How can we get universal healthcare in the United States?

[Alakazam123]

To those of you who study healthcare policy, or have studied it in the past, what do you feel we can change?

On the one hand, I can understand doctor's gripes. The insurance companies do not reimburse them properly for their efforts, and Medicare even less so.

However, on the other hand, we have poor and impoverished people in our country who cannot afford the expensive healthcare premiums. Do you think there is any sort of middle ground we can reach?

Would a single-payer system work? I've heard Denmark has a very good system in place and is one of the most efficiently run single-payer systems.

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[AnatomyGrey12]

 

[Goro]

Step I: figure out a way to pay for it.

 

[663697]

 

[allantois]

Step I: figure out a way to pay for it.

Look to Canada, Eh?

 

[Winged Scapula]

Moving to Topics IN Healthcare

 

[TJinDaHouse]

Yeah! We def need to get on this. What argument is there even against it

 

[Alakazam123]

I think we should have a two tier healthcare system:

1. if you are rich enough to afford your own healthcare insurance, you should purchase it.

2. If you fall below the poverty line, you qualify for Medicare

3. If you are just slightly above the poverty line but cannot afford private insurance, then you qualify for some but not all of the Medicare benefits

This way, we don't cut physician reimbursement, keep a cost-effective system, and don't unnecessarily tax people who don't need Medicare.

Also, we should get rid of the clause in Medicare Part D which prevents price negotiation with pharmaceutical companies, to make it more affordable for the population.

 

[TJinDaHouse]

Man why don't we all just get the same care? nobody life worth more than someone else life

 

[Alakazam123]

Man why don't we all just get the same care? nobody life worth more than someone else life

Single payer works if we don't compromise on how much we compensate our doctors/nurses. But based on what's happened in Canada and the UK, they seem to think that cutting doctor's salaries is the solution to an affordable healthcare system. But that's blatantly false.

 

[TJinDaHouse]

I mean why should we make a lot of money when ppl cant even get healthcare? im willing to give a lil bit so ppl can not suffer with there disease

 

[Alakazam123]

I mean why should we make a lot of money when ppl cant even get healthcare? im willing to give a lil bit so ppl can not suffer with there disease

Are you a doctor?

 

[TJinDaHouse]

no im a college premed student. what that matter

 

[Fluffyone]

I think if its paid for by lowering doctors pay it will only make the doctor shortage worse since medical schools are so expensive and people would be very deincentivized. Secondly, the U.S government is already 20 trillion dollars in debt so I think we should focus on spending less an not more before the whole economy collapses. Lastly, the libertarian side of me knows that everything the government does is super inefficient so I dont think it would be a good idea to put it in charge of healthcare where people lives are at stake. I definitely do want poor people to have access to healthcare but I dont think single payer is the right way to achieve this. I can be wrong and I'm still forming my opinions on this subject, but this is what I currently believe.

 

[Alakazam123]

I think if its paid for by lowering doctors pay it will only make the doctor shortage worse since medical schools are so expensive and people would be very deincentivized. Secondly, the U.S government is already 20 trillion dollars in debt so I think we should focus on spending less an not more before the whole economy collapses. Lastly, the libertarian side of me knows that everything the government does is super inefficient so I dont think it would be a good idea to put it in charge of healthcare where people lives are at stake. I definitely do want poor people to have access to healthcare but I dont think single payer is the right way to achieve this. I can be wrong and I'm still forming my opinions on this subject, but this is what I currently believe.

Well, what do you think of my two tier plan?

The government safety net is there to help prevent undue risk. I think at least that much is reasonable. We have to meet somewhere in the middle.

I feel the solution for inefficient government is making it more efficient, not just getting rid of it altogether. I believe healthcare is a necessity and not a commodity.

 

[Fluffyone]

Well, what do you think of my two tier plan?

The government safety net is there to help prevent undue risk. I think at least that much is reasonable. We have to meet somewhere in the middle.

I feel the solution for inefficient government is making it more efficient, not just getting rid of it altogether. I believe healthcare is a necessity and not a commodity.

