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Tags Elizabeth Warren , health care reform , Medicare For All , presidential candidates

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Old 3rd November 2019, 01:18 AM   #81
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Originally Posted by Bob001 View Post
Is the fee means-tested? If somebody doesn't have any money does he still get to see the doc?
Possibly. I'm not sure.

I think some consideration needs to be made for controlling costs, and having a modest, affordable co-pay would help to control costs vs. a scenario where the cost to the patient is zero.
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Old 3rd November 2019, 07:09 AM   #82
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Originally Posted by Bob001 View Post
Maybe it would resemble Medicaid as it's provided in some other states.

Here's the question: Do you accept the premise that everybody -- rich or poor, employed or not, healthy or sick -- should have access to health care? If so, how would you provide it?

If not, who would you leave out?
People should have access to healthcare just like they have access to any other necessity like food and shelter. When people can’t afford it themselves, they should get some help.
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Old 3rd November 2019, 07:24 AM   #83
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Originally Posted by xjx388 View Post
How so? Medicare doesn’t cover things that would be required for the general younger healthy population.
It doesn't cover a few things that would be covered in an expansion to the general population, such as compressive routine physical exams. But the huge bulk of what is covered, medical treatment of disease, would be the same. And the cost of providing this for a population whose average age is 38 is considerably cheaper per person than for a population who is all over 65. The added cost of providing comprehensive physicals, childbirth services, etc., would be trivial.
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Old 3rd November 2019, 07:30 AM   #84
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Originally Posted by Puppycow View Post
Have you heard of hypochondriacs or Munchausen Syndrome? Malingering? It happens.
It happens but I can't imagine they are more than a small fraction of people seeking legitimate medical help and that It has much impact on the system as a whole.
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Old 3rd November 2019, 07:35 AM   #85
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A reminder: many countries have universal health care plans that work. Some countries much poorer than we are. The question is not whether it is possible, but how best to achieve it.
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Old 3rd November 2019, 07:52 AM   #86
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Originally Posted by xjx388 View Post
People should have access to healthcare just like they have access to any other necessity like food and shelter. When people can’t afford it themselves, they should get some help.
Logically, then, you would eliminate health insurance entirely, right? After all, there's no food insurance or shelter insurance. Great plan.
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Old 3rd November 2019, 08:12 AM   #87
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Originally Posted by Silly Green Monkey View Post
That will never happen. Going to a doctor is time not spent doing anything else. No one goes "huh, nothing to do for a few hours. Well, lets go to the doctor!" Just as no one goes "huh, nothing to do for a few hours. Why not take the car to the dealership?" We go to places because we need to go to them or want to be there, not because they're free.
You ought to meet my sister-in-law.

As others have pointed out, it happens. It really does. The hard part is that people like that cn really suck up a lot of resources, asking for unnecessary tests, demanding to see specialists, all that. Any single-payer (or nearly single-payer) system is going to have to deal with people who do that.

The flip side is when the system requires too many visits. I have two examples I face:

I get allergen shots once a month for hay fever, I need to get them for another four years. That's not the problem, the problem is that I am required to see the Allergist Doctor every three months, even if I have no problem at all with the shots (and yes, the nurse asks every single time). Yet I have to go see him anyway. Just so he can asks the same questions the nurse asks, it takes about 30 seconds (literally, that's not hyperbole). Once a year would be more than sufficient. The Doctor says that the rule comes from the U.S. Department of Agriculture, apparently because the allergen shots are made from plant materials.

Then to an eye doctor every two years to be able to order contact lenses. Even if a person's eyesight does not change at all. I keep thinking that for a person whose eyesight changes very little, every five years ought to be enough, at least for younger people.

Every time I move from state to state, I need to scramble to find a Doctor right away because I am on Blood pressure medication and those prescriptions can't get filled in a state different from the state they were prescribed in. It does not matter how many refills I have left because I can't get refills in the new state. And I move somewhat often. I once spent several hours on the phone with an insurance provider that explained that they could authorize the pharmacy give me a refill in advance if the pharmacy would enter the right code into the system - but then they refused to tell me what the code was. Hours of going back and forth on that before someone finally, almost by mistake, said that the code was for a vacation. I could not get an advance refill for moving, but I could get one for going on vacation, so that's what I told them. I had to figure out what lie to tell them to get the medicine I needed to stay alive.

