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Even California Governor Jerry Brown Says

I'm supportive of price transparency, though it's limited by a number of factors: 1) the majority of health spending is on services that aren't shoppable, so this has no impact on them; 2) spending in any given year is concentrated on a relatively small segment of the population, and those folks will hit any reasonable out-of-pocket limit, again rendering this useless for them; and 3) the percentage of the population that doesn't have enough money saved to cover an unexpected $500-$1,000 expense is staggering--it's like two-thirds of the population or something. All of which make price shopping for health services more challenging.

1) the majority of health spending is on services that aren't shoppable
I'm curious how you've come to this conclusion. Please, inform me.
If you think of the larger expense procedures, such as surgery, those things are scheduled inside of a day, unless in an emergency life threatening situation. Aren't the follow up procedures and care, where even greater costs are, more so over the longer course of time?

2) spending in any given year is concentrated on a relatively small segment of the population, and those folks will hit any reasonable out-of-pocket limit, again rendering this useless for them
People stop shopping if they hit the out of pocket limit? Why would they? Because they think that someone else's paying for it? Even if they see the true costs involved?
Well, maybe they do, maybe they don't.

3) the percentage of the population that doesn't have enough money saved to cover an unexpected $500-$1,000 expense is staggering--it's like two-thirds of the population or something. All of which make price shopping for health services more challenging.
I suspect that this is unfortunately the case. But I also think that some of this lies at the feet of people who do make bad life decisions, and I don't think that society should be held, at the point of the government gun, responsible and liable for those bad decisions. Its part and parcel, and the cost of, having the freedom to make those decisions. It comes with responsibility.

And it's logistically difficult to implement under the current system. As you pointed out, prices are the results of contract negotiations between insurers and providers. Which means there is no set price for a service, it will depend on who your insurer is and what price they've negotiated. And that's usually considered proprietary information anyway.

If any sort of pricing competition is going to enter into this marketplace, if the true excessive padded cost are going to be bent downward, open pricing information is going to have to be part of it. Perhaps legislation that prohibits this information for being proprietary? Forcing these pricing deals out into the sunlight to disinfect it?

Expanding public coverage is already a major component of the ACA. That's what the Medicaid expansion is.

There was a proposal back in 2009 (and resurrected in the campaign last year by Hillary Clinton) to also allow older adults under age 65 to buy into Medicare but that was defeated.

Whether you force the public costs of caring for those that can't care for themselves out into the sunlight, or you continue on hiding them in the shadows, isn't the reality that these costs are going to be paid by the greater public one way or another? My vote is to make those costs and that pricing public, out in the open, and in the bright sunlight.
 
1) the majority of health spending is on services that aren't shoppable
I'm curious how you've come to this conclusion.

Spending on Shoppable Services in Health Care.

People stop shopping if they hit the out of pocket limit? Why would they? Because they think that someone else's paying for it? Even if they see the true costs involved?

Price transparency without price exposure is meaningless. If your plan has a zero deductible or if you've already hit your out-of-pocket limit, the relative prices of different providers is irrelevant to you. In fact, since people tend to associate quality with cost in health care (without much justification), it may even backfire. If your personal payment doesn't differ, why wouldn't you get the $6,000 service at a renowned academic medical center instead of getting the same service for $2,000 down the street at some lower cost outpatient chain?

I suspect that this is unfortunately the case. But I also think that some of this lies at the feet of people who do make bad life decisions, and I don't think that society should be held, at the point of the government gun, responsible and liable for those bad decisions.

I'm not speculating on why this is the case, I'm just saying it's difficult to see how introducing widespread shopping for relatively expensive services in a high-cost sector when nobody has any money is going to work.

If any sort of pricing competition is going to enter into this marketplace, if the true excessive padded cost are going to be bent downward, open pricing information is going to have to be part of it. Perhaps legislation that prohibits this information for being proprietary? Forcing these pricing deals out into the sunlight to disinfect it?.

