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Thread: Moderate Democrats are quitting on Obamacare

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Boo Radley View Post
    Your first point, how well you survive cancer depends a lot on what you can afford.
    True. For example, if you are Great Britain, you can't afford very much. Here in the U.S., however, you have a better chance. I would posit that

    Second point, it shouldn't effect the budget at all. The money we spend on insurance premiums, mark ups for the uninsured, and needless procedures would easily cover costs. Once you actually try to solve a problem, the more likely you are to solve it.
    ah. so it is your theory that we will continue to pay our insurance premiums, except that those companies will now immediately turn over 100% of all monies received to the government, cost-free?

    Reality, unfortunately, is not so kind. We could never catch in tax revenue enough to make up the costs you wish to put on the Federal Government.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by cpwill View Post
    CBC?

    Anyway, you guys are always flawed because you cherry pick. Try this one:


    * Canada had the highest percentage of patients (36%) who had to wait six days or more for an appointment with a doctor, but the United States had the second highest percentage (23%) who reported that they had to wait at least this long. New Zealand, Australia, Germany, and the U.K. all had substantially smaller numbers of people reporting waits of 6 days or longer. Canada and the United States, in that order, also had the lowest percentage of persons who said they could get an appointment with a doctor the same or next day.

    Wait Times For Medical Care: How The US Actually Measures Up - Better Health

    Or this:


    Myth: There are long waits for care, which compromise access to care.There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists' care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.


    Read more: Debunking Canadian health care myths - The Denver Post Debunking Canadian health care myths - The Denver Post
    Read The Denver Post's Terms of Use of its content: Terms of Use - The Denver Post
    Follow us: @Denverpost on Twitter | Denverpost on Facebook

    You should know that there are many systems out there. Most doing better than ours overall.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by cpwill View Post
    True. For example, if you are Great Britain, you can't afford very much. Here in the U.S., however, you have a better chance. I would posit that



    ah. so it is your theory that we will continue to pay our insurance premiums, except that those companies will now immediately turn over 100% of all monies received to the government, cost-free?

    Reality, unfortunately, is not so kind. We could never catch in tax revenue enough to make up the costs you wish to put on the Federal Government.
    Not entirely true. Few here can afford care. We pay a lot for insurance to cover it. Most of item paid by employers. We also do a lot of treatment not paid for, which rises costs.

    And no, I said nothing about paying insurance companies nor turning over anything. I said that money could be moved, paid in taxes. One insurer (which in and of itself would reduce costs).

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Boo Radley View Post
    Not entirely true. Few here can afford care. We pay a lot for insurance to cover it. Most of item paid by employers. We also do a lot of treatment not paid for, which rises costs.

    And no, I said nothing about paying insurance companies nor turning over anything. I said that money could be moved, paid in taxes. One insurer (which in and of itself would reduce costs).
    Yep. We have all seen that monopolies tend to help to keep those pesky product and service costs down.
    “The reasonable man adapts himself to the world: the unreasonable one persists to adapt the world to himself.
    Therefore all progress depends on the unreasonable man.” ― George Bernard Shaw, Man and Superman

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by ttwtt78640 View Post
    Yep. We have all seen that monopolies tend to help to keep those pesky product and service costs down.
    Not the same. Job would be to prove care at reasonable cost and not profit.


    On a side note, insurance companies as they stand have not kept costs down. In fact, long before reform, we've been paying more and more for less and less. The ob of the insurer is to take in money while trying not to pay out. The successful company has few sick people, and lots of well people paying, which largely defeats the purpose.
    Last edited by Boo Radley; 07-26-13 at 11:38 PM.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Boo Radley View Post
    Not entirely true. Few here can afford care. We pay a lot for insurance to cover it. Most of item paid by employers. We also do a lot of treatment not paid for, which rises costs.
    On the contrary. When we actually pay for care, the costs are dramatically lower. When we pre-pay for group care via third-parties, the incentives are for each individual to attempt to beggar his neighbor, and so that is what we do, with the result of rapidly rising costs.

    And no, I said nothing about paying insurance companies nor turning over anything. I said that money could be moved, paid in taxes. One insurer (which in and of itself would reduce costs).
    ah, so we are going to collect enough in taxes.

    Okay. Healthcare spending in this country is approximately 12% of GDP. So we need to add 12% of GDP in taxes.

    Situation. We are currently collecting around 16-17% of GDP in federal taxes. So in order to meet your standard of "not effecting the budget at all", we would need to increase revenues to about 28% of GDP.

