Medicare for All?
Senator Clinton resurrects an old, and still very bad, idea.
By James C. Capretta
health.nationalreview.com
Free Lunch Eternal
The administrative costs of private health insurance.
By Benjamin Zycher
The quest for the free lunch is eternal, and nowhere is that reality clearer than in the ongoing debate over reform of the U.S. health-care system. Many advocates of a single-payer (government) system of health insurance argue that “administrative” costs for private health insurance are much higher than those for such single-payer systems, such as Medicare. The adoption of a single-payer system for all Americans, they claim, would yield savings sufficient to cover all the uninsured.
And so the free lunch emerges yet again: We can have more “coverage” while losing nothing at all. New research published this week by the Manhattan Institute examines the data in detail, showing that it is highly problematic — a sharp understatement — to assert that the savings in administrative costs would be sufficient to “cover” the uninsured.
But there remains the implicit assumption, that the administrative costs borne by private insurers represent mere waste that can be eliminated without losing anything of value. If so, why do profit-seeking insurance companies continue to bear them? And why are the purchasers of health insurance services willing to pay for them? If important scale economies exist in administration, why do we not observe a long-term decline in the number of insurers accompanied by an increase in their average size?...
health.nationalreview.com
Out-of-Control S-CHIP
Presidential reins.
By Diana Ernst
health.nationalreview.com
"...The uninsured are relatively insignificant to health costs, especially in emergency rooms. Of the 15-percent of the U.S. population generally considered uninsured, only seven percent of them used an ER at all in 2000, whereas 10-percent of the privately insured did, and a whopping 18 percent of those on government benefits — which pay hospitals far less than private insurers do. The real cost shift, therefore, is from government programs, not the uninsured.
Further, most uncompensated care is covered by a confusing array of government programs that fund hospitals for unpaid bills. A scholarly effort to measure all truly uncompensated health costs figured them at $35 billion in 2001 — less than 3-percent of health spending that year, of which a significant fraction was bad debts from insured patients!..."
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