Universal Health Care: from someone who lived under both ...

[BahamaBob]

Please. Do you really think its pertinent to the discussion if it was an intertrochanteric fracture of the hip, or I just said.. "fractured her leg"... (even though it technically her hip is part of the thigh).. is that really what you think is a big deal here?
And I was there.

And no.. my whole.. Make them whole spew is not retarded. Sure.. they do corrective surgery and therapy in the US too. BUT.. when its malpractice.. many times its only AFTER.. they have had a cash payout.. and that payout has to be higher to cover the surgery AND the cost of the lawyer.

IF there was a better avenue.. like some other countries do.. where the focus was on making the person whole. In other words.. covering the surgery and getting it done..without having to go through a lawyer and a cash payout.. it would be cheaper.. and frankly many patients would have more satisfaction.

But now what often happens is say a patient has a failed rotator cuff surgery as a result of malpractice. AS soon as there is any hint of malpractice involved.. then health insurance says "whoa.. this is not our problem"..and now won't pay for anything related to the rotator cuff.shoulder.
So the patient stays in pain and is pissed. They get a lawyer.. the lawyer will get a chunk of that payout. . You say "but there are limits".. not really.. because most states only limit NON ECONOMIC awards.. in other words.. pain and suffering. The awards for lost wages and future lost wages, for current and future healthcare bills, other economics costs, are not generally limited.
So the lawsuit goes forward.. and its all about the payout.. the payout for pain and suffering.. lost wages.. future lost wages, costs of a corrective surgery, costs for travel.. and so on. And the lawyer is going to get a chunk of that.. so the payout in cash is important.

OR as they do in some countries. The patient could go get surgery to fix their shoulder and go back to work.. and have a lot less in lost wages.. pain and suffering etc.

But hey.. what do I know. I only pay medical malpractice insurance for me and all my employees.

And when European countries accepts an FDA approved drug.. it often means that the research and development costs are born by the US market. and when its perfected and cheaper, then the European countries adopt it.

More uninformed made up tripe from a guy who doesn't even know the difference between a hip and a leg. Just what I expected.

 

[Slavister]

The US tax payer has been subsidizing Western European Socialism for the last 7 decades tvia US defense spending.

Boy, where do I start... how about this...

1. The point of this thread is that rest of the world found a system that saves their citizens TIME and WORRIES about financial payments for their healthcare.

2. USA has been in much better financial position than European countries (esp after WWII) EVEN AFTER all of US defense spending taken out

3. Your point does NOT explain why other countries have systems that COST LESS for similar healthcare outcomes. I disagree with your assumption, but for a second let's pretend you are right, i.e. we ran out of money because we spent it all on defending other countries. Would not that mean we'd want a LESS costlier healthcare system even more then?

4. While we can discuss financial costs and benefits of universal healthcare (to the country as a whole) at length, again, this thread was not meant for THAT. This thread points out that all these discussions completely ignore how average citizens SAVE TIME and their own financial WORRIES. For some reason these ADDITIONAL benefits of Universal Healthcare are never discussed... (and yes, this is same as #1 but was worth repeating).

 

[Fenton]

Boy, where do I start... how about this...

1. The point of this thread is that rest of the world found a system that saves their citizens TIME and WORRIES about financial payments for their healthcare.

2. USA has been in much better financial position than European countries (esp after WWII) EVEN AFTER all of US defense spending taken out

3. Your point does NOT explain why other countries have systems that COST LESS for similar healthcare outcomes. I disagree with your assumption, but for a second let's pretend you are right, i.e. we ran out of money because we spent it all on defending other countries. Would not that mean we'd want a LESS costlier healthcare system even more then?

4. While we can discuss financial costs and benefits of universal healthcare (to the country as a whole) at length, again, this thread was not meant for THAT. This thread points out that all these discussions completely ignore how average citizens SAVE TIME and their own financial WORRIES. For some reason these ADDITIONAL benefits of Universal Healthcare are never discussed... (and yes, this is same as #1 but was worth repeating).

Countries that have a single payer system pay less because they RATION care. It's that simple Cost supercedes patient care, and long wait times are typical

For example, Canadian wait times are a record levels.

