The liberal mythology of healthcare being a right

[niteowl]

I'd like to make a point, if I may.

When Medicare was first proposed, we were told that it would be relatively cheap to provide coverage for the elderly. So cheap, in fact, that no new taxes would be required. The original plan was to pay for Medicare through a small allocation of Social Security tax. In fact, to support this idea, the government projected costs far into the future. They reckoned (in 1965), that by 1990, Medicare costs would still be only $10 billion.

In fact, by 1990, Medicare costs were $107 billion. The government, it turns out, was off by a factor of over 1,000%. Why were they so far off? Well, there were several reasons. (Ask yourself how many of these oversights you would have made yourself.) For one thing, all of their projections were based on medical procedures that were available in 1965 - it hadn't occurred to them, that by 1990, there would be new procedures (new, expensive procedures) that would contribute to longer life expectancies for the elderly. Which is another thing they overlooked - they knew there was about to be a shift in population (that is, that more people would be reaching age 65), but they hadn't considered that new procedures would actually contribute to people living longer. In 1965, average life expectancy was only about 65; by 1990, it was 75. This meant, that while they had anticipated the average person would be eligible for 0 months (since you had to be 65 to file a claim), the average person was eligible for 10 years. Another mistake they made: they forgot that anytime you have a government program, someone (or actually, many people) will work out a scheme to defraud it. Fraud has always been a major component of Medicare costs. Even Obama recognizes that - he's said he wants to eliminate $500 billion in Medicare costs over 10 years. No word on how he plans to do that, just yet. And just for comparison, the total economic loss suffered in the attacks on September 11, amounted to some $55 billion. The loss of life, of course, is incalculable.

Of course, any private insurer that exhibited that level of incompetence would long since have gone out of business, and good riddance to them. But that's where government has an edge - they can't go out of business. They simply raise taxes to cover their incompetence. You've probably realized already, if you receive a paycheck, that Medicare taxes are deducted from it (despite what LBJ and the Democrats in Congress promised us back in 1965.)

So, I've a couple of questions. What is it about our government, given its history, that would make anyone believe that they're capable of spending money responsibly? And why is it, that when medical costs rise, forcing insurance companies to raise their rates, the Left becomes unglued? Yet, when the government raises taxes to pay for those same increased medical costs, that's considered acceptable?

 

[bripat9643]

^ see, seeeething, like you're always in a temper tantrum. Hey, it's entertaining....and it makes your avy so deliciously ironic.

Read your posts and look at your avatar and try not to giggle. No really, just do it.

Are you done whining about my posting style yet?

 

[Bfgrn]

I'd like to make a point, if I may.

When Medicare was first proposed, we were told that it would be relatively cheap to provide coverage for the elderly. So cheap, in fact, that no new taxes would be required. The original plan was to pay for Medicare through a small allocation of Social Security tax. In fact, to support this idea, the government projected costs far into the future. They reckoned (in 1965), that by 1990, Medicare costs would still be only $10 billion.

In fact, by 1990, Medicare costs were $107 billion. The government, it turns out, was off by a factor of over 1,000%. Why were they so far off? Well, there were several reasons. (Ask yourself how many of these oversights you would have made yourself.) For one thing, all of their projections were based on medical procedures that were available in 1965 - it hadn't occurred to them, that by 1990, there would be new procedures (new, expensive procedures) that would contribute to longer life expectancies for the elderly. Which is another thing they overlooked - they knew there was about to be a shift in population (that is, that more people would be reaching age 65), but they hadn't considered that new procedures would actually contribute to people living longer. In 1965, average life expectancy was only about 65; by 1990, it was 75. This meant, that while they had anticipated the average person would be eligible for 0 months (since you had to be 65 to file a claim), the average person was eligible for 10 years. Another mistake they made: they forgot that anytime you have a government program, someone (or actually, many people) will work out a scheme to defraud it. Fraud has always been a major component of Medicare costs. Even Obama recognizes that - he's said he wants to eliminate $500 billion in Medicare costs over 10 years. No word on how he plans to do that, just yet. And just for comparison, the total economic loss suffered in the attacks on September 11, amounted to some $55 billion. The loss of life, of course, is incalculable.

Of course, any private insurer that exhibited that level of incompetence would long since have gone out of business, and good riddance to them. But that's where government has an edge - they can't go out of business. They simply raise taxes to cover their incompetence. You've probably realized already, if you receive a paycheck, that Medicare taxes are deducted from it (despite what LBJ and the Democrats in Congress promised us back in 1965.)

