View Poll Results: How do you feel about your private health insurance?
I have employer provided private insurance – I love it 46 23.35%
I have private insurance I obtained on my own – I love it 3 1.52%
I have employer provided private insurance – It’s OK 86 43.65%
I have private insurance I obtained on my own – It’s OK 15 7.61%
I have employer provided private insurance – It sucks 39 19.80%
I have private insurance I obtained on my own – It sucks 8 4.06%
Voters: 197. You may not vote on this poll

Reply
 
Thread Tools Display Modes
  #101  
Old 02-26-2020, 01:56 PM
Tim R. Mortiss's Avatar
Tim R. Mortiss is offline
Guest
 
Join Date: Apr 2002
Location: Lincoln Park, Chicago
Posts: 7,344
Quote:
Originally Posted by Riemann View Post
It is a bad thing that employers can wield this power. One of the benefits of implement UHC is that people are no longer beholden to their employers for healthcare. This is a feature of UHC, not a bug. Losing a job is traumatic enough already, it's truly horrific if that also means losing your insurance. It's a significant drag on the economy that healthcare is such a major consideration for somebody switching jobs, and most especially for an entrepreneur who wants to start a small business.

In any event, I'm not advocating any particular implementation. I think funding UHC out of income tax is probably preferable. But I'm pointing out the arithmetic - that there is already effectively a $30k payroll tax that goes to private insurers, so if this $30k is simply redirected to a public insurance pool, nobody's economics have changed.

Before UHC:
Employer pays $70k to employee plus $30k to insurance company
Employee receives $70k

After UHC:
Employer pays $100k
Employee receives $100k minus $30k in some form of tax that funds UHC

To call this a $30k tax increase is misleading - everyone is economically exactly the same.
This only makes sense if you believe that inserting the government into the equation does not decrease the overall efficiency of the system. Most conservatives, having a healthy distrust of government, do not buy that assumption in the slightest.
  #102  
Old 02-26-2020, 02:42 PM
Ravenman is online now
Charter Member
 
Join Date: Jan 2003
Location: Washington, DC
Posts: 27,891
Quote:
Originally Posted by Tim R. Mortiss View Post
This only makes sense if you believe that inserting the government into the equation does not decrease the overall efficiency of the system. Most conservatives, having a healthy distrust of government, do not buy that assumption in the slightest.
A raging flood once hit a small town, threatening to wipe it out. A family in a truck, fleeing the danger, saw a man fretting outside his house as the rain came down. "Jump in the truck and be saved!" the family yelled. The man said, "No, the Good Lord will provide!"

Hours later, the man was forced into the second story of this house by the water. A police boat came to his window, a the skipper yelled, "Jump in the boat and be saved!" The man said, "No, the Good Lord will provide!"

Hours later, the man is on his roof. A National Guard helicopter sees him and lowers the hoist. The pilot yelled, "Jump in the helo and be saved!" The man said, "No, the Good Lord will provide!"

Moments later, the man is washed away and drowns.

Up at the Pearly Gates, the man tells God, "Lord, I have been your devoted servant all my life. Why did you not look out for me?"

God says, "I sent a truck, a boat, and a helicopter, can't you take a fucking hint?"

Conservatives looking for more efficiency in healthcare should take the fucking hint.
  #103  
Old 02-26-2020, 03:38 PM
bump is offline
Guest
 
Join Date: Jun 2000
Location: Dallas, TX
Posts: 19,390
Quote:
Originally Posted by Red Wiggler View Post
That's a misleading question to ask. The right question is whether or not this will raise costs to the average citizen.

Yes, most employed people are going to pay more in taxes in a single payer US.
What's the difference? In a single-payer system, your populace will be paying taxes, and getting in return health care with no other out-of-pocket cost. The taxes ARE the costs in that model, as far as the citizen is concerned.

In other words, will the total cost to your average middle-class person on say.. an annual basis in terms of taxes paid for a single payer system be more or less than what they currently pay in health insurance premiums, copays, deductibles and out-of-pocket fees?

And if the answer is yes, then it's going to be a hard sell. In effect, you're costing people more money out of pocket than before for two things that *most* people don't actually see any advantage from- helping the un/underinsured, and situations that are theoretical for most people for the time period where this would differ significantly from Medicare.

You're effectively saying "Pay more money for other people who you don't know or care about, and also so *if* something dire happens, you're better off than you would have been. Oh, and it'll be less of a pain in the ass... we think."

