> Judah wrote:
> That's not true at all. Administrative costs in Medicare,

It's good conversation.

There are lots of reasons why medicare admin costs are lower (in some
areas!) and it has to do market segmentation, providers choice,
amongst all kinds of factors.  The point is that you can't simply
extrapolate the savings out.

One of the largest reasons the medicare model doesn't scale, however,
is doctors.  Right now there are all kinds of options for doctors to
spend different parts of their career in care vs. research vs. very
lucrative things like surgery.

Put another way, there's 'admin' and then there's product.  What do
the providers charge for what and why, what do the drugs cost, what do
the lab tests costs, et al.

Add to this that most large companies are self-insured.  That is, the
"insurance" company is ASO; administrative services only.  What this
means is that plans become ever more complicated as companies try to
drive down costs by stratifying plans that the insurance companies
administer.

As for preventative care, I was talking about disease management and
rewards for action.  What this means is providing people with a
monetary incentive to stay healthy.

What the government can do is create the infrastructure for consumer
driven health care and then let the private market take it over.

It's Dubai for health care.  Build it, and then let it run itself.

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