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Medicare-for-All Isn’t the Solution for Universal Health Care?

ludin said:
they take it and you can't have it. pretty simple if you ask me. you can demand a 2 dollar burger but if my price is 5 bucks
you are not getting a burger even if you promise to pay me next tuesday.
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Yet it works quite well in Canada and other countries
 
ludin said:
yet i can get surgery when i need to and see a specialist when i need to. in canada the average wait time to see a specialist is a a 6 months to a year?
the healthcare tax in canada is 20% + whatever income taxes?

sorry i can't support my family with 40+% of my check going to the government.

I had to get an MRI it took me a week to get the MRI. It is over a year wait unless you go to a private facility to get an MRI in Canada.

on top of those massive tax you still need private insurance to cover things your government plan doesn't.

Do Canadians Still Need Health Insurance? - Canada Protection Plan

what a joke. Massive taxes and you still need private insurance.
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sorry...but you're grossly overstating wait times in Canada.
 
ludin said:
yet i can get surgery when i need to and see a specialist when i need to. in canada the average wait time to see a specialist is a a 6 months to a year?
the healthcare tax in canada is 20% + whatever income taxes?

sorry i can't support my family with 40+% of my check going to the government.

I had to get an MRI it took me a week to get the MRI. It is over a year wait unless you go to a private facility to get an MRI in Canada.

on top of those massive tax you still need private insurance to cover things your government plan doesn't.

Do Canadians Still Need Health Insurance? - Canada Protection Plan

what a joke. Massive taxes and you still need private insurance.
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Here is an income tax calculator, calculate how much you would actually pay, you would have to be in the top 10% to pay the 40% income tax bracket. In order to pay an effective rate of 40% I would have to make $170,000/year. Wait times are a problem but pretending there are none in the US is ludicrous and yet is still more cost effective. Most Canadians get the supplemental coverage through work but it is rather cheap (I pay $25/month) otherwise and in Quebec things like drugs are also covered by the province. Look at it this way I wouldn't have to go into debt or pay a much more expensive health plan if I needed an MRI or chemotherapy for example and that is where the crux is, overall it is cheaper and no one is drowning in healthcare costs. Also the Canadian model is only one of many systems.
 
D_NATURED said:
What's really stupid is thinking that a universal human need is best left to operate for the benefit of private greed engines. Every time I hear someone say the government is inept, when they've provided effective coverage for the elderly and disabled for DECADES at a lower cost than the healthy pay to the private healthcare pimps, I see a really stupid agenda below the surface that cares more about conservative talking points than an accurate accounting of the facts.
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who do you think runs medicare? it isn't the government it is private insurance companies and all the government does is pay the premium.
however even with that most medicare subscribers pay 250 extra a month for supplemental coverage. i pay less than that now to cover my entire family.

if you were actually interested in facts then you would deal with fact or at least address them.

you the argument you have is that ol it's cheaper. cheaper is no always better.

I like seeing a specialist when i want to and not waiting a year because someone deemed my condition wasn't good enough.
it takes me like a day or two to see my GP if i need to see him.

it is only lower because the doctors there work for the government basically. the doctors here don't work for the government and you can't force them to accept government
healthcare.

the fact is that if you were honest then you would discuss cost.
Germany england and france i would be paying about 30-40% of my check.


I don't come close to paying that here even with my current insurance.
nor do i need additional insurance to cover what they don't.
 
ludin said:
who do you think runs medicare? it isn't the government it is private insurance companies and all the government does is pay the premium.
however even with that most medicare subscribers pay 250 extra a month for supplemental coverage. i pay less than that now to cover my entire family.

if you were actually interested in facts then you would deal with fact or at least address them.

you the argument you have is that ol it's cheaper. cheaper is no always better.

I like seeing a specialist when i want to and not waiting a year because someone deemed my condition wasn't good enough.
it takes me like a day or two to see my GP if i need to see him.

it is only lower because the doctors there work for the government basically. the doctors here don't work for the government and you can't force them to accept government
healthcare.

the fact is that if you were honest then you would discuss cost.
Germany england and france i would be paying about 30-40% of my check.


