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Explaining Why Federal Deficits Are Needed[W:5330]

Medicare is not in trouble financially. Thanks to Obamacare, Medicare's Trust Fund solvency was extended into the mid-late 2020's. And everyone pays into Medicare if they have a job via payroll taxes. Medicare is pay-go, meaning we are paying for the people who are currently using it. And when we retire, those working will be paying for us. Also, Medicare is funded right now with an all-in tax of just 2.9% (1.45% for individuals, 1.45% for business). That is extremely low. In fact, that is one of the lowest taxes Americans pay. But on top of that, we are also paying premiums to private insurance companies, deductibles, co-pays, co-insurance, drug costs, etc. So the out-of-pocket expense to the patient is much higher overall. Sanders' single-payer proposal set a payroll tax rate of 6.2% for workers and 6.2% for business. The average wage in this country is about $50K, and according to Kaiser the average worker spends about $5K a year in employer-provided coverage with the average business paying $12K a year. Under a single payer plan, the average worker would spend $3,100 on their health care and a business of 50 employees that clears $1M in profit a year would pay just $62,000 a year. That is decidedly less than the same company providing benefits to 50 employees at a cost of $12K per employee for a total cost of $600,000 a year. So that business is saving about $538,000 a year under a single-payer plan.

The single payer puts the bargaining power in the hands of the patients, rather than now where the power lies with providers and drug companies.

We have been over this.. ain't going to work.

So now you are talking about taking another 4% out of peoples pockets.. and another 4 percent out of business pockets. Which means that businesses will have to make up that cost somewhere. And the more they pay an employee.. they more they get penalized in taxes. You want to see a decrease in wage pressure.. there it is.

Here is what you don't understand. Yes.. medicare only takes 2.9%. You say "wow that is really low"... but you FRIGGIN FORGET THAT MONEY IS TAKEN OUT OVER DECADES OF A PERSONS WORKING LIFE AND ONLY AFTER 65 can they access it.

That's why saunders math does not work.
 
No they are really not. If you smoke 10 packs of cigarettes a day, eat 3 hoagies a meal, wash it down with six pack of beer and sit on your butt 24/7. And you die at 47? I am not at fault.. you doctor is not at fault.

OK, those measurements are done on the population as a whole, not individually. So yes, they are metric outcomes. Nothing you're saying above has anything to do with maternal mortality or infant mortality. You seized upon life expectancy, but people smoke, eat poorly, drink alcohol and are lazy in other countries too. If Life Expectancy is not an outcome metric, then nothing is.


The metrics you are using have far more to do with lifestyle, culture and genetics, than they do with actual healthcare.

Wow man...that's just crazy talk. Of course health care has everything to do with life expectancy. I think your argument is off the rails here by arguing life expectancy is not a metric outcome.


Yep.. and if you bothered to read it.. we actually scored 3rd in effective care, high in quality of care and high in timeliness in care. what pulled us to 11 was things like "equality of care, efficiency of care etc.. which has to do with the fact that we don't insure everyone. Not our healthcare system.

You just got done arguing with me that health insurance is a part of health care, saying patients are in the equation of reimbursements from insurers to providers. So this is a case of you talking out of both sides of your mouth. And you kinda tailed off there when it comes to equality of care, efficiency of care, etc. You just got done a couple posts ago saying how efficient private insurance is. Now you're saying it's not. The fact that 25,000,000 people are without insurance in this country proves that we don't have the best system. So you have to make up your mind if administration of reimbursement is part of the system or not, then make your argument accordingly.


how that insurer process and pays claims affects the care the patient receives.

No, it affects access to care. But access to care and care are two different things. I have access to buy one of Trump's mansions. But if I don't have $5M, then I can't. So "access to care" means nothing. And why should we pay middle men to access care anyway?


You just spouted a bunch of gobbledygook to hide the fact that I am right.