That may be the answer. But there are alternatives that may be more realistic given the constraints I mentioned above. Insurers could design products that induce the same sort of decision-making on the part of consumers as direct price exposure--except scaled to a more realistic out-of-pocket cost for the consumer than direct exposure to provider prices. It should cost you less out-of-pocket to go to a more efficient, lower-cost provider with whom your insurer has negotiated reasonable prices; you can even blend relative quality performance into the equation.

That's where I see the future value of insurers being--not in stepping back but in stepping up. On the consumer side they need to produce insurance products that price the relative value offered by providers so that consumer decision-making when people are getting care can begin to approximate something like a market (but perhaps actually better than a traditional market since realistically people don't know what they're doing when they shop for health care--cost-sharing incentives that bake in not only the relative prices of providers but an assessment of their relative clinical performance could actually be more valuable to the consumer than a straight list of prices ever could, and all without asking them to pay unrealistic amounts when they go to a provider).

And on the other side of it, those insurers need to be aggressively negotiating with providers on price, designing and offering high-value networks that can save consumers money by cutting out unnecessarily expensive providers whose services can be gotten elsewhere, and revamping the ways the insurers pay for care to encourage providers to become more cost effective. The fruits of these efforts are all bundled upfront for the consumer in the premium of the product the insurer sells. Do a better job keeping down costs with those strategies and you can offer the most competitively priced insurance products.

Of course, to prod insurers to do all of that on the consumer and the provider side and do it well, you need a competitive insurance market where insurers are competing aggressively on premium for price-conscious customers. In other words, you need exchanges. And you need to get a lot more people shopping through them.

That's been my great hope anyway; and I suppose I still hold on some optimism for it. I said before that you can't bend the cost curve just by focusing on 10-15 million people in exchanges. True, but if you had 100-150 million shopping directly for their insurance in exchanges, I think that would be a game-changer for health care markets of all sorts.

But the very concept of exchanges has been under assault for a while now, and neither side of the political spectrum seems to have any great fondness for them or markets in general. So we'll probably just end up with some sort of Americanized version of single-payer.
 
What are you for?

I am for providing coverage to the poor and making healthcare affordable to everyone else, but not primarily by subsidies or tax credits. We need to actually make healthcare less expensive, but not by stiffing the providers or billing the taxpayers. We need to get at the root causes of why healthcare is so expensive, such as the cost of health care professional's educations and the high cost of buildings and machines such as MRI's, etc. One thing that is ridiculous are networks and formularies so we need to completely get rid of all of these. Everything is covered to some extent, depending on the policy. Nobody should be forced to buy insurance they don't want but if we make it affordable then more people would be apt to buy it. I'm not in favor of single payer because all countries' single payer systems suck but I wouldn't be opposed to catastrophic insurance coverage which wouldn't really be health insurance per say but would pay off any health claims larger than a certain amount, which could be indexed to a family's income levels. The catastrophic insurance would be fairly cheap because it wouldn't really be used that much.
 
I am for providing coverage to the poor and making healthcare affordable to everyone else, but not primarily by subsidies or tax credits. We need to actually make healthcare less expensive, but not by stiffing the providers or billing the taxpayers. We need to get at the root causes of why healthcare is so expensive, such as the cost of health care professional's educations and the high cost of buildings and machines such as MRI's, etc. One thing that is ridiculous are networks and formularies so we need to completely get rid of all of these. Everything is covered to some extent, depending on the policy. Nobody should be forced to buy insurance they don't want but if we make it affordable then more people would be apt to buy it. I'm not in favor of single payer because all countries' single payer systems suck but I wouldn't be opposed to catastrophic insurance coverage which wouldn't really be health insurance per say but would pay off any health claims larger than a certain amount, which could be indexed to a family's income levels. The catastrophic insurance would be fairly cheap because it wouldn't really be used that much.


Thanks for the answer.

You are for more affordable healthcare but “not primarily by subsidies or tax credits”, meaning you do favor some subsidy and tax credit? I can tell you right now the high expense leaders are pharmaceuticals and medical equipment. Or, you could just go to Europe and find out why their costs are so much lower than ours.
 
Thanks for the answer.

You are for more affordable healthcare but “not primarily by subsidies or tax credits”, meaning you do favor some subsidy and tax credit? I can tell you right now the high expense leaders are pharmaceuticals and medical equipment. Or, you could just go to Europe and find out why their costs are so much lower than ours.