Now if the total tax increase is less than most people pay out in terms of copays, deductibles, out of pocket, etc... then that would probably be an easy sell, if the standard of care, ability to choose, and ability to get scheduled is still there as it is today. But that's a big "IF"- there are a lot of variables that might preclude you from seeing your current doctor in a timely fashion under a single-payer system.
  #104  
Old 02-26-2020, 05:02 PM
doreen is online now
Charter Member
 
Join Date: Dec 1999
Location: Woodhaven,Queens, NY
Posts: 6,945
Quote:
Originally Posted by bump View Post
Now if the total tax increase is less than most people pay out in terms of copays, deductibles, out of pocket, etc... then that would probably be an easy sell, if the standard of care, ability to choose, and ability to get scheduled is still there as it is today. But that's a big "IF"- there are a lot of variables that might preclude you from seeing your current doctor in a timely fashion under a single-payer system.
Can you describe some of those variables - because right now, in a not single-payer system, I hear people talking about being unable to get in to see their primary doctor within a week when they are sick. I don't know why they have this problem - but if the issue is that there is there is only one doctor for 11,000 square miles, I don't see that getting worse with single-payer. I can't imagine that in a country with a single-payer system there will be more doctors that don't participate in the single-payer plan and will rely on self-pay patients- we have doctors like that now, but not that many who don't take any insurance (except in specialties that are not typically covered by insurance). There will no longer be doctors who participate in eleventy-billion insurance plans but either stopped taking mine since my last visit or never took mine to begin with.

The only variable I can truly see is that some people have unrealistic expectations of what "seeing your doctor in a timely fashion means". Because while some people complain that they can't see their primary doctor within a week when they are sick, others complain that they can't call on Monday to get an appointment for the camp physical on Tuesday that is due back to the camp on Wednesday.
  #105  
Old 02-26-2020, 06:21 PM
Northern Piper is online now
Charter Member
 
Join Date: Jun 1999
Location: The snow is back, dammit!
Posts: 30,705
Quote:
Originally Posted by bump View Post
But that's a big "IF"- there are a lot of variables that might preclude you from seeing your current doctor in a timely fashion under a single-payer system.
Can you be more specific? Like Doreen, I’m curious what are the «lot of variables» in a single-payer system that you believe prevent you from seeing a doctor in a timely fashion. What specifically do you have in mind?
__________________
My great-grandparents came through emigrating to a new country.
My grandparents came through the Great War and the Great Depression.
My parents came through the Great Depression and World War II.
We will come through this pandemic. Hang on tight to the ones you love.
  #106  
Old 02-26-2020, 08:41 PM
Voyager's Avatar
Voyager is offline
Charter Member
 
Join Date: Aug 2002
Location: Deep Space
Posts: 47,479
Quote:
Originally Posted by Tim R. Mortiss View Post
This only makes sense if you believe that inserting the government into the equation does not decrease the overall efficiency of the system. Most conservatives, having a healthy distrust of government, do not buy that assumption in the slightest.
Hope your mind doesn't explode when you go on Medicare. I had a top notch private plan, damn good, but Medicare is even better.
Plus I don't get five letters at the beginning of each year telling me to certify that my wife doesn't have insurance. I respond to each one, but I guess they were hoping.
  #107  
Old 02-26-2020, 08:45 PM
Jophiel's Avatar
Jophiel is offline
Guest
 
Join Date: Mar 1999
Location: Chicago suburbia
Posts: 19,855
I voted that mine is "okay" but I'd happily drop it in an instant. Having "okay" insurance is still a big financial drain.

The only "great" insurance we ever had was when my wife was a department manager at a hospital.
  #108  
Old 02-27-2020, 02:04 AM
nelliebly is offline
Guest
 
Join Date: Jul 2017
Location: Washington
Posts: 2,830
Quote:
Originally Posted by Tim R. Mortiss View Post
This only makes sense if you believe that inserting the government into the equation does not decrease the overall efficiency of the system. Most conservatives, having a healthy distrust of government, do not buy that assumption in the slightest.
You think there's no inefficiency now? Think of the work your doctor's office has to do for insurance claims. First there's the receptionist who checks if you have insurance, makes a copy of your card and ID, and gives you a form allowing the office or hospital to bill insurance. Then there are people in the back office who file the claim, which entails, among other things, determining the code number for each of the charges. These folks also deal with insurance companies' questions or issues with claims. Then you have bookkeepers and others who process insurance payments and bill patients for what's not covered.

Pretty inefficient.
  #109  
Old 02-27-2020, 08:58 AM
Living Well Is Best Revenge is offline
Guest
 
Join Date: Apr 2011
Location: Memphis, TN
Posts: 3,479
Quote:
Originally Posted by Tim R. Mortiss View Post
This only makes sense if you believe that inserting the government into the equation does not decrease the overall efficiency of the system. Most conservatives, having a healthy distrust of government, do not buy that assumption in the slightest.
Yes, the open market has done a wonderful job
  #110  
Old 02-27-2020, 10:18 AM
Ashtura is online now
Guest
 
Join Date: Aug 2003
Posts: 2,800
My employer provided insurance is just sort of... there. I don't think about it all that much which would mean I don't love it.

