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Americans - would you support single-payer?

Would you support a single payer system in the US?

  • Total voters
    108
Tender Branson said:
Here in Austria, we actually have single-payer healthcare (but decentralized), unlike the NHS in Great Britain.

Until a few years ago, every of the 9 states had its own chapter of the ÖGK (Austrian Healthcare System), managing the finances on their own. This was merged into one a few years ago to make bureaucracy more efficient.

Now, the ÖGK has just 4 branches left (based on regularly-employed, self-employed, farmers and state bureaucrats, retirees).

Anyway, some say the merger has cut costs and lowered debts, others say it was useless and didn't lead to any major improvements ...

Austria's healthcare system is generally very solvent and despite single-payer (or slightly decentralized), it has virtually no debts. Only 1 billion € in debt, with more than 9 million people insured. Sometimes, it even runs surpluses.

The ÖGK (the Austrian Universal Healthcare System) is part of the Sozialversicherung (Social Insurance), which is universal and combines Health, Unemployment, Pension and Work Accident Insurance as well as Welfare payments and Asylum Compensation. This means that 99.9% of the Austrian population is insured for health and other insurances. Only a few thousand people are not insured at any time of the year because for example newly arrived asylum seekers who get their asylum applications processed and approved and only then they are fully insured. But even for these few thousand people, doctors will usually treat them and refund the costs later with the ÖGK once they are insured.

On top of that, Austrians who are wealthier, can of course have private insurances too. These will lead to swifter appointments with specialized doctors. But the universal healthcare appointments are also with no long waiting times. The Austrian healthcare system ranks in the top 10 worldwide.
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What can (could?) be and what our congress critters can (could?) get passed are two very different things.
 
ttwtt78640 said:
What can (could?) be and what our congress critters can (could?) get passed are two very different things.
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I'm not sure if our system could be introduced in the US. Maybe it would be a major improvement, maybe not.

But the concept that Americans have to "shop" for insurances on healthcare every other year or so and get "hospital bills" that they have to send in to their insurance provider to get refunded or something makes my head hurt.

Here in Europe, patients don't get a bill from a hospital or doctor after a treatment or surgery, listing thousands of dollars for everything (ultrasound, blood draw etc.)

The hospital and doctors will automatically refund all their costs with the universal health care agency and the patient never sees a bill or has almost nothing to do on their own.

We have very few out-of-pocket pays in fact and this usually just involves some medicines you get at the pharmacy. Many low-income earners are even exempt from drug purchases at pharmacies.
 
aociswundumho said:
Every country with UHC has a two-tiered system. A private system for wealth politicians and the like, and a public system for everyone else. Just like we have private schools along with shit public schools.
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aociswundumho said:
Politicians will not vote for a public system if they will be forced to use it.
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Weren't the congressional staffers also exempted from ObamaCare? So what you say here rings true.
 
washunut said:
The Share of Americans without Health Insurance in 2022 Matched a Record Low. In 2022, 26 million people — or 7.9 percent of the population – were uninsured, according to a report in September 2023 from the Census Bureau.Nov 9, 2023
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That's way to high
 
Allan said:
Just a temperature check on how Americans feel about single-payer universal health care.
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You may have already but if not, please define in this context. What sort of plan exactly?
 
zincwarrior said:
You may have already but if not, please define in this context. What sort of plan exactly?
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Single-payer healthcare is an abstract term.

There is for example the NHS in the United Kingdom, which is really a centralized single-payer healthcare system. From what I understand, this worked well in the past decades, but recently is also struggling a lot with long wait times and emergency units not being able to come to all patients quickly etc.

Then, there are modified versions of universal health care systems that we smaller countries like Austria and Switzerland have: they are also single-payer by construction, but decentralized into various different agencies or layers, to allow for more efficient planning, finances and so on. On top of that, people can insure themselves privately to get better access, creating a competing system of doctors which leads to better outcomes, better pay etc. also for universal healthcare doctors etc. and in turn better care for the patients. And not just 90% of people, like in the US, but for all.

I prefer our approach, even if it is not flawless and many improvements need to be made (as the Covid-situation has shown). Our Swiss and Austrian models are also made for smaller countries, and not for a 350 million country. But it could be introduced by a few US states and seen what the outcomes are.
 
Trippy Trekker said:
@Allan -

Glad to see the vast majority of members who participated in your POLL chose to support the concept of a single-payer health system.
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I'm not surprised. A year or so ago I posted an OP asking members which policies of the "other side" they supported. By far UHC was the policy that was most frequently embraced by the right.
 
Trippy Trekker said:
@Allan -

Glad to see the vast majority of members who participated in your POLL chose to support the concept of a single-payer health system.

In the Big Picture, we either choose to focus on the Common Welfare for the benefit of the most people or we don’t give a rat’s ass about the Common Welfare.

I have come to recognize which of the two camps many of our members belong in,
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There is vast difference between supporting a concept and supporting a particular piece of federal legislation (which includes the ‘pay for’) allegedly implementing that concept. Few object to the concepts of affordable housing, a living wage or public mass transit, but the devil is in those pesky implementation details.
 
eohrnberger said:
Weren't the congressional staffers also exempted from ObamaCare? So what you say here rings true.
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Nope, the opposite appears to be true.

Most Americans do not use the health insurance exchanges, but members of Congress and their staff are specifically required to use the exchange in order to maintain their employer-sponsored health benefits.
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www.verywellhealth.com

Is There a Penalty for Being Uninsured in 2024?