As for single payer in the US being cheaper ? Last year we spent a total of 3.65 trillion dollars for healthcare

Even Bernie Sanders estimates his plan would cost between 30 and 40 trillion over 10 years. That's NOT cheaper
Also yes, Europe needed help after the war so I have no issue with the US stepping up and defending them, but NATO was established 70 years ago, and most of our NATO partners still haven't met their agreed upon 2% of GDP defense spending targets

It's clear they're taking advantage of the US and the US tax payer

 

[Checkerboard Strangler]

Great post. My belief is that Obamacare was the best the democrats could get, sort of a foot in the door til something better showed up. Very telling to me was that they couldn't even get a public option in the legislation, such, I presume, is the power of the insurance lobbies. What would be nice might be for the public debate to start with a- admitting that we already have national health care in the form of Medicare, Medicaid, the VA, and whatever politicians and public employees get around the country, probably covering tens of millions of us; b- notions that we could benefit by the fact that we are going last among rich nations and can therefore study what others do to avoid pitfalls; c- have everyone become familiar with Ronald Reagan's apocalyptic, ridiculous screed against Medicare before it came about, and his apparent acceptance of it later in his political career, so that people will stop screaming socialism and d- stop calling it Obamacare so that republicans can accept that it is here to stay in some form or other, and try to improve it where and if necessary.

If we had actually WON the PUBLIC OPTION, we probably would not be having many of these discussions now.
Would our healthcare suddenly be PERFECT?
No, of course not. There would still be problems, but we would not see millions of people doing without insurance, millions more finding out their insurance doesn't cover hardly anything when they need it, and millions being bankrupted or otherwise sidelined needlessly.
It wouldn't be perfect but it might be much more manageable.

And if Medicare was allowed to negotiate for drug prices the way the VA is allowed to, we would be saving more money.
And if pigs could fly...

The point is, we have NONE of those things right now, so as great as our system is potentially, the negatives are too much for a lot of our most vulnerable people, and it is costing us in lost productivity, lost taxpayers, lost time, lost assets, and lost future stability.
People are scared ****-less ABOUT THEIR HEALTHCARE.
I can understand being peeved about it, but scared?

It's ridiculous.

 

[Nickyjo]

If we had actually WON the PUBLIC OPTION, we probably would not be having many of these discussions now.
Would our healthcare suddenly be PERFECT?
No, of course not. There would still be problems, but we would not see millions of people doing without insurance, millions more finding out their insurance doesn't cover hardly anything when they need it, and millions being bankrupted or otherwise sidelined needlessly.
It wouldn't be perfect but it might be much more manageable.

And if Medicare was allowed to negotiate for drug prices the way the VA is allowed to, we would be saving more money.
And if pigs could fly...

The point is, we have NONE of those things right now, so as great as our system is potentially, the negatives are too much for a lot of our most vulnerable people, and it is costing us in lost productivity, lost taxpayers, lost time, lost assets, and lost future stability.
People are scared ****-less ABOUT THEIR HEALTHCARE.
I can understand being peeved about it, but scared?

It's ridiculous.

Indeed. Amazing that some drug dealers give discounts for large quantities of coke, but the US can’t figure how to have Medicare get a similar deal with other drug dealers.

 

[Checkerboard Strangler]

Indeed. Amazing that some drug dealers give discounts for large quantities of coke, but the US can’t figure how to have Medicare get a similar deal with other drug dealers.

Medicare is flat out not allowed to. It's not that we cannot figure out how to, it's that we (apparently - nobody warned me, how about you?) allowed our Congress to vote that into law.
The law specifically states that Medicare is prohibited from negotiating.
I guess I will have to go look it up again, it's been a few years since I read it.

Forbes:
When you're one of the biggest buyers of pharmaceuticals on the planet, you should have a big stick to negotiate the best prices.

Medicare, which insures more than 60 million beneficiaries, doesn't have that power, mostly because Congress stopped it from getting the best drug prices years ago. But that could change.

