White Christian America versus Everybody Else

[james&olya 1,121]

Who says that privately administered and managed Medicare is more expensive than one that is gov't run? When has Medicare ever been turned over to the priate sector to be run as a for profit business?

I do! I give up on trying to get you to acknowledge the Medicare Advantage programs that did turn over Medicare "to the priate sector to be run as a for profit business"!

[ValerieA 350]

When did profits start meaning efficiency? Those are two different concepts entirely...

For example, non-profit organization A could produce a widget for $100, and sell it for $105 ($5 to cover their admin costs). Profitable company B could produce a widget for $105, but they are going to sell it for $125 ($10 admin costs, and $10 profit). Profitable company B is, well, profitable, but not efficient.

[Mr. Big Dog 10,747]

Who says that privately administered and managed Medicare is more expensive than one that is gov't run?

The Congressional Research Service says that. Medicare Advantage cost the government 14% more per beneficiary than traditional Medicare. In 2009, that was an additional cost of $12 billion.

[Teddy B 17,252]

Taxpayer money is not 'lost' in paying for health care for medicare recipients, the VA, military, etc.!! And the evidence is that for-profit companies are MORE expensive because they require.... A PROFIT!!!

There is absolutely no incentive for the gov't to run medicare in a cost effective manner, or any other program for that matter. Medicare is going to cost money no matter who runs it because it's a gov't handout, but it would lose a lot less money if it was run by a private company that was paid for it's services and maybe given cash back incentives to save the taxpayers money on certain aspects of the program.

[JohnR! 5,495]

There is absolutely no incentive for the gov't to run medicare in a cost effective manner, or any other program for that matter. Medicare is going to cost money no matter who runs it because it's a gov't handout, but it would lose a lot less money if it was run by a private company that was paid for it's services and maybe given cash back incentives to save the taxpayers money on certain aspects of the program.

a.k.a. The single payer system. Positively socialist! Pffff...

[Mr. Big Dog 10,747]

There is absolutely no incentive for the gov't to run medicare in a cost effective manner, or any other program for that matter. Medicare is going to cost money no matter who runs it because it's a gov't handout, but it would lose a lot less money if it was run by a private company that was paid for it's services and maybe given cash back incentives to save the taxpayers money on certain aspects of the program.

That was the very rationale for Medicare Advantage - turn the government run Medicare program administration over to private enterprise and save money that way. Problem is, these savings never materialized. To the contrary, Medicare Advantage costs MORE per beneficiary - 14% more to be exact. I know it's hard when reality hits and stands in the way of your wishful thinking but it's the reality all the same. You can try and hide from it, run from it but it'll always catch up with you.

[Teddy B 17,252]

The Congressional Research Service says that. Medicare Advantage cost the government 14% more per beneficiary than traditional Medicare. In 2009, that was an additional cost of $12 billion.

Did you even read the link you posted? That's not what it says at all.

Hey, I can do that hammer thingy too! Wow, that's wicked cool and really helps to get your point across, eh?

[Mr. Big Dog 10,747]

Did you even read the link you posted? That's not what it says at all.

It doesn't?

Though plans that manage their enrollees’ care have the potential to be less expensive than original Medicare, recent analyses by the Medicare Payment Advisory Commission (MEDPAC) find that Medicare is projected to pay private plans an average of 14% more per beneficiary in 2009 than it does for beneficiaries in the original Medicare program.

What does it say, then?

[james&olya 1,121]

There is absolutely no incentive for the gov't to run medicare in a cost effective manner, or any other program for that matter. Medicare is going to cost money no matter who runs it because it's a gov't handout, but it would lose a lot less money if it was run by a private company that was paid for it's services and maybe given cash back incentives to save the taxpayers money on certain aspects of the program.

I have a GREAT idea! Lets create a test program where we will turn over Medicare to any private sector insurance company to run and let them show what they can deliver! We can call it 'Medicare Advantage' and if they show that the private sector really can administer this progam cheaper it will prove your point!

