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Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

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

#131

Post by msbarnett »

forgetsusername wrote: post #116
msbarnett wrote: post #99

Earlier quoted context omitted.

> 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. Worth considering: Per http://www.chcf.org/publications/2016/05/health-care-costs-1... > US health spending reached $3.0 trillion in 2014, or $9,523 per capita, and accou…

> That's a better deal any way you look at it I'm Canadian and can't get a family doctor (nor can my wife). I don't consider that a "good deal". Maybe if it was more lucrative (read: doctors made more money, budgets were higher) we could attract more talent and I could?

The US system has the same issue -- many people don't have a regular family doctor and rely on clinics. It's a more complicated problem than pay -- family medicine simply isn't an attractive speciality to many medical students. Money could move the needle a bit, but treating strep throat is never going to be a prestigious pursuit versus a lot of other specialties. And if it doesn't improve overall longterm outcomes, it's not worth spending the money to move that needle.

At any rate, it's rarely impossible to find a family doctor, but it can take some persistence to find one accepting new patients. Almost every provincial medical association maintains a list of family doctors accepting new patients. If you're in a small town it might be a challenge, though.

edit: to put some numbers on this, 15% of Canadians don't have a family doctor (http://www.ctvnews.ca/health/canada-ranked-last-among-oecd-c...). In the much higher spending US system, 20% of Americans don't have a family doctor (http://www.fiercehealthcare.com/healthcare/one-five-american...).

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

#133

Post by Apocryphon »

rayiner wrote: post #106
Apocryphon wrote: post #93

So how can consumers respond to this corporate chicanery? In a capitalist system, the natural recourse is for citizens to turn to the private market for alternatives. Could this provide an incentive for Aetna's competitors to make it easier for Aetna's customers to switch to them? One would assume that libertarians and free marketeers would cheer the concept of boycotts, as it is one of the mechanisms that citizens a…

What corporate chicanery? They took a loss on exchange plans last year. They have every right to pull out of the exchanges until the government makes them stay. I'm a supporter of single payer. But the health care market is a sterling example of the "worst of all solutions" espoused by the Democrats. Instead of simply raising everyone's taxes to pay for public services, they try to get companies to do hidden cross-su…

It's more about opposing their attempts to thwart antitrust law. After AT&T's merger failed, T-Mobile used the money and the public fallout as an opportunity to reinvent themselves as a company that caters to the public. I'm wondering if this could be a similar opportunity for Aetna's competitors.

If the government is unable to prevent monopolies, then consumers should step in by punishing companies that seek to monopolize.

Edit: Again, that's one of the concepts behind libertarianism, isn't? The idea that instead of relying upon government regulation, there's almost some economic reputation system in place which would cause consumers to reject doing business with bad actors. So in theory, the recourse here would be for the individual consumer to reject Aetna directly in response for their monopolistic practices.

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

#134

Post by grandalf »

Apocryphon wrote: post #93

So how can consumers respond to this corporate chicanery? In a capitalist system, the natural recourse is for citizens to turn to the private market for alternatives. Could this provide an incentive for Aetna's competitors to make it easier for Aetna's customers to switch to them? One would assume that libertarians and free marketeers would cheer the concept of boycotts, as it is one of the mechanisms that citizens a…

Without a law requiring insurance companies to participate, why should they? Let's not pretend they have anything other than self-interest at stake.

Why not pass such a law? Because that would effectively mean semi-nationalizing a fairly large industry, and if we're going to do that, why not just create an actual single payer and a risk pool the size of the US population and skip the idea of having private firms involved at all.

The biggest problem with the idea of single payer "insurance" is that it's not actually insurance. It bundles in a variety of things such as pre-payment for services, wealth redistribution, price controls for services, and some actual insurance.

A social safety net is a good thing. But if we expect to benefit from the benefits of a competitive system, we have to let firms actually compete.

The core issues have to do with the lack of "insurance" market for things that are actually prepayment (like giving birth, dying of old age after $50K worth of end of life care, etc).

By mandating that consumers buy the "insurance" and mandating that insurers bundle all the non-insurance services into the package, the government essentially controls the market and avoids both the benefits of market competition and accountability for tough decisions such as which care should be covered, etc.

There have been many threats from industry and government. Government can nationalize and can pass laws that reduce profits, and firms can pull back, can merge with each other, and do other things to increase their market power.

The bottom line is that the entire system is ripe for corruption and lack of accountability. Let's face it, for a healthy young person, catastrophic insurance is next to free. Yet all of us are paying fairly high premiums so that old people can be exploited by a healthcare system that happily gives them ineffective surgeries and sells them overpriced and largely ineffective pharmaceuticals.

