How is Medicare so Efficient?

Damocles

Damocles

Accedo!
Staff member
http://www.youtube.com/watch?v=FSqAyjaCQQk&NR=1

It begins after about 3 minutes, before that is a story on Waterboarding and the missing CIA Tapes.

Basically, fraud runs rampant because they do not do manual checks and cross-checks that are routinely run in private health insurance companies...

If you don't need the manpower to do your checks, you can run it with efficient overhead, but you get robbed blind to the tune of 60 Billion per year.

This was the example of "good government" presented to me earlier by some people on this site.

Anyway, give it a watch. Imagine how many health care companies will get rich of of "nationalizing" our health care, especially if it is run without checks on expenditures and automatically billed and paid as it is now...
 
Insurance companies have overhead of 20%-30%. If you are saying that, to be efficient in fighting fraud, Medicare needs to have that amount of overhead, then fighting the fraud isn't even worth it. Besides, the fraud money goes back into the economy. The overhead is just pure waste.
 
Watermark said:
Insurance companies have overhead of 20%-30%. If you are saying that, to be efficient in fighting fraud, Medicare needs to have that amount of overhead, then fighting the fraud isn't even worth it. Besides, the fraud money goes back into the economy. The overhead is just pure waste.
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The fraud money is simply paying the overhead cost to the dishonest. Hidden costs don't make it cheaper, just hidden...
 
Watermark said:
Then why don't any insurance companies do that? Doesn't seem like it would make a difference.
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Because the fraud is more costly, insurance companies don't have the ability to ignore the loss, they choose to go in the direction that saves them more money and actually work to fight the fraud.
 
I have a solution to your deliema.

We dont short fund our universal coverage in a way that they have too few employees working to do the double checks like the corps do currently.

It will still be cheaper because we wont be seeking a profit on top of paying for the required employees.

In the current system you pay the people doing the checks just as surely as you would under a universal system.
 
Desh said:
I have a solution to your deliema.

We dont short fund our universal coverage in a way that they have too few employees working to do the double checks like the corps do currently.

It will still be cheaper because we wont be seeking a profit on top of paying for the required employees.

In the current system you pay the people doing the checks just as surely as you would under a universal system.
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Which cuts into the "amazing efficiency" reported by those who advocate it. It doesn't become cheaper, the overhead then matches the private corps that were doing it before.
 
I can hardly imagine hiring a little extra staff costing 80 billion, and I can hardly imagine 80 billion matching the overhead of the extremely wasteful private insurance companies, but I'll give you the benefit of a doubt you don't deserve.
 
Damocles said:
Which cuts into the "amazing efficiency" reported by those who advocate it. It doesn't become cheaper, the overhead then matches the private corps that were doing it before.
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Not when you dont have profit as your main goal.

When you set up any system you will have someone trying to make it work for their personal pocketbook. This is the main reason to try and take the complete control of healthcare out of the hands of those whos only reason is profit and not health.
 
I'd just like to know how we are defining "efficient." Maybe private insurers are better at rooting out fraud and not paying for unnecessary treatments, but the flip side of that coin is that they are probably also better at denying claims for necessary treatments and cutting off coverage to insureds.
 
Watermark said:
I can hardly imagine hiring a little extra staff costing 80 billion, and I can hardly imagine 80 billion matching the overhead of the extremely wasteful private insurance companies, but I'll give you the benefit of a doubt you don't deserve.
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I said it was more expensive, you dink. I said that they had no incentive to curb it as people crow about their massive "efficiency" which is true. They are efficient to the point of being designed for criminals to take advantage of.
 
Dungheap said:
I'd just like to know how we are defining "efficient." Maybe private insurers are better at rooting out fraud and not paying for unnecessary treatments, but the flip side of that coin is that they are probably also better at denying claims for necessary treatments and cutting off coverage to insureds.
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So did you watch the story, or did you pop in to just spout off without educating yourself first?
 
Desh said:
Not when you dont have profit as your main goal.

