Health Care systems

[Patrick Degan]

Man of Straw.

Degan, again, political realism? Would the current Republican Congress and Administration help themselves from infecting an existing federal health care bureaucratic apparatus with their fundie ideology?

Which rebuts the orignial point... how, exactly?

[Patrick Degan]

If your mother were poor she would be eligible for medicaid, which has more lenient standards for admittance of seniors. In such a scenario she would NOT HAVE 800 dollar copays....

In any event advertisement does have public health benifits....

I have NO problem with a mixed research system. My problem is that if just count on government to 'increase the research spending' it will suffer from the over centralization....

<voluminous piles of insurance company apologist bullshit>

American copays are largely symbolic as well. Typicly you have one two thousands dollars in deductible and then maybe a 80/20 or 90/10 spilt for the next thousand or two, and then the insured pays nothing....

Rather than try to duck your burden of proof, why don't you just do the legwork and find renormalized mortality numbers...?

Even if that means YOU are left to die from a treatable condition because you can't cough up the money, but someone else lives because they're wealthy? Do you really mean that? Are you willing to die without a peep for your stance?

At this point in time I'd like to say yes.

This fine Wall of Ignorance erected on this site by the Tharkun Construction Co. LLC.

[Keevan_Colton]

Tharkie, lets look at your logic here by taking another important emergency service...the police...

Isnt it shocking the mono-whatever that exists with the police? Isnt the lack of choice that faces people with regards to police departments terrible? Isnt it awful that advances in anti-crime technology is kept back due to lack of investment in the police service? Wouldnt it be so much better to give people choice to seek out which police department is best suited to their needs, perhaps with some kind of co-pay, with a deductable so that you need to pay for service on anything less than grevious bodily harm out of your own pocket?

Frankly Tharkie, you're a morally bankrupt little scum-fuck and I'm sick of you and your ilk who seem to think that deciding peoples chance to live or die based purely on economic worth is somehow acceptable in a civilized nation. I have no respect at all for your longwinded horseshit approach to debating, again and again you repeat reams and reams of nonsense and cloak your basic premise deep inside...hardly suprising as your premise is usually something along the lines of "It's peoples own fault if they cant get medical insurance"

[Illuminatus Primus]

Man of Straw.

Degan, again, political realism? Would the current Republican Congress and Administration help themselves from infecting an existing federal health care bureaucratic apparatus with their fundie ideology?

Which rebuts the orignial point... how, exactly?

You said that just that was a strawman. But how is it a distortion of a realistic political consequence of said implementation in the U.S.?

[Patrick Degan]

Degan, again, political realism? Would the current Republican Congress and Administration help themselves from infecting an existing federal health care bureaucratic apparatus with their fundie ideology?

Which rebuts the orignial point... how, exactly?

You said that just that was a strawman. But how is it a distortion of a realistic political consequence of said implementation in the U.S.?

Because it has nothing whatsoever to do with the original point: Tharkun was putting forth his usual blather about how Government Anything = Horrid Inefficency. The example of the Manhattan Project directly refutes this. So does the far more relevant example of the U.S. Army's biomedical research effort into more effective antibiotics during the Second World War. Furthermore, he goes on to make this equation:

Absolutely. I want a government that regulates the system, not one that runs the system. I shudder to think about the consequences of turning over the entire medical purse to the direct control of which ever interest group (fundies, greens, unions, etc.) is currently holding the balance of power.

—which isn't what anybody in this thread other than the aforementioned idiot, and yourself, are yammering on about. It's also something of a cartoon of government-sponsored R&D in the United States. Hence the Strawman, which seems to have given rise to a rather smelly Red Herring in the bargain.

So let's have an end to this speculative bullshit about the "political consequences" of the government healthcare system being taken over by the Fundies or the Greens or the Klingons, shall we?

[Illuminatus Primus]

Because it has nothing whatsoever to do with the original point: Tharkun was putting forth his usual blather about how Government Anything = Horrid Inefficency. The example of the Manhattan Project directly refutes this. So does the far more relevant example of the U.S. Army's biomedical research effort into more effective antibiotics during the Second World War. Furthermore, he goes on to make this equation

Sounds like an emotive strawman of his point heavy on rhetoric to me, actually.

