Tuesday, January 19, 2016

Bernie Sanders and the Medical Insurance Companies

Many have great trepidation regarding an ill-considered move to tear down the insurance companies in the Sanders Presidency and he has stated his intention to get the country out of their grips but it's an overreaction to believe he will go into these companies like Rambo and lay waste to them.

One of Bernie Sanders greatest strengths is his willingness to approach problems which will not be quickly solved and which have been largely ignored as a result.  He knows as well as anyone he can't immediately demolish the insurance companies no matter how much it will benefit the country to do so.


There is tremendous concern over what his plan will cost but not so much analysis is required.  In general, money from you plus the employer contribution goes to the medical insurance company to provide your coverage.  Assume instead this money goes to the government medical plan and subsequently to doctors and hospitals thus cutting the insurance companies out of the loop.

The overhead charges from insurance companies are exceptionally high and may even go up to 50% of all dollars for medical coverage go to the house and never go anywhere near a doctor.  There will be costs associated with the government program but nothing close to that which takes place within in the insurance companies right now, a large part of which is denying cover.  We believe a large part of whatever it costs to bring uninsured people into the government cover will be remedied by how much is saved by eliminating excessive insurance company costs.


The government insurance plan will not deny cover for anything because that function needs to go back to where it belongs:  the doctors and the hospitals.  It's unconscionable that some clerk in an insurance company can have the authority to deny testing and treatment for cancer but likely many of you know such stories in which the individual had to fight the insurance company for treatment.  This isn't medicine but rather a blazing outrage against humanity.  Sarah Palin ranted about death panels but insurance companies are loaded with them and she says nothing.

Note:  I can but will not give you the name of a friend who had to do exactly the above within the last two weeks.


We don't care beans about the Affordable Care Act because it's not even close to radical enough to solve the problem since it only consolidates business for the medical insurance companies.  Hillary Clinton can build statues for Barack Obama all she likes but she can do it on her own time and with her own money, she's sure as hell got enough of it to do it herself.  That kind of disingenuous hero worship rubbish serves no purpose for discussion because the basic functionality of the insurance companies is at question and not minor points of politics.


As to Bernie Sanders costing trillions with his plan, it's not true and you know it intuitively from how much you pay for medical insurance right now.  In high probability, the Sanders plan will cost you less than you pay right now because a large part of the insurance company infrastructure will be eliminated, most particularly the massive duplications in staffing, and the gigantic premium they take for the professed services is eliminated.

41 comments:

Anonymous said...

America spent almost $3T on healthcare last year. That was for only 85% of the population.
Most of that is not insurance premiums. Eliminating insurance companies will not save as much as you imagine.
Those numbers include medicaid and medicare. Which are already awash in corruption of inflated claims false claims not to mention piles and piles of paperwork.
So it will cost trillions it already does. The only differencr is who signs the check The insurance companies will be replaced by government flunkies like Kim Davis The government is not magically going to get smarter or more efficient.

Yeah Go team
Still no plan on how the changes will save money. Even if you save 15% from insurance elimination that washes with the cost of addding 15% more people to the system.
Again love the passion but I see nothing more than campaign talk
Similar to his dream of college for everyone.

Anonymous said...

Even your Germany doesnt send evrryone to University for free But those who qualify do attend almost free.
About 1 in 20 attend University
the rest attend tech schools
But there system is under stress because America has learned that it is cheaper to send thier kids to Germany and pay housing and support than send them to American schools. Germany allows international students to attend free if the are accepted
So Bernies plan to send all kids to school free is pie in the sky and he cant afford it or make it happen.
In Tennessee we already send all our kids to school for free but mostly only to two year schools and trade schools that teach the students a marketable skill.
The 4 year degrees schools require set GPA to maintain attendance
He says everyone can go but doesnt list how to make it work.
He listed tax on investments as how to pay for it but he is using that to pay for healthcare.

Anonymous said...

Sanders education for all act.
Earmark $47B federal funds manadating another $16 from the states. Funded by investment speculators tax(already spent on healthcare) but the large problem is secondary education is a $500B industry So I am assuming we will raise the levels for admission so 9 out of 10 students no longer qualify

Unknown said...

You have thrown out a big number but there's no information behind it. Even Medicare, etc uses insurance companies. It doesn't surprise me how much is spent in premiums but where else is it being spent.

You're going to get flunkies in the back office positions regardless of whether it's government or private because flunkies are the only people who will do them.

You have also assumed there will be more staff for government support than currently comes from private but there's no evidence to support that either.

Sorry but not enough substance to go anywhere with this one.

