tag:blogger.com,1999:blog-14162253.post2769032810971567693..comments2024-03-27T08:39:28.807-06:00Comments on Wash Park Prophet: Medicare More Efficient Than Private InsuranceAndrew Oh-Willekehttp://www.blogger.com/profile/02537151821869153861noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-14162253.post-23365628274612909402009-07-10T00:31:31.947-06:002009-07-10T00:31:31.947-06:00Private insurance companies spend more preventing ...Private insurance companies spend more preventing fraudulent claims. Better to pay the administrative overhead than to pay the fraud overhead.Michael Malakhttps://www.blogger.com/profile/10007582156392845677noreply@blogger.comtag:blogger.com,1999:blog-14162253.post-47892516051076217172009-07-09T23:11:08.262-06:002009-07-09T23:11:08.262-06:00but that is a tiny difference considering how many...<em>but that is a tiny difference considering how many more health care transactions Medicare must approve and pay for per beneficiary than a private insurance company handling a pool of basically healthy non-elderly children and adults.</em><br /><br />I'm not sure this is actually true. Firstly, most private insurers also offer c-plus, which means that for that population (which can be very large) they are seeing almost as many transactions as the government (since they are covering coinsurance, etc.). <br /><br />Further, while younger people are healthier, I've been personally surprised at just how high utilization is among those 40-65; I'll go look tomorrow, but I'm not sure it's really all that much lower than 65+. There's almost no such thing as a working population in the US that's healthy.<br /><br />Most of medicare's supposed administrative advantages are fishy, if not fictional. The government does a great job pushing costs onto the private sector, including the administrative costs it pushes onto providers, and customers. <br /><br />I'm sure you're aware, but many people aren't, that much of the reason MA insureds are more expensive is because insurance companies code much more aggressively than fee for service doctors. You can make a case this is exactly what the insurance company is supposed to do under the system as it is designed - maximize the amount of value for their customers. So are they being less efficient, or more?<br /><br />To me its another lesson on how screwed up incentives help screw up the system.<br /><br />-PitofBabelAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-14162253.post-12486672564851198672009-07-07T10:37:52.742-06:002009-07-07T10:37:52.742-06:00I don't think anyone is suggesting that Medica...I don't think anyone is suggesting that Medicare Advantage is bad from the customer's perspective. But, the way the Medicare Advantage Plan is drawn means that it is a money loser for the government compared to an ordinary plan -- unless the private insurance company is cutting a better deal with providers than Medicare does, or has unduly generous deal with Medicare.Andrew Oh-Willekehttps://www.blogger.com/profile/02537151821869153861noreply@blogger.comtag:blogger.com,1999:blog-14162253.post-3953320914917636252009-07-06T19:26:00.532-06:002009-07-06T19:26:00.532-06:00Despite the author's computations, my experien...Despite the author's computations, my experience indicates that I am better served in a private fee-for service medicare advantage plan. I pay no premium and, except for trivial amounts as part of some test costs and co-payments to physicians and hospitals, my medical expenses are covered. If the total of my payments should exceed a certain annual limit, all further expenses would be covered. This is much better coverage than Medicare plus my former gap policy gap policy at a much lower cost. It is not believable that my private insurer can offer this if his administrative costs are higher than Medicare's.Anonymousnoreply@blogger.com