In most states, there's no longer a penalty for being uninsured. But uninsured residents in a few states will owe a penalty on their state tax return.
www.verywellhealth.com www.verywellhealth.com
 
Allan said:
Just a temperature check on how Americans feel about single-payer universal health care.
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My condition would be to pay for the basic needed and emergency services, and have private health insurance companies still offer better plans that covered better options.
 
Lord of Planar said:
My condition would be to pay for the basic needed and emergency services, and have private health insurance companies still offer better plans that covered better options.
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I think that's kind off what we have. The system covers "essential" healthcare needs. Essential is determined by a person's physician.
 
ttwtt78640 said:
IMHO, the biggest problem with UHC is that the wonderful cost savings, advertised by switching to UHC, are largely obtained simply by paying medical care providers less. That likely means the cost of educating (training?) medical care provider personnel must also become publicly funded, as is the case in many (if not most) UHC nations.
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Most health care insurance providers also fix the cost of services at below uninsured rates which the health care provider agrees to as part of being "in network".

Do you have any comparisons between Medicare fixed rates and private insurer fixed rates?

I recently (2022) had to drop one health care provider because they would no longer accept my insurance because at the contracted private insurance fixed rates they were losing money with each patient visit.

[Not intended as a sealioning question. Really interested in an apples to apples comparison.]

WW
 
WorldWatcher said:
Most health care insurance providers also fix the cost of services at below uninsured rates which the health care provider agrees to as part of being "in network".

Do you have any comparisons between Medicare fixed rates and private insurer fixed rates?
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Yes.

www.kff.org

How Much More Than Medicare Do Private Insurers Pay? A Review of the Literature | KFF

This brief reviews findings from recent studies that compare Medicare and private health insurance payment rates for both hospital and physician services.
www.kff.org www.kff.org

WorldWatcher said:
I recently (2022) had to drop one health care provider because they would no longer accept my insurance because at the contracted private insurance fixed rates they were losing money with each patient visit.

[Not intended as a sealioning question. Really interested in an apples to apples comparison.]

WW
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This also occurs with (private) Medicare Advantage plans. Our (WellCare) Medicare Advantage plans pay us each $95/month by taking less in Medicare Part B premiums out of our SS retirement benefits.
 
ModernDiogenes said:
I would support it IF its quality of care was better.

The problem is it’s a staple of single payer health care that for everyday stuff it’s great. If you need specialty care that increases with age the lines get long.

If I need a hip I want it yesterday. I don’t want to wait six months till they get around to me. If I need cardiac surgery I don’t want single payer’s lack of cardiac surgeons to cause me to die while I’m waiting for a table and a cutter.

This nation sucks for health care if you aren’t rich or have great insurance. If you are rich or have great insurance it’s better than nations with single payer. I have great health insurance.

I get it if you have lousy or no insurance and I wish you better. Our system is broken and needs restructuring. It’s better for me personally though than a single payer alternative with my current situation.
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Do you find short lines today? We needed to find an endocrinologist, nobody was available within a 1hr drive for 6 months.
 
Allan said:
Just a temperature check on how Americans feel about single-payer universal health care.
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Looks like most posters want a single payer universal health care system. Pew Research Institute finds similar %
www.pewresearch.org

Increasing share of Americans favor a single government program to provide health care coverage

63% of U.S. adults say the government has the responsibility to provide health care coverage for all, up slightly from 59% last year.
www.pewresearch.org www.pewresearch.org

But we don't have universal health insurance. Instead we have this outrageous mess of high insurance and medical costs, insurance corporations that won't take risks, pharmaceutical corporations that won't negotiate, companies using religion to determine coverage, 26 million uninsured, employers large and small unfairly tasked with providing insurance companies with high profits, and abysmal national health statistics.

So what happens to candidates in the time between election when they say they will represent our needs in Congress and the next session of a new Congress that causes elected Senators and Representatives to completely forget what the public wants?
 
rickc said:
Could you give us a few details on why you feel the way you do?
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Because I am old and wise enough to work out the stupidity of the concept of "single payer", a system that would not work in the US, we cannot afford it, and it would simply lead to government rationing of healthcare as it has in any other nation that operates under a single payer system.
 
Allan said:
Just a temperature check on how Americans feel about single-payer universal health care.
Click to expand...


They should.

Canadians live longer, have a higher standard of living and no one goes bankrupt trying to pay for a heart transplant.

In fact, with our system, and its easy access, heart disease is usually detected early as was my case.
 
weaver2 said:
Looks like most posters want a single payer universal health care system. Pew Research Institute finds similar %
www.pewresearch.org

Increasing share of Americans favor a single government program to provide health care coverage

63% of U.S. adults say the government has the responsibility to provide health care coverage for all, up slightly from 59% last year.
www.pewresearch.org www.pewresearch.org

But we don't have universal health insurance. Instead we have this outrageous mess of high insurance and medical costs, insurance corporations that won't take risks, pharmaceutical corporations that won't negotiate, companies using religion to determine coverage, 26 million uninsured, employers large and small unfairly tasked with providing insurance companies with high profits, and abysmal national health statistics.

So what happens to candidates in the time between election when they say they will represent our needs in Congress and the next session of a new Congress that causes elected Senators and Representatives to completely forget what the public wants?
Click to expand...

OK, but when they come up with nonsense like H.R. 676 (M4A), it’s no surprise that it won’t pass.

 
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