If you expand Medicare so that everyone is on Medicare - then there is no more Medicare fraud. Everyone is already on the program and qualified.
The good news is you don’t have to waste a single penny hunting down the people who are trying to sneak onto the service because they can’t afford healthcare without it. Everyone is already on the service.
I don’t think it makes much sense to worry about collecting deductables from the Medicaid enrollees, either. That fifty bucks per procedure is just a spit in the bucket. The accounting and billing will cost less if you just send the bill straight to the single-payer. So much of medical expenses at the point of care is being eaten up right now in billing departments having to deal with random insurance - if we’re going to have single payer let’s streamline this as much as possible. It will be cheaper and more efficient.
We’ll need to raise taxes to pay for it. That’s ok. We can afford it. Every other first world country manages, and quite a few of the non-first world, as well.
Or possibly we could grab a trillion or two off the defense budgets. But I’d rather just raise taxes on the wealthy and use the defense budget on NASA and other US spending initiatives. Keeping our economy humming, our infrastructure standing and our space program functioning are all legitimate Defense objectives, when I’m President.
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Or possibly we could grab a trillion or two off the defense budgets.
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The defense budget in the US is less than a trillion…just sayin. Not sure how politically viable it would be to expand Medicare for everyone, but I’ve seen this proposal a lot so perhaps it could work. How would you sell it to the American people, and how would you sell your own party on it, let alone the opposition party? What would it take to get such a change passed in real terms?
You have to start really selling the idea that it’s good for business. Right now health care coverage is beyond most small businesses and a big headache for larger ones. Employment based health coverage inhibits labour movement. UHC standardizes a major factor with our European and Canadian trading partners. There needs to be hard push back that it’s a communist idea and present that it’s no different than a public police force or fire service.
Yeah, I agree…get enough large US businesses and well known US business people on board and they will help push. You’d need to figure out a way to package it to show what the actual costs would be…show that while taxes would go up, aggregate costs would go down or remain relatively the same, show that the care levels and offerings would be different but not worse (perhaps better). You’d need to figure out how to do this so that people would actually listen, but not over sell it or make it too complicated for the average person to understand, but have the meat in there so that the not so average could dig in and really go through it. And, IMHO, stop trying to make ‘but everyone else does it’ an argument. Frankly, and as someone who follows healthcare in other countries, I always found that argument less than compelling, and I think that a lot of those who are opposed actually find this argument reinforces their stubborn refusal to even look deeply at a UHC or single payer system. I think the package for this needs to be self contained and relevant to Americans.
Medicare fraud is mostly by doctors, not patients. It’s stuff like claims for procedures that were never done. It happens in the private insurance sector too.
The chief advantage of expanding Medicare to be America’s UHS is that it’s more efficient than starting a whole new healthcare program from the ground up, to be run in tandem. In Medicare (and rolling Medicaid in, as well as military medicine), we already have the infrastructure and the billing and so on.
Streamline it all into one billing system and drop the age limit. The crossover period is sure to be a vomit comet but once it sorts out, it will save money on efficiency. It will also make funding for it easier, since it won’t have to be done piecemeal.
It’s the same argument for any other mega-corp in the US.
Selling the idea all over the place, really. Politically there’s no way to get any sort of single-payer, UHC system in the US, because far too many citizens have been convinced that it’s a bad idea, after decades of propaganda to that effect.
So you need to counter that with pro-UHC propaganda, until enough citizens come around to supporting it.
So, fund a few billions of dollars worth of propaganda. Lifetime movies about regular families being bankrupted by unexpected health costs, or by being screwed by their insurance companies. Documentaries about people who can’t get insurance for any reason, and how that screws up their lives. Reality TV series about businesses that have to make hard choices because they can’t afford to fund their employees’ health insurance. People stuck in dead-end jobs because they don’t want to risk losing their insurance. People trying to navigate ridiculous mazes of coverage and non-coverage, to figure out if they can get the care they need. People finding out that the doctor/ER/hospital they went to while on vacation is “out of network”, and getting stuck with the bill after they thought everything was covered.
Couple that with similar stories from UHC countries like Canada and the UK, showing people just getting the care they need, without any hassles.
The crucial factor in the UK is that the doctors themselves are the system’s (or at least the principle’s) biggest defenders, with a few exceptions. You need to get them onside and show them how it would make life better for them: get them and the employers together, and you might have a powerful coalition.
But you’re still going to have to find an agreed way for costs to be controlled.
If universal health care would cause a massive influx of illegal immigrants (I think that’s what you’re saying), then why haven’t the illegal immigrants we have now mostly just continued on to Canada?
I’m sure Canada has controls in place to prevent non-Canadians from taking advantage of their health care system, but I presume universal health care in the U.S. could be implemented with similar controls.
Illegal immigrants comprise about 3% of the US population. But US healthcare spending is 50-100% higher than it should be. Even if illegal immigrants were total free riders (false) and even if there were a massive new influx (unlikely), the savings from single payer would still vastly outweigh the costs of covering illegal immigrants.
And even ignoring all that, it’s still likely to be a net savings. Illegal immigrants get their healthcare from emergency rooms, which obviously can’t collect on the bills. It would cost less to just provide actual free health care.
IIRC, in another thread one of our friends to the north said that to get free healthcare, you have to show a Canadian healthcare card - that only legal residents can get. Sounds simple to me.
We probably can’t do it in the US for some reason. Someone will be along soon to explain that…
Actually I’m all for the idea and I think it will spur small business because right now many people work for big companies or the government and really only so they can get the health insurance.
Well to go along with that, certain activities will also have to be excluded - like they are right now with regular insurance.
For example professional and even some amateur athletes are excluded and have to have their own insurance.
Certain dangerous activities are excluded such as scuba diving (divers carry PADI or other insurance), parachuting, hang gliding, rodeo, and others like racing. Most likely we will see signs in ski areas where say black diamond areas will be excluded.
Because it works quite well in most of the world. Speaking as someone who has experience with two different single payer systems, and of course also my experience of the U.S. debacle of primarily relying on employer benefits for health insurance.