Hospitals Stand to Lose Billions Under ‘Medicare for All’

SLC said:

Food is a basic human right ,lodging is a basic human right.

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Correct.

3leftsdoo said:

Correct.

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So do you think a person that refuses to work should have the same food and same lodging as a person that works hard and is otherwise successful?

SLC said:

So do you think a person that refuses to work should have the same food and same lodging as a person that works hard and is otherwise successful?

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Refuses to work comes with sooooo much baggage. As does "same food and lodging".

You mean they refuse to take a job that is likely to kill them before they hit 60? Or refuse a job that they aren't capable of physically, or mentally, of doing?

Does "same" mean clean safe functional? Or does it mean everyone gets a mansion?

Greenbeard said:

But decoupling resources and capacity from the actual need and instead subjecting both to artificial political budget targets is exactly the danger that's being described here.

If the argument is "underfund hospitals and they'll be forced to find a way to make it work," the VA is not an unreasonable example of how that thinking can go awry.

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No not really because even in the leanest years the VA has ever seen, even when the shortages of medical personnel are at record levels, the VA NEVER EVER turns down the chance to remodel, lay in hundreds of tons of new artwork, grand pianos (which are all perpetually LOCKED) new gardens, walkways, lobbies, atriums, even entirely brand new wings empty of equipment.

VA hospitals are almost a miniature version of the fabled Chinese ghost cities when it comes to facilities budgets.
It's a goddamn JOBS program for construction companies!!
The VA system is a case study in "artificial political budgets" because facilities and remodeling are sacred non discretionary budgets and their HEALTH CARE budgets are discretionary, which means the VA has to BEG every year to actually practice MEDICINE but if they want or DON'T WANT some remodeling, they're going to get it anyway.

So it's not that the VA can't get money, it's that Congress refuses to give the VA MONEY FOR MEDICINE.
So, it "goes awry" because Congress has been doing to the VA exactly what they've been doing to the Post Office and to every public school district in the country, funding pretty stuff and beauty projects but starving everything else, so that they can all pose for the cameras and scream about how the government is failing Americans.

A strict moratorium on bullcrap construction projects for ten years and divert that money to HEALTH CARE and the VA will do just fine. Also, merge the VA and the DoD health care systems and eliminate gazillions worth of unnecessary duplication and allow armed forces and veterans alike to access either or both as they please.

SLC said:

Food is a basic human right ,lodging is a basic human right.

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I was a starving student in Minneapolis in 1978, making minimum wage and going to school. My rent on a tiny bachelor pad was $110 a month but I was making about $350 a month maybe. That was enough for me to get by. Moonlighting a second job at night added another 150 bucks a month and suddenly I was doing well.
I didn't eat steak and lobster, a lot of hot dogs, ramen and Kraft mac and cheese but I ate.
I had an old jalopy but I could afford to put a couple of gallons of gas in it and get back and forth to school and work.

My 110 dollar a month bachelor pad was a 120 sf sardine can but it kept me safe and warm, even laid from time to time although that has nothing to do with the issue....I just thought I would throw that in there.

But the point is, it was doable then, so it could be doable now. Maybe the numbers won't match but then again the AMOUNTS can. A week or ten days wages pays the rent, another week for food, clothing and utilities, another week for other expenses and a week set aside in savings. Health care was the clinic down the street, free if you were poor and sliding scale if you weren't.

In a year and a half I was able to exercise my upward mobility and LEAVE the sardine can for better digs.
It's THE DESPAIR QUOTIENT, folks.
Fix the DESPAIR QUOTIENT and a lot of other problems slowly begin to heal themselves over time.

Despair is poison, and this country is overflowing with despair because forty percent of WORKING Americans don't have enough to cover a four hundred dollar emergency. Note I said WORKING Americans.

JustHanging said:

Refuses to work comes with sooooo much baggage. As does "same food and lodging".

You mean they refuse to take a job that is likely to kill them before they hit 60? Or refuse a job that they aren't capable of physically, or mentally, of doing?

Does "same" mean clean safe functional? Or does it mean everyone gets a mansion?

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Lots of people refuse to take jobs that they think are beneath them to do. Every hear the excuse for illegal aliens that they take jobs American won't do? Yes there are people that would rather sit at home than take a job they don't want to do. Do you think they should be eating ribeye and living in 3 bedroom 2 bath 2 car garage hones?

Greenbeard said:

That's a re-allocation of health spending, not actual savings. Which might be a great idea. But it still means we'll be spending what we're spending.

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We would be re-allocating billions if not trillions of dollars to actual health care. Hospitals would get paid for all services not having to over charge to compensate for all the people who currently do not pay. Everyone wins except the insurance people. No more getting rich using our money to pay our health care while taking trillions for themselves.

SLC said:

Lots of people refuse to take jobs that they think are beneath them to do. Every hear the excuse for illegal aliens that they take jobs American won't do? Yes there are people that would rather sit at home than take a job they don't want to do. Do you think they should be eating ribeye and living in 3 bedroom 2 bath 2 car garage hones?