I agree with you for the first part in that the safety net is neccessary to get rid of unnecessary risk. Like I do believe in a safety net, I just think it should be a small one. Like I do believe medicare serves a good purpose. Regarding the second point, I believe the issue with government is that it wont ever be efficient since there is no profit incentive. Of course, the government is necessary and plays many roles. I just think it should be as small as possible to preserve our freedom and to bring up efficiency. Regarding the last point, I view healthcare in the same way I view buying food. It is a necessity and poor people should have food stamps, but if the government steps in and takes away the free market, then it would create enormous food shortages since there is no profit incentive. There definitely a middle road that can be taken but I feel that anything more than a middle road is impractacle and probably would even cause more harm than good due to the reasons I mentioned before.

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[Alakazam123]

I agree with you for the first part in that the safety net is neccessary to get rid of unnecessary risk. Like I do believe in a safety net, I just think it should be a small one. Like I do believe medicare serves a good purpose. Regarding the second point, I believe the issue with government is that it wont ever be efficient since there is no profit incentive. Of course, the government is necessary and plays many roles. I just think it should be as small as possible to preserve our freedom and to bring up efficiency. Regarding the last point, I view healthcare in the same way I view buying food. It is a necessity and poor people should have food stamps, but if the government steps in and takes away the free market, then it would create enormous food shortages since there is no profit incentive. There definitely a middle road that can be taken but I feel that anything more than a middle road is impractacle and probably would even cause more harm than good due to the reasons I mentioned before.

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Fair enough. I agree. Do you like my two tier plan?

 

[Fluffyone]

Fair enough. I agree. Do you like my two tier plan?

This two tier plan?
"The government safety net is there to help prevent undue risk. I think at least that much is reasonable. We have to meet somewhere in the middle.

I feel the solution for inefficient government is making it more efficient, not just getting rid of it altogether. I believe healthcare is a necessity and not a commodity.

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[AnatomyGrey12]

I mean why should we make a lot of money when ppl cant even get healthcare? im willing to give a lil bit so ppl can not suffer with there disease

no im a college premed student. what that matter

Because you don’t know what you’re talking about.

 

[Alakazam123]

This two tier plan?
"The government safety net is there to help prevent undue risk. I think at least that much is reasonable. We have to meet somewhere in the middle.

I feel the solution for inefficient government is making it more efficient, not just getting rid of it altogether. I believe healthcare is a necessity and not a commodity.

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Well, in detail:


1. if you are rich enough to afford your own healthcare insurance, you should purchase it.

2. If you fall below the poverty line, you qualify for Medicare

3. If you are just slightly above the poverty line but cannot afford private insurance, then you qualify for some but not all of the Medicare benefits

This way, we don't cut physician reimbursement, keep a cost-effective system, and don't unnecessarily tax people who don't need Medicare.

Also, we should get rid of the clause in Medicare Part D which prevents price negotiation with pharmaceutical companies, to make it more affordable for the population.

 

[deleted927028]

Max98, for the last 40 years or so, the rich and powerful people use the corporate owned media to brainwash people by repeatedly lying that government is inefficient so that they can rob the people with no one there to control them. How come Government works efficiently in every other country except US? Do you have any specific instances where you saw government inefficiency. I do not see that anywhere. In fact they are far more efficient than greedy profit oriented private entities.

According to basic economic principles, free market will never work for essential commodities and services because the demand is inelastic. They should be handled by the entities whose purpose is to serve people and not make obscene profits. When you hand over the essential services to private people, they can charge whatever they want because the people HAVE to pay. It is basically ransom and extortion.

That’s why healthcare , energy, banking etc are provided or controlled by the government in almost every country except USA

Single payer healthcare with strict price control is the best option for the public. People say we cannot afford to pay for it. Are we getting free healthcare from private insurance companies? Are we not not paying three or four times in premiums compared to countries where government run healthcare? Yes, we can afford it and it will be a lot more cheaper. Now the employers pay a portion of the premiums and the employees rest. They can continue to do the same, but pay to the government instead of private companies with a lot less amount. The deductibles and copays etc will be history.

Of course, the Government also should control the obscene cost of medical education in private schools and make it free in the public schools. Other countries do it, we can and should do the same.

 

[Alakazam123]

Max98, for the last 40 years or so, the rich and powerful people use the corporate owned media to brainwash people by repeatedly lying that government is inefficient so that they can rob the people with no one there to control them. How come Government works efficiently in every other country except US? Do you have any specific instances where you saw government inefficiency. I do not see that anywhere. In fact they are far more efficient than greedy profit oriented private entities.

