver of higher medical liability premiums.11 Average medical liability premiums rose 18 percent in 2003 alone – more than twice the rate of overall health care spending per person.12 By 2003, medical liability costs reached $26 billion – a 2,000 percent increase over 1975.
Medical liability costs are rising far more rapidly than overall medical costs. From 1975 to 2000, medical costs rose 449 percent; medical liability costs rose by 1,642 percent.14 Since 1975, medical liability costs have risen at four times the rate of inflation and twice the rate of medical care inflation.
So your argument is that medical liability has reached $26 billion out of Americas $2,100 billion healthcare system and therefore it represents a major issue?

It's only just over 1%, even if you could halve it without harming those who actually need the compansation you'd save 0.7% on your healthcare bill, which is expected to increse by about 4-5% this year.

FEOS wrote:

Or this:
http://aspe.hhs.gov/daltcp/reports/mlupd2.htm

Interest groups supported by trial lawyers argue that the recent crisis in the medical litigation system is only a reflection of an "insurance cycle": they claim that the management practices of the insurance industry have caused the crisis. But their claims are not supported by facts. Comparisons of states with and without meaningful medical liability reforms provide clear evidence that the broken medical litigation system is responsible.
Or this:
http://www.heartland.org/policybot/resu … _Says.html

Medical malpractice liability--"the 'tort tax' on doctors and hospitals, whose costs constitute the majority of health expenses," as it is described in the report--has grown much faster than overall health care inflation, according to 2004 data from the global management corporation Tillinghast-Towers Perrin. Medical malpractice liability alone constitutes more than 10 percent of the U.S. tort tax, which by 2003 represented more than $3,300 for the average family of four, according to Tillinghast-Towers Perrin.
http://www.heartland.org/apps/images/im … 06_9_1.jpg
Why have you highlighted the fact that doctors and hospitals constitute the majority of healthcare expenses? I thought you were arguing that 'tort tax' was the major cost here?

This article says that medical tort adds $330 per family of 4 to the costs of US healthcare. Even if you could halve that that would represent a $42 per person saving on a $8000 per person system. You seem to be quoting things that directly say that you are utterly wrong and claiming your argument to be right.

FEOS wrote:

The drug maker Wyeth, for example, has set aside a reserve of $21 billion to deal with litigation related to the obesity medication Fen-Phen. Merck's exposure to Vioxx lawsuits may total as much as $50 billion, the report notes.

"Such figures are astronomical in comparison with these companies' individual budgets, representing nine to twelve times each company's annual research and development costs," the report notes. "In fact, since each drug was widely used for only about four years, the approximate annualized liability cost of these two drugs comes to almost $18 billion--equivalent to 10 percent of the annual revenues for the pharmaceutical industry as a whole."
The direct costs of health care litigation only scratch the surface of the toll such lawsuits exact on the U.S. economy and on health care, the Manhattan Institute report emphasizes. "Med-mal lawsuits tend to inflate health care costs by encouraging 'defensive medicine'--unnecessary procedures and referrals that doctors and hospitals prescribe in order to limit their exposure to future litigation," explains the report. "Studies suggest that defensive medicine costs are several times higher than the direct liability costs themselves."
Or this:
http://www.howardgroupinc.com/clients/l … s_2005.pdf

The cause of this crisis is an out-of-control legal system that allows for excessive, non-meritorious litigation and skyrocketing jury awards in medical liability lawsuits. The excesses of this system have led to sharp increases in physicians’ liability insurance premiums and have
caused most medical liability insurers to abandon the Illinois market because of huge losses, despite costly premiums.
A personal impact story (relayed via testimony to Congress) regarding the crisis induced by medical litigation.
Are you trying to argue that drug companies are being bankrupt by this system, as it's clearly not the case. The amount that they could be sued simply represents the potential costs if they are completely negligent and release a bunch of drugs that are massively harmful to a huge market. The large potential costs to being massively negligent are beneficial to people as they discourage drug companies from releasing useless or potentially harmful products. Defensive medicine has similar effects. This is the case in other countries that have vastly lower healthcare costs, which is a strong indicator that this isn't a significant factor in the different costs of the systems.

FEOS wrote:

There's much more out there. So no...my position is not without foundation.
You have more sources that contradict your own arguments?
2009-03-05 03:10:17
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

Way to put on ideological blinders.

Why don't you put a little intellectual rigor into this and look 1mm deeper?

Drug companies maintain a massive amount of cash as insurance to deal with litigation, whether they are negligent or not. It costs money to defend oneself, even against frivolous lawsuits...a point made in the text of one of the linked articles, which you clearly didn't bother to actually click on and read in their entirety. Where do you think that money comes from? The money fairy? It comes from passed on costs to consumers, both public and institutional (ie, hospitals).

The effect of litigation on the costs of goods and services in the medical field goes far beyond just the awards in courts. The linked articles make that pretty clear. It is that cascading cost that is lost in your stovepiped, ideological view.

You'll notice that not once have I said that administration shouldn't be overhauled. In fact, I've said the exact opposite. I haven't dismissed your argument...but you've put a lot of effort into dismissing mine. So I provide varied sources showing that medical litigation costs are a significant driver of overall health costs in this country...and you just read the tidbits I quoted and think that's the entirety of the information. Intellectual laziness, tbh. There are sources out there that point to the same problem in the UK and Australia...so private vs. public systems is independent of the impact of medical torts.

