But doesn’t this cause the same issue that is the #1 complaint in the US? That the rich get to see fine doctors and specialists with little wait time while the remainder of us are in a cattle line waiting for the scraps?
Do you mean doctors should have to accept Medicare patients, or accept being reimbursed at Medicare rates? They’re not the same thing.
If you mean patients, doctors lose money on average on 65-80% of their Medicare patients. So the more Medicare patients they accept, the more money they lose. If you mean rates, then the more patients they treat, the more money they lose.
“Buy at seven, sell at five, make up the difference with volume” isn’t exactly a loophole.
Regards,
Shodan
This is something always overlooked in these Medicare threads.
I don’t think you stated it entirely correct, though. Doctors take Medicare patients because that is who the vast majority of sick people are: old people. They can supplement their income by taking Medicare. They make their money on private pay clients through insurance reimbursement rates. As most costs are fixed, they are then able to make a little bit on the lower Medicare rates.
If everyone was on Medicare, you are right, they would definitely go out of business.
But to the thread, my response in post #2 was what I thought the answer was. If a plan is out there to cover everything, and I mean everything, absolutely free at the point of payment, paid for by a tremendous tax increase to boot, why would I want to pay for private insurance? What would it be doing for me?
If the new health care is so bad that people would rather pay for something that is already “free,” then that seems like a bad plan.
Yeah, the current system is super garbage. That’s not to say that a public system is perfect btw, there will be people that get bad care in a public system. For example in Canada they are having issues with getting enough practicing doctors in rural areas of some provinces. Getting a family doctor can also just be generally tricky in some provinces even in a city.
Delivering healthcare to a population is hard. All I know is that the current “insurance” system is complete garbage. I would take the Canadian system in a second over what we have.
As for the OP, part of it is simple practicality. The money that employers are currently paying into those private insurance schemes is going to have to go into the public system.
Generally you are paying for perks. Better rooms, better food etc. In practice you can cover “everything” but not all supplied services are of the same quality level. Personally I have a high level of expectation for service in general and would gladly pay extra for more room, better food, better amenities etc. Why not make this a profit center to subsidize the care itself which is the same for everyone?
But then high risk people can’t get medical care at a price they can afford–and anyone can become high risk at any time through no fault of their own–simply by aging, if nothing else. Does your ideal low risk pool kick people out when they become high risk?
Those are the *policy *reasons. The *political *reason is that the private insurance companies are pretty generally hated, and proposing their elimination will get votes.
I only used the term “abolish” because that was the term used in the question at the first debate that made the headlines and started the recent discussion about the details of Dems’ healthcare plans. It was politically neutral on my end, though I can see now how it would be seen as inflammatory. Lester Holt isn’t exactly a right-wing pundit so it slipped through my connotation radar - though, looking back, I’m sure Holt intended it to be inflammatory.
Ok. Moving on. I still don’t understand how the pooled risk argument applies here. Here are the two options as I understand them:
-
MFA, no private insurance: Government collects x taxes and has to use it to pay for everyone’s healthcare.
-
MFA, private optional:. Government still collects x taxes but only has to pay for those who don’t opt for private.
Under Medicare the government wouldn’t really be “insuring” anything in the traditional sense, they would just be outright paying for it. There’s no need for risk mitigation except for budgetary purposes. What am I missing? <- That’s intended sincerely.
Well like we agreed yesterday, doctors are gonna take a shellacking. Going over some stats it appears that doctors in countries with socialized medicine make about 2/3 of what US doctors do. I don’t know what other reforms would be required to make it work but it does work elsewhere. I, for one, would welcome a new wave of doctors who are in it for service to society rather than the title and BMW. With places like NYU Medical School offering free tuition maybe we can at least move towards lowering the debt burden for young doctors.
I would think that those things would (or at least should) be so relatively inexpensive in comparison with buying an insurance policy that insurance wouldn’t be needed.
I mean, what are we talking about? An upgrade from baked steak to T-bone, or are we talking Gordon Ramsay sit down dining with fine wine (if your health permits)?