The system was already corrupt before Obamacare, Obamacare simply cemented many of the most lucrative public/private deals. Both sides intended to scheme a bit after the programs got underway. So we'll see a bit of tit for tat with regulators and perhaps watch one or two of the entrants leave the market allowing the profits to be divided fewer ways.

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

#135

Post by X86BSD »

X86BSD wrote: post #122
njkanjsd wrote: post #94

Earlier quoted context omitted.

Here you go: http://www.commonwealthfund.org/publications/press-releases/... You can find other articles and studies echoing the same conclusions. > When people get sick they come to the US for treatment if they can. No they don't. And many Americans go to other countries for treatment because they can't afford it in the US. > You don't see world leaders and those with money going to Canada or Europe for treatment. '…

reading those now.

"Now that millions more of Americans have good coverage..."

This link is full of horse poop.

Good coverage? Have you seen what the new ACA plans cover and don't cover?? And the cost??

Good is not a word I would use to describe their coverage.

They should have said "access to coverage" and it would have been more believable.

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

#136

Post by nappy-doo »

VonGuard wrote: post #114
Randgalt wrote: post #97

Earlier quoted context omitted.

That's an excellent point. Medicare and SSI are equally bad programs that should be phased out.

I often wonder if John Galt ever found himself living alone in a room with no one to take care of him in his old age.

Who is John Galt? :)

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

#137

Post by nappy-doo »

VonGuard wrote: post #117
Frondo wrote: post #35

Earlier quoted context omitted.

Obamacare has had one significant, lasting effect: culturally, the idea is now that everyone should have access to health care. That's the default. Bringing in a public option will be an easy, natural next step, if not for Clinton, then for whoever succeeds her.

If Clinton brings us single payer, I will worship at her altar forever. She used to promise this stuff in the 90's, but basically gave it all up when she actually went into politics and gained public office, later saying single payer will not work. If she does get us single payer, she's the greatest trojan horse ever in American politics.

> If she does get us single payer, she's the greatest trojan horse ever in American politics.

Arguably, that'd be Trump instead of Clinton.

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

#138

Post by riboflava »

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 best is probably a mix, like Singapore. The citizens win in the case the government provider is efficient or inefficient, because in either scenario the government sets a floor of efficiency that private companies can't go under and survive. In a purely private market there's the potential for collusion, or in a heavily regulated market there's the potential for forced inefficiencies. When you just have the single government provider, you cut off the possibility of doing much better, and you create a big incentive for everyone in the industry to inflate their costs because the government always pays.

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

#139

Post by Analemma_ »

rayiner wrote: post #106
Apocryphon wrote: post #93

So how can consumers respond to this corporate chicanery? In a capitalist system, the natural recourse is for citizens to turn to the private market for alternatives. Could this provide an incentive for Aetna's competitors to make it easier for Aetna's customers to switch to them? One would assume that libertarians and free marketeers would cheer the concept of boycotts, as it is one of the mechanisms that citizens a…

What corporate chicanery? They took a loss on exchange plans last year. They have every right to pull out of the exchanges until the government makes them stay. I'm a supporter of single payer. But the health care market is a sterling example of the "worst of all solutions" espoused by the Democrats. Instead of simply raising everyone's taxes to pay for public services, they try to get companies to do hidden cross-su…

> ... sterling example of the "worst of all solutions" espoused by the Democrats. Instead of simply raising everyone's taxes to pay for public services ...

Nope, I'm not letting this slide by. The Democrats did try to do exactly what you propose in the 90s. If it had worked, we would've had a first-world health care system two decades ago. But it was screamed down by the Republican Congress with the usual taxes-liberty-communism-Stalin rhetoric. The ACA was intended as an improvement over the nightmare we had pre-2010 that was still digestible to Republicans. Remember: it's fundamentally a Republican idea. It's similar to what Gingrich proposed as a counter to Clinton's plan (which is what really boils my blood about conservation opposition to it), and it's more-or-less identical to what Romney implemented when he was governor of Massachusetts.

So yes, the ACA is a "worst of all worlds" compromise, and of course it sucks. Almost all the Democrats I know agree that it should be scrapped and replaced by a single-payer system tomorrow. But since that doesn't seem likely to happen, the ACA is what we've got. And your blaming of the Democrats for the failure of a Republican idea implemented because the Democrat's much better idea isn't politically possible is despicable and disingenuous in the extreme.

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

#140

Post by Mister_Snuggles »

graeme wrote: post #85
Mister_Snuggles wrote: post #24

Earlier quoted context omitted.

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.

I was replying to this part of the parent comment when I used the words "inefficiencies" and "waste":

> Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

I also acknowledged that I have no idea if $20B is good or bad. And I did not make the case that it's more or less expensive relative to the US.

Another commenter took the Alberta budget numbers and ran with it to get to a per-capita cost relative to the US.

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