ISF Logo   IS Forum
Forum Index Register Members List Events Mark Forums Read Help

Go Back   International Skeptics Forum » General Topics » USA Politics
 


Welcome to the International Skeptics Forum, where we discuss skepticism, critical thinking, the paranormal and science in a friendly but lively way. You are currently viewing the forum as a guest, which means you are missing out on discussing matters that are of interest to you. Please consider registering so you can gain full use of the forum features and interact with other Members. Registration is simple, fast and free! Click here to register today.
Tags Elizabeth Warren , health care reform , Medicare For All , presidential candidates

Reply
Old 4th November 2019, 12:33 AM   #121
Parsman
Muse
 
Parsman's Avatar
 
Join Date: Sep 2006
Location: Bonnie Scotland
Posts: 700
Originally Posted by xjx388 View Post
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.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.

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.
You keep going on about car insurance. I'm 57 live in the UK and have never learned to drive and therefore never owned a car or driven a car or paid insurance on a car. At 57 I am now going to the doctor more, need more medicines, need more help. I can't decide not to do that if I want to live. I pay a little more in taxes, I pay nothing for health insurance outside my general taxation and I'm damn sure I am better off in medical terms than your average USA citizen.
__________________
I was not; I have been; I am not; I am content - Epicurus

When you're dead you don't know that you're dead, all the pain is felt by others....................the same thing happens when you're stupid.
Parsman is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 12:58 AM   #122
Darat
Lackey
Administrator
 
Darat's Avatar
 
Join Date: Aug 2001
Location: South East, UK
Posts: 88,441
Originally Posted by BobTheCoward View Post
This thread is about what she wants.
I am uninterested in your opinion on that.
__________________
I wish I knew how to quit you
Darat is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 05:04 AM   #123
BobTheCoward
Penultimate Amazing
 
Join Date: Nov 2010
Posts: 17,959
Originally Posted by Darat View Post
I am uninterested in your opinion on that.
So am I.
BobTheCoward is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:05 AM   #124
xjx388
Philosopher
 
Join Date: Nov 2010
Posts: 7,524
Originally Posted by Parsman View Post
You keep going on about car insurance. I'm 57 live in the UK and have never learned to drive and therefore never owned a car or driven a car or paid insurance on a car. At 57 I am now going to the doctor more, need more medicines, need more help. I can't decide not to do that if I want to live. I pay a little more in taxes, I pay nothing for health insurance outside my general taxation and I'm damn sure I am better off in medical terms than your average USA citizen.
I am speaking from a USA perspective and auto insurance is an example of what insurance is supposed to be.


I don’t know how much “better off” you are than the average American. What can be said for sure is that the UK system provides similar outcomes in most measures compared to the US and the UK is able to run it cheaper. I have no quarrel with that.

Where I think the US will have problems is in converting to an NHS style single payer because of how entrenched the current system is and how different the socioeconomics are between the two countries. I think the US needs to find it’s own way that takes the best from other plans and innovates something new.
__________________
Hello.
xjx388 is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:24 AM   #125
CORed
Philosopher
 
Join Date: Dec 2008
Location: Central City, Colorado, USA
Posts: 9,164
Originally Posted by Craig4 View Post
This is a "we're not ready for it" fail. Let a candidate who advocates for "keep your private insurance but here's Medicare if you need it" proceed and let people gradually conclude Medicare for all is better. Maybe we will adopt a system like most of Western Europe. Just don't risk four more years of Trump over it.
I have a feeling that Warren's plan to eliminate private insurance and force everyone immediately into single payer may be a fatal flaw, politically, if not in implementation. Americans do not like to be forced to do much of anything. Fore example, the mandatory purchase of insurance in the ACA was probably its least popular feature. People who have good insurance plans will certainly be very unhappy at being forced into what they will likely perceive, rightly or wrongly, to be the inferior government plan. I suspect Warren will have a lot of difficulty getting her plan approved by even a Democrat controlled Congress. An opt-in type of plan will likely get us to single payer over time, as many employers will decide that they do not need to offer a full health insurance plan.
CORed is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:29 AM   #126
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by CORed View Post
I have a feeling that Warren's plan to eliminate private insurance and force everyone immediately into single payer may be a fatal flaw, politically, if not in implementation. Americans do not like to be forced to do much of anything. Fore example, the mandatory purchase of insurance in the ACA was probably its least popular feature. People who have good insurance plans will certainly be very unhappy at being forced into what they will likely perceive, rightly or wrongly, to be the inferior government plan. I suspect Warren will have a lot of difficulty getting her plan approved by even a Democrat controlled Congress. An opt-in type of plan will likely get us to single payer over time, as many employers will decide that they do not need to offer a full health insurance plan.
Great you just described the Public Option Obama wanted but got shot down.
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:33 AM   #127
CORed
Philosopher
 
Join Date: Dec 2008
Location: Central City, Colorado, USA
Posts: 9,164
Originally Posted by BobTheCoward View Post
They want to make Medicare 4 all and also completely change Medicare. Meanwhile there is a program that already does this called Medicaid (and actually knows how to do things like cover healthy adults under 65).
As I see it, Medicare for all is just the slogan being used to sell single payer. Of course a lot of changes will be made in the process of implementing it. The primary advantage of single payer over ACA is that under single payer, the government will have a lot more leverage to get a handle on costs. Of course, if they go too far in cost cutting, quality of care may suffer.
CORed is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:34 AM   #128
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by CORed View Post
As I see it, Medicare for all is just the slogan being used to sell single payer. Of course a lot of changes will be made in the process of implementing it. The primary advantage of single payer over ACA is that under single payer, the government will have a lot more leverage to get a handle on costs. Of course, if they go too far in cost cutting, quality of care may suffer.
They would have to get any cost cutting passed, and the traditional response has always been throw more money at the corporations to get them to agree to it, be it medicare part D or ACA.
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:35 AM   #129
CORed
Philosopher
 
Join Date: Dec 2008
Location: Central City, Colorado, USA
Posts: 9,164
Originally Posted by ponderingturtle View Post
Great you just described the Public Option Obama wanted but got shot down.
I'm pretty sure Obama really wanted single payer, but just didn't have the votes in Congress to pull it off. Thus we ended up with the ACA, which was at least a start, but ended up being an unpopular and flawed program.
CORed is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:52 AM   #130
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by CORed View Post
I'm pretty sure Obama really wanted single payer, but just didn't have the votes in Congress to pull it off. Thus we ended up with the ACA, which was at least a start, but ended up being an unpopular and flawed program.
Public option was the option of a single payer plan, with the option to choose other insurance plans. Option is literally in it's name. That is the thing here, you are talking about a single payer option for everyone. That failed to pass already.

