Medicare... It's not "Free"

[TakeYouToTasker]

6 minutes ago, Koko78 said:

 

I like how he thinks payroll taxes, which amount to roughly 6% of the GDP, will pay for healthcare, which costs 17.2% of GDP.

 

It's brilliant really. If you jack up payroll taxes by 400%, you'll be able to pay for healthcare, including all of the associated government waste and overspend! Granted, no one will actually be working after putting all but the largest companies out of business, but who the ***** cares? It's FREE!

 

The math isn't the worst part of the argument.

 

It's not even the second worst part.

 

The logical problems are peak; the moral problems second.

[Koko78]

1 minute ago, TakeYouToTasker said:

 

The math isn't the worst part of the argument.

 

It's not even the second worst part.

 

The logical problems are peak; the moral problems second.

 

Oh I know. I was just pointing out one of the many flaws that had not yet been highlighted.

[billsfan89]

12 hours ago, Koko78 said:

 

So the magical government fairy will wave its wand and suddenly make health care efficient and cost-effective?

 

Can I have some of whatever mind-altering drugs you're taking?

 

I don't know how you people think free markets address costs in healthcare, the US has the most free market oriented system in the world and it costs 17.2% of GDP.  I have over and over again explained in detail using the outcomes of other nations gain as to specifically how single payer healthcare leads to lower costs and better or at least similar outcomes. I will list the reasons below as to why single payer saves money and improves the overall system. Please tell me how a private market addresses theses issues other than government sucks free market rules. 

 

1- Billing - If you have one uniformed biller you only have to use one set of codes and abide by one set of coverage. In the US there are dozens of insurance companies, each with dozens of plan types and all with their own billing codes. Hospitals and providers all have to get paid on a per patient basis. They have to hound each insurance company for each patient. In single payer countries you only have one set of codes (even private over the top insurance that's used in other countries has to use the governments billing codes), hospitals and providers also only deal with one major provider for 90% of their claims thus a more streamlined system, and finally hospitals and larger providers can get paid in one lump sum yearly budgets which dramatically reduces their billing costs. Single payer systems spend half as much on billing as the US does. 

 

2- Preventative Care - If people are given a baseline level of care and don't have to fear navigating a complicated system where one mistake in going to the wrong doctor can cost you hundreds of dollars you have people getting more preventative care. Preventative care access means people catch more things early when they are cheaper and easier to treat. In the US people fear the expensive healthcare system due to being uninsured or under-insured. People wait for things to get worse as a result of fearing the costs of the healthcare system. 

 

3- Price negotiation on services and drugs - The US gets ***** in the ass when it comes to drug prices because the private market and Medicare get pitted against each other. You also have each insurance company negotiating their own prices on services each year (which takes up providers time and makes things more bureaucratic.) By having the government be the sole negotiator it uses the purchasing power of the public to leverage down the costs of services (the government can also compare one hospitals pricing to another and force them to justify higher fees or make them lower fees.) 

 

There are other ancillary cost drivers as well. These are real world proves that countries with single payer systems pay less and get the same or better quality of service. Yes there is a black market for services in nations like Canada but I can't find any verifiable estimates as to how large that system is. Even if the black market increased the GDP spending on healthcare by 20% (which is a large overestimate) the US still would spend more than the next closest nation by several percentage points. Its not magic and its not a coincidence that single payer systems are very popular in other industrialized nations while the US healthcare system is massively unpopular. Even the underfunded VA the big bad evil boogey man of single payer healthcare in the US is more popular than the private system. 

[billsfan89]

12 hours ago, Koko78 said:

 

I like how he thinks payroll taxes, which amount to roughly 6% of the GDP, will pay for healthcare, which costs 17.2% of GDP.

 

It's brilliant really. If you jack up payroll taxes by 400%, you'll be able to pay for healthcare, including all of the associated government waste and overspend! Granted, no one will actually be working after putting all but the largest companies out of business, but who the ***** cares? It's FREE!

 

You would have to increase payroll taxes, it would be the equivalent of taking the money employers already spend on their employees healthcare and taking the money already being spent on Medicare and Medicaid (which is 900 billion yearly) and spending it to provide universal coverage. If employers want to provide over the top coverage as an additional benefit that should be allowed but for most employees if the government provided baseline access to care they would be happy to pay a fixed cost and not have to worry about year to year rate increases and negotiating new benefits every year.  

