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A middle ground.

Renae

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Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.

Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.

You have to be unemployed or under a certain income level to qualify and each state is responsible for 35% of the costs.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.


What say you? And no this isn't all set in hard stone, feel free to comment on changes if you see a need.
 
Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.

Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.

You have to be unemployed or under a certain income level to qualify and each state is responsible for 35% of the costs.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.


What say you? And no this isn't all set in hard stone, feel free to comment on changes if you see a need.

If I am not mistaken the paperwork required for Medicare and Medicaid is lower than for the private insurers


The people working in the free clinics/hospitals would still require getting paid, the suppliers to the free hospital would need to get paid. People would want to ensure "bang for the bucK" so the number of patients would have to be tracked, what services they received, and by who

Last but not least, by making the unemployed automatically covered makes it failure from the start. If a person is $1000 over the income level, and they require $30 000 in medical care, they will have to quit their job and then will be covered. It encourages people to quit their jobs, and become unemployed in order to receive medical care.

Now over time I would expect those free hospitals to become vastly overcrowded and understaffed as cuts to such programs would be "easier" to get passed by saying the medical care is free even though it is not accessible due to shortages
 
Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.

Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.

You have to be unemployed or under a certain income level to qualify and each state is responsible for 35% of the costs.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.


What say you? And no this isn't all set in hard stone, feel free to comment on changes if you see a need.

I take this to mean that the old and/or poor (only?) will have government hospitals, clinics and nursing homes built and fully staffed in every city (and rural region?) to serve only those "special" folks. Basically building a government "hospital" for the poor and/or elderly for each post office. That seems both ridiculous and highly inefficient.
 
Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.

Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.

You have to be unemployed or under a certain income level to qualify and each state is responsible for 35% of the costs.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.


What say you? And no this isn't all set in hard stone, feel free to comment on changes if you see a need.

In principal, but the difficulty is phasing it all in. It is no good taking insurance away from folks we had promised they could get, when they decided to get no insurance in their youth.
Same more or less it true for Social Security.
 
Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.

Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.

You have to be unemployed or under a certain income level to qualify and each state is responsible for 35% of the costs.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.


What say you? And no this isn't all set in hard stone, feel free to comment on changes if you see a need.

Social engineering may be fun, but can you work your will on Congress?

What's going to keep your free clinics from becoming far worse than the VA?
 
Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.

Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.

You have to be unemployed or under a certain income level to qualify and each state is responsible for 35% of the costs.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.


What say you? And no this isn't all set in hard stone, feel free to comment on changes if you see a need.

As a policy, this is incoherent. I don't just mean ideologically, I mean performatively. After you abolish medicare, who distributes the funds to the hospitals? The Fairy Godmother? After the states pay 35% of the costs, who covers the remaining 65% of the costs? The "defunct", no longer extant Medicare administration that you just fired? What the hell does that even mean?

If the government quits dictating health care and the government is required to pay for low income housing's medical insurance, what stops doctors from charging poor people ten times as much for every procedure? Hell, what if one doctor charges a single patient a billion dollars for a procedure, and then pays the patient 300 million to agree to it?

Other than releasing regulations for people who have a sufficient income to pay for health care and thus making their health care enormously ****tier, what does this really actually accomplish? Like what, specifically, are you trying to have happen here? Other than abject chaos, of course.
 
As a policy, this is incoherent. I don't just mean ideologically, I mean performatively. After you abolish medicare, who distributes the funds to the hospitals? The Fairy Godmother? After the states pay 35% of the costs, who covers the remaining 65% of the costs? The "defunct", no longer extant Medicare administration that you just fired? What the hell does that even mean?

If the government quits dictating health care and the government is required to pay for low income housing's medical insurance, what stops doctors from charging poor people ten times as much for every procedure? Hell, what if one doctor charges a single patient a billion dollars for a procedure, and then pays the patient 300 million to agree to it?

Other than releasing regulations for people who have a sufficient income to pay for health care and thus making their health care enormously ****tier, what does this really actually accomplish? Like what, specifically, are you trying to have happen here? Other than abject chaos, of course.

I think you didn't read what I wrote.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.
 
Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.

Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

Yes. Awesome. Do it.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.

You have to be unemployed or under a certain income level to qualify and each state is responsible for 35% of the costs.

The rest of the cost is covered from the now defunct Medicaid/medicare programs, which in closing out would remove huge amounts of bureaucratic upkeep. I'm not abolishing the taxes for these programs. It would become a new "Free care" tax as it were. Cost the same. Since those two programs in 2015 for example were 26% of the federal budget, we should be able to make it work.

No thanks.

What say you? And no this isn't all set in hard stone, feel free to comment on changes if you see a need.

