Private sector or public sector: Which is more efficient?

[KrazyHorse]

I think it's hilarious you think the insurance companies actually compete in real terms. They compete in the same way that Bell, Rogers, Telus, and Shaw compete in Canada. They all charge absurdly high prices and no one rocks the boat.

Start acting like an intelligent human being again and I'll start responding again.

[Asher]

So it's obtuse then. Specifically, my point is that the semantic trick of wrapping up lifestyle into the same category as diagnostic screenings does not allow you to draw conclusions about diagnostic screenings from information about lifestyles.

I never talked just about diagnostic screenings. I talked about preventative medicine. One of the main tenets of preventative medicine is regular GP visits and conversations. The human component is quite important.

[Asher]

Start acting like an intelligent human being again and I'll start responding again.

I think it's cute that you're so old yet you're still an idealist. Not necessarily a socialist idealist like you used to be, but now an extreme capitalist idealist. Maybe in another ten years you'll gravitate towards realism. It's one extreme to another with you...

[Dauphin]

Illness presents itself when it becomes obvious to either the individual or to a doctor without the use of expensive diagnostic techniques.

GP visits aren't expensive, and the reason many people skip them yearly has absolutely nothing to do with cost. For instance, I haven't had a "routine physical" since I was 16 because I'm too lazy to take 2 hours out of my day to do it.

If they were a major cost-saver, by the way, insurance companies would require them as a condition of continuing coverage.

My private medical insurance coverage costs less if I go sign up for an annual physical. It also subsidises my gym membership. Anecdotal sure, but logical too. The only reason I don't take the former option is the same reason as you, that and my employer picks up the cost in either event.

[Hauldren Collider]

It's nice to know I'm not the only one thoroughly unimpressed by Asher's deliberate obstinacy.

[Asher]

My private medical insurance coverage costs less if I go sign up for an annual physical. It also subsidises my gym membership. Anecdotal sure, but logical too.

But but but, if any insurance company in the US discovered that they'd totally dominate the insurance market.

[Asher]

It's nice to know I'm not the only one thoroughly unimpressed by Asher's deliberate obstinacy.

I'm sure by "deliberate obstinacy" you mean "reasonable realism and rationality". I do agree it is very difficult to argue with someone who displays those traits, rather than spitting out pure economic theory detached from the realities of a very imperfect marketplace.

The simple facts are the US health care system costs twice as much as Canada's, with the same or worse results. Those are undeniable facts when you look at it statistically. Anecdotal arguments like "but my rich daddy can pay millions to get surgery within a minute" are ridiculous and ignore the vast majority of people.

Instead of actually addressing that issue and explaining why it costs so damn much, the proponents of the US system are either blaming blacks and Mexicans or hand-wavingly dismissing logical arguments based in reality in favour of market theory, which has clearly failed in the US in this area.

[DaShi]

This is perhaps the stupidest thing I have ever heard you say.

Insurance companies compete with each other. In particular, insurance companies compete with each other (in the US) mainly at the employer level, and employers are quite sensitive to cost. If there was an insurance plan that could offer identical coverage at a cost 10% lower because it required annual physicals then IT WOULD DESTROY THE COMPETITION.

Start ****ing thinking before you post.

Hardly, the American health care "market" has very little competition. And that that does exist is mostly zero-sum.

AMA Study Shows Competition Disappearing in the Health Insurance Industry

For immediate release:
Feb. 23, 2010

CHICAGO – Competition in the health insurance industry is disappearing with more markets across the country dominated by one or two insurers, according to the American Medical Association’s newly released edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets.

In 24 of the 43 states reported in the new AMA report, the two largest insurers had a combined market share of 70 percent or more. Last year, just 18 of 42 states had two insurers with a combined market share of 70 percent or more.

“The near total collapse of competitive and dynamic health insurance markets has not helped patients,” said AMA President J. James Rohack, M.D. “As demonstrated by proposed rate hikes in California and other states, health insurers have not shown greater efficiency and lower health care costs. Instead, patient premiums, deductibles and co-payments have soared without an increase in benefits in these increasingly consolidated markets.”

