Key Design Components and Considerations for Establishing a Single-Payer Health Care System

[sangha]

We don't know yet.

That's the point of the OP. We know that you cannot get the savings that are being claimed.. and savings that are being compared to other countries like Canada.. without having insurance that's like those countries. I mean.. you can't go "we are going to get savings from our single payer like Canada and other countries do"... then design a single payer that pays for way more than these countries do.. that doesn't cut reimbursements to providers like these other countries do, that doesn't put in controls like pre authorizations like these countries do, that doesn't decrease access to hospital beds and equipment that these other countries do. Its just not logical.

There is no free lunch with single payer.

Now.. I get that you will never listen to me.. because I have conservative in my lean... but Greenbeard here has done an excellent job on multiple threads of pointing out these various facts and why our system costs more.

You're right. The fictional plan you made can't possibly save any money.

However, no one cares about your fictional plan

 

[rickc]

Simple answer is for those who don't want a single payer system their answer will always be "It won't work"

But the truth is we are the only top tier country in the world that doesn't have health care for all.

Now what does that tell you?

Simple answer. Those who are profiting handsomely from our present system are very powerful. Those rich and powerful that believe health care for.all would get in ther pocket don't want it. Unfortunately those rich and powerful own one party of our government. They will fight it to the bitter end.

 

[Neomalthusian]

Simple answer is for those who don't want a single payer system their answer will always be "It won't work"

But the truth is we are the only top tier country in the world that doesn't have health care for all.

Now what does that tell you?

It tells us you don't comprehend the difference between single payer and universal health care.

You're right. The fictional plan you made can't possibly save any money.

However, no one cares about your fictional plan

In this sense, any single payer plan that could conceivably ever come to pass is a fictional plan at this point.

Some people are so ideologically gung-ho about single payer that they can't be bothered by literally any of the specifics pointed out in the OP. Any specificity is considered nay-saying. Details are sobering. This thing needs to run on pure, blind excitement.

 

[jaeger19]

You're right. The fictional plan you made can't possibly save any money.

However, no one cares about your fictional plan

My fictional plan actually would not save money.. .that's really not a very good goal..

Hurting our GDP doesn't really make sense. If we get the savings that Bernie hopes to get.. it lowers our GDP by 5-8%.. which is a greater decrease than the great recession. And those healthcare jobs are what props up a lot of communities . In fact.. healthcare is one of the top industries for hiring.

My plan will make insurance more affordable to people
Get everyone covered
Solve the portability problem
And uses the existing structure of Obamacare as a spring board.

But whatever man.. you know better because...…..?????

 

[jaeger19]

Simple answer is for those who don't want a single payer system their answer will always be "It won't work"

But the truth is we are the only top tier country in the world that doesn't have health care for all.

Now what does that tell you?

Simple answer. Those who are profiting handsomely from our present system are very powerful. Those rich and powerful that believe health care for.all would get in ther pocket don't want it. Unfortunately those rich and powerful own one party of our government. They will fight it to the bitter end.

The problem is..there is no simply answer here.

Sure.. we can have single payer.. other countries definitely do it.. we could here.

But.. as pointed out.. there is no free lunch. And you cannot get the savings that other countries do... while designing your single payer completely different than the way they do it.

By the way?

Those rich and powerful that believe health care for.all would get in ther pocket don't want it. Unfortunately those rich and powerful own one party of our government. They will fight it to the bitter end.

Actually single payer will be a boon to insurance companies. Those of you that think it won't be.. don't realize that right now.. 60% or so of private insurance company revenue comes from administering public insurance plans.

Single payer will be a boon to them. Collect nice fat fees from the government for administering public plans... with no risk. Then offer separate plans for the ultra wealthy and supplemental plans for the upper middle class at high rates.

 

[sangha]

My fictional plan actually would not save money.. .that's really not a very good goal..

Hurting our GDP doesn't really make sense. If we get the savings that Bernie hopes to get.. it lowers our GDP by 5-8%.. which is a greater decrease than the great recession. And those healthcare jobs are what props up a lot of communities . In fact.. healthcare is one of the top industries for hiring.

