Good. Then you can have a single payer system and have a robust economy. I knew we would finally get there. LOL
Well.. you can if you start with an economy that does not have almost 1/3 of its GDP as healthcare.
Which.. wait.. we do.
I am an actual expert. Who works in Insurance.
Single payer will magically just cost less, because of how hospitals set their prices.
They use something called a Chargemaster. Expecting to have to negotiate with hundreds of different insurance companies, and medicare. They set their prices about 1000 percent above cost. It's common for a client of mine to receive an out of network bill for double or triple, what it would cost in network. Now here's the thing, that in network cost is still marked up at least 100 percent above cost.
The only reason we even know what things cost is because of VA hospitals by the way, Hospital Cartels do not put those numbers out, and actively derail any attempt to do so. They lobby more than oil. To keep their price fixing game going.
Medicare, pays an average of an areas cost for a procedure. So hospitals jack up price in an area to drive up what medicare pays them.
A single payer system, means one negotiator, instead of thousands. One standardized set of prices. And an end to price fixing from hospitals. Under a single payer system. A broken arm won't cost 6,000 dollars. It will cost 400.
So yes. From an actual expert. Who works in Insurance. Who faces a 10,000 dollar fine and loss of license if knowingly misleads anyone about insurance.
Cost will magically go down under a single payer system.
Edit: and if the one person who works for the hospital disagrees, he is free to post the chargemaster list for his hospital to prove me wrong. Otherwise, let's not do this again.
Not relevant
Please explain why the state of the US economy and healthcare is not relevant to a discussion of what would happen if you cut healthcare in say half (to be around Canadian levels).
Why on earth would we cut healthcare in half when we have many many more people than they do? What utter nonsense?
Oh.. so then we are going to then spend exactly what we are now on healthcare? You don't make sense here.
If we did and cover everyone without excessive co pays or deductibles and they get services as good as what canadians get who happen to LOVE their system isn't that a great thing?
Sure.. and if we could have wages be doubled in this country.. while the costs of goods and services go down by 90%.. wouldn;t that be a good thing?
What if the North Korea dictator decides to step down and North Korea becomes a free and democratic and pro US state.. wouldn;t that be a good thing?
Wanted stuff is one thing...
Actually getting there is another... and so far.. you haven't provided a lick of evidence that suggest we can without having to make choices... like whether we want rural hospitals or whether we want lower wages and higher unemployment.. or we want longer wait times or loss of pharmaceutical coverage.
Except that Canada did it.....so there's that. I know you hate that but it remains true. LOL
Canada has good wages, low unemployment, rural hopspitals and drug coverage in the Canadian system (public and private) and they LOVE their system
Pros
- Universal coverage...
- Administrative simplicity ...
- Unified policy direction ...
- Rate-setting...
Cons
1.Cost. The single-payer wouldn't erase the high costs of the American health system, it would inherit them. Never has anyone tried to install single-payer on top of a system with such a high cost structure and constituting such a large percentage of GDP. The trillion plus dollars in premium revenue flowing through private insurers right now would instead have to flow through the treasury. That's a big tax issue, a tall order and responsibility for the federal government, and a philosophical and political tinderbox.
2.Politics. If part of our predicament has been that we've collectively avoided hard decisions for decades, I don't see much hope that single-payer would solve it. There are many reasons we pay so much for health care: we employ 'too many' people in that industry (including blue and white collar jobs), we pay them wages that are 'too' high, we get 'too many' services and have 'too much' capacity, we use 'too many' medicines, and have access to new drugs and new technologies 'too quickly.' And so on. [Note that it's the promise these "problems" will be fixed that leads to the constant discussion of increasing wait times.]
If we've collectively decided that this isn't worth the cost and we're willing to give it up (and I don't believe that we have agreed this), then we're still going to face individual defections from those conclusions. Maybe we in the U.S. have too many hospitals, but your local Congressman and local politicians certainly aren't going to be in favor of your local hospital closing. The politics of hospital closures and layoffs will be even tougher than the politics of base closures, affecting every single Congressional district in the country. Putting tough decisions about cold, hard realities in the political sphere seems to me less likely to produce needed outcomes, not more.
3.Rate-setting. ...Health care is increasingly what we as Americans do. It's where the job growth has been...
For the most part, I don't think either side is particularly realistic about what single-payer will look like when it comes.
Yep Canada did it... can you tell us all what the economic conditions were when Canada did it? Can you compare that to the US and the current US economy? Still waiting for that.
Canada has trouble with rural hospitals.. in fact access to healthcare in rural areas is a problem.. as is the lack of drug coverage in the Canadian government system..
Sure.. they love their system. So?
I know people that LOVE beer.. and I know people that LOVE marijuana..... doesn't mean that I love them.
.
