WSJ: Ten GOP Health Ideas for Obama

[ChumpDumper]

You're trying to tell us people in Britain actively seek dental care?

[TeyshaBlue]

So you ran out of arguments and resorted to ad hominem arguments and personal insults?




What do insurance companies gain from this alleged collusion?



This isn't collusion, it's the consequence of a system where the consumer isn't paying for the expenses.

The conclusion that the for-profit nature of insurance companies isn't a problem remains.

Saying you don't have an understanding of our electrical market is not an ad hominem. Nor is it a personal insult.

You appear to have the inablity to recognize that you don't know what you don't know. I worked inside the pharmaceutical industry for 12 years. At one point, I administered the Vetran's Administration's and the DOD's pharmaceutical contracts, in addition to most of the Indian Health contracts. I worked daily with Pharma companies, Insurance companies, GPO's and all the while was employed by the largest drug distributor in the world. I call it collusion because I watched it happen from the inside...I watched the contract pricing move around based on an arbitrary WAC pricing and massive rebates between all 3 players.. I wathced major insurers say, "We don't care about the cost as long as we can recover it."
If you're unwilling to understand that others might, just maybe, have a deeper understanding of an angle of a particular issue, then you lose any crediblity. Not that it matters.
Removing insurance profit from healthcare costs does not remove the costs that insurance companies drive.

[TeyshaBlue]

You're trying to tell us people in Britain actively seek dental care?

[mogrovejo]

You appear to have the inablity to recognize that you don't know what you don't know. I worked inside the pharmaceutical industry for 12 years. At one point, I administered the Vetran's Administration's and the DOD's pharmaceutical contracts, in addition to most of the Indian Health contracts. I worked daily with Pharma companies, Insurance companies, GPO's and all the while was employed by the largest drug distributor in the world. I call it collusion because I watched it happen from the inside...I watched the contract pricing move around based on an arbitrary WAC pricing and massive rebates between all 3 players.. I wathced major insurers say, "We don't care about the cost as long as we can recover it."
If you're unwilling to understand that others might, just maybe, have a deeper understanding of an angle of a particular issue, then you lose any crediblity. Not that it matters.
Removing insurance profit from healthcare costs does not remove the costs that insurance companies drive.

Your endless appeals to authority are tiring.

Either you want to present arguments or you don't. Repeating "I know because I worked there" and "I know because my brother works there" may function with high-schoolers but not with me.

http://en.wikipedia.org/wiki/Argument_from_authority

It's even more bizarre that you're not even making an argument. You're just saying "you're wrong because I know more than you and you don't have credibility because you don't recognize I know more than you do". Which is, to say the least, pathetic.

[TeyshaBlue]

Your endless appeals to authority are tiring.

Either you want to present arguments or you don't. Repeating "I know because I worked there" and "I know because my brother works there" may function with high-schoolers but not with me.

http://en.wikipedia.org/wiki/Argument_from_authority

It's even more bizarre that you're not even making an argument. You're just saying "you're wrong because I know more than you and you don't have credibility because you don't recognize I know more than you do". Which is, to say the least, pathetic.

You are beginning to blur the lines between "tiring" and "butthurt". If you're so tired, then run along little fella. Don't pay any attention to me.

No, I'm attempting to negate your demonstrably bogus assertion that insurance companies don't contribute to increased healthcosts because their profits are so miniscule by pointing out that profits are not the metric to define healthcare cost reductions.
It's these little tidbits of inane inaccuracies that fuel the continued obfuscation of improving health care in this country. You can't get this. Ok, I understand. Find a wiki for that.

I'm still waiting for you to present an arguement.

[Winehole23]

You sure act like an arrogant jerk for someone who claims to care about manners, mogro.

[TeyshaBlue]

You sure act like an arrogant jerk for someone who claims to care about manners.

Manners schmanners.

(funny edit!)

[mogrovejo]

No, I'm attempting to negate your demonstrably bogus assertion that insurance companies don't contribute to increased healthcosts because their profits are so miniscule by pointing out that profits are not the metric to define healthcare cost reductions.t.

This is a plain lie, I've never asserted that. As I've said, the insurance companies contribute to increased health care costs due to the nature of the system - insurance is always economically inefficient, due to the detachment between consumers and providers. But that doesn't change with a government system that runs on the same basis or with non-profit companies, etc.

My point is that their for-profit nature is immaterial to the debate and it's not the factor leading to a raise in health-care costs.

