On 2/8/2023 1:11 PM, rkshullat@rosettacondot.com wrote:
> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>> wrote:
>>
>>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>>> are going to cut or do away with Social Security and Medicare, but I
>>>> just don't see it. It's the same old same old scare tactics.
>>>
>>> From https://fiscaldata.treasury.gov/americas-finance-guide/federal-spending/
>>> federal government spending
>>> 19% social security
>>> 15% health
>>> 14% income security
>>> 12% national defence
>>> 12% medicare
>>> 11% education, training employment and social services
>>> 8% interest
>>> 4% veterans' benefits and services
>>> 2% transportation
>>> 2% general government
>>> 1% other
>>>
>>> where do you think they're going to make cuts?
>>
>> Well, instituting a proper national health service would roughly halve
>> that 15% health + 12% medicare, and probably takes a chunk out of that
>> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>> whole health insurance industry, bringing the US wasted overspend on
>> health down to the same ballpark as other democratic countries and quite
>> possibly getting you away from being bottom of the league for survival
>> rates across most demographics too.
>
> I suspect that it would do more to improve average life expectancy than it
> would to save money. There's currently a huge life expectancy gap between
> the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
> Even with single-payer you still have to deal with much higher salaries,
> higher infrastructure costs, higher liability costs (and the resulting
> defensive testing) and limited access (especially in rural areas).
> Studies vary, but the expected savings on administrative overhead is closer
> to 10% than 50%.
>
> Robert

Don't forget Pournelle's Iron Law of Bureaucracy:
https://en.wikipedia.org/wiki/Jerry_Pournelle#Pournelle's_laws

Basically, "In any bureaucracy, the people devoted to the benefit of the
bureaucracy itself always get in control and those dedicated to the
goals that the bureaucracy is supposed to accomplish have less and less
influence, and sometimes are eliminated entirely."

Lynn

On 2/8/2023 4:05 PM, pete...@gmail.com wrote:
> On Wednesday, February 8, 2023 at 4:23:58 PM UTC-5, Lynn McGuire wrote:
>> On 2/8/2023 12:37 PM, rksh...@rosettacondot.com wrote:
>>> Johnny1A <johnny1...@gmail.com> wrote:
>>>> On Tuesday, February 7, 2023 at 2:24:18 PM UTC-6, Lynn McGuire wrote:
>>>>> On 2/7/2023 12:07 AM, Dimensional Traveler wrote:
>>>>>> On 2/6/2023 4:23 PM, Mike Van Pelt wrote:
>>>>>>> In article <f7622c93-6a19-4dd5...@googlegroups.com>,
>>>>>>> Quadibloc <jsa...@ecn.ab.ca> wrote:
>>>>>>>> ... surely
>>>>>>>> we must ask why there even _is_ a national debt. During peacetime, it is
>>>>>>>> expected that a country would pay off all of its debts, and get back
>>>>>>>> to an
>>>>>>>> even keel!
>>>>>>>
>>>>>>> During the Gingrich Speakership with a GOP majority in both Houses,
>>>>>>> we at least had balanced budgets, though the debt remained high.
>>>>>>>
>>>>>>>> Of course, though, the way to get the country out of debt isn't by
>>>>>>>> cutting
>>>>>>>> Social Security! Not when taxes on the higher income brackets are so
>>>>>>>> much lower than they were back in the prosperous early 1960s. And,
>>>>>>>> indeed, the only reason Social Security has problems funding itself was
>>>>>>>> because money was basically stolen from it by earlier Congresses.
>>>>>>>>
>>>>>>>> They just want to force cuts to Social Security because they figure they
>>>>>>>> can get the voters to blame the Democrats for it instead of them.
>>>>>>>
>>>>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>>>>>> are going to cut or do away with Social Security and Medicare, but I
>>>>>>> just don't see it. It's the same old same old scare tactics.
>>>>>>>
>>>>>> Column: Mike Pence, would-be president, has a plan to kill Social
>>>>>> Security. It will cost you.
>>>>>>
>>>>>> https://www.msn.com/en-us/money/news/column-mike-pence-would-be-president-has-a-plan-to-kill-social-security-it-will-cost-you/ar-AA17bgN7?ocid=winpstoreapp&cvid=66271562145d45d9b4cc65f536e7f90a
>>>>>>
>>>>>> Republicans have been trying for decades to "privatize" Social Security,
>>>>>> "balance" MediCare and otherwise defund and eliminate various social
>>>>>> safety nets that taxpayers pay for. The current tactic of refusing to
>>>>>> raise the debt limit until budget cuts are agreed to is the _same_ thing
>>>>>> the Republicans have done several times before and the only budget cuts
>>>>>> they are ever willing to accept are to the so-called "Entitlement"
>>>>>> programs, especially Social Security. Which aren't actually
>>>>>> entitlements as we get taxed _specifically_ for them separate from the
>>>>>> general income tax.
>>>>> Never gonna happen. But, Social Security might be means tested like
>>>>> Australia did a decade or so ago. Bill Gates won't get a SS transfer
>>>>> each month into his checking account. Of course, the SS check would be
>>>>> a rounding error for him.
>>>>>
>>>>> Lynn
>>>>
>>>> The issue with means testing is that it sounds good, and it might even make economic sense, but political and culturally it's toxic. SocSec is popular and politically untouchable in part because it is mostly universal. Once you start breaking up that sense of 'everybody', the politics of the whole thing suddenly changes.
>>>
>>> It's not so much that it couldn't be done at all, it's that it would need to
>>> impact an extremely limited set of individuals (0.1%? 1%) and/or be
>>> implemented over a long time period. Telling 20-somethings that Social
>>> Security will be means-tested when they retire is very different from doing it
>>> to 60-somethings.
>>> You don't have to go very far down the percentile ranks for wealth before
>>> Social Security becomes a significant, or the predominant, source of income.
>>>
>>> Robert
>> I had been planning on the wife (65 next month) and I (62) both
>> receiving social security. I now suspect that SS will be means tested
>> by 2030 so I am going to work longer if I can. And those means will be
>> way lower than people suspect. Maybe as low as $100,000 in assets.
>
> My wife is retired and gets SS. I'm still working, so not. But our retirement
> planning includes a basic assumption that it needs to work even if SS goes
> away entirely.
>
> pt

Don't read The Mandibles book then.
https://www.amazon.com/Mandibles-Family-2029-2047-Lionel-Shriver/dp/006232828X/

Lynn

On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
<rkshullat@rosettacondot.com> wrote:

> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>> wrote:
>>
>>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>>> are going to cut or do away with Social Security and Medicare, but I
>>>> just don't see it. It's the same old same old scare tactics.
>>>
>>> From https://fiscaldata.treasury.gov/americas-finance-guide/federal-spending/
>>> federal government spending
>>> 19% social security
>>> 15% health
>>> 14% income security
>>> 12% national defence
>>> 12% medicare
>>> 11% education, training employment and social services
>>> 8% interest
>>> 4% veterans' benefits and services
>>> 2% transportation
>>> 2% general government
>>> 1% other
>>>
>>> where do you think they're going to make cuts?
>>
>> Well, instituting a proper national health service would roughly halve
>> that 15% health + 12% medicare, and probably takes a chunk out of that
>> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>> whole health insurance industry, bringing the US wasted overspend on
>> health down to the same ballpark as other democratic countries and quite
>> possibly getting you away from being bottom of the league for survival
>> rates across most demographics too.
>
> I suspect that it would do more to improve average life expectancy than it
> would to save money. There's currently a huge life expectancy gap between
> the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
> Even with single-payer you still have to deal with much higher salaries,
> higher infrastructure costs, higher liability costs (and the resulting
> defensive testing) and limited access (especially in rural areas).
> Studies vary, but the expected savings on administrative overhead is closer
> to 10% than 50%.

Tell that to countries managing to get better outcomes on half the
money.

You apparently have no idea how pernicious and enormous the "health
insurance" industry is.

Cheers - Jaimie

--
"Hey T-Rex! This ice cream cake is delicious!"
"Thanks! You don't think it tastes like... *philosophical compromise*?"
"Only a little!
-- http://www.qwantz.com/index.php?comic=1093

In article <k4j090Fr9i3U1@mid.individual.net>,
Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:

> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
> <rkshullat@rosettacondot.com> wrote:
>
> > Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
> >> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
> >> wrote:
> >>
> >>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
> >>>> Who is this "they"? The Democrats keep asserting that the Republicans
> >>>> are going to cut or do away with Social Security and Medicare, but I
> >>>> just don't see it. It's the same old same old scare tactics.
> >>>

<Snip of Federal Budget breakdown>
> >>
> >> Well, instituting a proper national health service would roughly halve
> >> that 15% health + 12% medicare, and probably takes a chunk out of that
> >> 4% veterans' services too. Lets say that frees up 13% by eliminating the
> >> whole health insurance industry, bringing the US wasted overspend on
> >> health down to the same ballpark as other democratic countries and quite
> >> possibly getting you away from being bottom of the league for survival
> >> rates across most demographics too.
> >
> > I suspect that it would do more to improve average life expectancy than it
> > would to save money. There's currently a huge life expectancy gap between
> > the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
> > Even with single-payer you still have to deal with much higher salaries,
> > higher infrastructure costs, higher liability costs (and the resulting
> > defensive testing) and limited access (especially in rural areas).
> > Studies vary, but the expected savings on administrative overhead is closer
> > to 10% than 50%.
>
> Tell that to countries managing to get better outcomes on half the
> money.
>
> You apparently have no idea how pernicious and enormous the "health
> insurance" industry is.

So how big is it? How many total employees do the various health
insurance companies have? If they are half the medical cost, there would
be roughly about 14 million of them.

--
"We have advanced to new and surprising levels of bafflement."
Imperial Auditor Miles Vorkosigan describes progress in _Komarr_.
—-----------------------------------------------------
Robert Woodward robertaw@drizzle.com

On 2/8/2023 10:01 PM, Robert Woodward wrote:
> In article <k4j090Fr9i3U1@mid.individual.net>,
> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>
>> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
>> <rkshullat@rosettacondot.com> wrote:
>>
>>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>>> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>>>> wrote:
>>>>
>>>>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>>>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>>>>> are going to cut or do away with Social Security and Medicare, but I
>>>>>> just don't see it. It's the same old same old scare tactics.
>>>>>
>
> <Snip of Federal Budget breakdown>
>>>>
>>>> Well, instituting a proper national health service would roughly halve
>>>> that 15% health + 12% medicare, and probably takes a chunk out of that
>>>> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>>>> whole health insurance industry, bringing the US wasted overspend on
>>>> health down to the same ballpark as other democratic countries and quite
>>>> possibly getting you away from being bottom of the league for survival
>>>> rates across most demographics too.
>>>
>>> I suspect that it would do more to improve average life expectancy than it
>>> would to save money. There's currently a huge life expectancy gap between
>>> the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
>>> Even with single-payer you still have to deal with much higher salaries,
>>> higher infrastructure costs, higher liability costs (and the resulting
>>> defensive testing) and limited access (especially in rural areas).
>>> Studies vary, but the expected savings on administrative overhead is closer
>>> to 10% than 50%.
>>
>> Tell that to countries managing to get better outcomes on half the
>> money.
>>
>> You apparently have no idea how pernicious and enormous the "health
>> insurance" industry is.
>
> So how big is it? How many total employees do the various health
> insurance companies have? If they are half the medical cost, there would
> be roughly about 14 million of them.
>
Berkshire Hathaway is one of the biggest conglomerates in the world
owned by one of the richest people in the world and insurance is its
biggest source of revenue.

--
I've done good in this world. Now I'm tired and just want to be a cranky
dirty old man.

