Sure: View attachment 67240687
Hmmm.. we score 5 in timeliness.. oh and 3.. in effective care... and what did Canada score? Oh that's right.. 7 in effective care.. and oh wait.. 11 in timeliness of care.
Well first.... how is it "artificially bloated".. please explain how our healthcare system is artificially bloated.
Hmmm So you think buggy riders made up 20-30 % of US GDP.. that's interesting. Nope.. I don't think buggy riders jobs are coming back..
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/
I would argue that we don't need to artificially create more jobs.. nor do we need to artificially DECREASE jobs in a growing industry that's growing not because of complexity.. but because of DEMAND for services from aging baby boomers.
Now.. IF we took your argument.. Since in America.. we pay wages WAY more than say in mexico.. or China.. or many developed countries.. we should purposely artificially lower wages to 1 dollar per hour to be on par with other countries.. Why should I be paying these bloated wages.. when other countries pay so much less???!?!?
Canada single-payer system covers these "elective" join replacement surgeries. So what's your point?
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My point was that profits go to zero for the services no longer needed, i.e. most of coverages. Yes, clearly with private insurance companies still needed for non-single-payer services, profits would still be made. However, this would be MUCH LESS of an insurance industry vs what it is today.
You are still misleading people... I randomly decided to fact check you on outpatient physical therapy... Let's see. In US, Medicare covers up to ~$2k in PT expenses, plus it does not pay all but 80% of charges via part B.
Sounds like Canada does better at this coverage than USA. Your claim is that Canada has no coverage at all if false, and you forgot about how our government insurance has quite a few limits in its coverage.
Oh.. so now we are walking it backwards.Yes, some classes are useful and needed indeed. I agree
Well accept that its not a waste. In fact.. in many ways its essential to get better more well rounded students into medical fields.You don't need to waste 4 years on those that are needed
'More of that should be implemented. Further, medicine is getting more and more specialized. Everyone here goes through med school first and then specializes. Not ALL of that med school training is needed for every specialty. Most Docs forget a lot of the medical school rotations quickly enough. They are simply not relevant to them.
Part 2 of 2 reply to jaeger19
First, what's your link for that image? Did you forget?
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Second, did you notice that USA is neither #1 nor #2 in ANY of the categories?? You are just helping me to make my point. In case you forgot, my point was "I don't think this is true ... that our medical outcomes or care is that much better or better at all than other countries."
I refer you back to your own image quoted above. Did you notice that last line? We spend way more than anyone else per capita and we are not #1 or #2 in any single category measured!
Depends on how its calculated.. and whats included.. that's why the range was presented... Its still a VERY significant portion of GDP.. and will likely grow.First, from what I found it's 18%. Not 20-30%.
Because demand fell. Meanwhile demand for healthcare is increasing. But hey.. lets ignore that fact shall we?Buggy riders were basically totally eliminated
You make it sound like single payer is going to destroy 18% of GDP. Noone is saying that. While there would be some layoffs (mostly in insurance industry), healthcare professionals will mostly be still employed, even if they make less money. So no, the damage will not be anywhere close to 18%.
The wholesale price index declined 33 percent (such declines in the price level are referred to as deflation). Although there is some debate about the reliability of the statistics, it is widely agreed that the unemployment rate exceeded 20 percent at its highest point. The severity of the Great Depression in the United States becomes especially clear when it is compared with America’s next worst recession, the Great Recession of 2007–09, during which the country’s real GDP declined just 4.3 percent and the unemployment rate peaked at less than 10 percent.
Due to the inexorable aging of the country—and equally unstoppable growth in medical spending—it was long obvious that health-care jobs would slowly take up more and more of the economy. But in the last quarter, for the first time in history, health care has surpassed manufacturing and retail, the most significant job engines of the 20th century, to become the largest source of jobs in the U.S.
In 2000, there were 7 million more workers in manufacturing than in health care. At the beginning of the Great Recession, there were 2.4 million more workers in retail than health care. In 2017, health care surpassed both.
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.
IF the government thinks is necessary.
Private insurance companies already make a ton of money off of public plans... and in all likelihood.. that will continue. So we will end up with a system where high cost, high risk folks who are middle class or poorer..and the poor.. will end up with a crappy government system that is administered by the private insurance companies...
