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Health Care

Health Care in America

  • best medical care you can afford

    Votes: 0 0.0%

  • best medical care not limited by your ability to pay

    Votes: 10 100.0%
  • Total voters
    10
  • Poll closed .
R

rickc

DP Veteran
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presently we spend more per capita on health care than any other developed nation by quite a bit. Those other nations all have bealth care for everyone with no pre-existing condition or danger of a medical emergency bringing on bankruptsy.

now no matter what road we take for the future of healthcare in this country we will have to collect that 3.2 trillion dollars to pay for it. nothing is free.

question is

should America be the land of the best medical care you can afford

or

the land of the best medical care not limited by your ability to pay
 
i support a good single payer system which resembles Medicaid for all at best and Medicare for all at worst.
 
Helix said:
i support a good single payer system which resembles Medicaid for all at best and Medicare for all at worst.
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Thst works for me too
 
Helix said:
i support a good single payer system which resembles Medicaid for all at best and Medicare for all at worst.
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That's the easy part - the hard part is how to fund it and how to prevent those that are going to lose billions with the conversion from mucking it up.
 
ttwtt78640 said:
That's the easy part - the hard part is how to fund it and how to prevent those that are going to lose billions with the conversion from mucking it up.
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considering how much more we're paying than everyone else, i doubt that it will be an increase in cost to the average patient.
 
Helix said:
considering how much more we're paying than everyone else, i doubt that it will be an increase in cost to the average patient.
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That is not the issue - we could have universal hamburgers without a major change in the cost of hamburgers too. The issue is do folks pay 20% of the cost of any hamburgers that they get or does everyone simply pay (based on their income?) into a universal hamburger fund and folks can show their universal "free" hamburger card any time they want a hamburger?

I am less concerned with total costs than I am about my personal 'fair share' of the cost and how that will be computed.
 
ttwtt78640 said:
That is not the issue - we could have universal hamburgers without a major change in the cost of hamburgers too. The issue is do folks pay 20% of the cost of any hamburgers that they get or does everyone simply pay (based on their income?) into a universal hamburger fund and folks can show their universal "free" hamburger card any time they want a hamburger?

I am less concerned with total costs than I am about my personal 'fair share' of the cost and how that will be computed.
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health care and hamburgers are not analogous. though i don't eat meat anymore, i could get a hamburger anywhere for a couple bucks. if i have a heart attack, however, i will be going to the hospital two minutes away, and i will be paying whatever they demand.

as for your share, that will most likely be a tax, which would be less than what you're paying for premiums and cost of care now. that's the way that it works in the rest of the first world, and i see no reason that it can't work that way here.
 
ttwtt78640 said:
That is not the issue - we could have universal hamburgers without a major change in the cost of hamburgers too. The issue is do folks pay 20% of the cost of any hamburgers that they get or does everyone simply pay (based on their income?) into a universal hamburger fund and folks can show their universal "free" hamburger card any time they want a hamburger?

I am less concerned with total costs than I am about my personal 'fair share' of the cost and how that will be computed.
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In order to minimise the cost it needs to be spread among the widest possible base. The entire (taxpayer) population is the widest base.

ps I won't vote as I live in and benefit from a single payer universal healthcare system. We do have insurance-based healthcare too, but the main difference is more appointment flexibility, and nicer hotel services.
 
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Helix said:
health care and hamburgers are not analogous. though i don't eat meat anymore, i could get a hamburger anywhere for a couple bucks. if i have a heart attack, however, i will be going to the hospital two minutes away, and i will be paying whatever they demand.

as for your share, that will most likely be a tax, which would be less than what you're paying for premiums and cost of care now. that's the way that it works in the rest of the first world, and i see no reason that it can't work that way here.
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I am now paying nothing and will soon be paying $134/month for Medicare.
 
ttwtt78640 said:
I am now paying nothing and will soon be paying $134/month for Medicare.
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well, most of us aren't legacy workers. however, good on you for reaching Medicare age. i'll be voting to prevent assholes from taking away your benefits.
 
Helix said:
well, most of us aren't legacy workers. however, good on you for reaching Medicare age. i'll be voting to prevent assholes from taking away your benefits.
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It is hard to imagine that I would be asked to pay less than $134/month but will have to wait and see. My girlfriend might well do better since her Medicare premium is also $134/month but she gets less than half of what I do in Social Security retirement benefits. Those likely to get screwed over the most are veterans or those now getting expanded Medicaid.
 
ttwtt78640 said:
It is hard to imagine that I would be asked to pay less than $134/month but will have to wait and see. My girlfriend might well do better since her Medicare premium is also $134/month but she gets less than half of what I do in Social Security retirement benefits. Those likely to get screwed over the most are veterans or those now getting expanded Medicaid.
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i hope that Medicare is a net benefit for you. my parents have had a good experience with it so far.
 
