What Will Universal Health Care Look Like

[washunut]

Nearly twelve years ago one of the keys to Obama's election was his call of what we term today as universal health care. After more than a year in congress we settled for ACA. So while it is fine for many presidential candidates to call for M4A does anyone here know what that truly means when implemented?

Has any candidate running for president put out an extensive white paper detailing this proposal,transition period costs and impact to current health care providers. Something that Pelosi and Schumer have reviewed and agreed to sign off on in 2021?

Many here will quickly respond that every other country has it why don't we. While a fair point we went down another road about 70 years ago and thus have a materially different system. Doesn't matter what others have what will ours look like.

Doubt any politician will detail his/her proposal. That being said,what do you think it will look like. The good,the baas and the ugly.

 

[ttwtt78640]

Nearly twelve years ago one of the keys to Obama's election was his call of what we term today as universal health care. After more than a year in congress we settled for ACA. So while it is fine for many presidential candidates to call for M4A does anyone here know what that truly means when implemented?

Has any candidate running for president put out an extensive white paper detailing this proposal,transition period costs and impact to current health care providers. Something that Pelosi and Schumer have reviewed and agreed to sign off on in 2021?

Many here will quickly respond that every other country has it why don't we. While a fair point we went down another road about 70 years ago and thus have a materially different system. Doesn't matter what others have what will ours look like.

Doubt any politician will detail his/her proposal. That being said,what do you think it will look like. The good,the baas and the ugly.

Here is one legislative proposal for M4A:

H.R.676 - 115th Congress (2017-2018): Expanded & Improved Medicare For All Act | Congress.gov | Library of Congress

The basic idea seems to be to provide medical care "insurance" which has no premiums, deductibles or co-pays and to "control costs" by forcing all medical care (goods/services) providers to become non-profit. The basic idea is for the federal government to be given the exclusive power to set "fair" prices for all medical care goods/services and to transform medical care "insurance" into a government monopoly.

The reason that I placed insurance in quotes is that insurance was never intended to become a level payment plan to cover all routine maintenance costs. That is why homeownwers/renters insurance does not cover lawn maintenance, replacing worn carpeting or periodic repainting and why auto insurance (even "full covergae") does not cover tune-ups, oil changes or replacing normal wear items (belts, hoses or tires).

 

[washunut]

Here is one legislative proposal for M4A:

H.R.676 - 115th Congress (2017-2018): Expanded & Improved Medicare For All Act | Congress.gov | Library of Congress

The basic idea seems to be to provide medical care "insurance" which has no premiums, deductibles or co-pays and to "control costs" by forcing all medical care (goods/services) providers to become non-profit. The basic idea is for the federal government to be given the exclusive power to set "fair" prices for all medical care goods/services and to transform medical care "insurance" into a government monopoly.

The reason that I placed insurance in quotes is that insurance was never intended to become a level payment plan to cover all routine maintenance costs. That is why homeownwers/renters insurance does not cover lawn maintenance, replacing worn carpeting or periodic repainting and why auto insurance (even "full covergae") does not cover tune-ups, oil changes or replacing normal wear items (belts, hoses or tires).

Is this the proposal that dems running for president are all running behind? If not what are they proposing.

For that matter I would to hear from the many progressives here who decry the fact we don't have it hear and want it.

That being said not sure will have any real thoughts as to what they are calling for. Time will tell if we get any thoughtful responses from progressives.

 

[ttwtt78640]

Is this the proposal that dems running for president are all running behind? If not what are they proposing.

For that matter I would to hear from the many progressives here who decry the fact we don't have it hear and want it.

That being said not sure will have any real thoughts as to what they are calling for. Time will tell if we get any thoughtful responses from progressives.

M4A is often described as Medicare for all, but much more resembles (expanded?) Medicaid for all except that it would require no state fund matching. Even with the most optimistic "cost savings" (at least a 40% reduction in per capita medical care expenses) M4A would still cost about $6K/person annually, or $24K/year ($2K/month) for a typical four person household.

Honest discussions must start with exactly what M4A means - generally a 100% single-payer (federally funded) system with no premiums, deductibles or co-pays, then determine the per capita cost of such a program and then how funding (taxation) will be raised to supply the required ($3.2T annually?) to pay providers of medical care goods/services.

