As the Left marches towards single payer, how would universal Medicare affect EM compensation?

[WilcoWorld]

Most of the unnecessary testing I do is to limit patient complaint letters. I would have no problem using evidence-based medicine to not order the CT/X-ray/Antibiotics that are inappropriate.

OK, throw that in there too.

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[VA Hopeful Dr]

OK, throw that in there too.

You think patient complaints will vanish with Medicare for all?

 

[Birdstrike]

It's a huge number, but I think you'd have to compare it with what Americans are already spending on healthcare. According to this .Atlantic article., we already spend $3.4 trillion per year on healthcare, which over 10 years is 34 trillion dollars.

It's also worthwhile to read Vox's response:
.

$32 trillion.

That is how much federal spending would increase over 10 years under Bernie Sanders’s Medicare-for-all bill, according to a brand-new estimate from the libertarian-leaning Mercatus Center at George Mason University.

Before you question the source (like Sanders did), you should know the left-leaning Urban Institute came up with the exact same number in 2016.

It sure sounds like a lot of money, and conservatives hopped all over the figure on Monday morning. But there are a lot of ways to think about $32 trillion — and one might be that it’s actually kind of a bargain.

Mercatus is projecting a $32 trillion increase in federal spending, above current projected government expenditures, from 2022 to 2031.

In terms of overall health care spending in the United States over the same period, however, they are actually projecting a slight reduction.

There is the rub. The federal government is going to spend a lot more money on health care, but the country is going to spend about the same..​

However, although I clearly lean liberal and theoretically approve of universal healthcare, I can't lie and say I'm not worried about how much my taxes are going to go up to pay for the people who I treat who don't work even though they are able-bodied and capable of working. I just took care of a young 30 year old man, muscular and in good shape. Asked him what he does for a living and he said "I'm on disability." .

From working in an outpatient setting the past 6 years and dealing with all types of insurances, I know that medicare works fairly well, and is fairly good insurance. I have to fight might less with them than private insurers which play horrible, manipulative, probably illegal games to deny my patients benefits and therefore, deny my ability to provide them care. But man, $32 trillion dollars?

That's going to be you and I paying for it, double, triple, quadruple what anyone else pays. And if the end result follows anything like Obamacare played out, we as higher income people will likely pay the largest portion of it, and get little if any benefit above and beyond what we get out of insurance now. In other words, you and I will pay the most and get the least, possibly even less than we get now. Not to mention the fact that once the system is under strain, "Guess what? Gotta cut your 'reimbursement' again, to close the gap." Also, it'll likely cost much much, much more than projected. Government projects almost always do.

I think medicare (right now) is pretty good insurance. I wouldn't mind having it myself, and I don't mind dealing with them as an outpatient doc (they don't always pay as much, but nothing needs pre-approval, you just follow published guidelines and they pay like clockwork, reliably and on time) but man, $32 trillion. Trillion?

What that always means is the upper income brackets pay the most and get the least.

"Sorry, you make above our income cutoff. You don't qualify for this benefit."

In the meantime you sure as hell do qualify to keep paying the bulk of the $32 trillion tax bill.

"Sorry, you make too much, you've got to pay for your 'free' medicare. And sorry, you've still got to pay off those student loans because you earn too much to deduct them. Sorry, not sorry."

I don't know. I'm just very, very skeptical of anytime the government wants to take extra chunks of my paycheck with the promise they can spend it better than me. It's almost always a false promise. By my nature, I'd rather keep it and manage on my own, and take care of my family on my own, as opposed to herding into some government program that likely will not measure up to promise and that I'll probably want to opt out of, pay my own way, then end up paying twice, on top of what would certainly be suffocating tax rates forever.

Could it work? I don't know. Maybe. But my instinct is to just say, "No" to socialism. Socialism always starts out well intentioned, then you end up so poor you're eating zoo animals. So, I'm out.

Socialist Venezuela's Starving People Are Now So Poor They've Had To Resort To Eating The Zoo Animals

 

[d2305]

The left would like to close all the private FP offices, and have community clinics throughout the country. Long waits would be the norm, with substandard care. One only need to look at the VA to see how well socialized medicine works. It's funny, communist China doesn't have socialized medicine.

 

[WilcoWorld]

You think patient complaints will vanish with Medicare for all?