No, what happened was you just realized that this isn't about care, but rather access to care. And that providing access to care is no guarantee the care you have access to will produce better outcomes. The one doing the hiding here, rhetorically, is you. You're hiding behind access and conflating that with care. Isn't it possible to have great access and still get sh*tty care? Does the sh*tty care depend on who is paying your provider? No. Does the sh*tty care depend on your provider? Yes. Does your provider give you sh*tty care because of who is paying them? No. Does your provider provide you with sh*tty care for the same procedure that a different patient with different insurance (but the same provider) gets? No.


85% of americans if not more have healthcare coverage. So not such a big if.

Yes, and of those 85%, what is their coverage like? Because those with employer-provided care don't automatically have great insurance. We've both seen the Gallup polling that shows patient satisfaction for employer-provided insurance is lower than that of government-provided insurance.
 
And yes.. a single payer means the government is in control of your healthcare. And often with single payer systems the doctor is actually an employee of the government. You sir are so wrong.

No...they're not unless the country makes it that way. A single payer means there is just a single payer of health care. All the government does is that administration. How would doctors become employees of the government in a single payer plan proposed by Sanders? All his proposal did was eliminate private insurance, but it kept doctors still private and a single payer levels the playing field for providers to compete for patients whereas now, insurers compete for providers. It's more free-market than anything currently in practice. So what that means is that you may think you are getting good health care...but that's because you don't know what else is out there. For all you know, your doctor that you think is so great might not be that great when stacked up against other doctors. Becuase there's just one payor, the patient can go and seek out the best doctor that best fills their needs whereas now, the patient has to find the best of the doctors included on their network. So there's no competition among providers for patients, which means there's no incentive for providers to improve outcomes. Because the providers are in the favorable bargaining position of having multiple payors all looking to be the reimbursement agent.
 
We have been over this.. ain't going to work.

We haven't been over this, and you haven't proven it won't work.


So now you are talking about taking another 4% out of peoples pockets.. and another 4 percent out of business pockets.

LOL! No. What I'm talking about is instead of paying $5K a year for limited access to health care, paying $3K for universal access. And for businesses instead of paying $600,000 to cover 50 workers, paying $62,000 instead and not having to worry about benefits. So if anything, it will move wages upward because the business is spending 90% less on benefits than it did before. So those savings can go into employee salaries and expansion.


Here is what you don't understand. Yes.. medicare only takes 2.9%. You say "wow that is really low"... but you FRIGGIN FORGET THAT MONEY IS TAKEN OUT OVER DECADES OF A PERSONS WORKING LIFE AND ONLY AFTER 65 can they access it.

And right now, Medicare is solvent through the mid-2020's. And that 2.9% covers the sickest people in the country.


hat's why saunders math does not work.

You didn't actually show how the math doesn't work because you are not including the savings from no longer to have private insurance and the deductibles, co-pays, co-insurance, and drug costs that come with it.
 
Yes, collectively...so stay with me here. What benefits patients more? A system with multiple payors and varying levels of access dependent on income, or a system with a single payer that covers everything and provides universal access? The first option leads to fragmentation among payors which results in the bargaining power going to the providers and drug companies, whereas the second option creates a space where patients have the bargaining power because there is only one payor. So instead of insurers negotiating from an unfavorable position, the single payer negotiates from a position of strength because it's the single payor and is the sole source of demand.

You're not going to talk me into single payer. As I have stated many times, I have pre-existing conditions myself and have talked to hundreds, if not thousands, of people around the world and I whole heartedly reject their crappy single payer healthcare systems. If you can come up with a good one let me know but so far I haven't seen one that is better than our system.
 
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We haven't been over this, and you haven't proven it won't work.

.

Of course I have.

LOL! No. What I'm talking about is instead of paying $5K a year for limited access to health care, paying $3K for universal access

Except the numbers really don't work. Not to mention that you put Trump in charge of everyones healthcare. Not to mention that to get the savings you think you do.. you will have to cut either services, or the number of providers.. which will limit the access.

