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[RedKing]

The statement "Governments can NEVER be more economically efficient than private entities" is objectively and provably false.

^^^^
This.


Also, kind of poor form to come in and basically say "I think all you people are wrong, but I'm not going to discuss it because you're just going to insult me". Especially when the thread's been going for 8 pages with civil disagreements and nary an insult or partisan screed to be seen.

[Euld]

So I can't stay and read all nine pages, but, does this mean the US has universal health care now?  o_O  I can be a bit clueless sometimes sorry D:

[Aklyon]

What, exactly, is unconstitutional?

We could make a forum out of that question alone.

[MetalSlimeHunt]

So I can't stay and read all nine pages, but, does this mean the US has universal health care now?  o_O  I can be a bit clueless sometimes sorry D:

No. It means you have to buy healthcare or you'll be fined a couple thousand dollars. The rest of the ACA will hopefully make that healthcare you have to buy affordable now, but who knows?

[GlyphGryph]

Or more specificaly, It's dropping a several thousand dollar static tax on the entire population, and then offering several thousand dollars worth of exemptions in exchange for certain economic activity.

Something I think is pretty utterly atrocious, since I'm opposed to both static taxes and the crass social manipulation of tax exemptions as a general rule, but it is clearly legal - had it been found unconstitutional, the entire foundation of our tax system would have to be rebuilt.

[Tellemurius]

So I can't stay and read all nine pages, but, does this mean the US has universal health care now?  o_O  I can be a bit clueless sometimes sorry D:

No. It means you have to buy healthcare or you'll be fined a couple thousand dollars. The rest of the ACA will hopefully make that healthcare you have to buy affordable now, but who knows?

No the government will provide their own or expand medicaid for at minimum preventive care and prescription services for people that can't afford regular insurance

[kaenneth]

My concern, is I was reading comments a while back that Insurance profits will be capped as a Percentage of costs.

If that's the case, then once everyone is covered.. the only was for the corps to increase profits, is to increase costs...

[Urist Imiknorris]

Relax, the health care system has the health insurance system covered.

[palsch]

My concern, is I was reading comments a while back that Insurance profits will be capped as a Percentage of costs.

If that's the case, then once everyone is covered.. the only was for the corps to increase profits, is to increase costs...

Sort of, only not quite.

The ACA sets the percentage of total insurance intake that must be spent on medical costs. This is before both internal overheads (advertising, etc) and profits. The percentage that must be spent on healthcare costs starts at 80% for small group and individual policies, going up to 85% for large group policies.

Now these aren't actually excessive compared to current healthcare expendature by companies (I seem to remember some numbers showing 90% of income going to healthcare costs). But they are fixed. This encourage companies to both minimise their internal overhead costs and to not avoid paying out on insurance claims too often.

Let's look at it this way. A company that has no minimum percentage outlay will want to minimise all expendature. The ideal for them would be to challenge or avoid every single claim issued against them.

But now they have to pay out a certain percentage of their total income. They now have a specific pool of funds that they want to pay out each year, or at least some general target amount based on projected figures. There may still be in an incentive to reject/avoid claims where the pool is being eaten away quickly, but the universal benefit from rejecting all claims is reduced.

[kaijyuu]

Woohoo!

[Aklyon]

My concern, is I was reading comments a while back that Insurance profits will be capped as a Percentage of costs.

If that's the case, then once everyone is covered.. the only was for the corps to increase profits, is to increase costs...

Sort of, only not quite.

The ACA sets the percentage of total insurance intake that must be spent on medical costs. This is before both internal overheads (advertising, etc) and profits. The percentage that must be spent on healthcare costs starts at 80% for small group and individual policies, going up to 85% for large group policies.

Now these aren't actually excessive compared to current healthcare expendature by companies (I seem to remember some numbers showing 90% of income going to healthcare costs). But they are fixed. This encourage companies to both minimise their internal overhead costs and to not avoid paying out on insurance claims too often.

Let's look at it this way. A company that has no minimum percentage outlay will want to minimise all expendature. The ideal for them would be to challenge or avoid every single claim issued against them.

But now they have to pay out a certain percentage of their total income. They now have a specific pool of funds that they want to pay out each year, or at least some general target amount based on projected figures. There may still be in an incentive to reject/avoid claims where the pool is being eaten away quickly, but the universal benefit from rejecting all claims is reduced.

But what happens when that percentage lowers?

[Bauglir]

-snip-

The major problem here is that people who don't have health insurance will still need healthcare, except it's going to be much more expensive (due to putting it off until it's life-threatening, which always jacks the price up), and since they can't pay for it, the cost has to be offloaded onto the "responsible" people who "chose" to have insurance. Allowing people to choose whether or not to have health insurance is only superficially increasing freedom of choice - when you look deeper, you see that you're not allowing the injured to make a choice they want, and you're forcing everyone who pays anything to pay for the health care of other people, whether they want to or not.

You might as well lessen that burden that gets spread around. If you create a system where people automatically pay a certain amount for healthcare (no matter what that healthcare might be), and can't opt out, you create an incentive to actually use it when it's most cost-effective, which could potentially save money. And if you're saving money, you're actually improving the freedom of the participants - not only are you giving them the choice of seeking healthcare or not, you're also giving them a greater degree of economic freedom.