No, of course not. But GV was saying that he performs unnecessary testing out of a fear of patient complaints. That could be mitigated.

 

[VA Hopeful Dr]

No, of course not. But GV was saying that he performs unnecessary testing out of a fear of patient complaints. That could be mitigated.

Kinda, sorta, maybe?

If you're working for not the government, you'll never escape patient satisfaction. Even if we did away with formal evaluations like PG of whatever the stupid acronym is for Medicare's surveys, if volume dropped in your clinic or when you're working, that will be noticed and its a problem. Whether its PP and your income depends on seeing patients or you're salaried by your employer and a decrease in volume means less profit for them.

Even at the VA I think enough patient complaints can cause problems for doctors. Not sure the exact mechanism in place, but as they have an entire department for dealing with pissed of vets I'm sure there's something.

 

[EctopicFetus]

You guys realize all the BS we deal with would exponentially bloat in a medicare for all model. Right now there are docs who dont take medicare/medicaid. You can also be sure step 1 isnt to ration care. That would be too unpopular even though it is the adult thing to do. Lets be honest when this was discussed with obamacare the republicans started with "death panel" chatter.

The government will pay you the doc based on your press ganey. It wouldnt make it go away. They would own us and our practices. Dont like something.. well the job across the street is no different. Same effective employer.

Also, what no one mentions is that hospitals can not afford a medicare for all model.

 

[EctopicFetus]

Libertarian think tank: Providers would pay for Medicare for All

Yes this is from a libertarian... but higher taxes, lower pay...

Nearly all the savings for national health spending come from across-the-board Medicare rate cuts, which Blahous projects would reduce provider payments by $384 billion in the first year, and by nearly $660 billion in 2030.

Another nugget.. CEO of West Virginia's largest hospital: There's no way to feel optimistic about Medicare margins.

While expanded coverage is a net positive, hospital leaders still complain that the government payment programs do not cover costs. For Medicare, hospitals received 88 cents for every dollar spent caring for beneficiaries in 2015 and 90 cents for Medicaid patients, according to the American Hospital Association. Combined underpayments from the government programs were $57.8 billion in 2015. This includes a shortfall of $41.6 billion for Medicare and $16.2 billion for Medicaid, the association reported.

Hospitals already lose money on these people.

 

[RustedFox]

I'm just gonna jump in and say that hospitals operating costs would probably be a hell of a lot lower if it weren't for all of those admins sitting around collecting paychecks and doing very little to actually contribute to patient care.

 

[Birdstrike]

I'm just gonna jump in and say that hospitals operating costs would probably be a hell of a lot lower if it weren't for all of those admins sitting around collecting paychecks and doing very little to actually contribute to patient care.

 

[southerndoc]

I'm just gonna jump in and say that hospitals operating costs would probably be a hell of a lot lower if it weren't for all of those admins sitting around collecting paychecks and doing very little to actually contribute to patient care.

All of them wearing white coats too... We have way too many auditors in healthcare. A significant amount of money could be cut from healthcare spending by eliminating the overhead, which includes chart auditors/abstractors, compliance officers, etc.

 

[namethatsmell]

The current economic regulations of medicine are lame.

Everything favors the businessman over the doctor. IMHO, either you a) take off all the restrictions and let the free market truly go to work and allow things like doctors to own hospitals or b) enact further regulations on the whole sector and do things like prohibit insurance companies from being for-profit and healthcare companies from being publicly traded.

 

[miacomet]

I believe Australia and Canada pay decently, with the added bonus that attendings down under don't do nights and have vastly better working conditions.

I believe in universal Medicare. But even I have to admit: it will likely lead to a huge hit to our salaries.

There is very little to wonder about this. Every other industrialized Western country in the world has some form of universal healthcare, and none of the ER doctors in those countries get paid well, especially in comparison to us.

I believe in universal Medicare. But even I have to admit: it will likely lead to a huge hit to our salaries.

There is very little to wonder about this. Every other industrialized Western country in the world has some form of universal healthcare, and none of the ER doctors in those countries get paid well, especially in comparison to us.

 

[Dr Mantis Toboggan]

I also have to think there are many fewer inappropriate ED visits than here, but that’s just a guess.

