Do you think that America will face problems?

[jmjj215]

Re: Do you think that America will face problems?

To VJW's point, I was talking with a very large dealer in the midwest (he owns about 70 various dealerships) and he was at a GM meeting of dealers. Their warranty cost per car is about $160. Toyota's warranty cost per car is estimated at about $7 (seven dollars).

That is a clear indicator of quality, in my mind (and in this dealer's) - that hits the bottom line in a very big, positive way.

[sweeps]

Re: Do you think that America will face problems?

You know, what’s interesting is that the conventional wisdom is that the problems with the American auto manufacturers are that their union workers make to much money, that their healthcare is too costly, and that their retirement costs are too expensive because of an aging population.

Yet, both the Japanese and German auto manufactures are very profitable, their workers earn more than their American counterparts, have much better healthcare and receive far more generous benefits, and their societies have just as old (Germany) or older (Japan) populations.

Related article: Saving General Motors

[nixuzer]

Re: Do you think that America will face problems?

You know, what’s interesting is that the conventional wisdom is that the problems with the American auto manufacturers are that their union workers make to much money, that their healthcare is too costly, and that their retirement costs are too expensive because of an aging population.

IMO, part of the problem with our healthcare costs is the average american consumer and the medical community. Having spent some time self insured (i.e. paying cash out-of-pocket) I can say that physicians, labs, etc pay zero attention to keeping things cost effective. It took a near shouting match with a physician to get him to schedule a single appointment with my wife for 3 different sets of tests and exams at one point. Instead he wanted 3 visits (at $100 a visit) as well as the associated lab costs. Why, because he said it would be difficult to make that happen (it only took us 5 minutes withe the receptionist to coordinate everything). He isn't corrupt by any means he just didn't see what the big deal was. We had this occur multiple times over our time as being self-insurance and I can say now that we conduct ourselves very much the same way as we have insurance. I've had doctors tell me now, "What does it matter, you only have a $30 co-pay?" Multiply this by the number of healthcare users out there an no wonder the insurance companies are raising rates. There is no such thing as a free lunch. Currently I'm trying to rally the C[x]O of my current employer to convert everyone to a low monthly stipend and giving us all a raise with the current 80% they're paying to our healthcare company. Doubt it will happen now but at the rate things are going I don't see how companies can continue to take it in the shorts like they are currently (and having their employees complain when their 20% goes up). I've learned so much that I could come out much better doing it myself...and that is with my own little baseball team (i.e. my kids).

Yet, both the Japanese and German auto manufactures are very profitable, their workers earn more than their American counterparts, have much better healthcare and receive far more generous benefits, and their societies have just as old (Germany) or older (Japan) populations.

VJW since you seem to have access to many number and stats would you mind passing on the average tax rate vs income for Japan, Germany and the U.S. Did some googling but couldn't seem to find anything that I was confident with linking to.

[VJW]

Re: Do you think that America will face problems?

IMO, part of the problem with our healthcare costs is the average american consumer and the medical community. Having spent some time self insured (i.e. paying cash out-of-pocket) I can say that physicians, labs, etc pay zero attention to keeping things cost effective. It took a near shouting match with a physician to get him to schedule a single appointment with my wife for 3 different sets of tests and exams at one point. Instead he wanted 3 visits (at $100 a visit) as well as the associated lab costs. Why, because he said it would be difficult to make that happen (it only took us 5 minutes withe the receptionist to coordinate everything). He isn't corrupt by any means he just didn't see what the big deal was. We had this occur multiple times over our time as being self-insurance and I can say now that we conduct ourselves very much the same way as we have insurance. I've had doctors tell me now, "What does it matter, you only have a $30 co-pay?"

You’re shocked that a physicians office wants to schedule multiple visits ? Then you’ll be surprised to learn that fraud by providers against Medicare is only 10%, whereas against private-sector health insurance companies it runs at 15%, or fifty percent higher.