According to basic economic principles, free market will never work for essential commodities and services because the demand is inelastic. They should be handled by the entities whose purpose is to serve people and not make obscene profits. When you hand over the essential services to private people, they can charge whatever they want because the people HAVE to pay. It is basically ransom and extortion.

That’s why healthcare , energy, banking etc are provided or controlled by the government in almost every country except USA

Single payer healthcare with strict price control is the best option for the public. People say we cannot afford to pay for it. Are we getting free healthcare from private insurance companies? Are we not not paying three or four times in premiums compared to countries where government run healthcare? Yes, we can afford it and it will be a lot more cheaper. Now the employers pay a portion of the premiums and the employees rest. They can continue to do the same, but pay to the government instead of private companies with a lot less amount. The deductibles and copays etc will be history.

Of course, the Government also should control the obscene cost of medical education in private schools and make it free in the public schools. Other countries do it, we can and should do the same.

If I had to pick between our current system and single payer, I'd pick single payer. There's far less hassle on physicians, and it's focused more on patient care rather than on profit for hospital systems. However, I just hope that we won't compromise on physician salaries as a result.

 

[Fluffyone]

Well, in detail:


1. if you are rich enough to afford your own healthcare insurance, you should purchase it.

2. If you fall below the poverty line, you qualify for Medicare

3. If you are just slightly above the poverty line but cannot afford private insurance, then you qualify for some but not all of the Medicare benefits

This way, we don't cut physician reimbursement, keep a cost-effective system, and don't unnecessarily tax people who don't need Medicare.

Also, we should get rid of the clause in Medicare Part D which prevents price negotiation with pharmaceutical companies, to make it more affordable for the population.

Oh sorry I didnt see that part. I think this is a very good idea and tackles most of this issues. I think the only major issue would be our Americas already crippling debt but I think even that might be balanced by the possible negotiations with pharmaceutical companies.

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[Stagg737]

Yeah! We def need to get on this. What argument is there even against it

Is this a serious question?

I mean why should we make a lot of money when ppl cant even get healthcare? im willing to give a lil bit so ppl can not suffer with there disease

Because we're paying for an extra 8 years of education, taking on an extra ~300k in debt, then are required to complete 3-7 more years of residency which pays an hourly rate worse than techs or even some fast food workers (my hourly rate was better when I worked in fast food than it is as a resident). If you understand basic finances and run the numbers you'll see that the average physician is actually worse off in terms of spending power and net financial worth than most professions until you are in your late 40's or 50's. That's assuming you're not trying to support a family with kids and pay for their college.

You're not "giving a lil", you're giving a lot and forcing your family to go through major sacrifices as well, both in terms of early financial support and security as well as your ability to interact with them on a social level.

Well, what do you think of my two tier plan?

The government safety net is there to help prevent undue risk. I think at least that much is reasonable. We have to meet somewhere in the middle.

I feel the solution for inefficient government is making it more efficient, not just getting rid of it altogether. I believe healthcare is a necessity and not a commodity.

This isn't far off from Australia's two-tier plan. I was an advocate for a system like that for a while but their system has been facing some major hurdles and seems to be heading towards unsustainability pretty quickly. At this point idk what the solution is, but I haven't seen any systems that jump out to me as something which could be successfully implemented in the US.

The other issue is that the US does not have a single aspect to our system, it's a conglomeration of several different styles. The VA is like a single payer system. Medicare is a universal system/modified two-tiered system (with ability to purchase part D). Medicaid/chip is like the system you have proposed (which is implemented disastrously in the US). For the general public we have a privatized system. This exists because different parts of the system have been implemented decades or even centuries apart (VA started around WWI, private insurance in around 1920's, Medicare in the 60's, CHIP more recently). So we basically have multiple systems working separately which serve specific populations instead of a single system like most countries have. The closest thing to the US is actually the Swiss model, which is largely the US's system but serves a smaller, healthier population.

 

[Fluffyone]

Max98, for the last 40 years or so, the rich and powerful people use the corporate owned media to brainwash people by repeatedly lying that government is inefficient so that they can rob the people with no one there to control them. How come Government works efficiently in every other country except US? Do you have any specific instances where you saw government inefficiency. I do not see that anywhere. In fact they are far more efficient than greedy profit oriented private entities.

