Thread: Private Health Insurance v Public Health Insurance

Question: What is your Total Healthcare cost value based on? How much is spent on healthcare period (ie, a combined total of what is spent to include $$$ coming from private insurance companies, government programs, and just private out of pocket)?

Originally Posted by ThorHammer

Question: What is your Total Healthcare cost value based on? How much is spent on healthcare period (ie, a combined total of what is spent to include $$$ coming from private insurance companies, government programs, and just private out of pocket)?

Overall total I believe..

Thor sorry, forgot the source.
Health policies and data - Organisation for Economic Co-operation and Development

Originally Posted by CowboyTed

Overall total I believe..

Thor sorry, forgot the source.
Health policies and data - Organisation for Economic Co-operation and Development

How ever much it is, it is too much per capita. We need to change our Tort laws to eliminate all of the CYA diagnostics that Drs over do.

Originally Posted by CowboyTed

Overall total I believe..

Thor sorry, forgot the source.
Health policies and data - Organisation for Economic Co-operation and Development

Gotcha.

You have to be careful with numbers like these, CowboyTed. They don't take into account what that money is spent on. I'd wager that overall costs in a public system are lower because, well, such a system wouldn't pay for many elective procedures and care choices that are taken into account for the numbers you put forward regardless of whether those are paid for out of pocket or with private insurance. We are a country of over 300 million where many elective procedures and care choices are available. That will tend to drive numbers higher.

This isn't exactly on point to your question, CT, but from an "industry" perspective, you can look at just about any state in the U.S. with a mandated insurance process. Take Florida for example: The private P&C companies about went broke trying to cover all the losses from Hurricane Andrew in '92. In fact, all but the most healthy companies DID go belly up, leaving a ton of former policyholders unreimbursed for their homes that were destroyed.

The surviving companies wanted to trim off some coverages, the state said "no." They wanted to drop the higher risk insureds, the state said "no." They wanted to raise rates, the state said "no."

So the state got busy and created the state-run P&C insurance carrier, now called "Citizens." They started out taking those folks who were just too uninsurable (by the private companies) and ended up being the biggest carrier in the state. The state insurance department routinely chided any private carrier who wanted to raise rates or otherwise adjust coverages.

Flash-forward to today, Citizens is having a lot of difficulty keeping its head above water. "suddenly," they think they've got too many insureds and/or don't charge enough for their insurance.

So, as Thor (I believe) pointed out, it is difficult to say which is less expensive when the public insurers seem to play by different rules than the private insurance companies.

Originally Posted by CalifornCracker

How ever much it is, it is too much per capita. We need to change our Tort laws to eliminate all of the CYA diagnostics that Drs over do.

Tort law is a bit of a red herring and only 3% of actual costs goto it.

What is a problem is that doctors are fearful of suits.

But the question has to be asked if a kid is mentally handicapped and needs 24 nursing care because of an accident at birth, who pays?
What is presently happening is everyone goes to court and a version of russian roulette happens with a pay out that may or may not happen. What happens if the there is no pay out? Guess who ends up paying.
24h care costs hundreds of thousands a year and the pay out is paid on life expentancy. It is very hard to know how long these people will live but the pay out is a lump sum. Therefore millions could be paid and the victim could die the next day or in 50 years time. But if there is a short fall the government ends up with the check. And by the way I haven't explained that the lawyer gets a huge cut.

The most sensible system I have seen is the french system. I explain a few systems in my blog http://www.uspoliticsonline.com/blog...und-world.html

France
Up until 2002, France’s malpractice system looked similar to the United States’. Patients brought their cases to court and then either settled or received an award. The two main differences between France and the United States’ practices are that first, France had no caps on malpractice awards, and second, there were several rules that made it more difficult for patients to win a case.

