Joe Biden promises to "provide health care for all"

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DrNotaDr said:
Medical care is not voluntary any more than eating food is voluntary. I hear a libertarian perspective; libertarianism cannot work, whereas socialized medicine can and does work in every country but ours.
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It is voluntary. Socialized medicine has just as many problems in the countries that people always quote (Canada, UK) than ours does. I do think we need to stop selling drugs to other countries cheaper than we do to ourselves though, and a few other things. These are issues with OUR government, something more government likely will not fix. IDK why people think other counties have it so great compared to us. Its like the new hip thing is to hate being in America when its still one of the best countries to live in dispute us being lazy, obese, and ignorant. I personally wouldn't want the healthcare those countries have, long waiting times, rationing of care, mostly cheap drugs only etc. Sorry, not my gig. Id rather have mantandory savings toward HSA funds than let the government dictate my practice/my healthcare.
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If you actually want a decent system it would be a mix described here. Probably has a mix of what both of us were talking about. Its def not single payer and its better than any single payer country. YW

Netherlands

By Joost Wammes, Niek Stadhouders, and Gert Westert, Radboud University Medical Center The Netherlands’ universal social health insurance approach merges public and private insurance. All residents are required to purchase statutory health insurance from private insurers, which are required to...
www.commonwealthfund.org www.commonwealthfund.org


The issue is we have to assume our government will do what is right when we hand the power over to them. Just because one government makes university healthcare work, doesn't mean ours can. Esp when our politicians are rampant thieves that love to take lobby money. Single payer doesn't hit the root issues.
 
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jambro said:
We do need pharmaceutical companies I agree, but shouldn't medicare be allowed to negotiate drug prices? yes or no? this is a huge part of the savings.

insurance companies on the other hand I have no love for. I believe they provide less than 0 value and only exist to extract money out of the system. what value does an insurance company have that medicare cannot do with far less overhead, no need for profit, and 0 people making millions of dollars or thousands of people whose jobs exist solely to navigate the stupid system that the insurance companies created?

have you asked any doctor how their practice would change if all their patients were covered by medicare instead of private insurance (assuming medicare rates were adjusted to be reasonable)? all it would do is reduce the bull**** that physicians have to do to stay afloat.

and no, its not that medical bankruptcies represent some sort of unpaid necessary cost to keep our system afloat. ask any other person in another country about medical bankruptcies and they'll look at you like your insane. Most of these bankruptcies are probably coming from inflated bills that the insurance industry is responsible for anyway since hospitals/physicians cannot bill medicare less than they bill other insurance companies for, so they end up billing every CPT code at the highest possible rate in case one insurance company happens to pay out. And then if someone doesn't have insurance these are the bills they get.
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You are clearly not practicing medicine if you are under the impression that Medicare has less overhead and hassles to deal with than private insurance.
 
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dpmd said:
You are clearly not practicing medicine if you are under the impression that Medicare has less overhead and hassles to deal with than private insurance.
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I think they are in medical school still probably reciting what some far left phD is telling them about healthcare economics, but I appreciate his or her effort nontheless.
 
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I'm not gonna quote all the posts that I've read, but you do not get a pay increase or have increase power in an industry with the government taking over, the opposite is actually true. The government is and always will be inefficient and a source of beurocratic waste. For those saying "well there's a profit in it, profit is bad", how are you going to feed your family and provide a good life for your kids? I went into medicine for a multitude of reasons, not just financial, but if you make it financially infeasible (which gov run healthcare will do), you will turn a lot of bright minds away from the field. I would like to one day give my kids a better life than I had but it won't be possible if I am saddled with 300k compounding debt and a severely reduced salary combined with increasing overhead (yes m4a will increase overhead, don't kid yourself if you think the beurocratic gov won't). If socialized medicine comes to the us, medicine will not be a sought after or prestigious field. In countries where socialized medicine is implemented, doctors are treated with a complete lack of respect financially and socially. What needs to be done in the US healthcare is trimming of admins. You hear stories of hospitals charging $90 for a pill of advil and other crazy stories, that kind of bloatedness is what has made healthcare for some people unaffordable. And this is going to ruin a lot of narratives, but the majority of Americans are satisfied with their private insurance plan. The short term gain of being able to say "everyone has access (not coverage) to affordable healthcare!" is a short term bandaid that will lead to many negative irreversible future consequences.
 