Private rooms meaning the same room which usually houses 2 patients now houses one, or are we talking the Four Seasons?
And wouldn’t these things be inversely proportional to your length of stay? If I have a minor health issue, I won’t be in the hospital long so a few nights wouldn’t be worth buying a policy, just paying as you go. Conversely, if I am so sick I am in there long term, I probably won’t be eating much or enjoying any extra amenities.
And I’ve always thought that hospitals could be more profitable by offering extra amenities. I mean, I’ve spent several nights in hospitals visiting people and when I want to eat, I have the same shitty cafeteria food and have to drive to a hotel (or usually motel) not affiliated with the hospital down the road. It would seem to be that a hospital could be profitable by operating a hotel on the grounds with restaurant options.
Any pooling at all is people not paying commensurate to their risk. You will never have two people with exactly the same risks of health costs, much less a “pool”. What you are advocating is getting rid of pooling altogether, and just paying it all on your own.
Otherwise, why should I, a 25 year old non-smoker with great genes who never does anything dangerous, pay for you, a 25 year old non-smoker with simply okay genes who occasionally goes for a hike at the local park(where you could have tree branch fall on you, or you could slip down a ravine)?
It’s not a matter of waiting in a “cattle line”, it is a matter of not even having a line to wait in. I have no problem with the wealthy getting “better” treatment, I only care about the minimum that is offered.
There are a number of savings involved as well. You don’t have to waste time coding your bills for different insurance companies, you don’t have to have a staff that deals with getting pre-approvals and remittances, and you don’t have the problem of people who cannot or will not pay their bills.
What do you mean by “everything?” Do you mena private rooms with a personal 5 star chef? I have no problem with a wealthy person having their own room and their own culinary expert, so long as they can find a bed for me when I need it.
Realistically the sky is the limit. I don’t understand why you think they would be relatively inexpensive. Imagine being in a ward with 6 patients behind curtains vs having your own spacious room with a nice marble shower. Massive difference in cost.
I would think a range of options up to and including four seasons level.
The insurance is just how employers would give this perk to employees. Health “insurance” now is more like a health maintenance plan anyway.
This does exist to some extent now.
So in the single example of real-world private insurance co-existing with UHC, it takes the form of what amounts to supplemental stuff.
That I could get behind; if someone’s willing and able to pay to get a private room, then maybe there could be private healthcare insurance available to help pay. Or if you wanted some procedure that’s not approved, or your doctor wants to prescribe you off-formulary medication, then private insurance could cover that.
Or even maybe to let people pay for more convenient surgery times or visit times… I wouldn’t have a problem with that either.
After all, the point of UHC isn’t to make it strictly fair and even, but rather to ensure that all residents get adequate health care, and aren’t financially destroyed by extreme healthcare events.
Faster cadillac service. Look both Canada and the UK have private insurance. There’s no reason to dump it.
And for most supporters MFA means just that= Medicare for all. Not a new cost free super expensive system.
Medicare, other than part A, has premiums. Affordable premiums, yes, but still they are there.
How can this be, when nobody would be paying anything?
Well, there’s also Medicare part C & D- “gap” and prescriptions. Both of which work very well (and profitably) for private insurers.
Also some people want and can afford private rooms, nurses, and the procedure done when they want it- sooner rather than later, and not during a planned vacation, for example.
If you can afford those, why not allow them to buy special insurance?
Why do you hate Humana?
Why couldnt they offer Gap insurance, drug or cadillac insurances?
Like birth control and abortions.
or is the plan that women have to seek out guys in alleys with coat hangers again?
I have Kaiser and I have never had that issue, not once in 20 years. Before kaiser, I had one issue like that. One. (They didnt want to cover the specialist, even tho he was at their office, and I had no way of knowing he was out of network. Eventually we settled)
We, today, pay the govt for part B. You pay a private insurer for parts C & D.
Now, apparently Sanders and maybe warrens ideas are not in any sense “Medicare for all” but another totally free and extremely expensive plan they have no solid details on.