How much of your health insurance premium is wasted on bloated overhead?

[blm]

And compared with costs to administer Medicare?





https://pnhp.org/

Here’s an overview of single payer.

Single-payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.

The program would be funded by combining our current, considerable sources of public funding (such as Medicare and Medicaid) with modest new taxes based on ability to pay. Over $500 billion in administrative savings would be realized by replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer.

Premiums would disappear, and 95 percent of all households would save money. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.

The Medicare for All Act of 2019, H.R. 1384, based on PNHP’s AJPH-published Physicians’ Proposal, would establish an American single-payer health insurance system.
.........

70% of Americans in 2018 said they want a Medicare for All system. Including the majority of independent voters.
https://thehill.com/hilltv/what-americas-thinking/412545-70-percent-of-americans-support-medicare-for-all-health-care

[Evergreen Emerald]

1. I have insurance through my employer

And I pay for everything until I meet the deductible for the year, which is usually around November. Plus, the co-pays. Warren is right and Pete B. is wrong.

[UniteFightBack]

2. I pay 50 bucks a month with no deductible through my employer. They'll pay for healthcare when I

retire.

[blm]

4. Lucky you. Many companies cut pensions and health benefits for retirees.

[Tanuki]

5. Your employer is writing off 100% of what they pay as a business expense,

thus reducing their tax burden and passing that share of the cost of government along to other taxpayers, including all those not fortunate enough to have an employer-sponsored health benefit. Not criticizing your employer or you in any way, just pointing out something that I think often gets overlooked.

[Demsrule86]

8. I am not for MFA...period. I like my health insurance through the job.

I also believe it will never be possible in our current political circumstances and will cost us 2020. I believe EW lost the nomination during the debate when she doubled down...even if she manages the nomination, ( I would of course vote for her), she will lose the general.

[blm]

12. Great point that usually goes undiscussed.

[Ohiogal]

3. I'm keeping this article on file

For the next time I get into a discussion over universal healthcare with a conservative. Thank you.

A few people have good insurance through their employers, but many more do not. How is workplace insurance “good” if you have a high deductible and copays for everything? I also disagree with Mayor Pete here.

[spanone]

6. K&R...

[MontanaMama]

7. I'm guessing we pay a lot of bloated overhead

at $1800 a month for my family of 3. We are self employed and there are no good deals with being self insured.

[blm]

10. Mine is over 700 a month just for me.

That is money that is NOT spent on actual medical care.

[MontanaMama]

13. You're absolutely right.

We have a $4000 per person deductible as well so we pay out a crap ton of money before a dime is spent on medical care. It’s so frustrating.

[Hoyt]

9. To be fair, 2011 was before ACA limited overhead to 15% for most health plans, 20% for individual

plans.

When you cut through all the bull, we might save 8 to 10% from eliminating overhead with a single payer system.

So, if all works out to our benefit -- and there is no increase in cost to us for picking up 20 million uninsured, eliminating copays and deductibles, increased utilization because care is "free" at point of service, etc. -- the poster above paying $1800 a month for their family will pay $1,620. That helps, but nothing to dance about.

To get where we need to be, we are going to have to make big changes in the entire system. I'm not sure we are up for it when it comes down to it.

Worse, I think running on mandatory Medicare-for-All (even if you don't want it) is a loser in 2020. A Public Option will get us to MFA faster, IMO.

[blm]

11. I wonder why media won't give this a thorough examination. It seems

the easiest thing for them is to rely on the packaged sound bites from GOP and Koch Bros.

It would be nice of them to do their job for the American people.

[uponit7771]

19. +1, "To get where we need to be, we are going to have to make big changes in the entire system"

THIS !!!

I'm sick of HCI being the only scapegoat as if we got rid of HCI and went totally government managed insurance that health care in America would be affordable, it wont.

We'd save around 15% tops !!

The hard conversation is capping profits for pharma and hospital groups or making more of them government run like Hong Kong.

[ismnotwasm]

22. Thank you

There’s is the desire we all have to have healthcare for everyone and then there is finding a pathway that won’t be an entire clusterfuck. Public option is an excellent idea.

[Hortensis]

14. The Medicare figure used this way is effectively a blatant LIE.

The VA, which is socialized medicine and has no bloated overhead, is about 3%.

The ACA is capped at (CORRECTION) 15% for companies selling through the exchanges. 80% has to go to patient care.

Medicare -- including the supplementary insurance that is absolutely necessary to compare to most policies -- is lower than that but far greater than the 3% of the VA.

Medicare costs are somewhat higher than the figures show, though, because some Medicare reimbursements are so low that providers are only able to treat at those rates because of income from higher payments made by regular insurers. NO WAY the entire nation could go on Medicare at current reimbursement rates, so using them is extremely deceptive.

