[Health Care Threads merged - please stop creating new threads]

[ace2000]

The ACA panels have absolutely no power over individual cases. They make overall cost saving recommendations to Medicare.

The insurance companies still do the same panels they have always done to discuss individual treatment decisions. The ACA does not do this.

The ACA does provide an appeal process where decisions are reviewed by a "panel". It is still decided by the insurance companies. I'll provide a source below. They don't get involved directly in the appeal process since Obamacare is relying on the health insurer to provide the insurance.

https://www.healthcare.gov/how-do-i-appeal-a-health-insurance-companys-decision/

If your health insurer refuses to pay a claim or ends your coverage, you have the right to appeal the decision and have it reviewed by a third party.

You can ask that your insurance company reconsider its decision. Insurers have to tell you why they’ve denied your claim or ended your coverage. And they have to let you know how you can dispute their decisions.

 

[ace2000]

You have been challenged by more than one person to back up your claims that corporations do a better job delivering the mail than the government.

Do so.

You are ducking the question. And I have strong suspicions as to why.

Really? Every time I've been asked to provide a source for my claims on this thread, I've done so. There were other times where I was misquoted or my quote was been twisted into something I never said, which I chose to clarify.

A strange thing happens though when I ask for a source from someone else to back up their claims... I get no reply - not even a clarification. To use your words... "I have strong suspicions why".

 

[ace2000]

You are ducking the question. And I have strong suspicions as to why.

Can you provide a link to a post where I even used the term "mail" in the broad terms that you keep going on and on about? The only fair comparison is to look at "services" that overlap. I have posted several times that I was referring to "package delivery" and even mentioned UPS and FEDEX a couple of times. Would you like a source on why people prefer those two over the Post Office?

 

[ace2000]

And I had major CANCER SURGURY LAST YEAR - how expensive would have been my "regular" insurance's new policy.

That would be a good question to know. Why would the ACA pay more than what you had before?

 

[ace2000]

That would be a good question to know. Why would the ACA pay more than what you had before?

I see... you're referring to the price of your new plan for this year. Sorry.

 

[Passepartout]

Can you provide a link to a post where I even used the term "mail" in the broad terms that you keep going on and on about? The only fair comparison is to look at "services" that overlap. I have posted several times that I was referring to "package delivery" and even mentioned UPS and FEDEX a couple of times. Would you like a source on why people prefer those two over the Post Office?

Even by your narrow definition, USPS does package delivery more efficiently, and at lower cost to the user than either UPS or FedEx, with greater security, and while we're at it, hires more veterans than any other single company.

But what does this have to do with health insurance? Oh, I remember. Private Enterprise vs. government service. I was just considering this. Hereabouts one can sign up with the city contracted trash removal company (private enterprise), or with any of several others, or take their trash to the dump themselves. Nobody cares. But every dwelling or business gets billed by the city for wastewater treatment. No private company has stepped up to open a sewage treatment plant. The only difference is that one is (mostly) solid, while the other is (mostly) liquid. I don't know that there is a law that says a private company can't do it, but they don't.

I really don't wonder why, do you? Surely people would pay to have their liquid waste removed. And if private enterprise could do it more efficiently with less 'waste, fraud, and abuse', why wouldn't they?

Jim

 

[Beefnot]

I don't necessarily believe the government is efficient at anything, even the post office (USPS is losing money hand over fist). But they are highly effective. There is a difference. Police, fire, military, mail, motor vehicles, etc. Local, state, and federal government provide generally very effective services, even if the are operated inefficiently.

 

[SMHarman]

Can you provide a link to a post where I even used the term "mail" in the broad terms that you keep going on and on about? The only fair comparison is to look at "services" that overlap. I have posted several times that I was referring to "package delivery" and even mentioned UPS and FEDEX a couple of times. Would you like a source on why people prefer those two over the Post Office?

