In article ,
"Robert Green" wrote:

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That isn't how it worked here. Indeed, with MCare paying about 60
cents for every dollar the Mean Old Insurance companies pay for similar
diagnosis (and MCaid less 50 cents) I would submit that government is
actually ADDING to costs by cost shifting.

So then why were insurers raising holy hell about the public option?
Something doesn't add up unless the premiums are wildly different, which I
suspect they are. Not allowing Medicare to negotiate drug prices the way
TriCare does might have something to do with their bad overall performance.
If MCare pays more, why do so many doctors balk at accepting MCare patients?

I said cost shifting, never said anything about where it was shifted
to. It came on through to policy holders, the insurance companies got
that back so they still made money. Heck maybe even a little more on the
"vig" so to speak when they passed it along.
It has nothing to do with MCare's bad performance since that
particular stat was for the hospital and docs sides only. And Part D
(1). Cut the prices for seniors substantially because the individual
insurance companies were able to negotiate better prices than Grandma
and Grandpa could on their own. In the first 3 years, it actually came
in UNDER projections.
I never said MCare pays more. I said specifically that MCare pays
60 cents for every $1 the insurance companies pay.

Good point. That's the ghost of WWII and wage controls. We got into a
crazy system (as we do with a lot of things) and then it grew like kudzu
vines until we were completely trapped in it.

Rather interesting history. This is actually only part of it since
even up to the mid-60s the bulk of healthcare expenditures (50% or so)
still came directly out of people's pockets. MCare came along and
effectively set a base under medical outlays and expectations (after all
unions weren't gonna let their workers get less than the retirees and
then the rest more or less followed). The part we reached into our
wallet to pay started going down about then. In the 70s and early 80s
the big companies thought it was cheaper to give health benefits than
actual wages (not like that did not come back to bite them on the ass
later). So they started doing things like low or no premiums, little in
the way of co-pays, etc. This, like MCare earlier, trickled down to
others.
The upstart is that over 80% of the costs of medical services in
the US is paid by others with the resultant increase in demand. Unlike
other countries that did the same on subsidization but managed to put
clamp of what was available.
I saw a really interesting slide in Health Affairs in the mid-90s
that showed as the %age out-of-pocket expenditures went down in the US,
the % of GDP taken up by healthcare went up.

--
People thought cybersex was a safe alternative,
until patients started presenting with sexually
acquired carpal tunnel syndrome.-Howard Berkowitz