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Tu stultus es
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Discussion Starter #1 (Edited)
Because it's still news.

http://www.apnews.com/09e06d686a1a481fa76e3fd91f3fcbc2/Study:-'Medicare-for-all'-bill-estimated-at-$32.6-trillion

A study brought to you by GWU.
 

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Have Bar, Will Travel
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Yeah all of that makes so much sense we should just jump right on that.


name one government program that isn't smurfed up all to hell and nearly useless to the end user when it comes to getting help.

I'd greatly prefer open competition - all open, competition.
 

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Tu stultus es
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Discussion Starter #4 (Edited)
He can smurf right off to hell.
The Sanders crowd will be presenting this argument:

Americans spend $35 trillion over ten years on health care. The program will cost $32.6 trillion over 10 years for all Americans. The plan for single-payer healthcare would provide more than $2 trillion in net savings in the program’s first decade. Yes you'll pay more in income tax, but it would be cheaper to the individual for taxes & healthcare than the current way it's done. Why not have healthcare for all when it would be cheaper overall?
 

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DW can't take a J... or a D
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Simple reason, because healthcare quality will drop. Demand will surge, and rationing will have to come into effect unless we are able to rapidly scale our ability to churn out healthcare professionals (which should happen anyway, but that's a separate discussion).

My health insurance bill, including employer contributions and my out of pocket maximums are far less than my income tax bill, which is not insignificant. No way it comes out cheaper for me.

Two more reasons. Medicare? People with Medicare end up having to buy additional health insurance to cover the massive gaps in coverage. Same exists in countries that already have single-payer (i.e., Belgium which takes half your income off the top).

It just doesn't work.
 

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Tu stultus es
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Discussion Starter #6 (Edited)
Simple reason, because healthcare quality will drop. Demand will surge, and rationing will have to come into effect unless we are able to rapidly scale our ability to churn out healthcare professionals (which should happen anyway, but that's a separate discussion).

My health insurance bill, including employer contributions and my out of pocket maximums are far less than my income tax bill, which is not insignificant. No way it comes out cheaper for me.

Two more reasons. Medicare? People with Medicare end up having to buy additional health insurance to cover the massive gaps in coverage. Same exists in countries that already have single-payer (i.e., Belgium which takes half your income off the top).

It just doesn't work.
That's my fear.
 

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Administrator
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Yeah, you end up plugging up the system with every hang-nail-sporting dullard and laggard. The providers will stop pursuing efficiency and profit margin because "fuck it; we get paid either way", and then you have the loller-wisdom of government control.

As noble an idea as Social Security is/was, this would be the same damned thing, but worse... because docs and nurses and hospitals cost more.
 

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Tu stultus es
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Discussion Starter #9
Yeah, you end up plugging up the system with every hang-nail-sporting dullard and laggard. The providers will stop pursuing efficiency and profit margin because "smurf it; we get paid either way", and then you have the loller-wisdom of government control.

As noble an idea as Social Security is/was, this would be the same damned thing, but worse... because docs and nurses and hospitals cost more.
How efficient is it now? Have you tried calling an insurance company to argue a billing or coverage claim?
 

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Born in a class 5 hurricane
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Right now my employers pays my health insurance. When we switch to a one-payer system, I certainly expect my employer to start paying that money directly to me. That should offset my additional tax burden, right?
 

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Tu stultus es
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Discussion Starter #11
Right now my employers pays my health insurance. When we switch to a one-payer system, I certainly expect my employer to start paying that money directly to me. That should offset my additional tax burden, right?
Will the employers still be on the hook for that? What about the ones that aren't on the hook to provide healthcare?
 

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How efficient is it now? Have you tried calling an insurance company to argue a billing or coverage claim?
Oh yeah... I know. Some shit needs to go down, and go down hard on that industry, but a gubbermunt-takeover would make it even worse, I think.


Right now my employers pays my health insurance. When we switch to a one-payer system, I certainly expect my employer to start paying that money directly to me. That should offset my additional tax burden, right?
:smurf:
 

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Have Bar, Will Travel
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How efficient is it now? Have you tried calling an insurance company to argue a billing or coverage claim?
well since I've been doing that since february I have to say cigna responds a hell of a lot faster that either Methodist healthcare, or Medicaid whom I've also had dealings with.

so of the set I'll stick with my healthcare insurnace today. And I bet if there was real competition I'd even better returns or like my auto insurnace I'll just swap companies.

Right now my employers pays my health insurance. When we switch to a one-payer system, I certainly expect my employer to start paying that money directly to me. That should offset my additional tax burden, right?
I guffaw in your general direction good sir.

I mean if we could have countrywide open insurnace competition - and they did away with the taxes because you have quality health insurnace - I'd be happy to go it alone instead of my company provided benefit. But I'm sure I'd see a cow fly first.
 

