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That is essentially what I stated. Again, what purpose does pooling that risk have when the source of the funds all come from the same location?Why? That idea is rather silly IMHO.
You have to ask yourself what purpose the insurance companies serve? Why do they exist?
The simple answer is that they exist to establish risk. An insurance companies sole purpose is to establish what your overall risk is to determine what you need to pay into the whole in order to come out even at worst. That is it. They do not exist to pay your bills - that is the consequence of the system not its primary purpose. If the government is paying those premiums then what purpose does the insurance companies serve? Nothing at all. They would make money for essentially moving money around.
You're conflating an insurance company with an actuary. Obviously insurers will employ actuaries for the function you're describing but more broadly insurers pool risk. They design and sell a financial product, the point being that they take on risk for your expenses if you have a health issue. (This is unavoidable--health spending is incredibly concentrated on a relative small segment of the population at any given time, which is why an insurance model--whether public or private--will always be needed to finance it.) And in doing so they have to do all of the administrative side of that: building and maintaining provider networks, negotiating prices, and yes actually paying the claims when you have a health issue.
If you imagine the basic template for single-payer health care being essentially Medicare-for-all, that program is still going to be administered by private insurers. That's how Medicare has always worked (today those insurers are called Medicare Administrative Contractors). They pay the claims, even as the government bears the actual financial risk and sets prices.
However, the trend of the past 20 years or so in public insurance has been away from that model. State Medicaid programs have gotten away from it and gone toward risk-bearing managed care organizations. In other words, they privatized. People in Medicaid tend to enroll in private insurance plans these days and their insurers are at risk for their expenses, not the state.
Same thing for the subset of Medicare that has been privatized (Medicare Advantage). Enrollees get to pick whether they want to enroll in traditional Medicare (which, again is still actually administered in practice by the MACs) or enroll in Medicare Advantage where they choose a private insurance plan. Enrollment in the latter has been growing pretty quickly.
So I would not expect that even if we ultimately migrate toward a "single-payer" model that it wouldn't follow the same trends that have re-shaped the single-payer programs we've had since the '60s. Namely partially privatized with less risk for the public sector and more risk for the private sector (in addition to the inevitable administrative role for the private sector).
That 'pilfering' is intrinsic to how SS works.The only time Social Security comes into the conversation is when someone repeats the "Social Security is going broke!!!! (And it's just a Ponzi scheme anyway)" myth, completely ignoring the pilfering from the SS Trust Fund that's been going on for decades.
That is essentially what I stated. Again, what purpose does pooling that risk have when the source of the funds all come from the same location?Why? That idea is rather silly IMHO.
You have to ask yourself what purpose the insurance companies serve? Why do they exist?
The simple answer is that they exist to establish risk. An insurance companies sole purpose is to establish what your overall risk is to determine what you need to pay into the whole in order to come out even at worst. That is it. They do not exist to pay your bills - that is the consequence of the system not its primary purpose. If the government is paying those premiums then what purpose does the insurance companies serve? Nothing at all. They would make money for essentially moving money around.
You're conflating an insurance company with an actuary. Obviously insurers will employ actuaries for the function you're describing but more broadly insurers pool risk. They design and sell a financial product, the point being that they take on risk for your expenses if you have a health issue. (This is unavoidable--health spending is incredibly concentrated on a relative small segment of the population at any given time, which is why an insurance model--whether public or private--will always be needed to finance it.) And in doing so they have to do all of the administrative side of that: building and maintaining provider networks, negotiating prices, and yes actually paying the claims when you have a health issue.
If you imagine the basic template for single-payer health care being essentially Medicare-for-all, that program is still going to be administered by private insurers. That's how Medicare has always worked (today those insurers are called Medicare Administrative Contractors). They pay the claims, even as the government bears the actual financial risk and sets prices.
However, the trend of the past 20 years or so in public insurance has been away from that model. State Medicaid programs have gotten away from it and gone toward risk-bearing managed care organizations. In other words, they privatized. People in Medicaid tend to enroll in private insurance plans these days and their insurers are at risk for their expenses, not the state.
Same thing for the subset of Medicare that has been privatized (Medicare Advantage). Enrollees get to pick whether they want to enroll in traditional Medicare (which, again is still actually administered in practice by the MACs) or enroll in Medicare Advantage where they choose a private insurance plan. Enrollment in the latter has been growing pretty quickly.
So I would not expect that even if we ultimately migrate toward a "single-payer" model that it wouldn't follow the same trends that have re-shaped the single-payer programs we've had since the '60s. Namely partially privatized with less risk for the public sector and more risk for the private sector (in addition to the inevitable administrative role for the private sector).
I cant see any other purpose than skimming money off the top.
That 'pilfering' is intrinsic to how SS works.The only time Social Security comes into the conversation is when someone repeats the "Social Security is going broke!!!! (And it's just a Ponzi scheme anyway)" myth, completely ignoring the pilfering from the SS Trust Fund that's been going on for decades.
That is where the 'ponzi' scheme claim comes from anyway.
That is essentially what I stated. Again, what purpose does pooling that risk have when the source of the funds all come from the same location?
I cant see any other purpose than skimming money off the top.
Title II of the actual law covers that:That 'pilfering' is intrinsic to how SS works.The only time Social Security comes into the conversation is when someone repeats the "Social Security is going broke!!!! (And it's just a Ponzi scheme anyway)" myth, completely ignoring the pilfering from the SS Trust Fund that's been going on for decades.
That is where the 'ponzi' scheme claim comes from anyway.
Really? Where in the Social Security Act of 1935 does it say "Congress can divert funds from the Social Security Trust Fund to pay for their favorite pork projects and not pay it back"?
That is essentially what I stated. Again, what purpose does pooling that risk have when the source of the funds all come from the same location?
I cant see any other purpose than skimming money off the top.
As I said, states and the federal government have both become increasingly reluctant to take on risk for health spending. That's why they've increasingly privatized both Medicare and Medicaid and shifted risk to private entities.
I don't foresee that reversing, even if everyone were put into a program like one of those. In practice single-payer would be: (1) real universal enrollment in some kind of insurance plan, (2) a stronger role for federal policy setting in the health sector (right now the feds and states push the market through policies implemented through Medicare and Medicaid; under single-payer they could be much more assertive about pushing change), and (3) perhaps a price-setting role for the government.
PropagandaWhen Democrats wrote the Social Security Act, FDR insisted that it be written so that Republicans could not kill Social Security when they got into office. Of course, that did not stop Republicans from trying to change it as did Bush with his privatization plan, but now with Social Security gaining acceptance it will be even harder for Republicans to drop, or change Social Security.
Single payer isn't insurance. It isn't "taking on risk". It's socializing the cost of health care via government.
Sure. That's the end-game. It's a statist's wet dream.
Single payer isn't insurance. It isn't "taking on risk". It's socializing the cost of health care via government.
These are different ways of saying the same thing.
The GOP has STILL not put a comprehensive alternative health care reform on the table.
After all these years.
That's how you know this is all theater for the rubes.
A DC health care lobbyist laughed when I said that. He said, "And the rubes all live along and below the Mason-Dixon line."
So...let's get back to the OP.....
Has anyone seen anything that looks remotely successful ?
So...let's get back to the OP.....
Has anyone seen anything that looks remotely successful ?
The thing with judging success is that we need some agreement on what the goals were. I've talked to a lot of ACA apologists who recognized it was a bad law, but supported it because it represented a "foot in the door" (a way for government to get a piece of the action?). I guess by that criteria, it was a success.
You have to be a monster to want Americans to suffer.