That is from 2018, but DID the Medicare Negotiation and Competitive Licensing Act do anything?
Nope, it was Referred to the Subcommittee on Health on 02/07/2019.
It appears to possibly be yet another one of the almost four hundred House bills that the McConnell Senate doesn't even wish to look at.

"As a result, Medicare Part D pays on average 73% more than Medicaid and 80% more than VA for brand name drugs.
The federal government could save between $15.2 and $16 billion a year if Medicare Part D paid the same prices as Medicaid or VA."
Sanders.gov

(To say nothing of what consumers would save, too!)

The Medicare Modernization Act is a product of the 2003 Congress, led by Republicans, of course.

The bill was introduced in the House of Representatives early on June 25, 2003 as H.R. 1, sponsored by Speaker Dennis Hastert.

 

[Nickyjo]

Medicare is flat out not allowed to. It's not that we cannot figure out how to, it's that we (apparently - nobody warned me, how about you?) allowed our Congress to vote that into law.
The law specifically states that Medicare is prohibited from negotiating.
I guess I will have to go look it up again, it's been a few years since I read it.



That is from 2018, but DID the Medicare Negotiation and Competitive Licensing Act do anything?
Nope, it was Referred to the Subcommittee on Health on 02/07/2019.
It appears to possibly be yet another one of the almost four hundred House bills that the McConnell Senate doesn't even wish to look at.



(To say nothing of what consumers would save, too!)

The Medicare Modernization Act is a product of the 2003 Congress, led by Republicans, of course.

I have no idea how it happened. But that it exists shows the hypocrisy of legislators who might, say, complain about people attempts to raise the minimum wage or wasteful government spending yet tolerate this.

 

[BahamaBob]

Countries that have a single payer system pay less because they RATION care. It's that simple Cost supercedes patient care, and long wait times are typical

For example, Canadian wait times are a record levels.

As for single payer in the US being cheaper ? Last year we spent a total of 3.65 trillion dollars for healthcare

Even Bernie Sanders estimates his plan would cost between 30 and 40 trillion over 10 years. That's NOT cheaper
Also yes, Europe needed help after the war so I have no issue with the US stepping up and defending them, but NATO was established 70 years ago, and most of our NATO partners still haven't met their agreed upon 2% of GDP defense spending targets

It's clear they're taking advantage of the US and the US tax payer

You hit the nail on the head. Progressives think changing the name of the healthcare system makes it cheaper. Anyone who thinks Medicare for all will make healthcare cheaper does not know how Medicare works. Unless the reasons that drive healthcare costs up are addressed the costs will not go down, no matter what you name it.

Progressives also think hiding the costs in some giant tax program and claiming the rich will pay for it will buy votes. They are counting on the American voter being ignorant enough to buy this trash. Progressives are much like naive children. Uncle Bernie pulls up next to them and says we have free candy just climb into my car. The next thing they know they are getting hosed and Bernie say well there just aren't enough rich people but it is for the general good.

 

[jdog21]

... one big reason why Universal Health Care is sane - time and worries saved

A good article here comparing what it's like.

I know im late to this conversation.
But in the US with my employer base healthcare (im not even middle class more like lower class) I broke my ankle, multiple spider fractures, I had a friend drive me to the ER, they did the assessment, took X-rays, splinted me up gave me some pills and scheduled me for a surgery for 2 days later. They gave me some pins and screws and stitched me up and put me in a cast and gave me some pain meds. A month later they cut a hole in the cast to take out some stitches and I wrapped the cast to keep the chunk they cut out back in place. A month later I got the cast off and they did more x-rays and placed me in a weird boot things for the next 2 months. When I got that off I did therapy a few times a week for the next 2 months. I paid $3,000 for the hospital, doctor, anesthesiologist, meds, cast etc. I think the therapy was a separate bill but I cant remember what the cost was just a few hundred dollars I think. You add that on top of what I paid for insurance for that year which was a little over $1,000 and I bet I paid close to 5 grand total. That's the highest expense I ever had except for my new one with having a baby. But that's another story for a different day.