pete...@gmail.com <petertrei@gmail.com> wrote:
> On Wednesday, February 8, 2023 at 4:23:58 PM UTC-5, Lynn McGuire wrote:
>> On 2/8/2023 12:37 PM, rksh...@rosettacondot.com wrote:
>> > Johnny1A <johnny1...@gmail.com> wrote:
>> >> On Tuesday, February 7, 2023 at 2:24:18 PM UTC-6, Lynn McGuire wrote:
>> >>> On 2/7/2023 12:07 AM, Dimensional Traveler wrote:
>> >>>> On 2/6/2023 4:23 PM, Mike Van Pelt wrote:
>> >>>>> In article <f7622c93-6a19-4dd5...@googlegroups.com>,
>> >>>>> Quadibloc <jsa...@ecn.ab.ca> wrote:
>> >>>>>> ... surely
>> >>>>>> we must ask why there even _is_ a national debt. During peacetime, it is
>> >>>>>> expected that a country would pay off all of its debts, and get back
>> >>>>>> to an
>> >>>>>> even keel!
>> >>>>>
>> >>>>> During the Gingrich Speakership with a GOP majority in both Houses,
>> >>>>> we at least had balanced budgets, though the debt remained high.
>> >>>>>
>> >>>>>> Of course, though, the way to get the country out of debt isn't by
>> >>>>>> cutting
>> >>>>>> Social Security! Not when taxes on the higher income brackets are so
>> >>>>>> much lower than they were back in the prosperous early 1960s. And,
>> >>>>>> indeed, the only reason Social Security has problems funding itself was
>> >>>>>> because money was basically stolen from it by earlier Congresses.
>> >>>>>>
>> >>>>>> They just want to force cuts to Social Security because they figure they
>> >>>>>> can get the voters to blame the Democrats for it instead of them.
>> >>>>>
>> >>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>> >>>>> are going to cut or do away with Social Security and Medicare, but I
>> >>>>> just don't see it. It's the same old same old scare tactics.
>> >>>>>
>> >>>> Column: Mike Pence, would-be president, has a plan to kill Social
>> >>>> Security. It will cost you.
>> >>>>
>> >>>> https://www.msn.com/en-us/money/news/column-mike-pence-would-be-president-has-a-plan-to-kill-social-security-it-will-cost-you/ar-AA17bgN7?ocid=winpstoreapp&cvid=66271562145d45d9b4cc65f536e7f90a
>> >>>>
>> >>>> Republicans have been trying for decades to "privatize" Social Security,
>> >>>> "balance" MediCare and otherwise defund and eliminate various social
>> >>>> safety nets that taxpayers pay for. The current tactic of refusing to
>> >>>> raise the debt limit until budget cuts are agreed to is the _same_ thing
>> >>>> the Republicans have done several times before and the only budget cuts
>> >>>> they are ever willing to accept are to the so-called "Entitlement"
>> >>>> programs, especially Social Security. Which aren't actually
>> >>>> entitlements as we get taxed _specifically_ for them separate from the
>> >>>> general income tax.
>> >>> Never gonna happen. But, Social Security might be means tested like
>> >>> Australia did a decade or so ago. Bill Gates won't get a SS transfer
>> >>> each month into his checking account. Of course, the SS check would be
>> >>> a rounding error for him.
>> >>>
>> >>> Lynn
>> >>
>> >> The issue with means testing is that it sounds good, and it might even make economic sense, but political and culturally it's toxic. SocSec is popular and politically untouchable in part because it is mostly universal. Once you start breaking up that sense of 'everybody', the politics of the whole thing suddenly changes.
>> >
>> > It's not so much that it couldn't be done at all, it's that it would need to
>> > impact an extremely limited set of individuals (0.1%? 1%) and/or be
>> > implemented over a long time period. Telling 20-somethings that Social
>> > Security will be means-tested when they retire is very different from doing it
>> > to 60-somethings.
>> > You don't have to go very far down the percentile ranks for wealth before
>> > Social Security becomes a significant, or the predominant, source of income.
>> >
>> > Robert
>> I had been planning on the wife (65 next month) and I (62) both
>> receiving social security. I now suspect that SS will be means tested
>> by 2030 so I am going to work longer if I can. And those means will be
>> way lower than people suspect. Maybe as low as $100,000 in assets.
>
> My wife is retired and gets SS. I'm still working, so not. But our retirement
> planning includes a basic assumption that it needs to work even if SS goes
> away entirely.

We do as well, although the some of the projections get pretty grim. For
example, if they apply the "spend down" concept to both Social Security
and Medicare our monthly income @70 drops by $6K and our monthly medical
costs rise by at least $1K. Making up for that is well past "beans, rice
and turn the A/C down" for cost cutting.

Robert
--
Robert K. Shull Email: rkshull at rosettacon dot com

Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
> <rkshullat@rosettacondot.com> wrote:
>
>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>>> wrote:
>>>
>>>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>>>> are going to cut or do away with Social Security and Medicare, but I
>>>>> just don't see it. It's the same old same old scare tactics.
>>>>
>>>> From https://fiscaldata.treasury.gov/americas-finance-guide/federal-spending/
>>>> federal government spending
>>>> 19% social security
>>>> 15% health
>>>> 14% income security
>>>> 12% national defence
>>>> 12% medicare
>>>> 11% education, training employment and social services
>>>> 8% interest
>>>> 4% veterans' benefits and services
>>>> 2% transportation
>>>> 2% general government
>>>> 1% other
>>>>
>>>> where do you think they're going to make cuts?
>>>
>>> Well, instituting a proper national health service would roughly halve
>>> that 15% health + 12% medicare, and probably takes a chunk out of that
>>> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>>> whole health insurance industry, bringing the US wasted overspend on
>>> health down to the same ballpark as other democratic countries and quite
>>> possibly getting you away from being bottom of the league for survival
>>> rates across most demographics too.
>>
>> I suspect that it would do more to improve average life expectancy than it
>> would to save money. There's currently a huge life expectancy gap between
>> the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
>> Even with single-payer you still have to deal with much higher salaries,
>> higher infrastructure costs, higher liability costs (and the resulting
>> defensive testing) and limited access (especially in rural areas).
>> Studies vary, but the expected savings on administrative overhead is closer
>> to 10% than 50%.
>
> Tell that to countries managing to get better outcomes on half the
> money.
>
> You apparently have no idea how pernicious and enormous the "health
> insurance" industry is.

And you apparently have no idea of the many other contributions to that 50%.
A select few...
Medical salaries are higher in the US...2-3 times compared to the UK, and not
just for specialists.
The US population is generally less healthy. We spend a significantly higher
percentage on treating chronic conditions...conditions of poverty and
lifestyle. We tend to spend more on expensive treatment than inexpensive
prevention.
Liability concerns push doctors toward defensive medicine...ordering tests
not because they think they're needed but because not doing them could be
used against them in future lawsuits.
Drug costs are higher, even for private insurance where the companies can
negotiate pricing or refuse to reimburse entirely.
Ignoring all of that, there are huge gaps in our existing healthcare system.
A national system would, presumably, have to serve the nation and not just
select bits of it. There are big chunks of the rural US where anything beyond
basic care is hours away and an emergency means a very expensive 100+ mile
helicopter flight. There are tens of millions of people not getting care for
chronic diseases right now. There's a huge expansion of capacity needed to
provide that care.

Robert
--
Robert K. Shull Email: rkshull at rosettacon dot com

Lynn McGuire <lynnmcguire5@gmail.com> writes:
>On 2/8/2023 1:11 PM, rkshullat@rosettacondot.com wrote:
>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>>> wrote:

>Don't forget Pournelle's Iron Law of Bureaucracy:
> https://en.wikipedia.org/wiki/Jerry_Pournelle#Pournelle's_laws

They're not laws, but rather aphorisms. And should be considered as such.

