Helping the uninsured by threatening them.

[Ramo]

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?

Administrative costs and pharmaceuticals. But that isn't all that terrible an idea, as long as doctor disbursements are so high.

[KrazyHorse]

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

Yeah, sorry. Though my methodology would lead to a less favourable result for medicare, I think.

[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?

Administrative costs and pharmaceuticals. But that isn't all that terrible an idea, as long as doctor disbursements are so high.

So you want to:

Increase the cost of services
Decrease amount of health care provided
Collect tax revenue

Is this correct?

[KrazyHorse]

Ramo, you still haven't explained to me exactly why it is that you think that out-of-pocket expenses being higher for old people means ANYTHING when it comes to the issue at hand.

[Ramo]

So you want to:

Increase the cost of services
Decrease amount of health care provided
Collect tax revenue

Is this correct?

The particular market failure is that there appear to be large medical expenditures with marginal benefit to public health. Taxing certain kinds of procedures may be helpful in eliminating these issues (i.e. decreasing the amount of a subset of health care provided), but I'm not familiar with a model that does this.

Ramo, you still haven't explained to me exactly why it is that you think that out-of-pocket expenses being higher for old people means ANYTHING when it comes to the issue at hand.

I'll admit that context needs to be added to those numbers. But health care inflation is driven by old people. Who utilize services at increasing rates. Higher growth rates of out of pocket expenses is an intuitive expectation. And you can see that in the number for people over 65 with private plans, which is barely distinguishable for those without.

It is an apples to oranges comparison, and there's no getting around that. That is why I changed to conversation to Medicaid, which is more germane.

[Ramo]

Is there a typo in that?

Yes.

[Ben Kenobi]

But then they're put into casts for free. And you get free crutches.

All the same, I'd rather not be kneecapped in the first place.

[KrazyHorse]

I'll admit that context needs to be added to those numbers. But health care inflation is driven by old people. Who utilize services at increasing rates. Higher growth rates of out of pocket expenses is an intuitive expectation. And you can see that in the number for people over 65 with private plans, which is barely distinguishable for those without.

a) "Health care inflation is driven by old people" is not a precise statement. Do you mean that there are more old people now? Or that old people spend more on health care than young people? Or that old people increase their use of services faster than young people? The first two are already corrected for. The latter is a non-trivial demographic issue. And it is not obvious to me from first principles that it is true.

b) None of this has anything to do with your claim that leaving out out-of-pocket expenses mitigates the above-mentioned demographic issue. Are you begging the question? Are you claiming that the last issue in (a) is true, therefore we have to lean on the scales the opposite way? And if that is what you are claiming, then why should anybody take you seriously?

c) I have no idea what the out-of-pocket expenses over-65s without medicare coverage have to do with anything. You seriously need to get a coherent argument going here. Instead of actually presenting and defending your viewpoint, you appear to be engaging in a shotgun technique.

[Ben Kenobi]

While we wait for Ramo to respond, here is a picture of an alpaca

Nice alpaca.

Ramo, when you outrank me as the '**** of the thread, that's a sure sign you are on the wrong track.

[DaShi]

A few things to deal with first:

1. That is a nice alpaca.

2. Ramo may be floundering, but he's still a ways from surpassing you Ben.


Ok, question about DD's article: What exact costs is he measuring?

[Ramo]

I'll admit that context needs to be added to those numbers. But health care inflation is driven by old people. Who utilize services at increasing rates. Higher growth rates of out of pocket expenses is an intuitive expectation. And you can see that in the number for people over 65 with private plans, which is barely distinguishable for those without.

a) "Health care inflation is driven by old people" is not a precise statement. Do you mean that there are more old people now? Or that old people spend more on health care than young people? Or that old people increase their use of services faster than young people? The first two are already corrected for. The latter is a non-trivial demographic issue. And it is not obvious to me from first principles that it is true.

People are living longer. There are old age diseases that we've only started to tackle in the past few decades. We're spending a whole lot of money in this sector, and I'm sure it's increasing at a rapid rate. I could find data to back this point up if you'd like, but it strikes me as intuitive.

b) None of this has anything to do with your claim that leaving out out-of-pocket expenses mitigates the above-mentioned demographic issue. Are you begging the question? Are you claiming that the last issue in (a) is true, therefore we have to lean on the scales the opposite way? And if that is what you are claiming, then why should anybody take you seriously?

What I'm saying is that's a completely reasonable point. It is not rigorous to tip the scales in the opposite direction. Which is why I switched the conversation to an apples to apples comparison like Medicaid.

c) I have no idea what the out-of-pocket expenses over-65s without medicare coverage have to do with anything. You seriously need to get a coherent argument going here. Instead of actually presenting and defending your viewpoint, you appear to be engaging in a shotgun technique.

No, everyone over 65 has Medicare. These are people who have supplementary private insurance. And their out of pocket expenses are reduced negligibly. A single data point doesn't indicate a growth rate obviously, but if Medicare out of pocket expenses were particularly high, that is not what I would expect.

[Ramo]

And a point about the piecemeal info (absolutely values vs. growth rates, etc.), I don't have the data. I'm posting what I can find, as I find them. These aren't supposed to be definitive arguments.

[SlowwHand]

Nice alpaca.

They're seeing each other exclusively.

[Ben Kenobi]

[DinoDoc]

Here's a good article on the public option being discussed by Obama and Kennedy.

An important question about any public provider of health insurance is whether it would have access to taxpayer funds. If not, the public plan would have to stand on its own financially, as private plans do, covering all expenses with premiums from those who signed up for it.

But if such a plan were desirable and feasible, nothing would stop someone from setting it up right now. In essence, a public plan without taxpayer support would be yet another nonprofit company offering health insurance. The fundamental viability of the enterprise does not depend on whether the employees are called “nonprofit administrators” or “civil servants.”

In practice, however, if a public option is available, it will probably enjoy taxpayer subsidies. Indeed, even if the initial legislation rejected them, such subsidies would be hard to avoid in the long run. Fannie Mae and Freddie Mac, the mortgage giants created by federal law, were once private companies. Yet many investors believed — correctly, as it turned out — that the federal government would stand behind Fannie’s and Freddie’s debts, and this perception gave these companies access to cheap credit. Similarly, a public health insurance plan would enjoy the presumption of a government backstop.

Such explicit or implicit subsidies would prevent a public plan from providing honest competition for private suppliers of health insurance. Instead, the public plan would likely undercut private firms and get an undue share of the market.