[Publib] Needing Librarians

Wed Sep 9 13:54:11 EDT 2009

Hard to find 31% for admin costs when the PWC report at 
http://www.ahip.org/content/pressrelease.aspx?docid=14702
indicates that 86% of every premium dollar goes to medical services....

Extracted from the PWC report at 
http://www.ahip.org/redirect/PwCCostOfHC2006.pdf concerning how the 
premium dollar is used:

    _Consumer services, provider support and marketing (5%)._ In
    addition to marketing
    and sales, this component includes communications with consumers
    regarding
    their existing and new benefits, disease management programs, care
    coordination,
    health promotion, wellness and prevention programs, and investments
    in health
    information technologies that benefit consumers.

    _Government payments, compliance, claims processing and other
    administration
    (6%)_ Taxes on premiums, costs of complying with government laws and
    regulations
    such as filing and reporting requirements and the recent Health
    Insurance
    Portability and Accountability Act are included in this cost
    component as well as the
    costs associated with claims processing, premium and eligibility
    processing and
    other administrative activities that support health plan operations.
    Health plan
    claims processing procedures rely on a significant investment in
    technology and
    training to provide timely coverage determinations to consumers and
    timely
    payment to providers as well as guard against fraudulent billing
    practices.

    Physician services (24%)

    Outpatient costs (22%) This includes free-standing facilities and
    outpatient departments of hospitals.

    Inpatient hospital costs (18%)

    Prescription drugs (16%)

    Other medical services (6%). This includes durable medical
    equipment, nondurable
    medical equipment, home health, other health professionals, and
    other personal care.

Also it notes:

    Overall, approximately 10 percent of the costs of medical
    services are attributed to the cost of litigation and defensive
    medicine.

