Current Healthcare System Vs. Single-Payer "Medicare-for-All"

[BigRedBuster]

Good post - see my resent post on the Democratic Primary thread and the costs to implement Bernie's plans.

I read it...what specifically are you wanting to discuss from it?

 

 

FYI....I thought my post was addressing the OP and yours.

 

 

 

 

OOOOOPPPPPPsssssss.......just reread your post. I thought you meant your post above about the "Democratic Debate". I'll go read your post in the other thread.

[BigRedBuster]

OK...I'm back....It was a short article.

 

 

It said 14 trillion dollars of his tax hikes comes from his health care plan. I really would need to see the specifics on this. Also, that doesn't happen in a vacuum.

 

I'm not sure how much the business world pays now in health care but it has to be staggering. We aren't even that big and I'm amazed in the dollars we pay out on it. So, that would need to be off set if my plan were to be put in place.

 

Also, as stated in my post, a major part of this success would have to come from the cost side. How can we actually reduce costs so that a simple MRI doesn't cost $7,000 and instead costs $500?

[JJ Husker]

BRB- A big piece of the puzzle driving premiums are the government mandates of who has to be covered, what has to be covered, etc. Free market solutions won't work if it's not truly free. The coverage mandates eliminated the insurance company's ability to limit their costs by not covering high risk, high cost customers. That is exactly why Obamacare is not working. The costs are still a runaway freight train. I don't have a solution, but free market won't work either if they are told who they must cover.

 

Only possible solution I see is the two far ends of the sp3ctrum. 1- complete and total free market, no government interference. 2- full blown socialism, state run medical, etc. Hopefully somebody much smarter than me can figure out how to blend the 2.

[BigRedBuster]

JJ....I understand that.

 

I am all for healthcare access for everyone. The system we have had the last 10-20 years has been horrible for that.

 

Other countries offer the same care items....MRIs, X-rays, Cancer treatment, surgeries...etc. MUCH cheaper than we do and there is no reason for that other than our system of payment allows these companies, hospitals and doctors to do it.

 

Now, on the flip side, I don't want our system to turn into basically a bunch of VA hospitals.

 

There has to be a middle ground that gets everyone most of what they want.

[84HuskerLaw]

The best solution would be to eliminate ALL HEALTH INSURANCE AND GOVERNMENT REGULATION THEREOF. Prohibit health 'insurance' as it is not really insurance in the true sense anyway. Any system with third party payers will not work efficiently.

 

When one party pays for services provided by a second party to any third party, the result will be dramatic price escalation.

 

The only possible way to encourage price and service competition and free market discipline for price and quality and quantity of a product is to have the consumer paying the cost.

 

I would suggest the best idea would be some kind of voucher issued by the government to the consumer to be then used to purchase health care products and services. Similar to food stamps - such as maybe healthcare stamps.

 

Each person should be granted a healthcare purchase stipend. The card can be used during the year to purchase medical care. At the end of the year, then any remaining balance would be given to the consumer as cash to do with as they wish. This in effect becomes like a savings account. Use on heathcare if you need it and the rest you can use for other things. Save it and let it grow and build. A healthcare savings account would work similary and could grow into a retirement fund for all funds not used.

[TGHusker]

• 84 trying to figure out how that would cover catastrophic situations - cancer, heart attack etc. A health care card would have to be loaded wt a lot of $$$$. Or the card is used for normal and preventative care and normal 'wear and tear' stuff. Large medical expenses - invoiced directly to the govt by the provider.

[Danny Bateman]

That's a very interesting idea, 84, and a great point, TG. I'd imagine that could work but like you said, serious medical events or long-term care for chronic conditions could easily exhaust the allotment.

 

What you propose would actually be very similar to the system the use in other single-payer nations. The gov't provides single-payer insurance for everyone, and then you have the option to turn to the private market for optional supplemental. It helps cover costs above and beyond the basics, which essentially makes available a higher level of care.

 

Medicare operates the same way. I actually had a PT I was shadowing a few years back tell me Medicare was her favorite insurance to deal with for billing. She said if you have the proper supplemental stuff, it will cover most everything and is super simple to work with.

 

So there's definitely merit to single-payer. Bernie has mentioned completely dismantling the private insurance market, which makes me question the availability of the supplemental.

 

Furthermore, Medicare doesn't significantly cut spending or help cost control. In order to do that, you have to reduce the salaries of all healthcare professionals, in addition to heightened bargaining power with big pharma and reducing administrative costs. And THAT is going to be a VERY tough sell.

 

I feel like single-payer is a great idea but perhaps a flawed one for the US. Currently, it may be more realistic to try to tweak the ACA to get costs down as much as possible and possibly transition to single-payer down the road.

[Danny Bateman]

Delete

[BigRedBuster]

That's a very interesting idea, 84, and a great point, TG. I'd imagine that could work but like you said, serious medical events or long-term care for chronic conditions could easily exhaust the allotment.

 

What you propose would actually be very similar to the system the use in other single-payer nations. The gov't provides single-payer insurance for everyone, and then you have the option to turn to the private market for optional supplemental. It helps cover costs above and beyond the basics, which essentially makes available a higher level of care.