So, I've a couple of questions. What is it about our government, given its history, that would make anyone believe that they're capable of spending money responsibly? And why is it, that when medical costs rise, forcing insurance companies to raise their rates, the Left becomes unglued? Yet, when the government raises taxes to pay for those same increased medical costs, that's considered acceptable?

Herein lies the conservative 'myths' ...your early points are valid, but Medicare is more cost effective than private insurance.

Here is a market-driven entrepreneur.

Bill Brody, M.D. President, Salk Institute for Biomedical Research

Dr. William R. Brody, an acclaimed physician-scientist, entrepreneur and university leader, joined the Salk Institute for Biological Studies on March 2, 2009 after 12 years as president of The Johns Hopkins University.

June 13, 2003

Is Medicare Cost Effective?

I recently spent a half-day in a meeting discussing a number of issues regarding Medicare. Most of us on the provider side of the street view Medicare as this multiheaded bureaucracy with more pages of regulations than the Internal Revenue Service's tax code. However, I came away from the meeting with some (to me at least) shocking revelations:

Medicare beneficiaries are overwhelmingly satisfied with their Medicare coverage, except for the absence of prescription drug benefits;

The administrative costs of Medicare are lower than any other large health plan.

In fact, Medicare is very efficient by any objective means:

According to the Urban Institute's Marilyn Moon, who testified before the Senate Committee on Aging, Medicare expenditures between 1970 and 2000 grew more slowly than those of the private sector. Initially, from 1965 through the 1980s, Medicare and private insurance costs doubled in tandem. Then Medicare tightened up, and per capita expenditures grew more slowly than private insurance, creating a significant gap. In the 1990s, private insurers got more serious about controlling their costs, and the gap narrowed. But by 2000, Medicare per capita expenditures remained significantly lower than the private sector.

Moon argues somewhat convincingly that Medicare has been a success. While not necessarily denying that certain reforms might be needed, she stresses the importance of preserving three essential tenets of the program:

1. Its universal coverage nature creates the ability to redistribute benefits to those who are neediest.

2. It pools risk in order to share the burdens of health care among the healthy and the sick.

3. Through Medicare, the government protects the rights of all beneficiaries to essential health care.

It has been argued that, in part, Medicare's cost effectiveness arises from the fact that it does not need to expend funds on marketing and sales-functions that are obligatory for the success of competitive, private-sector health plans. Moreover, some argue that the competitive model for health insurance has not been successful. In a market-driven economy, the healthy can and will change health plans for savings of only a few dollars a month, while the sick must remain in their existing plan in order to retain their physicians. Such behaviors lead to asymmetric risk pools and cost inequities.

This was all sobering news to a market-driven entrepreneur such as yours truly. However, given the perverse incentives that frequently drive behavior in health care, my take-home lesson is that there are examples in the success of Medicare we can apply to other sectors of our population.


The great enemy of truth is very often not the lie – deliberate, contrived and dishonest – but the myth – persistent, persuasive, and unrealistic. Too often we enjoy the comfort of opinion without the discomfort of thought.
President John F. Kennedy

 

[Listening]

Herein lies the conservative 'myths' ...your early points are valid, but Medicare is more cost effective than private insurance.

How could anyone draw that conclusion from this post ?

Cost effective in what regard ? On a unit basis ?

And there are no rights to essential health care. You don't have those rights when you are 30 and group rights are not rights...they are special interests.

 

[bripat9643]

Herein lies the conservative 'myths' ...your early points are valid, but Medicare is more cost effective than private insurance.

How could anyone draw that conclusion from this post ?

Cost effective in what regard ? On a unit basis ?

And there are no rights to essential health care. You don't have those rights when you are 30 and group rights are not rights...they are special interests.

Yep, it's hard to know what the term "more cost effective" means without some details. Sure, it doesn't spend a lot of money writing checks, that's why there is so much fraud in the program. Does this guy include all the fraud in his "analysis?"

Second: A lot of the expenses of the private healthcare system are imposed by the government, like treating people in the emergency room who can't pay. Government also limits the number of hospitals in any given local, so that drives up the cost of hospital stays. The list of government regulations that drive up the cost of private medical care is endless.

What exactly is being compared?

 

[Bfgrn]

Herein lies the conservative 'myths' ...your early points are valid, but Medicare is more cost effective than private insurance.

How could anyone draw that conclusion from this post ?

Cost effective in what regard ? On a unit basis ?