When you add up all the premiums and medical spending I have had over the Last 10 years which I consider normal everyday American probably pays I bet its around $24 thousand. So under a universal health care can I expect to pay less then $2,400 a year in taxes & medical expenses? A 4% increase in my effective tax rate would be about equal. Do I have to wait a week longer to have a surgery when I am in pain now? Cause that might be worth paying the private insurance like I am now.

 

[BahamaBob]

I know im late to this conversation.
But in the US with my employer base healthcare (im not even middle class more like lower class) I broke my ankle, multiple spider fractures, I had a friend drive me to the ER, they did the assessment, took X-rays, splinted me up gave me some pills and scheduled me for a surgery for 2 days later. They gave me some pins and screws and stitched me up and put me in a cast and gave me some pain meds. A month later they cut a hole in the cast to take out some stitches and I wrapped the cast to keep the chunk they cut out back in place. A month later I got the cast off and they did more x-rays and placed me in a weird boot things for the next 2 months. When I got that off I did therapy a few times a week for the next 2 months. I paid $3,000 for the hospital, doctor, anesthesiologist, meds, cast etc. I think the therapy was a separate bill but I cant remember what the cost was just a few hundred dollars I think. You add that on top of what I paid for insurance for that year which was a little over $1,000 and I bet I paid close to 5 grand total. That's the highest expense I ever had except for my new one with having a baby. But that's another story for a different day.

When you add up all the premiums and medical spending I have had over the Last 10 years which I consider normal everyday American probably pays I bet its around $24 thousand. So under a universal health care can I expect to pay less then $2,400 a year in taxes & medical expenses? A 4% increase in my effective tax rate would be about equal. Do I have to wait a week longer to have a surgery when I am in pain now? Cause that might be worth paying the private insurance like I am now.

Universal healthcare does not benefit the middle class. Most middle class workers have a good share of their healthcare costs paid by their employer. Under universal healthcare that benefit goes away and is replaced by a tax on the employee. Beyond that, no 4% tax will cover the costs. You are looking at a double digit tax increase.

You are correct it will also mean longer waits. Probably not for emergency service like you had but for things like knee and hip replacement or back surgery. Going through several more months of pain will be part of the costs. You will also have fewer options. It will not be up to the doctors as to what medications, tests and procedures you are entitled to. It will be up to some bureaucrat whose main purpose is to keep costs down.

 

[Slavister]

As for single payer in the US being cheaper ? Last year we spent a total of 3.65 trillion dollars for healthcare

Even Bernie Sanders estimates his plan would cost between 30 and 40 trillion over 10 years. That's NOT cheaper

As far as I know, Bernie never said anything about 40 trillion. I don't know where you come up with this. $32 trillion is the closest estimate (actually, 2 independent estimates). What we have now will cost $47 billion. So yes, M4A is cheaper.

And even if I took your number of 3.65 trillion / year. Even THAT is more expensive than $32 trillion over 10 years.

 

[Slavister]

... which I consider normal everyday American ...

You are forgetting a couple things:

1. There are a lot of unemployed Americans at any given time. They don't have employer sponsored insurances.

2. You got lucky and did not get cancer or some other terrible disease (yet?). Expenses are quite different for those cases. And last thing you want to do THEN is to figure out how much to pay for which treatment at which hospital, potentially considering that you may have to stop working (temporarily or permanently) due to your condition.

Finally, it may very well be the case that you'd pay less than what you describe in extra taxes if you are below middle class as you state. You can check out Bernie plan for sources of money to pay for Medicare for all here.

 

[jdog21]

Universal healthcare does not benefit the middle class. Most middle class workers have a good share of their healthcare costs paid by their employer. Under universal healthcare that benefit goes away and is replaced by a tax on the employee. Beyond that, no 4% tax will cover the costs. You are looking at a double digit tax increase.

You are correct it will also mean longer waits. Probably not for emergency service like you had but for things like knee and hip replacement or back surgery. Going through several more months of pain will be part of the costs. You will also have fewer options. It will not be up to the doctors as to what medications, tests and procedures you are entitled to. It will be up to some bureaucrat whose main purpose is to keep costs down.

