Many here on this forum as well as many others seen demonstrating at town hall meetings being held to discuss healthcare reform are decrying the idea of a "government option" in any proposed legislation. Private, for-profit companies can and will do a much better job, they say. But at the same time most seniors are vocal, sometimes even violent, demanding that Congress "don't touch my Medicare!"

In my own case, my wife and I pay a private insurer more than twice the premium I pay Medicare for secondary coverage. I'm left to assume that those who so vociferously resist a government option either have much cheaper secondary and presription drug insurance than I do. Or, they have a lot more money than I have, and are willing to spend it on more expensive insurance.

Is there something I'm missing here? Just wondering.

What your missing is what they see very clearly. Any government option will cost you more. Might seem to be a cheaper payment, but you need to consider taxes and inflation and paying the government bureaucrats to run it. It will always be the most expensive option. Nothing that the government has ever done has been the low cost option. Why would you think their involvement in health care would be any different?

and supplement.
What I am concerned about is the cuts in Medicare will reflect in what is not paid (of course). The supplemental will become the bearer of some of these costs. There will no doubt be a resultant increase in our premiums to merely maintain a status quo benefit package. Or there will be an out cropping of new coverages that will have to be subscribed to in order to maintain the status quo.

The cuts in Medicare are already being vocalized....trial balloons(?).

I suggest leaving the current Medicare/medicaid/supplemental/et al coverages in place. Grandfather the existing (and maybe even some number out in the future) participants. Go after, aggressively the abuse in the existing programs.
Then develop a health care program designed specifically for the non grand fathered, the non insured and any body else they want to throw into the pile.

Reform does not necessarily require the scrapping of those parts that are working to many of us satisfaction.

ANY program being promoted that involves a take away of existing coverage should not be viable. Any programs that have useless buerocracy like death counseling should automatically be struck out. And this type process continue until such time as a viable program results....not a political agenda....nor a forced calender march.

I no doubt strayed from your querry, but am feeling more vocal than normal this morning. I wish there was a local town hall meeting to go to.

btk

I corrected my original post. Our premium for secondary health insurance including prescription drug coverage, is twice the premium that we pay for Medicare coverage for both of us. I wasn't considering her Medicare premium in the initial post.

ANY program being promoted that involves a take away of existing coverage should not be viable. Any programs that have useless buerocracy like death counseling should automatically be struck out.

DEATH COUNSELING???.. Have you checked into a hospital lately.. YOU MUST have a living will WHY... so if something happens like Terry Shivo, your wish are known and legal. All the section is trying to do is for those less fortunate that cannot afford a lawyer be given the opportunity. I am sure it is drag on the health care system when someone is in a coma and has no money and no living will....

Originally Posted by l2ridehd

...Any government option will cost you more. Might seem to be a cheaper payment, but you need to consider taxes and inflation and paying the government bureaucrats to run it. It will always be the most expensive option....

I hear your argument, but to prove what you say is as impossible as that YouTube video someone posted here with the two fellows on a mountaintop, with one asking the other to "prove" that the proposed healthcare reforms would be an improvement. An impossible premise, just as trying to prove that Medicare is actually more expensive than private insurance would be.

What I do know is that income tax rates have been reduced pretty substantially over the last decade, to levels very near an all-time historical low. That's certainly shown up in my yearly tax bills. My Medicare premiums have increased, but roughly at the rate of inflation, the same as Social Security payments which fund the premiums. On the surface, your allegation that government insurance is "always more expensive" is incorrect.

The numbers are almost impossible to gather. You have the population going up, the GDP going down, illegal immigration going up, payments to doctors and hospitals (but not drug companies) going down, etc. No one can prove with any certainty what you allege. Certainly no one posting on this board.

Actually, the Medicare portion of my insurance has gotten cheaper in my household. At the same time, my private, for-profit insurance premiums for secondary insurance have shown the following percentage increases over the last five years...8%, 18%, 4%, 12% and 9%. All rates waay greater than the amounts that my Social Security payments increased in the same period. The privately-provided portion of my healthcare insurance is killing me. It's not yet unaffordable in my household, but there will be a day that if these premium increases continue, it will be! If my private secondary insurance becomes unaffordable and I have to drop it, I'll just join the illegals and unisureds and everyone else on the public dole, and let the rest of you pay for our healthcare.