Unknown said...

America is the only country in the world with an educational system the government cannot make work. There's a pie in the sky but it's not mine and it doesn't make any sense to say all the others are doing it wrong when all deliver the product without the problems observed here.

Comparing America to Germany has some merit insofar as they're turning out some of the most highly-educated graduates in the world and they are not buried in debt when they get out of school.

Anonymous said...

I like the German system we should emulate it. There only flaw is allowing internationals to possibly break it. But they might like it as it could be an interview process to keep the best minds

Anonymous said...

Even if you use the cost of VA care as the standard per capita healthcare cost. It is about $2T spent last year on healthcare.
My healthcare costs last year for 4 people was $17000 that was just out of pocket costs not what the insurance company paid.
So my healtcare costs are conservative As always id you dont like the numbers you dismiss them as,bogus because they dont fit your plan. You should run for office as all politicians put out numbers to fit thier plans no matter the true numbers
Why do you believe the government can run healthcare with less people than the private sector.

Anonymous said...

I dont care what social programs you want to install just pay for them Sanders is using the same investment tax to pay for his healthcare and gis eduxation plan
Cant soend money twice unless you are a politician

Anonymous said...

Again Germany only sends 5% to university

Anonymous said...

A sidebar to the endemic healhcare problem. Merck just announced a deal to produce 300000 doses of the new Ebola vaccine for $5M. For a non orofit agency in Africa A cost of $16 per. Probably the most they could charge a third world non profit agency and probably the only buyer
If it happen in America the stated cost would be $200 and Shrekreli would buy it and then charge $2000 per during thr next outbreak and that would all be legal

Unknown said...

There's not a problem with that as probably only 5% need to go uni anyway. I don't mean that in any elitist way except the student needs to be bright enough but also needs to have that type of interest and not all of them do.

I suspect where you may see some troubles in the more distant future which comes from 3D printers and a reducing need for people to build anything. That won't kill trade schools but it sure will change them.

Unknown said...

I'm not dismissing any numbers but they aren't coherent enough to make them out very well. I'm seeing great passion and large numbers flying about but so far they aren't accounting for where the money comes / goes all that well.

The VA isn't such a terrible example since the govt pays for all of it and nothing comes back to Uncle Sugar. Therefore the per capita cost should be more or less representative of the bigger system. That would not be accurate enough to sign a contract but it should be good enough for rock and to expand that to what if the entire population were covered this way.

Unknown said...

That Big Pharma problem is yet another bucket of unregulated sleaze. That Shkreli is finally under prosecution is ok news but it doesn't mean much because it was because of his financial crookedness with his companies and not with his practices in medical gouging.

Anonymous said...

I actually assume less total clerks as the duplication of processes would be eliminated as your one healthcare bureau would replace many of the insurance company clerks. But you would have to still process cases. And even more cases now as you would be adding 15% more cases with his plan. And again it takes 3 hours just to get a drivers license. The IRS readily admits it can audit less than 1% of all returns. They also admit they can answer less than 10% of all requests of thier customer services lines.
The wait for an electrical inspection by the Codes dept is presently 3 weeks.(upsets me as I have a house that I cant rent because they ant handle the cases load(cable company installation within 24 hours)
So why will the healthcare bureau be so efficient that they can handle the case load

Anonymous said...

I will gladly buy out of your system and go private
I believe that is an option i. both Germany and the UK.
I would have done the same for social security 40 years ago at a 50 % buy out and retired much earlier than 57 when I did
Please show me a well run government program
The 16 miles of road widening by my house is going on 6 years. And still not done They did build a 4 lane bridge for a two lane highway.
The Hong Kong airport was built on a manmade 7 sq mi island and opened in 6 years

Anonymous said...

I am sorry that your standard is VA coverage which is blasted as substandard by all but you.
Big Pharma is not another issue. It is s major cost of healtcare. How do you seperate drug costs out of total healthcare.
Ask any senior how much they spend on inflated drug prices.
Ask any Hep C patient about the cost of curing them is over $100k just in medication costs.
There are so many issues to solve and I have seen nothing but healthcare for everyone. It is the system that needs help not the funding. Fix the issues but as long as Big Pharma contributes to all politicians it is not changing.
Sanders is Diogenes and the outlook doesnt look good

Unknown said...

Well-run govt program: NASA, Post Office, etc

The specific problem with VA is resources and I live this stuff so I know what I say. When you are in the pipeline, it goes well but it's slow, due to resources, to get into it.

Throwing anecdotal clips about this road or that one doesn't tell me anything. The Boston Dig took maybe ten years but maybe it had to take ten years for valid reasons. How should I know.

