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This will be a short, angry diary. This is the first year my company shoe-horned us into a medical HSA. I had a simple question about how it works.

I had to speak with FOUR COMPANIES to get an answer.

My employer
Their benefits administrators
The health insurance company
The bank administering the HSA

That is 4 sets of expensive CEOs, 4 sets of admins, 4 sets of auto phone systems etc etc etc. All this took 45 minutes out of my working day. Single payer, free at point of service would have taken nothing out of my work time.

How in all that is holy is that "more efficient" than single payer? Can someone point me to credible studies that have examined the relative costs between our current system and single payer?

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Comment Preferences

  •  Tip Jar (11+ / 0-)

    I am a progressive because it reflects life. We learn, change, evolve and grow. When we stay stationary and conservative - we perish.

    by EastCoastProgressive1963 on Wed Jan 29, 2014 at 06:50:37 AM PST

  •  It's Far More Efficient At Generating Support for (24+ / 0-)

    election campaigns.

    You can't pass a law if you're not in office. You can't be in office without winning an election. You can't win an election without reaching and convincing a majority of voters. You can't have access to a majority of voters without hiring our corporately owned mainstream public square. You can't hire the public square without immense amounts of money. You can't get immense amounts of money except from large corporations and their owners and top management. They're not going to give you that kind of money if you're intending to use government instead of their corporations to serve the people.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Wed Jan 29, 2014 at 06:56:40 AM PST

  •  That's how right-wing policies "work" (3+ / 0-)

    Obama: self-described Republican; backed up by right-wing policies

    by The Dead Man on Wed Jan 29, 2014 at 06:59:54 AM PST

  •  Ir's mor efficient at funneling (8+ / 0-)

    money to the already rich.
    Next question?

    btw, kudos for making all those calls. I gave up after 3 days in a row of trying to contact the outfit that they tell me I have insurance with. I signed up, have an ID number, but no paperwork or bill from the ins. co. I have 4 numbers, all with the same recording, that after pushing all the correct buttons for 3 minutes, tells me that the call volume is heavy, and I should try back later.

    Only thing more infuriating than an ignorant man is one who tries to make others ignorant for his own gain. Crashing Vor

    by emmasnacker on Wed Jan 29, 2014 at 07:06:49 AM PST

  •  Has anyone ever said that the ACA is "more (11+ / 0-)

    efficient" than single payer?  I thought the reason we don't have single payer is because the votes weren't there.  Not because it is what is best.

    "Speak the TRUTH, even if your voice shakes."

    by stellaluna on Wed Jan 29, 2014 at 07:08:02 AM PST

  •  Please never say single payer is free (3+ / 0-)
    Recommended by:
    tardis10, Cedwyn, FG

    no matter how you qualify it it is not free nor should it be. Saying it is free gives conservative ammunition to discredit it as a massive big government spending program.

    If you are against sane gun regulations then by definition you support 30,000 deaths a year by firearms.

    by jsfox on Wed Jan 29, 2014 at 07:24:52 AM PST

    •  Single payer basically means you pay for it (5+ / 0-)
      Recommended by:
      VClib, Cedwyn, nextstep, SoCalSocialist, FG

      through increased taxes rather than through health insurance premiums.

      I, too, get irritated by people who think it's "free."  Single payer still means I pay for health care coverage, just differently.  Whether I would pay less depends on a lot of things (like what I'm actually paying out of pocket now).

      Given experiences in other countries, I think single payer would likely be better in some ways and for some people and worse in some ways and for some people.  How that plays out depends on how it's structured.  

      There's no solution out there that is going to be better in all ways for all people.  

      •  I would add that even under (2+ / 0-)
        Recommended by:
        tarkangi, Cedwyn

        single payer systems, there is nothing that prevents people with the resources to purchase additional levels of benefits and services in the private marketplace.  Single payer provides a coverage floor, not a ceiling, that is where private insurance kicks in even under a socialized system.

        The GOP seem to think a single payer system eliminates private insurance...it doesn't, it merely eliminates the inequities of an only private insurance system.

      •  A tax on gasoline to pay health care costs would (1+ / 0-)
        Recommended by:
        Cedwyn

        be a good start. It would help to alleviate two problems - health care and excessive hydrocarbon consumption.

        An even better solution would be to nationalize the oil companies. NOCs are in control of the majority of the world's hydrocarbon resources. Countries like Norway have free health care and drugs plus free dental care for students.

        While we are at it we should also look at nationalizing the banks.

        The world needs to drop the "American Dream" which is nothing more than excessive consumption fueled and driven by unfettered capitalism. Global warming and resource wars have been a direct consequence of holding this paradigm.

        We didn't get here by accident. It was deliberately engineered. If you want to understand how you should read Propaganda (1928) by Edward Bernays.

        What the world needs is a new paradigm to achieve global happiness. "Shop till you drop" doesn't accomplish happiness - it never has for more than a fleeting moment. It works just like a drug. A short, sharp high followed by a depressed mood that could only be alleviated with more shopping or distraction.

    •  ? (0+ / 0-)

      I don't understand this objection. "How you qualify it" certainly does matter; "free at point of service" doesn't mean free. Whether it's a good choice of language is a separate issue.