Helix said:
i hope that Medicare is a net benefit for you. my parents have had a good experience with it so far.
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I hope so as well. Initially it will simply be an added monthly expense but perhaps someday I will benefit from it.
 
ttwtt78640 said:
I hope so as well. Initially it will simply be an added monthly expense but perhaps someday I will benefit from it.
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i have a year and 4 months. employer paid now but i will be in the same as you soon.
 
rickc said:
i have a year and 4 months. employer paid now but i will be in the same as you soon.
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I am self-employed and my uncaring boss is not likely to give me a medical care insurance fringe benefit. ;)
 
All we need to do is get the EU to pay for our defense instead of us paying for theirs, and then we'll be able to do healthcare for all like the EU does.
 
ttwtt78640 said:
That's the easy part - the hard part is how to fund it and how to prevent those that are going to lose billions with the conversion from mucking it up.
Click to expand...

I don't think funding it is technically the hard part. You just raise taxes to pay for it and while it would be a big tax increase, it would still be cheaper than current health insurance premiums.

The hard part is that you contract the economic size of the healthcare sector over practically over night. The orthopedic surgeon currently bringing in 800k a year will fight pretty hard the pay cut that gets them down to 550k a year (and thus more in line with salaries in our peer nations). There are a lot of economic inefficiencies in healthcare in the United States and those inefficiencies are largely in the form of grossly inflated salaries in some professions (and too little in others like your GP). Everyone talks about prescription drugs, but prescription drugs are only 10% of overall health spending.

The only way to make healthcare in the United States less expensive is for providers to make less money. You can't have salaries for some professions in the healthcare sector in the United States much higher than in our peer nations and expect to get per-capita health spending in line with those peer nations. For example, if I earned 50% more as a Senior IT Professional here in the United States than I would in any of our peer nations like Germany, Australia, Japan and so on, then our per-capita IT spending here would be a lot more than it is in those countries as well.
 
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SouthernDemocrat said:
I don't think funding it is technically the hard part. You just raise taxes to pay for it and while it would be a big tax increase, it would still be cheaper than current health insurance premiums.

The hard part is that you contract the economic size of the healthcare sector over practically over night. The orthopedic surgeon currently bringing in 800k a year will fight pretty hard the pay cut that gets them down to 550k a year (and thus more in line with salaries in our peer nations). There are a lot of economic inefficiencies in healthcare in the United States and those inefficiencies are largely in the form of grossly inflated salaries in some professions (and too little in others like your GP). Everyone talks about prescription drugs, but prescription drugs are only 10% of overall health spending.
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Labour is big yes, but so are the admin costs that come from a system of fragmented payers and variable plans with myriad riders and other complexities/contingencies, nevermind the inputs lost to their profit margins which provide no value whatsoever to the healthcare system.

Obviously any transition to SP would have to be gradual and phased in over time.
 
SouthernDemocrat said:
I don't think funding it is technically the hard part. You just raise taxes to pay for it and while it would be a big tax increase, it would still be cheaper than current health insurance premiums.

The hard part is that you contract the economic size of the healthcare sector over practically over night. The orthopedic surgeon currently bringing in 800k a year will fight pretty hard the pay cut that gets them down to 550k a year (and thus more in line with salaries in our peer nations). There are a lot of economic inefficiencies in healthcare in the United States and those inefficiencies are largely in the form of grossly inflated salaries in some professions (and too little in others like your GP). Everyone talks about prescription drugs, but prescription drugs are only 10% of overall health spending.

The only way to make healthcare in the United States less expensive is for providers to make less money. You can't have salaries for some professions in the healthcare sector in the United States much higher than in our peer nations and expect to get per-capita health spending in line with those peer nations. For example, if I earned 50% more as a Senior IT Professional here in the United States than I would in any of our peer nations like Germany, Australia, Japan and so on, then our per-capita IT spending here would be a lot more than it is in those countries as well.
Click to expand...

I disagree - Medicare is primarily funded by a flat payroll tax, has premiums based on one's current income and requires the patient to pay 20% (or more) of care costs while Medicaid is funded primarily by a the federal income tax, has no premiums, no deductibles and no co-pays.
 
rickc said:
presently we spend more per capita on health care than any other developed nation by quite a bit. Those other nations all have bealth care for everyone with no pre-existing condition or danger of a medical emergency bringing on bankruptsy.

now no matter what road we take for the future of healthcare in this country we will have to collect that 3.2 trillion dollars to pay for it. nothing is free.

question is

should America be the land of the best medical care you can afford

or

the land of the best medical care not limited by your ability to pay
Click to expand...
Both.

IMO we should have a public health system that provides the at least good medical care to everyone who needs it, but then if you want extra **** and have the money you can pay for things like cosmetic surgery or whatnot.
 
ttwtt78640 said:
I disagree - Medicare is primarily funded by a flat payroll tax, has premiums based on one's current income and requires the patient to pay 20% (or more) of care costs while Medicaid is funded primarily by a the federal income tax, has no premiums, no deductibles and no co-pays.
Click to expand...