I don't come close to paying that here even with my current insurance.
nor do i need additional insurance to cover what they don't.
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In canada doctors generally do not work for the government
 
Carjosse said:
Here is an income tax calculator, calculate how much you would actually pay, you would have to be in the top 10% to pay the 40% income tax bracket. In order to pay an effective rate of 40% I would have to make $170,000/year. Wait times are a problem but pretending there are none in the US is ludicrous and yet is still more cost effective. Most Canadians get the supplemental coverage through work but it is rather cheap (I pay $25/month) otherwise and in Quebec things like drugs are also covered by the province. Look at it this way I wouldn't have to go into debt or pay a much more expensive health plan if I needed an MRI or chemotherapy for example and that is where the crux is, overall it is cheaper and no one is drowning in healthcare costs. Also the Canadian model is only one of many systems.
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I paid 30 dollar co pay for my MRI and owed nothing. it took me a week to get it.
I never said their wasn't wait times in the US but they are far from as bad as canada.

i just ran it against the US median income which is 55k. after converting it to canadian dollars.

the tax rate is about 25% average 30% marginal.

i don't come close to paying that.

Federal tax$ 9,284
Provincial tax$ 4,738
CPP/EI premiums $ 3,400
Total tax$ 17,423
 
ttwtt78640 said:
You can mandate a $2 hamburger or oil change but can you mandate that someone (in private industry) will make or serve one? That is the issue. Perhaps the starting point must be a maximum wage (in all fields?) - otherwise who is going to invest the time and effort to become a medical doctor when that pays less than another position (profession?) requiring the same or even less eduction?
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actually, doctors wages aren't the problem in hospital pricing. In fact I think they deserve more than they get on average. Administrators could use a pay cut though. The real problem is a price fixing system they call the Chargemaster. We don't have to mandate prices, we just have to remove their ability to price fix. No one wants to cripple hospitals financially, we do need them, we just need them to base their prices on the actual cost of care. Capping a doctors salary, wouldn't affect any price. Because the prices aren't based on cost. You could triple every doctors salary in any given hospital, wouldn't affect the price. The hospital could more than afford it, despite the public image of a struggling non profit that most hospitals try for. They rake in more than oil.

I wouldn't recommend integrating single payer, til the price fixing problem is resolved. Last thing the government needs atm is to be put on the hook for chargemaster prices for the whole country. Even then, going to single payer raises a whole slew of other problems. Insurance Companies turn a profit off interest generated from collected premiums. They build a pool of people, say for example 80 healthy people and 20 sick people. While they are paying out for the sick people, they are adding the premiums of the healthy people to their general investment portfolio. Which for a company like United Healthcare is worth a few billion. They then invest that money in things like energy, municipalities, and bonds. A great many local economies are funded through insurance investments. Killing the insurance industry could send us into a full blown depression. That is a real risk, its why Obama backed off the public option.
 
ThoughtEx. said:
actually, doctors wages aren't the problem in hospital pricing. In fact I think they deserve more than they get on average. Administrators could use a pay cut though. The real problem is a price fixing system they call the Chargemaster. We don't have to mandate prices, we just have to remove their ability to price fix. No one wants to cripple hospitals financially, we do need them, we just need them to base their prices on the actual cost of care. Capping a doctors salary, wouldn't affect any price. Because the prices aren't based on cost. You could triple every doctors salary in any given hospital, wouldn't affect the price. The hospital could more than afford it, despite the public image of a struggling non profit that most hospitals try for. They rake in more than oil.