Look the insurance, drug companies, and health care providers have too much money to spend on lobbying and advertisement to get anything passed. I mean we can't even regulate that what they say is in supplements is actually in them because of this power and that is nothing to all those.

We passed the event horizon to regulating and having a sensible system years ago, we just have to ride this out destroying the country before we can do anything about it.
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 10:58 AM   #131
Belz...
Fiend God
 
Belz...'s Avatar
 
Join Date: Oct 2005
Location: In the details
Posts: 86,992
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!"
No, but plenty of people go to the doctor for trivial nonsense.
__________________
Master of the Shining Darkness

"My views are nonsense. So what?" - BobTheCoward


Belz... is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 11:07 AM   #132
Segnosaur
Penultimate Amazing
 
Join Date: Jan 2002
Posts: 14,157
Originally Posted by Norman Alexander View Post
Quote:
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.
...
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.
That's an irrelevant distinction. Any costs related to malpractice insurance need to be covered by whatever fees the doctor or medical institution charges.
Quote:
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.
Yes, but those other countries often have ways to limit malpractice payouts and insurance... limits on payments, rules about how lawyers are paid, etc.

The point is that if you go to a single payer without changing the malpractice laws, your costs may still be higher than they could be.
Quote:
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.
Ah yes, the most crappy argument that was ever put forward, but which keeps getting repeated over and over again. "Be happy with waiting lists because at least you will be treated quickly if its an emergency". Its a bogus argument, because it ignores the real pain and suffering that can result from being stuck on a waiting list (not to mention it can also lead to premature death, even if its not an emergency).

Let me give you some real life examples...

I have a cousin. He injured his shoulder (possibly a rotator cuff injury). He finds it very painful for him to raise his arms, but has to suffer though because his job involves physical activity. He was stuck on a waiting list for several months to get an MRI for a proper diagnosis. To you his pain and suffering doesn't matter because "gee wiz if its an emergency he'll get treated". Its not an emergency. He's suffering. If he were in the United States he probably would have had an MRI within a week.

Here's another example that's a bit more personal... I may have sleep appnea... I often stop breathing at night. Its a condition that has been linked to an increased risk of Stroke or heart disease. I mentioned it to the doctor over 6 months ago, but they have yet to find a slot in a clinic to do a proper sleep study. So while it is not an emergency per se, it still may shorten my life. (I do believe there can be waiting lists in the United States, but those waiting lists are much shorter.)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933773/

Quote:
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.
Actually yes, yes it does.

In Canada, what treatments are provided/funded are determined by the government, which is sometimes slow to react and often has different priorities.

Let me give you an example: There is a genetic diseases called Fabry's disease which can cause serious health problems (including heart and kidney problems). There was a point where treatment was not being provided in Ontario, despite the fact that such treatment was being done (and covered by many user's insurance) in the United States.

Quote:
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?"
I do not doubt that knowing you will be covered by insurance (regardless of your employment situation) is a good thing.

What I am complaining about is people who ignore or hand-wave away all of the possible problems involved with various alternatives.

And let me make a prediction... if the Democratic party does decide to push a true single-payer (i.e. no private insurance) option in the next election, you will see a rush of right-wing newscasters to Canada to point out every patient who has ever been on a waiting list, in an attempt to say "See? This is what the Democrats want for your health care!"
__________________
Trust me, I know what I'm doing. - Sledgehammer

I'm Mary Poppin's Y'all! - Yondu

We are Groot - Groot
Segnosaur is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 11:50 AM   #133
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by Segnosaur View Post
That's an irrelevant distinction. Any costs related to malpractice insurance need to be covered by whatever fees the doctor or medical institution charges.

Yes, but those other countries often have ways to limit malpractice payouts and insurance... limits on payments, rules about how lawyers are paid, etc.

The point is that if you go to a single payer without changing the malpractice laws, your costs may still be higher than they could be.
Yes and no, a large part of the high malpractice payouts is paying for future medical care of those injured. If that was just part of the general health care costs you wouldn't have the courts trying to figure out what a reasonable amount is for someone who will live for years needing constant care.
Quote:
Ah yes, the most crappy argument that was ever put forward, but which keeps getting repeated over and over again. "Be happy with waiting lists because at least you will be treated quickly if its an emergency". Its a bogus argument, because it ignores the real pain and suffering that can result from being stuck on a waiting list (not to mention it can also lead to premature death, even if its not an emergency).
Except of course the wait times are often shorter than in america. And getting in to the right doctor your insurance covers is not exactly without a wait in the US.

Quote:
I have a cousin. He injured his shoulder (possibly a rotator cuff injury). He finds it very painful for him to raise his arms, but has to suffer though because his job involves physical activity. He was stuck on a waiting list for several months to get an MRI for a proper diagnosis. To you his pain and suffering doesn't matter because "gee wiz if its an emergency he'll get treated". Its not an emergency. He's suffering. If he were in the United States he probably would have had an MRI within a week.
Or you know not because the doctor who would even order the MRI can't see him for months.
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 11:51 AM   #134
Venom
Illuminator
 
Join Date: Apr 2011
Location: United States
Posts: 3,341
Originally Posted by Segnosaur View Post
And let me make a prediction... if the Democratic party does decide to push a true single-payer (i.e. no private insurance) option in the next election...
Probably don't have to worry about that anytime soon.

Originally Posted by Segnosaur View Post
...you will see a rush of right-wing newscasters to Canada to point out every patient who has ever been on a waiting list, in an attempt to say "See? This is what the Democrats want for your health care!"
They've been trying to smear the Democrats with that regardless. As usual for the most part they grossly exaggerate the number of elected Democrats who are for single-payer.
Venom is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 12:15 PM   #135
Darat
Lackey
Administrator
 
Darat's Avatar
 
Join Date: Aug 2001
Location: South East, UK
Posts: 88,441
Originally Posted by xjx388 View Post
I am speaking from a USA perspective and auto insurance is an example of what insurance is supposed to be.


I don’t know how much “better off” you are than the average American. What can be said for sure is that the UK system provides similar outcomes in most measures compared to the US and the UK is able to run it cheaper. I have no quarrel with that.

