You sound like a Clinton Democrat.
You sound like a Clinton Democrat.
Sorry for the double post. My computer froze, and I ended up resubmitting when I got back.
That is, the problem with some Democrats is defining the problem as, “you need a contract with a health insurer.” That’s like worshipping the finger that points to the moon; it confuses means with ends. I would say that the appropriate goal is actually applying medical skills and technology where thy can do the most good, and any market system perverts & derails that (at least a little). Health care should be rationed primarily according to medical ethics and a sort of triage principle–put the effort where it does the most good. Medicine for hire distracts doctors from treating those who would benefit most from care, as they seek a way to part the rich from their money.
I’m for public hospitals, myself. Or perhaps a sort of Medicaid-for-all. I would tell these stories to Democrats to make it clear that their relatively moderate solution, wherein “you can keep your insurance if you like it,” has divided us into relieved winners and angry losers.
Whatever the hell makes you think that would happen?
Sorry, too many dots there. Can you try a few connected, complete sentences instead?
It is indeed. So why carp at those who have tried so mightily to fix it?
Apparently you’re also an advocate of fuck-em-ism.
I’m pretty sure it’s you.
No, the insurance companies are. That’s who gets your sympathies, remarkably.
Adaher, thanks for responding to my suggestion why single-payer gets so much attention in the US asa possible model.
However, you didn’t respond to my question that I asked you earlier, in response to your suggestion that single-payer screws people.
In case you missed it, here’s my question again:
The second part is true. Medical bankruptcies are unheard of in UHC countries.
However, denial of medical care is not even a bug of single payer systems, it’s the whole point. Costs are kept down because it’s easier for the government to say no than private corporations. In Britain, NICE’s mission isn’t just to approve drugs if they are safe and effective, but also to take the cost to the system into account.
One of the other neat features of single payer is that often, you’ll never know if you were denied treatment, because doctors know to only offer treatment that will be paid for. In the US, where coverage levels vary, doctors prescribe whatever tests or treatments or drugs make medical sense. In Canada and Britain, they stay within the limits of the system. And since drug advertising is often illegal in UHC countries, consumers have no idea whether there’s a treatment for their condition or not.
One of the hilarious in a sad way aspects of denial of coverage in the US, is that in many cases newspapers will report on these cruel insurance companies, only to find that if you did a little research, the NHS nor Canada’s Medicare would have approved the treatment either! Sometimes doctors want to throw Hail Marys and try questionable stuff to save a life. Doesn’t mean taxpayers or insurance companies are obligated to pay hundreds of thousands for that 1% chance.
“Well, what you need to understand is that there are 25 million Americans who aren’t covered now. If the idea behind Obamacare was to get everyone covered, that’s one of the many failures. In addition to premiums going up, co-payments going up, deductibles going up. And many Americans who actually did get insurance when they did not have it before, have really bad insurance that they have to pay for and the deductibles are so high that it’s really not worth much to them. So it is chaotic. The status quo is simply unacceptable.” - Mitch McConnell.
So, McConnell’s argument appears to be that the ACA should cover more people, and should be less expensive. I’m sure that the GOP’s replacement will certainly address this issue, and if it does, I can’t see the Democrats not going along with it to help strengthen the law. Unless he is not being honest here, of course.
Also living in Soviet Canuckistan and for 2015 I paid $19,300 in federal and provincial income tax, and $2600 CPP and $930 EI payroll taxes on employment income of just under $100K. Paid $125 for the year for supplemental health insurance through my employer.
This is not exactly true, at least in the UK, for the patient (or their representative) who does their research. Decisions of NICE have been appealed in the past. And doctors are only human. They may not be aware of the latest wonder drug.
I don’t think you’ve ever had American-style HMO or PPO insurance, if you think “denial of medical care” is the point only of single payer systems.