And there are no rights to essential health care. You don't have those rights when you are 30 and group rights are not rights...they are special interests.

Dis you READ it?

Medicare is very efficient by any objective means:

Medicare expenditures between 1970 and 2000 grew more slowly than those of the private sector. Initially, from 1965 through the 1980s, Medicare and private insurance costs doubled in tandem. Then Medicare tightened up, and per capita expenditures grew more slowly than private insurance, creating a significant gap. In the 1990s, private insurers got more serious about controlling their costs, and the gap narrowed. But by 2000, Medicare per capita expenditures remained significantly lower than the private sector.

 

[Listening]

Herein lies the conservative 'myths' ...your early points are valid, but Medicare is more cost effective than private insurance.

How could anyone draw that conclusion from this post ?

Cost effective in what regard ? On a unit basis ?

And there are no rights to essential health care. You don't have those rights when you are 30 and group rights are not rights...they are special interests.

Dis you READ it?

Medicare is very efficient by any objective means:

Medicare expenditures between 1970 and 2000 grew more slowly than those of the private sector. Initially, from 1965 through the 1980s, Medicare and private insurance costs doubled in tandem. Then Medicare tightened up, and per capita expenditures grew more slowly than private insurance, creating a significant gap. In the 1990s, private insurers got more serious about controlling their costs, and the gap narrowed. But by 2000, Medicare per capita expenditures remained significantly lower than the private sector.

Yes, Medicare got so efficient that:

The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.

Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said.

“We firmly believe that Medicare needs to be reformed,” Yardley said in a Dec. 23 e-mail. “It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.”

Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients “to see if it could have implications beyond Arizona,” he said.

» Mayo Clinic to Stop Accepting Medicare Patients - Big Government

And this is going to happen more and more.

 

[francoHFW]

Health costs doubled just under Boosh. Finally ACA gives us some contol over health costs and abuses, with much more to come...

 

[Bfgrn]

How could anyone draw that conclusion from this post ?

Cost effective in what regard ? On a unit basis ?

And there are no rights to essential health care. You don't have those rights when you are 30 and group rights are not rights...they are special interests.

Dis you READ it?

Medicare is very efficient by any objective means:

Medicare expenditures between 1970 and 2000 grew more slowly than those of the private sector. Initially, from 1965 through the 1980s, Medicare and private insurance costs doubled in tandem. Then Medicare tightened up, and per capita expenditures grew more slowly than private insurance, creating a significant gap. In the 1990s, private insurers got more serious about controlling their costs, and the gap narrowed. But by 2000, Medicare per capita expenditures remained significantly lower than the private sector.

Yes, Medicare got so efficient that:

The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.

Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said.

“We firmly believe that Medicare needs to be reformed,” Yardley said in a Dec. 23 e-mail. “It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.”

Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients “to see if it could have implications beyond Arizona,” he said.

» Mayo Clinic to Stop Accepting Medicare Patients - Big Government

And this is going to happen more and more.

That is great news. Just more reason we need to go to a single payer. THEN, if doctors don't like it, they can move to Zimbabwe.

High health care costs
Who's to blame?

Health-cost trends shows that these players, in roughly descending order, contributed the most to rising costs:

Hospitals and doctors. Doctors and hospitals account for by far the largest share, 52 percent in 2006, of all national health spending. There's abundant evidence that some of that spending is unnecessary. Under the present system, hospitals and doctors earn more money by doing costly interventions than by keeping people healthy. And more medical care doesn't necessarily mean better care, according to research on Medicare expenditures by the Dartmouth Medical School's Institute for Health Policy and Clinical Practice.

Drug companies. Prescription drugs account for only one-tenth of total health-care expenditures. But drug spending has increased as a share of overall expenditures over the past decade.

Insurance companies. Health-insurance premiums have grown faster than inflation or workers' earnings over the past decade, in parallel with the equally rapid rise in overall health costs. Industry spending on administrative and marketing costs, plus profits, consumes 12 percent of private-insurance premiums.

Politicians and government regulators. Although the government directly controls only 46 percent of national health spending, many of its policies affect the bottom line of the health-care industry, for example, by setting Medicare reimbursement rates for doctors on which private insurers base their rates, or by regulating health insurance. Between 1999 and 2006, the health-care lobby spent more than any other business sector, according to a study by the Institute for Health & Socio-Economic Policy, a nonprofit policy and research group.

Lawyers. Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office. Defensive medicine, the practice of ordering extra tests or procedures to protect against lawsuits, might add another few percentage points, according to some estimates.

