> Cam wrote:
>> Because with Medicare there are infinite plans and infinite private
>> companies to run them.  And with Medicare Advantage (part c), they can
>> do so based on the amount of risk they want to accept.
>
> Do you see this scaling out to the entire US population?
>

Bluntly, I don't know.

It a VERY complicated system (<- the whole system, not just
"Medicare"), and I could think of a zillion things that need to fixed
with the system that could lower costs.

But theoretically I guess it could.  If you focus on the "payer" right
now you have:

1.) Gov't (Medicare, Medicaid)

2.) Employers (self-insured)

3.) Insurance companies (fully insured)

"Plan administrators" are ALL private companies no matter the payer,
including Medicare/Medicaid.

So the gov't could offer some basic benefits to all Americans (at the
payer level) without changing anything in "the system".

This would raise costs for the gov't simply because they'd have to
process more claims and have their own program admin costs.

But it should lower, maybe drastically, costs for employers and
insurers because some, much, or most of the risk would be taken away.

But if we really want to take cost out of the system we need to lower
admin costs and that can only be done through standardization and
automation.

I would also say through consumer-driven models (working on the
patient-provider level) where you put more money into the consumers
hands and allow them to make choices thus lowering costs on the
provider side (e.g., plastic surgery).

wow, this is complicated.

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