Administration is ONE area that can realize efficiencies that may bring down the costs of medical care. It can be done without nationalizing the system.

Tort reform is ANOTHER area that may bring down the costs of medical care. It can also be done without nationalizing the system.
“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-05 05:46:49
PureFodder
Member
+225|6588

FEOS wrote:

Way to put on ideological blinders.

Why don't you put a little intellectual rigor into this and look 1mm deeper?
Lets have a look shall we. Your article uses Vioxx as an example of a tort system causing large fiscal damage to drugs companies.

wiki wrote:

FDA analysts estimated that Vioxx caused between 88,000 and 139,000 heart attacks, 30 to 40 percent of which were probably fatal, in the five years the drug was on the market.
The tort system didn't create this masive cost, the drugs company did by killing a crazy number of people by releasing harmful drugs after fudging their testing data to make it appear safer. If companies want to lower their litigation costs, they should try releasing safer drugs. Surely the massive costs that they are facing should discourage these companies, but the examples that your article uses indicate that the costs of the tort system are not enough to discourage drugs companies from fudging their data and reseasing harmful drugs that kill tens of thousands of people.

FEOS wrote:

Drug companies maintain a massive amount of cash as insurance to deal with litigation, whether they are negligent or not. It costs money to defend oneself, even against frivolous lawsuits...a point made in the text of one of the linked articles, which you clearly didn't bother to actually click on and read in their entirety. Where do you think that money comes from? The money fairy? It comes from passed on costs to consumers, both public and institutional (ie, hospitals).

The effect of litigation on the costs of goods and services in the medical field goes far beyond just the awards in courts. The linked articles make that pretty clear. It is that cascading cost that is lost in your stovepiped, ideological view.
Your sources say that the total costs of all lawsuits, won or lost, comes to $26 billion, I'm really starting to wonder if you read or understood any of this?
Defensive medicine and potential massive costs for releasing harmful drugs are very beneficial for patients. Undoubtably if the financial penalties were reduced, it would result in more patients being killed. How do you put a price on that? Again, none of your sources even get close to claiming that reeling in medical liability costs would significantly lower the costs of US healthcare. They also don't show anything to differnetiate the US system from any other. Your sources state that the additional costs beyond the direct litigation amount to several times higher than that of the direct litigation costs, but this is based on a Daniel Kessler & Mark McClellan paper from 1996 which has since been widely critisized due to being based on a single study that focused on one condition that wass extrapolated up to account for the entire healthcare system. Similar studies on a wide range of similar and dis-similar conditions found nothing like the same results as their paper. Their results have since been completely contradicted by CBO and GAO investigations.

FEOS wrote:

You'll notice that not once have I said that administration shouldn't be overhauled. In fact, I've said the exact opposite. I haven't dismissed your argument...but you've put a lot of effort into dismissing mine. So I provide varied sources showing that medical litigation costs are a significant driver of overall health costs in this country...and you just read the tidbits I quoted and think that's the entirety of the information. Intellectual laziness, tbh. There are sources out there that point to the same problem in the UK and Australia...so private vs. public systems is independent of the impact of medical torts.

Administration is ONE area that can realize efficiencies that may bring down the costs of medical care. It can be done without nationalizing the system.

Tort reform is ANOTHER area that may bring down the costs of medical care. It can also be done without nationalizing the system.
We're off to name calling now are we? I'm not the one that failed to even understand tha data that you quoted. The fact that your selected quotes showed the exact opposite of your argument shows that you had no idea what they meant. Face it, the intellectual laziness was yours not mine.

Admin reform should be able to knock 20% off the costs of healthcare, as all your articles show, the savings from tort reform would be at most a full scale factor lower, and would be likely to result in increased deaths and injuries.
The problem with administering the US system is unavoidable with massive numbers of insurance companies with large numbers of different policies compaired to a single centralized admin system.The privatized system will always have this problem unless you start granting monopolies.

All your sources show that medical liability costs are rising, and doing so faster than the overall healthcare system, but if you apply some intellectual rigour and actually read what they say, they don't say that it is driving the incresed costs of the US healthcare system. The reason that they don't actually ever say that, is because even they know that it isn't true. All of the sources used in this thread say the same thing, there simply isn't enough money in the medical tort system to get close to accounting for the rising healthcare costs and tort reform.
2009-03-06 02:58:51
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

http://www.piccorp.com/AdminUtilCosts.htm

Health Care Costs by Category
Provider Claims     67.6%
Claims Administration     4.0%
Medical and Disease Management     1.8%
Network Access Fees and Network Management     1.8%
Benefit Consultation and Plan Management     4.8%
Human Resources Administration     4.8%
Risk Charge     15.1%
It's quite clear that your claim of administrative overhead being the bulk of health care costs is not true. At most, less than 10% of total health care costs.