That's what Im getting at. That an increase of more then 4% in my effective tax rate would then be spending more money on the tax then I would be on my healthcare. I prefer to keep my costs whether its to insurances/hospitals/doctors or in taxation to the one equals the lowest.
Secondly waiting for your health care I agree is a cost. But its hard to put a number on. I prefer to have the individual ability to determine what im willing to pay for the expedited care. That's why if we as a country are going to explore the option of a government ran health care it should be on a 2 tier system, where everyone still has their employer based health care but maybe the small business owner or the old and poor can be in a catastrophic government care plan that's subsidized by tax payers, where emergency only care is provided and all other care has long waits. And if you don't want the government plan and don't have an employer based plan then you can still go get a private plan if you want to pay that high price for it.

 

[BahamaBob]

As far as I know, Bernie never said anything about 40 trillion. I don't know where you come up with this. $32 trillion is the closest estimate (actually, 2 independent estimates). What we have now will cost $47 billion. So yes, M4A is cheaper.

And even if I took your number of 3.65 trillion / year. Even THAT is more expensive than $32 trillion over 10 years.

Wow, the last time we heard that line was with Obama Care. That was going to save us all $2,500 a year.

The American Public is not stupid. There is no way you can add tens of millions of people to the healthcare system, do away with all deductibles, remove all caps, have it controlled by a notoriously inefficient federal government and make it cheaper. Anyone who believes that should not be posting on an adult site.

If you want to see how government controlled healthcare works in this country, I can give you three example. The VA, Medicaid, and Indian Reservations.

 

[Slavister]

There is no way you can add tens of millions of people to the healthcare system, do away with all deductibles, remove all caps, have it controlled by a notoriously inefficient federal government and make it cheaper. Anyone who believes that should not be posting on an adult site.

I'll give you that cost estimates DO depend on a lot of assumptions and are UNcertain. However, with two $32 trillion estimates vs current estimates for 10 year spending do suggest it will be cheaper due to various factors (eliminating private insurance layer, administrative cost savings, lowering provider reimbursement, lower drug prices, etc.)

Further, I am sure by the time this program passes, there will still be some type of copayments / deductibles, and likely other compromises. People do need some skin in the game to avoid overuse, just not so much that it can completely ruin them.

If you want to see how government controlled healthcare works in this country, I can give you three example. The VA, Medicaid, and Indian Reservations.

In discussing Medicare-for-all, did you forget uh... Medicare? It's funny but I am not aware of anyone using Medicare or Medicaid wanting to abandon them in favor of what we currently have as status quo for the rest of the population.

 

[BahamaBob]

I'll give you that cost estimates DO depend on a lot of assumptions and are UNcertain. However, with two $32 trillion estimates vs current estimates for 10 year spending do suggest it will be cheaper due to various factors (eliminating private insurance layer, administrative cost savings, lowering provider reimbursement, lower drug prices, etc.)

Further, I am sure by the time this program passes, there will still be some type of copayments / deductibles, and likely other compromises. People do need some skin in the game to avoid overuse, just not so much that it can completely ruin them.



In discussing Medicare-for-all, did you forget uh... Medicare? It's funny but I am not aware of anyone using Medicare or Medicaid wanting to abandon them in favor of what we currently have as status quo for the rest of the population.

Your assumptions are not supported by empirical evidence. Fact: The private sector is always cheaper than the government controlled sectors because it is driven by competition. This is shown big time with the deregulation of Railroads and Airlines. Evidence also shows that Medicaid, VA and Indian Reservation healthcare is not only inferior to private care, it is more expensive. Not to mention, it would throw millions of tax paying people in the insurance industry out of work and create millions of tax dependent government jobs.

Funny you should mention Medicare. Here is how Medicare works. They take 3% of your salary for your entire working life and put it in Medicare. That usually is about 50 years that you are in effect prepaying your Medicare premium. Next, it takes 3 people who are still working to pay for the healthcare for every person on Medicare. Next, Medicare still isn't free you have to pay a monthly premium and it has a 20% copay. So if you have a 250K medical procedure, you are responsible for 50K. Oh by the way, not everyone is eligible for Medicare. You have to have worked a minimum number or years to acquire eligibility.