- Improved health delivery due to no concerns about costs. This is not discussed much for some reason. But when someone gets sick, ADDITIONAL worries about COSTS of treatment add to that person's and their family's concerns at quite the wrong time in their lives. As a result their health suffers as due to this ADDITIONAL layer of stress that other people in the world are not familiar with.
Significant cost cuts can be immediate due to BOTH effectively CUTTING all existing insurance company profits down to 0 and due to immense price-setting capabilities that you mention in Pro #4.
another reason: ... too costly of an education for the professionals. I think we need more specialized programs for the Docs that don't require BS degree first and much less costly education thereafter.
I don't think this is true in general; i.e. that our medical outcomes or care is that much better or better at all than other countries
.I think it's a flawed argument that we should support a bloated unnecessary system because it would result in firing of too many people. Many industries have gotten smaller over time. We should NOT be propping up a system for this reason EVER
Canada has a thriving economy and single payer as does other countries. We can too.
LOL
So does Canada and that's nothing new.. so why do you think cutting healthcare spending in the US.. won't affect access in rural areas of the US even further? please provide some evidenceThe US has trouble with rural hospitals. That is nothing new.
They LOVE their system and could end it at anytime if they wanted but you can't get elected dog catcher if you said you wanted to end it in Canada.
Yeah.. that assumes that all costs will be borne by the government. And very few single payers are that comprehensive.
Hmmm.. why do you assume this? Currently private insurance companies are making huge profits administering Medicare and Medicaid. So why do you assume a system will get rid of private insurance companies.
In fact.. Canada has a private healthcare insurance market as well. So does France.. and a number of other single payer countries. So this assumption is based on.....?
Hmmm.. what doctors do you think could do with less education?
Actually it depends on what you are measuring... we score very well on timeliness of care.. and part of that is because of our availability of physicians, hospitals etc.
Fine.. what do you think happens to the economy then when you drastically cut those jobs and salaries?
Yep. many industries have gotten smaller over time.. look at manufacturing..... oh wait.. aren;t we trying to get manufacturing back into the us? Hmmm what did the loss of good manufacturing jobs do to jobs and wages in this country? Do you think that loss of manufacturing jobs might contribute to wage stagnation in the US?
I am an actual expert. Who works in Insurance.
Single payer will magically just cost less, because of how hospitals set their prices.
They use something called a Chargemaster. Expecting to have to negotiate with hundreds of different insurance companies, and medicare. They set their prices about 1000 percent above cost. It's common for a client of mine to receive an out of network bill for double or triple, what it would cost in network. Now here's the thing, that in network cost is still marked up at least 100 percent above cost.
The only reason we even know what things cost is because of VA hospitals by the way, Hospital Cartels do not put those numbers out, and actively derail any attempt to do so. They lobby more than oil. To keep their price fixing game going.
Medicare, pays an average of an areas cost for a procedure. So hospitals jack up price in an area to drive up what medicare pays them.
A single payer system, means one negotiator, instead of thousands. One standardized set of prices. And an end to price fixing from hospitals. Under a single payer system. A broken arm won't cost 6,000 dollars. It will cost 400.
Significant cost cuts can be immediate due to BOTH effectively CUTTING all existing insurance company profits down to 0 and due to immense price-setting capabilities that you mention in Pro #4.
I don't think this is true in general; i.e. that our medical outcomes or care is that much better or better at all than other countries.
I think it's a flawed argument that we should support a bloated unnecessary system because otherwise it would result in firing of too many people. Many industries have gotten smaller over time. We should NOT be propping up a system for this reason EVER.
If such argument were ever true, then you should go ahead and argue that we should make healthcare MORE COMPLEX to provide more jobs for healthcare professionals. Make taxes MORE COMPLEX to employ more accountants. Make laws MORE COMPLEX to employ more lawyers. Make Government unnecessarily more bloated to provide more jobs.
Well a couple of points here. Most Total hips, total knees, most knee arthroscopies, and so on .. are elective surgeries.. Also what is considered "necessary " varies.. for example Frances government insurance will pay for your abdominal surgery.. but may not pay for the anesthesia.In most countries all of the necessary treatments are fully covered. Elective or most advanced ones may not be (but those are too out-of-reach cost-wise in US as well for much of population)
.
You are misleading people here. Canada's private health insurance market is NOT for the basic coverage that is the single-payer system. Private insurance companies in Canada are for non-covered services like drugs, dental and optometry.
First 4 years of education where Docs get their Bachelors-of-whatever degrees are mostly a waste and unrelated to practicing Medicine
Links? Proof? I showed you we do NOT score well on availability of hospital beds in fact and there are many other aspects on which we do NOT measure well listed in another link I posted.
Yes, holding on to those COAL jobs that we lost is the cure for our problems.. right... How about buggy riders, or all the jobs lost to robots? You think they are coming back?