By far the largest component of Health Care Costs and by far among the most misunderstood.  Health Care Delivery is unlike most other economic models whereby reduced Unit Costs do not always directly lead to lower costs.  In fact, in PIC's experience, we are witnessing a long term trend of substantial reductions in Physician Compensation with long term dramatic increases in overall Plan Costs.  Unique to the Health Care Delivery system, no Provider Claims expenditures can happen without the express order or "prescription" of a physician.  As we reduce the compensation and disenfranchise the decision makers, we tend to lose the engagement of the very decision makers in the system.  Coupled with an intense increase in Professional Liability premium rates and an increasingly educated and demanding patient base, very few physicians will actively invest substantial amounts of time with patients to talk them out of the need for additional diagnostic procedures or elective surgical procedures.
Some information on flawed reporting of administrative expenses:
http://www.voicefortheuninsured.org/pdf/admincosts.pdf
A closer look at administrative costs
These frequently cited estimates have been criticized for incorrectly measuring and reporting administrative costs in various ways that, together, exaggerate differences between private and public insurance, and the United States and Canada.

Major shortcomings of administrative cost estimates include the following:

Ignoring unreported administrative costs of government programs. Perhaps the most obvious shortcoming of many estimates is that they ignore unreported spending on administration of government programs. Such uncounted administrative costs are especially evident in the Medicare program and include:

• Tax collection to fund Medicare—this is analogous to premium collection by private insurers, but whereas premium collection expenses of private insurers are rightly counted as administrative costs, tax collection expenses incurred by employers and the Internal Revenue Service do not appear in the official Medicare or NHE accounting systems, and so are usually overlooked
• Medicare program marketing, outreach and education
• Medicare program customer service
• Medicare program auditing by the Office of the Inspector General
• Medicare program contract negotiation
• Building costs of the Centers for Medicare & Medicaid Services (CMS) dedicated to the Medicare program
• Staff salaries for CMS personnel with Medicare program responsibilities
• Congressional resources exhausted each year on setting Medicare payment rates for services

Reporting administrative costs as percentages rather than dollars. Presenting administrative costs as a percentage of total health care costs gives a misleading impression of Medicare’s efficiency relative to private insurance. Medicare patients are an expensive population, with much higher medical costs per person and per claim relative to the general privately insured population. Thus, an identical dollar amount of administrative cost per enrollee or per claim in the two sectors would make Medicare administrative costs appear lower. For example, a $10 administrative cost per insurance claim represents 10 percent of a $100 claim but only 1 percent of a $1,000 claim. Similarly, rising medical costs of Medicare enrollees create the appearance that Medicare is becoming administratively more efficient over time.

Confusing costs of regulatory compliance with health plan inefficiency. Private insurers face administrative costs
not imposed on public programs, such as the need to comply with multiple sets of state and federal regulations. Both
overregulation and arbitrary differences in regulation create unnecessary administrative costs and prevent cost-savings
from economies of scale. Private insurers also must pay premium taxes, usually counted as an administrative expense,
driving up administrative costs as a percentage of total costs and creating the appearance of reduced efficiency.

Failing to recognize indirect costs not reflected on an accountant’s ledger. Tallying up dollars spent on all administrative activities for public and private insurance alike, along with addressing the other issues just discussed, would greatly improve administrative cost estimates and comparisons— but still would not capture indirect, hidden costs
of insurance administration. These indirect costs depend on how basic administrative functions are accomplished, functions that are necessary for both private and public insurance, including collecting revenues, managing use of services, and paying physicians and hospitals. Adopting a single-payer system in the United States might eliminate health plans’ administrative expenditures on curbing use of services, for example, by preauthorizing services, establishing tiered benefits, and monitoring the practice patterns of physicians and hospitals. However, these activities would inevitably be replaced by other methods of curbing overuse that carry their own costs, such as longer waiting times and restricted treatment options.
A pair of studies of Medicare administrative costs that included unreported expenditures on the program made by numerous government agencies concluded that Medicare administrative expenditures were at least three times the amount reported in the federal budget in 2003—$15.0 billion vs. $5.2 billion.2,3 Another administrative cost analysis—possibly the most comprehensive and methodologically rigorous to date—examined a wide array of costs borne by insurers, health care providers, and patients in the United States and Canada, paying particular attention to indirect costs of carrying out basic administrative functions.4 The study calculated costs, net of associated benefits, of explicit
and implicit methods of collecting revenues, curbing use of services and paying providers. For example, longer waiting times in Canada implicitly keep utilization of health care services in check, generating indirect costs to patients from delayed treatment and missed work. The study found that indirect, hidden administrative costs dwarfed monetary expenditures, concluding that true administrative costs are many times higher in Canada than in the United States.
the AMA believes that even if administrative dollar expenditures were indisputably lower in a single-payer system, any administrative advantages would be offset by inefficiencies, longer wait times, restricted individual choice, lost productivity, reduced quality and decreased incentives for medical innovation. Likewise, the AMA regards administrative costs as being overshadowed by other, more fundamental flaws in the current health care system that, if corrected, would put coverage within everyone’s reach regardless of income or health status, as well as rein in excessive administrative costs.
So...after this wall of text...

Are there efficiencies that can be gained in new approaches to administration? Of course.

Is administration the burden that you claim it to be? Is the single payer system the panacea you claim? Only if you don't compare apples to apples.