Now you explain to me how you can have Medicare for all without prepaying for it, and having working people pay into it to cover those already on it?

What Bernie the con man is pushing is Medicaid for all and since he knows no thinking being would want to be in that, he is calling it Medicare for all. Disgusting and disgraceful.

Beyond that, what kind of fool thinks renaming a healthcare system without addressing the issues that make it expensive will make it cheaper. Only that kind of fool would vote for Bernie.

 

[Fenton]

As far as I know, Bernie never said anything about 40 trillion. I don't know where you come up with this. $32 trillion is the closest estimate (actually, 2 independent estimates). What we have now will cost $47 billion. So yes, M4A is cheaper.

And even if I took your number of 3.65 trillion / year. Even THAT is more expensive than $32 trillion over 10 years.

Bernie Sanders claims Medicare for All could cost 40 trillion....
Bernie Sanders Thinks Medicare for All Could Cost $40 Trillion – Reason.com

Where's the savings ?

 

[Slavister]

Bernie Sanders claims Medicare for All could cost 40 trillion....
Bernie Sanders Thinks Medicare for All Could Cost $40 Trillion – Reason.com

Where's the savings ?

Thanks for the link. And incidentally it contains the answer to your question as well. Status quo ~$50 trillion over next 10 years.

 

[Glitch]

Your assumptions are not supported by empirical evidence. Fact: The private sector is always cheaper than the government controlled sectors because it is driven by competition. This is shown big time with the deregulation of Railroads and Airlines. Evidence also shows that Medicaid, VA and Indian Reservation healthcare is not only inferior to private care, it is more expensive. Not to mention, it would throw millions of tax paying people in the insurance industry out of work and create millions of tax dependent government jobs.

Funny you should mention Medicare. Here is how Medicare works. They take 3% of your salary for your entire working life and put it in Medicare. That usually is about 50 years that you are in effect prepaying your Medicare premium. Next, it takes 3 people who are still working to pay for the healthcare for every person on Medicare. Next, Medicare still isn't free you have to pay a monthly premium and it has a 20% copay. So if you have a 250K medical procedure, you are responsible for 50K. Oh by the way, not everyone is eligible for Medicare. You have to have worked a minimum number or years to acquire eligibility.

Now you explain to me how you can have Medicare for all without prepaying for it, and having working people pay into it to cover those already on it?

What Bernie the con man is pushing is Medicaid for all and since he knows no thinking being would want to be in that, he is calling it Medicare for all. Disgusting and disgraceful.

Beyond that, what kind of fool thinks renaming a healthcare system without addressing the issues that make it expensive will make it cheaper. Only that kind of fool would vote for Bernie.

You left out the fact the because it is government they are only paying pennies on the dollar. If it normally costs $10,000, MediCare/MedicAid may pay only 10% of the total cost. Even though they are still charging you their 20% co-pay. The victim ends up paying $2,000 to government for a $10,000 medical procedure that the government only pays $1,000. Leaving an unpaid balance of $9,000 and enriching government by $1,000. Which is why medical costs and health insurance premiums have skyrocketed since the creation of MediCare/MedicAid in 1966. The market has to make up the cost of being robbed by government.

It should not come as any surprised as to why the Affordable Healthcare Act was even a concept - had government stayed out of our healthcare from the very beginning, there would never have been a need for an Affordable Healthcare Act. Democrats created the problem in 1966, and they are now compounding the problem after 2010. Democrats are determined to destroy the healthcare industry in the US if they can't control it utterly.

 

[BahamaBob]

You left out the fact the because it is government they are only paying pennies on the dollar. If it normally costs $10,000, MediCare/MedicAid may pay only 10% of the total cost. Even though they are still charging you their 20% co-pay. The victim ends up paying $2,000 to government for a $10,000 medical procedure that the government only pays $1,000. Leaving an unpaid balance of $9,000 and enriching government by $1,000. Which is why medical costs and health insurance premiums have skyrocketed since the creation of MediCare/MedicAid in 1966. The market has to make up the cost of being robbed by government.