Robert Woodward <robertaw@drizzle.com> writes:
>In article <k4j090Fr9i3U1@mid.individual.net>,
> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>
>> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
>> <rkshullat@rosettacondot.com> wrote:
>>
>> > Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>> >> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>> >> wrote:
>> >>
>> >>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>> >>>> Who is this "they"? The Democrats keep asserting that the Republicans
>> >>>> are going to cut or do away with Social Security and Medicare, but I
>> >>>> just don't see it. It's the same old same old scare tactics.
>> >>>
>
><Snip of Federal Budget breakdown>
>> >>
>> >> Well, instituting a proper national health service would roughly halve
>> >> that 15% health + 12% medicare, and probably takes a chunk out of that
>> >> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>> >> whole health insurance industry, bringing the US wasted overspend on
>> >> health down to the same ballpark as other democratic countries and quite
>> >> possibly getting you away from being bottom of the league for survival
>> >> rates across most demographics too.
>> >
>> > I suspect that it would do more to improve average life expectancy than it
>> > would to save money. There's currently a huge life expectancy gap between
>> > the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
>> > Even with single-payer you still have to deal with much higher salaries,
>> > higher infrastructure costs, higher liability costs (and the resulting
>> > defensive testing) and limited access (especially in rural areas).
>> > Studies vary, but the expected savings on administrative overhead is closer
>> > to 10% than 50%.
>>
>> Tell that to countries managing to get better outcomes on half the
>> money.
>>
>> You apparently have no idea how pernicious and enormous the "health
>> insurance" industry is.
>
>So how big is it? How many total employees do the various health
>insurance companies have? If they are half the medical cost, there would
>be roughly about 14 million of them.

The last 10-K I looked for UHC (United Health Care, one of the largest
insurers) indicated revenue of X and a profit of .3X, so that's a 30%
overhead hit right there. Add in all the clerks from the provider,
the pharmacies, the labs who must do the extensive paperwork, you'll
likely find the overhead is closer to 50%. It is a completely nutty
system designed to profit everyone up the chain; the more links in
the chain, the more profit is squeezed from the process.

Dimensional Traveler <dtravel@sonic.net> writes:
>On 2/8/2023 10:01 PM, Robert Woodward wrote:
>> In article <k4j090Fr9i3U1@mid.individual.net>,

>> So how big is it? How many total employees do the various health
>> insurance companies have? If they are half the medical cost, there would
>> be roughly about 14 million of them.
>>
>Berkshire Hathaway is one of the biggest conglomerates in the world
>owned by one of the richest people in the world and insurance is its
>biggest source of revenue.

Berkshire Hathaway doesn't do health insurance, they do property
and causualty insurance as well as reinsurance (insuring insurance companies).

On Wed, 8 Feb 2023 18:37:38 -0000 (UTC), rkshullat@rosettacondot.com
wrote:

>Johnny1A <johnny1a.again@gmail.com> wrote:

<snippo>

>> The issue with means testing is that it sounds good, and it might even make economic sense, but political and culturally it's toxic. SocSec is popular and politically untouchable in part because it is mostly universal. Once you start breaking up that sense of 'everybody', the politics of the whole thing suddenly changes.
>
>It's not so much that it couldn't be done at all, it's that it would need to
>impact an extremely limited set of individuals (0.1%? 1%) and/or be
>implemented over a long time period. Telling 20-somethings that Social
>Security will be means-tested when they retire is very different from doing it
>to 60-somethings.
>You don't have to go very far down the percentile ranks for wealth before
>Social Security becomes a significant, or the predominant, source of income.

And a significant source of political consequences to the idiots
imposing it.

Not just from the recipients, but also from their children, who now
find themselves expected to support their parents.

Which means that more people than might be expected are going to be
affected and up in arms (perhaps literally) over the issue.

Of course, the devil will, as always, be in the details ...
--
"In this connexion, unquestionably the most significant
development was the disintegration, under Christian
influence, of classical conceptions of the family and
of family right."

On Thu, 09 Feb 2023 14:55:03 GMT, scott@slp53.sl.home (Scott Lurndal)
wrote:

>Robert Woodward <robertaw@drizzle.com> writes:
>>In article <k4j090Fr9i3U1@mid.individual.net>,
>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>
>>> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
>>> <rkshullat@rosettacondot.com> wrote:
>>>
>>> > Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>> >> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>>> >> wrote:
>>> >>
>>> >>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>>> >>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>> >>>> are going to cut or do away with Social Security and Medicare, but I
>>> >>>> just don't see it. It's the same old same old scare tactics.
>>> >>>
>>
>><Snip of Federal Budget breakdown>
>>> >>
>>> >> Well, instituting a proper national health service would roughly halve
>>> >> that 15% health + 12% medicare, and probably takes a chunk out of that
>>> >> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>>> >> whole health insurance industry, bringing the US wasted overspend on
>>> >> health down to the same ballpark as other democratic countries and quite
>>> >> possibly getting you away from being bottom of the league for survival
>>> >> rates across most demographics too.
>>> >
>>> > I suspect that it would do more to improve average life expectancy than it
>>> > would to save money. There's currently a huge life expectancy gap between
>>> > the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
>>> > Even with single-payer you still have to deal with much higher salaries,
>>> > higher infrastructure costs, higher liability costs (and the resulting
>>> > defensive testing) and limited access (especially in rural areas).
>>> > Studies vary, but the expected savings on administrative overhead is closer
>>> > to 10% than 50%.
>>>
>>> Tell that to countries managing to get better outcomes on half the
>>> money.
>>>
>>> You apparently have no idea how pernicious and enormous the "health
>>> insurance" industry is.
>>
>>So how big is it? How many total employees do the various health
>>insurance companies have? If they are half the medical cost, there would
>>be roughly about 14 million of them.
>
>The last 10-K I looked for UHC (United Health Care, one of the largest
>insurers) indicated revenue of X and a profit of .3X, so that's a 30%
>overhead hit right there. Add in all the clerks from the provider,
>the pharmacies, the labs who must do the extensive paperwork, you'll
>likely find the overhead is closer to 50%. It is a completely nutty
>system designed to profit everyone up the chain; the more links in
>the chain, the more profit is squeezed from the process.

It is the very epitome of Capitalism.

Unfortunately.
--
"In this connexion, unquestionably the most significant
development was the disintegration, under Christian
influence, of classical conceptions of the family and
of family right."