The entire system is wildly inefficient. Less than half of every dollar that is paid in health insurance premiums goes to provide for medical care. The administrative overhead in the private-sector health insurance companies is 25%, whereas with Medicare it is less than 2%. Then there is the corporate compensation, the corporate jets, the corporate yachts, the fancy corporate headquarters, the sales commissions, the stock dividends, the corporate profits, and on and on and on...

It’s far worse than paying protection money to the mob.

VJW since you seem to have access to many number and stats would you mind passing on the average tax rate vs income for Japan, Germany and the U.S. Did some googling but couldn't seem to find anything that I was confident with linking to.

Both Japan and Germany have more progressive income tax systems than does America. Germany’s top rate is 42%, and Japan’s top rate is 37%. However, both have additional personal taxes.

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[nixuzer]

Re: Do you think that America will face problems?

You’re shocked that a physician’s office wants to schedule multiple visits? Then you’ll be surprised to learn that fraud by providers against Medicare is only 10%, whereas against private-sector health insurance companies it runs at 15%, or fifty percent higher.

You're kidding right? Funny thing is I've actually written software in the United States Department of Health and Human Services sector and the 2% your quoting may come from some report but I've seen entire departments that could be removed with minimal impact to the system. In the past I've actually recommended to certain government entities to remove individuals at a significant cost savings and they give me lip service but the best quote I can give came from a senior consultant, "The management level's power comes from their budget, if you strike at that you're striking at their livelihood." Both systems are inefficient but the stats you’re quoting do not reflect reality (at least to the government sector). I've been in budget planning sessions at a city government for a particular major software upgrade where they actually discussed implementing one major software system over another because it would add more staff to their department. On paper they would say their more efficient however in reality another software system could have saved them significant $$, excuse me, the taxpayers.

Plus you'll have to help me out but wouldn't private sector companies usually have a higher percentage (at first) because they're trying to track it. What motivation is it for a government entity to catch fraud? Wouldn't that mean a smaller budget?

It’s far worse than paying protection money to the mob.

LOL

Both Japan and Germany have more progressive income tax systems than does America. Germany’s top rate is 42%, and Japan’s top rate is 37%. However, both have additional personal taxes.

Ok but I don't want their system or one as large as we have. That's like taking a slightly obese man and comparing him to people fatter than him and saying, "See, you're really not that fat!"

The reality is all our discussions will change very little, people will cry to the goverment to fix things because they don't understand economics (which I'll admit I didn't but am learning more every day). Policiticians will gladly comply and in turn will create more taxes and more goverment to help us out (at least in their mind). Then by the time the people realize what they've done we'll go the way of all other systems where we've created a large, more inefficient goverment that we can only blame ourselves for.

The founders of the U.S. were truly wise men who understood what the role of goverment should and should not be.

[VJW]

Re: Do you think that America will face problems?

You're kidding right? Funny thing is I've actually written software in the United States Department of Health and Human Services sector and the 2% your quoting may come from some report but I've seen entire departments that could be removed with minimal impact to the system.

The reference was to Medicare, not HHS.

Plus you'll have to help me out but wouldn't private sector companies usually have a higher percentage (at first) because they're trying to track it.

Nope. It’s been rising, not falling.

Ok but I don't want their system or one as large as we have.

You have it backwards. Both Germany and Japan have larger federal governments than America does, as do the other 17 industrialized nations.

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[nixuzer]

Re: Do you think that America will face problems?

The reference was to Medicare, not HHS.

Well I just put HHS because I've done worked at the Federal and State level and didn't feel the need to get into a hair splitting exercise. As you know Medicare is a Federal Program (as opposed to Medicaid which is 'managed' by the States with a majority of the funding coming from the Federal government) which falls under HHS.

Nope. It’s been rising, not falling. But I'll humor you and say my experience at the Federal, State and City levels must not apply to the Medicare sector, the are an efficiency machine.

