Universal health care- what's the problem?

Great Debates
21

If you expand medicare to everyone, you save roughly $400 billion a year. You save roughly $300 billion in lower overhead and $100 billion in bulk purchases.

If California alone adopted single payer, they would save roughly $344 billion over 10 years.

http://www.pnhp.org/facts/single_payer_system_cost.php?page=all

The fact that medicare is insolvent is because it is a health program that covers the sickest americans (the elderly) who are rapidly becoming a bigger and bigger percentage of the country for a 2.9% tax rate. No matter how efficient a program is, if it is underfunded it will have problems. That doesn’t change the fact that medicare costs less and people are happier with it than with private insurance.
And people are happier with medicare than private insurance.

http://www.nationaljournal.com/njonline/mp_20090629_2600.php
So medicare is not perfect. But it is cheaper and more popular than private insurance.

22

You haven’t heard the “death panels”, “taxes are theft, unless it’s to fund killing arabs”, “fuck the poor and let em die in the streets”, and"Steven Hawking would be dead if he were British" Republican positions?

Are these reasonable?

Is sending people to willfully ignorant to know any better to shriek these “arguments” at townhall meetings like a retarded bonobos reasonable tactics?

Now why would UHC cost more then current healthcare? Do Republicans have so little faith in their own country that feel it can’t manage what the rest of the industrialized world pulls off with better outcomes and lower costs?

Why do Republicans think so little of America?

Why should we be forced to deal with dragging the economic dead weight of our current inefficient healthcare system because Republicans have no faith in their own country?

23

I do not deny or excuse a lot of silliness from the Pubs on this subject. My point was that it’s not unreasonable to raise the issue of cost.

And indeed I think is is dubious to try to sweep it away with offerings like “Now why would UHC cost more then current healthcare?” Possibly the example of how Medicare’s costs have run ahead of projections suggests we should proceed carefully.

24

Getting the “young people who don’t hardly use medical care in the system” to balance costs is misleading. Younger non-medicare people are already in the insurance system if they have it in their jobs and everyone says insurance is expensive.

If they DON’T have insurance, putting them in the system will only help lower costs on average if they are willing to PAY in.

Now why is insurance expensive? Is it those greedy whore-mongering insurance companies with their 3% markup? Perhaps is it that people CONSUME a lot of services? Even healthy people (when they get sick or pregnant)? Can’t be…it’s just ‘overhead’ and ‘profits’. “But some people hardly ever even get sick!”. That’s right, and a few of those people get sick at a cost of hundreds of thousands of dollars…it kind of balances out.

Medicare has low overhead because it pays out all bills. If you are an approved provider and submit a bill you get paid. There is no “management” at all. They have rampant fraud, they just send out the checks, no questions asked. Expanding medicare to cover teh whole population without having any kind of fraud monitoring would be ruinous. That’s where the dreaded ‘20% overhead’ (although for larger insurance companies it’s more like 12%) goes…it actually serves a purpose.

See the ‘watchman effect’. Home owner hires a watchman to keep out burglars. There aren’t any burglars so he fires the watchman. Figures he will save money as he is unneeded. Then his house is robbed the next day.

Are people in the US going to stand for being told “no you don’t need that test”. “No, you don’t need that drug, it works but you’re going to get the generic”? Because that’s how foreign countries get lower costs. No? How else do they do it? Less tests, less surgeries, less of just about everything.

So people paying insurance premiums through their work are going to pay the same and get less service and people paying nothing will get more service. Naturally people paying insurance already, don’t like this.

Why not have free gov’t care for poor people’s basic medical needs, dentistry, pregnancies, broken bones, diabetes/blood pressure care…it would cover teh cheap things that are important, not the expensive things which aren’t used much but are blowing up the medicare budget. But that would be “two tiered” and people wouldn’t stand for that.

25

Medicare does too have fraud monitoring, a PT and some physicians in Detroit just got busted for Medicare fraud. Also, the American people, even those with medicare get told “No, you don’t need that” by providers all the time, because it is often true. They often understand when I tell them why.

