Again, why Medicare for All would never work (1 Viewer)

[Greenbeard]

I find it rather interesting, and distressing at the same time, that some would think that 6 million patients being on waiting lists for medical care and patients with an over 6 months waiting list for medical care as examples of those systems as being 'working just fine', to me those measurements are an indication of failure.

It is further distressing that, even with those failing metrics, there is still a desire, and demand, to implement them here in the US.

I'm not aware of anyone ever suggesting implementation of an NHS in the U.S.

 

[aociswundumho]

I'm not aware of anyone ever suggesting implementation of an NHS in the U.S.

True, but medicare for all is similar to the Canadian system with private providers and a single payer.

 

[ColdHardTruth]

Here are some claims I believe to be true:

1) U.S. healthcare is insanely expensive.

2) Americans, as a group, are not healthy.

3) Most insurance plans are terrible - high deductibles, surprise bills, and claim denials are the norm.


Now imagine flipping a switch: healthcare is suddenly “free.” No co-pays, no deductibles - just walk in. First come, first served.

What happens next?

Everyone shows up.

People who’ve been putting off checkups, procedures, and diagnostics flood the system overnight. Not just the sick, but everyone. Because when something expensive becomes free, demand doesn’t just rise - it explodes.

Hospitals would be swamped. Doctors would be way overbooked.

The next step is waiting lists.

The NHS has 6 million patients on waiting lists.

In Canada, the average wait time from initial visit to treatment is over six months.

Our system would be 5x times larger than the NHS. Socialist institutions work worse the bigger they get.

Btw, can you guess what increased demand does to the price of a service like healthcare? It sends it up, up, up. That means the crazy taxes they imposed to pay for medicare for all aren't going to be nearly enough.

Medicare for All would bankrupt the country.

More baseless right-wing nonsense.

 

[rahl]

Thanks. As I expected it did not measure actually quality of healthcare.

Yes it did.

The us usually ranks 1pr 2 in quality of care and timeliness of care. Which are measurements of healthcare.

We score low on equity and efficiency which are functions of healthcare insurance.

Single payer systems provide better care than the US and at a fraction of the of the cost

 

[jaeger19]

Every time you resort to projection, I assume you have no intellectual argument.

Yeah, how can there be projecting from me??
I am the one providing scientific articles , objective research, .

You are the one using twitterx as your source. Using opinion from right wingers and you are the one that’s stated that they refuse to read just 28 pages to better understand Medicare.

Face it. You don’t know what you are talking about when it comes to Medicare , medical research etc.
And frankly you’ve made it clear you don’t want to know. It makes you uncomfortable to realize you are being lied to by your masters.

 

[jaeger19]

Yes it did.

Single payer systems provide better care than the US and at a fraction of the of the cost

No it didn’t. It used things like longevity, to measure “ healthcare”. That’s not a measure of healthcare that’s a measure of things like culture .
But okay explain this:


“Led by professor of medicine and of epidemiology Cary Gross, M.D., the global research team analyzed data on more than 170,000 older patients diagnosed with non-small cell lung cancer in England and the United States between 2008 and 2012. They compared several aspects of lung cancer care and outcomes, including patient characteristics, stage of cancer at diagnosis, treatment, and overall survival.

The research team found significant disparities in lung cancer care and survival between the two countries. In the United States, 25% of patients were diagnosed at the earliest stage of cancer compared with 15% of patients in England. Forty-five percent of U.S. patients were diagnosed late, at stage 4, versus 52% of their English counterparts.

Differences also emerged in treatment. Of U.S.patients diagnosed at stage 1, 60% had surgical treatment compared with only 55% of stage-1 patients in England.

These disparities from diagnosis through treatment appear to contribute to a substantial gap in overall survival rates, said the researchers. Two years after being diagnosed, 31% of U.S.lung cancer patients were still alive, while only 19% of English patients were, the researchers said.

“These findings — the first using age- and stage-specific, population-based data — show that lung cancer patients receive more active treatments and have better survival in the United States compared to England.”

Disparities found in lung cancer care, survival in U.S. versus England

Better lung cancer survival rates in the U.S. have been found to correlate with earlier diagnoses and more aggressive surgical treatment.

news.yale.edu

 

[jaeger19]

True, but medicare for all is similar to the Canadian system with private providers and a single payer.