Where I think the US will have problems is in converting to an NHS style single payer because of how entrenched the current system is and how different the socioeconomics are between the two countries. I think the US needs to find it’s own way that takes the best from other plans and innovates something new.
There are examples of myriad of different universal healthcare schemes, what they all have in common is cheaper and more people covered. The USA is in one way in an enviable position in that it has decades of emperical data to draw on to determine the best system. It needs no hypotheticals, no trials no further research, it simply needs the will to change.
__________________
I wish I knew how to quit you
Darat is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 12:20 PM   #136
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by Darat View Post
There are examples of myriad of different universal healthcare schemes, what they all have in common is cheaper and more people covered. The USA is in one way in an enviable position in that it has decades of emperical data to draw on to determine the best system. It needs no hypotheticals, no trials no further research, it simply needs the will to change.
But look how much less profit that is being generated by the worthwhile classes from the UK system, a total failure in that. I mean if you are the kind of socialist fool who measures a health care system not by the number of billionaires created but by the average life span and quality of the country what else totally antithetical to american values will you suggest?
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 12:35 PM   #137
Norman Alexander
Philosopher
 
Norman Alexander's Avatar
 
Join Date: Nov 2014
Posts: 6,431
Originally Posted by Segnosaur View Post
That's an irrelevant distinction. Any costs related to malpractice insurance need to be covered by whatever fees the doctor or medical institution charges.

Yes, but those other countries often have ways to limit malpractice payouts and insurance... limits on payments, rules about how lawyers are paid, etc.
True. The USA does seem extraordinarily prone to trying to solve even the smallest problems with law suits, an expensive business.

Quote:
The point is that if you go to a single payer without changing the malpractice laws, your costs may still be higher than they could be.
Possibly. But it will depend on how the system recompenses doctors. Most of them use a "standard fee" approach - a list of common services each with prescribed recompense (in Australia, this list is vast). The doctor may choose to charge the patient more than that amount, but s/he will get back only that amount from the government. The patient effectively pays the difference. So if the doctor wants to add their malpractice insurance costs on top, fine. But that is not an issue for the single-payer system, it is an issue for them.

Quote:
Ah yes, the most crappy argument that was ever put forward, but which keeps getting repeated over and over again. "Be happy with waiting lists because at least you will be treated quickly if its an emergency". Its a bogus argument, because it ignores the real pain and suffering that can result from being stuck on a waiting list (not to mention it can also lead to premature death, even if its not an emergency).
I never said it was a perfect argument. In fact, I made it clear it was over-simplified. Nor is it perfect or an excuse. There will be plenty of situations where people will be forced to wait for procedures while they are in pain.

But no system can afford to have a personal doctor and a fully stocked radiology suite and surgery suite and pharmacy standing by everywhere for every single person in the country. I exaggerate to make the point that available resources are scarce and not readily available everywhere, so patient care needs to be prioritised. That's what the waiting lists are, and the process is actually quite complex. Do not for one moment think that people get put on these longer lists because of neglect. Medical staff feel their pain and would love to treat everyone immediately. The reason is simply the lack of resources right now, NOT because some faceless wonk in Ottawa decided a rotator cuff injury is of no consequence.

The clue to better service is to have more resources available immediately, of course. And that means more money from government. And that in turn is an ongoing food-fight that happens in every country that has socialised medicine. And the generosity of neighbours like the USA in providing some specialised medical care for Canadians is another solution.

Quote:
Let me give you some real life examples...

I have a cousin. He injured his shoulder (possibly a rotator cuff injury). He finds it very painful for him to raise his arms, but has to suffer though because his job involves physical activity. He was stuck on a waiting list for several months to get an MRI for a proper diagnosis. To you his pain and suffering doesn't matter because "gee wiz if its an emergency he'll get treated". Its not an emergency. He's suffering. If he were in the United States he probably would have had an MRI within a week.

Here's another example that's a bit more personal... I may have sleep appnea... I often stop breathing at night. Its a condition that has been linked to an increased risk of Stroke or heart disease. I mentioned it to the doctor over 6 months ago, but they have yet to find a slot in a clinic to do a proper sleep study. So while it is not an emergency per se, it still may shorten my life. (I do believe there can be waiting lists in the United States, but those waiting lists are much shorter.)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933773/
Two examples. Meanwhile, how many people were NOT treated in the USA for necessary and urgent medical reasons because they had no insurance? How many were turned away? How many in poor rural areas now have to travel long distances to a city to be treated because their doctor has had to close up shop? How many hospitals closed because they were deemed financial nonviable by their insurance company owners?


Quote:
Actually yes, yes it does.

In Canada, what treatments are provided/funded are determined by the government, which is sometimes slow to react and often has different priorities.
Indeed. Sometimes this does indeed happen. Sometimes. But oftentimes it doesn't too.

Quote:
Let me give you an example: There is a genetic diseases called Fabry's disease which can cause serious health problems (including heart and kidney problems). There was a point where treatment was not being provided in Ontario, despite the fact that such treatment was being done (and covered by many user's insurance) in the United States.
It is fully covered now. More details.


Quote:
I do not doubt that knowing you will be covered by insurance (regardless of your employment situation) is a good thing.

What I am complaining about is people who ignore or hand-wave away all of the possible problems involved with various alternatives.
Nothing is being hand-waved away. Single-payer is not a perfect panacea. It has inherent problems, and depending on how each nation implements it, specific problems. But it is proven in hundreds of other countries to be generally a more efficient way of affording and delivering health care.

Quote:
And let me make a prediction... if the Democratic party does decide to push a true single-payer (i.e. no private insurance) option in the next election, you will see a rush of right-wing newscasters to Canada to point out every patient who has ever been on a waiting list, in an attempt to say "See? This is what the Democrats want for your health care!"
No country ever implements a "true" single payer system. There will always be some form of private health insurance required and involved. The Dems know that; they are not entirely dim. So I rather suspect the idea of them eliminating all private health insurance is a GOP fear tactic, not anything to do with reality. Although if Warren does push this particular line, that will be VERY silly.
__________________
...our governments are just trying to protect us from terror. In the same way that someone banging a hornets’ nest with a stick is trying to protect us from hornets. Frankie Boyle, Guardian, July 2015
Norman Alexander is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 05:04 PM   #138
fishbob
Seasonally Disaffected
 
fishbob's Avatar
 
Join Date: Jan 2003
Location: Chilly Undieville
Posts: 7,107
Originally Posted by Norman Alexander View Post
Can I ask you both: How much would your insurance cost if you were in low-paying or part-time work?