Health-care consumers.

Health-care security, who is to blame for high costs

 

[Listening]

That is great news. Just more reason we need to go to a single payer. THEN, if doctors don't like it, they can move to Zimbabwe.

Brilliant...

There is going to be a shortage as there is....

Just brilliant....

You must work for the administration.

 

[Listening]

Health costs doubled just under Boosh. Finally ACA gives us some contol over health costs and abuses, with much more to come...

Love it.

"Control"

What a joke.

 

[Bfgrn]

That is great news. Just more reason we need to go to a single payer. THEN, if doctors don't like it, they can move to Zimbabwe.

Brilliant...

There is going to be a shortage as there is....

Just brilliant....

You must work for the administration.

When I was growing up, doctors made house calls. They were upper middle class people who lived in our neighborhood.

Now, they don't have an office in their house or in a moderate office building, they have become profit centers where over-utilization is the GOAL. WHY should doctors and hospitals get a free pass? Is it because of the involuntary conservative Monica Lewinsky response towards people they worship? Doctors get away with murder, literally.

247 Americans Die Every Day from Doctors not Washing Their Hands


A Conversation With Dr. Peter J. Pronovost
[URL="http://www.nytimes.com/2010/03/09/science/09conv.html?hpw"]Doctor Leads Quest for Safer Ways to Care for Patients[/URL]

Q. WASH YOUR HANDS? DON’T DOCTORS AUTOMATICALLY DO THAT?

A. National estimates are that we wash our hands 30 to 40 percent of the time. Hospitals working on improving their safety records are up to 70 percent. Still, that means that 30 percent of the time, people are not doing it.

At Hopkins, we tested the checklist idea in the surgical intensive care unit. It helped, though you still needed to do more to lower the infection rate. You needed to make sure that supplies — disinfectant, drapery, catheters — were near and handy. We observed that these items were stored in eight different places within the hospital, and that was why, in emergencies, people often skipped steps. So we gathered all the necessary materials and placed them together on an accessible cart. We assigned someone to be in charge of the cart and to always make sure it was stocked. We also instituted independent safeguards to make certain that the checklist was followed.

We said: “Doctors, we know you’re busy and sometimes forget to wash your hands. So nurses, you are to make sure the doctors do it. And if they don’t, you are empowered to stop takeoff on a procedure.”

Q. HOW DID THAT FLY?

A. You would have thought I started World War III! The nurses said it wasn’t their job to monitor doctors; the doctors said no nurse was going to stop takeoff. I said: “Doctors, we know we’re not perfect, and we can forget important safety measures. And nurses, how could you permit a doctor to start if they haven’t washed their hands?” I told the nurses they could page me day or night, and I’d support them. Well, in four years’ time, we’ve gotten infection rates down to almost zero in the I.C.U.

We then took this to 100 intensive care units at 70 hospitals in Michigan. We measured their infection rates, implemented the checklist, worked to get a more cooperative culture so that nurses could speak up. And again, we got it down to a near zero. We’ve been encouraging hospitals around the country to set up similar checklist systems.

Q. WHAT EXACTLY WAS WRONG HERE?

A. As at many hospitals, we had dysfunctional teamwork because of an exceedingly hierarchal culture. When confrontations occurred, the problem was rarely framed in terms of what was best for the patient. It was: “I’m right. I’m more senior than you. Don’t tell me what to do.”

Doctor-Caused Disease

HOSPITAL INFECTIONS

In the 1840's Dr. Ignaz Semmelweis directed a teaching hospital in Vienna, where 75% of the women giving birth were dying of puerperal fever. He observed that doctors went from dissecting cadavers to delivering babies without washing their hands. Dr. Semmelweis made the "radical" policy change of requiring doctors to wash their hands before delivery a baby. An amazing thing happened - the mortality rate drop fifteen-fold. Unfortunately, his arrogant colleagues couldn't see the connection, so they dismissed him and ostracized him. The rejection ultimately drove Semmelweis to death in an insane asylum - another great moment in the history of iatrogenic disease.

But doctors are enlightened nowadays about sanitation, aren't they? A 1981 study of washing habits in intensive care units found that only 28% of the doctors washed between patients in a teaching hospital and only 14% washed in the private hospital! Dr. Mendelsohn noted:

. . . the sanitary practices of the medical personnel are often abominable and the hospital itself is probably the most germ-laden facility in town.

Your chances of getting an infection in the hospital are one in 20 with 15,000 people dying annually from hospital-acquired infections.