Actually no it’s not. Canada is not truly single payer. Each territory and province sets up their own healthcare insurance plan, funded by the government.

Medicare for all would be quite a different system.

 

[rahl]

No it didn’t. It used things like longevity, to measure “ healthcare”. That’s not a measure of healthcare that’s a measure of things like culture .
But okay explain this:


“Led by professor of medicine and of epidemiology Cary Gross, M.D., the global research team analyzed data on more than 170,000 older patients diagnosed with non-small cell lung cancer in England and the United States between 2008 and 2012. They compared several aspects of lung cancer care and outcomes, including patient characteristics, stage of cancer at diagnosis, treatment, and overall survival.

The research team found significant disparities in lung cancer care and survival between the two countries. In the United States, 25% of patients were diagnosed at the earliest stage of cancer compared with 15% of patients in England. Forty-five percent of U.S. patients were diagnosed late, at stage 4, versus 52% of their English counterparts.

Differences also emerged in treatment. Of U.S.patients diagnosed at stage 1, 60% had surgical treatment compared with only 55% of stage-1 patients in England.

These disparities from diagnosis through treatment appear to contribute to a substantial gap in overall survival rates, said the researchers. Two years after being diagnosed, 31% of U.S.lung cancer patients were still alive, while only 19% of English patients were, the researchers said.

“These findings — the first using age- and stage-specific, population-based data — show that lung cancer patients receive more active treatments and have better survival in the United States compared to England.”

Disparities found in lung cancer care, survival in U.S. versus England

Better lung cancer survival rates in the U.S. have been found to correlate with earlier diagnoses and more aggressive surgical treatment.

news.yale.edu

Single payer systems provide better care at a fraction of the cost we do, as you were shown.

 

[jaeger19]

Single payer systems provide better care at a fraction of the cost we do, as you were shown.

Explain if it provides better care why does the us do better with cancer survival than the uk.
Please explain.

 

[rahl]

Explain if it provides better care why does the us do better with cancer survival than the uk.

We don’t. But even if we did, medical treatment is orders of magnitude more than just cancer treatments.

Please explain.

 

[coyote505]

I completely agree with all of this.

As the years have gone by and as I've moved from employer based insurance to Medicare with a Supplemental, I very much see the wisdom in Medicare but also in keeping it just for us old folks. I hope Congress will fix Medicare such that it can be sustained.

If everyone was on it, it would be exactly like you described in your good comment - long wait times, delayed surgeries, crazy high taxes, overbooked docs, lack of hospital space, etc.

But as it is, when young and working, we do pay quite a bit for our insurance and we don't overuse the system because of deductibles and such. But then, when we turn 65, we go on Medicare and it's cheaper than it was but at the time of life when most medical problems crop up, it's readily available and plentiful for those on Medicare. I kind of did what you described - flooded the system when I reached Medicare age. I had some things I'd sort of held off on but once on Medicare, it was a piece of cake to have everything looked into and addressed. And I could get it all scheduled so quickly and easily. I saw multiple specialists and had many various scans and tests done - hip stuff, heart stuff, bone stuff and more. Now I'm very up to date on everything which I was concerned about or even just questioned.

That's not at all the way this would have turned out if the system were suddenly flooded with everyone, exactly like you described. Our healthcare is pricier for the young but it's fabulous, plentiful, and available for the old. No old person on Medicare needs to walk around on a joint needing replacement for many months or wait for an MRI (all while additional damage can be occurring due to a delay).

Great comment and great points made!!!

I live in New Mexico, which because it has been heavily HMO'd for at least 60 years, is probably a good approximation of what a universal healthcare system might look like. After Covid, I have a balance problem. My PCP referred me to a physical therapist for evaluation. She reffered me back to my PCP, with a recommendation that I see an audiologist. Took 5 months. She referred me to an ENT, another 5 months. If he thinks I need further audiology work, that is likely to be Another 5 months.

Went to my HMO's emergency room for chest pain. They did an EKG promptly, to rule out heart attack, then sent me to a crowded waiting room for 8 hours, then admitted me to the ER and hospital for 2 days, during all of which time I did not see any doc specializing in either cardiology or pulmonology. Discharged with a recommendation that I see the cardiology department, which took several months. Returned from a trip in which I suffered pneumonia, with a SAT of 70%, and a strong recommendation from the treating doc that I see a pulmonologist Immediately on return home. My HMO told me they could see me in Five Months, at the earliest. I said "by that time I will be either well, or Dead. Don't waste my time!" I went to my concierge PCP, who treated me with steroids for my remaining symptoms, and I felt decent after a couple weeks.