The Manhattan project is a highly peculiar and atypical project in many aspects, and is a very poor counterargument to a general rule.

Furthermore, he doesn't seem to state anything in the charicatured black/white that you do. Simply that typically, government run operations are less efficient and more wasteful than free market ones. Mike himself has anedotally noted the increased wastefulness in the government projects, not to mention this general rule obviously favors the predominance of capitalism in the modern world. What gives?

If you want to say government R&D would work for health care, dodging the possible politicization by radical and reactionary special intrest groups as a point against and using the Manhattan Project as a counterexample is rather poor argumentation.

—which isn't what anybody in this thread other than the aforementioned idiot, and yourself, are yammering on about. It's also something of a cartoon of government-sponsored R&D in the United States. Hence the Strawman, which seems to have given rise to a rather smelly Red Herring in the bargain.

So conservatives would not politicize it the way they are the morning after pill, government education regarding contraceptives, and the fucking HPV vaccine? All the pieces are there, and its an important point to raise when regarding the possibility of U.S. socialized medical care. I am afraid it is relevent to address if you are in favor. I'm afraid with the waves of evidence against, you ought to provide somesort of structured argument why this won't happen aside from a large-font "Man of Straw."

So let's have an end to this speculative bullshit about the "political consequences" of the government healthcare system being taken over by the Fundies or the Greens or the Klingons, shall we?

I find that rather unsettling from the same man who is sure to emote or post a sarcastic remark in every "the Christian Right is interfering with common sense and the basic apparatus in society" thread that appears in N&P.

[Patrick Degan]

Because it has nothing whatsoever to do with the original point: Tharkun was putting forth his usual blather about how Government Anything = Horrid Inefficency. The example of the Manhattan Project directly refutes this. So does the far more relevant example of the U.S. Army's biomedical research effort into more effective antibiotics during the Second World War. Furthermore, he goes on to make this equation

Sounds like an emotive strawman of his point heavy on rhetoric to me, actually.

Bullshit. It is exactly his position (which is quoted directly, BTW), as even a cursory readthrough of this entire thread demonstrates.

The Manhattan project is a highly peculiar and atypical project in many aspects, and is a very poor counterargument to a general rule.

How, exactly? Either it is an example of a government R&D effort which was a) very efficent and b) met its exact goal in timely fashion, or it is not.

Furthermore, he doesn't seem to state anything in the charicatured black/white that you do. Simply that typically, government run operations are less efficient and more wasteful than free market ones. Mike himself has anedotally noted the increased wastefulness in the government projects, not to mention this general rule obviously favors the predominance of capitalism in the modern world. What gives?

Are you fucking blind? What do you think is the thesis of his entire argument of private healthcare v. universal heathcare? And which position do you really imagine Mike has been arguing?

If you want to say government R&D would work for health care, dodging the possible politicization by radical and reactionary special intrest groups as a point against and using the Manhattan Project as a counterexample is rather poor argumentation.

YOU are the only one who's been dragging this idiotic Red Herring across the stage, which I will reiterate has nothing whatsoever to do with the original point that was argued.

—which isn't what anybody in this thread other than the aforementioned idiot, and yourself, are yammering on about. It's also something of a cartoon of government-sponsored R&D in the United States. Hence the Strawman, which seems to have given rise to a rather smelly Red Herring in the bargain.

So conservatives would not politicize it the way they are the morning after pill, government education regarding contraceptives, and the fucking HPV vaccine? All the pieces are there, and its an important point to raise when regarding the possibility of U.S. socialized medical care. I am afraid it is relevent to address if you are in favor. I'm afraid with the waves of evidence against, you ought to provide somesort of structured argument why this won't happen aside from a large-font "Man of Straw."

Centre for Disease Control —does that count as an example in your rarefied world? You will kindly demonstrate how its work has been "radically politicised" if you would be so kind. And what other areas of heathcare coverage have fallen subject to "radical politicisation" in this country? You're the one arguing that this must be so. Guess where that puts the burden of proof?

So let's have an end to this speculative bullshit about the "political consequences" of the government healthcare system being taken over by the Fundies or the Greens or the Klingons, shall we?