I should actually say that I am completely against subsidies. That whole system is stupid paying taxpayer money directly to health insurance companies and then tying that to tax returns where, if you got too much of a "subsidy", then you have to pay money back to the IRS. I am for limited tax credits, even refundable tax credits and I would be in favor of this in high enough amounts to eliminate HSA and all other types of accounts that give you a tax break for health dollars spent. I am for getting to the root causes of healthcare expenses instead of stiffing providers and insurers as a means to cut healthcare costs. We do need to look at the nuts and bolts of these root expenses and find ways to keep them low so that these savings can be passed on. I'm in favor of learning what we can from other countries in order to attack these root causes but healthcare in general in countries with UHC cuts many things that are unacceptable, such as having less doctors and more nurses, just to mention one. I have talked with many others around the world who have UHC and it comes at the price of unacceptable sacrifices which are not myths as the left would lead you to believe. It's also stupid for us to put taxpayers on the hook for letting healthcare costs rise exponentially and just billing it to the taxpayers.
 
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I should actually say that I am completely against subsidies. That whole system is stupid paying taxpayer money directly to health insurance companies and then tying that to tax returns where, if you got too much of a "subsidy", then you have to pay money back to the IRS. I am for limited tax credits, even refundable tax credits and I would be in favor of this in high enough amounts to eliminate HSA and all other types of accounts that give you a tax break for health dollars spent. I am for getting to the root causes of healthcare expenses instead of stiffing providers and insurers as a means to cut healthcare costs. We do need to look at the nuts and bolts of these root expenses and find ways to keep them low so that these savings can be passed on. I'm in favor of learning what we can from other countries in order to attack these root causes but healthcare in general in countries with UHC cuts many things that are unacceptable, such as having less doctors and more nurses, just to mention one. I have talked with many others around the world who have UHC and it comes at the price of unacceptable sacrifices which are not myths as the left would lead you to believe. It's also stupid for us to put taxpayers on the hook for letting healthcare costs rise exponentially and just billing it to the taxpayers.

HSA = snake oil.

I understand what you’re against and in favor of. What’s your argument against the inevitability of a single-payer/Medicare system? Not what you think is better, but the inevitability of what the system will be. What do you believe it will be
 
HSA = snake oil.

I understand what you’re against and in favor of. What’s your argument against the inevitability of a single-payer/Medicare system? Not what you think is better, but the inevitability of what the system will be. What do you believe it will be

Personally, I think it is hopeless for the foreseeable future. I don't know about 50 years down the road. I think a lot of lefties and single payer advocates do a lot of blinded wishful thinking. We can't wipe out an entire huge industry (health insurance) as it is a very huge part of our economy in many ways. It has tentacles webbed throughout the economy and like terminal cancer, can't just be removed without killing the patient. It's much deeper than just an insurance lobby. Hell, when Democrats had full control they didn't even shoot for single payer. It's nothing but a blind partisan dream to believe or hope that Obamacare failure is equal to single payer being inevitable. The left is naive to believe that voters matter. If Bernie would have won over Trump he would not have gotten single payer even if he were president for eight years. The left is delusional about their power, just as the right was delusional about their power after this last election.
 
Spending on Shoppable Services in Health Care.



Price transparency without price exposure is meaningless. If your plan has a zero deductible or if you've already hit your out-of-pocket limit, the relative prices of different providers is irrelevant to you. In fact, since people tend to associate quality with cost in health care (without much justification), it may even backfire. If your personal payment doesn't differ, why wouldn't you get the $6,000 service at a renowned academic medical center instead of getting the same service for $2,000 down the street at some lower cost outpatient chain?



I'm not speculating on why this is the case, I'm just saying it's difficult to see how introducing widespread shopping for relatively expensive services in a high-cost sector when nobody has any money is going to work.