Doctor and Patient
Why Don’t Doctors Wash Their Hands More?
By PAULINE W. CHEN, M.D.
Published: September 17, 2009

Over the last 30 years, despite countless efforts at change, poor hand hygiene has continued to contribute to the high rates of infections acquired in hospitals, clinics and other health care settings. According to the World Health Organization, these infections affect as many as 1.7 million patients in the United States each year, racking up an annual cost of $6.5 billion and contributing to more than 90,000 deaths annually.


"Harry Truman once said, 'There are 14 or 15 million Americans who have the resources to have representatives in Washington to protect their interests, and that the interests of the great mass of the other people - the 150 or 160 million - is the responsibility of the president of the United States, and I propose to fulfill it.'"
President John F. Kennedy

 

[dblack]

When I was growing up, doctors made house calls. They were upper middle class people who lived in our neighborhood.

Now, they don't have an office in their house or in a moderate office building, they have become profit centers where over-utilization is the GOAL. WHY should doctors and hospitals get a free pass? Is it because of the involuntary conservative Monica Lewinsky response towards people they worship? Doctors get away with murder, literally.

247 Americans Die Every Day from Doctors not Washing Their Hands
...

Uh... good point?

???

 

[The T]

Health costs doubled just under Boosh. Finally ACA gives us some contol over health costs and abuses, with much more to come...

Love it.

"Control"

What a joke.

And control is the point of government...that has no business in this.

 

[Bfgrn]

When I was growing up, doctors made house calls. They were upper middle class people who lived in our neighborhood.

Now, they don't have an office in their house or in a moderate office building, they have become profit centers where over-utilization is the GOAL. WHY should doctors and hospitals get a free pass? Is it because of the involuntary conservative Monica Lewinsky response towards people they worship? Doctors get away with murder, literally.

247 Americans Die Every Day from Doctors not Washing Their Hands
...

Uh... good point?

???

Why shouldn't there be more scrutiny of doctors and hospitals? Or aren't we allowed to question the 'masters'?

Doctors and hospitals account for by far the largest share, 52 percent in 2006, of all national health spending. There's abundant evidence that some of that spending is unnecessary. Under the present system, hospitals and doctors earn more money by doing costly interventions than by keeping people healthy. And more medical care doesn't necessarily mean better care, according to research on Medicare expenditures by the Dartmouth Medical School's Institute for Health Policy and Clinical Practice.

 

[Dr Grump]

Freedom isn't a list of things you can do, it's a state of being unhindered. Political freedom is a state of being unhindered by other people. This is why many of the founders were opposed to the Bill of Rights, and why the ninth amendment was added. The radical claim of the DOI was that governments are created to protect, as much possible, that natural state of freedom.

Even only a couple hundred years later, we seem to have lost the context of why their claim was so revolutionary. They were literally turning the status-quo upside down. Their idea of rights wasn't an explicit list of privileges granted to the people by government (the king). They claimed all freedom for the people and instead defined the power of government to limit that freedom with an explicit list of powers - powers granted to government by the people.

This is why it's so frustrating to hear health care, education, or any other goods and services described as "rights". It obfuscates the profound and novel conception of rights that our country is based on. I don't think it's deliberate. I think what people really mean, when they say "health care is a right", is that we should provide it via government as a taxpayer provided service (like the schools, fire depts, etc...).

And that is my point i guess. Who decides what is unhindered? What you might consider unhindered other might see as obstructionist. For example, you own land that has a river running through it that has enough to feed the farms around him. A farmer nearby wants to use the water to water his crops, but the other farmer who has access to the river says no, just because he can. Somebody's 'freedom' is being hindered.

As for the bolded part above. Maybe that is what people really mean. And there's nothing wrong with that...

 

[chikenwing]

For the sake of this post let's pretend you're right (which you're not).

Every right I can think of involves 2 paths. One to exercise it and one to deny it. Obamacare does the exact opposite. It FORCES you to exercise this so called right. So in essence it oppresses an individuals personal rights to decide for themselves.

You've all been claiming that healthcare is a right so exactly how does this law aid me in EXERCISING my rights? It doesn't, it FORCES me to take a path I may not want to take.

Where is my RIGHT to choose if Obama doesn't offer me a waiver like all his rich friends?

You have a waiver, simply go to Canada, Mexico or Somalia when you need medical care. Don't want to pay for something you will one day need that's fine with me and I'm sure it's fine with public hospitals too.