Fred

Sharon Foster wrote:
> Regarding Q12. Those profits sound small, but considering that private
> health insurance companies spend 31% of their income on administrative
> costs and other non-health-care related overhead, they're still high.
> Medicare, depending on what you read, spends about 3 to 6% on
> overhead.
>
> Sharon M. Foster, JD, MLS
> Technology Librarian
> http://firstgentrekkie.blogspot.com/
>
>
>
>
>
>
> On Wed, Sep 9, 2009 at 12:03 PM, Fred
> Beisser<fredbeisser at mesanetworks.net> wrote:
>   
>> Regarding Q11. It would appear axiomatic that private health insurance
>> companies provide a means of allowing those insured with them to know the
>> cost of medical and hospital needs via a monthly premium versus the way
>> things used to be decades ago when each person paid their own
>> medical/hospitalization expenses directly from their own pocket whether
>> large or small. High risk insureds in the plan are offset by those with
>> better health conditions and lower risk....same as automobile insurance or
>> insuring one's home or business. As a result, the cost to high risk insureds
>> is lower than if they had to pay the actual costs themselves.
>>
>> Regarding Q12:
>>
>> Price Waterhouse studied the reasons for increased health insurance premiums
>> and concluded that increased utilization accounts for 43% of premium
>> increases in their study (see summary at
>> http://www.ahip.org/content/pressrelease.aspx?docid=14702 ). Medical
>> liability and defensive medicine contribute to 10% of medical costs (those
>> darned lawyers again).
>>
>> It is my understanding that health insurance company profits are not high,
>> about 2 to 4% on total revenue after paying taxes, That is about $57 to
>> $85/insured in the three companies looked at. Not very excessive as I see
>> things. For a short study of this, see http://tinyurl.com/n96lzu. As a
>> percent of revenue, about the same as grocery chains.
>>
>> I see in US Census data in Historical Health Insurance Tables that the total
>> number of insureds (both private and governmental programs) has increased
>> from 238 million in 1999 to 253+ million in 2007, so I don't understand your
>> assertion.
>>
>> Sharon Foster wrote:
>>     
>>> 11. Will he explain what value private insurance companies add to the
>>> overall state of health care?
>>>
>>> 12. Will he explain why health insurance premiums have gone up while
>>> health insurance profits have gone up and the number of Americans with
>>> health insurance has gone down?
>>>
>>> Sharon M. Foster, JD, MLS
>>> Technology Librarian
>>> http://firstgentrekkie.blogspot.com/
>>>
>>>
>>>
>>>
>>>
>>>
>>> On Wed, Sep 9, 2009 at 9:48 AM, Fred
>>> Beisser<fredbeisser at mesanetworks.net> wrote:
>>>
>>>       
>>>> It's not my job, but here is something useful to consider the health care
>>>> reform issue.It's a ten-point checklist I ran across to help folks assess
>>>> topics arising in the President's speech tonight.
>>>>
>>>> In his proposals for reform, does the President include litigation
>>>> reform,
>>>> which 84% of Americans believe will help reduce costs and which is the
>>>> number one goal of doctors in any health reform?
>>>>
>>>> Does he include a section onsaving money by stopping payments to crooks
>>>> who
>>>> are bilking the taxpayers for $70-120 billion each year in Medicare and
>>>> Medicaid fraud? For 88 percent of Americans, this is the first place they
>>>> would look to find savings in our health care system. Is President Obama
>>>> willing to look there?
>>>>
>>>> Does his speech reject higher taxes, which the vast majority of Americans
>>>> believe will make the current economy even worse and increase
>>>> unemployment
>>>> even more?
>>>>
>>>> Does it reject all government rationing of health services which the
>>>> American people have vocally opposed at town hall meetings across the
>>>> country?
>>>>
>>>> Does it reject any government run, bureaucratic health plan?
>>>>
>>>> Is President Obama open to four or five bipartisan bills which could pass
>>>> with big bipartisan majorities? Or does he insist on a single omnibus
>>>> bill
>>>> of 1000-plus pages like the one that failed when Mrs. Clinton tried to
>>>> pass
>>>> it in 1993-1994?
>>>>
>>>> Is he for sustaining the Senate rule of 60 votes to ensure a bill that
>>>> has
>>>> wide, bipartisan support? Or is he prepared to destroy long-standing
>>>> Senate
>>>> tradition and ram through a radical bill with 51 votes?
>>>>
>>>> Does President Obama give any indication he is forincreasing the power,
>>>> information and choice of the individual and their doctor or is he giving
>>>> more power to the government?
>>>>
>>>> Does he focus on health, wellness, prevention, early detection and health
>>>> management to avoid or control the severity of chronic diseases? Or does
>>>> he
>>>> spend his time talking only about acute care?
>>>>
>>>> Does his plan invest in science and technology in order to increase
>>>> innovation and accelerate the discovery and adoption of new discoveries
>>>> and
>>>> breakthroughs in diseases such as Alzheimer's, cancer and diabetes?
>>>>
>>>> Fred Beisser
>>>>
>>>> Backwage at aol.com wrote:
>>>>
>>>> At the present time the nation is engaged in a series of policy debates
>>>> over
>>>> the future of health care reform.  If you watch the news, you have seen
>>>> politicians convene what are known as town hall meetings—gatherings of
>>>> the
>>>> community which are intended to permit questioning and the expression of
>>>> viewpoints.  Instead of rational discourse, what has occurred is a series
>>>> of
>>>> shouting matches and wild demonstrations with occasional fisticuffs.