Why people prefer, again you use anecdotal statements, a bit like these hypothetical 'people that have suffred under ACA'

So I dug for hard facts.

http://about.usps.com/publications/...ement-2013/annualreport2013_032.htm#ep1003809

Seems the USPS ships about 3,711,000,000 packages a year thats 14,273,076 a day based on a 260 working day year.

On to UPS

http://www.ups.com/content/us/en/about/facts/worldwide.html#

Daily delivery volume is 16.3 million packages and documents - Though that is worldwide, not US specific.

FedEx

http://investors.fedex.com/phoenix.zhtml?c=73289&p=irol-statbooks

If you have the time to dig.
http://wiki.answers.com/Q/How_many_packages_does_fedex_ship_a_day
Says 3.4m

So USPS and UPS seem about the same size.

If you want to look at profitability then you need to adjust for the USPS pension funding model that is mandated by congress and requires their pension to be currrent funded (overfunded) compared to any competition.

 

[SMHarman]

I don't necessarily believe the government is efficient at anything, even the post office (USPS is losing money hand over fist). But they are highly effective. There is a difference. Police, fire, military, mail, motor vehicles, etc. Local, state, and federal government provide generally very effective services, even if the are operated inefficiently.

Actually the USPS has been in the black since 1982.

The 2006 Postal Accountability and Enhancement Act mandate causes the accounting and cashflow loss. In that law they required the USPS to prefund it's retiree health care benefits for the next 50 years. Does your employer do that?

https://answers.yahoo.com/question/index?qid=20100724002941AAvehGg

 

[ace2000]

Why people prefer, again you use anecdotal statements, a bit like these hypothetical 'people that have suffred under ACA'

I have no idea what this means. Are you attributing that quote to me?

 

[ace2000]

I mentioned several overlaps where government and business compete. I'm not sure it's best to debate each one and yes, we are going off-topic here.

Here's a good source for my case.

Here's The Real Reason Why The Postal Service Can't Compete

So why has the USPS gone into the gutter while its biggest competitors -- FedEx and UPS -- pull multi-billion dollar profits despite the rise of email? Let's take a look.

The most obvious drain is the unions, and it's the big thing Donahoe has tried to address. He's asking for permission to cut the health and retirement plans for his half million employees and replace them with new programs, and try to impose significant layoffs. Labor is 80% of the Postal Service's expenses, compared to 53% at UPS and 32% at FedEx, according to the New York Times.

http://www.businessinsider.com/us-postal-service-congress-2011-9

 

[ace2000]

But there's a problem that runs deeper than its significant labor woes. The USPS brand is hurting, badly. Its product is just inferior to FedEx and UPS -- at least in consumers' minds.

Customer satisfaction matters, and the Postal Service doesn't provide the value people demand. The American Customer Satisfaction Index reported in June that UPS topped the mail services industry with an 85, with FedEx falling behind to 83.

The USPS scored a 79 in express mail and a dismal 74 in regular mail -- and that's actually an all-time high.

http://www.businessinsider.com/us-postal-service-congress-2011-9

 

[ace2000]

Actually the USPS has been in the black since 1982.

The 2006 Postal Accountability and Enhancement Act mandate causes the accounting and cashflow loss. In that law they required the USPS to prefund it's retiree health care benefits for the next 50 years. Does your employer do that?

https://answers.yahoo.com/question/index?qid=20100724002941AAvehGg

You're using Yahoo Answers as a source ??? Wow.

It's probably not fair to compare profits, since the USPS is supposed to set their rates at a break even point and not make a profit. However, it is fair to measure efficiency and how they manage costs...

 

[Beefnot]

Actually the USPS has been in the black since 1982.

The 2006 Postal Accountability and Enhancement Act mandate causes the accounting and cashflow loss. In that law they required the USPS to prefund it's retiree health care benefits for the next 50 years. Does your employer do that?

https://answers.yahoo.com/question/index?qid=20100724002941AAvehGg

In full disclosure, that was written by a USPS employee. Fair points though, although in 2012 when the USPS reported a $16 billion loss, much of it was due to the 2006 act. When it reported a $5 billion loss last year, it was all due to the act. At best it breaks even, and at worst it loses money. But based on the articles below, I will recant. USPS is a pretty doggone efficient organization all things considered.

http://www.sacbee.com/2013/04/16/5344613/how-congress-undercuts-the-postal.html
http://www.businessweek.com/article...stal-service-will-not-go-private-anytime-soon


Another question, is Medicare considered efficient?

