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by chimeracoder 2898 days ago
> It’s so strange, the people who would most benefit from universal healthcare (and those that currently do, like Medicare beneficiaries) tend to be the strongest objectors to it, citing hard-to-understand ideological reasons.

It's not so strange if you allow yourself to question the assumption that they'd benefit from it in the first place.

Medicare is a great example. Patients can opt to receive their Medicare inpatient and outpatient coverage through a private plan instead of through the government-managed plan. Since this program was introduced, it's gained popularity rapidly, over a third of Medicare beneficiaries receive their benefits from private plans. Many private plans are the same price as Medicare or cheaper.

From the data, the private plans beat government-managed plans on the three major metrics: medical outcomes, cost, and patient satisfaction. On the last one, the difference isn't even close: the worst of the major private plans (by patient satisfaction scores) still manages higher scores than Original Medicare does.

People who haven't ever dealt with Medicare themselves directly (which includes most HN commenters) find this hard to understand, but it really isn't: dealing with Medicare is awful. I could give you my personal anecdotes, but they'd overfill the comment length on HN, and again, at the end of the day, the numbers speak for themselves. Medicare beneficiaries themselves are turning to private plans to replace their government-managed plans, so it's really not surprising if they're not the biggest advocates of expanding government-managed plans.

1 comments

The private plans you refer to are mainly either simply administrators (the government pays them to administer the benefits) or supplemental providers or both. And their existence and popularity has more to do with their sponsorship by insurance funded politicians than anything else. Dealing with these administrators isn't generally better or worse than dealing with the government directly. Exceptions exist, but that goes without saying.
> The private plans you refer to are mainly either simply administrators (the government pays them to administer the benefits) or supplemental providers or both

No, they're much more than that.

> And their existence and popularity has more to do with their sponsorship by insurance funded politicians than anything else.

The programs are cheaper, provide better medical outcomes, and patients prefer them.

That doesn't mean they're perfect, but you have to bend over pretty far backwards to say that they're inferior and only popular because of "insurance-funded politicians".

> Dealing with these administrators isn't generally better or worse than dealing with the government directly. Exceptions exist, but that goes without saying.

It is monumentally easier to deal with private insurers than to deal with an Original Medicare plan.