New Mexico is a "a Medical Desert" with IIRC the Lowest ratio of Docs per population in the country, and they are retiring/fleeing at a frightening rate.

 

[Citizen]

Exactly. They follow Medicare which has steadily decreased reimbursement. And to get the saving from single payer Medicare for all that you plan? Reimbursement will drop even further . Causing facilities to close and reducing the number of providers and actually hurting the economy etc.
There is no free lunch here.

No insurance companies are for profit. In no way do they follow Medicine

 

[jaeger19]

We don’t. But even if we did, medical treatment is orders of magnitude more than just cancer treatments.

Well according to the research we do.
If you are a person with cancer it would matter quite a bit.

What if you are waiting for surgery?
“As the following chart also shows, waiting times for non-emergency surgeries also varied widely from one country to another. In 2023, the average waiting time was lowest in the U.S. and Switzerland (28 days), while it was highest in Spain (77 days) and France (63 days).”

Hmmm?

 

[rahl]

Well according to the research we do.

No we don’t.

If you are a person with cancer it would matter quite a bit.

It doesn’t matter.

What if you are waiting for surgery?

You’re better off in single payer countries.

“As the following chart also shows, waiting times for non-emergency surgeries also varied widely from one country to another. In 2023, the average waiting time was lowest in the U.S. and Switzerland (28 days), while it was highest in Spain (77 days) and France (63 days).”

Hmmm?

Single payer systems provide better care at a fraction of the cost the US does. Sorry.

 

[upsideguy]

Here are some claims I believe to be true:

1) U.S. healthcare is insanely expensive.

2) Americans, as a group, are not healthy.

3) Most insurance plans are terrible - high deductibles, surprise bills, and claim denials are the norm.

Agreed.... though I would argue a big part of the expense of the healthcare system is that is treats the outcomes of the unhealthy American lifestyle at a much greater cost than if it had a more preventative / consultative focus the prevented or mitigated the unhealthy choices in the first place. We have unhealthy lifestyles largely because of lack of access to doctors.

Now imagine flipping a switch: healthcare is suddenly “free.” No co-pays, no deductibles - just walk in. First come, first served.

I don't believe anyone is advocating "free no copay", no deductible insurance on a walk-in basis. Medicare is not that; nor would Medicare for all be that. So, your all or nothing line of reasoning here needs work, as the practical answer is a sensible Medicare for All system that is still managed.

What happens next?

Everyone shows up.

People who’ve been putting off checkups, procedures, and diagnostics flood the system overnight. Not just the sick, but everyone. Because when something expensive becomes free, demand doesn’t just rise - it explodes.

Yes, you might have a greater stress on the medical in the short run, but in the long run, the medical community would be focuses on maintenance (making sure unnecessary health catastrophes do not happen), rather than wasting resource on handling health catastrophes when they do --- fewer such catastrophes, more resources devoted to preventing them.

Hospitals would be swamped. Doctors would be way overbooked.

The next step is waiting lists.

The NHS has 6 million patients on waiting lists.

In Canada, the average wait time from initial visit to treatment is over six months.

Yet, the NHS and Canadian systems are far cheaper to operate, have better outcomes (a much longer life expectancy at a lower cost in those countries), with higher customer satisfaction than private insurance in the US....

Public satisfaction with national health systems by country worldwide 2019| Statista

According to the findings of a survey by IPSOS, satisfaction with national health systema varies widely between countries.

www.statista.com

Interesting that Medicare in the US also has higher customer satisfaction ratings then most private health insurance options.

Overall Satisfaction with Medicare is High, But Beneficiaries Under Age 65 With Disabilities Experience More Insurance Problems Than Older Beneficiaries | KFF

This brief analyzes data from the 2023 KFF Survey of Consumer Experiences with Health Insurance to get a current understanding of how Medicare is working for older adults and younger people with disabilities. The analysis shows that people with Medicare who are under 65 with disabilities...

www.kff.org

Our system would be 5x times larger than the NHS. Socialist institutions work worse the bigger they get.