And again...reduction in risk due to large awards associated with lawsuits would reduce the amount needed to be charged to cover malpractice insurance (both personal and institutional), fund provider "war reserve" accounts to cover potential jury decisions (at pharmaceutical companies, for instance), and other "hidden" costs associated with medical care...all of which contribute significantly to higher charges for serves rendered but are not directly measurable.
“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-06 03:17:24
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

PureFodder wrote:

We're off to name calling now are we? I'm not the one that failed to even understand tha data that you quoted. The fact that your selected quotes showed the exact opposite of your argument shows that you had no idea what they meant. Face it, the intellectual laziness was yours not mine.

Admin reform should be able to knock 20% off the costs of healthcare, as all your articles show, the savings from tort reform would be at most a full scale factor lower, and would be likely to result in increased deaths and injuries.
The problem with administering the US system is unavoidable with massive numbers of insurance companies with large numbers of different policies compaired to a single centralized admin system.The privatized system will always have this problem unless you start granting monopolies.

All your sources show that medical liability costs are rising, and doing so faster than the overall healthcare system, but if you apply some intellectual rigour and actually read what they say, they don't say that it is driving the incresed costs of the US healthcare system. The reason that they don't actually ever say that, is because even they know that it isn't true. All of the sources used in this thread say the same thing, there simply isn't enough money in the medical tort system to get close to accounting for the rising healthcare costs and tort reform.
Um...bullshit.

Nowhere did I call you a name. You see in those stats what you want to see, instead of accepting that there is another view and another approach out there that is just as valid and based in research as your own. The intellectual laziness is your refusal to consider other positions and reconsider your own. That's not name calling...that's describing your approach.

Your 20% number is completely bogus, as my previous post shows. Measuring the same government functions that are required to generate even a single payer system (which aren't measured in any of your studies) shows that, for instance, Canada's administrative costs are actually several times higher than the US system's, per capita by percentage.

Tort reform would remove significant costs from the overall fees charged, as the risk to the manufacturers and providers could be predicted. That known would then be factored in to charges. Since it is a complete unknown at this point--due primarily to uncapped punitive damages--the providers have to pay higher-than-required premiums and charge more for goods and services to build up reserves to handle potential, unknown eventualities. All of which drive up the cost of goods and services without being directly measurable.

Every hospital bill I have received (and I have received many...for both high- and low-end care needs) details out the costs. The supplies and equipment usage is a massive portion of the bill...immediately after physician's charges. The supply and equipment usage is high cost because it is high cost to purchase by the hospital...a cost which is passed on to the consumer (me). The physician's charges are high (partially) because of insurance costs (like malpractice insurance). My son receives services that provide durable medical equipment at home--I see the itemized bills every shipment. It is horrendously expensive. Why? Partially due to low volume of sales, partially due to the high cost of doing business in a litigious environment.

If the risk of tort were reduced or at least capped, then the counteractions (reflected in pricing) would not be required. And it would result in a significant reduction in overall cost to the patient.

PF wrote:

The reason that they don't actually ever say that, is because even they know that it isn't true.
I guess I'll leave the telepathic analysis to you, then...I can't see inside an author's mind.

I never said that tort reform is a panacea...like you have said with administrative costs. You're going to have to find another issue to stump on, as the administrative cost comparisons you preach have been shot out of the water by applying "some intellectual rigor" to what actually gets measured and reported.

I have been arguing for multiple places where reduced costs and efficiencies can be found. You've been arguing for one. One that has been proven to be questionable at best. You can't even question the fact that tort reform would reduce costs. Studies have shown for a fact that moving to a government-run system would actually increase the bogeyman administrative costs you trumpet as the only way to reduce health care costs.

The facts don't match your argument. But they do match mine.

I'm not making this shit up just to be argumentative.
“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-06 04:00:53
PureFodder
Member
+225|6588
The AMA are welcome to believe anything they want, but as almost everything they say is speculative opinion I'm not sure why I should care. They make lots of claims with no evident basis.

The AMA report appears, if anything, to indicate that admin costs are actually higher than the 31% of healthcare costs that was reported. They claim that there are a load of admin costs that should be counted, but aren't. They don't even go near to speculating how much any of these differences in determining admin costs would alter the figures, for all we know, even if we used their methods the numbers would work out about the same.

The entire report focuses on the wrong end of the admin cost problem. It focuses on the admin costs for insurers and medicaid/care, when the bulk of the admin costs actually come from doctors and hospitals, which indicates that even if everything they said was right, it wouldn't alter the percentage of money spent on admin significantly.
2009-03-06 04:56:57
PureFodder
Member
+225|6588

FEOS wrote:

PureFodder wrote:

We're off to name calling now are we? I'm not the one that failed to even understand tha data that you quoted. The fact that your selected quotes showed the exact opposite of your argument shows that you had no idea what they meant. Face it, the intellectual laziness was yours not mine.

Admin reform should be able to knock 20% off the costs of healthcare, as all your articles show, the savings from tort reform would be at most a full scale factor lower, and would be likely to result in increased deaths and injuries.
The problem with administering the US system is unavoidable with massive numbers of insurance companies with large numbers of different policies compaired to a single centralized admin system.The privatized system will always have this problem unless you start granting monopolies.