According to basic economic principles, free market will never work for essential commodities and services because the demand is inelastic. They should be handled by the entities whose purpose is to serve people and not make obscene profits. When you hand over the essential services to private people, they can charge whatever they want because the people HAVE to pay. It is basically ransom and extortion.

That’s why healthcare , energy, banking etc are provided or controlled by the government in almost every country except USA

Single payer healthcare with strict price control is the best option for the public. People say we cannot afford to pay for it. Are we getting free healthcare from private insurance companies? Are we not not paying three or four times in premiums compared to countries where government run healthcare? Yes, we can afford it and it will be a lot more cheaper. Now the employers pay a portion of the premiums and the employees rest. They can continue to do the same, but pay to the government instead of private companies with a lot less amount. The deductibles and copays etc will be history.

Of course, the Government also should control the obscene cost of medical education in private schools and make it free in the public schools. Other countries do it, we can and should do the same.

I disagree with the first part that you said about how the government is not inefficient and private sector is greedy. The free market deals with this issue because if someone is being greedy you can just buy the product from someone else but that cant be done with the government. I agree with what your saying about commodities and that's why I do believe in a safety net regarding that (i.e food stamps, medicare, etc). Regarding the last part about single payer, I wish it is practicle, but the cost, doctor pay cuts, and wait times would take away any benefits so I dont think it would work out without having atleast one of these issue.

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[deleted927028]

if we look beyond this misconceived notion that Government is inefficient, we can achieve a lot. If we honestly believe that the Government is inefficient, then we should look at fixing it rather than handing over all they keys to the private entities whose only motive is to make as much as profit possible. Because that’s what they want. I am talking only about essential services. Look at countries like Canada, UK, Denmark, Sweden , Germany, Norway or even Costa Rica etc, how they are able to give better healthcare without any deductible or copay but with only one half or one third cost? When it is practical for so many of them, why not for us?

I worked for a leading healthcare company for five years or so. To meet their quarterly numbers, do you know what they do? First option is to deny the claims , next option is to increase the premiums as much possible. They care and talk about only profit and nothing else. When the service is essential, the competition will never bring the price down, because the consumer has no option BUT TO PAY WHATEVER BE THE PRICE. That’s why every year the premiums, deductibles and copays skyrocket every year even though there are tons of insurance companies. They don’t compete but conspire. Do you remember the Epipen episode? It costs a few dollars in ever other country but here they are able to hike it up to $800. That is the efficiency of the private companies.

I agree that with single payer the doctor pay might be cut. That’s why we have to control the cost of medical education or make it free. By getting rid of profit seeking private companies we can still pay the doctors handsomely and still make it a lot cheaper.

 

[Stagg737]

Well, in detail:


1. if you are rich enough to afford your own healthcare insurance, you should purchase it.

2. If you fall below the poverty line, you qualify for Medicare

3. If you are just slightly above the poverty line but cannot afford private insurance, then you qualify for some but not all of the Medicare benefits

This way, we don't cut physician reimbursement, keep a cost-effective system, and don't unnecessarily tax people who don't need Medicare.

Also, we should get rid of the clause in Medicare Part D which prevents price negotiation with pharmaceutical companies, to make it more affordable for the population.

Do you believe that healthcare is a right? If so, how do you reconcile that idea with your bolded statement above, as they are in direct contradiction to each other.

Max98, for the last 40 years or so, the rich and powerful people use the corporate owned media to brainwash people by repeatedly lying that government is inefficient so that they can rob the people with no one there to control them. How come Government works efficiently in every other country except US? Do you have any specific instances where you saw government inefficiency. I do not see that anywhere. In fact they are far more efficient than greedy profit oriented private entities.

According to basic economic principles, free market will never work for essential commodities and services because the demand is inelastic. They should be handled by the entities whose purpose is to serve people and not make obscene profits. When you hand over the essential services to private people, they can charge whatever they want because the people HAVE to pay. It is basically ransom and extortion.