I believe Australia and Canada pay decently, with the added bonus that attendings down under don't do nights and have vastly better working conditions.

 

[GeneralVeers]

I also have to think there are many fewer inappropriate ED visits than here, but that’s just a guess.

OF course because their population has a higher level of education/basic knowledge and a lower level of entitlement.

 

[Angry Birds]

OF course because their population has a higher level of education/basic knowledge and a lower level of entitlement.

But isn’t it theft to fund even basic education with taxes which are STOLEN from your pocket?



Sorry. couldn’t help myself. Lol

 

[RustedFox]

But isn’t it theft to fund even basic education with taxes which are STOLEN from your pocket?

Sorry. couldn’t help myself. Lol

Before he replies; the same can be done in the private sector; better and less costly, with involved people and their buy-in.

I need to take some time to find the meme, but when it comes down to private enterprise beating federal (anything), I saw something akin to this very recently:

SHIPPING:

UPS: You ordered a package! Here's what it is... sweet! It left the facility. Its in city X, Y, and Z. Its out for delivery. Its on your doorstep. Here's a photo.

FedEx: You ordered a package? You'll get it. Soon. When we're ready to give it to you. Be patient.

US Postal Service: You ordered a package ? Uhhhh... okay.

 

[Angry Birds]

Before he replies; the same can be done in the private sector; better and less costly, with involved people and their buy-in.

I need to take some time to find the meme, but when it comes down to private enterprise beating federal (anything), I saw something akin to this very recently:

SHIPPING:

UPS: You ordered a package! Here's what it is... sweet! It left the facility. Its in city X, Y, and Z. Its out for delivery. Its on your doorstep. Here's a photo.

FedEx: You ordered a package? You'll get it. Soon. When we're ready to give it to you. Be patient.

US Postal Service: You ordered a package ? Uhhhh... okay.

Great joke.

But, terrible argument. Even the example you give works against your argument.

The USPS is far, far cheaper than FedEx and UPS. Additionally, USPS has been offering tracking for a long time now. In my experience, you can get the most reliable form of delivery with USPS even cheaper than what you can find at Fedex and UPS. I don't know about you, but I almost always use USPS... a habit from residency days I suppose: unlike you, Mr. Money Bags, I know I can send stuff dirt cheap through the post office. Ain't no private company going to let me mail anything for 32 cents...

The joke you made is based on out of date information, and also a result of the sheer amount of mail the USPS was dealing with before tracking technology came/improved.

Additionally, and perhaps more importantly, one of the best models--at least in my opinion--is the one where the government provides a ground floor but private industry can offer higher options for those who wish to pay a premium. In the case of healthcare, there are several advanced countries that offer universal coverage with a public option; wealthier clientele can opt for premium coverage through a private company.

It's the public option that prevents the private industry from fleecing its consumers. If the post office goes away, then Fedex and UPS will start working to establish a monopoly and also price rig with each other. You want to see how that works? Look at your cable company, i.e. Time Warner, Comcast, etc. You like dealing with Comcast? Guess what... If a public option came along--i.e. public wifi--these companies wouldn't be allowed to get away with their outlandish prices and practices, as well as horrible customer service.

Also, if the USPS goes away, it's quite possible--and I'm not sure if it's already the case now--that private companies like UPS and FedEx will simply not ship to certain underserved parts of the country. Whereas the government's role is to provide services to all of its citizens, a private company's job is to make money.

Lastly, there are numerous industries in which the government's presence is beneficial, and I can name them if you'd like. Watch from 2:57 and see how your question is easily answered:

 

[TheTruckGuy]

We just need the whole healthcare system to collapse and rebuild it from the ground up. Universal healthcare in this country won't work because of our culture of wanting everything now, and more is always better. People just won't accept it. And an all private system won't work, because the marginalized populations will continue to suffer due to unaffordable services.

Simplify everything, make everythign cash pay only, force price transparency. If you want your insurance to cover something, you file the claim yourself. Doctors offices get rid of all the costs associted with coding and billing and fighting with insurance for payments. Ideally they cut overhead and can charge less. And maybe figure out a way to get a tax deduction if you don't do bad stuff like smoke, and if you exercise, maintain a healthy weight, etc. Increase tax benefits for using a health savings account instead of insurance. But that stuff won't happen. Too much work.

