If we cut dramatically what we spend on drugs, which we would have to do if M4A is going to work, then we would be giving something up - namely, expensive drugs that may or may not work better than a cheaper version. Hence my example of statin drugs. And I think, some people will react badly to that, just as they would if the doctor said they couldn’t have what they saw on TV. Certainly they do that now to some extent - it would just be somewhat more common, and for more commonly currently prescribed drugs, than it is now.
Something related is people complaining about doctors’ reluctance to prescribe opiates for pain. In that case it is because of fear of addiction rather than cost, but people still complain about it, and not always because they are drug-seekers.
We’d be giving up the expensiveness, which is mainly due to administrative bloat and rent-seeking. Only we are saddled with it, not the civilized world.
I can understand some people are wary of the government “running” health care. The government doesn’t know how, doesn’t have the expertise, goes the argument.
Either we all pay insurance companies for private care, or we all pay the government for public care (assuming a simplified one size fits all system).
Part of the money we currently pay insurance companies is for their profit.
Take out the profit by abolishing the insurers, and the overall cost for everyone is decreased.
The government hires the now out of work health care administrators, who presumably have some almost unfathomable, ultra-high competent level of expertise, to run the new M4A system, and
I have a union job. I get ~3% raise every year, unless there is a big spike in inflation. I didn’t get a raise due to the corporate tax cut, so I highly doubt I’d see a raise after UHC. OTOH, I make decent money and don’t have an issue with pay/raises.
My attitude is that I basically have achieved my idea of the American Dream, and what’s next is to arrange for everyone else to have it, too. So, my pointing out potential problems with rolling out UHC wasn’t to disparage the plan but just an attempt to “be real.” Maybe it Would end up costing me more. Depending on how big a sacrifice we’re talking, I might still support it since I pretty much “got mine.”
So yeah, if it turned out as rosy as you say, I’d support it for sure!
Also, another bit of skepticism that the plan is to slash pay for doctors and nurses. I am not an expert on all of this, but I thought savings would come from ending insurance profit margins and the bureaucratic redundancy in our current system. Plus maybe lower drug prices. I dunno. Is there a concrete M4A plan put forward, or can we all only speculate?
You must not be old enough to remember when pharma did not advertise prescription medications in/on popular media – or so old that your mind has decayed to the point that you think they have always advertised Brlofiprindol, et al, on TV. Frankly, there is little benefit to widespread prescription medication advertising, information that is much better handled by professionals who (should, at least) understand the issues.
I mean, we do not allow nicotine products to be advertised, so why should we allow Nargblex to be pushed to the ignorati? Freedom of speech is just not a good enough excuse.
It’s not just profit. It is operating costs, employee wages, rent for offices, utilities and all that associated with an industry whose only function is to stand between a person and the medical care that they need.
If you don’t have adjusters denying claims, you not only don’t have claims being denied, you don’t have to pay that person to come up with reasons to deny the claim.
First, I didn’t say that’s what it’ll be. I said that’s what a lot of people think it’ll be.
Second, most people go to their primary care doctor and/or are referred to specialists for the majority of their health care. Hospital visits are likely few and far between for the vast majority of people. For example, I’ve been a hospital patient four times (knee injuries) and that’s more than most people I know who aren’t elderly.
Somewhere between 11-13% and 40% less.
I have to admit that the idea that M4A is going to get rid of administrative bloat by moving it TO the government’s administration is hysterically funny. I agree about the rent seeking part.
Ultimately the main problem is that profit motives and best outcomes can and often are opposed to each other. I don’t like the idea that my doctor is somewhat hamstrung in what he can prescribe me affordably, because some drugs are not on the insurance’s formulary, or they require him to try cheaper drugs first before prescribing the more potent and expensive ones. Presumably he knows what he’s doing and has a reason for prescribing what he does, better than the bean counters in the bowels of the insurance company.
Well, you are saying it as if you agree with them.
I know people that think that rainbows will taste like grapes. They are as relevant as your opinion on what other people think.
Well, yeah, and under a UHC they would do the same. You were the one who brought up hospital visits.
Why do you (or not you, but other whole lot of people that you are currently channeling) think that there would be a change of that sort?
That is not what that article says.
Some things that it did say:
I have to admit that the idea that M4A is going to get rid of administrative bloat by moving it TO the government’s administration is hysterically funny. I agree about the rent seeking part.
[/quote]
Because a privately run bureaucracy is always better? You get savings just from the fact that the government is already doing more than the amount of work that would be needed to administer a UHC. Eliminating means testing would streamline this further.
Essentially, you are getting rid of all the salaries of people who come up with reasons why you shouldn’t get the treatment that your doctor recommends. That actually could be enough to pay for the treatment that your doctor recommends in and of itself.
I find it hilarious that you find several duplication of effort in the private sector of paying people for the purpose of decreasing the amount of healthcare offered to not be bloat in and of themselves.