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DW can't take a J... or a D
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Will the employers still be on the hook for that? What about the ones that aren't on the hook to provide healthcare?
They'll pocket that money for 2-3 years, and as soon as we all realize how fucked our new government healthcare is and start needing supplemental policies, employers will start offering those as an incentive to retain talent.
 

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Tu stultus es
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Discussion Starter #15
Oh yeah... I know. Some shit needs to go down, and go down hard on that industry, but a gubbermunt-takeover would make it even worse, I think.



:smurf:
Absolutely. If there is any type of "single-payer" system it would need to be run by an independent federal entity like FDIC or NCUA.
 

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Tu stultus es
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Discussion Starter #16
They'll pocket that money for 2-3 years, and as soon as we all realize how smurfed our new government healthcare is and start needing supplemental policies, employers will start offering those as an incentive to retain talent.
That would be the smart thing to do. Don't know what they would consider talent. Not everyone in the company, I'm sure. Not sure if they would do the smart thing in any case.
 

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Have Bar, Will Travel
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HCE's would all get some other supplemental plan for certain at day one.

everyone else - probably zilch. And if you have a company with say a 50/50 mix of hourly and salary employees certainly zilch.

I don't care if you make a seperated new government agency to run it it will still be craptastic for the end users. No matter what.

Biggest thing people forget - once it's a government only program they have no real stake in the game. they don't have to . It's like comcast customer service in places where they have no competition - they person on the phone could litterally be jerking/jilling off while keeping you on hold and they'd get a bonus for their on phone time.

Vs having the ability to to trade suppliers at any time because they don't provide service. There's not incentive to provide and do. In my arena we always say we're only as good as our competition allows us. It's sadly true, but at least there's incentive to try.
 

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Tu stultus es
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Discussion Starter #18
Not always. Crop insurance is a good example of a system that works well. It's not a handout system, it's a multi-billion dollar insurance industry. The government underwrites it and private companies sell it to farmers. That's a Public/Private partnership that should be the model for healthcare.
 

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Porch Dick
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20,259 Posts
Simple reason, because healthcare quality will drop. Demand will surge, and rationing will have to come into effect unless we are able to rapidly scale our ability to churn out healthcare professionals (which should happen anyway, but that's a separate discussion).

My health insurance bill, including employer contributions and my out of pocket maximums are far less than my income tax bill, which is not insignificant. No way it comes out cheaper for me.

Two more reasons. Medicare? People with Medicare end up having to buy additional health insurance to cover the massive gaps in coverage. Same exists in countries that already have single-payer (i.e., Belgium which takes half your income off the top).

It just doesn't work.
Denmark is the same. I've touched on the mismanagement of my grandfather's health from a couple of years ago. The trip over there this spring included some stories from my uncle and his girlfriend that were similarly disappointing. We think waiting on the phone for a representative is bad...

My uncle had the testing and diagnosis of potential cancer of (I believe) his prostate. Not that it took a long time for the results to come back (though they did), but that it took a long time to get in front of one of the few specialists within a 2 hour radius. Mind you, he lives in the 3rd largest city in the country - 2nd largest on the mainland. The "next step" in diagnosis was always *months* away.

His girlfriend has been trying to get an infection (bacterial) properly diagnosed and treated. They can't get it right, which can admittedly be challenging, but follow-up visits are also scheduled really far apart due to availability. When my uncle went to pick up the last prescription they gave her, he had to go to a pharmacy over an hour away to find the stuff. Again, they live in the third largest city in the country.

The problem with a lot of the comparisons of what we do to what they do is that the word "healthcare" gets tossed around like all healthcare is of equal quality.

well since I've been doing that since february I have to say cigna responds a hell of a lot faster that either Methodist healthcare, or Medicaid whom I've also had dealings with.
Agreed with everything, but certainly this part. It certainly depends on the company you are dealing with, but either way, waiting on hold with a private insurance company isn't much of a justification for switching to a single-payer system.

That would be the smart thing to do. Don't know what they would consider talent. Not everyone in the company, I'm sure. Not sure if they would do the smart thing in any case.
How they do that is already in place. It would be no different than how successful companies currently structure compensation packages to attract and retain talent.
 

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Porch Dick
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I don't see one glaring issue with the plan mentioned here, yet. The figure quoted is based on the assumption that hospitals and doctors will, essentially, take a 40% pay cut. Not technically 40% across the board since they already see some Medicare patients, but you get the point.

The Mercatus study also takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients. Medicare rates are currently about 40 percent less than private insurance, according to the analysis.

The study found U.S. health care spending under Sanders’ plan would drop over time — about $300 billion lower in 2031.

However, it also found that potential savings would vanish if hospitals and doctors aren’t willing to accept lower fees for patients who are now privately insured. In that case, the U.S. would spend about $400 billion more in 2031.
If we're keeping the quality and availability of care we have now, we can't force a 40% paycut.

Cut *any* occupation's pay by 40% and tell me how that works out for staffing, both in terms of quantity and quality.
 
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