My plan will make insurance more affordable to people
Get everyone covered
Solve the portability problem
And uses the existing structure of Obamacare as a spring board.

But whatever man.. you know better because...…..?????

We should waste money on health care in order to prop up GDP?

That was the worst and most desperate argument against M4A I've ever heard!! :lamo

 

[sangha]

The problem is..there is no simply answer here.

Sure.. we can have single payer.. other countries definitely do it.. we could here.

But.. as pointed out.. there is no free lunch. And you cannot get the savings that other countries do... while designing your single payer completely different than the way they do it.

By the way?



Actually single payer will be a boon to insurance companies. Those of you that think it won't be.. don't realize that right now.. 60% or so of private insurance company revenue comes from administering public insurance plans.

Single payer will be a boon to them. Collect nice fat fees from the government for administering public plans... with no risk. Then offer separate plans for the ultra wealthy and supplemental plans for the upper middle class at high rates.

1. The only posts mentioning a free lunch are yours

2. Single payer plans have been estimated to save between $2 to $5 trillion over 10 years

3. SP will be a boon for insurance companies. That's why they oppose SP

 

[jaeger19]

We should waste money on health care in order to prop up GDP?

That was the worst and most desperate argument against M4A I've ever heard!! :lamo

Please explain how its a waste? Yeah.. you don't even have a clue what you are talking about.

Yep.. we pay more in healthcare than other countries. Is that a waste to you.

Okay.. well I pay way more in wages in the US than I do if my businesses were in mexico. So I guess those larger wages are just waste right? We should actively try to reduce the salaries of American workers.. because if we pay more than other countries.. we are paying for waste... right?

You really need to think before you write..

That GDP is kept in the US. Its very hard to outsource healthcare. That money in healthcare.. goes largely to wages, to construction etc. jobs that are done in the US. And when you consider that a good portion of that healthcare is done by non profits.. well then. it adds up to a lot of money that goes to wages, and other things that help our economy.

Its not a desperate argument against M4A... in fact.. its going to be a serious issue when it comes down to enacting medicare for all.. if it happens. So.. what do you think happens when communities find out that reduction in healthcare means that their local hospital has to close? That salaries in their communities are going down with reductions in healthcare worker salaries or reductions in hiring. What happens when contractors that were busy building and expanding non profit hospitals are out of work?]

You think that your representatives are going to vote for reductions in the payments, and money flowing into their states?


Oh wait.. that's right.. in medicare for all.. you are going to reduce healthcare cost in half.. but that's not going to have any effect on the economy.

AND.. all those savings? That's going to magically be doled out to the poor and middle class by some magical means.

 

[jaeger19]

1. The only posts mentioning a free lunch are yours

P

Right.. because I am speaking from reality.. not pie in the sky. As the OP points out.. none of this can be actually scored until we know the benefits, how its administered etc.


You are the folks that think that reducing healthcare costs and reducing GDP by more than it was reduced in the Great Depression is not going to have an effect on the US economy in terms of jobs (when healthcare is one if not the top industry for new hiring).. or in terms of salaries.

Single payer plans have been estimated to save between $2 to $5 trillion over 10 years

Sure.. which means that 2 to 5 trillion dollars will be taken out of the economy.. But of course.. that won't have any effect on said economy right?

SP will be a boon for insurance companies. That's why they oppose SP

They don't oppose single payer. Single payer is largely a boon for them. They would only say oppose a single payer that cut them out of administration since right now.. 60 percent of private insurance revenues are from public plans. but otherwise most forms of single payer are a boon to them.

 

[sangha]

Please explain how its a waste? Yeah.. you don't even have a clue what you are talking about.

Yep.. we pay more in healthcare than other countries. Is that a waste to you.

Okay.. well I pay way more in wages in the US than I do if my businesses were in mexico. So I guess those larger wages are just waste right? We should actively try to reduce the salaries of American workers.. because if we pay more than other countries.. we are paying for waste... right?