 

[Deuce]

Here is one legislative proposal for M4A:

H.R.676 - 115th Congress (2017-2018): Expanded & Improved Medicare For All Act | Congress.gov | Library of Congress

The basic idea seems to be to provide medical care "insurance" which has no premiums, deductibles or co-pays and to "control costs" by forcing all medical care (goods/services) providers to become non-profit. The basic idea is for the federal government to be given the exclusive power to set "fair" prices for all medical care goods/services and to transform medical care "insurance" into a government monopoly.

The reason that I placed insurance in quotes is that insurance was never intended to become a level payment plan to cover all routine maintenance costs. That is why homeownwers/renters insurance does not cover lawn maintenance, replacing worn carpeting or periodic repainting and why auto insurance (even "full covergae") does not cover tune-ups, oil changes or replacing normal wear items (belts, hoses or tires).

Never intended by whom? I see this a lot in economic discussions. “Intended.” Stuff like “minimum wage was never intended to support XYZ.” Intended by the aristocracy? Probably not. Who gives a **** about their opinion?

 

[ttwtt78640]

Never intended by whom? I see this a lot in economic discussions. “Intended.” Stuff like “minimum wage was never intended to support XYZ.” Intended by the aristocracy? Probably not. Who gives a **** about their opinion?

While it may be nice to rant about what is not intended, it does not address the OP of what is intended when folks advocate for M4A.

 

[Jetboogieman]

I think America has botched their chance at a good healthcare system because of decades of mismanagement and half of the population that thinks actually having a functioning healthcare system that doesn't screw them out of every penny they have is.... Somehow not in their best interest because, they may have to pay some taxes.

Instead of paying insane premiums, out of pocket costs, the highest drug prices in the world, paying taxes anyway for all the problems lack of insurance coverage causes and being denied coverage in the end anyway even though they worked hard for most of their life, did everything right, saved money, but because yah know they got sick, eat **** and die, should have been rich if you wanted to live you stupid idiot, work harder.

So yeah, M4A probably can't work because the entire system is ****ed and politicians have been bought to make sure it's never actually fixed and too many voters are too stupid to realize they're being screwed...

This is America.

 

[washunut]

M4A is often described as Medicare for all, but much more resembles (expanded?) Medicaid for all except that it would require no state fund matching. Even with the most optimistic "cost savings" (at least a 40% reduction in per capita medical care expenses) M4A would still cost about $6K/person annually, or $24K/year ($2K/month) for a typical four person household.

Honest discussions must start with exactly what M4A means - generally a 100% single-payer (federally funded) system with no premiums, deductibles or co-pays, then determine the per capita cost of such a program and then how funding (taxation) will be raised to supply the required ($3.2T annually?) to pay providers of medical care goods/services.

Have you ever heard a coherent explanation of how folks advocating M4A plan to achieve this alleged 40% savings? I have heard some vague comments like get rid of insurance companies or big pharma. I never hear about the costs to replace them,or how we will achieve advances in medicine which saves lives.

 

[ttwtt78640]

I think America has botched their chance at a good healthcare system because of decades of mismanagement and half of the population that thinks actually having a functionining healthcare system that doesn't screw them out of every penny they have is.... Somehow not in their best interest because, they may have to pay some taxes.

Instead of paying insane premiums, out of pocket costs, the highest drug prices in the world, paying taxes anyway for all the problems lack of insurance coverage causes and being denied coverage in the end anyway even though they worked hard for most of their life, did everything right, saved money, but because yah know they got sick, eat **** and die, should have been rich if you wanted to live you stupid idiot, work harder.

So yeah, M4A probably can't work because the entire system is ****ed and politicians have been bought to make sure it's never actually fixed and too many voters are too stupid to realize they're being screwed...

This is America.

Many of those arguments could be applied to current MIC funding by our current, congressionally "managed", single-payer DoD system. There is no doubt that "cost savings" could be achieved by outlawing for-profit "defense" contractors, yet that will never be done either.

 

[Deuce]

Have you ever heard a coherent explanation of how folks advocating M4A plan to achieve this alleged 40% savings? I have heard some vague comments like get rid of insurance companies or big pharma. I never hear about the costs to replace them,or how we will achieve advances in medicine which saves lives.

Every other first world nation on the planet has universal healthcare and in every single case it costs substantially less than ours. There’s immense evidence that universal healthcare reduces cost, you’re going to have to prove that it somehow wont in the US.

 

[Captain Adverse]

I think America has botched their chance at a good healthcare system because of decades of mismanagement and half of the population that thinks actually having a functioning healthcare system that doesn't screw them out of every penny they have is.... Somehow not in their best interest because, they may have to pay some taxes.