And if you were not employed / between jobs?

Also, would you need to renegotiate health insurance if you changed jobs?
1 - total cost would be about the same, but most or all of it would be out of my pocket, no assistance from the employer.

2 - same

3 - yes, and there is an "enrollment period", about a 2 month window. If you miss the enrollment period you are without insurance until the next one rolls around.
__________________
"When you believe in things you don't understand, then you suffer . . . " - Stevie Wonder.
"It looks like the saddest, most crookedest candy corn in an otherwise normal bag of candy corns." Stormy Daniels
I hate bigots.
fishbob is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 05:56 PM   #139
Norman Alexander
Philosopher
 
Norman Alexander's Avatar
 
Join Date: Nov 2014
Posts: 6,431
Originally Posted by fishbob View Post
1 - total cost would be about the same, but most or all of it would be out of my pocket, no assistance from the employer.

2 - same

3 - yes, and there is an "enrollment period", about a 2 month window. If you miss the enrollment period you are without insurance until the next one rolls around.
Thanks for that.

Would it help if your health COVER was consistent regardless of your employment status? And your age?

Would it help simplify things if you had one consistent method of contributing financially towards your health benefits? E.g. a small percentage levy on your pre-tax earnings?
__________________
...our governments are just trying to protect us from terror. In the same way that someone banging a hornets’ nest with a stick is trying to protect us from hornets. Frankie Boyle, Guardian, July 2015
Norman Alexander is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 07:50 PM   #140
Stacyhs
Philosopher
 
Join Date: Mar 2016
Posts: 9,845
We could always build it and have Canada pay for it.

Hey....it worked for Trump and his wall!
Stacyhs is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 4th November 2019, 07:52 PM   #141
Stacyhs
Philosopher
 
Join Date: Mar 2016
Posts: 9,845
Originally Posted by fishbob View Post
1 - total cost would be about the same, but most or all of it would be out of my pocket, no assistance from the employer.

2 - same

3 - yes, and there is an "enrollment period", about a 2 month window. If you miss the enrollment period you are without insurance until the next one rolls around.
IIRC, you can enroll outside the enrollment period due to a 'life-changing event' such as marriage, divorce, new job, etc. But that could be the mai tai talking.
Stacyhs is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 01:37 AM   #142
Giordano
Penultimate Amazing
 
Join Date: Apr 2011
Posts: 15,916
Just want to point out that health care is always "rationed" to some extent because society can't afford to, or does not wish to, deliver all procedures to all patients. X-amount of money is available to pay for Y numbers of procedures. Which procedures are to be paid for must be determined by some means.

In most countries with government run health care these decisions are made by panels including doctors and ethicists. This is not inherently evil: e.g. most people agree with limiting purely cosmetic surgeries, or one million dollar treatments in deep end stage disease patients unlikely to benefit at all or for more than a few days.

In the USA these decisions are based on how rich the patient or, if less wealthy, by their insurance company. A poor person with bad insurance may never get a crucial treatment whereas a wealthy person in less need will. And to emphasize, if less than wealthy it is one's private, profit-driven insurance company, not one's doctor, who determines whether you have an expensive treatment or not.

Neither are ideal and each has flaws. But ethically and in terms of fairness I feel the former is better than the latter. And in fact the wealthy usually find a way no matter what.
Giordano is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 02:40 PM   #143
Babbylonian
Penultimate Amazing
 
Babbylonian's Avatar
 
Join Date: Feb 2007
Posts: 11,996
Originally Posted by CORed View Post
I'm pretty sure Obama really wanted single payer, but just didn't have the votes in Congress to pull it off. Thus we ended up with the ACA, which was at least a start, but ended up being an unpopular and flawed program.
This is one of those things that seems true but really isn't. When Republican voters were polled - more than once over a long period - they quite liked the Affordable Care Act. It was only when pollsters called it Obamacare that the approval went down.

There's a reason the Republicans couldn't get rid of the ACA, and it's not just because they never came through with an alternative: People generally like it and consider it a positive step.
Babbylonian is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 04:10 PM   #144
Segnosaur
Penultimate Amazing
 
Join Date: Jan 2002
Posts: 14,157
[quote]
Originally Posted by Norman Alexander View Post
Quote:
The point is that if you go to a single payer without changing the malpractice laws, your costs may still be higher than they could be.
Possibly. But it will depend on how the system recompenses doctors. Most of them use a "standard fee" approach - a list of common services each with prescribed recompense (in Australia, this list is vast). The doctor may choose to charge the patient more than that amount, but s/he will get back only that amount from the government. The patient effectively pays the difference. So if the doctor wants to add their malpractice insurance costs on top, fine.
This depends on how the system is implemented, but I suspect that doctors 'adding fees' (in order to cover expenses like malpractice insurance, or anything else) would be considered illegal. That's the way Canada does it... everything (at least in terms of basic medical coverage, not including dental/eye care) is covered by the government program.
Quote:
But that is not an issue for the single-payer system, it is an issue for them.
Buy it is still a cost that impacts health care. That was the point of my earlier post: That there are costs that will not be impacted by a switch to single payer unless other changes are made.
Quote:
Quote:
Ah yes, the most crappy argument that was ever put forward, but which keeps getting repeated over and over again. "Be happy with waiting lists because at least you will be treated quickly if its an emergency". Its a bogus argument, because it ignores the real pain and suffering that can result from being stuck on a waiting list (not to mention it can also lead to premature death, even if its not an emergency).
I never said it was a perfect argument. In fact, I made it clear it was over-simplified. Nor is it perfect or an excuse.
Yet you still made that argument, without clarifying what that impact would be.
Quote:
But no system can afford to have a personal doctor and a fully stocked radiology suite and surgery suite and pharmacy standing by everywhere for every single person in the country.
No, nor is that necessary. A happy medium that allows treatment or diagnostics within a few days is superior to a months/years long waiting list.
Quote:
I exaggerate to make the point that available resources are scarce and not readily available everywhere, so patient care needs to be prioritised. That's what the waiting lists are, and the process is actually quite complex. Do not for one moment think that people get put on these longer lists because of neglect. Medical staff feel their pain and would love to treat everyone immediately. The reason is simply the lack of resources right now, NOT because some faceless wonk in Ottawa decided a rotator cuff injury is of no consequence.
I never claimed that waiting lists were due to negligence or lack of empathy.