I find that rather unsettling from the same man who is sure to emote or post a sarcastic remark in every "the Christian Right is interfering with common sense and the basic apparatus in society" thread that appears in N&P.

Oh PUHLEEZE! Trying to equate guidelines on sex eduction with how an actual NHS might be run in this country is patently absurd. No Bush Administration policy in regards to contraception has had the slightest impact on how Medicare or Medicaid has operated (being that the system regards anything outside of vital heathcare services as "elective" and not subject to coverage, which is how any NHS in this country would probably be structured as well). Nor has anybody —except yourself and Tharkun of the Long-Winded Imbecilities— been talking about any system which completely cuts private insurance or R&D out of the picture.

Further, if I recall, the Federal Government —even this government— isn't the entity involved in the present idiotic opposition to research into the HPV vaccine. So how is this "radical politicisation" impacting any Federal R&D into that line of research? And even if it were, how would that negate either the value of overall Federal R&D efforts, or a universal heath service, or my right to call "bullshit" on idiocy from the Christian Right? Exactly what is the fucking point of this entire tangent you're determined to drag this thread off to?

[Darth Wong]

Furthermore, he doesn't seem to state anything in the charicatured black/white that you do. Simply that typically, government run operations are less efficient and more wasteful than free market ones.

And when faced with concrete evidence that the US health-care system is a glaring exception to this rule (its staggeringly high administrative overhead costs alone put the lie to any idiotic notions of superior efficiency), the response from the "free market can do no wrong" crowd is to simply state the rule again and ignore the point. Much as you have done, much as Tharkun did, much as knee-jerkers always do.

There are concrete reasons why the "invisible hand" of the free market does not really work in the case of health-care, but it seems that it's easier for ideologues to mindlessly cite it as dogma rather than looking at the FACTS which clearly contradict it.

As for the brain-damaged notion that socialized health-care should be avoided in order to keep fundie influence away, grow a fucking brain; the fundies can already influence the health-care system through regulation, which is a wholly separate issue from expanding the already existing government-sponsored Medicare system to cover the whole population.

[tharkûn]

Isnt it shocking the mono-whatever that exists with the police?

It doesn't. The police are a supplier of goods and services and hence would be a monopoly if they were the only suppliers of protection, investigation, surveilance, etc. One can hire private investigators, body gaurds, and security gaurds (aka rent-a-cops). The police provide a minimum level of service, but for those who wish a greater level service - other options exist.

Isnt the lack of choice that faces people with regards to police departments terrible?

For a premium people can purchase services from other providers. For instance if your child is kidnapped you have the option of hiring a private dective or 30 to do independent detective work. Likewise if you don't beleive the police are patrolling enough in your area you can install video cameras, motion detectors, etc. or hire a private security gaurd.

Isn't it awful that advances in anti-crime technology is kept back due to lack of investment in the police service?

To a large degree the driving force in anti-crime technology is the high end security companies along with a strong defense/espionage overlap. The uber rich originally dumped all the money into the early electronic security markets and these days the prices are dropping down to the lower middle class.

Wouldnt it be so much better to give people choice to seek out which police department is best suited to their needs, perhaps with some kind of co-pay, with a deductable so that you need to pay for service on anything less than grevious bodily harm out of your own pocket?

The police service operates much like I beleive healthcare should - a minimum level of service is provided and anything above and beyond is paid by the individual seeking it. It isn't fair that if one of the Olson twins gets kidnapped she will have gratuitiously more resources devoted to her safe return, however the Olson estate spending those resources helps everyone.

hardly suprising as your premise is usually something along the lines of "It's peoples own fault if they cant get medical insurance"

My premise is that a basic level of care should be provided, benifits should scale down, and competition should be harnessed. The whole toss the poor out to die is a pathetic strawman.

Really I don't understand your position. Pick a basic level of care you wish to provide. Fund and implement it under a system of your choice - follow Canada, follow Germany, or follow Japan; it matters not which. Okay now you have a healthcare plan that provides the basic minimum health care and some rich citizen wants more. Why is it a bad thing if he gets more?