 

[SMHarman]

I have no idea what this means. Are you attributing that quote to me?

You have been continually dissing the USPS without providing evidence and even here have not taken any of the stats I provided that shows the USPS is preferred by volume of packages shipped and disputed it.

I mentioned several overlaps where government and business compete. I'm not sure it's best to debate each one and yes, we are going off-topic here.

Here's a good source for my case.
Here's The Real Reason Why The Postal Service Can't Compete
http://www.businessinsider.com/us-postal-service-congress-2011-9

http://www.businessinsider.com/us-postal-service-congress-2011-9

You're using Yahoo Answers as a source ??? Wow.
It's probably not fair to compare profits, since the USPS is supposed to set their rates at a break even point and not make a profit. However, it is fair to measure efficiency and how they manage costs...

Taking these together.
The Yahoo Answer was more than adequate. I do not have the time to dig through the relevant act to cite the specific para of the legislation anymore than you seem to want to take the time to dispute that the USPS ships more parcels than Fed Ex by a factor of 5 and more than UPS (especially as UPS is global and USPS is domestic).

Now you are on to comparing costs. I am sure that the USPS labor costs are higher, but hey there are lots of middle class americans living the american dream on those wages so don't knock them.

Did you normalize these numbers of labor cost to back out the pension funding requirements that UPS does not have to put on their books and records? I don't think so.

You then also go on to compare with percentages. As one is a not for profit and the other is for profit the percentages will never make sense.

So Say UPS has a target profit of 20% On a $10 shipment $5 is wages, $3 is other overhead $2 is profit.
Lets take the same USPS $8 is wages (and the fully funded pension commitment which is likely to be $2 of that), $2 is overhead. Profit is 0.

So the real likely difference is that the USPS wages are nearer 60% of costs and UPS 53% with the difference there being higher unionised wages (unless you think we all should earn minimum wage) and the pension mandate. These employees are also being provided with employee healthcare and not needing government subsidy to get insurance from the exchanges. Can the same be said for the 'contractors' who own their own FedEx painted van and do deliveries for FedEx?? Seems like a ruse from FedEx to get employees off the books and reduce employee / employee benefit costs.

http://en.wikipedia.org/wiki/Fedex
In December 2007, the U.S. Internal Revenue Service "tentatively decided" the FedEx Ground Division might be facing a tax liability of $319 million for 2002, due to misclassification of its operatives as independent contractors. Reversing a 1994 decision which allowed FedEx to classify its operatives that own their own vehicles, the IRS audited the years 2003 to 2006, with a view to assessing whether similar misclassification of operatives had taken place. FedEx denied that any irregularities in classification had occurred, but faced legal action from operatives claiming benefits that would have accrued had they been classified as employees.[7]

As noted in that Yahoo answer the USPS also has the branch mandate which means they cannot close that post office in the middle of nowhere that has $26 a day in revenue.

The post office also provide service for other government agencies. Passport application, Tax mailing, Money transfer service but is not allowed to add other services that would help drive traffic to the post office. Operating it from a gas station, or small village convenience store. The USPS offering basic banking service, savings accounts and checking accounts.

You talk above about satisfaction ratings. I think that translates into a 74/100 people approve of the USPS First Class Mail, 79 for Express Mail, 83 and 85 for FedEx and UPS respectivly, so the approval rating of all three for express mail / parcels is in the upper quartile.

I don't know if the US ran the ads back in the 80s for a brand of cat food where the strap line was 8/10 owners said their cats prefer it. Well the USPS, FedEx and UPS can all say 8/10 customers like our service! Hardly a resounding thumbs down to the USPS.