Instead of paying insane premiums, out of pocket costs, the highest drug prices in the world, paying taxes anyway for all the problems lack of insurance coverage causes and being denied coverage in the end anyway even though they worked hard for most of their life, did everything right, saved money, but because yah know they got sick, eat **** and die, should have been rich if you wanted to live you stupid idiot, work harder.

So yeah, M4A probably can't work because the entire system is ****ed and politicians have been bought to make sure it's never actually fixed and too many voters are too stupid to realize they're being screwed...

This is America.

Well, IMO we need to recognize two main factors, and one side factor.

1. Insurance companies are a prime problem, and

2. We forget that Medicine is a business.

The side factor is that people demand access to healthcare, whether they can afford it or not.

Issue #1. Insurance Companies. These businesses have so permeated our society that we seem to forget they exist to make a profit. They do so by offering to manage a "pool" of money which can be used in "emergency" and/or "unexpected" hazards to assist with or cover costs. That pool comes from contributors who buy a "share" of the pool by paying assigned "premiums" into that pool of funds. Then they wheel and deal with businesses so that the business can make some profit while the Insurance company also makes profits.

Issue #2. Medicine is a business. We hear how medical practitioners go into it to "serve people." But they are going to spend a lot of time studying and training at their own expense to become a qualified medical practitioner and they are going to not only want to recoup that expense, but to profit by selling their services. So they are going to pass all of the expenses on the "consumer." Rightly so.

Side issue: Many people seem to believe that they have a RIGHT to medical treatment. They've bought into the "Physician do no harm" propaganda and expect to be treated at as little cost, if any, to their pocketbooks.

These are the players in this dynamic. The issue is how to properly balance them to achieve what each wants without having to "suffer costs/losses."

When someone can figure that out, let me know.

 

[washunut]

Every other first world nation on the planet has universal healthcare and in every single case it costs substantially less than ours. There’s immense evidence that universal healthcare reduces cost, you’re going to have to prove that it somehow wont in the US.

Many here will quickly respond that every other country has it why don't we. While a fair point we went down another road about 70 years ago and thus have a materially different system. Doesn't matter what others have what will ours look like.

In other words you have nothing to add,thanks.

 

[Deuce]

Many here will quickly respond that every other country has it why don't we. While a fair point we went down another road about 70 years ago and thus have a materially different system. Doesn't matter what others have what will ours look like.

In other words you have nothing to add,thanks.

Uhh, you’re the one with nothing to add because you just artificially limited the entire discussion to “the exact system America currently has, and no other system can ever be discussed.” Great, you’ve categorically denied the possibility of ANY CHANGE WHATSOEVER to America’s healthcare system. So, this begs the question: what the **** are you even doing in this thread? The very concept of the thread revolves around ​making a material change to our system.

 

[Mr Person]

Uhh, you’re the one with nothing to add because you just artificially limited the entire discussion to “the exact system America currently has, and no other system can ever be discussed.” Great, you’ve categorically denied the possibility of ANY CHANGE WHATSOEVER to America’s healthcare system. So, this begs the question: what the **** are you even doing in this thread? The very concept of the thread revolves around ​making a material change to our system.

It's just the usual "prove to me that ______" challenge laid out by someone who fully intends to say some version of "dismissed" to anyone who makes an argument (ie, alternately, denying that something is "evidence", denying that they themselves have to establish any claims, etc). An attempt to create the appearance of wining a debate by simply announcing that every counter-point is "dismissed" in turn.

Many here will quickly respond that every other country has it why don't we. While a fair point we went down another road about 70 years ago and thus have a materially different system. Doesn't matter what others have what will ours look like.

In other words you have nothing to add,thanks.

He was pointing out that every other developed country seems to manage it with savings, so perhaps the burden is on YOU to show it doesn't. You're just trying to shift the burden by appearing to innocently just ask a question while intending to make a show of rejecting any answer that doesn't line up with what you want to hear.

Many here will quickly respond that every other country has it why don't we. While a fair point we went down another road about 70 years ago and thus have a materially different system. Doesn't matter what others have what will ours look like.

Doubt any politician will detail his/her proposal. That being said,what do you think it will look like. The good,the baas and the ugly.

See? You already know that "what it will look like" is something like what the other developed countries have, so you cleverly attempt to set up a rule for discussion that prohibits mentioning those other developed countries.

You know it absolutely does matter what others have, so you announce "Doesn't matter what others have." Transparent.