That’s why healthcare , energy, banking etc are provided or controlled by the government in almost every country except USA

Single payer healthcare with strict price control is the best option for the public. People say we cannot afford to pay for it. Are we getting free healthcare from private insurance companies? Are we not not paying three or four times in premiums compared to countries where government run healthcare? Yes, we can afford it and it will be a lot more cheaper. Now the employers pay a portion of the premiums and the employees rest. They can continue to do the same, but pay to the government instead of private companies with a lot less amount. The deductibles and copays etc will be history.

Of course, the Government also should control the obscene cost of medical education in private schools and make it free in the public schools. Other countries do it, we can and should do the same.

To the bolded: have you ever worked in a VA or military hospital? If not, I suggest you talk to those individuals and you'll quickly realize the inadequacies of a gov run system. When I can't even order certain generic meds for my patients because they're non-formulary and several labs have to be sent to outside labs and come back a week later after we've d/c'd patients where they got done same day in academic and community hospitals I've worked in. The gov is inefficient. If you choose to be blind to that reality that's on you.

 

[AnatomyGrey12]

Max98, for the last 40 years or so, the rich and powerful people use the corporate owned media to brainwash people by repeatedly lying that government is inefficient so that they can rob the people with no one there to control them

How come Government works efficiently in every other country except US?

Do you have any specific instances where you saw government inefficiency. I do not see that anywhere. In fact they are far more efficient than greedy profit oriented private entities.

if we look beyond this misconceived notion that Government is inefficient,

or even Costa Rica etc,

how they are able to give better healthcare

Yeah you have no idea either. Get your head out of the sand, you literally just said “Costa Rica” and “better healthcare” in the same statement.

 

[dpmd]

In this thread I see a lot of people who haven't seen how the VA operates and don't deal with medicare or medicaid so they have no idea what they are actually talking about. If they did they would never advocate for one of those being the only way to get medical care.

 

[deleted927028]

@AnatomyGrey12 , looks like you are accepting that the other countries I mentioned do better than us other than Costs Rica. Thank you . I included Costa Rica because even a poor country like them are able to run a single payer healthcare. That’s all. If you want to nitpick, please go ahead.

@Stagg737 , so do you mean you never encountered any issue private companies? Are they 100% perfect? Then why Epipen is getting sold for $800? My point is that Government is as efficient/inefficient as any private companies. The people work at government are same as the ones work at private . They are not aliens. As I said earlier, if you believe there is any deficiency in the Government , then we should attempt to fix it rather than become slaves of profit makers. It is not good for consumers.

As I mentioned earlier, if it works well for so many other countries, it will work for us. I am not the one buried his head in the sand. I have travelled many countries and I know how things work there

 

[LebronManning]

We won’t have the single payer abomination for at LEAST 50 years, perhaps not in our lifetime.

That’s something we all have to be grateful to the Republicans for. Another reason it will be so nice to have a generational advantage in the Supreme Court.

For the 19 year olds here who want free health care and don’t understand anything behind it, your time will come. You’ll realize that most people who can’t afford it qualify for Medicaid already. The rest who don’t have it simply don’t prioritize it over their pack of cigarettes or brand new car. Unfortunately a lot of middle class Americans who are healthy don’t feel the need to pay to insure themselves and then start bitching when they have a STEMI with a 60k bill.

Just look to the NHS and Canadian health care to see the major problems with socialized medicine. There’s a reason worldwide kings and leaders come to one place for their healthcare and that’s the USA. How much more proof do people need to see of capitalism working? There’s a reason we have the richest, most powerful country in the world with the highest quality everything (at its fair price)...capitalism baby.

 

[AnatomyGrey12]

@AnatomyGrey12 , looks like you are accepting that the other countries I mentioned do better than us other than Costs Rica. Thank you . I included Costa Rica because even a poor country like them are able to run a single payer healthcare. That’s all. If you want to nitpick, please go ahead.

@Stagg737 , so do you mean you never encountered any issue private companies? Are they 100% perfect? Then why Epipen is getting sold for $800? My point is that Government is as efficient/inefficient as any private companies. The people work at government are same as the ones work at private . They are not aliens. As I said earlier, if you believe there is any deficiency in the Government , then we should attempt to fix it rather than become slaves of profit makers. It is not good for consumers.

