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Missing The Point — Why Now?
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Missing The Point

This has to be one of the most clueless lead paragraphs to ever appear at  Corrente:

One of the goals of single-payer health insurance is to put the health insurance companies out of business. Another is to reduce the paperwork load at doctor’s offices, clinics, hospitals and for other health care providers.

It is the beginning of a post titled, Has anyone considered this? written by someone named Badger.

I’m sorry, but the one and only goal of the single-payer health insurance plan is to make health care available to all Americans. In the civilized world where everyone has health care coverage, there are health insurance companies, although many exist merely to provide health care coverage for people who travel to the US or other uncivilized countries.

In addition, while Medicare is administered by a government “bureaucracy”, this small number of people is the equivalent of the upper management of an insurance company. The claims processing is actually done under contract with private companies, health insurance companies among them, so the shift will not be as devastating as some people assume, and the “bureaucracy” will not balloon. The volume of claims will require more contractors than currently used, but there is no real need to change the existing Medicare structure in any massive or radical way.

Health care providers will be shedding jobs, because they won’t need the absurd number of people currently employed in billing departments to navigate the mine fields created by insurers to deny claims, and they won’t need collection agencies to go after the uninsured.

Accounting clerks and managers will always be in demand because there is no way of escaping paperwork in the business world. Finding a job won’t be easy in the current environment, but the savings of single-payer health insurance can fund new business, and increase employment opportunities.

17 comments

1 Moi { 12.26.08 at 10:59 pm }

There have been a lot of strange posts over there during the last year. Sometimes I am just not sure where they are coming from….

2 Bryan { 12.26.08 at 11:12 pm }

They opened up posting to encourage new voices and a wider community, but some of the new people don’t seem to be able to maintain a consistent voice or opinion.

It was just irritating to find someone who expended so little effort to do research before posting. Hipparchia does a lot of work on the issue and has written posts filled with links to all of the information needed, but Badger decided he had found a “major weakness”.

Personally, I couldn’t care less what happens to the insurance companies, I’m concerned with what happens to friends and family some of whom who are among the 45 million without any coverage.

3 cookie jill { 12.27.08 at 10:22 am }

The goal of single payer healthcare is to make sure folks, ALL folks, are able to get healthcare. As an asthmatic, I’m pretty much uninsureable with almost all “insurance” companies. They don’t care about my ability to be healthy, they are in the business of making money and not paying it out. Single payer healthcare also aids in keeping healthcare costs. Right now, uninsured folks wait until a disease or condition is in serious late stages to get medical help, and more than likely, they go to a doctor in the Hosptial’s ER, which is exceedingly more expensive than just a general doctor’s office.

The person who wrote that is clueless…or works for an insurance company.

4 Bryan { 12.27.08 at 12:22 pm }

Personally I feel that many of the people who will be losing jobs at insurance companies are ethically and morally guilty of criminally negligent homicide in the unnecessary deaths of policy holders. When you receive bonuses based on your success at denying health care to people who have paid you premiums, you belong in your own circle of hell.

When people have to fight with their insurance carrier after the EMTs take them to the nearest hospital, rather than to the “approved” hospital, the insurance company deserves to go out of business.

5 hipparchia { 12.27.08 at 12:51 pm }

badger is a pretty good guy actually [and one whom i like a lot], if perhaps overly concerned on this point. otoh, the republicans have done a good job over the past few decades of breaking as many parts of government as possible, and obama hasn’t shown much inclination to be liberal or progressive on health care [tom daschle? rahm emanuel’s brother, ezekiel? srsly], or a few other things either [fisa, wall st before main st…]. i can’t entirely blame badger for being concerned.

badger’s also correct, to some extent, about single payer killing off for-profit health insurance. i haven’t been exactly shy about my opinions on the insurance industry [it should go crawl under a rock and die], hurricanes and healthcare being my pet issues, but irl, single payer will only rein in the worst abuses of the industry, not kill it entirely.

most of the 400,000+ health insurance employees will have to look for new jobs, but i don’t expect a lot of the 2.4 million admin workers employed by healthcare providers to be in immediate peril [although with the economy in tatters, we’re all in peril]. a little more than half those 2.4 million are in non-billing functions — stuff like payroll and ordering medical supplies is important too. and we’ll need to keep some of the billing clerks, because even medicare won’t pay the bills unless someone actually *sends* them.

hospital corporations are almost as fat and happy and bloated as the insurance industry has become. in our present system, *all* their employees are profit centers, so i predict there won’t be huge rush to dump any of them. hr 676 calls for converting the providers to non-profits over a span of 15 years, which is long enough for anybody to find a new job.

