HomeLatest ThreadsGreatest ThreadsForums & GroupsMy SubscriptionsMy Posts
DU Home » Latest Threads » Forums & Groups » Retired » Retired Forums » 2016 Postmortem (Forum) » The US spends $3 trillion...

Sat Nov 21, 2015, 02:55 PM

 

The US spends $3 trillion a year on health care. How much goes to health insurance companies?

Anyone want to take a wild stab at how much goes to health insurance companies in aggregate as profits (yes, profits), administrative costs, underwriting, etc?

This is the amount that would be saved by going to a single payer model (before talking about negotiating prices, which would be my next question: how much of the $3 trillion is actually spent on drug prices).

And don't forget that in a single payer model, average number of procedures per person will go up so total expenditure will increase.

55 replies, 2208 views

Reply to this thread

Back to top Alert abuse

Always highlight: 10 newest replies | Replies posted after I mark a forum
Replies to this discussion thread
Arrow 55 replies Author Time Post
Reply The US spends $3 trillion a year on health care. How much goes to health insurance companies? (Original post)
hill2016 Nov 2015 OP
Duckhunter935 Nov 2015 #1
hill2016 Nov 2015 #2
TM99 Nov 2015 #3
hill2016 Nov 2015 #4
Duckhunter935 Nov 2015 #7
hill2016 Nov 2015 #11
Duckhunter935 Nov 2015 #14
hill2016 Nov 2015 #18
I_AM_SAM Nov 2015 #25
hill2016 Nov 2015 #26
I_AM_SAM Nov 2015 #28
hill2016 Nov 2015 #45
Duckhunter935 Nov 2015 #6
hill2016 Nov 2015 #8
Duckhunter935 Nov 2015 #12
hill2016 Nov 2015 #16
Duckhunter935 Nov 2015 #21
hill2016 Nov 2015 #29
AgingAmerican Nov 2015 #55
Ed Suspicious Nov 2015 #51
Ed Suspicious Nov 2015 #52
hill2016 Nov 2015 #53
Ed Suspicious Nov 2015 #54
Hoyt Nov 2015 #5
BootinUp Nov 2015 #9
Hoyt Nov 2015 #13
hill2016 Nov 2015 #10
Duckhunter935 Nov 2015 #15
hill2016 Nov 2015 #19
Duckhunter935 Nov 2015 #23
Hoyt Nov 2015 #17
hill2016 Nov 2015 #20
BootinUp Nov 2015 #22
Hoyt Nov 2015 #24
hill2016 Nov 2015 #32
MeNMyVolt Nov 2015 #30
Rosa Luxemburg Nov 2015 #27
hill2016 Nov 2015 #31
Rosa Luxemburg Nov 2015 #33
Recursion Nov 2015 #41
Recursion Nov 2015 #40
Armstead Nov 2015 #34
hill2016 Nov 2015 #35
TheFarS1de Nov 2015 #43
reformist2 Nov 2015 #36
hill2016 Nov 2015 #37
Recursion Nov 2015 #42
Recursion Nov 2015 #38
hill2016 Nov 2015 #44
Recursion Nov 2015 #47
hill2016 Nov 2015 #49
hill2016 Nov 2015 #46
Recursion Nov 2015 #48
hill2016 Nov 2015 #50
Recursion Nov 2015 #39

Response to hill2016 (Original post)

Sat Nov 21, 2015, 03:05 PM

1. Another fail

 

It is not just insurance company profits, what is the total amount spent on that model. If illness are treated earlier, procedures are not nearly expensive. It would be nice if you actually posted correct information in your smear posts.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Duckhunter935 (Reply #1)

Sat Nov 21, 2015, 03:13 PM

2. most of the health care expenditure are on

 

cancer, end of life treatment, chronic diseases like diabetes and obesity.