All your sources show that medical liability costs are rising, and doing so faster than the overall healthcare system, but if you apply some intellectual rigour and actually read what they say, they don't say that it is driving the incresed costs of the US healthcare system. The reason that they don't actually ever say that, is because even they know that it isn't true. All of the sources used in this thread say the same thing, there simply isn't enough money in the medical tort system to get close to accounting for the rising healthcare costs and tort reform.
Um...bullshit.

Nowhere did I call you a name. You see in those stats what you want to see, instead of accepting that there is another view and another approach out there that is just as valid and based in research as your own. The intellectual laziness is your refusal to consider other positions and reconsider your own. That's not name calling...that's describing your approach.
How is what you're doing any different? Despite multiple links, including your own ones showing you to be wrong, you persist.

FEOS wrote:

Your 20% number is completely bogus, as my previous post shows. Measuring the same government functions that are required to generate even a single payer system (which aren't measured in any of your studies) shows that, for instance, Canada's administrative costs are actually several times higher than the US system's, per capita by percentage.
You previous post believes that it could be slightly wrong, it doesn't prove anything. The opinions of the AMA can't seriously be considered as being objective as they will probably expect a pay cut in a single payer system, making their beliefs highly biased, especially if they don;t appear willing to back up any of their claims.

FEOS wrote:

Tort reform would remove significant costs from the overall fees charged, as the risk to the manufacturers and providers could be predicted. That known would then be factored in to charges. Since it is a complete unknown at this point--due primarily to uncapped punitive damages--the providers have to pay higher-than-required premiums and charge more for goods and services to build up reserves to handle potential, unknown eventualities. All of which drive up the cost of goods and services without being directly measurable.

Every hospital bill I have received (and I have received many...for both high- and low-end care needs) details out the costs. The supplies and equipment usage is a massive portion of the bill...immediately after physician's charges. The supply and equipment usage is high cost because it is high cost to purchase by the hospital...a cost which is passed on to the consumer (me). The physician's charges are high (partially) because of insurance costs (like malpractice insurance). My son receives services that provide durable medical equipment at home--I see the itemized bills every shipment. It is horrendously expensive. Why? Partially due to low volume of sales, partially due to the high cost of doing business in a litigious environment.
Sources such as the CBO estimate that even massive reforms of the tort system are only likely to knock 1% off those costs. The vast costs of things like medical equiptment and drugs stem from over compansation from the patent system, rewarding companies excessively for their research work. If you want those costs to come down, you need to look at the patent system, not the tort system.

FEOS wrote:

If the risk of tort were reduced or at least capped, then the counteractions (reflected in pricing) would not be required. And it would result in a significant reduction in overall cost to the patient.
They would result in some saving for the patients. A couple of percent possibly. The risk of tort comes primarily from the actions of the business. If they enact stong measures within the company to make sure that they don't release harmful products, they can go a long way to reducing their potential costs. As you reduce the potential tort costs to a company, you'll increase the risk of companies deciding to fake their safety trials and release harmful products onto the market because the amount they will gain minus the costs of the resultant lawsuits are less than the costs of abandonning the product and wasting all of the research money. It happens with the current tort costs, so if youthink you can significantly reduce those costs, then you'll inevitably increse the number of companies that do it.

FEOS wrote:

PF wrote:

The reason that they don't actually ever say that, is because even they know that it isn't true.
I guess I'll leave the telepathic analysis to you, then...I can't see inside an author's mind.

I never said that tort reform is a panacea...like you have said with administrative costs. You're going to have to find another issue to stump on, as the administrative cost comparisons you preach have been shot out of the water by applying "some intellectual rigor" to what actually gets measured and reported.
If intellectual rigour involved that almost certainly biased list of baseless AMA claims, then you have a remarkably low standard of intellectual rigor.

FEOS wrote:

I have been arguing for multiple places where reduced costs and efficiencies can be found. You've been arguing for one. One that has been proven to be questionable at best. You can't even question the fact that tort reform would reduce costs. Studies have shown for a fact that moving to a government-run system would actually increase the bogeyman administrative costs you trumpet as the only way to reduce health care costs.

The facts don't match your argument. But they do match mine.

I'm not making this shit up just to be argumentative.
I never said that admin costs were the only way to reduce costs, I just said that they were massively wasteful and add little if any benefit. You haven't presented any facts regarding this issue, just some opinions from an obviously biased source. I never disagreed that that tort reform would save money, it't just that the tort system does add benefits in terms of lives saved by discouraging malpractice and the release of harmful drugs and equiptment and the savings from overhauling the system are relatively small.
2009-03-07 15:10:22
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

You can't dispute the info, so you attack the source. How ridiculously predictable.
“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-07 23:34:07
nickb64
formerly from OC (it's EXACTLY like on tv)[truth]
+77|5914|Greatest Nation on Earth(USA)

rdx-fx wrote:

SgtHeihn wrote:

Change!!!!
heh. Fuck Obama's "change".

Throwing gobs of borrowed money at a problem doesn't work without a real plan.  Sounds bites and pretty speeches that get postive  spin on CNN - does NOT constitute a plan.

Find me a few thousand BR-4 or 205M primers in stock somewhere.  THAT is a change I could get to like.
All I have to say is this: F.B.O.
2009-03-08 00:50:52
PureFodder
Member
+225|6588

FEOS wrote:

You can't dispute the info, so you attack the source. How ridiculously predictable.
What info? it's opinion not info.