dpmd said:
You are clearly not practicing medicine if you are under the impression that Medicare has less overhead and hassles to deal with than private insurance.
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Would overhead be more or less if you had one insurance plan to deal with vs. dozens to hundreds? right now you have to do whatever medicare says to get reimbursed, plus deal with all the other insurance companies who may or may not follow medicare rules or have their own rules for prior auths, etc. You're saying it wouldn't be easier if you had to deal with medicare by itself? This is part of my issue with the public option. Perhaps the hugest positive for M4A on the physician side is lower overhead, but with a public option all you've down is add yet ANOTHER payer (and prob a low paying one at that).

Furthermore, we all know that medicare regulations can change quickly. when I say "medicare" i really am just using the name of the gov program that covers american citizens - not saying in a "medicare for all" program that "medicare" reimburses the same/cpt code or has the same regulations as it does now. Hypothetically, with a giant change in the system, we can imagine that the medicare program itself can be revamped as well.

whataschool_classof24 said:
I'm not gonna quote all the posts that I've read, but you do not get a pay increase or have increase power in an industry with the government taking over, the opposite is actually true. The government is and always will be inefficient and a source of beurocratic waste. For those saying "well there's a profit in it, profit is bad", how are you going to feed your family and provide a good life for your kids? I went into medicine for a multitude of reasons, not just financial, but if you make it financially infeasible (which gov run healthcare will do), you will turn a lot of bright minds away from the field. I would like to one day give my kids a better life than I had but it won't be possible if I am saddled with 300k compounding debt and a severely reduced salary combined with increasing overhead (yes m4a will increase overhead, don't kid yourself if you think the beurocratic gov won't). If socialized medicine comes to the us, medicine will not be a sought after or prestigious field. In countries where socialized medicine is implemented, doctors are treated with a complete lack of respect financially and socially. What needs to be done in the US healthcare is trimming of admins. You hear stories of hospitals charging $90 for a pill of advil and other crazy stories, that kind of bloatedness is what has made healthcare for some people unaffordable. And this is going to ruin a lot of narratives, but the majority of Americans are satisfied with their private insurance plan. The short term gain of being able to say "everyone has access (not coverage) to affordable healthcare!" is a short term bandaid that will lead to many negative irreversible future consequences.
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Sigh. I'm criticizing the profit motive endemic to the health insurance industry because it is their incentive to deny you care and they have the power to do that, simple as that. It's very different than saying an individual "provider" shouldn't make a "profit" (salary). You claim that medicare is inefficient, and yet medicare has about a 4% overhead and only after obamacare were health insurance companies limited to 20% overhead, so who's less efficient?

"Government-run healthcare" will also have completely different effects on different specialties so pretending it's going to cut the pay of everyone without even seeing an actual proposal is just conjecture. I can easily see pediatricians in poor areas getting a big pay bump, same with em physicians, or anyone who sees many medicaid or uninsured patients. PP ortho would be more likely to lose in this scenario but again it depends on the new negotiated CPT rates/conversion factors.

My whole argument for single payer is because i want to reduce the influence of non-patients and non-physicians in the field of medicine. The insanely bureaucratic for-profit system we have now is why you see those crazy charges for advil or the million administrators etc. This is the bloat that medicare for all fixes and saves money on.
 