I've always had employer provided insurance so I'm sure I take it for granted. I'm sure I would miss it if it wasn't there.

Last edited by Ashtura; 02-27-2020 at 10:19 AM.
  #111  
Old 02-27-2020, 11:35 AM
bump is offline
Guest
 
Join Date: Jun 2000
Location: Dallas, TX
Posts: 19,390
Quote:
Originally Posted by doreen View Post
Can you describe some of those variables - because right now, in a not single-payer system, I hear people talking about being unable to get in to see their primary doctor within a week when they are sick. I don't know why they have this problem - but if the issue is that there is there is only one doctor for 11,000 square miles, I don't see that getting worse with single-payer. I can't imagine that in a country with a single-payer system there will be more doctors that don't participate in the single-payer plan and will rely on self-pay patients- we have doctors like that now, but not that many who don't take any insurance (except in specialties that are not typically covered by insurance). There will no longer be doctors who participate in eleventy-billion insurance plans but either stopped taking mine since my last visit or never took mine to begin with.

The only variable I can truly see is that some people have unrealistic expectations of what "seeing your doctor in a timely fashion means". Because while some people complain that they can't see their primary doctor within a week when they are sick, others complain that they can't call on Monday to get an appointment for the camp physical on Tuesday that is due back to the camp on Wednesday.
What I'm seeing happen is a large surge in people who were un/underinsured and/or those for whom a copay or deductible visit was a hardship showing up to the doctor in the first place, or much more often than they used to.

I mean, I have known a lot of reasonably well off, but not financially flush people who avoided going to the doctor until they were sure they were well and truly sick, because they didn't want to pay the $35 copay or for a visit outright if they had a high deductible plan. Under a single-payer system, they'd likely go more often as there would be no impact to their finances.

Meanwhile, the number of doctors will continue to decline, meaning that the ones that are left will be at capacity. And that doesn't consider the number that will go self pay-only (assuming they can in the first place- having the whole self-pay option sets back up for insurance and undermines the single-payer system).

This tracks with what someone was saying in a thread somewhere around here about the situation in his part of Canada- you could get seen for free, but it wasn't necessarily convenient or timely.

The other things I foresee is much higher (and probably mandated) use of mid-level providers, which some people are fine with, and others are not. I mean, I don't have a problem seeing a PA or NP for a cold or sinus infection or whatever other routine illness I might have, but some people want to see an honest-to-God doctor for everything, and if they're essentially forced to see PAs and NPs for minor stuff, they're going to view that as crappy.

The other thing that bears mentioning is that the burden of proof is on the side of the UHC proponents- that's basically what I've been trying to say the whole time. I'm actually for UHC, but I think they've got a very steep uphill fight right now.

Last edited by bump; 02-27-2020 at 11:36 AM.
  #112  
Old 02-27-2020, 09:50 PM
actualliberalnotoneofthose is offline
Guest
 
Join Date: Dec 2012
Posts: 2,602
Personally, I don't like referring to subsidized employer provided insurance as "private." To me, private insurance is the insurance you go and purchase without employer or tax-subsidies.
  #113  
Old 02-28-2020, 12:08 AM
needscoffee is offline
Member
 
Join Date: Oct 2009
Posts: 7,582
Quote:
Originally Posted by bump View Post
Meanwhile, the number of doctors will continue to decline, meaning that the ones that are left will be at capacity. And that doesn't consider the number that will go self pay-only (assuming they can in the first place- having the whole self-pay option sets back up for insurance and undermines the single-payer system)
Doctors say that the reason they don't like doctoring anymore is that have spend so little of the time actually doctoring; they spend very little time with patients and most of their time dealing with paperwork and red tape to justify to insurance companies what they're doing. And they have to pay for any number of staff to handle the insurance billing. Taking that off the table would certainly encourage the numbers of doctors to increase.
  #114  
Old 02-28-2020, 07:27 AM
Red Wiggler is offline
Guest
 
Join Date: Jul 2012
Posts: 2,171
Quote:
Originally Posted by needscoffee View Post
Doctors say that the reason they don't like doctoring anymore is that have spend so little of the time actually doctoring; they spend very little time with patients and most of their time dealing with paperwork and red tape to justify to insurance companies what they're doing. And they have to pay for any number of staff to handle the insurance billing. Taking that off the table would certainly encourage the numbers of doctors to increase.
Also, there's no reason that a nation-wide commitment to universal health care couldn't include additional low-cost training. The citizenry needs tens of thousands of primary care physicians, trained people who can deal with the common ailments and recognize when they have to kick more complicated cases upstairs. And it could still be a good six-figure career for the people who take advantage of that training.