Yeah, and that is you, with insurance that is probably pretty good. Now, imagine if you didn’t have it, or it wasn’t as good.
I know where you’re coming from, at least in my pre-conceived notions about the inefficiency of the US government. I do wonder though how much of that is for real, and how much is just “myth”. Probably better suited to another thread…
Deflecting is a defense. You were defending by deflecting.
People who are pro-Trump do it all the time, when they are defending Trump. Whataboutism is a trademark defense tactic in politics. You were defending ACO (which I don’t care about, because she gets too much attention as it is). But it’s strange that you would deny something so obvious.
I don’t know… I do work for a municipal government, and while I’d say most people are dedicated to their jobs, the place isn’t really engineered for efficiency, in that it’s very difficult and/or time-consuming to fire people, even for cause. In addition, the motivation tends to be almost strictly professional- there’s not the carrot and stick approach of private business (i.e. they give you incentives/bonuses/options, and they threaten to shit-can you if you don’t perform). I mean, they still can fire you if you really suck, but they have to jump through flaming hoops to do so. And from what I understand, there’s little in the way of merit raises either- most everyone gets a fixed percentage every year. As a result, the power balance between workers and management is more skewed toward the workers than it is in private enterprises.
If I wanted something to be done efficiently, promptly and at minimum cost, I don’t think I’d make it part of a public institution as a result; the motivation’s just not there. Now as far as somewhere to work? It’s really good if you’ve come from a background of relatively coercive management that always holds the unspoken threat of firing you if you don’t perform, and doubly so if that same management was obnoxiously stingy with raises and promotions.
I don’t necessarily agree with them- most of what I’m saying is dumb-ass stuff my parents and relatives say. I’m just saying it with the same fervor for emphasis.
I will say that I’m skeptical that some kind of M4A or other single payer system can be implemented without beggaring the government or raising taxes significantly on the average middle-class person.
I didn’t mention hospitals at all. The fear on a lot of people’s part is that rather than be able to go to their PCP whenever they want, that a government-run healthcare system is going to force them to go to basically what amounts to a huge free clinic where they’d basically hang around like it was jury duty or the DMV and finally end up seeing some random doctor who they’ve never met before. I think a lot of it may come from experience with the military medical system in the 1960s and 1970s actually, and they’re expanding that and conflating it with other slow and shabby government offices. And on my parents’ part, I know that they were part of an HMO back in the 1980s that required just that- you had to go to the HMO’s clinic for primary care and then they could refer you. They hated it- it was inconvenient and rather cattle-call like.
I agree that the fears are not terribly realistic, but that’s the fear I’ve heard from more than one oldster of my acquaintance. The M4A/single payer side needs to make a point of smoothing the ruffled feathers of those folks- if for no other reason than the oldsters vote consistently and in large numbers.
My bad… I copied the wrong URL.
I didn’t mean that it wouldn’t reduce some kinds of bloat, but that in general efficiency and lean, streamlined processes are NOT the province of government agencies. See my last post for my commentary about working for the government- that’s my personal experience, but having had relatives and friends who have worked for most of their careers for other cities and for the state, it holds very true there as well. I can’t imagine that it suddenly changes at the Federal level.
And my insurance is… ok. It used to be much better overall prior to Obamacare. Prior to about 2009, everywhere I’d worked had pretty much the same insurance- a co-pay for doctor visits, 80/20 otherwise, no deductible. Then in 2009, it all changed, and ever since it’s been some combination of a multi-thousand dollar deductible, somewhere between 70/30 above that, much more restrictive in-network providers, and copays or incentives to visit urgent care clinics instead of your PCP.
The post 213 directly above this cites research showing Medicare is run more efficiently than private insurance. Maybe your instincts on motivation are off.
“Provider” in this case meant doctor, not insurance.
Already happening under the current system. That’s what insurance companies do.
Do we currently have even one?
Why is irrelevant, as they do. Or at least bring up specific medicines with their doctors instead of relying solely on the doctor’s first recommendation.
Valid point. Still not seeing a lot of anti-AOCers hitting current sitting Republicans hard for their stupidities.
And he’s saying that’s what it is already like.
Those changes were already happening. Happened to me in 2005.
Nobody has directly addressed the other half of the argument: the defense budget. It is a major liberal cause, cutting the absurdly large amount of revenue we pump into the MIC. But just cutting defense (which ought to happen) does have significant ramifications. My neighborhood has more than half a dozen large bases in a fairly compact area, that support several cities and towns. Those communities would suffer or collapse with those bases shut down or severely curtailed, as would almost certainly happen with realistic cut to the defense budget.
Even if the money is just accounting errors, some of it finds its way into the economy, into which Defense is deeply intertwined. Anyone who advocates for deep cuts fucking well better be putting forth a plan to offset the serious effects that those cuts will have on the lives of ordinary Americans.