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To: normlasky who wrote (3062)	7/11/2012 11:23:57 AM
From: Spekulatius	1 Recommendation Respond to of 3249

Re: WLP - anybody likes this health insurers.What got my attention is that they I think more important than single payer system is to simplify and standardize. Germany has a standardized health care system (in terms of government set prices for procedures etc) but multiple mutual insurers competing. They have a much simpler job to do than the health insurers here, that have to negotiate prices and access individually. The german health insurers typically spent 5% of the premiums on G&A costs, while US insurers spent in the low single digits (12-15%) plus some profit margin of course. Sometimes, public systems beat private systems in terms of efficiency.

To: normlasky who wrote (3062)	7/11/2012 12:41:01 PM
From: DoggyDogWorld	3 Recommendations Read Replies (2) \| Respond to of 3249

Re: WLP - anybody likes this health insurers.What got my attention is that they We need to cut our health care costs by $3600 or 50% per person to be competitive True. I think a good starting point is a single payer system. I think it would reduce health care costs annually by $1000 per person. Absurd. Single payer could cut $1k/person, or even more. Or it could add $1k/person. Or even more if it devolves into free boob jobs for the disadvantaged (e.g. crack whores, etc.). There are many differences between US and Canada/Europe besides single payer. End of life care is different. Other countries free ride off our generous pharma reimbursements. Malpractice suits, rare in single-payer countries, are a huge industry here. Think Obama will put even a single ATLA ambulance chaser out of work? 50% reduction in healthcare costs means roughly 50% reduction in healthcare employment. Think Obama or any other politician will antagonize that many voters? Think a single-payer government bureaucracy will voluntarily shrink its domain by half over time? Has that ever happened in the history of socialism? It's all about incentives. Even Obama-fan Warren Buffett says so, and further says Obamacare did zilch to address incentives. Likewise, single-payer by itself fixes none of our mal-incentives. In fact, it makes some worse. As long as healthcare is a political football we'll make no progress on costs. A real solution will require multiple decades of continual effort under under both Democratic and Republican administrations. Obama had a chance to show true leadership by putting together a bipartisan team to attack the problem, instead he chose to worsen matters by using his mandate (which had nothing to do with healthcare but sprang from the financial crisis) and a bunch of shady back-room maneuvers to cram a distasteful plate of crap down a weakened GOP's throat. This virtually guarantees the GOP will dismantle as much of his system as possible the minute they re-take power. We need a Bowles-Simpson type approach, with both parties committed to implement the recommendations. Everything else is just counter-productive gamemanship.