It can become a priority if we make it a priority.
  #115  
Old 02-28-2020, 08:58 AM
bump is offline
Guest
 
Join Date: Jun 2000
Location: Dallas, TX
Posts: 19,390
Quote:
Originally Posted by needscoffee View Post
Doctors say that the reason they don't like doctoring anymore is that have spend so little of the time actually doctoring; they spend very little time with patients and most of their time dealing with paperwork and red tape to justify to insurance companies what they're doing. And they have to pay for any number of staff to handle the insurance billing. Taking that off the table would certainly encourage the numbers of doctors to increase.
Based on my experience in the health care industry, it's not so much the insurance directly, but rather that doctors have to spend a bunch of time dicking around with stuff like electronic health records- entering CPT and ICD10 codes for the actual doctoring they did, as well as notes, orders for labs and procedures, and prescriptions. In many cases that stuff can take 2x the time or more than the actual clinical visit.

All that's necessary for insurance coverage, and I'm 100% certain that won't go away under UHC.

Another consideration is that over some time frame, there'll almost certainly be new reporting requirements and/or system interface requirements under UHC, as the government is going to want to collect "big data" about health care for analysis and optimization in a way that they currently can't under the current regime. That stuff costs pretty big money- who's going to pay? The doctors?
  #116  
Old 02-28-2020, 09:42 AM
BwanaBob's Avatar
BwanaBob is online now
Member
 
Join Date: Feb 2003
Location: Maryland
Posts: 4,348
I have great insurance but I think the concept of a copay sucks and would prefer a Canadian style system.

I feel the argument that people would use doctors more without a copay is ridiculous. I have never met anyone who "enjoys" going to the doctor. I wouldn't go any more often if I had zero copays. I go when I'm truly concerned about something.

We don't treat the military, police departments, fire departments and public schools as profit making centers and neither should we treat healthcare that way. These are all entities that keep the population at large from harm.
When we have a safe, secure and healthy populace all other business can maximize its profits.
__________________
Go wherever you can be
And live for the day
It's only wear and tear
-IQ
  #117  
Old 02-28-2020, 01:53 PM
Manda JO is online now
Charter Member
 
Join Date: Jul 1999
Posts: 11,909
Quote:
Originally Posted by BwanaBob View Post
I have great insurance but I think the concept of a copay sucks and would prefer a Canadian style system.

I feel the argument that people would use doctors more without a copay is ridiculous. I have never met anyone who "enjoys" going to the doctor. I wouldn't go any more often if I had zero copays. I go when I'm truly concerned about something.
But would you go less if every time you went, it cost you $150? I know I would go to the doctor a little more often--maybe 1-2 times a year for the family--if I had a copay, and not a high deductible. I would expect there to be a lot more doctor visits if people on high deductible plans or no plan suddenly had the option to go for less. But that's not an argument against MCA.
  #118  
Old 02-28-2020, 02:04 PM
Pantastic is offline
Guest
 
Join Date: Sep 2015
Posts: 4,846
I wonder how many people who 'love' their private insurance have tested it - have they done something like gotten a Coronavirus test because they came back from China, and had a reasonable charge? The guy in Florida who tried to be responsible got billed $3200 by the hospital, of which $1400 he had to pay after insurance. I think a lot of people that 'love' their health coverage have not had to deal with things more complicated than basic doctor's office procedures and specialist tests. My experience is that dealing with something serious or non-standard done results in a whirling miasma of 'hopefully this is covered' where you find yourself making lots of payments for hundreds or thousands of dollars without really knowing what it's for or if it's the final cost.
  #119  
Old 02-28-2020, 02:53 PM
doreen is online now
Charter Member
 
Join Date: Dec 1999
Location: Woodhaven,Queens, NY
Posts: 6,945
Quote:
Originally Posted by Manda JO View Post
But would you go less if every time you went, it cost you $150? I know I would go to the doctor a little more often--maybe 1-2 times a year for the family--if I had a copay, and not a high deductible. I would expect there to be a lot more doctor visits if people on high deductible plans or no plan suddenly had the option to go for less. But that's not an argument against MCA.
I might go less if I had to pay $150 each time* , but bump was talking about people going to the doctor less often because they have a $35 copay as well as people avoiding doctor visits because they would have a high deductible plan. I don't think a $35 copay is keeping anyone from the doctor - if you're inclined to go every time you sneeze, it might but I suspect there are other issues that keep people from seeing the doctor for every sneeze.