The new AMA study analyzed 43 states and 313 metropolitan markets against an index used by federal regulators for measuring market concentration. Markets that rate “highly concentrated” according to the federal index are areas of the country where insurer consolidation may have harmful effects on patients, physicians, employers and the economy.

By reviewing enrollments in private health maintenance organizations (HMOs) and preferred provider organizations (PPOs), the new AMA study found:

Ninety-nine percent of metropolitan markets are “highly concentrated” according to federal merger guidelines (up from 94 percent metropolitan markets the year before).
In 54 percent of metropolitan markets, at least one insurer had a market share of 50 percent or greater (up from 40 percent of metropolitan markets the year before).
In 92 percent of the metropolitan markets, at least one insurers had a market share of 30 percent or greater (up from 89 percent of metropolitan markets the year before).
“An absence of competition in health insurance markets is clearly not in the best economic interest of patients,” said Dr. Rohack. “The AMA has urged the Department of Justice (DOJ) and state agencies to more aggressively enforce antitrust laws that prohibit harmful mergers.”

To restore a competitive balance to health insurance markets, the AMA has also urged the DOJ to consider the following steps:

Perform a retrospective study of health insurance mergers similar to that performed by the Federal Trade Commission on hospital mergers;
Commission new research to identify causes and consequences of health insurer market power; and
Create a system for predicting the effects health insurer mergers will have on consumer and provider markets.

[Asher]

Hardly, the American health care "market" has very little competition. And that that does exist is mostly zero-sum.

Apparently the AMA is full of idiots like myself. Amiright?

[KrazyHorse]

My private medical insurance coverage costs less if I go sign up for an annual physical. It also subsidises my gym membership. Anecdotal sure, but logical too. The only reason I don't take the former option is the same reason as you, that and my employer picks up the cost in either event.

Mine subsidizes my gym membership too, to the tune of 200$ a year. And this gives a good idea as to the cost benefit associated with it (I'm usually too lazy to claim the benefit, though). Now multiply 200$ a year by the number of people who aren't insured in the US (say 15%). That adds up to 30$ a year per capita.

Big ****ing deal....

[DaShi]

Mine subsidizes my gym membership too, to the tune of 200$ a year. And this gives a good idea as to the cost benefit associated with it (I'm usually too lazy to claim the benefit, though). Now multiply 200$ a year by the number of people who aren't insured in the US (say 15%). That adds up to 30$ a year per capita.

Big ****ing deal....

So the problem isn't the preventive service, it's the lack of universal insurance coverage.

[KrazyHorse]

But but but, if any insurance company in the US discovered that they'd totally dominate the insurance market.

No, you ******, because the cost savings associated with it are relatively minor (a couple of hundred bucks a year per person).

My insurance costs ~8-10k per year for myself and my wife (including both my end and my employer's end). Subsidies for healthy living are 300$ (200 for me, 100 for my wife). That's ~3-4%, and IT'S ALREADY BEEN DISCOVERED. At most you can claim it applies to the 15% of individuals in the US who do not have insurance coverage. Big ****ing deal...

[KrazyHorse]

So the problem isn't the preventive service, it's the lack of universal insurance coverage.

Or the US federal government could simply give out 200$ towards gym membership for anybody without insurance coverage. that would cost 10 billion a year.

I think that probably is a better solution than attempting to further nationalize a 2.5 trillion dollar a year industry.

[Asher]

Or the US federal government could simply give out 200$ towards gym membership for anybody without insurance coverage. that would cost 10 billion a year.

I think that probably is a better solution than attempting to further nationalize a 2.5 trillion dollar a year industry.

Following Canada's lead yet again?

Once the budget is balanced, Canada will have a $500 per year fitness tax credit for adults. There is already one for children ($500 also).

[DaShi]

And how much will those $200 toward gym memberships save?