Actually more complex tends to decrease the number of professionals working.I repeat, if such argument were ever true, then you should go ahead and argue that we should make healthcare MORE COMPLEX to provide more jobs for healthcare professionals
Actually.. that argument has already been made and has been implemented. In fact.. we have the system we do because of the tax industry which does employee a number of folks and it lobbies like heck/taxes MORE COMPLEX to employ more accountants
More would be put in? Even the most conservative estimates say it would that an increase equal to 2/3 to 3/4 of what we're already paying in federal taxes.
Not according to the studies I've seen.Yep, and you wouoldn't be paying premiums. And employers wouldn't be paying. It comes out about a push.
I don't believe in Santa Claus either.Boo Radley said:Eventually, it might even shrink and on the while have more money in your pocket.
Not according to the studies I've seen.
I don't believe in Santa Claus either.
When everyone from Bernie Sanders to the Urban Institute and Mercatus Institute say federal spending will increase by 1.4 to 2.4 trillion a year I tend to believe them. Your miss that employer and employee costs will balance that out doesn't stand to reason. First off, not everyone HAS employer provide HCI and secondly not everyone is employed. tax will have to cover your insurance cost AND the cost of insurance for unemployed and their families too. Right now approximately 150 million workers are trying to pay Medicare for 60 million MC recipients and not succeeding. Now you want to burden those same workers to shoulder costs for 330 million?I don't know what studies you've seen, but I put something in the opening post that supported what I say. And I don't believe in Santa Claus either. As I've said, no system is perfect, but we spend a lot now, more than nearly anyone, and yet, we have many people uninsure and not able to get the care they need. It doesn't have to be that way. It worth an honest look.
When everyone from Bernie Sanders to the Urban Institute and Mercatus Institute say federal spending will increase by 1.4 to 2.4 trillion a year I tend to believe them. Your miss that employer and employee costs will balance that out doesn't stand to reason. First off, not everyone HAS employer provide HCI and secondly not everyone is employed. tax will have to cover your insurance cost AND the cost of insurance for unemployed and their families too. Right now approximately 150 million workers are trying to pay Medicare for 60 million MC recipients and not succeeding. Now you want to burden those same workers to shoulder costs for 330 million?
Insurance company profits are not the source of America's higher health care costs. The inputs we use to produce care--people, places, things--cost more here.
I wasn't comparing clinical outcomes--trying to do that across nations is really hard ("Challenges in International Comparison of Health Care System "). What's easier to comment on is why other OCED countries spend less, which is what I was talking about.
There are many reasons we pay so much for health care: we employ 'too many' people in that industry (including blue and white collar jobs), we pay them wages that are 'too' high, we get 'too many' services and have 'too much' capacity, we use 'too many' medicines, and have access to new drugs and new technologies 'too quickly.' And so on. [Note that it's the promise these "problems" will be fixed that leads to the constant discussion of increasing wait times.]
...
If we've collectively decided that this isn't worth the cost and we're willing to give it up (and I don't believe that we have agreed this), then we're still going to face individual defections from those conclusions. Maybe we in the U.S. have too many hospitals, but your local Congressman and local politicians certainly aren't going to be in favor of your local hospital closing. The politics of hospital closures and layoffs will be even tougher than the politics of base closures, affecting every single Congressional district in the country. Putting tough decisions about cold, hard realities in the political sphere seems to me less likely to produce needed outcomes, not more.
I'm not arguing "shoulds," I'm simply pointing out what is. Yes industries shrink and evolve over time. That doesn't change the political challenge of the government affirmatively stepping in to demand that major employers--in some communities, the single largest employer--engage in layoffs. Or even outright closures, if necessary for cost containment reasons. What strikes you as a more likely thing for politicians to do: 1) step in to prop up financially struggling facilities, or 2) step in and scale back or close financially successful ones?
This is a difficult issue to grapple with and it's something that has to be addressed, not swept under the rug. I post about it all the time; see: "A 'mercantilist jobs program for depressed cities'."
Well a couple of points here. Most Total hips, total knees, most knee arthroscopies, and so on .. are elective surgeries.. Also what is considered "necessary " varies.. for example Frances government insurance will pay for your abdominal surgery.. but may not pay for the anesthesia.
Nope.. you are misleading people here.. remember your point about taking insurance company profit "to zero"... oops.. not so fast there bucko...
by the way.. Canada's government insurance ALSO does not pay for outpatient physical therapy, outpatient physical therapy and speech therapy (outpatient).. nor home health services either... while our government insurances here.. do.
Really.. so you don't think chemistry, physics, statistics, cellular biology etc.. are "unrelated to the practicing of medicine?"
Hmmm.. so chemistry is unrelated to say.. prescribing medications? Interesting.. please make your case.
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