And this is normal in America. Ask most any adult American and they will have stories of fighting to get insurance providers to provide basic health care, fighting to get coverage for things that actually save money when the insurance sometimes seems to want to require more expensive options. I have fully accepted that my Health Insurance company exists primarily to provide value to its shareholders - healthcare is just the means to that end.

Which is why single payer, and eventually fully socialized medicine seems inevitable here. The free market has failed, very, very badly. The political apparatus has aided this by requiring too many limits (such as not being able to get prescriptions filled out of state) because that adds profit to the health care insurers and providers. We've got to cut the profit out of the loop, it it literally killing us and explains why the American health care system is the least cost-effective in the industrialized world.

Last edited by crescent; 3rd November 2019 at 09:04 AM.
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Old 3rd November 2019, 08:18 AM   #88
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Originally Posted by Bob001 View Post
Logically, then, you would eliminate health insurance entirely, right? After all, there's no food insurance or shelter insurance. Great plan.


I would argue that there is food and shelter insurance. It’s called life insurance, home insurance, savings, etc. When someone lives at or near the poverty line, there is a form of social insurance we call Housing, TANF, SNAP and Medicaid among others.

And that’s what I think insurance should be like: coverage for when things go bad. I wouldn’t eliminate health insurance, I would simply change it back to what it’s supposed to be. I wouldn’t eliminate social safety nets, either.
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Old 3rd November 2019, 08:35 AM   #89
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Originally Posted by BobTheCoward View Post
It probably costs more than she estimates, though. Vox had a good piece this morning comparing her estimates to the Urban Institute. Obviously each individual assumption is justifiable. She is smart and has a very smart team. But probably not a good sign when your five assumptions are all more optimistic just to reach your target.
Or you could simply look at other countries that have universal health systems and see how much a real system actually costs.
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Old 3rd November 2019, 08:37 AM   #90
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Originally Posted by rdwight View Post
I guess it's not possible since her claim is 'no middle class tax increase' but I'd be more interested in what the back up funding plan is when inevitably her projected funding sources run lower than what is needed. No matter how well planned, this will be a messy transition. There will be shortfalls in funding and borrowing to cover.

I just don't believe any Medicare-for-all plan that doesn't include tax hikes for the middle class. And they should still be able to sell it with that eventuality.
Why not look at what it actually costs rather than just wondering.
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Old 3rd November 2019, 08:40 AM   #91
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Originally Posted by Darat View Post
Or you could simply look at other countries that have universal health systems and see how much a real system actually costs.
Which country do you think is the closest to the US for the purposes of comparison?
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Old 3rd November 2019, 08:46 AM   #92
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Originally Posted by casebro View Post
Splain the math: Currently Medicare covers about 1/3 of the population. Warren is going to cover 3 times as many people for the same cost? I call Pie-in-the-sky.
Why not look at how much universal health care costs in the countries that already have it.

If you do you will be pleasantly surprised when you find out it is indeed possible to provide universal care for about 1/2 what the USA currently spends on healthcare as a percentage of GDP.
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Old 3rd November 2019, 08:52 AM   #93
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Originally Posted by Darat View Post
Or you could simply look at other countries that have universal health systems and see how much a real system actually costs.
Ask her.

One reason is she wants to cover different things.

Last edited by BobTheCoward; 3rd November 2019 at 08:54 AM.
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Old 3rd November 2019, 10:03 AM   #94
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Originally Posted by BobTheCoward View Post
Ask her.

One reason is she wants to cover different things.
I am uninterested in what she wants.
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Old 3rd November 2019, 10:11 AM   #95
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I'm tired of hearing about how Universal Healthcare is more efficient, because it misses the point.

Yes I'm aware of all the facts and stats and numbers that people in America pay more for healthcare. I accept them, they are true.