 

Yes it is possible that taxes would have to be increased in other areas like a national sales tax or a small income tax increase but there are a lot of estimates that a payroll tax increase would cover the money needed to fund a 2.4-2.7 trillion dollar single payer system (keep in mind that's not 2.4-2.7 needed to be raised since we already spend 900 billion via medicare and medicaid.) 

 

The US can't afford its existing system its a drain on average working people and its a drain on both large and small businesses. Most companies that operate in Canada and the US spend less on the healthcare taxes in Canada than they do providing private insurance to their employees in America. 

[GG]

37 minutes ago, billsfan89 said:

 

You would have to increase payroll taxes, it would be the equivalent of taking the money employers already spend on their employees healthcare and taking the money already being spent on Medicare and Medicaid (which is 900 billion yearly) and spending it to provide universal coverage. If employers want to provide over the top coverage as an additional benefit that should be allowed but for most employees if the government provided baseline access to care they would be happy to pay a fixed cost and not have to worry about year to year rate increases and negotiating new benefits every year.  

 

Yes it is possible that taxes would have to be increased in other areas like a national sales tax or a small income tax increase but there are a lot of estimates that a payroll tax increase would cover the money needed to fund a 2.4-2.7 trillion dollar single payer system (keep in mind that's not 2.4-2.7 needed to be raised since we already spend 900 billion via medicare and medicaid.) 

 

The US can't afford its existing system its a drain on average working people and its a drain on both large and small businesses. Most companies that operate in Canada and the US spend less on the healthcare taxes in Canada than they do providing private insurance to their employees in America. 

 

What is the acceptable level of healthcare rationing that you'd support in this scheme?  One week wait?  One year wait?

 

Nobody has claimed that the current trend of healthcare costs and insurance premiums are sustainable at the current pace.   But don't fool yourself that your proposal will be free of very severe drawbacks for the majority.

[Foxx]

US Hospitals Begin Posting Prices Online in Transparency Push by Trump Administration

[billsfan89]

20 minutes ago, GG said:

 

What is the acceptable level of healthcare rationing that you'd support in this scheme?  One week wait?  One year wait?

 

Nobody has claimed that the current trend of healthcare costs and insurance premiums are sustainable at the current pace.   But don't fool yourself that your proposal will be free of very severe drawbacks for the majority.

 

No system is perfect, but I think going to a much less regulated system and allowing healthcare to be treated like a full on commodity has far bigger draw backs than the negatives that come with a single payer system. People act like there isn't rationing in the US system, when someone is underinsured or uninsured and they don't have access we are rationing their care along non-sensible economic lines. I just don't see how a more free market oriented approach to healthcare drives down costs other than someone just having a dogmatic belief in the free market over government. I don't see the data and evidence driving the conclusion that deregulating healthcare will accomplish a better system. Billing, preventative care, negotiating drug costs, profit motive, and other factors don't get addressed by deregulating the market completely or nearly completely. 

 

Even the best example of a more market based approach to healthcare Switzerland has a more heavily regulated market than the US. The Swiss regulate healthcare more like a utility and they still get better care at a cheaper cost (although they typically do spend more than most single payer countries their standard of care is towards the top.) I just don't see what evidence points to deregulation as the cure for the US healthcare issues. 

Edited January 2, 2019 by billsfan89

[mead107]

Wife on it started January 1. I will be on it oct 1. 

About $400 a month with supplement.   

[GG]

32 minutes ago, billsfan89 said:

 

No system is perfect, but I think going to a much less regulated system and allowing healthcare to be treated like a full on commodity has far bigger draw backs than the negatives that come with a single payer system. People act like there isn't rationing in the US system, when someone is underinsured or uninsured and they don't have access we are rationing their care along non-sensible economic lines. I just don't see how a more free market oriented approach to healthcare drives down costs other than someone just having a dogmatic belief in the free market over government. I don't see the data and evidence driving the conclusion that deregulating healthcare will accomplish a better system. Billing, preventative care, negotiating drug costs, profit motive, and other factors don't get addressed by deregulating the market completely or nearly completely. 