Here's what we do know about national health expenditures (NHE) from 2007, the latest complete numbers available...

• NHE grew 6.1% to $2.2 trillion in 2007, or $7,421 per person, and accounted for 16.2% of Gross Domestic Product.
• Medicare spending grew 7.2% to $431 billion in 2007, or 19 percent of total NHE.
• Medicaid spending grew 6.4% to $329 billion in 2007, or 15 percent of total NHE.
• Private spending grew 5.8% to $1.2 trillion in 2007, or 54 percent of total NHE.
• Hospital expenditures grew 7.3% in 2007, up from 6.9% in 2006.
• Physician and clinical services expenditures increased 6.5% in 2007, the same rate of growth as in 2006.
• Prescription drug spending increased 4.9% in 2007, a deceleration from the 8.6% growth in 2006.

What I thought was important to note here is that every single expenditure category grew at rates substantially higher than inflation. All those expenditures went to private service providers.

I guess I might ask that if the government is so bad, so inefficient, at providing the insurance to pay these bills, how will adding a profit margin of 15-50% make things cheaper for us?

If you can come up with some real numbers, instead of just general "government is bad" generalizations, let us all know.

I did not limit my "government is always more expensive" statement to health care. So here is one real number for you. Dept of Energy formed in August of 77 to reduce the US dependence on foreign oil. Budget for current FY 24.7 billion. Dependence on imports? 1977, 38% 2008, 71% and those numbers will vary a few points depending on where you get them. So you are correct. I don't trust the government to provide any consumer service. Because I believe they will fail to meet the needs of the people. The objectives of those creating the plan is not to support us. It is strictly for their gain and re-election.

Medicare may cost you less but only because it is going broke. If premiums were raised to reflect true cost and sustain the program, it would cost you more. As for taxes, we don't need any more government spending to cause them to increase. Those already passed like the porkuless bill will cause that all by itself. So you will get your wish and taxes will go up.

I really can not think of a single successful government run program. So why should I expect health care to succeed. No it can't be proved that it will be more expensive, but their track record sure supports that premise. Before they add any new programs, don't you think the money would be better spent fixing some of the existing ones? Maybe SS and Medicare would be a good start. Let them show those can be managed successfully and I might be a little more supportive of health care.

If you think health care is expensive now...wait till it is free.

When has government ever done it cheaper, better or lowed costs?

Good case of can't see the forest for the trees here.

Originally Posted by Villages Kahuna

...

Here's what we do know about national health expenditures (NHE) from 2007, the latest complete numbers available...

• NHE grew 6.1% to $2.2 trillion in 2007, or $7,421 per person, and accounted for 16.2% of Gross Domestic Product.
• Medicare spending grew 7.2% to $431 billion in 2007, or 19 percent of total NHE.
• Medicaid spending grew 6.4% to $329 billion in 2007, or 15 percent of total NHE.
• Private spending grew 5.8% to $1.2 trillion in 2007, or 54 percent of total NHE.
• Hospital expenditures grew 7.3% in 2007, up from 6.9% in 2006.
• Physician and clinical services expenditures increased 6.5% in 2007, the same rate of growth as in 2006.
• Prescription drug spending increased 4.9% in 2007, a deceleration from the 8.6% growth in 2006.

What I thought was important to note here is that every single expenditure category grew at rates substantially higher than inflation. All those expenditures went to private service providers.

I guess I might ask that if the government is so bad, so inefficient, at providing the insurance to pay these bills, how will adding a profit margin of 15-50% make things cheaper for us?

...

This is interesting.

- A NHE/GDP ratio can be misleading, as the question to which method of computing GDP (e.g., output, income or expenditure method) and what factors (and their weighting) went into the computation is unknown (it does make a difference!. Change any factor, or not include it (such as the $23Billion in remissions each year) and the numbers can be radically different.
- The annual percentage of NHE growth in the categories reflects what happens when an industry is vibrant. The auto industry used to be like that. The junk food industry seems to grow equal to the NHE. In addition, the NHE involves technological advances which have high RDTE costs and short life-span for recovery (new stuff comes out each day!).
- An aging person tends to consume more health care services, ergo costs to maintain/repair the health of an aging person tends to be higer than younger folk. This to me is common sense, but it would be good to have a medical actuary confirm this. So, the Medicare payroll taxes that workers (as most of us used to be) pay, plus the Medicare premiums, plus private supplements (costing the same as private insurance for workers) are logically needed to maintain/repair health of older folk.