You really need to think before you write..

That GDP is kept in the US. Its very hard to outsource healthcare. That money in healthcare.. goes largely to wages, to construction etc. jobs that are done in the US. And when you consider that a good portion of that healthcare is done by non profits.. well then. it adds up to a lot of money that goes to wages, and other things that help our economy.

Its not a desperate argument against M4A... in fact.. its going to be a serious issue when it comes down to enacting medicare for all.. if it happens. So.. what do you think happens when communities find out that reduction in healthcare means that their local hospital has to close? That salaries in their communities are going down with reductions in healthcare worker salaries or reductions in hiring. What happens when contractors that were busy building and expanding non profit hospitals are out of work?]

You think that your representatives are going to vote for reductions in the payments, and money flowing into their states?


Oh wait.. that's right.. in medicare for all.. you are going to reduce healthcare cost in half.. but that's not going to have any effect on the economy.

AND.. all those savings? That's going to magically be doled out to the poor and middle class by some magical means.

If you spend $x on something that you could get for less than $x, then the difference is waste

 

[sangha]

Right.. because I am speaking from reality.. not pie in the sky. As the OP points out.. none of this can be actually scored until we know the benefits, how its administered etc.


You are the folks that think that reducing healthcare costs and reducing GDP by more than it was reduced in the Great Depression is not going to have an effect on the US economy in terms of jobs (when healthcare is one if not the top industry for new hiring).. or in terms of salaries.



Sure.. which means that 2 to 5 trillion dollars will be taken out of the economy.. But of course.. that won't have any effect on said economy right?



They don't oppose single payer. Single payer is largely a boon for them. They would only say oppose a single payer that cut them out of administration since right now.. 60 percent of private insurance revenues are from public plans. but otherwise most forms of single payer are a boon to them.

1. When you argue against people who think there is a free lunch, you aren't speaking from reality; you're imagining things

2. The plans do detail the benefits. Your statements about how we don't know what the benefits are is not you speaking from reality; it's you speaking from ignorance

3. The money we don't spend on health care doesn't magically disappear.

 

[jaeger19]

If you spend $x on something that you could get for less than $x, then the difference is waste

Okay.. so according to you.. paying my employees is a waste.. because in other countries.. I could pay 1 dollar an hour instead of a minimum wage of 10 dollars an hour.

So we should eliminate the minimum wage.. so we are not wasting money.

If you disagree.. please explain why its not a waste.

 

[sangha]

Okay.. so according to you.. paying my employees is a waste.. because in other countries.. I could pay 1 dollar an hour instead of a minimum wage of 10 dollars an hour.

So we should eliminate the minimum wage.. so we are not wasting money.

If you disagree.. please explain why its not a waste.

I don't know anything about how you run your business but I wouldn't be surprised if you are not doing it wisely

 

[jaeger19]

1. When you argue against people who think there is a free lunch, you aren't speaking from reality; you're imagining things
.

Nope.. facts are facts. IF you think you are going to get the same savings as in Canada.. but don't set up your system similar to Canadas.. and you think its simply by having single payer... well then you think there is a free lunch when it comes to single payer.

Sorry sir.. but just a fact.

The plans do detail the benefits. Your statements about how we don't know what the benefits are is not you speaking from reality; it's you speaking from ignorance

No they don't. We have one plan..that seems to leave a lot out. And as the article posted showed.. it has a lot of benefits that are much higher than in other single payer countries... but plans to get similar savings. That just doesn't jibe with reality.


You sir are the one that's been speaking from ignorance.

The money we don't spend on health care doesn't magically disappear.

Actually in a way...much of it does. Its the nature of growth in an economy. There is not a finite amount of money in our economy... as the economy grows..the money supply has to increase accordingly.. (or pull money out of savings which does happen.. but would likely not happen in reaction to single payer). If there is less growth..because you have hurt GDP... then the money growth will be lost as well.