That may be the answer. But there are alternatives that may be more realistic given the constraints I mentioned above. Insurers could design products that induce the same sort of decision-making on the part of consumers as direct price exposure--except scaled to a more realistic out-of-pocket cost for the consumer than direct exposure to provider prices. It should cost you less out-of-pocket to go to a more efficient, lower-cost provider with whom your insurer has negotiated reasonable prices; you can even blend relative quality performance into the equation.

That's where I see the future value of insurers being--not in stepping back but in stepping up. On the consumer side they need to produce insurance products that price the relative value offered by providers so that consumer decision-making when people are getting care can begin to approximate something like a market (but perhaps actually better than a traditional market since realistically people don't know what they're doing when they shop for health care--cost-sharing incentives that bake in not only the relative prices of providers but an assessment of their relative clinical performance could actually be more valuable to the consumer than a straight list of prices ever could, and all without asking them to pay unrealistic amounts when they go to a provider).

And on the other side of it, those insurers need to be aggressively negotiating with providers on price, designing and offering high-value networks that can save consumers money by cutting out unnecessarily expensive providers whose services can be gotten elsewhere, and revamping the ways the insurers pay for care to encourage providers to become more cost effective. The fruits of these efforts are all bundled upfront for the consumer in the premium of the product the insurer sells. Do a better job keeping down costs with those strategies and you can offer the most competitively priced insurance products.

Of course, to prod insurers to do all of that on the consumer and the provider side and do it well, you need a competitive insurance market where insurers are competing aggressively on premium for price-conscious customers. In other words, you need exchanges. And you need to get a lot more people shopping through them.

That's been my great hope anyway; and I suppose I still hold on some optimism for it. I said before that you can't bend the cost curve just by focusing on 10-15 million people in exchanges. True, but if you had 100-150 million shopping directly for their insurance in exchanges, I think that would be a game-changer for health care markets of all sorts.

But the very concept of exchanges has been under assault for a while now, and neither side of the political spectrum seems to have any great fondness for them or markets in general. So we'll probably just end up with some sort of Americanized version of single-payer.

I appreciate your well thought out and thorough post. I've been saving it for the weekend, so I can give it the time it deserves.
 
Personally, I think it is hopeless for the foreseeable future. I don't know about 50 years down the road. I think a lot of lefties and single payer advocates do a lot of blinded wishful thinking. We can't wipe out an entire huge industry (health insurance) as it is a very huge part of our economy in many ways. It has tentacles webbed throughout the economy and like terminal cancer, can't just be removed without killing the patient. It's much deeper than just an insurance lobby. Hell, when Democrats had full control they didn't even shoot for single payer. It's nothing but a blind partisan dream to believe or hope that Obamacare failure is equal to single payer being inevitable. The left is naive to believe that voters matter. If Bernie would have won over Trump he would not have gotten single payer even if he were president for eight years. The left is delusional about their power, just as the right was delusional about their power after this last election.


I don’t believe that “…Obamacare failure is equal to single payer being inevitable.” I do believe the ACA can be made to work better and doing so will take it closer to single-payer because it is already constructed with additional subsidy options that go in that direction. And, that option of increased government subsidy is at the top of the insurance industry wish list as needed to keep more companies in the game. To say it’s delusional thinking failis to recognize the writing on the wall, in the ACA as designed, and from the lips of the health insurance industry.
 
I don’t believe that “…Obamacare failure is equal to single payer being inevitable.” I do believe the ACA can be made to work better and doing so will take it closer to single-payer because it is already constructed with additional subsidy options that go in that direction. And, that option of increased government subsidy is at the top of the insurance industry wish list as needed to keep more companies in the game. To say it’s delusional thinking failis to recognize the writing on the wall, in the ACA as designed, and from the lips of the health insurance industry.

And that's the biggest fail with Obamacare. It does zero to control health care costs. It just relies on putting taxpayers on the hook for the always increasing runaway costs of healthcare while the middle class, who don't get much or any subsidies, get royally screwed with the out of control costs and insurance companies get richer and richer. Liberal solution: increase subsidies to cover more people. The left only wants to "fix" the unworking parts of Obamacare with more liberal ideas. Schumer, Pelosi, and others on the left have already signaled that they are willing to work with the right to fix Obamacare, as long as Obamacare is not repealed and as long as it is fixed with liberal solutions. Why don't the two sides meet in the middle, come up with an entirely new plan that is totally bipartisan, and then repeal and replace Obamacare with that? With both parties working together and leaving the Freedom Caucus out, it could pass but that solution is completely off the table to the left because it is either their way or the highway.
 