But that's besides the point.

Let's say you wake up tomorrow and some ultra-rich, hyper-talented investment banker or stock broker or whatnot, we'll use Warren Buffett as our example, has taken, without your permission or knowledge, a sum of money out of your checking account. When you complain his answer is he can use your money more efficiently then you can, he invests it and at a later date gives it, and extra, back to you. Should he be allowed to do this?

The argument is the same. You're just wasting money by not giving it to someone who can invest it better then you can. You shouldn't complain when someone does it against your wishes.

"I deserve your money because I think I can use it more efficiently then you do" is a bad, bad idea.

I get the Left screams strawman at every mention of socialism and the Right screams socialism at everything the Left does but that is, essentially, my argument with the primary argument for Universal Health Care; that it is "More efficient use of the money."

The problem isn't that it isn't technically true, it's that it's technically true about everything.

I spend X amount of housing. I'm sure the government could spend it more efficiently if I sent them however much they asked for and let them decide how much house I need and get it. Or food. Or clothing. Or transportation.

I will get a lot of "Well health care's different because..." but I have a feeling I will find the reasons lacking.
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Old 3rd November 2019, 10:22 AM   #96
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Originally Posted by JoeMorgue View Post
I'm tired of hearing about how Universal Healthcare is more efficient, because it misses the point.

Yes I'm aware of all the facts and stats and numbers that people in America pay more for healthcare. I accept them, they are true.

But that's besides the point.

Let's say you wake up tomorrow and some ultra-rich, hyper-talented investment banker or stock broker or whatnot, we'll use Warren Buffett as our example, has taken, without your permission or knowledge, a sum of money out of your checking account. When you complain his answer is he can use your money more efficiently then you can, he invests it and at a later date gives it, and extra, back to you. Should he be allowed to do this?

The argument is the same. You're just wasting money by not giving it to someone who can invest it better then you can. You shouldn't complain when someone does it against your wishes.

"I deserve your money because I think I can use it more efficiently then you do" is a bad, bad idea.

I get the Left screams strawman at every mention of socialism and the Right screams socialism at everything the Left does but that is, essentially, my argument with the primary argument for Universal Health Care; that it is "More efficient use of the money."

The problem isn't that it isn't technically true, it's that it's technically true about everything.

I spend X amount of housing. I'm sure the government could spend it more efficiently if I sent them however much they asked for and let them decide how much house I need and get it. Or food. Or clothing. Or transportation.

I will get a lot of "Well health care's different because..." but I have a feeling I will find the reasons lacking.
I'll say this very, very slowly, because you have made a very, very stupid argument:

It's the same ******* healthcare, it's just proposed to pay for it differently.

If that really, really matters to you, if seeing Dr Absalom for treatment of your Vitamin R deficiency while it's being paid for by biweekly payroll deductions to Cigna is radically different to you than seeing Dr Absalom for treatment of your Vitamin R deficiency while it's being paid for by biweekly payroll tax deductions to Medicare then your problem isn't with healthcare. It's something about money or something. No doubt it's a principle of some kind, and it matters very deeply to you, although it doesn't affect your medical treatment.

And because it doesn't affect your medical treatment guess what? Nobody cares. In healthcare we want to treat illnesses. The money is just to keep things running so we can treat illnesses. We don't care where the money comes from, or what libertarian principles or communist manifestos or dead Founding Father's racist slaveowning ghost said. Healthcare should be about healthcare, not money.

Sorry to be so blunt but seriously, it's annoying as hell when people cut off their noses to spite the principle of everyone else's faces.
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Old 3rd November 2019, 10:30 AM   #97
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Oh come one. Universal Health Care is going to one of, if not the, biggest social program in American history. You can't sit there and go "Don't worry, we promise that absolutely nothing is going to change after it is implemented card."

So the government has looked at the numbers and gone "We can provide you the exact same amount of health care at a lower cost."