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TwistedTea said:
Our two POV aren’t mutually exclusive.

the only type of universal healthcare I would maybe be for would be basic super cheap stuff for everyone and the people who can afford can get more expensive care. Where to draw the line I don’t know. Everyone can’t have Lexus care.
Maybe free care up to age 21 or so but adults need to have some skin in the game. And Americans are financial irresponsible so see my above and others above posts for ideas on that.
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I think everybody gets a Toyota and once that is accomplished, then and only then do we start upgrading those who can afford it to a Lexus
 
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TwistedTea said:
The lobbying and benefitting politicians was what I said was a government issue, you misread my message. Government problems are not fixed by adding more government. Fix that singular issue (lobbying to politicians) instead of turning to a single payer system. All medical care is voluntary (noone forces you into the hospital unless you are a danger to self or others) also, so those specialties are not exclusive to "less regulation"

I greatly appreciate the responses but I think we have a different world view of things. Profit is not perfect, capitalism has its flaws, but at its base state it is the best thing that has ever happened to people in history. Just read the history books, the free market is a wonderful tool when properly regulated and single pay goes against that, hence why even though i lean more left of center, I cannot go for a single payer system without at least substantial offerings in the free market for "better care".

But if you want your physician wages and healthcare dictated by a single government entity then so be it, plenty off countries have that and i hope we never get it here. Let's remove some of the anti-competitive practices our government is OK with in the current system instead of scrapping it for supposed greener grass on the M4A side.
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What do you mean by all medical care is voluntary? so if I'm in a car accident and bleeding out me going to the hospital is voluntary... how? In that I can choose to die? or if i think im having a heart attack i can choose to not to go the hospital and wait it out? If you don't see the difference between that sort of "voluntary" and getting a boob job I don't think we can continue our conversation
 
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jambro said:
Would overhead be more or less if you had one insurance plan to deal with vs. dozens to hundreds? right now you have to do whatever medicare says to get reimbursed, plus deal with all the other insurance companies who may or may not follow medicare rules or have their own rules for prior auths, etc. You're saying it wouldn't be easier if you had to deal with medicare by itself? This is part of my issue with the public option. Perhaps the hugest positive for M4A on the physician side is lower overhead, but with a public option all you've down is add yet ANOTHER payer (and prob a low paying one at that).

Furthermore, we all know that medicare regulations can change quickly. when I say "medicare" i really am just using the name of the gov program that covers american citizens - not saying in a "medicare for all" program that "medicare" reimburses the same/cpt code or has the same regulations as it does now. Hypothetically, with a giant change in the system, we can imagine that the medicare program itself can be revamped as well.



Sigh. I'm criticizing the profit motive endemic to the health insurance industry because it is their incentive to deny you care and they have the power to do that, simple as that. It's very different than saying an individual "provider" shouldn't make a "profit" (salary). You claim that medicare is inefficient, and yet medicare has about a 4% overhead and only after obamacare were health insurance companies limited to 20% overhead, so who's less efficient?

"Government-run healthcare" will also have completely different effects on different specialties so pretending it's going to cut the pay of everyone without even seeing an actual proposal is just conjecture. I can easily see pediatricians in poor areas getting a big pay bump, same with em physicians, or anyone who sees many medicaid or uninsured patients. PP ortho would be more likely to lose in this scenario but again it depends on the new negotiated CPT rates/conversion factors.

My whole argument for single payer is because i want to reduce the influence of non-patients and non-physicians in the field of medicine. The insanely bureaucratic for-profit system we have now is why you see those crazy charges for advil or the million administrators etc. This is the bloat that medicare for all fixes and saves money on.
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If they were all like medicare (or worse medicaid) it would be much more frustrating and time consuming (which equals needing more staff hours to deal with it).
 
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jambro said:
Would overhead be more or less if you had one insurance plan to deal with vs. dozens to hundreds? right now you have to do whatever medicare says to get reimbursed, plus deal with all the other insurance companies who may or may not follow medicare rules or have their own rules for prior auths, etc. You're saying it wouldn't be easier if you had to deal with medicare by itself? This is part of my issue with the public option. Perhaps the hugest positive for M4A on the physician side is lower overhead, but with a public option all you've down is add yet ANOTHER payer (and prob a low paying one at that).

Furthermore, we all know that medicare regulations can change quickly. when I say "medicare" i really am just using the name of the gov program that covers american citizens - not saying in a "medicare for all" program that "medicare" reimburses the same/cpt code or has the same regulations as it does now. Hypothetically, with a giant change in the system, we can imagine that the medicare program itself can be revamped as well.



