Who'd a thunk it?

Oh, gosh, that's just coffee money for the government. Shouldn't even have blinked at it. Wait till they show you how to do it Chicago style.

If I was looking over expendatures, I think the numbers would be higher. Check out what Medicare pays for wheel chairs and scooters.

Wes

-- "Additionally as a security officer, I carry a gun to protect government officials but my life isn't worth protecting at home in their eyes." Dick Anthony Heller

About the same that private insurance pays -- usually 80%.

Medicare has been starved for enforcement money for a long time. Private insurance companies do somewhat better, as a percentage, but their fraud estimates run from $63B (an industry group) to over $150B (summary of law-enforcement estimates). It's become a big target for criminals because it's so easy.

Obama has earmarked an increase in the enforcement budget for Medicare of $200 million. The private healthcare fraud organization (NHCAA) says you get something like $7 back for every $1 spent on investigations.

HUH! And how is Medicare implicated in this "scam"? What would they get out of it?

As for the argument against the public option, the most serious one is that it could be manipulated to control the insurance industry -- even to squeeze it out. Interestingly, that's also a serious argument *in favor* of the public option.

Which side of that argument do you fall on?

I doubt it. The electric wheelchair manufacturers do have pretty poor warranties (Tuffcare is a year; extended warranties are widely available, but you pay for them out of your pocket, so a lot of people don't get them). But Medicare is quite restrictive about who gets them at government expense. Private insurance is, too, but they aren't dealing with as many seniors, so it's a small budget item for them.

Having worked with them, I don't disagree on that point. It isn't that their people are vile; the problem is that the incentives they're chasing are antithetical to our interests.

However, I think we should look at Switzerland's program more closely. Their insurance is 100% private. But the insurance firms are run as not-for-profit companies. They've managed to structure their incentives so the whole system works fairly well in favor of the insured. Their per-person insurance costs are close to ours, but they have 100% coverage.

I have no desire to see the government run even the insurance business if there's a way to avoid it. But I'd accept a single-payer system if it could be made to work well, and if there's no chance we could have something like the Swiss system.

HUH! interesting. i'm for the public option but i had no idea how they were going to control "waste, fraud and abuse", and i was sure there'd be TONS of it. it's heartening to know the disastrous waste, fraud and abuse that occurs in medicare is partially due to a low enforcement budget, and there's lots and lots and lots in private healthcare too. whew! glad to know that's a weak argument against the public option. thanks ed. seems like it's a cash cow for crooks, both systems. there was a guy locally who was complaining that his powered wheelchair was a lemon, broke a month or two after he got it, and the warranty was like only two weeks or something. i can't remember the details of the story but in the end it seemed to me like it was a scam perpetuated by medicare and the scooter manufacturer. (just like the people who squeal loudest when they talk about reforming food stamps aren't the "welfare mothers" but supermarket associations and food producers, etc.)

b.w.

i dunno. nothing. just funneling money to the wheelchair manufacturer(?).

i want to see the private health insurance companies driven out of business.

b.w.

"William Wixon" wrote in

If waste, fraud, and abuse were ever controlled, we wouldn't need a dime in additional funds. The patient is hemorrhaging, and the leeches are thriving on the blood.

Steve

And now we have to wait to see a doctor like the line of people in "Parking Wars." Only worse. We can be rejected at the window, and go home with NOTHING.

Steve

Yeah, it will be the hell like they have in Switzerland. How *is* that medical care in Switzerland, anyway? How did all of those private doctors and hospitals slip into the "socialized" system? Hmm?

You want the lemon-lime? Or the goofy grape?

Don't confuse the Medicare program with the people running the Medicare program. Any time you have significant sums of money there will be people who will figure a way to get some of it for themselves. The real problems start when there are so many people that the system is sucked dry *BEFORE* the people for whom the money was intended get any of it.

=============== It all depends on which country and which century you are living in, and how wealthy you are.

The country, the culture and the economic context have radically changed and continue to change. The extended family/village/neighborhood has disappeared for the majority of people. Increasingly there are no kin, only the individual.