* And I say might because my primary no longer accepts my insurance and it costs $70 each time I go rather than my $20 copay. I still go the same 3-4 times a year as I did when he accepted it. If he raised the price to $150, I'd still go the same 3-4x and if there was no copay I wouldn't go any more frequently. The cost is not the reason I go 3-4x a year. I need blood tests 3x a year and most years I don't come down with any illnesses that aren't self-limiting.
  #120  
Old 02-28-2020, 04:03 PM
Moriarty's Avatar
Moriarty is offline
Guest
 
Join Date: Jun 2007
Location: Denver, CO, USA
Posts: 3,319
Quote:
Originally Posted by bump View Post
You still didn't answer my question, and went off on a right/wrong tangent. Can it be funded without raising taxes on people or not?
It will require raising taxes.

Now, if that's as far as you inquire, that might sound scary, or bad, or wasteful, or unfair, or whatever. And because too many Americans are mental incompetents, politicians therefore fear telling you this.

But, yes, it will require raising taxes.

However, and as proponents say repeatedly, it will lower overall costs.

How is that possible, some might ask, because they know that raising taxes actually results in people paying more money.

Well, the answer is people will no longer have to pay insurance premiums, copays, or endure high deductibles, meaning it's a wash for the typical person.

The reason that this doesn't seem to resonate with enough people is because health insurance, insofar as it is usually wrapped into payroll, is obscured and hidden, even though it is an expense wholly unrelated to the relationship between you, your employer, and your job. Simply put, if people actually cut a check each month to their insurance company, and were being promised not to have to write that check each month, they might have a better perspective on how a bump in taxes compares to overall costs.

It is important to add, though, that this comparison should not be the sole basis for considering a medicare for all type system.

Other benefits of such a system relate to a lowering of overhead and costs for doctors (who are relieved of the arcane system of navigating insurers) while also improving services for patients (who are no longer faced with whether a medical provider is 'in network').

And for those who are concerned about 'death panels', I'd suggest that you've just described what insurance companies already do: ration care despite what a doctor and patient decide is necessary. Under a universal system that is not profit driven, that death panel is disbanded.
  #121  
Old 03-02-2020, 08:42 AM
bump is offline
Guest
 
Join Date: Jun 2000
Location: Dallas, TX
Posts: 19,390
FTR, I'm not arguing against UHC. I'm pointing out things that politicians who are championing it will have to solve and/or address before it'll be a saleable product to the US populace. Raising taxes and lowering costs is all well and good, but the only costs the general public cares about are THEIR out of pocket costs- in other words, at the end of the year, am I going to pay more or less of the money I worked for on health care?

Most people also don't care about lowering overhead or whether or not it provides better care to other people. They're mostly concerned with out of pocket costs and whether or not they'll be able to visit the doctors they choose/facilities they choose, in a timely fashion. All the rest is noise that they don't care about. And why would they? It doesn't affect them.

So politicians, IMO, need to address those things first and foremost to get the population on board- this nonsense of saying "But it's better!" and then handwaving the rest away isn't going to cut it when they actually try and pass legislation that requires public buy-in.
  #122  
Old 03-08-2020, 08:15 AM
Northern Piper is online now
Charter Member
 
Join Date: Jun 1999
Location: The snow is back, dammit!
Posts: 30,705
Quote:
Originally Posted by bump View Post
What people fear about single payer health care is that it will cost more, reduce choice, and depersonalize the process.
Frankly, from your description of your system, I can't see how anyone can think your system costs less, has more choice, or is more personalized than a single-payer. I'm going to comment on your posts, but not in quote boxes; don't want any suggestion that I'm tinkering with stuff in quote boxes, per board rules. My comparison is the Canadian single-payer system; can't comment on how others would work, since I don't know.

bump: "As US health insurance goes, mine is ok to good. I pay about $600 a month with a 1500 individual/3000 family deductible, so it's not terribly expensive as such things go."

My costs are my income taxes. Various studies over the years have shown that the tax levels in Canada and the US are roughly proportionate. I've cited them before when this question has come up. When you mention the costs of your health insurance, that's on top of your taxes, correct? Of which a substantial portion goes to support the health-care industry, higher than any other OECD nation, on a GDP basis/share of public expenditure. You're also not including the cost to your employer. I realize that you're replying to the poll, but in any comparison to single-payer, those factors have to be taken into account.

bump: "It's through a major insurer, so the negotiated rates are pretty good and the network is pretty large."