 

[miacomet]

I also have to think there are many fewer inappropriate ED visits than here, but that’s just a guess.

I hear it's hard to get a PCP in Canada, so lots of people use the ED for general care, but I think it's pretty easy to say no to narcs. Medmal issues are much fewer, of course. It's true most of the rest of the world pays less for ER (the UK, for example) but what they've discovered there is that, shockingly, no one wants to work nights, weekends, or holidays for no money, so it's basically all locums, and they earn a decent (if not great) amount.

 

[miacomet]

We just need the whole healthcare system to collapse and rebuild it from the ground up. Universal healthcare in this country won't work because of our culture of wanting everything now, and more is always better. People just won't accept it. And an all private system won't work, because the marginalized populations will continue to suffer due to unaffordable services.

Simplify everything, make everythign cash pay only, force price transparency. If you want your insurance to cover something, you file the claim yourself. Doctors offices get rid of all the costs associted with coding and billing and fighting with insurance for payments. Ideally they cut overhead and can charge less. And maybe figure out a way to get a tax deduction if you don't do bad stuff like smoke, and if you exercise, maintain a healthy weight, etc. Increase tax benefits for using a health savings account instead of insurance. But that stuff won't happen. Too much work.

People accept it with Kaiser (and like it) and accept it with TriCare and the VA.

 

[GeneralVeers]

But isn’t it theft to fund even basic education with taxes which are STOLEN from your pocket?



Sorry. couldn’t help myself. Lol

I agree with you. It is theft.

 

[VA Hopeful Dr]

People accept it with Kaiser (and like it) and accept it with TriCare and the VA.

Most vets that have private insurance avoid the VA like the plague.

Didn't Kaiser just lose a big lawsuit for incentivizing their doctors to refuse to order imaging?

 

[RustedFox]

Great joke.

But, terrible argument. Even the example you give works against your argument.

It doesn't.

The USPS is far, far cheaper than FedEx and UPS. Additionally, USPS has been offering tracking for a long time now. In my experience, you can get the most reliable form of delivery with USPS even cheaper than what you can find at Fedex and UPS. I don't know about you, but I almost always use USPS... a habit from residency days I suppose: unlike you, Mr. Money Bags, I know I can send stuff dirt cheap through the post office. Ain't no private company going to let me mail anything for 32 cents...

The joke you made is based on out of date information, and also a result of the sheer amount of mail the USPS was dealing with before tracking technology came/improved.

That joke is very new. Freshly posted meme on an app that I have. The joke itself is even about the differences in tracking between shipping services. Apparently, your argument is rather out of date, as stamps stopped being 32 cents a long time ago. In addition, you know damn well that we're not talking about stamps-and-envelopes, so your equivocation (which follows your ad-hominem of "Mr. Moneybags") doesn't hold up. I even mention the word "package" three times in the joke. Sure, USPS is cheap. But as anyone who regularly sends/receives packages will tell you - there's a clear difference in terms of service and quality. Hence; the joke is funny because (like all jokes that are good), it contains a small kernel of truth. I will tell you firsthand that the joke is also accurate, as Mrs. RustedFox generally refuses to go to the mall or most brick-and-mortar retail stores in the real world. Where we live; I can't blame her - but that's a whole 'nother thread.

Additionally, and perhaps more importantly, one of the best models--at least in my opinion--is the one where the government provides a ground floor but private industry can offer higher options for those who wish to pay a premium. In the case of healthcare, there are several advanced countries that offer universal coverage with a public option; wealthier clientele can opt for premium coverage through a private company.

Here you argue *for* my statement that "private enterprise is better than federally funded anything."

It's the public option that prevents the private industry from fleecing its consumers. If the post office goes away, then Fedex and UPS will start working to establish a monopoly and also price rig with each other. You want to see how that works? Look at your cable company, i.e. Time Warner, Comcast, etc. You like dealing with Comcast? Guess what... If a public option came along--i.e. public wifi--these companies wouldn't be allowed to get away with their outlandish prices and practices, as well as horrible customer service.