...to get the savings that you believe you are going to get.. something has to give. OUR government insurances like Medicaid and medicare cover far more and are way more generous than just about any single payer system out there..
Nope.. you are misleading people. First of all Medicare covers far more than 2k in PT expense in outpatient therapy. Because there is an exemption process where patients can get far more than that first 2k.
Secondly.. based on medicare allowables.. that means that a patient with a total knee.. will pay about 20 dollars for an hour of therapy.. IF they don't have Medicaid or some other co insurance.. which most folks have. Oh and based on the allowables on medicare? That's about 20 visits of therapy for an hour each time.
Just to get to that 2000 dollars. (depends on your area fee schedule.. but that's close)
Canada? their Government insurance does not pay at all for outpatient therapy.
Oh.. so now we are walking it backwards.
Well accept that its not a waste. In fact.. in many ways its essential to get better more well rounded students into medical fields.
there is the irony here. First.. the reason that everyone specializes is because there is better reimbursement for specialties. They make more money and thus more people go into these specialties. Secondly.. this specialization is what INCREASES THE MEDICAL COST.
More specialists.. mean more costs to as its less efficient..
In addition.. the more you specialize physician training.. then you have high cost specialists.. treating things that before.. were more economically handled by general practitioners. We are seeing that now.. which is what has added to the cost. The less trained and knowledgeable a "gate keeper" or initial provider is..often the more likely they are to refer to a specialist (not to mention more likely to order unneeded tests)..
Right.. and did you notice that Canada and many other countries did not score very well either? Wait.. but we scored better when it came to quality care and effective care.. than.. who? Oh yeah Canada. Oh and timeliness of care as well. so its not as clear cut as you want to make it out.
Again.. how you do claim that is "artificially bloated".. Greenbeard has already supplied the evidence on why we pay more. A lot has to do with costs.. costs in paying nurses, and doctors and therapists and so on.. cost in having lots of medical equipment and lots in costs when it comes to having things like rural access hospitals. I would add that it also has to do with our demographics.. that americans often have more comorbidities like obesity and stress that raise costs... not to mention that our insurances also tend to pay for more in other countries.
Because demand fell. Meanwhile demand for healthcare is increasing. But hey.. lets ignore that fact shall we?
Wow.. okay lets use your numbers. Now.. according to the big thing here is that we should go to single payer to get the savings other countries get... okay.. Canada spends about 10% of the GDP is healthcare. So lets simply drop our GDP by 8%. Some layoffs?
Meanwhile.. you would be doing that while DEMAND for that very healthcare is growing. AND as Greenbeard points out.. you know where our growth in employment has been..
Sorry sir.. but you cannot get the savings you claim... without dramatically hurting our economy.
Once again, individuals, particularly people who pay tax will be paying those premiums THROUGH THEIR TAXES and also be paying the premiums of families of those that don't pay tax. The cost of bandaids in hospitals isn't high insurance premiums, or because they treat people unable to pay by the way. Our current tax system is taking in almost a trillion less that what it's paying out. Where do you think the money is going to come from to take on another $1.5-2.5 TRILLION to fund M4A? NO, it's not because we won't be paying premiums - that's private money you've earned NOT government revenue.Yes, it will increase. But again, the individual will not pay premiums, the employer won't be paying premiums, and hospitals won't have to charge $16 dollars for a bandaid because people can't pay. All ways in which the individual pays now. Which makes the increased federal spending and tax increase a push.
the average premium for an individual health insurance plan cost $2,889 per employee in 2001 ($3,886 adjusting for inflation). By 2015, that number had ballooned to $5,963, easily outstripping overall inflation and wage growth.
https://www.forbes.com/sites/willia...-big-problem-for-small-business/#1c03b85425d9
Add to the above what the individual pays.
If it fits the government criteria.. there generally is no free lunch here. One way in which single payer countries get their savings is by reducing what they consider "unnecessary" surgeries.. so a patient here in the US that would get a total knee.. because of their level of pain and their desire to see it go.. that same patient may NOT qualify in other countries with single payer. They may instead.. have to do injections and wait until it gets so dysfunctional that they qualify..... which is based on whether your Doctor thinks it's necessary. .