My rates are zero, and my network is very large: all doctors and hospitals in Canada, anywhere. My health card is good anywhere in my province. If I'm in another province, I'm still covered by my home province's system. If my home province has negotiated a reciprocal payment agreement with another province, I just have to show my health card in that other province and don't pay any cost. If there isn't a reciprocal agreement, I may have to pay in the other province, but then get fully reimbursed by my home province.

bump: "What I don't like is the general pain in the ass actions required to navigate the system and get the best outcomes. It's not unique to my insurance- it's the way all of them are. They may require a certain test to be run before they'll ok a different one, even if your doctor has an educated hunch that it's your gallbladder and not your colon. Or your doctor may want to prescribe you one hypertension medication, but they require them to prescribe some first-line drug off their specific formulary and prove that it doesn't work before they'll pay for the second one that your doctor actually wants."

There are no similar restrictions on a doctor's professional judgment in the Canadian system. Once a procedure or treatment is on the overall framework agreement between the province and the doctors, any doctor can order a treatment within that doctor's expertise. There is no government official or insurance adjuster who can second-guess the doctor's professional judgment.

bump: "Or you may end up in the ER needing emergency surgery and later get a bill finding out that the guy who the hospital assigned to you isn't actually in-network, despite the hospital itself being in-network."

No such thing in our system. All doctors in Canada are "in network" to use the US phrase, and there is no billing of patients.

bump: "And having to argue that point with them that you had no choice in the matter- it's not like you could go home and research and come back a week later for the emergency surgery."

No equivalent here. Arguing with a faceless bureaucrat of an insurance company in that situation sounds horrible and very depersonalising.

bump: "Or having a test done in an in-network facility for an in-network doctor, and getting a $200 bill, because the price of the test was $750, the negotiated rate was $225, and the insurance portion is $25, leaving you on the hook for the other $200 because your deductible hasn't been met."

Tests ordered by a doctor are covered by the provincial medicare system.

bump: "It's all that crap that drives people insane."

Certainly can understand that.

But that's my basic point. If you have that kind of system, single-payer doesn't cost more, reduce choice, or is more depersonalized. I would say it's just the opposite: the US system costs more, reduces choices and is more impersonal.

• The most basic point from a health-care perspective is that a doctor in a single-payer on the Canadian model has greater professional discretion to treat patients than do doctors in the US.

• The implementation of a profit motive through giving insurance adjusters the power to veto treatment ordered by doctors reduces doctors' independence.

• The whole concept of in-network reduces your choice.

• The fact that your health-care is tied to your employer reduces your freedom of employment. Frankly, it sounds like medieval serfs, who were bound to the land of the lord, and couldn't leave without great personal risks.

• The power of the insurance adjuster depersonalizes the medical care, since ultimately, choice of treatment is not left to you and your doctor; it's left to a faceless bureaucrat, whose motivation is to cut costs and increase profits.

Quote:
Originally Posted by bump View Post
Proponents need to gin up a bunch of examples, or maybe a website that would explain how it would be cheaper for your average middle-class family of four making about $70-80k a year, and how it won't prevent them from seeing the doctors they like, when they like, etc... Nobody's quite stupid enough to think it'll be absolutely free for anyone, except maybe the indigent, but proponents do need to show that whatever tax increases will be necessary will offset the aggregate premiums, copays and deductible payments for most people.
Here, I'm in full agreement with you. It's impossible to say in the abstract how much any single-payer system will cost, until you have a very detailed plan. Will it be cost-shared between the federal and state governments? Will there be a payroll tax? How will the payment schedules for doctors be negotiated and by whom? Will there still be a private option?

Those are all key questions, and can't be answered in the abstract.

And, posters like XT, survinga, shodan and ultra vires have done a very good job over the years of pointing out that one of the high costs of the US system is doctors' compensation rates. That can't be changed overnight; it's a baked-in cost that has to be dealt with. A proposal that cuts their compensation as of X date just won't fly. Doctors are a well-connected lobby group, and their buy-in is needed. (Aneurin Bevan, the minister in the British government who implemented the NHS, was asked how he got the doctors' agreement. His reply: "I stopped their mouths with gold.")

The most that can be expected is a gradual "bending of the curve" to reduce the rate of increase. That's a long-term change, not an immediate one.


(I won't originally going to respond to this post, because the thread was a poll of US dopers, but since the thread's gradually morphed into a a general discussion of single-payer v the US system, I thought I would do so.)
__________________
My great-grandparents came through emigrating to a new country.
My grandparents came through the Great War and the Great Depression.
My parents came through the Great Depression and World War II.
We will come through this pandemic. Hang on tight to the ones you love.
  #123  
Old 03-08-2020, 01:41 PM
Mangosteen is offline
Guest
 
Join Date: Jul 2005
Location: Namche Bazaar
Posts: 2,710
So far the Poll on this decidedly left leaning website is 144 people like or, at least, are satisfied with their Private Healthcare situation vs 43 who are not satisfied with it.