For instance if I was in a queu for prostate surgery and a rich man is also in the queu - what does it harm me if he purchases additional healthcare for himself? He drops his waiting time but either he was behind me (and a priori did nothing to my wait time) or he was ahead of me - and removed himself from the queu pumping me up a notch. Why is it so terrible if you have inequitious healthcare distribution? If the rich are willing to pay more, then let's suck as much from their purses as they are willing to spend.

And when faced with concrete evidence that the US health-care system is a glaring exception to this rule (its staggeringly high administrative overhead costs alone put the lie to any idiotic notions of superior efficiency), the response from the "free market can do no wrong" crowd is to simply state the rule again and ignore the point. Much as you have done, much as Tharkun did, much as knee-jerkers always do.

I'm still waiting for numbers backing the superior efficiency.

Take the staggeringly high administrative overhead costs. First it should be obvious that the US has higher overhead costs - it does more to administer. Doubling the number of heart surgeries, ceteris parabis, doubles the overhead costs.

Of course that is nowhere near enough to account for the difference. So we come back to the actual numbers. The most oft cited numbers I've found in this regard are from Woolhandler and Hammerstein to get this number they followed this type of procedure:
1. First they calculate the amount each country spends on administration, not surprisingly various assumptions about what is "administration" complicate the process exceedingly.
2. This number is divided to get per capita spending.
3. Currency conversions are done using purchasing power parity.
4. The difference between the figures (now in common figures) is multiplied by the US population.

The problem here is that it doesn't take into account wage disparity. One can use this same procedure to get the laughable result that the best administered healthcare in the US is in the rural south and Applachia (in some cases it would even appear to be superior to Toronto). A better methodology would be to find the percentage differential between the two systems and multiply that by the total US expenditures. Using wage reflective economics makes 25% of the disparity vanish.

However that doesn't address a more fundemental problem. Canada introduced price controls (using that term loosely) via doctors payments. Since then the real earnings American doctors have gone up 30 odd percent while their Canadanian counterparts did not experience such increases. So even using a wage corrected process for calculating the administrative differential overlooks the fact that doctors' wages inflate relative administrative costs.

This still leaves a healthy differential, however Canada has standardized paperwork and fewer legal requirements. Both of those need necessarily be corrected via full socialization. There is no reason a regulatory standardization cannot experience the same efficiency increase as a socialized standardization. Likewise tort reform would reduce the administrative overhead due CYA medicine.

But all this discussion is quite academic, Mike hasn't bother to post any numbers regarding this administrative cost differential, let alone the methodology used to derive them. Once he gets around to doing that then we start in on the mechanism by which these costs are reduced. The real question isn't "Are Canadian Administrative Costs Lower?", but rather "WHY are they lower?". Mike and I will likely answer that question differently - I tend to look to methodology, wage disparities, form standardization, legal costs, etc.; Mike will simply attribute the entire balance to the glories of socialized medicine.

There are concrete reasons why the "invisible hand" of the free market does not really work in the case of health-care, but it seems that it's easier for ideologues to mindlessly cite it as dogma rather than looking at the FACTS which clearly contradict it.

Wonderful, when you get around to posting some peer reviewed quantitative facts attesting this we can get around to discussing them.

The truth is Okun did a very nice job of showing that increasing access above a free market equilibrium results in a decrease in efficiency, ceteris parabis. Until I see hard data showing that: socialization is more efficient
and that added efficiency isdue mostly to variables intside of the ceteris parabis condition; I'm going to follow economic theory and assume that the ceteris parabis position does not hold.

fundies can already influence the health-care system through regulation, which is a wholly separate issue from expanding the already existing government-sponsored Medicare system to cover the whole population.

Regulation has a higher burden to get through the courts. Turning off the public money flow is largely outside of the courts oversite. For instance Libby Dole wanted to increase the drinking age nationwide to 21. The federal government cannot do that by regulation. So they decided that any state which didn't have a drinking age of 21 or older would receive less highway funding. Federal regulation would have been tossed by the first intelligent court to hear it, funding allocation however does violate seperation of powers. This is also how Bush finagles No Child Left Behind, abstinance only education, and a host of other policies that congress simply cannot accomplish by majorative legislative fiat. It is ridiciously easier to cut funding and let it wither and die that way than to outright ban it; in most cases the fundies would either have to go on a state by state crusade, amend the constitution, or both.