1. The best solution is to always put the responsibility on the individual. When people are personally responsible they tend to make decisions that benefit themselves.

2. You want to trade a conglomerate of government nightmare programs that are constantly subject to the current political whims with a single...bigger...government nightmare program that is subject to the current political whims.

3. When in doubt...reduce spending and tax rates.
 
Yes. Awesome. Do it.



No thanks.



1. The best solution is to always put the responsibility on the individual. When people are personally responsible they tend to make decisions that benefit themselves.

2. You want to trade a conglomerate of government nightmare programs that are constantly subject to the current political whims with a single...bigger...government nightmare program that is subject to the current political whims.

3. When in doubt...reduce spending and tax rates.

I agree yes, the individual, but since there is this "push" for single payer...
I believe that single payer is atrocious to foist on everyone, if the goal is to help those who really need it, aim it straight at those that need it.
 
Yes. Awesome. Do it.



No thanks.



1. The best solution is to always put the responsibility on the individual. When people are personally responsible they tend to make decisions that benefit themselves.

2. You want to trade a conglomerate of government nightmare programs that are constantly subject to the current political whims with a single...bigger...government nightmare program that is subject to the current political whims.

3. When in doubt...reduce spending and tax rates.

I agree yes, the individual, but since there is this "push" for single payer...
I believe that single payer is atrocious to foist on everyone, if the goal is to help those who really need it, aim it straight at those that need it.
 
Medicare for all.
 
Imagine if the Government ended 90% of its muckraking about in the Healthcare industry. Insure across state lines, go right ahead. Medicaid and Medicare ended tomorrow.
Here we go


Government quit dictating care, demanding doctors file tons of paperwork (they do, a lot of it's FOR those programs) and so forth.

In replacement, each city, each population area had a free "hospital" and more locally regionally as population needed, free clinics.
How large are the cities that get free medical services? 1 million people? 500k? 100k?

What happens to the people who live in remote towns, with no free hospital or medical services nearby?

You do understand that what you propose is pretty much how the VA works? VA care generally works well, but also has some well-known challenges, including limited access in remote / rural areas, and getting overwhelmed by needs. (E.g. during a recession, this free hospital system will need to expand rapidly; and as it recedes, it may need to pare back -- not an easy thing to do with health care.)

Are you going to set the eligibility standards the same as, or looser than, or tighter than, Medicare and Medicaid?


That said, this system could work out well if we are aware of the challenges, use it to address issues (e.g. providing more general care to low-population areas) and don't hold its budgets hostage on a regular basis.


But... what happens to everyone else? Yeah, they get screwed.

The problem with health care in the US isn't regulation. It's the profit motive.

For most goods and services, markets and profit motives work reasonably well. It's not a perfect system (hence regulation) but works well for most things, including critical goods like food, housing and clothing.

However, markets don't work well for health care, because "patients" are not the same thing as "consumers." If you go to the supermarket, you can almost always make a free choice between bell peppers and tortilla chips, or between candy bar and carrots, or between beer and soda, and so on. You can comparison shop between brands, you can make a choice based on a multitude of criteria -- cost, nutrition, branding, packaging, color, whatever you like.

In comparison, what happens if you have....
• a heart attack? You can't call up a half-dozen hospitals and select based on price, or rating, or the food. You don't have time for that.

• cancer? You aren't likely to get the best outcome if you choose a course of treatment based on price.

• diabetes? You have the time to change doctors, but you won't do well if you select your medication based on price. Plus, in an unregulated environment, any insurer can blackball you because you have a chronic condition.

• a Daraprim situation? In your unregulated universe, someone can jack the price of a life-saving drug from $13.50 per pill to $750 per pill overnight, with no changes in cost to justify the increase, and everyone just has to lump it for a year until a generic can be manufactured and approved (at a higher cost than $13.50 per pill...). And that option isn't available as long as the drug is patented.

In other words: The issue is that with essentials like food or housing or transportation, you can make a free choice. With health care, you can't. Health care is not a normal market. There are too many monopolies, too little choice, too much urgency, not enough elasticity for that to work.

We also know that unregulated environments turn into nightmares. Insurers redline customers, or find excuses to refuse to cover expensive conditions. Hospitals jack up their base prices ("chargemaster lists") as a negotiating tactic with the insurers. Insurers raise rates by double digits, and make it impossible to understand what they offer. Pharmaceuticals jack up their prices with impunity, and flout the patent process by making minor tweaks to re-establish a monopoly. It emphasizes services that are far less useful as they seem, like MRI scans or excess tests. It doesn't have a viable way to set standards, and obviously there is minimal oversight.

Deregulation and laissez-faire do no work for health care. This is why pretty much every nation, other than the US, has adopted a single-payer, socialized or hybrid health care system.
 
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