Oh.. you mean except for the fact that RIGHT NOW.. Medicaid and medicare is being administered by private insurance companies for a large profit. SO.. your assumption is that the federal government is going to suddenly.. abandon decades of using private insurance companies for managing public plans... and take over all that administration themselves.. BUT then add the rest of the population in that administration as well.You can claim this, but I see no proof of any of it
Further, part of the issue with Medicaid is that few doctors take it. If we go to single payer, many more Docs would have to accept it in order to have enough business.
AS greenbeard points out.. that's not why our system costs so much. but.. you seem to forget.. that private insurance is going to be handling that public plan.. like they do now.. OR you are going to have to create a whole new government administration to handle it. the savings here is going to be negligible.. and it may even cost more because of having to create new infrastructure.Private insurance infrastructure costs + profits.
Administrative overhead for health facilities related to dealing with multiple insurance companies
Bingo.. and its going to have to be a HUGE cut to get the savings you want.. as Greenbeards numbers show. Because this is one of the largest costs.Lower (perhaps not by much) compensation
Assuming that the government does a 180 degree turn on their policy.Lower drug costs
Many other countries have done it and despite your claims on how bad their healthcare is, that's NOT what the comparative studies show
Do you know for sure that Canada does not have an exemption process too?
The legislation enacted today provides a fix for the therapy cap by permanently extending the current exceptions process, eliminating the need to address this issue from year to year. Among the provisions included in the new policy:
•Claims that go above $2,010 (adjusted annually) still will require the use of the KX modifier for attestation that services are medically necessary.
•The threshold for targeted medical review will be lowered from the current $3,700 to $3,000 through 2027; however, CMS will not receive any increased funding to pursue expanded medical review, and the overall number of targeted medical reviews is not expected to increase.
•Claims that go above $3,000 will not automatically be subject to targeted medical review. Instead, only a percentage of providers who meet certain criteria will be targeted, such as those who have had a high claims denial percentage or have aberrant billing patterns compared with their peers.
Part 2 of 2 reply ...
Lots of claims here. Yet no proof. Why don't you show me some medicare links describing what you just said?
You might instead find something like this: "Original Medicare covers outpatient therapy at 80% of the Medicare-approved amount. When you receive services from a participating provider, you pay a 20% coinsurance after you meet your Part B deductible ($183 in 2018)." So, AFTER deductible, you are paying 20%, not $20...
Did you miss the link I provided where they DO cover outpatient therapy?
Yeah.. when you start with "well the undergraduate degree is unnecessary".. and then you now walk back.. well "some classes are necessary".. face it.. you don't know what you are talking about.I agreed that some classes are useful indeed. You have an issue with that?
Clearly, I disagree. You can tack on many years for the purpose of "well-roundness" but it does not make any difference as far as practicing medicine
Missing the point.When you can concentrate on a specialty, it's MORE efficient
To some degree yes.. which means that it is more inefficient. Now a patient that could be well managed by one practitioner.. now has a pulmonologist, a pain specialist, a neurologist, and a cardiologist, and a urologist. None of whom are coordinating well with each other and understand little of what the other is doing.Docs from different specialties are already so much removed from the other areas that they are quite useless in them.
I agree with what you said above. I am saying we can reduce costs while retaining specialization by starting to eliminate some things that are less relevant to each specialty.
there generally is no free lunch here.
Now.. sometimes.. that is appropriate.. in the US.. yes..we have people that run to surgery. (for a number or reasons).. when its unnecessary. However, when the government looks at cost containment.. the flip side is that patients that need it.. sometimes don't get it.. or have to wait a long time.
Oh.. you mean except for the fact that RIGHT NOW.. Medicaid and medicare is being administered by private insurance companies for a large profit.
SO.. your assumption is that the federal government is going to suddenly.. abandon decades of using private insurance companies for managing public plans...
And the reason they don't accept it is because the reimbursement is too low.. and the admin costs of it are too high (hoops to jump through)...
if we go to single payer.. you may simply see a decrease in the number of physicians..