If they presented some info then I'd take a look, but as it's pure opinion, there's nothing there to talk about.
2009-03-08 01:21:39
Bertster7
Confused Pothead
+1,101|6884|SE London

Say what you like, it does seem like the US healthcare system is horrendously mismanaged. Most expensive in the world, 37th in overall performance. That's not good for starters.

Since the government spends $2.25 trillion/year on healthcare - it looks like somewhere savings could be made easily through restructuring and better management.

It seems bizarre that healthcare spending is so high, performance is sub-par and the US is the only wealthy industrialised nation in the world where all citizens do not have some form of healthcare cover provided to them. There is clearly something wrong with the system.
2009-03-08 03:01:46
PureFodder
Member
+225|6588

Bertster7 wrote:

Say what you like, it does seem like the US healthcare system is horrendously mismanaged. Most expensive in the world, 37th in overall performance. That's not good for starters.

Since the government spends $2.25 trillion/year on healthcare - it looks like somewhere savings could be made easily through restructuring and better management.

It seems bizarre that healthcare spending is so high, performance is sub-par and the US is the only wealthy industrialised nation in the world where all citizens do not have some form of healthcare cover provided to them. There is clearly something wrong with the system.
The low performance comes primarily from the very low rating in regards to access. ie. the fact that lots of Americans have to avoid getting treatment for serious illnesses and injuries due to the costs that they will face. In terms of care, the US is one of the highest ranking countries.
The other aspect to this is that due to the lower rate of people treated in the US,the healthcare costs per patient are even higher than the healthcare costs per person indicate.

Overall the low ranking does not actually indicate bad medical care, but for the same reason, it underestimates the waste in the US system.
2009-03-08 03:23:39
Bertster7
Confused Pothead
+1,101|6884|SE London

PureFodder wrote:

Bertster7 wrote:

Say what you like, it does seem like the US healthcare system is horrendously mismanaged. Most expensive in the world, 37th in overall performance. That's not good for starters.

Since the government spends $2.25 trillion/year on healthcare - it looks like somewhere savings could be made easily through restructuring and better management.

It seems bizarre that healthcare spending is so high, performance is sub-par and the US is the only wealthy industrialised nation in the world where all citizens do not have some form of healthcare cover provided to them. There is clearly something wrong with the system.
The low performance comes primarily from the very low rating in regards to access. ie. the fact that lots of Americans have to avoid getting treatment for serious illnesses and injuries due to the costs that they will face. In terms of care, the US is one of the highest ranking countries.
The other aspect to this is that due to the lower rate of people treated in the US,the healthcare costs per patient are even higher than the healthcare costs per person indicate.

Overall the low ranking does not actually indicate bad medical care, but for the same reason, it underestimates the waste in the US system.
I'm not suggesting it does indicate bad medical care - but it's not the best (it's up there, but not top) and it's by far and away the most expensive.

Add to that the fact that what the US government spends on healthcare is only a fraction of the overall amount of money going into the healthcare system (about 45%), since you need to have private medical insurance, and it is plain there is a lot of waste within the system. The government spends more on healthcare as a percentage of overall government spending than any Western countries with nationalised healthcare plans.

It's a wasteful system.
2009-03-08 04:29:57
Chorcai
Member
+49|6951|Ireland
When ever we go to the US on a hoilday, I make sure I get insurance for everything. It's the only time I take travel/health insurance. I would hate to think how much it would cost if I broke a leg/got sick in the USA ! Mean while last year in Spain I went scuba diving the wax in my ear expaned, went to the hospital, cost me nothing to see a doctor and about 10€ for meds. Even in Ireland with our shity health care we look after our people in the US if ya cant pay ya fuck all. IMO.
2009-03-08 07:46:25
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

PureFodder wrote:

FEOS wrote:

You can't dispute the info, so you attack the source. How ridiculously predictable.
What info? it's opinion not info.

If they presented some info then I'd take a look, but as it's pure opinion, there's nothing there to talk about.
So you can't even be bothered to look at the sources...or the sources cited within those sources.

Just because it contradicts your strongly-held belief.

Typical.
“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-08 07:47:34
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

Chorcai wrote:

When ever we go to the US on a hoilday, I make sure I get insurance for everything. It's the only time I take travel/health insurance. I would hate to think how much it would cost if I broke a leg/got sick in the USA ! Mean while last year in Spain I went scuba diving the wax in my ear expaned, went to the hospital, cost me nothing to see a doctor and about 10€ for meds. Even in Ireland with our shity health care we look after our people in the US if ya cant pay ya fuck all. IMO.
Wouldn't your govt-provided health care take care of that? Just bill the govt of Ireland, right?

Or are you saying your govt-provided healthcare isn't portable?
“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-08 10:32:13
PureFodder
Member
+225|6588

FEOS wrote:

PureFodder wrote:

FEOS wrote:

You can't dispute the info, so you attack the source. How ridiculously predictable.
What info? it's opinion not info.

If they presented some info then I'd take a look, but as it's pure opinion, there's nothing there to talk about.
So you can't even be bothered to look at the sources...or the sources cited within those sources.