Again, what motivation does the government have to address potential fraud? Plus I'm a little confused about your 10% statistic. If I read the statistic from the GAO correctly (although older, pre-2K stats) the percentage I saw was around 12-15%, would you concur? I've not kept up with the latest info so if you have something newer let me know and please provide links. Of course statistics will be produced that show the government as being more efficient, private sector must answer to shareholders, public sector answers to the taxpayers which with all due respect, have little perspective of what they're looking at.

You have it backwards. Both Germany and Japan have larger federal governments than America does, as do the other 17 industrialized nations.

Actually I didn't have it backwards; you read what I said incorrectly. If you looked at the analogy I gave it made sense. Just because we have the least obese of all the governments does not mean ours is correctly sized. It is obvious to any reader that you usually believe the 'facts' support the government being a better caretaker of our money than the private sector.

Let me give you an example of a stat that may appear correct and used to show how the rich are 'abusing' the poor without including the full picture.

Let's say we read an article that says that a country's per capita income is staying the same while the 'rich are getting richer.' Imagine a 3rd World Country with 100 million people, 1/4 of whom average $1,000 a year in per capita income, another 1/4 average $2,000 year, another 1/4 $4,000 year and the top 1/4 $5,000 year. Now imagine that (1) everyone's income rises by 20% and (2) the two poorest classes double in size as a result of reduced mortality rates (due to lets say for fun purposes contributions by the Bill & Melinda Gates Foundation), while the two top classes remain the same size since they could always afford the best health care, right. If you work out the arithmetic, you will see the per capita income for the country as a whole remains the same. Obviously, if the income had risen by less than 20%, per capita income would have fallen, even tough each individuals income rose.

Thanks again for your time on this.

[VJW]

Re: Do you think that America will face problems?

Well I just put HHS because I've done worked at the Federal and State level and didn't feel the need to get into a hair splitting exercise.

Segregating Medicare from HHS when it comes to administrative overhead is most certainly not a “hair splitting exercise”.

Again, what motivation does the government have to address potential fraud?

A lot, if an administration’s goal is good government. Non at all, if an administration wants to scrap Medicare to begin with.

Plus I'm a little confused about your 10% statistic.

It’s not my “10% statistic”. It’s Medicare’s statistic from Congressional testimony.

If I read the statistic from the GAO correctly (although older, pre-2K stats) the percentage I saw was around 12-15%, would you concur?

Yes, it was more like 12% back then, but declined in the second half of the ‘90s.

Actually I didn't have it backwards; you read what I said incorrectly. If you looked at the analogy I gave it made sense. Just because we have the least obese of all the governments does not mean ours is correctly sized.

But if you are the TWENTIETH smallest, it cannot be such a problem.

It is obvious to any reader that you usually believe the 'facts' support the government being a better caretaker of our money than the private sector.

Not at all.

Let me give you an example of a stat that may appear correct and used to show how the rich are 'abusing' the poor without including the full picture.

Let's say we read an article that says that a country's per capita income is staying the same while the 'rich are getting richer.' Imagine a 3rd World Country with 100 million people, 1/4 of whom average $1,000 a year in per capita income, another 1/4 average $2,000 year, another 1/4 $4,000 year and the top 1/4 $5,000 year. Now imagine that (1) everyone's income rises by 20% and (2) the two poorest classes double in size as a result of reduced mortality rates (due to lets say for fun purposes contributions by the Bill & Melinda Gates Foundation), while the two top classes remain the same size since they could always afford the best health care, right. If you work out the arithmetic, you will see the per capita income for the country as a whole remains the same. Obviously, if the income had risen by less than 20%, per capita income would have fallen, even tough each individuals income rose.

You have a problem right off the bat, as “per capita income” is an average, which never provides an accurate representation.

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[jmjj215]

Re: Do you think that America will face problems?

VJW, do you know of any good books on the single-payer system?

[VJW]

Re: Do you think that America will face problems?