For example, I’ve got a reasonably good private insurance program provided by my employer. The prescription drug plan, for example, has a list (“formulary”) of approved medications and a list of “prior-authorization-required” medications; if my doctor wants to give me something off the latter list, some bureaucrat in some other state gets to decide whether they’ll pay one cent or not. There are “network” and “non-network” providers; for a few years, one of the two major hospitals in my town was “non-network,” and the insurance would cover ZERO non-emergency expenses incurred there. St. Francis Hospital had some specialized equipment and services that the other one lacked, but St. Francis was effectively off limits because my insurance said so. I would also question your statement that “it’s easier for the government to say no than private corporations”; at least with the government, I have a congressional representative to complain to and a voice at the ballot box. I have no corresponding influence over my employer’s contracted insurance provider.
When I was at the doctor’s last week, he asked what insurance I had BEFORE discussing what prescriptions might be available, and that seems to be increasingly common. At least for the major insurance plans, the medical providers around here all seem to know what is and isn’t covered. YMMV.
[quote=“adaher, post:67, topic:776438”]
And since drug advertising is often illegal in UHC countries, consumers have no idea whether there’s a treatment for their condition or not.
Unless you’ve got a really common and profitable condition, drug advertising in the U.S. isn’t going to give you that information either. (When was the last time you saw a TV ad for a new chemo drug, for example? The ones I see are mostly for cholesterol, bladder control, diabetes, and sexual disfunction, with a few weight control and smoking cessation meds thrown in.) Moreover, the treatment options might not be drugs anyway; when was the last time you saw a TV ad for a new surgical technique or new method of physical therapy?
First, McConnell is lying. I’m dismayed, although not surprised, that the Republicans aren’t being any more honest selling their ideas than Democrats.
Second, Republican plans can lower costs. That’s actually achievable. Everytime you pass a complex bill, you’re going to prioritize certain things. You can never have everything. Democrats sold ACA as cost cutting but the cost cutting measures were weak and counteracted by coverage mandates, which were considered more important. Just eliminating those coverage mandates will reduce the cost of insurance, while of course giving people less coverage. Nevertheless, this is politically very smart if Republicans want an early win. Just eliminate the coverage mandates or loosen them into meaninglessness, which Trump can actually do himself, and consumers will immediately be presented with cheaper choices. And it won’t actually hurt many, because no one needs everything in their insurance coverage.
Third, Republicans can’t improve the % of people with health insurance over ACA, at least not without abandoning key Republican principles. There is no bill they can realistically pass that will cover more people than ACA. If they do it right, then the bulk of the coverage loss will be from people just choosing not to carry insurance.
But this thread isn’t really about the virtues of single payer on merit, or even about the GOP’s alternatives. Chances are, the GOP will screw this up. If they don’t, then this thread is moot because Democrats won’t get the chance to revisit health care while most of us are still alive. A GOP success, or even a wash, on health care(speaking in political terms here, not the merits of their plan), gets them past their toughest challenge. Everything after that is relatively easy. But that probably won’t happen. Democrats will probably get everything back in 2020. So, what do they do, taking into account that Democrats don’t have majorities without Blue Dogs and so have to pass something Blue Dogs will vote for? And also keeping in mind that the new generation of Blue Dogs won’t fall on their swords for the party again since it did them zero good last time and it’s not like the liberals appreciated them anyway.
People here are talking about single payer as if that’s politically possible given what even a Democratic Congress will look like, not to mention voter tolerance for higher taxes. “Oh, we’ll just sell it as those taxes replacing their premiums, and it’s cheaper!” If it couldn’t work in Vermont, why would it work nationally? You’d lose labor in an instant, because most union members have excellent plans they don’t pay much for.
I started a thread about it, but I think another possibility is that the Republicans essentially abandon their principles and fashion a Trumpcare which is largely similar to the ACA but rebranded, and find out that most of their voters don’t actually care about the conservative principle that the government shouldn’t be involved heavily in helping people get health care and insurance. Such a thing might be politically very successful, but I think in the long run most progressives would be incredibly pleased by such a development.