Just because it contradicts your strongly-held belief.

Typical.
Clearly I read it.

I pointed out that
a) It's all about the minor component of admin costs ie the costs of the insurance industry vs. Medicare/aid. The majority of the admin costs come from doctors/hospitals and they say nothing in particular about that. This means that the major costs are unaffacted by the things that they say. This means that there cannot be any massive changes from their redefining of what is/isn't admin costs and the plans they propose.

b) They provide no sources or backing of almost anything they say.

c) They have an obvious bias towards the private system as they'd expect a pay cut if a nationalized system was put in place

d) They don't even guess at how much the admin costs would change if they used their own particular method for calculating it. It's very possible that the nearly $0.7 trillion costs of admin wouldn't change much if you use their calculation methods.

e) Additionally: Some of the things they suggest are just strange. Take for example they suggest including the costs of collecting taxes to the public sector admin costs. You're going to collect taxes anyway whether you use the money to pay for a public health system or not, so you are going to pay that cost regardless of what goes on in your medical system. If you have a public system you can avoid the admin costs of premium collections.
Medicare marketing: If there's only one provider, you don't need to advertise.

Try taking a more open minded look at your sources rather than posting anything that even remotely suggests you could be right, however biased or poorly backed it is.
2009-03-09 02:47:36
FEOS
Bellicose Yankee Air Pirate
+1,182|6714|'Murka

PureFodder wrote:

FEOS wrote:

PureFodder wrote:

What info? it's opinion not info.

If they presented some info then I'd take a look, but as it's pure opinion, there's nothing there to talk about.
So you can't even be bothered to look at the sources...or the sources cited within those sources.

Just because it contradicts your strongly-held belief.

Typical.
Clearly I read it.

I pointed out that
a) It's all about the minor component of admin costs ie the costs of the insurance industry vs. Medicare/aid. The majority of the admin costs come from doctors/hospitals and they say nothing in particular about that. This means that the major costs are unaffacted by the things that they say. This means that there cannot be any massive changes from their redefining of what is/isn't admin costs and the plans they propose.
The point being that, regardless which system is used, the true admin costs are as good or better under the private system. Hospital and provider admin costs may see a savings, but that will be overshadowed by other "soft" admin costs that further reduce availability to the population.

PF wrote:

b) They provide no sources or backing of almost anything they say.
Just as much as your sources do. The fact that they point out your sources' studies are founded on flawed assumptions is backed up. You can't source original findings.

PF wrote:

c) They have an obvious bias towards the private system as they'd expect a pay cut if a nationalized system was put in place
Actually, they are biased toward a national health care system...they want universal medical coverage so they don't have to eat the costs of treating people without coverage.

PF wrote:

d) They don't even guess at how much the admin costs would change if they used their own particular method for calculating it. It's very possible that the nearly $0.7 trillion costs of admin wouldn't change much if you use their calculation methods.
That's because the information that's relevant was not made available to them. If you weren't blinded by your own ideology, you would see the logic in their argument. Someone is questioning your precious...quickly, to the discreditthesourcenottheinfomobile!

PF wrote:

e) Additionally: Some of the things they suggest are just strange. Take for example they suggest including the costs of collecting taxes to the public sector admin costs. You're going to collect taxes anyway whether you use the money to pay for a public health system or not, so you are going to pay that cost regardless of what goes on in your medical system. If you have a public system you can avoid the admin costs of premium collections.
Medicare marketing: If there's only one provider, you don't need to advertise.
You have to take in the cost of collecting those taxes that pay for the medical premiums. That is what they are saying. Using your logic, any insurance company that is diversified outside of medical care can say there is no cost associated with collecting medical premiums, because they already collect other types of premiums...pretty sure you don't want to say that, now do you? Even when there is only one provider, there is still a need to advertise to make people aware of what their benefits are, changes to coverage, etc. There is a fairly substantial Medicare advertising budget...but according to you, they shouldn't need to advertise anything.

PF wrote:

Try taking a more open minded look at your sources rather than posting anything that even remotely suggests you could be right, however biased or poorly backed it is.
I suggest you do the same. Oh, and look at others' sources with an open mind, as well--instead of just trying to discredit their sources rather than actually deal with the information provided...and take your bullshit condescending (that means "talking down to to people") attitude elsewhere.

Last edited by FEOS (2009-03-09 02:48:09)

“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
― Albert Einstein
Doing the popular thing is not always right. Doing the right thing is not always popular
2009-03-09 05:04:56
PureFodder
Member
+225|6588

FEOS wrote:

PureFodder wrote:

FEOS wrote:

So you can't even be bothered to look at the sources...or the sources cited within those sources.

Just because it contradicts your strongly-held belief.

Typical.
Clearly I read it.

I pointed out that
a) It's all about the minor component of admin costs ie the costs of the insurance industry vs. Medicare/aid. The majority of the admin costs come from doctors/hospitals and they say nothing in particular about that. This means that the major costs are unaffacted by the things that they say. This means that there cannot be any massive changes from their redefining of what is/isn't admin costs and the plans they propose.
The point being that, regardless which system is used, the true admin costs are as good or better under the private system. Hospital and provider admin costs may see a savings, but that will be overshadowed by other "soft" admin costs that further reduce availability to the population.
No, hospital and doctor admin costs are the major component, savings in thier admin costs overshadow the changes in the smaller admin costs of the insurance agancies.