As I mentioned earlier, if it works well for so many other countries, it will work for us. I am not the one buried his head in the sand. I have travelled many countries and I know how things work there

All you have given us are broad generalizations based on a fantasy. If you think single payer would work so well here I want a detailed response as to why. Give me facts instead of logical fallacies. I don’t care how many countries you’ve visited, that doesn’t mean you understand jack about healthcare.

Oh and I wasn’t nitpicking, you literally said Costa Rica has better healthcare than us. None of the other countries have better healthcare than the US either, so nice try but no.

 

[deleted927028]

Between the premium, deductible and copay, a typical family has to pay $20k to $24k before insurance companies begin to pay a dime. I don’t think this is affordable for 90% of the families but of course it is affordable for the kings and world leaders.

According to WHO, we are ranked 38th in the world, not first

 

[deleted927028]

By the way, I like capitalism too. But there is difference. It will not work for essential goods and services like healthcare, energy etc because the demand is inelastic. Any economist will attest to that

 

[Stagg737]

@AnatomyGrey12 , looks like you are accepting that the other countries I mentioned do better than us other than Costs Rica. Thank you . I included Costa Rica because even a poor country like them are able to run a single payer healthcare. That’s all. If you want to nitpick, please go ahead.

@Stagg737 , so do you mean you never encountered any issue private companies? Are they 100% perfect? Then why Epipen is getting sold for $800? My point is that Government is as efficient/inefficient as any private companies. The people work at government are same as the ones work at private . They are not aliens. As I said earlier, if you believe there is any deficiency in the Government , then we should attempt to fix it rather than become slaves of profit makers. It is not good for consumers.

As I mentioned earlier, if it works well for so many other countries, it will work for us. I am not the one buried his head in the sand. I have travelled many countries and I know how things work there

Of course there are problems with the private sector. Major ones. Like the Epipen issue you pointed out of the possibility of people like Shkreli manipulating the system. The question becomes which system does the worst job of not only treating patients, but being able to stay financially viable and actually provide resources. That system is certainly not the VA if you've ever worked at one (which it sounds like you haven't).

The issue which you seem to not understand is that the administrative and bureaucratic systems in place at the VA are ridiculous and actually detrimental to patient treatment (moreso than insurance companies in many cases). Employees are also straight salaried without incentives, which means they are encouraged to do the bare-minimum work (aka patients not getting surgeries or other procedure). I see this every day from the physician level to nurses to support staff. This is the reality of single-payer in the US.

You also seem to be under the illusion that a system that works in a country with a population of a few million people which has a better overall level of health would work in the US which is a country of 350 million+ people with a much higher rate of chronic disease. There is no country which has a population even 1/4th the size of the US that implements universal care in a remotely effective manner. In fact, the vast majority of countries which had successful universal systems are relatively small (pops less than 20 million), have homogenous demographics, and limit the therapies offered more than the US (you can have single payer and limit the care everyone is able to receive or you can have possibility for more/less limited care but base it on who can pay, you don't get both).

Between the premium, deductible and copay, a typical family has to pay $20k to $24k before insurance companies begin to pay a dime. I don’t think this is affordable for 90% of the families but of course it is affordable for the kings and world leaders.

According to WHO, we are ranked 38th in the world, not first

This is a blatantly false statement and makes me wonder what kinds of plans you're looking at to believe this is true.

By the way, I like capitalism too. But there is difference. It will not work for essential goods and services like healthcare, energy etc because the demand is inelastic. Any economist will attest to that

What aspect of healthcare? Emergency care? Yea. Preventative care is very elastic though. Just ask people how much they're willing to pay for their yearly physical and you'll see massive shift in demand with relatively minimal price changes.

 

[AnatomyGrey12]

Between the premium, deductible and copay, a typical family has to pay $20k to $24k before insurance companies begin to pay a dime. I don’t think this is affordable for 90% of the families but of course it is affordable for the kings and world leaders.

According to WHO, we are ranked 38th in the world, not first

By the way, I like capitalism too. But there is difference. It will not work for essential goods and services like healthcare, energy etc because the demand is inelastic. Any economist will attest to that

So instead of the details and facts that I asked for you give me a red herring and blatantly false statements, further confirming that you don’t really know what you’re talking about.

I want coherent factual discussion points, with citations. Hyperbolic statements like, “I don’t think this is affordable for 90% of families” do nothing to help you look like you actually understand anything.