 

[jaeger19]

I don't know anything about how you run your business but I wouldn't be surprised if you are not doing it wisely

I see that you failed to answer my question.

Again.. according to you..by paying my employees minimum wage.. rather than the 1 dollar an hour that I could have paid them in another country.. its a waste of money.

So..should we eliminate the minimum wage.. so that we are not wasting money?

If you disagree..please explain why paying more for something that we could pay less.. its not a waste? (since before you argued that it was wasteful).

 

[sangha]

Nope.. facts are facts. IF you think you are going to get the same savings as in Canada.. but don't set up your system similar to Canadas.. and you think its simply by having single payer... well then you think there is a free lunch when it comes to single payer.

Sorry sir.. but just a fact.

No they don't. We have one plan..that seems to leave a lot out. And as the article posted showed.. it has a lot of benefits that are much higher than in other single payer countries... but plans to get similar savings. That just doesn't jibe with reality.


You sir are the one that's been speaking from ignorance.



Actually in a way...much of it does. Its the nature of growth in an economy. There is not a finite amount of money in our economy... as the economy grows..the money supply has to increase accordingly.. (or pull money out of savings which does happen.. but would likely not happen in reaction to single payer). If there is less growth..because you have hurt GDP... then the money growth will be lost as well.

1. Nothing you said has anything to do with facts

2. The plan has been studied and estimates have been made of the savings that will result. You can obsess about "savings like Canada's " of you want to but I like the way "saving trillions of dollars " sounds

3. The money will not magically disappear

 

[sangha]

I see that you failed to answer my question.

Again.. according to you..by paying my employees minimum wage.. rather than the 1 dollar an hour that I could have paid them in another country.. its a waste of money.

So..should we eliminate the minimum wage.. so that we are not wasting money?

If you disagree..please explain why paying more for something that we could pay less.. its not a waste? (since before you argued that it was wasteful).

It's a waste of money if you don't mind the fines

 

[Lovebug]

If you don't understand, or haven't read, Bernie's plan, Vox did a pretty good rundown on it - Bernie Sanders’s Medicare-for-all plan, explained - Vox

I esp like

Sanders’s single-payer proposal would create a universal Medicare program that covers all American residents in one government-run health plan.

including our veterans.
However, what I have trouble finding is a specific stipulation that all, the rich and the poor, including Congress, have to partake, no exceptions.
That is a sticking point for me.

 

[sangha]

I esp like

including our veterans.
However, what I have trouble finding is a specific stipulation that all, the rich and the poor, including Congress, have to partake, no exceptions.
That is a sticking point for me.

No one has to accept coverage but

1. Insurers are not allowed to sell policies that cover care that single payer covers

2. A person's tax liability remains the same regardless if they accept coverage or not

The end result is that a person who refuses coverage will have to pay out of pocket for care that they could receive for free

 

[jaeger19]

1. Nothing you said has anything to do with facts

Everything I have said has to do with facts. Its a fact that yes..Canada pays less in healthcare costs than the US. One of those reasons is that Canadian Medicare covers less than our current Medicare. Particularly if you compare our Medicare part a plus B, plus D.

Its simply a fact that its not logical to assume the same savings will be generated.. when your insurance will cover so much more.

The plan has been studied and estimates have been made of the savings that will result. You can obsess about "savings like Canada's " of you want to but I like the way "saving trillions of dollars " sounds

I am sure you do. But... 1. Those estimates are based on pie in the sky assumptions. For example.. one of the main assumptions is that by reducing the number of insurances (which is not likely given the way other single payer countries work..since most still have private insurances to handle what the government insurance doesn't handle) that this is going to reduce the amount of administration that healthcare has to do. But this is an erroneous assumption and underscores the lack of understanding of our healthcare system. My administration costs are not due to the number of insurance companies we have to deal with. Insurance companies generally all use standard billing form... right straight out of HCFA..

Its not the number of insurances that have to be dealt with... its WHAT THOSE INSURANCE COMPANIES REQUIRE. Things like preauthorizations, documentation, yada yada yada…


Well.. two of the worst to deal with are Medicaid, and the VA with Medicare being a close third. Government programs. So the assumption that simply going to single payer is going to reduce administration is pure bunk.