Don't buy that argument. America has its own health infrastructure that current accommodates the demand. No reason it could not continue to deliver

Btw, can you guess what increased demand does to the price of a service like healthcare? It sends it up, up, up. That means the crazy taxes they imposed to pay for medicare for all aren't going to be nearly enough.

Medicare for All would bankrupt the country.

No, it would not ..... all the money people spend on private health insurance premiums with extensive inefficiencies in the administration would spend that money either in taxes or premium payments for Medicare for All..... Medicare would benefit from having a more profitable group that has less health insurance risk and pays good premiums.

Sorry, but the one area the government seems far to superior to private industry is in the management of health insurance systems. The US spends 50% more on this than any other country, yet has the poorest outcomes in the 1st world.

Why the U.S. Healthcare System Is So Much Worse Than Its Peers

Given its collective wealth, technologic sophistication, and spending, the United States should lead, not lag, the world in its healthcare performance. But based on 70 performance measures across five domains — access to care, health outcomes, administrative efficiency, care process, and equity...

hbr.org

 

[jaeger19]

No insurance companies are for profit. In no way do they follow Medicine

No they definitely follow Medicare.
In fact Medicare is managed by private insurers .
“While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.”

33. Medicare is a Private–Public Partnership - Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of...

medicareadvocacy.org

This is why people telling you that Medicare for all will get private insurance companies out of healthcare are full of bunk.

 

[jaeger19]

No we don’t.

It doesn’t matter.

You’re better off in single payer countries.

Single payer systems provide better care at a fraction of the cost the US does. Sorry.

1. You are welcome to provide the research on survival rates with lung cancer refuting my cited research.
2. Sure it does . As my citation shows
And it matters if you are waiting for elective surgery.
3. Depends on your definition of “ better”.
If you don’t have insurance in the us? Absolutely. If you have Medicare or Medicaid ?
You are better off here. If you have private insurance”. Mostly you are better off here.
4. Not better care. If they did , issues with like cancer wouldn’t be found or increase wait times for elective surgeries like a total shoulder wouldn’t be found now would they.?

You don’t really have a response now do you.?

 

[Citizen]

No they definitely follow Medicare.
In fact Medicare is managed by private insurers .
“While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.”

33. Medicare is a Private–Public Partnership - Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of...

medicareadvocacy.org

This is why people telling you that Medicare for all will get private insurance companies out of healthcare are full of bunk.

So you agree that Medicare is like private insurance. Good

 

[jaeger19]

Agreed.... though I would argue a big part of the expense of the healthcare system is that is treats the outcomes of the unhealthy American lifestyle at a much greater cost than if it had a more preventative / consultative focus the prevented or mitigated the unhealthy choices in the first place. We have unhealthy lifestyles largely because of lack of access to doctors.

No . We have unhealthy lifestyles due to culture that’s independent of access to doctors

I don't believe anyone is advocating "free no copay", no deductible insurance on a walk-in basis. Medicare is not that; nor would Medicare for all be that. So, your all or nothing line of reasoning here needs work, as the practical answer is a sensible Medicare for All system that is still managed.

Well that’s an interesting thought. So what happens to people that have Medicaid that don’t have co pays or deductibles like Medicare.

Yes, you might have a greater stress on the medical in the short run, but in the long run, the medical community would be focuses on maintenance (making sure unnecessary health catastrophes do not happen), rather than wasting resource on handling health catastrophes when they do --- fewer such catastrophes, more resources devoted to preventing them.

Medicare doesn’t do much preventative medicine . And due to the decrease in reimbursement facilities will begin closing.

Yet, the NHS and Canadian systems are far cheaper to operate, have better outcomes (a much longer life expectancy at a lower cost in those countries), with higher customer satisfaction than private insurance in the US....

Longer lifespans are not indicative of the healthcare system .

Public satisfaction with national health systems by country worldwide 2019| Statista

According to the findings of a survey by IPSOS, satisfaction with national health systema varies widely between countries.

www.statista.com

Interesting that Medicare in the US also has higher customer satisfaction ratings then most private health insurance options.

It is better generally for clients. That will change if you want to have the savings you plan. You will have to ration care as other countries with single payer do.