 

[deleted927028]

@Stagg737 , I agree that you are making good points. But think this way, now a profit oriented private company collect the premiums, take out operating cost and a big chunk as profit and pay the Doctors and hospitals. Now if the government collects the premiums, removes the profit and pay the hospitals and doctors the same amount, how the efficiency will go down? What is wrong with it? Why people are so alarmed about this and calling it socialism or capitalism?

The numbers I gave are from my friends, I did not make it up. The premiums for PPO plans are so high , all my colleagues have gone for high deductible plans.

 

[sunshinefl]

@Stagg737 , I agree that you are making good points. But think this way, now a profit oriented private company collect the premiums, take out operating cost and a big chunk as profit and pay the Doctors and hospitals. Now if the government collects the premiums, removes the profit and pay the hospitals and doctors the same amount, how the efficiency will go down? What is wrong with it? Why people are so alarmed about this and calling it socialism or capitalism?

The numbers I gave are from my friends, I did not make it up. The premiums for PPO plans are so high , all my colleagues have gone for high deductible plans.

That other “saved” chunk will be eaten up by committees, hierarchy, government entities who exist to justify other government entities. Oh and PS if you feel people currently don’t have the access they should and you give everyone such access, the core healthcare costs would go up.

 

[deleted927028]

Instead of giving 100% control to the private companies, the government should at least give the people the option to buy into Medicare if they choose to. And remove the stupid mandate that Medicare cannot negotiate drug prices. The politicians cry about freedom , competition and options , but why block this ? Because they know people will flock to Medicare in a heartbeat. I would.

 

[Stagg737]

@Stagg737 , I agree that you are making good points. But think this way, now a profit oriented private company collect the premiums, take out operating cost and a big chunk as profit and pay the Doctors and hospitals. Now if the government collects the premiums, removes the profit and pay the hospitals and doctors the same amount, how the efficiency will go down? What is wrong with it? Why people are so alarmed about this and calling it socialism or capitalism?

The numbers I gave are from my friends, I did not make it up. The premiums for PPO plans are so high , all my colleagues have gone for high deductible plans.

Theoretically that's true, but cutting out the middle man (insurance) and shifting everything to gov does not cut costs in reality from what I've seen. When it does it's because patients are receiving less treatment. Efficiency on physician part goes down because docs aren't being incentivized to see more patients. Why treat 20 people and work yourself to the bone when you can treat 10 and get paid the same price and likely provide better care because you're not missing things in your burnt out state? This is the reality of hospital medicine and human nature in general. People work more when incentives to do so are provided. When there's no incentives they'll do less. This is basic psychology which is true of pretty much all mammals.

Your friends have terrible plans then, because those are outrageous deductibles unless they're for families of 8+ people

Instead of giving 100% control to the private companies, the government should at least give the people the option to buy into Medicare if they choose to. And remove the stupid mandate that Medicare cannot negotiate drug prices. The politicians cry about freedom , competition and options , but why block this ? Because they know people will flock to Medicare in a heartbeat. I would.

I don't necessarily disagree with some of this, but I very much doubt people would abandon their insurance and flock to medicare. I absolutely would not as I see how often Medicare denies medications and treatments and know the other administrative issues of even finding providers who accept it.

 

[AnatomyGrey12]

Do you have literally any experience with Medicare? Because Medicare is terrible.

Because they know people will flock to Medicare in a heartbeat. I would.

 

[Alakazam123]

Is this a serious question?



Because we're paying for an extra 8 years of education, taking on an extra ~300k in debt, then are required to complete 3-7 more years of residency which pays an hourly rate worse than techs or even some fast food workers (my hourly rate was better when I worked in fast food than it is as a resident). If you understand basic finances and run the numbers you'll see that the average physician is actually worse off in terms of spending power and net financial worth than most professions until you are in your late 40's or 50's. That's assuming you're not trying to support a family with kids and pay for their college.

You're not "giving a lil", you're giving a lot and forcing your family to go through major sacrifices as well, both in terms of early financial support and security as well as your ability to interact with them on a social level.



This isn't far off from Australia's two-tier plan. I was an advocate for a system like that for a while but their system has been facing some major hurdles and seems to be heading towards unsustainability pretty quickly. At this point idk what the solution is, but I haven't seen any systems that jump out to me as something which could be successfully implemented in the US.