Sigh. I'm criticizing the profit motive endemic to the health insurance industry because it is their incentive to deny you care and they have the power to do that, simple as that. It's very different than saying an individual "provider" shouldn't make a "profit" (salary). You claim that medicare is inefficient, and yet medicare has about a 4% overhead and only after obamacare were health insurance companies limited to 20% overhead, so who's less efficient?

"Government-run healthcare" will also have completely different effects on different specialties so pretending it's going to cut the pay of everyone without even seeing an actual proposal is just conjecture. I can easily see pediatricians in poor areas getting a big pay bump, same with em physicians, or anyone who sees many medicaid or uninsured patients. PP ortho would be more likely to lose in this scenario but again it depends on the new negotiated CPT rates/conversion factors.

My whole argument for single payer is because i want to reduce the influence of non-patients and non-physicians in the field of medicine. The insanely bureaucratic for-profit system we have now is why you see those crazy charges for advil or the million administrators etc. This is the bloat that medicare for all fixes and saves money on.
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Medicare, medicaid, and triwest/tricare (insurance vets get), deny claims at much higher rates than private insurance while also paying far less in reimbursements! The government will be just as inclined, if not more so, to save money by denying claims. And having them being the only one running the show would be an utter mess. I don't think beurocrats should be deciding who gets to have the life-saving procedure or decide who gets to have the elective case performed.

Edit: The hoops you have to jump through to get medicare reimbursement is far more than private, and medicare red tape is a big reason why overhead has become increasingly expensive. The contrary to your argument is true, if you decrease medicare involvement and increase private there is less red-tape and overhead to deal with.
 
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FutureInternist said:
I think everybody gets a Toyota and once that is accomplished, then and only then do we start upgrading those who can afford it to a Lexus
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But what you fail to see is you're taking away people's nicer cars who worked for them, to give them a worse car (toyota) than what they deserved and worked for and have obtained(in this analogy lets say a bmw). This is equality of outcomes not opportunity
 
jambro said:
What do you mean by all medical care is voluntary? so if I'm in a car accident and bleeding out me going to the hospital is voluntary... how? In that I can choose to die? or if i think im having a heart attack i can choose to not to go the hospital and wait it out? If you don't see the difference between that sort of "voluntary" and getting a boob job I don't think we can continue our conversation
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The overwhelming majority of medicine is elective cases, and it's incredibly, incredibly rare that private insurance will not cover almost the full, if not the entire bill of an imminent life-saving procedure or emergency.
 
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whataschool_classof24 said:
The overwhelming majority of medicine is elective cases, and it's incredibly, incredibly rare that private insurance will not cover almost the full, if not the entire bill of an imminent life-saving procedure or emergency.
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I’m in the middle of life saving care, so far this year I’ve racked up 45,000 of medical expenses. I’m very soon going to hit my max out of pocket of 5,000 still in the month of January. I’ve got “good” insurance, too.
 
DrNotaDr said:
I’m in the middle of life saving care, so far this year I’ve racked up 45,000 of medical expenses. I’m very soon going to hit my max out of pocket of 5,000 still in the month of January. I’ve got “good” insurance, too.
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Not that good if you have a $5000 share of cost (though I suppose you mean that it isn't as bad as it could be). I would have to have like 500 doctor visits or 20 surgeries to hit that amount in a year. Well I guess 17 brand name meds taken daily for a year would get there too.
 
dpmd said:
Not that good if you have a $5000 share of cost (though I suppose you mean that it isn't as bad as it could be). I would have to have like 500 doctor visits or 20 surgeries to hit that amount in a year. Well I guess 17 brand name meds taken daily for a year would get there too.
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It’s the most comprehensive insurance offered for one of the biggest healthcare conglomerates in the country. Private for profit Insurance gets worse every year, and the libertarians here just want more of it. Their answer is, just die of your treatable disease, that’s your choice.
 
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whataschool_classof24 said:
But what you fail to see is you're taking away people's nicer cars who worked for them, to give them a worse car (toyota) than what they deserved and worked for and have obtained(in this analogy lets say a bmw). This is equality of outcomes not opportunity
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99% sure this is sarcasm, cos if it not then dang do people need an education in how things are supposed to work in a society.