    Problem: We have never in the history of the United States of America managed to collect that much tax revenue, even when top nominal rates were 91%



    The dream of "well we'll just run that money through the government instead" is a pipe dream, and has about as much substance behind it as the smoke it implies. That's before you get to the dynamic effects (which, hint: make the numbers even worse).

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by cpwill View Post
    On the contrary. When we actually pay for care, the costs are dramatically lower. When we pre-pay for group care via third-parties, the incentives are for each individual to attempt to beggar his neighbor, and so that is what we do, with the result of rapidly rising costs.



    ah, so we are going to collect enough in taxes.

    Okay. Healthcare spending in this country is approximately 12% of GDP. So we need to add 12% of GDP in taxes.

    Situation. We are currently collecting around 16-17% of GDP in federal taxes. So in order to meet your standard of "not effecting the budget at all", we would need to increase revenues to about 28% of GDP.

    Problem: We have never in the history of the United States of America managed to collect that much tax revenue, even when top nominal rates were 91%



    The dream of "well we'll just run that money through the government instead" is a pipe dream, and has about as much substance behind it as the smoke it implies. That's before you get to the dynamic effects (which, hint: make the numbers even worse).
    Lower, but not affordable for all. You merely cut out a segment of the population, and a larger one than you think.

    As for taxes, we most reroute money, which would less than we're spending now.

    Financing

    The program would be federally financed and administered by a single public insurer at the state or regional level. Premiums, copayments, and deductibles would be eliminated. A single payer system as embodied in national legislation (H.R. 676) could be financed in several ways. One progressive option would be to fund it with a combination of existing federal and state revenues for health care, a payroll tax on employers (4-7 percent, much less that what employers pay today to provide less secure coverage), a 6 percent tax on unearned income, a 6 percent surtax on the highest 5 percent of income-earners, and a small tax on financial transactions.

    Under this plan, 95 percent of people would pay less for health care. (Gerald Friedman, "Medicare for All" would save billions, and could be redistributive. Dollars and Sense, March/April 2012).

    What is Single Payer? | Physicians for a National Health Program

    A universal public system would be financed in the following way: The public funds already funneled to Medicare and Medicaid would be retained. The difference, or the gap between current public funding and what we would need for a universal health care system, would be financed by a payroll tax on employers (about 7%) and an income tax on individuals (about 2%). The payroll tax would replace all other employer expenses for employees’ health care, which would be eliminated. The income tax would take the place of all current insurance premiums, co-pays, deductibles, and other out-of-pocket payments. For the vast majority of people, a 2% income tax is less than what they now pay for insurance premiums and out-of-pocket payments such as co-pays and deductibles, particularly if a family member has a serious illness. It is also a fair and sustainable contribution.

    Single-Payer FAQ | Physicians for a National Health Program

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Middleground View Post
    If there was universal healthcare, he'd have a lot less worry.

    Tell me, American... what do you think is so great about the system you have now?
    I have a good insurance policy, with very low co-pays.
    "He who does not think himself worth saving from poverty and ignorance by his own efforts, will hardly be thought worth the efforts of anybody else." -- Frederick Douglass, Self-Made Men (1872)
    "Fly-over" country voted, and The Donald is now POTUS.

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    Re: Moderate Democrats are quitting on Obamacare

    Quote Originally Posted by Boo Radley View Post
    Lower, but not affordable for all. You merely cut out a segment of the population, and a larger one than you think.
    No, lower. Thanks to the wonderful laboratory of Democracy, we actually have an increasingly good idea of what kinds of reforms are capable of reducing costs (or, at least, holding them steady) while continuing to provide equal or greater actual health care.

    The chief problem with our current healthcare system is an abundance of awkward and disruptive government interference. This has led to the dominance of a third-party-payment model which discourages cost-awareness and encourages over-consumption among health care consumers. Government pays for roughly half of our healthcare consumption, and of all third-party payment options, government is the one least likely to be capable or willing to nimbly find ways to impose cost awareness on those capable of sending it bills. The result is a healthcare system in which costs rapidly spiral out of control (we have a similar problem in our higher education industry). Any system which does not alter that disruption and incentivize cost-awareness among consumers for the vast majority of medical purchases will not address the chief underlying flaw of our current system, and we will continue to see costs spiral outside of the control of the citizenry and government.

    Reforms which have pushed cost-awareness back onto consumers have demonstrated impressive results at lowering expenditures:

    Indiana offered HSA's, - which have patients save money in tax-free accounts (where it grows and remains theirs forever and ever unless theys pend it) - matched with high deductible plans to it's employees. Employees began to respond to price signals, and medical costs per patient were reduced by 33% and expenditures to the state were reduced by 11%.

