"Health insurers are committed to improving health care choices for small businesses and bringing costs under control for all Americans,"
A woman who’ll say anything in absolute opposition to the facts, so long as it makes her patrons look better. Don’t you think she’d make a good next attorney-general?
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“John, reducing consumption of gas does reduce the cost of gas . . .”
Peter, you continue to respond as though I’ve been talking about total expenditures for BUYING gas. I have not been talking about expenditures for BUYING gas, but about the cost of PRODUCING gas.
Remember, you brought up the idea that auto manufacturers should control the cost of gasoline. The cost of gasoline is not relevant except to observe that (1) auto manufacturers cannot control the cost of gasoline and, similarly, (2) insurance companies cannot control the cost of delivering health care. This is not difficult stuff.
“the real power of single pay. Mandate cost reductions by limiting budgets and force institutions to get better at providing healthcare at less cost.”
I’ve held positions in for-profit companies, not-for-profit companies, and in government. I’ve lived thru more than a few budget reductions mandated from above. When the cost cutting mandates came down, results have been the same always and everywhere. They do produce reduced spending. They do not force institutions to “get better”. Budget reductions can produce layoffs, overworked staff, inattention to detail, reduced services, lower staff salaries, high turnover, difficulty recruiting, fewer opportunities for advancement, “who cares” attitudes in employees, shorter operating hours, inadequate and/or antiquated equipment, deteriorating facilities, less product and service reliability, reductions to long-term maintenance and planning – you get all those things, too.
“Your observations/opinions only reinforce the view that market forces in healthcare do not/will not take the necessary actions”
Maybe. Maybe not. My opinion is based on my experience. Organizations that competed with each other to generate revenue by providing what their clients want actually did get better, and earned money delivering more of what the clients want. Growing revenue led to developing capacity for providing more or newer services. In the organizations dominated by budget officers, the management competed primarily on getting budget allocations. Those managers served their budget officer first and their clients after. Those organizations found it hard to grow, or to change, and suffered from inability to innovate and compete with other organizations. I suppose you will continue to see the world otherwise, for which I wish you good luck.
John, reducing consumption of gas does reduce the cost of gas and reduce global warming. It either saves people from filling up as much or it reduces consumption which “should”, cartels aside, reduce prices in the long haul. Consumption, price, cost, all part of the same equation. But I don’t believe low prices for gasoline are a good thing. This country should have instituted a global warming gas tax long ago. Even an Iraq War tax. Then use those funds to promote better technology and a shifting from inefficient processes. Exxon does not allocate system wide policy with its profits, a tax can though. If reducing consumption reduces prices then the addition of a tax is softened for the consumer.
As to health insurers, if they aren’t part of a cost reducing solution then as I said they are not worth the overhead they generate. We know that health providers have no interest in reducing costs/prices, we know the insured consumer either has no interest or power to reduce costs, if the insurance industry can’t/won’t do it then single pay gov insurance is the only way to drag the whole system kicking and screaming to reduce costs. Here in NC one local hospital cancelled its contract with an insurer because that insurer wanted to reduce reimbursements to a level not acceptable to the hospital. What would that insurer have done with the savings? More profits, lower premiums? Is the hospital interested in reducing costs or maintaining reimbursements? So I guess as a system, if insurers also don’t have power to control costs then the system needs to change. When private companies go on a cost control kick upper management usually does not get into the nuts and bolts of day to day cost generators. They usually issue a mandatory percentage cost reduction that departments need to meet. How those departments meet that and maintain efficiency is up to them. That’s the real power of single pay. Mandate cost reductions by limiting budgets and force institutions to get better at providing healthcare at less cost. Your observations/opinions only reinforce the view that market forces in healthcare do not/will not take the necessary actions to head off unaffordable heathcare for ALL of us, insured or not.