 

[ScoopKona]

Can you provide a link to a post where I even used the term "mail" in the broad terms that you keep going on and on about? The only fair comparison is to look at "services" that overlap. I have posted several times that I was referring to "package delivery" and even mentioned UPS and FEDEX a couple of times. Would you like a source on why people prefer those two over the Post Office?

If you wish to keep deflecting, I can roll with that, too....

"People prefer those two over the post office," is a made-up fact. In reality, all major US delivery services have the same customer satisfaction rates. And anyone who mails a LOT of packages will prefer the post office.

Want to make this strictly a package delivery exercise? No problems.

I can send a overnight Priority Mail express box to the following locations for $45 each -- Lahaina, Hawaii; St. John's, USVI; Deadhorse, Alaska; and my neighbor across the street (we're not on speaking terms ever since he dissed the US Postal Service). Grand total, less than $180.

Please get back to me with the cost of mailing a small overnight package to the same locations, using any company or firm that you'd like. Delta Dashmail, Purolator Courier, DHL Express, no restrictions at all.

When you find a company that can do the same thing for $180 or less, please let me know.

 

[SMHarman]

In full disclosure, that was written by a USPS employee. Fair points though, although in 2012 when the USPS reported a $16 billion loss, much of it was due to the 2006 act. When it reported a $5 billion loss last year, it was all due to the act. At best it breaks even, and at worst it loses money. But based on the articles below, I will recant. USPS is a pretty doggone efficient organization all things considered.

http://www.sacbee.com/2013/04/16/5344613/how-congress-undercuts-the-postal.html
http://www.businessweek.com/article...stal-service-will-not-go-private-anytime-soon


Another question, is Medicare considered efficient?

Yes it was but the facts as I understand them are accurate and it allowed you to continue the research and equally conclude that the USPS is not a financial sinkhole, but has a pension mandate like no other.

Medicare efficient.
Premium collection - does not get much more efficient than using payroll tax. Every employer is an unpaid collection agent (including government employers).
Claim Processing Ratio - I understand that this is in the low single digits. Some argue that this is due to less dilligence in claim processing and more fraud but the Cignas of the world don't really publish the fraud numbers and spend about 3x more on claim processing.

 

[ace2000]

If you wish to keep deflecting, I can roll with that, too....

"People prefer those two over the post office," is a made-up fact. In reality, all major US delivery services have the same customer satisfaction rates. And anyone who mails a LOT of packages will prefer the post office.

LOL on the deflecting. I'm just glad you're finally on the same page.

When I say "people prefer those two over the post office", I backed it up with a source. You're just giving your opinion. Agree or disagree, at least I've provided something to back up my opinion.

This year, ACSI expands its treatment of express delivery services to include both consumer senders and receivers. The measure now encompasses packages people pay to have sent to other people and express-delivered merchandise they pay to have shipped from companies. Customer satisfaction for the category inches up for a second straight year, gaining 1.2% to an ACSI score of 84. Double-digit growth in online sales during the first quarter has increased demand for consumer-paid shipping of Internet purchases.

FedEx led the industry for more than a decade, but this year UPS moves into the number-one position, up 4% to 85. Satisfaction with FedEx dips slightly, falling 2% to 83. UPS has outperformed its rival in the stock market as well, with a 19% share increase over the past year.

The United States Postal Service gains 3% for its express delivery services, but its score of 79 keeps the USPS well behind both UPS and FedEx.

http://www.theacsi.org/index.php?op...acsi-commentary-june-2011&catid=14&Itemid=335

 

[ace2000]

When you find a company that can do the same thing for $180 or less, please let me know.

I'm willing to grant the fact that the USPS is almost always the cheapest route. However, UPS has advantages that USPS can't offer. Cheapest is not always the best option.

 

[ace2000]

Chart on the Ground Shipping Market Share (2007). The chart shows 2007, UPS still has a current position of a 50% share.

Source: http://www.gurufocus.com/news/169552/warren-buffetts-ups-has-an-enviable-durable-market-position

 

[ace2000]

Yes it was but the facts as I understand them are accurate and it allowed you to continue the research and equally conclude that the USPS is not a financial sinkhole, but has a pension mandate like no other.