However, since 2002 things work differently in France. France has moved to a out-of-court, no-fault system in which wronged patients bring claims before their regions’ government-appointed review board which is responsible for determining whether or not compensation is in order, and if so, how much. Money for patient relief comes from a national compensation fund which gets its funds from insurance premiums placed on doctors and hospitals or from general fund revenues.

Originally Posted by ThorHammer

Gotcha.

You have to be careful with numbers like these, CowboyTed. They don't take into account what that money is spent on. I'd wager that overall costs in a public system are lower because, well, such a system wouldn't pay for many elective procedures and care choices that are taken into account for the numbers you put forward regardless of whether those are paid for out of pocket or with private insurance. We are a country of over 300 million where many elective procedures and care choices are available. That will tend to drive numbers higher.

Thor,
Very few countries in the would is 100% private or public. Thats why I did a statistical correlation to find out does the more money (per % GDP) spent publicly reduce the overall bill.
There is many elective procedures in all the first world countries and the US is only one data point on this correlation.

13504d1347918592-graph-healthcare-expenditure-private-public-breakdown-country-healthcare-expend.jpg

This is not a totally focused on the US but from datapoints from countries all over the world.

Originally Posted by CowboyTed

Thor,
Very few countries in the would is 100% private or public. Thats why I did a statistical correlation to find out does the more money (per % GDP) spent publicly reduce the overall bill.
There is many elective procedures in all the first world countries and the US is only one data point on this correlation.

13504d1347918592-graph-healthcare-expenditure-private-public-breakdown-country-healthcare-expend.jpg

This is not a totally focused on the US but from datapoints from countries all over the world.

Have you seen any accurate studies which relate to the % of GDP spent for excessive diagnostics by medical personnel to CTA from malpractice suits? I have seen some sites say those costs are high and others say those costs are negligible. I more believe the former.

Originally Posted by Good1

This isn't exactly on point to your question, CT, but from an "industry" perspective, you can look at just about any state in the U.S. with a mandated insurance process. Take Florida for example: The private P&C companies about went broke trying to cover all the losses from Hurricane Andrew in '92. In fact, all but the most healthy companies DID go belly up, leaving a ton of former policyholders unreimbursed for their homes that were destroyed.

The surviving companies wanted to trim off some coverages, the state said "no." They wanted to drop the higher risk insureds, the state said "no." They wanted to raise rates, the state said "no."

So the state got busy and created the state-run P&C insurance carrier, now called "Citizens." They started out taking those folks who were just too uninsurable (by the private companies) and ended up being the biggest carrier in the state. The state insurance department routinely chided any private carrier who wanted to raise rates or otherwise adjust coverages.

Flash-forward to today, Citizens is having a lot of difficulty keeping its head above water. "suddenly," they think they've got too many insureds and/or don't charge enough for their insurance.

So, as Thor (I believe) pointed out, it is difficult to say which is less expensive when the public insurers seem to play by different rules than the private insurance companies.

This was one of my most interesting studies. A huge percentage of a persons overall healthcare expenses come from the very early 0-4ys and there last 5 years of life. Who covers most people for the last few years of life. These are NHS (UK) figures:


As you can see healthcare from for 65 -85 costs over 200% of the average and for above 85 it is over 500% of the average.
These are UK figures. These are good as they have a standard delivery of care from cradle to grave therefore we can see that using direct comparison of healthcare delivery.
Sorry lost hyperlink source.

Originally Posted by CowboyTed

This was one of my most interesting studies. A huge percentage of a persons overall healthcare expenses come from the very early 0-4ys and there last 5 years of life. Who covers most people for the last few years of life. These are NHS (UK) figures:


As you can see healthcare from for 65 -85 costs over 200% of the average and for above 85 it is over 500% of the average.
These are UK figures. These are good as they have a standard delivery of care from cradle to grave therefore we can see that using direct comparison of healthcare delivery.
Sorry lost hyperlink source.