We will retire early and get out.. and there will be fewer that want to take our place. Particularly in general practice
you seem to forget.. that private insurance is going to be handling that public plan.. like they do now.. OR you are going to have to create a whole new government administration to handle it. the savings here is going to be negligible.. and it may even cost more because of having to create new infrastructure.
one of the biggest insurance headaches is often dealing with public insurances.. like Medicaid. or the VA. And sometimes medicare.
not to mention.,, you just pointed out that there would still be private insurances to deal with.
Bingo.. and its going to have to be a HUGE cut to get the savings you want.. as Greenbeards numbers show. Because this is one of the largest costs.
Assuming that the government does a 180 degree turn on their policy.
Nice try. I have simply provided more than just claims. There IS a tradeoff and you don't want to be honest about it. YOU want to say how terrible America has.. and how we have terrible outcomes... but oops.. we score 3 on quality of care. Canada.. not so high.. as well as host of other countries. Where we fall down. is things like efficiency and equity because we don't have universal coverage.
You need to look at that again. When. and if they pay. its not the basic government single payer.. its often addition coverage depending on your Territory or province.. and when you are either older than 65 or a child.
Meanwhile.. all those working class adults on Medicaid in the US.. get it.
Yeah.. when you start with "well the undergraduate degree is unnecessary".. and then you now walk back.. well "some classes are necessary".. face it.. you don't know what you are talking about.
It actually makes a lot of difference. Especially when it comes to the art of practicing medicine. Look.. maybe you don't think taking some educational classes on effective education in your undergraduate will help a physician... but it actually does when the doctor is trying to explain a procedure to you.. or what is going on with you. Maybe you don't think the language classes I took help.. but they definitely do when I can speak in a patients native language.. just trying.. helps reassure them and reduces anxiety and that leads to better outcomes. And so on.
The fact is.. you would have worse doctors..
Missing the point...
To some degree yes.. which means that it is more inefficient. Now a patient that could be well managed by one practitioner.. now has a pulmonologist, a pain specialist, a neurologist, and a cardiologist, and a urologist. None of whom are coordinating well with each other and understand little of what the other is doing.
YEah.. explain exactly how you plan to do it. Especially when you consider.. that physicians generally decide on a specialty after having seen more of the gamut of medicine. Many of the lesser known but vital specialties only get recruits because of that very education that introduces them to that specialty.
Actually it depends on what those things are.. AND you need to understand why we do poorly in certain categories. And by the way. its NOT due to "not having single payer".. if you will note.. there are plenty of single payer systems out there.. ALL with widely varying costs and varying outcomes. Which is something that you folks that love single payer and claim its going to be a panacea.. can't seem to explain. IF the issue is single payer.. why is it that so many countries with the similar system.. have widely varying costs and outcomes?What's clear cut is that US is NOT better than others. It's somewhere in the middle of the pack. At much higher costs!
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Easy. Many (all?) other countries provide health care for cheaper. US health care is NOT better. Overheads are clear and I listed them in earlier reply.
I never said healthcare should disappear. I've been saying the opposite.
If we have 8% of overhead and fat, then yes, SOME layoffs in HEALTHCARE field, MANY layoffs in INSURANCE field and medical BILLING staff, SOME paycuts, LESS profits for insurance company owners.
Killing off insurance companies and billing services does not affect how we service increased demand for healthcare.
So, once again, then let's have more complex and inefficient healthcare to help our economy!
Problem is.. as Greenbeard pointed out with his links.. our costs are not due to "complexity and inefficiency"..then let's have more complex and inefficient healthcare to help our economy
Yes, there is free lunch. I already described all the free lunch you get with single payer. All those cuts to insurance industry and admin overheads are free lunch.
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Yes, just like other countries, we'd need to balance having healthcare affordable and attending to health needs of the population.
However 95% of care would be done via single payer and EVERYONE would be covered and would not have to worry about how to pay for it at the time of need.
Well, guess what. That large profit by insurance companies - let's instead get rid of them and use that large profit to help pay for the single payer WITHOUT the insurance companies. That's how others do this. USA can do it too. There is nothing inherently wrong with that.
That's not my assumption. I don't know how "sudden" is has to be. But that's the desired outcome for most people in the country, IMHO.