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They can only do this if we pay them to do it.

distraff said:

Other developed nations don't pay their doctors nearly as much, and still have more doctors than we do, but I don't think people are going to revolt because a few doctors got a pay cut. A lot of our healthcare costs go to corporate profits, administrative costs, executive salaries, R&D, red tape, actuaries, middlemen, technology, and facilities. Only a tiny fraction of healthcare costs goes to the direct cost of middle class healthcare labor (including nurses, CNAs, and family practice doctors, and excluding specialized doctors). Cutting healthcare costs will hurt some people, mostly wealthy people, and help tens of millions of middle class and lower class people better afford healthcare.

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The cost of med school and malpractice insurance completely justifies what doctors are paid. If you plan to pay doctors less than we need to do away with medical malpractice lawsuits and drastically slash the cost of med school. Otherwise we’ll have a severe doctor shortage very quickly.



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SLC said:

So do you think a person that refuses to work should have the same food and same lodging as a person that works hard and is otherwise successful?

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Refuses?

Work?

Same food and lodging?

Works hard?

Is otherwise successful?

Feel free to clarify what any of that means.

But if you're arguing that food and lodging/shelter aren't a basic human right, we have nothing to discuss.

JustHanging said:

Refuses to work comes with sooooo much baggage. As does "same food and lodging".

You mean they refuse to take a job that is likely to kill them before they hit 60? Or refuse a job that they aren't capable of physically, or mentally, of doing?

Does "same" mean clean safe functional? Or does it mean everyone gets a mansion?

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Thank you; kind of unreal some of the stuff that comes up here...

SLC said:

Lots of people refuse to take jobs that they think are beneath them to do. Every hear the excuse for illegal aliens that they take jobs American won't do? Yes there are people that would rather sit at home than take a job they don't want to do. Do you think they should be eating ribeye and living in 3 bedroom 2 bath 2 car garage hones?

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Monumentally irrelevant, weird and fantastic.

PIPEWRENCH said:

We would be re-allocating billions if not trillions of dollars to actual health care. Hospitals would get paid for all services not having to over charge to compensate for all the people who currently do not pay. Everyone wins except the insurance people. No more getting rich using our money to pay our health care while taking trillions for themselves.

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People receiving basic health care?

That's un-American!!!

Rogue Valley said:

We can't simply keep accepting ballooning doctor, hospital, procedure, and drug costs.

This trajectory has to change or someday in our lifetimes, routine healthcare will only be available to the wealthy.

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Indeed, it is time to bite the proverbial bullet and remedy what's wrong with out system.

The OP article seems to be an effort to extort by fear somehow.

3leftsdoo said:

Thank you; kind of unreal some of the stuff that comes up here...

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Yeah, it seems some always have an excuse to exclude people they don't like, which strangely enough often seems to center around the colour of their skin.

Reagan's "Young bucks and Welfare Queens" comment comes to mind. Or in current times, Trump gaining his political street cred with conservatives by being the leader of the racist Birther Movement, and spending almost a decade accusing a POTUS of being UnAmerican because of the colour of his skin.

ajn678 said:

Many hospitals are barely profitable.

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Braindead answer. PLENTY of hospital networks are non-profit. St Lukes by me is non-profit, as is their primary competitor. In order to maintain their exempt status they buy up all the small providers and empty lots and keep opening more and more emergency walk in clinics.

As is usual, this part of the problem is completely ignored.

I don't give a damn about the profits of conglomerates. Hospitals mploy benefits managers that overinflate and overcharge on purpose.

If these places are "barely profitable" it's because they're cooking their numbers and avoiding the reality of it.

Northern Light said:

The prices of providers are overinflated to begin with. They have been feasting at a banquet for far too long, propped up by insurance companies who in turn charge high premiums. As we see in our western neighbors, cost of care is not that high. Most hospitals could benefit from price reform in management and administration.

When government controls payout, providers have to start cutting costs, and so they should.

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In reality, what happens is that providers have to do more with less. That translates into poor patient care and less-than-optimal outcomes.
Progressives seem to believe that healthcare providers should not be compensated for their education, time and skills which quite literally, keep human beings alive.

JustHanging said:

Every other Western nation has managed it, and spends roughly 1/2 what America spends on healthcare per capita, usually with better outcomes.

Surely Trump can come up with a plan to fix th....oh. Right. Never mind.

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After the 2020 election Trump and the Republicans will be sharing with us their big beautiful healthcare plan. He said so. Be patient, my friend.

JustHanging said:

Every other Western nation has managed it, and spends roughly 1/2 what America spends on healthcare per capita, usually with better outcomes.

Surely Trump can come up with a plan to fix th....oh. Right. Never mind.

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Like I said, I have talked to literally hundreds, if not thousands around the world due to my pre-existing conditions and I wouldn't want to trade my employer based health insurance for anything in any other country. We need to focus on those who don't have insurance through their employers and not screw everyone else. Medicare for all only helps those 20% and screws the 80%. That's not a price I want to pay. Just help the 20% and leave everyone else alone.