    Safeway has instituted a program that gave financial incentives to people who engaged in healthy behavior by allowing price signals in the insurance side of the market to work (Indiana worked on the medical side), and saw it's per-captia health care costs remain flat from 2005-2009; when most companies saw theirs jump by 38%.

    Whole Foods instituted HSA's, and let's the employees choose what they want the company to fund. This institutes price pressure on the medical side (WF covers the high-deductible plan 100%), and their CEO points out that as a result Whole Foods' per-capita costs are much lower than typical insurance programs, while maintaining employee satisfaction.

    Medicare Part D utilized market pressure on the insurance side, and saw expenditures come in at 40% UNDER expenditures - the only such government program in history to do so.

    Wendy's instituted HSA's, and saw the number of their employees who got preventative and annual checkup care climb even as they saw claims decrease by 14% (in one year).

    Wal-Mart's low cost clinics and prescriptions save us oodles of cash. Wal-Mart reports that "half of their clinic patients report that they are uninsured" and that "if it were not for [Wal-Marts'] clinics they would haven't gotten care - or they would have gone to an emergency room".

    Dr Robert Berry runs a practice called PATMOS (payment at time of service). he doesn't take insurance at all - but simply posts the prices of his services. By removing the cost of dealing with mutliple insurance agencies, medicare, and medicaid, the prices he is able to list are one half to ONE THIRD of industry standard.

    So we know what works, because we've seen it. It's simply that implementing what works means less power in our nations capitals, which means less cash for our nations' politicians, which means less support for implementing it in the first place.

    As for taxes, we most reroute money, which would less than we're spending now.
    Oh, we'll just magically "reroute" it. sure. We'll hit the "reroute" button because people treat purchasing goods and services exactly the same way they treat paying taxes.

    Financing

    The program would be federally financed and administered by a single public insurer at the state or regional level. Premiums, copayments, and deductibles would be eliminated. A single payer system as embodied in national legislation (H.R. 676) could be financed in several ways. One progressive option would be to fund it with a combination of existing federal and state revenues for health care, a payroll tax on employers (4-7 percent, much less that what employers pay today to provide less secure coverage), a 6 percent tax on unearned income, a 6 percent surtax on the highest 5 percent of income-earners, and a small tax on financial transactions.

    Under this plan, 95 percent of people would pay less for health care. (Gerald Friedman, "Medicare for All" would save billions, and could be redistributive. Dollars and Sense, March/April 2012).

    What is Single Payer? | Physicians for a National Health Program

    A universal public system would be financed in the following way: The public funds already funneled to Medicare and Medicaid would be retained. The difference, or the gap between current public funding and what we would need for a universal health care system, would be financed by a payroll tax on employers (about 7%) and an income tax on individuals (about 2%). The payroll tax would replace all other employer expenses for employees’ health care, which would be eliminated. The income tax would take the place of all current insurance premiums, co-pays, deductibles, and other out-of-pocket payments. For the vast majority of people, a 2% income tax is less than what they now pay for insurance premiums and out-of-pocket payments such as co-pays and deductibles, particularly if a family member has a serious illness. It is also a fair and sustainable contribution.

    Single-Payer FAQ | Physicians for a National Health Program
    Yeah, raising taxes. Except as I've already demonstrated, never in the history of our country have we raised enough taxes to "reroute our spending" into the federal coffers. You're simply not going to get it, especially once you factor in the fact that when you raise the cost of employment by (for example) 9%, you reduce demand for employees. These people think that making rates higher by 9%-15% would fund UHC? When our rates were 60 % higher we didn't raise enough to fund UHC.

    But I'm open to being convinced. Average revenues in the pre-Great Recession Era were about 18.5% of GDP. If you can describe for me a single tax structure in American history that collected 6% of GDP over that amount for a 5 year period, I will re-assess my statement on the utter implausibility of the pie-in-the-sky notion that we can afford a massive new entitlement program.
    Last edited by cpwill; 07-27-13 at 02:25 AM.

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    Re: Moderate Democrats are quitting on Obamacare

    Worth noting: if you want to provide universal coverage to American citizens, then I have already described how that can be accomplished without the fairy tale of magical mountains of tax revenues that we have never seen in our past and are unlikely to see in our future. It even has the added benefit of helping our low-income and poorer populations build wealth and have actual access to healthcare (since Medicaids' reimbursement schedules are lower, many providers cannot afford to take, or have to limit their acceptance of Medicaid recipients).

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