How is it equality of outcomes if some folks do get a lexus, while most don’t? 🤔

Things will NEVER be equal, and that is not the goal.
There will ALWAYS be have and have nots.

The decision is what is the lowest level we are prepared to accept for the have nots?

>50% of families cannot afford an emergency $500 expense.
Minimum wage is a joke in most states and one has to work full time just to afford a 1-2 bedroom apartment, never mind ever thinking of owning a house.
People are food insecure.
People are one minor accident away from bankruptcy.
People are DYING due to lack of meds.

USA has done a good (bad) job of equating the wealth of a person with their value, and that is literally killing people cos it allows folks to blame the homeless person for dying in the cold
 
DrNotaDr said:
It’s the most comprehensive insurance offered for one of the biggest healthcare conglomerates in the country. Private for profit Insurance gets worse every year, and the libertarians here just want more of it. Their answer is, just die of your treatable disease, that’s your choice.
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Libertarians make Republicans seem like Einsteins 🙄
 
DrNotaDr said:
I’m in the middle of life saving care, so far this year I’ve racked up 45,000 of medical expenses. I’m very soon going to hit my max out of pocket of 5,000 still in the month of January. I’ve got “good” insurance, too.
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Good luck, dude/dudette 🤞
 
whataschool_classof24 said:
The overwhelming majority of medicine is elective cases, and it's incredibly, incredibly rare that private insurance will not cover almost the full, if not the entire bill of an imminent life-saving procedure or emergency.
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😂😂😂... seriously?

Do you not know about lifetime maximums?
I have awesome insurance through work (although for some reason they don’t cover massages at shady parlours 😏), and I have a lifetime max that a 2-3 week ICU stay would easily obliterate
 
whataschool_classof24 said:
I'm not gonna quote all the posts that I've read, but you do not get a pay increase or have increase power in an industry with the government taking over, the opposite is actually true. The government is and always will be inefficient and a source of beurocratic waste. For those saying "well there's a profit in it, profit is bad", how are you going to feed your family and provide a good life for your kids? I went into medicine for a multitude of reasons, not just financial, but if you make it financially infeasible (which gov run healthcare will do), you will turn a lot of bright minds away from the field. I would like to one day give my kids a better life than I had but it won't be possible if I am saddled with 300k compounding debt and a severely reduced salary combined with increasing overhead (yes m4a will increase overhead, don't kid yourself if you think the beurocratic gov won't). If socialized medicine comes to the us, medicine will not be a sought after or prestigious field. In countries where socialized medicine is implemented, doctors are treated with a complete lack of respect financially and socially. What needs to be done in the US healthcare is trimming of admins. You hear stories of hospitals charging $90 for a pill of advil and other crazy stories, that kind of bloatedness is what has made healthcare for some people unaffordable. And this is going to ruin a lot of narratives, but the majority of Americans are satisfied with their private insurance plan. The short term gain of being able to say "everyone has access (not coverage) to affordable healthcare!" is a short term bandaid that will lead to many negative irreversible future consequences.
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Paragraphs
 
FutureInternist said:
😂😂😂... seriously?

Do you not know about lifetime maximums?
I have awesome insurance through work (although for some reason they don’t cover massages at shady parlours 😏), and I have a lifetime max that a 2-3 week ICU stay would easily obliterate
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The ACA eliminated lifetime maximums unless you have a grandfathered plan
 
dpmd said:
Not that good if you have a $5000 share of cost (though I suppose you mean that it isn't as bad as it could be). I would have to have like 500 doctor visits or 20 surgeries to hit that amount in a year. Well I guess 17 brand name meds taken daily for a year would get there too.
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5k out of pocket max isn't that bad in truth.
 