Once again, I'd be grateful if you could leave the personal arguments out of this.

[TeyshaBlue]

This is a plain lie, I've never asserted that. As I've said, the insurance companies contribute to increased health care costs due to the nature of the system - insurance is always economically inefficient, due to the detachment between consumers and providers. But that doesn't change with a government system that runs on the same basis or with non-profit companies, etc.

My point is that their for-profit nature is immaterial to the debate and it's not the factor leading to a raise in health-care costs.

Once again, I'd be grateful if you could live the personal arguments out of this.

But, it's my contention that the for-profit nature is central to the debate. Were they non-profit, then they would likely say "Hey, $5 for a bottle of Aspirin seems a little steep. You want to re-work that a little?" Or, "Hey 20k for 9mg of Remicade seems to be quite a stretch. We can't recover that from our customers. Can something be done to mitigate this?" The loss of the for profit nature could actually create more of an bargaining atmosphere. It's the same way the VA or DOD approaches their contract pricing. Their stance is, "We want the best contract pricing on the planet, bar none. Then we want you to pull 10% from that. If you screw us with the pricing on Tylenol, then we'll put Enbrel on contract for .10 until you figure it out." The VA cannot recover their costs from their customers...they are non-profit....same as the DOD same as IHS. Their pricing is far superior to any contract from contemporary GPO, hence, that aspect of costs is significantly reduced.

btw...I haven't insulted you yet. You'll know when I do.

[Winehole23]

Once again, I'd be grateful if you could leave the personal arguments out of this.

You call others liars, unreliable and ignorant for merely disagreeing with you, then plead for civility.

[Winehole23]

HYPOCRITE, n. One who, professing virtues that he does not respect, secures the advantage of seeming to be what he despises.

[mogrovejo]

But, it's my contention that the for-profit nature is central to the debate. Were they non-profit, then they would likely say "Hey, $5 for a bottle of Aspirin seems a little steep. You want to re-work that a little?" Or, "Hey 20k for 9mg of Remicade seems to be quite a stretch. We can't recover that from our customers. Can something be done to mitigate this?" The loss of the for profit nature could actually create more of an bargaining atmosphere. It's the same way the VA or DOD approaches their contract pricing. Their stance is, "We want the best contract pricing on the planet, bar none. Then we want you to pull 10% from that. If you screw us with the pricing on Tylenol, then we'll put Enbrel on contract for .10 until you figure it out." The VA cannot recover their costs from their customers...they are non-profit....same as the DOD same as IHS. Their pricing is far superior to any contract from contemporary GPO, hence, that aspect of costs is significantly reduced.

Yeah, but why?

Why would insurance companies employees be more likely to bargain for better deals if they didn't need to worry about the bottom line? Generally it happens the opposite, profit is the most powerful incentive to achieve efficiency gains.

Why couldn't a non-profit company recover costs from their consumers?

btw...I haven't insulted you yet. You'll know when I do.

I don't care, my problem is with personal arguments and they don't even need to be insults.

[TeyshaBlue]

Yeah, but why?

Why would insurance companies employees be more likely to bargain for better deals if they didn't need to worry about the bottom line? Generally it happens the opposite, profit is the most powerful incentive to achieve efficiency gains.

There's truth in this. They can drive overall cost reductions if there were incentive to do so. Where's their incentive? They have a captive population who cannot realistically drop their coverage because it's part of their compensation..and if they do, the same population will have to wait, often 90 days before they're eligible for benefits if the leave their company. Even then, if it's a pre-existing condition, they're hosed. Efficiency does not always = effectiveness. If a 5% cost reduction is realized via efficiency, then it's meaningless unless it's passed to the consumer. That's where the for profit model fails. It can drive efficiencies but without guarantee that they'll pass those along. As insurance companies operate today, there's just not much pressure to develop efficiency...the byzantine construct of do entation should serve as proof enough of that. Each company has it's own discreete coding system...it's own triplicate forms, it's own methodology. There's literally millions if not billions, to be harvested just in standardization alone. But they steadfastly refuse to do so..even under the pressure brought to bear by HIPAA.

Why couldn't a non-profit company recover costs from their consumers?

Perhaps due to the particular economic standing of their consumers? In the case of the VA, their consumers don't bring in alot of scratch. How are they going to force a rate increase?


I'm not saying either stance is absolute...it isn't. The truth, as usual, is somewhere in the middle. But there is demonstrable evidence that a non-profit insurance organization cuts costs, significantly in the case of the VA and their drug pricing contracts, compared to some for profit companies.