No.. the reimbursement is too low to make a profit or even to break even at times. Its simply not worth the hassle.Yes, reimbursement is too low COMPARED to their other options.
Yeah not really. I mean.. have you ever owned healthcare facilities? Doesn;t sound like you do... I do.. and most insurances use a standard billing form based on the HCFA billing form. so its pretty standard. In fact.. a lot of places.. which is what we do.. is use a clearinghouse. So there is not this massive extra cost in having "20 insurance companies"... the cost is in dealing with 1 insurance company like Medicaid.. or the VA.. (both government programs).. that make you jump through multiple hoops to get paid.. AND THEN their reimbursement is the lowest. (which is why places don't like taking these insurances).And yes, costs are too high because of all the hoops to jump though - the hoops of dealing with 20 insurance companies.
Actually you can't compare because the economics are vastly different. Many other countries.. shift their healthcare costs (we haven't even gotten into that.. but its another reason that they have lower healthcare bills.. but in reality.. don't) from healthcare to education. for example.. a country spends a ton on educating their physicians.. and thus can reimburse their physicians less.. (because they have less debt).May or may not. Are you saying other countries have less physicians per capita?
You have MANY insurance companies, EACH with their own infrastructure. Having a SINGLE on of them (and NON-PROFIT at that) would be (should be) CHEAPER.
QUOTE] Well... that's 1. A huge assumption that the government will set up its own separate insurance company to manage them the single payer. Especially when you consider that private insurance companies right now.. administer medicare and Medicaid.
2. Its a huge assumption that a government entity will necessarily..be more efficient when there is no reward for efficiency ( in other words.. no profit motive to be more efficient).
Yeah..no.. that's pretty unlikely... just go do a search on dealing with Medicaid.. or the VA. Even medicare can be a hassle (but generally not that bad anymore).One thing to note is that EVEN IF gov't insurances were the hardest to deal with (again, I heard the opposite),
. Actually that's not true.. generally that's not true at all. In fact. .most insurance companies standardize their billing and procedures with medicare.. .. In fact the billing forms etc... that they all use tend to be rather standardized. The hassles are really the one or two.. that require some extra hoops.. like workers comp.. or VA or Medicaidthe BIGGER problems for the Docs is dealing with 20 of them, even if each one is easier. Why? Because they are all different in their own way
That's a pretty big assumption when you just said how you were going to cut reimbursement.. etc..They won't HAVE TO. Right now, they have to deal with many insurances because they can't be picky and just choose one. With Single-Payer, most docs could choose to deal with just 1
In all likelihood.. providers are going to have to have use private insurance to bolster the declining reimbursement.. oh.. like they do now. You don't get that. I could just decide to take medicare.. that's it.. I could just decide to take Medicaid.. just that. There is nothing that says I have to take a particular insurance. In fact.. we don't accept a number in some areas. But guess what.. If we only accepted medicare.. we would go out of business.. because we would have the volume but reimbursement is too low.
And here is another thing: all the savings companies will have from NOT having to provide the insurance for their employees - all that could also help pay for and go toward paying the expenses and minimize the pay cuts to Docs and Medical staff.
Which we can easily solve without a single payer system.I never said we have terrible outcomes. We are terrible at costs and not covering people and requiring health care to be related to work.
Yep.. and we are ahead of many comparable wealthy and sizable countries on many metrics... its about what you value to some degree. There is no free lunch here.Inconsistent or unavailable data and imperfect metrics make it difficult to firmly judge system-wide health quality in the U.S., but a review of the data we do have suggests that the system is improving across each of these dimensions, though it continues to lag behind comparably wealthy and sizable countries in many respects.".