VA Hopeful Dr said:
The ACA eliminated lifetime maximums unless you have a grandfathered plan
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Hmm... maybe I need to take another look at the wording in my job’s plan.... and then rent a Lambo to drive around 😏, now that I can afford 3 months in the ICU when I invariably wreck it
 
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DrNotaDr said:
For a physician, 5k is a couple extra shifts. For many people, 5k is bankruptcy.
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Most people in most countries will pay $5k (or the equivalent when normalizing for GDP) on healthcare through taxes. Yes, we pay more overall, but the bankruptcy comes from sudden/surprise billing, and there are many more appropriate ways to bring down costs of medicine in the US Also, M4A won't solve our overspending problems. Even the most leftwing healthcare economists estimate a 10% overall savings from M4A, and in reality most of that will benefit will go to big companies who no longer have to pay for expensive benefits, but will obviously get huge tax breaks. We allow way too much of the cost of medicine to bleed into deductibles and cost sharing, rather than simply requiring higher premiums. One of the huge benefits to a single payer system is that essentially everything is covered by a premium, so payment is consistent. We could have that right now, but Americans would overwhelmingly prefer to gamble, take a lower premium, and hope they don't need expensive care.

So the problem isn't even really the overall cost of care for most Americans, and M4A wouldn't really even fix that issue anyway, just even out the spending and force people to be a little more financially prudent year over year. The problem with unaffordable healthcare goes back to unaffordable anything for Americans making low wages. Our entire financial/economic system is corrupt and won't allow for appropriate change in its current state. The same can be said about the fact that the taxes required to enact single payer would bankrupt a lot of small businesses (see Green Mountain Care). I would argue this particular point is a flaw in our overall financial system primarily. As long as this financial reality exists in the US, trying to enact single payer in the US is like trying to grow flowers in depleted soil.

Since we keep coming to this predicament, maybe the answer is to fix some of these massive flaws in our financial and economic systems first so that our attempt at single payer doesn't burn to the ground the way Green Mountain Care did. If you fix the economy and the financial systems we have in place, it only makes it easier to pass better, left-wing reforms. The focus of politicians like Bernie and the Squad should be primarily on creating fertile soil for things like single payer, UBI, and the Green New Deal, not forcing them through under poor conditions.
 
dpmd said:
5k deductible is unusual? Or people not planning for that deductible is unusual?
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I don't think either is unusual. I'm not about blaming physicians and healthcare because people don't plan to pay for medical expenses, but certainly we can acknowledge that we need to even out expenses such that costs are shared more evenly between the sick and healthy.

The problem is that higher premiums and lower deductibles would be so unpopular. People in America would rather gamble, hope they don't get sick, and not even plan for the event that they do. Then they'll blame the healthcare system. The reality is that many, but not all, of the people who are going bankrupt from $5k in sudden medical expenses are living better lifestyles than I am, and that's where the issue lies.

This would even translate to single payer. People would consistently vote to underfund the system for lower taxes and just hope they didn't get sick. Can't you already hear the tax cut proposals from Republicans the first election cycle after single payer goes into effect? What an awful corner we've backed ourselves into. Many of the victims are also the ones to blame, but so many decent people get caught in the crossfire.
 
ChordaEpiphany said:
I don't think either is unusual. I'm not about blaming physicians and healthcare because people don't plan to pay for medical expenses, but certainly we can acknowledge that we need to even out expenses such that costs are shared more evenly between the sick and healthy.

The problem is that higher premiums and lower deductibles would be so unpopular. People in America would rather gamble, hope they don't get sick, and not even plan for the event that they do. Then they'll blame the healthcare system. The reality is that many, but not all, of the people who are going bankrupt from $5k in sudden medical expenses are living better lifestyles than I am, and that's where the issue lies.

This would even translate to single payer. People would consistently vote to underfund the system for lower taxes and just hope they didn't get sick. Can't you already hear the tax cut proposals from Republicans the first election cycle after single payer goes into effect? What an awful corner we've backed ourselves into. Many of the victims are also the ones to blame, but so many decent people get caught in the crossfire.
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Republicans loved the doubling of the deficiet under trump running at about 1T a year. They voted for it. They are bought by the healthcare lobby. Get dark money out of politics first, then we have a chance.
 
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ChordaEpiphany said:
I don't think either is unusual. I'm not about blaming physicians and healthcare because people don't plan to pay for medical expenses, but certainly we can acknowledge that we need to even out expenses such that costs are shared more evenly between the sick and healthy.