[ElNono]

It's funny how one can't use peer-reviewed scientific studies to get some insight and suggestions about the effect of socialized health-care but you can use your absolutely subjective and potentially misinformed view of how the rest of the world to argue in favour of your position.

Strawman. The peer-reviewed scientific studies your brought up study insured vs non-insured under the current insurance model. The studies obviously do not attempt to quantify socialized health-care simply because socialized health-care is not the current model.

You have no idea about what you're talking about. Accessing a public health-care dentist is a nightmare - in Portugal, England, France, Australia, whatever.

I know exactly what I'm talking about. Accessing a public health-care dentist in Argentina is just a phone call away.

That's in Argentina, not in France. I can find an even cheaper dentist in Luanda, for example.

Still socialized health-care. That's bad, right?

First, I'd always pay.

That's your choice, and one of many people that can afford to pay.
It's not an option if you can't.

It's amazing you simply can't grasp that everybody pays an insane amount of money to health-care by default, without even having the choice to pay/not pay for it.

I do grasp that. And we do that for an enormous amount of different services that the state provides, not just health-care. Some I agree spending in, some don't. A public option I agree spending in.

Secondly, saying that I'd be able to get service is wishful thinking. I wasn't. I couldn't live with a tooth ache for months and months. Lot's of people don't get surgery they need on time, they die before. And many medical services aren't available on the public service. I mean, try to get a dental implant in a public service dentist.

So, your complaint is that you're unhappy with the public service, but you already said you can afford a private service. What exactly are you complaining about?

Thirdly, you seem completely oblivious to the fact that people would only go bankrupt due to the fact that they're paying an obscene amount of money to the national health care/insurances. I suspect you simply have never done the math. I'd be very comfortable in paying my medical expenses out of the pocket if I could save all the money that I was forced to give away to pay for health-care I don't use.

No, you're entirely unaware how the healthcare system works here in America. If you happen to get a condition that prevents you from working, you will get laid off and lose your insurance. No other insurance will take you because of your pre-existing condition. Furthermore, this is exactly the time when you need to coverage the most. What ends up happening is that if you have access to credit, you're going to end up cleaning credit cards paying out of pocket for all the stuff you need done. At some point, you're going to be able to go back to work, but it's going to take you 15-20 years to repay all that. This happened to my wife 20 years ago, BTW. This is very real stuff. And I'm not even mentioning those that end up crippled and cannot get a job anymore. Or people that simply do not happen to have access to credit. About half of all bankruptcy cases in the US today are related to medical expenses. I'm not making this up, these are real numbers.

What? Remove of those what?

Remove the barriers that separate people from accessible, affordable care.

Rated by who? By governmental ins utions? What are the criteria?

The WHO.

The "fraction of the cost" is completely useless. Do you think health-care costs will diminish in the US if government takes over the system? You're into a big disappointment.

I don't want the US government to take over the system. For the 10000th time, I want a mixed system, like those in many other countries.

Police and private security services don't do the same thing - at best, they can be complementary. But there's a reason why the state needs to offer the police service (or the military, or the judicial). Locke explains.

Sure they do the same thing. They overlap in certain areas, and they complement each other in others. No different than private vs public health-care services you know so well.

Why? I disagree. As long as they are at their current level, I don't see taxes as an inevitability.

Strawman, again. Considering nobody in power is advocating doing away with taxes entirely, they're indeed a inevitability right now, for all practical purposes.

No. The question is if the services that politicians are offering and paying for by using others people money are needed or, on the other hand, could be offered without evolving politicians and without forcing everybody to pay for it.

If the services are being offered and available to everybody without government intervention, then there would be no clamoring for the government to intervene. Obviously, services are not being offered or available to everybody on certain cir stances, and that's exactly why this is a political talking point at all.

Your ideas about taxes and spending are frankly amusing. You'd probably be happy in Cuba.

You don't know me at all. But I can see you're quick to jump into conclusions.
I think certain spending is justified. I think certain spending is not.
For example, I think the humongous military spending can and should be trimmed off.
I simply don't agree with you on what needs to be cut and what needs to be spent.

Lots of things are cheaper in Europe than in the US. I'm always surprised why people think this is a big deal and indicative of anything de per si.

