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On January 13 2017 05:44 farvacola wrote:You're conflating issues and therein lies the problem. There is a lot of administrative bloat in healthcare, but if you actually start allocating culpability in a meaningful manner, it'll become readily apparent that cost inflation runs in both directions at the same time. For example, it is true that administrative complexity adds to costs unnecessarily, but a large component of that administrative complexity can be attributed to the extreme limits placed on federal program implementation via Supreme Court 10th and 11th Amendment jurisprudence. There's reason to believe that the PPACA would have worked far better at tamping down prices had the Supreme Court upheld the practically mandatory Medicare expansion that came with the law, but alas, our collective decision to lionize the states above the feds renders that an unexplored conclusion. Naturally, that's a contentious subject, but it's a mistake to look at the bloat in healthcare and chalk it all up to public bureaucracy from the top down. In any case, any sort of "basic economic intuition" needs to be heavily disclaimed relative to healthcare.
Either you missed my point, or I'm not understanding you. So let's start with a basic statement which you can affirm or deny: Because of the economy of scale, if there was only one corporation/government system handling every person's health care, the total costs of it would decrease. (That doesn't mean necessarily that the costs to any particular individual would drop, just that the base amount of money required to give coverage for each person is less.) True or false?
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I realize now that you were likely saying mostly the same thing I was, namely that there is a good argument behind pinning a lot of the administrative bloat in healthcare on private and not public behavior. So, while I'm not a big fan of generalized rules like the one you posted, I do think its true.
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On January 13 2017 12:33 Nyxisto wrote:
This woman is apparently going to be "senior director of strategic communications for the National Security Council", please tell me that job is less important than it sounds. The fuck
I facepalmed so hard my hand almost broke.
What the hell!?... I mean, how stupid does one need to be to tweet something like that?
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On January 13 2017 22:31 Biff The Understudy wrote:I facepalmed so hard my hand almost broke. What the hell!?... I mean, how stupid does one need to be to tweet something like that?
That's why I think it's a troll. Now we can have a discussion whether whatever fancy title she's getting should be trolling people on twitter, but I'd rather she's an internet troll than extremely dumb. I will go against Hanlon's razor here and say she's just being evil, rather than stupid. And that fits well with my view of the NSA as evil incarnate, so huzzah for me.
Did I sound a bit like opisska there? I think I did... and it scares me 
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On January 13 2017 22:25 LightSpectra wrote:
Either you missed my point, or I'm not understanding you. So let's start with a basic statement which you can affirm or deny: Because of the economy of scale, if there was only one corporation/government system handling every person's health care, the total costs of it would decrease. (That doesn't mean necessarily that the costs to any particular individual would drop, just that the base amount of money required to give coverage for each person is less.) True or false?
true. next?
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Never underestimate the reality distortion field of anyone associated with the Trump campaign or administration (see: Katrina Pierson).
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On January 13 2017 22:25 LightSpectra wrote:Show nested quote +On January 13 2017 05:44 farvacola wrote:You're conflating issues and therein lies the problem. There is a lot of administrative bloat in healthcare, but if you actually start allocating culpability in a meaningful manner, it'll become readily apparent that cost inflation runs in both directions at the same time. For example, it is true that administrative complexity adds to costs unnecessarily, but a large component of that administrative complexity can be attributed to the extreme limits placed on federal program implementation via Supreme Court 10th and 11th Amendment jurisprudence. There's reason to believe that the PPACA would have worked far better at tamping down prices had the Supreme Court upheld the practically mandatory Medicare expansion that came with the law, but alas, our collective decision to lionize the states above the feds renders that an unexplored conclusion. Naturally, that's a contentious subject, but it's a mistake to look at the bloat in healthcare and chalk it all up to public bureaucracy from the top down. In any case, any sort of "basic economic intuition" needs to be heavily disclaimed relative to healthcare. Either you missed my point, or I'm not understanding you. So let's start with a basic statement which you can affirm or deny: Because of the economy of scale, if there was only one corporation/government system handling every person's health care, the total costs of it would decrease. (That doesn't mean necessarily that the costs to any particular individual would drop, just that the base amount of money required to give coverage for each person is less.) True or false?