Its the public option that almost invariably sucks. I'd rather willingly spend my money on services that I know will get the job done in a timely and satisfactory fashion, rather than waste it involuntarily on an inferior service/product. If the cost is prohibitive or I decide that I have a better way to spend my money, then I won't use that service. The difference being; the choice is mine to make, not some politician's who doesn't have to live with the consequences of their own decisions (as in healthcare). I've had Xfinity for 3 years now, and their product and service are actually pretty awesome.

Also, if the USPS goes away, it's quite possible--and I'm not sure if it's already the case now--that private companies like UPS and FedEx will simply not ship to certain underserved parts of the country. Whereas the government's role is to provide services to all of its citizens, a private company's job is to make money.

Refuse to ship to certain underserved parts of the country? If you say so, but I doubt this is at all true - as it would hurt the company's overall footprint. After all, you can have Amazon ship to your hotel room or car now; and they've shipped items to me way out at the trail's end on some of my travels.

Lastly, there are numerous industries in which the government's presence is beneficial, and I can name them if you'd like. Watch from 2:57 and see how your question is easily answered:

There was no question in my post.

 

[TheTruckGuy]

People accept it with Kaiser (and like it) and accept it with TriCare and the VA.

I can't speak for Kaiser, as i have no experience with them. But I am a military doc. It is not uncommon at all for patients to not believe we're real doctors and will go out in town and pay for a doc in the box to give them what they want.

Just the other day I had a patient come back to me for follow up. This was his 4th encounter for a cough. First encounter another provider told him it was viral, and gave cough meds. 2nd encounter with me, I got a CXR (which was normal), and gave some allergy meds as he did have some mucous in his throat. 3rd encounter was with a doc in the box that had a CXR that showed "fluid on the lungs" and he got his antibiotics. And, big suprise, his 4th encounter with me, still coughing. And, he also informed me that our very large hospital's xray system must have something wrong with it, because the CXR the day after seeing me showed fluid.

And, for the most part, in my experience, the only patients that go to the VA are the ones that can't afford an outside option. Which sadly, are quite a few.

People think more is better. And we're humans, and medicine is hard, we're going to miss things and get things wrong. Right now our acceptable miss rate is lower than what we're willing to pay for.

 

[miacomet]

I can't speak for Kaiser, as i have no experience with them. But I am a military doc. It is not uncommon at all for patients to not believe we're real doctors and will go out in town and pay for a doc in the box to give them what they want.

Just the other day I had a patient come back to me for follow up. This was his 4th encounter for a cough. First encounter another provider told him it was viral, and gave cough meds. 2nd encounter with me, I got a CXR (which was normal), and gave some allergy meds as he did have some mucous in his throat. 3rd encounter was with a doc in the box that had a CXR that showed "fluid on the lungs" and he got his antibiotics. And, big suprise, his 4th encounter with me, still coughing. And, he also informed me that our very large hospital's xray system must have something wrong with it, because the CXR the day after seeing me showed fluid.

And, for the most part, in my experience, the only patients that go to the VA are the ones that can't afford an outside option. Which sadly, are quite a few.

People think more is better. And we're humans, and medicine is hard, we're going to miss things and get things wrong. Right now our acceptable miss rate is lower than what we're willing to pay for.

Agreed on all counts. Kaiser patients seem happy (I don't get why- I see their patients when they visit and wow, they won't let them get anything done out of network, amongst other issues). Agreed people aren't huge fans of Tricare or the VA, but people still pick military careers and still go to the VA, so they apparently find it acceptable, if not ideal.

 

[miacomet]

Most vets that have private insurance avoid the VA like the plague.

Didn't Kaiser just lose a big lawsuit for incentivizing their doctors to refuse to order imaging?

Probably. They also had their kidney transplant program shut down for killing too many patients, and they apparently aren't allowed to have Level I trauma centers in Cali as they can't handle it. But patients love Kaiser because it's easy and they can always get in to see a doc. I think Kaiser sucks, but they have high pt satisfaction.

 

[EctopicFetus]

I'm just gonna jump in and say that hospitals operating costs would probably be a hell of a lot lower if it weren't for all of those admins sitting around collecting paychecks and doing very little to actually contribute to patient care.

All there due to mandated govt programs.

 

[MechEDoc]

Ranting here...