 

Even the best example of a more market based approach to healthcare Switzerland has a more heavily regulated market than the US. The Swiss regulate healthcare more like a utility and they still get better care at a cheaper cost (although they typically do spend more than most single payer countries their standard of care is towards the top.) I just don't see what evidence points to deregulation as the cure for the US healthcare issues. 

 

Where did you see me post anything about removing all regulations from the health insurance market?

 

You keep falling into the single payer claptrap that divines that the biggest problem with healthcare is the administrative and billing side as opposed to the medical care side.   That 20% vs 2% administrative cost saving fantasy is pure baloney because it doesn't compare identical services that are captured by those costs.   If you go to single payer, you will just shift that administrative expense to the government.

 

If you are advocating for a full switch to a single payer system in the US you should be honest with the implications to the significant majority of US citizens and how they will lose access to their current levels of healthcare.  PPP is a forum that knew very well that when somebody pronounced that if you liked your doctor you could keep your doctor, it was a bald faced lie.

[billsfan89]

31 minutes ago, GG said:

 

Where did you see me post anything about removing all regulations from the health insurance market?

 

You keep falling into the single payer claptrap that divines that the biggest problem with healthcare is the administrative and billing side as opposed to the medical care side.   That 20% vs 2% administrative cost saving fantasy is pure baloney because it doesn't compare identical services that are captured by those costs.   If you go to single payer, you will just shift that administrative expense to the government.

 

If you are advocating for a full switch to a single payer system in the US you should be honest with the implications to the significant majority of US citizens and how they will lose access to their current levels of healthcare.  PPP is a forum that knew very well that when somebody pronounced that if you liked your doctor you could keep your doctor, it was a bald faced lie.

 

Every study even ones done by conservative think tanks state that billing is a major cost saver in single payer systems. You have singular coding, lump sum payments, and less entities to deal with. The amount of money single payer nations and Medicare/Medicaid spend on administration/billing is 40-70% less, that's comparing all administrative costs in total so yes the government is paying those costs but its paying less overall costs on billing and administration due to those reasons stated. 

 

I will be honest and say that a single payer system is not perfect and some people will lose their current levels of care (Although I would be for any system that allows Medigap coverage to expand a basic government plan that can be provided by employers over the top or bought privately.) But I think the vast majority of people will see better care and lowered cost or not see much of a difference in care. Our privatized system is so broken and expensive. The only solution on here that I have seen is to loosen regulations on healthcare and treat it like a commodity. I don't think that would work as I think it doesn't address the core issues and it further allows insurance companies the incentive to make their coverage confusing and deny service. I also did not mean to imply that was your personal solution (although I would like to hear your ideas) but rather that in general people were advocating for less regulations and more of a market based approach.

 

 Single payer in my opinion is the best solution even if it isn't perfect. Obamacare was an attempt to emulate the Swiss model of healthcare but the law was so poorly written that it just became useless other than a few popular provisions. 

Edited January 2, 2019 by billsfan89

[Foxx]

want to eliminate a good portion of bureaucracy? one word... blockchain.

[keepthefaith]

4 hours ago, billsfan89 said:

 

Every study even ones done by conservative think tanks state that billing is a major cost saver in single payer systems. You have singular coding, lump sum payments, and less entities to deal with. The amount of money single payer nations and Medicare/Medicaid spend on administration/billing is 40-70% less, that's comparing all administrative costs in total so yes the government is paying those costs but its paying less overall costs on billing and administration due to those reasons stated. 

 

I will be honest and say that a single payer system is not perfect and some people will lose their current levels of care (Although I would be for any system that allows Medigap coverage to expand a basic government plan that can be provided by employers over the top or bought privately.) But I think the vast majority of people will see better care and lowered cost or not see much of a difference in care. Our privatized system is so broken and expensive. The only solution on here that I have seen is to loosen regulations on healthcare and treat it like a commodity. I don't think that would work as I think it doesn't address the core issues and it further allows insurance companies the incentive to make their coverage confusing and deny service. I also did not mean to imply that was your personal solution (although I would like to hear your ideas) but rather that in general people were advocating for less regulations and more of a market based approach.

 

 Single payer in my opinion is the best solution even if it isn't perfect. Obamacare was an attempt to emulate the Swiss model of healthcare but the law was so poorly written that it just became useless other than a few popular provisions. 