How do you save on these?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #2)

Sat Nov 21, 2015, 03:18 PM

3. All of those you list

 

are actually about the pharmaceuticals. Let the government instead of insurer negotiate the costs, and there will be incredible savings as well as life-treating drugs for all who need it - unlike the current fucked up model.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to TM99 (Reply #3)

Sat Nov 21, 2015, 03:18 PM

4. and guess how much

 

of total health expenditures goes to specialty drugs?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #4)

Sat Nov 21, 2015, 03:21 PM

7. And Hillary is so much better

 

Right? What is her plan?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Duckhunter935 (Reply #7)

Sat Nov 21, 2015, 03:26 PM

11. the drug companies fear Hillary

 

So I'm sure she has a good plan to deal with them.

Remember how the stocks of the drug companies fell after she made a simple tweet?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #11)

Sat Nov 21, 2015, 03:29 PM

14. What is her plan?

 

I know "Just cut it out" right?

Reply to this post

Back to top Alert abuse Link here Permalink



Response to hill2016 (Reply #18)

Sat Nov 21, 2015, 04:00 PM

25. Oooh.. identical to Bernie except for a few things

 

That $250 cap? It'll be passed along toward the following year's premiums. Hell, it was written by a lobbyist, so zero credit for Hillary Plan.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to I_AM_SAM (Reply #25)

Sat Nov 21, 2015, 04:02 PM

26. Hillary has been fighting for healthcare

 

since the 1990's.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #26)

Sat Nov 21, 2015, 04:03 PM

28. Then why did she support Heritage Foundation version of HillaryCare

 

also known as Obamacare?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to I_AM_SAM (Reply #28)

Sat Nov 21, 2015, 10:53 PM

45. what's your point here?

 

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #2)

Sat Nov 21, 2015, 03:19 PM

6. Treat the people

 

Before they have full blown diabetes and obesity is a part would cut down on cost. Not to mention that we pay by each procedure so they do more than required now. With single payer that incentive is not there. Not to mention negotiate for lower drug prices would be much easier to cut costs.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Duckhunter935 (Reply #6)

Sat Nov 21, 2015, 03:23 PM

8. you know

 

that there's nothing medically that can be done to cure diabetes or obesity right? It's often due to poor diet habits.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #8)

Sat Nov 21, 2015, 03:28 PM

12. They can be prevented in the first place

 

Annual checkups will help with information on diets and catching these early. Many people just do not go to the doctor as they can not afford to and wait until it is much more expensive to treat them. I am sure Hillary has the magic cure.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Duckhunter935 (Reply #12)

Sat Nov 21, 2015, 03:33 PM

16. that's not really the problem

 

the problem is the junk food that society consumes.

Why do you think Bloomberg wanted to ban large soda drinks?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #16)

Sat Nov 21, 2015, 03:38 PM

21. I disagree somewhat

 

Yes, that is a part due to availability of good food. Another part that has to be admitted to is a lack of knowledge and the lack of preventive health care. So what is Hillary going to do for this problem?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Duckhunter935 (Reply #21)

Sat Nov 21, 2015, 04:09 PM

29. yeah

 

you could probably save a very small amount by better education and preventive health care.

But my point remains: most health care costs are from cancer, end of life treatment, and lifestyle diseases. You can't get people to change their lifestyle no matter how much education you tell them.

Flossing is good for your teeth but how many people floss daily?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #29)

Sun Nov 22, 2015, 02:51 PM

55. This is the GOPs position

 

...to the letter. They use this 'logic' as an excuse to let AIDS patients die. At least you are consistent.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #8)

Sat Nov 21, 2015, 11:36 PM

51. I believe you don't know shit about diabetes and obesity. Your ignorant post just showed that

plainly.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #8)

Sat Nov 21, 2015, 11:40 PM

52. I am and many in my extended family are diabetic. If we eat a perfectly balanced diabetic diet

we will still be diabetic. My grandmother is the most careful eater I have ever met. She follows her doctor's diet and medication regimine to the letter every day without fail. Still diabetic.

You don't die from diabetes, you die from complications that can arise from diabetes. Early detection and long term maintenance can help prevent renal failure and the cost of dialysis that comes along with stage 4/5 renal failure caused by the destruction of the kidneys that can come from diabetes and high blood pressure. Amputations are pretty costly, well with preventive care, we can avoid those costs.

There are times where I make the choice to eat rather than buy my injectables which are very expensive. Luckily my doctor is going to try to help me find some assistance next year. But without assistance I will be on the road to fatal and costly complications.