>>>> Nothing like genuine debate, which of course requires two preconditions:
>>>> that the participant have a genuine desire to be convinced of another
>>>> viewpoint, and that he arrive in possession of at least the bare outline
>>>> of
>>>> the matter at hand.
>>>>
>>>>
>>>>
>>>> It might seem that the asylums of the nation had been emptied to fill
>>>> these
>>>> meetings, but your intelligent observer knows otherwise—that these people
>>>> really are a slice right out of the middle of the American pie.  You hear
>>>> them talking on the train and cringe; their sources of information tilt
>>>> toward rumor and the internet legend.  Obama is going to kill off old
>>>> people; Obama is going to make insurance free for everybody.  We are
>>>> headed
>>>> for fascism and socialism, simultaneously, while also being left
>>>> completely
>>>> without leadership.
>>>>
>>>>
>>>>
>>>> As librarians you are in for no surprise if you ask these folks where
>>>> they
>>>> get their information.  And the folks on the train would be in for a
>>>> surprise if they were told that they (1) had no idea what they were
>>>> talking
>>>> about, and (2) that they could very easily find out the history, current
>>>> prospects and likely outcomes of the health care debate by visiting their
>>>> local library.
>>>>
>>>>
>>>>
>>>> I am not one of those folks who believes that the internet is God.  In
>>>> fact,
>>>> I regard it as a failure.  The only previously occurring failure of
>>>> similar
>>>> magnitude was television, and the internet is worse.  You see, television
>>>> could have been something other than the “vast wasteland” but that it
>>>> didn’t
>>>> do better has to do with its owners as much as its consumers.  After all,
>>>> ordinary folk didn’t write Congress asking for reruns of the Beverly
>>>> Hillbillies any more than they asked for the original broadcast, and it
>>>> wouldn’t have made much difference anyhow—the folks at home are only
>>>> responsible for having made such shows an unfortunate part of our shared
>>>> heritage.
>>>>
>>>>
>>>>
>>>> The internet on the other hand is terrifically varied, in effect millions
>>>> of
>>>> television channels broadcasting all at once.  Certainly 90% of what is
>>>> there is trash but the viewer has a choice, and some of the choices are
>>>> superb—far better than the best stuff of television at any time in its
>>>> history.
>>>>
>>>>
>>>>
>>>> The sin and crime of the internet comes from the failure of its users to
>>>> employ the thing to its highest and best uses.  Given a sort of universal
>>>> channel changer, they stick to the same sort of stuff that appears on
>>>> television.  And consider themselves “informed” because they spend hours
>>>> a
>>>> day looking up movie stars’ profiles.
>>>>
>>>>
>>>>
>>>> If you suppose that I consider the average person an idiot, you are
>>>> wrong.
>>>> The average person is average—by which figuring idiocy is rendered normal
>>>> and commonplace.
>>>>
>>>> The ordinary person needs a guide to information.  It is not and has not
>>>> ever been true that most folks will on their own seek out the right way
>>>> to
>>>> live, the better sort of entertainments or food worthy of the name.  In
>>>> fact, they will not even bother to find out whom to vote for.  Though
>>>> they
>>>> certainly will vote.  And eat, and everything else (and with what
>>>> discernment!)
>>>>
>>>>
>>>>
>>>> The librarian can be a guide, and should be.  At the very least to
>>>> sources
>>>> of genuine information, which as we all learned in library school (before
>>>> it
>>>> became information science, a science fiction term if ever there was one)
>>>> possess something called authority.  It is authority they need, and
>>>> authority we have—in ourselves and in the sound references we can
>>>> provide.
>>>>
>>>>
>>>>
>>>> Mind you, not very many will approach.  Here we see that the idea of the
>>>> passive librarian is simply wrong and moreover harmful.  Librarians need
>>>> to
>>>> advertise their availability and the strength of their resources.  What
>>>> could be a better remedy for the current fracas than for a local library
>>>> to
>>>> advertise itself as the place to find the answers, the information, the
>>>> past
>>>> of the whole ball of wax?
>>>>
>>>>
>>>>
>>>> The librarian is the only reliable human guide to the internet.  The
>>>> librarian is the one person in town who can dig up print sources.  The
>>>> librarian is, bless her heart, largely impartial, generally genial, and
>>>> bound by profession to serve.  Who better to dust off Clinton’s old plan
>>>> so
>>>> that it may be compared to Obama’s formulations?
>>>>
>>>>
>>>>
>>>> We gave them the Federalist Papers and the Pentagon Papers and everything
>>>> in
>>>> between.  We gave them Billy Mitchell’s reports and John Hersey’s
>>>> Hiroshima.  We can give them health care in all its hideous and expensive
>>>> complexity.  They are waiting for the truth.  We should be ready to throw
>>>> it
>>>> at them.   Don’t sit back and wait for the kids to come by with their
>>>> term
>>>> papers; don’t let the internet rumor mill determine the course of debate.
>>>> Maybe they won’t listen—but if they don’t know the truth when the time
>>>> comes
>>>> to decide, don’t let it be because your library didn’t point the way.
>>>>
>>>>
>>>>
>>>> Tomorrow morning, get off your chair and put together something useful.
>>>> That’s our job, isn’t it?
>>>>
>>>>
>>>>
>>>> M. McGrorty
>>>>
>>>> ________________________________
>>>>
>>>> ________________________________
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>>>>
>>>>
>>>>         
>>>       
>
>   
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