Here's a good book:

CRITICAL CONDITION: HOW HEALTH CARE IN AMERICA BECAME BIG BUSINESS--AND BAD MEDICINE

<blockquote>"Bestselling investigative journalists Barlett and Steele (America: What Went Wrong?) deliver a devastating indictment, supported by excellent research, of a health-care system that they say is failing to provide first-rate services to its citizens, 44 million of whom are without insurance. According to these Pulitzer Prize–winning reporters, now with Time magazine, the U.S. compares poorly with other Westernized nations in delivering quality care and a healthy life expectancy, and preventing infant mortality. Per capita health-care spending continues to exceed the amount spent by many other countries, the authors say, because one out of every three U.S. dollars pays for administrative costs. The authors also present case histories of patients, some with life-threatening conditions, who were ignored by bureaucratic HMOs that put profit first. Barlett and Steele describe how health care first became driven by profits on Wall Street during the Reagan administration. Competing insurance plans, they say, led not to better choices for consumers, but to physicians who are prevented by insurers from prescribing needed treatments; a severe shortage of nurses; and unsafe hospitals where staff shortages and unsanitary conditions result from cost-cutting. The authors, who strongly advocate a single payer plan, successfully depict a health-care system in crisis."</blockquote>

But first, go HERE:

And click on 'GET THE FACTS' in the top menu. There you will find an entire list of articles explaining Single Payer.

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[nixuzer]

Re: Do you think that America will face problems?

Here's a good book:

CRITICAL CONDITION: HOW HEALTH CARE IN AMERICA BECAME BIG BUSINESS--AND BAD MEDICINE

<blockquote>"Bestselling investigative journalists Barlett and Steele (America: What Went Wrong?) deliver a devastating indictment, supported by excellent research, of a health-care system that they say is failing to provide first-rate services to its citizens, 44 million of whom are without insurance. According to these Pulitzer Prize–winning reporters, now with Time magazine, the U.S. compares poorly with other Westernized nations in delivering quality care and a healthy life expectancy, and preventing infant mortality. Per capita health-care spending continues to exceed the amount spent by many other countries, the authors say, because one out of every three U.S. dollars pays for administrative costs. The authors also present case histories of patients, some with life-threatening conditions, who were ignored by bureaucratic HMOs that put profit first. Barlett and Steele describe how health care first became driven by profits on Wall Street during the Reagan administration. Competing insurance plans, they say, led not to better choices for consumers, but to physicians who are prevented by insurers from prescribing needed treatments; a severe shortage of nurses; and unsafe hospitals where staff shortages and unsanitary conditions result from cost-cutting. The authors, who strongly advocate a single payer plan, successfully depict a health-care system in crisis."</blockquote>

But first, go HERE:

And click on 'GET THE FACTS' in the top menu. There you will find an entire list of articles explaining Single Payer.

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We're getting OT but it is good information. One of the complaints of the current system (from the pnhp.org website) is the following

In the current US system, there are literally tens of thousands of different health care organizations—HMOs, billing agencies, etc. By having so many different payers of health care fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.) In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

Administrative costs aside wouldn't you agree that the different forms and standards could be resolved by the government setting the standards for the health care organizations? As we both well know I'm not for more government intervention but fail to see how going from the current to just let us manage everything would be a significant jump instead the goverment could place certain standards in place which should reduce the current cost overhead, would you agree? It is like the energy building codes, the goverment doesn't build all the buildings however they have worked with people from all sectors to develop standards.

DOE's Building Energy Codes Program is an information resource on national model energy codes. We work with other government agencies, state and local jurisdictions, national code organizations, and industry to promote stronger building energy codes and help states adopt, implement, and enforce those codes.

The Program recognizes that energy codes maximize energy efficiency only when they are fully embraced by users and supported through education, implementation, and enforcement.

[jmjj215]

Re: Do you think that America will face problems?

Thanks for the info.