Neither false nor true.
The administrative costs match the complexity of the system. So unless the government also manages medical research, technology research, and healthcare application (hospitals and doctors also become government controlled) then you will simply need a similar sized administrative body to deal with the still private industry of drug research, machine research, doctors fees, hospital fees, etc...
Those different organizations will also compensate to match in order to not decrease their yearly income, which will translate to a steep shift upwards in costs. Not because it "costs" more, but because Capitalism encourages them to have continual upwards earnings.
If the entire process was run by one body: Healthcare Costs, Healthcare Research, Healthcare Application, Healthcare Infrastructure... then yes, it would be cheaper overall.
But unifying one portion of that web of industries would not reduce costs in and of itself.
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it's worth pointing out that a pure percentage comparison isn't quite right, since CMS spends quite a bit more per patient (understandably so due to the covered population being sick, elderly, disabled, etc.) which helps drive up the medical spend portion of total expense. iirc estimates are like 50-100% more? it doesn't explain the entire gap in admin cost burden, but is definitely a factor.
equally, CMS reimbursement rates are kinda lousy and most providers don't want to have to deal with 'em.
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On January 13 2017 23:56 Thieving Magpie wrote:Show nested quote +On January 13 2017 22:25 LightSpectra wrote:On January 13 2017 05:44 farvacola wrote:You're conflating issues and therein lies the problem. There is a lot of administrative bloat in healthcare, but if you actually start allocating culpability in a meaningful manner, it'll become readily apparent that cost inflation runs in both directions at the same time. For example, it is true that administrative complexity adds to costs unnecessarily, but a large component of that administrative complexity can be attributed to the extreme limits placed on federal program implementation via Supreme Court 10th and 11th Amendment jurisprudence. There's reason to believe that the PPACA would have worked far better at tamping down prices had the Supreme Court upheld the practically mandatory Medicare expansion that came with the law, but alas, our collective decision to lionize the states above the feds renders that an unexplored conclusion. Naturally, that's a contentious subject, but it's a mistake to look at the bloat in healthcare and chalk it all up to public bureaucracy from the top down. In any case, any sort of "basic economic intuition" needs to be heavily disclaimed relative to healthcare. Either you missed my point, or I'm not understanding you. So let's start with a basic statement which you can affirm or deny: Because of the economy of scale, if there was only one corporation/government system handling every person's health care, the total costs of it would decrease. (That doesn't mean necessarily that the costs to any particular individual would drop, just that the base amount of money required to give coverage for each person is less.) True or false? Neither false nor true. The administrative costs match the complexity of the system. So unless the government also manages medical research, technology research, and healthcare application (hospitals and doctors also become government controlled) then you will simply need a similar sized administrative body to deal with the still private industry of drug research, machine research, doctors fees, hospital fees, etc... Those different organizations will also compensate to match in order to not decrease their yearly income, which will translate to a steep shift upwards in costs. Not because it "costs" more, but because Capitalism encourages them to have continual upwards earnings. If the entire process was run by one body: Healthcare Costs, Healthcare Research, Healthcare Application, Healthcare Infrastructure... then yes, it would be cheaper overall. But unifying one portion of that web of industries would not reduce costs in and of itself.
But we're not talking about actual medical care, equipment, research, training, or any of that. We're talking about exactly one thing, which is insurance. In every country with single-payer UHC, everybody is insured by the same source. In America, there's dozens of providers, which means due to the economies of scale, the net cost per capita is higher.