Rather surprising and not a good sign for Single Payer.
__________________
Its only funny until someone gets hurt, then its fuckin' hilarious!
  #124  
Old 03-08-2020, 03:44 PM
Voyager's Avatar
Voyager is offline
Charter Member
 
Join Date: Aug 2002
Location: Deep Space
Posts: 47,479
Quote:
Originally Posted by Mangosteen View Post
So far the Poll on this decidedly left leaning website is 144 people like or, at least, are satisfied with their Private Healthcare situation vs 43 who are not satisfied with it.

Rather surprising and not a good sign for Single Payer.
Not surprising at all. Ask anyone who has bought a product, and odds are they will be satisfied with it. Endowment effect and cognitive dissonance. If you weren't satisfied, then you should do something, so to prevent that you tend to feel satisfied.
Plus we don't know how much respondents used the system. Easy to feel satisfied if all you do is visit the doctor for a checkup or a cold. Big items are the test.
Also, the poll did not include options for public single payer plans, like Medicare. Satisfaction with those tend to be higher than satisfaction with private plans. I had an excellent private plan, but Medicare is even better.
And it also did not include those who can't afford a plan.
So the results are not that good - not that a poll here means much.
  #125  
Old 03-08-2020, 04:56 PM
Broomstick's Avatar
Broomstick is offline
Charter Member
 
Join Date: Mar 2001
Location: NW Indiana
Posts: 30,040
Quote:
Originally Posted by Mangosteen View Post
So far the Poll on this decidedly left leaning website is 144 people like or, at least, are satisfied with their Private Healthcare situation vs 43 who are not satisfied with it.

Rather surprising and not a good sign for Single Payer.
Not necessarily, because the question wasn't about single payer.

I'm OK with my current insurance but if the US could convert to a system like Canada or the UK I'd go with it in a heartbeat because I believe it would be a much better thing than what I currently have.
  #126  
Old 03-10-2020, 10:41 AM
Doug K. is offline
Guest
 
Join Date: Jul 1999
Location: Hutchinson, KS
Posts: 4,132
Quote:
Originally Posted by Pantastic View Post
I wonder how many people who 'love' their private insurance have tested it - have they done something like gotten a Coronavirus test because they came back from China, and had a reasonable charge? The guy in Florida who tried to be responsible got billed $3200 by the hospital, of which $1400 he had to pay after insurance. I think a lot of people that 'love' their health coverage have not had to deal with things more complicated than basic doctor's office procedures and specialist tests. My experience is that dealing with something serious or non-standard done results in a whirling miasma of 'hopefully this is covered' where you find yourself making lots of payments for hundreds or thousands of dollars without really knowing what it's for or if it's the final cost.
Raises hand. Twice. My wife had a stint in ICU with a brain hemorrhage followed by another stay in ICU with blood clots in the lung. Then colon cancer for me 6 years later. BCBS took care of us nicely, though in my case I also had a <$20.00/month cancer policy. I think it passed the test quite easily.
  #127  
Old 03-10-2020, 11:13 AM
Ann Hedonia's Avatar
Ann Hedonia is offline
Guest
 
Join Date: Apr 2009
Posts: 3,925
I like some things about my private insurance and hate other things about it.

First, I’m 62 and not employed. There are no good options for insurance. And technically, I don’t have insurance. I have a “health care benefit plan”.

I’ve only used my health care plan once. Basically, the plan gives you a debit card to use for health care, much like some HSA’s. And they have a price schedule based on the going rate in your area.

You go to the doctor and pay on the spot with your card. Then you sent the health plan the bill and you are credited ,according to their schedule, an amount equal to 80% of the going rate. The difference is your coinsurance. But if you can find a lower price for the service, you pay less out of pocket. If you find a really good price for the services, you can pocket the difference.

I like this plan because, even though I’m being reimbursed, the doctor THINKS I’m paying out of pocket. And they don’t pad the visit with unnecessary bullshit. And it gives me cover to question the necessity (and the price) of everything.

Once my annual expenses go over 10K, they reimburse the full value, not 80%. In the unlikely event that happens they will cancel me next year, I’m sure.