Just like other single payer countries do. there is a reason that their system is like our Medicaid if not slightly worse.,

And right now, Medicare is solvent through the mid-2020's. And that 2.9% covers the sickest people in the country.

right.. because that 2.9% is being spent year after year by people WHO ARE NOT USING IT.. and CANNOT USE IT.

You didn't actually show how the math doesn't work because you are not including the savings from no longer to have private insurance and the deductibles, co-pays, co-insurance, and drug costs that come with it

Well.. Don't seem to realize that medicare HAS deductibles, has co pays. most people who have Medicaid have Co insurance, and they have to purchase drug coverage and have substantial drug costs and they have a monthly payment as well for medicare part B..
 
OK, those measurements are done on the population as a whole, not individually. So yes, they are metric outcomes. Nothing you're saying above has anything to do with maternal mortality or infant mortality. You seized upon life expectancy, but people smoke, eat poorly, drink alcohol and are lazy in other countries too. If Life Expectancy is not an outcome metric, then nothing is.
.

Yeah.. you don't get it.. maternal mortality has to do with how old you are having children. how high risk your pregnancy and so on. The same with infant mortality. A lot of things that don't have to do with your medical care.
And we actually have worse demographics than most countries.

Wow man...that's just crazy talk. Of course health care has everything to do with life expectancy. I think your argument is off the rails here by arguing life expectancy is not a metric outcome.

Yeah no. life expectancy is an outcome.. just not that valid when it comes to healthcare services and delivery.

Right now.. in some countries life expectancy is low because of war... that's not their healthcare.

In our country.. we have a lower life expectancy because of things like obesity, sedentary lifesyles and stress.. which lower lifespan.

You just got done arguing with me that health insurance is a part of health care, saying patients are in the equation of reimbursements from insurers to providers.

Yes I did. So on some metrics.. like quality, timeliness, and effectiveness of healthcare we rank high because in large part we have great physicians, technology etc.. and because most folks have better insurance than most other countries.

However, on the metrics they use like efficiency, and equality of care.. we suffer because not everyone has insurance in America.

Understand?

No, it affects access to care. But access to care and care are two different things. I have access to buy one of Trump's mansions. But if I don't have $5M, then I can't

if you don't have the money to buy his mansion and its not for sale.. then you don't have access to it.

Sorry man but you are wrong.. access effects care.. its just that simple.

No, what happened was you just realized that this isn't about care, but rather access to care.

no.. I realize that access to care effects care. You don't get that.. don't understand that and apparently are being purposely obtuse.

Yes, and of those 85%, what is their coverage like?

Better than most single payer countries government insurance.

As far as your statistic.. I have already discussed the problems with its validity.
 
So by "limit liability", you're really just saying "mitigate risk" which is another way to say "for-profit administration". Also, the insurance company doesn't set the price, providers and drug companies do. They do that by playing insurers off one another. All that playing does nothing to improve or enhance your care, and only increases cost.

Like I asked before, who has the bargaining power when there are more buyers than sellers?

No, I am talking about limiting liability to you, the insured. It limits the maximum you will ever pay out of pocket.

Health Insurance companies negotiate prices with providers and drug companies. But in all cases of negotiation of pricing when it comes down to it.. is two things:

1) Are creme de la creme?

Basically, if your the best hospital in the region, you got a strong negotiation position because your outcomes are better.

2) How many competitors do you have?

If you are in a City, you typically got 2/3 or more providers that Insurance companies can leverage for lower prices.
 
As I have stated many times, I have pre-existing conditions myself and have talked to hundreds, if not thousands, of people around the world and I whole heartedly reject their crappy single payer healthcare systems.

And as I have stated many times, I don't take anecdotes as legitimate facts.
 
No, I am talking about limiting liability to you, the insured. It limits the maximum you will ever pay out of pocket.

It does now, thanks to the ACA. That wasn't the case prior to 2009. So don't misrepresent that the current normal has been the normal all along. And just wondering aloud, why even have a lifetime cap? Oh right, because that's how insurance companies stay profitable. Their profit is not directly linked to your care. Conservatives seem to think it is, but it's not. What the insurance company does is administration. The provider delivers care. The insurer restricts access to care. A single payer system has no access restrictions, so patients can then go and find the best doctor for their needs rather than finding the best doctor of who is in your network. You understand and see that difference, right?