Maybe you and others like you need a medical bracelet with this inscription: "I'm too stupid to buy medical insurance I will one day need, please do not treat me; if you do I will not pay but I will sue you".

Of course you'll demand the governemnt pay for your bracelet.

There are many that just can't afford 1000+ every month call people stupid for not wanting to be forced to payout large percentages of income?? Health care costs haven't gone down and won't,but we will bleed people dry and feel good about it.

The same group that cry's a river about the big bad insurance companies,want to hand them 40+ million more forced customers??

 

[dblack]

Freedom isn't a list of things you can do, it's a state of being unhindered. Political freedom is a state of being unhindered by other people. This is why many of the founders were opposed to the Bill of Rights, and why the ninth amendment was added. The radical claim of the DOI was that governments are created to protect, as much possible, that natural state of freedom.

Even only a couple hundred years later, we seem to have lost the context of why their claim was so revolutionary. They were literally turning the status-quo upside down. Their idea of rights wasn't an explicit list of privileges granted to the people by government (the king). They claimed all freedom for the people and instead defined the power of government to limit that freedom with an explicit list of powers - powers granted to government by the people.

This is why it's so frustrating to hear health care, education, or any other goods and services described as "rights". It obfuscates the profound and novel conception of rights that our country is based on. I don't think it's deliberate. I think what people really mean, when they say "health care is a right", is that we should provide it via government as a taxpayer provided service (like the schools, fire depts, etc...).

And that is my point i guess. Who decides what is unhindered? What you might consider unhindered other might see as obstructionist. For example, you own land that has a river running through it that has enough to feed the farms around him. A farmer nearby wants to use the water to water his crops, but the other farmer who has access to the river says no, just because he can. Somebody's 'freedom' is being hindered.

If your point is that government exists to resolve disputes when rights come into conflict, that's certainly uncontroversial. I agree completely. That's the whole point of having it.

As for the bolded part above. Maybe that is what people really mean. And there's nothing wrong with that...

Obviously, I disagree. Which is why I'm raising a fuss here. When people say one thing, but mean another, it leads to problems. With casual followers of politics, its relatively benign. But for leaders like Bernie Sanders to make such claims is inexcusable. He knows better and is deliberately equivocating on the term to avoid making a real case for government provided health care.

It's generally understood that, as a fundamental purpose, the government is there to protect our rights. So Sanders, and others pursuing this angle, hope to have the "health care is a right" mantra accepted uncritically by voters. Once a majority accept the notion it makes it much easier to push through their plans for centralizing health care under government control. They can do so without proving why it is necessary, or a even good idea, by simply falling back on the (erroneous) assumption that health care is a right.

 

[niteowl]

I've never heard of Dr. Brody, but I can tell you this: he didn't write this quote -

The administrative costs of Medicare are lower than any other large health plan.

This came straight from the Medicare Administration's own propaganda mill.

You see, Medicare doesn't process it's own claims; all it does, is create rules. All of the actual work involved (data entry, processing, adjudicating and paying claims), is done by contractors. So, shouldn't that work be called "Administrative costs"?

Not according to the government. No, the government considers those activities to be "Contractor fees", and aren't included in Administrative costs. Administrative costs, it turns out, include only government salaries, benefits, and expenses for its own staff.

What happens is, Medicare claims are forwarded to the contractor - say, Blue Cross. Blue Cross enters the claim, processes it (for which a small fee is charged, whether the claim is paid or denied), adjudicates it (either accepts it, or contacts the provider for additional information), and then pays the claim (if the claim is paid, a huge fee is attached again). Typically, hundreds of people are employed to perform these many and varied functions. Which is very similar to what happens to a typical Blue Cross claim filed from a policyholder. But, by denying that processing and paying claims is part of administrative costs, Medicare manages to make themselves look good, at the expense of private insurers.

Is that deceptive? Yep. You bet it is.

 

[Greenbeard]

You see, Medicare doesn't process it's own claims; all it does, is create rules. All of the actual work involved (data entry, processing, adjudicating and paying claims), is done by contractors. So, shouldn't that work be called "Administrative costs"?

Not according to the government. No, the government considers those activities to be "Contractor fees", and aren't included in Administrative costs. Administrative costs, it turns out, include only government salaries, benefits, and expenses for its own staff.

Open a trustees report sometime. You'll note that every listing of "Salaries and expenses, CMS" is accompanied by a footnote clarifying that this line "Includes administrative expenses of the carriers and intermediaries."