3. The money will not magically disappear

It just won't be in the economy. Wages will be less.. jobs will be lost.. hospital systems will close or not grow...despite the increase in demand expected with the baby boomers aging.


You seem to assume that decreasing GDP by more than it was reduced in the great depression.. will have no detrimental economic effect.

 

[jaeger19]

It's a waste of money if you don't mind the fines

So according to you then.. we should get rid of minimum wage because its a waste of money.

Okay then.

I would disagree..but if you think we should get rid of minimum wage because it would be good for the country... well... there is not much good here trying to explain the healthcare system to you.

 

[sangha]

Everything I have said has to do with facts. Its a fact that yes..Canada pays less in healthcare costs than the US. One of those reasons is that Canadian Medicare covers less than our current Medicare. Particularly if you compare our Medicare part a plus B, plus D.

Its simply a fact that its not logical to assume the same savings will be generated.. when your insurance will cover so much more.



I am sure you do. But... 1. Those estimates are based on pie in the sky assumptions. For example.. one of the main assumptions is that by reducing the number of insurances (which is not likely given the way other single payer countries work..since most still have private insurances to handle what the government insurance doesn't handle) that this is going to reduce the amount of administration that healthcare has to do. But this is an erroneous assumption and underscores the lack of understanding of our healthcare system. My administration costs are not due to the number of insurance companies we have to deal with. Insurance companies generally all use standard billing form... right straight out of HCFA..

Its not the number of insurances that have to be dealt with... its WHAT THOSE INSURANCE COMPANIES REQUIRE. Things like preauthorizations, documentation, yada yada yada…


Well.. two of the worst to deal with are Medicaid, and the VA with Medicare being a close third. Government programs. So the assumption that simply going to single payer is going to reduce administration is pure bunk.

It just won't be in the economy. Wages will be less.. jobs will be lost.. hospital systems will close or not grow...despite the increase in demand expected with the baby boomers aging.


You seem to assume that decreasing GDP by more than it was reduced in the great depression.. will have no detrimental economic effect.

1. No one is saying that our savings will be the same as Canada's

2. Insurers don't all use the same form and Medicare and Medicaid are not the hardest to get reimbursement from

3. The money doesn't magically disappear.

 

[sangha]

So according to you then.. we should get rid of minimum wage because its a waste of money.

Okay then.

I would disagree..but if you think we should get rid of minimum wage because it would be good for the country... well... there is not much good here trying to explain the healthcare system to you.

Once again, your post has nothing to do with facts or reality

 

[jaeger19]

Once again, your post has nothing to do with facts or reality

Once again..my post has everything to do with facts or reality.

If you disagree.. fine.. you should easily be able to debunk everything I have posted.

So.. I suggest you get to it..

But no one here better hold their breath.... because you will find out that I am exactly right.

 

[manofknowledge]

And start with which medicare you are talking about. Medicare Part A..Medicare Part B..or Medicare Part D.

Because.. if you plan on getting the savings like Canada.. or other countries..their single payer is NOT like all three medicares put together...

They are like Medicare Part A.. and actually usually less comprehensive than our medicare part A.

Nope..not true. Sorry but that's just one part of Medicare.. not all Medicare.

There is only one Medicare. If you are eligible for one you are eligible for all. Part A is covered without a premium, Part B requires the $125 dollar annual premium, Part C is a private insurance replacement for Parts A, B and D. Part D is pharmacy coverage.
Canada is irrelevant to the conversation. My reference is to current Medicare.

24.7 million Americans still have no health insurance. For them Medicare for All is by far the best solution.

Key Facts about the Uninsured Population | The Henry J. Kaiser Family Foundation

41% of working age Americans have unpaid medical debt. Medicare for All eliminates this drag on the economy.

Survey: 79 Million Americans Have Problems with Medical Bills or Debt | Commonwealth Fund