stdreb27
Active Member
Originally Posted by Suzy
http:///forum/post/2515260
And I'm still waiting for a government program that is more efficient than it was in the private sector...
Medicare vs Private Insurance
Medicare:
*Covers the sickest, oldest patients. A large percentage of our health care costs are spent on the last few weeks of life. Medicare is the primary insurance for this group.
*Has deductibles, has premiums, has limitations.
*Has no CEO, no CM (they do have few auditors).
*Pays their bills as long as the provider follows the rules, that are written in stone.
Private insurance companies:
*Covers the healthiest portion of our population.
*Have CEOs who make enormous salaries.
*Have CMs who get large bonuses for denying care to patients.
*Have administration costs for each one.
*Providers must have staff that is able to prove to the CMs that pts need care, every day, adding more to the cost of care.
*Coverage is limited to a certain length of time.
Provider payments are very similar.
If only it was solvent
the problem is that market controls caused the problem, more market controls aren't the solution.
Because in a way an insurance company and the way it operates is similar to the way the government operates when you plug it into an economic model. It sets a fixed price. It takes money from everyone and redistributes it to the user of the service and most don't use as much as they pay in. So in a way, you have seen a small case study in a single payer system.
http:///forum/post/2515260
And I'm still waiting for a government program that is more efficient than it was in the private sector...
Medicare vs Private Insurance
Medicare:
*Covers the sickest, oldest patients. A large percentage of our health care costs are spent on the last few weeks of life. Medicare is the primary insurance for this group.
*Has deductibles, has premiums, has limitations.
*Has no CEO, no CM (they do have few auditors).
*Pays their bills as long as the provider follows the rules, that are written in stone.
Private insurance companies:
*Covers the healthiest portion of our population.
*Have CEOs who make enormous salaries.
*Have CMs who get large bonuses for denying care to patients.
*Have administration costs for each one.
*Providers must have staff that is able to prove to the CMs that pts need care, every day, adding more to the cost of care.
*Coverage is limited to a certain length of time.
Provider payments are very similar.
If only it was solvent
the problem is that market controls caused the problem, more market controls aren't the solution.
Because in a way an insurance company and the way it operates is similar to the way the government operates when you plug it into an economic model. It sets a fixed price. It takes money from everyone and redistributes it to the user of the service and most don't use as much as they pay in. So in a way, you have seen a small case study in a single payer system.