What happens when they look at the numbers on our housing and tell us the same thing? Our food? Our clothes?
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Old 3rd November 2019, 10:36 AM   #98
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Originally Posted by JoeMorgue View Post
Oh come one. Universal Health Care is going to one of, if not the, biggest social program in American history. You can't sit there and go "Don't worry, we promise that absolutely nothing is going to change after it is implemented card."

So the government has looked at the numbers and gone "We can provide you the exact same amount of health care at a lower cost."

What happens when they look at the numbers on our housing and tell us the same thing? Our food? Our clothes?
Yes, yes, the sky will fall, cats and dogs will have sex with each other, and the Antichrist will flood the world with meteorite strikes. That's what they thought would happen when they introducted Social Security, income tax, gay marriage, and freeing the slaves. I don't see tumbrels and Marks of the Beast and statues of Mao everywhere, do you?
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Old 3rd November 2019, 10:50 AM   #99
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Originally Posted by Bob001 View Post
Details, please. Who paid previously, who pays now, and what makes it "not as good?" Maybe you switched jobs? Maybe your employer cut the percentage he paid? That was not the common experience, and under the ACA 20+ million people got insurance that they couldn't get before. I doubt they're sorry about it.

Oh I'm sure they are not sorry! But you see I'm not some wealthy guy, I barely get by right now. We helped some people by hurting others, like me. What the hell did I do - ME - that justifies paying almost double rates? I stay in shape, I eat okay, and I'm healthy, yet my rates skyrocketed, based solely on my age, nothing else.

How many people lost insurance so these others could get theirs? This is not reforming health care and the ACA has largely been a disaster.

20 million more supposedly got insurance. This is a county of 320 million people so I'm not sure that's a great victory. It wasn't for me, and many other voters. Was it worth it?

Once bitten twice shy.

To answer your questions:

I paid previously out of my pocket, 100%. I was my own employer.

Taxpayers pay for it now. I could not afford the 90% rise. I pay nothing out of pocket.

I had Kaiser and a decent plan. Now I have Medi-Cal. Do you need a rundown of why that is worse? The service and care sucks.

I agree that the health system is bad, but hurting people like me to help others isn't the best approach - not if you want my support.

From my perspective there is little reason to believe what Warren is saying, or any politician.

Finally, she'd better have an airtight detailed plan that we can read before voting, not after (Ms Pelosi).

I live in Cali. I pay a buttload of taxes and nothing gets done. Bad power grid, highest homelessness, highest poverty. Why the F would I listen now? I've heard it all before. My taxes won't go up? I can keep my doctor? F you. I don't even have "a doctor" now.
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Old 3rd November 2019, 11:11 AM   #100
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Originally Posted by Darat View Post
I am uninterested in what she wants.
This thread is about what she wants.
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Old 3rd November 2019, 11:15 AM   #101
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Originally Posted by BobTheCoward View Post
This thread is about what she wants.
Indeed. As Warren said last Saturday:

Quote:
Yo, I'll tell you what I want, what I really, really want
so tell me what you want, what you really, really want
I'll tell you what I want, what I really, really want
so tell me what you want, what you really, really want
I wanna, I wanna, I wanna, I wanna,
I wanna really, really, really wanna universal healthcare.
Let's don't go wasting her precious time, we should get our act together because we could be just fine!
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Old 3rd November 2019, 11:36 AM   #102
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Originally Posted by mgidm86 View Post
.....
I paid previously out of my pocket, 100%. I was my own employer.

Taxpayers pay for it now. I could not afford the 90% rise. I pay nothing out of pocket.
.....
So previously you had insurance with Kaiser, and you paid 100% of the premiums yourself? Under the new system Kaiser is not available to you, and your premiums have nearly doubled? And that's the only option available to you? Why can't you still get Kaiser? It looks like Medic-Cal is the California Medicaid program. Is anything else available to you on the insurance exchange, or through a broker? I'm sorry you got screwed, but there's no evidence that a huge number of people lost coverage so others could get it. And a large percentage of people get their health insurance through their employer; the individual market, which the ACA was intended to help, is relatively small. A universal plan, whether it's Medicare-for-All or public option or something else, would benefit everybody. It particularly would take employers out of the insurance business, which most would see as good news.