Because we don't have everyone on insurance.. and some of that is because of culture.. of being rugged and not going to the doctor.The U.S. has the highest rate of deaths amenable to health care among comparable countries
THAT is not due to our healthcare system.. that is due to our demographics.. the number of immigrants we take in from other countries, our obesity rate, our stress levels.. lack of vacation and downtime.. work related stress, sedentary rates of living.. working hours.. etc.Disease burden (years of life lost due to premature death as well as years of productive life lost to poor health or disability) is higher in the U.S. than in comparable countries
A variety of reasons for this.. but its not due to single payer.The U.S. has higher rates of medical, medication, and lab errors than comparable countries
this is most likely due to obesity. return to work.. etc.Post-op suture ruptures are worse in the U.S. than in comparable countries
Obesity, smoking, sedentary lifestyles and environmental factors.. like smog.The mortality rate for respiratory diseases is higher in the U.S. than in comparably wealthy countries
Yep I did. I provided the physician fee schedule and the code 97110 which is probably the most used therapy code..it runs about 25 to 35 per 15 minutes.. so for 1 hour.. that translates to 80% of the allowable.. 20 bucks to 28 dollars.And regarding Medicare, you still did not prove as far as costs. As I said, you pay 20%, not $20 as you claimed
Not true. especially the "everyone gets it when a doctor says they need it"..In Canada, everyone over 65 and under 19 gets it no matter what. Everyone in between gets it when a Doctor says they need it.
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Actually everyone with insurance gets it.. its part of the essential benefits.In USA, people over 65 get it (used to be with cap, not maybe won't be with cap). People under 65 only get it if they have no assets and have to be on Medicaid.
Nope I was right. My assertion was that Canadian government insurance.. their "single payer" does not pay for outpatient therapy.. nor homeheath, or pharma etc.Either way, your original assertion was Canada does not cover PT and it's wrong.
Again.. you are making a giant assumption that there is the massive number of irrelevant classes. Your opinion is noted and rejected as false. There is no reason to have a BS in chem or bio? So you don't think a physician having a background in chemistry or biology.. is an asset? What classes do you think are irrelevant? botany? Oh wait.. people take all sorts of supplements now.. you now.. cause its "natural". Maybe if you knew some botany.. you would know that the patient eating certain greens or supplements is actually making his blood to thin in addition to the blood thinner you are giving him.. or maybe if you understand botany.. you are understanding why this child developed an unknown rash.. because he was around a certain ornamental shrub.Yes, undergraduate degree is unnecessary. You don't need ALL 4 years of irrelevant classes
YEp.. so whats your point? You just pointed out that more education was good for a doctor.You can also add a lot of years of education as well. Just go to school until you are 50 and then start practicing. That would make you an even BETTER doctor
Actually the HUGE improvement in interview skills, rapport etc.. from taking Spanish.. is huge.The marginal improvement in the Doc skills from that German-language class are negligible compare to the time and effort and costs invested in it.
WHICH IS A HUGE COST SAVINGS AND IS VASTLY MORE EFFICIENT. You seem to gloss over that fact.Your example is just that better GP will have less steps to go through.
That's kind of ironic when you consider your premise. The reality is that WE DO NOT "now need a specialist".. why would you suddenly "now need" a specialist? The reason specialists are now more prevalent is because.. 1. More docs specialize because there is yore money in it. and more docs specializing means that they have to fill those spots.. so now there is more marketing that Americans need a specialist.. when the reality is that they don't. but the expectation now is that they get a referral for a specialist.. and that they continue when a GP could assess and maintain their chronic conditions just as well. Its interesting that you have bought into that belief because it IS one of the reasons that American healthcare is more expensive. AND by the way.. most other countries.. REDUCE their number of specialists to control those costs.Yes, a good GP is still needed. But to really to take care of many conditions, you now need a specialist who knows a lot of SUBAREAS of that general area.
.And even if they are going through their rotations and decided to set their heart on a specialty after being exposed to it, I don't see why they need to finish the rest and not start concentrating as soon as they are ready
IF the issue is single payer.. why is it that so many countries with the similar system.. have widely varying costs and outcomes?
I can answer that.. and that's because of differences in economies, in demographics etc which are far and away a bigger issue than whether its single payer or not.
And many countries with the same system have varying costs.. is that do to "being bloated" or are those differences due to things like Greenbeard.. pointed out.. wages and demand?
Well.. other countries pay less in wages and have lower minimum wages.. I guess that means our current minimum wage is bloated right?
Right.. you mean when you gave the examples of buggy drivers? You mean that example?
But.. you just again.. went on a diatribe about how much we pay.. and you want to reduce that amount.. dramatically (if you want other countries levels of cost).. but for some reason.. you don't think that reducing what we pay in healthcare in half.. is going to have any negative effects on the amount of healthcare available? Hmm.. please explain that.