But, here in Canada it is due to a combination of slow government response and a need to fulfill multiple priorities that also include non-medical needs (such as basic infrastructure, defense, policing). Plus, the priority of the patient may not necessarily line up with the priority of the officials making the health care decisions.

Again, the issue is if people push for single payer because "gee wiz, its cheaper" then they will have to justify how people may have their health care treatments delayed.

Quote:
Quote:
Let me give you some real life examples...

I have a cousin. He injured his shoulder (possibly a rotator cuff injury)....He was stuck on a waiting list for several months to get an MRI for a proper diagnosis.

Here's another example that's a bit more personal... I may have sleep appnea...they have yet to find a slot in a clinic to do a proper sleep study.
Two examples.
Yes, 2 examples. I gave those specifically to personalize the type of situations find themselves under, so that hopefully people recognize that "Waiting lists? No big deal" is a foolish argument.
Quote:
Meanwhile, how many people were NOT treated in the USA for necessary and urgent medical reasons because they had no insurance?
I have no doubt that many people were.

But here's the thing: keep in mind that many (probably most) people DO have health insurance of some kind. And those people can often get better treatment (read: faster service, better tools) than people in places like Canada.

Now, the problem when people discuss health care is that not everyone agrees on the same terms. To many, "Single payer" simply means "universal". To others, Single payer is a lot more focused: it means no private insurance at all; everything is covered by the government program. (This appears to be what Sander's plan is. I'd have to look at Warren's plan in more detail to see if it is the same.)

I think the U.S. system needs to be reformed. But I think going to a true 'single user' system is a mistake. The best health care systems are the ones that merge private and public systems.

If you tell people who do have coverage "Your own health care and that of your family will get worse, so that some unnamed person might be better off", you might have a hard time getting broad public support.

Quote:
Re: Patients not getting treatment with new techniques...

Quote:
Actually yes, yes it does.

In Canada, what treatments are provided/funded are determined by the government, which is sometimes slow to react and often has different priorities.
Indeed. Sometimes this does indeed happen. Sometimes. But oftentimes it doesn't too.
But when it does happen, the patient has no options. (Well, unless they're rich enough to become a medical tourist).

Quote:
Quote:
Let me give you an example: There is a genetic diseases called Fabry's disease which can cause serious health problems (including heart and kidney problems). There was a point where treatment was not being provided in Ontario, despite the fact that such treatment was being done (and covered by many user's insurance) in the United States.
It is fully covered now.
Yes, I know its covered now. That's why I said "There was a point" where treatment was not provided in Ontario. It was an accepted treatment in the United States, but the government here said "Nope".

The fact that the government finally adopted it doesn't change the fact that there was a time period when it didn't cover the treatments.
Quote:
Nothing is being hand-waved away. Single-payer is not a perfect panacea. It has inherent problems, and depending on how each nation implements it, specific problems. But it is proven in hundreds of other countries to be generally a more efficient way of affording and delivering health care.
Not exactly...

Again we have to deal with what exactly 'single payer' means. Universal coverage but with private options for better service? A public option to cover those that private health care missed? True single payer with no private options at all?

The only western country that has adopted a 'no private insurance' scheme (like the one pushed by Sanders) is Canada, and we generally rank near the bottom of various health care rankings. The better options mix private and public in various ways, and usually end up better off for it.

Quote:
No country ever implements a "true" single payer system. There will always be some form of private health insurance required and involved.
When it comes to basic health care (i.e. not including drugs, vision, dental) Canada comes closest to a "true" single payer. And our system falls behind other countries.

Strangely enough, I have no problem getting fast treatment for vision or dental. But then those are paid for by private insurance. What are the odds?
Quote:
The Dems know that; they are not entirely dim. So I rather suspect the idea of them eliminating all private health insurance is a GOP fear tactic, not anything to do with reality. Although if Warren does push this particular line, that will be VERY silly.
Well, that is the line that Sanders seems to be pushing.

From: https://www.cnn.com/2019/07/03/polit...ity/index.html
Under the Sanders proposal, private health insurance companies would be eliminated. Every resident would be covered by a single government insurance program that would pay the entire cost of almost every health care service and product...

Its a plan that goes beyond even what Canada offers.

And then there is Warren's plan:

From: https://www.businessinsider.com/what...dustry-2019-11
Private insurance would be eliminated. Warren argues that would save hundreds of billions of dollars in administrative spending, and relieve patients of the hassle of dealing with their insurer.
  • Americans would no longer have to worry about reaching their deductibles or whether their doctors are in their insurance network.
  • They'd pay no premiums and have "virtually no" out-of-pocket costs, according to Warren. They'd have expansive health benefits, including long-term care, audio, visual, and dental.
  • They'd also have no choice about any of this.
The first 2 points may sound great. The last point may cause some problems.
__________________
Trust me, I know what I'm doing. - Sledgehammer

I'm Mary Poppin's Y'all! - Yondu

We are Groot - Groot
Segnosaur is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 04:34 PM   #145
Tero
Graduate Poster
 
Tero's Avatar
 
Join Date: Oct 2010
Location: North American prairie
Posts: 1,636
As long as the healthcare is being paid by insurance, what difference would it make whether Medicare or private insurance pays for it? Would it not cost roughly the same, no matter what?

If you were adding say 30% more patients, then costs would go up.
Tero is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 05:27 PM   #146
Norman Alexander
Philosopher
 
Norman Alexander's Avatar
 
Join Date: Nov 2014
Posts: 6,431
Originally Posted by Segnosaur View Post
This depends on how the system is implemented, but I suspect that doctors 'adding fees' (in order to cover expenses like malpractice insurance, or anything else) would be considered illegal. That's the way Canada does it... everything (at least in terms of basic medical coverage, not including dental/eye care) is covered by the government program.

Buy it is still a cost that impacts health care. That was the point of my earlier post: That there are costs that will not be impacted by a switch to single payer unless other changes are made.
I understand. In Australia we "copied" the Canadian model because it was a good fit. But it is not pure single-payer for everything. Ours is a single-payer for basic coverage grafted to optional private coverage for the rest.

Quote:
Yet you still made that argument, without clarifying what that impact would be.
As we both know, the specifics of the positives and negatives could take volumes to cover. I think we are limited to 65536 characters here on the forum.

