Helping the uninsured by threatening them.

[Ramo]

Ramo, are being deliberately retarded?

You INITIALLY CLAIMED that the exact OPPOSITE argument (which ignored a large component of private health care spending) was PERFECTLY VALID as an argument that medicare was more efficient. Then when somebody demonstrates that your initial analysis was flawed and that a more complete analysis shows the opposite conclusion you begin to argue about the more subtle points like the fact that direct cost growth comparisons in two vastly different demographics is a bad idea (which I believe is true).

That's indicative of incredible intellectual dishonesty.

No, I brought up the demographic argument at the very beginning. Again, I skimmed DD's link, and misread it initially. But the most common comparisons exclude out of pocket spending. One reason to do that is you mitigate the age-dependent variations. It seems like a more sensible comparison.

[KrazyHorse]

But the most common comparisons exclude out of pocket spending. One reason to do that is you mitigate the age-dependent variations.

This makes no sense whatsoever.

[KrazyHorse]

And could you please explain to me where you brought up the demographic issue in posting your initial study? Because what I see is:

What makes this all the more remarkable is that the people in the private system form a relatively low risk pool (the poorest people, the elderly, and veterans are largely excluded). While Medicare covers a terrible risk pool (people over 65). You would expect Medicare cost growth to be wildly out of control. Yet it manages to be cheaper than the private system on a fairly consistent basis.

Which is completely retarded for reasons already listed, and which should have actually run something like:

"Now, it's difficult to compare two different groups over time as these studies attempt to do. Different demographics may experience different growth rates for procedure costs. Percent increases in the costs for procedures on young people could be higher than for those on old people or vice versa"

Seriously, Ramo: you're not making any sense at all. Could you please act like an adult instead of engaging in silly little games?

[KrazyHorse]

It's become apparent to me, both in this thread and in the other one where you spent your time throwing around terminology instead of explaining yourself clearly that you are far too invested in this issue to discuss it meaningfully. The fact that DINODOC is more interesting than you are on this subject should be an indication that you're walking the wrong path here.

[Ramo]

Ok, let's pick similar demographics.

This paper addresses the question of whether Medicaid is in fact a high-cost program after adjusting for the health of the people it covers. We compare and simulate annual per capita medical spending for lower-income people (families with incomes under 200% of poverty) covered for a full year by either Medicaid or private insurance. We first show that low-income privately insured enrollees and Medicaid enrollees have very different socioeconomic and health characteristics. We then present simulated comparisons based on multivariate statistical models that estimate the effects of private and Medicaid coverage on the likelihood of using services, and the level of expenditures, given any use, holding constant demographic, economic, and health status characteristics. The simulations demonstrate that if people with Medicaid coverage—with their health status, disability, and chronic conditions—were given private coverage, they would cost considerably more than they do today. Conversely, if the privately insured were given Medicaid coverage, spending would be lower. We find no evidence that spending differences between Medicaid and private coverage for low-income people are due to lower service use by Medicaid beneficiaries. We conclude that most of the difference in expenditures is due to differences in provider payment rates.

http://www.inquiryjournalonline.org/inqronline/?request=get-abstract&issn=0046-9580&volume=040&issue=04&page=0323

[KrazyHorse]

Ramo, are you deliberately avoiding addressing the criticisms of your arguments? Either statements like this:

But the most common comparisons exclude out of pocket spending. One reason to do that is you mitigate the age-dependent variations.

make sense or they do not.

This does not bode well.

[Ramo]

You don't expect out of pocket expenses to correlate strongly with age? Really?

[KrazyHorse]

As to this NEW study that you're posting (while still not addressing the last study): if the major effect of going to public plan is simply to pay doctors less for the same services then why don't we simply levy a special tax on doctors' services?

[Ramo]

http://healthaff.highwire.org/cgi/reprint/20/6/267

See page 6. The average out of pocket expense for people under 65 with private coverage is $386/year. For over 65 is $910/year. Huge, huge difference.

In fact, private coverage reduces out of pocket expenses (for people over 65) from only $924 to $910.

[KrazyHorse]

You don't expect out of pocket expenses to correlate strongly with age? Really?

Does this make sense in the parallel world which you're apparently inhabiting? You're getting dangerously close to **** territory here.

When we're comparing growth rates of costs then the absolute amount DOES NOT MATTER.

What matters is the percent CHANGE in costs.



What the DD study claims is that out-of-pocket expenses have increased far more quickly for people under Medicare than for people under private insurance. When you strip out out-of-pocket expenses you are INCREASING the apples-to-oranges comparison problem. I have no idea why you think it would MITIGATE this problem.

Stop being a ****wit and start thinking please.

[Kuciwalker]

See page 6. The average out of pocket expense for people under 65 with private coverage is $386/year. For over 65 is $910/year. In fact, private coverage reduces out of pocket expenses (for people under 65) from $924 to $910. Huge, huge difference.

Is there a typo in that?

[KrazyHorse]

http://healthaff.highwire.org/cgi/reprint/20/6/267

See page 6. The average out of pocket expense for people under 65 with private coverage is $386/year. For over 65 is $910/year. Huge, huge difference.

Yes, but chicken feet in Brazil sell for 38 cents a pound.

[Kuciwalker]

What the DD study claims is that out-of-pocket expenses have increased far more quickly for people under Medicare than for people under private insurance. When you strip out out-of-pocket expenses you are INCREASING the apples-to-oranges comparison problem. I have no idea why you think it would MITIGATE this problem.

Wait, it does? Really? I thought it was considering all out-of-pocket expenses under the "private" category.

edit: yeah, I think you're misreading the study

[KrazyHorse]

Ramo, you've now crossed into being a ****.

[Kuciwalker]

Yes, but chicken feet in Brazil sell for 38 cents a pound.

What does that have to do with the price of tea in China?

2 pages minimum, double-spaced