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

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

#81

Post by blocktuw » Wed, Aug 17, 2016, 6:30 PM UTC

Randgalt wrote: post #29

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 purpose of government is not to require the most efficient option. Government isn't capable of it anyway. Government is force - nothing more. The purpose of government is to protect our rights. "Single payer" (a euphemism for socialized medicine) by definition violates rights by forcing people to do things against their will. For example, in Canada (until recently) people were prohibited from using private health…

I believe your examples of public services being worse than their private counterparts is a specious argument. Most private schools are paid for by rich people. The cost to attend is higher than public school so it would reason that the quality is better. Same for USPS vs FedEx. The shipping rates for USPS are much cheaper.

Some people are price sensitive. Cheaper is all they can manage to afford and are willing to accept less quality in return. As a healthy person I'd rather take a two percent annual increase in insurance premiums for lower quality of care since I do not have much need for services.

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

#82

Post by Randgalt » Wed, Aug 17, 2016, 6:30 PM UTC

loteck wrote: post #75

Randgalt wrote: post #29

Earlier quoted context omitted.

The purpose of government is not to require the most efficient option. Government isn't capable of it anyway. Government is force - nothing more. The purpose of government is to protect our rights. "Single payer" (a euphemism for socialized medicine) by definition violates rights by forcing people to do things against their will. For example, in Canada (until recently) people were prohibited from using private health…

For example, in Canada (until recently) Until recently. This means that all people can obtain health care regardless of their ability to pay, and that the system is flexible enough to continue to experiment with the ideal implementation. Are public schools better than private schools? Public schools are exactly 100% better than private schools for students who can't afford to attend private schools. Is the US postal…

1. Try getting an MRI in Canada. Canada rations care via wait lists.

2. Your argument implies that there wouldn't be low cost schools in the absence of public schools. The evidence is overwhelming that the opposite is true.

3. I live in Panama. When I need something mailed here I use FedEx or DHL. The USPS is unreliable and takes far too long. If there weren't laws against private first class mail in the US they'd be undercut in that market as well.

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

#83

Post by uptown » Wed, Aug 17, 2016, 6:30 PM UTC

addicted wrote: post #64

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.

Absolutely. But I'd wager the vast majority of the increases land well above the rate of inflation. And since open-enrollment begins a few days before the Presidential election, it'll be interesting to see how those numbers are managed given that Hillary has hitched her campaign to the Affordable Care Act as an extension of her original campaign for universal health insurance when she was First Lady.

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

#84

Post by mhurron » Wed, Aug 17, 2016, 6:30 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…

You must be pretty healthy or never actually had to pay for care in the US. You also probably shouldn't assume you're the only one in the room who moved to the US from another country.

I moved to the US from Canada, thankfully I am pretty healthy and don't need the healthcare system beyond my yearly checkups. The first place I lived had someone who lived down the street who will be paying off a $100k bill until they die because of a heart surgery they had to have. Wonderful system.

On the other hand my father, who still lives in Canada, complained of shortness of breath one Thursday. Called his doctor and was told to go into the emergency room right then. He did, because he didn't have to worry about how much the visit would cost. They found a 90% blockage in his aorta. Was immediately admitted for surgery that occurred Friday. Was free to leave the next week. Total cost, $150.

Ya, US health care system is fucking awesome.

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

#85

Post by graeme » Wed, Aug 17, 2016, 6:30 PM UTC

Mister_Snuggles wrote: post #24

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?

It's hard to tell if there are inefficiencies and waste or if health care is just simply really expensive. Health care is done by the Provinces in Canada, with transfers from the Federal Government to help out. The most recent Alberta budget[0] puts the cost of health care at about $20B. This represents approximately 40% of Alberta government spending. Is that due to waste or inefficiencies? I honestly have no idea.…

Why do you say inefficiencies? 40% is entirely out of context, because you haven't listed what other budgeting responsibilities Canadian provinces have.

Canada spends far less per capita on health than the us, and gets better outcomes.

It's certainly expensive, but it's hard to make the case that Canadian care is expensive relative to the US.

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

#86

Post by marxidad » Wed, Aug 17, 2016, 6:30 PM UTC

bcohen5055 wrote: post #15

njkanjsd wrote: post #5

Earlier quoted context omitted.

The healthcare system in countries like France, Canada, Germany is much more efficient and provides better healthcare to most of it's citizens than the US healthcare system pre and post obamacare. https://www.oecd.org/eco/growth/46508904.pdf http://www.commonwealthfund.org/publications/press-releases/...

*citations needed

http://healthaffairs.org/blog/2011/09/20/medicare-is-more-ef...

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

#87

Post by CodeSheikh » Wed, Aug 17, 2016, 6:31 PM UTC

We need a serious disruption of insurance industry. A paradigm change.

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

#88

Post by MrQuincle » Wed, Aug 17, 2016, 6:32 PM UTC

madhadron wrote: post #69

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…

The Netherlands has also a private market like this: https://www.government.nl/topics/health-insurance.

I always go for a high deductible (and lower monthly fee) for example.

Edit:

(1) Costs for individual: It does cost me around 80 euros, my deductible is 800 euros (maximum allowed) and I'm 100% covered for medical costs at the physician and at the hospital.

(2) Costs for government: 11.9% of GDP.

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

#89

Post by brightball » Wed, Aug 17, 2016, 6:32 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 benefit vs how they happened are very different things.

Initially, the benefit was that people paid all medical expenses out of pocket and could purchase insurance in case of extreme medical issues.

Businesses started offering health insurance as a perk to attract employees and would negotiate a group rate. This benefits the business by both helping to attract / retain employees as well as helping to keep those employees healthy.

Labor unions campaigned to have employer sponsored health insurance which lead to insurance lock-in to a business, usually on 3-5 year agreements, without the employee having any say in where they were getting their insurance from or how much it cost. In effect, this removed health insurance from the consumer market. Compounding the problem, businesses could tax deduct the cost of insurance while employees could not.

So both the cost and quality of insurance was removed from the consumer market. Insurance removes the cost of medical care from the consumer market. Federal tax deductions only for businesses incentivize this arrangement.

The problem here is not caused by capitalism.

This is also before we take into account sheer supply/demand factors around doctors and the regulatory bodies involved in the supply side.

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

#90

Post by tracker1 » Wed, Aug 17, 2016, 6:32 PM UTC

gnaritas wrote: post #63

tracker1 wrote: post #42

Earlier quoted context omitted.

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.…

And the problem is that everyone in congress is trying to push for their own optimal interests, so the compromises are less ideal than a more pragmatic approach that would have the same effect as compromise from all parties. It's not either's ideal, but still better.

If I had the financial independence to run for Congress, I absolutely would.. unfortunately I need to work for a living, and being able to sustain a living while even trying to run isn't something I'd be able to do. Beyond this, running as a Libertarian would be even more difficult.

First, I'm in favor of voting for no incumbents for a few election cycles... from there, I'd love to see actual politicians working to sell pragmatic choices towards consensus instead of the give/take we get today, with the boatloads of pork that come with it.