Kaiser - never been a patient of Kaiser or worked at a full Kaiser facility. But did work in a facility was that was ~1/3rd Kaiser patients. They had a full time skill nurse coordinator in the emergency department. They were very good at arranging outpatient logistics. E.g. one could diagnose new onset atrial fibrillation, placed the patient on anticoagulation, rate control medications, and arrange cardiology follow-up with an echo for the patient the following morning. That type of logistical coordination was very common. I was impressed. I did have the coordinator nurse try to block a transfer outside of Kaiser once ($$), I steamrollered them pretty fast and they gave up (I offered to chart their name, their actions, and how I felt was likely going to lead to direct harm and then followed up that I would furthermore proceed to disregard everything they had to say and manage the patient as I saw fit - I don't always win congeniality awards!).

VA - that place sucked hard. Nurses were usually incompetent, doctors were highly variable, admin was next to useless. Never been able to transfer anyone successfully to the VA either. Records request from their facilities are met with silence. I guess it's one step up from no healthcare.

Military in general - never been in but have worked next to some large facilities. Seems to be a bimodal distribution, first group is tougher than nails it is pretty reasonable, next group is complete group of wimps. Antibiotics for everything, super entitled, unable to identify a reason for presenting to the emergency department. If there is a war with China, I fully expect half the Air Force to show up for work note claiming back pain or something that will excuse them from having to fight the enemy.

 

[d2305]

It's amazing what they come up with to avoid a deployment. I had a patient drop a car on his foot to avoid going to the sandbox. Military medicine is socialized too.

 

[TheTruckGuy]

It's amazing what they come up with to avoid a deployment. I had a patient drop a car on his foot to avoid going to the sandbox. Military medicine is socialized too.

They come up with stuff to avoid doing their job. Then when they're getting outprocessed they come up with stuff to stay in for a workup, all the while drawing a check for doing pretty much nothing.

 

[carbonizedeyesockets]

Before he replies; the same can be done in the private sector; better and less costly, with involved people and their buy-in.

I need to take some time to find the meme, but when it comes down to private enterprise beating federal (anything), I saw something akin to this very recently:

SHIPPING:

UPS: You ordered a package! Here's what it is... sweet! It left the facility. Its in city X, Y, and Z. Its out for delivery. Its on your doorstep. Here's a photo.

FedEx: You ordered a package? You'll get it. Soon. When we're ready to give it to you. Be patient.

US Postal Service: You ordered a package ? Uhhhh... okay.

As someone who uses the USPS to ship and receive collectable items (records) and have been doing so for nearly 20 years, that meme does not hold water. At all.

 

[RustedFox]

As someone who uses the USPS to ship and receive collectable items (records) and have been doing so for nearly 20 years, that meme does not hold water. At all.

As a sports card collector, I politely disagree. To suggest USPS shipping in our circles is heresy.

 

[GeneralVeers]

The post office lost $2.7 billion last year. They hardly should be held up as a paragon of the success of government program. Any private company would have gone out of business decades ago with such poor financial performance.

 

[Psai]

The post office lost $2.7 billion last year. They hardly should be held up as a paragon of the success of government program. Any private company would have gone out of business decades ago with such poor financial performance.

This must be a joke

 

[deuist]

If you're working for not the government, you'll never escape patient satisfaction.

When I was active duty, we still had patient satisfaction surveys.

 

[GeneralVeers]

This must be a joke

Nope. Sad but unfortunately true. $2.7 billion.

 

[TheTruckGuy]

The post office lost $2.7 billion last year. They hardly should be held up as a paragon of the success of government program. Any private company would have gone out of business decades ago with such poor financial performance.

Do remember a few things:

UPS and Fedex do not have to serve the entire country.
They do not have to ship a letter from New York to California for the same 50 cents it costs to send a letter from New York to DC.
They do not have Congress controlling how much they charge for mailing those letters.
UPS and Fedex aren't required by congress to pre-fund 75 years worth of retiree medical benefits in 10 years.
They also don't have to provide free mailing services to congress, blind people, and I think a few other entities

 

[VA Hopeful Dr]

Do remember a few things:

UPS and Fedex do not have to serve the entire country.
They do not have to ship a letter from New York to California for the same 50 cents it costs to send a letter from New York to DC.
They do not have Congress controlling how much they charge for mailing those letters.
UPS and Fedex aren't required by congress to pre-fund 75 years worth of retiree medical benefits in 10 years.
They also don't have to provide free mailing services to congress, blind people, and I think a few other entities

I think points 3, 4, and 5 are exactly the sort of thing GV is talking about.