Well.. that's your assumption that 8% of our GDP is simply "fat" in the healthcare system.
BUT that 8% is actually healthcare costs.. not "insurance field and profits for insurance".. that's direct hospitals, doctors and medical equipment and so forth.
And you are talking about reducing our GDP by 8%.. which is DOUBLE the amount our GDP dropped in the GREAT recession. and you claim its going to cause" some layoffs? SOME layoffs?
You really don't understand the economics here do you. Its not just going to cause layoffs in healthcare.. that dramatic decrease in GDP is going to cause ripples in all sorts of industries
One.. that's not going to happen as I explained since you still have to process all those claims. and you may find your government system is not as efficient.. and in all likelihood it will be private insurance companies still administering it.
Its things like the fact that we pay a lot more in wages...
that we have a lot more access than needed
because the public demands more when it comes to healthcare
Nope.. there is no free lunch.. you overblow costs that aren;t there.. and underestimate where the real costs are..
No.. the reimbursement is too low to make a profit or even to break even at times. Its simply not worth the hassle.
Where you will get your savings.. is because with one insurance.. the government has a monopoly and can force reimbursement way down.. which ends up getting rid of small hospitals, etc.
Actually you can't compare because the economics are vastly different. Many other countries.. shift their healthcare costs (we haven't even gotten into that.. but its another reason that they have lower healthcare bills.. but in reality.. don't) from healthcare to education. for example.. a country spends a ton on educating their physicians.. and thus can reimburse their physicians less.. (because they have less debt).
1. A huge assumption that the government will set up its own separate insurance company to manage them the single payer. Especially when you consider that private insurance companies right now.. administer medicare and Medicaid.
2. Its a huge assumption that a government entity will necessarily..be more efficient when there is no reward for efficiency ( in other words.. no profit motive to be more efficient).
Yeah..no.. that's pretty unlikely... just go do a search on dealing with Medicaid.. or the VA. Even medicare can be a hassle (but generally not that bad anymore).
That's a pretty big assumption when you just said how you were going to cut reimbursement.. etc..
In all likelihood.. providers are going to have to have use private insurance to bolster the declining reimbursement.. oh.. like they do now. You don't get that. I could just decide to take medicare.. that's it.. I could just decide to take Medicaid.. just that. There is nothing that says I have to take a particular insurance. In fact.. we don't accept a number in some areas. But guess what.. If we only accepted medicare.. we would go out of business.. because we would have the volume but reimbursement is too low.
Nope I was right. My assertion was that Canadian government insurance.. their "single payer" does not pay for outpatient therapy.. nor homeheath, or pharma etc.
Now.. provinces and territories have their own plans.. that will cover the elderly and those who are children for some of those things.. not its not universal.
IF what you contend is everyone gets it especially if a doctor needs it...Well then.. why the need for supplemental coverage insurance?
Again.. you are making a giant assumption that there is the massive number of irrelevant classes. Your opinion is noted and rejected as false.
YEp.. so whats your point? You just pointed out that more education was good for a doctor. Actually the HUGE improvement in interview skills, rapport etc.. from taking Spanish.. is huge.
WHICH IS A HUGE COST SAVINGS AND IS VASTLY MORE EFFICIENT. You seem to gloss over that fact.
That's kind of ironic when you consider your premise. The reality is that WE DO NOT "now need a specialist".. why would you suddenly "now need" a specialist?
Okay.. Remember all those medical mistakes and so forth? You are just pointing out one reason for it in the US. And that's the proliferation of specialists and specialist care. All the specialists.. that aren;t coordinated or know to consider what other issues the patients are having.. and what other physicians may be doing leads to polypharmacia.. it leads to drug interactions.. it leads to all sorts of mistakes because you have too many cooks.. rummaging about.
Sorry if this has already been covered, but dont Medicare, Medicaid and the VA, plus the various plans that governmental employees get qualify as single payer systems? If so, isn’t a significant portion of the US population already covered by single payer? I can’t imagine the math, but couldn’t Medicare be phased in gradually, that is, first covering 60 and older, then 50, etc.? Or start with the young.
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