Expanding Medicare? Are you kidding? The average Medicare 'premium' was around 600 dollars in 2003, in that same year private industry was rolling around 250; granted demographics go a long way for explaining this disparity, but on the flip side there are economies of scale as well as market-share leverage. As far as simplifying administrative costs, please have you ever READ the medicare billing requirements? There are 111,000 pages of medicare regulations which are updated hapazardly and notification lags implementation. I fail to see how expanding the most expensive system with the most byzantine rules and possibly the most ass-backward approach to care in the world (we will pay for expensive remedial crap, but not follow best practice preventative medicine) will improve American healthcare either in patient outcomes or in cost effectiveness. Medicare is vastly inferior to even the Canadian system. Medicare is a prime example of how the US government can be hideously inefficient when it comes to health management.

[Plekhanov]

Tharkun you keep on asking for proof of the US health Care systems inefficiency then ignoring the abundant proof that has already been given in this thread showing just that. Here's an excellent post by Predator on this matter from a previous health care thread link

Let’s see if your spectacularly well developed wall of ignorance gonna let you avoid all this evidence shall we?

I love the bit about "market mechanisms that contain costs and promote quality". Lets take a look at that, shall we?

Healthcare Figures for multiple western countries

Healthcare Comparisons - The USA

Amount spent on health per person: US$3,950
Total health expenditure as a % of GDP: 13.0
Public expenditure on health as % of GDP: 5.8
Private expenditure on health as % of GDP: 7.2
Public: Private ratio: 45:55
Hospital beds per 1,000 population: 3.7
Practising physicians per 1,000 population: 2.7
Practising nurses per 1,000 population: 8.3
Life expectancy at birth in years: 73.04(M) 79.75(F)
Infant mortality (per 1,000 live births): 6.67

Healthcare Comparisons - France

Amount spent on health per person: US$2,102
Total health expenditure as a % of GDP: 9.4
Public expenditure on health as % of GDP: 7.3
Private expenditure on health as % of GDP: 2.1
Public: Private ratio: 77:23
Hospital beds per 1,000 population: 8.1
Practising physicians per 1,000 population: 3.3
Practising nurses per 1,000 population: 4.97
Life expectancy at birth in years: 75.02(M) 82.72(F)
Infant mortality (per 1,000 live births): 4.58

Comparing healthcare - The Netherlands

Amount spent on health per person: US$2,070
Total health expenditure as a % of GDP: 8.5
Public expenditure on health as % of GDP: 6.0
Private expenditure on health as % of GDP: 2.5
Public: Private ratio: 70:30

Hospital beds per 1,000 population: 11.3
Practising physicians per 1,000 population: 2.6
Practising nurses per 1,000 population: N/A
Life expectancy at birth in years: 75.43(M) 80.61(F)
Infant mortality (per 1,000 live births): 5.23

Healthcare Comparisons - Australia

Amount spent on health per person: US$1,980
Total health expenditure as a % of GDP: 8.5
Public expenditure on health as % of GDP: 5.9
Private expenditure on health as % of GDP: 2.6
Public: Private ratio: 69:31
Hospital beds per 1,000 population: 8.5
Practising physicians per 1,000 population: 2.5
Practising nurses per 1,000 population: 7.8
Life expectancy at birth in years: 77.49(M) 83.48(F)
Infant mortality (per 1,000 live births): 4.97

Those are just a few. Doesnt list Canada, however we can find some figures for Canada:

Canadian vs US healthcare

In 2003 the U.S. will spend $399.4 billion ($1,389 per capita) on health bureaucracy, out of total expenditures of $1660.5 billion ($5,775 per capita). The states could save $286.0 billion dollars in 2003 if they streamlined administration to Canadian levels by adopting a single-payer national health insurance system. The potential savings are equivalent to at least $6,940 for each of the 41.6 million Americans uninsured in 2001."

Ah. There's a nice table here. I wont try copying and formatting that... but Canada's figures are:

Canada
Life expectancy: 79.3
Infant Mortality: 5.6
Per capita expenditure on health (USD): 2,163
Healthcare costs as a percent of GDP: 9.5
% of government revenue spent on health: 16.2
% of health costs paid by govenrnemt: 70.8
% of health costs paid by private sector: 29.2

Further comparisons here.

