Supreme Court upholds the Affordable Health Care Act in its entirety

[bergmann620]

The part you snipped attempts to compare administrive cost for the same age groups.

No, it doesn't. It compares all enrollees under each coverage.

[Felya]

No, it doesn't. It compares all enrollees under each coverage.

These administrative spending numbers have been challenged on the grounds that they exclude some aspects of Medicare’s administrative costs, such as the expenses of collecting Medicare premiums and payroll taxes, and because Medicare’s larger average claims because of its older enrollees make its administrative costs look smaller relative to private plan costs than they really are.

However, the Congressional Budget Office (CBO) has found that administrative costs under the public Medicare plan are less than 2 percent of expenditures, compared with approximately 11 percent of spending by private plans under Medicare Advantage. This is a near perfect “apples to apples” comparison of administrative costs, because the public Medicare plan and Medicare Advantage plans are operating under similar rules and treating the same population.

---------- Post added 2012-07-03 at 08:27 PM ----------

No, it doesn't. It compares all enrollees under each coverage.

I cannot copy and paste from your heritage article, but it's in the paragraph that starts with "Medicare beneficiaries are by definition elderly" and ends with "because its administrative cost is spread over a larger base of actual healthcare costs".

[bergmann620]

These administrative spending numbers have been challenged on the grounds that they exclude some aspects of Medicare’s administrative costs, such as the expenses of collecting Medicare premiums and payroll taxes, and because Medicare’s larger average claims because of its older enrollees make its administrative costs look smaller relative to private plan costs than they really are.

However, the Congressional Budget Office (CBO) has found that administrative costs under the public Medicare plan are less than 2 percent of expenditures, compared with approximately 11 percent of spending by private plans under Medicare Advantage. This is a near perfect “apples to apples” comparison of administrative costs, because the public Medicare plan and Medicare Advantage plans are operating under similar rules and treating the same population.

The first highlighted portion is an objection to your numbers.

For the second part, am I to take the author's word for it, or are they going to state how they arrived at those figures? There are no raw numbers, no explanation of what they're actually measuring, nothing.

Further, it still boils down one interpretation versus another. Why is yours better or truer?

[Felya]

The first highlighted portion is an objection to your numbers.

No, CBO numbers. Your articles uses the same, but adjusts it.

For the second part, am I to take the author's word for it, or are they going to state how they arrived at those figures? There are no raw numbers, no explanation of what they're actually measuring, nothing.

You can click the linked PDF that goes into more detail.

Further, it still boils down one interpretation versus another. Why is yours better or truer?

Because mine doesn't arbitrarily discount elderly using more services through Medicare as the young using insurance, by comparing the same age group.

Your interpretation compensates for age difference, mine compares two of the same age group.

[Laize]

Isn't there a woman all over the news that sprained her ankle on a swing, but ended up having flash eating bacteria? Lost her hands and feet so far and is in critical care...

And necrotizing fasciitis is so absurdly rare that for every patient saved by exhaustive testing for it, tens of thousands of patients with cellulitis or similarly presenting symptoms will have had thousands of dollars of tests done for no reason at all.

It's not efficient to exhaustively test for specific diseases and waste millions or even billions of dollars to save one life. And that's not cold-hearted for me to say because wasting billions of dollars to save ONE life extinguishes the lives of people who had far more legitimate and immediate need for those resources.

[bergmann620]

Because mine doesn't arbitrarily discount elderly using more services through Medicare as the young using insurance, by comparing the same age group.

Your interpretation compensates for age difference, mine compares two of the same age group.

The study I link tries for a more apples-to-apples measure, which makes sense as explained, while the one you link simply lops off the vast majority of private insurance patients.

I feel that the first method paints a more relevant picture. Per enrolled person, Medicare costs more than private insurance in non-benefits.

[Felya]

The study I link tries for a more apples-to-apples measure, which makes sense as explained, while the one you link simply lops off the vast majority of private insurance patients.

It compares the same age... both articles agree that age is a factor. One adjusts it's numbers to try and make the two even, while the other compares same age.

I feel that the first method paints a more relevant picture. Per enrolled person, Medicare costs more than private insurance in non-benefits.

I'm sure you think it's more relevant to your point of view, but I don't think it's reliable in how it adjusts it's numbers for age. The only way yours is apples and apples, is if there is a 50 year gap in the age of apples.

[Wells]

CBO "apples to apples" comparisons put medicare administrative costs at 2% to private industry's 11% under medicare advantage.

The advantage here is the CBO isn't a right wing propaganda super store like Heritage is.