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On January 14 2017 00:15 LightSpectra wrote:Show nested quote +On January 13 2017 23:56 Thieving Magpie wrote:On January 13 2017 22:25 LightSpectra wrote:On January 13 2017 05:44 farvacola wrote:You're conflating issues and therein lies the problem. There is a lot of administrative bloat in healthcare, but if you actually start allocating culpability in a meaningful manner, it'll become readily apparent that cost inflation runs in both directions at the same time. For example, it is true that administrative complexity adds to costs unnecessarily, but a large component of that administrative complexity can be attributed to the extreme limits placed on federal program implementation via Supreme Court 10th and 11th Amendment jurisprudence. There's reason to believe that the PPACA would have worked far better at tamping down prices had the Supreme Court upheld the practically mandatory Medicare expansion that came with the law, but alas, our collective decision to lionize the states above the feds renders that an unexplored conclusion. Naturally, that's a contentious subject, but it's a mistake to look at the bloat in healthcare and chalk it all up to public bureaucracy from the top down. In any case, any sort of "basic economic intuition" needs to be heavily disclaimed relative to healthcare. Either you missed my point, or I'm not understanding you. So let's start with a basic statement which you can affirm or deny: Because of the economy of scale, if there was only one corporation/government system handling every person's health care, the total costs of it would decrease. (That doesn't mean necessarily that the costs to any particular individual would drop, just that the base amount of money required to give coverage for each person is less.) True or false? Neither false nor true. The administrative costs match the complexity of the system. So unless the government also manages medical research, technology research, and healthcare application (hospitals and doctors also become government controlled) then you will simply need a similar sized administrative body to deal with the still private industry of drug research, machine research, doctors fees, hospital fees, etc... Those different organizations will also compensate to match in order to not decrease their yearly income, which will translate to a steep shift upwards in costs. Not because it "costs" more, but because Capitalism encourages them to have continual upwards earnings. If the entire process was run by one body: Healthcare Costs, Healthcare Research, Healthcare Application, Healthcare Infrastructure... then yes, it would be cheaper overall. But unifying one portion of that web of industries would not reduce costs in and of itself. But we're not talking about actual medical care, equipment, research, training, or any of that. We're talking about exactly one thing, which is insurance. In every country with single-payer UHC, everybody is insured by the same source. In America, there's dozens of providers, which means due to the economies of scale, the net cost per capita is higher.
No, what I am saying is that none of the health insurance companies only do insurance and hence has to teams that match. The ones that are related to only insurance are working in a different market and hence there are different forces that affects them, those forces are affected by the markets they are trying to interact in.
For example: Kaiser is both a hospital and a health insurance provider--so it will always have more administrative costs than a pure insurance service provider because they need people to manager the non-insurance portion of their businesses. And that's the same for all other insurance providers. Since they are private businesses, they spend as much time managing research teams, product teams, and product diversification projects as they do just providing healthcare.
So no, I do not think the actual administrative costs of running and maintaining a health insurance system will go down, but the current admin costs of the other projects in current health insurance companies would go away. Hence why I said neither yes or no.
Now if the entire process was unified, and we put all research, hospitals, and insurance under one roof--then the administrative costs of healthcare as a whole will go down.
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You'd have to substantiate that claim. There are more countries with private health insurance and they all have lower costs than the US.
Economies of scales doesn't automatically make something cheaper. If that were the case we'd be most efficient with monopolies in every sector.
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I don't know what's complicated about this.
If I print 100 copies of book X, the cost for each one is $2. If I print 1,000 copies of the same book, the cost to print each one is $1.75, because of the efficiency of automation of scale. What's cheaper, then? Have 10 factories that each print 100 copies, or have 1 factory that prints the 1,000 copies? The former's total cost to society is $2,000. The latter is $1,750. Therefore, by consolidating all the factories, we have a net gain of the difference between the two, i.e. $250.
It's true that competition can cause a company to cut costs, or improve quality, in places where a state-run industry might not--and that might be a great argument for privatized medical care. But for medical insurance, the micro-efficiencies that are gained from a dozen private companies is massively dwarfed by the economy of scale, when you factor in how much all of the lawyers and IT and bureaucrats and lobbyists and advertisers costs.
