I've been bumping around the exchange...

**RandomGuy** · 10-03-2013

Insurance company profits are less than the inflation rate in healthcare; eliminate them completely and you've bought yourself six months of savings.

That isn't the way the time value of money and costs savings works. Your statement is incorrect.

The avoided costs are carried at the finance rate into the future indefinitely. The net present value of such a move would save society somewhere on the order of trillions of dollars. If I get the time, I will run the numbers for you to support that.

**RandomGuy** · 10-03-2013

Originally Posted by Th'Pusher

We'll explain to me why the big insurers don't have their hand out to get a piece of this massive government largesse? Honest question.

They do. Their support was bought with the particulars. Without it, the law would not have passed.

**101A** · 10-03-2013

Originally Posted by RandomGuy

The government needs to step in as a huge insurance company. That will end up being far more cost-effective than the private insurance mish-mash we have now.

Hate to break it to you, but we end up paying for all this either way. The way we pay for health care now is already hideously expensive.

Of course we're paying for it either way; who pays isn't the problem - it's how much is being paid that is the issue.

**RandomGuy** · 10-03-2013

Originally Posted by 101A

I have said it in the thread, but have not made it clear - although I know I said it in here at the time; the biggest problem with the ACA is that it is essentially does nothing to combat the single biggest problem with healthcare in this country: Spiraling Costs; and it remains to be seen how effective it is at correcting the other travesty; people without coverage. In the meantime, Republicans are fighting it, but not even citing what's REALLY wrong with it, and Democrats are defending it like it's something worth defending. When the fights over, no one is going to want to enter the fray again for, what, 20 years??? It's what we've got. It's not addressing the real problem, and we're stuck with it for the foreseeable future.

I agree with that 100%

The ultimate solution to what ails us, pun intended, is that we need to be increasing the supply of doctors, as well as changing the way that health care is practiced.

Move from fee for service to salaries, and you remove some perverse incentives.

**RandomGuy** · 10-03-2013

http://www.newyorker.com/reporting/2...a_fact_gawande

interesting bit

**101A** · 10-03-2013

Originally Posted by RandomGuy

That isn't the way the time value of money and costs savings works. Your statement is incorrect.

The avoided costs are carried at the finance rate into the future indefinitely. The net present value of such a move would save society somewhere on the order of trillions of dollars. If I get the time, I will run the numbers for you to support that.

Economists. I know you'll explain it, but if insurance companies only make a couple billion, how can the savings be trillions?

Again, if you want to save money on healthcare, you HAVE to save money on the cost of heathcare; focusing on the payor is missing the larger picture. For instance, RG, if you wrecked your Trabant, and the repair shop wanted 50 grand to repair it (value = $45), would you question the insurance company that wants to raise your premium, or would you possibly talk to the owner of the shop?

**101A** · 10-03-2013

Originally Posted by RandomGuy

I agree with that 100%

The ultimate solution to what ails us, pun intended, is that we need to be increasing the supply of doctors, as well as changing the way that health care is practiced.

Move from fee for service to salaries, and you remove some perverse incentives.

You finally got far enough in the thread to see that, huh?

Sorry about the Trabant crack.

, transparency and uniformity in billing would do wonders ALL by itself. Educating the population about medical test and Rx overreach wouldn't hurt, either.