Health Insurance companies negotiate prices with providers and drug companies. But in all cases of negotiation of pricing when it comes down to it.. is two things:

Nope and nope. The provider is always going to be in the favorable negotiating position because there are multiple payors (aka buyers) all negotiating against one another for the "right" to administrate payments to that particular provider. So tell me, what happens in any market where there are more buyers than sellers? Who has the bargaining power?
 
Except the numbers really don't work. Not to mention that you put Trump in charge of everyones healthcare. Not to mention that to get the savings you think you do.. you will have to cut either services, or the number of providers.. which will limit the access.

Ah, but the numbers do work, and I even laid them out for you using average wages. Because I'm such a nice guy, I'll do so again:

Right now, according to the Kaiser Family Foundation, the average worker costs $17,000 to insure in an employer-provided plan. Of that $17,000, $5,000 is paid by the worker, and $12,000 is paid by the employer. So a business of 50 employees spends roughly $600,000 to provide health care to their workers. And that health care doesn't even take into account prescription drugs, co-pays, co-insurance, or deductibles. That's just the premium cost.

Sanders' single payer proposal was to do away with all that noise above, and instead put in its place a 6.2% payroll tax, with no cap, that everyone who earns a check pays. The average worker in this country makes about $50K a year. So 6.2% x $50K = $3,100 paid by the worker. Most businesses of 50 employees or less do not clear more than $1M in profit a year. But let's say for the sake of this exercise that they do. OK, so keeping in mind that business of 50 employees paid $600K for benefits, under Sanders' proposal, that business would pay 6.2% x $1,000,000 = $62,000. That's just about 10% of what the business was paying before. So they would save about $540,000 a year they could then put back to their employees by raising wages, or by expansion.

And as far as Trump limiting access, how would he go about doing that? If this is legislation, he can't unilaterally make that change...not can Congress without expecting a court challenge. The entire point of a single payer plan is to provide universal access. Trump himself even said single payer made the most sense. Of course, that was before he went crazy...


Just like other single payer countries do. there is a reason that their system is like our Medicaid if not slightly worse.,

You keep saying this and you offer no support of it. You are making an assumption that single payer here would be the same level of...of...coverage? Care? I don't even know what you mean because all we're talking about is how the provider is reimbursed for your care. Whether Medicaid pays for it or Blue Cross pays for it has no bearing on how your provider treats you. As I said, it may limit access, but access to health care by itself is no guarantee of health care. We all have access to buy one of Trump's mansions for $5M...that doesn't mean we have a guarantee to it. Who pays your provider does not affect the care your provider gives you. You are making it sound like doctors do a half-ass job when it's a Medicaid patient vs. an Anthem patient. But Medicaid doesn't employ doctors and neither does Anthem. This is always the part where Conservative arguments about health care fall apart because they so badly want there to be a lower quality of care for Medicaid than for private insurers. But neither Medicaid or Anthem actually provides you with care. They just provide you with access. In some cases, it's even the same provider!


Well.. Don't seem to realize that medicare HAS deductibles, has co pays. most people who have Medicaid have Co insurance, and they have to purchase drug coverage and have substantial drug costs and they have a monthly payment as well for medicare part B..

Yes, which is exactly why we should have a single-payer, universal system. So patients can spend the money in the consumer economy they would otherwise be spending within the very narrow spectrum of health care.
 
Yeah.. you don't get it.. maternal mortality has to do with how old you are having children. how high risk your pregnancy and so on. The same with infant mortality. A lot of things that don't have to do with your medical care. nd we actually have worse demographics than most countries.

And you don't think that has anything to do with how insurance companies restrict access in order to maintain profit margins?


Yeah no. life expectancy is an outcome.. just not that valid when it comes to healthcare services and delivery.