6 hipparchia { 12.27.08 at 1:07 pm }

btw, i really like michael’s solution: we pay them all to stay home.

7 Bryan { 12.27.08 at 1:17 pm }

Some of my Mother’s doctors have had to join group practices because they couldn’t keep up with the insurance paperwork and still be doctors. Other doctors have shifted to not accepting insurance, because it was so expensive to collect.

There will be a lot of people required to process the insurance claims, no matter what system is decided on, and 45 million more people entering the system, so insurance company processing clerks will still have jobs. It is in the billing departments of health care providers that the cuts will take place, as they won’t need all of the people currently employed to deal with insurance companies. There is a lot of churn in those jobs anyway, so the impact will be minimal. Hospitals and group practices don’t pay their clerks very well, and people who have some experience tend to change jobs frequently.

Worrying about the jobs of a million when discussing the health care of tens of millions is just incongruous. Health care costs are a major drag on the US economy, and reducing those costs will help everyone. It will hurt some people, even people who write software that translates the medical procedures into the codes for particular insurance companies and produces the proper form [people I know and almost went to work for], but such programs should never have been necessary.

Badger’s post sounds a lot like a concern troll operation. If the Senate Republicans aren’t interested in the jobs of auto workers, I can’t see them having a hissy fit over billing clerks at hospitals.

8 Bryan { 12.27.08 at 2:43 pm }

There are a lot of them that would love to stay home, Hipparchia, because they aren’t making much more than they have to pay for child care. I had a neighbor who made a dollar an hour from her job, after she paid for child care. That isn’t much of a career, but they needed the dollar for the utility bills.

9 Badtux { 12.27.08 at 4:15 pm }

If the problem is jobs for the people put out of business by Medicare For All, we can just open the Depression-era CCC back up for business. I have a place for them, doing some trail building in a national park that has been long neglected to the point where most of the trails have disappeared due to landslides and time. So I propose we just take them out to do some trail building. In Death Valley National Park. In July. Problem solved 😉 .

– Badtux the Snarky Penguin

10 Bryan { 12.27.08 at 4:37 pm }

My Dad was in the CCC after high school, and he thought it was a great change from my grandfather’s poultry farm.

The high school my Mother and I graduated from was built by the WPA and is still in use. One of my great uncles worked on that project after he lost his farm to the bank.

There are a lot of things that need doing, that governments at all levels have been putting off, and this is an opportunity to get them done and build a foundation for the next century.

The National Parks all need help, because there are a lot of things that haven’t been taken care of since the CCC was disbanded.

11 hipparchia { 12.27.08 at 5:06 pm }

that’s one of the problems with tender-hearted liberals, they do get caught up in stuff floated by the concern trolls.

death valley national park, in july. the idea has appeal.

the hospital corporations around here do offer health insurance to their employees, even the lowly clerks, which is more than many of the other employers around here offer, so i’m not sure what the turnover is here. if in general the turnover is high [makes sense to me] then that’s one group of workers we can let right-size itself by attrition, rather than actively make provisions for.

various acquaintances of mine are in these jobs just for the insurance. as you say, the child care alone takes up most of the actual income.

there are a number of cottage industries [and not-so-cottage] that will take a hit if we get single payer, including software writers of various stripes. just one example, i had no idea the denial management industry even existed, let alone how many flavors of computer program you can buy, until i stumbled over it while researching single payer. glad to hear *your* income doesn’t rest entirely on keeping our present system [or does it?] i’d feel guilty about advocating for the eradication of teh kittehz’ meal ticket.

12 hipparchia { 12.27.08 at 5:10 pm }

as far as i can tell, there isn’t much in the way of wpa/ccc projects around here. after some extensive googling i found a post office mural nearby. i keep meaning to go see it, but have never gotten a round tuit.

