Ask someone on Medicare. Then extrapolate to everyone.
Fwiw in a single payer system there shouldn’t be anymore in network or out of network coverage issues. All providers should be in network.
Personally I doubt we get true uhc anytime soon (uhc doesn’t have to be single payer, but it does have to all but eliminate uninsurance and under insurance). We could build a true uhc system by expanding the ACA. But I doubt we do.
Voters are too divided by race and politicians are too enamored of the rich. I personally am predicting true uhc starts on the state level in the 2030s (in a blue state) and goes national in the 2050s.
But … American exceptionalism! We’re just *different *! In some undefinable way that invalidates the experiences of entire rest of the world, but different! So there.
Would that even be possible without the resources and existing infrastructure of the federal government? And if so, why would a small blue state wait that long? Seems like a perfect “experiment” for an Oregon or a Connecticut.
WADR I don’t think this addresses the issue. Which of the options should we implement? If it is going to be cheaper, we will need to spend less than we do now. If we are going to spend less than we do now, where specifically do we cut?
Is the model we adopt Medicare for All? That means that doctors and health care providers and drug companies will experience a 25-40% cut in their payments. According to reports by the Urban Institute and the Mercatus (sp?) Institute, a doubling of federal personal and corporate taxes will not be enough to cover the cost of M4A, even if nobody has to pay insurance premiums. And those reports assume that we do, in fact, cut payments to health care providers by 25-40%. So the model for M4A would not be cheaper. Americans would have to pay more in taxes than they do now in premiums. Which is probably part of what the respondents to the survey I cited had in mind.
Better and cheaper would be great. But that is something that needs to be shown, not merely asserted.
Especially since premiums for the average American family have not, in fact, gone down by $2500 a year.
You think all the payments to insurers are passed along whole, without anyone taking a cut? Uh, no.
Are they assuming our current corporate welfare system stays in place, except without having any work to do? That’s how those numbers fit. I *would *say your devotion to preserving Aetna’s executive bonuses above all else is admirable, except it isn’t.
A. Where did you get that “promise”? B. When have insurance costs not gone up annually? C: How about if your party weren’t as successful as they have been in financially sabotaging ACA?
UHC didn’t work in Vermont, it just doesn’t work on a state level. It has to be national or nothing. On a state level, it simply invites exploitation from out-of-staters and also gets doctors and nurses to leave the state.
This, and all the profits skimmed by people who don’t contribute to patient care. Patients benefit from the services provided by doctors, nurses, therapists, technicians of various kinds, pharmacists, etc. What they don’t benefit from are the stockholders in Anthem, Aetna, Pfizer, and the stockholders of other insurance and big pharma companies. Those people could disappear and be replaced by a nonprofit federal agency and ordinary people wouldn’t be able to tell the difference.
That’s what I thought (though I’d forgotten about Vermont). I imagine there might also a degree of retaliation by insurers against multi-state providers: “Continue to do business in Oregon and we’ll have to take another look at our compensation policies in California.”
This is just total nonsense, on several levels. First of all medical innovation occurs worldwide; for example, as I noted elsewhere, the majority of companies developing innovative diagnostic imaging technologies like MRI scanners are not American – 7 or 8 out of the top 10 (depending on how you measure it) are European. Many of the major global pharmaceutical companies are European.
But the main point is that how the health care system is funded has absolutely nothing to do with medical innovation. Insurance companies contribute exactly nothing to medical research or innovation, or to anything else, for that matter. They’re essentially useless parasites, leeching off the health care system. Since you mention drug patents, we can take drugs as an example. The reason the US has ridiculously high drug prices compared to other countries is that other countries responsibly regulate prices and require justification for them. France has the Economic Committee for Health Products, the UK has the Pharmaceutical Price Regulation Scheme (PPRS), Canada has the Patent Medicine Prices Review Board. What does the US have? It has Martin Shkreli, who raised the price of an AIDS drug by more than 5,000% in 2015. It has Nirmal Mulye, founder and president of Nostrum Pharmaceuticals, who recently raised the price of an essential antibiotic 400% and claimed that it’s “a moral requirement to make money when you can” and “to sell the product for the highest price.”
Take a look at this graph and tell us again that you’re totally mystified why US health care costs are so astronomically high compared to all other countries. It’s certainly not because it’s “better”, because outcomes are similar and sometimes worse than in other developed countries. It’s certainly not because the cost of living is so much higher, because it’s comparable to that in other developed countries. It’s not because medical equipment is more expensive, because it all comes from the same places.