You mean not valid when it doesn't support your argument. So you say life expectancy is an outcome, then you say it isn't. And round and round we go...


So on some metrics.. like quality, timeliness, and effectiveness of healthcare we rank high because in large part we have great physicians, technology etc.. and because most folks have better insurance than most other countries.

But those aren't metrics. Quality is subjective -not a metric. Timeliness? Also subjective and not a metric. Effectiveness? Sensing a pattern here...also subjective. What's not subjective are life expectancy, infant mortality, maternal mortality, and cost. So all the things that make you feel good about yourself are "metrics" and all the things that throw cold water on that aren't? And that study you are referring to ranks us low when it comes to efficiency and access, right (two objective things)? So you got done saying in an earlier post that private insurance is more efficient, but then you produce a study that says it's not. So which narrative are you going to commit to? Because you're going to have to eventually.


However, on the metrics they use like efficiency, and equality of care.. we suffer because not everyone has insurance in America.

So our system isn't great, then. It isn't better than systems that guarantee access to health care. This is what you are saying. The healthcare system in the US is kinda, sorta good...but only if you can access it. So I'm wondering how you think that is indicative of a system that doesn't make it obvious single payer is the way to go?


if you don't have the money to buy his mansion and its not for sale.. then you don't have access to it.

Being on sale means that you have access to it. So you're conflating whether or not you have enough money to buy the mansion with the ability to buy the mansion at all. It's a nuanced difference, but it is a difference. So if Trump puts one of his mansions on the market for $5M, we all have access to buy that mansion...whether or not we actually can is a separate question entirely. And that is at the heart of this debate on health care.

I realize that access to care effects care.

Affects care (sorry, I'm a nerd), and no it doesn't. If the same doctor performs the same procedure on two different patients, one with Medicaid and the other with Anthem, the doctor doesn't do a poorer job with the Medicaid patient than the Anthem one (within the scope of just that procedure) do they???? Of course not, because that would be malpractice. So if it doesn't matter to your doctor who reimburses them, why are we allowing providers and drug companies to rake us over the coals on costs?


Better than most single payer countries government insurance.

According to whom? In a single payer, universal plan, you get universal access. So how is that worse than what they get in Britain or Canada, both nations that provide universal coverage? You just got done singing the praises of the medical professionals in this country, now you're saying they aren't that great if a universal coverage, single payer system will lead to worse....coverage? Care? Still not sure what you're talking about here.
 
And as I have stated many times, I don't take anecdotes as legitimate facts.

Of course you want to deny anything and everything that is contrary to your OPINION. As I have stated many times, I don't take your cherry picked facts.
 
Of course you want to deny anything and everything that is contrary to your OPINION. As I have stated many times, I don't take your cherry picked facts.

No, I don't want to accept things that I cannot verify as true, and rely on me trusting in your honesty. My question to you is; why should I?
 
Ah, but the numbers do work, and I even laid them out for you using average wages. Because I'm such a nice guy, I'll do so again:

.

Yeah.. no.

Alright.. I will explain it to you fully why Saunders numbers don't work. Because he makes large faulty assumptions as you do regarding medicare.. how it works and private insurance.

First:

1. Medicare is made up of four parts. Medicare A, Medicare B, Medicare C, and Medicare D.

When you and it appears saunders you are talking about medicare and its cost.. you are only talking about Medicare A. Which is the hospital benefit.. which is what all americans that have paid into medicare enough get without a premium. That hospital benefit does have extra costs though.. it has a deductible and if your hospital stays are long enough.. you have a copay as well. It only pays for hospital and rehab and home health if you qualify... it does not pay for outpatient procedures or pharmaceuticals outside the hospital.

Now.. there is Part B.. which pays for outpatient visits and medical equipment.. BUT it requires a monthly premium, has a copay of 20%, has a deductible,
You are not factoring in these costs.