That is because the government artificially suppresses the costs (or, as Thor said, arbitrarily controls the services and, therefore, the costs) of providing government insurance. Those figures you cite above are perfectly and absolutely to be expected: We buy insurance hoping we don't ever need it .... but as we age (and factoring in infant mortality which is presumably higher at age 0 - 4), we use it more. Costs are associated with use: Use more, pay more (and cost more)... that is the function of the actuarial department: To set premium based on pay outs and associated costs within a certain group. Also, and for the record, "age" is not the only grouping insurers use these days. They also use geographic locale, demography of your surrounding area, credit rating (sometimes), and health status... amongst many other strata...

Originally Posted by CalifornCracker

Have you seen any accurate studies which relate to the % of GDP spent for excessive diagnostics by medical personnel to CTA from malpractice suits? I have seen some sites say those costs are high and others say those costs are negligible. I more believe the former.

It would be fair to say that excessive diagnostics and over medication is one a result of an over legalised health system. But there is nothing to say that Tort Reform would actually stop that... Gettign sued is getting sued and doctors defend there actions... The strange thing is many medical professions are way more afriad of lawyers/insurance than of the government.

The problem is not the size of the payouts but the way the whole thing is handled. The legal profession is about blame and cost. They see an injured party and try to a portion blame.

The French system takes out the lawyers from the question and first says you have been injured. Lets look after you first and we will handle what went wrong seprately. And how you are looked after is not one big baloon payment but a steady income and services offered until you are better or for the rest of your life...

If you don't like that then you have an option of court and take your chances in a country which has a higher burden of proof than the US.

I believe the system is independent of government but is guarenteed by government... Doctors all pay into the fund(income linked) and this is there medical insurance....

Originally Posted by CowboyTed

I have asked this question in the past and just wondering if any one could answer this.
I have done a corelation of health systems worldwide when comapring private v public health funding.





Simple Correlation of Total Healthcare spending verses Total Healthacre cost with graph.

The .81 shows a strong link between more privatised care and total cost while there is a very weak link between more public care and total cost.

Can show me empirical evidence of a health system manging a general population where private insurance is cheaper than public insurance?

I worked in Pharmaceutical advertising and I can tell you that 50% or more of a drug's budget is advertising. A lot of that is spending millions of dollars to send doctor's and sales reps to exotic locations around the world to solicit their latest drugs. Hundreds of millions more in skewing clinical trial results to make their drugs look less harmful and/or more effective than they really are and even more than that for direct to consumer advertising. It's a huge scam, really.

By going with a public health system and getting rid of most private care (the very wealthy will still want their pet MDs to keep the pills flowing) the costs would go down dramatically. It would also alleviate the need for expensive malpractice insurance that MDs these days are complaining about and we would see a lot more preventive care meaning less costly treatments long-term and more general practitioners entering the market.

Originally Posted by Good1

This isn't exactly on point to your question, CT, but from an "industry" perspective, you can look at just about any state in the U.S. with a mandated insurance process. Take Florida for example: The private P&C companies about went broke trying to cover all the losses from Hurricane Andrew in '92. In fact, all but the most healthy companies DID go belly up, leaving a ton of former policyholders unreimbursed for their homes that were destroyed.

The surviving companies wanted to trim off some coverages, the state said "no." They wanted to drop the higher risk insureds, the state said "no." They wanted to raise rates, the state said "no."

So the state got busy and created the state-run P&C insurance carrier, now called "Citizens." They started out taking those folks who were just too uninsurable (by the private companies) and ended up being the biggest carrier in the state. The state insurance department routinely chided any private carrier who wanted to raise rates or otherwise adjust coverages.

Flash-forward to today, Citizens is having a lot of difficulty keeping its head above water. "suddenly," they think they've got too many insureds and/or don't charge enough for their insurance.

So, as Thor (I believe) pointed out, it is difficult to say which is less expensive when the public insurers seem to play by different rules than the private insurance companies.

On top of all that, nobody here understands just what insurance is... A primmer...

Insurance