AEIdeas

The public policy blog of the American Enterprise Institute

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Discussion: (8 comments)

  1. Edward Ptaszek

    I believe Medicare has a MLR of 98% because a substantial portion of the administration expenses are allocated to another governmental agency.

  2. RonRonDoRon

    I believe fraud reduction efforts are required to go on the admin/profit side, not the medical loss.

    Fraud reduction – good place to skimp. If a company doesn’t detect fraud, it counts toward the 80% required to go to medical loss.

  3. I wish I had a license to bill.

  4. From Reason this seven and a half minute video clip with Nick Gillespie: Would ObamaCare Kill Medical Innovation?

  5. Todd Mason

    Mr. P’s source for the $60B figure is a Pittsburgh Post-Gazette reporter who cites GAO testimony to congress that the extent of Medicare fraud is unknown, and then goes on to cite unnamed outside experts who say it “could be” $60B.

    Disruptive innovation is equal-sized BS. Colonoscopies in my part of the world are done at an outpatient surgical center run by the hospital system that dominates this market. The cost is $3k. The same procedure in Canada? $157. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660815/

    To match that cost reduction, starting from scratch with a rival surgical center, would take a whole lotta disruption, no?

    1. Todd Mason

      My bad. $3k is medicare reimbursement, “Retail” is $6k. Anyone care to explain why it costs 40 times more south of the 49th parallel, (and how a profit motive could balance the scale)?

  6. There is a ton of competition for the “Single Worst Decision” in this bill–stay tuned.

  7. Robert Arvanitis

    A different perspective:

    Obamacare conflates several different functions:
    * actual provision of medical care
    * “lay-away” for routine expenses. People are too indolent or irresponsible to budget for these so seize a flat amount each week, in the guise of “insurance.” But it’s still just the old “Christmas clubs.”
    * real insurance, for the one in a hundred event.

    Obamacare forces MOST medical expenses through a charade, but marks them up by 25%. Remember, give back only 80% in loss ratio. So a $100 annual exam now costs $125, for no reason other than Obama must substitute his own judgement about people’s needs.

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