FEOS wrote:

PF wrote:

b) They provide no sources or backing of almost anything they say.
Just as much as your sources do. The fact that they point out your sources' studies are founded on flawed assumptions is backed up. You can't source original findings.
As you would have seen in the article you posted:
1. Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration
in the United States and Canada. N Engl J Med. 2003;349(8):768–775.

FEOS wrote:

PF wrote:

c) They have an obvious bias towards the private system as they'd expect a pay cut if a nationalized system was put in place
Actually, they are biased toward a national health care system...they want universal medical coverage so they don't have to eat the costs of treating people without coverage.
Actually the AMA's national healthcare policy agenda makes no mention of a desire to move to universal healthcare.

FEOS wrote:

PF wrote:

d) They don't even guess at how much the admin costs would change if they used their own particular method for calculating it. It's very possible that the nearly $0.7 trillion costs of admin wouldn't change much if you use their calculation methods.
That's because the information that's relevant was not made available to them. If you weren't blinded by your own ideology, you would see the logic in their argument. Someone is questioning your precious...quickly, to the discreditthesourcenottheinfomobile!
How do you know that it was not made available to them? Making assumptions? Can you not see that even if you accepted everything they said, it can quite easily make no difference to the 31% admin costs that were found through researching the actual numbers?

FEOS wrote:

PF wrote:

e) Additionally: Some of the things they suggest are just strange. Take for example they suggest including the costs of collecting taxes to the public sector admin costs. You're going to collect taxes anyway whether you use the money to pay for a public health system or not, so you are going to pay that cost regardless of what goes on in your medical system. If you have a public system you can avoid the admin costs of premium collections.
Medicare marketing: If there's only one provider, you don't need to advertise.
You have to take in the cost of collecting those taxes that pay for the medical premiums. That is what they are saying. Using your logic, any insurance company that is diversified outside of medical care can say there is no cost associated with collecting medical premiums, because they already collect other types of premiums...pretty sure you don't want to say that, now do you? Even when there is only one provider, there is still a need to advertise to make people aware of what their benefits are, changes to coverage, etc. There is a fairly substantial Medicare advertising budget...but according to you, they shouldn't need to advertise anything.
The government is going to tax everyone regardless of the healthcare system. The cost is going to be paid for whatever, increasing the percentage tax on people shouldn't make any significant difference to the governments admin costs. Private comapnies insure people with no other business with them, and also will have medical insurance as the primary admin costs for people paying for multiple services, which are likely to generate additional admin as they are usually billed as seperate services, ie. the company bills you seperately for the two services, whereas the government doesn't make you go through the entire tax process for each service they provide.

Overall, a nationalized healthcare system can avoid paying the admin costs associated with private billing, but the admin costs of taxation remain fixed either way. Billing costs of private insurers are an entirely additional cost created by the private system.

FEOS wrote:

PF wrote:

Try taking a more open minded look at your sources rather than posting anything that even remotely suggests you could be right, however biased or poorly backed it is.
I suggest you do the same. Oh, and look at others' sources with an open mind, as well--instead of just trying to discredit their sources rather than actually deal with the information provided...and take your bullshit condescending (that means "talking down to to people") attitude elsewhere.

FEOS wrote:

Way to put on ideological blinders.
Why don't you put a little intellectual rigor into this and look 1mm deeper?
which you clearly didn't bother to actually click on and read in their entirety. Where do you think that money comes from? The money fairy?
your stovepiped, ideological view.
Intellectual laziness, tbh
The intellectual laziness
How ridiculously predictable
So you can't even be bothered to look at the sources
If you weren't blinded by your own ideology,
Condescending attitude?

As far as actually reading the sources goes, with the heartland.org source you apparently didn't understand it at all. You appear to have thought
Medical malpractice liability--"the 'tort tax' on doctors and hospitals, whose costs constitute the majority of health expenses,"
read "the 'tort tax' on doctors and hospitals constitutes the majority of health expenses". Hence why you quoted a passage and highlighted it as proof of your stance despite it actually saying the opposite of that. You continued to quote some number that also discredited your stance, then claimed that your stance had been proved.

FEOS wrote:

Your 20% number is completely bogus, as my previous post shows. Measuring the same government functions that are required to generate even a single payer system (which aren't measured in any of your studies) shows that, for instance, Canada's administrative costs are actually several times higher than the US system's, per capita by percentage.
If you read the article or the reference you'd notice that this is primarily about the cost of the administration of an idealized private insurance industry, not the actual total US healthcare industry. It compares the costs of a purely private US insurance system, forgetting the costs from medicare/aid and the effects of it on hospital and doctor admin costs. So, yes if you move to a vastly more efficiently operating private system and ignore the government component that is in this system and the actual bulk of the admin costs, which come from hospitals and doctors, and compare it to Canadas sytem it doesn't look great, but that's because you aren't compairing remotely the same thing.

You don't appear to have properly read or understood your own links, so it's rather unfair of you to accuse me of not reading them or not reading them with an open mind, as you have failed to understand them yourself.

 

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