On 2/9/2023 6:56 AM, Scott Lurndal wrote:
> Dimensional Traveler <dtravel@sonic.net> writes:
>> On 2/8/2023 10:01 PM, Robert Woodward wrote:
>>> In article <k4j090Fr9i3U1@mid.individual.net>,
>
>>> So how big is it? How many total employees do the various health
>>> insurance companies have? If they are half the medical cost, there would
>>> be roughly about 14 million of them.
>>>
>> Berkshire Hathaway is one of the biggest conglomerates in the world
>> owned by one of the richest people in the world and insurance is its
>> biggest source of revenue.
>
> Berkshire Hathaway doesn't do health insurance, they do property
> and causualty insurance as well as reinsurance (insuring insurance companies).
>
I spent some time working in the Workers Compensation Insurance section,
which is a form of medical insurance.

--
I've done good in this world. Now I'm tired and just want to be a cranky
dirty old man.

Dimensional Traveler <dtravel@sonic.net> wrote:
> On 2/9/2023 6:56 AM, Scott Lurndal wrote:
>> Dimensional Traveler <dtravel@sonic.net> writes:
>>> On 2/8/2023 10:01 PM, Robert Woodward wrote:
>>>> In article <k4j090Fr9i3U1@mid.individual.net>,
>>
>>>> So how big is it? How many total employees do the various health
>>>> insurance companies have? If they are half the medical cost, there would
>>>> be roughly about 14 million of them.
>>>>
>>> Berkshire Hathaway is one of the biggest conglomerates in the world
>>> owned by one of the richest people in the world and insurance is its
>>> biggest source of revenue.
>>
>> Berkshire Hathaway doesn't do health insurance, they do property
>> and causualty insurance as well as reinsurance (insuring insurance companies).
>>
> I spent some time working in the Workers Compensation Insurance section,
> which is a form of medical insurance.

It pays for medical care in job-related causes, but I'd say it's closer
to liability insurance than medical given that it also compensates for lost
income, burial, survivors' benefits, etc.

Robert
--
Robert K. Shull Email: rkshull at rosettacon dot com

Robert Woodward <robertaw@drizzle.com> wrote:
> In article <k4j090Fr9i3U1@mid.individual.net>,
> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>
>> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
>> <rkshullat@rosettacondot.com> wrote:
>>
>> > Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>> >> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>> >> wrote:
>> >>
>> >>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>> >>>> Who is this "they"? The Democrats keep asserting that the Republicans
>> >>>> are going to cut or do away with Social Security and Medicare, but I
>> >>>> just don't see it. It's the same old same old scare tactics.
>> >>>
>
> <Snip of Federal Budget breakdown>
>> >>
>> >> Well, instituting a proper national health service would roughly halve
>> >> that 15% health + 12% medicare, and probably takes a chunk out of that
>> >> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>> >> whole health insurance industry, bringing the US wasted overspend on
>> >> health down to the same ballpark as other democratic countries and quite
>> >> possibly getting you away from being bottom of the league for survival
>> >> rates across most demographics too.
>> >
>> > I suspect that it would do more to improve average life expectancy than it
>> > would to save money. There's currently a huge life expectancy gap between
>> > the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
>> > Even with single-payer you still have to deal with much higher salaries,
>> > higher infrastructure costs, higher liability costs (and the resulting
>> > defensive testing) and limited access (especially in rural areas).
>> > Studies vary, but the expected savings on administrative overhead is closer
>> > to 10% than 50%.
>>
>> Tell that to countries managing to get better outcomes on half the
>> money.
>>
>> You apparently have no idea how pernicious and enormous the "health
>> insurance" industry is.
>
> So how big is it? How many total employees do the various health
> insurance companies have? If they are half the medical cost, there would
> be roughly about 14 million of them.

Roughly 600,000, apparently at an average salary of over $3 million (if they
account for half of healthcare expenditures). I went into the wrong field.
Realistically you could get much of the benefit of a national(ized) health
care system by looking at the German system. There were a lot of compromises
and lawsuits surrounding the ACA, but that appears to have been its starting
point. Losing the statutory coverage requirement was a major blow...it
eliminated the large pool of healthy people that are needed to keep it
affordable.

Robert
--
Robert K. Shull Email: rkshull at rosettacon dot com

On 9 Feb 2023 at 14:03:15 GMT, "rkshullat@rosettacondot.com"
<rkshullat@rosettacondot.com> wrote:

> The US population is generally less healthy. We spend a significantly higher
> percentage on treating chronic conditions...conditions of poverty and
> lifestyle. We tend to spend more on expensive treatment than inexpensive
> prevention.

And why would that be? Because it costs too much to go to a primary care
doctor and prevent something.

> Liability concerns push doctors toward defensive medicine...ordering tests
> not because they think they're needed but because not doing them could be
> used against them in future lawsuits.

And because they get paid for doing them. Plus a public health service
could mandate govt insurance for the medics.

> Drug costs are higher, even for private insurance where the companies can
> negotiate pricing or refuse to reimburse entirely.

And why would *that* be? Because it's a cosy "we all win megabucks!"
profiteering cycle between the pharma companies and the insurance
companies and the for-profit hospitals.

So yes, all your "reasons" are all the same single reason - you have
private insurance running the health business.

Except this:
> There are big chunks of the rural US where anything beyond
> basic care is hours away

which is common American exceptionalism, unaware that these issues are
as solved as they physically can be in other countries. Free at point of
service includes videocalls and air ambulance.

Cheers - Jaimie

--
Imagine there were no hypothetical situations.

On 2/9/2023 12:05 PM, Jaimie Vandenbergh wrote:
> On 9 Feb 2023 at 14:03:15 GMT, "rkshullat@rosettacondot.com"
> <rkshullat@rosettacondot.com> wrote:
>
>> The US population is generally less healthy. We spend a significantly higher
>> percentage on treating chronic conditions...conditions of poverty and
>> lifestyle. We tend to spend more on expensive treatment than inexpensive
>> prevention.
>
> And why would that be? Because it costs too much to go to a primary care
> doctor and prevent something.
>
>> Liability concerns push doctors toward defensive medicine...ordering tests
>> not because they think they're needed but because not doing them could be
>> used against them in future lawsuits.
>
> And because they get paid for doing them. Plus a public health service
> could mandate govt insurance for the medics.
>
>> Drug costs are higher, even for private insurance where the companies can
>> negotiate pricing or refuse to reimburse entirely.
>
> And why would *that* be? Because it's a cosy "we all win megabucks!"
> profiteering cycle between the pharma companies and the insurance
> companies and the for-profit hospitals.
>
> So yes, all your "reasons" are all the same single reason - you have
> private insurance running the health business.
>
> Except this:
>> There are big chunks of the rural US where anything beyond
>> basic care is hours away
>
> which is common American exceptionalism, unaware that these issues are
> as solved as they physically can be in other countries. Free at point of
> service includes videocalls and air ambulance.
>
But free services don't generate profits! :P

--
I've done good in this world. Now I'm tired and just want to be a cranky
dirty old man.