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On January 14 2017 00:23 RvB wrote:
You'd have to substantiate that claim. There are more countries with private health insurance and they all have lower costs than the US.
Economies of scales doesn't automatically make something cheaper. If that were the case we'd be most efficient with monopolies in every sector.
You're conflating some things that can't be conflated. A monopoly is bad because it is profit driven. Even if you remove profit from the equation a monopoly can be bad if it doesn't incentivize innovation.
In health insurance, for instance, innovation would be focusing more on preventive care. Some of the more interesting developments in health insurance are actually from private insurances that try to offer discounts for not having some known unhealthy habits (smoking and drinking mostly, but eating habits is also being investigated... however it's all rather hard to prove). But in general, preventive medicine is underfunded by insurances who seem to prefer to pay for a coronary bypass than an annual checkup on cholesterol levels (and other indicators).
But the actual cost of administration would go down in a monopoly simply by cutting out redundancies. And in health insurance that seems to be what people are looking at right now, a massive overhead cost, so single payer (a monopoly) would make it cheaper. That there are other ways of making health insurance cheaper doesn't counter that point.
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Canada8990 Posts
On January 13 2017 22:31 Biff The Understudy wrote:I facepalmed so hard my hand almost broke. What the hell!?... I mean, how stupid does one need to be to tweet something like that?
I'm so confuse, I keep trying to make sense of it but it's just stupid all around. It just sound like a troll a democrat would make, if he want to joke about Trump idea... Unless she think the wall of Berlin protected Europe from socialist (And I really can't belive she would be that ignorant). I really don't see how talking about a wall build by communist, universally talk about as a catastrophy and the representation of the fall and defeat of an entire regime is somehow an argument to build another one. I would understand if it was like the Israel wall, even how stupid it is it would make sense since the wall didn't fall
Maybe she was just talking about the drawing on the wall and how it work to make good picture?
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United States15743 Posts
lol @ Cory Booker voting against Canadian medicine. The disconnect within the democratic party is insane. To think they are trying to groom this guy for a presidential run, while completely shitting on any hope of a positive image in the eyes of young democrats.
Cory Booker - GTFO
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If my Facebook is any indication, even moderate Democrats are onto Booker's con game, so I'm hopeful.
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Can't imagine this train wreck of an ego will blow up in foreign policy down the road...we can only cross our fingers that Trump voters' incredible gamble won't end in disaster. They are certainly to blame if it happens, because it was predictable.
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House Speaker Paul Ryan was asked point-blank Thursday by a woman whose parents brought her to the US as an undocumented immigrant at age 11, and who has remained in the country for 21 years since: "Do you think that I should be deported?"
"I can see that you love your daughter and you're a nice person who has a great future ahead of you, and I hope your future's here," Ryan responded during a CNN town hall in Washington moderated by Jake Tapper.
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Tapper asked Ryan if Republicans would seek a law barring the federal government from using information submitted by those allowed to remain in the US through Obama's executive actions to deport those individuals.
Ryan responded that though some fear a deportation force, "it's not happening."
Tapper responded that Trump had actually talked of creating a "deportation force" on the campaign trail.
"I know, I know," Ryan said, laughing. "But I'm here to tell you, in Congress, it's not happening."
CNN
Now tell me, why did Trump call for a deportation force for all illegals? Reasonable people don't want it. Racist people do.
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LOL
But hey she has a point, walls DO work, am I right?
Holy shit who the fuck is this person
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I still can't believe Trump is so unhinged as to believe anyone will care what Russia has to say about the subject of them having compromising material on him (in every potential reality they would say they don't, save one where they are acting wholly irrationally). Maybe he thinks Americans actually cannot think about something for more than 1 second or exercise rudimentary logic.
Also, it's fucking hilarious he said "Russia says nothing exists. Probably..." because he's using a shit medium.
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EPT