And that's the biggest fail with Obamacare. It does zero to control health care costs. It just relies on putting taxpayers on the hook for the always increasing runaway costs of healthcare while the middle class, who don't get much or any subsidies, get royally screwed with the out of control costs and insurance companies get richer and richer. Liberal solution: increase subsidies to cover more people. The left only wants to "fix" the unworking parts of Obamacare with more liberal ideas. Schumer, Pelosi, and others on the left have already signaled that they are willing to work with the right to fix Obamacare, as long as Obamacare is not repealed and as long as it is fixed with liberal solutions. Why don't the two sides meet in the middle, come up with an entirely new plan that is totally bipartisan, and then repeal and replace Obamacare with that? With both parties working together and leaving the Freedom Caucus out, it could pass but that solution is completely off the table to the left because it is either their way or the highway.


The top two drivers of healthcare cost are administrative and drugs. Administrative due to all the clerical work needed to deal with the many insurers different forms and requirements, especially billing. Drugs are a huge expense, as I think we all know, and the drug makers got a sweetheart deal from Congress when Medicare Part D was not put under government competitive pricing rules, disallowing government from negotiating prices with drug makers. A single-payer system would make most of the staffing for administering healthcare unnecessary and put negotiated drug pricing into place. And, the cost would be shared by every tax-payer, thus a larger base (which insurance is all about, the law of large numbers) and with possibly progressive premiums based on income levels.
 
The top two drivers of healthcare cost are administrative and drugs. Administrative due to all the clerical work needed to deal with the many insurers different forms and requirements, especially billing. Drugs are a huge expense, as I think we all know, and the drug makers got a sweetheart deal from Congress when Medicare Part D was not put under government competitive pricing rules, disallowing government from negotiating prices with drug makers. A single-payer system would make most of the staffing for administering healthcare unnecessary and put negotiated drug pricing into place. And, the cost would be shared by every tax-payer, thus a larger base (which insurance is all about, the law of large numbers) and with possibly progressive premiums based on income levels.

I have occasional dealings with the medical field and there is no more red tape and administration than Medicare and Medicaid where government bureaucracy is at it's finest. There are more and more doctors who refuse to even take these patients anymore. You're talking about swapping health insurer's red tape for government red tape. It's a pretty much even swap but if it does lean one way, there is more red tape and administration going through the government.
 
Have you or he heard of Europe?

Thanks for editing my post. Did you happen to read the rest of it or were you too busy editing it? Even though I often disagree with you I don't remember you being this dishonest before.
 
I have occasional dealings with the medical field and there is no more red tape and administration than Medicare and Medicaid where government bureaucracy is at it's finest. There are more and more doctors who refuse to even take these patients anymore. You're talking about swapping health insurer's red tape for government red tape. It's a pretty much even swap but if it does lean one way, there is more red tape and administration going through the government.


If you think that administering a multitude of companies and their paperwork would be no less than a government single-payer system, you’re making stuff up. Your “occasional dealings with the medical field” does not make for much of an expert testimonial. Here are four more reasons along with the two I already gave:

6 Reasons Healthcare Is So Expensive in the U.S. | Investopedia
 
If you think that administering a multitude of companies and their paperwork would be no less than a government single-payer system, you’re making stuff up. Your “occasional dealings with the medical field” does not make for much of an expert testimonial. Here are four more reasons along with the two I already gave:

6 Reasons Healthcare Is So Expensive in the U.S. | Investopedia

Wish I had time to tear that apart but I don't. But, I'll try to address them in a quickie.

2. The US is pretty much the one who does research and development on new drugs. That's probably the main reason why they cost more here. For the most part, other countries use the US to make new drugs and then when they become generic, other countries make them cheap. The other countries don't provide new drugs to their citizens anywhere near the time frame that we do. We are the ones who have access to cutting edge treatments.