I wouldn't recommend integrating single payer, til the price fixing problem is resolved. Last thing the government needs atm is to be put on the hook for chargemaster prices for the whole country. Even then, going to single payer raises a whole slew of other problems. Insurance Companies turn a profit off interest generated from collected premiums. They build a pool of people, say for example 80 healthy people and 20 sick people. While they are paying out for the sick people, they are adding the premiums of the healthy people to their general investment portfolio. Which for a company like United Healthcare is worth a few billion. They then invest that money in things like energy, municipalities, and bonds. A great many local economies are funded through insurance investments. Killing the insurance industry could send us into a full blown depression. That is a real risk, its why Obama backed off the public option.
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Canada did it. They figured it out. We can too
 
vegas giants said:
Canada did it. They figured it out. We can too
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Canada has thirty million people, we have 300 million. And when they did it, insurance companies were not one of the pillars that held up their economy. And their economy isn't the backbone of the world's economy. While they have a great system that works for them, I highly doubt it would work for us. And even if we could somehow get Insurance companies untangled from our markets, should we? We are capitalists, and the reason the current system isn't working is because hospitals aren't competing. The reason insurance is so high, is because hospital prices are high, because hospitals aren't competing. Lets try replacing the filters before buying a new car, is all I'm saying. Especially if its going to be one of those socialist foreign cars.
 
ThoughtEx. said:
Canada has thirty million people, we have 300 million. And when they did it, insurance companies were not one of the pillars that held up their economy. And their economy isn't the backbone of the world's economy. While they have a great system that works for them, I highly doubt it would work for us. And even if we could somehow get Insurance companies untangled from our markets, should we? We are capitalists, and the reason the current system isn't working is because hospitals aren't competing. The reason insurance is so high, is because hospital prices are high, because hospitals aren't competing. Lets try replacing the filters before buying a new car, is all I'm saying. Especially if its going to be one of those socialist foreign cars.
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Health insurance companies are a tiny part of our economy
 
vegas giants said:
Health insurance companies are a tiny part of our economy
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Lol, I wish you could see the irony in making that statement to me in particular. As I am an FA/Underwriter for a medium size insurance company with an 8 billion dollar portfolio that owns around 40 smaller insurance companies. Some of whom own a couple more companies themselves. The company I work for is owned by a Finance company in partnership with a capital management group. I could go into the other things under the umbrella of that finance company and capital management group. But I think you get the point. Insurance companies are complex corporate hive structures, designed to generate capital and funnel it up for redistribution. If you counted each corporate hive structure as one business, from the companies you see advertising at the bottom all the way to capital management groups at the top, there may be 4 actual insurance companies in the whole country. The public couldn't actually name a single one of them. And they are by no means a small part of the economy.
 
Praxas said:
The way we have done healthcare before the ACA wasn't working. So what do you suggest be done?
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Building on the ACA would be my preference, with a likely aim of blurring the lines (in the direction of the exchanges) between the different segments of the health care landscape that exist today.

Carjosse said:
Well the entire principle of single-payer is to negotiate better prices with the bargaining power of an entire entity like a province or state. You can much better prices when you have the power to bargain for 7 million people compared to pretty much any private insurer. Same goes for pay of doctors but that is not working too well mainly they just keep demanding more and more and more, if you want massive pay raises every year become a Canadian doctor.
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vegas giants said:
Yes. We set the price. Take it or leave it
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Is it negotiating or is just aggressive price-setting? The former implies that ultimately the rates will be reasonable and more or less in line with what providers need to sustain their operations today (which is how it works in Maryland, where the states and hospital community collaborate to come up with all-payer rates set by the state). The latter implies they'll be set unilaterally with the goal of immediate disruption in the name of savings and there's nothing anyone can do about it. Those are very different circumstances with pretty significant political, economic, and policy implications.
 
Greenbeard said:
Building on the ACA would be my preference, with a likely aim of blurring the lines (in the direction of the exchanges) between the different segments of the health care landscape that exist today.




Is it negotiating or is just aggressive price-setting? The former implies that ultimately the rates will be reasonable and more or less in line with what providers need to sustain their operations today (which is how it works in Maryland, where the states and hospital community collaborate to come up with all-payer rates set by the state). The latter implies they'll be set unilaterally with the goal of immediate disruption in the name of savings and there's nothing anyone can do about it. Those are very different circumstances with pretty significant political, economic, and policy implications.
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Negotiation, a lot easier to get bulk deals buying for millions of people.
 
vegas giants said:
Yes. We set the price. Take it or leave it
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Who is we? Government? You want government dictating prices in the private sector? If that happens, I'm moving to South America where I can live under a friendly dictator.
 