Quote:
A happy medium that allows treatment or diagnostics within a few days is superior to a months/years long waiting list.
Agreed. In Australia, a fairly broad diagnostic service industry has sprung up to meet the demand for this sort of thing. They are private businesses, but they are recompensed to a large extent by government out of the health budget. Most major suburbs and towns have such a centre. Not all are fully stocked with everything. But the vast majority of common diagnostics, usually blood-work, X-ray and CAT scan, can be done. So delays in getting diagnostics is more a matter of being able to access one of these centres, i.e. proximity, as no doubt you have in Canada. But rarely does the queue for services exceed a few days.

Quote:
I never claimed that waiting lists were due to negligence or lack of empathy.

But, here in Canada it is due to a combination of slow government response and a need to fulfill multiple priorities that also include non-medical needs (such as basic infrastructure, defense, policing). Plus, the priority of the patient may not necessarily line up with the priority of the officials making the health care decisions.
Do doctors in Canada really have to bow to the will of the faceless Ottawa wonk? I suspect they will get patients into diagnostics and procedures as soon as they can.

Quote:
Again, the issue is if people push for single payer because "gee wiz, its cheaper" then they will have to justify how people may have their health care treatments delayed.
I think that is too narrow a view. In the USA, while services may be readily available on demand, we see frequent reports that many people do not avail themselves of it due to cost factors. Posters here bitch about how ACA has made it even more expensive! If they are out of work, or even if they have low incomes, they could have no effective insurance, or insurance that does not cover their needs. So the cost of a CAT-scan or MRI would not be covered. So they have no choice - they cannot afford their necessary care. It doesn't matter if the Rolls Royce on sale is silver or gold if you have only a dollar to spend on food this week.

Quote:
Yes, 2 examples. I gave those specifically to personalize the type of situations find themselves under, so that hopefully people recognize that "Waiting lists? No big deal" is a foolish argument.
I agree. It is a foolish argument...that I never made. They will happen; it's not good; the issue needs addressing. I hope you can kick some butt in Canada about it (I have Canadian friends). But being on a waiting list of any length is better than not being on a waiting list at all.

Quote:
But here's the thing: keep in mind that many (probably most) people DO have health insurance of some kind. And those people can often get better treatment (read: faster service, better tools) than people in places like Canada.
The news we hear is that is not the case. It would be more accurate to say "Most employed adult people have health insurance of some kind". That's not the same as in Canada.

Quote:
Now, the problem when people discuss health care is that not everyone agrees on the same terms. To many, "Single payer" simply means "universal". To others, Single payer is a lot more focused: it means no private insurance at all; everything is covered by the government program. (This appears to be what Sander's plan is. I'd have to look at Warren's plan in more detail to see if it is the same.)
Could not agree more. But mostly because the terms being thrown around by the GOP have become pejoratives. Anything they don't like gets labelled "SOCIALISM!!TM" and is to be expelled like the Devil himself.

Quote:
I think the U.S. system needs to be reformed. But I think going to a true 'single user' system is a mistake. The best health care systems are the ones that merge private and public systems.
Also agree.

Quote:
If you tell people who do have coverage "Your own health care and that of your family will get worse, so that some unnamed person might be better off", you might have a hard time getting broad public support.
But they are willing to throw huge amounts of federal taxes into a big pot to fund their military in exactly the same way a unified public health system would require, even though they won't get a personal soldier to come defend their private property.

Quote:
But when it does happen, the patient has no options. (Well, unless they're rich enough to become a medical tourist).
There's that issue again - cost!

Quote:
Yes, I know its covered now. That's why I said "There was a point" where treatment was not provided in Ontario. It was an accepted treatment in the United States, but the government here said "Nope".

The fact that the government finally adopted it doesn't change the fact that there was a time period when it didn't cover the treatments.
We have a similar issue. Our government often waits to see if new treatments are proven and popular in the USA before providing support here. It's simply cost - they aren't prepared to run testing regimes parallel to the US ones when they can get the same outcomes by just waiting and watching over the Pacific.

Quote:
Again we have to deal with what exactly 'single payer' means. Universal coverage but with private options for better service? A public option to cover those that private health care missed? True single payer with no private options at all?

The only western country that has adopted a 'no private insurance' scheme (like the one pushed by Sanders) is Canada, and we generally rank near the bottom of various health care rankings. The better options mix private and public in various ways, and usually end up better off for it.
Australia is such a mix. It has its issues though. There's a constant shift of the balance between coverage under the general health scheme, the cost to the taxpayer, and the benefits of private health insurance/care. It's complicated...

Quote:
When it comes to basic health care (i.e. not including drugs, vision, dental) Canada comes closest to a "true" single payer. And our system falls behind other countries.

Strangely enough, I have no problem getting fast treatment for vision or dental. But then those are paid for by private insurance. What are the odds?
Same here. Because they are paid-for private services that make a profit. So they should deliver. Yes, I do understand that is what medical care is supposed to be about, and that's why the US mode is to expect good medical care because of the profit motive. The problem is that the profit becomes more important than the customer. If the customer is not profitable, they will prefer not to service them.

Quote:
Well, that is the line that Sanders seems to be pushing [all public only].

From: https://www.cnn.com/2019/07/03/polit...ity/index.html
Under the Sanders proposal, private health insurance companies would be eliminated. Every resident would be covered by a single government insurance program that would pay the entire cost of almost every health care service and product...

Its a plan that goes beyond even what Canada offers.

And then there is Warren's plan:

From: https://www.businessinsider.com/what...dustry-2019-11
Private insurance would be eliminated. Warren argues that would save hundreds of billions of dollars in administrative spending, and relieve patients of the hassle of dealing with their insurer.
  • Americans would no longer have to worry about reaching their deductibles or whether their doctors are in their insurance network.
  • They'd pay no premiums and have "virtually no" out-of-pocket costs, according to Warren. They'd have expansive health benefits, including long-term care, audio, visual, and dental.
  • They'd also have no choice about any of this.
The first 2 points may sound great. The last point may cause some problems.
Indeed. From a broader perspective, it gives the GOP a point to lever the clarion accusation of "SOCIALISM!!TM" come election time.
__________________
...our governments are just trying to protect us from terror. In the same way that someone banging a hornets’ nest with a stick is trying to protect us from hornets. Frankie Boyle, Guardian, July 2015
Norman Alexander is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 05:58 PM   #147
Craig4
Penultimate Amazing
 
