Because (and I can’t believe I am taking THIS side) why should I have to wait 4 to 6 weeks for a procedure when a bed could be open sooner but for Scrooge McDuck taking up enough space in the hospital for 4 people?
It depends on what the private insurance is for.
There is “complementary” insurance. That will pay for procedures and treatments that are covered under the UHC plan, over and above the statutory rates. The advantage of this has been mentioned before - you can jump to the head of a queue, doctors will prefer to treat you over other UHC-only patients because they make more money, etc. The objection to this kind of insurance is that it’s not fair that the rich can buy their way to the head of the line. Complementary insurance is illegal in Canada, but is encouraged in Australia, both of whom have UHC. Go figure.
There is “supplementary” insurance, that covers things the UHC system won’t. Elective cosmetic surgery has already been mentioned. There is also stuff like dental insurance, which is sort of the same thing. A system where “absolutely everything is covered” - you are correct, nobody would want or need it. But, suppose there is some drug or treatment for your condition that works, say, 10% better but costs five times as much. And the UHC plan says “no, we won’t cover that - if you want treatment, you can use the cheaper drug and like it”. There might be a market for insurance that covers that.
Saying No is difficult and uncomfortable in health care. Because, supposing we implement UHC but it only covers things the government thinks are cost-effective - limited numbers of experimental treatments, lower cost but marginally less effective drugs, etc.
Sooner rather than later, there will some cute little white kid with some obscure disease and an experimental treatment for it that costs $250K. Immediately the family and the media go to work with appeals (“Don’t let little Justin die!”) and they will set up a GoFundMe page and also go to work on the politicians, pointing out all the while that funding the treatment will cost the average taxpayer less than the price of a cup of coffee per day. And then the politicians who want to get re-elected get going on a bill, called the Justin Unpronounceable Disease Act, funding the treatment and rush it thru, and all the politicians who are not incumbent point to the politicians who are and mention in their campaign ads that they are in favor of dead children in order to save coffee money.
And then Justin gets the treatment and dies anyway, and the act authorizing payment for the treatment still remains, or Justin gets better and they double the funding.
Lather, rinse, repeat, and your cost savings from UHC suffers the death of a thousand cuts.
The only realistic solution to the cost of health care, especially in the US but also in Europe, is rationing. And that means saying, “No. We would rather let your grandma/cute kid/you die, because we would rather not spend the money.”
That’s not always going to be true. Lots of countries spend less on health care and have comparable or better outcomes. That’s due to several factors - lifestyle, culture, the fact that a lot of health care spending doesn’t affect outcomes all that much - but mostly it is due to culture, where people don’t demand the level of health care they get in the US because they’re used to not getting it.
Whether that can be brought off in the US is not clear - probably not for fifty years or so, even if we implement UHC. Witness the Medicare Sustainability Act, passed with the worthwhile intent of limiting growth in Medicare spending. Which, for seven years running and with bipartisan support, never reduced Medicare spending by a single penny. Then it was thrown out altogether.
And here we are, proposing Medicare for All because it will cut spending back and limit its future growth.
And this time, we mean it!
Regards,
Shodan
Well, isnt Medicare part of the current system? I would like to see Medicare for all. However, as you must know, two parts of Medicare are covered by private insurers.
I have grave doubts as to sanders plan, whatever the hell it is, since he gives no real specifics.
I want MFA, but I see no reason to ban private insurance also.
Why couldnt there be the current gap and drug policies? Why not cadillac policies? I dont think anyone could “opt out” from MFA, so there is *no chance at all *of “private insurance carving out the most profitable group of people” since those people still would have to pay the extra taxes involved. Maybe they could skip part B, sure, like I do.
Because the wealthy should not be monopolizing the resources. Without that wealthy person taking up their space, then a 6 week wait becomes a 5 week 4 day wait.
If the wealthy jumping the line or getting better treatment while others are no longer able to access those resources at all, as in the current system, that is a problem. That the wealthy get better treatment at only a slight detriment to others is perfectly acceptable.
Once again, this is not about making sure that everyone is treated equally, only that everyone is treated at a minimum, adequately.
Everyone who has earned income pays for medicare.
Also would you rather have the people in charge of the rationing your healthcare see you as a voter they want to keep happy for the next election, or as a drain on their bottom line.
Because Scrooges hospital isnt open for you, anyway. It’s a private hospital.
This is an important point, and although this is Elections, my question here is GQ.
How do other countries deal with such a thing? Does UHC cover absolutely anything, I mean the latest and greatest, we will spare no expense to save you? I’m not talking about catered food and posh rooms. I mean a scenario where Joe Q. Citizen has a terminal illness. But there is this very expensive treatment that may save his life, may kill him, but the most recent and best studies show modest improvement. Does the government pay? Will our government pay under any of the Dem plans?
