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Resolution/Claims adjustment/Administrative Costs:
posted by UMRBlog @ 07:35
22 comments
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22 Comments:
Why do people rag on the Post Office so much? I've never quite understood that. When I think inefficiency in the government I think Pentagon- the folks that gave us "Hurry up and wait"
You've fallen prey to fuzzy math. On a per-person basis Medicare's administrative costs are actually higher than those of private insurance
0959,
Your statement is correct but inconsequential. It deals with dollar amounts among older adults and compares them to rates for groups including healthy twenty-five-year-olds. Three percent of the pot still leaves 97 percent of the pot for patients.
0921,
And the $5500 screwdriver and the $4500 toilet seat. Fair Point.
TYBFCB
I think the other comment is quite "consequential".
If private insurers insured all healthy people, administrative costs would be 100%. If they had all elderly that had knee surgeries and various extended hospital visits, the increase in payouts would bring down the costs you listed as a percentage of total, but the costs would remain the same.
Besides that, Medicare is supported by other parts of the government, eg. the Treasury to collect taxes. One estimate says adding those costs in would double that 3% number (which is meaningless anyway, unless you know, 3% of what?)
The government's lack of "due diligence" also allows a ton of fraud. Even the mafia is getting in on the "scam Medicare game".
This article debunks your point ... nice try though.
http://rossputin.com/blog/index.php/taking-apart-the-medicare-efficiency-myt
1:12 PM, December 08, 2009
You really believe 97% goes to patients?
It's not inconsequential. Given the same dollar amounts and the same demographics, what would that percentage look like if the private sector handled it? You also don't take into account the massive fraud that takes place in Medicare. Apples and oranges little buddy.
1354,
I'll look at your article but your argument is difficult for me to follow. I guess you're postulating that healthy people have zero medical costs.
TYFCB
1359,
I believe that the Director of the Cleveland Clinic believes it. That's pretty learned analysis.
TYFCB
1421,
And you know the difference in private insurance fraud and medicare (as opposed to Medicaid) fraud?
TYFCB
Private sector watches efficiencies and fraud more closely, since they have to make a profit.
Government keeps promising to reign in Medicare fraud, but they always get bought off by lobbyists instead. Congressmen take care of their lobbyists interests, not the bottom line.
(and no, I'm not postulating what you said ... I'm demonstrating how silly your math is.
If patient care costs are $80K instead of $4K, the percentage going to patients is of course going to be higher. It is meaningless to compare the percentages without real costs)
0101,
That's a very nice theory and I'm sure very comforting for privatists. It's also wrong on about two counts. First, as insurance companies have merged, they have decreased SIU's dramatically as a percentage of the whole. That's because they view SIU's as cutting into their profits. Thus, they refer their stinky claims to.......drum roll...government investigators.
Second, many of the invesigators who look into Medicare Fraud aren't in Medicare's budget. They carry gold badges and work for Treasury, FBI or even DEA. It should also be noted these folks have powers that Private SIU's will never have.
You are correct that first instance fraud is easier to commit against Medicare (almost as easy as against Medicaid) but that does not mean that fraud goes unpunished or undetected. Hell, ask QMG about that sometime.
TYFCB
UMR
If you want some more proof that you can pretend doesn't completely debunk your claims, read this:
http://www.heritage.org/Research/HealthCare/wm2505.cfm
0726,
The article said just what you said ( I guess it was you), stating the proposition. It does nothing on the fraud side, which was the latest "but, but..." I got.
TYFCB
UMR 7:38 AM
I knew you could do it.
We are arguing whether the government can handle healthcare better than the private sector, right?
When did I miss somebody proving that the government has any business running healthcare regardless of how efficiently it does so?
Who cares what percentage of medicare expenses go to administrative costs? We cannot afford it. Your 3% crap will be as much comfort to my children as Bernie Madoff's April 2003 statements are to his clients.
But we, as a society, can afford the non-system in place now?
Whatever gets you up in the morning, I guess. No point looking at something practically when you can make polemic pronouncements.
TYFCB
2:35 PM
You seem to be in the "we gotta do something" camp, even if it's wrong.
You're right to this extent. We have to so something about universality. It really chaps me that the first $1000.00 I pay every year for my health insurance pays for other people using the ER as their primary care physician because they can't be refused there.
This is the only industrialized country where folks go bankrupt because of a major illness or injury. That probably needs tweaked.
We don't need health care reform but we need health insurance reform.
TYFCB
the first $1000.00? how many $1000's does your city provided health ins require you to pay?
One good suggestion I heard ... long term insurance contracts ... meaning, if I pay for 20 years, I've accrued some benefits, and can't be cut off for a major illness.
Those that wait till they need it to buy in have to pay more, or get the Medicaid lower level service, (and death panels).
The two tier thingy seems to work in Australia. Does the illegal alien really deserve the same top quality health care as US workers that paid through the nose for 20 years?
A walk in like clinic next door to the emergency room might restrain some of those $1000 bloody nose ER visits.
But no matter what, let's protect the trial lawyers ... Democrats need those payoffs.
Seriously, you said the "first $1000.00 I pay every year". Is there a second, third? I doubt you pay a $1000 towards it in a whole year.
At least admit you didn't tell the truth about how much you pay for health ins.
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