[Felya]

CBO "apples to apples" comparisons put medicare administrative costs at 2% to private industry's 11% under medicare advantage.

The advantage here is the CBO isn't a right wing propaganda super store like Heritage is.

That's the thing, adjusting for age, lets opinion dictate what sort of adjustment is made. Comparing the same age, does not require adjustment and you can compare straight numbers.

According to the CBO, when looking just at the numbers of similar age and coverage, it's a 9% swing. Harritage claims that the fact elderly need more care, yet are covered by less administration, is the result of volume per client. Instead of saying Medicare is more efficient, they adjust the numbers in their idea of what is fair. Same comparison, even according to harritage because they adjusted the numbers to fit their view, is very clearly in favor of Medicare.

---------- Post added 2012-07-03 at 09:18 PM ----------

I feel that the first method paints a more relevant picture. Per enrolled person, Medicare costs more than private insurance in non-benefits.

Most of the people on Medicare need more treatments than those insurance cover, thus the cost of per person on insurance is slanted as compared to Medicare. Who do you think needs more health care, an average 65 year old or an average 30 year old? Yet, you think comparing per person is fair? Each exta care measure a 65 year old needs, generates more administrive cost. The numbers are slanted... You need to compare same age...

You should look at the cost in your graph and wonder how an average person before age 65, without pre-existing conditions, costs insurance companies that close to what an avarege over 65 year old costs.

[bergmann620]

CBO "apples to apples" comparisons put medicare administrative costs at 2% to private industry's 11% under medicare advantage.

The advantage here is the CBO isn't a right wing propaganda super store like Heritage is.

The government certainly has no interest in preserving itself, or in making itself look efficient.

As the PDF won't open, I'm wondering if the CBO excludes costs to other governmental agencies from Medicare administrative costs.

---------- Post added 2012-07-03 at 05:28 PM ----------

Most of the people on Medicare need more treatments than those insurance cover, thus the cost of per person on insurance is slanted as compared to Medicare. Who do you think needs more health care, an average 65 year old or an average 30 year old? Yet, you think comparing per person is fair? Each exta care measure a 65 year old needs, generates more administrive cost. The numbers are slanted... You need to compare same age...

You should look at the cost in your graph and wonder how an average person before age 65, without pre-existing conditions, costs insurance companies that close to what an avarege over 65 year old costs.

I think administrative costs per patient are a more valid measure. If Medicare cost less per patient, I would still think that.

I don't have to wonder. It is administrative costs, not care costs. From my link:

Administrative costs can be divided broadly into three categories:
-Some costs, such as setting rates and benefit policies, are incurred regardless of the number of beneficiaries or their level of health care utilization and may be regarded as "fixed costs."
-Other costs, such as enrollment, record-keeping, and premium collection costs, depend on the number of beneficiaries, regardless of their level of medical utilization.
-Claims processing depends primarily on the number of claims for benefits submitted.

[Felya]

The government certainly has no interest in preserving itself, or in making itself look efficient.

As the PDF won't open, I'm wondering if the CBO excludes costs to other governmental agencies from Medicare administrative costs.

Direct link:
http://institute.ourfuture.org/files...lan_Choice.pdf

Both my and your article site the same numbers. Yours compares average cost of those on insurance, to those over 65 on Medicare. Yes, people over 65 need more care thn those before it, that is all your graph tells us. If you compare same age, that is where the difference is clear.

In 2005, according to your graph, the difference on per person, between someone disabled or over 65 on Medicare, is only 50 bucks more than a relatively healthy person without pre existing conditions on insurance. You think that makes Medicare less efficient?

---------- Post added 2012-07-03 at 09:38 PM ----------

I think administrative costs per patient are a more valid measure. If Medicare cost less per patient, I would still think that.

I don't have to wonder. It is administrative costs, not care costs. From my link:

Do you think, that an average elderly or disabled on Medicare generates more fixed costs, processing and record keeping, than an average person without pre-existing conditions on insurance?

You think comparing the cost of elderly on Medicare is fair to those on insurance, who get kicked out for pre existing conditions. Medicare covers pre existing conditions and ends up covering the oldest and sickest demographic. Yet, only spends 50 bucks more per person a year. That is pretty damn good...

Medicare covers those insurance deem too expensive. Than we get told that insurance need to be around, because Medicare per person is more expensive than insurance. What a racket!

[Wells]

The government certainly has no interest in preserving itself, or in making itself look efficient.

Saying this after defending Heritage is pretty lulzy dude. The CBO is a nonpartisan group of glorified accountants. Their data is good.