Prevention that comes from affordable care and medication is a massive cost saver.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Ed Suspicious (Reply #52)

Sat Nov 21, 2015, 11:44 PM

53. then as you know

 

there's type 1 and type 2 diabetes.

I did say that diabetes is "often" due to poor diet not "always". There are other risk factors like genetics and environmental.

Don't have to go around calling people idiot.


IF diabetes is not linked to diet, what's the point of putting her on a diet regime?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #53)

Sat Nov 21, 2015, 11:49 PM

54. We are all type 2. The point of putting her on a diet regime is the control blood glucose levels.

This helps to mitigate the complications that can arise from type 2 diabetes, but she will always and forever be a type 2 diabetic. She will alway and forever be insulin resistant. She will always and forever have a pancreas that creates too little insulin to be effective at removing the glucose from her blood stream. Always and forever she will be a diabetic.




http://www.webmd.com/diabetes/type-2-diabetes-guide/reversing-type-2-diabetes

http://www.bbc.com/news/health-13887909

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Original post)

Sat Nov 21, 2015, 03:19 PM

5. Unless we make other changes to the system, you'd be lucky to cut 10% out of monthly premiums by

 

getting rid of insurance companies. I don't think that's enough to make people stop complaining.

Now, if one could cut out most of the profits others in the system make, patients were willing to accept some restrictions, etc., we could do much better. But, if you hold your breath until that happens, you'll end up in the morgue. Have you priced a traditional funeral nowadays?

Of course, guess who pays claims under Medicare and pretty much administers the entire program? -- yep, insurance companies contract with the government to handle that. Who maintains quality assurance programs under Medicare? -- insurance companies. Who handles questions from beneficiaries and providers? -- insurance companies. Who audits providers for fraud and abuse? -- insurance companies and other contractors. Who maintains networks of providers to inject some degree of coordination of care into our badly disjointed health care system? -- insurance companies. Who is the only one even marginally negotiating drug prices under Medicare Advantage? -- insurance companies.

All of that, and more, would have to continue with Medicare for all, which I do believe is the best way to go at this point. But Medicare has a lot of issues and will need a lot of infrastructure that the government is not going to pay for any time soon. So who will invest the money for that -- probably insurance companies.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Hoyt (Reply #5)

Sat Nov 21, 2015, 03:24 PM

9. The root of the problem imho is inequality.

Inequality drives up the cost. Until that is addressed it ain't gonna get much better by tinkering with medical coverage programs.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to BootinUp (Reply #9)

Sat Nov 21, 2015, 03:29 PM

13. You make a good point.

 

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Hoyt (Reply #5)

Sat Nov 21, 2015, 03:24 PM

10. thank you

 

amazing how the more you know about an issue the more you realize it's more complex than you thought.

There's no simple solution that will cure everything.

Well complexity and nuance isn't Sanders' strong point. I'm proud to support a candidate who has good grasp of the issue. She has been working on health care reform since the 1990s!

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #10)

Sat Nov 21, 2015, 03:30 PM

15. So what is her plan?

 

Reply to this post

Back to top Alert abuse Link here Permalink



Response to hill2016 (Reply #19)

Sat Nov 21, 2015, 03:41 PM

23. A good start for drug prices

 

I still do not trust her after they give her the money.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #10)

Sat Nov 21, 2015, 03:34 PM

17. We'd be so much better off if people had accepted Hillary Care in the early 1990s. I think she'll

 

come up with something better as Prez, and has a real chance of getting it enacted. But, it won't be easy.


Reply to this post

Back to top Alert abuse Link here Permalink


Response to Hoyt (Reply #17)

Sat Nov 21, 2015, 03:37 PM

20. amazing isn't it?

 

she has been fighting for this for 20 years even though she was "only" First Lady and vilified by the Republicans.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Hoyt (Reply #17)

Sat Nov 21, 2015, 03:40 PM

22. I admit to forgetting how her plan was structured back then

but I remember having a high opinion of it at the time, and just being a strong supporter of reform in general.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to BootinUp (Reply #22)

Sat Nov 21, 2015, 03:55 PM

24. It was a bit complicated for folks, but it had authority/input at the local level to help with a

 

transition. It focused on prevention, quality, and affordability.