Advances in medicine and science mean that individuals with conditions such as heart disease, cancer, diabetes, etc. that would have promptly died in the past, with little "fuss" and expense, now are chronic patients surviving, perhaps years, at great expense.

It is also unclear what socially useful function the medical insurance companies now perform for the majority of citizens/customers for their very considerable "piece of the action."

What is clear is that the current spending patterns are unsustainable, and become catastrophic when the trend lines are extended even a few years for medical costs, population demographics [older is sicker] and reduction/elimination of the ability to pay because of the elimination of high[er] wage jobs with benefits.

It is by no means certain that any of the proposed health plans, in total or in part, will be any better. While there is a great deal of smoke and heat produced, very little light has been generated, with the typical Washington "Chinese menu" approach, i.e. one benefit from list A and two from list B to keep everyone happy.

There appears to have been no effort to establish what the goals of U.S. national health care should be [1 paragraph mission statement], nor any effort made to examine the strengths/weaknesses/costs of existing national health care plans of the UK, France, Germany, the nordic countries, etc.

The current Congressional approach appears to be a very toxic combination of "reinventing the wheel" and "quick, do something

-- don't just stand there." I keep hearing an echo that sounds like "shut up and drink your Kool-Aid."

Unka' George [George McDuffee]

------------------------------------------- He that will not apply new remedies, must expect new evils: for Time is the greatest innovator: and if Time, of course, alter things to the worse, and wisdom and counsel shall not alter them to the better, what shall be the end?

Francis Bacon (1561-1626), English philosopher, essayist, statesman. Essays, "Of Innovations" (1597-1625).

The goofy grape, but only if it has LSD in it. There used to be a LSD tablet called goofy grape that had a grape flavor.

Steve

I think the reference was to "Jim Jones and Co". Koolaid

Gunner

"Upon Roosevelt's death in 1945, H. L. Mencken predicted in his diary that Roosevelt would be remembered as a great president, "maybe even alongside Washington and Lincoln," opining that Roosevelt "had every quality that morons esteem in their heroes.""

yep, but you do have a choice of flavors!

Hear, Hear! I agree, the Swiss have us beat hands down. I also agree with your sentiment about the single-payer system.

Anyone who thinks we have an excellent system in place already and who doesn't want to change it ought to look at maternal mortality rates in the developed world. The U.S. is too far down that list.... And that is just one example of a dramatic failure of our current "system."

You've been listening to only one side of the arguement. Look here:

The Swiss system is remarkably different from ours, and it appears to work. Why shouldn't we give it a shot?

Do you know just how much your employer has to pay for your health insurance coverage? Wouldn't you prefer to get that pay instead, AND have more choices about what health insurance policies you get to choose from, knowing that they are not profiteering in the process?

Are you simply afraid of change?

No, I haven't looked at only one side. I lived in Switzerland for a year, a long time ago, studying politics at the Univ. of Lausanne, and it continues to be of great interest to me. I find many aspects of their society and government to be emminently sensible, although only parts of it are applicable here, for a variety of reasons. There are many parts of it that I wouldn't want to see implemented here. But their health care system is one from which we could draw some useful lessons and ideas.

But this is no place to make nuanced or balanced arguments. The only way to come close to sensibility here is to try to balance the extremes. It's sad and unsatisfying, but that's as far as you'll get on many subjects.

I think we should at least look at how they managed to make a private insurance system work so much better in terms of serving the interests of the customers. In some ways it just makes too much sense -- we have a hard time with non-profit corporations, for example, except for things like charities.

Yes -- my wife's employer, actually.

Again, the Swiss system is a pretty good model. Basic care is uniform; on top of that, you can pay for all sorts of optional amenities, and the insurers can make a profit on those things. But those are things that are matters of convenience or comfort, or of stabilizing the annual costs of something that isn't life-or-death, such as dental care. That sounds good to me.

Never. I'm the opposite about many things, especially financial ones.

The only difference is that the poison is in a syringe instead of a cup? That is, if that moron Allan Grayson is to be believed.