Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger • Hacker News Board

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#61

Post by guelo » Wed, Aug 17, 2016, 6:23 PM UTC

jasonlotito wrote: post #39

mhurron wrote: post #16

Earlier quoted context omitted.

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance For the citizen, none. For the insurance companies, they get forced signups. > Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste? The US spends the most of any nation on he…

> For the citizen, none. Actually, that's false. I can assure you that having lived in Canada and having moved to the US because of health care, having options beyond "deal with it" when not getting any sort of care or service is wonderful. Single-payer is great if you are actually getting the care you need. But when it fails, you are left with little to no alternative. What's worse is that because of the perception…

Somewhat off topic, it seems to be easier for Canadians to permanently move to the US then for Americans to move to Canada. In your experience is that true?

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#62

Post by skylan_q » Wed, Aug 17, 2016, 6:23 PM UTC

bitwize wrote: post #54

skylan_q wrote: post #22

Earlier quoted context omitted.

free market systems are dynamic and adjustable to real-world inputs in a way that no planned system can match in terms of providing the most service/product to the most people. what people really want when they push for socialized medicine is equality over improvement. envy holds us back so much.

Equality for all is much better than improvement for the 1% and misery for everyone else. Read your Wilkinson and Pickett. Aside from perhaps the environment, equality is the political and economic issue that will shape the 21st century.

Equality for all is much better than improvement for the 1% and misery for everyone else.

Don't be dense. You know there are happy mediums.

* Read your Wilkinson and Pickett. Aside from perhaps the environment, equality is the political and economic issue that will shape the 21st century.*

I've read Pickett. Equality is horrifying. Eastern Europe is the result. The handicapper general is terrifying.

It's the end to any human greatness.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#63

Post by gnaritas » Wed, Aug 17, 2016, 6:24 PM UTC

tracker1 wrote: post #42

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

Personally, I would have split the difference... I would have created an NPO insurance corporation that was the default for all government paid access programs (employees, retired va, medicare/aid, state programs backed by federal funding)... this likely would have cost less than was already being paid out, in effect consolidating the management of several government programs as well as opening that corporation up to…

That's not how government works; it's not about pragmatic solutions or logical solutions; it's about what you can get enough people to agree on, which is what Obamacare is, the most enough people could agree on to get it passed. Whatever isn't in there, isn't there because it wouldn't have passed so all Monday morning quarterbacking about what it should have been entirely misses the point about how government works.

Governing is about consensus among ideologically opposed members, not about correctness or efficiency.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#64

Post by addicted » Wed, Aug 17, 2016, 6:24 PM UTC

uptown wrote: post #60

The public is starting to get a peek at the 2017 rates. To put it lightly, they're not pretty. This post shows the proposed premium increases, averaging around 24%. It's likely these may land somewhere below those numbers, but the cost of simply being insured before any co-pays or paying any deductibles has rapidly become unsustainable for a huge percentage of the population, especially the middle-class who earn too…

The "leaked" numbers have always been higher than what actually happens.

The insurance companies always propose higher increases in order to have a stronger bargaining position, and those numbers have historically been bargained down to something decent.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#65

Post by bitwize » Wed, Aug 17, 2016, 6:24 PM UTC

skylan_q wrote: post #55

vidarh wrote: post #36

Earlier quoted context omitted.

That's great for the people with lots of money. Not great for the people who die or go bankrupt in the name of "improvement".

Liberalize healthcare to allow anyone to provide it. Did you know that before the AMA was created that doctors had to do house calls or face living in abject poverty as a result of the market being flooded with healthcare professionals?

You mean snake oil salesmen?

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#66

Post by vidarh » Wed, Aug 17, 2016, 6:24 PM UTC

skylan_q wrote: post #38

vidarh wrote: post #28

Earlier quoted context omitted.

Gee, I missed the bread lines when I grew up in Norway, and I must've managed to miss them in the UK too.

I live in Canada so I get "free" healthcare as well. Norway's system of delivering food isn't a full socialist/single-payer model, so you wouldn't get breadlines there.