[Felya]

Saying this after defending Heritage is pretty lulzy dude. The CBO is a nonpartisan group of glorified accountants. Their data is good.

That's why I didn't want to say anything bad about it. The numbers can be true, but their collection hides the reality of the care people need while on insurance versus on Medicare. Medicare covers the sickest demographic, disabled and elderly. Yet, spend only 50 bucks more on administration, than an avarege, none smoking, none disabled pre-65 person on insurance. It's bad not on where it's from, but what it compares.

[belfpala]

I was going to say something... but... all that came out was:

Indefatigable.

Bergmann, Felya, and Wells... get after it.

[moff]

Coming from one of the wealthies countries in the world (and of course we have an "obamacare" similiar model, just like all wealthy countries), I never understood why so many americans are afraid of obamacare. I can tell you, from a european point of view, the old american model was simply a nightmare. the idea of the possibility that you are not immediately treated in a hospital NO MATTER WHAT is really frightening and I am really happy for the americans that the supreme court upholds it. Sure, for a huge country like the USA many things might be different, but it is my understanding that true wealth, stability and peace can only come to a country where the weakest are treated as good as possible and everyone can provide for himself and his family.

[Kirse]

Coming from one of the wealthies countries in the world (and of course we have an "obamacare" similiar model, just like all wealthy countries), I never understood why so many americans are afraid of obamacare. I can tell you, from a european point of view, the old american model was simply a nightmare. the idea of the possibility that you are not immediately treated in a hospital NO MATTER WHAT is really frightening and I am really happy for the americans that the supreme court upholds it. Sure, for a huge country like the USA many things might be different, but it is my understanding that true wealth, stability and peace can only come to a country where the weakest are treated as good as possible and everyone can provide for himself and his family.

I am also European (from England), have lived in Canada since 1991, and feel the same way. Obamacare isn't the best program because it involves too many compromises, but Canadian healthcare has its flaws. Regardless, I would never want to be without it. Even in it's most barest form, it's better than nothing.

What I don't understand is why American and Canada don't model healthcare after the most successful programs in the world (mostly European). All countries should learn from one another, and use what works. It would be easy advertising, to sell the healthcare programs that we know already work. "America, we are modeling our system after Country X due to its known success. If you have any concerns about the funding, implications and success of this program, the research is there for you to explore" It seems simple.

[Felya]

I was going to say something... but... all that came out was:

Indefatigable.

Bergmann, Felya, and Wells... get after it.

I think it means I am dull, but I think it's fun and I get to learn stuff. Like the numbers berg posted, I've never seen those. I did a bit of reading and was able to learn a lot about it. It really is a learning experience at times, so fatigue does not really come into play.

I had to look up indefatigable...

[Cthulhu 2020]

[Usako]

With it passed, my family will soon be cut from the state medical insurance. I have many many health issues, and my husband is currently only working 30 hours a week. They are cutting us off because it passed and we will no longer qualify for it, as we will make to much money. He gets paid 7.50 an hour so figure the math out yourself. With this law we will be forced to purchase health insurance for myself, my husband and daughter. We barely get by as it is with the money we do make, and being forced to purchase health insurance is an expense we do NOT need right now. Thank-you US of A government for truly caring for your people while passing a law that you made sure you was opted out of.

I am truly happy I am going to college currently to try to make a better life for my family and now just so we can afford to purchase health insurance so we don't go to jail. Thank-you, once again you soulless uncaring politicians. ALL OF THEM. All of them are corrupt and only care about themselves. What a surprise.

[Kasierith]

With it passed, my family will soon be cut from the state medical insurance. I have many many health issues, and my husband is currently only working 30 hours a week. They are cutting us off because it passed and we will no longer qualify for it, as we will make to much money. He gets paid 7.50 an hour so figure the math out yourself. With this law we will be forced to purchase health insurance for myself, my husband and daughter. We barely get by as it is with the money we do make, and being forced to purchase health insurance is an expense we do NOT need right now. Thank-you US of A government for truly caring for your people while passing a law that you made sure you was opted out of.

I am truly happy I am going to college currently to try to make a better life for my family and now just so we can afford to purchase health insurance so we don't go to jail. Thank-you, once again you soulless uncaring politicians. ALL OF THEM. All of them are corrupt and only care about themselves. What a surprise.

Ummm..... the medicaid income requirements changed, sure... increasing to I believe 133% of the poverty level. Overall its making medicaid better and increasing its scope. So unless you're currently cheating the system and the reform is somehow going to track down unreported income, no, unless I'm looking in the wrong place you're not going to be cut off.