Right but in the end its taxes you pay either way. Do Medicare for all and your payroll taxes have to go up to pay for it. At the same time, your insurance premiums are eliminated (or greatly reduced). That's not the complicated part, the complicated part is getting providers to accept less than what they are able to get out of private insurers now.
 
And once again, no one bothers to look at WHY healthcare is so expensive, and instead looks for ways for more people to pay into an ineffectual system.

Trading the government as an expense payer in place of private insurance companies is not the answer. Removing the third party is closer to it - Patient to Doctor. Price regulation of pharmaceuticals. Additional physical access (immediate care clinics) to healthCARE on a sliding scale basis (also creates jobs) to eliminate ER visits for non-emergency care.
 
SouthernDemocrat said:
1) Right but in the end its taxes you pay either way. Do Medicare for all and your payroll taxes have to go up to pay for it. At the same time, your insurance premiums are eliminated (or greatly reduced). 2) That's not the complicated part, the complicated part is getting providers to accept less than what they are able to get out of private insurers now.
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1) I disagree, few would tolerate the required very large increase of the flat rate (regressive?) payroll tax even if the employer had to match half of it in any M4A plan. Remember that not all employers, especially small businesses, offer an employee insurance benefit - they too, would get screwed by any such large payroll tax increase while the large employers, that now do offer significant employee insurance benefits, would likely come out ahead. Of course, any self-employed folks would have to pay double the new higher M4A payroll tax.

2) The idea that care providers will simply accept whatever the 'cost savers' on some government unelected panel decide is 'fair' is another problem, indeed. Perhaps we should try that cost saving idea with SNAP first, just to prove the concept. Instead of SNAP simply paying (any and all?) food provider's their full current retail price (including profit) let's adjust SNAP such that the provider is paid 75% for most grocery items 65% for meat, eggs and dairy products and 50% for anything containing sugar or high fructose corn syrup. That places a new burden on any food provider who accepts SNAP purchases which must then not only comply with those new government reporting requirements, but suffer a financial loss by accepting less from SNAP customers than they get from customers paying by any other means.
 
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ttwtt78640 said:
1) I disagree, few would tolerate the required very large increase of the flat rate (regressive?) payroll tax even if the employer had to match half of it in any M4A plan. Remember that not all employers, especially small businesses, offer an employee insurance benefit - they too, would get screwed by any such large payroll tax increase while the large employers, that now do offer significant employee insurance benefits, would likely come out ahead. Of course, any self-employed folks would have to pay double the new higher M4A payroll tax.

2) The idea that care providers will simply accept whatever the 'cost savers' on some government unelected panel decide is 'fair' is another problem, indeed. Perhaps we should try that cost saving idea with SNAP first, just to prove the concept. Instead of SNAP simply paying (any and all?) food provider's their full current retail price (including profit) let's adjust SNAP such that the provider is paid 75% for most grocery items 65% for meat, eggs and dairy products and 50% for anything containing sugar or high fructose corn syrup. That places a new burden on any food provider who accepts SNAP purchases which must then not only comply with those new government reporting requirements, but suffer a financial loss by accepting less from SNAP customers than they get from customers paying by any other means.
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Right now I pay over 300 dollars a month for health insurance for my portion, and my employer pays another 1200 dollars a month. Total for my family is 1500 dollars a month and that doesn't even include HSA / FSA contributions. Now, let's say our taxes went up by a 1000 dollars a month, some me paying directly, some my employer paying, to pay for Medicare for everyone. That would a deal compared to what we pay now.
 
ttwtt78640 said:
1) I disagree, few would tolerate the required very large increase of the flat rate (regressive?) payroll tax even if the employer had to match half of it in any M4A plan. Remember that not all employers, especially small businesses, offer an employee insurance benefit - they too, would get screwed by any such large payroll tax increase while the large employers, that now do offer significant employee insurance benefits, would likely come out ahead. Of course, any self-employed folks would have to pay double the new higher M4A payroll tax.

2) The idea that care providers will simply accept whatever the 'cost savers' on some government unelected panel decide is 'fair' is another problem, indeed. Perhaps we should try that cost saving idea with SNAP first, just to prove the concept. Instead of SNAP simply paying (any and all?) food provider's their full current retail price (including profit) let's adjust SNAP such that the provider is paid 75% for most grocery items 65% for meat, eggs and dairy products and 50% for anything containing sugar or high fructose corn syrup. That places a new burden on any food provider who accepts SNAP purchases which must then not only comply with those new government reporting requirements, but suffer a financial loss by accepting less from SNAP customers than they get from customers paying by any other means.
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payroll taxes are another wealthy elite scam. only those who collect wages pay it and only on a portion of their earnings.

i say expand the medicare and social security tax to all forms of income. then if necessary raise the tax rate.

of course you would have to have a way to keep congress from stealing the money and then claiming the system was bankrupt.
 
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