“they don’t want to be part of any solution”
That’s you talking, Peter. I never said they don’t WANT to reduce the cost of gasoline. My point is that they can’t. They are unable to. They don’t have the expertise. They don’t control any of the factors of exploration, drilling, extraction, transportation, refinement, and distribution of petroleum products. If you disagree, please explain how you think a car company can reduce the cost of gasoline.
And, BTW, you misrepresent what I said in a second way. Your post above refers to “reducing fuel comsumption” but I never mentioned fuel consumption, only the cost of gasoline. Can auto makers improve their cars’ fuel consumption? Sure. Can they do this with improved auto technology and weight-saving measures? Sure. Do those actions reduce consumption of gasoline? Per car, sure. But those actions do NOT reduce the cost of gasoline. Why is this difficult to understand?
My point was – and is – that the same kind of observation applies for health insurers. They can restrict benefits and apply other rationing techniques but these actions do not and cannot reduce the cost of health care. They can negotiate prices and reduce providers’ incomes, but that does NOT reduce providers’ costs of supplying health care.
“I actually think that business has an obligation to participate in solving problems.”
And so do I. I believe strongly that each company has an obligation to contribute what it can to solving societal problems. We don’t disagree about that.
“Car companies are part of the problem for global warming”
And so you conclude that car companies should reduce global warming by . . . trying to reduce the cost of gasoline? Have you really thought this through?
“health insurers part of the problem in health costs.”
Yes, to the extent that they provide what their customers want – overly-rich benefits that stimulate excess utilization of health care services that cost more in the U.S. than any other country in the world. But you aren’t blaming insurance companies for that – you’re blaming them for not reducing the cost of health care. I don’t think that holds water and you haven’t refuted the basic contention that health insurance companies CANNOT reduce the cost of health care. Any more than auto companies can reduce the cost of gasoline.
John, I actually think that business has an obligation to participate in solving problems. Car companies are part of the problem for global warming as are health insurers part of the problem in health costs. The fact that I think health insurers are excess baggage in the system does not diminish my belief they need to do something except add overhead. But since they don’t want to be part of any solution then their part in the system is superflurous and therefore they are not needed.
“According to John Fembup health insurers have no more business trying to reduce system costs as do car builders have any incentive in reducing fuel comsumption.”
A perfectly reasonable point of view, and BTW thanks for agreeing with me.
(If you feel that insurers do have some important role in reducing system costs, you wouldn’t be advocating their demise, would you?)
And its fee for service for everyone!!
“the faster we’ll be closer to controlling costs.”
“faster we’ll be closer”?? Nice phrase.
May I infer that you include yourself in “we” but exclude anyone who disagrees with you? Good strategy. See, that way you always get a favorable vote.
But seriously, it’s such a shame that you are not dictator. Then you could also control those energy, food, housing, college tuition, and transportation costs, too. And if only you were dictator for life, you could control them for a lifetime. Quel dommage.
According to John Fembup health insurers have no more business trying to reduce system costs as do car builders have any incentive in reducing fuel comsumption. The faster we get rid of insurers, the faster we’ll be closer to controlling costs.
OK, so I have a question.
> “Failure to take any action at all would be the most
> expensive course of action for the entire care
> system — including small businesses — due to the
> cost shifting that is associated with uncompensated
> care for the uninsured,” [Ignagni] told the
> legislators.
How does cost-shifting make anything more expensive?
I do not see how it changes the total bill. It seems to me that cost-shifting might even save money because we don’t have to market plans to the uninsured, or permit insurers to earn a margin on their accounts. Until recently, cost-shifting was considered a feature of the system, not a problem. The Great Social Bargain had been that The Guild was permitted monopoly power in return for taking care of everyone regardless of ability to pay. Isn’t this the very definition of “cost-shifting”? It seems to me Ignagni is just complaining she doesn’t get a margin on the spending done on behalf of the uninsured…
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PS: Love the Mad Libs crack…
This is like a Mad Libs press release “Health insurers are committed to improving (insert health policy issue) for (insert healthcare entity) and bringing (insert health policy issue) control for all (insert demographic group).”