Last edited by Bob001; 3rd November 2019 at 11:51 AM.
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Old 3rd November 2019, 12:30 PM   #103
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Originally Posted by xjx388 View Post
...
And that’s what I think insurance should be like: coverage for when things go bad. I wouldn’t eliminate health insurance, I would simply change it back to what it’s supposed to be. I wouldn’t eliminate social safety nets, either.

And what what does that even mean? What do you think it's supposed to be? And when was that? Government employees, employees of large businesses and union members have mostly been covered by comprehensive group health insurance since the 1950s. Universal coverage would extend to all Americans what most already take for granted. You would end that? Everybody gets limited, catastrophic coverage and pays for everything else out-of-pocket -- or not at all? What is your actual plan?

Quote:
President Harry S. Truman proposed a system of public health insurance in his November 19, 1945, address. He envisioned a national system that would be open to all Americans, but would remain optional. Participants would pay monthly fees into the plan, which would cover the cost of any and all medical expenses that arose in a time of need. The government would pay for the cost of services rendered by any doctor who chose to join the program. In addition, the insurance plan would give cash to the policy holder to replace wages lost because of illness or injury. The proposal was quite popular with the public, but it was fiercely opposed by the Chamber of Commerce, the American Hospital Association, and the AMA, which denounced it as "socialism".[26]

Foreseeing a long and costly political battle, many labor unions chose to campaign for employer-sponsored coverage, which they saw as a less desirable but more achievable goal, and as coverage expanded the national insurance system lost political momentum and ultimately failed to pass. Using health care and other fringe benefits to attract the best employees, private sector, white-collar employers nationwide expanded the U.S. health care system. Public sector employers followed suit in an effort to compete. Between 1940 and 1960, the total number of people enrolled in health insurance plans grew seven-fold, from 20,662,000 to 142,334,000,[27] and by 1958, 75% of Americans had some form of health coverage.[28]
https://en.wikipedia.org/wiki/Health...e-TAHP_2008-28

Universal coverage has been on the table since the end of WWII. Maybe it's time to take the leap.
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Old 3rd November 2019, 04:00 PM   #104
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Once again it seems some posters here are talking past each other.

The proposal on the table is about Universal Health CARE. The operative word is CARE. That is, the provision of actual health medicine and services.

The opposition argument is about the cost of health INSURANCE. And INSURANCE is a bet that you will pay less than it will cost for a medicine or medical service. (Needless to say, you lose the bet if your insurance costs more than the health services you require.)

Now I hope we don't have to explain that the broad concepts of CARE and INSURANCE are not the same thing.

So if you are going to argue that you can do better by yourself rather than trusting to some faceless gubmit entity, you need to take into account that you also need to ensure that you, PERSONALLY, can get cheaper medicines (bargaining power) and have access to more readily available services at cheaper prices (bigger facilities) than they can. And that that you can get them whether you are in work or not. Retired or not. And for your children too.

And you can't. Your current system says you can't. It is pretty much that exact system of adult-only employed-only user-pays. Where you think that shopping round insurance, that is, shopping for cheaper personal costs, is "winning". It isn't. You will always lose because you have failed to understand that the whole system is based on the simple principle that the provider of services is forcing you to pay more and more without actually having to provide the services. Their profit is your loss. And they are bigger than you all the time. Meanwhile, health SERVICE is getting more expensive and scarcer in delivery. That is, by definition, losing.

You need to change up the game if you are to get out of that cycle. Most other countries recognised this already. That's why their health systems are not the US model.
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Old 3rd November 2019, 04:34 PM   #105
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Originally Posted by JoeMorgue View Post
I spend X amount of housing. I'm sure the government could spend it more efficiently if I sent them however much they asked for and let them decide how much house I need and get it. Or food. Or clothing. Or transportation.

I will get a lot of "Well health care's different because..." but I have a feeling I will find the reasons lacking.
Health care is different because there's not a normal market for it - in fact, it's not hardly a market at all.

How often do people fall unconscious and somehow rack up a $30k food or housing bill during that time?