What would be better is if this were implemented through a graduated tax, and when you checked into a hospital, you didn't have to pay at all. The system would just assume you'd paid your share in tax money, and you'd get treated. Hospitals get a budget each year paid out of those taxes. Maybe institute a check for tax delinquency or convictions for tax fraud*, but no actual monetary transactions should really be necessary. Leaving the insurance industry and the healthcare industry as profit-driven enterprises converts the "you cannot opt out" part of the idea into a way of shackling you to a machine that has every interest in charging you, and no interest in treating you.

EDIT: I'd actually be against this, because it undermines the whole point, but it might be necessary to sell it to people who believe that there's a moral aspect to who "ought" to pay

[Mr. Palau]

My concern, is I was reading comments a while back that Insurance profits will be capped as a Percentage of costs.

If that's the case, then once everyone is covered.. the only was for the corps to increase profits, is to increase costs...

Sort of, only not quite.

The ACA sets the percentage of total insurance intake that must be spent on medical costs. This is before both internal overheads (advertising, etc) and profits. The percentage that must be spent on healthcare costs starts at 80% for small group and individual policies, going up to 85% for large group policies.

Now these aren't actually excessive compared to current healthcare expendature by companies (I seem to remember some numbers showing 90% of income going to healthcare costs). But they are fixed. This encourage companies to both minimise their internal overhead costs and to not avoid paying out on insurance claims too often.

Let's look at it this way. A company that has no minimum percentage outlay will want to minimise all expendature. The ideal for them would be to challenge or avoid every single claim issued against them.

But now they have to pay out a certain percentage of their total income. They now have a specific pool of funds that they want to pay out each year, or at least some general target amount based on projected figures. There may still be in an incentive to reject/avoid claims where the pool is being eaten away quickly, but the universal benefit from rejecting all claims is reduced.

But what happens when that percentage lowers?

Then they have would have to accept lower profits in order to stay competitive.

Proponents of the bill have been cited saying that the bill itself will probably not cause the rise in premiums, but that the general cost of healthcare just keeps going up. However, it needs to be recognized that if the bill passes and costs go down, it could just be because the general cost of healthcare went down regardless of the new laws of the bill. It's a straw man argument which kind of personifies the political atmosphere today. The bill's job is to lower premiums and cut costs and being told that there is no guarantee of either really makes me hesitant to support such a proposition.

I still think think reform is necessary, but not in the way that is outlined in the current proposed plan. If the U.S. is a country of choice, and if someone willingly chooses not to purchase health insurance, I find it hard to justify levying what is essentially tax on a the consumer. What is the government going to do when this tax is not collected? Garnish wages? Sent to jail? It's been a while since I last glossed over the bill so I can't say for certain what/if any repercussions there are. I think it would be much more beneficial for the U.S. government to prioritize a system which promotes regulated privatization of insurance instead of creating another social safety net.

Governments can NEVER be more economically efficient than private entities. The whole profit/non-profit argument is misleading. If the government run program ends up operating at a loss (and I will bet my bacon it will), the funds must be taken from elsewhere to balance it out. I believe the new bill will further exacerbate our problems for many while giving relief to some (relatively speaking of course).

These conversations always become hostile. I am no expert and I learn new things everyday, but I have no interest in debating such an issue in which the typical insult is "you stupid *enter political party here*" So now, I need to go back to work!

Ok, lets break this down. 1. Health care inflation in the US will likley still increase, as will your premiums, as it is increasing all over the world. The differnce is that it will reduce the rate of the increase. 2. Actually there is no penalty for not paying the fine. Liberals got really pissed when it looked like the government was going to garnish poor people's wages and/or throw them in jail for not meeting the mandate. They will send you the fine, and then you can just toss it in the trash. 3. In healthcare, limited or total government involvement is more efficent than just private providers. The system Singapore has setup is much more efficent than the one in the US (and anywhere else), and it includes a larger role for the government. Healthcare, retirement planning, long-term R&D, are all areas where the government is more efficent than private firms. Economically speaking there are areas where the private sector is more efficent and areas in which the government is more efficent.

There is no magic in privatization that makes it more efficient. There is no actual reason govornment can not perform more efficiently than private industry. The opposite is however true. The profit margin of private industry IS inefficiency from the perspective of the cost of a utility.

The statement "Governments can NEVER be more economically efficient than private entities" is objectively and provably false.

Over time a private provider would seek to increase the efficiency of any operation in order to increase profits. As other proiders do the same, they are forced to lower prices in order to retain market share, ultimatly lowering the cost of the good provided. Private providers have a greater incentive to increase efficiency than government providers because they directly benefit from the increase.

The statement "Private entities can NEVER be more economically efficient than governments" is just as false.

[Aseaheru]

but when they strive for profit then they normally raise costs, and anyways add waste so normally by definition they ARE less efficient.

and even NPO's do that.

[Mr. Palau]

but when they strive for profit then they normally raise costs, and anyways add waste so normally by definition they ARE less efficient.

and even NPO's do that.

If they raise costs they jepordize losing a percentage of their customer base. And futhermore, they would still strive for efficiency, because that would mean more money on top of the money they got from raising costs.

In a sufficently competitive market place, you should see firms that raise costs loss customers. http://moneyland.time.com/2011/10/13/raise-prices-in-a-slow-economy-nice-try/