Craig4's Avatar
 
Join Date: Aug 2010
Location: Alexandria, VA Home to the Deep State.
Posts: 19,257
Originally Posted by CORed View Post
I have a feeling that Warren's plan to eliminate private insurance and force everyone immediately into single payer may be a fatal flaw, politically, if not in implementation. Americans do not like to be forced to do much of anything. Fore example, the mandatory purchase of insurance in the ACA was probably its least popular feature. People who have good insurance plans will certainly be very unhappy at being forced into what they will likely perceive, rightly or wrongly, to be the inferior government plan. I suspect Warren will have a lot of difficulty getting her plan approved by even a Democrat controlled Congress. An opt-in type of plan will likely get us to single payer over time, as many employers will decide that they do not need to offer a full health insurance plan.
I have no doubt that a national health insurance program similar to most of Europe could work. I just don't see it as politically feasible right now. The winning health care plan would be, bring back he ACA to include mandate and offer Medicare as a plan option in those markets where there are few or no private options. You offset some of the cost by having the customer pay the means tested premium that they would have paid for a commercial plan.
__________________
A MAGA hat = a Swastika arm band. A vote for Trump is a vote for treason.
Craig4 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 06:27 PM   #148
Tero
Graduate Poster
 
Tero's Avatar
 
Join Date: Oct 2010
Location: North American prairie
Posts: 1,636
Most of Europe is not all. Germany has private insurance. It is more like a co-op, with members employing the minimal crew to process the claims. If enough patients pool together they can become the insurance company. They take it out the paycheck I think, except for disabled etc.
Tero is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 06:42 PM   #149
kellyb
Penultimate Amazing
 
kellyb's Avatar
 
Join Date: Jan 2006
Posts: 12,631
Originally Posted by Craig4 View Post
I have no doubt that a national health insurance program similar to most of Europe could work. I just don't see it as politically feasible right now.
I think it is, if marketed well.

https://thehill.com/hilltv/what-amer...ll-health-care

Quote:
Seventy percent said they supported providing "Medicare for all," also known as single-payer health care, for Americans, according to a new American Barometer survey.

The poll, conducted by Hill.TV and the HarrisX polling company, found that 42 percent of respondents said they "strongly" supported the proposal, while 28 percent said they "somewhat" supported it.

Fifteen percent said they "somewhat" opposed the measure, while another 15 percent said they "strongly" opposed it.

The results mirrored a Reuters-Ipsos poll released in August, which also found that 70 percent of Americans supported "Medicare for all."
__________________
"We are enjoined, no matter how uncomfortable it might be, to consider ourselves and our cultural institutions scientifically — not to accept uncritically whatever we’re told; to surmount as best we can our hopes, conceits, and unexamined beliefs; to view ourselves as we really are." - Carl Sagan
kellyb is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 07:27 PM   #150
rdwight
Muse
 
rdwight's Avatar
 
Join Date: Dec 2016
Posts: 563
Originally Posted by Darat View Post
Why not look at what it actually costs rather than just wondering.
Because both sides of the equation are best guesses. And being optimistic for the lowest cost and highest revenue to make a plan work seems like a bad recipe. Do you think a backup funding plan is necessary? And at what point should it be implemented?

If after the change is made, deficits become apparent that run large but decreasing yearly, should that burden simply be added to the national debt for however long it takes? So funding lacks 800b first year, 700b second, 600b third, 575b fourth, the trajectory is right but the timeframe until even is troublesome and would reflect a need for some modifications to the funding. When you run on 'no middle class tax increase', the political ramifications for fixing it become a deterant.

Originally Posted by Darat View Post
There are examples of myriad of different universal healthcare schemes, what they all have in common is cheaper and more people covered. The USA is in one way in an enviable position in that it has decades of emperical data to draw on to determine the best system. It needs no hypotheticals, no trials no further research, it simply needs the will to change.
How many of those examples we can draw from finance in the same way as Warren's plan? Since we are discussing a specific plan, we should focus on that I would think.
rdwight is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 09:02 PM   #151
kellyb
Penultimate Amazing
 
kellyb's Avatar
 
Join Date: Jan 2006
Posts: 12,631
Originally Posted by rdwight View Post

If after the change is made, deficits become apparent that run large but decreasing yearly, should that burden simply be added to the national debt for however long it takes?
Yes. As long as the deficit isn't so excessive it causes (or is at serious risk of causing) inflation, it's fine.
__________________
"We are enjoined, no matter how uncomfortable it might be, to consider ourselves and our cultural institutions scientifically — not to accept uncritically whatever we’re told; to surmount as best we can our hopes, conceits, and unexamined beliefs; to view ourselves as we really are." - Carl Sagan
kellyb is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 5th November 2019, 10:29 PM   #152
PhantomWolf
Penultimate Amazing
 
PhantomWolf's Avatar
 
Join Date: Mar 2007
Posts: 19,081
Originally Posted by Segnosaur View Post
If you tell people who do have coverage "Your own health care and that of your family will get worse, so that some unnamed person might be better off", you might have a hard time getting broad public support.
The thing is that there is no need for that to happen even with a single payer.

The US system has privately run hospitals and doctors. All that really has to happen is to change who the payer is. Heck, under a single payer system it should be possible to prefund hospitals based on their population and the number of cases they are seeing every year. If they have a situation that would cause them to over run the projected costs, then that case can go to a board of doctors who can work with the doctors of the hospital to determine the best course of treatment for the patient(s), and then either approve the cost overrun if that is considered the best, or follow another path is there is a better option for the patient.

There is no need to make the service worse just because there is a single payer. In fact, just to put a level between the politicians and the hospitals, having a Federal Health Board who would act like an insurance company in that it negotiates costs, lobbies to get the money from Congress, does the paying, and works to organise specialists to help with any special cases.
__________________

It must be fun to lead a life completely unburdened by reality. -- JayUtah
I am not able to rightly apprehend the kind of confusion of ideas that could provoke such a question. -- Charles Babbage (1791-1871)


Last edited by PhantomWolf; 5th November 2019 at 10:32 PM.
PhantomWolf is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 04:11 AM   #153
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by Babbylonian View Post
This is one of those things that seems true but really isn't. When Republican voters were polled - more than once over a long period - they quite liked the Affordable Care Act. It was only when pollsters called it Obamacare that the approval went down.

There's a reason the Republicans couldn't get rid of the ACA, and it's not just because they never came through with an alternative: People generally like it and consider it a positive step.
Yea bringing back lifetime maximums and exclusions for preexisting conditions are hugely unpopular.
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 04:14 AM   #154
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by Tero View Post
As long as the healthcare is being paid by insurance, what difference would it make whether Medicare or private insurance pays for it? Would it not cost roughly the same, no matter what?