13 Bryan { 12.27.08 at 5:53 pm }

The local groups over here think working 12 hour shifts at the hospital is all the health care coverage anyone needs, and they use volunteers for a lot of the office work.

I didn’t go to work for those guys, they were jerks. They had problems because they messed over the last guy who had the job. They weren’t programmers, and the actual product was created by “an employee”. After reading their employment contract I told them to stuff it – if I create it, I own the copyright and get paid a lot of money to give it up.

I was also unhappy with some of the “features” of the program that cut a little too close to stealing the work of other companies.

There was a lot of art financed by the FDR programs, something that has never been approached at any time since. The Smithstonian is the store house for a lot of great work that was financed by these programs, and there are wonderful murals in a lot of the buildings that the WPA created.

14 Kryten42 { 12.27.08 at 8:59 pm }

We used to have a decent medicare system, and it was mostly funded by a small contribution from wages (taken out with the tax). When Howard got in he destroyed it. He couldn’t totally get rid of medicare without being assassinated, but he slowly changed it over a decade and created a two-part system. Medicare for *basic* (and I do mean basic!) health care and Medibank Private (which is now a private health insurance company like the others). Medicare is now a refund system. You pay the bills and get a partial refund, eventually. If you are on a pension or unemployed, you get a ‘health care card’ which enables one to have free basic medical cover. None of the medical cover schemes, even most of the private ones, cover dental and most don’t cover optical. Of course, poor people don’t need good teeth or eyes. 🙂 But wait… several research has conclusively proven that bad teeth has a big impact on overall health and has *increased* the strain on, and the cost of, health care systems all over the World. But, the morons will still have none of it. You can prove that giving free dental cover will ease the strain on all parts of the medical system, but the problem is that word that makes them cringe like a crucifix to a vampire… *free*. The fact that it will ease the burden and the cost of the medical system for everyone (including Government) is immaterial when that most hated word *free* is part of the deal. 🙂

Don’t you love intelligent and compassionate Government? I do… I may see one one day. I doubt it will ever happen in my lifetime. I’d live to just meet an intelligent. honest, compassionate, unselfish Politician. That would be rarer than an albino kangaroo! LOL (I don’t think there has ever been an albino kangaroo… at least, I’ve never heard of one. *shrug* Just sayin…)

15 Bryan { 12.27.08 at 10:23 pm }

What is this “free” crap? If you have the fee deducted from your paycheck, it isn’t free. Being paid for by the government doesn’t make anything free. Every bloody penny that the Hedgemony spent on their unnecessary war is going to be paid by taxpayers with interest added.

I’ve never understood why some people think it’s a bad idea for citizens to benefit from the same sort of volume purchasing that has made Walmart the largest retailer in the world. The process is called free market capitalism.

16 Kryten42 { 12.28.08 at 4:24 am }

LOL No matter which Nation has Gov medicare, it’s paid for by the people. Every single thing any Gov does is paid for by the people, of course. 🙂 Most Governments increase tax to cover the costs of medicare. Our Labor (at the time) Gov decided to be a tad more honest, and have a medicare levy separate to the normal payroll taxes. They did it mainly so that it could be monitored and audited so that people would know the money was *actually* being spent on medicare and nothing else. We were given the choice, it’s the way we wanted it. Aussies are nothing if not pragmatic. We know nothing is *free* and we expect to pay for services. But we better damned well get what we pay for!! (As Howard found out).

It wouldn’t surprise me a bit to discover that many (or even most) Americans don’t understand that they are paying for every single thing Bush has done, and will be paying for a long time. 🙂

17 Bryan { 12.28.08 at 1:39 pm }

The anti-tax idiots can’t make the connection. They seem to believe that they can have all the services that they want and not pay for them – they want a “free lunch”.

I don’t know where the mythical “fat in government spending” is supposed to be, but it usually ends up being some pet project of one of the people who don’t want to pay anything for government services.

Like all dishonest people, the anti-tax people think everyone is dishonest. You get what you pay for, and if they knew as much as they claim to know about a budget, they could see it.