I don’t like this plan, though. I just like it better than the other options for me, all which had deductibles of 7500 or more.
  #128  
Old 03-10-2020, 02:59 PM
Pantastic is offline
Guest
 
Join Date: Sep 2015
Posts: 4,846
Quote:
Originally Posted by Doug K. View Post
Raises hand. Twice. My wife had a stint in ICU with a brain hemorrhage followed by another stay in ICU with blood clots in the lung. Then colon cancer for me 6 years later. BCBS took care of us nicely, though in my case I also had a <$20.00/month cancer policy. I think it passed the test quite easily.
What do you mean by 'took care of us nicely' exactly? Did they tell you up front what your expenses would be and stick to that, or did you just keep getting bills from various bits of the hospital and it wasn't entirely clear when you'd be paid up on them? Because I also have BCBS, and for a much less severe procedure (technically surgical, though there was no cutting) I never got a clear answer on what it would cost, and just had bills turn up for a while. I don't consider the weird non-answer on the cost of the procedures and treatment, or the fact that it cost me a couple of thousand dollars in the end (instead of being, well, insured) to be 'taken care of nicely'.
  #129  
Old 03-11-2020, 09:31 AM
Doug K. is offline
Guest
 
Join Date: Jul 1999
Location: Hutchinson, KS
Posts: 4,132
Quote:
Originally Posted by Pantastic View Post
What do you mean by 'took care of us nicely' exactly? Did they tell you up front what your expenses would be and stick to that, or did you just keep getting bills from various bits of the hospital and it wasn't entirely clear when you'd be paid up on them? Because I also have BCBS, and for a much less severe procedure (technically surgical, though there was no cutting) I never got a clear answer on what it would cost, and just had bills turn up for a while. I don't consider the weird non-answer on the cost of the procedures and treatment, or the fact that it cost me a couple of thousand dollars in the end (instead of being, well, insured) to be 'taken care of nicely'.
I mean that even though I fully expected (and was cool with) having to pay my full out of pocket maximum for my policy that year, by the time the smoke cleared my cancer insurance reimbursed me not only for what I'd paid out of pocket to the hospital and the clinic where I did my chemo, but also made up for my lost wages (I used up all my paid time off the first month I was diagnosed, and missed about 4 days a month for the next 5 months) and many of my day to day expenses that I would have had cancer or not.
  #130  
Old 03-11-2020, 03:21 PM
robby's Avatar
robby is offline
Charter Member
 
Join Date: Dec 2000
Location: Connecticut, USA
Posts: 5,771
I selected: "I have employer provided private insurance – I love it" mainly because I think I am fortunate to have very good insurance when compared to others in the U.S. Nevertheless, it's overstating to actually say I truly "love it" because of some negatives as well.

I currently pay about $450/month for family health coverage. There are no deductibles for in-network care. Excellent selection of health care providers, because it's a major insurance complany. Co-pays are minimal (ranging from $20 for office visits to $250 for hospitalization). No charge for preventative care.

My employer plan is better than anything offered at my wife's work (and she works for the federal government). My 23-year old son is also still on my plan, because my employer's plan is better than his. (Under the current rules, he will have to switch to his own employer's plan when he turns 26.) FWIW, my wife is also eligible for Medicare, but she has not yet signed up because my employer health care is better.

My plan has been put to the test: it paid for my wife's hip replacement and back surgery, and we only paid $250 for each.

Now the negatives: our rates have risen precipitously. We are now paying more than three (3) times what we were paying back in 2012 (which is as far back I have data).

Also, they keep dropping drugs from their formulary, requiring us to repeatedly switch drugs, even ones that we have been using for years (like for hypertension and cholesterol). Also, they refused to pay for a common steroid cream for a severe poison ivy rash I got last year because the urgent care doctor didn't prescribe some other steroid that they insisted be tried first. (How was the urgent care doctor supposed to know this?)

Finally, I will of course lose all this if I ever leave my job.

But all in all, these are fairly nitpicky stuff in the grand scheme of things. As I stated above, I think our insurance is much better than the average, and fear that any government-run single-payer coverage would be worse than what we currently have. I would therefore support “Medicare, For All Who Want It,” but would not support getting rid of private health insurance -- at least for now. My opinion may well change if my health coverage rates get high enough and/or benefits decrease, or if we get switched from a PPO to an HSA/high-deductible plan.
  #131  
Old 03-12-2020, 10:58 AM
Red Wiggler is offline
Guest
 
Join Date: Jul 2012
Posts: 2,171
Quote:
Originally Posted by robby View Post
Finally, I will of course lose all this if I ever leave my job.
This doesn't appear to be a nitpicky thing as the nature of our economy continues to evolve.
Reply

Bookmarks

Thread Tools
Display Modes

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 Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 08:33 AM.

Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2020, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@straightdope.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Copyright © 2019 STM Reader, LLC.

 
Copyright © 2017