When you set up any system you will have someone trying to make it work for their personal pocketbook. This is the main reason to try and take the complete control of healthcare out of the hands of those whos only reason is profit and not health.
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LOL. And you think that government will never reject services to save money? Really?
 
Watermark said:
Why does single-payer healthcare work so efficiently in so many other countries, Damo? So much more efficiently than here?
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Well, we'd have to check and read the stats. If they are automatically paying bills to people without double checking I believe that they are paying too much. (Which would make it even more secksi to voters if you could show how you could make it more efficient). If all you use is overhead to measure efficiency, as was done in all the examples of the "extreme efficiency" of Medicare, you will consistently find those who don't attempt to stop fraud to be "more efficient".

Many of them will have, like Canada, outlawed private practice. One of the very reason that they actually lose many Canadian educated Doctors to the US. While they attempt to get them to come from out of Canada, they largely lose them because they create red tape and they come to the US too.

One of the "amazing" things about Medicare though was it's fantastic ability to be "more efficient" than even the French model. I suspect that is largely due to the fact that they just let people steal without even checking. What amazed the woman is that after she reported the fact that they were using her Medicare account to defraud people (AIDS Charges when she didn't have AIDS nor was likely to catch it), nobody did ANYTHING ABOUT IT.

We are paying huge amounts to the people who defraud us, all while lauding the "amazing efficiency" of the program. Anything can be "amazingly efficient" if you don't hire the people who would ensure we weren't being robbed blind.
 
I am constantly amazed by the total lack of any wish for oversight into how the government spends funds.

All I have heard on this site is how "efficient" they are, remarking on the low overhead cost as compared to the private companies. Then we find out that we are spending far more than the overhead in fraudulent charges we have absolutely no urge to stop.
 
Medicaid is a State run program.

Medicare is a Federal run program.

Medicare is successful at rooting out fraud. Medicaid is, as you indicate, far more suceptible to fraud.

Which would seem to suggest that, contrary to republican mythology, the Feds are better at running a tax payer funded program for health care, than the States are.

GAO Finds Rampant Medicaid Schemes

Senator Grassley (R-Iowa) said the government needs to do more.

"CMS has a problem with Medicaid fraud, and its limited oversight is insufficient to protect the integrity of the program," he said.

By contrast, Grassley said, the government's Medicare health care program for older and disabled Americans is more successful in rooting out abuse.

Other studies have found that the federal government recovers 20 times as much money from prosecuting fraud in Medicare as in Medicaid -- $1 billion compared with $43 million in 2001, according to the Washington-based Taxpayers Against Fraud Education Fund.

http://www.washingtonpost.com/wp-dyn/articles/A13220-2004Aug18.html
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Cypress said:
Medicaid is a State run program.

Medicare is a Federal run program.

Medicare is successful at rooting out fraud. Medicaid is, as you indicate, far more suceptible to fraud.

Which would seem to suggest that, contrary to republican mythology, the Feds are better at running a tax payer funded program for health care, than the States are.
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I'm sorry I used the wrong one in the title, nothing better than absolute evidence you didn't watch than repeating my mistake and attempting to use it in your argument FOR something that is robbing you blind because they don't spend enough on overhead...

I'll correct the title. It is Medicare that allows them to steal 60 Billion a year from us.

I didn't even catch my own mistake until I saw your post, yet I used Medicare in the rest of the thread. It should have given people a hint.

And if it is "better" at rooting out fraud, it still sucks big wind without any sign that anybody plans on doing anything about it at all. Cypress, your amazingly "efficient" program, is only efficient because they don't do enough to catch thieves that are stealing our money. Why is there wind on the East Coast? Because DC sucks more than anyplace in the US. It's the sound of the vacuums attempting to take our money to spend it on "efficient" programs that solve our "problems" through fraud and misrepresentation.

I can't fricking believe people are defending this crap and willing to let these people waste our money like this. Why? Because Truman signed it? WTF?
 
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