Anonymous said...

You surely joke about the post office it losses on average of $25M per day
Again you say use the numbers of the VA to be a starting point but they are underfunded so you must increase the funding and now you are spending what is being spent now
The Boston Dig is another prime example of government ineptitude
NASA maybe be a good agency but they are asking private companies and foreign nations to help complete the job
If the government cant build roads effectively how are they going to run the healthcare system.

Anonymous said...

We can always use the education system that spends 30% more per child in my county than I pay for one of the best private schools in my county. The on time graduation rate is only 85%
There are so many to chose from
But you will always dismiss them not important or irrelevant

Unknown said...

Accounting for Post Office costs has been a Washington game for some while as I'm sure you know the GOP wants to privatize it. What I know of the Post Office for sure is they have been delivering reliably since the days they did it on horses and for remarkably little cost.

You're making some bogus cost comparisons for these conclusions and I'm not dismissing anything but there's not enough content to them to support what you're saying. I don't know what education system is paying 30% more than something else, it's not clear from what you wrote. I'm not trying to be dickish about it, the logic isn't clear is all.

Anonymous said...

No worries
The government costs per student in my county is 30% higher than my granddaughters private school tuition.
Public school class size 30 student per teacher
Fairy Princess has 11 students in her class
As to the post office, it is cheap because of the government subsidizes its losses. It is far more expensive and less reliable to ship vis USPS than Fedex UPS or DHL This is basex on shipping on average of 15 items per week.
The only function of the USPS is to me is to fill my mailbox full of junk advertising mailers. Almost anything important comes via computer or via a private shipper

Which costs are bogus

Anonymous said...

The $25M daily loss is quoted from the Huffington Post and is the smaller dollar value of any article I read

Unknown said...

They have to get their numbers from government sources which can say whatever they like. The GAO probably has more or less accurate numbers.

Prescription medicine has been delivered to me by mail traditionally and that's how it arrives now.

I understand the U.S. spends a tremendous amount on education but the money is not working effectively and people can argue all day on why. I believe you're talking about any pre-college costs and there's no argument about the expense being too high for the value. That's not the same as a university level in which the state can't interfere in the curriculum. The fastest way to the Stone Age is if the state gives itself the right to interfere in any curriculum at the university level.

Anonymous said...

My point on education is it is just one more example of government bureaus that ate hugely expensive and basically inept

Anonymous said...

The state already dictates curriculum at the university level. It sets the requirements for each degree level

Unknown said...

Now that one is rubbish. Accreditation for higher education is done by peer review and the Department of Education does no more than provide a list of accreditation agencies.

Unknown said...

And there are agencies which work better than you want. IRS, for example. Generalizing all government departments are inept doesn't make much of a case. It's true U.S. spends more per kid than elsewhere but there's little analysis as to why.

Anonymous said...

The IRS is a bad example just research the wait times for customer service and the number of calls that are not even answered. Or the minimal number of returns that are even audited
Education is well funded we generally dont even test in the top 20 industrialized nations of the world. Not to mention the very high drop out rate co.pared to other countries
You dont care why we waste so much money on healthcare just nationalize it and the government will fix it. The nationslized education dept doesnt work.
Most private schools spend less per child and get better returns. I will admit that the parental support for private school children is higher and will slightly skew those numbers

Unknown said...

The IRS will do as well as any for an example as I'm sure you can offer statistics for call centers in the private world which operate so much more efficiently. I can't think of one but I'm sure they must exist.

Education is something I noted previously gets a lot of money spent but doesn't deliver the product. Since this is the same socialist education as anywhere else, maybe it wouldn't be such a bad idea to discover how other countries organize their public school systems because the people who do it here are complete crap.

It doesn't help to tell me what I do or don't care as that's like yer squeeze goin' on about how 'you always do that' and that leaves no option but get up and walk away.

I care quite a bit about how much is wasted in medical care but it's not your job or mine to define that which is waste and that which is not and it's absolutely not the job of some insurance company.

When every other country in the world makes socialized public education work, saying flat it doesn't work simply isn't true. It doesn't work here presumably due to the incompetence and myopia of those who build it and/or the politicians who want to torpedo it.

Anonymous said...

It is our job to make those decisions.
As long as,teachers can block merit based performance ratings. Education is hard to change.
No child left behind. Not all people need education. In all societies there are worker bees.
I am a worker bee no problem with that
The IRS is a travesty but it cant be privatized just fixed.
The post office cant work be ause all the profitable shipping is done privately. As long as they are required to deliver evrryday to every addtess they are doomed to failure
Healthcare is broken because Drs Insurance companies and Big Pharma run it and are the oversight committee
The government is exactly the same way there is no ac ountability for failure

Unknown said...