If you were adding say 30% more patients, then costs would go up.
Well for starters the overhead in medicare is 6% of costs as opposed to 30% when the efficiency of private coverage comes into the game. Then there is the simplification of medical billing and hopefully less "reject everything twice to make it go away before paying" make work positions in insurance.
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 04:34 AM   #155
Tero
Graduate Poster
 
Tero's Avatar
 
Join Date: Oct 2010
Location: North American prairie
Posts: 1,636
Originally Posted by ponderingturtle View Post
Well for starters the overhead in medicare is 6% of costs as opposed to 30% when the efficiency of private coverage comes into the game. Then there is the simplification of medical billing and hopefully less "reject everything twice to make it go away before paying" make work positions in insurance.
My point was more to do with the fact that they throw up 52 trillion and say "too expensive" when medicare is involved. Yet the same amount is paid if you use private insurance. And it also ends up as "bad healthcare" if the government is paying and good if you pay thru the nose to insurance. Yet the doctor gets the same amount of income.
Tero is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 05:20 AM   #156
Puppycow
Penultimate Amazing
 
Puppycow's Avatar
 
Join Date: Jan 2003
Posts: 24,206
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?
Let me tell you how it works in Japan in my experience. When you arrive at a doctor's office you are asked for your insurance card, not cash up front. That happens only after you've seen the doctor. So medical care is provided before they ask for payment every time I've ever encountered the system.
__________________
A fool thinks himself to be wise, but a wise man knows himself to be a fool.
William Shakespeare
Puppycow is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 09:13 AM   #157
Bob001
Philosopher
 
Join Date: Dec 2006
Posts: 9,405
A thoughtful critique of the Warren plan:
Quote:
Another, deeper issue—which a number of writers, not to mention Warren’s primary rival Bernie Sanders, have pointed out—is that the centerpiece of her proposal is fundamentally unfair to many businesses and workers. It’s specifically a raw deal for companies that already offer their employees generous insurance, as well as for low-wage workers, who would somewhat indirectly shoulder a disproportionate share of the burden from the tax scheme she has concocted.
https://slate.com/business/2019/11/e...er-unfair.html
Bob001 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 09:15 AM   #158
Belz...
Fiend God
 
Belz...'s Avatar
 
Join Date: Oct 2005
Location: In the details
Posts: 86,992
Originally Posted by Puppycow View Post
Let me tell you how it works in Japan in my experience. When you arrive at a doctor's office you are asked for your insurance card, not cash up front. That happens only after you've seen the doctor. So medical care is provided before they ask for payment every time I've ever encountered the system.
In Canada you're simply not asked for payment, except in private clinics of course, and for specific treatments. Anything that's even mildly expensive is covered.
__________________
Master of the Shining Darkness

"My views are nonsense. So what?" - BobTheCoward


Belz... is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 10:20 AM   #159
Segnosaur
Penultimate Amazing
 
Join Date: Jan 2002
Posts: 14,157
Originally Posted by PhantomWolf View Post
Quote:
If you tell people who do have coverage "Your own health care and that of your family will get worse, so that some unnamed person might be better off", you might have a hard time getting broad public support.
The thing is that there is no need for that to happen even with a single payer.
Canada has been attempting to deal with the issue of how to allocate health care resources in a 'single payer' system (for basic medical services) for decades, and yet we are stuck with long waiting lists.

Why exactly do you think the U.S. will somehow be magically different? That somehow the U.S. will be able to somehow solve the problems that Canada (a pretty normal western country with no major corruption issues) has been unable to?
Quote:
The US system has privately run hospitals and doctors. All that really has to happen is to change who the payer is.
Its a little bit more complex than that I think.

Governments will have to budget for whatever health care costs are expected, and plan for any expected infrastructure upgrades that are needed. (After all, you probably don't want to give private hospitals and clinics free reign to decide "We want to buy X and the government will pay".) That means health care will be subject to the actions of a government that will have multiple competing priorities.
Quote:
There is no need to make the service worse just because there is a single payer.
Keep in mind that I am not saying single payer makes the system worse overall... I am saying it will probably make the system worse for certain people.
Quote:
In fact, just to put a level between the politicians and the hospitals, having a Federal Health Board who would act like an insurance company in that it negotiates costs, lobbies to get the money from Congress, does the paying, and works to organise specialists to help with any special cases.
Whatever levels of government bureaucracy are implemented to lobby politicians and negotiate costs, ultimately the decisions about how much to fund health care will come down to the president and congress critters.

Would you really feel confident putting complete control of your health care funding in the hands of a President Paul Ryan a decade from now?

I can just imagine the conversation at the GOP headquarters:
"We need to give the rich another tax cut"
"But that will increase the deficit"
"Maybe we can cut down on defense spending."
"Ha ha! good joke"
"I thought you would think that was funny"
"Lets just cut a few extra billion out of health care. After all, by the time waiting lists get too long the Democrats will be back in power."
__________________
Trust me, I know what I'm doing. - Sledgehammer

I'm Mary Poppin's Y'all! - Yondu

We are Groot - Groot
Segnosaur is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 6th November 2019, 10:49 AM   #160
ponderingturtle
Orthogonal Vector
 
ponderingturtle's Avatar
 
Join Date: Jul 2006
Posts: 48,289
Originally Posted by Segnosaur View Post
Canada has been attempting to deal with the issue of how to allocate health care resources in a 'single payer' system (for basic medical services) for decades, and yet we are stuck with long waiting lists.
Yet it is better in the UK with the NHS and in general the US has longer wait times to see specialists than other nations that have universal care. It seems waits are remarkably bad in canada but that is not a universal feature of universal systems.
__________________
Sufficiently advanced Woo is indistinguishable from Parody
"There shall be no *poofing* in science" Paul C. Anagnostopoulos
Force ***** on reasons back" Ben Franklin
ponderingturtle is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Reply

International Skeptics Forum » General Topics » USA Politics

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT -7. The time now is 10:17 AM.
Powered by vBulletin. Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.

This forum began as part of the James Randi Education Foundation (JREF). However, the forum now exists as
an independent entity with no affiliation with or endorsement by the JREF, including the section in reference to "JREF" topics.

Disclaimer: Messages posted in the Forum are solely the opinion of their authors.