If not, where is the cutoff? Only if it doesn’t cost $X? Or if you aren’t older than Y? Or if your likelihood of survival is above Z? Who determines it?
Of course it’s not exactly, but actuaries can group people based on relative risk. The tighter the grouping, the more accurate the rating and thus premium in relation to risk.
My understanding is that Canada doesn’t allow private insurance for items that are covered in their UHC.
[/quote]
Canadians can purchase supplemental private coverage for services that are not covered by the public plan, but cannot purchase private insurance for basic services. As CBC News points out, private health insurance is “a crucial part of the system,” and Canadians spent about $43.2 billion on private coverage in 2005. Private insurance covers “anything beyond what the public system will pay for. For instance, should you have to spend some time in the hospital, the public system will cover the cost of your bed in a ward, which usually has three other patients. If you want a private room, the extra charge will come out of your pocket, unless you have extended health coverage either through your employer or through a policy you have bought yourself.”
Basic services are covered by the government precisely because the large risk pools allow the government to negotiate cheaper rates with providers and control health care costs. The government fears, with good reason, that if Canadians can leave the purchasing pools, the government’s market power would diminish./quote]
Do you think Medicare doesn’t require out of pocket spending?
There are many systems out there, but they pretty much have universal is that they have a list of covered procedures, and if a doctor orders that procedure, it is covered.
If there is a new, untested procedure, that may not be available, but often times, insurance isn’t going to cover experimental medicine either, and their view of “experimental” is far more judgmental than a UHC’s is.
Let me ask you this, who currently makes these decisions? Are you comfortable having your life in the hands of someone who sees the bottom line as the most important factor when considering whether or not to approve your treatment?
Again, I was only asking and I still am. A “list of covered procedures” really doesn’t answer the question because that list could be extensive or small.
But having worked in government before, I see little difference between a private company wanting to save money and a government bureaucrat wanting to show his or her higher ups how frugal the agency became once he or she “cut waste” from it. I think you have that everywhere, especially when the economy goes south. I’m sure that in a UHC you would have “little white Justin” stories like Shodan discussed.
And the most accurate would be having the tight group of having no pool at all. It’s a balance between accurately assessing risk, to ensure that everyone pays exactly their medical costs + overhead, vs spreading the risk around to make sure that no one ends up with a bill they cannot pay, or a life saving treatment they cannot have.
Towards the former basically gets rid of the idea of pools altogether, and the latter lends itself to suggesting a UHC.
If you work for a big corporation that offers healthcare, you are paying into a big pool. You are subsidizing others with more medical costs than you, and being subsidized by those with fewer. You are also subsidizing other employer’s families, or childless employees are subsidizing yours.
I’m sure it does. But does the proposed MFA require out of pocket spending?
*snip. Color me unimpressed. A “ward” with four patients? I get better than that. The poorest people on Medicaid get better than that.
I’m glad to hear that you’ve never had a health calamity. Your experience is not relevant to those who have.
They’re not going to pull all this nonsense for people going in for routine care, because that will lose them customers. They only pull it for the expensive customers, who they want to lose. When someone comes down with a chronic cancer or something, that’s when they suddenly decide that that impacted hangnail back in third grade was a pre-existing condition and they don’t have to cover anything.
Most people have never experienced this, because most people don’t suffer calamitous health issues (that fact being why insurance is even possible). And most people don’t pay attention to things that don’t happen to them. So most people think that they’re satisfied with their current insurance, because the nice lady on the phone sounds so friendly, and they didn’t give any trouble about covering that routine checkup. But insurance that will stop covering you as soon as you get expensive isn’t even insurance at all. And so most of those people who think they’re satisfied with their insurance, don’t even actually have insurance.
Yes, for basic “items that are covered in their UHC”. However, GB does allaow it.
There’s no risk of that, since all Canadians are taxed for it.
The covered lists are pretty extensive, and I’m certainly not going to even try to enumerate it. Basically, though, if it is a standard procedure, something that most doctors would agree is a reasonable treatment for a condition, it’s covered.
Those higher ups would be horrified if one of their underlings caused their constituents to not be covered for procedures in the name of “cutting costs”. We are the bosses of that hypothetical bureaucrat’s higher ups, and we will not be all that impressed.
OTOH, this is pretty standard practice in the private insurance system that we have now. Denying procedures to save money gets you a bonus. If this is actually a concern of yours, then you would be advocating for a UHC system of some kind, MFA or otherwise.
That’s how PPO’s can work. That’s not all all how HMO’s work. I had cancer. Kaiser covered it, fast, easy and cheap. No such thing as "out of service’ in a HMO.
I did read your whole post which I why I quoted your ending jibe rather than your initial qualifier.