Are unexpected clothing, transportation, and food bills the #1 cause of bankruptcy?
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Old 3rd November 2019, 04:46 PM   #106
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Originally Posted by Norman Alexander View Post
The proposal on the table is about Universal Health CARE. The operative word is CARE. That is, the provision of actual health medicine and services.

The opposition argument is about the cost of health INSURANCE.
I think part of the problem in America is that we are not consistent with our terminology. When most Americans talk about our health insurance, we are really referring to health coverage, or as you phrase it, health care. The comparison is sometimes made that we don't expect our car insurance to pay for oil changes and tune-ups, but we do expect our (so called) health insurance to pay for routine exams and checkups.

I think that inconsistent language really does lead to a lot of cross-talk and differing expectations.
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Old 3rd November 2019, 05:01 PM   #107
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Originally Posted by JoeMorgue View Post
I'm tired of hearing about how Universal Healthcare is more efficient, because it misses the point.

Yes I'm aware of all the facts and stats and numbers that people in America pay more for healthcare. I accept them, they are true.
My concern is that people are looking at the greater health care costs in the U.S. and assuming single payer health care will fix the problem without looking at exactly [i]why[i] those costs are higher.

Are there inefficiencies caused by having multiple health care providers? Most certainly. And single payer might help a little in that regard. But remember, the insurance companies do actually provide a valuable service: ensuring doctors get paid, helping to prevent fraud, etc. and much of what they do will need to continue under a single payer health care system, so not all of those costs are going to disappear.

So what other costs are there? Well there is:

- Malpractice insurance and lawsuits. Those can be quite pricey. In some countries, there may be limits as to how much settlements can be. As a society, does the U.S. want to set similar limits (with the knowledge that people who are the victim of malpractice may not get proper reimbursement.) Note that I'm not saying it is the only reason for the higher costs, just a contributing factor

- Over-capacity. For example, the United States has more MRI machines per capita than most other countries. What this means is that if a person wants/needs quick treatment, they can get it. (Compare that to Canada, where waiting lists are legendary.) A single payer system might reduce the overcapacity but at the risk of introducing waiting lists.

- Use of new technology and/or heroic measures. I know that I sometimes hear of Canadians getting treatment using new techniques that are simply not available in Canada. But such cutting edge treatment can be expensive. A single-payer system may seek to limit such treatments in the interest of saving money, but for a person who will now be subject to alternative treatment, they will be less satisfied.
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Old 3rd November 2019, 06:58 PM   #108
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Well we need those death panels. Hospitals will run endless useless procedures on terminal patients. Just because they are insured. Lifespan and quality of life are not improved.

But funds should not be withheld for pain medication. That is valid use, for terminal patients.
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Old 3rd November 2019, 07:09 PM   #109
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Tell that to the caregivers who refused to give the morphine to my dying mother because she might get addicted.
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Old 3rd November 2019, 07:14 PM   #110
Norman Alexander
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Originally Posted by Segnosaur View Post
My concern is that people are looking at the greater health care costs in the U.S. and assuming single payer health care will fix the problem without looking at exactly [i]why[i] those costs are higher.

Are there inefficiencies caused by having multiple health care providers? Most certainly. And single payer might help a little in that regard. But remember, the insurance companies do actually provide a valuable service: ensuring doctors get paid, helping to prevent fraud, etc. and much of what they do will need to continue under a single payer health care system, so not all of those costs are going to disappear.

So what other costs are there? Well there is:

- Malpractice insurance and lawsuits. Those can be quite pricey. In some countries, there may be limits as to how much settlements can be. As a society, does the U.S. want to set similar limits (with the knowledge that people who are the victim of malpractice may not get proper reimbursement.) Note that I'm not saying it is the only reason for the higher costs, just a contributing factor
That's a doctor-related issue, not a medical care related issue. I'm sure doctors can organise such insurance and coverage outside of any public medical care system. They certainly seem able to do that in other countries. How that figures in their single-payer system varies.