[tharkûn]

Tharkun you keep on asking for proof of the US health Care systems inefficiency then ignoring the abundant proof that has already been given in this thread showing just that.

No I haven't. People like yourself keep saying here is a stastic for country A and here is a stastic for country B. Then you compare the two and conclude that the difference must be due to the healthcare system. That is BS.

Take life expectancy. What other causes beside healthcare systems might drop life expectancy? Well maybe higher homocide rate in the US has something to do with it, no? If you are more likely to die young in gang warfare, there is piss all non-emergency care can do to alter that. Or perhaps we might look at the fact that Americans are obese as hell. Obesity correlates with increased morbidity across just about all causes of death. Then we might look at the rest of the factors that different. Attributing the difference in life expectancy solely to health system is BAD SCIENCE. If you want to say that people die younger in the US because of the healthcare system then you need a bit more robust data.

If we use your method then Utah has superior healthcare to PE Island. Utah has a infant mortality of 5.0 per 1,000 and life expectancy of 78.5. PE Island has an infant mortality rate of 7.2 per 1,000 and life expectancy of 78.1. Obviously the market orientated healthcare system of Utah is superior to that of PE Island

The truth is you can't derive causalty without getting rid of other variables. So you have some stasticaly choices; you can stasticly renormalize the data to get rid of obesity rates, homocide rates, level of exercise, and all the OTHER variables besides healthcare systems; or you can find two populations within both countries which are otherwise identical and track differences that way. Data which is not normalized or controlled with respect to other variables cannot show causation.

In 2003 the U.S. will spend $399.4 billion ($1,389 per capita) on health bureaucracy, out of total expenditures of $1660.5 billion ($5,775 per capita). The states could save $286.0 billion dollars in 2003 if they streamlined administration to Canadian levels by adopting a single-payer national health insurance system. The potential savings are equivalent to at least $6,940 for each of the 41.6 million Americans uninsured in 2001."

Is by the very authors whose method I already dealt with. Administrative costs are going to be higher because America does a greater amount of healthcare. Himmelstein and Woolhandler again make no note of comparative wages - in other words Missippi has the best healthcare administration in the US, have made some fun assumptions regarding administrative costs, and haven't looked at any alternative except Canadian style single payer healthcare.

I don't understand this. I've read the health care data before, hell I've actually gone through risk adjusted data; why do you think repeating the same stastistics is a valid arguement? In order to show causation you need to get rid of all the other crap besides healthcare that effects the stastics.

Once you finally meet your basic scientific burden of proof then we can look at why any remaining differential exists.

[Patrick Degan]

I'm still waiting for numbers backing the superior efficiency.

Um, ahem:

Life Expectancy
Australia 80.0

Canada 79.3

France 79.3

Germany 78.2

Japan 81.4

UK 77.5

USA 77.0


Infant Mortality Rate
Australia 5.6

Canada 5.6

France 5.7

Germany 5.2

Japan 4.1

UK 5.9

USA 6.4



Per-capita Expenditure on Health (US$)
Australia 1,741

Canada 2,163

France 2,109

Germany 2,412

Japan 2,627

UK 1,835

USA 4,887


Healthcare Costs as % of GDP
Australia 9.2

Canada 9.5

France 9.6

Germany 10.8

Japan 8.0

UK 7.6

USA 13.9


% of government revenue spent on healthcare
Australia 16.8

Canada 16.2

France 13.7

Germany 16.6

Japan 16.4

UK 15.4

USA 17.6



% of costs paid by government
Australia 67.9

Canada 70.8

France 76.0

Germany 74.9

Japan 77.9

UK 82.2

USA 44.4



% of costs paid by private sector
Australia 32.1

Canada 29.2

France 24.0

Germany 25.1

Japan 22.1

UK 17.8

USA 55.6


note that these figures include all areas of health care including dentistry, optometry, and drugs.

Eat it, bullshitter.

[Darth Wong]

Administrative costs are going to be higher because America does a greater amount of healthcare.