Very sad news! We got the results in on that very concept. It was tried and failed miserably. A number of private insurance companies tried and they all failed. It cost 14% MORE to have these programs run by private companies! I guess this news will never get mentioned by the right-wingers and especially not on faux news. We need to really keep this quiet, even pretend it never happened or people will start to get the idea that this claim that private businesses are more efficient than the federal government is just another giant load of BS!!!

[james&olya 1,121]

I will concede that it is true that private insurance could be a lot cheaper than medicare if government regulations were eliminated. If you allowed them to refuse pre-existing conditions, drop patients who get too expensive, have arbitrary annual or lifetime limits on total benefits, restrict patients choices of doctors and hospitals to only a very few, etc. These are all techniques used by private, for-profit insurance and they are quite effective in producing huge profits for their share-holders.

[Mr. Big Dog 10,747]

I have a GREAT idea! Lets create a test program where we will turn over Medicare to any private sector insurance company to run and let them show what they can deliver! We can call it 'Medicare Advantage' and if they show that the private sector really can administer this progam cheaper it will prove your point!

Very sad news! We got the results in on that very concept. It was tried and failed miserably. A number of private insurance companies tried and they all failed. It cost 14% MORE to have these programs run by private companies! I guess this news will never get mentioned by the right-wingers and especially not on faux news. We need to really keep this quiet, even pretend it never happened or people will start to get the idea that this claim that private businesses are more efficient than the federal government is just another giant load of BS!!!

There you are again with that fcuking reality. It's very destructive to Teddy B's argument.

[Teddy B 17,252]

I will concede that it is true that private insurance could be a lot cheaper than medicare if government regulations were eliminated.

Which has been my arguement all along. This "example" of Medicare Advantage you keep touting as your smoking gun, is in no way, shape, or form a true comparison of a privately run insurance company, nor is it even a true comparison to Medicare. And btw, your claim that it would cost 14% for the exact same insurance is false. It states right in the link you posted that the Medicare Advantage offered more coverage and lesser deductables, hence the 14% increase in cost.

From your link:

In general, Medicare Advantage plans offer additional benefits or require smaller co-payments or

deductibles than original Medicare. Sometimes beneficiaries pay for these additional benefits

through a higher monthly premium, but sometimes they are financed through plan savings. The

extent of extra benefits and reduced cost sharing vary by plan type and geography, creating an

inequity that can frustrate some beneficiaries. However, Medicare Advantage plans are seen by

some as an attractive alternative to more expensive supplemental insurance policies found in the

private market.

Though plans that manage their enrollees’ care have the potential to be less expensive than

original Medicare, recent analyses by the Medicare Payment Advisory Commission (MEDPAC)

find that Medicare is projected to pay private plans an average of 14% more per beneficiary in

2009 than it does for beneficiaries in the original Medicare program. While some support the

higher Medicare expenditures for MA enrollees because funds are used to provide reduced cost

sharing or additional benefits,

Edited June 21, 2012 by Teddy B

[Mr. Big Dog 10,747]

Which has been my arguement all along. This "example" of Medicare Advantage you keep touting as your smoking gun, is in no way, shape, or form a true comparison of a privately run insurance company, nor is it even a true comparison to Medicare. And btw, your claim that it would cost 14% for the exact same insurance is false. It states right in the link you posted that the Medicare Advantage offered more coverage and lesser deductables, hence the 14% increase in cost.

Right, rather than saving the taxpayer money - which was the intention of turning Medicare over to private MA plans - what the MA plans have done is increase the cost to the taxpayer. Whether that is due to increased coverage or reduced deductibles or less efficient administration or a combination thereof, the bottom line is that the MA plans cost the taxpayer 14% more per beneficiary. That's a fact and there's no dispute about that.

[Teddy B 17,252]

Right, rather than saving the taxpayer money - which was the intention of turning Medicare over to private MA plans - what the MA plans have done is increase the cost to the taxpayer. Whether that is due to increased coverage or reduced deductibles or less efficient administration or a combination thereof, the bottom line is that the MA plans cost the taxpayer 14% more per beneficiary. That's a fact and there's no dispute about that.