Most importantly, it was doing something to get us started on the long road to a civilized system.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Hoyt (Reply #24)

Sat Nov 21, 2015, 04:13 PM

32. the fact that she was

 

attacked viciously by the health care industry tells me a lot.

Hope she took names because she's going to be kicking butt

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Hoyt (Reply #5)

Sat Nov 21, 2015, 04:10 PM

30. K&R for this sub-thread, and the OP. Interesting discussion. nt

 

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Original post)

Sat Nov 21, 2015, 04:03 PM

27. the av number of procedures goes down doesn't it?

In a public health system unnecessary procedures are not performed. Here in the USA doctors want to do more procedures to make money?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Rosa Luxemburg (Reply #27)

Sat Nov 21, 2015, 04:13 PM

31. why would the number of procedures go down?

 

If the system not the patient is paying, wouldn't doctors have even more incentives to do unnecessary procedures?


Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #31)

Sat Nov 21, 2015, 04:26 PM

33. Hopefully it would reduce the number of unnecessary procedures

How will we keep doctors from doing too many procedures?

This is a problem in any system that reimburses physicians on a fee-for-service basis. In today’s health system, another problem is physicians doing too little for patients. So the real question is, “How do we discourage both overcare and undercare?”

One approach is to carefully control new capital expenditures. Once a hospital or imaging center purchases a multimillion-dollar CT scanner, it will try to generate enough scans to pay off the fixed cost. Explicit health planning should be done to assure that expensive machines and facilities are sited where they are needed and not where they are redundant and likely to generate overuse.

Another approach is to compare physicians’ use of tests and procedures to their peers with similar patients. A physician who is “off the curve” will stand out. A related approach is to set spending targets for each specialty. This encourages doctors to be prudent stewards and to make sure their colleagues are as well, because any doctor doing unnecessary procedures will be taking money away from colleagues.

In addition, expert guidelines by groups like the American College of Physicians, etc., can help shape professional standards - which will certainly change over time as treatments change. This really gets to the heart of “how do you improve the quality of health care,” which is a longer topic. Suffice it to say that single-payer, universal coverage provides a framework for achieving thoughtful quality improvement.

http://www.pnhp.org/facts/single-payer-faq#what-is-single-payer

It depends what type of system is created?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Rosa Luxemburg (Reply #33)

Sat Nov 21, 2015, 10:39 PM

41. It very much depends on the type of system, and Medicare isn't very good at that either

Medicare is only slightly better than private insurance at reducing unnecessary procedures -- just look at the pushback when a government board pointed out that yearly mammograms for women under 50 doesn't actually save lives.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Rosa Luxemburg (Reply #27)

Sat Nov 21, 2015, 10:38 PM

40. Why would it go down? We have 30 million uninsured and 50 million underinsured.

Frankly that is the unicorn here: the idea that usage will go down. Usage will go way, way up. If it doesn't, the problem of people not getting healthcare isn't being solved.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Original post)

Sat Nov 21, 2015, 04:35 PM

34. I love reading Republican Underground....er, wait a minute. Sorry.

 

Got a little confused there reading about how useless public health coverage is compared to those wonderfully enlightened private health insurers.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Armstead (Reply #34)

Sat Nov 21, 2015, 09:21 PM

35. real world facts

 

and maths are neither liberal or conservative leaning

do you care to actually make a fact based substantive argument?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Armstead (Reply #34)

Sat Nov 21, 2015, 10:49 PM

43. It's like stepping into the Twilight zone ...

I keep rechecking the address bar .