REpublicans have already conceded government involvement in health care to a large extent, so that’s definitely possible. ACA-lite is a very real option, and all you have to do to achieve it is eliminate some parts they don’t like and call it a win. Of course, there’s the issue of ACA already having problems and Republican changes making it worse.
But I think the most realistic option is a repeal, as much as possible anyway, through budget reconciliation and executive actions, followed by agreeing on one of the six GOP alternative plans, which all look very different from ACA. But which all have serious flaws, mostly in that they don’t cover nearly as many people as ACA.
what should happen too is other states should follow CA’s example and enshrine the aca into state law for low income patients at least …
Certainly, my employer pays a portion of my insurance…IIRC, it’s 70/30, so they are paying the bulk of it. Presumably in the new system, however, they would still be paying taxes equivalent to what they are paying today, however, so I’m not sure how MY portion going up by that amount (approximately $600 a month to me) helps the argument, however. Assuming Horatius and I make approximately the same amount (i.e. he’s not at the very top tax bracket but down a bit as I am), and assuming our own taxes went up the same you’d be talking about MY taxes going up over 50% to what I’m paying today (64% increase if I have my math right). I could (maybe) afford to pay $600 more a month in taxes, though it would hurt…but I’m guessing this isn’t going to be a universal. And it certainly wouldn’t be the same thing or even close to what I’m paying (for very good coverage btw) today, even combining everything together.
I knew Canadian’s paid more in taxes than we did, but I am having a hard time grasping that sort of difference. Hopefully Horatius is going to come back and say s/he made a typo or perhaps that s/he is at the very top of the tax brackets and paying the maximum for his or her high 6 figure salary…otherwise I guess I won’t be retiring to Canada as I had hoped and I am not seeing how such a system would work in the US, assuming it would cost something similar.
Aren’t you assuming that the differece is due to healthcare? But if it was, he should be paying less than you.
Yes, that was my assumption. What else would be the difference since s/he said they were paying $1700+ a month for taxes? Unless the taxes are across the board more for everything I would assume (possibly a bad assumption I admit) that taking my current taxes and including everything I currently pay for healthcare should be fairly close to that figure…and it’s not. Possible differences, as I noted, could be the poster is at the highest tax bracket…which I’m not…so is being taxed the maximum. Other than that, the only difference would seem to be that they are paying for healthcare and it’s all bundled in while mine isn’t.
If you are an American, look at your own pay stub. It should list all of your local and federal taxes, plus any 401K or retirement deductions AND whatever is being taken out for health insurance. That’s what I did…and my own, including my health care insurance (HC plus vision and dental), retirement (which is 10% of my salary taken out automatically by the organization), SS and Medicare, Fed WH and SIT comes to $1100. Which seems to indicate a $600 gap, all things being equal (again, assuming they are). Feel free to give a ballpark for your own as I’m interested in how this would play out. I always assumed that a single payer system, bundling the costs together would come out with me paying more on my taxes but not a lot more. This would be a 64% increase over my current tax burden for…what? I already have great insurance today. Granted, I’m willing to pay more for folks who aren’t being currently covered…but not sure $600 more a month would work very well. Certainly that’s going to hurt a lot of folks (I’m at the upper end of the tax brackets, so obviously those at the lower end will take less of a hit…but even a hit of a hundred or two is going to hurt middle or lower income folks).
If I’m making wrong assumptions here or missing something then let me know…I WANT to be, so I’m receptive to missing something where I can come back with a :smack: and concede I was wrong or didn’t think of something.
My understanding of the Canadian system is that it is funded from income taxes, not a corporate tax. So, if we wave a magic wand and convert the US system to Canada’s - the that 70% employer share goes to your paycheck and then taken back as a tax.
You are still getting the same take home pay but your tax went up a bunch.
The 70% that your employer pays for your health coverage needs to be added to that $1100, because it’s part of your compensation too, just a part that is taken away before you have your hands on it.
What do Canadian employers pay towards employee health insurance?