The MA plan is not a reasonable comparison to Medicare to support the arguement that gov't does it better. The MA plan is completely different.

Bottom line, as you and I have already pointed out, gov't is not set up to operate economically or at a profit. Which is why they should not be involved in these programs unless absolutely neccessary.

[Mr. Big Dog 10,747]

The MA plan is not a reasonable comparison to Medicare to support the arguement that gov't does it better. The MA plan is completely different.

Bottom line, as you and I have already pointed out, gov't is not set up to operate economically or at a profit. Which is why they should not be involved in these programs unless absolutely neccessary.

You're dancing around the point, buddy. What was the reason that private Medicare plans were established? To cut cost. What have these private plans actually done? Run cost up. So they failed to deliver on their promise. Taxpayers and medicare beneficiaries pay more today because of these private Medicare plans. It's just that simple.

Now, MA plans are indeed different than traditional Medicare. Many are structured in ways that deter those elderly that have a high risk profile from signing up. They do this by structuring the cost sharing unfavorably to the insured for certain services - like chemo therapies. That way, old folk with cancer are better off under traditional Medicare and the private insurance plans don't have to worry about the high cost of cancer treatments. Since MA plans are paid based on average costs in any given location, it makes perfect sense that they are trying to grab the healthier population and make themselves rather unattractive for the not so healthy. That leaves the high cost patients solely on Medicare and the healthier and less expensive crowd to private insurance. But that's not enough. Medicare pays the MA plans premiums on top of what per patient cost is for traditional Medicare and voila, there's more profit to be made. Doesn't save Medicare a dime, doesn't save the taxpayer a dime, it actually costs those under traditional Medicare extra premiums and the Medicare fund tens of billions of extra dollars but sure, shareholders and executives make out like bandits.

The insurance industry makes no quibbles about this. Faced with cuts in government subsidies as was proposed in the health care reform legislation (subsidies being the money the government pays them on top of typical Medicare rates) AHIP has come out to say that such cuts would mean that premiums and co-payments for their plans would rise and benefits would be cut back. So, w/o the additional subsidies, these plans cannot compete with Medicare on premiums, co-pays and benefits. The insurance industry is quite open about that and does not deny that they are not competitive. Why do you?

But it's in Humana's government business that things get really interesting. Humana, it turns out, boosted premiums for its Medicare, military and Medicaid enrollees by 3.7 percent to 11 percent, and cut benefits for its Medicare Advantage members to boot. There's more to come: Humana officials were very clear that the company intends to begin charging premiums across the country for Medicare Advantage -- a program in which companies like Humana get a federal subsidy to take over the administration of Medicare benefits for seniors -- starting next year.

Since Humana has traditionally offered its Advantage programs at no premium in many parts of the country, its move is a frank admission that it can't match the efficiency of Medicare itself, even with the government kicking in a 13-17 percent bonus. In fact, it's something of a kick in the teeth to the whole rationale for Medicare Advantage, which according to its largely Republican congressional supporters was supposed to harness the power of the free market to improve efficiency and lower costs. Instead, Humana claims that it has little choice but to pocket monthly charges from seniors in addition to its federal payments while trimming the expanded benefits that were supposed to be the big selling point for privatized Medicare.

Despite insurers' claims, a large portion of the overpayments benefit insurers rather than provide additional benefits to enrollees. For example, the Medicare Payment Advisory Commission (MedPAC) has found that among private fee-for-service plans — one type of Medicare Advantage plan — less than one-fourth of overpayments go toward additional benefits, on average.

Even though they are paid more, Medicare Advantage plans have not been found to provide better quality of care. Beneficiaries in poorer health can end up worse off and have higher cost-sharing for certain services if they enroll in Medicare Advantage. Some private plans impose substantially higher cost-sharing charges than traditional Medicare for certain costly services like chemotherapy in order to deter sicker people from signing up.

By increasing Medicare costs, these overpayments also drive up premiums for the 31 million seniors and people with disabilities enrolled in traditional Medicare — by $86 for a couple in 2009. In addition, the overpayments weaken Medicare's long-term finances.

Edited June 21, 2012 by Mr. Big Dog