Then there is Part D. which is for pharma.. and this also has copays, a premium and a deductible.. Which again.. you are not factoring in.

then there is medicare Part C.. and this is because the out of pocket premiums and expense are too much for some people.. so instead they opt for PRIVATE insurance.. to REPLACE traditional medicare because the monthly premium is better.

So Saunders is not factoring this in when calculating the "cost of medicare"..

2. Saunders doesn't understand the Kaiser family foundation numbers.

First.. the cost of that insurance for the most part provides not just hospital insurance.. (which is medicare part A) BUT ALSO includes outpatient services and pharmaceuticals.. Also included is the cost of dental and vision for those companies that have them.. something medicare in any form does not pay for.

Second.. that premium cost IS NOT just going to pay premium for that years employees. Its also a premium that pays for existing retirees who receive benefits after retirement and for FUTURE retirees to have supplemental coverage for what medicare doesn't cover.

So.. you are fudging the numbers here. You are using Medicare numbers that are not providing comprehensive care.. but only the hospital benefit. While comparing that to private employer insurance that is not only providing comprehensive outpatient, hospital, and pharma coverage and in some cases dental and vision as well BUT also covering retirees and future retirees.

You are comparing apples to bananas.

3. the numbers don't work because Medicare Part A is in fiscal trouble. Since 2003.. medicare part A has been paying out more money out than its been taking in. That's at already 3%. And that 3% is paid by people WHO ARE NOT ABLE TO ACCESS IT for decades.

And as the baby boomers age.. the well gets even deeper. Just to keep medicare part A solvent.. the medicare tax will probably have to go up by at least 25%. And that's just to pay for part A.

And now you are talking about adding millions to the plan who can take out immediately.. AND talking about covering way way more than Part A.. but all parts of medicare.. and eliminating the copays and deductibles and premiums that are already associated with those programs.. and for EVERYONE.

dude.. it just doesn't work out.
You keep saying this and you offer no support of it

Now now.. that's a lie.. I have posted links to what other countries pay for. Take Canada.. its government plan doesn't pay for outpatient therapy.. durable medical goods etc. It has less choice etc.. our Medicaid is better.

I strongly urge you to get educated.
 
As I said, it may limit access, but access to health care by itself is no guarantee of health care. We all have access to buy one of Trump's mansions for $5M...that doesn't mean we have a guarantee to it.

Yeah.. I don't know why you bring up that analogy..It proves my point. You don't have access to trumps mansions if you don't have 5 million. and if you don't have access to say a biopsy for your prostate because your government insurance won't pay for one unless you have two positive PSA's in a year.. you can be at a disadvantage compared to getting a biopsy after the first high PSA and positive digital exam. Access affects care.. no matter how much you deny the truth.

And as far as Trump limiting access, how would he go about doing that? If this is legislation, he can't unilaterally make that change...not can Congress without expecting a court challenge. The entire point of a single payer plan is to provide universal access.

Easy.. right now there is a prohibition on any government plan paying for elective abortion. Its been in place for democrat and republican administrations.

Yes, which is exactly why we should have a single-payer, universal system. So patients can spend the money in the consumer economy they would otherwise be spending within the very narrow spectrum of health care

not sure how you are getting that. You are taking more out of peoples take home pay.. and medicare.. which is what you plan on replacing insurance with has deductibles, copays etc.
 
And you don't think that has anything to do with how insurance companies restrict access in order to maintain profit margins?

.

No.
You mean not valid when it doesn't support your argument. So you say life expectancy is an outcome, then you say it isn't. And round and round we go...

Well that's because you don't understand science. Life expectancy is an metric of things like lifestyle, genetics etc..

It is not a very valid metric to compare medical systems UNLESS you have very similar lifestyles, cultures genetics, number of comorbidities etc. And the US has some of the worst demographics in the first world when it comes to health.

But those aren't metrics. Quality is subjective -not a metric

Sir.. you really need to get educated. Quality is a metric. We can easily measure things like ROM after total hip operation. Level of function like walking, ability to go up stairs etc after total knees. Arterial perfusion after heart surgery. etc There are objective measures that are used all over medicine to determine the most effective treatments based on outcome measures.