This kind of analysis is so crappy... for example, a big reason why health care is more expensive in the US is because doctors are better paid. How are you going to solve that? By paying an American doctor the same a French doctor makes? You'd run out of doctors in a couple of months.

Same was said when the HMO/Insurance system we have was introduced. Doctors took it up their asses and still do today. They still make a good amount of money, just not as much as before. And yeah, they're going to get used to driving a domestic car instead of a german car. It's part of reducing costs.

Most of those cost comparative analysis nothing but lazy, cheap propaganda. Europeans spend a lot of money in health-care indirectly that isn't factored - like in training doctors, for example.

So the cost comparative analysis that don't agree with you are bull , but I should take your word for it...

The fact that their system isn't economic sustainable is a problem that you seem to be undervaluing. I mean, it's all nice and fine, but in the end non sustainable systems go bankrupt and terminate.

Or find a way to be sustainable.

What's exactly unconvincing?

That the systems are unsustainable and are going to disappear.

The co-pays are just a temporary palliative. The current system is economic suicide. They simply don't have the money to pay for it and they can't raise taxes - otherwise they'll keep losing companies and jobs. What's so difficult to understand about this?

That there have been there for 60+ years and are still there with no plan of doing away with them?

Once again, your making a comparison forgetting part of the equation. It's amazing how you keep making the same mistake endlessly.

What part of the equation I missed? I guess I'll keep on missing parts of the equation that disagree with your view. Fine by me.

I agree, the current health-care system in America is a disgrace. It's just a bit better than the alternative you propose.

No way. I've been in both. Neither is perfect, but one of them provides a safety net, the other does not.

[spursncowboys]

elnono: who's safety net? Why does someone need a safety net? Who is funding this safety net? How does this work with the idea that taxes should go to services that benefit everyone?

[ElNono]

elnono: who's safety net? Why does someone need a safety net? Who is funding this safety net? How does this work with the idea that taxes should go to services that benefit everyone?

Everyone.
And people need a safety net when it comes to health because sometimes they don't have access to credit, or a family around that can help them out.
Because you get a temporary condition doesn't mean you need to be set back for 15-20 years, or declare bankruptcy.

[mogrovejo]

Strawman. The peer-reviewed scientific studies your brought up study insured vs non-insured under the current insurance model. The studies obviously do not attempt to quantify socialized health-care simply because socialized health-care is not the current model.


I know exactly what I'm talking about. Accessing a public health-care dentist in Argentina is just a phone call away.

Still socialized health-care. That's bad, right?

Are you familiar with the concept of purchasing power parity?

That's your choice, and one of many people that can afford to pay.
It's not an option if you can't.

It's not my choice. How hard is this to understand? I'm forced to pay, if I don't I go to jail.

So, your complaint is that you're unhappy with the public service, but you already said you can afford a private service. What exactly are you complaining about?

Again, you seem completely oblivious to the fact that I pay for something that doesn't work for those who need it and I don't use.

No, you're entirely unaware how the healthcare system works here in America. If you happen to get a condition that prevents you from working, you will get laid off and lose your insurance. No other insurance will take you because of your pre-existing condition. Furthermore, this is exactly the time when you need to coverage the most. What ends up happening is that if you have access to credit, you're going to end up cleaning credit cards paying out of pocket for all the stuff you need done. At some point, you're going to be able to go back to work, but it's going to take you 15-20 years to repay all that. This happened to my wife 20 years ago, BTW. This is very real stuff. And I'm not even mentioning those that end up crippled and cannot get a job anymore. Or people that simply do not happen to have access to credit. About half of all bankruptcy cases in the US today are related to medical expenses. I'm not making this up, these are real numbers.

Huh? Why am I unaware? How is this related to anything I wrote? I'm tired of cheap personal dramatizations and anecdotes.

I don't want the US government to take over the system. For the 10000th time, I want a mixed system, like those in many other countries.

You have a mixed system in the US. THe US government spends more per capita in health-care than any other government in the entire world. And your argument is "the government should spend more".

Sure they do the same thing. They overlap in certain areas, and they complement each other in others. No different than private vs public health-care services you know so well.

Of course they don't do the same thing. Ask any private security officer if they can do what a policeman does.

Strawman, again. Considering nobody in power is advocating doing away with taxes entirely, they're indeed a inevitability right now, for all practical purposes.

You failed to read "at their current level".

If the services are being offered and available to everybody without government intervention, then there would be no clamoring for the government to intervene. Obviously, services are not being offered or available to everybody on certain cir stances, and that's exactly why this is a political talking point at all.