      Saying it is free gives conservative ammunition to discredit it as a massive big government spending program.
      Compared to what? Conservatives will try to do that regardless. Do you have evidence that avoiding the word "free" would undermine their efforts?

      "I am not sure how we got here, but then, I am not really sure where we are." -Susan from 29

      by HudsonValleyMark on Wed Jan 29, 2014 at 07:34:23 AM PST

      [ Parent ]

      •  But it isn't free (0+ / 0-)

        you have paid for it through your tax dollars just like you pay for it now through premiums.

        There is a strong fiscally conservative argument for single payer, but when you throw the word free into the mix you have lost the battle before you even start.

        If you are against sane gun regulations then by definition you support 30,000 deaths a year by firearms.

        by jsfox on Wed Jan 29, 2014 at 01:47:41 PM PST

        [ Parent ]

  •  But, HSA puts your skin in the game! (2+ / 0-)
    Recommended by:
    churchylafemme, greengemini

    Magically making you aware of the true cost of all medical procedures from a hangnail to a herniated disk.

    This will, so they assure me, reduce the extravagant medical spending in which I previously indulged.

    Or not, as I go to the hospital designated for easiest access within the associated network - and then spend the next couple of weeks tracking down and rationalizing source and applicability of myriad co-pays. (It's like Oprah - everyone gets a co-pay, everyone bills you with a residual).

  •  East Coast Progressive - no one suggests it's more (2+ / 0-)
    Recommended by:
    Murphoney, Cedwyn

    efficient. Even people who oppose single payer don't argue that it is less efficient than some of the current options. The fact that single payer is more efficient is certainly one of its positive points. However, from a political perspective it's a much more complex subject including structuring a single payer healthcare delivery system and a revenue plan that has bipartisan support.

    "let's talk about that"

    by VClib on Wed Jan 29, 2014 at 07:52:18 AM PST

  •  Well, first of all, since all our dollars for the (0+ / 0-)

    fifty states come from the federal Treasury, there is only one payer. Single payer for health care was a mis-nomer which actually served to disguise this truth.

    Secondly, we have a federal system and insurance regulation and supervision is one of the functions performed by and guarded jealously by the governmental entities in the fifty states.

    Thirdly, most insurance actually exists to syphon dollars from individuals and accumulate them on behalf of investors, who are not satsified with the fact that the Treasury distributes dollars to banks on demand, thereby insuring a "cut" for the money changers before a dollar is exchanged in the transaction of real goods and services.

    Fourthly, since medical care is something that most people need, rather than want as an option, and since most people needing medical care are not in a position to judge ahead of time whether the care on offer is actually appropriate (never mind that if they die, they can't pay), it is advisable to have a middleman making judgements as to both appropriateness and cost. Adding fifty million people into a pool of service recipients requires additional service adjustors and payment authenticators. Whether those middlemen are public bureaucrats or private bureaucrats is not very important, as long as the latter's profits are capped, as they are in the ACA. In exchange for taking on clients whose premiums are sure to be paid and augmented by subsidies, private insurers were prompted to participate. While these insurers won't be delivering as many surplus dollars to banksters to invest, their own income is more secure.

    Subsidies paid out from the Treasury for specific purposes (health insurance, child care, education) is basically more efficient, even when they are dealing with individuals because those individuals make choices and provide feed-back. Your having to deal with four entities and being distressed will likely contribute to the recognition that employers in the mix is a layer of middlemen we can do without. While employers definitely benefit from having a workforce that's less sick, defining compensation as a benefit and designating it for medical services is demeaning to the employee even as it undermines the efficiency of the enterprise. It is much more efficient to pay bills when they are due.

    Obamacare at your fingertips: 1-800-318-2596; TTY: 1-855-889-4325

    by hannah on Wed Jan 29, 2014 at 08:54:35 AM PST

  •  Medicare's costs (1+ / 0-)
    Recommended by:
    greengemini
    Can someone point me to credible studies that have examined the relative costs between our current system and single payer?
    I haven't found the HSA cost comparison.  With conventional insurance vs. Medicare, the conventional insurance overhead costs are something in the range of 15 - 20%.  Medicare's overhead costs, including collecting the taxes and fraud enforcement, are around 3%.  Do keep in mind that this is as a percentage of the total, not figured per capita.  We elderly use more medical resources than the young, so there are more costs run up by fewer people.  And, in many cases Medicare doesn't pay enough with the excess costs shifted to other patients.
    http://theincidentaleconomist.com/...

    There are lots of ways to run single payer.  Medicare is one example where it is subsidized national insurance.  Canada's system has a separate plan run by each province with Canadian federal money added.

  •  Insurance works by cost-spread-out (0+ / 0-)

    therefore single-payer, in which every worker contributes, gets more money despite taking smaller bites of each person's check.

    Not free.
    But way cheaper than insurance -- why do you think they call 'em "premiums"?

    LBJ, Van Cliburn, Ike, Wendy Davis, Lady Bird, Ann Richards, Barbara Jordan, Molly Ivins, Sully Sullenburger, Drew Brees: Texas is NO Bush League!

    by BlackSheep1 on Wed Jan 29, 2014 at 01:01:47 PM PST

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