PIPEWRENCH said:

No. The trillions of dollars spent to maintain the insurance companies would go towards healthcare. The billions paid to the CEO's so they can afford penthouses, private jets, multimillion dollar bonuses and such would now actually be available to pay for health care. The billions of dollars going to all the insurance workers would now go directly to health care. The burden taken away from the employer would allow more money to be paid in wages and taxes to fund health care. Trade offs. But clearly eliminating all the middle men would free up plenty of money to pay health care cost instead. Plus all the dickering over who is responsible for bills and who will pay is cleared up stream lining billing and payment which is half the staff of a lot of medical facilities. Oh and a Tylenol would go from $10. back to 10cents.




There would be no devastation. All the people in the insurance industry would move to health care where they would provide health care instead of just syphoning away money needed for heath care.

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As usual, the left are focused on what looks good and sounds good on paper and then in reality it doesn't work out anywhere near like they thought it would. Everything they touch backfires. Our system is entrenched in what we currently have. The roots are everywhere. You can't just wave a magic wand and poof, we've got single payer. And, you can't destroy one of the biggest industries we have, putting thousands and thousands of people out of work. It's not just CEO's working at these insurance companies.

Checkerboard Strangler said:

I remember our conversations where you claimed to "know all sorts of people in other countries, mumble mumble public health care is horrible mumble mumble etc" and I found out quickly that you had made all of that crap up.
Time to go dig up those conversations so others can witness you flailing around like a carp out of water.

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That's a lot of BS. I have at least two pre-existing chronic conditions and have I posted on health boards with countless people all over the world. I will admit that they all love their single payer healthcare but that is because of two things:

1. All they mostly hear of the US is liberal BS like the horror stories that make the news and think that only the rich get good care in the US and everyone else dies in the streets or goes bankrupt

2. It is basically free to them so they think free is better than paying

Fact is, with everything they describe that happens with them I wouldn't want with a ten foot pole. Even when I was poor I received far better care than what I hear them describe. Everything I wrote in my first post in this thread is true.

"Exactly. Medicare for all relies heavily on screwing providers. I have pre-existing conditions and have talked to many others in single payer countries. They wait excessively for appointments, wait excessively while at the appointment, see nurses instead of doctors, when having issues are told to go to the emergency room because there are no appointments for months, have to travel to metropolitan areas for providers because there aren't any in rural areas, and can't receive the latest expensive medicines. The only reason why they like their health care systems is because they are basically free so they have financial peace of mind. The cold hard fact is that millions in the US are better off with our current system of employer based health insurance than they would be if we went to medicare for all. What we need to concentrate on is the people who don't have employer based insurance, which is less than 20% of Americans.


None of this even takes into account the economic devastation from basically eliminating an entire industry."

distraff said:

As for uncharted territory, every other 32 developed nations has successfully implemented universal healthcare systems that are far cheaper than the US and most are very good. This territory is at charted as it can get and all we have to do is copy.

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Yes, but these systems are not merely cost-sharing schemes operating in the same for-profit environment we have now as MFA proposes. Emulating those other systems would require nationalization of healthcare providers, mountains of price regulations, and a very high tax rate among other things. Is it charted? That’s not really the right question. The question should be whether or not it’s scalable.

Greenbeard said:

Looks like this time around we're getting to the level of seriousness where trade-offs and winners-and-losers will get explored. Which is good! But it underscore the risks that primary candidates run in hitching their wagons to a very speculative idea without fully exploring those trade-offs.

Hospitals Stand to Lose Billions Under ‘Medicare for All’



The Stuart Altman quote is the crux of it:



This would be uncharted territory.

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Something that has been absent in the conversation of why healtcare costs are so high is that part of the reason is they use those fees to offset the losses they take providing subsidized services.

Imho if we want to lower costs something that needs to be looked at is lowering the investment people make in beoming a doctor. They have student loans to pay off just like everyone else but theres are much higher

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Groogrux said:

The cost of med school and malpractice insurance completely justifies what doctors are paid. If you plan to pay doctors less than we need to do away with medical malpractice lawsuits and drastically slash the cost of med school. Otherwise we’ll have a severe doctor shortage very quickly.



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France pays for medical school which means they get a lot more doctors and don't have to pay them nearly as much.

Napoleon said:

Yes, but these systems are not merely cost-sharing schemes operating in the same for-profit environment we have now as MFA proposes. Emulating those other systems would require nationalization of healthcare providers, mountains of price regulations, and a very high tax rate among other things. Is it charted? That’s not really the right question. The question should be whether or not it’s scalable.

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Most universal healthcare systems actually don't nationalize healthcare providers, and most still have a lot or even mostly private healthcare providers. Some of them do have price regulation on private companies like we have on utilities, but others simply have government-run healthcare like we do for government-run fire fighting services, or others have a government monopoly on the customer base and can use that to negotiate lower prices. In addition, other developed countries pay about the same or less for public universal healthcare than we do for our public Medicare and Medicaid so the end result doesn't require a big tax hike. Japan and Germany are both very big countries in terms of population and manage universal healthcare just fine. We can always have healthcare providing done on the state level to scale our system better.