Quote:
- Over-capacity. For example, the United States has more MRI machines per capita than most other countries. What this means is that if a person wants/needs quick treatment, they can get it. (Compare that to Canada, where waiting lists are legendary.) A single payer system might reduce the overcapacity but at the risk of introducing waiting lists.
Woah. "Legendary Canadian waiting lists" are a far more complex situation than is generally understood.

But to keep it simple, ELECTIVE procedures, i.e. procedures that do not prevent a relatively normal life meanwhile, may indeed have longer wait times for exactly the same equipment types than for URGENT requirements. In short, wait queues are constantly re-prioritised depending on need versus availability. There will always be a balance required, and there are ongoing arguments as to what is elective and what is urgent.

What is misleading are the reports about AVERAGE wait times for procedures. They are quite misleading as they do not take the balance into account, they are just stats (did you know, on average, most humans have less than two legs?). These reports are usually produced by organisations with interests in the field, so reader beware.

Suffice to say, in Canada, if an MRI is needed urgently, you will get it urgently.

Quote:
- Use of new technology and/or heroic measures. I know that I sometimes hear of Canadians getting treatment using new techniques that are simply not available in Canada. But such cutting edge treatment can be expensive. A single-payer system may seek to limit such treatments in the interest of saving money, but for a person who will now be subject to alternative treatment, they will be less satisfied.
Actually, no it won't limit such procedures. In fact it encourages them if the cost factor is less or zero issue. It's also less stressful for the patient. They don't have to panic about "Is my kidney transplant going to bankrupt me and my family?! What about getting the insurance policy to play along with this! SO MANY phone calls to make!!" The worry becomes more about "Will I be OK?"
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Old 3rd November 2019, 07:19 PM   #111
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Originally Posted by Trebuchet View Post
Tell that to the caregivers who refused to give the morphine to my dying mother because she might get addicted.
What I call "reglets" - people who apply the rules without questioning why they exist or their applicability in any situation. Sometimes they hurt others without knowing why...
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Old 3rd November 2019, 07:52 PM   #112
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Originally Posted by Bob001 View Post
And what what does that even mean? What do you think it's supposed to be?
Look at car insurance. It doesn't pay for your preventive maintenance and routine breakdowns. It covers when something really goes wrong. Insurance covers, for the most part, catastrophic occurences. Not so in the Health Insurance segment. We expect it to cover our preventive care and most of our routine healthcare costs. What it used to be, for the most part was indemnity plans: They didn't cover until a certain deductible was met and only then, they only covered a percentage. And you paid the doctor directly and got reimbursed by the insurance.
Quote:
And when was that?
Indemnity was the predominant form of health insurance until the mid 70s with the passage of the HMO Act of 1973. Before that there were a few scattared HMOs around, like Kaiser Permenente. Then, in the early 80's PPOs became prevelant. And here we are today.

Quote:
Universal coverage has been on the table since the end of WWII. Maybe it's time to take the leap.
Maybe it is, but I don't think it's as easy to do at this point in time as it might have been had we followed the rest of the world after WWII.
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Old 3rd November 2019, 08:01 PM   #113
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Originally Posted by Bob001
Universal coverage would extend to all Americans what most already take for granted. You would end that? Everybody gets limited, catastrophic coverage and pays for everything else out-of-pocket -- or not at all? What is your actual plan?
Sorry, don't know how I snipped this part out . . .

My plan? I don't have one plan. There is room for a lot of innovative models that are actually in use right now here in the USA. One option: A catastrophic plan that covers only hospital care and specialist care over X coupled with a Direct Primary Care plan that takes care of primary care for a low monthly fee. In fact, many new insurance plans are begining to operate this way: Paying the primary care provider $X per member/per month and then heavily gatekeeping when patients can go to specialists, get imaging/diagnostic tests, etc. But it would be much cheaper if you just paid for such plans yourself.
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Old 3rd November 2019, 08:04 PM   #114
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Originally Posted by xjx388 View Post
Maybe it is, but I don't think it's as easy to do at this point in time as it might have been had we followed the rest of the world after WWII.
Australia introduced Medicare, our single-payer system, in 1975. That is, just after the Apollo space program completed. So that's fairly recent.