Overall Satisfaction with Medicare is High, But Beneficiaries Under Age 65 With Disabilities Experience More Insurance Problems Than Older Beneficiaries | KFF

This brief analyzes data from the 2023 KFF Survey of Consumer Experiences with Health Insurance to get a current understanding of how Medicare is working for older adults and younger people with disabilities. The analysis shows that people with Medicare who are under 65 with disabilities...

www.kff.org

Don't buy that argument. America has its own health infrastructure that current accommodates the demand. No reason it could not continue to deliver

Well except that it will respond by closing facilities and mass retirements.

No, it would not ..... all the money people spend on private health insurance premiums with extensive inefficiencies in the administration would spend that money either in taxes or premium payments for Medicare for All..... Medicare would benefit from having a more profitable group that has less health insurance risk and pays good premiums.

That is possible.

Sorry, but the one area the government seems far to superior to private industry is in the management of health insurance systems. The US spends 50% more on this than any other country, yet has the poorest outcomes in the 1st world.

Why the U.S. Healthcare System Is So Much Worse Than Its Peers

Given its collective wealth, technologic sophistication, and spending, the United States should lead, not lag, the world in its healthcare performance. But based on 70 performance measures across five domains — access to care, health outcomes, administrative efficiency, care process, and equity...

hbr.org

Except those aren’t really healthcare outcomes that measure our healthcare system .

 

[jaeger19]

So you agree that Medicare is like private insurance. Good

Well no.
Medicare reimburses considerably less than private insurance.

 

[Citizen]

Well no.
Medicare reimburses considerably less than private insurance.

You can’t have it both ways

 

[jaeger19]

You can’t have it both ways

What “ both ways”
It’s not “ either/or”.
That’s the problem with both sides of this issue . Reality is different than either sides propaganda.

 

[Citizen]

What “ both ways”
It’s not “ either/or”.
That’s the problem with both sides of this issue . Reality is different than either sides propaganda.

So therefore, Medicare would in no way make healthcare worse

 

[jaeger19]

So therefore, Medicare would in no way make healthcare worse

Well it would in that lowered reimbursement would speed up facilities including hospitals closing and reduce the number of physicians and other healthcare providers .

That would decrease the timeliness and perhaps the quality of care.

 

[KingLeo]

Here are some claims I believe to be true:

1) U.S. healthcare is insanely expensive.

2) Americans, as a group, are not healthy.

3) Most insurance plans are terrible - high deductibles, surprise bills, and claim denials are the norm.


Now imagine flipping a switch: healthcare is suddenly “free.” No co-pays, no deductibles - just walk in. First come, first served.

What happens next?

Everyone shows up.

People who’ve been putting off checkups, procedures, and diagnostics flood the system overnight. Not just the sick, but everyone. Because when something expensive becomes free, demand doesn’t just rise - it explodes.

Hospitals would be swamped. Doctors would be way overbooked.

The next step is waiting lists.

The NHS has 6 million patients on waiting lists.

In Canada, the average wait time from initial visit to treatment is over six months.

Our system would be 5x times larger than the NHS. Socialist institutions work worse the bigger they get.

Btw, can you guess what increased demand does to the price of a service like healthcare? It sends it up, up, up. That means the crazy taxes they imposed to pay for medicare for all aren't going to be nearly enough.

Medicare for All would bankrupt the country.

Not that much different here in the US.
Recently needed to see a urologist but my BCBS requires I first go through my primary care doctor.
Called my primary care doctor and got an appointment in 2 weeks.
Went to that appointment and the doctor spent maybe 4 minutes with me and agreed I need to see a specialist, a urologist, and he would make the referral.
Was charged for the appointment plus the labs.
Since my BCBS requires I first meet my yearly out of pocket costs before the full insurance benefits kick in that cost me money.
Got the appointment with the Urologist which was 3 1/2 weeks out.
Went to that appointment and was examined and labs ordered again.
Urologist determined I needed some more tests.
Paid for the appointment and the labs again.
Got an appointment for the new testing 1 1/2 weeks out.
Got the testing and was charged for the testing (I have not yet met my BCBS yearly out of pocket amount).
Testing showed I have bladder cancer and am now referred to a cancer doctor with an appointment 4 weeks out.
Am waiting for that appointment.
So the process so far has taken 11 weeks, and it is not over yet, and about $3,000 out of pocket expenses, and again it is not over yet.
My friend in Winnipeg told me that the wait in Canada probably would have been a little longer but my out of pocket would have been $0.