 

No thank you.

 

We don't have a free market system of health care insurance in this country.  Not even close.  We have over 70 million on Medicaid and over 60 million on Medicare.  Both of these are essentially single payer systems which are supposed to be funded by tax dollars.  We have an ever increasing share of the population being covered by these programs and they are underfunded because subscribers and services provided are increasing much faster than are tax receipts.  Obamacare made this a certainty when it expanded Medicaid enrollment and coverage benefits.  Both Medicare and especially medicaid pay doctors and hospitals way under market rates so to think that we can cover an entire population at the same rates is a fallacy. 

 

We have in this country 50 separate state markets created by government all monopolized by the health care insurance companies.  Since coverage levels are mandated and markets are closed to outside competition, there essentially isn't competition.  It's essentially government mandated coverage funded privately and funded at much higher rates because 40% of the population is serviced through Medicare and Medicaid at deep discounted rates.  That and the few carriers in each state fight over the business of large employers giving them larger discounts meaning small businesses or individuals pay the most for insurance.

 

And speaking of pricing, people and their carriers are charged wildly different amounts for the same services without pricing being published and without any practical way of negotiating those costs if they have no coverage or crappy coverage. 

 

Our laws prevent most from having a health savings account.  Only some can have those.  Dumbest law ever.

 

As for your comments on billing, Health insurance stopped being insurance a long time ago when it got involved every time someone saw a doctor or got a simple prescription.

 

Our U.S. Federal government has never in history administered a broad based entitlement in a fiscally responsible or cost effective manner.  

 

What we have in this country is a patchwork of very restrictive laws that prevents us from having the free market system which to some extent once existed in my lifetime.  We won't have cost efficiency until we lift restrictions and make people more personally responsible for maintaining and funding their own health and care. 

 

Edited January 3, 2019 by keepthefaith

[GG]

16 hours ago, billsfan89 said:

 

 Single payer in my opinion is the best solution even if it isn't perfect. Obamacare was an attempt to emulate the Swiss model of healthcare but the law was so poorly written that it just became useless other than a few popular provisions. 

 

See Keep's post above.   Obamacare had very little intention to create a Swiss type regulated-market healthcare system.  Obamacare was designed to implode the private insurance model where single payer would be the ultimate solution.

[TakeYouToTasker]

7 hours ago, GG said:

 

See Keep's post above.   Obamacare had very little intention to create a Swiss type regulated-market healthcare system.  Obamacare was designed to implode the private insurance model where single payer would be the ultimate solution.

 

Correct.

 

The framers of the ACA designed a Trojan Horse with the intention of destroying markets and driving up prices in order to collapse the US system.

[billsfan89]

8 hours ago, GG said:

 

See Keep's post above.   Obamacare had very little intention to create a Swiss type regulated-market healthcare system.  Obamacare was designed to implode the private insurance model where single payer would be the ultimate solution.

 

I mostly disagree, Obamacare was written by the Healthcare lobby for the most part. Why would the healthcare insurance industry influence the writing of a law to put themselves out of business? The approach was a poor emulation of the Swiss market (The Swiss have an individual mandate, non-profit plans/companies, and a lot of regulations of policies) but it failed due to trying to keep the private market the primary provider of insurance and other bad decisions when a single payer system would have worked best. 

 

So I fail to buy the pseudo conspiracy theory that the law crafted by the insurance industry (based off of a 1990's Republican proposal) was designed to put the insurance industry out of business. 

[3rdnlng]

16 minutes ago, billsfan89 said:

 

I mostly disagree, Obamacare was written by the Healthcare lobby for the most part. Why would the healthcare insurance industry influence the writing of a law to put themselves out of business? The approach was a poor emulation of the Swiss market (The Swiss have an individual mandate, non-profit plans/companies, and a lot of regulations of policies) but it failed due to trying to keep the private market the primary provider of insurance and other bad decisions when a single payer system would have worked best. 

 

So I fail to buy the pseudo conspiracy theory that the law crafted by the insurance industry (based off of a 1990's Republican proposal) was designed to put the insurance industry out of business. 

You mean a Heritage Foundation paper, right?

[Deranged Rhino]