Timeliness? Also subjective and not a metric
Time is rather easily measured dude. Have a watch and a calendar?
Come on.. you have to work at being this obtuse.

So you got done saying in an earlier post that private insurance is more efficient, but then you produce a study that says it's not. So which narrative are you going to commit to? Because you're going to have to eventually.

The answer to that is both. If you have insurance.. its generally more efficient if its private. Compared to our entire healthcare system.. its not efficient to not have everyone covered.. whether public OR private.

So our system isn't great, then. It isn't better than systems that guarantee access to health care. This is what you are saying. The healthcare system in the US is kinda, sorta good...but only if you can access it. So I'm wondering how you think that is indicative of a system that doesn't make it obvious single payer is the way to go?

Well.. lets see. the two worse insurances to have in America are Medicaid and VA. Medicaid is actually BETTER than almost ALL single payer insurances in other countries. So.. to get the savings of other countries, we would need to go to system WORSE than Medicaid right now. That means we make the insurance coverage of 85% of americans WORSE than it is right now.. in order to improve 15%.

I would say it makes much more sense to simply make it easier to get that 15% the type of coverage.. the coverage that the other 85% which is far superior to anything the single payer countries have.

Incisor.. you are enamored of other countries and single payer but you have demonstrated a tremendous lack of knowledge about these systems.. and you demonstrate a tremendous lack of understanding of government programs here. and of healthcare and healthcare insurance in general

You have made a conclusion of single payer.. that has no logic or substance behind it.

Affects care (sorry, I'm a nerd), and no it doesn't

yes it does.

If the same doctor performs the same procedure on two different patients, one with Medicaid and the other with Anthem, the doctor doesn't do a poorer job with the Medicaid patient than the Anthem one (within the scope of just that procedure) do they???? Of course not, because that would be malpractice. So if it doesn't matter to your doctor who reimburses them, why are we allowing providers and drug companies to rake us over the coals on costs?

If Medicaid refuses to pay for the therapy after your physician does your total knee (procedure).. then you outcome will be significantly worse than the person that as anthem that got better aftercare.

Like I said.. you have to work at being this obtuse.

So how is that worse than what they get in Britain or Canada, both nations that provide universal coverage
See above..
 
...
Sanders' single payer proposal was to do away with all that noise above, and instead put in its place a 6.2% payroll tax, with no cap, that everyone who earns a check pays. The average worker in this country makes about $50K a year. So 6.2% x $50K = $3,100 paid by the worker. Most businesses of 50 employees or less do not clear more than $1M in profit a year. But let's say for the sake of this exercise that they do. OK, so keeping in mind that business of 50 employees paid $600K for benefits, under Sanders' proposal, that business would pay 6.2% x $1,000,000 = $62,000. That's just about 10% of what the business was paying before. So they would save about $540,000 a year they could then put back to their employees by raising wages, or by expansion.


Sorry to post a counter point, but where does the money come from, then? We say that the health insurance company skims 20% of the premiums and then pays out 80% to providers, generally. Assuming that, how can we possibly expect to pay to the gov't only 10-20% in tax of what we now pay to insurance companies in premiums? Are doctors going to cut their prices by 75% simply because the gov't is now reimbursing them instead of insurance companies?
 
Sorry to post a counter point, but where does the money come from, then? We say that the health insurance company skims 20% of the premiums and then pays out 80% to providers, generally. Assuming that, how can we possibly expect to pay to the gov't only 10-20% in tax of what we now pay to insurance companies in premiums? Are doctors going to cut their prices by 75% simply because the gov't is now reimbursing them instead of insurance companies?

Actually .. you bring up a very good point. Part of the projections are that reimbursement will be like medicare and Medicaid.. which are the among the lowest payers in healthcare. BUT part of the reason that providers can tolerate Medicaid and medicare patients is because they get reimbursed better by private insurances. Basically.. private insurance subsidizes to an extent Medicaid and medicare.
 
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