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Thread: Explaining Why Federal Deficits Are Needed[W:5330]

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by jaeger19 View Post
    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.

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by jaeger19 View Post
    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.

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by Incisor View Post
    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.

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by Moderate Right View Post
    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?

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by Incisor View Post
    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.

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    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.

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by Incisor View Post
    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..

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by Incisor View Post
    ...
    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?
    I'm not going to chase you while you run around with the goalpost in your arms.

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    Re: Explaining Why Federal Deficits Are Needed[W:5330]

    Quote Originally Posted by Critter7r View Post
    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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