I think the USA, who sent men to the moon, is more than capable of developing a reasonably decent single-payer national medical care system today!
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Old 3rd November 2019, 08:16 PM   #115
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UHC is a hard sell because Americans have been brain-washed into thinking that taxes are evil. They'd rather pay a private corporation $1000/month for health care/insurance than $100/month for the same health care/insurance because taxes are evil.
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Old 3rd November 2019, 08:17 PM   #116
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Originally Posted by Tsukasa Buddha View Post
A left critique focusing on head vs payroll tax:



Linky.
David Dayen on some of that:
https://daviddayen.tumblr.com/post/1...hings-new-when
Quote:
He doesn’t like the employer payment and wants it to be a different employer payment. That’s a valid argument to make, though I don’t think it’s as big a deal as he does (I’ll discuss later). But what he’s really mad about is a headline I wrote suggesting that Warren’s plan doesn’t add any new middle-class taxes. He wants to focus on the word “taxes.” I want to focus on, and have been focusing on, the word “new.”

Bruenig is deeply committed to the idea that replacing the employer contribution to personal premiums with an employer contribution to a government-run universal Medicare program equals an increase in indirect taxes. Of course, for years now, Bruenig has been insisting that premiums are actually best thought of as taxes. Here he is in the New York Times making the argument in April.

In this sense, converting the employer premium contribution to an employer Medicare contribution is a tax. It’s just nothing new. Under our system of employer-sponsored insurance, businesses segregate a bunch of money to pay insurance premiums, and then use the rest to determine salaries. Under the new system, businesses will segregate a bunch of money to pay Medicare taxes, and then use the rest to determine salaries. I see this as a semantic difference. Not a new tax.
Quote:
On 2), the gaming would come in two forms, Bruenig says. First, companies could split and shrink and create affiliates to get under 50 employees. Second, companies could hire a bunch of independent contractors and not have to pay a share for them under the head tax.

So, the system we have now has the same exemption. We have an employer mandate, with an exemption for small businesses under 50 employees. If this has led to a mass shifting of companies into 50 employees or less, let me know; in fact we’re in a time of frequent mergers. Now, independent contractors have been a problem, particularly with tech startups. Warren’s campaign says that they will expand the definition of employee, along the lines of California’s Dynamex decision, as well as an expansive joint employer standard.
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Old 3rd November 2019, 08:18 PM   #117
Norman Alexander
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Originally Posted by thaiboxerken View Post
UHC is a hard sell because Americans have been brain-washed into thinking that taxes are evil. They'd rather pay a private corporation $1000/month for health care/insurance than $100/month for the same health care/insurance because taxes are evil.
Call it a "levy" then. That's what ours is. A levy, not a tax. Of course, by any other name...
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Old 3rd November 2019, 08:19 PM   #118
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Originally Posted by thaiboxerken View Post
UHC is a hard sell because Americans have been brain-washed into thinking that taxes are evil. They'd rather pay a private corporation $1000/month for health care/insurance than $100/month for the same health care/insurance because taxes are evil.
I think only about 30% or less are really like that.
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Old 3rd November 2019, 08:53 PM   #119
thaiboxerken
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Originally Posted by kellyb View Post
I think only about 30% or less are really like that.
Ask the same people if they realize that their taxes may go up, while their premiums for insurance go away and they might change their tunes. The "taxes go up" turns off many Americans and they stop listening at that point.
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Old 3rd November 2019, 09:57 PM   #120
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Originally Posted by thaiboxerken View Post
Ask the same people if they realize that their taxes may go up, while their premiums for insurance go away and they might change their tunes. The "taxes go up" turns off many Americans and they stop listening at that point.
Frame it as "the health scheme Trump said he would provide - cheaper than ACA and available for everyone". Of course, Donny wouldn't know one end of any health scheme from another. But he's been consistently claiming other peoples' good works as his own. So time to play him off a break. Get him to stand up and say that single-payer is his truly perfect, wonderful new health scheme, and see if the GOP will follow him, or try to oppose him.
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