The problem is that higher premiums and lower deductibles would be so unpopular. People in America would rather gamble, hope they don't get sick, and not even plan for the event that they do. Then they'll blame the healthcare system. The reality is that many, but not all, of the people who are going bankrupt from $5k in sudden medical expenses are living better lifestyles than I am, and that's where the issue lies.

This would even translate to single payer. People would consistently vote to underfund the system for lower taxes and just hope they didn't get sick. Can't you already hear the tax cut proposals from Republicans the first election cycle after single payer goes into effect? What an awful corner we've backed ourselves into. Many of the victims are also the ones to blame, but so many decent people get caught in the crossfire.
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When you are making $7-8 per hour and have no benefits from work, and can barely rent an apartment at that wage, let alone food, car, clothes, etc, then it is easy to see why insurance is not anywhere on people’s list of things to buy.
 
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VA Hopeful Dr said:
Same here, but in my state only the lowest tier plans were like that and not even all of them.
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It was crazy. The best coverage plan still had a 5k deductible. Luckily the guy I pay my overhead to called me some part of his business which allowed me to get on their group health plan (I just paid the full premium rather than him covering it like he did for the employees). For less in monthly premium I got no deductible, and low copay insurance (HMO but I don't mind it) plus dental. Now my husband has a job that provides the same (actually the copay is less) with the premium included. If I wanted their HSA qualifying plan we would have to pay extra each month. That is crazy to me.
 
FutureInternist said:
When you are making $7-8 per hour and have no benefits from work, and can barely rent an apartment at that wage, let alone food, car, clothes, etc, then it is easy to see why insurance is not anywhere on people’s list of things to buy.
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These statements, when presented in this manner, unfiltered and without context, only weaken the argument for expanded health coverage by giving Republicans easy targets to dunk on. It also places blame on the healthcare system when the primary blame is on employers and overall wealth inequality in the US. Finally, I explicitly acknowledged that these people get caught in the crossfire.

It's not hard to see why we are divided (and outright tribal) in our beliefs when the standard method of communication is snarky one-liners online aimed at people who agree with about 95% of what you have to say.

This a poor argument because the number of people in that situation is actually relatively low. So there are a number of counter-points that are just too easy to make, which any well-versed Republican will rattle off and derail the conversation.

1) Only ~20 states have a minimum wage that low (mostly low population states, though Texas is one of them).

2) The employer mandate to purchase health insurance for employees if your organization has more than 50 employees exists all over.

3) Many of these workers qualify for Medicaid (depending on the state and how many weeks/year they work).

4) Many people who choose to take jobs at Mom and Pop shops giving no benefits take those jobs because they get coverage from a spouse or family member.

I'm not denying that there are people in those situations, but rather than mention the extreme situation with no specifics to back up the statement, why not focus are far more salient and far-reaching issues? Many states have failed to expand Medicaid. Most people are underinsured. The self-employed middle class doesn't have enough subsidies to afford healthcare plans off the marketplace. Etc...

The fact remains that Americans, from the poor to the upper middle class, are very likely to skimp on health insurance, and the system allows them to do so. Many of those who are currently uninsured are the same who vote against things like Medicare for All, because they don't want to be forced to buy any health insurance. To make things worse, as much as Americans are likely to skimp on health insurance, their employers are even more likely to do so, which is why we have such ridiculously low premium-to-deductible ratios. Our risk pools are not broad enough. Our cost-sharing is too high. The amount of financial burden borne by the sick is an absurd percentage compared to the healthy.

There are so many good, serious arguments to be made without resorting to hyperbole.
 
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VA Hopeful Dr said:
5k out of pocket max isn't that bad in truth.
Click to expand...
I agree with you. It is not a that bad of a deal, considering it is America that we are talking about. . In Canada, they pay a very huge amount of $5000 in total premium, they don’t have to pay copay or deductibles and all prescriptions covered. Compared to that we are paying just peanuts , that is , very low deductible of $5k, copays in addition to a very very low premium of $25k. So, please don’t be ungrateful and crib about paying up. We have the best healthcare in the entire world for such a low cost. Yes, we are ranked handsomely at 39.
 