The other issue is that the US does not have a single aspect to our system, it's a conglomeration of several different styles. The VA is like a single payer system. Medicare is a universal system/modified two-tiered system (with ability to purchase part D). Medicaid/chip is like the system you have proposed (which is implemented disastrously in the US). For the general public we have a privatized system. This exists because different parts of the system have been implemented decades or even centuries apart (VA started around WWI, private insurance in around 1920's, Medicare in the 60's, CHIP more recently). So we basically have multiple systems working separately which serve specific populations instead of a single system like most countries have. The closest thing to the US is actually the Swiss model, which is largely the US's system but serves a smaller, healthier population.

Australia is still doing a lot better than we are with sustainability. Two-tier will work if there is cost controls on pharmaceuticals and medical equipment. That is what is hemmoraging our healthcare system's costs. Furthermore, we don't focus nearly enough on preventative care, as much as other countries.

People here smoke like a chimney, eat greasy food, and then get surprised when they have heart problems.

 

[deleted480308]

No one has a right to someone else’s time or goods. If you cannot afford it and cannot find someone to donate it, you don’t get it.

 

[deleted927028]

@AnatomyGrey12 , actuallly I happened to be right about Costa Rica. According to 2018 WHO ranking, Costa Rica is ranked 36 and we are 37. Sorry to nitpick, couldn’t resist

 

[deleted927028]

@sb247 , I agree as an individual you are free to say that. But I believe that it is the Government’s duty to protect everyone from being exploited by the powerful. For example, if a medical procedures cost $1000 around the world , it has to make its best attempt to make it available for around that price and not let fleeced by greedy ones for $20000.

 

[deleted480308]

@sb247 , I agree as an individual you are free to say that. But I believe that it is the Government’s duty to protect everyone from being exploited by the powerful. For example, if a medical procedures cost $1000 around the world , it has to make its best attempt to make it available for around that price and not let fleeced by greedy ones for $20000.

No. If $1000 in canada is a better deal for you than $2000 here then you should go there and get it

Don’t use the force of govt on someone just because you don’t like their prices

 

[sunshinefl]

@AnatomyGrey12 , actuallly I happened to be right about Costa Rica. According to 2018 WHO ranking, Costa Rica is ranked 36 and we are 37. Sorry to nitpick, couldn’t resist

The 2000 study that used these measures:

WHO's assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system's financial burden within the population (who pays the costs).

That is not a measurement of outcomes following medical intervention. 3 of 5 of the measures relate to payment when you boil it down. I don’t think anyone is saying we have the greatest access, most equitable, or cheapest care. The point is that the US has great tertiary care.

@sb247 , I agree as an individual you are free to say that. But I believe that it is the Government’s duty to protect everyone from being exploited by the powerful. For example, if a medical procedures cost $1000 around the world , it has to make its best attempt to make it available for around that price and not let fleeced by greedy ones for $20000.

I have heard, but not independently confirmed, that the costs in the US for devices/medications/etc subsidize the costs in other countries. If this is true and every one paid pennies on the dollar (with the idea of adding us to that list) then there would be no goods left.

 

[deleted927028]

The Government need not force the private entities to provide the service for $2000 . What it should do is, like UK and some other countries, it has to build its own hospitals, recruit its own doctors and import medicines from whoever is ready to sell for cheaper prices (we like freedom, right?). When they do that the private companies will have no choice but come around and provide the same service for $1100. The private entities dictate terms now like you are asking people to go to Canada because they removed this option from the public by buying the politicians and brainwashing the people.

 

[deleted927028]

The above reply is for @sb247

 

[AnatomyGrey12]

@AnatomyGrey12 , actuallly I happened to be right about Costa Rica. According to 2018 WHO ranking, Costa Rica is ranked 36 and we are 37. Sorry to nitpick, couldn’t resist

No one cares about the WHO rankings, as rankings like that often include criteria that have nothing to do with quality of healthcare. Example, one of their biggest criteria is health of the population. Guess who leads the world in chronic disease? Us. We have the best healthcare in the world, hence why people fly here from all over the world to get treated here.

How about this, you go to Costa Rica and get your care and I’ll stay here and get mine, and we’ll see how much better it is.