On 2/8/2023 4:05 PM, pete...@gmail.com wrote:
> On Wednesday, February 8, 2023 at 4:23:58 PM UTC-5, Lynn McGuire wrote:
>> On 2/8/2023 12:37 PM, rksh...@rosettacondot.com wrote:
>>> Johnny1A <johnny1...@gmail.com> wrote:
>>>> On Tuesday, February 7, 2023 at 2:24:18 PM UTC-6, Lynn McGuire wrote:
>>>>> On 2/7/2023 12:07 AM, Dimensional Traveler wrote:
>>>>>> On 2/6/2023 4:23 PM, Mike Van Pelt wrote:
>>>>>>> In article <f7622c93-6a19-4dd5...@googlegroups.com>,
>>>>>>> Quadibloc <jsa...@ecn.ab.ca> wrote:
>>>>>>>> ... surely
>>>>>>>> we must ask why there even _is_ a national debt. During peacetime, it is
>>>>>>>> expected that a country would pay off all of its debts, and get back
>>>>>>>> to an
>>>>>>>> even keel!
>>>>>>>
>>>>>>> During the Gingrich Speakership with a GOP majority in both Houses,
>>>>>>> we at least had balanced budgets, though the debt remained high.
>>>>>>>
>>>>>>>> Of course, though, the way to get the country out of debt isn't by
>>>>>>>> cutting
>>>>>>>> Social Security! Not when taxes on the higher income brackets are so
>>>>>>>> much lower than they were back in the prosperous early 1960s. And,
>>>>>>>> indeed, the only reason Social Security has problems funding itself was
>>>>>>>> because money was basically stolen from it by earlier Congresses.
>>>>>>>>
>>>>>>>> They just want to force cuts to Social Security because they figure they
>>>>>>>> can get the voters to blame the Democrats for it instead of them.
>>>>>>>
>>>>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>>>>>> are going to cut or do away with Social Security and Medicare, but I
>>>>>>> just don't see it. It's the same old same old scare tactics.
>>>>>>>
>>>>>> Column: Mike Pence, would-be president, has a plan to kill Social
>>>>>> Security. It will cost you.
>>>>>>
>>>>>> https://www.msn.com/en-us/money/news/column-mike-pence-would-be-president-has-a-plan-to-kill-social-security-it-will-cost-you/ar-AA17bgN7?ocid=winpstoreapp&cvid=66271562145d45d9b4cc65f536e7f90a
>>>>>>
>>>>>> Republicans have been trying for decades to "privatize" Social Security,
>>>>>> "balance" MediCare and otherwise defund and eliminate various social
>>>>>> safety nets that taxpayers pay for. The current tactic of refusing to
>>>>>> raise the debt limit until budget cuts are agreed to is the _same_ thing
>>>>>> the Republicans have done several times before and the only budget cuts
>>>>>> they are ever willing to accept are to the so-called "Entitlement"
>>>>>> programs, especially Social Security. Which aren't actually
>>>>>> entitlements as we get taxed _specifically_ for them separate from the
>>>>>> general income tax.
>>>>> Never gonna happen. But, Social Security might be means tested like
>>>>> Australia did a decade or so ago. Bill Gates won't get a SS transfer
>>>>> each month into his checking account. Of course, the SS check would be
>>>>> a rounding error for him.
>>>>>
>>>>> Lynn
>>>>
>>>> The issue with means testing is that it sounds good, and it might even make economic sense, but political and culturally it's toxic. SocSec is popular and politically untouchable in part because it is mostly universal. Once you start breaking up that sense of 'everybody', the politics of the whole thing suddenly changes.
>>>
>>> It's not so much that it couldn't be done at all, it's that it would need to
>>> impact an extremely limited set of individuals (0.1%? 1%) and/or be
>>> implemented over a long time period. Telling 20-somethings that Social
>>> Security will be means-tested when they retire is very different from doing it
>>> to 60-somethings.
>>> You don't have to go very far down the percentile ranks for wealth before
>>> Social Security becomes a significant, or the predominant, source of income.
>>>
>>> Robert
>> I had been planning on the wife (65 next month) and I (62) both
>> receiving social security. I now suspect that SS will be means tested
>> by 2030 so I am going to work longer if I can. And those means will be
>> way lower than people suspect. Maybe as low as $100,000 in assets.
>
> My wife is retired and gets SS. I'm still working, so not. But our retirement
> planning includes a basic assumption that it needs to work even if SS goes
> away entirely.
>
> pt
>

Very early in our careers we made maximum contributions to 401Ks or
whatever and made other investments so that we would never have to
depend on our SS. Or rather, mine. She was under the old federal service
retirement plan which meant she didn't do SS. I was stuck with it though.

In article <ts2mjr$lnqm$1@dont-email.me>,
Dimensional Traveler <dtravel@sonic.net> wrote:

> On 2/8/2023 10:01 PM, Robert Woodward wrote:
> > In article <k4j090Fr9i3U1@mid.individual.net>,
> > Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
> >
> >> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
> >> <rkshullat@rosettacondot.com> wrote:
> >>
> >>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
> >>>> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
> >>>> wrote:
> >>>>
> >>>>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt
> >>>>> wrote:
> >>>>>> Who is this "they"? The Democrats keep asserting that the Republicans
> >>>>>> are going to cut or do away with Social Security and Medicare, but I
> >>>>>> just don't see it. It's the same old same old scare tactics.
> >>>>>
> >
> > <Snip of Federal Budget breakdown>
> >>>>
> >>>> Well, instituting a proper national health service would roughly halve
> >>>> that 15% health + 12% medicare, and probably takes a chunk out of that
> >>>> 4% veterans' services too. Lets say that frees up 13% by eliminating the
> >>>> whole health insurance industry, bringing the US wasted overspend on
> >>>> health down to the same ballpark as other democratic countries and quite
> >>>> possibly getting you away from being bottom of the league for survival
> >>>> rates across most demographics too.
> >>>
> >>> I suspect that it would do more to improve average life expectancy than
> >>> it
> >>> would to save money. There's currently a huge life expectancy gap between
> >>> the lowest 1% income (72.7 years for men) and the highest 1% (87.3
> >>> years).
> >>> Even with single-payer you still have to deal with much higher salaries,
> >>> higher infrastructure costs, higher liability costs (and the resulting
> >>> defensive testing) and limited access (especially in rural areas).
> >>> Studies vary, but the expected savings on administrative overhead is
> >>> closer
> >>> to 10% than 50%.
> >>
> >> Tell that to countries managing to get better outcomes on half the
> >> money.
> >>
> >> You apparently have no idea how pernicious and enormous the "health
> >> insurance" industry is.
> >
> > So how big is it? How many total employees do the various health
> > insurance companies have? If they are half the medical cost, there would
> > be roughly about 14 million of them.
> >
> Berkshire Hathaway is one of the biggest conglomerates in the world
> owned by one of the richest people in the world and insurance is its
> biggest source of revenue.