And of course, it would be idiotic to say it will look like any one thing. Depends on the candidate, depends on the congress. Some want government to be the sole provider. Others want government to provide all basic care for free. Others might want government to guarantee basic care to all BUT to charge fees to those able to pay. Etc.

 

[washunut]

It's just the usual "prove to me that ______" challenge laid out by someone who fully intends to say some version of "dismissed" to anyone who makes an argument (ie, alternately, denying that something is "evidence", denying that they themselves have to establish any claims, etc). An attempt to create the appearance of wining a debate by simply announcing that every counter-point is "dismissed" in turn.




He was pointing out that every other developed country seems to manage it with savings, so perhaps the burden is on YOU to show it doesn't. You're just trying to shift the burden by appearing to innocently just ask a question while intending to make a show of rejecting any answer that doesn't line up with what you want to hear.



See? You already know that "what it will look like" is something like what the other developed countries have, so you cleverly attempt to set up a rule for discussion that prohibits mentioning those other developed countries.

You know it absolutely does matter what others have, so you announce "Doesn't matter what others have." Transparent.

And of course, it would be idiotic to say it will look like any one thing. Depends on the candidate, depends on the congress. Some want government to be the sole provider. Others want government to provide all basic care for free. Others might want government to guarantee basic care to all BUT to charge fees to those able to pay. Etc.

Or perhaps you don't know the details of what others have. I admit I don't. I also am pretty sure that "others" don't all have the same system although the arrogant here will say it is all free thus all the same.

ACA followed the path of Mass or so I am told. Do you consider Mass M4A.

I had expected that this site would elicit the type of responses from the left that I have. While not surprised that no one of the left brought a thoughtful response I am not surprised. You really don't know what you want,that is why we got ACA.

 

[Mr Person]

Or perhaps you don't know the details of what others have. I admit I don't. I also am pretty sure that "others" don't all have the same system although the arrogant here will say it is all free thus all the same.

What are you babbling about? Nobody said "others all have the same system". What you responded to pointed out the many possible variations. Are you choosing to not read what you reply to, or are you unable to comprehend it?

And who specifically is "arrogant"?

Who specifically has said "it is all free thus all the same"?

ACA followed the path of Mass or so I am told. Do you consider Mass M4A.

This is a completely incoherent response to the post you hit "reply" to.

I had expected that this site would elicit the type of responses from the left that I have. While not surprised that no one of the left brought a thoughtful response I am not surprised.

Another accidental admission. It was just another stupidly hamfisted attempt to create a *gotcha* thread. You don't want to discuss universal health care vs. single payer vs. any other variant. You just want to pretend you are clever by asking questions and then announcing you have rejected whatever was said.

Then again, there's a reason I typically don't respond to your posts. Several, in fact.

 

[ataraxia]

Bernie uses the Nordic model, what the Scandinavian countries have. They do OK. They beat us on almost all metrics of public health. And they achieve that spending less per capita on healthcare.

Even rapidly emerging economies are quickly developing systems of universal health care, and they see very dramatic results. Thailand has been the latest example. The improvement in the public health of the nation has been accompanied by a feedback loop to continue to improve the economy. They have also been able to eliminate the category of extreme poverty in their country altogether, because it turns out a lot of people falling into that category were from families where kids were dropping out of school to work, and everyone in the family was chipping in their life savings to help a family member who had been diagnosed with an catastrophic illness. So dramatically improved public health, improved economy, and elimination of extreme poverty. What's not to love? The adaption of a system of universal healthcare in Thailand has been an unquestionable success.

Thailand gave healthcare to its entire population and the results were dramatic | World Economic Forum

 

[washunut]

What are you babbling about? Nobody said "others all have the same system". What you responded to pointed out the many possible variations. Are you choosing to not read what you reply to, or are you unable to comprehend it?

And who specifically is "arrogant"?

Who specifically has said "it is all free thus all the same"?





This is a completely incoherent response to the post you hit "reply" to.





Another accidental admission. It was just another stupidly hamfisted attempt to create a *gotcha* thread. You don't want to discuss universal health care vs. single payer vs. any other variant. You just want to pretend you are clever by asking questions and then announcing you have rejected whatever was said.

Then again, there's a reason I typically don't respond to your posts. Several, in fact.

Please continue in this vein.

 

[washunut]

Bernie uses the Nordic model, what the Scandinavian countries have. They do OK. They beat us on almost all metrics of public health. And they achieve that spending less per capita on healthcare.