 

[GeneralVeers]

Do remember a few things:

UPS and Fedex do not have to serve the entire country.
They do not have to ship a letter from New York to California for the same 50 cents it costs to send a letter from New York to DC.
They do not have Congress controlling how much they charge for mailing those letters.
UPS and Fedex aren't required by congress to pre-fund 75 years worth of retiree medical benefits in 10 years.
They also don't have to provide free mailing services to congress, blind people, and I think a few other entities

You've made my point as to why they should cease to exist better than I ever could.

 

[Apollyon]

You've made my point as to why they should cease to exist better than I ever could.

So, they (UPS and FedEx) don't deliver everywhere in the US. Are those people just out of luck?

And, does Canada Post lose money? I haven't looked that up.

 

[RustedFox]

So, they (UPS and FedEx) don't deliver everywhere in the US. Are those people just out of luck?

Do we know this for sure? Source?

 

[GeneralVeers]

So, they (UPS and FedEx) don't deliver everywhere in the US. Are those people just out of luck?

And, does Canada Post lose money? I haven't looked that up.

Canada Post made money last year ($74M pre-tax). I'm not sure what they are doing differently than the USPS to account for this.

 

[deleted109597]

So, they (UPS and FedEx) don't deliver everywhere in the US. Are those people just out of luck?
And, does Canada Post lose money? I haven't looked that up.

There are places without power, cable, cellular reception, or internet. I would argue that they are more important today than the post.
This is like the people who complain the rent is too high in SF or NYC. We aren't trees.

 

[Apollyon]

Do we know this for sure? Source?

Right off the top of my head, Lake Minchumina, AK. USPS delivers there 3d a week. FedEx and UPS don't, at all. Closest is more than 150 miles away.

 

[TheTruckGuy]

I think points 3, 4, and 5 are exactly the sort of thing GV is talking about.

You've made my point as to why they should cease to exist better than I ever could.

You think those points indicate why they should cease to exist? Or you think they need to no longer be under congressional control?

I think it would require a constitutional amendment to get rid of the post office. I'm certainly fine with removing congressional control over the post office and allowing the USPS to set its own prices, but I don't follow how anything I said indicates a good reason why it should cease to exist.

 

[GeneralVeers]

You think those points indicate why they should cease to exist? Or you think they need to no longer be under congressional control?

I think it would require a constitutional amendment to get rid of the post office. I'm certainly fine with removing congressional control over the post office and allowing the USPS to set its own prices, but I don't follow how anything I said indicates a good reason why it should cease to exist.

There's no reason that they should exist AND run a deficit in the billions. It might almost be cheaper to subsidize UPS and Fedex to deliver to those underserved areas. Unfortunately nothing will change, because the USPS employs thousands of unionized workers who represent good Democratic voters.

 

[iqe2010]

The GOP has been trying to defund and privatize USPS for some time now. Their latest attempt was the retirement funding thing, which is ridiculous.

If the USPS was completely privatized I don’t think service would improve, and like someone else said it would be devastating for rural areas, which is a significant part of the country.

I know government sucks and taxation is theft and what not but i don’t think it’s wise to privatize everything. Especially something like the post office.

 

[GeneralVeers]

The GOP has been trying to defund and privatize USPS for some time now. Their latest attempt was the retirement funding thing, which is ridiculous.

If the USPS was completely privatized I don’t think service would improve, and like someone else said it would be devastating for rural areas, which is a significant part of the country.

I know government sucks and taxation is theft and what not but i don’t think it’s wise to privatize everything. Especially something like the post office.

If you really believe we need free/cheap mail service to every rural home in the country (I don't) then why not downsize the postal service to just provide that service? Do away with regular mail, parcels, etc for places already serviced by multiple other companies.

 

[iqe2010]

If you really believe we need free/cheap mail service to every rural home in the country (I don't) then why not downsize the postal service to just provide that service? Do away with regular mail, parcels, etc for places already serviced by multiple other companies.

If it can be rolled out in a way that won’t negatively impact and inconvenience people then I’m all for it.

Why don’t you think everyone needs mail service?