I thought the source was a good read, and I learned from it. And I appreciate the other feedback to my comments. They have a pension mandate like no other, because they have a pension like few others. Are you saying it's a bad idea to pre-fund their commitment? I don't believe you are, but you have to factor in those long term costs somehow. There are several pension funds that are set up to be pre-funded in the same manner.

 

[ScoopKona]

I'm willing to grant the fact that the USPS is almost always the cheapest route. However, UPS has advantages that USPS can't offer. Cheapest is not always the best option.

Name these advantages.

I'm showing apples to apples comparisons of overnight package delivery services to the most far-flung corners of our country. That's what you asked for. That's what you got. Face it, even with the millstone around it's neck of having to maintain post offices in places like Wake Island and Deadhorse, USPS is still the fastest, least expensive, most reliable delivery service. (FedEx will win every time mailing packages from New York to Los Angeles. Sure thing. But in the race to Deadhorse, my money's on the post office.)

No other company offers anything akin to their registered mail service. The US government trusts them to deliver state secrets via registered mail. When lives are at stake, send it USPS.

As for customer satisfaction, this site was already linked before: http://www.theacsi.org/news-and-res...i-press-releases-2013/press-release-june-2013

"Both FedEx and UPS enjoy high levels of customer satisfaction. FedEx climbs 4% to an ACSI score of 85, just a point above UPS, up 4% to 84. Both carriers beat U.S. Postal Service Express/Priority Mail, which slides 5% to 77. The regular mail services of the U.S. Postal Service edge up by 2.7% to a new ACSI high of 77."

And that's with the USPS being a conservative whipping post (for whatever bizarro-world reason) for years. If people would learn how to use the USPS's internet label system (so they don't have to wait in line at the post office) I'll bet that number would increase substantially. As it stands, the eight percentage points don't amount to a hill of beans considering the mandate the USPS has to fulfill compared to their competition.

And, for the umpteenth time, you are missing the point that the government service does not cherry pick locations. They keep their offices open in Wake Island and Deadhorse and all the other little rural and far-flung locations; they pay their people well and offer some of the best benefits on the planet; and they're less expensive than their competitors.

People have repeatedly offered up examples of why the system is NOT fraught with waste, fraud and inefficiency. And you simply ignore all of it.

 

[Patri]

I think you should all take your baseball gloves, bats and balls and go home. It is suppertime. Mom is calling.

 

[ace2000]

Name these advantages.

I can tell you a big one for me on a personal basis. If I go to my local post office to mail something, I end up waiting in line for about 15 minutes... sometimes more, and sometimes less. UPS has always been a quick process for me.

If you want more than that, here's a link to eBay's comparison.

http://www.ebay.com/gds/Shipping-UPS-vs-USPS-/10000000001545951/g.html

People have repeatedly offered up examples of why the system is NOT fraught with waste, fraud and inefficiency. And you simply ignore all of it.

I don't ignore it. I read it. I choose to comment, if I have something to say, as I did above. Sometimes, there's truth on both sides. This stuff isn't life or death.

 

[Beefnot]

I thought the source was a good read, and I learned from it. And I appreciate the other feedback to my comments. They have a pension mandate like no other, because they have a pension like few others. Are you saying it's a bad idea to pre-fund their commitment? I don't believe you are, but you have to factor in those long term costs somehow. There are several pension funds that are set up to be pre-funded in the same manner.

Pre-funding a commitment seems reasonable, but doing so for the next 50 years within a 10 year span? That doesn't seem to make a whole lot of sense.

As for medicare, IF it is indeed considered efficient, then why is there any reason to believe that universal healthcare would necessarily be any less efficient? Or effective for that matter? Efficiency and efficacy are matters of pragmatism, but when it gets right down to it, I imagine that most folks have an ideological perspective, and they subsequently layer in selective pragmatic arguments as it suits their fancy.