3. We do a lot of defensive medicine in the US because we live in a sue happy country and don't have tort reform. If we did, doctors wouldn't have to do so much defensive medicine.

4. This is one thing I don't like about other countries in not having many specialists. I have more than one pre-existing condition and have talked to people all over the world thousands of times and I am appalled at how health conditions requiring specialists in the US are handled over there. There are very long waits to schedule an appointment, something which allows your condition to get much worse before you finally see a specialist many months down the road. The regular doctors really don't know how to treat these diseases. Many specialists are so scattered around that they require long distances to travel to many times. The specialists usually only see you once and then after that a nurse handles your case from then on. A nurse! Not even a doctor! And if you have an emergency and can't wait months to see your specialist, you are told to go to the ER, where doctors really aren't versed in treating your condition because they are geared more to emergency medicine.
 
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Wish I had time to tear that apart but I don't. But, I'll try to address them in a quickie.

2. The US is pretty much the one who does research and development on new drugs. That's probably the main reason why they cost more here. For the most part, other countries use the US to make new drugs and then when they become generic, other countries make them cheap. The other countries don't provide new drugs to their citizens anywhere near the time frame that we do. We are the ones who have access to cutting edge treatments.

3. We do a lot of defensive medicine in the US because we live in a sue happy country and don't have tort reform. If we did, doctors wouldn't have to do so much defensive medicine.

4. This is one thing I don't like about other countries in not having many specialists. I have more than one pre-existing condition and have talked to people all over the world thousands of times and I am appalled at how health conditions requiring specialists in the US are handled over there. There are very long waits to schedule an appointment, something which allows your condition to get much worse before you finally see a specialist many months down the road. The regular doctors really don't know how to treat these diseases. Many specialists are so scattered around that they require long distances to travel to many times. The specialists usually only see you once and then after that a nurse handles your case from then on. A nurse! Not even a doctor! And if you have an emergency and can't wait months to see your specialist, you are told to go to the ER, where doctors really aren't versed in treating your condition because they are geared more to emergency medicine.


You certainly didn’t have the time to “tear that apart”, because you didn’t. I already “tore apart” your administrative argument, so allow me to keep going:

2. What do you mean by “pretty much”? Like the 118 new drugs created by US companies vs. the 98 new drugs by Euro countries 1998 – 2007? Over half on new drugs in the US come out of publicly funded universities and small bio-techs, not the large drug companies. Marketing’s budget is 19x that of R&D. And, as I already said, Big Pharma does not competitively bid on Medicare Part D, so when Part D came out, Big Pharma profits jumped 35% and they’ve been chuggin’ along ever since.

3. Defensive medicine practices make up 2.4% of total healthcare cost.

4. “There are very long waits to schedule an appointment,”. Of the eleven OECD countries, the US ranked second to last in wait times. Canada was last. In Boston, which has the most physicians and specialists in the US, the wait times are the worst. The EU has 3.4 physicians per 1,000. The US has 2.5. The US has 64.5 surgical specialists per 100,000 while Europe and Central Asia has 76.8. There is no comparison of specialists being “scattered around” in Europe compared to the rural areas of the US. Another reason for higher cost in US healthcare is that more nurses and physician assistants can do much of the care where a doctor is not needed.

Maybe if you spent more time, you would’ve found the info I just gave you and have been better informed.
 
You certainly didn’t have the time to “tear that apart”, because you didn’t. I already “tore apart” your administrative argument, so allow me to keep going:

2. What do you mean by “pretty much”? Like the 118 new drugs created by US companies vs. the 98 new drugs by Euro countries 1998 – 2007? Over half on new drugs in the US come out of publicly funded universities and small bio-techs, not the large drug companies. Marketing’s budget is 19x that of R&D. And, as I already said, Big Pharma does not competitively bid on Medicare Part D, so when Part D came out, Big Pharma profits jumped 35% and they’ve been chuggin’ along ever since.