The problem with government management goes back to: 1) can we conscript all medical professionals into government-run care clinics? 2) can the government establish salary limits on private medical professionals in private businesses similar to the NFL's salary cap program on teams? and 3) will the government agencies responsible to manage and operate national health care be limited in their funding to that collected specifically for health care, like the US Citizenship and Naturalization Service which operates solely on fees collected for immigration services?

#1 and #2 are legal problems (those "details" which seem minor to HR 3200 proponents) which fundamentally change our government and society - and so may require amending the Constitutional to be legal.

#3 is the killer. If the health care agencies are to be industrially funded, then the CBO forecasts are crucial to know what it really will cost us all - today, tomorrow, and the next decade. If the agency funding is to also depend on revenue from the General Treasury in addition to fees, that's a "hidden cost" to-be-determined - and that's where the overruns and "favorable estimation" come to play, and also higher taxes at numbers totally unknown at this time since there are no reliable estimates because all of the "how we're going to do this" stuff is still to-be-determined.

It still seems funny that folk are in a dire rush to spend potentially $trillion$ on the short and long term without any sound set of numbers to back up what will be provided for the money and if it will even stand legal review (or it will be shut down after a lot of money is spent along the way). Those "nasty details" again....

Unfortunately is today's world, too many people are having massive, costly health problems and some are dying young. How can we say that the "aging" population is the problem? I have so many friends and family (to say nothing of the ones that I just read about) that don't even make it to 65, much less beyond. Many of the 65+ group are much healthier and also more productive than their younger counterparts, so maybe a closer look is warranted. Take it a step further and compare the "older" driver to the younger drivers and you have the same thing. The younger ones so often think of themselves as immortal and drive accordingly. I, for one, just don't hold with generalizations.

Just one persons opinion.

Originally Posted by dillywho

Unfortunately is today's world, too many people are having massive, costly health problems and some are dying young. How can we say that the "aging" population is the problem? I have so many friends and family (to say nothing of the ones that I just read about) that don't even make it to 65, much less beyond. Many of the 65+ group are much healthier and also more productive than their younger counterparts, so maybe a closer look is warranted. Take it a step further and compare the "older" driver to the younger drivers and you have the same thing. The younger ones so often think of themselves as immortal and drive accordingly. I, for one, just don't hold with generalizations.

Just one persons opinion.

Health and life insurance are based on mortality and health tables. Actuaries get very well paid by keeping those statistics so the rates (all by age and risk) are set to make sure the companies don't spend more than they receive.

Generally, older folk require more maintenance. There are always folk who fit the profiles you describe, but in general, those younger than the TV population are stronger, healthier, have better reflexes, see and hear better. That does not mean they all have better sense.

A few things I have heard today that maybe someone will either validate of discuss....

......heard that the labor unions have been called in to go to these town hall meetings to "counterbalance" those who are there to show objection.

......heard a bunch of different numbers but hearing that even with the obscene spending on this or any health plan being considered there will be MILLIONS of americans without insurance which is amazing with all the money figures being tossed around.

.....heard that the talk is now swirling around about simply making those "wealthy" seniors pay more for drugs, etc. (what is wealthy and how would that definition stay constant)

Not sure what is true and what is not but have we gone nuts ! Pushing through a bill simply to say you did it and leave so many millions without insurance anyway does not make any sense !

Here is a good quote I heard today.( paraphrased, of course)
The freedom the protesters are defending can sometimes be messy and imperfect. A lack of freedom, however, is eternally oppressive. It is an unrelenting prison that poisons the human spirit, even when cloaked in allegedly humane programs such as government-run health care.

Everyone here should send any Social Security and Medicare payments back! Show the government we don't need them! We don't need a military, police or fire department and close those public schools! We don't need a federal highway or airport system! The uber-wealthy need all those tax dollars they are wasting on such useless things!