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Original post)

Sat Nov 21, 2015, 09:27 PM

36. So supporting Hilary now means attacking single-payer, aka medicare-for-all???


I thought Obamacare was supposed to be just a step in the right direction toward the goal of universal health care. It seems as if Hillary has decided to get off the road of progress, and has decided to check into the Status Quo motel.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to reformist2 (Reply #36)

Sat Nov 21, 2015, 09:39 PM

37. um

 

i am attacking the premise that going to single payer will save substantial amounts.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to reformist2 (Reply #36)

Sat Nov 21, 2015, 10:43 PM

42. No, but supporting math means recognizing that it won't save us money

Nothing but a radical change in how providers are paid -- which Medicare for All doesn't provide -- would make universal health care cost less than our current system. Because the whole point of any reform should be to get people medical care. That means actually providing care to the 30 million people with no insurance, and the 50 million people with insurance they can't afford to use. That's more than a quarter of the population. If they use medical services at the same rate as the currently insured, and providers still are paid at the same inflated rate they are, that means an increase of costs of 12% (the half of the country with private insurance gets its treatments 20% cheaper because of Medicare, but the usage goes up 25% because the uninsured and underinsured can now access health services -- run the numbers, and you wind up at 112% of current costs).

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Original post)

Sat Nov 21, 2015, 10:35 PM

38. No need to "take a stab", CMS has the numbers. It's about 4% of that.

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

As of 2013, overheads (including profit) for the various public and private insurers were:

Private insurance: $115 billion, or 12% of insurance spending, or 4% of total spending
Medicare: $35 billion, or 6% of Medicare spending, or 1% of total spending
Medicaid: $39 billion, or 9% of Medicaid spending, or 1% of total spending
CHIP: $2 billion, or 15% of CHIP spending, or less than 1% of total spending
DoD: $3 billion, or 8% of DoD spending, or less than 1% of total spending
VA: $33 million (note the "m" there), 0.6% of VA spending, or not even on the radar of total spending
Workers' Comp: $12 billion, or 27% of Workers' Comp spending, or less than 1% of total spending

All told, all overhead and profit runs to about 10% of our total spending; slightly less than half of that (4% of the total) is going to insurance companies.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Recursion (Reply #38)

Sat Nov 21, 2015, 10:50 PM

44. yup

 

I wrote it about it in another post.

Much less than people imagine


http://www.democraticunderground.com/1251834909#post67

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #44)

Sat Nov 21, 2015, 10:56 PM

47. And half of that 4% isn't profit

There's legitimate administrative overhead costs, too; Medicare's overhead rate is 6%, and private insurance's is 12%. If private insurance had the same overhead as Medicare (it's always going to cost some amount of money to process this stuff) then its overhead would be half of what it is, or 2% of total expenditures.

So, yes: removing the profit motive from insurance would save us some money, about 2% of what we're spending.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Recursion (Reply #47)

Sat Nov 21, 2015, 11:00 PM

49. you also

 

cut out the underwriting and marketing costs.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Recursion (Reply #38)

Sat Nov 21, 2015, 10:56 PM

46. which table are you using?

 

I'm looking at the row "net cost of health insurance" which is about $200b a year

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Reply #46)

Sat Nov 21, 2015, 10:58 PM

48. Above that one (in the CMS spreadsheet): Total Administration and Total Net Cost

That includes some overhead categories that Net Cost doesn't, though I can't remember what they are specifically.

Total Administration and Total Net Cost of Health Insurance Expenditures 210588
Out of pocket 0
Health Insurance 194947
Private Health Insurance 115749
Medicare 35157
Medicaid (Title XIX) 38607
Federal 22163
State and Local 16444
CHIP (Title XIX and Title XXI) 2185
Federal 1505
State and Local 680
Department of Defense 3215
Department of Veterans Affairs 33
Other Third Party Payers and Programs 15641
Worksite Health Care 0
Other Private Revenues 0
Indian Health Services 107
Workers' Compensation 12573
General Assistance 0
Maternal/Child Health 121
Federal 3
State and Local 118
Vocational Rehabilitation 59
Federal 46
State and Local 13
Other Federal Programs* 2696
SAMHSA 85
Other State and Local Programs** 0
School Health 0
Total CMS Programs (Medicaid, CHIP and Medicare) 75949

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Recursion (Reply #48)

Sat Nov 21, 2015, 11:05 PM

50. you're right

 

it should be $115b. My $200b figure includes the government programs, according to the footnote.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to hill2016 (Original post)

Reply to this thread