26

Now see you make a fairly reasonable point. I disagree, but I find your position honest spirited. My biggest frustration is there isn’t enough of you, and you’re drowned out by the dittoheads.

This is why the public option is the big controversy it is right now. Let’s say the public option was medicare level efficient. Would it still be worth the current poo flinging levels coming from the Republican side? The same side that brought us the pointless Iraqi war?

27

That already happens. Insurance companies do it all the time. Same goes for the sick poor. Big insurance also tries to weasel out of contracts if someone develops an expensive condition. Deathly sick people lose their coverage. Welcome to America.

Universal doesn’t mean monopoly. In the UK, for example, you’re perfectly free to use a private company if the public option isn’t to your liking. That’s what we’d have here.

Should misfortune fall you, a public test is better then no test.

28

Part of the objections stem from this statement in the OP “The people who don’t want government health care can stay with their current insurance” because of this clause in the bill:

A Republican congressman (Mike Rogers, I believe) I heard yesterday interprets this as to mean IF an employer has a new hire and attempts to offer them insurance, the entire staff of that company will lose their coverage because it is a change in the terms and conditions of their policy.

That doesn’t sound like a valid interpretation to me, but it does seem to suggest that if you lose your coverage via a job change, you will not be allowed to enroll in private insurance through your new employer. Here is the bill (pdf) if anyone wants to try and figure out what exactly section 102 is driving at if it’s not this. Frankly, I think that the definition of “grandfathered health insurance coverage” is as clear as mud, and later instances of the term refer back to section 102 as if that’s illuminating.

29

For something as big as UHC, the costs are minor. A 10 year plan will cost a trillion, of which about $500-600 billion would be funded in various cuts to various federal programs. Ending subsidies to medicare advantage and letting medicare negotiate drugs alone would save the US about $300-500 billion over 10 years. Other savings are supposed to be added in too (I don’t know if they are allowing medicare to negotiate, but if they did that alone would fund 1/5-1/3 of health reform).

So that is about $500 billion invested over 10 years when savings are taken into account for health reform, so $50 billion a year. Really not a huge number for something as important as health reform and which will help economic growth (by increasing job mobility), reduce bankruptcy and foreclosure rates and dramatically add to national morale. The Iraq war alone costs about $150 billion a year, so 3x what we spend on health care.

Ending the Iraq war, ending medicare advantage subsidies and letting medicare negotiate drug prices alone would pay for health reform and leave us tons of money to spare.

Also keep in mind meaningful health reform will slow the rate of health cost growth. The commonwealth fund predicts if reform is done right it’ll cut medical inflation from 6.7% a year to 5.5%, which will mean $3 trillion less spending over 10 years, and who knows how many trillions after that.

So a $500 billion investment could save trillions in lower medical costs over a decade (and possibly trillions after that), increase productivity (by allowing people to leave their jobs w/o worrying about health care) dramatically reduce bankruptcy and foreclosures (foreclosures, which brought on the economic crisis, are linked to medical bills at least 60% of the time). All for far less money than the Iraq war cost. End the war and that alone will pay for it.

30

Wrongo. Medicare covers everyone who reaches the age of 65. When you reach 65 ,they send you a letter and you can activate it. Your health and your potential costs are not part of the equation. Just reach 65. They send you info about what you qualify for. When you get to 66, they send you a list of preventative tests that you now qualify for. They want you to stay on top of potential health problems . It is so much better than getting a letter saying you are getting less coverage every year and your copays are climbing again.
Insurance companies get to jettison the elderly . They get rid of the potential expensive cases and still raise rates every year. They also dump as many sick people as they can. they often refuse to pay for services you have paid for.
Medicare has been a playground for fraudulent health care companies. Hospitals and doctors and clinics have been rip[ping it off for decades. That has to be stopped.

31

Wesley, as a political moderate, and fiscal conservative, this is just the type of thinking and fuzzy math that has me break into a cold sweat when I hear us talk about health care.