Even rapidly emerging economies are quickly developing systems of universal health care, and they see very dramatic results. Thailand has been the latest example. The improvement in the public health of the nation has been accompanied by a feedback loop to continue to improve the economy. They have also been able to eliminate the category of extreme poverty in their country altogether, because it turns out a lot of people falling into that category were from families where kids were dropping out of school to work, and everyone in the family was chipping in their life savings to help a family member who had been diagnosed with an catastrophic illness. So dramatically improved public health, improved economy, and elimination of extreme poverty. What's not to love? The adaption of a system of universal healthcare in Thailand has been an unquestionable success.

Thailand gave healthcare to its entire population and the results were dramatic | World Economic Forum

Thanks for the response. I see our nation as being way more complicated that Nordic nations. I know Bernie uses them as an example but not sure it is an apples to oranges comparison.

In 2009 I was for Medicare for All. Still see many benefits. Lets remember however that Medicare is NOT free. Employees and their companies pay throughout their working lives and folks on Medicare also pay for certain services. Approximately a third of folks on Medicare have some type of supplement as well. If not there would be a lot of bankruptcies even if you have Medicare.

M4A would certainly benefit large corporations more than the Trump tax cuts. I don't cite to knock it,simply a fact. No lesser an expert in corporate finance than Warren Buffett stated that fixing healthcare is more important than tax cuts to benefit companies.

All that being said we know the plusses. When reducing the costs there will certainly be tradeoffs. Not as a scare tactic,just common sense. If we pay big pharma less there will be less R&D. Little impact short term,longer term who knows. Pay doctors less,some of the best and brightest will do other things to provide for their families. Again not something that will impact us much for a couple of decades. An easier fix could be the profits carved out by the large drug distributors and hospitals. They are a key reason list prices are so high. Most don't pay list price but for the uninsured or the people in the "doughnut hole" they are catastrophic. Prices won't matter to consumers in M4A so there will have to be some government intervention. In theory should be no problem,but who trusts any politician to do what is right for the country not their district or state.

Just a few thoughts.

 

[Mr Person]

Please continue in this vein.

Don't like it when someone calls you on your stupid lies and stupid games? Don't do that stuff. :shrug:

 

[washunut]

Don't like it when someone calls you on your stupid lies and stupid games? Don't do that stuff. :shrug:

Please point out what you consider a lie in my post. I would would like a mod to infract wither of us who lied.

 

[Good4Nothin]

The basic idea is for the federal government to be given the exclusive power to set "fair" prices for all medical care goods/services

It is not possible for the federal government to set "fair" prices. How can they possibly know what prices are fair? Fair prices are determined by supply and demand, not dreamed up by government agencies.

I don't know how they do this in the socialized medicine countries.

 

[aociswundumho]

I don't know how they do this in the socialized medicine countries.

It works just like rent control in NYC, or price ceilings on food in Venezuela. It creates shortages and waiting lists.

 

[Good4Nothin]

It works just like rent control in NYC, or price ceilings on food in Venezuela. It creates shortages and waiting lists.

Although we're always hearing from Democrats that socialized medicine works great in Scandinavia, Canada, etc. Now I'm curious about how that could be possible.

 

[Da Mole]

Nearly twelve years ago one of the keys to Obama's election was his call of what we term today as universal health care. After more than a year in congress we settled for ACA. So while it is fine for many presidential candidates to call for M4A does anyone here know what that truly means when implemented?

Has any candidate running for president put out an extensive white paper detailing this proposal,transition period costs and impact to current health care providers. Something that Pelosi and Schumer have reviewed and agreed to sign off on in 2021?

Many here will quickly respond that every other country has it why don't we. While a fair point we went down another road about 70 years ago and thus have a materially different system. Doesn't matter what others have what will ours look like.

Doubt any politician will detail his/her proposal. That being said,what do you think it will look like. The good,the baas and the ugly.

The following is a list of some of the good and the bad. I think that the bad outweighs the limited good. I vote not to socialized anything.



Advantages
Lowers overall health care costs

Lowers administrative costs.

Standardizes service.

Creates a healthier workforce.

Prevents future social costs.

Guides people to make healthier choices.

Disadvantages
Healthy people pay for the sickest.

People have less financial incentive to stay healthy.

Long wait times.

Doctors may cut care to lower costs.

Health care costs overwhelm government budgets.

The government may limit services that have a low probability of success