3. Defensive medicine practices make up 2.4% of total healthcare cost.

4. “There are very long waits to schedule an appointment,”. Of the eleven OECD countries, the US ranked second to last in wait times. Canada was last. In Boston, which has the most physicians and specialists in the US, the wait times are the worst. The EU has 3.4 physicians per 1,000. The US has 2.5. The US has 64.5 surgical specialists per 100,000 while Europe and Central Asia has 76.8. There is no comparison of specialists being “scattered around” in Europe compared to the rural areas of the US. Another reason for higher cost in US healthcare is that more nurses and physician assistants can do much of the care where a doctor is not needed.

Maybe if you spent more time, you would’ve found the info I just gave you and have been better informed.

You can't really compare generalized and averaged stats on US figures compared to countries with nationalized health insurance. Even the left admits that our averaged figures are comparable to other countries, with basically the only thing of much difference is the cost. This proves that there are many in the US who have both much better healthcare outcomes and longer life expectantcies than do countries with nationalized health insurance but our averages are weighed down by those in the US who don't.
 
At the same time the taxes go up to pay for it, the costs will also go up (government budget and money management being what they are), quality will spiral down, in typical government performance. Just have to look at the VA, welcome to your government rum single payer healthcare.

Fix the VA, have it run well for 10 years, establish that track record, then maybe. Other than that, leave my healthcare the **** alone.

Sent from my HTC6515LVW using Tapatalk

The VA in the US is roughly equivalent to that of the entire Canadian health Care system, not surprisingly both are run inefficiently, ineffectively, and third world.

Enough said,

Tim-
 
The VA in the US is roughly equivalent to that of the entire Canadian health Care system, not surprisingly both are run inefficiently, ineffectively, and third world.

Enough said,

Tim-

I wonder why, from the left's standpoint, that they don't want to get rid of the VA altogether and just put all veterans on Medicare or Medicaid, since the left believes them to be such a great example of a single payer system?
 
You can't really compare generalized and averaged stats on US figures compared to countries with nationalized health insurance. Even the left admits that our averaged figures are comparable to other countries, with basically the only thing of much difference is the cost. This proves that there are many in the US who have both much better healthcare outcomes and longer life expectantcies than do countries with nationalized health insurance but our averages are weighed down by those in the US who don't.


I can compare “…and longer life expectantcies than do countries with nationalized health insurance..”
You believe being 31st is better than countries with nationalized health insurance? I won’t even bother to name them but then to give you the following reference:

https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

You are becoming a boor. I’m doing all the work and you are throwing spaghetti onto the wall.
 
I can compare “…and longer life expectantcies than do countries with nationalized health insurance..”
You believe being 31st is better than countries with nationalized health insurance? I won’t even bother to name them but then to give you the following reference:

https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

You are becoming a boor. I’m doing all the work and you are throwing spaghetti onto the wall.

We were having a good conversation at one point but it has degenerated into both of us staking out our sides. There's no point to rehashing the same old **** over and over. I'm smart enough to retain the same old stuff you and others have posted numerous times. Posting the same stuff over and over again doesn't do anything to change my mind unless you actually have something new to offer.
 
We were having a good conversation at one point but it has degenerated into both of us staking out our sides. There's no point to rehashing the same old **** over and over. I'm smart enough to retain the same old stuff you and others have posted numerous times. Posting the same stuff over and over again doesn't do anything to change my mind unless you actually have something new to offer.


That you refuse to acknowledge facts by generalizing them as what equates to the same "stuff" as what of yours is plainly refuted is your backdoor out of debate. Pick something or two that is specific and let's see whom of us has the facts to support what we are saying. But to runaway while claiming over your shoulder an equal sided debate is a ruse on your part.
 
That you refuse to acknowledge facts by generalizing them as what equates to the same "stuff" as what of yours is plainly refuted is your backdoor out of debate. Pick something or two that is specific and let's see whom of us has the facts to support what we are saying. But to runaway while claiming over your shoulder an equal sided debate is a ruse on your part.

Both sides can cherry pick facts. I don't play that game. This stuff has been debated endlessly over and over. The same exact stuff. Your side likes to compare apples to oranges and then call them facts and that you have proven your case. I'm not going to change your mind and you aren't going to change my mind, no matter how many apple facts you want to produce. I'm talking about oranges.
 
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