Honestly, I've lost patience with Tharkun's mega-posts in which every sentence gets two or three huge paragraphs stating the same sophistic bullshit over and over and over, but this kind of thing is just too damned funny. If it's all due to the sheer amount of health-care being done, then why is the administrative cost proportionally higher as a fraction of overall health care spending in the US?

It's long ago become obvious that you will simply make up whatever bullshit you need in order to justify your nonsensical claims, and then try to use sheer verbosity to paper over the holes in your argument.

[Patrick Degan]

I think it's time to open the betting-book on how many posts before Tharkie gets his Village Idiot title hung on him.

[Xon]

Um, ahem:

<snip>note that these figures include all areas of health care including dentistry, optometry, and drugs.[/b]

Neat, Australia's healthcare system is one of the best in the world going by those figures.

[tharkûn]

If it's all due to the sheer amount of health-care being done, then why is the administrative cost proportionally higher as a fraction of overall health care spending in the US?

You'll notice I didn't say that the disparity is completely due to sheer amount. Higher volume is PART of the reason administrative costs are higher.

Proportionally it is higher for several reasons.

It takes more paperwork to cover your ass when the inevitable lawsuit comes around, tort reform - particularly a loser pay's system like Canada's goes a long way.

It takes more when you have unstandardized paperwork and the largest player in the market has thousands of pages of billing regulations. Standardization through regulation sounds like a decent idea.

It the relative wages, particularly with respect to nurses are grossly different. Increasing the supply of nurses through better secondary education priorities is a must.

I apologize for the length, but most healthcare questions don't have simple answers. Explaining the multifaceted nature of problems, let alone methodology, cannot be done in single sentence format.

[Illuminatus Primus]

Furthermore, he doesn't seem to state anything in the charicatured black/white that you do. Simply that typically, government run operations are less efficient and more wasteful than free market ones.

And when faced with concrete evidence that the US health-care system is a glaring exception to this rule (its staggeringly high administrative overhead costs alone put the lie to any idiotic notions of superior efficiency), the response from the "free market can do no wrong" crowd is to simply state the rule again and ignore the point. Much as you have done, much as Tharkun did, much as knee-jerkers always do.

There are concrete reasons why the "invisible hand" of the free market does not really work in the case of health-care, but it seems that it's easier for ideologues to mindlessly cite it as dogma rather than looking at the FACTS which clearly contradict it.

As for the brain-damaged notion that socialized health-care should be avoided in order to keep fundie influence away, grow a fucking brain; the fundies can already influence the health-care system through regulation, which is a wholly separate issue from expanding the already existing government-sponsored Medicare system to cover the whole population.

I said nothing about government insurance at all (the most I did say was that I was sympathetic to your argument). I simply suggested this would be a possible problem if the government also assumed pharmceutical R&D responsibilities. This would give special inference groups more direct clout.

[Darth Wong]

I said nothing about government insurance at all (the most I did say was that I was sympathetic to your argument). I simply suggested this would be a possible problem if the government also assumed pharmceutical R&D responsibilities. This would give special inference groups more direct clout.

Since when do government R&D grants to private industry mean that the government would be conducting the research itself? This is just yet another gross exaggeration on the part of the right wing and knee-jerk apologists for the existing system such as Tharkun.

[Illuminatus Primus]

I said nothing about government insurance at all (the most I did say was that I was sympathetic to your argument). I simply suggested this would be a possible problem if the government also assumed pharmceutical R&D responsibilities. This would give special inference groups more direct clout.

Since when do government R&D grants to private industry mean that the government would be conducting the research itself? This is just yet another gross exaggeration on the part of the right wing and knee-jerk apologists for the existing system such as Tharkun.

When the comparison is to the Manhattan Project and we already do private grants for the private pharmceutical industry, I did not think it was a gross exaggeration to suggest that the implication was literal government agencies running drug programs.

[tharkûn]

When the comparison is to the Manhattan Project and we already do private grants for the private pharmceutical industry,

The US does very little private grants for pharma. Most of those come from academic basic research being used as a stepping stone ot commercialization. The big way the US government tries to direct research by pharma is by extending patents and FDA constraints on new drugs. Some of that is good, some of it sucks.