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dpmd said:
5k deductible is unusual? Or people not planning for that deductible is unusual?
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Isn’t it awesome that the healthcare discussion in America has come down to “People’s affordability of paying DEDUCTIBLE “? We are totally forgetting the PREMIUM they have ALREADY PAID.

I have a great suggestion for the poor private insurance companies who struggle to $100 millions of dollars for their genius CEOs. That is, if you go around the world, you can see that governments provide their citizens comprehensive coverage with no deductibles, copays, out of pocket of costs FOR A TOTAL PREMIUM OF $5k. Since we have successfully brainwashed the people that an out of pocket cost of $5k is very normal, the insurance companies can outsource our healthcare to foreign governments by giving them the out of pocket cost of $5k and THEY CAN FREE UP THE ENTIRE PREMIUM OF $25k AND THE MANDATORY YEARLY RAISE OF 20% TO PAY THEIR CEOs 100s OF MILLIONS AND EMPLOYEES 100s OF THOUSANDS FOR NOT BOTHERING THE CITIZENS WITH THEIR BS. At least, the foreign governments won’t raise the out of pocket costs and won’t ask for deductibles and the people can sleep peacefully.
 
LoveAll said:
I agree with you. It is not a that bad of a deal, considering it is America that we are talking about. . In Canada, they pay a very huge amount of $5000 in total premium, they don’t have to pay copay or deductibles and all prescriptions covered. Compared to that we are paying just peanuts , that is , very low deductible of $5k, copays in addition to a very very low premium of $25k. So, please don’t be ungrateful and crib about paying up. We have the best healthcare in the entire world for such a low cost. Yes, we are ranked handsomely at 39.
Click to expand...
Very few people pay 25k in premiums. If I bought gold level insurance through the exchange, and I make too much to get subsidies, I'd pay for the year around 12k for my whole family which would get a 3.6k deductible/OOP max.

But keep making up your nonsense.
 
VA Hopeful Dr said:
Very few people pay 25k in premiums. If I bought gold level insurance through the exchange, and I make too much to get subsidies, I'd pay for the year around 12k for my whole family which would get a 3.6k deductible/OOP max.

But keep making up your nonsense.
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Just give it 2 more years. You too will get the privilege of paying $25k.
 
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VA Hopeful Dr said:
OK, not at all what I said. What did your premiums do in that time?
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We were talking in general about the total cost of healthcare which in this country goes up disproportionately to inflation while healthcare outcomes remain among the worst in the developed world. You can mince words and talk about premiums all you want. I hit my max out of pocket of 5k in less than 30 days of treatment, close to 100k billed to insurance (so far) and it was also 100% outpatient. What a great system we have.
 
DrNotaDr said:
We were talking in general about the total cost of healthcare which in this country goes up disproportionately to inflation while healthcare outcomes remain among the worst in the developed world. You can mince words and talk about premiums all you want. I hit my max out of pocket of 5k in less than 30 days of treatment, close to 100k billed to insurance (so far) and it was also 100% outpatient. What a great system we have.
Click to expand...
I wonder what sort of wait time you would have had in other countries for the same care (assuming it was approved care).
 
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DrNotaDr said:
We were talking in general about the total cost of healthcare which in this country goes up disproportionately to inflation while healthcare outcomes remain among the worst in the developed world. You can mince words and talk about premiums all you want. I hit my max out of pocket of 5k in less than 30 days of treatment, close to 100k billed to insurance (so far) and it was also 100% outpatient. What a great system we have.
Click to expand...
So out of 100k of healthcare costs you only had to pay 5 thousand? Sounds like a fair deal to me
 
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Captain_Falcon said:
So out of 100k of healthcare costs you only had to pay 5 thousand? Sounds like a fair deal to me
Click to expand...

It was billed completely out of proportion to the cost of what was provided to try to make as much money as possible based on insurance rejections. We have a deeply immoral healthcare system with the poorest outcomes in the developed world.
 
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