It should not come as any surprised as to why the Affordable Healthcare Act was even a concept - had government stayed out of our healthcare from the very beginning, there would never have been a need for an Affordable Healthcare Act. Democrats created the problem in 1966, and they are now compounding the problem after 2010. Democrats are determined to destroy the healthcare industry in the US if they can't control it utterly.

This is also the main reason a large number of doctors and private hospitals will not accept medicaid patients. They actually lose money on them. What is mind boggling is how can the system that pays the least be the most expensive to operate?

 

[jaeger19]

More uninformed made up tripe from a guy who doesn't even know the difference between a hip and a leg. Just what I expected.

Nice try dude. But your failure is noted.

 

[jaeger19]

You are forgetting a couple things:

1. There are a lot of unemployed Americans at any given time. They don't have employer sponsored insurances.

L].

If they are that poor.. they generally qualify for Medicaid.. or they qualify for subsidies under Obamacare for health insurance.

 

[jaeger19]

I'll give you that cost estimates DO depend on a lot of assumptions and are UNcertain. However, with two $32 trillion estimates vs current estimates for 10 year spending do suggest it will be cheaper due to various factors (eliminating private insurance layer, administrative cost savings, lowering provider reimbursement, lower drug prices, etc.)

Further, I am sure by the time this program passes, there will still be some type of copayments / deductibles, and likely other compromises. People do need some skin in the game to avoid overuse, just not so much that it can completely ruin them.
.

Just to point out... this whole.. "some skin in the game to prevent overuse".. is really complete BS. Who really overuses healthcare? Actual healthcare? Sorry but you can't be like "gee I have insurance so lets get a total hip today". and doctors visits? You WANT to encourage people who are not sure if they need to go to the doctor to see the doctor. that's how you get your preventative medicine savings.

It's funny but I am not aware of anyone using Medicare or Medicaid wanting to abandon them in favor of what we currently have as status quo for the rest of the population.

Well... I have tons of patients that are ecstatic when they get off Medicaid and get on private insurance through their employer.

Medicare? pretty dang popular. BUT... there is no free lunch here. Medicare as its now.. is far and away better than almost any other countries government single payer. SO.. the idea that Bernie can get the savings like other countries... while NOT doing what other countries do... does not make logical sense.

 

[BahamaBob]

Just to point out... this whole.. "some skin in the game to prevent overuse".. is really complete BS. Who really overuses healthcare? Actual healthcare? Sorry but you can't be like "gee I have insurance so lets get a total hip today". and doctors visits? You WANT to encourage people who are not sure if they need to go to the doctor to see the doctor. that's how you get your preventative medicine savings.

Well... I have tons of patients that are ecstatic when they get off Medicaid and get on private insurance through their employer.

Medicare? pretty dang popular. BUT... there is no free lunch here. Medicare as its now.. is far and away better than almost any other countries government single payer. SO.. the idea that Bernie can get the savings like other countries... while NOT doing what other countries do... does not make logical sense.

I disagree somewhat with you assertion that skin in the game does not lower use of healthcare. While I agree there are very few hypochondriacs who hang around the Doctor's office. However, it is shown that higher co pays and higher deductions have caused reduced usage.

One of the biggest problems with Medicaid is because a large number of doctors will not accept them, they are forced to go to emergency rooms for healthcare.

Medicare works because 1st you prepay it for 50 years or so before you use it and there are 3 working people paying into the system to cover every 1 person who is using it. If you eliminate those two aspects, it is no longer Medicare and will not work period.

 

[jaeger19]

I disagree somewhat with you assertion that skin in the game does not lower use of healthcare.

Oh.. sure it lowers the use of healthcare. What we were talking about is "overuse"... or "overutilization". And I was pointing out that was a bit of a crock (the idea that people are really "overusing" healthcare on a consistent basis)..

The problem with lowering the use of healthcare with copays etc.. is that well.. it lowers the use of healthcare... so the fellow that has a fever, and cough, and hasn't gotten better in the last week.. doesn't go to the doctor because he doesn't want to pay the copay. And then he ends up in the ER with pneumonia.

Or the fellow that has felt general malaise for weeks, some sob and has had some swelling in his legs, and he avoids going to the doctor... until he is in the ER with congestive heart failure.