So what’s left? What are the key differences between health care in the US and in all other developed countries? The private health insurance industry is a plague on the entire health care system, creating massive unnecessary costs both directly and indirectly – directly, because of huge administrative costs at both the insurer and provider ends (it costs a lot of money to review and adjudicate each and every claim in an effort to try to deny it), and indirectly, in terms of the system that is necessary to support the private insurance model, including the lack of any means of cost control. This has been discussed more times than I can remember; stop trying to pretend that it’s some kind of incomprehensible mystery.
That’s an odd conclusion, because if you look at the graph linked above, the US already spends more public funds on health care per capita than most OECD countries, which manage with lesser public expenditures to have health care for all with the same or better outcomes.
Well it doesn’t lay out a detailed plan of how to get there no. I don’t think that’s the first step though.
any of them would be better.
that will be the end result, yes.
that’s cart before the horse. You don’t necessarily get to a more optimal end system by cutting anything that you have now. If I claimed that a UHC system would be $200 billion dollars a year cheaper, you shouldn’t be asking “OK, where do you want to make those $200 billion dollars of cuts”? That doesn’t get you there.
Your lying. You have no proof. Plain and simple. Also being damn rude.
Initially I was against it to. Its only after me talking to relatives who live in foreign countries and talking to people who’ve lived elsewhere do I support a government system.
Public sector spending already accounts for 71% of health care spending, at least in California (I’m guessing the rates are about the same in most other states, maybe a few % points lower in red states).
27% - medicaid
20% - medicare
12% - tax subsidies for employer based health insurance
4% - government employee health insurance
3% - county health programs
3% - VA
2% - ACA subsidies
In theory, you redirect that money into a single payer system, and just raise taxes a bit to replace the 29% in private spending.
However I don’t understand all the legal tricks to do this. I know you need federal legal waivers which obviously wouldn’t happen under Trump.
I think it’ll take until the 2030s because democratic politicians don’t want to offend the rich, and true UHC will offend the rich. So the democrats will pretend to support UHC, but always find some reason they can’t get it passed. Thats what is happening in California, the democrats have talked about medicare for all but only when they know they can’t get it passed. Gavin Newsom is putting on a show of passing medicare for all now that he knows Trump wouldn’t allow it.
It’ll probably take another 15 years for the public to catch on and demand better, or for some state to pass it via a ballot initiative (the Colorado single payer ballot intiative failed miserably).
I’m predicting in the 2030s, some states will pass UHC via ballot initiative. It may not be medicare for all, but it’ll be true UHC that eliminates uninsurance and underinsurance. Maybe half a dozen states pass that before a blue state passes it via legislation. After a dozen or so states have it via a mix of ballot initiatives and legislation, then it might become possible on the federal government. IT’ll be like marijuana legalization. Started on the state level as a ballot initiative, then became a blue state legislative agenda, then it will become a purple state legislative agenda, then a federal legislative agenda.
If employers were taxed at a level to match their current expenditures for employee health insurance, the individual tax increase could be a small bit - perhaps just a bit more than their current spending for premiums, co-pays and deductibles .
Vermont is too small to attempt UHC on it’s own. It be a different story if California or New York tried it (or even if all of New England banded together).
But Iceland is a sovereign country, not one of 50 states in a federal union. True, it is part of the EHIC scheme, which allows people from elsewhere in the European Economic Area to access its public medical care services while in Iceland, but there’s no great disparity in provision between EEA member countries, so there’s not so much in the way of “health tourism” for them to worry about.
That’s not correct, at least here in the UK. We have WPA, BUPA, PPP, and others.
This happened to me. The NHS assigned me to a practice and that was that. But if you’re ill and away from home you just go to the nearest chemist, pharmacy, walk-in centre, GP, or hospital as appropriate. Again, this happened to me. My uveitis recurred and I went to a pharmacy. They were unwilling to prescribe the medicine I needed so I went to the hospital, was seen, and that was that. No problem at all, just a lot of time.
This is a real concern here in Scotland with our remote islands. Technology - telephone and video calls - have made things much easier and in emergencies the air ambulance and RNLI (both of which I financially support) will help. But ultimately, it’s up to you to choose between your lifestyle and your health: living on Rockall (yes, I know) with a dicky heart is NOT a good idea. And don’t think private healthcare insurance will help - it’s simply not profitable for them to put a doctor and hospital on a small island. Unless, of course, you’re willing to pay their salaries (in which case you likely have a 7-figure income).