Btw, BOTH the ACA and Medicare are based on for-profit medicine. There is nothing socialized about either. The VA is currently shifting patient care to the PRIVATE sector, like ACA and Medicare, courtesy of all those who helped elect Republicans in 2016.

Don't like to see our only socialized medicine system destroyed? Blame Bernie Sanders. The Republicans don't pretend to be anything but against it, but they couldn't have done it without help.

[blm]

15. PNHP states that its single-payer plan is based in private medical service.

Perhaps you missed that.

[Hortensis]

17. Here are reliable and understandable data for DUers:

Understandable is important because we live in a grad school-level world, while millions of citizens would be hard put to make it through 2-year technical college. That's a huge problem for our democracy because people don't even need to lie to deceive, often the truth misrepresented works even better.

I apologize for brain-farting the ACA figure: The ACA was capped at 15%. 85% of premium costs have to go to patient care.

Also btw, ProPublica has more recent data than I remembered in an article about the costs so far of private care to those shifted off socialized medicine. It's 8.6% for basic Medicare PLUS 13% for supplementary policies. Which totals 21.6% compared to 15%.

Under the Affordable Care Act, large-group commercial insurers are not allowed to spend more than 15 percent of their premium income on administration, including marketing and profit. Ten percent to 12 percent is the industry standard, according to Andrew Naugle, who advises health insurers on administrative operations as a consultant at Milliman, one of the world’s largest actuarial firms.

For

Medicare Advantage plans, company expenses eat up about 13 percent of premiums

, according to Doug Sherlock, a researcher who tracks insurance plans that reach over 70 percent of the private market.

For Medicaid managed care, overhead was 8.6 percent in 2017, according to a Milliman survey of 186 companies across 35 states.

In the Defense Department’s Tricare health benefits program for military service members, retirees and family members, overhead was 8 percent of private sector health care expenses in 2017.

Between the estimated fees and the implementation costs, TriWest and Health Net received about $1.9 billion for administration. The overhead rate, known in the industry as the “administrative loss ratio,” is the $1.9 billion in overhead costs divided by the sum of those overhead costs and the $6 billion in claims. That computes to 24 percent.

https://www.propublica.org/article/how-we-crunched-the-numbers-on-the-vas-private-care-program

That last, btw, is about what the Republicans are doing to destroying socialized medicine. That LAST thing veterans and their families want is to lose it and have to go to a for-profit program, not MfA, not workplace insurance, not the ACA.

They have Sanders to thank for the mess the VA's in. The Republicans wouldn't be in power if he didn't tell millions of Americans it wouldn't make any real difference if the Republicans won in 2016 instead of the Democrats because we're really just as bad. And he still feels the same way and is saying the same things.

[blm]

18. My reply was to your statement about ACA and Medicare being based

In for profit medical care. I was just letting you know that Physicians for a National Health Program proposal is based in for profit medical services, as well.

[Hortensis]

20. Okay. I was still under the influence of that "1.3%."

Medicare is currently very underfunded.

Basic Medicare doesn't begin to deliver the benefits today's Americans need for lifetime health maintenance.

The data I posted also do not include medication costs, for which another separate and expensive policy is required.

Medicare is also reportedly trying to deal with inadequate budget by shorting end-of-life patients.

Just the kind of little details that 1.3% suggests people need not know. And there are a bunch more. A bunch.

We older people who have its guaranteed coverages love our Medicare, but it's very inadequate in many ways. Many millions are seriously undercovered, just one of the reasons that suggesting its figures would extend to a national healthcare program is deceptive.

The ACA was developed with the benefit of learning from Medicare and Medicaid in place, and it's far better for patients than Medicare and far, far better than Sanders has unconscionably tried to make the nation believe. Any comparison of estimated MfA costs should be to the ACA, including estimates of its costs with the public option implemented.

[blm]

21. Alcohol? 😁

Heh

[uponit7771]

16. Sooooooo, HCI would only go down 25% at the most? what about deductibles etc? I don't think anyone

... addressing the issue of the amount of profit the pharma, doctors and hospital groups are making when we're sick in the US.

Hong Kong's health care system could work for us, our bigger problem is handing Red States military welfare fir Maginot Devices instead of spending on our health.

[Kid Berwyn]

23. Guy who runs Blue Cross Blue Shield in Michigan got $19.2M in 2018.

Life is good for some not-for-profit CEOs.

PS: The debate crew really bent themselves over backwards trying to get Sen. Warren to say she will raise taxes to pay for her universal coverage plan.

[Skidmore]

24. Under ACA, 80%

had to go to healthcare. But somehow that wasn't good enough as a starting point to build on for dome.