Of course the services are being offered. It's just a matter of price.

Same was said when the HMO/Insurance system we have was introduced. Doctors took it up their asses and still do today. They still make a good amount of money, just not as much as before. And yeah, they're going to get used to driving a domestic car instead of a german car. It's part of reducing costs.

Doctors in France or Spain or England also drive German cars. You seem completely oblivious to the fact that one reason why American doctors are so well paid relatively to their counterparts is because their training is so expensive and they have to pay for it.

If you think that you can have doctors with the standard living of janitors or primary school teachers you're out of your mind. I'm sorry to break this news for you, but price controls don't work: never did, never will.

So the cost comparative analysis that don't agree with you are bull , but I should take your word for it...

I made my argument on why the comparative analysis are bogus. Your inability to refute my argument is very telling.

What part of the equation I missed? I guess I'll keep on missing parts of the equation that disagree with your view. Fine by me.

This part: the affordable, free, safety-net, health-care is extremely expensive and people spend a lot of money paying for it - some even go bankrupt because of the money they spend on it.

[mogrovejo]

There's truth in this. They can drive overall cost reductions if there were incentive to do so. Where's their incentive? They have a captive population who cannot realistically drop their coverage because it's part of their compensation..and if they do, the same population will have to wait, often 90 days before they're eligible for benefits if the leave their company. Even then, if it's a pre-existing condition, they're hosed. Efficiency does not always = effectiveness. If a 5% cost reduction is realized via efficiency, then it's meaningless unless it's passed to the consumer. That's where the for profit model fails. It can drive efficiencies but without guarantee that they'll pass those along..

I thought we'd already gone through this. If they're getting that efficiency and not passing it to the consumer, than they should be getting much higher profit margins. So, the gains in efficiency either goes to the bottom line or is passed to the consumer (generally both).

Why are you going backwards? I thought we had already settled that the profit margin of insurance companies isn't that big.

As insurance companies operate today, there's just not much pressure to develop efficiency

Why? To me it seems that:

- need to be solvent and not being run out of business

- need to deliver profits

are good enough incentives.

But it seems that you believe that removing the incentive of the profit and just keeping the solvency one would result in a better overall incentive. That's extremely odd and that's why I want to know why do you think that way.

Perhaps due to the particular economic standing of their consumers? In the case of the VA, their consumers don't bring in alot of scratch. How are they going to force a rate increase?

I'm not saying either stance is absolute...it isn't. The truth, as usual, is somewhere in the middle. But there is demonstrable evidence that a non-profit insurance organization cuts costs, significantly in the case of the VA and their drug pricing contracts, compared to some for profit companies.

Uh, wouldn't the consumers be the same? I'm puzzled. What are you talking about? The consumers that you have now are the same consumers you'd have tomorrow.

Sorry, but you need to explain why would insurance companies employees be more likely to bargain for better deals if they didn't need to worry about the bottom line? This is a truly extraordinary claim - I've never seen it made before anywhere, probably because it's so far-fetched - so I'd like to see some sort of rationale supporting it.

[ElNono]

Are you familiar with the concept of purchasing power parity?

Sure. What's next? A dissertation on the Geary-Khamis dollar?

It's not my choice. How hard is this to understand? I'm forced to pay, if I don't I go to jail.

Really? You go to jail if you don't purchase private insurance?
You need to keep up with the thread and what you post.

Again, you seem completely oblivious to the fact that I pay for something that doesn't work for those who need it and I don't use.

It works fine. It's not faultless, but the burden is on you to prove that in the vast majority of the cases it doesn't work. Furthermore, that you don't like or agree with what you personally deem functional service doesn't amount to failure.

Huh? Why am I unaware? How is this related to anything I wrote? I'm tired of cheap personal dramatizations and anecdotes.

When you write:

Thirdly, you seem completely oblivious to the fact that people would only go bankrupt due to the fact that they're paying an obscene amount of money to the national health care/insurances.

in response to:

No, you pay because you choose to pay. If you couldn't pay, you would still be able to get service without going bankrupt.

Then you're completely unaware why people go bankrupt in this country with regards to healthcare spending.

You have a mixed system in the US. THe US government spends more per capita in health-care than any other government in the entire world. And your argument is "the government should spend more".

No, we have a scam by insurance companies in the US. When people are old enough to require increased healthcare spending, they toss them to the public system. In the meantime, they collude to concentrate markets and keep premium prices up.