The biggest problem is probably their obsession with conformity and turning out Pink Floydian sausage people. As you say, not all need the same education and some only need know where to get to laboring and where to cash the check.

There's not much left for the Post Office to do about delivery because personal mail has just about stopped and business mail has gone paperless as much as possible to cut costs. Ultimately the Post Office will go but it shouldn't be from financial swindles in Washington since evolution will do it anyway. Given the proud history of the Post Office it would be so blazing insulting to farm it out to some penny ante huckster for it's last gasp.

Doctors don't run medical care and are frequently overturned by insurance companies.

Anonymous said...

But Drs control how many drs there are. So we need to allow more drs to be made.
Becoming a Dr should be akin to hitting the lottery.
when a dr can force a patient to be seen every 4 weeks or they will not refill a perscription that is abuse.
Or whem my daughter wss in the hodpital after surgery. The surgeon charged $1000. The pediatrician who referred her visited her in the hospital room each day. Less thN 2 minutes each day to say hello and say if everything was fine. Even though I said she was undercthe surgeon care and didnt need his visits. He charged the insurance company $1500 $300 per day
So yes Drs are everu bit a part of the problem

Unknown said...

I sure don't want second-string doctors on the team just to pad out the roster! Some hit the lottery but most don't and the salaries for the majority of doctors aren't that high. I think for a GP, he's likely to be running somewhere around $150K and that's medium to the bottom of executive pay, not anywhere close to CEO.

There are stories like that you can pong back and forth. I have my own. For the first surgery on my shoulder, the bill was somewhere over twenty grand. The surgeon was two grand out of that.

Those kinds of anecdotes don't prove anything and I'm sure you know that.

Anonymous said...

Have it your way Drs are saints and have no accountabilty to the failing system. Move the entire system to the same people that run medicaid and medicare and the VA. It will be a fabulous system.
Research thr number of Drs per year charged with filing false claims with medicare.
I glad that I will not have to live in the world you want to create.
My point on her case was doctors being paid for doing nothing not the total cost.
Hospitals already have a two tier pricing those with insurance and those without.

Unknown said...

They're not all saints and some of tiny minority are dope-selling whores but they're not all trying to break the system for their personal profits either. I would need to know the number of false claims filed, the number of ones which were not false, how many of the false ones were legitimate mistakes, etc. Your brush takes out the entire medical profession so you might want to tighten the focus a tad.

Anonymous said...

In just one case list on the DOJ listed 243 people billing $740M
A drop in the bucket unless you are paying the bill.
My point has been all along that the entire system is rife with issues. So switching to a government control without wholesale changes is pointless.
The left acts like socializing the industry will fix everything
Try emulating the German system since you love all things German
Ask Cat a very simple two tier system

Anonymous said...

In just one case list on the DOJ listed 243 people billing $740M
A drop in the bucket unless you are paying the bill.
My point has been all along that the entire system is rife with issues. So switching to a government control without wholesale changes is pointless.
The left acts like socializing the industry will fix everything
Try emulating the German system since you love all things German
Ask Cat a very simple two tier system

Unknown said...

The Left is operating under reality rather than fantasy from within some ivory tower. I've been ripped off cold by insurance companies and it's not some newspaper exercise. My arm wouldn't do anything if not for Dr Nayak because it was a third necrotized when he went into it. As to medical incompetence, sure. The doctor in Rhode Island who never even looked at my shoulder was the same one who said I wasn't disabled. Some doctors are paid way the hell too much while others aren't paid close to enough. Dismissing all of them as criminals is just Fox News rubbish.

It's not statistics, it's real life and I live it every fucking minute of the day. Defend your corporations all you like but, sorry, I won't be joining you.

Anonymous said...

I havent dismissed all Drs but there are many causing the broken down system. I am not supporting any corporations. I have continually asked for how to fix it and the only retort is I am wrong. I dont care who pays the bill.

Anonymous said...

The German system as I said is fairly viable. The government pays for people earning under 50kDM. And above that they buy private insurance for thier coverage.
It works better than your VA models and is about 30% cheaper.
Defend your government all you want it doesnt work even NASA hires private companies to get the job done and foreign nations.
Because Musk can do it better than they can

Anonymous said...

I sent you a report from New York University giving an average profit percent by industry. Only the Financial Planning Industry break 20% that is because most of them are crooks.
Average corporate taxable profit is as I previously stated about 8-10%