ThoughtEx. said:
Lol, I wish you could see the irony in making that statement to me in particular. As I am an FA/Underwriter for a medium size insurance company with an 8 billion dollar portfolio that owns around 40 smaller insurance companies. Some of whom own a couple more companies themselves. The company I work for is owned by a Finance company in partnership with a capital management group. I could go into the other things under the umbrella of that finance company and capital management group. But I think you get the point. Insurance companies are complex corporate hive structures, designed to generate capital and funnel it up for redistribution. If you counted each corporate hive structure as one business, from the companies you see advertising at the bottom all the way to capital management groups at the top, there may be 4 actual insurance companies in the whole country. The public couldn't actually name a single one of them. And they are by no means a small part of the economy.
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A tiny tiny part of the economy. It is not our job to keep you in business. You can still provide other types of insurance and there still will be a small private health insurance market with single payer. But we could get rid of you all and it would not be a blip on the radar. Canada did it and were not plunged into a recession. In fact they did quite well afterwards. So would we.
 
fmw said:
Who is we? Government? You want government dictating prices in the private sector? If that happens, I'm moving to South America where I can live under a friendly dictator.
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Yes. Government already does this for medicare and medicaid. It works quite well in every country that has tried it. And doctors are not starving. LOL
 
ludin said:
yet i can get surgery when i need to and see a specialist when i need to. in canada the average wait time to see a specialist is a a 6 months to a year?
the healthcare tax in canada is 20% + whatever income taxes?

sorry i can't support my family with 40+% of my check going to the government.

I had to get an MRI it took me a week to get the MRI. It is over a year wait unless you go to a private facility to get an MRI in Canada.

on top of those massive tax you still need private insurance to cover things your government plan doesn't.

Do Canadians Still Need Health Insurance? - Canada Protection Plan

what a joke. Massive taxes and you still need private insurance.
Click to expand...

Medicare works that way. We pay the government for plan B on a monthly basis and we pay an insurance company for supplemental coverage. The only truly free healthcare in America is Medicaid.
 
vegas giants said:
Yes. Government already does this for medicare and medicaid. It works quite well in every country that has tried it. And doctors are not starving. LOL
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It is the government budget that is starving and the debt climbing. The reason doctors aren't starving is that the government subsidizes most of the difference between what government dictates and what medical services need to cost. It is done outside the the medicare system in a separate law passed each year by congress. Don't kid yourself that medicare for everyone won't break the bank. It will. If it doesn't it will break the backs of American taxpayers.
 
fmw said:
It is the government budget that is starving and the debt climbing. The reason doctors aren't starving is that the government subsidizes most of the difference between what government dictates and what medical services need to cost. It is done outside the the medicare system in a separate law passed each year by congress. Don't kid yourself that medicare for everyone won't break the bank. It will. If it doesn't it will break the backs of American taxpayers.
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We already pay more than anyone else in the world for healthcare. Single payer cuts the prices dramatically. The bank is already broken. Single payer fixes it
 
fmw said:
Medicare works that way. We pay the government for plan B on a monthly basis and we pay an insurance company for supplemental coverage. The only truly free healthcare in America is Medicaid.
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which is utter garbage.
 
vegas giants said:
A tiny tiny part of the economy. It is not our job to keep you in business. You can still provide other types of insurance and there still will be a small private health insurance market with single payer. But we could get rid of you all and it would not be a blip on the radar. Canada did it and were not plunged into a recession. In fact they did quite well afterwards. So would we.
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Well I'm not about to explain how capitalism works on the basis of investors providing capital, either you get it or you don't. Just know, if you take a huge capital investor off the table it will affect way more than you think it will.
 
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