Of course they don't do the same thing. Ask any private security officer if they can do what a policeman does.

They can certainly do certain things a policeman does.
What part of 'both complement and overlap' is so hard to understand?

You failed to read "at their current level".

Again, are we doing away with taxes?

Of course the services are being offered. It's just a matter of price.

I didn't omit 'available' right next to 'offered'. You did.

Doctors in France or Spain or England also drive German cars.

As long as you're part of the union, that's a 'domestic' car for all intents and purposes.

You seem completely oblivious to the fact that one reason why American doctors are so well paid relatively to their counterparts is because their training is so expensive and they have to pay for it.

My wife is a registered nurse. That's how oblivious I am to that fact.
But that's another scam for another thread: The government backed student loans.

If you think that you can have doctors with the standard living of janitors or primary school teachers you're out of your mind. I'm sorry to break this news for you, but price controls don't work: never did, never will.

Do doctors in Europe have the standard of living of janitors or primary school teachers? It's rhetorical questions, BTW. I know the answer and you do too.

I made my argument on why the comparative analysis are bogus. Your inability to refute my argument is very telling.

This is what you posted:

Most of those cost comparative analysis nothing but lazy, cheap propaganda. Europeans spend a lot of money in health-care indirectly that isn't factored - like in training doctors, for example.

That's your argument? It reads a lot more like an unsubstantiated rant to me.

This part: the affordable, free, safety-net, health-care is extremely expensive and people spend a lot of money paying for it - some even go bankrupt because of the money they spend on it.

Something to substantiate this please? I mean, I know people go to jail for evading taxes, but I also know people get tax exemptions/rebates under certain pressure conditions.

[TeyshaBlue]

I thought we'd already gone through this. If they're getting that efficiency and not passing it to the consumer, than they should be getting much higher profit margins. So, the gains in efficiency either goes to the bottom line or is passed to the consumer (generally both).

Why are you going backwards? I thought we had already settled that the profit margin of insurance companies isn't that big.

Generally both? Really? I'm not sure any meaningful efficiency gains have been made in the last decade anyway. As I tried to illustrate, the savings in standardization of forms and methodology alone could reap millions, yet there is no movement towards gains in this area. Why would they not do this? I wonder about this alot. Standardization lends itself to some forms of transparency.....if every company adhered to the same standard of methodology, it sure would be easier to devise metrics for performance which would invite some unkind comparisons perhaps. I dunno...I cant figure it out. There's a whole industry out there of HIS coders who would love to see some kind of standardization so the multiples upon multiples of platforms could be unified.
Why the fixation on margins? That's borderline irrelevant and is certainly not the only component of healthcare costs inflated by insurance. I keep trying to steer you towards other methods they can cause costs to increase, but you keep bringing the discussion back to this. I don't get it

Why? To me it seems that:

- need to be solvent and not being run out of business

- need to deliver profits

are good enough incentives.

But it seems that you believe that removing the incentive of the profit and just keeping the solvency one would result in a better overall incentive. That's extremely odd and that's why I want to know why do you think that way.

No, that's not what I'm saying at all. I swear, we are just talking right past each other. Those are good enough incentives to insure quarterly bonuses. But you're going to have to show me where those incentives + better profits = lower premiums because I just don't think the correlation exists.

Uh, wouldn't the consumers be the same? I'm puzzled. What are you talking about? The consumers that you have now are the same consumers you'd have tomorrow.

No. The customers the VA have are not the same customers that United Healthcare has. Two completely different populations with completely different economic pictures.

Sorry, but you need to explain why would insurance companies employees be more likely to bargain for better deals if they didn't need to worry about the bottom line? This is a truly extraordinary claim - I've never seen it made before anywhere, probably because it's so far-fetched - so I'd like to see some sort of rationale supporting it.

Sorry, but you are either intentionally mis-stating my point or I'm simply failing to make it understandable. I never said they would be more likely to bargain for better deals if they weren't worried about the bottom line. That's absurd. My point is, if the bottom line wasn't mobile, then they would have an incentive to bargain. As it stands now, the bottom line can simply be moved higher and higher...ie the costs passed on to the consumer.
Non profits tend to operate with a static bottom line....