 

Medicare operates the same way. I actually had a PT I was shadowing a few years back tell me Medicare was her favorite insurance to deal with for billing. She said if you have the proper supplemental stuff, it will cover most everything and is super simple to work with.

 

So there's definitely merit to single-payer. Bernie has mentioned completely dismantling the private insurance market, which makes me question the availability of the supplemental.

 

Furthermore, Medicare doesn't significantly cut spending or help cost control. In order to do that, you have to reduce the salaries of all healthcare professionals, in addition to heightened bargaining power with big pharma and reducing administrative costs. And THAT is going to be a VERY tough sell.

 

I feel like single-payer is a great idea but perhaps a flawed one for the US. Currently, it may be more realistic to try to tweak the ACA to get costs down as much as possible and possibly transition to single-payer down the road.

Agree with your last statement.

[Landlord]

I don't know sh#t about how all of this stuff works but here's what I've found to be a really cool solution.

 

 

A lot of my friends and co-workers (I work at a church) have health insurance through a Christian Healthcare solution. Essentially, it works as a resource-pooling network, where you pay a fixed, flat rate each month, and then any time you have an illness or something go wrong, you get billed by the hospital/doctor/pharmacy/whatever, then you get a check written out to you for cost, with the money coming from monthly payments from other members. In months where all the people are generally healthy the money just gets stockpiled to save for future use by anyone for any legitimate medical problems.

 

 

No idea if something like that could be adopted as a government model, but everyone I know that's been a part of it absolutely loves it and would never go back to "normal" insurance. I would be on it if I could afford it currently.

[Danny Bateman]

 

Study: Bernie Sanders's single-payer plan is almost twice as expensive as he says

 

Bernie Sanders's health care plan is underfunded by almost $1.1 trillion a year, a new analysis by Emory University health care expert Kenneth Thorpe finds.

 

http://www.vox.com/2016/1/28/10858644/bernie-sanders-kenneth-thorpe-single-payer

 

I knew I was skeptical for a reason. It's a bit alarming the way the Sanders campaign changed established figures on the spot as they were questioned.

 

Color me still unimpressed.

[cornographic]

I don't think Bernie, or anybody, claims that a transition to single payer would be "seamless". Fighting the extreme profit motive in all branches of the USA medical/pharma industry will be a major pain in the tush, actually. But, other countries have done it, so it is doable, and preferable, IMO.

[cornographic]

I would absolutely love to get my Healthcare premiums cut back to only 9% or 10% of my gross income. I am currently paying about $1450/mo or $17,400 annual for my Obamacare plan. It has better coverage than the plan I had prior to Obamacare but the premiums are still increasing about 20% per year. If somebody can come up with a plan, single payer or otherwise, that only costs 9% to 15% of my gross income, and prevents the yearly 20% increase, count me in.....way in.

Ouch! What I gather from Obamacare, is that the middle class, in particular, has seen increases in what they are paying for insurance to cover the millions of working and poorer folk who now have insurance at the very low cost. It's like anything, insurance co.s need to make their $ somewhere, so they shift it to the middle class.

 

I have insurance thru my trade unions plan, "cadillac plan', it's awesome. Not sure how they do it, but it's awesome, the contractors pay into it and all I usually have to deal with is a small co-pay. And, fortunately, I'm healthy, so rarely go to the doc.

[Danny Bateman]

I don't think Bernie, or anybody, claims that a transition to single payer would be "seamless". Fighting the extreme profit motive in all branches of the USA medical/pharma industry will be a major pain in the tush, actually. But, other countries have done it, so it is doable, and preferable, IMO.

 

I agree it's going to be a struggle making this better, no matter the route.

 

But I take issue with the last sentence. I feel like that is a very common fallacy that a lot of Sanders supporters point to as support for Medicare-for-all.

 

It's true that other countries utilize single payer. The most common single-payer comparisons I've heard bandied about are the UK, Canada, and even France, who utilizes a two-tier system where private supplemental is also available in addition to the gov't provided public coverage.

 

But they started doing so LONG ago: UK in 1948, Canada in 1966, and France in 1974. Their total healthcare expenditure was MUCH lower than ours at the time they implemented single-payer-- smaller countries and they haven't soaked up the inflation that the US has since then.

 

The problem comes when you try and slap a single-payer system on a country that spends the outlandish amount we do today, far outstripping any other country per capita, and expect it to fix things. A lot of economists think it just won't happen. To make it work, you need to increase taxes a WHOLE lot more than Bernie's proposing, as the Vox article points out. If you want another example, look to the Bloomberg article about Vermont's proposal and the math in the OP.

 

Essentially, Medicare-for-all may not be the cure-all we think it is, as our spending may just be "TOO DAMN HIGH!"

 

Furthermore, the Sanders response to Thorpe's work is reprehensible. They tried to discredit him by saying he "worked for BC/BS," despite that fact he's a respected academic and a single-payer advocate.

 

I want to believe this could work, but looking at the math, I just don't. Not with the numbers he's proposing. Very real possibility it ends up being a neutral move, or, as the article stated, ends up costing a lot of people even more.