The costs are minor at a trillion fucking dollars? What planet do you live on? You then proceed to wish away $600B like it’s nothing?

Discretionary spending is less that 40% of the federal budget. And I’ll go out on a limb and guess that you aren’t going to cut any other social program. So how are you sweeping up your half a trillion?

Bottom line for me is the national debt is over $30,000 for every man woman and child in American today, and it’s only getting larger. Wesley, that’s right, you own $30,000 right now, on top of your credit cards, mortgage, and other bills. And you want to tack onto that bill, with the economy the way it is? And Social Security? Going up. Medicare? Going up. I don’t see how we can pay for this increase in UHC when we can’t pay our bills now.

And when I see people saying that a trillion dollars is minor, it’s clear to me that they don’t get it, and as Americans, we don’t get it.

32

spifflog, how much of that $30,000 is for the Iraqi war? Killing Arabs more important then taking care of Americans?

33

I have no idea if you replied to the wrong message or what because not a single sentence you wrote refutes anything I said. It’s as if you cut & pasted a typical Medicare cheerleading blurb without actually stopping t think if it actually fits into this particular discussion.

34

A tiny drop in the bucket compared to the total debts incurred during the years when there was no Gulf conflict.

35

UHC is even less then the Iraqi war, and comes with economic gains, access to healthcare for all, and less and of the GDP spent on healthcare.

36

Incorrect.

UHC is a noble goal and has many compelling moral justifications.

However, it is total mathematically ignorant bs to say it will cost less than the Iraq war. The more likely scenario is that it will cost triple or quadruple or more than the government projections ever imagined. It will add to the federal deficit and add to the debt.

UHC will cost more – period; there’s no way around that.

37

You didn’t bring up the fact that health reform would save far more money than it would cost.

Would I invest $5000 over 10 years for something that would increase quality of life, lower stress, possibly grow the economy and save me $30000? Yes. I don’t see why the nation doing it with billions instead of singles makes it any different.

You also didn’t address the foreclosure problem. The US economic crisis started because houses started foreclosing in record numbers, putting banks at risk. Roughly half or more of foreclosures, and even more bankruptcies are due to medical costs. In other countries like France or Canada people don’t lose their homes due to medical costs. So a strong UHC program can protect the economy in that way by reducing the number of bankruptcies and foreclosures, as well as giving more career mobility to workers to switch jobs w/o worrying about health care.

Health reform, as proposed would be paid for roughly 50-70% by cuts to and changes in various federal health programs. The other 30-50% would be paid for with new taxes, either taxes on those making over 250k a year, or taxes on certain insurance companies.

We do have to worry about the long term debt (around $80 trillion in liabilities over 75+ years), and our trade deficit. I’m not denying that.

However I do not consider $500 billion invested to save 3 trillion to be a waste of money.

Your arguments are not persuasive to me at all.

38

Maybe 1/10th. However had Al Gore won in 2000 (here we go people), and we didn’t have the Bush tax cuts or the Iraq war, I’m sure our national debt would be far far lower than it is now.

Our long term debt (we have about $70+ trillion in unfunded liabilities) are mostly in medicare and social security.

39

This pie-in-the-sky scenario of a new government spending entitlements being funded 70% by changes to other government programs has never happened in the history of U.S. Federal budget actuals.

Oh, and that “paperwork” savings of $389 billion you cited earlier? That’s another mathematics rainbow.

If you favor UHC, it becomes so seductive to believe that bs math. However, it doesn’t mean it’s true.

If everyone wants UHC, by all means, you’ll be able to eventually vote it in … but don’t be gullible and believe it will cost less. It will not cost less.

40

The problem is that people are having false fears stoked by a political party that is more interested in saving their own future (by damaging the other party) than in helping the American people.

We could have an actual honest intelligent discussion about the pros and cons of different plans - single payer, public option, regulated private insurance with subsidies, etc. - but instead we get political theater.

And it doesn’t help that the insurance companies are spinning as hard as they can to keep something resembling the status quo, except possibly with everybody required to buy their product.