[mogrovejo]

Generally both? Really? I'm not sure any meaningful efficiency gains have been made in the last decade anyway. As I tried to illustrate, the savings in standardization of forms and methodology alone could reap millions, yet there is no movement towards gains in this area. Why would they not do this? I wonder about this alot. Standardization lends itself to some forms of transparency.....if every company adhered to the same standard of methodology, it sure would be easier to devise metrics for performance which would invite some unkind comparisons perhaps. I dunno...I cant figure it out. There's a whole industry out there of HIS coders who would love to see some kind of standardization so the multiples upon multiples of platforms could be unified.
Why the fixation on margins? That's borderline irrelevant and is certainly not the only component of healthcare costs inflated by insurance. I keep trying to steer you towards other methods they can cause costs to increase, but you keep bringing the discussion back to this. I don't get it

You're confusing issues.

If no gains of efficiency have been made in the last few years, then there have been no gains to be passed on to the consumer.

If there were, they were passed on to the consumer and/or to the profit margin.

I'm not saying that efficiency gains were made; the issue was your statement that the for profit model fails because "It can drive efficiencies but without guarantee that they'll pass those along".

No, that's not what I'm saying at all. I swear, we are just talking right past each other. Those are good enough incentives to insure quarterly bonuses. But you're going to have to show me where those incentives + better profits = lower premiums because I just don't think the correlation exists.

Uh? Do you care to explain how the incentives that work for every other market known to the mankind don't work in the health-care insurance markets?

No. The customers the VA have are not the same customers that United Healthcare has. Two completely different populations with completely different economic pictures.

I beg your pardon? What was your point bringing up VA then?

The consumers of the current for-profit insurers would be the same consumers if those companies weren't for-profit.

So, when you say something like "Perhaps due to the particular economic standing of their consumers?" is just nonsensical.

Sorry, but you are either intentionally mis-stating my point or I'm simply failing to make it understandable. I never said they would be more likely to bargain for better deals if they weren't worried about the bottom line. That's absurd.

Great. I never said you said that though (not worried about the bottom line?). I said you stated that they would be more prone to exercise their bargain power if they were non-profit companies. Unfortunately you seem completely unable to explain why.

My point is, if the bottom line wasn't mobile, then they would have an incentive to bargain. As it stands now, the bottom line can simply be moved higher and higher...ie the costs passed on to the consumer.
Non profits tend to operate with a static bottom line....

What exactly is a static bottom line and why would they have an incentive to bargain more in that case? I've never hard such an extraordinary line of reasoning.

[mogrovejo]

If non-profits were more effective making efficiency gains then all you have to do is to allow non-profits to compete with for-profits: if your theory is true, that the formers will drive the laters out of the market rather quickly.

[Winehole23]

That you've never heard of something is no proof against it, profe.

[TeyshaBlue]

You're confusing issues.

If no gains of efficiency have been made in the last few years, then there have been no gains to be passed on to the consumer.

If there were, they were passed on to the consumer and/or to the profit margin.

I'm not saying that efficiency gains were made; the issue was your statement that the for profit model fails because "It can drive efficiencies but without guarantee that they'll pass those along".




Uh? Do you care to explain how the incentives that work for every other market known to the mankind don't work in the health-care insurance markets?

Insurance companies operate in a quasi-monopolistic mode. Not too many markets in which to make a comparison, are there?

I beg your pardon? What was your point bringing up VA then?

The consumers of the current for-profit insurers would be the same consumers if those companies weren't for-profit.

Don't be thick. In any contemporary discussion of a public option, there has also been a provision for private insurance. Where do you suppose the line of deliniation would form? Most likely income with those with lower or restricted incomes moving towards public option and those with cash sticking with a private plan.

So, when you say something like "Perhaps due to the particular economic standing of their consumers?" is just nonsensical.

No, it's not as explained above.

Great. I never said you said that though (not worried about the bottom line?). I said you stated that they would be more prone to exercise their bargain power if they were non-profit companies. Unfortunately you seem completely unable to explain why.

I've explained the concept multiple times. Inexplicably, you fail to recognize that.

What exactly is a static bottom line and why would they have an incentive to bargain more in that case? I've never hard such an extraordinary line of reasoning.

Ditto the above.

Look, you're not interested in a discussion. This is turning into some weird validation exercise. You've done nothing but refute without a single counter arguement. Fine....if you want to sit and pick apart a post, knock yourself out kid. When you're ready to propose a solution of your own, I'll be ready to listen.

[ElNono]

Or the laters will adapt to offer a complementary service to the formers... which is not a theory really. You can see that in a lot of different parts of the economy. For example, the postal service.