GEICO is Auto insurance, not health insurance. Gen Re is reinsurance
which means that it covers severe insurance company losses.

--
"We have advanced to new and surprising levels of bafflement."
Imperial Auditor Miles Vorkosigan describes progress in _Komarr_.
—-----------------------------------------------------
Robert Woodward robertaw@drizzle.com

On 9 Feb 2023 20:05:50 GMT, Jaimie Vandenbergh
<jaimie@usually.sessile.org> wrote:

>On 9 Feb 2023 at 14:03:15 GMT, "rkshullat@rosettacondot.com"
><rkshullat@rosettacondot.com> wrote:
>
>> The US population is generally less healthy. We spend a significantly higher
>> percentage on treating chronic conditions...conditions of poverty and
>> lifestyle. We tend to spend more on expensive treatment than inexpensive
>> prevention.
>
>And why would that be? Because it costs too much to go to a primary care
>doctor and prevent something.
>
>> Liability concerns push doctors toward defensive medicine...ordering tests
>> not because they think they're needed but because not doing them could be
>> used against them in future lawsuits.
>
>And because they get paid for doing them. Plus a public health service
>could mandate govt insurance for the medics.
>
>> Drug costs are higher, even for private insurance where the companies can
>> negotiate pricing or refuse to reimburse entirely.
>
>And why would *that* be? Because it's a cosy "we all win megabucks!"
>profiteering cycle between the pharma companies and the insurance
>companies and the for-profit hospitals.
>
>So yes, all your "reasons" are all the same single reason - you have
>private insurance running the health business.
>
>Except this:
>> There are big chunks of the rural US where anything beyond
>> basic care is hours away
>
>which is common American exceptionalism, unaware that these issues are
>as solved as they physically can be in other countries. Free at point of
>service includes videocalls and air ambulance.

I'm trying to think of a European country which has big chunks of
rural territory ... nothing comes to mind.

Australia, OTOH, almost certainly has such chunks. How are they doing
with videoconferencing and air ambulances in the Outback?

Canada probably has them as well. Same question applies.
--
"In this connexion, unquestionably the most significant
development was the disintegration, under Christian
influence, of classical conceptions of the family and
of family right."

It turns out that using whatever "“" and "â€" are when they are at
home is no more acceptable to Eternal September than fancy quote marks
are.

C'mon, guys, how hard is it to use ASCII?

On Thu, 9 Feb 2023 19:36:11 -0000 (UTC), rkshullat@rosettacondot.com
wrote:

>Robert Woodward <robertaw@drizzle.com> wrote:
>> In article <k4j090Fr9i3U1@mid.individual.net>,
>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>
>>> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
>>> <rkshullat@rosettacondot.com> wrote:
>>>
>>> > Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>> >> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>>> >> wrote:
>>> >>
>>> >>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>>> >>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>> >>>> are going to cut or do away with Social Security and Medicare, but I
>>> >>>> just don't see it. It's the same old same old scare tactics.
>>> >>>
>>
>> <Snip of Federal Budget breakdown>
>>> >>
>>> >> Well, instituting a proper national health service would roughly halve
>>> >> that 15% health + 12% medicare, and probably takes a chunk out of that
>>> >> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>>> >> whole health insurance industry, bringing the US wasted overspend on
>>> >> health down to the same ballpark as other democratic countries and quite
>>> >> possibly getting you away from being bottom of the league for survival
>>> >> rates across most demographics too.
>>> >
>>> > I suspect that it would do more to improve average life expectancy than it
>>> > would to save money. There's currently a huge life expectancy gap between
>>> > the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
>>> > Even with single-payer you still have to deal with much higher salaries,
>>> > higher infrastructure costs, higher liability costs (and the resulting
>>> > defensive testing) and limited access (especially in rural areas).
>>> > Studies vary, but the expected savings on administrative overhead is closer
>>> > to 10% than 50%.
>>>
>>> Tell that to countries managing to get better outcomes on half the
>>> money.
>>>
>>> You apparently have no idea how pernicious and enormous the "health
>>> insurance" industry is.
>>
>> So how big is it? How many total employees do the various health
>> insurance companies have? If they are half the medical cost, there would
>> be roughly about 14 million of them.
>
>Roughly 600,000, apparently at an average salary of over $3 million (if they
>account for half of healthcare expenditures). I went into the wrong field.
>Realistically you could get much of the benefit of a national(ized) health
>care system by looking at the German system. There were a lot of compromises
>and lawsuits surrounding the ACA, but that appears to have been its starting
>point. Losing the statutory coverage requirement was a major blow...it
>eliminated the large pool of healthy people that are needed to keep it
>affordable.

That's because of how we think about health insurance: we /want/ to
use it.

Nobody /wants/ to use their auto or home or renter's insurance; they
would rather not suffer the damage required.

And pretty much everybody hopes that their /life/ insurance never has
to pay out.
--
"In this connexion, unquestionably the most significant
development was the disintegration, under Christian
influence, of classical conceptions of the family and
of family right."

Paul S Person <psperson@old.netcom.invalid> writes:
>On 9 Feb 2023 20:05:50 GMT, Jaimie Vandenbergh
>
>I'm trying to think of a European country which has big chunks of
>rural territory ... nothing comes to mind.

Sweden, Norway and Finland come to mind instantly. Germany,
Poland and Austria a close second. Large swaths of Italy, particularly
in the north.