So your earlier comment is entirely irrelevant then, seeing as we're not talking about bread delivery, but delivery of healthcare, where - irrespective of whether we'd agree on the feasibility of efficient delivery of "singlepayer bread" - it has been conclusively proven by example that efficient delivery in a single payer model is possible.

In fact, not only is it possible, but almost every country in the world that has it does it cheaper than the US (depending on currency fluctuations, Norway is ironically one of the less than a handful of countries that is occasionally more expensive than the US - largely driven up by high salaries).

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#67

Post by serge2k » Wed, Aug 17, 2016, 6:25 PM UTC

jasonlotito wrote: post #39

mhurron wrote: post #16

Earlier quoted context omitted.

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance For the citizen, none. For the insurance companies, they get forced signups. > Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste? The US spends the most of any nation on he…

> For the citizen, none. Actually, that's false. I can assure you that having lived in Canada and having moved to the US because of health care, having options beyond "deal with it" when not getting any sort of care or service is wonderful. Single-payer is great if you are actually getting the care you need. But when it fails, you are left with little to no alternative. What's worse is that because of the perception…

The US system is great if you have money.

When some asshole sucker punches you and breaks your jaw, I'd rather be in Canada where getting it fixed is affordable.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#68

Post by skylan_q » Wed, Aug 17, 2016, 6:25 PM UTC

Frondo wrote: post #57

skylan_q wrote: post #49

Earlier quoted context omitted.

Single payer systems ration the amount and quality of care given. When you ration the amount and quality of care given, you can drive costs down.

Private insurers also ration the amount and quality of care given.

Everyone rations.

The difference between the US and the single-payers is that more care is given and better care is given vs. the rest of the world where gov't budgets are constrained so care is constrained.

I'm in Ontario and I can't even get a general practitioner. This is worse than communism.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#69

Post by madhadron » Wed, Aug 17, 2016, 6:25 PM UTC

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

The only place I know that actually has a market is Switzerland. Insurers are required to offer "basic insurance." Everyone in the country is required to buy it. If you are below poverty line, it is paid for by the government. What is covered by basic insurance is set by the government, and so independent of insurer. Likewise, what insurers can ask to set rates is set by the government (age, income, sex, and smoking status basically). Insurers are required to sell basic insurance to anyone who wants to purchase. All insurance billing uses the same set of forms, so there's very little office overhead. This actually produces something that looks like a market. You can get on a website, put in a couple of values, and get a lot of quotes instantly, pick one, put in your credit card, and you're insured. Companies also sell further insurance beyond basic, and compete on quality of service for basic.

Swiss healthcare is regarded as decent but far too expensive for what it is compared to the single payer systems in all its neighbors.

Paying for healthcare isn't the place you worry about inefficiencies and waste. It's going to get paid for, and the possible efficiencies of pushing paper around are dwarfed by the cost of actually delivering medical care. So what you actually care about is delivery of health care. Italy does this really well. They have public hospitals and clinics and private ones, too. If you go to a public one, you're covered. If you go to a private one, the government pays the same to the clinic that it would pay to the public clinic. So the public system serves as a reference that the private system has to match in efficiency, performance, and price.

There is no medical or macroeconomic justification for private insurance companies. It's historical accident perpetuated by monied interests.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#70

Post by jasonlotito » Wed, Aug 17, 2016, 6:26 PM UTC

guelo wrote: post #61

jasonlotito wrote: post #39

Earlier quoted context omitted.

> For the citizen, none. Actually, that's false. I can assure you that having lived in Canada and having moved to the US because of health care, having options beyond "deal with it" when not getting any sort of care or service is wonderful. Single-payer is great if you are actually getting the care you need. But when it fails, you are left with little to no alternative. What's worse is that because of the perception…

Somewhat off topic, it seems to be easier for Canadians to permanently move to the US then for Americans to move to Canada. In your experience is that true?

Not sure. I'm American. My wife is Canadian. My children, by virtue of being my children, have dual citizenship.

Edit: Just to be clear, I can't fairly compare. My wife has an easy time because of me and my children, and I had an easy time moving and working in Canada because of my skills.