This is the argument the insurers make but I don't understand why providers sell their services below cost or why insurers don't insist on a lower price. It seems to me this would only happen if providers were legally compelled to participate in medicare which they are not and if providers had the market power to compel insurers to pay their price which is usually not the case. Tim
Timothy Stoltzfus Jost
Robert Willett Family Professor
Washington and Lee University
From my Blackberry
----- Original Message -----
From: Anglo-American Health Policy Network <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Sent: Wed Mar 25 16:23:23 2009
Subject: Re: AAHPN
I am NOT an economist, so my answering may be a bit of "fools rush in
where angels fear to tread",
but here's what I see as the difference....
the public payers, MediCare and MediCaid, set the rates that they will
pay...and typically those rates are below the actual cost of providing
the service
....and then the hospitals in particular eat the cost of providing
uncompensated care to the uninsured....wo when the private pay/
commercial insurance companies come along, the rates that the
providers offer up for negotiation are set high--high enough to cover
the losses that they are incurring serving the rest of teh population
...and so it IS cost-shifting and in many respects the employers/
employees who are insured are paying a double "tax"--their taxes to
support public service and then increased costs in the service they
pay for
<unknown.jpg>
Neal Adams MD MPH
Director of Special Projects
CiMH
2125 19th St 2nd floor
Sacramento CA 95818
NOTE: new mailing address
2735 Fulton St
Berkeley CA 94705
408.591.2110 cell
831.401.2632 fax
>
> On Mar 25, 2009, at 12:56 PM, Adam Oliver wrote:
>
>> If a private insurer agrees to insure someone, they cannot really
>> complain too much if the person uses the insurance, can they (well,
>> they can complain, but you know what I mean)?
>>
>> Next time somebody borrows my books, I'll say it's unfair if they
>> read them (actually, I frequently don't get them back, which is
>> unfair).
>>
>> Anyway, Tim, I don't really understand their argument. I would have
>> thought the private sector would cherry pick the good risks (if
>> there are any) among the elderly, and thus, if anything, the public
>> payers are left with the 'worst' risk pools. But I guess other
>> Americans of the list can more usefully help you with this one.
>>
>>
>> -----Original Message-----
>> From: Anglo-American Health Policy Network [mailto:[log in to unmask]
>> ] On Behalf Of Jost, Timothy
>> Sent: 25 March 2009 19:44
>> To: [log in to unmask]
>> Subject: Re: AAHPN
>>
>> Assuming everyone is not sick and tired of talking about US health
>> care reform, I would like help from the health economists on the
>> list. The insurance industry issued a statement today opposing the
>> public plan alternative. One of their arguments is that Medicare
>> and other public payers in the United States "cost shift" to
>> private plans and that this is unfair. This seems to me as
>> economic nonsense. Providers presumably maximize their income from
>> whatever source they can get it, and do not charge private insurers
>> more or less depending on what they get from Medicare and
>> Medicaid. At least, they would not charge private insurers less if
>> Medicare paid them more. I see this argument a lot and can't
>> understand why anyone takes it seriously. Or am I wrong?
>> Tim
>>
>> Timothy Stoltzfus Jost
>> Robert Willett Family Professor
>> Washington and Lee University School of Law
>> Lexington, Va. 24450
>> 540 458 8510
>> fax 540 458 8488
>>
>>
>> -----Original Message-----
>> From: Anglo-American Health Policy Network [mailto:[log in to unmask]
>> ] On Behalf Of Adam Oliver
>> Sent: Wednesday, March 25, 2009 3:25 PM
>> To: [log in to unmask]
>> Subject: AAHPN
>>
>>
>> The latest on Obama's proposals is below.
>>
>> We haven't really talked too much lately about the Anglo aspect of
>> the Anglo-American network. The fact is (I think), there's not that
>> much new happening re. health policy here. There is a heavy
>> emphasis on pushing quality (whatever that means), arising in large
>> part out of the Darzi review, there is another big push on health
>> inequalities (probably driven by our Health Secretary, Alan
>> Johnson, who himself grew up in disadvantaged circumstances), there
>> are seemingly increasing efforts to stop people drinking too much,
>> and generally, to uptake healthier lifestyles (a new £30 million
>> programme to create 'healthy towns', which doesn't seem to be being
>> evaluated very well). There is also a big push for greater
>> disclosure of performance of providers etc., in the hope of
>> generating league table competition. There are a lot of parallels
>> between what's going on (or at least being proposed) in the US and
>> in England, actually. Maybe its due to Americans really deep down
>> thinking that t
>> hey're still British subjects?
>>
>> The Sunday Times had a big spread this weekend saying that people
>> are getting fed up with Obama overexposing himself, so to speak
>> (i.e. they'd rather watch X Factor, or whatever it's called). So
>> please feel free to tell me to shut up, because I need to sustain a
>> popularity rating that at least reaches single digits, for my own
>> self esteem.
>>
>>
>> SPOTLIGHT: OBAMA POINTS TO HEALTH CARE
>> President Obama during a prime-time news conference links issues
>> within the U.S. budget in part to high health care costs. He says
>> that "almost every single person" who has examined the nation's
>> budget has concluded that the government must find a way to reduce
>> health care costs. Obama says, "It's going to be an impossible task
>> to balance our budget if we are not tackling rising health care
>> costs." However, he says, "We're not going to be able to do it this
>> year or next year or three years from now." Obama says that
>> congressional lawmakers likely will maintain his budget priorities
>> in their budget resolutions. He says, "We never expected when we
>> printed out our budget that they would simply Xerox it and vote on
>> it," adding, "The bottom line is that I want to see health care,
>> energy, education and serious efforts to reduce our budget
>> deficit." (story) <>
>>
>> Please access the attached hyperlink for an important electronic
>> communications disclaimer: http://www.lse.ac.uk/collections/secretariat/legal/disclaimer.htm
>>
>>
>>
>> Please access the attached hyperlink for an important electronic
>> communications disclaimer: http://www.lse.ac.uk/collections/secretariat/legal/disclaimer.htm
>
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