[Keevan_Colton]

Tharky, you're a fucking retard, even in Canada or the UK it is possible to pay a premium to get private service despite a comprehensive system being in place...

So...I ask again, what seperates the police and healthcare so widely in your mind that one is essential to the public good and the other is best left in the hands of those with a profit motive?

[Patrick Degan]

You'll notice I didn't say that the disparity is completely due to sheer amount. Higher volume is PART of the reason administrative costs are higher.

Proportionally it is higher for several reasons.

It takes more paperwork to cover your ass when the inevitable lawsuit comes around, tort reform - particularly a loser pay's system like Canada's goes a long way.

Um, ahem:

Another major factor is an insurance company's administrative expenses. The cost of personnel, marketing, and sales expenses have a major impact upon the price of insurance. A recent trend of insurance companies is to offer insurance direct to you, thus reducing costs by not having to pay sales commissions to insurance brokers/agents.

And:

Understanding Health Plan Administrative Costs

What are administrative costs?

To better manage healthcare expenses, it is important to identify how premium costs are allocated and the key forces behind rising healthcare costs. Health insurance premiums are broken down into three general categories: medical claims, profits and administrative costs.

Administrative costs are the costs associated with the different functions of a health plan or health insurance company that are necessary to ensure quality, cost-effective services are being provided to its members. The 10 most common administrative functions identified in the Milliman report are:

Claims Processing

Finance and Underwriting

Provider Service and Contracting

Information Technology

Enrollment and Billing

Sales and Marketing

Customer Service

General Administration

Medical Management

Other Healthcare Services

For this study, Milliman used the Milliman Health Plan Operations Benchmarks from approximately 88 organizations. The sample used to formulate the benchmarks is representative of a wide range of organization types, membership sizes, and geographic regions. Milliman tracks administrative data at a very detailed level, categorizing employees by specific healthcare administrative functions.

. . .

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Key findings from Milliman’s research include:

Average health insurer administrative costs grew 4.6 percent during the period studied – slower than overall premiums, which grew 7.4 percent.
Almost 80 percent of the increase in health plan administrative costs is a result of increased spending on customer service information technology.

Spending on customer service grew at an average rate of 15 percent annually.

Information technology costs also grew at an average rate of 15 percent annually.

Milliman found that compliance with Y2K and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) were significant factors in rising information technology costs.

Health plans also are making significant investments in e-commerce to streamline administrative processes and have helped generate average savings of nearly 20 percent in claims, provider services and contracting and general administration.

General administration (such as management and supervision, executive staffing, and employee legal support) costs declined on average by more than 8 percent.

Costs for provider services and contracting have decreased on average by almost 9 percent.

Costs associated with claims have dropped an average of more than 2 percent.

The role administrative costs play in overall premiums costs varies depending on the type of insurance product – fully insured or self-insured. Fully insured products consist of premiums that are paid directly to the insurance company. Fully insured products are regulated by each state in which the product is sold. The insurance company manages premiums paid, assumes all the risk associated with medical costs and pays claims as part of that risk. Typically, people think of insurance in terms of the fully insured model. About 70 percent of all health insurance is fully insured.

3
Drivers of Health Plan Administrative Costs:

38.8%
Customer Service

38.8%
Information Technology

15.5%
Medical Management

4.1%
Enrollment and Billing

2.8%
Finance and Underwriting

Source: Milliman USA, Health Plan Administrative Cost Trends, 2003

[Castor Troy]

Tharkun, would you respond as to how a system that is actually a hybrid of free-market and socialized healthcare would be inferior to an all free-market system?

[SirNitram]

Tharkun, would you respond as to how a system that is actually a hybrid of free-market and socialized healthcare would be inferior to an all free-market system?

He already has; he decries Canada, where socialized healthcare is availiable, but private insurance is availiable.

[Xon]

Tharkun, would you respond as to how a system that is actually a hybrid of free-market and socialized healthcare would be inferior to an all free-market system?

He already has; he decries Canada, where socialized healthcare is availiable, but private insurance is availiable.

I think it is actually closer to utterly ignoring the private insurance part while stating "teh big government is bad" over and over again.

But I'm not going to re-read that highly-repetitive crap to actually check.