On 2/10/2023 8:53 AM, Paul S Person wrote:
> It turns out that using whatever "“" and "â€" are when they are at
> home is no more acceptable to Eternal September than fancy quote marks
> are.
>
> C'mon, guys, how hard is it to use ASCII?
>
> On Thu, 9 Feb 2023 19:36:11 -0000 (UTC), rkshullat@rosettacondot.com
> wrote:
>
>> Robert Woodward <robertaw@drizzle.com> wrote:
>>> In article <k4j090Fr9i3U1@mid.individual.net>,
>>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>>
>>>> On 8 Feb 2023 at 19:11:20 GMT, "rkshullat@rosettacondot.com"
>>>> <rkshullat@rosettacondot.com> wrote:
>>>>
>>>>> Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
>>>>>> On 8 Feb 2023 at 01:37:53 GMT, "Hamish Laws" <hamish.laws@gmail.com>
>>>>>> wrote:
>>>>>>
>>>>>>> On Tuesday, February 7, 2023 at 11:23:32 AM UTC+11, Mike Van Pelt wrote:
>>>>>>>> Who is this "they"? The Democrats keep asserting that the Republicans
>>>>>>>> are going to cut or do away with Social Security and Medicare, but I
>>>>>>>> just don't see it. It's the same old same old scare tactics.
>>>>>>>
>>>
>>> <Snip of Federal Budget breakdown>
>>>>>>
>>>>>> Well, instituting a proper national health service would roughly halve
>>>>>> that 15% health + 12% medicare, and probably takes a chunk out of that
>>>>>> 4% veterans' services too. Lets say that frees up 13% by eliminating the
>>>>>> whole health insurance industry, bringing the US wasted overspend on
>>>>>> health down to the same ballpark as other democratic countries and quite
>>>>>> possibly getting you away from being bottom of the league for survival
>>>>>> rates across most demographics too.
>>>>>
>>>>> I suspect that it would do more to improve average life expectancy than it
>>>>> would to save money. There's currently a huge life expectancy gap between
>>>>> the lowest 1% income (72.7 years for men) and the highest 1% (87.3 years).
>>>>> Even with single-payer you still have to deal with much higher salaries,
>>>>> higher infrastructure costs, higher liability costs (and the resulting
>>>>> defensive testing) and limited access (especially in rural areas).
>>>>> Studies vary, but the expected savings on administrative overhead is closer
>>>>> to 10% than 50%.
>>>>
>>>> Tell that to countries managing to get better outcomes on half the
>>>> money.
>>>>
>>>> You apparently have no idea how pernicious and enormous the "health
>>>> insurance" industry is.
>>>
>>> So how big is it? How many total employees do the various health
>>> insurance companies have? If they are half the medical cost, there would
>>> be roughly about 14 million of them.
>>
>> Roughly 600,000, apparently at an average salary of over $3 million (if they
>> account for half of healthcare expenditures). I went into the wrong field.
>> Realistically you could get much of the benefit of a national(ized) health
>> care system by looking at the German system. There were a lot of compromises
>> and lawsuits surrounding the ACA, but that appears to have been its starting
>> point. Losing the statutory coverage requirement was a major blow...it
>> eliminated the large pool of healthy people that are needed to keep it
>> affordable.
>
> That's because of how we think about health insurance: we /want/ to
> use it.
>
I think that may be more of a "we know we will _have_ to use it".
Health insurance is also a dual use kind of deal. It can keep you from
being bankrupted by massive medical bills for events you usually can't
control or avoid, like the other kinds of insurance, and it can keep the
costs of the routine medical checkups and treatments down to something
you can afford so you don't need that first usage of it.

> Nobody /wants/ to use their auto or home or renter's insurance; they
> would rather not suffer the damage required.
>
> And pretty much everybody hopes that their /life/ insurance never has
> to pay out.

--
I've done good in this world. Now I'm tired and just want to be a cranky
dirty old man.

On Friday, February 10, 2023 at 12:32:35 PM UTC-5, Scott Lurndal wrote:
> Paul S Person <pspe...@old.netcom.invalid> writes:
> >On 9 Feb 2023 20:05:50 GMT, Jaimie Vandenbergh
> >
> >I'm trying to think of a European country which has big chunks of
> >rural territory ... nothing comes to mind.
> Sweden, Norway and Finland come to mind instantly.

Indeed. They actually are much less densely populated than the US.

William Hyde

Jaimie Vandenbergh <jaimie@usually.sessile.org> wrote:
> On 9 Feb 2023 at 14:03:15 GMT, "rkshullat@rosettacondot.com"
> <rkshullat@rosettacondot.com> wrote:
>
>> The US population is generally less healthy. We spend a significantly higher
>> percentage on treating chronic conditions...conditions of poverty and
>> lifestyle. We tend to spend more on expensive treatment than inexpensive
>> prevention.
>
> And why would that be? Because it costs too much to go to a primary care
> doctor and prevent something.

Some of it is expense, some is because we're lazy as hell, eat too much lousy
food, drink too much, take too many drugs and beat, stab and shoot each other
for any or no reason. For the 90% of the population that does have coverage
screenings and vaccinations are supposed to be free, although you do have
to actually do them, which involves a visit (telehealth has its limits).

>> Liability concerns push doctors toward defensive medicine...ordering tests
>> not because they think they're needed but because not doing them could be
>> used against them in future lawsuits.
>
> And because they get paid for doing them. Plus a public health service
> could mandate govt insurance for the medics.

We've now moved away from "getting rid of the insurance companies will
eliminate half the cost", which was my original disagreement, to what appears
to be "doctors, labs and hospitals being paid for their work". So, from
single-payer to single-provider, which is fine, but not your original claim.

>> Drug costs are higher, even for private insurance where the companies can
>> negotiate pricing or refuse to reimburse entirely.
>
> And why would *that* be? Because it's a cosy "we all win megabucks!"
> profiteering cycle between the pharma companies and the insurance
> companies and the for-profit hospitals.
>
> So yes, all your "reasons" are all the same single reason - you have
> private insurance running the health business.

No. Private insurance is not private doctors is not private hospitals (which
may or may not be for-profit) is not private drug companies. These are all
different entities and the neither the hospitals and insurance companies
nor the insurance companies and the drug companies have a cozy relationship.
They squeeze each other for every penny possible.

> Except this:
>> There are big chunks of the rural US where anything beyond
>> basic care is hours away
>
> which is common American exceptionalism, unaware that these issues are
> as solved as they physically can be in other countries. Free at point of
> service includes videocalls and air ambulance.

I'm not saying it hasn't been solved, I'm saying that providing care where
it's not currently being provided is going to cost money. You can't wave
the sparkly magic wand of single-payerdom and have the resulting wave of fairy
dust cause hospitals to spring up out of the ground complete with equipment and
staff. When the closest hospital is 25 miles away and has six beds and
no lab and you have to travel over 100 for any sort of testing that's a
gap that a universal system in the US would have to meet, legally and morally.
(Videocalls? Now I'm envisioning telecolonoscopies and remote-manipulator
prostate exams.)

Robert
--
Robert K. Shull Email: rkshull at rosettacon dot com